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INDONESIA
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 822 Documents
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Clinical Response of Convalescent Plasma Therapy in COVID-19 Patients in Dr. Saiful Anwar General Hospital Burhan, Niniek Budiarti; Brahmantyo, Herwindo Pudjo; Hermanto, Djoko Heri; Arsana, Putu Moda
Jurnal Kedokteran Brawijaya Vol 31, No 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.04.5

Abstract

The use of convalescent plasma has been beneficial for more than a century to treat various infections.  The lack of effective treatment currently available for COVID-19 has reemerged the use of convalescent plasma as a potential therapeutic option. This is an observational descriptive study in 13 COVID-19 patient who got convalescent Plasma. Consist of 11 (84%) male patient, 2 (16%) female patient. Divided into two groups based on severity, and outcome. 38% patient included in severe disesase and 62% patient in critically Ill condition. 30% patient who got convalescent plasma deceased, and 70% had a resolve condition.
Case Report: Penoscrotal Hypospadias, A 10- Year Follow-Up Alam, Danu Caraka; Wikanto, Dodo
Jurnal Kedokteran Brawijaya Vol 31, No 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Penoscrotal hypospadias, a severe congenital abnormality, can interfere with urinary, sexual, and aesthetic functions. This paper reports a 10-year follow-up of a penoscrotal hypospadias case undergoing urethroplasty using the Koyanagi-Nonomura technique. After surgery, side effects of fistula that caused urinary problems and infection were found. Urethroplasty repair and catheter stenting were performed and provided fistula recovery and urination function, as well as normal penis size.
Characteristics of Benign Prostatic Hyperplasia (BPH) Patients Undergoing Transurethral Resection of the Prostate (TURP) Prasetyo, Zen Ary; Budaya, Taufiq Nur; Daryanto, Besut
Jurnal Kedokteran Brawijaya Vol 31, No 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

ABSTRACTBenign prostatic hyperplasia (BPH) is one of the most common diseases affecting the elderly, and Transurethral Resection of the Prostate (TURP) is a gold standard surgical procedure in BPH patients. Although the TURP rate is high, the publication of TURP profile data in Indonesia is still limited. This study aimed to determine the characteristics of BPH patients who underwent TURP at Saiful Anwar General Hospital. This study is a descriptive study by collecting data of BPH patients who underwent TURP from January 2015 to August 2017. As many as 162 patients with BPH underwent TURP. TURP is primarily performed in patients aged 61-70 years (39.5%). Recurrent urinary retention was the most common indication for the procedure (54.9%) followed by bladder stone (21%), pharmacological therapy failure (10.5%), inguinal hernia (8%), severe LUTS (3.7%), and renal insufficiency (1.9%). As many as 94 patients (58%) have a prostate volume higher than 50 ml. Urinary retention is the most common complaint among BPH patients who underwent TURP, and recurrent urinary retention is the most common TURP indicator.
Factors Associated with Fatigue in Chronic Kidney Disease Patients Undergoing Hemodialysis: A Systematic Review Prastiwi, Firman; Wihastuti, Titin Andri; Ismail, Dina Dewi Sartika Lestari
Jurnal Kedokteran Brawijaya Vol 31, No 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Fatigue is the primary complaint most frequently reported by patients on hemodialysis. The importance of knowing the factors related to fatigue is a strategy that can be carried out by health workers in optimally applying interventions to reduce patient fatigue problems. This systematic review aimed to determine the factors associated with fatigue in patients undergoing hemodialysis. The systematic review method began by identifying research articles in the Pubmed, ProQuest, Ebsco, and ScienceDirect databases in 2011–2020. Articles were selected using PRISMA. Based on the results of the analysis, it was obtained 23 articles that discussed demographic factors, physiological factors, socioeconomic factors, situational factors, and psychological factors that could be associated with fatigue in hemodialysis patients. There is much to learn about fatigue in patients undergoing hemodialysis, including causative factors, assessment of severity, and effective management of fatigue so that it can be used as a benchmark for determining appropriate interventions
Development of Caesarean Section Clinical Pathway : a lesson learnt Sastrawan, I Gede
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Clinical pathway is a crucial clinical management strategy aimed to ensure quality and cost. However, the development of clinical pathway at the hospital was mainly for administrative purpose as it is required by accreditation standards leading to high variation. Study aims to develop clinical pathway for caesarean section and explore the problem during development and initial implementation (simulation). The selection of caesarean section is based on its high volume, risk, and cost. Using participatory action research, the researcher started the program by performing literature review and regulation to proposed the first revised version draft. A group of relevant expert in the hospitals than discuss and proposed review, considering the available resources, current practice and behavior. The main differences of the new clinical pathway are: 1) it was developed based on literature and current practice, 2) adding notification, explanation, inclusion and exclusion criteria, and references.  Before initial implementation (simulation), the hospital also develop a procedure operational standards for the implementation, resources, and monitoring.  The first simulation on two cases found differences in type of medication and documentation method, which than further discussed with all care providers involved to define the agreed solution. Professional engagement and openness culture that embrace along the process are the main important key lesson learnt in addition to the understanding that clinical pathway development and implementation is a continuous learning process. Therefore continuous monitoring and evaluation is of paramount important to reach quality and efficiency, the ultimate goals of clinical pathway.
Factors Affecting Patient's Length of Stay In The Era Of Covid-19 Pandemic In Emergency Room Persada Hospital Simanungkalit, Sylvia Kitty; Holipah, Holipah; Dewanto, Aryo; David, David
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Length of stay (LOS) of a patient in an Emergency Room (ER) is the interval between the time the patient arrives and the time the patient physically leaves the ER. Prolonged LOS has potential to cause crowding. Meanwhile, from a clinical point of view, the factor of LOS has an impact on service suspension, which can reduce patient safety, even to death. Covid-19 pandemic has made hospitals establish a strict patient screening system and has the potential to increase the LOS of patients in the ER. The purpose of this study was to identify the factors that contribute to the LOS of patients. This study is an observational study of 38 respondents who came to the Emergency. LOS was compared between before and during Covid-19 pandemic condition. Observations were carried out by the Time Motion Study method to determine the patient's average time at each stage of the ER. The results showed the average LOS for emergency room patients with inpatient plans was 2 hours 7 minutes, while the LOS during pandemic was 4 hours 46 minutes 52 seconds. There were 2 hours 39 minutes 52 seconds time extension. The time extension is due to several factors: results of laboratory tests SARS COV-2; approval process for the Covid-19 Screening Team; Emergency Room and Laboratory were located in separate buildings.
WHY VISITS OF EMERGENCY DEPARTMENT DECREASED DURING THE COVID-19 PANDEMIC? CASE STUDY IN X HOSPITALS, MALANG REGENCY Kusumawati, Anita Mardiana; widyaningrum, kurnia
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

The visits rate to the Emergency DepartmentofX Hospital in the period April to June 2020, on average, decreased by 45.11% compared to the January - March 2020 period. The study aimed to identify the factors causing the decrease in the number of the Emergency Departmentduring the Covid-19 pandemic at X hospital. This study used a qualitative descriptive approach with Focus Group Discussion (FGD) data collection techniques analyzed using Fishbone Diagram combined with 5 WHYs.The subjects were determined based on purposive sampling, namely 8 respondents consisting of Nurses, Doctors and CoordinatorofEmergency Department, Head of Public Relations and Marketing Unit, Coordinator of Security Guard and Coordinator of Patient Registration Office. The results showed that there were several root causes of the decrease in the number of the Emergency Departmentat Xhospital: Emergency departmentstaffs had difficulty in providing education about Covid-19 screening and isolation care to patients and their families, patients refused further treatment, and patients refused to go to the hospital. Thus the decrease in the number of inpatients of the Emergency Department during the Covid-19 pandemic were caused by various factors, especially the difficulty of Emergency Departmentstaffs in providing education on Covid-19 screening and its subsequent care.
Workload of The Inpatient Nurses: What Are The Affecting Factors? Asjanti, Lidia
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Tingginya beban kerja perawat dapat berdampak terhadap mutu pelayanan rumah sakit. Perawat merupakan ujung tombak pelayanan, sehingga harus mendapat perhatian dan dikelola secara profesional agar memberikan kontribusi yang positif bagi kemajuan rumah sakit. Studi ini dilakukan untuk menjelaskan faktor-faktor yang memengaruhi tingginya beban kerja perawat di Instalasi Rawat Inap Bedah dan Dalam B (IRNA BDB) RS. Baptis Batu. Metode studi kualitatif dan kuantitatif dengan pendekatan deskriptif eksploratif. Penentuan akar masalah menggunakan diagram fishbone. Faktor-faktor yang berpengaruh terhadap tingginya beban kerja perawat ruang rawat inap rumah sakit adalah jumlah perawat kurang memenuhi kebutuhan beban kerja, penempatan perawat yunior dan magang meningkatkan beban kerja perawat yang lebih senior, perawat melakukan tugas administrasi keuangan, sampling darah untuk pemeriksaan laboratorium dan dispensing sediaan steril, serta fasilitas nurse call dan kamar mandi pasien yang kurang mendukung. Kesimpulan penyebab tingginya beban kerja perawat adalah kurangnya jumlah perawat, kualitas perawat berbeda-beda, beban tugas non asuhan keperawatan serta fasilitas yang kurang mendukung.
Laboratory Service Process Checklist: Preventive Measures to Increase Blood Glucose Test Accuracy Setyawan, Yudi; Wardhani, Viera
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

The accuracy of the blood glucose test results is an important measure for hospital quality due to its effect on treatment plan, decision and outcome. This study aims to develop checklists model to improve the laboratory results accuracy. The development of the checklist was based on laboratory services process: pre-analytic, analytic, and post-analytic which further implemented for all requests for blood glucose tests during study period (65 examination) in the first week of October 2020. After the implementation, result showed no incidence of test in-accuracy when conformed with patient clinical information. Staff express that the checklist is fast and easy to complete (3-5 minutes), and beneficial. Problem occurs when the workload is high because of limited number of staff at night shift or high patient volume leading to delay in checklist completeness. Therefore, regular monitoring and evaluation was suggested to ensure compliance, in addition to dividing the checklist performed in 2 stages. The pre-analytic stage is carried out first for all patients followed by the analytical and post-analytic stages because these two activities were located in different floor. It can be concluded that the use of checklists is effective as preventive measure increase the conformity of laboratory examination results with patient clinical information.Keywords: Laboratory checklist, test accuracy, patient safety.
PRE-TRIAGE SYSTEM : A SOLUTION TO FACING SURGE OF PATIENT DURING OF COVID-19 PANDEMIC Yuvita, Emilda; Fitriasari, Nikma; Harjayanti, Nofita Dwi
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

It is difficult to predict the end of Covid-19 pandemic. The emergency department (ED) as the main access for health services in the hospital has the highest risk of infection and overwhelmed by surge of patients. Modification of the emergency service system by implementing a pre-triage system can be a solution to dealing with surge of patients. The results of the preliminary study succeeded in forming a pre-triage system model. The pre-triage system model was carried out by identifying patients with the risk of Covid-19 in ED and modification of the emergency service flow. The implementation of the pre-triage system requires the readiness of the emergency department’s team. The sample used was all staff of emergency department of X Hospital which total 30. The results showed that 23,3% of respondents had good category knowledge, 56,67 % respondents had sufficient category knowledge, and 20% had less knowledge. The level of readiness found that 90% of respondents are ready for implementation of the pre-triage system. The Chi-Square test result show that the level of knowledge of the pre-triage system is not related to readiness to implement the pre-triage system.

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