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Clinical Practices and Hospital Management
Published by Universitas Airlangga
ISSN : -     EISSN : 3163303X     DOI : 10.20473/cphm.v2i1.85755
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The journal encourages submissions from scholar-practitioners and professionals who contribute to the fields of Medical Innovations and Technologies, Clinical Practices and Patient Care, Healthcare Management and Policy, Ethical Issues in Healthcare, and Healthcare Informatics and Telemedicine, as well as excellent service related to Health Prevention and Promotion, particularly in Healthcare services.
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Articles 20 Documents
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Family Perspectives on ICU–ICCU Nurses’ Assertive Communication at Universitas Airlangga Hospital for Service Excellence Kartika Nurhayati; Syaifuddin Kurnianto
Clinical Practices and Hospital Management Vol. 1 No. 1 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i1.75611

Abstract

Assertive communication by staff in intensive care units (ICU–ICCU) is essential for delivering family-centered care and achieving service excellence. This study aimed to explore patient families’ perceptions of ICU–ICCU nurses’ assertive communication at Universitas Airlangga Hospital, Surabaya. A quantitative descriptive-analytic design was employed involving 30 purposively selected family members. Data were collected using a validated 10-item assertive communication questionnaire (α = 0.93; r = 0.514–0.929) and analyzed using descriptive statistics, one-sample t-test, one-way ANOVA, and Pearson correlation. The mean total assertive communication score was 36.9 ± 3.7, with 74.2% of respondents rating the nurses’ communication as very assertive. The highest-rated indicators were empathetic listening (mean = 3.87) and comfort in asking for help (mean = 3.80), while openness to criticism received the lowest rating (mean = 3.07). A one-sample t-test showed the mean score was significantly higher than the theoretical midpoint of 25 (t(29) = 17.80; p < 0.001). No significant differences were found based on gender, age, education, or duration of accompaniment. However, a significant difference was observed based on the respondent’s relationship to the patient (F(3, 26) = 3.40; p = 0.032). Although ICU–ICCU nurses were generally perceived as highly assertive communicators, the low rating for feedback openness reveals a relational gap. Assertive communication training should therefore emphasize not only clarity and confidence, but also empathy, receptiveness to criticism, and inclusive, relationship-centered approaches to strengthen family engagement in care.
Preventing Employee Turnover in Hospital Management: Preliminary Study Mochamad Kevin Romadhona; Rachmat Dimas Oktafenanda; Soekkyu Kim; Noureldin Samy Elkhashab
Clinical Practices and Hospital Management Vol. 1 No. 1 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i1.75643

Abstract

Turnover intention can be triggered by organizational and job factors. there are several studies related to work factors, namely, job involvement and organizational citizenship behavior while to organizational factors namely employee engagement, job involvement or employee work involvement is a form of responsibility or full commitment of employees in involving themselves through roles and concern with their work both in terms of physic, knowledge, and emotional. The research used a quantitative research approach, and the analytical method used validity and reliability tests as a measure of accuracy instruments in the measurement and testing of data collection tools and as a test tool to determine consistency instrument measurement.
The Impact of Reverse Osmosis Water on the Prognosis of Dialysis Patients at Universitas Airlangga Hospital, Indonesia Motoi Adachi; Muhammad Amin; Yuichiro Ide; Yuji Nishikubo; Makoto Abe; Rifky Maulana; Ardian Cahya Laksana; Wiwin Is Effendi; Yoshimitsu Tsutsumi; Makiko Suzuki; Rei Matsui; Harumichi Higashi
Clinical Practices and Hospital Management Vol. 1 No. 1 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i1.75931

Abstract

Mortality after introducing hemodialysis was high at the beginning of the project. St Mary’s hospital has started the cooperation to improve Reverse Osmosis (RO) water, by changing the hemodialysis circuit to the hygienic piping route, verifying bacteriological tests with adequate sampling, and introducing endotoxin filter. The above interventions were only implemented in ward 1 but not in ward 6. Totally, 415 patients who had hemodialysis from March 2018 to December 2023 were enrolled. 181 patients were in Ward 1 and 234 were in ward 6. These patients were followed until they dropped off. Biochemical data from 68 patients and culture and endotoxin data from RO water were analyzed at the available period of the month.  The outcome of ward 1 became better than that of ward 6 and the improvement of prognosis was more obvious under 55 patients. The viable bacteria data in RO water showed the eminent fluctuations in Ward 1. Biochemical data were not significantly different, except for the anemia level. Endotoxin level was drastically improved and have reached National standards. The improvement of RO water was attributed to the better prognosis and its effect was more obvious in younger patients. Further study is needed to clarify factors, such as renal function, complications of patients.
In Silico Insight of Endothelin Signaling in Idiopathic Pulmonary Fibrosis (IPF) Wiwin Is Effendi; Andreas Haryono; Gusti Rizky Teguh Ryanto; Ratih Paramita Suprapto; Tatsuya Nagano
Clinical Practices and Hospital Management Vol. 1 No. 1 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i1.75932

Abstract

Idiopathic pulmonary fibrosis (IPF), a form of interstitial lung disease (ILD), is characterized by progressive lung scarring with a poor prognosis. Endothelin signalling has emerged as a key player in lung fibrogenesis under various pathological conditions. However, its specific contribution to IPF pathogenesis remains poorly elucidated. We propose that leveraging in silico modelling approaches can provide valuable insights into the role of endothelin signalling in IPF, potentially paving the way for novel therapeutic and diagnostic strategies. We employed datasets curated from the Gene Expression Omnibus (GEO) database. Comprehensive data analyses from lung, bronchoalveolar lavage cells, blood and human primary fibroblast samples from both control and IPF patients were utilized to uncover the expression patterns and clinical correlations of endothelin genes. Furthermore, single-cell RNA-sequencing (scRNA-seq) was leveraged to explore the cellular heterogeneity and specific cell types harboring aberrant endothelin expression in the IPF lung microenvironment. Our analysis revealed a significant changes of endothelin genes expression pattern in IPF patient samples as compared to healthy control. Notably, IPF patients with upregulation of endothelin-1, demonstrated a statistically significant poorer survival. These findings implicate endothelin signalling as a novel and potentially targetable pathway in IPF. Further investigations are warranted to validate these findings and explore the therapeutic potential of modulating endothelin signalling in this lung disease.
The Correlations Between Brand Image and Patient Loyalty at the Universitas Airlangga Hospital Yuni Hisbiyah; Prisma Andita Pebriaini; Fatimatuz Zahro
Clinical Practices and Hospital Management Vol. 1 No. 1 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i1.75951

Abstract

The rapid progression of technology and information has revolutionized public awareness and decision-making in healthcare, leading people to become more discerning based on perceived competency and brand reputation rather than only on cost or proximity. This research examines the correlation between brand image and patient loyalty at Universitas Airlangga Hospital (RS UNAIR), a teaching hospital in Surabaya that has seen substantial development since its inception in 2018. Data were acquired using a cross-sectional observational approach using questionnaires provided to 80 outpatient visitors (general and BPJS patients) chosen via purposive selection. The independent variable, brand image, was evaluated by hospital choice, strength, and uniqueness, whilst the dependent variable, patient loyalty, was quantified by interest in repeat visits and the propensity to suggest the hospital. Statistical analysis included descriptive and correlation tests, with significance established at p < 0.05. The findings revealed that patients with over three years of visits reported a more robust brand image than fresher patients. The research revealed that, while a favorable brand image correlates with increased competitiveness, employee morale, and public trust, there is no statistically significant relationship between brand image and patient loyalty. The results indicate that while brand image affects the hospital's reputation, other variables may impact long-term patient loyalty.
Analysis of Nursing Care for Chemotherapy Patients through the Implementation of Telenursing to Reduce the Risk of infection at Universitas Airlangga Hospital Esa Rilasti
Clinical Practices and Hospital Management Vol. 1 No. 2 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i2.76066

Abstract

Cancer patients have an increased risk of infection caused by treatment and also by the malignancy itself. Cancer treatments such as chemotherapy, radiotherapy and surgery are known to increase the incidence of local to systemic infections and lead to death. The purpose of the study is to analyze the application of whatsapp-based telenursing to overcome the risk of infection in chemotherapy patients at Airlangga University Hospital. The study used a descriptive analysis that described case management by applying evidenced-based nursing using a nursing care process approach to Mr. G with stage IIIA anorectal cancer postoperatively, Low Anterior Resection, Colotranversostomi and open systotomy-railroading urethra et causa iatrogenic injury who was undergoing chemotherapy on the first cycle of FOLFOX regimen. Data collection was carried out for 14 days, 3 days at the hospital from January 24 to 26, 2024, continued for up to 11 days while the patient was at home with infection prevention interventions using telenursing from January 27 to February 5, 2024 including complaints related to infection or chemotherapy side effects, wound conditions and colostomy, laboratory results, education to increase nutritional intake,  Hand washing education is carried out with leaflet and video media via telenursing. Evaluation after infection prevention intervention through telenursing while at home, the patient did not experience infection as evidenced by the achievement of the criteria for increased hand and body hygiene results, no fever, redness, swelling in the wound, leukocyte results, and normal amounts of neutrophils. Telenursing expands the range of infection prevention monitoring in chemotherapy patients so that morbidity and mortality can be reduced. There is no doubt that telenursing is the solution of the future in opening communication barriers that support the implementation of comprehensive nursing care.  
Potential Role of Ferritin Levels in Distinguish the Severity and Predict the Outcome of COVID-19 Patients Rinaldy; Resti Yudhawati
Clinical Practices and Hospital Management Vol. 1 No. 1 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i1.77793

Abstract

Ferritin is a key mediator of immune dysregulation through its direct pro-inflammatory effects, which contribute to inflammatory cytokine storms and tissue damage. This study aims to analyze ferritin roles in distinguish the severity and predict the outcome of COVID-19 patients. An observational analytic study, using a cross-sectional design, enrolled 142 patients which subsequently divided into a non-severe (mild to moderate cases) and a severe (severe to critically ill cases) group. The levels of ferritin was examined using Enzyme Immunoassay Test Kit on the first day patients was hospitalized. Mann Whitney test was used to analyze the correlation between ferritin levels with severity and outcome of COVID-19 patients. The median of ferritin level was higher in the severe group (1532.1 ng/ml, SD= 1715.552) compared to non-severe group (413.3 ng/ml, SD= 459.804) with a statistically significant difference (p< 0.001), cut off point of 865.1 ng/ml, sensitivity of 86.96% (95% CI: 76.68%–93.86%), and specificity of 87.67% (95% CI: 77.88%–94.20%). Ferritin levels were also higher in non-survivors (1496.55 ng/ml, SD = 1798.677) than in survivors (662.05 ng/ml, SD = 1293.026), with a significant difference (p < 0.001), cut off point of 1032.85 ng/ml, sensitivity of 63.33% (95% CI: 43.86% to 80.07%), and specificity of 63.39% (95% CI: 53.76% to 72.29%). This results showed that ferritin levels may not good enough to predict the outcomes, with Contingency coefficient of 0.244 that showed a very weak correlation. The baseline ferritin levels at admission was closely related to the severity of COVID-19, thus it may be considered a potential biomarker for assessing disease severity. However, ferritin levels appear to be insufficiently accurate for predicting clinical outcomes in COVID-19 patients.  
From Passive to Transformative: Applying Brain-Based and Personalized Learning Strategies in Residency Education Hermanto Tri Joewono
Clinical Practices and Hospital Management Vol. 1 No. 2 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i2.81130

Abstract

Residency training is increasingly challenged by complex healthcare demands, limited clinical exposure, and the diverse learning styles of Generation Z trainees. Traditional apprenticeship models such as “see one, do one, teach one” no longer provide adequate safety or depth of learning in modern hospitals. This paper proposes an integrated conceptual framework Active Personalized Outcome-based Learning (APOL), D4P4 procedural mastery, and Brain-Based Learning (BBL) to humanize and optimize postgraduate medical education. APOL emphasizes personalization, reflection, and supportive feedback; D4P4 provides a structured scaffold for procedural skill acquisition; and BBL explains the neuroscientific basis for psychological safety, visualization, and empathy in learning. Together, they create a learning ecosystem that is outcome-oriented, psychologically safe, and aligned with how the brain naturally learns.
Advancing Echocardiography for Precise Heart Failure Diagnosis and Management: A Comprehensive Review Emildha Dwi Agustina; Dian Paramita Kartikasari
Clinical Practices and Hospital Management Vol. 1 No. 2 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i2.81194

Abstract

Heart failure (HF) is a prevalent and complex clinical syndrome demanding accurate and timely diagnosis due to its high morbidity, mortality, and substantial healthcare burden worldwide. Echocardiography, as the premier non-invasive cardiac imaging modality, plays a central role not only in the initial diagnosis but also in longitudinal monitoring throughout the spectrum of HF. Traditionally, Left Ventricular Ejection Fraction (LVEF) has served as the cornerstone for HF classification into three key phenotypes—Heart Failure with reduced Ejection Fraction (HFrEF, LVEF ≤40%), mildly reduced Ejection Fraction (HFmrEF, LVEF 41–49%), and preserved Ejection Fraction (HFpEF, LVEF ≥50%). While this remains clinically essential, emerging evidence highlights significant limitations of relying solely on LVEF, particularly in the detection of early or subtle myocardial dysfunction. Advances in echocardiographic technology have shifted the field toward more refined and quantitative evaluation of cardiac performance. Techniques such as Global Longitudinal Strain (GLS), three-dimensional (3D) volumetric imaging, and Point-of-Care Ultrasound (POCUS) provide enhanced diagnostic precision and prognostic insight across diverse HF populations. The clinical application has proven particularly valuable in challenging scenarios including Acute Decompensated HF (ADHF), HF in individuals with Atrial Fibrillation (AF), and Cancer Therapy-Related Cardiac Dysfunction (CTRCD), where conventional methods are often insufficient. Recent scientific data strongly support the use of strain-based imaging for earlier detection of myocardial injury, more accurate risk stratification, and improved guidance of therapeutic decision-making, reinforcing the expanding and transformative role of echocardiography in contemporary HF care.
Behind the Hospital–Insurance Deal: Untangling Indonesia’s Legal Maze Zahry Vandawati Chumaida; Mochamad Kevin Romadhona; Bambang Sugeng Ariadi Subagyono; Alaa Basil Baqer Alfadhel
Clinical Practices and Hospital Management Vol. 1 No. 2 (2025): Clinical Practices and Hospital Management
Publisher : Rumah Sakit Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cphm.v1i2.81933

Abstract

This study examines the legal framework governing cooperation agreements between hospitals and health insurance companies in Indonesia. These agreements play an essential role in regulating the provision and financing of healthcare services for insured patients, yet they often operate within a fragmented and inconsistently applied regulatory environment. Using a juridical-normative approach, the research analyzes relevant legislation, contractual principles, and doctrinal interpretations to understand the legal nature, structure, and implementation challenges of such agreements. The findings reveal significant regulatory gaps and a lack of harmonization between health-sector and insurance-sector rules, which contribute to legal uncertainty and inconsistent contractual practices. The study also identifies administrative burdens, information asymmetry, and weak dispute-resolution mechanisms as major obstacles in the implementation of these agreements. Based on these findings, the research proposes several improvements, including regulatory standardization, enhanced institutional coordination, more efficient dispute settlement procedures, and stronger transparency and consumer protection measures. Overall, the study contributes to a deeper understanding of the legal dynamics of hospital–insurance cooperation and offers recommendations for strengthening legal certainty, contractual fairness, and the effectiveness of healthcare financing in Indonesia.

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