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Fakultas Kedokteran Universitas Brawijaya Gedung Graha Medika Lt. 1, Ruang 104
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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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Characteristics of Benign Prostatic Hyperplasia (BPH) Patients Undergoing Transurethral Resection of the Prostate (TURP) Zen Ary Prasetyo; Taufiq Nur Budaya; Besut Daryanto
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.2021.031.04.4

Abstract

Benign 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 at determining the characteristics of BPH patients who underwent TURP at Saiful Anwar General Hospital. This study is a descriptive study by collecting data of 162 BPH patients who underwent TURP from January 2015 to August 2017. 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 Lower Urinary Tract Symptoms (LUTS) (3.7%), and renal insufficiency (1.9%). As many as 58% of patients who underwent TURP had 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. 
Relationship between Knowledge and Preparedness Levels of ER Staff on Pre-Triage System Implementation Yuvita, Emilda; Fitriasari, Nikma; Harjayanti, Nofita Dwi
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.2021.031.02.8s

Abstract

The Emergency Department (ED), as the main entrance of health service access in hospitals, faces the highest infection risk and high service load due to the increasing number of patients during the Covid-19 pandemic. Implementing a pre-triage system offers a solution to deal with a surge in the number of patients who demand staff preparedness. This study aimed to determine the knowledge level on the pre-triage system and its relationship with the preparedness of emergency room staff in implementing the pre-triage system. The study was conducted with a cross-sectional approach in a private type C hospital in Malang District on all 30 ER staff as respondents. The research instrument used were questionnaires. Data analysis was done using descriptive analysis and the Fisher exact test. The results show that although 76.7% of respondents have insufficient knowledge, 86.7% of respondents are ready to implement the pre-triage system. The test results prove that there is no relationship between the knowledge and the preparedness levels of the emergency room staff in implementing the pre-triage system.
Hospital's Dental Clinic Service Readiness in Facing Covid-19 Kurniawan, Gladys; Hakim, Lukman; Al Rasyid, Harun; Djauhari, Thontowi
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.2021.031.02.1s

Abstract

This research was conducted to find the root of the problem and the solution to the inactivity of X Hospital Dental Clinic since the Covid-19 pandemic. The findings from the study are expected to be an input for the hospital to be able to immediately reopen Dental Clinic services. The research design used descriptive analysis of observation data, interviews, and literature study. The Fishbone Diagram combined with 5 WHYs is used to find the root of the problem. Determination of problem solutions using the CARL method (Capability, Accessibility, Readiness, and Leverage) through the Forum Group Discussion (FGD). The results showed that the root cause of the inactivity of X Hospital Dental Clinic since the Covid-19 pandemic was the unavailability of infrastructure in accordance with the minimum standards. Therefore, X Hospital needs to procure appropriate infrastructure and support the X Hospital Dental Clinic facilities in providing services during the Covid-19 pandemic. This procurement must be adjusted to the conditions of the space and environment around the Dental Clinic and the capabilities of the hospital. The proposed adjustment is a modification to the infrastructure that will be provided and the existing Dental Clinic facilities. The infrastructure that must be provided is related to air circulation, practice room management, and patient procedures.
Loss of Linen Stock at Puri Bunda Mother and Child Hospital: What Affects This? Drie, Ivan; 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.2021.031.02.16s

Abstract

An insufficient number of linens, lack of linen cleanliness, and untimely linen provision will affect patient satisfaction, service quality, and hospital financing. Data at Puri Bunda Mother and Child Hospital Malang showed 108 linen loss incidents from the initial stock of 792 linens. This study was conducted to identify the factors that influence linen loss at Puri Bunda Mother and Child Hospital Malang. The root of the problems was identified through observations, interviews, and Focus Group Discussion (FGD) with the laundry staff, followed by analysis using a fishbone diagram and creating a Pareto diagram to select the main root of the problems. The study results indicate the absence of hospital policies that regulate the technical management of linen, weak evaluation monitoring, and inadequate linen management planning that contribute to the incidence of linen loss.
Completeness of Medical Record Documents: Exploration on Causes and Solutions Syukria, Orin Annahriyah; 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.2021.031.02.11s

Abstract

The delay in returning inpatients' medical record documents (MRDs) to the medical records subdivision can cause some effects. This study was conducted to explore MRD completeness and the factors causing the delays in returning the document. This study used a descriptive observational method. Exploration was carried out on 21 MRDs using a checklist as an instrument. Besides, data were obtained through interviews involving the heads of related subdivisions and surveys on 52 nurses. Data were collected using an interview guide and a nursing work index-revised (NWI-R) instrument adapted into Indonesian. MRDs returned on time were complete in content and form than documents returned late to the medical records subdivision. One of the root causes of this problem is the officer factor, in this case is the nurse. The result of the NWI-R assessment is 3.15 (a maximum score of 4), meaning that the work environment in X Hospital supports nurses in carrying out their duties well. The highest score, 3.31, is the nurse-doctor relationship factor. The lowest value, 2.93, is the factor of resources adequacy to provide quality services. The possible solutions are to carry out routine briefings related to filling in and returning DRM followed by training.
Why Do Inpatient Visits Decrease during the Covid-19 Pandemic? A Case Study in Hospital, Malang Regency Lukito, Anggun Agatha Cristy; 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.2021.031.02.3s

Abstract

The Covid-19 pandemic has caused a decreasing number of non-Covid-19 inpatient visits in almost all hospitals, including the hospital where the study was conducted, which experienced decreasing Bed Occupancy Rate (BOR) up to 35.5%. This study aimed to identify the factors causing the decrease in the number of inpatients at the hospital. The research was conducted using a case study approach at a type D hospital in Malang Regency. Data was collected through a Focus Group Discussion (FGD) analyzed using a Fishbone Diagram combined with 5 whys and triangulation using secondary data and surveys. FGD respondents determined were eight respondents consisting of the Head of Inpatient Room, the Coordinator of Inpatient Room, the Coordinator of Outpatient, the Head of the Public Relations and Marketing Unit, and the Coordinator of the Admission Department. The results show that the causes can originate from human, method, market, and environmental aspects. Distrust in hospitals is caused by negative stigmatization and instructions to delay hospital services and communication barriers due to media as a consequence of implementing health protocols.
Causes of Decreasing Hospital Visit during the Covid-19 Pandemic Megawati, Devvy; Ratri, Devita Rahmani; Erzi, Alfan
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.2021.031.02.2s

Abstract

The problem of decreasing bed utilization resulted in a decrease in hospital income during the Covid-19 pandemic, including in a class D private hospital, Tulungagung, that experienced a 32.5% decrease in revenue. The decrease in hospital income has made the hospital suffer losses and, at the same time, threatened the cash flow, the operating expenses, and the continuity of service operations. The study was conducted to identify the root cause of the decreasing patient visits at the hospital. The research was conducted with a case study approach at a private hospital in Tulungagung in September and October 2020. The data were collected using a Focus Group Discussion (FGD) with eight respondents who were determined based on purposive sampling. Data were analyzed using Fishbone diagrams and priorities were set based on cumulative percentages. The public's stigma about hospitals during the Covid-19 pandemic and the cost of rapid tests are the two root causes that are suspected of contributing to the decline in patient visits at the hospital.
Key Strategies to Reduce Waiting Time in Outpatient Pharmacy Rahmawati, Menis; 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.2021.031.02.10s

Abstract

Waiting time in the outpatient pharmacy is still a problem in hospitals. This study aimed to identify the root causes and implement solutions to reduce the waiting time at a type C hospital. This study applied a descriptive approach. The potential causes were identified using HFMEA (Healthcare Failure Mode Effect and Analysis) confirmed through an online survey on 15 staff involved in pharmacy services. Scoring and Focus Group Discussion were used to identify the priority problems and solutions. The study results revealed six causing factors of the lengthy waiting time at the outpatient pharmacy, which were doctor's schedule, absence of specific time target for each drug preparation stage, changes of the drug storage, drug stock different from the planning, incomplete standard operating procedures, and one counter for prescription collection and drug dispensing. Three solutions were implemented in six days: checking drug stock in every shift, developing an SOP, and separating the counters for prescription collection and drug dispensing. The implementation results showed a significant increase in the waiting time percentage of compounded drugs, which met the standard (≤60 minutes) from 26% to 43%. This increase was even higher for non-compounded drug waiting time (<20), from 27% to 48%. Drug stock checking, procedure standardization, and separation of service counters are the keys to reducing outpatient pharmacy waiting time.
Role of Stocktaking Application using Barcode Scanning in Improving Stock Conformity in Hospital Pharmacy Installation Halim, Ratna Suryati; Fitriasari, Nikma
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.2021.031.02.12s

Abstract

One of the most important managerial activities for hospitals is an internal control activity for drug supplies, including during the Covid-19 pandemic. A preliminary study at Graha Sehat Medika hospital (GSM hospital) showed that the inaccuracy of stocktaking results in the last six months was 40% -70%. The solution taken is the use of "SO PINTAR RS" application with barcode scanning. The purpose of this study was to determine the effectiveness of "SO PINTAR RS" application with barcode scanning in improving the accuracy of the stocktaking results at GSM hospital. The method used in this research is quasi-experimental. The data used is primary data from stocktaking activities in July-November 2020. A total of 162 drug items were used as research samples taken from the purposive sampling technique. The discrepancy between drug items in the hospital management information system (HIS) and the physical count results before and after using the application was measured in this study. The analysis of the results was carried out through nonparametric statistical tests with the Wilcoxon test. The results showed a significant difference in the results of stocktaking activities before and after using "SO PINTAR RS" application (p <0.001). The difference between the calculation results of the stocktaking with the data in the HIS decreased significantly. In addition, using this application can reduce the number of staff involved and reduce the loss of uncounted medicine items. This application is still not linked to HIS, so it is necessary to manually merge the results into HIS.
Factors Contributing to Length of Stay Prolongation among Emergency Room Patients during the Covid-19 Pandemic: A Study at Persada Hospital Simanungkalit, Sylvia Kitty; Holipah, Holipah; Dewanto, Aryo; David, David
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.2021.031.02.4s

Abstract

Extended length of stay (LOS) in the Emergency Department (ED) results in crowding, potentially causing adverse events and patient dissatisfaction. The Covid-19 pandemic has forced hospitals to implement screening procedures that can extend the LOS of patients in the ED. This study aimed to provide an overview of changes in ED LOS during the pandemic and its contributing factors. This study used a descriptive approach through observation and interviews. LOS observations were conducted using the time & motion study method to determine the average time in each ED stage. The observation results identified the differences in the average LOS during the Covid-19 pandemic, which was 2 hours 39 minutes 52 seconds, and the longest time was on laboratory examination (2 hours 59 minutes 27 seconds). A lengthy laboratory examination duration is due to the additional laboratory examination procedure (serology) for SARS COV-2, suboptimal screening team, and the absence of notification in the hospital information system.

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