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The ICU is one of the largest clinical cost centers in hospitals due to its high demand for human resources, medical equipment, and operational costs. This situation emphasizes that intensive care unit efficiency is a multidimensional issue that cannot be assessed solely from a single aspect. This study aims to analyze the efficiency of the intensive care unit at Ciremai Hospital, Cirebon City, using the Data Envelopment Analysis (DEA) model to determine resource optimization. Analytical quantitative study with a cross-sectional design. The population in this study consisted of personnel in the ICU of Ciremai Hospital from 2023 to 2025, with total sampling applied. The input variables included the number of physicians, nurses, beds, monitors, and ventilators, while the output variables consisted of BOR, LOS, and recovered patients. The ICU input variables remained stable during the study period, while output variables fluctuated with a declining trend in BOR and LOS. The results of the Data Envelopment Analysis (DEA) indicated that all study periods achieved an efficiency score of 1.00 (efficient), with a slack value of 0.00 across all input variables.

Hypertension is one of the most common chronic diseases among the elderly and is often accompanied by insomnia. This condition can increase anxiety and reduce quality of life. Progressive Muscle Relaxation (PMR) is an effective non-pharmacological therapy to lower blood pressure and improve sleep quality. This paper describes nursing care for elderly patients with hypertension and insomnia through PMR application at RSUD Embung Fatimah Batam City in 2025. A case study approach was used through the nursing process, including assessment, nursing diagnosis, intervention, implementation, and evaluation. The main nursing diagnosis was sleep pattern disturbance related to physical discomfort and anxiety. Interventions included education and PMR exercises for six consecutive days. Results showed blood pressure decreased from 180/100 mmHg to 130/80 mmHg, sleep quality improved from difficulty sleeping to 6–7 hours per night, and anxiety levels reduced. Progressive muscle relaxation therapy proved effective as an independent nursing intervention to reduce blood pressure and improve sleep quality in elderly patients with hypertension and insomnia. Nurses should use this therapy as a routine non-pharmacological intervention in gerontological nursing practice.

Meningitis is a serious infectious disease that can be prevented through vaccination; however, the vaccination process often causes anxiety in patients, especially during the pre-procedure phase. Uncontrolled anxiety can affect patient readiness and comfort. Therapeutic communication by nurses is one intervention that has the potential to reduce this level of anxiety. This study aims to determine the relationship between nurses’ therapeutic communication and the anxiety levels of patients prior to meningitis vaccination at Pambalah Batung Amuntai Regional General Hospital. This study used a quantitative analytic design with a cross-sectional approach. The sample consisted of 107 respondents selected using a convenience sampling technique. Data on therapeutic communication were collected using an observation sheet, while anxiety levels were measured using the DASS questionnaire (anxiety subscale). Data analysis was conducted using univariate and bivariate methods with the Chi-Square test at a significance level of 0.05. The results showed that most therapeutic communication was in the good category, and patient anxiety levels were predominantly in the normal category. Statistical test results indicated a significant relationship between nurses’ therapeutic communication and patient anxiety levels (p = 0.000 < 0.05). The better the therapeutic communication provided, the lower the patient’s anxiety level. In conclusion, nurses’ therapeutic communication plays an important role in reducing patient anxiety prior to meningitis vaccination and needs to be optimized in nursing practice.

This study investigated the logical function of clause complexes in two selected English nursery tales, Jack the Giant Killer and Jack and the Beanstalk, using Halliday’s Systemic Functional Linguistics (SFL) framework. The research focuses on the realization of clause interpendency through the taxis system (parataxis, hypotaxis, and taxis combination) and logico-semantic relations (elaboration, extension, enhancement, idea and locution). The method employed is qualitative content analysis based on Krippendorf involving processes such as unitizing, sampling, coding, reducing, interpreting, and narrating. From 1,048 clauses analyzed, 341 wereidentified as clause complexes. The findings show that enhancement is the most dominant logico-semantic relation (164 cases), followed by extension (123 cases), elaboration (100 cases), locution (57 cases), andidea (22 cases). The findings show that paratxis is the most dominant taxis in selected English nursery tales. While hypotaxis relations mostly realized in enhancement, while extension appeared dominantly in parataxis. These results reveal that although nursery tales are intended for children, they often employ complex grammatical structure, therefore, balancing narrative engagement and linguistic accessibility is crucial to support children’s language development and reading comprehension.

Herpes zoster is a skin infection caused by the reactivation of the varicella-zoster virus, characterized by unilateral skin lesions corresponding to dermatome distribution and complaints of pain or itching. This disease is more common in adults and the elderly, especially in individuals with reduced immunity due to stress or work overload. A case was reported of a 40-year-old woman who worked as a nurse and came to a primary health care facility complaining of itching and red spots on her right breast area that had spread to the surrounding area two weeks before the examination and had worsened in the last few days. Physical examination revealed unilateral red skin lesions in a dermatomal pattern without crossing the midline of the body, consistent with the early phase of herpes zoster. Management was comprehensive, including medication, patient education about the disease and skin care, prevention of complications, and family support. A holistic approach is necessary to improve the success of therapy and the patient's quality of life.

Background: In the competitive healthcare landscape, where human resources are pivotal to organizational success, affective commitment defined as emotional attachment to the workplace is essential for nurse retention and service quality. Satya Negara Hospital in North Jakarta exemplifies the challenges faced by Indonesian healthcare institutions, with a notably high nurse turnover intention of 30% in 2024, signaling low affective commitment and underscoring the urgency to identify its drivers. While person-job fit and career development are established antecedents of commitment, their combined influence within Indonesia’s nursing context, along with the potential moderating role of meritocracy, remains underexplored.. Methods:  Using a quantitative, cross sectional design, data were collected via a validated questionnaire from all 108 nurses at the hospital and analyzed using multiple regression.. Results: The results revealed that person-job fit, career development, and meritocracy collectively explain 96.6% of the variance in affective commitment. Furthermore, when meritocracy was tested as a moderating variable, the explanatory power of the model increased significantly, with the adjusted R² value rising from 96.6% to 98.5%. This indicates that the presence of a meritocratic system substantially amplifies the positive effects of both person-job fit and career development on commitment.. Conclusion: The study concludes that a synergistic combination of job fit, growth opportunities, and a merit-based system is fundamental to fostering nurses’ emotional attachment. These findings contribute to organizational and psychological theory integration and offer practical human resource strategies for enhancing nurse commitment and reducing turnover in healthcare settings.

Patient-Centered Care (PCC) is a healthcare approach that places the patient at the center of every interaction and clinical decision-making. However, a preliminary study at Tarumajaya Hospital showed that 58% of healthcare workers had not yet optimally implemented the PCC approach. This study aimed to analyze the influence of self-efficacy and social support on the implementation of Patient-Centered Care, with safety culture as a mediating variable, at Tarumajaya Hospital. The research method used was quantitative analytic with a cross-sectional design. The study sample used a saturated sampling technique of 132 healthcare workers, consisting of doctors, nurses, and medical support staff. Data analysis used Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results showed that self-efficacy and social support had a positive and significant effect on safety culture and PCC implementation. Safety culture also had a positive and significant effect on PCC implementation. Furthermore, safety culture was shown to mediate the influence of self-efficacy and social support on PCC implementation. The coefficient of determination value indicates that the model has strong ability to explain variations in PCC.

Work motivation is one of the important factors influencing time management and nurses’ performance in providing nursing care. Good time management enables nurses to complete tasks in a timely, efficient, and effective manner. This study was conducted to determine the relationship between work motivation and time management among staff nurses at ML Hospital in 2025. This research used a quantitative approach with a cross-sectional design. A total of 40 staff nurses were selected using a total sampling technique. The instruments used were questionnaires on work motivation and time management. Data were analyzed using the Spearman Rank statistical test with a significance level of < 0.05. The results showed that most respondents had good work motivation (62.5%), while the majority demonstrated a moderate level of time management (75%). The Spearman Rank test yielded a p-value of 0.005, indicating a significant relationship between work motivation and time management among staff nurses. In conclusion, there is a significant relationship between nurses’ work motivation and time management, in which higher work motivation is associated with better time management. It is recommended that hospitals enhance nurses’ motivation through managerial support and a positive work environment.

Non-hemorrhagic stroke occurs due to blockage of blood flow to the brain by a thrombus or embolus. The blockage results in focal neurological disorders that affect the musculoskeletal system, namely weakness in the extremities, which gives rise to nursing problems of impaired physical mobility. To overcome the problem of impaired physical mobility, rubber ball grip exercises (ball squeezing) are given. These exercises have been shown to increase muscle strength, prevent joint stiffness, and improve blood circulation. This scientific paper was conducted to determine the description of nursing care for non-hemorrhagic stroke patients with nursing problems of impaired physical mobility. During the meeting, the nurse provided rubber ball grip exercises (ball squeezing) for 10-15 minutes for 3 times in 24 hours. Evaluation of these actions showed that the patient who initially experienced weakness in the upper extremities with muscle strength 2-3 and after being given rubber ball grip exercises (ball squeezing), the problem of impaired physical mobility was resolved, as evidenced by the patient being able to perform therapy, the extremities feeling slightly lighter, and muscle strength 4. Therefore, it is recommended that non-hemorrhagic stroke patients be given rubber ball grip exercises (ball squeezing) to overcome impaired physical mobility.

Severe preeclampsia is a condition characterized by systolic blood pressure exceeding 160 mmHg and diastolic pressure exceeding 110 mmHg, occurring after 20 weeks of gestation and accompanied by edema and proteinuria. One intervention used to save both mother and fetus is a cesarean section. This final nursing scientific paper analyzes the implementation of evidence-based practice, specifically warm foot soak therapy, for mothers with severe preeclampsia during the pre- and postpartum periods who are at risk for ineffective cerebral perfusion. This descriptive case study method used a nursing care approach. Assessment results identified five major nursing problems, including the risk for ineffective cerebral perfusion. After four days of warm foot soak therapy, this problem was resolved, as blood pressure decreased from 147/101 mmHg to 120/88 mmHg. Conclusion: Warm foot soak therapy effectively lowers blood pressure in pre- and postpartum mothers with severe preeclampsia. Recommendation: Nurses can implement warm

Rapid global environmental changes, especially due to advances in technology and information, have had a significant impact on various sectors of life, including the health sector. In the context of modern health services, hospitals are no longer just places of healing, but also institutions that are required to provide high-quality services, based on patient safety, and are able to adapt to the dynamics of community needs. This change requires a transformation in human resource management, especially related to the interpersonal and psychosocial competencies of nurses as the spearhead of medical services.Purposes:​ to analyze the effect of effective communication and Assertive Attitude on Nurses' Work Productivity in hospitals, with Work Fatigue as a mediating variable.Methods: This type of research is quantitative, using statistical figures to measure the influence of independent variables on dependent variables. The research design is a cross-sectional study.Results: The results of this study indicate that effective communication, assertiveness, and job fatigue collectively significantly influence nurses' work productivity. Communication and assertiveness positively contribute to job fatigue, which in turn affects productivity. Job fatigue is also shown to be a significant mediator in the relationship between communication and assertiveness on work productivity .Conclusion : The importance of strengthening effective communication as a strategy to increase productivity. Organizations need to design communication systems that support openness, transparency, and clarity of information and culture-based assertiveness training, so that employees can express their opinions appropriately without causing resistance in the team.

This research aims to determine the growth of Rhizophora apiculata mangroves based on height, number of leaves and stem diameter in mangrove nurseries in the Segara Ayu Group, Kedonganan, Bali. The research was conducted for six months, from March to August 2025, using quantitative descriptive methods. Observations were made on 40 plants spread across four demonstration plots, with data collected every two weeks. The environmental parameters measured include temperature and salinity. The results showed that the absolute growth in plant height ranged between 27–31 cm, with relative growth of 27.4–33.7%. The average number of leaves reaches 11 to 18 pieces, while the stem diameter ranges from 1.7–2.7 cm. Environmental conditions at the research location are classified as supporting optimal growth, with salinity of 24–28 ppt and temperature of 28–31°C, In general, Rhizophora apiculata plants show good growth during the nursery period, which indicates that the Segara Ayu location has ecological conditions that are suitable for mangrove rehabilitation activities.

There is one problem related with source Power man that is turnover that occurred at Hospital X and is known reach more from 10%. Research aiming for analyze Job Satisfaction as an intervention in connection between compensation compensation, leadership transformational, and burden Work to turnover intention in nurses power Work contract at Hospital X. Research use approach quantitative with type explanatory. Population in study is all over Labor Nurse Contract at Hospital as many as 562 people. The sampling method used is non-probability sampling. Research data This using primary data that is done with share questionnaire in a way direct through google form with alternative answer use scale Likert. Research This use approach Structural Equation Model (SEM) with measurement model using Smart PLS program version 3.2.9. Research results This find that in a way simultaneous all over variable influential to turnover intention. In partial compensation, leadership transformational, and burden Work found own influence significant to Job Satisfaction. More carry on in a way partial satisfaction too work, compensation, leadership transformational, and burden Work own influence significant to turnover intention.

Anxiety among family member in the Intensive Care Unit (ICU) is a common psychological issue. This situation arises from the uncertainty about the patient’s condition. Effective therapeutic communication by nurses is one of the key strategies to help reduce anxiety. This study was conducted from June 4 to July 20, 2025. This study aims to analyze the relationship between nurses’ therapeutic communication and the anxiety levels of family members in the ICU of RSUD Meuraxa, Banda Aceh. This research employed a quantitative, correlational design. The population consisted of 66 family members of ICU patients, with a sample of 57 respondents selected using a purposive sampling technique. The results showed that most families received therapeutic communication at a moderate level (50.9%) and a good level (49.1%). The anxiety levels experienced by the families were mostly moderate (54.4%) and mild (45.6%). The analysis revealed a p-value of 0.003, indicating a statistically significant relationship between nurses’ therapeutic communication and the anxiety levels of family member. These findings prove that therapeutic communication given by nurses plays a vital role in influencing the anxiety levels of patients’ families in the ICU. Therefore, the hospital management is encouraged to improve nurses’ therapeutic communication skills and establish supportive communication policies to enhance services and reduce anxiety among the family members in the ICU.

Oil palm (Elaeis guineensis Jacq.) is an important plantation commodity that makes a significant contribution to Indonesia's economy. One of the macro nutrients that plays a role in supporting plant growth is potassium (K), which is involved in various physiological processes. The effectiveness of nutrient utilization is not only determined by the amount of fertilizer applied but also influenced by the application method, especially during the early seedling phase. This study aims to examine the growth response of oil palm seedlings to variations in KCl fertilizer doses and different fertilizer application methods during the pre-nursery phase. The experiment was arranged using a Factorial Randomized Block Design (RBD) with two treatment factors, namely KCl fertilizer dose and fertilizer application method, each with three replications. The KCl doses consisted of five levels, while the application methods included watering, broadcasting, and localized application (pocket). The observation data were analyzed using analysis of variance and followed by Duncan Multiple Range Test (DMRT) at a 5% level if there were significant differences. The results of the study showed that there was no interaction between the dose of KCl fertilizer and its application method on all observed oil palm seedling growth parameters.

This study aims to evaluate the effectiveness of the green water system in the nursery phase of Nile tilapia Oreochromis niloticus by observing growth performance, water quality, and survival rate. The experiment was conducted for 21 days using 450-liter circular tanks with two treatments: green water and clear water systems. The green water system was established by adding plankton starter to stimulate algal growth, while the clear water system used clean water with routine siphoning. Observations included absolute length, absolute weight, water quality parameters pH, temperature, dissolved oxygen, nitrite, and phosphate, and survival rate. The results indicate that the green water system provided superior nursery performance compared to clear water. Tilapia seeds reared in green water exhibited higher growth in length and weight, more stable water quality, and a greater survival rate 90% than those in the clear water system 80%. These improvements are attributed to the presence of microalgae, which serve as natural feed as well as bioremediation agents that reduce ammonia, nitrite, and phosphate toxicity. Therefore, the green water system proves to be more effective, economical, and environmentally friendly for tilapia nursery culture compared to the clear water system.

The increasing global energy demand drives the search for efficient and sustainable renewable energy solutions. Solar panels have become one of the most widely used technologies; however, their efficiency remains limited when installed in a static position. This research aims to analyze the performance of a single-axis auto tracking system on a 10WP solar panel integrated with the Internet of Things (IoT) for real-time monitoring, specifically in powering a portable powerbank. The research method employed was a quantitative experimental design with three testing scenarios: powerbank charging using an auto-tracking solar panel, a static solar panel, and conventional household electricity as a comparison. Charging data were collected via an IoT system integrated with the Blynk application in real-time. The results indicate that the auto-tracking system increased charging efficiency by around 10%, compared to only 6% with a static panel in one hour. This performance is nearly equal to household electricity charging, which reached approximately 10–11%. The study concludes that the single-axis IoT-based auto-tracking system significantly enhances the performance of small-scale solar panels and holds strong potential for portable energy solutions in remote areas.

Anxiety is an emotional response to uncertainty or threats that cause feelings of anxiety, worry, excessive tension, which are continuous and can interfere with the patient's process of action and healing, therefore it is necessary to have good and correct therapeutic communication, to build a relationship of mutual trust, empathy, support and help the patient in problem solving. This study aims to identify the Relationship between Nurse Therapeutic Communication and Anxiety Level in Preoperative Patients at Santa Elisabeth Hospital Medan in 2024. The research design uses correlational with a cross sectional approach, purposive sampling technique with a sample of 64 respondents. The instruments used were the nurse therapeutic communication questionnaire and the anxiety questionnaire. The results of the study showed that the majority of therapeutic communication among nurses in the inpatient room of Santa Elisabeth Hospital Medan was in the good category as many as 34 respondents (53.1%), and the level of anxiety of preoperative patients was majority in the medium category as many as 30 respondents (46.9%). The spearman rank statistical test on SPSS obtained a P-Value = 0.000 which means that there is a relationship between the therapeutic communication of nurses and the level of patient anxiety at Santa Elisabeth Hospital Medan. It is expected that the nurses in Pauline's room will further improve therapeutic communication to pre-operative patients.

Healthcare Associated Infections (HAIs) are serious occurrences and problems that are often found in all hospital facilities. HAIs cause extended hospitalization, permanent disability, increased treatment costs, and death. Hand Hygiene has an important role in the prevention and control of HAIs. This study aims to see the compliance of nurses' hand hygiene and nurses' knowledge of healthcare associated infections (HAIs) in the intensive care unit of Santa Elisabeth Hospital Medan in 2024. The type of research design used was descriptive with a sampling technique using a total of 31 respondents. Based on the results of the study, it was found that most nurses were obedient in carrying out hand hygiene (83.9%) and knowledge that is about the prevention of HAIs was found to be a large number of nurses who had high knowledge (67.7%). It is hoped that nurses maintain compliance in performing hand hygiene so that HAIs do not occur.

Penelitian ini bertujuan untuk mengembangkan sistem pendukung keputusan yang dapat membantu tim Marketing Officer (MO) PT. Alvarel Technology Innovation dalam menentukan status pelanggan secara objektif dan terstruktur. Sistem ini dirancang menggunakan kombinasi metode Analytical Hierarchy Process (AHP) dan Weighted Sum Model (WSM). Metode AHP digunakan untuk menentukan bobot kriteria yang meliputi Potensial Pasar, Urgensi, Finansial, serta Hubungan dan Reputasi, dengan memastikan konsistensi matriks perbandingan berpasangan. Hasil pembobotan kemudian digunakan dalam metode WSM untuk melakukan perhitungan skor total pelanggan dan menyusun pemeringkatan status berdasarkan nilai tertinggi hingga terendah. Data penelitian diperoleh dari catatan internal perusahaan dan wawancara dengan Marketing Officer, dengan jumlah sampel 30 pelanggan. Hasil pengujian menunjukkan bahwa sistem dapat menghasilkan peringkat status pelanggan dalam lima kategori, yaitu potensial, prospek, pending, pasif, dan skip. Temuan utama memperlihatkan bahwa kategori prospek memperoleh skor tertinggi dan menjadi prioritas tindak lanjut. Dengan demikian, sistem pendukung keputusan berbasis AHP–WSM ini mampu mengurangi subjektivitas, meningkatkan efisiensi, serta memberikan rekomendasi yang lebih akurat dan terukur untuk mendukung pengambilan keputusan strategis perusahaan dalam pengelolaan pelanggan.