BackgroundThe prevalence of diabetes mellitus is increasing in Indonesia due to population growth, urbanization, and lifestyle. Diabetes mellitus (DM) is the leading cause of chronic kidney disease that escalates mortality rate, but not all DM develop into chronic kidney disease.AimsTo estimate the prevalence of kidney dysfunction (KD) in DM and the associated dominant risk factors among productive age Indonesian based on the National Health Survey (Riskesdas) 2013.MethodsThe statistical data consisted of 15,791 females and 10,349 males, aged 20 to 54, who lived in rural and urban areas. The data was obtained from National Institute of Health Research and Development (NIHRD), Ministry of Health. Data were collected from 33 provinces using cross sectional method. The variables data analyzed were sociodemographic, lifestyle, anthropometric, blood pressure, blood lipid, blood glucose, and creatinine. Kidney dysfunction was defined according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Multivariable logistic regression was used to analyze the dominant associated risk factors.ResultsThe prevalence of KD in DM was 4% (CI 95% 3.1–5.1) and only 0.6% had been diagnosed. Many associated risk factors could affect DM leading to KD such as age, sex, rural, economic status, sugary food/drinks, salty food, coffee, hypertension, hypercholesterolemia, low HDL, high LDL, and hypertriglyceridemia. The dominant associated risk factors were age, sex, economic status, sugary food/drinks, and low HDL.ConclusionThe prevalence of KD in DM among productive age Indonesian was 4% and only 0.6% had been diagnosed. Early detection of identification of KD in DM is needed in order to slow progression and complications. The dominant associated risk factors of KD in DM were age, sex, economic status, sugary food/drinks, and low HDL. Controlling of risk factors in DM should be done in order to prevent diabetic kidney disease.

To provide an optimal nutrition care to the patients in a hospital, a proper human resource planning should be implemented. The workload indicators of staffing need (WISN) method is a health worker need calculation based on real workload in every facility. This study was aimed to assess the real need for cook in the Nutrition Department of Pancaran Kasih General Hospital Manado by using WISN method.This was an analytical observational study using quantitative method. Work sampling method was used to acquire the number of activity time for each cookand WISN method was used to calculate the need for cook. The population and samples in this study were 11 cooks from Nutrition Department in Pancaran Kasih General Hospital Manado; all were female. This study also used 6 informants consisted of the Vice Ancillary Hospital Director and Human Resource Department, Head of Human Resource Department, Head of Nutrition Department, and cooks to discuss about the cook staff human resources planning and the workload in the Nutrition Department. The result of the need for cooks using WISN method was 19. Currently,there were only 11 cooks in the Nutrition Department, which meant lack of eight from the calculated ideal. The calculation result for productivity proportion to workforce in Pancaran Kasih General Hospital Nutrition Department was 72.21% which was in normal baseline compared to standard productivity. To date, the hospital plan for cook need used ratio of beds and cooks method. Conclusion: There were eight cooks lacked at the Nutrition Department in Pancaran Kasih General Hospital, albeit, the workload was still within normal baseline, hence the need to add more staff was not urgent. The method to calculate manpower need of the hospital was not yet ideal because it only calculated the number of staffs inspite of the productivity level of staffs in the hospital. It is suggested to add male cooks since the workload was quite heavy and to consider the human resource planning using workload analysis in the future since it is more objective compared to ratio method.Keywords: cooks, WISN, nutrition department, hospitalAbstrak: Dalam upaya menjamin pelaksanaan pelayanan gizi yang optimal di rumah sakit diperlukan adanya perencanaan kebutuhan tenaga di Instalasi Gizi. Workload indicators of staffing need (WISN) adalah metode penghitungan kebutuhan sumber daya manusia (SDM) kesehatan berdasarkan beban kerja pekerjaan nyata yang dilaksanakan oleh tiap kategori SDM kesehatan pada tiap unit kerja fasilitas pelayanan kesehatan. Penelitian ini bertujuan untuk mendapatkan kebutuhan riil tenaga pemasak di Instalasi Gizi RSU Pancaran Kasih GMIM Manado dengan menggunakan meteode WISN.Jenis penelitian ialah observasional analitik dengan metode kualitatif. Metode work sampling digunakan dalam pengamatan untuk mendapatkan jumlah penggunaan waktu setiap aktivitas tenaga pemasak danmetode WISN untuk penghitungan kebutuhan tenaga pemasak. Populasi dan sampel dalam penelitian ialahtenaga pemasak di Instalasi Gizi RSU Pancaran Kasih GMIM Manado yang berjumlah 11 orang berjenis kelamin perempuan. Penelitian ini dilengkapi dengan 6 informan terdiri dari Wakil Direktur Penunjang dan SDM, Kepala Bagian SDM, Kepala Instalasi Gizi, dan tenaga pemasak, yang membahas mengenai perencanaan tenaga pemasak dan beban kerja di Instalasi Gizi.Hasil penghitungan kebutuhan tenaga pemasak dengan metode WISN ialah 19 orang. Saat ini di Instalasi Gizi RSU Pancaran Kasih GMIM Manado memiliki tenaga pemasak sebanyak 11 orang, yang berarti masih kekurangan 8 orang tenaga pemasak. Hasil penghitungan proporsi waktu produktif terhadap beban kerja tenaga pemasak sebesar 72,21%, yang masih dalam batas normal menurut standar produktivitas. Saat ini perencanaan kebutuhan tenaga pemasak di RSU Pancaran Kasih GMIM Manado menggunakan metode rasio antara jumlah tempat tidur rumah sakit dengan jumlah tenaga pemasak.Simpulan: Terdapat kekurangan tenaga pemasak di Instalasi Gizi RSU Pancaran Kasih GMIM Manado sebanyak 8 orang, tetapi karena beban kerjanya masih dalam batas normal, maka penambahan tenaga pemasak sifatnya tidak mendesak. Metode perencanaan kebutuhan tenaga pemasak di RSU Pancaran Kasih GMIM Manado masih kurang tepat karena metode ini hanya mengetahui jumlah tenaga secara total tetapi tidak bisa mengetahui produktivitas SDM rumah sakit, dan kapan tenaga tersebut dibutuhkan oleh setiap unit atau bagian rumah sakit yang membutuhkan. Disarankan penambahan tenaga pemasak berjenis laki-laki karena pekerjaan di Instalasi Gizi cukup berat dan perencanaan kebutuhan tenaga kesehatan ke depan diharapkan menggunakan analisis beban kerja karena lebih obyektif daripada metode rasio.Kata kunci: tenaga pemasak, WISN, instalasi gizi, rumah sakit