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ANALISA BUDAYA KESELAMATAN PASIEN PADA IMPLEMENTASI PELAPORAN INSIDEN KESELAMATAN PASIEN DALAM UPAYA MENINGKATKAN MUTU PELAYANAN DI RAWAT INAP RUMAH SAKIT X Wardhana, Bagus Kusuma; Aziz, Abdul; Subardi, Arda Yunita; Dwinuarisha, Eggie
Jurnal Penelitian Kesmasy Vol 7 No 1 (2024): JURNAL PENELITIAN KESMASY
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Deli Husada Delitua

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36656/jpksy.v7i1.2046

The incident reporting system in Indonesia in 2019 found around 12% of 2877 hospitals reporting patient safety incidents, with the number of patient safety incident reports as many as 7465, the number consisting of Near Miss Incidents 38%, Non-Injury Incidents 31% and Adverse Events 31% (Daud, 2020). The aim is to analyze the implementation of patient safety incident reporting in inpatient care at Hospital X so that priority problems are found and alternative solutions are obtained. The design processes the data obtained using a qualitative approach through in-depth interviews, observations, and comparisons with ideal conditions based on the latest regulations. This activity was carried out during the period from May to July 2024. The results of the examination during the research process found several problems, namely there was a fear of reporting patient incidents, not being used to carrying out the reporting process and not understanding the categories of patient incidents, limited human resources in the safety culture quality team, having a sense of burden such as getting additional tasks if reporting patient incidents, the safety culture quality team has several other important tasks / is not focused, and the implementer feels that complaints related to the cause of the incident are not followed up. Based on the priority assessment using the Urgency, Seriousness and Growth method, the highest point was 24, which came from the problem of the implementer feeling that complaints related to the cause of the incident were not followed up or the implementer's misperception of the follow-up to reporting patient safety incidents. Hospital X should develop a patient safety incident reporting system (SIPENKES) by showing the incident reporting follow-up process on the front page of the information system so that it is more transparent and the implementer is expected to understand that there is feedback and remain enthusiastic about cultivating the reporting of patient safety incidents.

IMPLEMENTASI REKAM MEDIS ELEKTRONIK PADA UNIT RAWAT JALAN DI RSUD X BEKASI Situmorang, Budi Asih; Aziz, Abdul; Subardi, Arda Yunita; Dwinuarisha, Eggie
Jurnal Penelitian Kesmasy Vol 7 No 1 (2024): JURNAL PENELITIAN KESMASY
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Deli Husada Delitua

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36656/jpksy.v7i1.2047

Electronic medical records (EMRs) represent a significant technological transformation in Indonesia's national health system, but they still pose challenges. According to Minister of Health Regulation No. 24 of 2022, all health service facilities in Indonesia are mandated to implement EMRs. However, the adoption of EMRs across the country's healthcare facilities has not been uniform. RSUD X has been preparing for the digitization of health services since 2018 by using SIMRS Khanza, but after four years, it has yet to fully implement EMRs. In October 2022, RSUD X transitioned to a new system, SIMRS BJB Hope, and began rolling out EMRs for outpatient services in August 2023. After 10 months of implementation, this initiative was expanded to include inpatient services. The initial results show an improvement in performance indicators for outpatient services, with faster provision of medical record documents in 2023 compared to 2022. However, these improvements still fall short of the Minimum Service Standards outlined in Minister of Health Regulation No. 43 of 2016, indicating ongoing challenges in the effective implementation of EMRs in hospital services.

ANALISIS IMPLEMENTASI MANAJEMEN CASEMIX DALAM PENINGKATAN PENDAPATAN DI RSUD X Herdiani, Erni; Aziz, Abdul; Subardi, Arda Yunita; Dwinuarisha, Eggie
Jurnal Penelitian Kesmasy Vol 7 No 1 (2024): JURNAL PENELITIAN KESMASY
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Deli Husada Delitua

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36656/jpksy.v7i1.2048

Hospitals are currently facing high VUCA (vulnerability, uncertainty, complexity & ambiguity) challenges. In order to remain able to compete in a healthy manner, to grow and develop successfully in accordance with its vision and mission, hospitals need to respond to these changes quickly and appropriately. One form of response to these changes is that hospital management understands the Casmix system and can implement it. Therefore, research was carried out at Hospital The research was carried out using a qualitative method with a descriptive analytical approach where this research carried out observations of the management casemix activity process, documented and interviewed and analyzed the research results. The results obtained are the implementation of casemix management at RSUD X in the Casemix unit. It can be concluded that Casemix management is less than optimal. The obstacles to less than optimal casemix management are the lack of optimal mapping of workload analysis and empowerment of casemix team personnel evenly and optimally and the lack of re-socialization of both coding and clinical pathway compliance for medical service teams. Apart from that, the work mechanism does not yet contain minimum time standards for each step of filing, coding and submission and there is no completeness checklist so that monitoring and eval__uation cannot be carried out optimally. Apart from that, RME is not yet optimal, especially in inpatient settings, it is not yet integrated and does not include interoperability. Optimization can be carried out, including by optimizing the casemix team by analyzing workloads and job descriptions whose performance indicators can be measured by updating existing SKs according to the analysis carried out, optimizing BPJS Claims SOPs, equipped with time limits for each step, making it easier to carry out monitoring and eval__uation. It is also necessary to prepare a checklist for completeness of files so that proper monitoring and eval__uation can be carried out, improving supporting facilities, namely RME, is very vital to be able to carry out Competency improvement can continue to be carried out periodically, especially in inpatient settings, periodically increasing competency for casemix teams and resocializing clinical pathways.

ANALISA INDIKATOR MUTU PPI (PENCEGAHAN DAN PENGENDALIAN INFEKSI) UNIT RAWAT INAP DI RS X Rosidin, Rona Qurrotul Aina; Aziz, Abdul; Subardi, Arda Yunita; Dwinuarisha, Eggie
Jurnal Penelitian Kesmasy Vol 7 No 1 (2024): JURNAL PENELITIAN KESMASY
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Deli Husada Delitua

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36656/jpksy.v7i1.2049

The increasing incidence of HAIs has become an important problem in the world. The increased risk of HAIs infection is due to the lack of implementation of the IPC program, including implementing isolation precautions, implementing HAIs bundles and implementing surveillance. Nurses play an important role in preventing and controlling the transmission of infections through the implementation of standard precautions and maintenance of the Health care environment. The aim of this research is to carry out an analysis of quality indicators for Infection Prevention and Control so that priority problems can be found for which alternative solutions will be sought. The research design uses a qualitative approach through in-depth interviews, observations, and comparisons with ideal conditions based on the latest regulations. The research was conducted during the period May to July 2024. The results of examinations during the residency process found several problems, namely not optimal hand hygiene for officers (germs were found on the palms of the hands after Hand Hygiene), lack of compliance by officers in washing hands, lack of compliance with using PPE according to indications, lack of trained PPI team, found cases of HAIs Surgical Area Infection (SSI) and lack of reporting of cases of HAIs Phlebitis. Based on the priority assessment using the USG (Urgency, Seriousness and Growth) method, a priority problem was found, namely that the hand hygiene of staff was not optimal (germs were found on the palms of the hands after Hand Hygiene. Hospital in the treatment room.

Strategi Edukasi Berbasis Literasi dalam upaya meningkatkan Budaya Keselamatan Pasien di RSUD Kabupaten Bekasi Subardi, Arda Yunita; Wijaya, Anna Maria Nurhayati; Yuliana, Roma
Journal Scientific of Mandalika (JSM) e-ISSN 2745-5955 | p-ISSN 2809-0543 Vol. 6 No. 8 (2025)
Publisher : Institut Penelitian dan Pengembangan Mandalika Indonesia (IP2MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36312/10.36312/vol6iss8pp2240-2246

Patient safety is one of the main pillars in improving the quality of health services. In the preliminary study, it was found that the implementation of patient safety was low, so it is necessary to increase knowledge and understanding related to patient safety. This study aims to evaluate the effectiveness of literacy-based education strategies in improving the understanding and implementation of patient safety. This study uses both descriptive analytical methods to explain the education strategy through the applied Learning Model and Method, as well as quasi-experimental methods with a pretest-posttest design involving hospital staff to assess the effectiveness of learning. The literacy-based education program is designed using an interactive approach, such as e-learning modules, simulation videos, and PDSA and FMEA competitions to trigger brainstorming and group discussions in all units as learning and sharing of patient safety experiences. This will improve critical and analytical thinking skills in solving patient safety problems in their work units. The focus of the education material covers 6 (six) patient safety targets. The results of this study showed a significant increase in medical personnel's understanding of patient safety by up to 78% and an increase in active participation of units in PDSA learning by up to 100%. In addition, there was a reduction in Adverse Events (KTD) by up to 30% after the implementation of the education program. This study concludes that literacy-based education strategies are an effective approach and can be integrated into routine training systems in health facilities to improve patient safety culture.

Effect of FSMP on Weight Gain in Severely Underweight and Stunted Under-Five Patients Subardi, Arda Yunita; Yunilasari, Yunilasari; Kusaeri, Yuliana; Widjaja, Anna Maria Nurhajati; Fitroh, Nur Nida; Novitasari, Prihatini Dini
Indonesian Journal of Global Health Research Vol 7 No 5 (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.v7i5.7009

Severely underweight in children under five, particularly severely underweight and stunting, remains a major public health issue with long-term impacts on human resource quality. One of the recommended interventions is the provision of Food for Special Medical Purposes (FSMP) in healthcare facilities. This study aimed to determine the effect of the program on weight gain among underweight and stunted under-five patients in the Sakura Inpatient Ward of Bekasi Regional General Hospital. This was a true experimental study with a one-group pretest-post-test design. The sample was obtained through total sampling of all under-five patients aged 0–36 months with severely underweight and stunting who were hospitalized in the Sakura Inpatient Ward from January 2024 to June 2025, totalling 71 patients. Data were analyzed using paired t-tests with a significance level of 5% (α = 0.05). There was an increase in the average body weight among severely underweight children from 5.31 kg to 5.63 kg (Δ = 0.32 kg; p < 0.001), and among those with both severely underweight and stunting from 4.97 kg to 5.34 kg (Δ = 0.37 kg; p < 0.001). The provision of program significantly increased body weight in under-five children with severely underweight, as well as those with combined severely underweight and stunting.

Description of Malnutrition and Stunting in Pediatric Patient in Sakura Ward Subardi, Arda Yunita; Yunilasari, Yunilasari; Nitroh, Nur Nida; Komarudin, Heru; Rahmanida, Nindya; Rahmadani, Putri
Jurnal Penelitian Perawat Profesional Vol 7 No 1 (2025): Februari 2025, Jurnal Penelitian Perawat Profesional
Publisher : Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/jppp.v7i1.5133

Malnutrition and stunting conditions in pediatric patients undergoing hospitalization also contribute to the increase in morbidity, mortality, length of treatment, and health costs. This Study aims to identify the characteristics of children with severe malnutrition and stunting in the inpatient ward of RSUD Bekasi in 2023. A descriptive cross-sectional study conducted from January to December 2023 in the Sakura inpatient ward of RSUD Bekasi. Data were collected from a total sample 343 patients based on nutrition records and reports, including patients aged 0-18 years who were hospitalized during the period in 2023. The data were then analysed to determine the proportion of malnutrition and stunting based on age, length of stay, and medical diagnosis. The result show proportion of malnutrition and stunting is highest among patients aged 0-3 years (64.8%), a length of stay ≤7 days (64.8%) being far more common than those with a length of stay >7 days (35.2%). Pediatric patients with malnutrition and stunting are in the medical diagnosis group of gastrointestinal disorders (28.6%), and respiratory disorders (20.9%). This indicates that patients with malnutrition and stunting require more attention improve their nutritional status and address complication to order to reduce the length of hospital stay.

Upaya Optimalisasi Program Nasional Penanganan Stunting di RSUD Kabupaten Bekasi Subardi, Arda Yunita; Rizana, Ana; Komarudin, Heru; Yuliana, Roma
Jurnal Cahaya Mandalika ISSN 2721-4796 (online) Vol. 3 No. 3 (2022)
Publisher : Institut Penelitian Dan Pengambangan Mandalika Indonesia (IP2MI)

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

Pelayanan Program Prioritas Nasional Penurunan Stunting menjadi salah satu indikator mutu rumah sakit yang harus dilaksanakan sesuai standar (Kemenkes, 2022). Rumah sakit harus turut serta melaksanakan program penurunan prevalensi stunting dan wasting. Dalam mendukung Program Prioritas Nasional ini, rumah sakit melakukan intervensi dan pengelolaan gizi serta penguatan jejaring rujukan kepada rumah sakit kelas di bawahnya dan FKTP di wilayahnya serta rujukan masalah gizi. Rumah sakit harus mempunyai program penurunan prevalensi stunting dan wasting antara lain peningkatan pemahaman dan kesadaran seluruh staf, pasien dan keluarga tentang masalah stunting dan wasting, intervensi spesifik dan penerapan rumah sakit sayang ibu dan bayi (Keputusan Menteri Kesehatan RI, 2022). Tujuan penelitian ini adalah untuk mendeskripsikan pelaksanaan perubahan mekanisme kerja dengan Inovasi Cantingmas untuk meningkatkan penanganan Stunting dan Risiko Stunting di RSUD Kabupaten Bekasi. Penelitian ini dilaksanakan menggunakan metode case report yang mencakup kegiatan identifikasi masalah, analisa masalah, Plan of Action (POA), implementasi dan evaluasi. Pengumpulan data dilakukan dengan menggunakan kuesioner dan dilaksanakan di RSUD Kabupaten Bekasi. Hasil evaluasi Program Inovasi didapatkan data antara lain terbentuknya Tim Stunting baik internal maupun eksternal (94%), komunikasi dan koordinasi tim yang baik (88%), perencanaan program penanganan stunting lebih terpadu, terdapat (94%), alur kerja yang lebih jelas (94%), proses rujukan internal menjadi lebih jelas/ terstruktur masing-masing sebesar 94%, pencatatan, pelaporan menjadi lebih baik dan terintegrasi sebesar 88%, adanya panduan penanganan stunting sebesar 76%, dan pelaksanaan asuhan pasien stunting sebesar 76%. Inovasi CANTINGMAS sebagai upaya peningkatan mutu penanganan Stunting di RSUD Kabupaten Bekasi telah berhasil dengan kategori nilai baik di atas 80%. Terdapat dua aspek dimana kedua aspek tersebut masing-masing memiliki nilai 76% sehingga perlu mendapatkan perhatian dan upaya perbaikan strategis dalam rangka meningkatkan mutu penanganan stunting/ risiko stunting di RSUD, yaitu tersedianya panduan penanganan stunting untuk PPA dan terlaksananya asuhan keperawatan pasien stunting sesuai dengan standar.

Analisis Budaya Keselamatan Pasien sebagai Langkah Pengembangan Keselamatan Pasien di RSUD Kabupaten Bekasi Subardi, Arda Yunita; Rizana, Ana
Malahayati Nursing Journal Vol 6, No 7 (2024): Volume 6 Nomor 7 2024
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mnj.v6i7.13615

ABSTRACT Good Patient Safety Culture in hospital may decrease the incidence related by patient safety. World Health Organization (WHO, 2023) estimated that 1 in every 10 patients is harmed in health care and more than 3 million deaths occur annually due to unsafe care. There are as many as 4 in 100 people die from unsafe care in low-to-middle income countries. The purpose of this study’s are to analyze the patient safety culture among the staff by survey and evaluating culture as well as action which implement by the hospital. The study employs a mix method approach includes both quantitative and qualitative methods. Quantitative design use main data while score and percentage as an outcome of response from checklist based on AHRQ’s quostionaire as a quantitative study supported with qualitative study by in-depth interview. Measurement of Hospital Patient Safety Culture was carried out in Bekasi District Hospital (BDH) and responses were obtained one time. The result shows score at BDH in 2022 was 65%, categorized as Strong enough. Based on the culture category, there is 25% culture dimension was Strong, 58% culture dimension was Enough and 17% culture dimension was Weak. Culture dimension with Very Strong was Learning Organization (92%) and The Weakness was Staffing (36,3). The patient safety culture score at BDH was 65% which categorized as Strong enough. Dimension need to be maintained is Learning Organization. The other dimension needs attention and to be achieve with a strategic-improvement efforts to improve patient safety. BDH has to improve the patient safety program, create the work environment which the patient safety oriented as main priority, improve SPEAK UP program, positive reinforcement to increase motivation of incident report. Staffing evaluation such as Competence workforce recruitment, compatibility workload with number of staff, workforce planning, staff competence improvement which adjusted with standard of each profession by in-house training. Keywords: Safety Culture, Patient Safety Improvement, Bekasi District Hospital (BDH) ABSTRAK Adanya budaya keselamatan karyawan rumah sakit yang baik dapat memperkecil timbulnya insiden yang berhubungan dengan keselamatan pasien. World Health Organization (WHO, 2023) memperkirakan 1 dari 10 pasien dirugikan dalam pelayanan kesehatan dan lebih dari 3 juta pasien meninggal akibat pelayanan yang tidak aman. Sedangkan sebanyak 4 dari 100 meninggal karena perawatan yang tidak aman terjadi pada negara berkapita rendah sampai menengah. Tujuan penelitian ini adalah untuk menganalisis hasil survey budaya keselamatan pasien diantara staf dan mengevaluasi penerapan budaya keselamatan pasien di RSUD Kabupaten Bekasi. Penelitian ini dilaksanakan menggunakan pendekatan mix methode, baik metode kuantitatif dan kualitatif. Desain Kuantitatif menggunakan hasil skor survei budaya keselamatan pasien berdasarkan checklist dari AHRQ’s dan ditunjang data kualitatif melalui wawancara mendalam. Pengukuran budaya keselamatan pasien dilaksanakan di RSUD Kabupaten Bekasi dan dilakukan pengukuran satu kali. Hasil survei menunjukkan bahwa nilai budaya keselamatan pasien di RSUD Kab. Bekasi tahun 2022 sebesar 65%, dikategorikan dalam nilai sedang atau cukup kuat. Berdasarkan kategori nilai budaya, maka terdapat 25% dimensi budaya memiliki nilai kuat, 58% dimensi budaya memiliki nilai sedang, dan 17% dimensi budaya yang memiliki nilai lemah. Dimensi budaya yang memiliki nilai yang sangat kuat adalah pembelajaran organisasi sebesar 92% dan yang terlemah adalah staffing dengan nilai 36,3%. Budaya keselamatan pasien di RSUD Kabupaten Bekasi dalam kategori Cukup dengan nilai 65%. Dimensi budaya yang perlu dipertahankan adalah pembelajaran organisasi. Sedangkan dimensi budaya lain perlu mendapatkan perhatian dan upaya perbaikan strategis untuk meningkatkan keselamatan pasien di RSUD. RSUD Kabupaten Bekasi harus mengembangkan program keselamatan pasien dan menciptakan iklim kerja yang berorientasi pada keselamatan pasien sebagai prioritas utama, mengembangkan program SPEAK UP, Reinforcement positif untuk meningkatkan motivasi unit dalam pelaporan insiden. Evaluasi staffing meliputi perekrutan tenaga yang kompeten. Selain itu kesesuaian beban kerja dengan jumlah staf, perencanaan perekrutan tenaga, peningkatan kompetensi staf yang harus disesuaikan dengan standar tiap profesi melalui pelatihan ataupun in house training. Keywords: Budaya Keselamatan, Pengembangan Keselamatan Pasien, RSUD Kabupaten Bekasi

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