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In order to raise the standard of healthcare services in the contemporary period, digital transformation in hospital management has become a phenomena. The purpose of this study is to investigate the adoption, advantages, difficulties, and success aspects of digital transformation in healthcare facilities. A literature review employing a narrative review system was the methodology. 14 papers that met the inclusion requirements were found using data sources from Google Scholar, PubMed, and ScienceDirect databases with publication years ranging from 2020 to 2025. To determine the primary study themes, data analysis was carried out utilising a thematic synthesis approach. According to the study's findings, digital transformation can enhance operational effectiveness, service quality, and patient safety by using technology including electronic health records (EHR), telemedicine, and hospital management information systems. However, there are still a number of obstacles to its adoption, such as inadequate infrastructure, inadequate human resource competency, expensive investment costs, and data security threats. Significant barriers also include a lack of system integration and opposition to change. Government policies and regulatory assistance have an impact on the success of digital transformation in hospital administration.

Preeclampsia is one of the leading causes of maternal mortality and may result in various complications during pregnancy and childbirth. In Tegal Regency, preeclampsia contributed to 27% of maternal deaths in 2024; therefore, studies on childbirth characteristics among mothers with this condition are needed. This study aimed to identify the characteristics of childbirth events in mothers with preeclampsia at Dr. Soeselo Slawi Regional Hospital, Tegal Regency. A descriptive design with a retrospective approach was used by reviewing the medical records of 202 mothers who delivered with preeclampsia during 2025. Data were analyzed univariately and presented as frequency distributions and percentages. The results showed that most mothers underwent operative delivery (62.38%), while spontaneous and induced labor accounted for 37.13% and 0.50%, respectively. Most deliveries occurred at preterm gestational age (62.38%), followed by term (36.14%) and postterm (1.49%) deliveries. Maternal and obstetric complications included bleeding (6.93%), fetal distress (4.95%), eclampsia (1.49%), and HELLP syndrome (0.99%). Most neonates had normal birth weight (82.18%) and did not require NICU care (95.05%), although low birth weight (17.82%) and NICU admission (4.95%) were still identified. The maternal clinical condition was dominated by blood pressure of 140–159/90–109 mmHg (75.74%). Proteinuria was found in 46.53% of respondents, with moderate proteinuria (+2) as the predominant category (38.30%). In conclusion, childbirth among mothers with preeclampsia was dominated by operative and preterm deliveries. These findings emphasize the importance of early detection and optimal management of preeclampsia to reduce maternal and neonatal complications and improve the quality of maternal-infant health services overall.

Background: Adenoid hypertrophy is a condition characterized by enlargement of the adenoid tissue which can cause nasopharyngeal obstruction and potentially affect the function of the Eustachian tube. Dysfunction of the Eustachian tube may disrupt middle ear ventilation and increase the risk of otitis media. The degree of adenoid hypertrophy can be objectively assessed using a lateral nasopharyngeal radiograph by calculating the adenoid–nasopharyngeal ratio (A/N ratio). Objective: This study aimed to determine the relationship between adenoid hypertrophy based on the adenoid–nasopharyngeal ratio and the incidence of otitis media. Methods: This study was a quantitative research with an analytic observational design using a cross-sectional approach. Data were obtained from the medical records of patients with adenoid hypertrophy who underwent lateral nasopharyngeal radiographic examination at RSI Purwokerto from 2022 to 2025. The sample consisted of 31 patients who met the inclusion and exclusion criteria. Data analysis was performed using the Spearman correlation test because the data were not normally distributed based on the Shapiro–Wilk test. Results: The results showed that most of the subjects were male (17 subjects, 54.8%) and female (14 subjects, 45.2%). The median age of the subjects was 7 years with an age range of 4–9 years. The median adenoid–nasopharyngeal ratio was 0.90 with a range of 0.68–0.99. Otitis media was found in 11 subjects (35,5%), while 20 subjects (64,5%) did not experience otitis media. The Spearman correlation test showed a correlation coefficient of r = 0.015 with a p-value of 0.936 (p > 0.05), indicating that there was no significant relationship between the adenoid–nasopharyngeal ratio and the incidence of otitis media. Conclusion: There was no statistically significant relationship between adenoid hypertrophy based on the adenoid–nasopharyngeal ratio and the incidence of otitis media.

Chronic rhinosinusitis (CRS) is a long-term inflammatory condition affecting the nasal mucosa and paranasal sinuses, which significantly impacts patients’ quality of life due to persistent and recurrent symptoms. Limited epidemiological data regarding CRS are available in Central Kalimantan, particularly at RSUD dr. Doris Sylvanus in Palangka Raya, prompting this study to determine its prevalence and patient distribution characteristics. This research employed a quantitative descriptive design with a cross-sectional approach. Data were collected from medical records of patients diagnosed with CRS in 2023 and 2024. Univariate analysis was conducted, and results were presented in tables and diagrams illustrating frequency distributions by year, gender, age, and main complaints. The findings showed a total of 118 CRS patients, with 53 cases in 2023 and 65 cases in 2024. The prevalence of CRS increased from 4.91% in 2023 to 10.83% in 2024. Based on gender, males accounted for 50.8% (60 patients), while females represented 49.2% (58 patients). The age group most affected was 46–55 years (31%), indicating a predominance among individuals of productive age. Nasal congestion was the most frequent primary complaint, reported by 35% of patients. The study concludes that the prevalence of CRS at RSUD dr. Doris Sylvanus increased notably from 2023 to 2024, with a slightly higher incidence among males in the productive age group. These findings highlight the need for enhanced preventive measures and early diagnosis to manage CRS more effectively in the local population.

Breast cancer has a high global incidence and is the most prevalent cancer among women. Chemotherapy is a primary treatment option, but it may cause various physical and psychological side effects that can reduce patients’ quality of life. This study aimed to describe the characteristics of breast cancer patients undergoing chemotherapy and examine the relationship between chemotherapy side effects and quality of life at the outpatient unit of Ciremai Hospital. A cross-sectional analytical observational design was applied, with 30 patients receiving chemotherapy between May and July as the sample. Data were collected from medical records and the Indonesian version of the WHOQOL-BREF questionnaire, then analyzed using Spearman rank correlation. Most patients were aged 40–60 years, had a senior high school education, were housewives, and were in the 2nd or 5th chemotherapy cycle. Frequently reported side effects included nausea, vomiting, decreased appetite, early satiety, dizziness, sleep disturbances, body pain, and alopecia, mostly categorized as moderate. Most patients had a relatively poor quality of life. The analysis indicated a strong positive correlation between chemotherapy side effects and patients’ quality of life, with a Spearman correlation coefficient of 0.604 (p = 0.000 < 0.05), demonstrating a significant and strong relationship.

Breast cancer has a high global incidence and is the most prevalent cancer among women. Chemotherapy is a primary treatment option, but it may cause various physical and psychological side effects that can reduce patients’ quality of life. This study aimed to describe the characteristics of breast cancer patients undergoing chemotherapy and examine the relationship between chemotherapy side effects and quality of life at the outpatient unit of Ciremai Hospital. A cross-sectional analytical observational design was applied, with 30 patients receiving chemotherapy between May and July as the sample. Data were collected from medical records and the Indonesian version of the WHOQOL-BREF questionnaire, then analyzed using Spearman rank correlation. Most patients were aged 40–60 years, had a senior high school education, were housewives, and were in the 2nd or 5th chemotherapy cycle. Frequently reported side effects included nausea, vomiting, decreased appetite, early satiety, dizziness, sleep disturbances, body pain, and alopecia, mostly categorized as moderate. Most patients had a relatively poor quality of life. The analysis indicated a strong positive correlation between chemotherapy side effects and patients’ quality of life, with a Spearman correlation coefficient of 0.604 (p = 0.000 < 0.05), demonstrating a significant and strong relationship.

Data security in Electronic Medical Records (EMR) is a crucial issue in health information governance in Indonesia. This study evaluates the compliance of health facility information security systems with Ministry of Health Regulation (PERMENKES) No. 24 of 2022 and Personal Data Protection Law (UU PDP) No. 27 of 2022, and analyzes the impact of non-compliance on service quality and patient trust. The method employed is a systematic narrative literature review on the Google Scholar database (2023–2026) using the keywords "data security and privacy," "electronic medical records," and "CIA Triad," focusing on the implementation of Confidentiality, Integrity, and Availability. The four healthcare facilities examined have implemented controls such as role-based access control, Electronic Signatures (TTE), Virtual Private Networks (VPN), data encryption, and SSL/TLS protocols in accordance with PERMENKES provisions and Article 35 of the UU PDP. However, the effectiveness of implementation is hindered by weak authentication due to the use of simple passwords and excessively long auto-logout durations, the absence of comprehensive written standard operating procedures (SOPs), low staff compliance with security protocols, and minimal patient awareness regarding personal data protection rights. These weaknesses heighten the risk of patient data breaches as well as potential administrative sanctions and fines, and carry negative implications for service quality and public trust. Recommendations include strengthening internal security policies, developing written SOPs, providing continuous training for healthcare workers, implementing stronger authentication mechanisms (e.g., multi-factor authentication/MFA), and conducting patient awareness programs to ensure regulatory compliance and maintain public confidence.

The implementation of Electronic Medical Records (EMR) is a key component of healthcare digital transformation, as mandated by the Minister of Health Regulation Number 24 of 2022. EMR is expected to enhance efficiency, accuracy, and the quality of nursing services. However, its implementation at M Hospital continues to face challenges, particularly in terms of infrastructure readiness and the digital literacy of nursing staff. This study aims to analyze the effects of infrastructure readiness and digital literacy on the implementation of nursing EMR, with perceived usefulness as an intervening variable. A quantitative cross-sectional design was employed, involving all nurses at M Hospital, with a total sample of 100 respondents using total sampling. Data were collected through structured questionnaires and analyzed using SEM-PLS. The results indicate that infrastructure readiness and digital literacy have both direct and indirect effects on EMR implementation through perceived usefulness (p < 0.05). Among the independent variables, infrastructure readiness demonstrates the strongest influence. These findings support existing theories and prior research. From a managerial perspective, the results highlight the importance of improving infrastructure to optimize EMR implementation. In conclusion, infrastructure readiness and digital literacy significantly influence the successful implementation of nursing EMR, with perceived usefulness acting as a key mediating factor.

Background: Acute respiratory infection (ARI) remains a major public health concern, particularly in primary care settings. Lifestyle factors such as dietary patterns and physical activity are increasingly recognized as potential contributors to respiratory health. Objective: This study aimed to examine the association between dietary patterns, physical activity, and ARI among primary care patients in East Halmahera, Indonesia. Methods: A cross-sectional study was conducted at a primary health care facility in East Halmahera, Indonesia, from January to February 2026, involving 106 respondents selected using a total sampling technique. Data were collected using structured questionnaires and medical records. Variables included sociodemographic characteristics, dietary patterns, physical activity, and ARI status. Data were analyzed using descriptive statistics and Chi-square tests with a significance level of p < 0.05. Results: The prevalence of ARI among respondents was 77.4%. Bivariate analysis showed that dietary patterns (p = 0.006) and physical activity (p = 0.015) were significantly associated with ARI. In contrast, age, gender, marital status, education level, employment status, smoking, and alcohol consumption were not significantly associated with ARI (p > 0.05). Conclusion: Dietary patterns and physical activity were significantly associated with ARI among primary care patients in East Halmahera. These findings highlight the importance of lifestyle-related factors in addressing respiratory infections at the primary care level.  

Dengue Hemorrhagic Fever (DHF) remains a major public health problem in Indonesia, particularly in densely populated areas. Control efforts require accurate data and spatial analysis to understand disease distribution patterns. Geographic Information System (GIS) is an effective tool for visualizing case distribution and supporting surveillance and planning of control programs at the primary healthcare level. This study aims to describe the spatial distribution of Dengue cases based on medical record data and produce a geographic distribution map to support Dengue control efforts at the Puskesmas level. This study used a quantitative descriptive design with secondary data from medical records at Karangsari Health Center. The sample consisted of 255 DHF patients in 2025, selected using a total sampling technique. Data were processed through editing, geocoding patient addresses, and spatial analysis using QGIS software.The results showed 255 Dengue  cases in 2025 with fluctuating monthly trends, peaking in April and lowest in December. Case distribution was uneven and tended to cluster. High-risk areas accounted for 15.7%–21.2%, moderate-risk areas 9.8%–15.7%, and low-risk areas 7.1%–9.8%. Megu Cilik Village had the highest proportion of cases, while other villages were categorized as moderate and low risk. This pattern indicates that Dengue incidence is influenced by environmental conditions, vector density, host factors, rainfall, and Aedes aegypti presence. GIS provides clearer spatial visualization, helping identify high-risk areas and supporting targeted public health interventions.

The right to privacy and the right to health are fundamental human rights that are closely interconnected. The protection of privacy for patients with Human Immunodeficiency Virus (HIV) constitutes a critical issue, given that HIV status is classified as highly sensitive health data and is particularly vulnerable to stigma and discrimination. In Indonesia, the legal framework governing the protection of HIV patients’ health data has been normatively strengthened through the Personal Data Protection Law and the Health Law; however, its implementation continues to face various challenges. This article aims to analyze the right to privacy of HIV patients and the obligations of the state in protecting sensitive health data, as well as to examine the limitations and exceptions to the disclosure of HIV-related data within the framework of law and human rights. This study employs a normative legal research method using statutory, conceptual, and human rights-based approaches. Legal materials are analyzed qualitatively through juridical interpretation and prescriptive analysis. The findings indicate that HIV status is legally categorized as sensitive personal data that is entitled to a high level of legal protection. The state bears tripartite obligations to respect, protect, and fulfill the privacy rights of HIV patients. Nevertheless, a gap persists between legal norms and their implementation, particularly in the management of electronic medical records. The protection of HIV patients’ privacy rights requires strengthened legal implementation, regulatory harmonization, and the adoption of a human rights-based approach to ensure that data protection does not conflict with public health interests.

Digitalization in the healthcare sector is a strategic step to enhance efficiency, accuracy, and service quality. One of the key innovations gaining significant attention is the use of Electronic Medical Records (EMR). Purpose: This study aims to analyze nurse competence, social influence, and usability on actual use electronic medical record with perceived ease of use as intervening variable at Satya Negara Hospital. Methods: The research method used a quantitative approach with a cross-sectional design, involving 108 nurses as respondents selected through a saturated sampling technique. Data were collected using a questionnaire and analyzed using a Structural Equation Model (SEM) based on Partial Least Squares (PLS). Findings: The results indicate that nurse competence, social influence, and usability significantly affect the actual use of EMR. Additionally, perceived ease of use mediates these relationships, enhancing the adoption and utilization of EMR systems. Implications: The managerial implications of this study include the need to enhance nurse competency training, strengthen social support in the workplace, and improve the usability of the Electronic Medical Records (EMR) system to encourage more optimal use. This study also contributes to the development of literature on health information technology implementation by integrating human, social, and technical factors into the analytical model.

This reflective autoethnographic study explores the lived experience of being an only child caring for an elderly mother with Parkinson's disease while working as a full-time lecturer. The research aims to understand how this dual role affects the caregiver's mental health, work productivity, and relationship with the mother. Using a reflective autoethnographic approach based on Ellis, data were collected through three techniques: autobiographical narratives and memos, analysis of personal artifacts (work schedules, medical records, photographs), and an integrated self-interview. Thematic-reflective analysis revealed three main themes. First, structural loneliness describes the profound isolation resulting from having no sibling to share physical, emotional, and decisional responsibilities, which informal support cannot easily remedy. Second, stealth strategies at work refer to hidden tactics such as leaving early without disclosure, using breaks to check on the mother, and concealing caregiving struggles to avoid being perceived as less committed or losing professional opportunities. Third, fought for bonds shows that despite exhaustion and initial frustration, the caregiver’s relationship with her mother deepened through daily effort, patience, and reframing caregiving as meaningful devotion, a process aligned with filial maturity. The findings highlight the unique pressures faced by only-child working caregivers, including invisible productivity loss and the inadequacy of general social support. Practical implications for employers, social workers, and policymakers are discussed. This study contributes a rich first-person account to the underexplored area of only-child caregiving and offers recommendations for workplace cultural change, targeted support groups, and subsidized respite services.

This regulation, which requires all healthcare facilities to implement EMR by December 31, 2023, stemmed from the emergence of Health Ministerial Regulation No. 24 of 2022. Santosa Hospital, Bandung Kopo, has implemented EMR, but no research has been conducted on it. This study aimed to determine the effect of EMR implementation on service quality in the emergency unit at Santosa Hospital, Bandung Kopo. The research methods used were descriptive verification analysis and multiple linear regression analysis. Data collection used a questionnaire distributed to all emergency unit staff. The results of the descriptive analysis were generally considered very good. The results of the verification analysis, both partially, showed a negative and insignificant effect on system quality and service quality, while information quality and use statistics showed a positive and significant effect. Simultaneously, these positive and significant effects were proven, and the researchers recommend maintaining and further improving them.

Supraventricular tachycardia (SVT) is one of the most common arrhythmias in the pediatric population, often resulting from re-entry mechanisms involving accessory pathways or dual atrioventricular nodal physiology. Although generally well tolerated in children with structurally normal hearts, its management can be challenging, particularly in recurrent or persistent cases. This study is a case report describing a pediatric patient with hemodynamically stable SVT treated at Dr. Wahidin Sudirohusodo Hospital. Data were collected retrospectively from medical records, including history taking, physical examination, and supporting investigations such as serial electrocardiography (ECG), laboratory tests, chest radiography, and transthoracic echocardiography. Management was conducted according to current clinical guidelines, including vagal maneuvers, pharmacological therapy with beta-blockers and antiarrhythmic agents (amiodarone), and monitoring of treatment response based on clinical evaluation and ECG, along with identification and treatment of underlying triggers. We report a case of a 10-year-old female presenting with suspected SVT and pericarditis, who experienced episodes of narrow QRS complex tachycardia that were successfully converted to sinus rhythm following amiodarone administration. Echocardiographic evaluation revealed mild to moderate tricuspid regurgitation with preserved ventricular function. Laboratory and radiological findings suggested an underlying inflammatory process, which was considered a triggering factor. This case highlights the importance of a comprehensive approach in the diagnosis and management of pediatric SVT, including addressing underlying conditions and ensuring continuous monitoring to prevent recurrence.

Turbinate hypertrophy is a condition characterized by abnormal enlargement of the nasal turbinate mucosa, which can lead to chronic nasal obstruction and decreased quality of life. This condition is associated with inflammatory processes in which eosinophils play a role as part of the immune response. This study aimed to determine the relationship between eosinophil levels and the degree of turbinate hypertrophy based on blood examination in hospitalized patients. This research used an observational analytic design with a cross-sectional approach involving 40 patients diagnosed with turbinate hypertrophy at Cut Meutia General Hospital, North Aceh. Data were obtained from medical records, including patient characteristics, eosinophil levels, and the degree of turbinate hypertrophy. The results showed that most patients were aged 17–25 years, predominantly female, and commonly had non-allergic underlying conditions. The majority of patients had normal eosinophil levels (80%), while most cases were classified as grade III turbinate hypertrophy (65%). Statistical analysis using Fisher’s Exact Test demonstrated no significant relationship between eosinophil levels and the degree of turbinate hypertrophy (p>0.05). These findings suggest that eosinophil levels may not be a reliable indicator in assessing the severity of turbinate hypertrophy, particularly in patients with non-allergic conditions. This study highlights the need to consider other contributing factors in the evaluation and management of turbinate hypertrophy to improve diagnostic accuracy and treatment outcomes.

The implementation of digital health information systems, such as e-Puskesmas, plays an important role in supporting electronic medical records in primary healthcare facilities. However, technical constraints, including network instability and system integration issues, may affect user satisfaction among healthcare workers. This study aims to analyze healthcare workers’ satisfaction in using e-Puskesmas based on the End User Computing Satisfaction (EUCS) method. This research employed a quantitative analytic approach with a cross-sectional design, involving 35 healthcare workers at Puskesmas Klangenan using total sampling. The variables consisted of five EUCS dimensions, namely content, accuracy, format, ease of use, and timeliness. Data were collected using a structured questionnaire with a Likert scale and analyzed using descriptive statistics and Spearman correlation test. The results showed that user satisfaction was categorized as very satisfied across all EUCS dimensions, with mean scores ranging from 4.11 to 4.47. All EUCS dimensions had a positive and significant relationship with user satisfaction (p < 0.05), with format and ease of use showing the strongest correlations. It can be concluded that the quality of system and information in e-Puskesmas significantly influences healthcare workers’ satisfaction, indicating the need for continuous system development to support optimal healthcare services.

The hospitality industry is a strategic sector within the global tourism system that heavily depends on service quality and food safety assurance. In hotel operations, the pastry division represents a high-risk unit due to the use of perishable ingredients and intensive manual handling processes. This study aims to analyze the implementation of hygiene and sanitation practices in the Pastry Division of Hotel Aruss Semarang in supporting food safety standards within the hospitality industry. This research employs a qualitative approach with a case study design. Data were collected through participatory observation, semi-structured interviews, and document analysis, including Standard Operating Procedures (SOPs), sanitation checklists, and temperature control records. Data validity was strengthened through triangulation and member checking, while thematic analysis was used to identify key implementation patterns. The findings indicate that the implementation of personal hygiene, environmental sanitation, and Good Manufacturing Practices (GMP) has generally complied with most of the requirements of Good Processed Food Manufacturing Practices (CPPOB). The availability of sanitation facilities, periodic medical check-ups, equipment maintenance, and FIFO-based storage systems demonstrate management commitment to preventive risk control. However, inconsistencies in handwashing practices and minor construction details that do not fully meet hygienic design standards indicate areas requiring improvement. Overall, hygiene and sanitation implementation in the Pastry Division has been effective in supporting food safety. Strengthening behavioral compliance, continuous training, and facility optimization are recommended to achieve a more sustainable and comprehensive food safety management system.

The practice of independent nursing by nurses is a form of professional health services that require assurance of certainty and legal protection, especially after the enactment of Law Number 17 of 2023 concerning Health (Health Law) which integrates various health regulations. This study aims to analyze the form of legal protection for nurses in independent practice and identify the supporting and inhibiting factors for this legal protection. Problem formulation, 1) What is the form of legal protection for nurses who provide independent nursing practice services, 2) What are the supporting and inhibiting factors for legal protection for nurses who provide independent nursing practice. The research method used is normative legal research with a qualitative approach, sourced from secondary data in the form of laws and regulations and related legal literature. The results of the study show that the form of legal protection for nurses includes legality guarantees through STR and SIPP, compliance with professional standards and SPO, and the function of medical records as authentic evidence. The main supporting factors include the existence of a clear legal umbrella and nurses' compliance with regulations, while the inhibiting factors involve illegal practices (without permission), negligence in documentation, and ambiguity of authority. Conclusion: Legal protection for Nurse Practitioners in independent nursing practice is conditional and highly dependent on nurses' compliance with applicable legal norms and professional standards. Compliance with licensing, practice standards, and accurate documentation is the main key in optimizing the guarantee of legal protection.

The implementation of Electronic Medical Records (EMR) has become an important element in improving healthcare service quality, efficiency, and patient safety in hospitals. However, the benefits of EMR depend not only on system availability but also on the quality of the information provided and how actively the system is used by healthcare professionals. This study aims to analyze the influence of electronic medical record content and perceived ease of use on the net benefits of EMR, with actual system use acting as an intervening variable. The research applied a quantitative approach with a cross-sectional design conducted at RSM Hospital. The population consisted of all general practitioners and specialist doctors working at the hospital, totaling 51 respondents, and the study used a total sampling technique. Data were collected through structured questionnaires measured using a Likert scale and analyzed using the Structural Equation Modeling–Partial Least Squares (SEM-PLS) method. The results show that EMR content and perceived ease of use significantly influence the net benefits of EMR. Both variables also significantly affect the actual use of the system, while actual use significantly influences the benefits obtained. Furthermore, actual use mediates the relationship between EMR content, ease of use, and net benefits, indicating that better information quality and usability can encourage greater system utilization and maximize the advantages of EMR implementation.