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Background: Nurses who are in charge of the Neonatal Intensive Care Units (NICUs) have a different workload and work assignments compared to other units. Evidence suggests that higher nurse workloads will increase the risk of missed nursing care. Missed nursing care in the NICU will eventually worsen the neonatal prognosis. This is a major problem in developing countries, which currently still have a high neonatal mortality rate. Methods: This was a cross sectional study using questionnaires to collect data from 48 nurses who work in Dr. Soetomo Hospital NICU from April 15th 2021 to July 25th 2021. The collected data was then processed with descriptive statistics, meanwhile the correlation between workload with missed nursing care was analyzed with Pearson and Spearman correlation. Results: The total mean of NICU nurse workload score according to the NASA-TLX (National Aeronautics and Space Administration Task Load Index) was 68.36, indicating a moderate overall workload, with effort as the highest component. Overall, 91.67% of the nurses had missed at least 1 out of 21 basic neonatal nursing care components. Labor resource factor was the most frequent missed nursing care factor, in which urgent patient situations were the most frequent problem. There was no significant correlation between the total nurse workload and the frequency of any missed nursing care (P=0.536). Conclusions: Effort was the biggest component of the NICU nurse total workload. The most frequently missed nursing care was giving emotional support for the patient’s parents and/or family. Labor resource factor was the most frequent problem which caused missed nursing care. However, there is no statistically significant correlation between the total workload with the frequency of missed nursing care.

Introduction: Health literacy on the coronavirus disease 2019 (COVID-19) affects people’s capability to ascertain their health and health care quality during the pandemic. The objective of this study was to determine the levels of health literacy about COVID-19 vaccines and vaccinations (Vaccines and Vaccinations literacy-VL) in the Indonesian adult general population, assessing the perceptions of the respondents about current adult immunization and beliefs about vaccinations in general, and analyzing correlations of these variables with the VL levels. Methods: A cross-sectional study using a rapid survey was administered via the Internet. Data were analyzed using descriptive and inferential statistics; the internal consistency of the VL scales was evaluated using Cronbach’s alpha coefficient; the inter-correlation between the functional and interactive-critical VL questions, the underlying components (factors) and each question’s load on the components were identified using a Principal Component Analysis (PCA). An alpha level lesser than 0.05 was considered significant. Results: Responses to functional- and interactive/ critical- VL questions were acceptable and showed internal consistency (Cronbach’s alpha = 0.817 and 0.699, respectively), lowest values observed were 0.806 for functional scale and 0.640 for the interactive-critical scale. The PCA demonstrated that there were two components accounting for 52.45% of the total variability. Approximately 60% of respondents were females (n=686). Almost all respondents used the internet to seek information regarding COVID-19 and COVID-19 vaccinations. Many used at least one social media actively with 74.4% of respondents sometimes believing the validity of this information. Conclusions: High scores were observed in both functional- and interactive/ critical-VL, and were quite in a balance between sexes in the prior VL and higher in females for the latter; these were also closely related to the educational level and age group. It is crucial to increase public health literacy in managing the pandemic.

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Objectives: In the blood culture procedure for neonatal sepsis, time to positivity (TTP) reflects the pathogenic bacterial load and the time required for empirical antibiotic regimen administration prior to definitive treatment. This study aims to identify the differences in TTP among causative pathogens and its predictive value for the overall survival of neonates with sepsis at a tertiary healthcare center in Indonesia. Methods: A retrospective cohort study was conducted from January 2020 to August 2022 at Dr. Soetomo General Hospital, Surabaya, Indonesia. Neonates with blood culture-proven neonatal sepsis were included in the analysis. TTP was defined as the time between the acceptance of a blood culture specimen from the neonatal intensive care unit and reports of positive culture growth by the laboratory. Results: Across 125 cases, the median TTP was 58.1 hours (IQR = 24.48). Blood cultures were positive within 48 hours for 41.6% of cases, 72 hours for 86.4%, and 96 hours for 98.4%. A significantly shorter TTP was exhibited by the three major gram-negative organisms (Klebsiella pneumoniae,Acinetobacter baumannii,Enterobacter cloacae) compared to coagulase-negative Staphylococci. The neonatal sepsis mortality rate was 49.6% during the study period. In the Cox multivariate regression model, a shorter TTP was an independently predicted mortality in the entire cohort (hazard ratio (HR) = 0.985, 95% CI: 0.973–0.998) and the gram-negative sepsis cohort group (HR = 0.983, 95% CI: 0.968–0.999). Conclusions: TTP predicts different causative pathogens and the overall survival of neonatal sepsis cases at a tertiary healthcare facility in Indonesia.