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Good work results and optimal benefits and the achievement of expected goals will be successful through effective and efficient organizational management. So that we need an effective and efficient way of hospital governance. For this reason, it is necessary to implement the principles of good corporate governance (GCG) as a guideline for implementing governance in the Tk. IV Singaraja Hospital organization. Based on the Law of the Republic of Indonesia No. 44 of 2009 states that the hospital is an institution that provides individual health services which completely plays a strategic role in realizing the highest degree of health. The purpose of this study was to determine the relationship between the implementation of good corporate governance and the performance of Tk. IV Singaraja Hospital, Buleleng, Bali, 2020. This research is a quantitative study with a cross sectional design. Based on the results of the univariate analysis of the performance of Tk. IV Singaraja Hospital, Buleleng, Bali is currently in a fairly good performance condition with a mean of 76.08 (SD 11.50 and 95% CI: 73.48-78.67) and there has been an implementation of GCG principles at the Tk. IV Singaraja Hospital with the results of applying the principle of transparency is fairly good with a mean of 19.81 (SD 2.35 and 95% CI: 19.28-20.34), accountability is fairly good with a mean of 19.00 (SD 2.97 and 95% CI: 18.33-19.67), the responsibility was fairly good with a mean of 19.21 (SD 2.75 and 95% CI: 18.59-19.82), the independence was fairly good with a mean of 18 , 89 (2.67 and 95% CI: 18.29 - 19.49), the fairness was fairly good with a mean of 20.12 (SD 2.27 and 95% CI: 19.60 - 20.63). With the interval estimation above, the fairness principle has a more dominant implementation / application. Based on the results of bivariate analysis through simple linear regression statistical tests, it was found that there was a significant relationship between the implementation of GCG principles (transparency, accountability, responsibility, independence and fairness with the performance of Tk. IV Singaraja Hospital (p = 0.0001). Based on the results of multivariate analysis through multiple linear regression statistical tests, the five principles of GCG (transparency, accountability, responsibility, independence, and fairness) can explain hospital performance by 76.2% while the rest is explained by other influencing factors. Interpretation of the relationship obtained from the implementation of GCG principles with the performance of Tk. IV Singaraja Hospital, namely: Every increase in the transparency score of 1 score, then the hospital performance score will decrease by 0.49 score. Every increase in the accountability score of 1 score, the hospital performance score will increase by 1.09 score. Every increase in the responsibility score of 1 score, then the hospital performance score will increase by 0.91 score. Every increase in the independence score of 1 score, then the hospital performance score will increase by 1.84 score. Every increase in the fairness score of 1 score, then the hospital performance score will increase by 0.43 score. From this interpretation, it was found that the principles of GCG had the greatest influence on the determination of the performance of Tk. IV Singaraja Hospital is the principle of independence. Researcher's suggestion is that the hospital's performance and the application of the principles of GCG in Tk. IV Singaraja Hospital, which is fairly good, needs to be further improved in various ways such as socialization and more sustainable unit guidance accompanied by a strong commitment between the leadership / directors and all employees in order to increase professionalism and improve the quality of hospital service
ABSTRAK
Diabetes Mellitus Tipe 2 (DM Tipe 2) adalah kelainan metabolik yang ditandai dengan hiperglikemia yang diakibatkan kurangnya sekresi insulin, resistensi insulin, atau keduanya. Kondisi hiperglikemia yang kronis dapat menyebabkan berbagai komplikasi salah satunya adalah kaki diabetik yang menjadi penyebab utama dilakukannya amputasi pada klien dengan DM tipe 2. Tujuan penelitian ini adalah untuk mengetahui pengalaman klien DM tipe 2 pasca amputasi mayor ekstremitas bawah. Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi deskriptif. Hasil analisa data menghasilkan enam tema, yaitu: perubahan dalam kehidupan setelah amputasi, respon atau perasaan terkait amputasi, mekanisme koping, dukungan sosial yang diterima, makna hidup, dan pelayanan kesehatan yang diterima. Hasil penelitian ini diharapkan dapat menjadi masukan dalam meningkatkan kualitas asuhan keperawatan melalui peningkatan dukungan rehabilitasi secara fisik, psikososial, dan spiritual pada klien DM tipe 2 pasca amputasi mayor ekstremitas bawah.
ABSTRACT
Type 2 Diabetes Mellitus (Type 2 DM) is a metabolic disorder characterized by hyperglycemia as a result of insulin deficiency, insulin resistance, or both. Chronic hyperglycemia conditions can lead complications such as the diabetic foot as a major cause of amputation in clients with type 2 DM. The purpose of this study was to determine the experience of client with type 2 DM following major lower limb amputation. This study used a qualitative method with descriptive phenomenology approach. Result of the data analysis revealed six themes: live changes of amputees, amputation response or related feelings, coping mechanisms, social support received, the meaning of life, and health care received. The results of this research are expected to contribute positively in improving the quality of nursing care through physical, psychosocial, and spiritual rehabilitation support enhancement in client with type 2 DM following major lower limb amputation.
Having an effective leader is a very prominent component for an organization, includes managing human resources. The purpose of this study was to analyze the relation of the leadership style applied at Siloam Hospital Bali on the performance of non-medical staff working at the forefront in 2020. The design of this study was an explorative crosssectional with a combination of quantitative tests to determine the relation between independent variables with performance, and qualitative research to gain a deeper understanding of staff perceptions of their leaders. The results showed that the most dominant leadership style felt by frontline staff was Responsible Leadership, and there was no significant impact between leadership style and performance. There is a high enough motivation among staff, especially at the supervisor level, so that there is no significant difference between the staff's motivation and performance as both already good.
The challenges of antimicrobial resistance facing Indonesia are similar to those of many countries in the Asian Region and beyond. The results of a survey on the use of antimicrobials conducted by EXPLAIN * (Exploration of Antimicrobial Consumption to Identify Targets for Quality Improvement in Indonesian Hospitals) in all inpatient wards of Royal Taruma Hospital on 19-22 March 2019, out of 100 patients studied, it was found that 97% of empirical antibiotics were used. consisting of 81% for empiric therapy, 12% for medical prophylaxis, 4% for surgical prophylaxis, with the most common diagnoses for antibiotics being typhoid, pneumonia and dengue fever. 16% of patients without a clear indication received antibiotics. Royal Taruma Hospital in November 2018 formed the PPRA Team to support the national program and reduce the use of irrational antibiotics at the Royal Taruma Hospital. The purpose of this study was to determine the implementation of PPRA policies on the use of antibiotics at the Royal Taruma Hospital. This research is a descriptive analytical study by analyzing the quantitative use of antibiotics, DDD (Defined daily dosage) / 100 patient-days periodically by taking secondary data from the PPRA Team for the quarterly months of February, May and August 2020. Followed by a qualitative approach with in-depth interviews with 14 sources. informants to find out about their perceptions, opinions, thoughts about the use of antibiotics related to the implementation of PPRA policies at Royal Taruma Hospital. From the DDD / 100 patient-days results, the three most widely used antibiotics were Cetriaxon (64.7%), Levofloxacin (20.1%) and Meropenem (6.9%), which belong to the broad-spectrum antibiotic class. Total antibiotic use was 1206.59 DDD / 100 patient-days or in one day there were 12.1 DDD antibiotics used in 100 hospitalized patients with a total length of stay of 5547 days. From the results of the in-depth interview it can be concluded that the implementation of PPRA policies has been implemented but has not run optimally and needs to be further improved
Permasalahan yang dihadapi oleh rumah sakit adalah kurang baiknya kinerja perawat rumah sakit sebanyak 47,3% dan berdasarkan hasil survey kepuasan pegawai masih banyak terdapat pegawai merasa tidak puas terhadap kinerjanya selama di rumah sakit. Masalah mengenai kinerja perawat yang buruk perlu dilakukan penilaian kinerja, salah satu sistem penilaian kinerja dapat menggunakan instrumen Quality of Work Life. Penelitian ini bertujuan untuk mengetahui Hubungan Quality of Work Life dengan Kinerja Perawat PNS di Instalasi Rawat Inap RS. Bhayangkara TK I Raden Said Sukanto Tahun 2011. Penelitian ini menggunakan metode Kuantitatif dengan desain cross sectional terhadap total populasi perawat. Hasil studi ini menunjukkan terdapat dua variabel yang paling berhubungan dengan kinerja perawat yaitu keterlibatan karyawan dan rasa bangga terhadap pekerjaan. Selain itu, terdapat beberapa pernyataan perawat yang dapat menjadi masukan bagi rumah sakit meliputi: kurang dilibatkannya perawat dalam pengambilan keputusan, kurangnya kompensasi yang seimbang, beban kerja cukup berat, kurangbangganya perawat terhadap pekerjaannya, kurang memadainya pengembangan karir, kurang baiknya penyelesaian masalah dan komunikasi belum berjalan dengan baik. Saran yang dapat diberikan adalah agar perawat dapat dilibatkan dalam pengambilan keputusan dan dimintakan ide-ide dari tiap perawat sebagai masukan. Juga dengan membangun rasa bangga terhadap pekerjaan dengan peningkatan pelayanan terhadap pasien. Peningkatan pelayanan terhadap pasien bisa dengan lebih peduli terhadap pemberian insentif yang sesuai dengan beban kerjanya, pemberian beban kerja sesuai dengan uraian tugas atau asuhan keperawatan yang jelas, pengembangan karir pegawai / perawat, penyelesaian masalah yang cepat tanggap dan komunikasi yang efektif antar rekan kerja dan juga dengan pasien. Kata Kunci : Komponen Quality of Work Life (QWL), Kinerja Perawat
The problem faced by hospital is bad performance of nurses (47,3%) and bases on the staff’s job satisfaction there are a lot of staff’s felt dissatisfy performance in hospital. Therefore, it needs to do performance appraisal, can be done by using Quality of Work Life instrument. This research intent to know relationship Quality of Work Life with nurse performance in Inpatient ward at Hospital of Bhayangkara TK I Raden said Sukanto. This research utilize quantitative method with cross sectional design to the total nurse population. The show results there are two variables have relationship with nurse performance whice are employee imvolvement and the pride of their job. Besides, there are some nurses statements that cans become input for hospital management: lack of involvement of nurses in decision making process, imbalance of compensation, quite heavy work load, lack of pride of their job, inadequate career development, improper problem solving process and ineffective communication. This study suggests to involve the nurses in decision making process, gain ideas from nurses, increase the pride of the job by improving services to patient. Key word : Quality of Work Life (QWL), Nurse performance
A good drug logistics cycle is needed by hospital management in meeting the availability of drugs in the hospital. The drug logistic cycle starts from the planning stage to supervision and control, which involves all elements of the organization from the top management to the user level. This study was motivated by the high number of visits by cardiovascular patients so that the availability of cardiovascular drugs is important at RSIJCP. The purpose of this study was to determine the input factors, namely human resources, budget, policies, facilities, and information systems on the drug logistics cycle in an effort to meet the availability of cardiovascular drugs at RSIJCP. The research design was an observational case study at RSIJCP with the IPO (Input Process Output) theory approach. This research is qualitative studies accompanied by the calculation data of the ABC Critical Index analysis, Economic Order Quantity (EOQ) and Reorder Point (ROP) as a method of controlling cardiovascular drug supplies. The conclusion of the study shows that each factor affects the availability of cardiovascular drugs, but the factors that are considered to be lacking and need to be improved by management are information systems, warehouse facilities, and smooth cash flow as input factors, as well as planning and storage factors as process factors. The availability of cardiovascular drugs at RSIJCP is quite good, but from a total of 257 items of cardiovascular drugs, there are 22 drug items (8.56%) whose prices are higher than the E-Catalog price for BPJS Kesehatan services. Collaboration between divisions and management support is needed in managing drugs, especially cardiovascular drugs
Each state has its own history on the development of hospital, eventhough nowadaysfor many different reason, all countries in the world is talking about governance inhospital. In Indonesia cuurent situation, Indonesian Hospital Law does notspecifically refer to corporate governance, however in the Elucidation of Article 29para (1) point r of the Hospital Law, it is implied that corporate governance waspart of hospital governance. Meanwhile the conception and terminology of corporategovenance in Indonesia belongs to corporation, especially public corporation. Insuch conception, all corporations must comply with Corporate Law, including allcorporations with line of business of hospital. The aim of this research is to provethat there has been a misconception of corporate governance terminology in hospitalmanagement. This research tries to contrast the conception of corporate governanceused in Hospital Law against the Corporate Law. This research uses qualitativeresearch. This reseacrh uses secondary data, with triangulation to maintain validityof result. This research also uses comparative legal method to understand theconcept of corporation and corporate governance in order to explain the applicationof corporate governance in hospital. Result of the research shows that Hospital Lawhas misinterpreted the status of hospital. It has mislead the function of hospital,which shall be seen as a line of business of a corporation. It means that hospital mustbe seen as part of the corporation as organisation and not vice versa. Researcherrecommends to make amendments to some articles of the Hospital Act in order tomake it inline with the prevailing concept and can be consistently applied.Key Words: corporate governance, corporation, governance in hospital, hospital
The INA-CBG payment system is a paymend basd on the rate of grouping diagnoses that have clinical closeness and homogeneity of the resources used. Hospitals will be paid based on the average cost spent by a diagnostic group. This system has been implemented by the Ministry of Health of the Republic of Indonesia in order to improve service quality. This study aims to determine the description of the calculation of hemodialysis service rates using the Activity Based Costing method. The research is a quantitative research with a descriptive design. The results of this study indicate that in the hemodialysis service there is a difference between the average unit cost using the Activity Based Costing method on the Nipro machine and the Fresenius machine. Costs with this methods are known to be lower when compared to HD BPJS rates and hospital rates. This shows that using the Activity Based Costing method provides a advantage for the hospital.
