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A Systematic Review: Early Warning System for Hospital Wards Sasmito, Priyo; Aljufri, Salim; Mulyati, Leli; Rasmita, Dina; Syafridawita, Yetti; Deviana, Elina; Komariah, Elis; Gayatri, Sri Wahyuni; Arifani, Nisa
International Journal of Public Health Excellence (IJPHE) Vol. 3 No. 2 (2024): January-May
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v3i2.782

Most of the unexpected events occur in the hospital wards. An Early Warning System (EWS) is a system created to identify worsening patients outside the Intensive Care Unit (ICU). EWS is one of the requirements that must be met to get hospital accreditation. Hospitals have to choose the appropriate EWS to get optimal outcomes. This study aims to describe some of the EWS in the wards that have been researched and developed, as well as their performance in predicting severe adverse events (SAE). This study is a literature review design, conducting a systematic review by selecting relevant articles on Pub Med and Science Direct using the keyword "Early Warning Systems" in the 2018-2023 period. Out of 269 articles, only 12 articles that met the criteria. The selected articles are then systematically reviewed and analyzed. Based on the extraction results of 12 articles, 9 EWS were grouped into National Early Warning Score (NEWS) and its variants, Modified Early Warning Score (MEWS) and its variants, and EWS integrated with Electronic Medical Record (EMR). In choosing an EWS, hospitals must consider the complexity of the cases being managed and the capabilities of existing resources. The recommended EWS in hospital wards with limited resources is weighted EWS or EWS with combinations, such as NEWS and MEWS with variants. Meanwhile, hospitals that have used EMR can choose EWS integrated with EMR to increase their predictive value for SAE, as well as improve protocol compliance.

Venom-induced consumption coagulation in a hematotoxin snake bite in East Java, Indonesia: A case report Sasmito, Priyo; Mulyatiindo, Leli; Bernadus, Janno Berty Bradly; Arifani, Nisa; Astuti, Novia Dwi; Prasetya, Fika Indah; Librianty, Nurfanida; Wirawan, Nandar
Malahayati International Journal of Nursing and Health Science Vol. 7 No. 11 (2025): Volume 7 Number 11
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v7i11.668

Background: Located in Southeast Asia, Indonesia is one of the countries with the highest incidence of fatal snakebites in the world. Difficulty in identifying snake species and limited availability of antivenom often pose challenges in treating snakebites. Purpose: To illustrate a case of consumption coagulation caused by a hematotoxin-containing snake venom. Method: A case study study describes a snakebite incident managed in the Emergency Department (ED) of a secondary general hospital in Tulungagung, East Java. A 53-year-old male patient presented with pain, swelling, and bleeding in his left thumb, after being bitten by a yellow-brown Bandotan snake, approximately two hours prior to arrival. Results: The patient was given antivenom therapy according to the guidelines. Patients were also given antitetanus, antibiotics, platelet transfusions and fresh frozen plasma (FFP), supportive therapy, and strict monitoring. in the surgical high care unit (HCU). The patient showed improvement on the fifth day and was discharged on the tenth day. Conclusion: The use of local polyvalent antivenom combined with antibiotics, antitetanus therapy, platelets, and FFP transfusion has shown promising results in the management of toxin-induced coagulopathy. Suggestion: Further studies are needed to evaluate the effectiveness of therapy in different age groups, including children, adults, and the elderly. In addition, this study only focused on therapeutic management and did not assess the impact of treatment on organ dysfunction caused by post-treatment lesions.

Sepsis protocol adherence and emergency department overcrowding: An observational study Arifani, Nisa; Mulyati, Leli; Sasmito, Priyo; Sujana, Treesia; Gayatri, Sri Wahyuni; Astuti, Novia Dwi; Librianty, Nurfanida; Lie, Sukirman; Deviana, Elina; Ihsan , Farly
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 2 (2025): Volume 8 Number 2
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i2.870

Background: Emergency Department (ED) overcrowding is a persistent global challenge that affects the quality and timeliness of patient care, particularly for sepsis management. Despite established guidelines such as the hour-1 sepsis bundle and national sepsis guideline, adherence remains inconsistent. Purpose: To analyze the relationship between sepsis protocol compliance and emergency unit crowding. Method: A retrospective observational cohort study was conducted, analyzing adult sepsis and septic shock patients triaged as Priority 1. Data on patient demographics, sepsis severity scores, ED occupancy rates, and adherence to sepsis protocols using the Hour-1 sepsis bundle and the National Sepsis Guideline were collected. Statistical analysis was performed using Fisher’s Exact Test to examine associations between ED overcrowding and compliance with sepsis protocols, with a significance threshold of p<0.05. Results: This study included 38 cases with a mean age of 56.6 years and the majority (52.6%) of patients were female. Most cases were diagnosed with septic shock (55.3%) and the average occupancy rate of the emergency department was 80.8%. Serum lactate measurements were performed in 68.4% of cases, blood culture sampling in 21.1%, and broad-spectrum antibiotics were given in 94.7%. Full compliance with both sepsis protocols was only 5.3%. Compliance with fluid resuscitation was high at 97.4%, while compliance with blood culture sampling was low at 5.3% and 7.9%. No significant association was found between protocol compliance and ED crowding (p > 0.05). Conclusion: There was no significant correlation between ED crowding and adherence to sepsis protocols. Strategic and clinical policy interventions are needed to improve adherence to sepsis management guidelines. Suggestion: Future research should investigate additional barriers to sepsis care, such as financial constraints, physician decision-making processes, and variations in adherence across healthcare settings to develop more comprehensive strategies to improve sepsis outcomes worldwide.

A Systematic Review: Early Warning System for Hospital Wards Sasmito, Priyo; Aljufri, Salim; Mulyati, Leli; Rasmita, Dina; Syafridawita, Yetti; Deviana, Elina; Komariah, Elis; Gayatri, Sri Wahyuni; Arifani, Nisa
International Journal of Public Health Excellence (IJPHE) Vol. 3 No. 2 (2024): January-May
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v3i2.782

Most of the unexpected events occur in the hospital wards. An Early Warning System (EWS) is a system created to identify worsening patients outside the Intensive Care Unit (ICU). EWS is one of the requirements that must be met to get hospital accreditation. Hospitals have to choose the appropriate EWS to get optimal outcomes. This study aims to describe some of the EWS in the wards that have been researched and developed, as well as their performance in predicting severe adverse events (SAE). This study is a literature review design, conducting a systematic review by selecting relevant articles on Pub Med and Science Direct using the keyword "Early Warning Systems" in the 2018-2023 period. Out of 269 articles, only 12 articles that met the criteria. The selected articles are then systematically reviewed and analyzed. Based on the extraction results of 12 articles, 9 EWS were grouped into National Early Warning Score (NEWS) and its variants, Modified Early Warning Score (MEWS) and its variants, and EWS integrated with Electronic Medical Record (EMR). In choosing an EWS, hospitals must consider the complexity of the cases being managed and the capabilities of existing resources. The recommended EWS in hospital wards with limited resources is weighted EWS or EWS with combinations, such as NEWS and MEWS with variants. Meanwhile, hospitals that have used EMR can choose EWS integrated with EMR to increase their predictive value for SAE, as well as improve protocol compliance.

The Role of Healthcare Worker Motivation in the Relationship between Work Culture, Patient Satisfaction, and Performance at a Primary Healthcare Clinic Ekasari, Anita; Orbaningsih, Dwi; Wijayanti, Tri Cicik; Arifani, Nisa
International Journal of Public Health Excellence (IJPHE) Vol. 5 No. 2 (2026): January-May
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v5i2.1805

Healthcare worker performance plays a crucial role in determining the quality of services in primary healthcare clinics. Organizational and service-related factors, such as work culture, patient satisfaction, and healthcare worker motivation, are considered important determinants of performance. However, empirical evidence regarding the mediating role of healthcare worker motivation in primary healthcare settings remains limited. This study aimed to examine the relationship between work culture and patient satisfaction with healthcare worker performance, both directly and indirectly through healthcare worker motivation as a mediating variable, in a primary healthcare clinic. An observational analytic study with a quantitative approach was conducted at a primary inpatient healthcare clinic in Mojokerto Regency, Indonesia, during September–October 2025. The study involved 20 healthcare workers and 50 patients, selected using total sampling. Data were collected through structured questionnaires and analyzed using descriptive statistics and Spearman correlation tests to assess relationships among variables. The results showed that work culture was positively associated with employee motivation (r = 0.476; p = 0.034), while patient satisfaction was positively related to healthcare worker performance (r = 0.446; p = 0.049). Healthcare worker motivation also demonstrated a significant mediating role in the relationship between work culture and healthcare worker performance (r = 0.508; p = 0.022). Improving healthcare worker performance in primary healthcare clinics requires an integrated managerial approach that emphasizes strengthening work culture, enhancing patient satisfaction, and maintaining healthcare worker motivation to support sustainable improvements in service quality.

Climate Change and Vector-Borne Diseases in Southeast Asia: A Systematic Literature Review Akbar, Putri Wulan; Suminarti, Nur Edy; Arifani, Nisa
Journal of Islamic Medicine Vol 10, No 1 (2026): Journal of Islamic Medicine
Publisher : Faculty of Medicine and Health Science, Universitas Islam Negeri Maulana Malik Ibrahim

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18860/jim.v10i1.41558

Background: Climate change contributes to the increasing risk of vector-borne diseases by altering environmental conditions that influence vector dynamics and disease transmission patterns. Southeast Asia is a region highly vulnerable to the impacts of climate change while simultaneously bearing a substantial burden of vector-borne diseases. However, scientific evidence that systematically examines the relationship between climatic variables and vector-borne diseases in this region remains limited and fragmented. Objective: This study aims to synthesize the most recent scientific evidence on the relationship between climate change and climate variability and the occurrence of vector-borne diseases in Southeast Asia. Methods: A literature search was conducted in the Scopus, EBSCOhost, and PubMed databases using combinations of keywords related to climate change and vector-borne diseases. Included studies were original research articles published in English between 2021 and 2026 and conducted in Southeast Asian countries. The selection process followed the PRISMA guidelines. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Data synthesis was performed narratively. Results:Seven studies met the inclusion criteria. Temperature exhibited a non-linear relationship with disease risk, whereby increases within an optimal range enhanced transmission, while extreme temperatures tended to exert a protective effect. Absolute humidity and rainfall were generally positively associated with increased incidence, although their effects depended on intensity and temporal distribution. Heatwaves and drought demonstrated delayed effects that may elevate risk, whereas extremely wet conditions showed potential to reduce transmission in certain contexts. Environmental factors also played a significant role: high urban density supported the dominance of specific vectors, and air pollutants demonstrated protective associations in several studies. Conclusion: The relationship between climate variables and vector-borne diseases is complex, non-linear, and context-specific. The integration of extreme climate indicators and environmental factors into early warning systems and area-based control strategies is essential to address the challenges posed by climate change in Southeast Asia.

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