OBJECTIVE: In Indonesia, stunting is a nutritional problem that is a threat to the growth and development of toddlers since the beginning of life. The total stunting of children under-five in 2018 in Palu city was 30.8%. Hence, it is necessary to strengthen the system that supports the determination of continued government policies in achieving a reduction in the incidence of stunting. METHODS: A case control with research subjects totaling 520 toddlers. The sampling technique used was proportional stratified random sampling at all Puskesmas Kota Palu. RESULTS: There is a multifactorial relationship between knowledge variables (p = 0.019), children have been sick (p = 0.000), mother’s height (p = 0.050), and mother’s education (p = 0.000) against the incidence of stunting. Low knowledge has a chance of 1.581 times and the status of the child having been sick has a chance of 9.166 times the incidence of stunting. CONCLUSION: Multiple factors play a role in causing stunting in the city of Palu. Analysis of factors related to the incidence of stunting in children under-five in the working area of the Palu City Health Center is considered necessary in supporting the government in determining policies to tackle stunting problems.
Latar belakang: Stroke memiliki angka kematian dan kecacatan yang tinggi. Stroke menjadi penyebab nomor 1 admisi pasien ke rumah sakit. Penggunaan clinical pathway dapat mengurangi variasi dalam tindakan medis untuk kondisi klinis yang sama sehingga meningkatkan kualitas pelayanan stroke. Penelitian mengenai pengembangan clinical pathway sesuai Integrated Clinical Pathway Appraisal Tools (ICPAT) di Indonesia masih sangat terbatas. Tujuan: Penelitian ini bertujuan mengevaluasi proses pengembangan dan penerapan clinical pathway kasus stroke iskemik akut di RS Anutapura Kota Palu. Metode: Rancangan Penelitian ini adalah action research. Pengumpulan data dilakukan dengan triangulasi metode melalui wawancara terstruktur, diskusi kelompok terarah, survei, observasi, dan telaah dokumen. Integrated Clinical Pathway Appraisal Tools (ICPAT) digunakan sebagai alat ukur. Subyek penelitian sebanyak 25 responden terdiri dari petugas kesehatan RS Anutapura dan tim clinical pathway, 1 responden keluarga pasien dan 30 responden pasien yang dirawat inap di bagian saraf RS Anutapura yang memenuhi kriteria eligibilitas. Hasil: Pada proses pengembangan hasil evaluasi dengan ICPAT menunjukkan dimensi 1 terpenuhi persyaratan secara keseluruhan. Dimensi 1 memberikan kepastian bahwa dokumen yang dikembangkan merupakan clinical pathway. Pada proses penerapan clinical pathway dilakukan evaluasi uji coba clinical pathway stroke iskemik akut sejak pasien masuk RS sampai pasien diijinkan keluar RS. Indikator proses pelayanan yang dinilai adalah pemeriksaan EKG sebesar 100%, penilaian kemampuan menelan sebesar 100%, pemberian antiplatelet (aspirin 80mg atau clopidogrel 75mg) diberikan 24-48 jam sejak masuk RS sebesar 100%, pemberian anti platelet (aspirin 325mg atau clopidogrel 300mg) diberikan 24-48 jam sejak masuk RS sebesar 46,7 % dan penilaian status gizi dan diet seawal mungkin sebesar 100%. Kepatuhan pengisian clinical pathway dokter dan case manager mencapai 80%. Kesimpulan: Berdasarkan evaluasi CP baru stroke iskemik akut menunjukkan kesesuaian dengan ICPAT. Sinergi seluruh manajemen RS, clinical champion, dokter spesialis saraf dan tim multidisiplin menjadi kunci keberhasilan pengembangan dan penerapan clinical pathway.
Emergency Room (ER) is a unit of a hospital that provides early containment procedures for emergency patients to saving lives and preventing further disability. Things that determine the success of the rescue of patients with response time. Response time is the speed of patients treated since patients came to receive medical service in a matter of minutes. Response time is good for the patient in accordance with the minimum service standards on the Minister of Health of the Republic of Indonesia number 129 of 2008 is < 5 minutes. Response time is one indicator of hospital quality services is an indicator of the process to achieve results indicators. Patient satisfaction is an evaluative response, emotional related to the quality of existing services in hospitals and patient expectations of the services. This study aimed to analyze the relationship between the physician response times to the satisfaction of the patient's in the Emergency Room at Anutapura General Hospital Palu. Using observational method with cross sectional approach. Non-probability sampling technique is consecutive sampling. Total sample of 50 respondents in accordance with the inclusion and exclusion criteria. The research instrument used watches and questionnaires. Data Analyze with chi square test and Wilcoxon test. The results showed that the variables of gender, age, education and occupation there was no correlation with the level of patient satisfaction. This is evident from the value of p > 0.05 for all variables. To test the variable level of satisfaction and response time there is a relationship. This is evidenced by the p-value is less than the alpha (0.023> 0.05). Physician response times are very important in the treatment of emergency patients and it will certainly affect the quality of life and patient satisfaction, including suppression of the incidence of mortality and morbidity of patients in the ER.
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