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All Journal Media Penelitian dan Pengembangan Kesehatan Jurnal Ilmiah Ilmu Keperawatan Indonesia (Indonesian Nursing Scientific Journal) Journal of Nursing Science Update Enrichment: Journal of Multidisciplinary Research and Development
Emiliana Tjitra
Pusat Teknologi Terapan Kesehatan dan Epidemiologi Klinik, Badan Litbangkes, Kemenkes RI
Humanities Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Engineering Health Professions Nursing Public Health Social Sciences

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RASIONALISASI PENGGUNAAN OBAT SIMPTOMATIK DAN OBAT LAIN YANG DIBERIKAN BERSAMAAN DENGAN OBAT ARTESUNATE-AMODIAKUIN PADA SUBYEK MALARIA DI DELAPAN PUSKESMAS SENTINEL KALIMANTAN DAN SULAWESI Isnawati, Ani; Gitawati, Retno; Tjitra, Emiliana; Rooslamiati, Indri; Raini, Mariana; -, Delima
Media Penelitian dan Pengembangan Kesehatan Vol 21, No 3 Sept (2011)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/mpk.v21i3 Sept.94.

Abstract

Background. Since 2004, Malaria Program in Indonesia has used Artemisinin Combination Therapy (ACT) to replace the chloroquine resistance. The recommended ACT is Artesunate dan Amodiaquine (AAQ) combination for uncomplicated falciparum malaria. To relieve side effects and clinical complaints of malaria , health workers usually gave  symptomatic and other drugs in addition to antimalarial drugs. Methods. The methodology implemented in this study was a cross-sectional study to evaluate symptomatic and other drugs given together with antimalarial (AAQ) to uncomplicated malaria subjects (patients) infected by falciparum, vivax and mixed (falciparum dan vivax) plasmodium. Data were collected from case report form in 6 months (July to December 2010) from 8 (eight) sentinels puskesmas (primary health centers) in North Sulawesi, Central Sulawesi, West Kalimantan and East Kalimantan. Results. Total number of cases (89,4%) were given symptomatic and other drugs in addition to antimalarial drugs. Symptomatic and other drugs that mostly given were antipyretic/analgesic (90.8%) and vitamin-mineral (70%). There seemed to be over-use of vitamin-minerals since the indication to giving those medications were not quite clear. Antibiotics were mostly given to subjects with gastrointestinal complaints such as nausea, vomiting, and abdominal pain. The administration of antibiotic for non-bacterial infection were  irrational. Antihistamines were given to 94,3% subjects without cold and flu, and this cases also be defined as inappropriate use of medicine. In addition, antacids were also given to 12,5 %  subjects  without gastrointestinal complaints to anticipate side effects of antimalarial. AbstrakLatar belakang.Tahun 2004 Program Pemberantasan Malaria mulai menggunakan ACT menggantikan klorokuin yang telah resisten. ACT yang direkomendasikan adalah kombinasi Artesunat dan Amodiakuin (AAq), untuk malaria falsiparum tanpa komplikasi. Untuk mengatasi efek samping obat malaria dan untuk mengurangi gejala klinik akibat penyakit malaria serta gejala klinik penyakit penyerta, maka tenaga kesehatan (Nakes) akan memberikan obat simtomatik atau obat lain selain obat malaria. Pemberian obat kadang-kadang tidak hanya satu jenis tetapi berupa kombinasi dari beberapa jenis obat. Metode.Desain penelitian cross-sectional (potong lintang) dengan jenis penelitian observasional non intervensi, untuk mengetahui obat simtomatik atau obat lain yang diberikan tenaga kesehatan selain obat terapi malaria dengan Artesunat-Amodiakuin (AAq). Subyek penelitian adalah semua pasien yang didiagnosis malaria falsiparum, vivaks dan infeksi campuran (falsiparum dan vivaks) tanpa komplikasi Pelaksanaan pengumpulan data dimulai dari bulan Juli sampai dengan awal Desember 2010. Tempat penelitian dilakukan di empat provinsi yaitu provinsi Sulawesi Utara, Sulawesi Tenggara, Kalimantan Timur dan Kalimantan Barat. Hasil.  Obat simtomatik paling banyak diberikan oleh Nakes adalah Antipiretik/analgesik sebesar 90,8% dan vitamin-mineral (70%). Vitamin-mineral diberikan tanpa indikasi jelas dan cenderung berlebihan.  Antibiotik  banyak diberikan pada subyek untuk indikasi gangguan saluran cerna (mual, muntah, nyeri abdomen) non-infeksi bakteri adalah cenderung tidak rasional. Antihistamin tercatat diberikan pada subyek tanpa keluhan batuk pilek dan ini termsuk pemberian obat yang tidak tepat. Ditemukan pemberian antasida dan antiemetik untuk subyek tanpa keluhan gangguan saluran cerna dalam upaya mengantisipasi efek samping obat malaria.
EFIKASI DAN KEAMANAN DIHIDROARTEMISININ-PIPERAKUIN (DHP) PADA PENDERITA MALARIA FALSIPARUM TANPA KOMPLIKASI DI KALIMANTAN DAN SULAWESI Avrina, Rossa; Risniati, Yenni; Tjitra, Emiliana; Siswantoro, Hadjar; Hasugian, Armedy Ronny
Media Penelitian dan Pengembangan Kesehatan Vol 21, No 3 Sept (2011)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/mpk.v21i3 Sept.95.

Abstract

Since 2008, Dihydroartemisinin-Piperaquine (DHP) has been used as the first-line drug for treatment of falciparum malaria in Papua, which gradually will also be used in other endemic areas. The objective of the study was  to determine the safety and efficacy of DHP. Patients with uncomplicated malaria due to Plasmodium falciparum were enrolled and treated with supervised DHP (arterakin ®, no. batch 010 909) daily dose for three days. Patients were followed for 42 days. Patients during follow up did physical examination and checked for microscopic parasites, measurement of hemoglobin levels (day 0, 14, 28 and 42), making the blood spot PCR (day 0 and day relapse), pregnancy test for women of childbearing age (Day 0 and 28). 119 patients were enrolled in the study. Therapeutic efficacy of DHP by day 42 in ITT and PP population were 98.3% (95% CI: 94.1-99.5%) and 100% (95% CI: 96.9-100%). The means of parasite clearance and fever clearance were 1.0 day and 1.6 days, and clinical symptoms was reduced by over 50% by day-7 follow up. All patients with gametocytes on day 0, generally were cleared on day 28 . There were an increasing number of patients with recovery hemoglobin at day 14, 28 and 42: 61%, 78% and 84%. Adverse events were mild, ie cough (31%) and abdominal pain (10%). Dihydroartemisinin-piperaquine was safe and effective for the treatment of uncomplicated P. falciparum malaria. AbstrakSejak 2008, program telah menggunakan dihidroartemisinin-piperakuin (DHP) sebagai pilihan pertama pengobatan malaria falsiparum di Papua, yang secara bertahap juga akan digunakan di wilayah endemis lainnya. Tujuan penelitian ini adalah untuk menilai keamanan  dan efikasi obat DHP. Pasien malaria falsiparum tanpa komplikasi diikutkan dalam studi dan diobati DHP (arterakin ®, no. batch 010 909) dengan pengawasan minum obat dosis satu kali sehari selama tiga hari. Selanjutnya pasien dipantau selama 42 hari. Pasien selama kunjungan ulang dilakukan pemeriksaan fisik dan cek parasit mikroskopis, diukur kadar hemoglobin (hari 0, 14, 28 dan 42), dibuat spot darah PCR (hari 0 dan hari kambuh), tes kehamilan pada wanita usia subur. Sebanyak 119 pasien direkruit pada penelitian ini. Efikasi terapeutik obat DHP pada hari ke 42 per populasi ITT dan PP adalah 98.3% (95% CI: 94.1-99.5%) dan 100% (95% CI: 96.8-100%). Rerata bebas parasit dan bebas demam adalah 1.0 hari dan 1.6 hari, dan gejala klinis berkurang hingga di atas 50% pada hari ke-7 kunjungan ulang. Pasien dengan karier gametosit pada saat rekruitmen, umumnya pada hari ke-28 sudah bebas gametosit. Terdapat peningkatan jumlah pasien dengan perbaikan hemoglobin pada hari ke 14, 28 dan 42: 61%, 78% dan  84%.  Kejadian sampingan adalah ringan, yaitu batuk (31%) dan sakit perut (10%).Dihidroartemisinin-piperakuin adalah aman dan efektif pada pengobatan malaria falsiparum tanpa komplikasi.
The Effect of The Combination of Slow Deep Breathing and Humming on Improving Oxygen Saturation of Inpatients With Pneumonia at RSUD Jayapura Jufuwai, Susana; Prabawati, Dewi; Tjitra, Emiliana
Journal of Nursing Science Update (JNSU) Vol. 11 No. 2 (2023): November
Publisher : Department of Nursing, Faculty of Health Sciencce, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jik.2023.011.02.06

Abstract

Pneumonia is an infectious disease affecting the lower respiratory tract with signs and symptoms such as coughing and shortness of breath. Pneumonia cases in Indonesia are estimated to have 4 million deaths due to pneumonia every year. This study aims to analyze the effectiveness of Slow, Deep Breathing and Humming techniques on changes in oxygen saturation in pneumonia patients at Jayapura Regional Hospital. This quantitative research uses a quasi-experimental pre-test and post-test approach without a control group design. The sample consisted of 30 subjects who were given a slow deep breathing technique intervention of 5 cycles in 15 minutes and humming four cycles in 10 minutes, done once daily for six days. The instruments in the research used the Pulse Oximetry tool. The sampling technique used nonprobability sampling with total sampling. The results showed a difference in SpO2 values before and after the Slow, Deep Breathing, and Humming intervention was carried out in subjects with pneumonia with a p= 0.001 (p < 0.05). It can be interpreted that the Hypothesis (Ha1) is accepted so that it can be concluded that the slow, deep breathing and humming interventions can help improve Sp02. There is a need for further research on nurses' complementary therapy in oxygenation management, where this exercise is one of the nurse's interventions in overcoming decreased SpO2 in pneumonia patients.
Pengaruh Clinical Pathway Terhadap Mutu Pelayanan Keperawatan dan Kepuasan Pasien widjaja, lenny; Wijayanti, Catharina Dwiana; Tjitra, Emiliana
Jurnal Ilmiah Ilmu Keperawatan Indonesia Vol 9 No 03 (2019): Jurnal Ilmiah Ilmu Keperawatan Indonesia Edisi September 2019
Publisher : UIMA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (417.22 KB) | DOI: 10.33221/jiiki.v9i03.364

Abstract

ABSTRACT At X Hospital, 6 Clinical Pathways (CPs), 4 medical surgeries and 2 infectious diseases have been performed by nurse since 2014. To improve the quality of nursing services and patient satisfaction, a study was conducted on the effect of increasing the application of CP. The design of this study was a quasi experimental pre-post test and with a control group. The study group was determined based on the distribution of 6 CP cases and the type of inpatient services (private and government insurance). The study was conducted for 8 weeks in 4 nursing wards. During the first 4-week and after the intervention CP documents were auditted, analyzed the quality of nursing services and patient the standard X hospital forms. CP refreshing was given to 35 nurses of the intervention group selected satisfaction using by purposive sampling technique from 2 predetermined nursing wards The characteristics of nurses between the study groups did not differ, except more proportion of male nurses in the intervention than in control groups (22,9% vs 3,0%) Characteristics of inpatients, at before and after the intervention between the study groups were varied in age , and admitted diagnosis. The application of CP at pre-test was incomplete in both study groups, and after CP refreshing there was an improvement implementation of CP only in the intervention group (0 vs 68,6%). The quality of nursing services also improved only in the intervention group (62,9% vs 97,1%). Patient satisfaction had not significantly improved in both study group, either at pre or post tests.Overall, characteristics of nurse and patient and refreshing of CP did not affect the implementation of CP, quality of nursing services and patient satisfaction. While the of CP affected patient satisfaction, and the quality of nursing services affected the patient satisfaction. In conclusion, increasing the implementation of CP can improve the quality of nursing services and patient satisfaction. Keywords: Clinical Pathway, quality of nursing services, patient satisfaction
The Effect of 6c Training for IGD Nurses on Increasing IGD Patient Satisfaction at ABL Hospital noti, daud; Leo Bunga, Asnet; Tjitra, Emiliana
Enrichment: Journal of Multidisciplinary Research and Development Vol. 2 No. 11 (2025): Enrichment: Journal of Multidisciplinary Research and Development
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/enrichment.v2i11.305

Abstract

The emergency department is the front line in treating patients. This study aims to determine the effect of 6C’s based services on patient satisfaction in the Hospital Emergency Department. ABL. Used pra experimental design with approach pre-posttest-in one group only, without control group design. The research subjects were all patients who sought treatment at the ER at RS ABL. The treatment used was 6C’s training for ER nurses at RS.ABL. Data were analysed using SPSS 24, the results of the paired sample t test found that there was an increase in the average patient satisfaction of 2.48 before and after the intervention with a p-value of 0.015<0.05 and there was an increase in the quality of 6C’s services regarding patient satisfaction, each item namely compassion, competence, confidence, conscience, commitment and comfort each increased significantly with a p value of 0.000<0.05 on patient satisfaction. the results of the linear regression test found that there was an influence of the characteristics of emergency room nurses and the quality of the 6C’s services on the satisfaction of emergency room patients at ABL Hospital. The results of the multivariate linear regression analysis showed that the significant variable (p-value: 0.05) was gender with a p-value of 0.002<0,05, compassion with a p-value of 0.032<0.05, Confidence with a p-value of 0.044<0.05, and Conscience with a p-value of 0.025<0.05. It was concluded that there was an influence of the 6 C's of emergency room nurses' training on the satisfaction of emergency room patients at ABL Hospital.
Co-Authors Aisyah Aisyah Ani Isnawati Armedy Ronny Hasugian Avrina, Rossa Boy Yandri Budi Prasetyorini Cyntia Theresia Lumintang D. Wijayanti, Chatarina Delima -, Delima Dwi Astia Ningrum, Sella Endah Ariyanti Eni Yuwarni Ervi Salwati Ferdinand Laihad Hadjar Siswantoro Indri Rooslamiati Jufuwai, Susana Khairiri Khairiri Leo Bunga, Asnet Lidwina Yanuar Lukman Hakim Tarigan Maladi Maladi Mariana Raini Marvel Renny noti, daud Nurhayati Nurhayati P. N. Harianto P. R. Arbani Pascal Ringwald Popy Kawulur Prabawati, Dewi Reni Herman Retno Gitawati Risniati, Yenni Riyanti E Sarwo Handayani Sri Laning Sri Oemijati Sri Suprianto Suprapti, Fitriana Syahrial Harun Telly Purnamasari Tersila Dedang widjaja, lenny Wijayanti, Catharina Dwiana Wita Pribadi