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"Tingginya tingkat hunian rumah sakit telah mendorong kebijakan untuk memulangkanpasien secara dini. Risiko infeksi luka operasi tidak hanya terjadi selama perawatan dirumah sakit. Infeksi luka operasi dapat juga terjadi ketika pasien sudah pulang dari rumahsakit. Kesinambungan pelayanan perawatan diperlukan agar tidak terjadi infeksi lukaoperasi selama pasien membutuhkan perawatan. Tujuan penelitian adalahmengembangkan model sistem pelayanan keperawatan berkesinambungan pasien operasiuntuk peningkatan kepuasan dan menyingkatkan waktu penyembuhan luka operasi.Metode penelitian meliputi tahap satu dilakukan penelitian kualitatif melalui focus groupdiscussion dengan peserta perawat pelaksana, kepala ruangan, dan perawat manajer dirumah sakit umum daerah Karawang berjumlah 25 orang, wawancara mendalam terhadap8 partisipan, dan uji coba model dengan sampel sebanyak 140 orang di RSUD Karawangdan RSUD Bayu Asih Purwakarta. Pada tahap tiga dilakukan uji coba model denganmetode kuasi eksperimen. Hasil penelitian tahap satu adalah terdapat empat tema danenam subtema. Hasil penelitian tahap tiga adalah variable jenis luka operasi berpengaruhterhadap lama kesembuhan luka operasi. Lama kesembuhan luka operasi lebih cepat 5hari pada kelompok intervensi. Tingkat kepuasan kelompok intervensi lebih tinggidibandingkan dengan kelompok kontrol. Model sistem pelayanan keperawatanberkesinambungan pasien operasi sangat penting diterapakan pada pelayanankeperawatan untuk meningkatkan kepuasan pasien dan penyingkatan waktupenyembuhan luka operasi.

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The high level of hospital occupancy had prompted policies to repatriate patients early.Surgical site infection risk did not only occur during hospitalization, surgical site infectioncould also occur when the patient have been discharged from the hospital. Continuity ofcare intervention was required to avoid surgical wound infections as long as the patientneeded. Objective of this study was to explorer the existing situation of continuity ofnursing care sistem for surgical patient, especially monitoring service to prevent surgicalsite infection. Research method include the first stage was conducted qualitative researchthrough focus group discussion with the staff nurses, head nurses, and nurse managers inpublic hospitals Karawang area amounted to 25 people and test model with a sample of140 people in public hospital Karawang and public hospital Bayuasih. In the third phaseexperimental model was conducted with quasi experimental method. The result of thestudy was found 4 themes and 6 subthemes in continuity of care flow of surgical patient.Longer wound healing was 5 days faster in the intervention group. The level of satisfactionof the intervention group was higher than the control group. Continuity of care systemmodel in surgery patients was very important to be applied in nursing care to improvepatient satisfaction and shorten wound healing time."

"ABSTRAK Ulkus kaki diabetik mengakibatkan mortalitas yang semakin meningkat terutamapasca amputasi, beban yang signifikan pada pembiayaan kesehatan danmenyebabkan hilangnya produktivitas. Penelitian ini bertujuan untuk mengetahuiefektivitas terapi kombinasi dari laserpunktur dan perawatan luka konvensionaldibandingkan dengan laserpunktur sham dan perawatan luka konvensionalterhadap penyembuhan ulkus kaki diabetik. Uji klinis acak tersamar ganda denganpembanding dilakukan terhadap 36 pasien yang dialokasikan ke dalam kelompokkasus atau kelompok kontrol. Tindakan laserpunktur dilakukan pada titik LI4Hegu, ST36 Zusanli, SP6 Sanyinjiao, dan KI3 Taixi bilateral serta penyinaranpada ulkus dua kali seminggu, selama empat minggu. Rerata ukuran ulkus kakidiabetik sebagai keluaran primer diukur setiap minggu. Hasil penelitianmenunjukkan perbedaan yang bermakna antara penurunan luas luka akhir dikelompok laserpunktur dan perawatan luka konvensional dengan kelompoklaserpunktur sham dan perawatan luka konvensional (p=0,006). Dapatdisimpulkan bahwa terapi kombinasi laserpunktur dan perawatan lukakonvensional efektif mempercepat penyembuhan ulkus kaki diabetik denganfrekuensi terapi dua kali seminggu. ABSTRACT Diabetic foot ulcers result in mortality is increasing, especially after theamputation, a significant burden on health financing and lead to loss ofproductivity. This study aims to determine the effectiveness of the combinationtherapy between laserpuncture and conventional wound care compared withsham laserpuncture and conventional wound treatment for healing diabetic footulcers. Double-blind randomized clinical trial with a control carried out on 36patients allocated to the case group or control group. Laserpuncture actionsperformed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3bilateral as well as exposure to ulcers twice a week, for four weeks. The mean sizeof diabetic foot ulcers as the primary output is measured every week. The resultsshowed a significant difference between the reduction in wound area at the end ofthe group laserpuncture and conventional wound care compare withlaserpuncture sham group and conventional wound treatment (p = 0.006). It canbe concluded that the combination therapy laserpuncture and conventional woundcare effectively accelerate the healing of diabetic foot ulcers with frequencytherapy twice a week.;Diabetic foot ulcers result in mortality is increasing, especially after theamputation, a significant burden on health financing and lead to loss ofproductivity. This study aims to determine the effectiveness of the combinationtherapy between laserpuncture and conventional wound care compared withsham laserpuncture and conventional wound treatment for healing diabetic footulcers. Double-blind randomized clinical trial with a control carried out on 36patients allocated to the case group or control group. Laserpuncture actionsperformed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3bilateral as well as exposure to ulcers twice a week, for four weeks. The mean sizeof diabetic foot ulcers as the primary output is measured every week. The resultsshowed a significant difference between the reduction in wound area at the end ofthe group laserpuncture and conventional wound care compare withlaserpuncture sham group and conventional wound treatment (p = 0.006). It canbe concluded that the combination therapy laserpuncture and conventional woundcare effectively accelerate the healing of diabetic foot ulcers with frequencytherapy twice a week.;Diabetic foot ulcers result in mortality is increasing, especially after theamputation, a significant burden on health financing and lead to loss ofproductivity. This study aims to determine the effectiveness of the combinationtherapy between laserpuncture and conventional wound care compared withsham laserpuncture and conventional wound treatment for healing diabetic footulcers. Double-blind randomized clinical trial with a control carried out on 36patients allocated to the case group or control group. Laserpuncture actionsperformed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3bilateral as well as exposure to ulcers twice a week, for four weeks. The mean sizeof diabetic foot ulcers as the primary output is measured every week. The resultsshowed a significant difference between the reduction in wound area at the end ofthe group laserpuncture and conventional wound care compare withlaserpuncture sham group and conventional wound treatment (p = 0.006). It canbe concluded that the combination therapy laserpuncture and conventional woundcare effectively accelerate the healing of diabetic foot ulcers with frequencytherapy twice a week."

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Latar belakang: Autologus growth factor (AGF) merupakan sitokin yang menarik perhatian para ilmuwan di bidang kedokteran dikarenakan memiliki fungsi yang penting dalam memperbaiki dan mempercepat  proses penyembuhan luka. Platelet rich fibrin matrix (PRFM) merupakan generasi terbaru konsentrat trombosit dengan tahapan persiapan yang praktis dan sederhana. Berbagai macam operasi di bidang THT-KL, salah satunya Laringektomi Total (LT). Komplikasi yang sering terjadi adalah terdapatnya fistula faringokutaneus, sehingga diperlukan perhatian dengan seksama terhadap proses penyembuhan luka pasca-LT. Tujuan penelitian: Membuktikan bahwa pemberian PRFM dapat memperbaiki tatalaksana untuk mempercepat penyembuhan pada luka operasi pasca-LT dibandingkan Kelompok kontrol. Metode: Penelitian ini dilakukan pada Divisi Laring Faring THT-KL/ FKUI – RSCM selama Juni – Desember 2019, merupakan penelitian pendahuluan dengan  desain Randomized Control Trial (RCT). Penelitian ini melibatkan 20 pasien dengan karsinoma sel skuamosa (KSS) Laring yang ditatalaksana dengan LT dan dibagi menjadi 10 pasien yang menjalani LT dengan augmentasi menggunakan autologus PRFM intra operasi dan 10 pasien sebagai kontrol. Proses penyembuhan luka diobservasi hingga 2 minggu pascaoperasi. Hasil: Telah dilakukan analisis bivariat dengan uji chi-square, didapatkan perbedaan yang signifikan pada ambang nyeri, edema dan dehisence pada luka stoma (p<0.001), keberhasilan tes minum yang dilakukan pada hari kelima (p<0.001) dan terbentuknya early fistula faringokutan (p=0.03) pada luka pascaoperasi kelompok subjek dengan PRFM dibandingkan tanpa PRFM. Kesimpulan: PRFM terbukti dapat mempercepat penyembuhan luka pasca-LT. Tes minum dapat dilakukan pada hari kelima pada seluruh kelompok subjek dengan PRFM dan menjadikan masa perawatan menjadi lebih singkat. Angka kejadian fistula juga ditemukan sangat berkurang sehingga tatalaksana kemoradiasi tidak tertunda.

Kata kunci: PRFM, Laringektomi total, Fistula faringkutaneus

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Background: Autologous growth factor (AGF) is a cytokine that attracts the attention of scientists, because of its beneficial to improve and accelerate process of wound healing. Platelet rich fibrin matrix (PRFM) is the latest generation of thrombocyte concentrate with simple preparation. Various kinds of operations in Otolaryngology, for example Total Laryngectomy (TL), a common complication is the presence of pharyngocutaneus fistula, so needed truly attention for wound healing process after TL.  Objective: Proving that administration of PRFM can improve management to accelerate surgical wound healing after TL compared without PRFM. Method: This research was performed in Larynx Pharynx Division of ENT Department FKUI-RSCM from June – Desember 2019. This study is preliminary study using Randomized Control Trial (RCT). There were 20 patients with Laryngeal squamous cell carcinoma treated with TL. Subjecst divided into 10 patientsunderwent TL with autologus PRFM augmentation intra operation and 10 more patients as a control group, then observed two weeks after surgery. Results: Bivariate analysis was performed with chi-square test, showed significant differences in the pain threshold, edema, presence of dehisence in stoma wounds (p<0.001), success of the drinking test conducted on the fifth day (p<0.001) and formation of pharyngocutaneous early fistule (P:0.03) in postoperative wounds between groups of patients that given PRFM and without PRFM. Conclusion: PRFM is proven to accelerate post-operative wound healing after TL. Drinking test can be performed on the fifth day in all subjects of PRFM groups so that time of hospitalized becomes shorter. Incidence rate of fistule is more decreased so that no delayed of chemoradiation.

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"Kepuasan pasien merupakan komponen utama penilaian mutu pelayanan rumah sakit. Kepuasan pasien terhadap layanan keperawatan peripoperatif perlu diidentifikasi agar perawat lebih termotivasi dalam memberikan pelayanan yang prima. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara persepsi mutu pelayanan keperawatan  peripoperatif dengan kepuasan pasien. Metode: Studi cross-sectional dengan teknik pengambilan sampling simple proporsi, serta menggunakan kuesioner Service Quality (ServQual) dan LPPSq (Leiden Perioperative care Patient Satisfaction questionare) ini melibatkan 140 responden yang menjalani operasi di salah satu rumah sakit di Depok. Hasil: Terdapat hubungan antara mutu pelayanan keperawatan peripoperatif dengan tingkat kepuasan pasien dalam menjalani operasi (p = 0,000; α = 0,05). Kesimpulan: Persepsi mutu pelayanan keperawatan peripoperatif berhubungan erat dengan kepuasan pasien dan faktor jenis operasi adalah faktor yang paling mempengaruhi tingkat kepuasan pasien. Saran: Perawat dan pemangku kepentingan dari bidang Pendidikan dan Pelayanan diharapkan mau meningkatkan kompetensi perawat di bidang layanan peripoperatif agar bisa memberikan pelayanan yang lebih prima.

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Patient satisfaction is an important indicator of quality of services in healthcare facilities. Patient satisfaction of perioperative nursing care should be assessed in order to motivate nurses in providing better services. Objective: This study aimed to identify correlation between perception on quality of perioperative nursing care and patient satisfaction. Method: this cross-sectional with simple proportion sampling, and using questionare Service Quality (ServQual) and LPPSq (Leiden Perioperative care Patient Satisfaction questionare study involved 121 participants who underwent surgery in certain hospital in Depok. Result: there was a significant correlation between quality of perioperative nursing care and patient satisfaction who underwent surgery. Conclusion: Perception on quality of nursing care is closely associated with patient satisfaction, and type of surgery is the most significant factor affecting patient satisfaction. Conclusion: Nurses and stakeholders in Education and Services should be more concerned about improving nurse competencies in perioperative care in order to provide better services."

"Latar belakang. Berbagai studi telah berhasil menemukan faktor-faktor yang mempengaruhi penyembuhan luka khususnya terkait fungsi ginjal dan albumin. Akan tetapi, belum terdapat studi yang mengevaluasi hubungan fungsi ginjal dan albumin terkhusus pada penyembuhan luka pasca amputasi pasien luka diabetik.Metode. Penelitian ini merupakan studi kohort retrospektif, yang dilakukan pada bulan Oktober–Desember 2022. Pasien ulkus kaki diabetik yang telah mendapatkan tindakan amputasi di RSUPN Cipto Mangunkusumo, yang mana keputusan amputasinya diambil berdasarkan skor WIfI [berada pada zona merah (risiko amputasi tinggi) skor WIfI yang dipetakan berdasarkan derajat luka, iskemia, dan infeksi] diinklusi ke dalam penelitian. Variabel yang diteliti meliputi kadar albumin, ureum, kreatinin, laju filtrasi glomerulus (LFG), kesembuhan luka, usia, status gizi, terapi insulin, merokok, hipertensi, durasi penyakit DM, dan onset luka.Hasil. Peneliti mengikutsertakan 61 pasien luka kaki diabetik yang menjalani tindakan amputasi di RSUPN Dr. Cipto Mangunkusumo, yang terdiri dari 23 (37,7%) pasien laki-laki dan 39 (63,9%) pasien dengan status gizi berlebih. 65,6% pasien mengalami reepitelisasi sempurna dalam 28 hari pasca tindakan amputasi. Kadar albumin, ureum, dan kreatinin pasien ditemukan sebesar 2,56 (1,11–4,98) g/dL, 71,00 (0,56–210) U/L, dan 1,40 (0,50– 11,50) U/L. LFG ditemukan sebesar 52,60 (4,10–117,30) mL/menit. Kadar albumin yang lebih tinggi (≥ 2,605 g/dL) dan kadar ureum yang lebih rendah (< 71,6 U/L) ditemukan berhubungan dengan probabilitas penyembuhan luka yang lebih tinggi (p < 0,050).Simpulan. Kadar albumin ditemukan lebih tinggi, sementara kadar ureum ditemukan lebih rendah pada kelompok luka sembuh pasien luka kaki diabetik 28 hari pasca amputasi.

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Background. Various studies have succeeded in finding factors that affect wound healing, especially related to kidney function and albumin. However, there have been no studies evaluating the relationship between kidney function and albumin, especially in post-amputation wound healing in diabetic wound patients.

Methods. This is a retrospective cohort study, conducted in October–December 2022. Diabetic foot ulcer patients who have received an amputation procedure at Cipto Mangunkusumo Hospital, where the decision to amputation is made based on the WIfI score [is in the red zone (high risk of amputation) WIfI scores charted according to degree of injury, ischemia, and infection] were included in the study. The variables studied included albumin, urea, creatinine, glomerular filtration rate (GFR), wound healing, age, nutritional status, insulin therapy, smoking, hypertension, duration of diabetes mellitus, and onset of injury.

Results. We included 61 patients with diabetic foot injuries who underwent amputation at RSUPN Dr. Cipto Mangunkusumo, which consisted of 23 (37.7%) male patients and 39 (63.9%) patients with excess nutritional status. 65.6% of patients experienced complete re-epithelialization within 28 days after the amputation. The patient's albumin, urea, and creatinine levels were found to be 2.56 (1.11–4.98) g/dL, 71.00 (0.56–210) U/L, and 1.40 (0.50–11 ,50) U/L. GFR was found to be 52.60 (4.10–117.30) mL/minute. Higher albumin levels (≥ 2.605 g/dL) and lower urea levels (< 71.6 U/L) were found to be associated with a higher probability of wound healing (p < 0.050).

Conclusion. Albumin levels were higher, while urea levels were lower in the group of healed wounds of patients with diabetic foot ulcer in 28 days following the amputation surgery."

"Diabetes Melitus merupakan penyakit kronik yang memiliki konotasi kebudayaan oleh karena itu dalam penanganannya perlu memperhatikan aspek kebudayaan pasien. Keberagaman kebudayaan pasien berdampak pada adanya kebutuhan asuhan keperawatan yang peka budaya. Penelitian ini bertujuan untuk mengembangkan Model Asuhan Keperawatan Peka Budaya (Model AKPB) dan mengidentifikasi pengaruh model tesebut terhadap kepuasan pasien Diabetes Melitus. Penelitian dengan desain kuasi eksperimen melibatkan 208 orang pasien Diabetes Melitus yang dirawat di dua rumah sakit umum pusat di Jakarta.Instrumen yang digunakan merupakan hasil modifikasi sejumlah instrumen yang berhubungan dengan kompetensi budaya dan kepuasan pasien terhadap asuhan keperawatan. Hasil penelitian diperoleh ada perbedaan yang bermakna antara kepuasan pasien pada kelompok intervensi dibandingkan dengan kelompok kontrol(p= 0,000). Hasil analisis multivariat menunjukkan bahwa pasien yang mendapat asuhan keperawatan peka budaya lebih tinggi kepuasannya sebanyak 5,2 kali dibandingkan dengan pasien pada kelompok kontrol. Kesimpulan penelitian ini adalah Model Asuhan Keperawatan Peka Budaya terbukti dapat meningkatkan kepuasan pasien Diabetes Melitus. Saran untuk penelitian selanjutnya adalah perlu dilakukan penelitian pada kasus pasien dengan gangguan kesehatan yang lain.

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As a chronic disease Diabetes Mellitus has a cultural association therefore its management should consider the cultural aspect of the patient.The cultural diversity among patients has an impact on the increase demand of culturally sensitive nursing care. The purpose of this study is to develop a model of culturally sensitive nursing care (Model AKPB) for diabetic patient and its impact on patient satisfaction regarding nursing care. The design of quasi experimental was used with 208 diabetic patient from two different hospitals involved in this study.Modified instrument from culturally competent nursing care and satisfaction for nursing care were developed and utilized. The result shown that there is a statistically different between the staisfaction of patient amongs intervention group and control group (p= 0,000). Multivariate analysis shown that the satisfaction of patients from intervention group 5.2 times higher than control group. As conclusion, there is an evidence that the model of culturally sensitive nursing care has increased the satisfaction of diabetic patient. Further research needed to identify the effectiveness of this model for other different health problems."

"Latar Belakang: Pelayanan keperawatan di Puskesmas saat ini belum sepenuhnya menampilkan kemandirian profesi keperawatan sehingga kinerja dan kepuasan kerja perawat terkait pemberian asuhan keperawatan menjadi tidak optimal. Model Tata Kelola Klinis Pelayanan Keperawatan INPRO merupakan upaya penataan kegiatan pelayanan keperawatan dalam gedung puskesmas untuk meningkatkan kinerja dan kepuasan kerja perawat puskesmas. Penelitian ini bertujuan untuk menguji efektifitas model tata kelola klinis pelayanan keperawatan INPRO terhadap peningkatan kinerja dan kepuasan perawat di Puskesmas. Metode: Penelitian ini merupakan penelitian operasional dengan tiga tahap penelitian. Tahap pertama yakni penelitian eksplorasi melalui studi kuantitatif dan kualitatif dengan jumlah responden studi kuantitatif sebanyak 96 responden dan 18 partisipan untuk studi kualiatif. Tahap kedua, proses pengembangan model melibatkan 3 pakar dan 7 responden untuk uji keterbacaan .Tahap ketiga merupakan uji efektivitas model dengan disain kuantitatif kuasi eksperimen pre-post test with control group, dengan jumlah responden sebanyak 56 responden yang terbagi dalam dua kelompok. Hasil: Penelitian tahap 1 teridentifikasi 6 temuan yang menunjukkan bahwa perlu upaya penataan pelayanan keperawatan didalam gedung puskesmas. Tahap 2 dihasilkannya model tata kelola pelayanan keperawatan INPRO dalam gedung Puskesmas yang berlandaskan pada otonomi profesi, kepemimpinan dan hubungan profesional. Tahap 3 diperoleh hasil terdapat perbedaan signifikan peningkatan rerata kepuasan kerja (p<0,05) dan kinerja perawat (p<0,05) sebelum dan sesudah intervensi pada kelompok intervensi. Kesimpulan: Model tata kelola klinis pelayanan keperawatan Inpro efektif dapat meningkatkan kepuasan dan kinerja perawat. Saran: Model ini dapat digunakan pada pelayanan keperawatan dalam gedung puskesmas untuk meningkatkan kepuasan dan kinerja perawat.

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Background: Nursing services at Community Health Centers (Puskesmas) currently do not fully display the independence of the nursing profession so that Nurse performance and job satisfaction regarding to providing the nursing care was not optimal. The INPRO Nursing Service Clinical Governance Model is an effort to manage nursing service activities for increasing the satisfaction and performance of nurses. This study aims to examine the effectiveness of the INPRO nursing service clinical governance model for increasing nurse satisfaction and performance at community health center. Methods: This study used an operational research with three stages of research. The first stage is exploratory research through quantitative and qualitative studies with 96 respondents and 18 participants for qualitative studies. The second stage is the model development process involved 3 experts and 7 respondent to test readability.. The third stage is a test of the effectiveness of the model with a quasi experiment pre-post test with control group design, with a total of 56 respondents divided into two groups. Results: Stage 1 research identified 6 findings that showed that efforts were needed to manage nursing services. stage 2 produced a clinical governance model of INPRO nursing services at Puskesmas based on professional autonomy, leadership and professional relationships. Stage 3 obtained the results that there was a significant difference in the average increase in job satisfaction (p<0.05) and nurse performance (p<0.05) before and after the intervention for the intervention group. Conclusion: The clinical governance model of Inpro nursing services can effectively improve nurse satisfaction and performance. Suggestion: This model can be used for nursing services at puskesmas to improve nurse satisfaction and performance."

"Rendahnya kualitas hidup lansia di PSTW belum mendapatkan perhatian dari berbagai pihak, sementara keinginan lansia tinggal di panti semakin meningkat di Sumbar. Salah satu penyebab adalah pergeseran nilai budaya perawatan lansia di keluarga. Tujuan penelitian untuk memperoleh model keperawatan pendampingan lansia berbasis budaya minang, untuk meningkatkan kualitas asuhan, status kesehatan, kepuasan dan kualitas hidup lansia di panti. Disain penelitian yang digunakan riset operasional, terdiri dari tiga tahap. Tahap I: identifikasi dasar pengembangan model, melaluimetode campuran dengan desain ethnografi terfokus dan desain deskriptif. Tahap II: pengembangaan model keperawatan pendampingan lansia berbasis budaya merupakan integrasi tema tahap 1, studi literatur dan konsultasi pakar; Tahap III: uji coba model dengan quasi experiment with control group design. Jumlah sampel kelompok intervensi 52 orang, dan 51 orang kelompok kontrol. HasilSal penelitian  tahap I: kompetensi budaya, perilaku merawat, status kesehatan, kepuasan dan kualitas hidup status masih rendah (kurang 50%), penelitian kualitatif diperoleh 19 tema; tahap II, dihasilkan model pendampingan lansia berbasis budaya minang dilengkapi 3 modul, 1 buku kerja, dan panduan bagi komponen model; tahap III: intervensi berhasil meningkatkan kualitas asuhan, status kesehatan, kepuasan dan kualitas hidup lansia di PSTW Sumbar. Kesimpulan: model memiliki efektifitas intervensi tertinggi pada kualitas asuhan (komunikasi, kebersihan dan pelayanan), kualitas hidup (spiritualitas), status kesehatan, kepuasan hidup, kompetensi budaya dan perilaku merawat. Rekomendasi: 1) model dapat dipakai di PSTW diwilayah lain diluar Sumbar dengan melakukan penyesuaian; 2)Pendidikan dan pelatihan berkelanjutan bagi seluruh staf panti; 3)Penelitian lanjutan yaitu pengembangan instrument kompetensi budaya untuk petugas panti.

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The low quality of life of the elderly at PSTW has not received much attention from various parties, while the desire of the elderly to live in the institution has increased in West Sumatra. This happened because of the shift in the value of the elderly care culture in the family. The aim of the study was to obtain a nursing assistance model for elderly people based on Minang culture, to improve the quality of care, health status, satisfaction and quality of life for elderly people at the orphanage. Research uses the operational research research design, which consists of three stages. Stage I: identification of basic model development, through mixed research with focused ethnographic design and descriptive design. Stage II: development of a culture-based elderly mentoring nursing model is the integration of the theme of stage 1, literature study and expert consultation; Stage III: trial model with quasi experiment with control group design. The number of samples in the intervention group was 52 people, and 51 were control groups. The results of phase I research: cultural competence, caring behavior, health status, satisfaction and quality of life status are still low (50% less), qualitative research obtained 19 themes; phase II, produced an elderly mentoring model based on Minang culture equipped with 3 modules, 1 workbook, and guidance for model components; stage III: the intervention managed to improve the quality of care, health status, satisfaction and quality of life of the elderly in West Sumatra PSTW. Conclusion: the model has the highest effectiveness of intervention on the quality of care (communication, cleanliness and service), quality of life (spirituality), health status, life satisfaction, cultural competence and caring behavior. Recommendations: 1) the model can be used in PSTW in other regions outside of West Sumatra by making adjustments; 2) Continuous education and training for all nursing staff; 3) Further research is the development of cultural competency instruments for nursing staff."

"Cairan NaCl 3% pada penelitian sebelumnya terbukti mampu menarik kelebihan eksudat dan mengurangi bau luka karena bersifat hipertonik. Penelitian eksperimen dengan penyamaran ganda dilakukan untuk mengetahui efektivitas perawatan luka dengan cairan NaCl 3% terhadap penurunan jumlah eksudat dan bau ulkus diabetik. Intervensi dilakukan selama 14 hari terhadap 15 sampel yang dibagi menjadi kelompok NaCl 0,9% dan NaCl 3% melalui randomisasi blok. Tidak terdapat perbedaan signifikan jumlah eksudat setelah intervensi antara kedua kelompok namun terdapat perbedaan signifikan pada skor bau luka. Perawatan ulkus diabetik dengan NaCl 3% tidak lebih efektif dalam menurunkan jumlah eksudat luka dibandingkan NaCl 0,9% namun lebih efektif NaCl 3% dalam menurunkan skor bau.

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Previous studies on wound care had proved that NaCl 3% solution able to absorbs the wound exudate and reduces the odor because it is hypertonic. A randomized controlled trial with double blinded technique was conducted to determine the effectiveness of wound care using NaCl 3% solution to decrease amount of exudate and odor of diabetic ulcers. Interventions performed for 14 days on 15 subjects blocked randomly allocated to NaCl 0,9% and NaCl 3% groups.

The result showed that there was no significant difference in the amount of exudate between the groups, however there was significant difference in the odor score. Wound care using NaCl 3% is no more effective to reduce the amount of exudate than NaCl 0,9%, however NaCl 3% is effective to reduce the odor score of diabetic ulcer."

"Pendahuluan: Ulkus dekubitus adalah suatu kerusakan jaringan lunak akibat penekanan yang berkepanjangan di atas tonjolan tulang. Sebagian besar studi menggunakan madu Manuka sebagai perawatan luka (dressing), di mana madu tersebut mahal. Atas landasan tersebut, studi ini menggunakan madu lokal, yaitu madu Nusantara, dengan tujuan untuk membuktikan penggunaan madu lokal pada pasien pressure injury memiliki luaran yang lebih baik, diobservasi dari penyembuhan luka, profil bakteri, dan harga, dibandingkan dengan dressing standar, yaitu hydrogel.Metode: Studi eksperimental ini dilakukan kepada pasien pressure injury yang dikonsultasikan ke divisi kami. Observasi dilakukan selama satu bulan. Parameter profil bakteri diambil melalui kultur jaringan. Proses penyembuhan luka dinilai berdasarkan Pressure Ulcer Scale for Healing (PUSH) Tool. Biaya diakumulasikan dari awal sampai akhir tata laksana. Analisis data menggunakan T-test atau Mann-Whitney (jika distribusi tidak normal), dengan signifikansi didefinisikan sebagai p<0,05.Hasil: Dari 26 luka, terdapat 12 luka ditata laksana dengan hydrogel dan 14 madu. Karakteristik pasien dinilai berdasarkan jenis kelamin, usia, indeks massa tubuh, tingkat kesadaran, status mobilisasi, penyebab imobilisasi, komorbiditas, derajat dan luas luka, kadar hemoglobin, leukosit, dan albumin. Terdapat reduksi luas luka yang signifikan secara klinis berdasarkan PUSH Tool (p=0,118). Profil bakteri dan reduksi bakteri serupa di antara kedua grup. Madu lebih efisien dalam hal biaya, terkait dengan harga dressing (p<0,001) dengan total biaya lebih rendah.Kesimpulan: Dressing madu lokal memiliki kemampuan penyembuhan luka yang lebih baik, walaupun tidak signifikan secara statistik. Kemampuan penurunan bakteri sama dengan dressing standar, dengan biaya yang lebih murah, terutama harga dressing. Madu lokal dapat dipakai untuk perawatan luka di area di mana tidak tersedia dressing modern.

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Background: Pressure injury is a localized soft tissue injury caused by prolonged pressure over bony prominence. Most published papers used Manuka honey as dressing, while this product is expensive. As this reason, this study will use local product honey called Nusantara honey, to prove the use of local honey has better healing process, bacterial profile, and cost effectiveness, compared to the standard dressing, hydrogel.

Methods: This is a one-month experimental study conducted in patients with pressure injury that referred to our division. Parameter of the bacterial profile was taken from deep-tissue specimen. The healing process was examined with Pressure Ulcer Scale for Healing (PUSH) Tool. Cost was accumulated after all the treatment. Data was analyzed with T-Test or Mann Whitney (if the distribution is not normal), with statistical significance was define as p<0.05.

Results: Of 26 wounds, 12 were randomized to hydrogel and 14 to honey dressing. Characteristics were determined by sex, age, body mass index, level of consciousness, mobilization status, immobilization etiology, comorbidities, grade and location of ulcer, hemoglobin, leukocytes, and albumin level. There was clinically significant wound size reduction in honey dressing according to PUSH Tool (p=0.118). The bacterial profile and reduction were similar. Honey dressing appeared to be more cost effective in terms of dressing cost (p<0.001) and lower total cost.

Conclusion: The local honey dressing has better wound healing outcome, although it is not statistically significant. Its capability of decreasing pathogens is similar with hydrogel, with lower cost, particularly the dressing cost. This local honey dressing could be a good choice as wound dressing in areas where the modern dressings are not available."