Search results for: Indonesian hospitals

Authors: Routsukol Sunalai

Abstract:

This research was to study the relationship between the organizational culture like bureaucratic system, and patronage system in government hospitals with hospital accreditation and its impact on the quality of service in the government hospital accredited. Qualitative research was applied in this study by in-depth interviews with samples containing 20 public welfare service providers, i.e. doctors, nurses and practical nurses and 20 service recipients in the units of study. It was found that the bureaucracy still existed and was evidenced by the structure of the line of command; work systems, clear cut duty divisions, procedures and plans, and the patronage system hindered the quality of service in the government hospitals under the process of development and accreditation. The administrators should encourage and support the creation of a learning process in the organization for self-improvement and work development.

Keywords: hospital in Dusit Area, organization culture, the quality of service, economics and financial engineering

Procedia PDF Downloads 322

Authors: Gatot Dwi Hendro, Hayyan ul Haq

Abstract:

This work aims to explore the strategy in embodying the ecological validity in creating the sustainability of public policy, particularly in strengthening the green economy in Indonesia. This green economy plays an important role in supporting the national development in Indonesia, as it is a part of the national policy that posits the primary priority in Indonesian governance. The green economy refers to the national development covering strategic natural resources, such as mining, gold, oil, coal, forest, water, marine, and the other supporting infrastructure for products and distribution, such as fabrics, roads, bridges, and so forth. Thus, all activities in those national development should consider the sustainability. This sustainability requires the strong commitment of the national and regional government, as well as the local governments to put the ecology as the main requirement for issuing any policy, such as licence in mining production, and developing and building new production and supporting infrastructures for optimising the national resources. For that reason this work will focus on the strategy how to embody the ecological values and norms in the public policy. In detail, this work will offer the method, i.e. legal techniques, in visualising and embodying the norms and public policy that valid ecologically. This ecological validity is required in order to maintain and sustain our collective life.

Keywords: ecological validity, sustainable development, coherence, Indonesian Pancasila values, environment, marine

Procedia PDF Downloads 478

Authors: Makkia Ahmad Ali Al-Falahi, Abdullah Abdelaziz Muharram

Abstract:

Background: Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. Objective: To assess the prevalence of occupational health hazards among healthcare workers and associated risk factors in public hospitals in Sana'a City, Yemen. Method: Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. Results: More the half (60.6%) of HCWs aged between 20-30 years, (50.8%) were males, (56.3%) were married, and (45.5%) had a diploma qualification, while (65.2%) of HCWs had less than 6 years of experience. The result showed that the highest prevalence of occupational hazards was (99%), (ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p >0.05). Conclusion and recommendations: The study showed the highest prevalence of occupational hazards; regarding the prevalence of biological hazards exposure to sharp-related injury, the most prevalent physical hazards were slip/trip/and fall. Ergonomic hazards had back or neck pain during work. Chemical hazards were allergic to medical gloves powder. On psychosocial hazards was suffered from verbal and physical harassment. The study concluded by raising awareness among HCWs by conducting training courses to prevent occupational hazards.

Keywords: health workers, occupational hazards, risk factors, the prevalence

Procedia PDF Downloads 72

Authors: Grace Omowunmi Soyebi

Abstract:

A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved, this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, computing, data, innovation

Procedia PDF Downloads 117

Authors: Ridho Al-Hamdi, Sakir, Tanto Lailam

Abstract:

During the democratic period of 1999-present, Indonesia has consistently applied a List Proportional Representation (List PR) system in the parliamentary election. Between 1999 and 2004, it adopted a closed-list proportional representation (CLPR) system. In the meantime, it employed open-list proportional representation (OLPR) system from 2009 to 2019. Recently, some parties intended to propose the application of CLPR while others are still consistent in adopting OLPR. An unfinished debate is taking place. Thus, this article aims to evaluate the application of CLPR in Indonesia and, in turn, analyze its compatibility in contemporary parliamentary election system. From a methodological standpoint, it is qualitative research by applying a case study approach. Data-gathering relies on field data, mainly focus group discussion (FGD) and in-depth interviews with political parties, electoral management bodies (EMBs), NGO activists, and scholars spread in six provinces and nine regencies/cities across the country. Using SWOT analysis and the compatibility of CLPR and embedded democracy framework, the finding demonstrates that CLPR is no longer relevant for contemporary Indonesian elections. This paper recommends OLPR by considering that CLPR has numerous weaknesses and threats that can jeopardize embedded democracy. More importantly, CLPR can remove inclusive suffrage significantly.

Keywords: closed-list proportional representation, embedded democracy, Indonesia, parliamentary election

Procedia PDF Downloads 156

Authors: Y. S. Darmanto, P. H. Riyadi, S. Susanti

Abstract:

Recently, approximately 9.1 million people of 237.56 million of Indonesian population suffer diabetes. Such condition was caused by high rice consumption of most Indonesian people. It has been known that rice contains low amylose, high calorie, and possesses hyperglycemic properties. Through this study, we tried to solve that problem by creating a super food in order to provide an alternative healthy and balanced diet. We formulated Taro and Seaweed flour based analog rice that fortified by various fishes bone collagens. Corms of Taro contain easily digestible starch and seaweed is rich in fiber, vitamin, and mineral. That mixture was fortified with collagen-containing unique amino acids such as glysine, lysine, alanine, arginine, proline, and hydroxyprolin. Subsequently, super analog rice was characterized about its nutritional composition such are proximate analyses, water, dietary fiber and amylose content. Furthermore, its morphological structure was analyzed by using scanning electron microscopy while the level of consumer preferences was performed by hedonic test. Results demonstrated that fortification by using various fishes bone collagen into analog rice were significantly different in nutritional composition, morphological structure as well as its preferences. Thus, this study was expected as new avenue in functional food discovery especially in the treatment and prevention of diabetic diseases.

Keywords: analogue rice, taro, seaweed, collagen

Procedia PDF Downloads 261

Authors: Eliza Torrigue, Efrelyn Iellamo

Abstract:

Maternal death is one of the rising health issues in the Philippines. It is alarming to know that in every hour of each day, a mother gives birth to a child who may not live to see the next day. Statistics shows that intrapartum period and third stage of labor are the very crucial periods for the expectant mother, as well as the first six hours of life for the newborn. To address the issue, The Essential Intrapartum Newborn Care (EINC) was developed. Through this, Obstetric Delivery Room (OB-DR) Nurses shall be updated with the evidence-based maternal and newborn care to ensure patient safety, thus, reducing maternal and child mortality. This study aims to describe the compliance of hospitals, especially of OB-DR nurses, to the EINC Protocols. The researcher aims to link the profile variables of the respondents in terms of age, length of service and formal training to their compliance on the EINC Protocols. The outcome of the study is geared towards the development of appropriate training program for OB-DR Nurses assigned in the delivery room of the hospitals based on the study’s results to sustain the EINC standards. A descriptive correlational method was used. The sample consists of 75 Obstetric Delivery Room (OB-DR) Nurses from three government hospitals in the City of Manila namely, Ospital ng Maynila Medical Center, Tondo Medical Center, and Gat Andres Bonifacio Memorial Medical Center. Data were collected using an evaluative checklist. Ranking, weighted mean, Chi-square and Pearson’s R were used to analyze data. The level of compliance to the EINC Protocols by the respondents was evaluated with an overall mean score of 4.768 implying that OB-DR Nurses have a high regard in complying with the step by step procedure of the EINC. Furthermore, data shows that formal training on EINC have a significant relationship with OB-DR Nurses’ level of compliance during cord care, AMTSL, and immediate newborn care until the first ninety minutes to six hours of life. However, the respondents’ age and length of service do not have a significant relationship with the compliance of OB-DR Nurses on EINC Protocols. In the pursuit of decreasing the maternal mortality in the Philippines, EINC Protocols have been widely implemented in the country especially in the government hospitals where most of the deliveries happen. In this study, it was found out that OB-DR Nurses adhere and are highly compliant to the standards in order to assure that optimum level of care is delivered to the mother and newborn. Formal training on EINC, on the other hand, create the most impact on the compliance of nurses. It is therefore recommended that there must be a structured enhancement training program to plan, implement and evaluate the EINC protocols in these government hospitals.

Keywords: compliance, intrapartum, newborn care, nurses

Procedia PDF Downloads 381

Authors: A. Alrasheed, I. Connerton

Abstract:

Providing patients with safe meals on a daily basis is one of the challenges in the healthcare sector. In Saudi Arabia matters related to food safety and hygiene have been the heart of the Ministry of Health (MOH) and Saudi Food and Drugs Authority (SFDA). The aim of this study is to examine the causes of inadequate implementation of food safety management systems such as HACCP in Riyadh’s MOH hospitals. By the law, food safety must be managed using a documented, HACCP based approach, and food handlers must be appropriately trained in food safety. Food handlers in Saudi Arabia are not required to provide a certificate or attend a food handling training course even in healthcare sectors. Since food safety and hygiene issues are of increasing importance for Saudi Arabian health decision makers, the SFDA has been established to apply food hygiene requirements in all food operations. It should be pointed out that the implications of food outbreaks on the whole society may potentially go beyond individual health impacts but also impact on the Nation’s health and bring about economic repercussions.

Keywords: food safety, patient, hospital, HACCP

Procedia PDF Downloads 864

Authors: Wanutchaya Duanginta, Napaporn Apiratmateekul, Tippawan Sangkaew, Sunaree Wekinhirun, Kunchit Kongros, Wanvisa Treebuphachatsakul

Abstract:

Thailand has a tropical climate with an average outdoor ambient air temperature of over 30°C, which can exceed manufacturer recommendations for the storage of glucose test strips. This study monitored temperature and humidity at actual sites of five sub-district health promoting hospitals (HPH) in Phitsanulok Province for the storage of glucose test strips in refrigerated conditions. Five calibrated data loggers were placed at the actual sites for glucose test strip storage at five HPHs for 8 weeks between April and June. For the stress test, two lot numbers of glucose test strips, each with two glucose meters, were kept in a plastic box with desiccants and placed in a refrigerator with the temperature calibrated to 4°C and at room temperature (RT). Temperature and humidity in the refrigerator and at RT were measured every hour for 30 days. The mean temperature for storing test strips at the five HPHs ranged from 29°C to 33°C, and three of the five HPHs (60%) had a mean temperature above 30°C. The refrigerator temperatures were 3.8 ± 2.0°C (2.0°C to 6.5°C), and relative humidity was 51 ± 2% (42 to 54%). The maximum of blood glucose testing by glucose meters when the test strips were stored in a refrigerator were not significantly different (p > 0.05) from unstressed test strips for both glucose meters using amperometry-GDH-PQQ and amperometry-GDH-FAD principles. Opening the test strip vial daily resulted in higher variation than when refrigerated after a single-use. However, the variations were still within an acceptable range. This study concludes that glucose tested strips can be stored in plastic boxes in a refrigerator if it is well-controlled for temperature and humidity. Storage of glucose-tested strips in the refrigerator during hot and humid weather may be useful for HPHs with limited air conditioners.

Keywords: environmental stressed test, thermal stressed test, quality control, point-of-care testing

Procedia PDF Downloads 185

Authors: Grace Omowunmi Soyebi

Abstract:

A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved; this may cause an unexpected to happen to the patient. This data mining application is to be designed using a structured system analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the design and implementation of a computerized medical record system. This computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, data, software development, innovation

Procedia PDF Downloads 79

Authors: Adrian Rifqi, Febe Napitupulu, Erdi Hermawan, Edwin Putra, Yang Leprilian

Abstract:

This article focuses on the implementation of the production improvement process of the Indonesian land certificate product that printed in Perum Peruri as the state-owned enterprises. Based on the data obtained, there are several complaints from customers of the 2019 land certificate production. The complaints become a negative value to loyal customers of Perum Peruri. Almost all the complaints are referring to ‘defective printouts and the difference between products in packaging and packaging labels both in terms of type and quantity’. To overcome this problem, we intend to make an improvement to the production process that focuses on complaints ‘there is a difference between products in packaging with packaging labels’. Improvements in the land certificate production process are relying on the technology of the scales and QR code on the packaging label. In addition, using the QR code on the packaging label will facilitate the process of tracking product data. With this method, we hope to reduce the error rate between products in packaging with the packaging label both in terms of quantity, type, and product number on the land certificate and error rate of sending land certificates, which will be sent to many places to 0%. With this solution, we also hope to get precise data and real-time reports on the production of land certificates in the near future, so track and trace implementation can be done as the solution of the land certificate production.

Keywords: land certificates, QR code, track and trace, packaging

Procedia PDF Downloads 151

Authors: Sri Wartini

Abstract:

Based on the sovereignty over natural resources principle, the Indonesian government has an authority to exploit the natural resources within a national jurisdiction of Indonesia. The forest is one of the natural resources which is very valuable for Indonesia. It becomes the source of raw material for many industrial activities, such as pharmaceutical industry, pulp industry, and household furniture industry. Hence, it contributes to the economic development of Indonesia. However, the exploitation of the forest may cause negative impacts, such as environmental pollution and environmental degradation. The implementation of the sovereignty over natural resources principle in Indonesia may jeopardize the forest and affect the sustainability of the forest if there is no appropriate policy of the government to exploit the forest in a sustainable manner. The exploitation of the forest in Indonesia, in some extent, has caused serious impact to environment and biodiversity. Hence, in order to sustain and to maintain the forest as the valuable resources to the future generation, the government of Indonesia has already adopted many programmes and action plans. The aim of the research is to undertake a critical examination of the issues relating to the the implementation of sovereignty over natural resources to the exploitation of the forest in Indonesia. It is a normative research and the methodology employed in this research is library research. While the approaches employed in the research are conceptual approach., statutory approach, and comparative approach. The research finds that the implementation of sovereignty over natural resources principle in the exploitation of the forest in Indonesia is limited by other principles of international environmental law, such as sustainable development principle, intergenerational principle and common concern principle which have been adopted in the government policy and various regulations regarding the exploitation of the forest in Indonesia.

Keywords: Environmental damage, negative impacts, pollution, the sovereignty over natural resources

Procedia PDF Downloads 377

Authors: Wong Yat Cheung Maggie

Abstract:

Occupational Safety and Health Ordinance (OS&HO) (Chap 509) was enacted in 1997, OHS in HK should be growing and maturing, with a holistic approach to occupational health and safety in the workplace including physical, mental, social and spiritual well-being. The question is “How effective are OHSPs in meeting the current needs of HK health workers?” This study was designed to explore the issue for the first time, to empirically analyse the views of those who work in the system. The study employed a mixed method approach to collect various data from Occupational Health Service Providers (OHSPs), Occupational Health Service Consumers (OHSC): Registered nurses working in the hospital setting. This study was designed in two phases and two stages. Phase I Stage I was a paper survey to collect the data on OHSP. Then Phase I Stage II was a follow-up interview. Phase II Stage I was a paper survey to collect the data on OHSC. Then Phase II Stage II was a follow-up focus group study on OHSC for further clarification of the Phase II and Stage I result. The Phase I result reflects HK OHSPs point of view and their experience in the existing OHS practice in the local hospitals. It reflects various styles of reporting systems, staff profiles background and resource in providing OHS in HK hospitals. However, the basic OHS concern is similar between hospitals. In general, the OHS policies and procedures are available on site even though they may have different foci. The Phase II result is reflecting the HKs OHSCs echoes the OHSP feedback at providing of OHS, OHS concern and related policies and procedure are available on site. However, the most significant feedback from the OHSC at Phase II Stage II shows, nurses experienced various OHS concern most commonly work stress, workplace harassment and back strain without formal or official report to the related parties. The lack of reporting was due to the management handling attitude, stakeholders’ compliance and term of definition still have room to be improved even the related policies and procedures are available on site.

Keywords: occupational health service, registered nurse, Hong Kong hospital, mixed method

Procedia PDF Downloads 326

Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli

Abstract:

Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.

Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures

Procedia PDF Downloads 391

Authors: Takalani Tshitangano

Abstract:

Background: In Limpopo province the rate of new tuberculosis (TB) cases increase daily. The Infection Control (IC) plan is one of the essential actions for TB IC. This study aimed to establish the availability of these plans at health care facilities. Objectives: The objectives were to explore and describe the awareness and knowledge of health care workers (HCWs) of the availability and content of TB IC plan; and to identity the role of infection control committees from the perspective of HCWs. Method: A qualitative approach using a cross-sectional descriptive design was adopted. The target population was all HCWs from the seven hospitals of Vhembe district. A purposive sampling approach was used to select 57 participants. The approval to conduct this study was obtained from the relevant authorities and participants. Data were collected through seven focus group discussions comprising five to 10 members. An unstructured discussion guide was used to collect data, and an open-coding method was used to analyse the data. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results: Findings revealed that HCWs were not aware of the availability and the information contained in the TB IC plans. No person was designated as TB IC officer at hospital level. There was lack of a TB IC Committee and teams as well as ineffective utilisation of those that did exist. Conclusions: It was concluded that if the TB IC plans are not available at health care facilities, then the TB IC practices implemented by HCWs vary, resulting in TB nosocomial infection transmission. It was recommended that the World Health Organisation’s TB IC plans be adopted and implemented in Vhembe district.

Keywords: health care workers' awareness, health care workers' knowledge, availability of TB infection control plans, rural hospitals

Procedia PDF Downloads 215

Authors: Masnur Marzuki

Abstract:

As in other democratic countries, the constitutional court of Indonesia has the role of interpreting and applying the Constitution in order to preserve its supremacy testing the constitutionality of statutes. With its strong power to enforce and guard the Constitution, the court is now challenged to provide people an opportunity to understand their constitutional rights close up. At the same time, the court has built up an enviable reputation among constitutional courts in new democracies for the technical quality of its legitimacy in the legal sense. Since its establishment in 2003, the Constitutional Court of Indonesia has decided more than 190 statutes in judicial review case. It has been remarkably successful to make a credible start on its work of guarding the Constitution. Unsurprisingly, many argue that the Court has elevated Indonesia’s democracy to a whole new level. In accomplishing its roles judicial review, the basic principle that can be identified is that the Constitutional Court must always be subordinated to the Constitution. It is not being allowed to invade the field of the legislator. In doing so, the court does not have any discretionary political basis in order to create legal norms or provisions that could not be deducted from the Constitution itself. When interpreting a statute “in accordance with the constitution”, the court recognizes and reasserts that it is strictly forbidden to extend the scope of a legal provision in such a way that would create a general norm not established by the law-maker. This paper aims to identify and assess the latest role of Indonesian Constitutional Court in interpreting and applying the Constitution. In particular, it questions 1) the role of the Constitutional Court in judicial review; and 2) the role of the court to assist the legislators in the accomplishment of their functions in order to preserve its supremacy testing the constitutionality of statutes. Concerning positive legislator, jurisprudential and judicial review theories will be approached. The empirical part will include qualitative and comparative research. Main questions to be addressed: Can the Constitutional Court be functionalized as positive legislator? What are the criteria for conducting role of Constitutional Courts as Positive Legislators and how can it be accepted? Concerning the subordination of Constitutional Courts to the Constitution and judicial review, both qualitative and quantitative methods will be used, and differences between Indonesia and German Constitutional Court will be observed. Other questions to be addressed: Can Constitutional Courts have any discretionary political basis in order to create legal norms or provisions that could not be deducted from the Constitution itself. Should the Constitutional Court always act as a negative legislator? However, the Constitutional Court in Indonesia has played role as positive legislators which create dynamic of Indonesian legal development. In performing the task of reviewing the constitutionality of statutes, the Constitutional Court has created legal norms or provisions that could be deducted from the Constitution itself.

Keywords: constitution, court, law, rights

Procedia PDF Downloads 423

Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

Abstract:

Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

Procedia PDF Downloads 242

Authors: Minhae Shim Roth

Abstract:

The “Deinstitutionalization movement” refers to the spatial transition in the United States during the mid-20th century when the treatment of mental illness purportedly moved from long-term psychiatric institutions to community integrated care. Contrary to the accepted narrative of mental health care in the U.S., asylums did not close or empty. Some remained psychiatric hospitals, which came to be called forensic hospitals or state hospitals; others were converted into prisons or carceral institutions. During Deinstitutionalization, the asylum system became an appendage of the carceral system, with state hospitals becoming little more than holding centers for prisoners who were civilly committed, those incompetent to stand trial, offenders with mental health issues, and those found not guilty by reason of insanity. Psychiatric patients who became prisoners and prisoners who became patients became entangled in the phenomenon called transinstitutionalization. This paper investigates the relationship between psychiatric and criminal incarceration in 20th century California and focuses particularly on the case of Korean-American Chol Soo Lee, who fought detention in the psychiatric-prison system through the writ of habeas corpus. This study uses methodologies like critical theory, close reading, and archival research. This paper argues that during his psychiatric hospitalization at Napa State Hospital and incarceration in the California Department of Corrections, Lee underwent what sociologist Erving Goffman coined in his 1960 text Asylums as the process of “mortification.” After a burst of Asian American solidarity and legal aid that resulted in Lee’s triumphant release from Death Row in 1983 through a writ of habeas corpus, Lee struggled in the free world due to the long-lasting consequences of institutionalization, which led to alienation, recidivism, and an early death at the age of 62. This paper examines the trajectory of Lee’s trial and the legal activism behind it within the context of Goffman’s theory of total institutions and offer a nuanced reading of Lee’s case both during and after his incarceration.

Keywords: criminal justice, criminal law, law and mental capacity, habeas corpus, deinstitutionalization, mental health

Procedia PDF Downloads 20

Authors: Anupam Sibal

Abstract:

Apollo Quality Program(AQP) was launched across the Apollo Group of Hospitals to address the four patient safety areas; Safety during Clinical Handovers, Medication Safety, Surgical Safety and the six International Patient Safety Goals(IPSGs) of JCI. A measurable, online, quality dashboard covering 20 process and outcome parameters was devised for monthly monitoring. The expected outcomes were also defined and categorized into green, yellow and red ranges. An audit methodology was also devised to check the processes for the measurable dashboard. Documented clinical handovers were introduced for the first time at many locations for in-house patient transfer, nursing-handover, and physician-handover. Prototype forms using the SBAR format were made. Patient-identifiers, read-back for verbal orders, safety of high-alert medications, site marking and time-outs and falls risk-assessment were introduced for all hospitals irrespective of accreditation status. Measurement of Surgical-Site-Infection (SSI) for 30 days postoperatively, was done. All hospitals now tracked the time of administration of antimicrobial prophylaxis before surgery. Situations with high risk of retention of foreign body were delineated and precautionary measures instituted. Audit of medications prescribed in the discharge summaries was made uniform. Formularies, prescription-audits and other means for reduction of medication errors were implemented. There is a marked increase in the compliance to processes and patient safety outcomes. Compliance to read-back for verbal orders rose from 86.83% in April’11 to 96.95% in June’15, to policy for high alert medications from 87.83% to 98.82%, to use of measures to prevent wrong-site, wrong-patient, wrong procedure surgery from 85.75% to 97.66%, to hand-washing from 69.18% to 92.54%, to antimicrobial prophylaxis within one hour before incision from 79.43% to 93.46%. Percentage of patients excluded from SSI calculation due to lack of follow-up for the requisite time frame decreased from 21.25% to 10.25%. The average AQP scores for all Apollo Hospitals improved from 62 in April’11 to 87.7 in Jun’15.

Keywords: clinical handovers, international patient safety goals, medication safety, surgical safety

Procedia PDF Downloads 254

Authors: Yanuar Tri Wahyu Saputra, Ramadhani Pamapta Putra

Abstract:

Karimunjawa is one among Indonesian islands which is lacking of electricity supply. Despite condition above, Karimunjawa is an important tourism object in Indonesia's Central Java Province. Solar Power Plant is a potential technology to be applied in Karimunjawa, in order to fulfill the island's electrical supply need and to increase daily life and tourism quality among tourists and local population. This optimation modeling of Karimunjawa uses HOMER software program. The data we uses include wind speed data in Karimunjawa from BMKG (Indonesian Agency for Meteorology, Climatology and Geophysics), annual weather data in Karimunjawa from NASA, electricity requirements assumption data based on number of houses and business infrastructures in Karimunjawa. This modeling aims to choose which three system categories offer the highest financial profit with the lowest total Net Present Cost (NPC). The first category uses only PV with 8000 kW of electrical power and NPC value of $6.830.701. The second category uses hybrid system which involves both 1000 kW PV and 100 kW generator which results in total NPC of $6.865.590. The last category uses only generator with 750 kW of electrical power that results in total NPC of $ 16.368.197, the highest total NPC among the three categories. Based on the analysis above, we can conclude that the most optimal way to fulfill the electricity needs in Karimunjawa is to use 8000 kW PV with lower maintenance cost.

Keywords: Karimunjawa, renewable energy, solar power plant, HOMER

Procedia PDF Downloads 460

Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

Abstract:

Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

Procedia PDF Downloads 348

Authors: Anjana Sreedharan, Harish Rao

Abstract:

Background: India has the world’s third largest population of people living with HIV/AIDS, with a prevalence rate of 0.69 in the state of Karnataka. This study aims at assessing the HIV/AIDS related knowledge, attitude and behavior of the medical personnel in 3 hospitals in the city of Mangalore. Methods: Surgeons, Anesthetists, OT staff nurses, ward nursing staff, House surgeons working in the hospitals associated with Kasturba Medical college, Mangalore were given questionnaires and interviewed. Their knowledge about HIV, their attitude towards HIV positive patients and bias in management of the patients was assessed. Conclusion: So far, it has been found that amongst doctors, discrimination was mainly in the form of HIV testing without consent and a lack of confidentiality. However, the doctors rarely changed the treatment plan on knowing the HIV status of the patient. Amongst the nursing staff and interns, there is a serious lacuna of knowledge regarding HIV transmission, as compared to consultants. The patient seldom faced verbal abuse from the team. Use of universal precautions is less among the entire team due to insufficient availability of the same.

Keywords: discrimination, HIV/ AIDS, medical colleges, stigma

Procedia PDF Downloads 325

Authors: Rosmini Yanti, Safira Aviolita, Marsetio

Abstract:

Indonesia has several straits that are very important as a shipping lane, including the Sunda Strait and the Lombok Strait, which are the part of the Indonesian Archipelagic Sea Lane (IASL). An increase in traffic on the Marine Archipelago makes the task of monitoring sea routes increasingly difficult. Indonesia has proposed the establishment of a Traffic Separation Scheme (TSS) in the Sunda Strait and the Lombok Strait and the country now has the right to be able to conceptualize the TSS as well as the obligation to regulate it. Indonesia has the right to maintain national safety and sovereignty. In setting the TSS, Indonesia needs to issue national regulations that are in accordance with international law and the general provisions of the IMO (International Maritime Organization) can then be used as guidelines for maritime safety and security in the Sunda Strait and the Lombok Strait. The research method used is a qualitative method with the concept of linguistic and visual data collection. The source of the data is the analysis of documents and regulations. The results show that the determination of TSS was justified by International Law, in accordance with article 22, article 41, and article 53 of the United Nations Convention on the Law of the Sea (UNCLOS) 1982. The determination of TSS by the Indonesian government would be in accordance with COLREG (International Convention on Preventing Collisions at Sea) 10, which has been designed to follow IASL. Thus, TSS can provide a function as a safety and monitoring medium to minimize ship accidents or collisions, including the warship and aircraft of other countries that cross the IASL.

Keywords: archipelago state, maritime law, maritime security, traffic separation scheme

Procedia PDF Downloads 124

Authors: Taufik Hidayat, Yudha Nurhantari, Bambang U. D. Rianto

Abstract:

Introduction: The examination of the Short Tandem Repeats (STR) locus on nuclear DNA is very useful in solving the paternity cases. The purpose of this study is to know the description of paternity cases and paternity index/probability of paternity analysis based on Indonesian allele frequency at Sardjito Hospital Yogyakarta. Method: This was an observational study with cross-sectional analytic method. Population and sample were all cases of disputed paternity from January 2011 to June 2015 that fulfill the inclusion and exclusion criteria and were examined at Forensic Medicine Unit of Sardjito Hospital, Medical Faculty of Gadjah Mada University. The paternity index was calculated with EasyDNA Program by Fung (2013). Analysis of the study was conducted by comparing the results through unpaired categorical test using Kolmogorov-Smirnov test. This study was designed with 95% confidence interval (CI) with α = 5% and significance level is p < 0,05. Results: From 42 disputed paternity cases we obtained trio paternity cases were 32 cases (76.2%) and duo without a mother was 10 cases (23.8%). The majority of the fathers' estimated ages were 21-30 years (33.3%) and the mother's age was 31-40 years (38.1%). The majority of the ages of children examined for paternity were under 12 months (47.6%). The majority of ethnic clients are Javanese. Conclusion of inclusion was 57.1%, and exclusion was 42.9%. The Kolmogorov-Smirnov test obtained p-value = 0.673. Conclusion: There is no significant difference between paternity index/probability of paternity based on Indonesian allele frequency between trio and duo of paternity.

Keywords: disputed paternity, paternity index, probability of paternity, short tandem

Procedia PDF Downloads 164

Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

Abstract:

Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

Procedia PDF Downloads 296

Authors: Almas Athif Fathin Wiyantoro, Fransiskus Xaverius Ivan Budiman, Fithra Faisal Hastiadi

Abstract:

The growth of clothing and technology as a marketing tool has a great influence on online business owners to know how much the characteristics and psychology of consumers in influencing purchasing decisions made by Indonesian women consumers. One of the most important issues faced by Indonesian women consumers is the suitability of clothing. The suitability of clothing can affect the body cathexis, identity, and confidence. So the thematic analysis of clothing fitness and body cathexis of women consumers when and after using virtual fitting room technology to purchase decision is important to do. This research using group method of pre-post treatment and considers how the recruitment technique of snowball sampling, which uses interpersonal relations and connections between people, both includes and excludes individuals into 39 participants' social networks to access specific populations. The results obtained from the study that the results of body scans and photos of virtual fitting room results can be made an intervention in women consumers in assessing their body cathexis objectively in the process of making purchasing decisions. The study also obtained a regression equation Y = 0.830 + 0.290X1 + 0.292X2, showing a positive relationship between suitability of clothing and body cathexis which influenced purchasing decisions on women consumers and after (personal and psychological factors) using virtual fitting room, meaning that all independent variables influence Positive towards the purchasing decision of the women consumers.

Keywords: body cathexis, clothing fitness, purchasing decision making and virtual fitting room

Procedia PDF Downloads 209

Authors: Siti Dewi Aisyah

Abstract:

Islamic Muslim fashion has become a trend in Indonesia. It is said that social media has a huge impact on its development. Indonesia is ranked among the most users of social media. That is why people who wear hijab also use social media for different purposes, one of this is to introduce hijab fashion. Consequently, they are becoming famous in social media. Social media has become a tool for communicating their beliefs as a Muslim as well as personal branding as a good hijabi yet with a fashionable style. This research will examine the social media such as Blog and Instagram, how it triggers the consumer culture to hijabi, what is the actual meaning behind of their feed posts in their social media, how they produce good photograph in their social media and for what reason they use social media. This research had been conducted through in-depth interviews with several bloggers who created Hijabers Community who have made a new trend in Muslim fashion and also Instagrammers who made their feeds as a style inspiration. The methodology used for this research is by analyzing Blog and Instagram through visual analysis that also examines the semiotic meaning behind the photographs that are posted by the people on the social media especially about the Islamic Modest Fashion trend. The theoretical framework for this research is about studying social media that is examined through visual analysis. The Muslim fashion trend was lead by several bloggers and continued to Instagram which then created a consumption pattern. From colourful colors, pastel colors, monochrome colors to neutral coffee tone colors, it was influenced by the Muslim fashion designers that also become digital influencers in social media. It was concluded that social media had been a powerful promotional and effective tool to change the trend in Indonesian Muslim Fashion trend.

Keywords: blog, instagram, consumer culture, muslim fashion, social media, visual analysis

Procedia PDF Downloads 361

Authors: Yosi Maria Wijaya, Florisma Arista Riti Tegu

Abstract:

Background: Hypertension in pregnancy can be prevented by controlling the lifestyle. However, the majority of research on this topic has been conducted on lifestyle in women with normal pregnancy. Few studies of lifestyle have focused on Indonesian pregnant women with hypertension. Aim: The purpose of this study is to determine the association of demographic characteristics and the lifestyle of pregnant women who have hypertension. Methods: In this cross-sectional study, 76 women with hypertension during pregnancy were recruited from primary health care, West Java, Indonesia. Inclusion criteria were gestational age ≥ 28 weeks with the blood pressure systole ≥ 140 mmHg and diastole ≥ 90 mmHg. Data were collected using two instruments: demographic data and Health Promoting Life Style Profile (HPLP II). Data were analyzed with descriptive statistic and linear regression analysis. Results: The majority of participants were married, mean age was 27.96 years old (SD=6.77) with the mean of gestational age 33.21 (SD=3.49), most of them unemployed (94.7%) and more than a half participants have an education less than twelve years (59.2%). The total score of lifestyle was 2.44 (SD=0.34), more than a half participants experience unhealthy lifestyle (59.2%). Lifestyle was predicted by income, education years, occupation, and access to health care services, accounting for 20.8% of the total variance. Conclusion: Pregnant women with hypertension with low income, low level of education, non-occupational and hard to access health care services were related to unhealthy lifestyle. Understanding the lifestyle and associated factors contributes to health care providers ability to design effective interventions intended to improve healthy lifestyle among pregnant women with hypertension.

Keywords: demographic characteristics, hypertension, lifestyle, pregnancy

Procedia PDF Downloads 187

Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

Abstract:

Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

Procedia PDF Downloads 303

Authors: Sonny Dewi Judiasih

Abstract:

Every person retains the right to marry and starts a family through a legitimized marriage. Indonesian Marriage Act has regulated the minimum age for boys to marry is 19 while the girls is 16, with an exception that the parents could ask for an exemption to the court or to the authorized official. Despite the age limit is set by the Marriage Act, however, with the influences from adat law and islamic law which allows younger persons to marry, the child marriage phenomenon is inevitable to happen in Indonesia. Child marriages in Indonesia have shown such alarming fact where 4.8 percentage of total marriage number come from persons with the age of 10 to 14 years old. The percentage was the result from a research conducted by the National Population and Family Planning Board (BKKBN). The result shows 41.9 percent of child marriages was contributed by girls who marry in the age of 15 to 19, which mostly comes from villagers. Other fact shows 50 percent of child marriages end in divorce with grounds varied from the mental health of the children, economic situation, and so on. With more children committed early marriages, more babies will be borned from indebted families. Subsequently, the government’s program to alleviate poverty will be short of expectations. Other risk for child marriages includes death of the mother and the child after giving birth. The people have challenged the legality of child marriages through judicial review filed to the Constitutional Court. The Court decided to reinforce the age limitation previously set by the Marriage Act by issuing judicial decision no: 30-74/PUU-Xii/2014. The Court stated that changes to the age limit must be in conform with cultural and traditional situation. Further, it stated child marriages are allowed to be arranged as an “emergency exit” if the parents filed such request to an exemption on the grounds of coercive situation and after the court or the authorized officials issued its approval.

Keywords: child, marriage, court, Indonesia

Procedia PDF Downloads 352