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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.

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).

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.

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.