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Redesigning Clinical Pathway of Elective Caesarean Section Using Activity-Based-Costing Reduce Exposure to COVID-19 Lidia Asjanti; Nikma Fitriasari; Ali Djamhuri
Journal of Accounting and Strategic Finance Vol 4 No 1 (2021): JASF (Journal of Accounting and Strategic Finance)
Publisher : UNIVERSITAS PEMBANGUNAN NASIONAL VETERAN JAWA TIMUR

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jasf.v4i1.145

This research objective is to discover non-value-added activities in the elective cesarean section (CS) clinical pathway (CP) through cost analysis using the ABC method and redesign elective CS CP at W Hospital. Activity-Based Costing (ABC) is an accounting system designed through activity management. The ABC system identifies all functions in the service process chain, calculates the activity costs, and assigns costs to cost objects, such as activity-based service products. This calculation method emphasizes the service process. The ABC method is seen as a unit cost calculation system that is suitable for hospitals. CP costing using the ABC method is a cost analysis using CP as the basis for service activities. The CP of Elective CS consists of various activities. This study used a case study approach. The eight informants were the head of finance, the head of medical services and support, one ob-gyn specialists, one anesthetist specialists, one outpatient installation nurse, one midwife, one inpatient installation midwives, and one nutritionist. The COVID-19 changed the procedures and influenced the activities of CS CP. The analyses were conducted using the ABC method and data triangulation. Non-value-added activities found were clinical assessment in the emergency room (ER), laboratory activities, and organic waste treatment. Non-value-added found in clinical assessment in the ER, laboratory examinations, and organic waste treatment. CP CS redesign consists of activities of admission, pre-operation, and post-operation, surgery, pharmacy, nutrition, medical records, laundry, billing, logistics, and management administration. The researchers suggest that W hospital should redesign elective CS CP activities to eliminate non-value-added activities.

Spirituality in The Workplace: Solution to Reduce Nurse Turnover Intention Nikma Fitriasari
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol 9, No 2 (2020): August
Publisher : Universitas Muhammadiyah Yogyakarta in Clollaboration with ADMMIRASI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.92125

A frequent problem in hospitals is nurse turnover, which reaches 27.3% annually in Indonesia. The solution to this problem is increasing spirituality intelligence through the formation of spirituality in the workplace. Good spirituality in the workplace can increase productivity and organizational commitment, and reduce turnover. The study was conducted to determine the effect of spirituality in the workplace on nurse turnover intention. The study used a quantitative design with a cross-sectional approach. The sample used was 92 nurses who were determined by Proportionate Random Sampling. Data were processed using Partial Least Square (PLS). The PLS results showed T statistics of 8.927 with direct coefficients of -0.423. The application of spirituality in the workplace shapes nurses’ perceptions more positively towards hospitals, so that, nurse turnover intention is low.

Analisis Pelaksanaan Timbang Terima Pasien Antar Perawat di Unit Rawat Inap RSU “X” Tahun 2019 Hendra Setiawan; Nikma Fitriasari
Media Penelitian dan Pengembangan Kesehatan Vol 31 No 2 (2021)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/mpk.v31i2.3736

Inpatient care is a patient safety centered care. Inter-shift handover is a critical time that needs special attention to maintain and improve patient safety. This study aims to identify problems in nurse shifts handover implementation in inpatient unit and determine solutions to overcome those problems. This research is a social qualitative research using focus group discussion (FGD) method preceded by secondary data identification. The research was conducted from August to October of 2019 in one of the adult inpatient units of class C hospitals in Malang, East Java. The informants involved in this study were twelve executive nurses and three nursing management who were divided into two different discussion groups. The chosen solutios are determine the needs to make policy draft that define communication methods, effective communication guidelines that include monitoring and evaluation obligations as well as SOPs for implementation of inter-shift handover as well as compiling proposals for socialization, training and workshops. The conclusion of this study shows that inter-shift handover implementation at the hospital “X” has problems related to internal regulation and understanding of human resources for health workers on their professional duties. The process of identifying problems and determining solutions by involving stakeholders will be able to reflect conditions that are closer to reality in daily implementation. Abstrak Layanan rawat inap adalah pelayanan kesehatan berpusat pada keselamatan pasien. Timbang terima adalah salah satu waktu kritis yang perlu mendapat perhatian khusus untuk menjaga dan meningkatkan keselamatan pasien. Penelitian ini bertujuan untuk mengidentifikasi masalah dalam pelaksanaan timbang terima antar shift perawat pada unit rawat inap dan menentukan solusi untuk mengatasi masalah tersebut. Penelitian kualitatif sosial ini dilaksanakan menggunakan metode diskusi terarah yang didahului dengan dengan identifikasi data sekunder. Penelitian dilaksanakan pada bulan Agustus hingga Oktober tahun 2019 di salah satu unit rawat inap dewasa rumah sakit umum kelas C di daerah Malang, Jawa Timur. Partisipan yang terlibat dalam penelitian ini berjumlah dua belas orang perawat pelaksana dan tiga orang pihak manajemen bidang keperawatan. Hasil yang diperoleh yaitu belum ada kebijakan yang menetapkan metode komunikasi, belum ada usulan sosialisasi dari Bidang Keperawatan, belum ada kebijakan yang menetapkan metode monitoring dan evaluasi komunikasi timbang terima yang menyebabkan belum adanya metode komunikasi yang dibakukan dan panduan pelaksanaan yang mengatur tentang bagaimana komunikasi efektif tersebut dilaksanakan, serta kurangnya advokasi peran perawat. Pada tahap penentuan solusi didapatkan penyusunan draf kebijakan yang menetapkan metode komunikasi, panduan komunikasi efektif yang menyertakan kewajiban monitoring dan evaluasi serta SOP pelaksanaan timbang terima disertai dengan menyusun usulan sosialisasi, pelatihan, dan workshop pelaksanaan timbang terima dari Bidang Keperawatan. Kesimpulan penelitian ini menunjukkan pelaksanaan timbang terima di rawat inap RSU “X” memiliki masalah yang berkaitan dengan regulasi internal dan pemahaman sumber daya manusia tenaga kesehatan terhadap tugas keprofesiannya.

Pencegahan Primer Membentuk Masyarakat Sehat Di Era Covid-19 Nikma Fitriasari
SALAM: Jurnal Sosial dan Budaya Syar-i Vol 7, No 12 (2020)
Publisher : Faculty of Sharia and Law UIN Syarif Hidayatullah Jakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15408/sjsbs.v7i7.15407

The situation of the growth of COVID-19 cases is very fast in Indonesia. Primary prevention efforts become the most appropriate prevention because there is no drug for COVID-19 therapy. This research aims to further study the proper and rational primary prevention to establish a healthy society as an effort to prevent transmission of COVID-19. Primary prevention can be done in the form of health promotion and special protection. Primary prevention through promotion is done by selectively selecting information from social media, applying a cough ethic, consumption of nutritious food, and exercise. Primary prevention through special protection is done by resignation. cleaning hands regularly, using masks, social distancing and self-isolation, and avoiding unprotected contact with wild animals.Keyword: COVID-19, primary prevention, healthy society Abstrak Situasi pertumbuhan kasus COVID-19 sangat cepat di Indonesia. Upaya pencegahan primer menjadi pencegahan yang paling tepat karena belum ada obat untuk COVID-19. Penelitia ini bertujuan untuk mengkaji lebih jauh tentang pencegahan primer yang tepat dan rasional untuk membentuk masyarakat sehat sebagai upaya pencegahan penularan kasus COVID-19. Pencegahan primer dapat dilakukan berupa promosi kesehatan dan perlindungan khusus. Pencegahan primer melalui promosi dilakukan dengan selektif memilih informasi dari media sosial, menerapkan etika batuk, konsumsi makanan bergizi, dan olahraga. Pencegahan primer melalui perlindungan khusus dilakukan dengan resignasi. membersihkan tangan secara rutin, menggunakan masker, social distancing dan isolasi diri, serta menghindari kontak tanpa pelindung dengan hewan liar.Kata Kunci: COVID-19, pencegahan primer, masyarakat sehat

COMPARISON BETWEEN ANTHROPOMETRIC MEASUREMENT RESULTS BY CADRES AND MEDICAL PROFESSION STUDENTS USING TIPS (TIKAR PENDETEKSI STUNTING) Siti Dwi Astuti; Lilik Zuhriyah; Alfryan Janardhana; Arum Sulistyarini; Indriani Ningrum; Rifqi Rinanto; Thalia Suharli; Rochelle siem; Zahra Zahra; Wandira Lalitya; Ahmad Ikbal P; Eleonora Sucahyo; Adeliza Firzarosany; Fariza Kusuma W; Helen Lioni; Ardy mahendra; Asrini Kaninta; Nafisa Naaz; Pedro gonzales; Proscilla Maiselina; Ekkel Aisyiyah; Nikma Fitriasari
Journal of Community Health and Preventive Medicine Vol. 3 No. 1 (2023): JOCHAPM Vol. 3 No. 1 2023
Publisher : Universitas Brawijaya

Stunting prevalence in District Kalipare on February 2019 was about 14%. Based on the results of the preliminary studies, one of the obstacles to achieving a free stunting rate is caused by anthropometric measurement errors by cadres. The objective of this study was to compare cadres of District Kalipare anthropometric measurement results with medical profession students' anthropometric results using the Tikar Pendeteksi Stunting (TIPS). This quasi-experimental study was conducted using a non-randomized control group pretest-posttest design. The sample of toddlers is 51 toddlers. The experiment was carried out by training 50 community-based health or posyandu cadres who were representatives from 8 villages in Kalipare District. Of the 50 cadres, 25 were selected by purposive sampling according to posttest scores per village. The selected cadres were asked to measure 1-3 infants or toddlers who had previously been measured before attending the training. The variables studied were nutritional status and height. The results showed that the Kappa test obtained a value of p = 0.838 or very good agreement. This study concludes that the results of height measurements by toddler posyandu cadres are the same as or close to the results of height measurements carried out by medical profession students. Therefore, after they have received training, we can include posyandu cadres in measuring anthropometrics.

Redesigning Clinical Pathway of Elective Caesarean Section Using Activity-Based-Costing Reduce Exposure to Covid-19 Lidia Asjanti; Nikma Fitriasari; Ali Djamhuri
JASF: Journal of Accounting and Strategic Finance Vol. 4 No. 1 (2021): JASF (Journal of Accounting and Strategic Finance) - June 2021
Publisher : Accounting Department, Faculty of Economics and Business, Universitas Pembangunan Nasional Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jasf.v4i1.145

This research objective is to discover non-value-added activities in the elective cesarean section (CS) clinical pathway (CP) through cost analysis using the ABC method and redesign elective CS CP at W Hospital. Activity-Based-Costing (ABC) is an accounting system designed through activity management. The ABC system identifies all functions in the service process chain, calculates the activity costs, and assigns costs to cost objects, such as activity-based service products. This calculation method emphasizes the service process. The ABC method is seen as a unit cost calculation system that is suitable for hospitals. CP costing using the ABC method is a cost analysis using CP as the basis for service activities. The CP of Elective CS consists of various activities. This study used a case study approach. The eight informants were the head of finance, the head of medical services and support, one ob-gyn specialist, one anesthetist specialist, one outpatient installation nurse, one midwife, one inpatient installation midwife, and onenutritionist. COVID-19 changed the procedures and influenced the activities of CS CP. The analyses were conducted using the ABC method and data triangulation. Non-value-added activities found were clinical assessment in the emergency room (ER), laboratory activities, and organic waste treatment. Non-value-added found in clinical assessment in the ER, laboratoryexaminations, and organic waste treatment. CP CS redesign consists of activities of admission, pre-operation, and post-operation, surgery, pharmacy, nutrition, medical records, laundry, billing, logistics, and management administration. The researchers suggest that W Hospital should redesign elective CS CP activities to eliminate non-value-added activities.

Spirituality in The Workplace: Solution to Reduce Nurse Turnover Intention Nikma Fitriasari
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 9 No. 2 (2020): August 2020
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.92125

A frequent problem in hospitals is nurse turnover, which reaches 27.3% annually in Indonesia. The solution to this problem is increasing spirituality intelligence through the formation of spirituality in the workplace. Good spirituality in the workplace can increase productivity and organizational commitment, and reduce turnover. The study was conducted to determine the effect of spirituality in the workplace on nurse turnover intention. The study used a quantitative design with a cross-sectional approach. The sample used was 92 nurses who were determined by Proportionate Random Sampling. Data were processed using Partial Least Square (PLS). The PLS results showed T statistics of 8.927 with direct coefficients of -0.423. The application of spirituality in the workplace shapes nurses’ perceptions more positively towards hospitals, so that, nurse turnover intention is low.

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