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Background: Self-efficacy is the perception of the ability to consider and implement behavior patterns as self-regulation that is obtained through motivation and determining achievement of expectations. Good self-efficacy is needed not only for healthy people but also for sick people, especially people with chronic illnesses. Decreased self-efficacy can occur in people with chronic illnesses. We know that people with chronic diseases have long treatment programs, even for a lifetime, such as taking medication and sometimes this feels boring or boring. Consuming drugs or running a continuous treatment program can lead to boredom so that it is possible to want to stop taking medication. This is the background for wanting to know what actions can be taken to increase self-efficacy in people with chronic diseases. Self-efficacy increases if there is effort in dealing with existing obstacles. Interventions can be provided by health workers in increasing self-efficacy in people with chronic diseases. Objective: This study aims to describe the effect of Beapreasi therapy on self-efficacy in patients with chronic diseases at the Bergas Health Center, Semarang Regency. Methods: The research design used was descriptive and was carried out on 6 respondents, all of whom became the experimental group or all of whom became respondents. The method used to determine respondents is a purposive sampling technique. All respondents were assessed for self-efficacy using a self-efficacy scale questionnaire which was measured 2 times, namely before and after being given Beapreasi therapy. Results: The study showed that the mean value of the self-efficacy scale in the experimental group before the intervention was 81.79 and the value of the efficacy scale in the experimental group after the intervention was 89.36. this shows that there is an increase in the value on the self-efficacy scale and there is a difference in the mean value on the self-efficacy scale in the experimental group before giving the intervention with after giving the intervention with a p value of 0.00, p value <0.05 so that there is a significant/significant effect of giving reward therapy on improvement self-efficacy. Conclusion: Beapreasi therapeutic intervention can be used to maintain self-efficacy or increase self-efficacy in patients with chronic diseases, with the hope that patients will remain enthusiastic in carrying out their care and life. Beapreasi therapy can be used as a nurse's independent intervention in accompanying the care of patients with chronic diseases who require lifelong treatment and this is in an effort to increase self-efficacy in sufferers of chronic diseases.  

Lean is a concept and technique for systems that optimizes patient benefit by decreasing waste and waiting time. The literature review approach is used in this study to acquire research data, with internet searches serving as a supplementary tool while looking for relevant papers. According to the study findings, mean hospital length of stay (LOS) fell by 24% throughout the intervention period in 259 patients with PMV (131 pre-intervention; 128 post-intervention) (29 vs. 22 days, p 0.001). This demonstrates that clinical redesign based on Lean Six Sigma decreases LOS in intensive care units. Other studies show that utilizing Lean Six Sigma has resulted in a 57% reduction in length of stay and an 88% reduction in the identification of non-value added tasks. Lean management in hospitals is a step toward greater service efficiency that has been shown to outperform Total Quality Management (TQM) and Plan, Do, Check, Action (PDCA) improvements. Customers and their families gain from shorter wait times, as do healthcare employees (medical, emergency, and non-medical) and hospital administration. The use of the lean six sigma approach in conjunction with the DMAIC cycle effects LOS reduction, indicating that lean six sigma can reduce LOS in hospitals.

Measures to prevent disease, personal hygiene, choosing food, sanitation, and so on. Should be done with a healthy behavior. In order for the public to understand healthy behavior, it is carried out by applying the Strong Fital Yoga Booklet Scientific Media (Let's Take Care of Physical and Mental Health by Behaving Healthy). The purpose of the Community Service activities is so that PKK cadres in Eretan Kulon Village, Kandanghaur District, Indramayu Regency understand: 1) How to maintain Physical and Mental Health by Behaving Healthy, 2) How to use the Strong Fital Yoga Booklet (Let's Take Care of Physical and Mental Health by Behaving Healthy ), 3) How to educate the public about the importance of maintaining physical and mental health. The method used in PKM activities is carried out through training on the importance of maintaining physical and mental health by healthy behavior as well as explaining how to use the Booklet entitled Strong Fital Yoga with the mentoring model. Results: Availability of supporting media for PKM in the form of a Strong Fital Yoga Booklet, Implementation of training and outreach especially related to the use of a Strong Fital Yoga Booklet. There are HKI documents and reporting. Conclusion: PKM activities run smoothly and there is positive support from partners, Partnerships run well and smoothly and partners are happy to accept the booklet innovation product entitled Yoga Fital Strong. Recommendation: Partners should provide health education to the community both at the Posyandu and outside the Posyandu, paying attention not only to the physical aspect but also to the mental problems, this is because being healthy is not only seen from the physical aspect but also the mental and other aspects.

The aim of this research is to determine the relationship between knowledge about danger signs in pregnancy and the regularity of Antenatal Care at the Batua Community Health Center, Manggala District. The research design used in this study is observational with a "Cross Sectional Study" approach, where the dependent variable and independent variables are collected simultaneously at the same time to obtain information about the relationship between pregnant women's knowledge about danger signs in pregnancy and the regularity of Antenatal Care. The population in this study were all 45 mothers who had their pregnancy checked. The sampling technique in this research was purposive sampling so that the sample obtained was 35 people. Data collection was obtained through questionnaires given directly to respondents. The data analysis techniques used are bivariate analysis and univariate analysis. The research results showed that knowledge of pregnant women about danger signs in pregnancy was mostly in the good category, namely 25 people (80.6%), the regularity of Antenatal Care among pregnant women was mostly in the regular category, namely 21 people (67.7%), and knowledge about danger signs in pregnancy. with the regularity of Antenatal Care for pregnant women at the Batua Community Health Center, Manggala District, Makassar City for the period February 2022 (p=0.003).

Antenatal care is care or care provided to pregnant women before birth, which is useful for facilitating healthy and positive outcomes for pregnant women. Perfect health services have an impact on the quality of service that gives satisfaction to everyone. This study aims to determine the relationship between the quality of health services (tangible, reliability) to the level of satisfaction of the visit of TM I pregnant women at the Labuhan Deli Health Center, Labuhan Deli District, Deli Serdang Regency. This research is an analytical quantitative research using a cross sectional design. The population in this study were all TM I pregnant women who visited the Labuhan Deli Health Center, namely 56 respondents at the Labuhan Deli Health Center, Labuhan Deli District, Deli Serdang Regency in 2023. The sampling technique was accidental sampling. Data collection was analyzed by chi-square test. The results of this study indicate that there is a correlation between the satisfaction of pregnant women at the Labuhan Deli Health Center, Labuhan Deli District, Deli Serdang Regency in 2023 based on the tangible dimension (physical evidence), and there is no relationship between the level of satisfaction of pregnant women at the Labuhan Deli Health Center, Labuhan Deli District, Deli Serdang Regency in 2023 based on dimension of realibility (reliability).

Pregnancy exercise is a movement therapy therapy given to pregnant women to prepare themselves both physically and mentally for childbirth. Pregnancy exercise is needed by every pregnant woman, because it can make the body fit and healthy, and able to carry out daily activities, so that stress due to anxiety before giving birth can be minimized. However, many pregnant women do not do pregnancy exercise because they are unsure and afraid of their pregnancy if they do pregnancy exercise. Pregnancy exercise exercises that are carried out regularly both at the gym and at home in their spare time can lead pregnant women towards a physiological delivery as long as there are no pathological conditions accompanying the pregnancy. The purpose of Community Service in the Work Area of the Caile Health Center is to increase the ability of pregnant women and cadres to practice pregnancy exercises, so that they will increase the knowledge and health of pregnant women and prepare for childbirth. This community service activity begins with training for existing Posyandu cadres, providing supporting facilities and infrastructure in the form of leaflets and modules for pregnant women exercise, and doing pregnancy exercises in home care. The results of this Community Service activity are the formation of pregnancy exercise cadres, pregnant women can practice pregnancy exercise at home, as well as the provision of facilities and infrastructure in the form of leaflets and pregnancy exercise modules  

The challenges of the 21st century nursing world demand that nursing educators be able to prepare future nurses who can adapt to changes in the health care system, new technologies, changes in information systems (computerized), changes in pharmacological therapy, increased workload for nurses, increased infectious diseases in the community. , increasing cases of antibiotic-resistant infections, increasing aging population, and increasing number of chronic and co-morbid conditions (Aiken, Clarke, Cheung, Sloane, & Silber, 2003). Nurse educators are responsible for preparing graduates who can adapt to this rapidly changing health system. The simulation learning strategy is proposed as a suitable method to overcome this problem and can bridge the gap between education and clinical practice in hospitals. This literature search aims to analyze the results of related research that focuses on the effect of Simulation-Based Learning on the critical thinking of nursing students. This study was conducted using the review method of research results from 2010 – 2020 which have been published in electronic media such as ProQuest, Pubmed, and CINAHL. The number of journals obtained was 10 journals and 6 of them met the criteria. The conclusion of the research results obtained was that simulation is an interactive teaching-learning process, learning knowledge about critical care from a simulation of real patient situations, learning clinical skills and presenting holistic patient care by playing a role , and bridging the theory-practice gap to enhance critical thinking. In addition, simulations can hone critical thinking skills through feedback from simulators and monitor displays, develop communication skills through teamwork, and improve task delegation skills in complex situations.

A 52 year old male patient with complaints of weakness in the body. Initially the patient was brought to the Health Center with complaints of weakness since 3 days. Weakness is felt suddenly throughout the body and feels continuously. Complaints of weakness are also accompanied by a feeling of dizziness in the head. The patient also complained of frequent urination at night, urinating more than 10 times in one night. The patient also constantly feels thirsty, but his appetite has decreased since the last 2 years or so. The patient feels a loss of weight. In addition, the patient also complained of a wound on his left leg which had not healed since 1 year ago. Primary data were obtained through anamnesis and physical examination by conducting home visits, filling out family folders, and filling out patient files. The assessment was carried out based on the initial holistic diagnosis, process and end of the visit both quantitatively and qualitatively. Patients and families are given education about diabetes mellitus including the symptoms and complications that will arise, education about the patient's motivation to take medication regularly as well as educating and teaching patients about foot care and diabetes exercise. An approach with family doctor intervention is able to improve habits that are influential in the treatment of diabetes mellitus.

The provision of nutrition education and healthy food for pregnant women and toddlers is crucial in promoting maternal and child health. This project aims to implement a nutrition education program at the Kemuning 2 Keturen Integrated Health Post (Posyandu) to improve the nutritional knowledge and practices of pregnant women and caregivers of toddlers. The project will involve a series of educational sessions conducted by healthcare professionals and trained volunteers. The sessions will cover topics such as the importance of balanced nutrition during pregnancy, appropriate complementary feeding for infants and young children, and the selection of nutritious foods. Visual aids, interactive discussions, and practical demonstrations will be used to enhance the learning experience. Additionally, a nutritious food distribution program will be implemented to provide pregnant women and caregivers of toddlers with access to healthy and affordable food options. Local partnerships will be established with farmers, suppliers, and community organizations to ensure the availability of fresh and nutritious ingredients. The project's success will be evaluated by assessing the participants' knowledge and practices related to maternal and child nutrition before and after the intervention. Feedback from participants and healthcare providers will also be gathered to assess the program's effectiveness and identify areas for improvement. By providing nutrition education and access to healthy food, this project aims to empower pregnant women and caregivers of toddlers in making informed choices regarding their own and their children's nutrition. Ultimately, it is expected to contribute to improved maternal and child health outcomes in the Kemuning 2 Keturen community.

Educational activities and physical examinations regarding ear canal hygiene and tympanic membrane health have the aim of increasing public knowledge about the importance of maintaining ear hygiene and maintaining the integrity of the tympanic membrane. In this activity, counseling is given to the public to provide a correct understanding of cerumen, proper ear care, and signs of damage to the tympanic membrane. This community service activity was carried out on June 9, 2023 by involving 52 respondents. All respondents attended community counseling and physical examinations. On the results of the physical examination it was found that 3 (5.8%) respondents had a perforated tympanic membrane, and 6 (11.5%) respondents had prop cerumen. The results of this educational activity and physical examination are expected to increase public understanding of the importance of maintaining ear hygiene and maintaining the health of the tympanic membrane. With the right knowledge, it is hoped that people will be able to adopt healthy habits in caring for their own ears and take the necessary precautions to maintain optimal ear health.

Indicators to measure the quality of health services in an area can be seen from the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR). One of the ways that can be done to reduce maternal mortality (MMR) and infant mortality (IMR) is by implementing continuous care. The purpose of this continuous midwifery care is to be able to provide comprehensive midwifery care to Mrs. "S" from pregnancy to family planning in accordance with midwifery care standards. Case study research method. The results of the implementation of midwifery care on an ongoing basis (Continuity of Care) on Mrs. "S" G1P0A0 age 24 years starting from the gestational age of 30 weeks 3 days to the age of 38 weeks. At the first pregnancy visit there was a problem in the mother, namely pregnancy with breech location. At the second visit the baby's position was in a normal position. The delivery process ended by cesarean section because the baby had an Early Rupture of Membranes. The baby was born at Budi Kemuliaan Hospital with a weight of 3000 gr Body Length : 48 cm Head Circumference: 33 cm, Chest Circumference: 32 cm. In the postpartum period, physiological complaints were found such as pain in the suture wound but not accompanied by signs of suture wound infection. Mrs. "S" chose to use 3-month injectable birth control. The conclusion of this assessment is that midwives are expected to be able to provide comprehensive care from pregnancy to family planning services and apply care in accordance with midwifery service standards.

Our Community Service Program is about "Creating a Literacy Corner for Developing Potential Early Childhood (PAUD) and Education on Environmental Hygiene and How to Wash Hands Correctly." they do not constantly look at gadgets or cellphones and it is hoped that reading interest in Indonesia can increase again because our reading interest is in the 60th place out of 61 countries about reading interest, which means only 0.0001% or only 1 person who is interested to read therefore the literacy corner program itself can be a breakthrough for young people so that interest in reading does not disappear but instead develops in the future, Then as for our second program where we focus on the cleanliness of the surrounding environment through; Not littering, Cleanliness in terms of dressing, And how to wash hands properly and correctly. Because there are still many people who are not aware or still take it lightly about cleanliness in the surrounding environment, therefore we care about it as well as a form of prevention from disease outbreaks that continue to haunt us all this time.

Kerta Village is one of the villages located in Gianyar Regency. Along with the development of Kerta Village, currently Kerta Village already has a Waste Management Site (TPS). However, waste management in Kerta Village is not yet optimal. People still like to throw garbage carelessly and do not know how to handle waste, especially household domestic waste. This zero waste-based waste management training was held at the Penyabangan Banjar Hall, Kerta Village, Payangan District, Gianyar with the target being teenagers. The material presented to partners includes socialization of the concept of zero waste in waste management, counseling and training on waste segregation, training and demonstrations on making eco enzymes, and ends with a discussion or question and answer session. Waste management training activities for youth groups in Kerta Village were successfully carried out smoothly and were able to increase youth knowledge about waste management. Through this activity, youth are expected to become agents of change in creating a healthy and environment caring society that is sustainable.

According to Law No. 36 of 2009, health is a state of health, both physically, mentally, spiritually and socially that allows everyone to lead a socially and economically productive life. To ensure this health, the government established a health insurance known as the National Health Insurance (JKN). In its implementation, the JKN program experienced several challenges and obstacles. Therefore, this study aims to evaluate the JKN program in terms of increasing public health access. The research method used was a literature review obtained from eight journals from the Google Schoolar online database  between 2018 and 2023. Based on BPJS Kesehatan data as of October 2022, as many as 89.35% of the entire Indonesian population has been guaranteed health financing through the JKN program. There are several factors that affect the implementation of the JKN program, namely internal and external factors. To overcome this, various strategies are needed to optimize the JKN program in Indonesia. In addition, collaboration between stakeholders and the implementation of digitalization of health services in various health care facilities are also needed as readiness to face the global world. In its implementation, the implementation of JKN still experiences various obstacles such as low stakeholder readiness and responsiveness,  facilities and infrastructure that have not been maximized, and regulations regarding the JKN program have not been available and socialized properly.

Patient is a person who, directly or indirectly, consults a doctor or medical service about a health problem in order to receive the medical care the patient needs. After registering, patients need to wait until they get health services from the intended poly. The waiting time is understood as the time required from the arrival of the patient to the moment when the specialist performs the service. This study aims to review the length of waiting time for cardiac outpatient services at the Cilandak Marine Marine Hospital in 2022 using a quantitative approach with descriptive research methods, namely conducting direct interviews with outpatients and directly reviewing the length of waiting time for patients. 74 patient samples, there were 23 patients (31.08%) whose waiting time was appropriate or below the minimum service standard of waiting time (≤60 minutes), while for 51 patients (68.92%) the waiting time did not meet the minimum service standard of time. waiting time (>60 minutes), with an average patient waiting time of 96 minutes. The fastest waiting time for patients is 41 minutes, while the longest waiting time for patients is 173 minutes. Factors that cause long waiting times for outpatients are the inadequate number of medical record officers and medical personnel, the number of patients who come at the same time, causing queues at the registration counter and queues at the poly, doctors' practice hours are quite at odds with registration hours at the counter, negligence of the patient when registering, not carrying a medical card, not carrying the necessary documents, and not the patient concerned who registers, and the number of medical personnel and officers is not sufficient.    

Physiological newborns are babies born with a gestational age of more than or equal to 37 weeks with a body weight of 2500 grams to 4000 grams. During the birth period, many physical and psychological changes begin to occur in the baby's body, therefore it requires careful supervision to determine how to adjust to life outside the womb. The purpose of this study was to apply midwifery physiology care to By "Z" at the Panincong Health Center. The care provided uses the Varney 7 Step Midwifery Care Management approach and forms of documentation through SOAP. The case study conducted on By “Z” revealed that there were no obstacles when implementing Varney's 7 Step Midwifery Care Management approach. Thus, it is easy for caregivers to solve problems related to this. The form of midwifery care provided to By "Z" includes taking anamnesis on the baby's parents, carrying out physical examinations, and providing counseling to the parents, in this case to By "Z"'s mother about how to carry out effective care when caring for babies. This case study uses a descriptive observational method with a Continuity of care approach. The subject is By “Z” newborn. How to collect data anamnesis, observation, examination and documentation. Next, compare the data obtained with the existing theory

Introduction: Health Care Associated Infections (HAIs) often occur in hospitals. Infections classified as HAIs are surgical site infections. Compliance with wound care according to SPO, application of SSI budles and SC patient factors, namely: age, blood sugar levels and albumin levels contribute to the incidence of surgical site infections. This study aims to explain the relationship between SPO adherence to wound care, application of bundles surgical site infection, and patient factors with the incidence of SSI in sectio caesarea patients. Methods: This study uses a literature review. Search strategy on ProQuest, Google Scholar, PubMed. The journal reviewed is research on the relationship between SPO compliance with wound care, application of bundles surgical site infection, and patient factors with the incidence of SSI in cesarean section patients published in 2016-2023. Journals that did not meet the inclusion criteria were excluded, so that 5 journals were reviewed. Results: there is a relationship between adherence to SPO wound care, application of bundles surgical site infection, age, blood sugar levels, and albumin levels of SC patients to the incidence of SSI. Discussion: Research recommends that nurses adhere to SPO and implement SSI bundles strictly in a compliant manner, as well as monitoring patient factors, such as: age, blood sugar levels, patient albumin levels are very important in preventing infection in the operating area.    

The Care service is an itegral part of the health service included basic service and refered service. The care service done by paramedics are in the forms of care parented . Most petients complain that the medical personels often show unfriendly attitude and lack of interest on the patient needs with simple and careless services . some studies showed that around 33.58% of patient satiasfication was influenced by their perception on service quality . the objective of the research is to know the short time effectivity of them method on care service in Myria hospital.. It is a quantitative descriptive research. The research population were all of 46 paramedics in task the stayed care room. The research sample was the total population , as much as 43 paramedics. The research variables were the effectivity components, onsisting , of productivity, efficiency, and satisfaction. Data were analyzed by the univariat anaiysis on the three variables. The results of research showed that the good respondent productivity were done by 24 personels (44.2%), and poorrespondents productivity were done by 19 personels (55.8%). On the efficiency,variable 23 respondents (53.5%) showed poor efficiency and 20 respondents (46.5%) showed good efficiency ,and on the satisfaction variable , 15 respondent (34.9%) showed high satisfaction and 28 respondents (65.1%) showed low satisfaction. Based on the research result, it is recomended to the Myria Hospital to make some efforts in increasing working productivity by giving a chance to its paramedics to follow some training and higher education programs.    

Chronic energy shortage in pregnant women can have a number of consequences significant negative impacts on the health and development of the mother and the fetus. The study aims to analyze the impact of chronic energy deficiency on pregnant women based on an overview of the existing literature. The study involved analysis and synthesis of a variety of reliable sources that included scientific research and related health reports. Results of literature reviews suggest that chronic energy deficiency in pregnant women can lead to a variety of health problems. Pregnant women who experience chronic energy shortages have a higher risk of experiencing persistent fatigue, unwanted weight loss, and a decrease in physical strength. In addition, chronic energy shortages can also cause problems on the mother’s immune system, increase the risk of infection, and affect the body’s ability to recover after childbirth. To raise awareness about the dangers of chronic energy shortages on pregnant women, further research is needed to understand the underlying mechanisms and the effectiveness of appropriate interventions. Thus, this information can be used to improve prenatal care and provide the necessary support for pregnant women to ensure optimal health and development for the mother and fetus.

Antenatal care (ANC) visits are contacts between pregnant women and caregivers in terms of assessing the health and well-being of the baby as well as opportunities to obtain information and provide information to the mother and health workers. If a pregnant woman does not have a pregnancy check-up, it will not be known whether her pregnancy is going well or whether she is experiencing a high risk situation and obstetric complications which are dangerous for the life of the mother and fetus and can also cause high morbidity and mortality. The aim of this research is to determine the relationship between Antenatal Care (ANC) Management and Childbirth Complications at the Pratama Kita Clinic, Langkat Regency in 2023. This type of research uses a correlational research method with a cross sectional approach. The subjects of this study were pregnant women, totaling 49 respondents. Retrieval of data using a questionnaire on the management of antenatal care with labor complications. The analysis was carried out univariately and bivariately. The formula in this study uses the Chi Square formula. The management of antenatal care (ANC) is associated with labor complications with a p value = 0.000. The results of the study showed that there was a relationship between antenatal care (ANC) management and birth complications.