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All Journal Belitung Nursing Journal Jurnal Pendidikan Kesehatan Advances in Cancer Science Journal of Health Research and Technology
Widiastuti, Zeni
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Materials Science & Nanotechnology Medicine & Pharmacology Nursing Public Health

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Infection-related mortality and infection control practices in childhood acute myeloid leukemia in a limited resource setting: Experience with the Indonesian national protocol Supriyadi, Eddy; Purwanto, Ignatius; Widiastuti, Zeni; Armytasari, Inggar; Sandi, Salsabila; Ardianto, Bambang; Kaspers, Gertjan J. L.
Belitung Nursing Journal Vol. 10 No. 2 (2024): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3139

Abstract

Background: In resource-limited settings, addressing infections remains a substantial challenge in the management of children with Acute Myeloid Leukemia (AML). In Indonesia, infection-related mortality (IRM) is thought to be high compared to high-income countries. However, there has been no previous study of infection profile and IRM in Indonesian patients with AML. Objective: This study aimed to describe infections and IRM in children with AML treated according to the Indonesian National AML protocol and to describe the implementation of infection control practices in resource-limited settings. Methods: This retrospective observational study used secondary data from the medical records of pediatric patients with AML treated with the National Protocol at Dr. Sardjito Hospital, Yogyakarta, Indonesia, from April 2012 to September 2018. Essential patient characteristics, time of IRM, and cause of death were recorded, and infection control practices were observed. Data were analyzed using descriptive statistics. Results: 113 patients with AML were treated with the National protocol, and 83 met the inclusion criteria. Infections occurred in 69 (83%) patients with a total of 123 episodes (mean 1.8/patient). Death was seen in 48 (58%) patients, with 19 (23%) IRM. The majority of infections were in the gastrointestinal tract (n = 51, 30.5%), sepsis (n = 29, 17%), and respiratory tract (n = 28, 17%). Infections mostly occurred during the first induction (41%). There were 90 (73%) episodes of clinically documented infection and 33 (27%) episodes of microbiologically documented infection. The positivity rate of blood cultures was only 27%. The majority of bacteria detected were gram-negative (n = 25, 69%), and among them were Klebsiella pneumonia (19%) and Escherichia coli (19%). Candida albicans was detected in 1 (2%) culture. Suboptimal infection prevention and control were found in the clinical practice. Conclusion: Infections and infection-related mortality in children with AML treated using the National protocol were frequent, mainly occurring during the first induction phase. Compliance with infection prevention and control measures needs improvement. Urgent attention is required for better supportive care, including isolation rooms, antibiotics, and antifungals. The predominance of Gram-negative bacterial infections highlights the necessity for further research into effective prophylaxis. Enhanced healthcare and nursing professional vigilance and tailored antibiotic strategies are vital. Improving compliance and ensuring adequate supportive care resources are essential, emphasizing nursing’s pivotal role. Further research is crucial to drive advancements in infection control strategies.
EFFECTIVENESS OF AUTOMATED DISPENSING MACHINE (ADM) TO REDUCE THE EVENTS OF DISPENSING ERROR ON MEDICATION ERROR IN INCREASING PATIENT SAFETY: Literature Review WIDIASTUTI, ZENI
Journal of health research and technology Vol. 1 No. 2 (2023): Journal of health research and technology
Publisher : Sahabat Publikasi Kuu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58439/jhrt.v1i2.72

Abstract

Background: patient safety is one of the main things in providing health services in hospitals. Medication error is one frequent incidents that could harm the patient. Dispensing error is one of the stages in medication errors that can be caused due to high workload, inadequate number of staff, LASA medication, drug packaging that is similar or almost the same, LASA drug storage system, and environmental factors such as distractions and interruptions. Aim: to determine the effectiveness of the Automated Dispensing Machine (ADM) for reduce the incidence of dispensing errors in medication errors to improve patient safety. Methods: this study uses a literature review study by using various journal databases, such as Google Scholar, Science Direct and ProQuest, with journal spanning the last five years. Results: study was shows that the implementation of the Automated Dispensing Machine (ADM) is effective reduce the incidence of dispensing errors in medication errors by being integrated with barcode system and hospital information system. This article can used a refrence in research on the effectiveness of ADM for reduce the incidence of dispensing errors in medication errors.
Penerapan Terapi Bermain Puzzle Terhadap Penurunan Tingkat Kecemasan Pada Anak Usia Toddler Dengan Acute Myeloid Leukemia Patrianto; Diahsari, Armenia; Widiastuti, Zeni
JURNAL PENDIDIKAN KESEHATAN Vol. 5 No. 2 (2025): Jurnal Pendidikan Kesehatan
Publisher : LPPM Sekolah Tinggi Ilmu Kesehatan Pekanbaru Medical Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.64931/jks.v5i2.188

Abstract

Acute Myeloid Leukemia merupakan masalah keganasan hematologi yang berdampak signifikan terhadap kondisi fisik, psikologis, dan kualitas hidup pasien. Secara fisik, anak mengalami supresi sumsum tulang yang mengakibatkan anemia, risiko perdarahan, dan infeksi berulang. Secara psikologis, prosedur medis invasif dan lingkungan rumah sakit yang asing memicu ansietas (kecemasan). Kondisi ini jika tidak ditangani akan mengganggu proses tumbuh kembang serta menurunkan kooperatifitas anak dalam menjalani terapi pengobatan jangka panjang. Tujuan: studi kasus ini adalah untuk memberikan gambaran asuhan keperawatan komprehensif pada pasien anak dengan penerapan terapi bermain puzzle terhadap penurunan tingkat kecemasan dengan Acute Myeloid leukemia mengevaluasi efektifitas intervensi nonfarmakologis berupa teknik distraksi dalam mengurangi kecemasan. Metode yang digunakan adalah studi kasus dengan pendekatan deskriptif melalui observasi, wawancara, pemeriksaan fisik, analisis rekam medis dengan menggunakan SDKI, SLKI dan SIKI. Hasil: menunjukkan bahwa setelah intervensi selama lima hari, skala kecemasan menurun dari 149 kecemasan tinggi menjadi 117 kecemasan sedang, pasien tampak lebih rileks, tidak rewel dan mulai beraktifitas ringan. Teknik nonfarmakologi menunjukkan penurunan kecemasan, meningkatkan kenyamanan. Kesimpulan: Terapi bermain puzzle menunjukkan adanya penurunan tingkat kecemasan pada anak yang menjalani hospitalisasi.
Semi-Immersive Virtual Reality: Distracting Children with Cancer from the Side Effects of Post-Chemotherapy Margaretha, Sumarti; Widiastuti, Zeni; Purwaningsih, Iswanti
Advances in Cancer Science Vol. 2 No. 3 (2025): October
Publisher : Indonesian Journal Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47134/acsc.v2i3.10

Abstract

This study aims to explore the role of semi-immersive virtual reality (VR) as a non-pharmacological distraction technique to alleviate post-chemotherapy side effects among pediatric cancer patients. Using a qualitative descriptive approach through a library-based study, data were collected from peer-reviewed journal articles, clinical reports, and systematic reviews published between 2018 and 2025. The data analysis involved thematic identification, data reduction, categorization, and inductive interpretation to synthesize conceptual and empirical findings. The results reveal that both immersive and semi-immersive VR significantly reduce chemotherapy-related anxiety, pain, nausea, and emotional distress in children, with semi-immersive systems demonstrating comparable efficacy to immersive ones while offering greater practicality and fewer adverse effects. Semi-immersive VR also enhances engagement, emotional well-being, and perceived control during treatment, contributing to improved psychological adaptation. These findings affirm the theoretical basis of the Gate Control Theory of Pain and the Cognitive-Behavioral Distraction Model, highlighting VR’s effectiveness in modulating sensory and emotional responses to medical stressors. The study concludes that semi-immersive VR represents an innovative, feasible, and child-friendly therapeutic adjunct in pediatric oncology care. The implications extend to healthcare practice, where VR can be integrated as a supportive digital therapy, and to future research, which should employ triangulated, longitudinal approaches to evaluate its long-term psychosocial benefits.
Co-Authors Ardianto, Bambang Armytasari, Inggar Diahsari, Armenia Eddy Supriyadi, Eddy Ignatius Purwanto Kaspers, Gertjan J. L. Margaretha, Sumarti Patrianto Sandi, Salsabila