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All Journal Jurnal Kedokteran Brawijaya Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Indonesian Journal of Human Nutrition Indonesian Journal of Tropical and Infectious Disease Berkala Kedokteran MNJ (Malang Neurology Journal) Majalah Kesehatan FKUB MAGNA MEDICA: Berkala Ilmiah Kedokteran dan Kesehatan Jurnal Respirologi Indonesia Oto Rhino Laryngologica Indonesiana Jurnal Respirasi (JR) Medica Hospitalia Journal of Issues in Midwifery Abdi Dosen : Jurnal Pengabdian Pada Masyarakat Babali Nursing Research Caring : Jurnal Pengabdian Masyarakat Journal of Global Pharma Technology Journal of Community Health and Preventive Medicine (JOCHAPM) Jurnal Ilmu Kedokteran Keluarga JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Cermin Dunia Kedokteran
Nanik Setijowati
Department Of Family Medicine, Faculty Of Medicine, Brawijaya University.
Religion Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Earth & Planetary Sciences Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences

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REDUCING VENTILATOR-ASSOCIATED PNEUMONIA THROUGH ROTATIONAL VENTILATOR SYSTEM WITHIN LEAN MANAGEMENT FRAMEWORK IN THE ICU OF DR. SOEBANDI HOSPITAL JEMBER Santika, Suparno Adi; Setijowati, Nanik; Holipah, Holipah
Journal of Community Health and Preventive Medicine Vol. 5 No. Issue Supplement 1 (2025): JOCHAPM Vol. 5, Issue Supplement 1, March 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Ventilator-associated pneumonia (VAP) is a major nosocomial infection in intensive care units (ICUs). Rotational therapy has been effective in reducing VAP incidence. The high incidence of VAP and the cost of ventilator maintenance indicate the need for a new management strategy. This study aimed to evaluate whether a rotational ventilator system based on lean management principles could reduce VAP incidence. The 5S method (Sort, Set in Order, Shine, Standardize, Sustain) was implemented to facilitate rapid change, while the Plan-Do-Study-Act (PDSA) cycle was used to control process variation and assess effectiveness over a 30-day period. The study involved 259 patients selected through total sampling. Data were analyzed using an independent t-test. Implementation of the revised management flow led to decreased waiting times, reduced non-clinical time wastage, improved patient and family satisfaction, minimized human error, and a 20% reduction in VAP rates within five days. The process was continuously evaluated, refined as needed, and formalized into a standard operating procedure (SOP) and clinical pathway for ICU ventilator management. The rotational ventilator system based on lean management, implemented in the ICU of Dr. Soebandi Hospital Jember, effectively reduced VAP incidence and management costs through the integration of 5S and PDSA methods.
THE IMPACT OF VARIATIONS IN CLINICAL PATHWAY IMPLEMENTATION ON POTENTIAL REVENUE LOSS FROM CESAREAN SECTION SERVICES AT DR. SAIFUL ANWAR REGIONAL HOSPITAL, EAST JAVA, INDONESIA Indrawan, I Wayan Agung; Setijowati, Nanik; Rahmah, Shofi Nur
Journal of Community Health and Preventive Medicine Vol. 5 No. Issue Supplement 1 (2025): JOCHAPM Vol. 5, Issue Supplement 1, March 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

This study examines the impact of variations in clinical pathway (CP) implementation on potential financial losses in Sectio Caesarea (SC) services at Dr. Saiful Anwar Regional Hospital, East Java, Indonesia. Applying a quantitative approach with a cross-sectional study design, secondary data in the form of medical records and patient treatment costs were analyzed using the categorical comparative method from February to May 2024. The results showed that the majority of patients (78.4%) had good compliance with CP, while 21.6% did not comply. The group with appropriate CP implementation showed a lower average hospital cost (IDR 24,435,564.29) compared to the non-compliant group (IDR 30,996,638.89). CP implementation variance significantly affected cost containment, where the compliant group had a smaller average deficit (-IDR 15,741,421.43) compared to the non-compliant group (-IDR 20,243,246.30). Logistic regression tests showed that the more appropriate the CP, the greater the cost efficiency achieved. However, demographic factors and patient clinical conditions did not significantly affect the implementation of CP. This study concludes that proper CP implementation enhances cost efficiency and reduces potential hospital losses in SC actions. Finally, evaluation and development of evidence-based CP and periodic monitoring of its implementation are recommended to improve the efficiency of hospital services.
EFFECT OF SERVICE QUALITY ON INPATIENT SATISFACTION AT DR. SAIFUL ANWAR REGIONAL GENERAL HOSPITAL, EAST JAVA PROVINCE Laili, Nurul; Hariyanti, Tita; Setijowati, Nanik
Journal of Community Health and Preventive Medicine Vol. 5 No. Issue Supplement 1 (2025): JOCHAPM Vol. 5, Issue Supplement 1, March 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

This study aimed to analyze the effect of service quality on inpatient satisfaction at Dr. Saiful Anwar Hospital. This study was conducted using a quantitative method, and data were collected through questionnaires from 204 inpatients selected using probability sampling techniques. The results showed that the tangibles, assurance, and empathy dimensions had a positive and significant effect on patient satisfaction, which indicates that improvements in these areas lead to higher satisfaction levels. In contrast, reliability and responsiveness had a positive but not statistically significant effect on patient satisfaction, thus improvements in these areas may lead to increased satisfaction, although the impact is not statistically significant. Among the five dimensions, assurance emerged as the most dominant factor influencing inpatient satisfaction. As the study identified assurance as the dominant factor influencing patient satisfaction, Dr. Saiful Anwar Hospital is expected to improve patient safety assurance. One potential initiative is the implementation of a QR-based medical record system to streamline access to patient information and minimize the risk of human error.
FACTORS INFLUENCING NON-BPJS PATIENTS CHOICE OF HOSPITALS FOR OUTPATIENT SERVICES Rini, Kartika; Setijowati, Nanik; Aminingrum, Rahmawati
Journal of Community Health and Preventive Medicine Vol. 5 No. Issue Supplement 1 (2025): JOCHAPM Vol. 5, Issue Supplement 1, March 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Non-BPJS patients have greater autonomy in selecting healthcare providers, making them a vital segment in ensuring the sustainability and growth of hospital businesses. These patients tend to consider various factors when choosing healthcare services, including accessibility, service quality, hospital reputation, medical technology, and overall patient experience. This study aims to identify the key factors influencing the decision of non-BPJS patients to return to a private hospital for further treatment. By highlighting the importance of this patient segment, the study emphasizes how hospitals can better understand and respond to patient preferences in order to enhance competitiveness. A qualitative research design was employed, with data collected through in-depth interviews involving 10 outpatients from specialist clinics at a private hospital in Malang City. The data were analyzed using thematic analysis, whereby the interview findings were categorized according to emerging themes aligned with the research objectives. The study reveals that, based on patient experiences, several key factors influence the decision of non-BPJS patients to return for services at private hospitals. Among the primary considerations for revisiting outpatient specialist clinics in Malang City are the friendliness of specialist doctors, the availability of medication delivery services, the hospital’s proximity, and affordable medical fees. Conversely, several issues were identified that could negatively impact patient satisfaction if not addressed. These include the lack of clear registration instructions, particularly for new patients; unfriendly behavior from some staff members; cramped facilities; limited patient waiting areas; and prolonged waiting times.
MATERNAL PATIENT EXPERIENCE AND INTENTION TO REVISIT: A STUDY IN A PRIVATE HOSPITAL IN MALANG CITY Oktaviana, Ratih; Setijowati, Nanik; Aminingrum, Rahmawati
Journal of Community Health and Preventive Medicine Vol. 5 No. Issue Supplement 1 (2025): JOCHAPM Vol. 5, Issue Supplement 1, March 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Maternal health care is an important component of the national health system since it directly affects maternal and child health. The quality of maternal care is evaluated not only based on clinical outcomes, but also on the patient's experience with the preceding treatment. This experience encompasses emotional factors, interactions with health care providers, hospital facilities, and service accessibility. Patients who have pleasant pregnancy, delivery, and postpartum experiences are more likely to revisit and use the same health services in the future. This study employs a qualitative methodology with a phenomenological approach. Data was collected through in-depth interviews with seven outpatients chosen based on particular criteria at the gynecological clinic at X Hospital in Malang City. The data were evaluated using thematic analysis, which involved categorizing interview results based on themes that arose in line with the research objectives. The findings of this study indicate that pregnant patients desire to revisit to Hospital X for a variety of reasons, including the availability of qualified specialist doctors, comprehensive facilities and infrastructure, good and courteous staff service, and the hospital's Islamic brand image. The majority of the informants expressed great happiness and satisfaction with their interactions at this facility. However, there were also less pleasant encounters, such as long and inconvenient lines and doctors who arrived late. Exploring the experiences of these maternal patients is one of the initiatives to find measures to boost patients' intent to visit this hospital again.
Exploring How Albumin Supplementation Affects Serum Albumin Levels, CD8+ Lymphocyte Counts, and Interferon Gamma In Rifampicin-Resistant TB Patients Yusdianto, Adrian; Chozin, Iin Noor; Sartono, Teguh Rahayu; Tantular, Rezki; Chilmi, Syahrul; Setijowati, Nanik
Jurnal Respirologi Indonesia Vol 45 No 3 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i3.874

Abstract

Background: Drug-resistant tuberculosis (DR-TB) remains a global health threat, with increasing cases unresponsive to rifampicin therapy. Diagnosing rifampicin-resistant TB (RR-TB) requires a multidisciplinary approach, in which markers such as interferon-gamma (IFN-ɣ) are useful for diagnosis, monitoring, therapy evaluation, and prognosis. Hypoalbuminemia commonly accompanies TB patients, evidenced by weight loss and reduced serum albumin levels. TB infection stimulates cytokine production, which suppresses albumin synthesis and regulation, affecting both prognosis and treatment success, particularly in RR-TB. This study aimed to evaluate the role of albumin supplementation in improving serum albumin levels, CD8+ lymphocyte counts, and IFN-ɣ levels in RR-TB patients. Methods: This true experimental study with a pre- and post-test control group design was conducted at Saiful Anwar Hospital. Thirty subjects were recruited: 10 healthy individuals (control group), 10 RR-TB patients receiving albumin supplementation (egg white extract) for 30 days (RR-TB + Albumin), and 10 RR-TB patients without supplementation (RR-TB only). Peripheral blood samples were collected before and after anti-TB drug (ATD) and albumin administration. Flow cytometry was used for analysis. Data were analyzed using SPSS and Partial Least Squares (PLS) analysis. Results: Significant differences in albumin and IFN-ɣ levels were observed between the control and RR-TB groups before supplementation. No significant differences were found in CD8+ lymphocyte counts (P=0.402) or IFN-ɣ levels (P=0.390) between supplemented and non-supplemented RR-TB patients. However, albumin levels (P=0.003) and body weight (P=0.014) increased significantly in the supplemented group. Conclusion: Albumin supplementation significantly increases serum albumin levels and body weight in RR-TB patients, but does not significantly affect CD8+ lymphocyte counts or IFN-ɣ levels.
Significance Level of Pleural Fluid Tissue Inhibitor Metalloproteinase-1 (TIMP-1) and Glucose Levels as Biomarkers of Malignant Pleural Effusion Michaela, Cleine; Putra, Ngakan Putu Parsama; Djajalaksana, Susanthy; Setijowati, Nanik; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.208-215

Abstract

Introduction: Distinguishing between malignant and non-malignant pleural effusions is often challenging due to overlapping biochemical profiles. Conventional diagnostic methods, including cytology and biopsy, are limited by their invasive nature, high costs, and potential complications. Emerging biomarkers, such as tissue inhibitor of metalloproteinase-1 (TIMP-1) and pleural fluid glucose levels, show promise as alternative diagnostic tools, but their clinical utility requires further validation. This study investigated the diagnostic value of TIMP-1 and pleural fluid glucose levels in differentiating malignant from non-malignant pleural effusions and explored their correlation in malignant cases. Methods: This cross-sectional analytical study included patients with exudative pleural effusion, categorized as malignant or non-malignant based on cytology and/or biopsy results. Biomarker levels of TIMP-1 and pleural fluid glucose were measured using enzyme-linked immunosorbent assay (ELISA) and biochemical analysis. Diagnostic thresholds for both biomarkers were determined using receiver operating characteristic (ROC) curve analysis. Results: Among 88 patients studied (33 malignant, 55 non-malignant), pleural fluid glucose levels were significantly lower in malignant cases (55.97 vs. 93.71 mg/dL; p=0.001), while TIMP-1 levels were notably higher (13.88 vs. 13.34 pg/mL; p<0.001). Tissue inhibitor of metalloproteinase-1 demonstrated superior diagnostic accuracy (86.5%) compared to glucose (70.6%) and the combined biomarker model (76.5%), with the sensitivity and specificity of 84.8% and 83.6%, respectively. Conclusion: Elevated TIMP-1 levels and reduced pleural fluid glucose levels are promising diagnostic biomarkers for malignant pleural effusion (MPE). Tissue inhibitor of metalloproteinase-1 exhibited the highest diagnostic accuracy, highlighting its potential as a non-invasive diagnostic tool in clinical practice.
“SEHATKU” BOOK MODIFICATION FOR DISEASE PREVENTION IN THE SURABAYA DIASPORA COMMUNITY Ritunga, Imelda; Setijowati, Nanik; Mellyanawati, Mellyanawati; Santoso, Jemima Lewi; Wartiningsih, Minarni; Jasin, Jessica Lingga; Soplantila, Chelsy Gravia; Maelo, Clara Angraini; Paskadita, Nafiri Eldya; Himawan, Asavita Rhena; Wilmida, Anggun Diah; Zhakia, Jelita Zhufatul; Pardosi, Delima Silvani; Mahulette, Aisyah Nurulhisa
Abdi Dosen : Jurnal Pengabdian Pada Masyarakat Vol. 9 No. 3 (2025): SEPTEMBER
Publisher : LPPM Univ. Ibn Khaldun Bogor

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32832/abdidos.v9i3.3062

Abstract

The epidemiological shift from communicable to non-communicable diseases poses a significant challenge in today’s health development efforts. Preventing chronic diseases has become a shared priority, one of which is through routine health screenings. The large number of adult and elderly members in the GBI Diaspora community highlights the need for health examinations as a concrete step in disease prevention. Psychological and financial barriers, along with often-overlooked documentation issues, can hinder individuals from undergoing health checks. A health record system was proposed as a solution through a mini project at GBI Diaspora Sejahtera Surabaya, delivered alongside health screening activities. The implementation involved collaboration and coordination in designing the “SEHATKU” pocketbook, which was distributed during the screenings. A total of 71 GBI Diaspora participants underwent health screenings and received the “SEHATKU” pocketbook as a tool for recording results and providing education. Post-activity questionnaires completed by 65 participants showed that more than 50% demonstrated increased knowledge and awareness of the importance of regular health check-ups. With the use of the “SEHATKU” pocketbook, proper documentation supports ongoing individual health monitoring within the community. Regular health screenings accompanied by the distribution of the “SEHATKU” pocketbook represent a promotive and preventive measure for non-communicable disease prevention at the primary care level.
Model Prediktor Prognosis Pasien Trauma Multipel Berdasarkan Lokasi Anatomis Cedera di RSSA Malang, Indonesia: Sub-Studi dalam Penyusunan Model Multikomponen: Hasil Penelitian Prasetyadjati, Ari; Setijowati, Nanik; Irsan, Istan Irmansyah; Zaiyanah, Munsifah; Johan, Willy
Cermin Dunia Kedokteran Vol 52 No 9 (2025): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i9.1316

Abstract

Introduction: Management of trauma still poses a challenge in Indonesia without significant improvement in mortality rates in the last 12 years, especially in multiple trauma involving at least 2 organ systems. This study aims to predict the prognosis of multiple trauma patients treated at Saiful Anwar Hospital (RSSA) Malang based on the anatomical location of the injury. Methods: Retrospective cohort study of 506 multiple trauma patients in RSSA during 2021-2022. The analyses used a chi square test and logistic regression test to obtain a regression equation. Results: Multiple trauma cases in RSSA were dominated by males in productive age (15-54 years). Head injury was the most influential variable in predicting the prognosis of multiple trauma patients in hospital, followed by thoracic injury, spinal injury, and abdominal injury. The logistic regression model was quite capable of explaining the data (p=0.931; Hosmer-Lameshow test), while the area under the curve (AUC-ROC) for prognosis in hospital care from this equation was 0.706 with a 95% confidence interval of 0.653-0.759 (good category). Conclusion: Head injuries, thoracic injuries, abdominal injuries, and spinal injuries are predictors of mortality of trauma cases in hospital care in RSSA, Malang, Indonesia.
The Effect of Anemia on Prognostic in Non-Small Cell Lung Cancer Patients Receiving Platinum-Based Chemotherapy Kartikasari, Ulfah; Pratiwi, Suryanti Dwi; Astuti, Tri Wahju; Setijowati, Nanik
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.120-129

Abstract

Introduction: Lung cancer has the highest incidence and mortality rate, which contributes to approximately 2.2 million cancer cases (11.4%) of total cancers worldwide. More than 70% of lung cancer cases present in the late, non-operable stage. Anemia is one of the conditions that could precipitate cancers and affect the patient's clinical presentation, including tissue oxygenation, organ function, and quality of life. It could also increase the risk of bleeding, post-operative mortality, and iron absorption rate in the case of ineffective erythropoiesis. All of these could affect the prognostic factor of the cancer. This study aimed to evaluate the effect of the severity of anemia on overall survival (OS) and progression-free survival (PFS) in non-small cell lung cancer (NSCLC) patients treated with platinum-based chemotherapy. Methods: This was a retrospective cohort study involving 80 subjects of NSCLC patients treated with platinum-based chemotherapy from January 2018 to December 2020. Subjects were divided into two groups (39 patients in the normal group and 41 patients in the anemia group). Results: The mean pre-treatment hemoglobin (Hb) was 10.55 ± 1.25 g/dL in NSCLC patients with anemia. The bone metastasis, OS, and PFS values of the normal and anemia groups were significant (p = 0.008; p = 0.002; p = 0.27). Anemia was significantly related to OS (r = 0.146, p = 0.000) and PFS (r = 0.264, p = 0.000) in NSCLC patients treated with platinum-based chemotherapy. Conclusion: Higher severity of anemia can reduce OS and PFS in NSCLC patients treated with platinum-based chemotherapy.
Co-Authors Aisyah Aisyah Amalia Pradanti Widarso, Amalia Pradanti Anjelin, Isabella Kusuma Arinto Yudi Ponco Wardoyo Asmika Asmika Badrul Munir Bimo Mubyarto Catur Ari Setianto Chozin, Iin Noor Damayanti, Gita Retno DAMAYANTI, ZUHRIA PUSPITA Dasa Novita, Khuznita Dessika Rahmawati Deuina Grishelda, Irma Dewi Santosaningsih Dhelya Widasmara Dhiar Widianingtyas, Dhiar Dian Kusumaningtyas, Dian Djajalaksana, Susanthy Dwi Rahayu, Indriati Eddy, Mochammad Istiadjid Eko Arisetijono Erlangga, Eggi Eviana Norahmawati Fadli, Muhammad Luqman Fitria, Ruman Freddy, Antonius Hanggara, Dian Sukma Hatimul Asmy Hendradi Surjotomo, Hendradi Himawan, Asavita Rhena Holipah, Holipah I Wayan Agung Indrawan Ida Sri Maduretno, Ida Sri Imelda Ritunga Imowanto, Yuddy Indradmojo, Christyaji Indriati Dwi Rahayu irsan , Istan Irmansyah Irsan, Istan Irmansyah Jasin, Jessica Lingga Jemima Lewi Santoso Johan, Willy Johannes, Jeffrey Kartika Rini Kartikasari, Ulfah Kuntadi, Muhammad Lilik Zuhriyah Listuhayu, Kararawi Listyoko, Aditya Sri Maelo, Clara Angraini Mahendra, Reza Aditya Mahulette, Aisyah Nurulhisa Marini . Marini, Gita Mellyanawati Mellyanawati Michaela, Cleine Minarni Wartiningsih Muhammad, Athaya Rahmanardi Natasha Halim, Angie Nazila Tanasya Nia Novita Wirawan, Nia Novita Normawati Normawati, Normawati Novita, Khuznita Dasa Nugroho, Soeryanto Eko Agung Nurul Laili Oktaviana, Ratih Panjaitan, Damaris Gabrielle Valentine Pardosi, Delima Silvani Paskadita, Nafiri Eldya Prasetyadjati, Ari Pratiwi, Suryanti Dwi Pratiwi, Suryanti Dwi Prihatiningsih, Riska Dwi Putra, Ngakan Putu Parsama Putu, Ngakan rahmah, shofi nur Rahmawati Aminingrum Rakhma, Sastia Rakhmani, Alidha Nur Rusnianah, Farida Santosa, Andrew Sartono, Teguh Rahayu Sitompul, Boyke Soehartono Soehartono Soplantila, Chelsy Gravia Sri Andarini Sugiri, Yani Jane Suparno Adi Santika, Suparno Adi Syahrul Chilmi, Syahrul Tantular, Rezki Tita Hariyanti Titin Andri Wihastuti Tri Wahju Astuti, Tri Wahju Triyuliarto, Dwiwardoyo Wahyudi, Mgs Ahmad Widowati, Yenny Wilmida, Anggun Diah Yoga Sedana, I Ketut Yusdianto, Adrian Yuyun Yueniwati Zaiyanah, Munsifah Zamroni Afif Zarithsyafiqah, Siti Zhakia, Jelita Zhufatul