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All Journal Faletehan Health Journal Jurnal Keperawatan (JKEP) Journal of Telenursing (JOTING) Indonesian Journal of Global Health research Malahayati International Journal of Nursing and Health Science Indonesian Journal of Global Health Research
Krisna Yetti
Universitas Indonesia
Education Health Professions Languange, Linguistic, Communication & Media Nursing Public Health

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Use of medium cut-off membrane dialyzer compared to high flux membrane dialyzer in improving the clearance of middle to large molecule uremic toxins: A Systematic Review Wasal Desrial Siregar; Krisna Yetti; Agung Waluyo; yulia yulia
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 3 (2025): Volume 8 Number 3
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i3.934

Abstract

Background: The loss of kidney function in patients with kidney disease leads to the accumulation of dissolved substances known as uremic toxins, which can negatively impact patient health. Membranes with a high number of pores, such as those in high-flux dialyzers, allow some medium-sized molecules like beta-2 microglobulin to pass through. However, these membranes are less effective at filtering out larger dissolved substances. Larger medium-sized molecules (>25 kD) need to be removed either by convection or through the use of highly permeable membranes such as Medium Cut-Off (MCO) membranes. Therefore, it is important to understand the improvement in uremic toxin clearance when using MCO dialyzers compared to high-flux dialyzers. Purpose: To evaluate and compare the effectiveness of using medium cut-off (MCO) membrane dialyzer with high flux membrane dialyzer. Method: A systematic review with article selection guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The systematic review process begins with the formulation of clinical questions relevant to the topic. Before this, the authors establish PICOS criteria, which stand for: P (problem, patient, or population), I (intervention, prognostic factor, or exposure), C (comparison or control), O (outcome), and S (study design). For this article, P: Patients with chronic kidney disease undergoing hemodialysis, I: Use of dialyzers with medium cut-off (MCO) membrane, C: Use of dialyzer with high flux membrane, O: Increased clearance of uremic toxins of middle to large molecules, such as β2-microglobulin, kappa and lambda free light chains, S: Randomized controlled trials. The article search was conducted systematically using the keywords: "Medium cut-off dialyzer" AND "High flux dialyzer" AND "Uremic toxins" AND "Middle molecules" AND "Large molecules" AND "Clearance Hemodialysis". Results: The use of MCO membranes was more effective in eliminating medium-to-large uremic toxins while maintaining safety and regulation comparable to conventional hemodialysis with high-flux dialyzers. MCO membranes were also more effective even with low blood flow, without significantly increasing albumin loss. Additionally, MCO membranes contributed to reducing inflammation and allowed for shorter recovery times post-hemodialysis treatment. Conclusion: Given its comparable safety to high-flux dialyzers, the use of MCO membranes can be expanded in clinical practice at hemodialysis centers, including those in resource-limited settings.
Komunikasi End of Life dengan Penyusunan Dokumen Wasiat Hidup: Qualitative Evidence Synthesis Jathu Dwi Wahyuni; Krisna Yetti; Dewi Gayatri; Imami Nur Rachmawati; Ati Surya Meidiawati
Faletehan Health Journal Vol 10 No 03 (2023): Faletehan Health Journal, November 2023
Publisher : Universitas Faletehan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33746/fhj.v10i03.640

Abstract

End of Life (EoL) communication is carried out when the patient's condition is palliative and documented in an advance Directives (ADs) document which contains of patient's preferences of treatment options. ADs are highly important documents for patients, families and health worker, but have not been applied in Indonesia. This study aimed to identify the stages of preparing ADs with qualitative evidence synthesis research design. The Data sources used several data bases, namely Sage Journals, ProQuest, Scopus, Taylor & Francis, ScienceDirect, and ClinicalKey Nursing from 2003 to 2023. The article selection was based on the category of qualitative research on EoL communication and ADs drafting. The results of the study obtained 6 out of 38,185 articles. The articles contained of the stages of preparing ADs starting with the initiation of patients or health workers, providing an explanation of ADs and the course of patient's disease, discussion or EoL communication between families and health workers, reviewing the decisions in ADs according to patient's condition, and making ADs according to local regulations. The researchers concluded that ADs document as the result of EoL communication should be made by health workers and patients. ADs document is important for patients, families and health workers and can help patients become calmer to face a follow-up care and end-of-life care.
Optimization of the Role and Function of Ward Manager in the Development of the Family Meeting Innovation Program in the Intensive Care Unit Arhamsyah Arhamsyah; Krisna Yetti; Tuti Afriani; Dyah Fitri Wulandari
Indonesian Journal of Global Health Research Vol 7 No 1 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i1.5376

Abstract

Hospitalization in the ICU has an impact on families, making it essential to meet the needs of families in the care of patients in the ICU. Caring for patients in the Intensive Care Unit (ICU) requires family support and involves various health disciplines, including the active role of the head nurse. The head nurse can facilitate all parties to be involved in patient management, one of which is through family meetings. (family meeting). A family meeting is an important forum to discuss the patient's condition, prognosis, and care preferences, to listen to the family's concerns, and to make decisions about appropriate treatment goals. Objective to enhance family satisfaction in patient care in the ICU through the development of an innovative family meeting program. Using the case report method in managing care in the ICU through stages of data collection, problem identification, discussion, and determining alternative solutions. Utilizing fishbone analysis to find the root cause of the problem. Once the problem is identified, the next steps include prioritizing the issues, developing a plan of action, implementing it, and conducting evaluations along with follow-up plans. The development of the family meeting innovation program with the establishment of guidelines for the implementation of family meetings, Standard Operating Procedures (SOP), and documentation formats for family meetings. The implementation of family meetings serves as a programmed communication medium between families and caregiving professionals, thereby enhancing the satisfaction of patient families.
Enhancing Nurses' Ethical Knowledge in Hospitals Through the Initiation of Nursing Ethic Navigation and A Nurses' Ethical Guideline E-Book Citra Hafilah Shabrina; Krisna Yetti; Hanny Handiyani; Shanti Farida Rachmi; Erna Puspita Sari; Roro Tutik Sri Hariyati
Indonesian Journal of Global Health Research Vol 7 No 4 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i4.6399

Abstract

Nurses in hospitals often face complex ethical situations; however, there are still gaps in the understanding and application of nursing ethical principles, and a structured, easily accessible ethical guideline is not yet available. This study aims to develop two main solutions Nursing Ethic Navigation (an ethical guideline web search engine) and the Nurses' Ethical Guideline E-Book using John Kotter’s Eight-Step Change Model approach. The method used is a case study conducted at Hospital X during September–October 2024, encompassing problem identification, action planning, implementation, and evaluation. The respondents in this study were the Head Nurse, Primary Nurse, Nursing Department staff, members of the Nursing Committee, and nurses in the IGD-COT unit at Hospital X. Data were collected through interviews, observations, and questionnaires, then analyzed using problem priority scoring and a fishbone diagram to identify root causes as the basis for developing action plans and change strategies. The results showed a significant improvement in nurses’ knowledge, awareness, and ability to apply ethical principles after the intervention. Digital media such as the e-book and web-based tools proved effective as learning platforms and practical references that can be accessed anytime. This study recommends expanding the implementation of ethical guidelines to other service units, supported by managerial involvement and continuous evaluation, to ensure integration into the organizational culture and daily nursing practice.
Roles and Functions of Nursing Management in Strengthening the Healthy Nurse Program for Nurses at Hospital Rio Verdiansyah; Rr. Tutik Sri Hariyati; Tuti Afriani; Hanny Handiyani; Krisna Yetti
Indonesian Journal of Global Health Research Vol. 7 No. 6 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i6.152

Abstract

Nurse well-being is a critical foundation for ensuring the quality of healthcare services. However, the high prevalence of physical fatigue, occupational stress, and biopsychosocial-spiritual (BPSS) imbalances among nurses indicates an urgent need for strategic interventions rooted in nursing management. This residency project aimed to develop and implement the Healthy Nurse Program as an innovative initiative to holistically enhance nurse well-being at X Hospital. The program adopted Kurt Lewin’s planned change theory, encompassing the stages of unfreezing, changing, and refreezing. Implementation began with problem identification through interviews, observations, and BPSS-based questionnaires, followed by the formulation of a Plan of Action, socialization, and interventions such as workplace stretching, ergonomic education, MBCA monitoring, and spiritual reflection sessions.The study involved 32 newly hired nurses (≤1 year experience) selected through purposive sampling, with data analyzed using a fishbone diagram. Initial evaluation revealed a high prevalence of muscle fatigue, work-related stress, and over-fat conditions among nurses, along with strong support for program implementation. The Healthy Nurse initiative strengthened core nursing management functions and fostered a culture of sustainable workplace wellness. These findings provide a critical foundation for integrating occupational health promotion into hospital systems based on evidence-based practice.
Development of Guidelines and Continuing Professional Development (CPD) Program for Nursing Mahmul Rivai Siregar; Tuti Afriani; La Ode Abd Rahman; Krisna Yetti; Dyah Fitri Wulandari
Indonesian Journal of Global Health Research Vol. 8 No. 1 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i1.335

Abstract

Professional development of nurses plays a crucial role in improving the quality of nursing services. The implementation of continuing competency development programs has not been optimal due to the absence of structured guidelines and programs at Hospital This lack of structure results in low consistency and uniformity in program implementation across nursing units. This study aims to develop a structured and sustainable professional development guideline and program for nurses that can serve as a reference for systematic and targeted implementation within the hospital environment. The study was conducted through a nursing management residency program held from May 27 to June 30, 2025. Data were collected through interviews, observations, and questionnaires distributed to nursing staff and nursing leadership. The questionnaire used the Q-PDN to measure various aspects of Continuing Professional Development (CPD) among nurses, with a Cronbach’s alpha reliability value of 0.89. Data analysis involved the Ishikawa diagram approach, SWOT analysis, and problem prioritization using the USG method. The analysis identified the absence of CPD guidelines and programs as the main problem, with the highest priority score. A draft guideline and CPD program were developed, covering staffing standards, facilities, implementation procedures, quality control, reporting, and follow-up mechanisms. Initial evaluation showed that 91% of stakeholders had a strong understanding of the document and provided positive feedback on its usefulness. The development of CPD guidelines and programs is a strategic step to strengthen the implementation of continuous professional development for nurses.
Optimization of Medical Equipment Inventory Management Through Barcode-Based Digitalization Maria Indah Septirini; Tuti Afriani; La Ode Abdul Rahman; Krisna Yetti; Dyah Fitri Wulandari
Indonesian Journal of Global Health Research Vol. 8 No. 1 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i1.526

Abstract

Digital transformation in medical equipment logistics is a vital part of healthcare reform, aiming to enhance efficiency, accuracy, and patient safety. One of the main challenges at hospital is the manual documentation system for borrowing and returning medical equipment, which results in low accountability, service delays, and a high risk of equipment loss. : Case report area focused on the HCU/PICU unit. This study aims to describe the implementation process of a barcode-based digital medical inventory system through a managerial approach and planned change intervention based on Kurt Lewin's theory. A case report was conducted using Kurt Lewin’s planned change approach (unfreezing, moving, and refreezing), data analysis through observation, questionnaires, interviews, and implementation evaluation. The Assessment of Medical Equipment Management (MEM) questionnaire administered to 103 nurses revealed that 87.4% of units still use manual recording and 50.98% reported suboptimal coordination in equipment returns, with reliability  0.86 and validity loading factor ±0.5; content validity 85%. The intervention involved developing Standard Operating Procedures (SOPs) and technical guidelines for the "MedScan-KISA" barcode system, conducting simulation trials using Google Forms and barcode scanners, and directly supervising the implementation process. The implementation of a barcode-based digital inventory system in the HCU/PICU unit of hospital was carried out through a gradual change process based on Kurt Lewin’s theory. In the unfreezing phase, problems with the manual inventory system were identified through interviews, observations, and cross-unit discussions, leading to the design of a simple digital inventory system for the HCU/PICU unit. In the moving phase, an SOP was developed, simulations using barcodes and Google Forms were conducted, and intensive socialization and mentoring were provided to staff. Finally, in the refreezing phase, the new system was consistently practiced and integrated into daily routines in the HCU/PICU unit, thereby facilitating inventory recording and the return of medical equipment.
Optimization of Mentorship Implementation to Enhance the Competence of Rotating Nurses in the NICU Sitta Diani Fichara; Enie Novieastari; Krisna Yetti; Hening Pujasari; Sarvita Dewi
Indonesian Journal of Global Health Research Vol. 8 No. 1 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

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

Abstract

X Hospital Jakarta Barat is a hospital that has implemented various competency development programs and continuing professional development initiatives for nurses. However, the implementation of mentorship as a clinical learning method has not yet run optimally and is not integrated across all units. A change is needed to optimize the implementation of mentorship activities by strengthening the roles and functions of nurse managers. Objective to optimize mentorship implementation in the NICU by strengthening nurse managers’ roles to enhance clinical competence and structured learning. This was a pilot project. The process started with problem identification, problem analysis, priority setting, preparation of a Plan of Action, implementation, and evaluation using Lewin’s change theory approach. The implementation of mentorship in the NICU showed an increase in clinical learning activities, with mentees beginning to independently carry out self-reflection without direct supervision. Mentors also felt assisted in monitoring mentee development through the provided guidelines and documentation formats. The head nurse and team leaders supported this program and were ready to facilitate its sustainability. Strengthening managerial roles improved mentorship implementation, increased mentee reflection, and enhanced mentor monitoring. With strong managerial support and clear documentation, mentorship can be sustainably integrated into institutional competency programs.
Development of A New Nurse Orientation Program in the Intensive Care Unit Masitho Masitho; Rr Tutik Sri Haryati; Hanny Handiyani; Krisna Yetti; La Ode Abdul Rahman; Tuti Afriani
Indonesian Journal of Global Health Research Vol. 8 No. 1 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i1.593

Abstract

The transition of newly graduated nurses into high-intensity environments such as Intensive Care Units (ICU) presents significant challenges, often resulting in psychological stress and a gap between theoretical knowledge and clinical practice. To bridge this gap, a structured and systematic orientation approach is essential. One proven method is preceptorship, in which senior nurses act as clinical mentors to support new nurses in their professional adaptation. This approach facilitates the development of professional identity, enhancement of clinical competence, and gradual internalization of a patient safety culture. Objective: To evaluate and strengthen the roles of head nurses and primary nurses in mentoring newly graduated nurses to optimize ICU orientation and enhance patient safety.  A pilot project method was applied, beginning with problem identification, problem analysis, priority setting, development of a Plan of Action, implementation, and evaluation. The implementation of a preceptorship-based orientation program, supported by clear guidelines and checklists, improved the effectiveness of clinical mentoring by Primary Nurses in the ICU. Through a systematic change approach, the program successfully strengthened the role of preceptors, accelerated the adaptation of new nurses, and fostered a sustainable clinical learning culture. The preceptorship-based orientation program effectively facilitated the transition of newly graduated nurses into the ICU setting by enhancing clinical competence, confidence, and professional adaptation. Strengthening the role of preceptors and implementing structured guidelines fostered a supportive learning environment, reduced the theory–practice gap, and promoted a sustainable culture of patient safety and continuous professional development.
Napping Affects Night-Shift Nurses' Occupational Safety Anika Kartika; Krisna Yetti; Tuti Afriani; Hanny Handiyani; Dyah Fitri Wulandari
Indonesian Journal of Global Health Research Vol. 8 No. 2 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i2.1812

Abstract

Napping is an evidence-based method used to reduce fatigue and increase alertness during night shift work. Objective: This study aims to identify the relationship between napping in night shift nurses and the work safety of nurses in hospitals. Method of This research uses a quantitative research design using a cross sectional method. Data was collected from 213 nurses using the Napping Nurse Questionnaire and the Occupational Safety questionnaire. Data collection was carried out from June to December 2024. Data analysis included univariate analysis in the form of a frequency distribution table, bivariate analysis using the chi-square test, and multivariate analysis using the multiple logistic regression test (p>0.05). Results There is a significant relationship between the implementation of night shift nurse napping and work safety at Khidmat Sehat Afiat Regional Hospital, Depok City and Graha Permata Ibu Hospital (p=0.001). Nurses with good napping will have the opportunity to have good work safety. The implementation of napping is the factor that most influences nurses' work safety.
Co-Authors Ade Suhendri Ade Suhendri Agung Waluyo Ahsan Ahsan Anik Maryunani Anik Maryunani Anika Kartika Arhamsyah Arhamsyah Ati Surya Meidiawati Citra Hafilah Shabrina Cori Tri Suryani Deby Zulkarnain Rahadian Syah, Deby Zulkarnain Rahadian Dewi Gayatri Dudi Mashudi Dyah Fitri Wulandari Dyah Fitri Wulandari Dyah Fitri Wulandari Dyah Fitri Wulandari Endang Sudjiati Enie Novieastari Erna Puspita Sari Eva Oktaviarini Hadi, Muhammad Hanny Handiyani Hening Pujasari Imami Nur Rachmawati Jathu Dwi Wahyuni Junaiti Sahar Khairul Nasri Khairul Nasri Kristina Ana La Ode A. Rahman La Ode Abd Rahman La Ode Abdul Rahman Lia Dwi Jayanti Mahmul Rivai Siregar Maria Indah Septirini Masfuri - Masitho Masitho Mastia Wiraya Megawati Tabroni Mery Anglelia Sirait Mu'minah Mu'minah Nurdiana Nurdiana Rio Verdiansyah Roro Tutik Sri Hariyati Rr Tutik Sri Haryati Rr. Tutik Sri Hariyati Sarvita Dewi Shanti Farida Rachmi Sitta Diani Fichara Tuti Afriani Wasal Desrial Siregar Yulia Yulia Yunisar Gultom