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Ethical Dilemma in Diabetes Wound Care: A Literature Review Zainudin, Harsah Bahtiar; Susanto, Tantut
Babali Nursing Research Vol. 6 No. 1 (2025): January
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.61455

Abstract

Background: One of the main complications of diabetes is diabetic foot ulcer (DFU), which often requires intensive care and involves collaboration between various disciplines. In managing diabetic foot ulcers, several ethical dilemmas arise regarding autonomy, beneficence, non-maleficence, and justice. This review of the literature aims to examine ethical dilemmas in the care of diabetic wounds. Methods: A literature review was conducted to analyze articles published over the last five years (2019–2024). The analysis involved a detailed review of healthcare workers' ethical dilemmas, particularly nurses, in managing diabetic wounds. Results: Nurses are crucial in addressing ethical dilemmas in diabetic wound care. They must have a comprehensive knowledge of diabetic wounds, including their pathophysiology, complications, and treatment options. Nurses must also have strong decision-making skills, allowing them to analyze situations, weigh various factors, and make appropriate decisions. Furthermore, they must maintain effective relationships with patients and their families. Conclusion: Ethical dilemmas in wound care present complex and multidimensional challenges. Nurses must possess adequate knowledge, skills, and support to navigate these situations effectively. By doing so, they can provide high-quality, dignified care to patients while protecting their well-being.
Dilemmatic of Management of Wound Care of Diabetic for Risk Amputation in Rural Areas: A Case Report Zainudin, Harsah Bahtiar; Sutanto, Tantut; Suhari, Suhari
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.v7i5.6893

Abstract

Diabetic wounds are one of the most challenging complications faced by individuals with diabetes. These wounds not only pose serious physical threats, such as infection and limb loss, but also cause significant psychological distress. One ethical dilemma commonly encountered in diabetic wound care involves decision-making about treatment options, especially when patients request amputation due to pain or economic burden, while healthcare providers aim to preserve the limb through advanced wound care techniques. This situation requires careful consideration of both medical and ethical aspects to ensure patient-centered care. The objective of wound care in such cases is not only physical healing but also improving the patient’s psychological well-being. When care is holistic and empathetic, patients are more likely to engage in treatment positively and without fear, especially during painful procedures such as dressing changes. This case highlights a 55-year-old man with a 20-year history of uncontrolled diabetes and a chronic, infected wound on his right leg. The patient's initial desire for amputation was addressed through a multidisciplinary approach using the TIME method Tissue management, Inflammation control, Moisture balance, and Epithelial advancement. The structured, ethical, and compassionate care helped the patient reconsider amputation, demonstrating that rural nurses and health teams can resolve ethical dilemmas and support better patient outcomes.
SIP-DAL (Sistem Informasi Pemulangan: Dengarkan, Ajarkan, Dan Bekali) Dalam Meningkatkan Mutu Pelayanan Discharge Planning Di RS Perkebunan Jember, Klinik Jember zainudin, harsah bahtiar; Khoirul Romadhan; Tantut Susanto; Niken Wahyu Puspitarini
Jurnal Manajemen Kesehatan dan Keperawatan Vol. 2 No. 3 (2025): Jurnal Manajemen Kesehatan dan Keperawatan
Publisher : Universitas Dirgantara Marsekal Suryadarma

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35968/q92pxc06

Abstract

Manajemen keperawatan berperan penting dalam menjaga mutu layanan kesehatan, salah satunya melalui perencanaan pemulangan pasien (discharge planning). Edukasi pemulangan sering belum optimal karena tidak adanya media standar, materi yang tidak seragam, dan penyampaian informasi yang terburu-buru, sehingga berpotensi meningkatkan angka readmisi dan menurunkan kepuasan pasien. Penelitian ini mengembangkan inovasi Sistem Informasi Pemulangan: Dengarkan, Ajarkan, dan Bekali (SIP-DAL) untuk meningkatkan efektivitas discharge planning di Ruang Anthurium 3 RS Perkebunan Jember Klinik. Metode yang digunakan mencakup pendekatan partisipatif melalui pengkajian 6M, analisis USG, penyusunan inovasi berbasis SWOT, implementasi, dan evaluasi. Inovasi diwujudkan dalam bentuk booklet edukasi digital berisi materi perawatan, penggunaan obat, tanda bahaya, jadwal kontrol, dan modifikasi gaya hidup yang diakses melalui QR Code dan Google Drive. Uji coba pada 20 pasien menunjukkan peningkatan pemahaman hingga 100% dan kemudahan akses media sebesar 80%.. SIP-DAL terbukti efektif meningkatkan pemahaman pasien, mendukung akreditasi rumah sakit, serta berpotensi menurunkan angka readmisi dan meningkatkan kepuasan pasien. Program ini layak diintegrasikan ke dalam standar operasional prosedur pelayanan keperawatan dan dikembangkan lebih lanjut untuk optimalisasi mutu layanan.   Nursing management plays an important role in maintaining the quality of healthcare services, one of which is through effective discharge planning. Patient discharge education is often suboptimal due to the absence of standardized media, inconsistent educational materials, and the hurried delivery of information, which may increase readmission rates and decrease patient satisfaction. This study developed the Discharge Information System: Listen, Teach, and Equip (SIP-DAL) to enhance the effectiveness of discharge planning in the Anthurium 3 Ward of Jember Klinik Plantation Hospital. The method employed a participatory approach consisting of 6M assessment, USG analysis, SWOT-based innovation design, implementation, and evaluation. The innovation was realized in the form of a digital educational booklet containing materials on home care, medication usage, warning signs, follow-up schedules, and lifestyle modification, accessible via QR Code and Google Drive. A trial conducted on 20 patients demonstrated a 100% improvement in patient understanding and 80% satisfaction with the accessibility of the digital media. SIP-DAL proved effective in improving patient comprehension, supporting hospital accreditation, and potentially reducing readmission rates while enhancing patient satisfaction. This program is recommended for integration into the standard operating procedures of nursing services and further development to optimize service quality.