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FACTORS RELATED TO THE REDUCTION OF MEDICATION DISCREPANCIES AT TRANSITION OF CARE: A SYSTEMATIC REVIEW Ida Bagus Nyoman Maharjana; Adik Wibowo
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Adverse drug events (ADE) are a leading cause of injury and death within health care systems around the world. Up to 67% of patients’ prescription medication histories recorded on admission to hospital have one or more errors and 30 – 80% of patients have a discrepancy between the medicines ordered in hospital and those they were taking at home. This study aims to systematically evaluate the available literature on the medication history records as a quality improvement in reducing medication discrepancies during the transition of care. Methods: This study was used systematic review which performed according to the PRISMA method. The search included articles were obtained through databases: MEDLINE (1946), EMBASE (1966), CINAHL (1937) and PubMed (1946). Some of the key words or Medical Subject Heading (MeSH) terms used in the search were: “transition of care,” “medication discrepancies,” “medication errors,” “patient safety,” “medication history,” “patient admission,” “patient discharge,” “patient transfer,” and “hospital”. Only studies published in English were included. Exploring literature was focused on the articles published from 2009 to 2019. Results: Initially, a total of 162 potentially relevant articles were obtained. After screening tittle and reviewing abstracts, 14 full text were assessed for eligibility. Of the 10 articles met all inclusion criteria, 5 studies were randomized controlled trials, 2 quasi-experimental studies, 1 cohort study, and 2 qualitative studies with quantitative approaches. All studies found that involving best possible medication history in identifying medication discrepancies and communicating this information affected medication discrepancies in the medical record. Conclusions: The available literature such as lack of well-designed studies precluded us from concluding that no effect exists. Medication reconciliation supported by information technology was an important tool for minimizing the percentage of medications with unintentional discrepancies

PREVENTION AND MANAGEMENT FOR THE COMPLICATION OF THIRD MOLAR SURGERY : A SYSTEMATIC REVIEW Ida Ayu Wirastuti; Ida Bagus Nyoman Maharjana; Prastuti Soewondo
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Impacted third molar surgery is one of the most common procedures performed by maxillofacial surgeons and it is often attended by complications. Although clinical conditions associated with retained third molars are well understood, little is known about the impact of those conditions on the quality of life among affected patients. There is growing recognition that the impact of oral conditions on quality of life is an important outcome that can be quite useful in making treatment decisions. All the information in this review could be useful for the clinicians in order to show the surgical and pharmacologic parameters that may influence the postoperative discomfort in the third molar surgeries. Methods: This systematic review followed the recommendations in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Some of the key words or Medical Subject Heading (MeSH) terms used in in the two data bases (Proquest and Google Scholar) were: (1) Third Molar Surgery, (2) Complication, (3) Prevention. The articles were published in English from 2009 to 2019. Results: Studies were eligible if they evaluated prevention and management for the complication of third molar surgery, and eight studies for qualitative synthesis. Of the eight articles, all studies were selected with Randomized Control Trial. Eight studies were included because they discussed the prevention and management of third molar surgery complication. Almost all of the practices of prevention and management of third molar surgery complication described that analgetic ibuprofen and paracetamol were used for decreasing the pain, and also amoxicillin tablet was used as an antibiotic for preventing high risk complication. According to studies, prophylactic use of chlorhexidine mouth rinse in third molar surgery are equally effective in keeping post operative infection to a minimum level in medically competent patient. Conclusions: All studies revealed that the most common complications of third molar surgery were pain, trismus, swelling, alveolar osteitis, and dry socket. Those studies discussed the prevention and management third molar surgery complication. Ibuprofen and paracetamol were used to decrease the pain, amoxicillin (1g) and amoxicillin/clavulanate (875/125mg) had similar efficacious in preventing infection after retained third molar extraction, but amoxicillin and clavunate (875/125mg) produced more gastrointestinal discomfort. Prophylactic use of chlorhexidine mouth rinse and gel in third molar surgery were equally effective in keeping post operative infection. Corticosteroid had a significant and sustained anti- inflammatory effects.

ANTIMICROBIAL STEWARDSHIP STRATEGY TO REDUCE LENGTH OF STAY AND COST OF ANTIBIOTIC CONSUMPTION: A SYSTEMATIC REVIEW Anak Agung Istri Agung Sri Stuti Damayanti; Ida Bagus Nyoman Maharjana; Atik Nurwahyuni
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Reducing the cost of care and length of stay for patient in hospital are important to monitor the benefits of implementing an antimicrobial management program. An antimicrobial management program is a strategy to decrease Antimicrobial Resistance (AMR) that affect to the treatment of the patient. One of the antimicrobial management programs is Antimicrobial Stewardship Programs (ASP). This study aims to determine the appropriate strategies in the application of Antimicrobial Stewardship Programs (ASP) that can reduce the length of stay and cost of antibiotic consumption for patient in hospital. Methods: This study was a systematic review that used PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Data obtained from Electronic databases ProQuest and Medline (PubMed) that published five years times span. By using keywords such as antimicrobial stewardship, antimicrobial resistance, length of stay, length of the hospital and patient cost to find the relevant journal. Results: The search found 3,541 studies, of which 26 studies were included in the systematic review. After excluded the article review, there were 9 studies that used quasi-experimental, observational cohort studies and Randomized Control Trial (RCT). These studies conducted majority in Europe and USA, only 1 study that conducted in Asia. Analysis of the studies found out that 6 of 9 studies mentioned if ASP can reduce the length of stay of the patient in hospital. Only 3 of 9 studies that examined the effect of ASP in cost of care and these 3 studies mentioned ASP can reduce the cost of care. Conclusion: This study showed that implementing ASP can reduced the length of stay and antibiotics consumption among patient in hospital by manage the antimicrobial use, conduct audits and feedback in an appropriate step, and intravenous to oral switch program. Keywords: Antimicrobial stewardship, length of stay, cost of care

FACTORS RELATED TO THE REDUCTION OF MEDICATION DISCREPANCIES AT TRANSITION OF CARE: A SYSTEMATIC REVIEW Ida Bagus Nyoman Maharjana; Adik Wibowo
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: Adverse drug events (ADE) are a leading cause of injury and death within health care systems around the world. Up to 67% of patients’ prescription medication histories recorded on admission to hospital have one or more errors and 30 – 80% of patients have a discrepancy between the medicines ordered in hospital and those they were taking at home. This study aims to systematically evaluate the available literature on the medication history records as a quality improvement in reducing medication discrepancies during the transition of care. Methods: This study was used systematic review which performed according to the PRISMA method. The search included articles were obtained through databases: MEDLINE (1946), EMBASE (1966), CINAHL (1937) and PubMed (1946). Some of the key words or Medical Subject Heading (MeSH) terms used in the search were: “transition of care,” “medication discrepancies,” “medication errors,” “patient safety,” “medication history,” “patient admission,” “patient discharge,” “patient transfer,” and “hospital”. Only studies published in English were included. Exploring literature was focused on the articles published from 2009 to 2019. Results: Initially, a total of 162 potentially relevant articles were obtained. After screening tittle and reviewing abstracts, 14 full text were assessed for eligibility. Of the 10 articles met all inclusion criteria, 5 studies were randomized controlled trials, 2 quasi-experimental studies, 1 cohort study, and 2 qualitative studies with quantitative approaches. All studies found that involving best possible medication history in identifying medication discrepancies and communicating this information affected medication discrepancies in the medical record. Conclusions: The available literature such as lack of well-designed studies precluded us from concluding that no effect exists. Medication reconciliation supported by information technology was an important tool for minimizing the percentage of medications with unintentional discrepancies Keywords: Adverse drug events, Medication discrepancies, Patient safety, Transition of care

PREVENTION AND MANAGEMENT FOR THE COMPLICATION OF THIRD MOLAR SURGERY : A SYSTEMATIC REVIEW Ida Ayu Wirastuti; Ida Bagus Nyoman Maharjana; Prastuti Soewondo
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: Impacted third molar surgery is one of the most common procedures performed by maxillofacial surgeons and it is often attended by complications. Although clinical conditions associated with retained third molars are well understood, little is known about the impact of those conditions on the quality of life among affected patients. There is growing recognition that the impact of oral conditions on quality of life is an important outcome that can be quite useful in making treatment decisions. All theinformation in this review could be useful for the clinicians in order to show the surgical and pharmacologic parameters that may influence the postoperative discomfort in the third molar surgeries. Methods: This systematic review followed the recommendations in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Some of the key words or Medical Subject Heading (MeSH) terms used in in the two data bases (Proquest and Google Scholar) were: (1) Third Molar Surgery, (2) Complication, (3) Prevention. The articles were published in English from 2009 to 2019. Results: Studies were eligible if they evaluated prevention and management for the complication of third molar surgery, and eight studies for qualitative synthesis. Of the eight articles, all studies were selected with Randomized Control Trial. Eight studies were included because they discussed the prevention and management of third molar surgery complication. Almost all of the practices of prevention and management of third molar surgery complication described that analgetic ibuprofen and paracetamol wereused for decreasing the pain, and also amoxicillin tablet was used as an antibiotic for preventing high risk complication. According to studies, prophylactic use of chlorhexidine mouth rinse in third molar surgery are equally effective in keeping post operative infection to a minimum level in medically competent patient. Conclusions: All studies revealed that the most common complications of third molar surgery were pain, trismus, swelling, alveolar osteitis, and dry socket. Those studies discussed the prevention and management third molar surgery complication. Ibuprofen and paracetamol were used to decrease the pain, amoxicillin (1g) and amoxicillin/clavulanate (875/125mg) had similar efficacious in preventing infection after retained third molar extraction, but amoxicillin and clavunate (875/125mg) produced more gastrointestinal discomfort. Prophylactic use of chlorhexidine mouth rinse and gel in third molar surgery were equally effective in keeping post operative infection. Corticosteroid had a significant and sustained antiinflammatory effects.

ANALISIS STRATEGI PEMASARAN LAYANAN BABY CARE DI RSU BHAKTI RAHAYU DENPASAR TAHUN 2020 Semarajana, I Nyoman Gede; Maharjana, Ida Bagus Nyoman
Jurnal ARSI : Administrasi Rumah Sakit Indonesia
Publisher : UI Scholars Hub

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Baby massage has long been known to be beneficial in helping baby's growth and development and is a hereditary tradition. The benefits of baby massage have been shown in various studies, but the lack of mother's knowledge about how to properly massage a baby also encourages mothers to seek baby massage services to both shamans and baby spas. These factors enable Bhakti Rahayu Hospital to develop Baby Care services in 2020 as a form of continuity of services provided to post-partum mothers. The purpose of this study was to analyze the marketing strategy of Baby Care services at Bhakti Rahayu Denpasar Hospital in 2020. The research design used was descriptive with a cross-sectional approach. Analysis was carried out by segmenting, targeting, and positioning of the Baby Care service, followed by determining the 4P (Product, Price, Place, and Promotion) marketing mix. Baby Care service has eight products at affordable and competitive prices, and activities carried out at home will make it easier for mothers to get services. Promotion of Baby Care services needs to be expanded and further evaluation needs to be done so that it can be known about the utilization of Baby Care services at Bhakti Rahayu Hospital Denpasar

TREATMENT BEHAVIOR OF TUBERCULOSIS PATIENTS IN TABANAN HEALTH CENTER Sutema, Ida Ayu Manik Partha; Wijayaningrum, I Dewa Ayu Indah; Maharjana, Ida Bagus Nyoman; Ardianta, I Putu Riska
Journal Pharmaceutical Science and Application Vol 5 No 2 (2023): Journal Pharmaceutical Science and Application
Publisher : Departement of Pharmacy, Faculty of Mathematic and Natural Science, Udayana University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JPSA.2023.v05.i02.p02

Background: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. The treatment behavior of tuberculosis patients plays an important role in preventing transmission and recovery of tuberculosis patients, if the treatment behavior of tuberculosis patients is not good it can cause drug resistance, recurrence of tuberculosis disease, even death. Objective: to describe the treatment behavior of tuberculosis patients in the Tabanan Community Health Center area. Methods: This research is a type of quantitative descriptive research conducted in April 2023 at Tabanan Health Center. Measurements were carried out using TPB (Theory of Planned Behavior) questionnaires. Results: This study presents that most respondents had attitudes with enough categories , while the fewer categories amounted and the good category amounted. Conclusion: We found that 57% of respondents suffering from tuberculosis at the Tabanan Health Center had adequate behavior. There is a need for education for tuberculosis patients to prevent and overcome tuberculosis transmission and increase knowledge about tuberculosis infectious diseases either with booklets, leaflets, or animated videos. Keywords: Treatment behavior; Tuberculosis patient; Health center

Hubungan Dukungan Keluarga Terhadap Kepatuhan Minum Obat Diabetes Melitus Tipe 2 di Puskesmas Mengwi II Ni Putu Helena Priscayanti; Ida Bagus Nyoman Maharjana; Ni Putu Wintariani; I Putu Gede Adi Purwa Hita
Jurnal Mahasiswa Ilmu Kesehatan Vol. 1 No. 3 (2023): Juli : Jurnal Mahasiswa Ilmu Kesehatan
Publisher : STIKes Ibnu Sina Ajibarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59841/jumkes.v1i3.95

Diabetes melitus tipe 2 merupakan kasus yang biasanya memiliki riwayat kelainan yang dimulai dengan resistensi insulin. Berbagai komplikasi akibat diabetes dapat terjadi pada semua system tubuh seperti saraf, jantung, pembuluh darah, ginjal, mata, dan otak. Jika tidak segera ditangani akan menyebabkan kematian. Kepatuhan pengobatan yang rendah terhadap terapi dapat menyebabkan peningkatan risiko biaya pengobatan, peningkatan komplikasi penyakit dan risiko rawat inap. Selain itu, dukungan keluarga juga menjadi satu faktor yang berpengaruh terhadap peningkatan kepatuhan pengobatan pada pasien diabetes melitus tipe 2. Penelitian ini bertujuan untuk mengetahui hubungan dukungan keluarga terhadap kepatuhan minum obat pada pasien diabetes melitus tipe 2 di Puskesmas Mengwi II. Metode penelitian dilakukan secara observasional dengan jumlah sampel yang digunakan 100 sampel. Teknik pengambilan sampel secara purposive sampling. Analisis statistik yang digunakan yaitu uji Spearman Rank dengan instrument kuesioner dukungan keluarga dan MMAS-8. Hasil penelitian menunjukkan bahwa sebanyak 65 responden (65%) mendapatkan dukungan keluarga yang baik dengan tingkat kepatuhan minum obat dengan kategori sedang. Analisa Spearman Rank menunjukkan nilai Sig. (2-tailed) sebesar 0,000 (<0,05). Hal ini berarti ada hubungan dukungan keluarga terhadap kepatuhan minum obat pasien diabetes melitus tipe 2. Kesimpulan dari penelitian ini menunjukkan bahwa ada hubungan antara dukungan keluarga dengan kepatuhan minum obat pasien diabetes melitus tipe 2 di Puskesmas Mengwi II.

FAKTOR-FAKTOR YANG MEMPENGARUHI KEPATUHAN PASIEN HIPERTENSI DALAM MENGONTROL TEKANAN DARAH SELAMA PANDEMI COVID-19 DI WILAYAH KERJA PUSKESMAS SELAT Anjani, Ni Luh Putu Mely; Maharjana, Ida Bagus Nyoman; Apsari, Dewi Puspita
Bali International Scientific Forum Vol. 2 No. 2 (2021): Bali International Scientific Forum
Publisher : Bali International University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34063/bisf.v2i2.302

Abstrak Latar Belakang: Dimasa pandemi Covid-19 penderita hipertensi mendapatkan tantangan untuk tetap memantau kepatuhan dalam mengontrol tekanan darah. Kepatuhan dianggap penting karena hipertensi merupakan penyakit kronis dan memerlukan pengobatan jangka panjang. Tingkat pengetahuan, akses menuju kepelayanan kesehatan, dukungan keluarga, peran petugas kesehatan merupakan faktor yang tidak dapat diabaikan karena merupakan faktor yang dapat mempengaruhi kepatuhan pasien. Tujuan: Mengetahui faktor-faktor yang mempengaruhi kepatuhan pasien hipertensi dalam mengontrol tekanan darah selama pandemi Covid-19 di wilayah kerja puskesmas selat yang ditinjau dari segi faktor predisposisi, faktor pendukung (enabling factors) dan faktor pendorong (reinforcing factors). Metode: Metode penelitian kualitatif dengan jenis pendekatan fenomenologi. Informan berjumlah 13 orang. Uji validitas dalam penelitian ini menggunakan teknik triangulasi sumber. Hasil: Faktor predisposisi terdiri dari tingkat pengetahuan informan yang masih kurang. Faktor pendukung (enabling factors) meliputi akses menuju pelayanan kesehatan, dimana mayoritas dipengaruhi dari segi jarak rumah yang jauh dengan pusat pelayanan kesehatan. Faktor pendorong (reinforcing factors) meliputi dukungan keluarga dan peran tenaga kesehatan yang masih kurang, serta faktor pandemi Covid-19 yang memberikan kekhawatiran terhadap informan untuk berobat ke pelayanan kesehatan. Kesimpulan: Faktor predisposisi meliputi tingkat pengetahuan, faktor pendukung (enabling factors) meliputi akses menuju kepelayanan kesehatan, dan faktor pendorong (reinforcing factors) meliputi peran tenaga kesehatan, dukungan keluarga dan faktor pandemi Covid-19. Kata Kunci: Hipertensi, pengetahuan, keluarga, tenaga kesehatan, pandemi

Pengabdian Masyarakat Penggunaan Antibiotik yang Bijak pada Ibu Rumah Tangga di Desa Punggul Kabupaten Badung Widowati, I Gusti Ayu Rai; Maharianingsih, Ni Made; Maharjana, Ida Bagus Nyoman; Sutema, Ida Ayu Manik Partha
Jurnal Pengabdian kepada Masyarakat Wahana Usada Vol. 7 No. 1 (2025): Juni: Jurnal Pengabdian kepada Masyarakat Wahana Usada
Publisher : Sekolah Tinggi Ilmu Kesehatan KESDAM IX/Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47859/wuj.v7i1.548

Background: Antimicrobial resistance (AMR) is an increasing global health challenge, especially due to the irrational use of antibiotics. Increasing public awareness of the dangers of AMR is an important step in prevention and control efforts. A counseling program on AMR awareness has been implemented as part of the Community Service Program by Bali International University students in Punggul Village, Badung Regency, Bali Province. Method: This community service activity was carried out on September 5, 2023 and was attended by more than 50 participants, the majority of whom were housewives. The methods used included the presentation of educational materials, interactive sessions, and local culture-based campaigns to increase public understanding regarding the proper and wise use of antibiotics. Results: Evaluation through posttest showed that there was fair knowledge (73.0%) and positif attitude of participants (100%) regarding the importance of rational use of antibiotics. In addition, this activity had a positive impact on students as implementers, especially in improving communication skills, leadership, and community empowerment. Conclusion: This program showed that a community-based educational approach that is sensitive to the local context has significant potential in raising awareness of AMR. Active involvement of young people as agents of change can be a sustainable strategy to support AMR control efforts at the local and global levels.

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