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Mechanical ventilator is one of the important aspects and frequently used for treatment of critical patients in the Intensive Care Unit (ICU). The duration for using mechanical ventilator is important factors caused VAP. This research aimed to find the correlation between duration of mechanical ventilator use and Ventilator Associated Pneumonia (VAP) case in ICU RSUD Tarakan Hospital Jakarta 2014 2017. This was an analitic research with observational study (cross-sectional design). Sampling method used consecutive sampling by observed medical records of patients who used mechanical ventilator at least 48 hours and treated at least 3 days in ICU RSUD Tarakan Hospital Jakarta January 2014 December 2017, as many as 106 sampels. Data was analyzed by chi-square, t-test independent, and logistic regression. Prevalention of Ventilator Associated Pneumonia (VAP) was about 17,9%. Duration of mechanical ventilator use and duration of treatment had significant correlation to VAP. While age, basic disease, sleep position, surgery and antibiotic treatment insignificant to VAP. Multivariate analysis showed that duration of mechanical ventilators use variable was the most dominant variable related to VAP OR=5,265 (95% CI: 1,084-25,548)
Hospitals are health institutions that provide health services for patients, thus transmission of infectious diseases in hospital must be controlled. Study was conducted to determine whether or not there were underreported cases of VAP. This research is a qualitative observational study with descriptive data from 96 patients with positive sputum culture results from January - December 2018 as initial data. It was found from a review of medical record documents of patients with ventilator usage history that there were 5 cases of VAP. Based on FGD results, in-depth interviews, and fishbone diagram, it was found that VAP surveillance policy and implementation of VAP bundle were not detailed, there was no integrated SOP, human resource factors such as lack of discipline and no audit system that guaranteed the validity of surveillance and uniformity of health services quality. With PDCA method, researcher formulated a workframe, namely updating the policy for prevention and control of VAP, improvement and refinement of SOPs related to surveillance and implementation of VAP bundles, developing VAP surveillance and VAP bundle audit system, developing educational systems periodically to ensure a common level of understanding at the level of policy implementers and a comprehensive evaluation of policies and SOPs.
Nosocomial infections are infections acquired in hospital patients. These infections can occur due to germs from other patients or from the environment can be transferred through the hands of nurses at the variety of nursing care to patients. Nosocomial infections will exacerbate the patient's condition, extending the day care of patients, even to the cause of death. Patients in the ICU also exposed to the risk of nosocomial infection. ICU is a place for patients who need intensive care and total care. ICU patient's immune system is certainly not as good as the patient's immune system does not require total care. ICU patients therefore more susceptible to infection.
Pneumonia merupakan salah satu penyebab kematian anak umur di bawah 5 tahun. Perkiraan kematian yang disebabkan batuk dan nafas cepat sebesar 6 permil. Program pemberantasan penyakit ISPA diupayakan untuk mengurangi kematian karena pneumonia. Penatalaksanaan kasus pneumonia oleh petugas menggunakan tata laksanana ISPA. Keberhasilan upaya program P2 ISPA merupakan daya ungkit penurunan kematian karena ISPA.. Secara teori target penemuan kasus pneumonia adalah 10 % dari jumlah balita. Penemuan kasus pneumonia didukung oleh tenaga kesehatan terlatih penatalaksanaan ISPA dan sarana penemuan kasus pneumonia. Penelitian ini dilakukan untuk mengetahui faktor-faktor yang berhubungan dengan cakupan penemuan kasus pneumonia di Puskesmas, diantaranya faktor tenaga, sarana dan manajemen.Jenis penelitian ini merupakan penelitian deskriptif analitik dengan cross sectional dengan sampel sebanyak 33 puskesmas atau total populasi di Kabupaten Bekasi. Data primer diperoleh melalui wawancara dengan kuesioner dan data sekunder dari data hasil cakupan penemuan kasus pneumonia tahun 2001. Analisis data dilakukan dengan bantuan komputer menggunakan perangkat lunak Epi Info dan perangkat lunak statistik lainnya.Hasil penelitian menunjukkan bahwa cakupan penemuan kasus pneumonia di 75,8 % puskesmas adalah kurang. Secara proporsional faktor tenaga yang kurang, berada pada puskesmas dengan cakupan penemuan kasus pneumonia kurang. Begitu pula faktor sarana yang kurang, berada pada puskesmas dengan cakupan penemuan kasus pneumonia yang kurang. Sementara faktor manajemen, bila dilihat satu per satu yaitu pembuatan rencana kerja tahunan, staff meeting, bimbingan teknis dan evaluasi tidak memberikan pengaruh terhadap cakupan penemuan kasus pneumonia.Penelitian ini hendaknya dilanjutkan dengan penelitian kualitatif dengan penajaman kuesioner atau observasi serta melihat faktor lain melalui pendekatan individu sehingga didapatkan gambaran yang utuh mengenai faktor-faktor yang berhubungan dengan cakupan penemuan kasus pneumonia.
Correlation Factors of Number of Pneumonia Case Finding in Public Health Center in Bekasi District for year 2001Pneumonia is the one of cause of death in under five children. The estimated of death caused by cough and rapid breath are sixth per miles. The Acute Respiratory Infections (ARI) Program is an effort to reduce of death caused by pneumonia. The management of pneumonia by health worker is using the management of ARI. The aim of ARI Program is to decrease the death caused by ARI. Theoretically, the target of pneumonia case finding is 10 % from the number of under five children. The pneumonia case finding is done by specially trainee health workers in ARI management. The aim of this research is to know about the factors correlated with the number of pneumonia case finding in public health center, including human factor, equipment factor and management factor.The research is designed with descriptive analysis by cross sectional on 33 Public Health Center (PHC) as samples which are similar with total PHC District Bekasi. Primary data was collected trough interviewing respondent with questioner; secondary data was collected from annual report of the number of pneumonia case finding in Bekasi District 2001. The data was analyzed using to Epi Info software and related statistical software.The result of this research indicated that the prevalence of pneumonia found in PHC 75,8 % was considered as under reported. Proportionally, it trained health worker shows that the lower the number of pneumonia case found in PHC. Also, PHC having less equipment has lower number of pneumonia case found. Analysis on individual management factors including annual planning, staff meeting, technical assistance, and evaluation, shows no impact on the number of pneumonia case finding.This research must be followed up by qualitative research using more accurate questioner or observation and other factors with individual approach to get the complete picture about factors correlated with the number of pneumonia case finding.
The strategy that must be applied by insurance companies is to recognize, fulfill, and satisfy the needs of their customers. Optimizing service quality is something that needs to be considered in health insurance companies because almost all customers depend on and interact directly with providers and the company itself. Many insurance companies in Indonesia have conducted regular insurance participant satisfaction surveys and are always trying to improve the quality of their services. This study aims to determine the factors that influence the satisfaction of health insurance participants in various countries. It is hoped that the literature findings can be lessons learned and used as additional indicators in the participant satisfaction survey. The method used in this study is a literature review. Search studies using online databases such as PubMed, ScienceDirect, ProQuest, Wiley Online, and Scopus found a total of 3,060 journal articles. After the selection, there were 11 studies used in this research from various countries. From this study it was found that there are 6 factors that affect the satisfaction of health insurance participants, such as organizational factors, types of insurance, benefit packages, sociodemographic factors, health services, and consumer personal factors. The most dominant factors influencing satisfaction in various countries are service quality, participant expectations, and utilization of health services.
