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HUBUNGAN ACCESS BLOCK DENGAN PERBURUKAN KONDISI PASIEN DI INSTALASI GAWAT DARURAT RSUD ULIN BANJARMASIN Julianto Julianto; Izma Daud; Sari Milyati
DINAMIKA KESEHATAN: JURNAL KEBIDANAN DAN KEPERAWATAN Vol 11, No 1 (2020): Dinamika Kesehatan Jurnal Kebidanan dan Keperawatan
Publisher : Universitas Sari Mulia

AbstrakÂ Â Latar Belakang :Access block adalah situasi dimana pasien yang mengalami lama rawat di IGD 6 karena kurangnya akses ke ruang rawat inap dan kepadatan jumlah pasien yang tidak terkendali, dampaknya ditemukan bahwa semakin lama access blockÂ semakin tinggi pula perburukan pasien dalam 24 jam.Tujuan : ini bertujuan untuk mengetahui hubungan access block dengan perburukan kondisi pasien di Instalasi Gawat Darurat RSUD Ulin Banjarmasin.Metode :Penelitian menggunakan desain analitik dengan pendekatan cross sectional. Jumlah sampel yang diambil berjumlah 40 orang dengan teknik pengambilan accidental sampling. Analisis data melalui uji spearman rank.Hasil : Hasil uji dipapatkan nilai p hitung 0,000 (0,05) ada hubungan antara access block dengan perburukan kondisi pasien di instalasi gawat darurat RSUD Ulin Banjarmasi.Simpulan: Berdasarka hasil penelitian Ada hubungan antara access block dengan perburukan kondisi pasien di Instalasi Gawat Darurat RSUD Ulin Banjarmasin dengan nilai P= 0,000 nilai Î± = 0,05 dengan nilai koefisien korelasi 0,588Â Kata kunci: Access Block, Perburukan Pasien.Â AbstractÂ Background :Access block is a situation where patients who experience length of stay in the ED 6 due to lack of access to the inpatient room and uncontrolled density of patients, it is found that the longer the access block the higher the deterioration of patients in 24 hours.Purpose: This study aims to determine the relationship of access block with deteriorating condition of patients in Emergency Installation Ulin Hospital Banjarmasin.Method : The research method uses an analytical design with a cross sectional approach. The number of samples taken is 40 people using the accidental sampling technique. Data analysis through spearman rank test.Result: The test results obtained p value calculated 0,000 (0.05) there is a relationship between the access block and deterioration of the patient's condition at the Ulin Banjarmasin Hospital emergency department.Conclusion: Based on the results of the study, there is a relationship between the access block and the worsening of the patient's condition at the Emergency Department of RSUD Ulin Banjarmasin with a value of P = 0.000 value Î± = 0.05 with a correlation coefficient value of 0.588.Â Keywords: Access Block, Patient worseningÂ

HUBUNGAN KEHADIRAN KELUARGA DENGAN TINGKAT KECEMASAN PERAWAT SAAT RESUSITASI DI RUMAH SAKIT BANJARMASIN Atika Luqyana; Julianto Julianto
Journal of Nursing Invention Vol 1 No 1 (2020): Journal of Nursing Invention
Publisher : LPPM Universitas Sari Mulia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (599.94 KB)

A life-saving medical action can bring anxiety, because there is a threat of bodily integrity, emergency response measures always prioritize patient safety, where the presence of a patient's family who sees a nurse's actions while taking a nurse's resuscitation must act quickly and eventually feel anxious caused by anticipation of misconduct. This study aimed to determine the relationship of nurse anxiety levels when resuscitation with the presence of the family beside the patient. This study used a cross sectional design. The population is all nurses who are in the ICU with a sample taken with a total sampling technique of 30 people. Data analysis using Spearman rank. The results of the study found that most nurses experienced mild anxiety, there was a family relationship with the anxiety level of nurses when resuscitation in the ICU Hospital Dr. H. Moch Ansari Saleh Banjarmasin with the strength of a moderate relationship. It is expected that as nurses who will carry out nursing actions can overcome and reduce the sense of anxiety of nurses. Suatu tindakan medis menyelamatkan jiwa dapat mendatangkan kecemasan, karena terdapat ancaman integritas tubuh, tindakan penanggulangan kegawatdaruratan selalu mengutamakan keselamat pasien, dimana kehadiran keluarga pasien yang melihat tindakan perawat saat melakukan tindakan resusitasi perawat harus bertindak cepat dan akhirnya cenderung merasa cemas yang disebabkan oleh antisipasi terhadap kesalahan tindakan. Penelitian ini bertujuan untuk mengetahui hubungan tingkat kecemasan perawat saat tindakan resusitasi dengan kehadiran keluarga di samping pasien. Penelitian ini menggunakan desain cross sectional. Populasi adalah semua perawat yang berada di Ruang ICU dengan sampel diambil dengan tehnik total sampling berjumlah 30 orang. Analisis data menggunakan spearman rank. Hasil didapatkan bahwa sebagian besar perawat mengalami kecemasan ringan, ada hubungan kehadiran keluarga dengan tingkat kecemasan perawat saat tindakan resusitasi di Ruang ICU RSUD Dr. H. Moch Ansari Saleh Banjarmasin dengan kekuatan hubungan yang sedang. Diharapkan Sebagai perawat yang akan melakukan tindakan keperawatan dapat mengatasi serta mengurangi rasa kecemasan perawat.

P PENGARUH PEMBERIAN PIJATAN PADA TUNGKAI KAKI TERHADAP PENURUNAN SKALA KELELAHAN PADA PASIEN GAGAL JANTUNG DI RUMAH SAKIT X Julianto Julianto; Yuniarti Yuniarti; Mariana Mariana
Journal of Nursing Invention Vol. 2 No. 2 (2021): Journal of Nursing Invention
Publisher : LPPM Universitas Sari Mulia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33859/jni.v2i2.144

Heart failure is where the heart as a pump that is incapable of meeting the blood requirement for tissue metabolism is due to an increase in age. Heart failure sufferers experience fatigue. Pharmacological and non-pharmacological therapy with complementarytherapies such as leg massage. This study aims to determine the influence of leg massage to decrease the allergic scale in heart failure patients. An expression method that uses a one-group pre-post design approach or draft test. The number of research samples is 20 patients fatigue in heart failure that is experiencing fatigue. The results of this research before massage limbs obtained the value of 0,370, after massage limbs can be a significant value of 0,558. Results of the p-value (0.000) < α (0,05) have seen the decline of massage limbs in patients with heart failure.

H Hubungan Prehospital Delay Dengan Tingkat Keparahan Pada Pasien Stroke Di Rumah Sakit Banjarmasin Julianto Julianto; Solikin; Muhammad Firdaus
Journal of Nursing Invention Vol. 3 No. 2 (2022): Journal of Nursing Invention
Publisher : LPPM Universitas Sari Mulia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33859/jni.v3i2.274

Background: Stroke patients need golden time in treatment Â±3 hours which means that in the first 3 hours after having a stroke the patient must get complete and optimal care. Objective: To determine the relationship between prehospital delay and severity in stroke patients in Banjarmasin city hospitals. Method: This research is a quantitative study using a correlational descriptive research design with a retrospective approach. Sampling was carried out using purposive sampling techniques, the sample in this study was 124 respondents. Data collection using prehospital observation of stroke patients with Spearman Rank statistical test. Results: The results of statistical tests in this study obtained a p-value of 0.000 < 0.05 and it can be stated that there is a significant relationship between prehospital delay and the severity of stroke patients at Banjarmasin City Hospital. The relationship between these two variables indicates in the direction of a negative correlation with the Spearman Rank value - 0.948 which means that the relationship between the two variables has perfect relationship. Conclusion: There is a significant relationship between prehospital delay and the severity of stroke patients at Banjarmasin City Hospital.

Analisis Faktor-Faktor yang Berhubungan dengan Overcrowding Pada Pasien Access Block di Instalasi Gawat Darurat RSUD X Risma Risma Yulidah; Julianto Julianto; Izma Daud; Mira Mira
Malahayati Nursing Journal Vol 8, No 4 (2026): Volume 8 Nomor 4 (2026)
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mnj.v8i4.24861

ABSTRACT Overcrowding in the Emergency Department (ED) is a serious problem affecting service quality and patient safety, with access block as one of the main contributing factors. Access block occurs when patients who require hospitalization cannot be immediately transferred to inpatient wards, resulting in patient accumulation in the ED. This study aimed to analyze factors associated with overcrowding among access block patients in the Emergency Department of RSUD X.= This study employed a quantitative observational analytic design with a prospective cross-sectional approach. Data were collected through direct observation of service conditions in the Emergency Department during December 2025 with a total sample of 430 patients. Variables included access block, overcrowding level measured using the National Emergency Department Overcrowding Score (NEDOCS), human resources, facilities and infrastructure, and patient output. Data were analyzed using univariate and bivariate analysis with the Chi-Square test. The results showed that most Emergency Department conditions experienced overcrowding (88.4%), and 45.6% of patients experienced access block. There was a significant relationship between access block and overcrowding (p = 0.008), human resources and overcrowding (p 0.001), facilities and infrastructure and overcrowding (p = 0.004), and patient output and overcrowding (p = 0.008). Access block and internal Emergency Department factors are significantly associated with overcrowding at RSUD X. Improvements in patient flow management, optimization of human resources, and enhancement of facilities and infrastructure are needed to reduce overcrowding in the Emergency Department. Keywords : Access Block, Overcrowding, Emergency Department, NEDOCS. ABSTRAK Overcrowding di Instalasi Gawat Darurat (IGD) merupakan permasalahan serius yang berdampak pada mutu pelayanan dan keselamatan pasien. Salah satu penyebab utama overcrowding adalah access block, yaitu kondisi ketika pasien yang telah diputuskan untuk rawat inap tidak dapat segera dipindahkan ke ruang perawatan sehingga terjadi penumpukan pasien di IGD. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kejadian overcrowding pada pasien access block di Instalasi Gawat Darurat RSUD X. Penelitian ini menggunakan desain kuantitatif observasional analitik dengan pendekatan cross sectional prospektif. Pengumpulan data dilakukan melalui observasi langsung pada setiap momen pelayanan di Instalasi Gawat Darurat RSUD X selama bulan Desember 2025 dengan jumlah sampel sebanyak 430 pasien. Variabel penelitian meliputi kejadian access block, tingkat overcrowding berdasarkan National Emergency Department Overcrowding Score (NEDOCS), kondisi sumber daya manusia (SDM), sarana dan prasarana, serta output pasien. Analisis data dilakukan secara univariat dan bivariat menggunakan uji Chi-Square. Hasil penelitian menunjukkan bahwa sebagian besar kondisi IGD mengalami overcrowding (88,4%) dan hampir setengah pasien mengalami access block (45,6%). Terdapat hubungan yang signifikan antara access block dengan overcrowding (p = 0,008), antara kondisi SDM dengan overcrowding (p 0,001), antara sarana dan prasarana dengan overcrowding (p = 0,004), serta antara output pasien dengan overcrowding (p = 0,008). Access block dan faktor internal IGD berhubungan signifikan dengan terjadinya overcrowding di Instalasi Gawat Darurat RSUD X. Diperlukan perbaikan manajemen alur pasien, optimalisasi sumber daya manusia, serta peningkatan sarana dan prasarana untuk menurunkan kejadian overcrowding di Instalasi Gawat Darurat. Kata Kunci: Access Block, Overcrowding, Instalasi Gawat Darurat, NEDOCS.

Efektivitas RTS dan Rems untuk Memprediksi Outcome Pasien Cedera Kepala di Ruang Instalasi Gawat Darurat RSUD Ulin Banjarmasin Nuzula Elfa Salama; Mira Mira; Julianto Julianto; Hanura Aprilia
Malahayati Nursing Journal Vol 7, No 12 (2025): Volume 7 Nomor 12 (2025)
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mnj.v7i12.21742

ABSTRACT Head injury is a major consequence of traffic accidents and significantly contributes to global morbidity and mortality. Rapid and accurate initial assessment is essential for predicting clinical outcomes, especially in emergency departments. The Revised Trauma Score (RTS) and Rapid Emergency Medicine Score (REMS) are commonly used predictive tools. To evaluate and compare the effectiveness of RTS and REMS in predicting the outcomes of head injury patients in the Emergency Department of RSUD Ulin Banjarmasin. This was an analytical observational study with a retrospective cohort approach involving data from 75 head injury patients recorded between January and December 2024. Samples were selected based on inclusion criteria: patients aged ≥19 years with complete vital signs data. AUROC and the Youden index were used to assess predictive accuracy. Most patients were aged 19–44 years (54.7%) and male (72%). The most common injury mechanism was traffic accidents (70.7%). RTS categorized 90.7% of patients as low-risk, while REMS identified 56% as high-risk. RTS showed an AUC of 0.932 (sensitivity 82.6%; specificity 100%), and REMS showed an AUC of 0.954 (sensitivity 85.5%; specificity 100%). Results indicated that both RTS and REMS were significantly associated with patient outcomes (p0.05). RTS and REMS are effective in predicting outcomes of head injury patients; however, REMS offers slightly better predictive accuracy and may serve as a more comprehensive early evaluation tool. Keywords: Head Injury, RTS, REMS, Patient Outcome, Trauma Score, Emergency Care. ABSTRAK Cedera kepala merupakan dampak utama kecelakaan lalu lintas dan berkontribusi terhadap morbiditas dan mortalitas global. Penilaian awal yang cepat dan akurat diperlukan untuk memprediksi outcome klinis, khususnya di instalasi gawat darurat. Revised Trauma Score (RTS) dan Rapid Emergency Medicine Score (REMS) merupakan instrumen prediksi yang umum digunakan. Menilai dan membandingkan efektivitas RTS dan REMS dalam memprediksi outcomepasien cedera kepala di IGD RSUD Ulin Banjarmasin. Penelitian observasional analitik dengan pendekatan kohort retrospektif menggunakan data 75 pasien cedera kepala Januari–Desember 2024. Sampel ditentukan berdasarkan kriteria inklusi usia ≥19 tahun dengan data tanda vital lengkap. Analisis AUROC dan Youden index digunakan untuk mengukur akurasi prediktif. Sebagian besar pasien berusia 19–44 tahun (54,7%) dan laki-laki (72%). Mekanisme cedera terbanyak adalah kecelakaan lalu lintas (70,7%). RTS mengkategorikan 90,7% pasien pada risiko mortalitas rendah, sedangkan REMS menunjukkan 56% berisiko tinggi. RTS memiliki AUC 0,932 (sensitivitas 82,6%; spesifisitas 100%) dan REMS AUC 0,954 (sensitivitas 85,5%; spesifisitas 100%). Hasil menunjukkan bahwa RTS dan REMS memiliki hubungan yang signifikan terhadap outcome pasien (p0,05). RTS dan REMS efektif dalam memprediksi outcome pasien cedera kepala, namun REMS memberikan akurasi prediksi yang lebih unggul dan dapat digunakan sebagai alat evaluasi awal yang lebih komprehensif. Kata Kunci: Cedera Kepala, RTS, REMS, Outcome Pasien, Prediksi Mortalitas, Instalasi Gawat Darurat.

Peningkatan Pengetahuan Orang Tua Murid tentang Penanganan Tersedak melalui Penyuluhan Demonstratif Teknik Heimlich Maneuver di TK Aisyiyah 31 Banjarmasin Abdus Salam; Desy Satriani; Diah Retno Wulan; Izma Daud; Julianto Julianto; Hanura Aprilia; Noorkhalilati Noorkhalilati
Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) Vol 9, No 2 (2026): Volume 9 Nomor 2 (2026)
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jkpm.v9i2.24124

ABSTRAK Tersedak (choking) merupakan kondisi kegawatdaruratan pada anak usia dini yang berpotensi menimbulkan kematian apabila tidak ditangani secara cepat dan tepat. Tingginya risiko tersedak pada anak prasekolah dipengaruhi oleh keterbatasan kemampuan motorik anak serta rendahnya keterampilan orang tua dan guru dalam melakukan pertolongan pertama yang sesuai prosedur medis. Panduan kegiatan pengabdian kepada masyarakat ini dirancang sebagai upaya promotif dan preventif melalui edukasi kesehatan berbasis demonstrasi langsung teknik heimlich maneuver. Kegiatan ini bertujuan untuk meningkatkan pengetahuan, keterampilan, serta kesiapsiagaan orang tua dan guru TK dalam menangani kejadian tersedak pada anak usia dini. Metode Penelitian yang digunakan berupa penyuluhan kesehatan disertai demonstrasi langsung dan praktik berkelompok, dengan desain evaluasi pre-test dan post-test. Kegiatan dilaksanakan di TK Aisyiyah 31 Kota Banjarmasin dengan melibatkan 50 peserta yang terdiri dari orang tua murid dan guru TK. Evaluasi menunjukkan peningkatan signifikan kemampuan peserta, di mana kategori pengetahuan dan keterampilan “Baik” meningkat dari 12% pada pre-test menjadi 92% pada post-test, serta tidak ditemukan lagi peserta pada kategori Kurang dan Cenderung Kurang. Metode demonstrasi langsung terbukti efektif dalam meningkatkan pemahaman kognitif dan keterampilan psikomotorik peserta. Penyuluhan kesehatan dengan metode demonstrasi langsung efektif meningkatkan kesiapsiagaan dan kemampuan mitigasi choking emergency pada anak usia dini, sehingga layak direkomendasikan sebagai model edukasi berkelanjutan di lingkungan pendidikan anak. Kata Kunci: Tersedak, Himlick Manuver, Keperawatan Gawatdarurat. ABSTRACT Choking is an emergency condition in early childhood that can potentially cause death if not treated quickly and appropriately. The high risk of choking in preschool children is influenced by their limited motor skills and the low level of skills of parents and teachers in providing first aid in accordance with medical procedures. This community service activity guide is designed as a promotional and preventive effort through health education based on direct demonstrations of the Heimlich maneuver technique. This activity aims to improve the knowledge, skills, and preparedness of parents and kindergarten teachers in handling choking incidents in young children. Health education accompanied by direct demonstrations and group practice was used, with a pre-test and post-test evaluation design. The activity was carried out at Aisyiyah 31 Kindergarten in Banjarmasin City, involving 50 participants consisting of parents and kindergarten teachers. The evaluation showed a significant improvement in participants' abilities, with the “Good” category for knowledge and skills increasing from 12% in the pre-test to 92% in the post-test, and no participants remaining in the ‘Poor’ and “Tending to be Poor” categories. The live demonstration method proved effective in improving participants' cognitive understanding and psychomotor skills. Health education using the direct demonstration method is effective in improving preparedness and mitigation skills for choking emergencies in young children, making it a recommended model for continuing education in early childhood education settings. Keywords: Choking, Heimlich Manoeuvre, Emergency Nursing.

Peningkatan Keterampilan Masyarakat Dalam Pertolongan Pertama Pada Gigitan Ular Melalui Metode Pelatihan Simulasi Novia Heriani; Noor Khalilati; Hanura Aprilia; Julianto Julianto; Indrayadi Indrayadi
Sahabat Sosial: Jurnal Pengabdian Masyarakat Vol. 4 No. 2 (2026): Sahabat Sosial: Jurnal Pengabdian Masyarakat (Maret)
Publisher : Asosiasi Guru dan Dosen Seluruh Indonesia

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Snake bites are a potentially life-threatening health problem, especially in residential areas near swamps and bushes. Inappropriate initial treatment can worsen the victim's condition and increase the risk of complications. This community service activity aims to improve the community's knowledge and skills in providing first aid for snake bites through simulation training. The activity was held on October 7, 2025, in Kelayan Barat Village, RT 09, Banjarmasin City, with 41 participants. The methods used included education, demonstrations, simulations, and hands-on practice. The results of the activity showed an increase in the community's understanding and skills in recognizing the signs of snake bites, providing correct first aid, and avoiding erroneous actions. This activity is expected to increase community preparedness in dealing with snake bites and reduce the risk of complications due to inappropriate treatment.

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