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Peningkatan kualitas pelayanan rawat jalan di rumah sakit indonesia melalui manajemen lean healthcare: A systematic review Priladiantika, Berta Ivana; Intiasari, Arih Diyaning; Mulyanto, Joko
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1542

Background: Lean management, part of the Toyota Production System, is now applied across various industries to improve service quality. The implementation of lean in hospitals aims to enhance efficiency, reduce the length of hospital stays, and minimize medical errors, although the outcomes vary depending on factors such as leadership, training, and staff engagement. Purpose: To examine the improvement of the quality of outpatient services in Indonesian hospitals through lean healthcare management. Method: This article uses a PICO approach and follows the PRISMA guidelines, starting with a database search that yielded 256 articles. These were then screened based on inclusion and exclusion criteria, resulting in 12 relevant articles. The selection process included the removal of duplicate articles, screening of titles and abstracts, and full-text evaluation. Results: The implementation of lean management in Indonesian hospitals was carried out by observing and recording service flow from registration to payment, then analyzing service time based on Value-Added and Non-Value-Added Activities using Visual Stream Mapping or spaghetti diagrams, and discussing solutions through the 5 Whys and Fishbone Analysis methods. Conclusion: Lean management has been proven effective and suitable for application in hospital outpatient services to improve efficiency by eliminating waste and optimizing systems. Keywords: Healthcare; Hospital; Lean Management; Outpatient. Pendahuluan: Manajemen Lean, bagian dari Toyota Production System, kini diterapkan di berbagai industri untuk meningkatkan kualitas layanan. Implementasi manajemen lean di rumah sakit bertujuan untuk meningkatkan efisiensi, mengurangi lama pelayanan, dan meminimalkan kesalahan medis, meskipun hasilnya bervariasi tergantung pada faktor-faktor seperti kepemimpinan, pelatihan, dan keterlibatan staf. Tujuan: Untuk mengkaji peningkatan kualitas pelayanan rawat jalan di rumah sakit Indonesia melalui manajemen lean healthcare. Metode: Artikel ini menggunakan pendekatan PICO dan mengikuti pedoman PRISMA, dimulai dengan pencarian database yang menghasilkan 256 artikel. Artikel-artikel ini kemudian disaring berdasarkan kriteria inklusi dan eksklusi, menghasilkan 12 artikel yang relevan. Proses seleksi mencakup penghapusan artikel duplikat, penyaringan judul dan abstrak, serta evaluasi fulltext. Hasil: Implementasi manajemen lean di rumah sakit Indonesia dilakukan dengan mengamati dan mencatat alur layanan dari pendaftaran hingga pembayaran, kemudian menganalisis waktu layanan berdasarkan Aktivitas Bernilai Tambah (Value-Added) dan Aktivitas Tidak Bernilai Tambah (Non-Value-Added) menggunakan Visual Stream Mapping atau diagram spageti, dan mendiskusikan solusi melalui metode 5 Whys dan Analisis Fishbone. Simpulan: Manajemen lean terbukti efektif dan cocok untuk diterapkan di layanan rawat jalan rumah sakit untuk meningkatkan efisiensi dengan menghilangkan pemborosan (waste) dan mengoptimalkan sistem. Kata Kunci: Healthcare; Manajemen Lean; Rawat Jalan; Rumah Sakit.

Efektivitas latihan ankle pump terhadap pencegahan neuropati perifer pada pasien diabetes mellitus tipe 2 Sari, Rita; Sofiani, Yani; Yunitri, Ninik; Kurniasari, Septi
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1565

Background: Introduction: Peripheral neuropathy is one of the most common chronic complications in patients with type 2 diabetes mellitus (DM) and carries a risk of diabetic ulcers and amputation. One non-pharmacological intervention that can be used is ankle pump exercises to improve peripheral circulation. Purpose: To evaluate the effectiveness of ankle pump exercises in preventing peripheral neuropathy in patients with type 2 diabetes mellitus. Method: This study used an Evidence-Based Nursing Practice (EBNP) approach with a pre-post quasi-experimental design. A total of 15 participants were selected using purposive sampling based on inclusion criteria. The ankle pump intervention was carried out for 4 weeks, twice daily, for 10 minutes each time. Data were analyzed using univariate tests and paired t-tests. Results: The prevalence of neuropathy decreased from 67% to 40% after the intervention. The paired t-test showed a p-value of 0.024 (p<0.05), indicating a significant difference before and after the intervention. Conclusion: Ankle pumps are effective in improving peripheral circulation and reducing neuropathy symptoms. Suggestion: This intervention is expected to be integrated into preventive nursing practice and patient education. Keywords: Ankle Pump; Peripheral Neuropathy; Type 2 Diabetes Mellitus. Pendahuluan: Neuropati perifer merupakan salah satu komplikasi kronis yang paling sering terjadi pada pasien diabetes mellitus (DM) tipe 2 dan berisiko menyebabkan ulkus diabetikum hingga amputasi. Salah satu intervensi nonfarmakologis yang dapat digunakan adalah latihan ankle pump untuk meningkatkan sirkulasi perifer. Tujuan: Untuk mengevaluasi efektivitas latihan ankle pump terhadap pencegahan neuropati perifer pada pasien diabetes mellitus tipe 2. Metode: Penelitian ini menggunakan pendekatan Evidence-Based Nursing Practice (EBNP) dengan desain quasi-experiment pre-post. Sebanyak 15 partisipan dipilih dengan purposive sampling sesuai kriteria inklusi. Intervensi ankle pump dilakukan selama 4 minggu, dua kali sehari, masing-masing 10 menit. Data dianalisis menggunakan uji univariat dan paired t-test. Hasil: Prevalensi neuropati menurun dari 67% menjadi 40% setelah intervensi. Uji paired t-test menunjukkan nilai p=0.024 (p<0.05), menandakan adanya perbedaan signifikan sebelum dan sesudah intervensi. Simpulan: Ankle pump efektif dalam meningkatkan sirkulasi perifer dan mengurangi gejala neuropati. Saran: Diharapkan intervensi ini diintegrasikan dalam praktik keperawatan preventif dan edukasi pasien. Kata Kunci: Ankle Pump; Diabetes Mellitus Tipe 2; Neuropati Perifer.

Hubungan pekerjaan ibu dengan ketepatan waktu, jenis, porsi, dan tekstur pemberian MP-ASI Masitah, Ravi; Novianty, Novianty
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1570

Background: The period of complementary feeding for children aged 6–23 months is a crucial phase for their growth and development. Inappropriate complementary feeding practices, whether in terms of timing, type, portion, or texture, can increase the risk of stunting, malnutrition, and developmental disorders. Maternal employment status is suspected to influence the appropriateness of complementary feeding. Purpose: To determine the relationship between maternal employment and the appropriateness of complementary feeding. Method: This quantitative study used a cross-sectional approach and was conducted in July 2025 in the working area of the 7 Ulu Community Health Center, Palembang, South Sumatra. The sampling technique used purposive sampling with a sample size of 30 participants. The independent variable in this study was maternal employment, while the dependent variable was the provision of complementary feeding. Data were analyzed using univariate analysis with frequency distribution and bivariate analysis with the chi-square test. Results: There was no significant relationship between compliance with complementary feeding and the four variables in this study. This is indicated by the p-values for the variables time (p=0.272), type (p=1.000), portion (p=0.714), and texture (p=1.000), all of which were greater than the 0.05 significance level. Conclusion: There is no significant relationship between maternal employment status and the appropriateness of complementary feeding, either in terms of time, type, portion, or texture (p-value > 0.05). Keywords: Nutrition; Mother's Occupation; Provision of Complementary Feeding. Pendahuluan: Periode pemberian makanan pendamping ASI (MP-ASI) usia 6–23 bulan merupakan fase kritis bagi pertumbuhan dan perkembangan anak. Praktik pemberian MP-ASI yang tidak tepat, baik dari segi waktu, jenis, porsi, maupun tekstur, dapat meningkatkan risiko stunting, malnutrisi, dan gangguan tumbuh kembang. Status pekerjaan ibu diduga berpengaruh terhadap ketepatan pemberian MP-ASI. Tujuan: Untuk mengetahui hubungan antara pekerjaan ibu dengan ketepatan pemberian MP-ASI. Metode: Penelitian kuantitatif dengan pendekatan cross sectional, dilaksanakan bulan Juli 2025 di wilayah kerja Puskesmas 7 Ulu Palembang Sumatera Selatan. Teknik pengambilan sampel menggunakan puposive sampling dengan jumlah sampel yang digunakan sebanyak 30 partisipan. Variabel independent dalam penelitian ini adalah pekerjaan ibu, sedangkan variabel dependen adalah pemberian MP-ASI. Analisis data yang digunakan univariate dalam bentuk distribusi frekuensi dan bivariate menggunakan uji chi square. Hasil: Tidak terdapat hubungan yang bermakna antara kepatuhan pemberian MP-ASI dengan keempat variabel dalam penelitian ini. Hal ini ditunjukkan oleh p-value pada variabel waktu (p=0.272), jenis (p=1.000), porsi (p=0.714), dan tekstur (p=1.000) yang seluruhnya lebih besar dari nilai signifikansi 0.05. Simpulan: Tidak terdapat hubungan yang signifikan antara status pekerjaan ibu dengan ketepatan pemberian MP-ASI, baik dari segi waktu, jenis, porsi, maupun tekstur (p-value > 0.05). Kata Kunci: Gizi; pekerjaan ibu; pemberian MP-ASI.

Dampak climate crisis terhadap pola penyakit ibu hamil dan maternal mortality Fajarina, Mira; Utama, Reka Julia; Malem, Rehmaita
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1571

Background: Climate change directly impacts maternal health, increasing the risk of pregnancy complications, delayed antenatal care (ANC) visits, and maternal mortality. Purpose: To analyze the impact of the climate crisis on maternal disease patterns and maternal mortality. Method: An observational analytic study with a case-control design was conducted on 364 pregnant women at the Baitussalam and Blang Bintang Community Health Centers in Aceh Besar. The sample was selected purposive sampling, consisting of case groups (mothers with complications) and controls. Data were collected using a validated questionnaire (CVI by three experts, Cronbach's Alpha ≥0.7) and medical records. Analysis used Chi-square and multiple logistic regression. Results: Exposure to extreme temperatures (OR=2.27; p=0.010), air pollution (OR=1.91; p=0.036), and weather changes (OR=2.85; p=0.006) were significantly associated with pregnancy complications, while counseling played a protective role (OR=0.49; p=0.010). Cancelling antenatal care due to extreme weather increases the risk of complications (OR=3.16; p=0.001). Conclusion: Environmental factors related to the climate crisis impact maternal health, necessitating mitigation strategies such as education, increasing access to antenatal care, and strengthening health system capacity to reduce the risk of maternal complications. Keywords: Climate Crisis; Maternal Diseases; Maternal Mortality. Pendahuluan: Perubahan iklim berdampak langsung pada kesehatan maternal, meningkatkan risiko komplikasi kehamilan, keterlambatan kunjungan antenatal care (ANC), dan mortalitas ibu. Tujuan: Untuk menganalisis dampak climate crisis terhadap pola penyakit ibu hamil dan maternal mortality. Metode: Studi observasional analitik dengan desain kasus-kontrol dilakukan pada 364 ibu hamil di Puskesmas Baitussalam dan Blang Bintang, Aceh Besar. Sampel dipilih secara purposive sampling, terdiri dari kelompok kasus (ibu dengan komplikasi) dan kontrol. Data dikumpulkan menggunakan kuesioner tervalidasi (CVI oleh tiga ahli, Cronbach’s Alpha ≥0.7) dan rekam medis. Analisis menggunakan Chi-Square dan regresi logistik berganda. Hasil: Paparan suhu ekstrem (OR=2.27; p=0010), polusi udara (OR=1.91; p=0.036), dan perubahan cuaca (OR=2.85; p=0.006) berhubungan signifikan dengan komplikasi kehamilan, sedangkan penyuluhan berperan protektif (OR=0.49; p=0.010). Batal ANC karena cuaca ekstrem meningkatkan risiko komplikasi (OR=3.16; p=0.001). Simpulan: Faktor lingkungan terkait krisis iklim memengaruhi kesehatan ibu hamil, sehingga diperlukan strategi mitigasi seperti penyuluhan, peningkatan akses ANC, dan penguatan kapasitas sistem kesehatan untuk mengurangi risiko komplikasi maternal. Kata Kunci: Climate Crisis; Maternal Mortality; Penyakit Ibu Hamil.

Model rehabilitasi berpusat keluarga terintegrasi terapi medis pada spastisitas cerebral palsy (CP): A systematic literature review Alami, Fidya Ifah; Najwa, Yusri Chizma
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1580

Background: Cerebral palsy (CP) is a neurological disorder affecting motor function, posture, and overall quality of life in children. In children with spastic CP, medical therapies such as Bobath and hydrotherapy have shown positive outcomes in improving gross motor function, walking speed, reducing spasticity, and promoting muscle relaxation. Purpose: To analyze a family-centered rehabilitation model integrated with medical therapy in cerebral palsy (CP) spasticity. Method: A descriptive method with a qualitative approach through a Systematic Literature Review (SLR). Literature was analyzed based on relevance to family-centered rehabilitation, medical therapy interventions, and the ICF framework in pediatric spastic CP. Results: The study found that family involvement in rehabilitation significantly improves motor function, increases social participation, and strengthens adherence to home exercise routines. The integration of medical therapies with a supportive family-centered approach contributed to both physical improvement and psychosocial well-being, producing sustained positive effects on therapy outcomes and overall quality of life. Conclusion: There is a positive impact of combining medical therapy with a family-centered rehabilitation model in improving motor function, social participation, and adherence to home-based exercises in children with spastic cerebral palsy. Keywords: Cerebral Palsy (CP) Spasticity; Family-Centered; Integrated Medical Therapy; Rehabilitation Model. Pendahuluan: Cerebral palsy (CP) merupakan gangguan neurologis yang memengaruhi fungsi motorik, postur, dan kualitas hidup anak. Pada anak dengan CP spastik, terapi medis seperti Bobath dan hidroterapi terbukti memberikan dampak positif dalam meningkatkan fungsi motorik kasar, kecepatan berjalan, mengurangi spastisitas, serta memberikan relaksasi otot. Tujuan: Untuk menganalisis model rehabilitasi berpusat keluarga terintegrasi terapi medis pada spastisitas cerebral palsy (CP). Metode: Deskriptif dengan pendekatan kualitatif melalui systematic literature review (SLR). Literatur dianalisis berdasarkan relevansi terhadap model rehabilitasi berbasis keluarga, intervensi terapi medis, dan kerangka ICF pada CP spastik anak. Hasil: Keterlibatan keluarga dalam proses rehabilitasi berkontribusi signifikan terhadap peningkatan fungsi motorik anak, memperluas partisipasi sosial, serta memperkuat kepatuhan dalam menjalankan latihan di rumah. Integrasi antara terapi medis dan pendekatan berbasis keluarga juga memberikan dampak positif berkelanjutan pada efektivitas terapi dan kesejahteraan psikososial anak. Simpulan: Terdapat pengaruh positif dari integrasi terapi medis dengan model rehabilitasi berbasis keluarga dalam meningkatkan fungsi motorik, partisipasi sosial, dan kepatuhan latihan rumah pada anak dengan cerebral palsy spastik. Saran: Strategi rehabilitasi yang melibatkan dukungan keluarga secara aktif perlu diterapkan secara luas untuk meningkatkan efektivitas terapi dan kualitas hidup anak. Kata Kunci: Berpusat Keluarga; Model Rehabilitasi; Spastisitas Cerebral Palsy (CP); Terintegrasi Terapi Medis.

Evaluasi ketepatan dan keamanan terapi obat kardiovaskular pada lansia program rujuk balik (PRB) Listiyanti, Melly; Priyanto, Priyanto
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1600

Background: The elderly population is a vulnerable age group prone to degenerative diseases, including cardiovascular diseases, which are the leading causes of global morbidity and mortality. The management of cardiovascular diseases in the elderly requires special attention to the accuracy and safety of drug therapy to prevent dangerous complications. Purpose: To evaluate the accuracy and safety of cardiovascular drug therapy in elderly patients enrolled in the referral back program. Method: This study employed a descriptive-comparative observational design with a quantitative approach. Data were collected using total sampling from elderly patients during the study period. The variables analyzed included drug accuracy, dosage, frequency, timing, and therapy safety related to adverse effects and drug interactions. Results: The study showed drug accuracy of 99.22%, dosage accuracy of 86.82%, frequency accuracy of 100%, and timing accuracy of 92.00%. Reported adverse effects included leg edema (2.4%), dry cough (1.6%), muscle pain (2.8%), and severe dizziness (0.4%). Drug interaction categories were identified as major (9.63%), moderate (67.45%), and minor (22.91%). Conclusion: The accuracy of cardiovascular drug therapy in elderly patients was generally good; however, safety aspects particularly those related to adverse effects and drug interactions require greater attention in clinical practice. Keywords: Cardiovascular; Safety; Accuracy; Elderly; Referral Program . Pendahuluan: Lansia merupakan kelompok usia yang rentan terhadap penyakit degeneratif, termasuk penyakit kardiovaskular yang menjadi penyebab utama morbiditas dan mortalitas global. Penatalaksanaan penyakit kardiovaskular pada lansia memerlukan perhatian khusus terhadap ketepatan dan keamanan terapi obat untuk mencegah komplikasi yang berbahaya. Tujuan: Untuk mengevaluasi ketepatan dan keamanan terapi obat kardiovaskular pada pasien lansia yang terdaftar dalam program rujuk balik (PRB). Metode: Desain observasional deskriptif-komparatif dengan pendekatan kuantitatif. Data dikumpulkan melalui total sampling pada pasien lansia selama periode penelitian. Variabel yang dianalisis meliputi ketepatan obat, dosis, frekuensi, waktu, serta keamanan terapi terkait efek samping dan interaksi obat. Hasil: Ketepatan obat sebesar 99.2%, ketepatan dosis 86.8%, ketepatan frekuensi 100%, dan ketepatan waktu 92.0%. Efek samping yang ditemukan adalah kaki bengkak (2.4%), batuk kering (1.6%), nyeri otot (2.8%), dan pusing berlebih (0.4%). Interaksi obat kategori mayor ditemukan sebesar 9.6%, moderat 67.5%, dan minor 22.9%. Simpulan: Ketepatan terapi obat kardiovaskular pada lansia tergolong baik, namun aspek keamanan, khususnya terkait efek samping dan interaksi obat, masih memerlukan perhatian lebih dalam praktik klinis. Kata Kunci: Kardiovaskular; Keamanan; Ketepatan; Lansia; Program Rujuk Balik (PRB).

Risiko jatuh lansia berbasis aktivitas harian dan machine learning Indrawati, Endah; Lilyanti, Henny; Puspita, Nita
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1614

Background: Falls are a major health problem in older adults, with serious physical and psychological consequences. Identifying fall risk factors is crucial to support prevention efforts, particularly for older adults in nursing homes. Purpose: To analyze fall risk scores for older adults based on daily activities and machine learning. Methods: The study used a mixed methods design with 31 elderly respondents in nursing homes. Quantitative analysis was conducted using logistic regression, ROC, and Spearman Rank correlation. Qualitative data were obtained through in-depth interviews and analyzed thematically. Results: Logistic regression analysis showed that the Timed Up and Go Test (TUGT) was a significant predictor of fall risk (p = 0.012; Exp(B) = 0.202), with an AUC of 0.75 and an accuracy of 73%. Qualitative findings identified six main themes: fall experience, feelings after a fall, daily activities, use of walking aids, fear of activities, and ways to prevent falls. Integration of the results demonstrated consistency between objective mobility limitations (TUGT) and the subjective experiences of older adults, who tend to limit activities due to fear of falling. Based on these findings, a simple risk score prototype was developed using the TUGT (Triggered Daily Activity Score), daily step count, activity calories, and cognitive status (MMSE) as indicators. A total score of 4 or greater is categorized as high risk for falls. Conclusion: The TUGT has been shown to be an important indicator of fall risk in older adults, but subjective experience suggests that psychological factors also play a significant role in limiting activity. The developed daily activity-based risk score has the potential to be a rapid screening tool in nursing homes, although external validation in a broader population is still needed. Suggestion: Healthcare workers and nursing home managers are advised to use this risk score as an initial screening tool and to provide preventive interventions for high-risk seniors. Future researchers are encouraged to conduct prospective validation with a larger sample size and consider integrating the risk score into wearable technology or digital applications for rapid screening and ongoing monitoring. Keywords: Daily Activity; Fall Risk; Machine Learning; Older Adults. Pendahuluan: Jatuh merupakan salah satu masalah kesehatan utama pada lansia yang dapat menimbulkan dampak serius, baik fisik maupun psikologis. Identifikasi faktor risiko jatuh menjadi penting untuk mendukung upaya pencegahan, terutama pada lansia di panti werdha. Tujuan: Untuk menganalisis skor risiko jatuh lansia berbasis aktivitas harian dan machine learning. Metode: Penelitian menggunakan desain mixed methods dengan 31 responden lansia di Panti Werdha. Analisis kuantitatif dilakukan menggunakan uji regresi logistik, ROC, serta korelasi Spearman Rank. Data kualitatif diperoleh melalui wawancara mendalam dan dianalisis tematik. Hasil: Analisis regresi logistik menunjukkan bahwa Timed Up and Go Test (TUGT) merupakan prediktor signifikan risiko jatuh (p = 0.012; Exp(B) = 0.202), dengan AUC sebesar 0.75 dan akurasi 73%. Temuan kualitatif mengidentifikasi enam tema utama, yaitu pengalaman jatuh, perasaan setelah jatuh, aktivitas sehari-hari, penggunaan alat bantu jalan, rasa takut beraktivitas, dan cara mencegah jatuh. Integrasi hasil menunjukkan konsistensi antara keterbatasan mobilitas objektif (TUGT) dengan pengalaman subjektif lansia yang cenderung membatasi aktivitas karena takut jatuh. Berdasarkan temuan ini, dikembangkan prototipe skor risiko sederhana dengan indikator TUGT, jumlah langkah harian, kalori aktivitas, dan status kognitif (MMSE). Skor total ≥ 4 dikategorikan risiko tinggi jatuh. Simpulan: TUGT terbukti sebagai indikator penting risiko jatuh pada lansia, namun pengalaman subjektif memperlihatkan bahwa faktor psikologis juga berperan besar dalam pembatasan aktivitas. Skor risiko berbasis aktivitas harian yang dikembangkan berpotensi menjadi alat skrining cepat di panti werdha, meskipun masih memerlukan validasi eksternal pada populasi yang lebih luas. Saran: Bagi tenaga kesehatan dan pengelola panti, disarankan untuk menggunakan skor risiko ini sebagai alat skrining awal serta memberikan intervensi preventif bagi lansia berisiko tinggi. Bagi peneliti selanjutnya, dianjurkan melakukan validasi prospektif dengan sampel lebih besar dan mempertimbangkan integrasi skor risiko ke dalam teknologi wearable atau aplikasi digital untuk skrining cepat dan pemantauan berkelanjutan. Kata Kunci: Aktivitas Harian; Lansia; Machine Learning; Risiko Jatuh.

Analisis indikator kriteria diagnosa keperawatan ketidakefektifan perfusi jaringan perifer dengan ankle brachial presur index lansia Supriatna, Lalu Dedy; Nadrati, Bahjatun; Oktaviana, Elisa
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1625

Background: Ankle Brachial Index (ABI) is a ratio of ankle and brachial systolic pressure that can be used to assess the severity of peripheral arterial occlusion, which is a general description of arterial blockage. If peripheral perfusion increases, it means that the adequacy of blood flow in distal blood vessels to support tissue function increases, with the outcome criteria to prove that peripheral perfusion increases, namely increased peripheral pulse strength, decreased pale skin color, improved capillary refill, improved acral, and improved skin turgor. Purpose: To analyzing the nursing diagnosis criteria indicators for ineffective peripheral tissue perfusion with ankle brachial pressure index in the elderly. Method: Cross sectional in studying the ankle brachial pressure index (ABPI) as a criterion indicator for establishing a nursing diagnosis of ineffective peripheral tissue perfusion in the elderly with a sample size of 45 respondents. The results of the bivariate test of the relationship between the nursing diagnosis criteria indicators of ineffective peripheral tissue perfusion in the elderly at the Mandalika NTB Elderly Social Service Center consisting of six independent variables, namely the results of the CRT examination, skin color, acral, Edema, Peripheral Pulse, and the results of the Edinburgh claudication questionnaire (ECQ), on the right ankle brachial pressure index. Results: Only the Peripheral Pulse has a significant relationship with the results of P Value 0.015 <0.05 and on the left ankle brachial pressure index is not much different from the results of the right ankle brachial pressure index, only the Peripheral Pulse has a significant relationship with the results of P Value 0.006 <0.05, and the other five independent variables do not have a significant relationship with the ankle brachial pressure index. Conclusion: Most respondents who have a normal peripheral pulse value in one minute will also have a normal ankle brachial index value. Keywords: Ankle Brachial Presure Index; Elderly; Peripheral tissue perfusion. Pendahuluan: Ankle brachial index (ABI) adalah ratio tekanan sistolik ankle dan brachial dapat digunakan untuk menilai severitas oklusi arteri perifer yang merupakan gambaran penyumbatan arteri secara umum. Jika perfusi perifer meningkat berarti keadekuatan aliran darah pembuluh darah distal untuk menunjang fungsi jaringan meningkat dengan kriteria hasil untuk membuktikan bahwa perfusi perifer meningkat adalah kekuatan nadi perifer meningkat, warna kulit pucat menurun, pengisian kapiler membaik, akral membaik, turgor kulit membaik. Tujuan: Untuk menganalisis indikator kriteria diagnosa keperawatan ketidakefektifan perfusi jaringan perifer dengan ankle brachial presur index lansia. Metode: Cross sectional dalam mempelajari ankle brachial pressure index (ABPI) sebagai indikator kriteria untuk menegakkan diagnosa keperawatan ketidakefektifan perfusi jaringan perifer pada lansia dengan jumlah sampel yaitu 45 responden. Hasil uji bivariat hubungan antara indikator kriteria diagnosa keperawatan ketidakefektifan perfusi jaringan perifer pada lansia di Pusat Pelayanan Sosial Lanjut Usia (PPSLU) Mandalika NTB yang terdiri dari enam variabel bebas yaitu hasil pemerikasaan CRT, warna kulit, akral, Edema, Nadi Perifer, dan hasil kuesioner klaudikasio Edinburgh (ECQ), pada ankle brachial presur index kanan. Hasil: Hanya nadi perifer yang memiliki hubungan yang signifikan yaitu dengan hasil p-value 0.015 < 0.05 dan pada ankle brachial presur index kiri tidak jauh berbeda dengan hasil ankle brachial presur index kanan, hanya Nadi perifer yang memiliki hubungan yang signifikan yaitu dengan hasil p-value 0.006 < 0.05, dan kelima varriabel bebas lainnya tidak memiliki hubungan signifikan dengan ankle barachial presur index. Simpulan: Sebagian besar responden yang memiliki nilai denyut nadi perifer normal dalam satu menit akan memiliki nilai ankle brachial index yang normal juga. Kata Kunci: Ankle Brachial Index; Ketidakefektifan Perfusi Jaringan Perifer; Lansia.

Kepuasan pasien terhadap pelayanan kesehatan rawat inap di rumah sakit: Sebuah tinjauan sistematis Taufiq, Fildzah Hashifah; Fitri, Rahmi; Prameswari, Ayu; Tari, Putri Inrian; Arifin, Jafar
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1627

Background: High patient satisfaction is crucial for healthcare institutions, with national standards in Indonesia targeting greater than 95% satisfaction in healthcare services, underscoring its importance for quality assurance. Purpose: To examine patient satisfaction with inpatient healthcare services in hospitals. Method: This literature review combined quantitative and qualitative methodologies, focusing on various determinants of satisfaction, such as service quality, communication effectiveness, healthcare professional competence, and infrastructure. Twelve studies were included, with sample sizes ranging from 39 to 476 participants. Results: Findings indicate that patient satisfaction is significantly influenced by dimensions of service quality, including tangibles, reliability, responsiveness, assurance, and empathy. Empathy emerged as the most dominant factor across all studies, underscoring the importance of personalized and attentive service. Variations in satisfaction levels were observed based on factors such as hospital type, insurance status, and demographic characteristics. Conclusion: Infrastructure quality has a variable impact, with some environments showing a significant correlation with satisfaction, while others did not. Keywords: Inpatient Healthcare; Hospital; Patient Satisfaction; Service Quality. Pendahuluan: Kepuasan pasien yang tinggi sangat penting bagi institusi pelayanan kesehatan, dengan standar nasional di Indonesia yang menargetkan kepuasan lebih dari 95% dalam layanan kesehatan, yang menggarisbawahi pentingnya hal ini untuk jaminan mutu. Tujuan: Untuk mengkaji kepuasan pasien terhadap pelayanan kesehatan rawat inap di rumah sakit. Metode: Penelitian kajian psutaka ini menggabungkan metodologi kuantitatif dan kualitatif, dengan fokus pada berbagai determinan kepuasan, seperti kualitas layanan, efektivitas komunikasi, kompetensi tenaga kesehatan, serta infrastruktur. Sebanyak 12 studi disertakan dengan jumlah sampel berkisar antara 39 hingga 476 peserta. Hasil:Temuan menunjukkan bahwa kepuasan pasien sangat dipengaruhi oleh dimensi kualitas layanan, termasuk bukti fisik (tangibles), keandalan (reliability), daya tanggap (responsiveness), jaminan (assurance), dan empati (empathy). Empati muncul sebagai faktor yang paling dominan di seluruh studi, menegaskan pentingnya pelayanan yang personal dan penuh kepedulian. Variasi tingkat kepuasan diamati berdasarkan faktor-faktor seperti jenis rumah sakit, status asuransi, dan karakteristik demografis. Simpulan: Kualitas infrastruktur memiliki dampak yang bervariasi beberapa lingkungan menunjukkan korelasi signifikan dengan kepuasan, sementara yang lain tidak. Kata Kunci: Kepuasan Pasien; Kualitas Layanan; Pelayanan Kesehatan Rawat Inap; Rumah Sakit.

Faktor risiko kejadian hepatitis B Andrean, Heppy Maulizar; Fahdhienie, Farrah; Zahara, Meutia; Ichwamsyah, Fahmi; Aramico, Basri
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1633

Background: Hepatitis B is an infectious disease that has a significant impact on public health, especially in areas with low vaccination coverage and limited knowledge. Transmission can occur through blood, body fluids, and vertically from mother to child. Purpose: To analyze risk factors associated with hepatitis B incidence. Method: A case-control study design with a sample size of 170 respondents (85 cases and 85 controls) using purposive sampling technique was conducted in North Aceh Regency. Data were collected through a questionnaire and analyzed using the chi-square test and multiple logistic regression. Results: There was no significant association between knowledge and hepatitis B incidence (p=0.071). However, there were significant associations between transmission through blood and body fluids (p=0.000), transmission through childbirth (p=0.000), community behavior and habits (p=0.001), hepatitis B vaccination (p=0.005), and the social environment (p=0.000). The most dominant factor was transmission through childbirth (OR=4.61). Conclusion: Transmission through childbirth, blood and body fluids, and community behavior are the main risk factors for hepatitis B. Preventive interventions should focus on education and increasing vaccination coverage. Keywords: Community Behavior; Hepatitis B; Risk Factors; Transmission; Vaccination. Pendahuluan: Hepatitis B merupakan salah satu penyakit menular yang berdampak besar terhadap kesehatan masyarakat, terutama di wilayah dengan cakupan vaksinasi rendah dan pengetahuan yang terbatas. Penularan dapat terjadi melalui darah, cairan tubuh, serta secara vertikal dari ibu ke anak. Tujuan: Untuk menganalisis faktor-faktor risiko yang berhubungan dengan kejadian hepatitis B. Metode: Desain penelitian case-control dengan jumlah sampel sebanyak 170 responden (85 kasus dan 85 kontrol) menggunakan teknik purposive sampling dilakukan di Kabupaten Aceh Utara. Data dikumpulkan melalui kuesioner dan dianalisis menggunakan uji chi-square dan regresi logistik berganda. Hasil: Tidak terdapat hubungan signifikan antara pengetahuan dengan kejadian hepatitis B (p=0.071). Namun, terdapat hubungan signifikan antara transmisi darah dan cairan tubuh (p=0.000), penularan dari persalinan (p=0.000), perilaku dan kebiasaan masyarakat (p=0.001), vaksinasi hepatitis B (p=0.005), dan lingkungan sosial (p=0.000). Faktor paling dominan adalah penularan dari persalinan (OR=4.61). Simpulan: Penularan dari persalinan, transmisi darah dan cairan tubuh, serta perilaku masyarakat merupakan faktor risiko utama kejadian hepatitis B. Intervensi pencegahan perlu difokuskan pada edukasi dan peningkatan cakupan vaksinasi. Kata Kunci: Faktor Risiko; Hepatitis B; Perilaku Masyarakat; Transmisi; Vaksinasi.

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Teguh Pribadi

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Jalan Pramuka No.27 Kemiling Bandar Lampung -Indonesia.

Location
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INDONESIA

Abstract

Abstract

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Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Teguh Pribadi

Contact Email teguh@malahayati.ac.id

Phone +6282282204653

Journal Mail Official holistik@malahayati.ac.id

Editorial Address Jalan Pramuka No.27 Kemiling Bandar Lampung -Indonesia.

Location Kota bandar lampung, Lampung INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Teguh Pribadi

Contact Email
teguh@malahayati.ac.id

Phone
+6282282204653

Journal Mail Official
holistik@malahayati.ac.id

Editorial Address
Jalan Pramuka No.27 Kemiling Bandar Lampung -Indonesia.

Location
Kota bandar lampung,

Lampung

INDONESIA