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Fakultas Kedokteran Universitas Brawijaya Gedung Graha Medika Lt. 1, Ruang 104
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Jurnal Kedokteran Brawijaya
Published by Universitas Brawijaya
ISSN : 02169347     EISSN : 23380772     DOI : http://dx.doi.org/10.21776/ub.jkb
Core Subject : Health,
Medicine & Pharmacology
JKB contains articles from research that focus on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 16 Documents
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Search results for , issue "Vol. 31 Supplement 2 (2021)" : 16 Documents clear
Factors Causing Stock-Outs and Drug Stagnation at Pharmacy Installation of Puri Bunda Mother and Child Hospital Malang Tri Utami, Ni Nyoman Ayu; Ratri, Devita Rahmani; Nuthea, Merry
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.14s

Abstract

Hospital pharmacy service is a supporting service as well as a revenue center in a hospital. More than 90% of hospital services utilize pharmaceutical supplies, and 50% of hospital revenues originate from pharmaceutical supply management. In the Covid-19 pandemic situation, the pharmacy installation must calculate the logistics management of the medicine correctly. However, based on stocktaking in May-July at Puri Bunda Mother and Child Hospital, there were stock-outs (4.06%) and drug stagnation (2.44%) due to poor drug procurement, causing declining drug sales. This study analyzed the factors causing stock-outs and drug stagnation in the Pharmacy Installation of Puri Bunda Mother and Child Hospital. This study uses a descriptive approach with data collection methods using observations, Focus Group Discussion (FGD), and Likert-scale questionnaires to find the roots of the problems. The data were analyzed using the Fishbone Diagram and Pareto Diagram. The research subjects based on total sampling were all 12 staff of the Pharmacy Installation. The results obtained through the Fishbone Diagram were 13 root causes covering the aspects of Man, Money, Method, Machine, Material, and Environment. The priority of the root cause of stock-outs and drug stagnation in the Pharmacy Installation of Puri Bunda Mother and Child Hospital Malang is the suboptimal use of the Hospital Management Information System (HMIS). The possible solutions are conducting intensive training for Pharmacy Installation staff in using HMIS, developing HMIS related to drug procurement, as well as repairing warehouse and pharmacy installation facilities and infrastructure.
Why the Emergency Department Visit Decreased during the Covid-19 Pandemic? Case Study in Hospital, Malang Regency Kusumawati, Anita Mardiana; Widyaningrum, Kurnia
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.5s

Abstract

During the 2020 Covid-19 pandemic, emergency department experienced a drastic decreasing visit that could disrupt hospital financing. This study was conducted to identify the root cause of the declining ED visit. The study was conducted descriptively from FGD involving eight selected respondents, surveys on 83 patients regarding service perceptions and satisfaction, as well as secondary data on visits and requests of discharge against medical advice. The results showed that the decreasing visit was due to the patient's refusal on treatment in the isolation room, the staff's skills to provide communication and education, and the potential of cooperation termination from partners. Those refusals were due to the patient's perception of hospital services and the differences in patient needs on health protocols resulted from the lack of individual and organizational communication. Hospitals need to build staff's skills in communication and education as well as intensive communication strategies with partners to communicate policies and service system changes so that trust and a positive image are built.
Laboratory Service Process Checklist: Preventive Measures to Increase Blood Glucose Test Accuracy Setyawan, Yudi; Wardhani, Viera
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.15s

Abstract

The accuracy of the blood glucose test results is an essential measurement for hospital quality since it affects the plan, decision, and outcome of the treatment. This study aimed to develop a checklists model to improve the laboratory results accuracy. The checklist development is based on the laboratory services processes covering pre-analytic, analytic, and post-analytic stages, which are implemented in all blood glucose test requests during the study period (65 examinations), the first week of October 2020. The implementation resulted in no incidence of test inaccuracy when conformed with patient clinical information. The staff expressed that completing the checklist is quick and easy to complete (3-5 minutes) and beneficial. The problem occurs when staff works alone, causing delays in completing the checklist. Therefore, regular monitoring and evaluation are suggested to ensure compliance and divide the checklist into two stages. The pre-analytic stage is first carried out for all patients, followed by the analytical and post-analytic stages because the last two activities were located on different floors. In short, checklists are effective as preventive measures to increase the conformity of laboratory examination results with patient clinical information.
Seven Rights of Medication Administration: Nurses' Knowledge, Attitude, and Compliance Puspitasari, Shinta Dwi; Dewanto, Aryo; Holipah, Holipah; Muliawan, Arrasyid Indra
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.9s

Abstract

Medication error becomes one of the main concerns in ensuring patient safety. In 2020, X Hospital reported medication error incidents. Although categorized near miss, the incidents should have been prevented. One of the methods to prevent medication errors is by applying the seven rights of medication administration. This study aimed to identify the inhibiting factors in the implementation of the seven rights of medication administration in X Hospital and obtain alternative solutions to those obstacles. This study used an analytic observational design with a cross-sectional design. Data were collected from observations and a survey. Observations and a survey through questionnaires to 20 nurses at X Hospital were made to see the implementation of the procedure. At the end of the data collection, interviews were conducted to find out the obstacles in the inpatient installation in applying the seven rights of medication administration. The results show that the main root causes of medication administration errors were the standard operating procedure (SOP) that has not been standardized and nurses' non-compliance behavior on the seven rights procedure. To resolve medication administration errors, the hospital manager should revise the SOP, conduct internal workshops, and perform scheduled supervision to the nurses.
How Do Hospital Staff Cope with Covid-19 at Work? A Phenomenological Study Febrianto, Wahyu; Indriani, Wiwin; Dewanto, Aryo; Holipah, Holipah
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.6s

Abstract

The Covid-19 pandemic has brought negative consequences on hospital finances, the mental health of health care workers (HCWs), and even resulted in the deaths of several health workers at Hasta Brata Hospital (HBH). This study aimed to explore the experiences of HBH's staff in dealing with the pandemic in the hospital. This research is qualitative research with a phenomenological approach. Data were collected using in-depth interviews with two of HBH's staff and then followed by the theme analysis. Hospital staff experienced job demands including emotional and physical stress at work, fear of infection, repeated conflicts with patient visitors, different mindsets among staff, increased workload, and feelings of frustration towards people who do not comply with prevention protocols. Fortunately, they had adequate job resources, ranging from the provision of personal protective equipment, nutrition improvement, and regular Covid-19 screening; update knowledge and methods of handling Covid-19; to motivational and spiritual support from HBH leaders. The staff also had strong personal resources so that they could cope with stressful work situations, feel optimistic that they could win against Covid-19, and hoped that the pandemic would end. Spiritual support embodies tawakal, an Islamic concept that gives complete surrender to God after employing maximum effort. The presence of strong job and personal resources has moderated job demands and resulted in work engagement. Tawakal is an added value for personal resources staff who finally realize that Covid-19 cannot be avoided and must be fought before surrendering entirely to God.
Development of Caesarean Section Clinical Pathway: A Lesson Learned Sastrawan, I Gede; Wardhani, Viera
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.7s

Abstract

Although clinical pathway (CP) is aimed to ensure quality and cost, the development of CP at hospitals is primarily for administrative purposes as it is required by accreditation standards, thus causing high variations in its implementation. This study aimed to develop a clinical pathway for caesarean section and explore the problem during development and implementation test. The selection of caesarean section was based on high volume, risk, and cost. Using participatory action research, the researcher started the program by performing an implementation evaluation, literature review, and regulatory development. The evaluation identified implementation discrepancies and prolonged length of stay. Based on the evaluation and literature review results, the Professional Care Provider (PCP) in the hospital conducted discussions and made suggestions by considering available resources, current practices, and behavior. The main differences of the new clinical pathway are: 1) it is developed based on literature and current practice, and 2) it should be added with notification, explanation, inclusion and exclusion criteria, and references. Before the implementation test, the hospital provide resources, develops a standard operational procedure followed by monitoring and evaluation. Differences in the type of medication and documentation method were found, which then further discussed with all involved PCP to define the agreed solutions. Professional engagement and openness culture that embraces along the process are the main key lesson learned in addition to the understanding that CP development and implementation is a continuous learning process.

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