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Introduction: Elderly is a life where from babies, toddlers, teenagers, adults and the elderly. In this process there are significant Bio-Psycho-Social changes in his life such as social changes, namely the breaking of relationships with colleagues, loss of status or role (tasks, authorities and responsibilities) in the workplace environment, changes in individual roles in the family and public. Method: The research method used in this study is a qualitative descriptive research method. The collection techniques for this research were interviews, observations, physical examinations and documentation. Results: The results showed that before giving dhikr and meditation therapy, 4 patients (80%) were in the moderate stress category, and 1 patient (20%) was in the severe stress category. After giving dhikr and meditation therapy, 4 patients (80%) were found with mild stress category, and 1 patient (20%) with moderate stress category. Conclusion: Prior to the remembrance therapy, the mental condition of the elderly at the Peni Griya Jannati experienced depression due to the pressures of daily life, experiencing loneliness due to living with family or loved ones, mental emotional disorders that were not yet stable, and anxiety disorders. So that the process of dhikr therapy must be carried out in the elderly.  

Patients with Sectio Caesarea in some cases have worsened so they have to be rushed to the ICU to get intensive care. This case study aims to obtain an overview of the application of progressive mobilization to improve functional status and muscle strength in post-sectio patients with eclampsia in the ICU. This case study uses a descriptive design. The application of progressive mobilization performed on patients has been successfully implemented up to level 3. The results of this case study found that progressive mobilization can increase muscle strength from 0 to 56 and functional status from 0 to 65, and can reduce the risk of ICU-AW, speed up the length of release ventilator. Progressive mobilization is effective in increasing muscle strength, and functional status, and can improve the improvement of hemodynamic status and oxygenation status, and prevent the occurrence of ICU-AW. Progressive mobilization can be implemented immediately to shorten the length of stay in the ICU.    

This study aims to evaluate the level of patient satisfaction with home care services in West Java. The research method used is qualitative study with survey and face-to-face techniques on 10 home care patients and 10 patient families in West Java. The results of the study showed that patients and patient families were very satisfied with the home care services because they provided comfort and fulfilled patient needs. In addition, healthcare workers who worked in the field of home care felt connected and useful in providing personal care focused on the patient. However, the study also identified several challenges in home care services, such as coordination between healthcare workers and families, as well as accessibility and quality of home care services. Therefore, support and cooperation from various parties, such as patient families, the community, and the government, are needed to improve the quality of home care services and ensure that patients receive the best care at home.

The hospital also has the main task of providing complete individual health services with efforts to heal, recover, improve, prevent, referral services, research and development and community service. The purpose of writing this scientific article is to find out and review theoretically from various literature and strategies to improve patient satisfaction and quality of service in hospitals. The method used is a theoretical study by analyzing and comparing existing theories. The results of this theoretical study, namely the strategies carried out by increasing human resources, the speed of staff response, and satisfaction can be identified by comparing the expectations and experiences of the performance of health service providers. By doing this strategy can provide a desire of patient hope. It was concluded that strategies to increase patient satisfaction and health quality can realize patient expectations arising from the actions of health workers as the performance of health services and during a good treatment process. In the strategy carried out the patient will evaluate and assess the product or service quality that has been received. Hospital agencies also need to improve service quality strategies to realize patient expectations. Patient satisfaction in assessing quality or good service, and is an important measurement that is fundamental to the quality of service. This is also because by providing information on the success of quality service providers, the values ​​and expectations of patients will increase.

Strategic management has a very important role and needs to be implemented in improving the accreditation status of the hospital. The strategy that has been made must be implemented properly in order to ensure development and sustainability. This strategy must be applicable to all hospital parties in order to improve service quality and accreditation status. The purpose of writing this scientific article is to find out and review from a theoretical point of view various literatures. The method used is a theoretical study by analyzing and comparing existing theories. The results of this theoretical study are the function of strategic management in improving accreditation status by carrying out procedures so that it can assist hospitals in making better plans with a more logical, rational and systematic approach for each option that will be found by forming a plan. It can be concluded that in improving the quality of health, strategic management is also needed to improve services. With accreditation strategic management, the hospital becomes the object of focus or a process of assessing and determining the eligibility of the hospital according to service standards set by an independent accreditation agency. So that it can improve the image and trust of patients in choosing health care facilities. For hospitals strategic management is very important and needs to be done optimally to support the improvement of accreditation status. So agencies improve infrastructure facilities, adequate human resources and supporting facilities.

Facing the JKN era is not easy, especially for private hospitals. Private hospitals need strategy, understanding, understanding and mutual agreement throughout the internal hospital, both doctors, nursing staff, general staff and management. The strategy for promoting health services in hospitals and other health facilities is not much different from the marketing strategy in general. It aims to promote and introduce the Hospital and the services provided. The purpose of writing this scientific article is to find out and review from a theoretical point of view how the strategy is carried out by private hospitals in this JKN era. The method used is a theoretical study by analyzing and comparing existing theories. It then learns more about a subject in theory or research and helps readers understand it better and with implications. The results of this theoretical study are private hospital services by implementing strategies and principles for implementing the National Health Insurance Program (JKN) such as mutual cooperation, non-profit, openness, portability, membership, trust funds, and management. It can be concluded that the strategy for promoting health services in private hospitals is to implement them in accordance with established standards and laws. The health service quality strategy is also the main key to service promotion to increase patient satisfaction in receiving care. It is expected that hospital institutions will continue to provide excellent and comprehensive health services and meet the basic health needs of patients.

Background: Diabetic ulcer is a complication of peripheral neuropathy in people with diabetes mellitus which often ends in disability or death. Proper handling of infection is closely related to the rational use of antibiotics to avoid the occurrence of resistance. The emergence of resistance to antibiotics has an effect on the risk of increasing infection status, increasing the length of stay in the hospital, the risk of amputation and even death. Objectives: This study aims to determine the type and percentage of bacteria present in diabetic ulcers and to test the sensitivity of antibiotics prescribed in diabetic patients with ulcers in the inpatient room of RSUD Kraton, Pekalongan Regency. Methods: The research model used was descriptive to describe the profile of bacteria and the sensitivity of antibiotics prescribed to bacterial findings from diabetic ulcer isolates in inpatients at Kraton Hospital, Pekalongan Regency. The research method was carried out by biochemical identification and sensitivity testing of the Kirby Bauer technique on 2 samples of diabetic patients with ulcer complications taken by total census during March-April 2022. Results: Staphylococcus aureus, Enterobacter aerogenes, Pseudomonas aeruginosa were found with a percentage of 50% each. The sensitivity test showed that Ampicillin was resistant to Staphylococcus aureus, Ciprofloxacin was resistant to Enterobacter aerogenes and intermediate to Pseudomonas aeruginosa. The percentage of effectiveness of Meropenem and Metronidazole antibiotics had the highest sensitivity values, namely 100%, 50% Ampicillin and 25% Ciprofloxacin. Conclusion: From the research that has been done, it can be concluded that Ampicillin is resistant to Staphylococcus aureus, Ciprofloxacin is resistant to Enterobacter aerugenes, Ciprofloxacin intermediate is resistant to Pseudomonas aeruginosa, Meropenem and Metronidazole are sensitive to the three bacterial findings namely Staphylococcus aureus, Enterobacter aerogenes, Pseudomonas aeruginosa

Introduction. Tuberculosis (TB) is one of the oldest diseases known to attack humans, caused by the bacterium Mycobacterium tuberculosis. Multi-drug-resistant TB (MDR-TB) is a stage or condition in which Mycobacterium tuberculosis becomes minimally resistant to rifampicin administration and also insonicotinylhydrazine (INH). Extensive-drug-resistant TB (XDR-TB) is an MDR-TB with Mycobacterium tuberculosis immune characteristics against one of the fluoroquinolone class drugs and one of the second-line injection OAT (capreomycin, kanamycin, and amikacin). The aim of this study was to find out the description of variation in laboratory costs of MDR-TB/XDR patients on one treatment cycle. Method. The inclusion criteria were patients who had been diagnosed with MDR-TB/XDR and performed laboratory tests. The design of this study was a cross-sectional retrospective analytics using medical records of MDR-TB/XDR patients in MDR division. Results. There were 30 MDR-TB research subjects and 2 XDR-TB research subjects examined for laboratory examination. Comparison of laboratory mean of MDR-TB/XDR (p = 0,018). Discussion. There was a significant difference in the total cost of MDR-TB/XDR laboratory examinations in one treatment cycle. Conclusion. Laboratory examination of MDR-TB/XDR patients requires considerable cost, this is due to the side effects of OAT that require patient clinical monitoring.    

The Pharmacy Installation Section of the BPJS Outpatient Unit is that there are still many patients who complain about the waiting time for drug services. Calculating the waiting time for prescription drug service and concoction medicine, then analyzing compliance with the minimum service standard for the long waiting time category. Evaluating performance in providing health services to BPJS Outpatient patients and can help improve the quality and efficiency of health services. Quantitative and qualitative methods in analyzing the data obtained. Quantitative methods can be used to calculate average waiting times and other statistical analyses, while qualitative methods can be used to analyze interview data and gain a deeper understanding of the factors that affect waiting times. Average waiting time needed to complete a concoction recipe is 49 minutes and to complete a non concoction recipe 32 minutes. The number of standard non-concoction recipes is 699 recipes. Meanwhile, there were 2 recipes that did not meet the standards. For concoction recipes, 146 recipes have met the standard. The waiting time for prescription service at the pharmacy installation for outpatients at BPJS Bella General Hospital for non-concoction recipes still does not meet the standards, while for concoction recipes they meet the minimum standards.

Pregnancy is a physiological and natural condition that occurs in women. There are various complaints experienced by pregnant women during their pregnancy, one of the most common complaints is dizziness. Objective: LTA provides comprehensive midwifery care to pregnant, maternity, postpartum, BBL, neonate and family planning women using a midwifery management approach for Mrs "P" who complained of dizziness. Method: Care in this LTA is through interviews, observation and care management. The subject in this care is Mrs "P" at the Pratama Riyyan Kabanjahe Clinic. Results: results of comprehensive midwifery care for Mrs "N" during pregnancy in the second trimester and third trimester with dizziness, in normal labor, spontaneously without complications, in the postpartum period with normal puerperium, in BBL with BBLN, in patients.                                                                    

Effective COVID-19 patient referral system is crucial to ensure that patients in need of care can receive timely and appropriate treatment. The Regional Health Department of North Sulawesi Province plays a crucial role in the COVID-19 patient referral system in the region. The purpose of this study is to evaluate the role of the Regional Health Department of North Sulawesi Province in the COVID-19 patient referral system. This study was conducted using literature review. The results of the study showed that the Regional Health Department of North Sulawesi Province plays a very important role in coordinating between units within the department, overseeing the implementation of programs and policies, and ensuring the availability of sufficient facilities and medical personnel in the COVID-19 patient referral system. This role has ensured that the COVID-19 patient referral system in North Sulawesi Province runs well and effectively. However, further research can be conducted to deepen the understanding of the COVID-19 patient referral system in the region. Further research can be conducted to compare the COVID-19 patient referral system in other regions in Indonesia, so that a more comprehensive understanding of the role of regional health departments in handling the COVID-19 pandemic in Indonesia can be obtained.    

Asthma is a chronic disease that interferes with the airway due to inflammation and swelling of the walls in the airways so that becomes very sensitive to the entry of foreign objects which cause an overreaction. Based on data from the Ministry of Health for 2020, the number of asthma sufferers in Indonesia is 4.5% of the total population of Indonesia or as many as 12 million more. Meanwhile, based on Aceh Health Service in 2022, it was noted that Asthma sufferers in the Banda Aceh area has reached 11,534 cases. This study is a case report study with data obtained through autoanamnesis, physical examination, home visit to complete family data, psychosocial, and environmental data. Patient Mrs. NS, 51 years old, came with complaints of coughing and a runny nose for 3 days before coming to the Ulee Kareng Health Center, occasionally the patient coughed to the point of causing chest pain. The patient already has a history of asthma since elementary school. The application of family doctor services to asthma patients is necessary to prevent acute exacerbations and prevent the occurrence of asthma in the patient's family.

People with gout arthritis complain of pain in the joints, toes, hands, knees and have never used lemongrass water to reduce joint pain and choose analgesic drugs as pain relief. Lemongrass plant contains essential oil that has chemical properties and pharmacological effects, namely a spicy and warm taste as an anti- inflammatory and relieving analgesic pain.. The purpose of this research was to find out the effect of lemongrass (cymbopogon citratus) on the reduction of gout arthritis pain in The Community In The 1st Winenet Village, Bitung. This research used a pre experimental method with one group pretest-posttest design. The population were residents who suffered from gout arthritis and who experienced joint pain. Sampling using a purposive sampling technique with the number of samples were 12 respondents using the Lamesho formula. The instruments used in this research were observation sheets and pain intensity scale measurement sheets using the Numeric Rating Scale (NRS). The collected data was processed by running the computer program be analyzed by a Wilcoxon Signed Rank test with the significance level α = 0,05.The results of this research indicated that there are differences in pain intensity before and after giving lemongrass, with a ρ value (0,001) < (0,05), meaning that there is an effect of giving lemongrass on reducing gout arthritis pain.The conclusion of this research is that lemongrass can be used as a non- pharmacological therapy to reduce pain in gout arthritis. It is expected that the result of this research will be useful in reducing pain in patients with gout arthritis and can be used as an additional reference for further research.    

The condition of the feet of DM patients is one of the indicators that must be studied in monitoring the incidence of ulcers. In DM patients, ulcer problems can occur as a result of vascular and neurological damage. Both causes are initiated through poor metabolic control as assessed by blood glucose levels. The purpose of this study is to analyze several factors that are theoretically and empirically related to the condition of the feet. This cross-sectional study was conducted on the DM group in Palembang city (n = 50), by filling out a characteristic questionnaire, examining foot conditions, and measuring fasting blood sugar levels. The research findings revealed that of all the factors tested with Kendall Tau, blood sugar levels were the only one that was significant (p-value = 0.002) so that it could be significant as a predictor of the condition of the feet. Controlling these levels is important in controlling the incidence of ulcers in patients. The next step that can be taken is to carry out a thorough examination of the patient's neurovascular condition with the Ankle Brachial Index (ABI) and the Michigan Neuropathy Screening Instrument (MNSI).

Queue printers and outpatient registration are systems used in hospitals to help speed up the patient registration process and provide a better patient experience. This system uses information technology to automate the registration process, reduce waiting times and prevent crowding in the registration area. After receiving the queue number, the patient then waits for a call to get an examination or service. The system can be programmed to provide information about expected waiting times, enabling patients to make more effective use of their time. The outpatient registration system uses information technology to help patients speed up the registration process, reduce waiting times, and optimize the use of resources, such as doctors' space and time. This system can also help improve the patient experience by providing convenience and comfort in the registration process. Overall, the use of queuing presses and outpatient registration systems can help improve efficiency and patient experience in a hospital, as well as optimize resource use.

Tuberculosis (TB) is an infectious disease that can attack various organs, especially the lungs. People with Diabetes Mellitus are more susceptible to tuberculosis infection because there is damage to the function of immune cells. This study was conducted to determine the relationship between Diabetes Mellitus type 2 and the area of lesions in thoracic photos of tuberculosis sufferers at Konawe Hospital. This study used an observational analytical research design with a cross-sectional approach. The results of this study obtained 7.4% of Diabetes Mellitus type 2 patients with Tuberculosis in the broad lesion category and based on the results of the spearman test obtained a value (p = 0.036) (r = 0.405) which means that there is a significant relationship between Diabetes Mellitus type 2 and the area of the lesion in the thoracic photo of tuberculosis sufferers at Konawe Regency Hospital

Background: Surgery or surgery that has been planned can bring about a stress reaction in patients, both physiological and psychological stress. The occurrence of this stress can lead to a condition of preoperative patient anxiety. Planned surgical actions can cause physiological and psychological responses in patients. The psychological response that usually occurs in preoperative patients is anxiety. Research Objectives: Knowing the effect of giving spiritual therapy guided by prayer on the level of anxiety in preoperative patients with spinal anesthesia in Jombang Hospital. Research Methods: This type of research uses a quasi experimental method with a pre post test research design with a control group design. Respondents were given pretest and posttest treatment using the APAIS scale measurement. The sample in this study was 22 respondents in the intervention group and 22 respondents in the control group. The sampling technique used consecutive sampling technique. Data collection was carried out in November - June 2021. Research Results: The results of data collection were processed using the Wilcoxon test in the intervention group of 0.000 and in the control group of 0.014 and using the Mann Whitney test. Results The Mann Whitney test yielded p=0.006 (p<0.05), so Ha was accepted. Conclusion: There is a significant effect of prayer guidance therapy on the anxiety level of preoperative patients with spinal anesthesia.  

Background Surgical planning for preoperative patients is a psychosocial stressor that can cause stress, anxiety, and depression. Preoperative is the period before surgery is performed, starting from the time the decision is made for surgery until the patient is on the operating table. Laparotomy is one of the major surgical procedures by making an incision in the lining of the abdominal wall to obtain problems in the abdominal organs, such as cancer, bleeding, obstruction, and perforation. Research objectives: The general objective of this study was to determine the effect of implementing education on anxiety levels in preoperative apparatus patients with general anesthesia. Research methodology: This type of research is a quantitative study, with a quasy experimental research plan, with a non-randomized post-test one group design. . Results: It is known that the asymo.sig, (2-tailed) value is 0.000 <0.05. So it can be concluded that the "hypothesis is accepted". Thus it can be said that there are differences in the results of the intervention group and the control group. Because there is a significant difference, it is said that "there is an effect of providing education to preoperative laparotomy patients" Conclusion: Based on the results of the research and discussion that has been put forward under the title "the effect of providing pre-anesthesia education on anxiety levels in laparotomy patients with general anesthesia" it can be concluded as follows: There is a significant effect on providing education on preoperative anxiety of laparotomy with general anesthesia p = 0.000 (p <0.05) in the central surgical installation of Siti Fatimah Az-Zahra Hospital, South Sumatra Province.  

Before the patient is delivered to the operating room, the sign-in action is carried out in the reception room by the health worker before the patient is escorted to the operating table, the sign-in compliance includes identifying the patient, checking the informed consent (consent sheet), checking the surgical site marking, allergy history and supporting examination documents. Every health worker will take action on pre-operative patients in the application of health workers still do not properly identify patients during routine medical / nursing actions, patient identity is mentioned by health workers, health workers do not immediately record and report the results of sign in. This study aims to determine the relationship between sign-in compliance with the accuracy of pre-operative patient identification at Primaya Betang Pambelum Hospital, Method: This type of research is correlational using Cross sectional. The technique of determining respondents using purposive sampling using the Chi Square statistical test. The sample is patients who will undergo surgery at Primaya Betang Pambelum Hospital totaling 109 respondents. Results: The results of the Chi Square statistical test that obtained p value = 0.000 or the level of significance p < 0.05 so that there is a relationship between sign-in compliance with the accuracy of pre-operative patient identification, Conclusion: There is a relationship between sign-in compliance with the accuracy of pre-operaif patient identification as evidenced by the results of p < α with a significant level of 0.05 indicating a significant and meaningful relationship between sign-in compliance with the accuracy of patient identification at Primaya Betang Pambelum Hospital.

A disaster becomes an extraordinary event that disrupts and threatens life and livelihoods caused by nature and humans, or both. The existence of natural disasters can have both small and large impacts on the environment. The thing that can be done to reduce the consequences of disasters is that synergy from various parties is needed, one of which is the involvement of nurses. Nurses have a huge role to play in preparing and handling communities in the face of disasters.  As health workers, nurses are at the forefront of disaster management so that they can anticipate the prevention of disasters and their impacts (Doondori, A. K., & Paschalia, Y. P. 2021). Cianjur Regency is one of the areas that experienced the impact of natural disasters, namely earthquakes.  The earthquake occurred on November 21, 2022 at 13:21:10 WIB with a magnitude of 5.6 in the Cianjur area, West Java. The earthquake caused a lot of infrastructure damage and casualties. This has a great influence on the condition of the community, one of which is in terms of health biopsychosocially and spiritually. Based on the phenomenon that occurs along with the existence of the role of the nurse as a healthcare provider. Universitas Esa Unggul sent a team of health volunteers to carry out several activities for the community such as, providing comprehensive nursing services, becoming collaborators, conducting education and trauma healing. This action is considered sufficient to help patients who have health problems both who come to the post and who are in refugee tents. They feel happy because of the existence of health service facilities so that the public can consult, get education and also trauma healing.