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Medistra Medical Journal (MMJ)
Published by Institut Kesehatan Medistra Lubuk Pakam
ISSN : -     EISSN : 30263492     DOI : https://doi.org/10.35451/mmj.v2i1
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Aims and Scope Medistra Medical Journal (MMJ) Aims to disseminate conceptual thoughts or ideas, reviews and research findings obtained by academics, researchers and practitioners in the field of Medicine and Health Medistra Medical Journal (MMJ) Scope: Biomedical Science & Clinical Practice Preventive Medicine Family Medicine Occupational Medicine Bioethics Trauma and Medical Emergencies Public Health Epidemiology and Biostatistics Mental Health Clinical Nutrition Clinical Pathology Anatomical Pathology
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 42 Documents
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A Community-Based Disaster Preparedness-Based Catastrophic Emergency Management Model at Grandmed Lubuk Pakam Hospital in 2023 Ganda Impola
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/ds7gh439

Abstract

Hospitals, as vital facilities in the healthcare service system, play a crucial role in responding to disaster events, particularly large-scale catastrophic disasters. However, many hospitals in Indonesia still lack an integrated emergency management system that incorporates a community-based approach (Community-Based Disaster Preparedness/CBDP). This study aims to design a catastrophic emergency management model based on CBDP at RSU Grandmed Lubuk Pakam. This research is a qualitative study using an exploratory case study approach. Data collection techniques included in-depth interviews, participatory observations, and document reviews involving key informants such as hospital management, healthcare workers, surrounding community members, and related institutions such as BPBD and PMI. Data were analyzed thematically using the Miles & Huberman model. The results show that although RSU Grandmed has established a disaster management structure, its implementation has not been optimal due to weaknesses in training, coordination, and SOP comprehension. Community involvement in preparedness systems remains minimal, and cross-sectoral coordination has not been formally established.
The Relationship Between Medical Staff Workload and Response Time in Catastrophic Emergency Cases at Sembiring General Hospital, Deli Tua, 2023 Herlina
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/4x4dkh06

Abstract

Workload is one of the critical factors that can influence the response time of medical staff in handling emergency cases, particularly catastrophic emergencies that require immediate action. This study aimed to examine the relationship between medical staff workload and response time in catastrophic emergency cases at Sembiring General Hospital, Deli Tua, in 2023. An analytical study with a cross-sectional design was applied. The sample consisted of 40 medical staff working in the Emergency Department, selected through purposive sampling. Data were collected using a workload questionnaire and response time observation sheet, then analyzed using the chi-square test.The results showed that most medical staff experienced high workloads, while their response times tended to fall within the moderate to slow categories. Statistical analysis indicated a significant relationship between workload and response time (p < 0.05). This finding confirms that higher workloads are associated with slower response times in managing emergency patients.In conclusion, optimal workload management is essential to improve medical staff responsiveness. Hospital management should focus on fair task distribution, increasing the number of staff during peak hours, and ensuring adequate supporting facilities to provide faster, more effective, and safer emergency care for patients.
Improving General Practitioners’ Competence in Catastrophic Emergency Management through Simulation-Based Training at Grandmed General Hospital Lubuk Pakam in 2023 Peni rio Ginting
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/s5n4t088

Abstract

Catastrophic emergencies present major challenges for health care systems because they involve large numbers of victims, diverse clinical conditions, and limited resources. General practitioners, as the frontline providers in hospitals, are required to have optimal competencies in initial management, triage, resuscitation, and team coordination. This study aimed to evaluate the effectiveness of simulation-based training in improving the competence of general practitioners at Grandmed General Hospital Lubuk Pakam in 2023. The research employed a pre-test and post-test design with a quantitative approach. The study sample consisted of 30 general practitioners selected through total sampling. Data collection instruments included a knowledge questionnaire, skills checklist, and performance observation during the simulation. The findings revealed a significant improvement in the average competence scores of general practitioners after the training. The mean pre-test score was 65.3 (categorized as fair), which increased to 85.7 (categorized as good) in the post-test. Improvements were observed in several aspects: knowledge (29.6%), clinical skills (32.9%), team coordination (31.1%), decision-making (32.7%), and self-confidence (29.7%). Statistical analysis showed a significant difference (p < 0.05) between pre-test and post-test results. These findings confirm that simulation-based training is an effective method for enhancing the preparedness of general practitioners in handling disaster scenarios. In conclusion, simulation-based training has proven effective in improving the knowledge, clinical skills, and readiness of general practitioners at Grandmed General Hospital Lubuk Pakam. It is recommended that such training be conducted regularly, expanded to include other health professionals, and established as a key hospital strategy for strengthening preparedness in catastrophic emergency management.
Strategies for Improving Medical Personnel Resilience in Facing Catastrophic Emergencies at Patar Asih Hospital, Lubuk Pakam, in 2023 Herryaanto Lumbantobing
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/rk6g5n96

Abstract

Catastrophic emergencies, such as natural disasters, mass accidents, and pandemics, demand high preparedness and resilience from medical personnel in hospitals. This study aims to identify the resilience level of medical staff at RSU Patar Asih Lubuk Pakam and to formulate strategies to enhance resilience in facing catastrophic emergency situations in 2023. The research method employed a mixed-methods approach with a descriptive-analytical design. Quantitative data were collected using the Connor-Davidson Resilience Scale (CD-RISC) questionnaire administered to 120 medical personnel selected through stratified sampling. Qualitative data were obtained through in-depth interviews with 10 key informants from various hospital units. The results indicate that the majority of medical personnel have a moderate level of resilience (50%), with an average score of 28.5 out of a maximum of 40. Factors significantly influencing resilience are social support (β=0.381; p<0.01), self-efficacy (β=0.295; p<0.01), and workload (β=-0.271; p=0.015). The strategies implemented mostly focus on technical aspects, while psychosocial elements and disaster simulations remain inadequate. In-depth interviews revealed an urgent need for disaster SOPs, coping mechanism training, and psychological support for medical personnel. The study recommends a multilevel approach that includes enhancing individual capabilities, strengthening team support and organizational culture, as well as developing crisis management policies and SOPs integrated with psychosocial services. This strategy is expected to improve the resilience and preparedness of medical personnel in effectively and sustainably facing catastrophic emergencies.
Mortality Prediction Model in Sepsis Emergency: Combination of Biomarkers and Clinical Parameters at Grandmed Hospital Lubuk Pakam in 2023 Arif Sujatmiko
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/7c6yq649

Abstract

Background: Sepsis is a complex clinical syndrome and a life-threatening medical emergency with a high global mortality rate. Worldwide, sepsis accounts for an estimated 11 million deaths annually, equivalent to nearly 20% of all global deaths. In Indonesia, mortality rates in intensive care units remain between 30–60%. One of the major challenges in sepsis management is delayed diagnosis and the difficulty in identifying patients at high risk of death. Conventional prognostic tools such as SOFA or qSOFA scores are widely used, but their predictive accuracy is limited. Biomarkers such as procalcitonin (PCT), C-reactive protein (CRP), and lactate have been shown to provide diagnostic and prognostic information, yet their utility as single predictors remains insufficient. Objective: This study aimed to develop a mortality prediction model for septic patients by combining biomarkers (PCT, CRP, lactate) and clinical parameters (SOFA score) at RS Grandmed Lubuk Pakam in 2023. Methods: An observational analytic study with a prospective cohort design was conducted on 110 adult patients diagnosed with sepsis based on Sepsis-3 criteria. Demographic, clinical, and biomarker data were collected within the first 24 hours of admission. Statistical analysis included bivariate testing and multivariate logistic regression. Model performance was assessed using ROC curves, AUC, sensitivity, specificity, PPV, and NPV. Results: The overall sepsis mortality rate was 59.1%. Multivariate analysis identified SOFA ≥9 (OR=3.74; p=0.006), PCT ≥10 ng/mL (OR=2.91; p=0.028), and lactate ≥4 mmol/L (OR=4.56; p=0.001) as independent predictors of mortality. The combined model of SOFA, PCT, and lactate demonstrated the highest accuracy with an AUC of 0.91, sensitivity 85%, and specificity 83%, outperforming any single predictor. Conclusion: The integration of SOFA score, procalcitonin, and lactate substantially improves the predictive accuracy of mortality in septic patients compared to conventional approaches. This model may serve as a valuable clinical decision support tool for early risk stratification, although external validation in larger cohorts is required before routine clinical implementation.
DENGUE HAEMORRHAGIC FEVER IN PREGNANCY: MATERNAL AND PRENATAL OUTCOMES Maulinda Putri
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/t93c2r83

Abstract

Dengue infections are increasing worldwide with 20,000 deaths per year. Indonesia is also experiencing an increase in dengue cases, with 15,977 cases and 124 deaths by 2024. Laboratory confirmation of dengue infection is essential as the wide spectrum of clinical presentations, ranging from mild febrile illness to multiple severe syndromes, can make accurate diagnosis difficult. DENV infection causes pathological changes, including upregulation of proinflammatory cytokines such as interleukin 6, interleukin 8, and TNF-5, which can alter normal pregnancy physiology. Studies found that dengue fever during pregnancy triples the risk of maternal mortality and dengue infection during pregnancy is associated with a higher risk of fetal growth disorders to miscarriage. In pregnancy, the management of dengue should be through a multidisciplinary team approach.
Model for Increasing the Capacity of Emergency Response Teams in Catastrophic Emergencies at the Teaching Hospital at Grandmed Hospital, Lubuk Pakam in 2023 Lutfi Indra Jaya Sebayang
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/tktp8p22

Abstract

Catastrophic emergencies are critical conditions that require hospital readiness to provide a rapid, precise, and coordinated response. Teaching hospitals, in addition to functioning as health service centers, also play a crucial role in developing human resource capacity, including in handling large-scale disasters and emergencies. This study aims to design and develop a model for enhancing the capacity of the Emergency Response Team (ERT) in dealing with catastrophic emergencies at Grandmed General Hospital. The research method used was descriptive analytical with a case study approach, involving needs identification, initial team capacity analysis, intervention strategy formulation, and evaluation of the effectiveness of training and simulation programs. The results indicate that ERT capacity enhancement can be achieved through a combination of technical training, integrated simulations, the development of structured standard operating procedures (SOPs), and strengthening cross-unit coordination. The resulting model is able to improve individual competency and teamwork in responding to emergencies, as evidenced by improved skill evaluation scores and response speed during disaster simulation tests. Therefore, this model can be used as a reference in developing a disaster management system in teaching hospitals to realize resilient, adaptive, and patient safety-oriented health services.
Implementation of the Hospital Surge Capacity Model in Catastrophic Emergency Management at Sembiring Deli Tua General Hospital in 2023 Simion Sembiring
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/s8y6t002

Abstract

Disasters are a public health threat that can occur suddenly and cause a surge of patients exceeding the normal capacity of hospitals. This condition requires hospitals to have integrated preparedness through the concept of Hospital Surge Capacity (HSC), which consists of four main components: staff, stuff, structure, and system. This study aims to analyze the implementation of the HSC model in catastrophic emergency management at Sembiring Deli Tua General Hospital in 2023. The research design used a mixed-methods approach with a sequential explanatory strategy, beginning with the collection of quantitative data through questionnaires distributed to 85 health workers in the Emergency Department, followed by qualitative data collection through in-depth interviews with 10 key informants and field observations. Quantitative data were analyzed descriptively, while qualitative data were analyzed thematically to enrich the findings. The results show that in terms of staff, about 80% of medical personnel are considered sufficient and 65% have participated in emergency training such as BLS, ACLS, BTCLS, and PPGD, although there are still shortages of critical specialists. For stuff, the availability of emergency drugs is adequate (70%), but only 8 ventilators are available and the blood supply is limited, making the hospital unprepared for mass casualties. Regarding structure, the Emergency Department has 12 beds which are often full, disaster isolation rooms are not yet available, and ambulance access is limited. In terms of system, the hospital already has disaster SOPs, applies the START triage system, and has established fairly good external coordination; however, the last disaster simulation was conducted in 2021 and communication facilities remain limited. Overall, the implementation of HSC at Sembiring Deli Tua General Hospital in 2023 falls into the moderately prepared category, with strengths in human resources and management systems, but significant weaknesses in logistics and physical facilities. These findings highlight the need to strengthen the capacity of critical medical equipment, provide disaster isolation rooms, enhance advanced training, and conduct regular disaster simulations so that hospitals can respond optimally to catastrophic emergencies.
Integration Model of Primary and Referral Services in Catastrophic Emergency Management at Grandmed General Hospital Lubuk Pakam in 2023 Wenny Dwi Chandra
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/xa3xhf87

Abstract

Background: Catastrophic emergencies require effective integration between primary care and referral services to accelerate patient management. However, the implementation of the referral system in Indonesia still faces challenges, including limited infrastructure, human resources, and inter-facility coordination. Objective: This study aimed to analyze and develop an integrated model of primary care and referral services in the management of catastrophic emergencies at RSU Grandmed Lubuk Pakam in 2023. Methods: A mixed-method approach with a sequential explanatory design was applied. Quantitative data were collected through questionnaires distributed to 80 healthcare workers involved in the referral process, while qualitative data were obtained from in-depth interviews and focus group discussions with 15 key informants. Quantitative data were analyzed using descriptive and inferential statistics, whereas qualitative data were analyzed thematically. Results: Findings revealed that ambulance availability was considered adequate (70%), while emergency equipment (55%) and digital communication systems (40%) remained limited. Most healthcare workers had received emergency training (62.5%), yet only 48% felt confident in referral coordination. The referral process was relatively clear (60%), but inter-facility coordination (45%) and patient data integration (35%) were suboptimal. Qualitative analysis highlighted four main issues: weak integrated communication, limited trained human resources, the need for digitalization of the referral system, and insufficient cross-sector coordination. Conclusion: This study proposes an integration model consisting of four key components: (1) strengthening infrastructure, (2) enhancing healthcare workers’ capacity through training and simulations, (3) implementing an application-based referral information system, and (4) reinforcing cross-sector coordination. This model is expected to improve the effectiveness of catastrophic emergency management at RSU Grandmed Lubuk Pakam and serve as a reference for other hospitals in Indonesia
Implementation of an Interprofessional Approach in the Management of Acute Respiratory Failure in the Emergency Unit at Grandmed Hospital, Lubuk Pakam in 2023 Kangga Chandra Adi Surya
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/wz17aq24

Abstract

Acute respiratory failure (ARF) is a critical condition frequently encountered in Emergency Departments (EDs) and requires rapid and collaborative management. Although various clinical guidelines have recommended the use of technologies such as CPAP, HFNO, and non-invasive ventilation, their effectiveness heavily depends on the synergy of medical teams from different professional backgrounds. Interprofessional collaboration (IPC) has been shown to improve service quality, expedite clinical decision-making, and reduce medical errors. However, its implementation at the local hospital level—particularly in the ED of RSU Grandmed Lubuk Pakam—has not been extensively studied. This study aims to explore in depth how the interprofessional approach is applied in managing acute respiratory failure in the ED of RSU Grandmed Lubuk Pakam, as well as to identify the barriers and supporting factors. This research employed a qualitative descriptive design with a case study approach. Data were collected through in-depth interviews, non-participatory observations, and document reviews. Informants were selected purposively and consisted of physicians, nurses, respiratory therapists, and pharmacists. Data were analyzed using thematic analysis.The study revealed five main themes:(1) team coordination that occurs informally but is not yet based on formal SOPs;(2) overlapping perceptions of professional roles; (3) verbal communication that is undocumented and lacks structure; (4) barriers such as limited interprofessional training and unclear collaborative systems; and (5) supporting factors including strong interpersonal relationships and open leadership. The implementation of the interprofessional approach in managing ARF at RSU Grandmed’s ED has been functionally present but is not yet systemically optimized. Strengthening efforts through collaborative SOPs, interprofessional training, and structured communication systems are required to improve the quality of care for patients with acute respiratory failure

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