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Nurse workload is the total number or volume of tasks that must be completed by nurses during their professional practice in hospitals, including both physical and mental responsibilities in providing nursing care to patients. Meanwhile, nurse burnout is a condition of emotional and mental fatigue experienced by nurses due to prolonged work pressure and the high intensity of emotional demands in the hospital environment. However, workload problems are still commonly found in hospitals, with one of the main contributing factors being work stress caused by excessive job demands and continuous pressure during work activities. The population in this study were outpatient, inpatient and emergency nurses at Ibnu Sina Islamic Hospital, Bukittinggi in 2025 This study used a quantitative method with a cross-sectional approach, analyzing the relationship between one variable and another. This study had 130 samples consisting of outpatient nurses, inpatient nurses, and emergency room nurses. Sampling was carried out using a total sampling technique. The results of this study indicate a significant relationship between workload and burnout at a significance level of 0.00 (≤ 0.05). There is a significant relationship between workload and nurse fatigue at Ibnu Sina Islamic Hospital Bukittinggi in 2025.

Ventricular septal defect (VSD) is a congenital heart defect characterized by a gap in the interventricular septum, with a prevalence of 20–30% of all cases of congenital heart disease. Based on their location, VSD is divided into perimembrane, muscular, and subarterial. This case report discusses a patient who came to the emergency room of Cut Meutia Hospital with good consciousness (GCS E4M6V5) and complained of shortness of breath, cough, nausea, and chest pain spreading to the neck and hands. The anamnesis showed chronic symptoms in the form of coughing up phlegm for two weeks, accompanied by throbbing headaches, dizziness, flatulence, and sleep disturbances. Physical examination showed vital signs of TD 140/90 mmHg, HR 86 x/min, RR 23 x/min, SpO₂ 37%, and temperature 37°C.  Supporting examinations in the form of chest X-rays showed cardiomegaly of the pulmonary segment, while ECG showed rhythmic sinuses with LAD axis, T-inverted in AVL, V1, V2, RsR' in V2, positive Cornell criteria, anterolateral myocardial infarction, RBBB, and LVH. Echocardiography shows the presence of a bidirectional shunt with a dominant right-to-left shunt. This case confirms the importance of comprehensive diagnosis through clinical and supporting examinations to determine optimal management in patients with VSD, as well as prevent further complications.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an obligate intracellular bacterium that affects the skin, peripheral nerves, upper respiratory mucosa, and eyes. Type 2 diabetes mellitus (T2DM) is a comorbidity that can worsen the course of leprosy. The female patient, Mrs. D, aged 55 years came to the emergency room of Cut Meutia Hospital with the main complaint of red bumps accompanied by pain on the face, hands, chest, and back since 3 days ago and additional complaints such as fever, joint pain, and numbness and loss of feeling in the legs, weakness, frequent thirst, and frequent urination. Dermatologic status is obtained in the facial region in the form of erythema nodules with firm boundaries with numular size, multiple. Laboratory examination showed anemia and leukocytosis. The therapy given was MDT MB package, ferrous sulfate 1x325 mg and PRC transfusion 3 kolf. Complaints arose acutely after the patient resumed taking MDT (multidrug therapy) leprosy drugs which had previously been stopped for more than 3 months. Based on the time of onset of symptoms, history of leprosy treatment, and the manifestation of systemic inflammatory lesions with signs of neurotropism, it can be suspected that the patient is experiencing a type 2 leprosy reaction or Erythema Nodosum Leprosum (ENL).

Asthma is a heterogeneous disease characterized by chronic inflammation of the airways and respiratory symptoms such as wheezing, shortness of breath, chest tightness, and cough, which vary over time in both frequency and severity. This condition is accompanied by limitations in expiratory airflow, which can be either reversible or persistent. In asthma patients, especially those treated in the Emergency Department (ED), a common nursing problem is ineffective airway clearance due to mucus accumulation and bronchospasm. One strategy to address this is the administration of warm drinking water, aimed at improving airway clearance. The design used in this final nursing scientific paper is a qualitative case study with an intervention of warm water intake. The subjects of this study consisted of 3 asthma patients in the ED, and the intervention was conducted from January 3-11, 2026, at the Emergency Department of Charitas Hospital Km.7 Palembang. Airway clearance was measured before and after the intervention, which involved giving 200 ml of warm water at 38ºC, without a control group. After the intervention, all three patients showed improved airway clearance, indicated by more effective coughing, decreased sputum production, reduced wheezing, improved breathing patterns, and improved respiratory rate. The implementation of this evidence-based practice (EBP) is expected to provide additional information regarding the use of nonpharmacological therapy, specifically the administration of warm drinking water, in asthma patients with ineffective airway clearance.

Bronchopneumonia is a lower respiratory tract infection that remains a major health problem, especially in children, which can cause impaired gas exchange and ultimately decrease oxygen saturation. This condition, if not immediately treated, can lead to hypoxia and improve the patient's clinical condition. One intervention frequently administered in the emergency room is nebulizer therapy, which functions to help widen the airways, reduce secretion production, and improve pulmonary ventilation. This study aims to determine the effect of nebulizer therapy on increasing oxygen saturation in bronchopneumonia patients in the emergency room of Dr. Dody Sardjoto Air Force Hospital. This study used a quasi-experimental design with a one-group pretest-posttest approach. The study sample was bronchopneumonia patients who received nebulizer therapy intervention in the emergency room. The results showed an increase in oxygen saturation after nebulizer therapy with a p-value of 0.000 (p < 0.05), indicating a significant effect. Thus, nebulizer therapy is proven effective in increasing oxygen saturation and can be used as a treatment intervention in the management of oxygenation disorders in bronchopneumonia patients.  

Early Warning Score (EWS) is early detection instrument for predicting severity or worsening of a patient's condition. Therefore, nurses' compliance with the assessment is crucial. The goal is to reduce the incidence of code blues in general care units. Code blue is a procedure code used for conditions where a victim is found to be at risk of cardiac arrest or respiratory arrest. Methods: This study is a quantitative analytical survey, a form of research that examines the effects and risk factors. The study design was cross-sectional, examining the dynamics of correlation between dependent and independent variables. The number of respondents in this study was 150, drawn from a total sampling of the nurse population in general care units. The data obtained were subjected to statistical analysis using a non-parametric Chi-Square test. Results: Respondents, based on their level of compliance with the EWSS monitoring form, were mostly in the compliant category (94%), and most had an impact on the absence of code blues (94%) in the emergency risk group. Conclusion: There is a significant relationship between nurses' compliance in monitoring the completion of the EWSS and the occurrence of code blue in inpatient rooms (P-Value <0.05).

This study aims to assess the quality of patient care at the Emergency Unit of Sentani City Community Health Center, Jayapura Regency, by examining the experiences and perceptions of patients, their families, and healthcare workers regarding the service. The study used a qualitative approach with a descriptive design. Informants were selected using purposive sampling involving ER patients, their families, and healthcare workers involved in the ER service process at Sentani Community Health Center. Data were collected through in-depth interviews, non-participatory observation, and documentation studies. The data obtained were analyzed qualitatively through the stages of data reduction, data presentation, and conclusion drawing. The research analysis refers to seven dimensions of service quality, namely direct evidence (tangibles), reliability, responsiveness, assurance, empathy, service accessibility, and service systems and flows. The results of the study showed that service quality at the Sentani Community Health Center ER was in the fairly good category, especially the dimensions of empathy, reliability, and responsiveness of healthcare workers. Healthcare workers were friendly, responsive, and provided fair services without discriminating against patient backgrounds. However, a number of obstacles are still found that affect the optimization of services, including limited facilities and infrastructure, the number of health workers that is not commensurate with the service load, patient waiting times in certain conditions, the operating hours of the Emergency Room that are not yet 24 hours, and the low understanding of some patients regarding the applicable service system and flow.

The Emergency Room (ER) is a hospital service unit that plays a strategic role in treating patients with critical and emergency conditions. The high number of patient visits and limited resources require an effective triage system to ensure quality of service and patient safety. The Emergency Severity Index (ESI) is a five-level triage system that classifies patients based on the level of severity and resource requirements. This study aims to analyze the relationship between the implementation of triage based on the Emergency Severity Index and the improvement of EAD service quality at Sari Asih Cipondoh Hospital. This study used a quantitative design with a cross-sectional approach. The study sample consisted of EAD patients who met the inclusion criteria. Data were collected through observation of triage implementation and patient satisfaction questionnaires, then analyzed using univariate and bivariate analysis. The results showed that the proper implementation of ESI triage was significantly associated with improved quality of ED services, particularly in terms of speed of service and patient satisfaction. The conclusion of this study confirms that the implementation of ESI triage is an important factor in efforts to improve the quality of ED services.

This study aims to design and develop an electrical installation panel by applying engineering safety principles in the water spray booth of a vehicle body painting system. Field observations indicate that electrical panels in painting rooms often do not meet safety standards, which can lead to short circuits and potential fire hazards. The research employed a Research and Development (R&D) method using a simplified Borg and Gall model consisting of nine stages, starting from problem identification to effectiveness testing. Expert validation results obtained a score of 87.5% (highly valid), practicality testing yielded 90% (very practical), and effectiveness tests showed an average current of 4.1 A, with both the MCB and emergency stop functioning optimally. The developed panel product is declared feasible to be used as a practical learning media for automotive electrical systems. Based on the test results, the panel product was declared suitable for use and can be used as a learning medium in automotive electrical practice, helping to increase understanding of the application of safety in electrical installations in the automotive industry.  

Response time refers to the speed of nurses in providing initial responses to patients, measured from the moment patients arrive at the hospital entrance until they receive medical attention from emergency room staff. Patient satisfaction is an important indicator of healthcare quality, reflecting the comparison between patient expectations and the services received. This study passed the ethical review process with approval number 66/EC-LPPM/UWHS/IV-2025 and used a quantitative correlational design with a cross-sectional approach. The sampling technique applied purposive sampling involving 197 respondents. Data were collected using a nurse response time observation sheet and a patient satisfaction questionnaire that had undergone validity and reliability testing. The validity test using the Pearson Product Moment method showed that the calculated r value was greater than the r table value of 0.361, indicating that all questionnaire items were valid. The reliability test using Cronbach’s alpha produced a coefficient value of 0.855, confirming that the instrument was reliable. Data analysis used univariate and bivariate analysis with the Spearman’s rho test. The results showed that nurse response time was categorized as fast (≤ 5 minutes) for 177 respondents (89.8%). Patient satisfaction levels showed that 177 respondents (89.8%) were very satisfied, 10 respondents (5.1%) were satisfied, and 10 respondents (5.1%) were moderately satisfied. The Spearman Rank test produced a p-value of 0.000 (<0.05) with a correlation coefficient of 0.893, indicating a strong and positive relationship between nurse response time and patient satisfaction in the Emergency Room of Charlie Hospital Kendal.

Health care facilities are places used for promotive, preventive, curative, and rehabilitative health services carried out by the government and the community. Calculating the germ count on door handles of healthcare facilities is very important, because patients are not aware that the door handles contain and transmit germs that cause infections. This study aims to determine the percentage of germ contamination on door handles of healthcare facilities at X Hospital and X Community Health Center. The type of research conducted is descriptive quantitative with an observational case report approach. This study is a frequency distribution in tabular form using a percentage formula. The number of samples used by the researchers was 8 samples, using 4 sampling points at the Hospital and 4 sampling points at the Community Health Center (Puskesmas): the Emergency Room, Main Door, Pharmacy Room, and Laboratory Room. Data collection by conducting laboratory tests on door handle swab samples was then examined using the ALT method. The results showed that the percentage of door handles that did not meet ALT standards was 3 samples (75%) at X Hospital. Meanwhile, on door handles at health facilities Puskesmas. The percentage of door handles at Puskesmas was obtained 4 samples (100%) at X  Puskesmas. Door handles at health facilities do not meet the standards of the Republic of Indonesia's Minister of Health Decree No. 1204 / MENKES / SK / X / 2004, the decision Ho was accepted H1 was rejected.

Errors in the pre-analytical phase are a dominant factor causing inaccurate laboratory test results, including blood serum cholesterol analysis. Pre-examination specimen handling is crucial to ensure the quality of measurement results. This study aimed to compare serum cholesterol levels in blood frozen before centrifugation with those immediately centrifuged. The research method was analytical using a cross-sectional design. A total of 35 respondents were involved, consisting of laboratory staff, emergency room staff, pharmacists, and administration at Sinar Kasih GKST Tentena Hospital. Blood samples were obtained via venipuncture after participants had fasted for 10–12 hours. Each sample was then separated into two groups: those immediately centrifuged and those frozen 20–30 minutes before centrifugation. Data collection was carried out by examining serum cholesterol levels using an Erba Mannheim Chem-7 photometer. The results showed that the average cholesterol level in frozen samples was higher (161.4 mg/dL) compared to samples immediately centrifuged (140.45 mg/dL). The Mann-Whitney statistical test yielded a p-value of 0.006 (p<0.05), indicating a significant difference between the two treatments. This confirms that pre-analytical handling of blood specimens significantly impacts the validity of cholesterol test results. Therefore, careful attention to the pre-analytical stage is essential to ensure the accuracy of laboratory results.

The Emergency Severity Index (ESI) is a triage method that determines the escalation of treatment for patients based on the severity of their emergency condition. In order to improve the level of satisfaction of individuals receiving health services, it is necessary to provide quality services that are responsive to the expectations and needs of patients. This study aims to explore the relationship between the ESI (Emergency Severity Index) level and patient satisfaction in the Emergency Room of Pertamedika Ummi Rosnati Hospital. The research design applied is analytical with a cross-sectional method. From a total population of 500 patients in December, 51 respondents were selected using purposive sampling. The instruments used included the ESI (Emergency Severity Index) Questionnaire and CSQ-8 (Client Satisfaction Questionnaire), with univariate and bivariate data analysis using the Chi-Square test. The results showed that in the high ESI index category, most participants (37 people or 92.5%) expressed satisfaction with the services received, while 3 people (7.5%) were dissatisfied. In the moderate ESI group, 9 respondents (90.0%) reported satisfaction, while only 1 respondent (10.0%) reported dissatisfaction. Conversely, in the mild ESI level, there were no patients who were satisfied (0%), and one patient (20.0%) was dissatisfied. Through analysis using the Chi-Square statistical test, a ρ value of 0.009 (≤ 0.05) was obtained, indicating a significant relationship between ESI levels and patient satisfaction. Based on these findings, it can be concluded that there is a correlation between ESI classification and the level of satisfaction of service users in the Emergency Department. The researchers recommend that patients gain a better understanding of the ESI stages, and the Emergency Department is expected to provide education, such as putting up informative banners related to ESI (Emergency Severity Index) to increase patient understanding of the triage process in the Emergency Department.

This study analyzes the potential use of solar cells as a renewable energy source on the MV SARI INDAH. With the increasing demand for energy and the negative environmental impacts of fossil fuels, solar cells provide a promising eco-friendly alternative. The research focuses on developing a prototype system to charge batteries using solar power, converting DC power into AC for ship operations. The methodology includes measuring sunlight intensity, current, and output voltage, while also calculating the battery capacity and the ship’s electrical load. Tests were conducted at various tilt angles, with data recorded hourly over two days to assess performance. The results show that a 75° tilt angle yields the highest voltage, current, and power output when compared to other angles. Based on these findings, the study recommends installing solar panels at a 75° angle on the compass deck. The system design utilizes two panels positioned opposite each other, forming a 150° angle to optimize energy capture. This setup is capable of supplying power to key areas on the ship, such as seven lamps in the E/R 2nd Deck, Control Room, Emergency Generator Room, and CO₂ Room. The system is designed to meet the total daily energy demand of approximately 1,400 Wh, which can be efficiently fulfilled by eight solar cells rated at 50 Wp each, providing a sustainable and efficient energy solution for the vessel.

The digestive system plays a role in processing food into nutrients so that they can be absorbed and utilized by the body, but it is often found that the digestive system experiences disorders that can be caused by various factors such as infection, inflammation, motility disorders, or even neoplasms (Suryati et al., 2025).One of the diseases caused by digestive system disorders is ileus obstruction, which is a disorder of the digestive system that occurs due to a mechanical blockage in the intestine and is often found in patients with intestinal obstruction. One of the diseases resulting from digestive system disorders isileus obstruction, which is a disorder of the digestive system caused by a mechanical obstruction in the intestines and is commonly found in patients who visit the emergency room. It is estimated that approximately 2-8% and 15% of patients require treatment in the surgical unit (Andi Nailah et al., 2024). Obstructive ileus occurs in the small intestine and can be caused by incarcerated hernia, intussusception, intestinal adhesions or adhesions, ascariasis, volvulus, tumors, or gallstones entering the ileum (Su’un, Gani, & Purnama, 2024). The purpose of this writing is to understand and provide nursing intervention  for Mrs. T with a digestive system disorders: a case of ileus obstruction in Mawar 2 ward dr. Soeselo Regional General Hospital, Tegal Regency. The method used in this writing is a descriptive method. From the case review, it was found that the patient's main complaint was pain in the lower right abdomen. Three diagnoses emerged: acute pain, anxiety, and knowledge deficit. Interventions were developed based on SDKI, SLKI, and SIKI, which can be implemented.

Electronic Medical Records (EMR) are medical records compiled and stored through an electronic system used to support the provision of healthcare services. The implementation of EMR facilitates faster, more practical, and integrated patient data recording. Electronic Medical Records (EMR) are designed to improve the efficiency, accessibility, and accuracy of patient information within healthcare institutions. This study used a qualitative descriptive approach with a case study design through interviews to assess the readiness of EMR implementation in terms of the 5M management aspects (Man, Money, Material, Machine, Method) at Muhammadiyah General Hospital, Ponorogo Regency. The study sample consisted of 27 healthcare workers selected using a purposive sampling technique. The case study design allowed researchers to capture in-depth insights from healthcare workers directly involved in EMR implementation. The results showed that from the Man element, most healthcare workers were ready to use EMR, as indicated by their comfort and skills in operating the application. In the Money element, there is a system maintenance budget and support for EMR development in the inpatient unit and the Emergency Room. The Material element indicates the availability of adequate software, while the Machine element includes computer devices, internet connections, and a stable server to support users. These technological resources ensure a user-friendly and reliable system. The final element, Method, is demonstrated by the existence of clear SOPs and workflows, enabling healthcare workers to understand and effectively follow the EMR implementation process. Overall, the findings indicate that the hospital is institutionally prepared for EMR adoption.    

Nurses need to improve the quality of their responses and complaint handling in serving patients, so that the quality of nursing services can be considered good and patients feel satisfied. In conditions of response time, healthcare personnel, especially nurses, are required to provide quick, accurate, and holistic handling immediately. The objective of this study is to determine the relationship between nurses' response time and family complaint handling in the Emergency Room of RSUD Maria Walanda Maramis. The research uses a cross-sectional design. The sample in this study consisted of 68 respondents using the purposive sampling technique. Data collection on response time and complaint handling was conducted using observation sheets and questionnaires, and analyzed using the chi-square statistical test. The research results showed that the most common response time was the quick response time category, with 61 respondents (89.7%), and the most common complaint handling was in the good category, with 59 respondents (86.8%). The result of the chi-square test obtained a p-value of 0.004 where < α 0.05. Conclusion: There is a relationship between the nurses' response time and the handling of family complaints in the Emergency Room of RSUD Maria Walanda Maramis. Patient families are expected to provide constructive feedback regarding the emergency department services so that the hospital can continue to improve the quality of its services.

Priapism is a urological emergency that can cause permanent disability so it requires fast and precise treatment by a doctor, we recently treated a man with intermittent idiopathic ischemic priapism with oral gabapentin 300 mg and dutasteride 0.5 mg, Before we decided on pharmacological therapy as an effort to prevent recurrent episodes of erection, we had planned invasive therapy as a first-line therapy option, namely aspiration, irrigation, inter cavernosal therapy with winter procedure, but before we had time to do the procedure the penis had detumescence so we canceled the procedure considering that massive bleeding occurred and there was no clinical benefit if the procedure was continued, the treatment immediately showed results after administration with a decrease in the frequency and duration of erections. In the second week the patient came back to our hospital emergency room, we planned the same action winter procedure but before we could do it the penis had detumescence, we gave additional pharmacological therapy Dutasteride 1x0.5 mg, After giving a combination of gabapentin and dutasteride for 2 weeks and we noted no reports of recurrent erectile episodes after and after stopping the drugs there were no reports of recurrent erectile episodes. Gabapentin and Dutasteride may be the main safe choice for the management of intermittent idiopathic ischemic priapism.

The Emergency Department is one of the busiest hospital units dealing with patients with various medical conditions, including high-risk patient cases requiring intensive care. This requires competent health workers. However, a stressful work environment can lead to high levels of job stress and burnout, which negatively impacts job satisfaction. This study aims to examine the effect of competence, job stress, and burnout on job satisfaction of health workers, especially doctors and nurses in the emergency room of Tzu Chi Hospital. This study used a quantitative approach with a questionnaire involving 38 respondents, analyzed using the Structural Equation Modeling (SEM) Partial Least Squares (PLS) technique through the SmartPLS application. The results showed that competence significantly affects job satisfaction, indicating that increasing competence increases job satisfaction. and competence also has a positive effect on burnout where the higher the competence, the lower the risk of burnout. In contrast, job stress and burnout have a negative influence on job satisfaction; the higher the stress and burnout, the lower the level of job satisfaction. These findings emphasize the importance of competency development as a strategic measure to reduce stress and burnout and increase job satisfaction. These results provide guidance for hospital management in designing effective competency improvement and stress management programs.

The success of implementing patient safety in the emergency department cannot be separated from various factors that influence it, one of which is the workload of medical staff.The availability of facilities also plays a significant role in the implementation of patient safety.The objective of this study is to determine the relationship between nurse workload and the availability of facilities with the implementation of patient safety in the Emergency Department of RSUD ODSK, North Sulawesi Province.The research uses a cross-sectional design.The sample in this study consisted of 30 respondents using the purposive sampling technique.Data collection on workload, facilities, and patient safety was conducted using a questionnaire and analyzed using the chi-square statistical test.The research results showed that the highest workload was the light workload category, with 21 respondents (70%).The most available facilities and infrastructure were found, with 21 respondents (70%).The most common implementation of patient safety was the implementation of patient safety in the good category, with 22 respondents (73.3%).The chi-square test results obtained p values of 0.003 and 0.032, where < α 0.05.Conclusion: There is a relationship between nurse workload and the availability of facilities with the implementation of patient safety in the Emergency Room of RSUD ODSK, North Sulawesi Province.