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All Journal Jurnal Ners Journal of Innovative and Creativity
Herniwanti Herniwanti
Universitas HangTuah Pekanbaru
Education Health Professions Languange, Linguistic, Communication & Media Mathematics Medicine & Pharmacology Nursing Social Sciences Other

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Evaluasi Screening Dokumen Verifikasi Internal Dalam Menentukan Kodingan Di Era Bpjs Tri Jenny Minarsih; Herniwanti Herniwanti
Journal of Innovative and Creativity Vol. 6 No. 1 (2026)
Publisher : Fakultas Ilmu Pendidikan Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/joecy.v6i1.8060

Abstract

The implementation of the National Health Insurance (JKN) system through BPJS Kesehatan requires accurate diagnosis and procedure coding to ensure appropriate claim reimbursement. Inaccurate coding and incomplete medical documentation often lead to pending and disputed claims, affecting hospital financial sustainability. This study aimed to evaluate the internal verification document screening process in determining BPJS claim coding at Hospital X and to formulate improvement strategies. A qualitative approach using SWOT analysis was applied to identify internal and external factors influencing the coding and verification process. Data were collected through interviews, document review, and SWOT questionnaires, and analyzed using IFAS and EFAS matrices. The results indicated that internal weaknesses were more dominant, particularly related to coder competency, documentation completeness, and manual screening processes, while external opportunities included regulatory support, coding training availability, and health information technology development. The SWOT analysis placed Hospital X in Quadrant III (Weakness–Opportunity), indicating that leveraging external opportunities to address internal weaknesses is essential to improve coding accuracy and reduce pending and disputed BPJS claims.
Evaluasi Penggunaan Alat Pelindung Diri (Apd) Pada Perawat di Unit Gawat Darurat (Ugd) Rumah Sakit Mesra Tahun 2025 Rizki Samur; Nofiyadi Nofiyadi; Herniwanti Herniwanti
Jurnal Ners Vol. 10 No. 2 (2026)
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v10i2.53470

Abstract

The use of Personal Protective Equipment (PPE) is an important component in preventing infection transmission, especially for nurses working in the Emergency Unit (ER) with high risk. Occupational Safety and Health (OSH) is an important aspect in every work environment in the world as an effort to prevent accidents and health problems due to work. This study aims to evaluate the level of compliance and effectiveness of the use of personal protective equipment (PPE) among nurses in the Emergency Unit (ER) of a hospital. The methods used include observation, interviews, and risk analysis using the USG and Fishbone Analysis approaches. The results of the study indicate that there are still shortcomings in aspects of human resources, standard operating procedures (SOP), supervision, facilities, and budget limitations that have the potential to increase the risk of accidents and exposure to occupational hazards. Conclusion: that although some nurses have implemented the use of PPE correctly, there is still a need for continuous education, supervision, and the provision of PPE facilities to improve occupational safety in the ER. It is hoped that the results of this study will be the basis for policy making related to occupational safety and health at Mesra Hospital
Co-Authors Nofiyadi Nofiyadi Rizki Samur Tri Jenny Minarsih