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This study investigates the implementation of a simple supply chain strengthening program to enhance the competitiveness of Indonesian micro, small, and medium enterprises (MSMEs) in the Malaysian market. Indonesian MSMEs face challenges in market entry, including limited knowledge of export procedures, high distribution costs, and low product acceptance due to labeling and packaging issues. The research aims to evaluate whether targeted, low-cost interventions can improve MSME readiness and performance in international trade. A total of 40 MSMEs from the food and beverage, handicraft, and processed product sectors participated, with 55 owners, managers, and employees engaged in training and mentoring activities. Data were collected using pre–post knowledge questionnaires, logistics cost records, product placement monitoring, in-depth interviews, and focus group discussions. The program resulted in a 35% increase in knowledge scores, a 15% reduction in average distribution costs, a rise in product acceptance from 45% to 72%, and successful distribution partnerships for 8 MSMEs, leading to a 180% increase in monthly orders. The findings indicate that practice-based, contextual training combined with logistics optimization and market facilitation significantly enhances MSME competitiveness. Low-cost interventions are shown to be effective and scalable, providing practical guidance for policymakers and support institutions. The study contributes to the literature on MSME export readiness by demonstrating that structured, simple supply chain strategies can deliver measurable outcomes in low-resource settings. Future research should examine larger samples, longer monitoring periods, and additional markets to assess long-term sustainability and sector-specific strategies

The rate of deliveries by cesarean section (CS) continues to increase globally and is projected to reach 29% by 2030. Although CS is medically effective in ensuring maternal and neonatal safety, the procedure often results in moderate to severe postoperative pain, which may hinder early mobilization, slow recovery, and reduce the mother’s overall quality of life. Effective pain management is therefore crucial. Non-pharmacological therapies such as endorphin massage and lavender aromatherapy have been recognized as complementary approaches that stimulate the release of relaxation hormones, provide natural analgesic effects, and help reduce anxiety. This study aimed to analyze the effect of combining endorphin massage and lavender aromatherapy on reducing pain levels in post-cesarean section mothers. A quasi-experimental design with a pre–posttest control group was employed. A total of 34 respondents were selected using purposive sampling and divided into intervention and control groups. The study was conducted in the maternity ward of SMC Telogorejo Hospital from March to April 2025. The intervention group received endorphin massage combined with lavender aromatherapy for 10–30 minutes, while the control group was given deep breathing relaxation only. Pain levels were measured before and after the intervention using the Numeric Rating Scale (NRS). Data were collected through questionnaires and medical records, and analyzed using univariate and bivariate techniques with the Mann–Whitney test. Results showed a p-value of 0.000 and Z = -3.774, indicating a significant effect of the intervention. These findings suggest that endorphin massage combined with lavender aromatherapy is effective in reducing postoperative pain. Further studies with larger samples are recommended to explore the optimal duration and frequency of therapy.

This Study aimed to Analisys the accounting system and Procedures for village fund management and their impact on improving village government performance. Village fund, sourced from the National Budget (APBN), play a crucial role in rural development and community empowerment. An effective and transparent accounting system is essential to ensure accountibility and efficiency in utilising these funds. This research employed a qualitative upproach, using a case study method, conducted in Munerana Village, Hewokloang Sub- District. The Analysis covered the stages of planning, implementation, administration, reporting, and accountability in village fund management. The findings indicated that the accounting system and procedures in Munerana Village complied with the Minister Of Home Affairs Regulation No. 20 of 2018. However, challenges such as limited community participation and resource constraints must be addressed to enhance service effectiveness. Strengthening the capacity of village officials and enhancing village information system are critical steps toward achieving better and more ustainable village government performance.

Monitoring hemodynamic conditions, particularly oxygen saturation (SpO₂) and heart rate, is a crucial aspect of neonatal care, especially in critical conditions. In addition to therapeutic interventions, supportive measures such as repositioning (postural change) can help optimize ventilation distribution and lung function, which directly affect hemodynamic stability. This study aimed to examine the effect of repositioning on oxygen saturation and heart rate levels in neonates in the Peristi Room at RSI Sultan Agung Semarang. This research employed a one-group pretest-posttest design with 27 neonatal respondents. The procedure involved alternating the neonates’ positions to supine, right lateral, and left lateral for two hours in each position, followed by measurement of SpO₂ and heart rate before and after repositioning. Data analysis was conducted using the Wilcoxon signed-rank test, as some data were not normally distributed. The results showed a significant difference in heart rate after the right lateral position (p=0.027), while the change in SpO₂ was not significant (p=0.125). The left lateral and supine positions showed no significant changes in either heart rate or SpO₂ (p>0.05). It can be concluded that repositioning, particularly in the right lateral position, positively influences hemodynamic stability in neonates. Future studies are recommended to include a larger sample size for more comprehensive findings.

This study examines the relationship between nurses’ physical and mental workload and the implementation of patient safety at Baitul Hikmah General Hospital Kendal in 2025. Patient safety is a critical component of healthcare quality, and nurses, as the front-line providers, are directly involved in ensuring that safety standards are consistently maintained. However, high job demands often contribute to both physical and mental workload, which may affect compliance with patient safety practices. The research employed an analytical survey design with a cross-sectional approach, involving a total of 55 nurses from the emergency and inpatient units, selected using a total sampling technique. Data were collected through structured questionnaires assessing physical workload, mental workload, and adherence to patient safety procedures. Descriptive results showed that most respondents were in their productive age group, held a Diploma in Nursing, and had more than five years of clinical experience. The inferential analysis revealed a significant relationship between physical workload and patient safety (p-value = 0.023), whereas no significant relationship was found between mental workload and patient safety (p-value = 0.089). These findings suggest that while physical workload has a measurable impact on the implementation of patient safety, non-physical factors such as emotional maturity, professional responsibility, and coping strategies may play a more crucial role in ensuring safe and effective patient care. The study highlights the need for hospital management to address workload distribution and strengthen supportive measures that enhance nurses’ resilience and adherence to patient safety standards.

Nosocomial infections continue to be a critical challenge in healthcare settings, often emerging within two to four days after patients begin receiving treatment. Such infections not only prolong hospital stays but also increase morbidity, mortality, and healthcare costs. One of the most effective strategies for preventing nosocomial infections is ensuring strict adherence to handwashing procedures by nurses, who play a central role in direct patient care. This study aimed to evaluate nurses' adherence to handwashing procedures and to examine the relationship between the presence of role models and this adherence. A quantitative research method with a cross-sectional design was employed, involving 103 purposively selected respondents. Data collection was carried out using a structured questionnaire, and analysis was performed using the Spearman correlation test. The results indicated that the majority of respondents were between 26 and 45 years old and predominantly female. Findings revealed that most nurses rated role models as good (80.6%), which was consistent with their high level of handwashing compliance (80.6%). Statistical analysis demonstrated a significant relationship between the presence of role models and adherence to handwashing procedures (p = 0.000; r = 0.235), although the correlation was categorized as weak. These results highlight the importance of role modeling in promoting good clinical practices. Strengthening positive role models in clinical environments can serve as an effective strategy to improve hand hygiene adherence among nurses, thereby reducing the risk of nosocomial infections and enhancing patient safety.

Fractures are conditions of discontinuation of bone or cartilage, either partially or completely, which often require surgical treatment. One of the commonly used procedures is Open Reduction Internal Fixation (ORIF), which is an open surgical procedure with the installation of fixation tools such as pins, screws, and plates to repair broken bones. This procedure generally causes postoperative pain that needs to be treated effectively. Pain management can be done through pharmacological and non-pharmacological approaches. Lavender aromatherapy is one of the non-pharmacological methods that has the potential to provide a relaxing and analgesic effect. This study aims to determine the effect of lavender aromatherapy on the level of pain in patients after ORIF surgery. The research method uses a qualitative approach with a Quasi Experiment design. The sampling technique was carried out in total sampling with a total of 28 respondents post-operative ORIF patients at Dr. H. Soewondo Kendal Hospital. The data were analyzed using the Wilcoxon test to determine the difference in pain levels before and after the administration of aromatherapy. The results showed a p value of 0.000, which indicated a significant influence between the administration of lavender aromatherapy on the reduction of the patient's pain level. The conclusion of this study is that lavender aromatherapy is effective in reducing the intensity of postoperative pain of ORIF, so that it can be used as an alternative to nonpharmacological therapy in postoperative pain management. This study recommends the integration of aromatherapy in nursing practice to improve patient comfort.

This study discusses legal protection for customer data security in internet banking systems in Indonesia, especially after the enactment of various related laws and regulations. The purpose of this study is to analyze how legal protection is applied and the legal measures that can be taken by customers if their data is not protected. The research method used is normative legal research with a qualitative approach, through data collection from secondary sources such as laws, legal literature, and official documents. The final findings show that although legal protection has improved with the existence of relevant laws, there are still challenges in its implementation. Customers have the right to file complaints and legal claims in the event of a data breach, which includes complaint procedures with banks and the Financial Services Authority. Compliance with regulations and the principles of legal justice are essential to maintaining public trust in the banking sector.

Hemoglobin examination constitutes an essential procedure in clinical diagnosis, with the SLS-hemoglobin method serving as a non-toxic alternative to cyanmethemoglobin. However, the limited availability of sulfolyser has prompted investigations into the use of soap solutions, which also contain sodium lauryl sulfate (SLS), as a potential substitute. This study employed a quasi-experimental design with a posttest-only control group on 24 blood samples, comparing the standard sulfolyser reagent with three types of commercial soaps. The analysis revealed significant differences in hemoglobin levels across groups (p < 0.001), with dishwashing soap yielding values most comparable to the control, albeit still statistically lower. These findings confirm that soap solutions are capable of lysing erythrocytes and forming hemoglobin complexes, though variations in product composition constrain the consistency of results. Practically, soap demonstrates potential as a more accessible and cost-effective alternative reagent; however, its application requires concentration standardization to ensure diagnostic validity.

Public Company (Perum) BULOG is a business entity engaged in food logistics and has a strategic role in national food security. However, the company faces obstacles in the implementation of the Total Quality Management (TQM) system which is not fully in accordance with the applicable Standard Operating Procedures (SOP), as well as low work motivation for some employees. This study aims to analyze the influence of TQM implementation and work motivation on employee performance at the Perum BULOG head office. The research method used was a quantitative approach with data collection techniques through interviews and questionnaire distribution to 97 respondents selected using purposive sampling techniques. The research will be carried out in May 2025. The results of the analysis showed that partially, the implementation of TQM did not have a significant effect on employee performance (tcount = 1,533 < ttable = 1,985; sig. = 0.129 > 0.05). On the other hand, work motivation has a significant influence on employee performance (tcount = 5,411 > ttable = 1,985; sig. = 0.00 < 0.05). Simultaneously, TQM and work motivation had a significant effect on employee performance (Fcal = 16,602 > Ftable = 3,093; sig. = 0.00 < 0.05). These findings indicate that increasing work motivation is a key factor in encouraging employee performance, while the implementation of TQM needs to be adjusted to SOPs to be more effective in supporting organizational productivity.

This study provides an in-depth examination of the emergence of servitude rights (hak servituut) arising from procedural errors in land parcel division, which result in landlocked plots without road access. Servitude rights, as regulated in Article 674 of the Indonesian Civil Code and reinforced by the Conversion Provision of Article I point 6 of the Basic Agrarian Law (UUPA), constitute a legal burden imposed on one parcel of land for the benefit of another, thereby ensuring that landlocked owners gain reasonable access. Although the UUPA serves as the national agrarian framework, the servitude concept remains highly relevant and functions as a crucial legal instrument to safeguard the rights of affected landowners. This research employs a normative juridical approach, integrating statutory and conceptual analyses to explore the consistency between legal theory and practice. The findings demonstrate that parcel division conducted without considering the social function of land, as mandated by Article 6 of the UUPA, can trigger access disputes that adversely affect community interests. Dispute resolution may proceed through litigation or non-litigation channels, with mediation emerging as the more effective and efficient option for maintaining harmonious relations between parties. Article 667 of the Civil Code provides a clear legal basis for landlocked property owners to obtain access while obligating them to pay fair compensation to the burdened land. Based on these findings, the study recommends strict adherence to lawful land division procedures and the development of detailed technical guidelines on servitude compensation to prevent future disputes and to strengthen legal certainty for all stakeholders.

Anxiety and sleep quality are two closely related aspects in patients undergoing surgical procedures. High levels of anxiety in the preoperative phase often result in decreased sleep quality, while poor sleep can exacerbate anxiety, thus affecting the postoperative recovery process. This study aims to compare anxiety levels and sleep quality in patients before and after surgery. The research design used was a quasi-experimental with a pre-post test approach. The study sample consisted of 119 respondents selected through a purposive sampling technique in the Kenanga Ward of Dr. H. Soewondo Kendal Regional Hospital. The instruments used included the Zung Self-Rating Anxiety Scale (SAS) questionnaire to measure anxiety levels and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Data were analyzed using the Chi-Square test with the help of SPSS version 25 software. The results showed a significant relationship between anxiety levels and sleep quality in both the pre- and postoperative phases (p = 0.000; p < 0.05). A total of 54.4% of patients with poor sleep quality before surgery showed improvement after surgery. Furthermore, in the group with moderate anxiety, 54.8% experienced a reduction to mild anxiety. In conclusion, reducing anxiety levels has been shown to positively impact patients' sleep quality after surgery.

In order for hospitals to detect and intervene early, pediatric patient care must be of high quality. When making clinical decisions, assessing the risk of clinical deterioration, and providing appropriate emergency and critical care, the Pediatric Early Warning Score (PEWS) can be an excellent tool for nurses. This study aims to determine how Harapan Anda Hospital in Tegal City applies patient safety compliance and adherence to PEWS implementation. A cross-sectional approach was used in this quantitative study. A complete sampling approach was used to generate a sample size of 88 nurses from various healthcare facilities, including pediatric inpatient wards, PICU, NICU, and the emergency department. Patient safety surveys and PEWS compliance surveys were used to collect data. Spearman's test was used to analyze the data. The results showed that the majority of individuals (45 out of 63) were categorized as compliant in the implementation of the Pediatric Early Warning Score (PEWS). Meanwhile, the majority of nurses, 41 out of 106, or 46.6%, were compliant in their efforts to ensure patient safety. There was a significant relationship between the compliance of PEWS implementation and patient safety at RSU Islam Harapan Anda Tegal City with a p-value of 0.000. The results of this study are expected to be applied by healthcare workers to implement PEWS according to procedure, in order to ensure pediatric patient safety quickly and accurately.

Craniotomy is a medical procedure to open the skull in order to repair and assess damage to the brain, which can cause fever due to thermoregulatory disturbances in the central nervous system. Monitoring the body temperature of post-craniotomy patients is crucial, as hyperthermia can increase the risk of complications. One non-pharmacological therapy to reduce fever is the use of ice gel compresses. This study aims to compare the effect of ice gel compress placement between the chest and armpit on body temperature changes in post-craniotomy patients in the ICU of RSI Sultan Agung Semarang. This research uses a pre-experimental design with a two-group pretest-posttest design, involving 22 respondents selected through total sampling technique. Data were collected using observation sheets, and statistical analysis was performed using the Paired Samples Test. The analysis results showed that the p-value for the chest was 0.867 (p > 0.05) and for the armpit was 0.199 (p > 0.05), indicating no significant difference in body temperature before and after the ice gel compress at both locations in relation to the body temperature changes of post-craniotomy patients. In conclusion, the application of ice gel compresses to the chest and armpit locations did not show a significant effect on reducing body temperature in post-craniotomy patients.

Hemodialysis is a medical procedure used to correct blood biochemical abnormalities caused by impaired kidney function, with the aid of a hemodialysis machine. One of the most commonly used accesses in this procedure is the Arteriovenous Fistula (AVF), which is an anastomosis between the artery and vein in the arm or other parts of the body to facilitate the cannulation process. However, during the AVF cannulation procedure, patients often experience pain, which can cause discomfort and anxiety. Cold compresses are one of the non-pharmacological techniques that can be used to alleviate this pain. This study aims to examine the effect of cold compresses on reducing pain during AVF cannulation in hemodialysis patients. This research uses a Quasi-Experimental design with a Pretest-Posttest Control Group Design model, involving 116 hemodialysis patients at RSI Sultan Agung Semarang. Patients were divided into two groups: the intervention group, which received cold compresses, and the control group, which did not receive treatment. Pain intensity was measured before and after cannulation using a visual analog scale (VAS). The results of the study show that the administration of cold compresses significantly reduced pain intensity, with a p-value of 0.000 (< 0.05). In addition, there was a significant difference in effectiveness between the intervention group and the control group, with the same p-value. In conclusion, cold compresses proved to be an effective, simple, safe, and easy-to-apply non-pharmacological intervention to reduce pain in hemodialysis patients during the AVF cannulation procedure. Therefore, the use of cold compresses can be recommended as a method to improve the comfort of hemodialysis patients.

This study explains the analysis of the relationship between nurses' knowledge and compliance in implementing fall risk prevention in the inpatient ward of RSI Sultan Agung Banjarbaru. Fall risk is one of the most common patient safety incidents in hospitals, with significant impacts on the physical, psychological, and financial conditions of patients. Data from RSI Sultan Agung Banjarbaru in 2024 recorded three fall incidents, while a preliminary survey showed that 40% of nurses had insufficient knowledge of fall risk prevention and 60% were not compliant with existing preventive procedures. This study aims to determine the relationship between nurses' knowledge and compliance in reducing patient fall risk. The study design used a quantitative approach with a cross-sectional method, involving 97 nurses selected through simple random sampling. The instruments used were questionnaires designed to measure nurses' knowledge and compliance. Data were analyzed using Somers’ D test. The results showed that the majority of nurses had good knowledge (87.6%) and high compliance (90.7%). Additionally, a very strong and significant relationship was found between nurses' knowledge and compliance in implementing fall risk prevention (Somers’ D = 0.844; p = 0.000). This indicates that good knowledge of fall risk prevention procedures is strongly related to nurses' compliance in applying preventive measures. Therefore, it is essential for hospitals to provide ongoing education and training to enhance patient safety. With improved knowledge and compliance among nurses, fall risks are expected to be minimized, and patient safety can be better maintained.

Patient safety is a crucial aspect of hospital service quality, with one of the main indicators being the prevention of fall risks. Fall risks among patients often lead to serious injuries and impact the quality of care, making preventive measures essential. Nurses play a central role in implementing these preventive actions. However, the level of nurse compliance in following preventive procedures is often influenced by work motivation. This study aims to analyze the relationship between work motivation and nurse compliance in implementing fall risk prevention at the Sultan Agung Islamic Hospital in Banjarbaru. This quantitative study used a cross-sectional design, involving 97 inpatient nurses as respondents. The instruments used in this study included a 20-item Likert scale questionnaire to measure motivation and an observation sheet with 10 items to assess nurse compliance in applying fall risk prevention procedures. The data collected were analyzed using the Somers’ D test to determine the strength and direction of the relationship between the two variables. The results showed that the majority of nurses had high motivation (92.8%) and high compliance (90.7%) in implementing the prevention procedures. The Somers’ D test revealed a significant relationship between work motivation and nurse compliance in fall risk prevention (p = 0.003; d = 0.866), indicating that higher work motivation leads to higher compliance. The conclusion of this study is that work motivation is closely related to nurse compliance in fall risk prevention. Therefore, enhancing work motivation should be an important strategy for hospital management in developing a better patient safety culture.

Patient safety is one of the main components in determining the quality of hospital services. Every hospital is required to minimize incidents that may harm patients. Among various patient safety incidents, falls in children rank second after medication errors, making them a serious issue that requires attention. This study aims to evaluate the relationship between nurses’ motivation and compliance in conducting fall risk assessments with the incidence of falls among pediatric patients in the inpatient ward of QIM Hospital Batang. This study employed a descriptive quantitative design with a correlational approach. A total of 44 nurses who met the inclusion criteria were recruited as respondents. Research instruments included a motivation questionnaire, an observation sheet on compliance, and records of patient fall incidents. Data were analyzed using the Spearman Rank test to measure the strength of the relationship between variables. The findings showed that most respondents (84.1%) had a high level of motivation, and all nurses (100%) demonstrated full compliance in performing fall risk assessments according to standard operating procedures. During the study period, no cases of pediatric falls were reported in the inpatient ward, indicating the effectiveness of fall risk assessment implementation. Statistical analysis produced a p-value of 0.011, indicating a significant relationship between motivation and nurses’ compliance. These findings emphasize that work motivation plays an important role in maintaining nurses’ consistency in adhering to safety procedures. Motivation can be enhanced through managerial support, continuous training, and the establishment of a strong patient safety culture, thereby reducing the risk of falls and improving the overall quality of healthcare services.

This study aims to determine the effect of varying hybrid composite volume fractions of luffa (Luffa cylindrica) fiber and fiberglass on the tensile strength of the material. The composite matrix used was polyester resin, while the reinforcements consisted of luffa fibers treated with 5% KOH alkaline solution to improve adhesion with the matrix, and fiberglass as an additional strengthening material. The composition variations applied in this research were 90%:5%:5%, 85%:7.5%:7.5%, and 80%:10%:10% (polyester resin : luffa fiber : fiberglass). The fabrication process was carried out using the hand lay-up method, which is widely used for producing layered composites, followed by tensile testing according to standard mechanical testing procedures to evaluate tensile strength and elongation. The results showed that the addition of luffa fiber and fiberglass fractions had a significant influence on the mechanical properties of the composites. The 80%:10%:10% variation demonstrated the highest tensile strength value of 13.65 MPa and the highest elongation of 0.0105%, indicating better mechanical performance compared to other variations. These findings confirm that the hybridization of natural luffa fiber and synthetic fiberglass can work synergistically to improve the tensile strength of the composite. However, higher fiber fractions should be considered carefully, as they may affect the homogeneity of the mixture and the quality of interfacial bonding. Further research is recommended to optimize volume fractions, enhance fiber surface treatments, and evaluate additional mechanical properties such as impact strength and hardness, in order to explore the potential of hybrid composites as eco-friendly materials with promising mechanical performance.

This qualitative research investigates the critical factors inhibiting ship arrival efficiency and their impact on shipping agency performance at PT. Berkah Tata Baruna Banten Branch. Through comprehensive interviews with maritime professionals, port operators, and agency management, the study examines three primary variables: pilot tugboat services, cargo loading-unloading productivity, and document processing efficiency. Utilizing thematic analysis and narrative synthesis, findings reveal significant operational integration challenges that directly affect agency performance metrics. The research demonstrates that synchronized maritime service delivery substantially influences stakeholder satisfaction and business sustainability. Results indicate that technological integration barriers, communication gaps, and human resource development needs constitute primary obstacles to optimal port performance. Beyond identifying constraints, the study highlights how fragmented coordination between service providers creates inefficiencies that extend vessel turnaround times and increase operational costs. Respondents emphasized that transparent communication channels, standardized documentation procedures, and adequate training programs are essential to building resilient port systems. Moreover, the research shows that investment in digital platforms for real-time data sharing could accelerate clearance processes, while workforce development initiatives would ensure higher service reliability. The study contributes theoretically by developing frameworks of integrated maritime service performance and practically by offering policy-oriented recommendations to strengthen agency competitiveness. Overall, the findings provide valuable insights for stakeholders seeking to enhance Indonesia’s maritime logistics capacity, aligning operational improvements with the nation’s broader economic and global shipping ambitions.