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Antimicrobial resistance is a persistent threat to hospital care, particularly when empirical therapy relies on broad-spectrum antibiotics without continuous evaluation of local use and susceptibility patterns. This literature review aimed to synthesize evidence from four Indonesian hospital-based studies regarding antibiotic utilization, rationality assessment, and bacterial resistance profiles. A structured narrative review was conducted using four selected articles provided by the author. Data were extracted for study design, setting, population, antibiotic evaluation method, dominant antibiotic classes, rationality indicators, resistance profile, and stewardship implications. The four studies were descriptive and hospital-based, using retrospective records, concurrent observation, ATC/DDD with DU 90%, qualitative rationality criteria, and antibiogram data. The synthesis showed a consistent concentration of antibiotic use in broad-spectrum groups, especially third-generation cephalosporins, penicillins, quinolones, and macrolides. In a Bandung public hospital, total antibiotic consumption reached 95,719.01 DDD, with penicillins, cephalosporins, quinolones, macrolides, and sulfonamides included in the DU 90% segment. In intensive care, ceftriaxone was the most frequently used antibiotic and most rationality indicators were appropriate, although clinically significant drug interactions were still identified. In pediatric acute respiratory infection inpatients, cefotaxime and ceftriaxone dominated empirical therapy. Resistance mapping in Denpasar highlighted relevant Gram-positive and Gram-negative pathogens and recommended antibiotics according to susceptibility levels. Overall, the reviewed evidence supports an integrated antimicrobial stewardship model combining ATC/DDD-DU 90% surveillance, qualitative rationality evaluation, antibiogram-based empirical guidance, and periodic feedback to prescribers.

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.

Pressure ulcers are a common complication in patients with impaired consciousness due to prolonged immobilization. This condition can increase morbidity and prolong the length of stay, thus requiring effective preventive interventions such as progressive mobilization. To determine the outcomes of implementing progressive mobilization on the incidence of pressure ulcers in patients with impaired consciousness at the Anggrek 2 High Care Unit (HCU) of Dr. Moewardi General Hospital. This study employed a case study design involving two participants with impaired consciousness. The intervention, consisting of progressive mobilization, was conducted over 3 days with monitoring of skin condition and pressure ulcer risk. Findings: Following the implementation of progressive mobilization, both participants showed improvement in skin condition and a reduction in the risk of pressure ulcers, as evidenced by the absence of progression to more severe wounds and an increase in skin integrity. The application of progressive mobilization is effective in preventing and reducing the risk of pressure ulcers in patients with impaired consciousness. This intervention can serve as a safe and planned nursing intervention in the intensive care unit.

Thalassemia is a chronic genetic disease that requires long-term treatment and affects children's quality of life physically, psychologically, socially, and academically due to chronic anemia and regular blood transfusion needs. This study aimed to determine factors influencing the quality of life of children with thalassemia at Rumah Sakit Anak dan Bunda Harapan Kita. A descriptive design with a cross sectional approach was used, involving 41 respondents through total sampling. Data were collected using the Pediatric Quality of Life Inventory (PedsQL 4.0 Generic Core Scale) and respondent characteristics including age, gender, socioeconomic status, parental education, and frequency of blood transfusions. Data were analyzed using univariate and bivariate analysis with the Chi-Square test. The results showed most respondents were under ten years old, female, from families with socioeconomic status below the minimum wage, had parents with high school or higher education, and received blood transfusions every three weeks. Bivariate analysis indicated only the frequency of blood transfusions was significantly associated with quality of life, while other variables were not. Thus, transfusion frequency is the main factor influencing quality of life in children with thalassemia.

This case report examines the effectiveness of a combined pulmonary rehabilitation and musculoskeletal physiotherapy program for a 26-year-old male post-pulmonary tuberculosis patient with lumbar tuberculous spondylitis. The patient, who had completed anti-tuberculosis treatment, presented with low back pain, shortness of breath, fatigue, and limited mobility. Spirometry indicated severe restrictive ventilatory impairment (FVC 1.28 L, 32% of predicted), and lower extremity muscle strength was reduced (MMT 2-3/5). The patient used a TLSO brace and walking aid. Over a three-week physiotherapy program, the patient participated in breathing exercises, spinal mobilization, muscle strengthening, functional exercises, and education on brace use. Evaluation occurred at the first, second, and third weeks. After treatment, pain intensity decreased from VAS 6 to VAS 3, FVC improved to 1.72 L, chest expansion increased, muscle strength improved to MMT 4/5, and performance on the Five-Times Sit-to-Stand Test showed progress. The Functional Independence Measure (FIM) score increased from 98 to 115, reflecting improved functional independence. These findings suggest that the combination of pulmonary and musculoskeletal physiotherapy effectively improved respiratory function, muscle strength, and the patient’s overall functional capacity.

Burnout among nurses is a serious problem that can reduce the quality of nursing services and the well being of nurses. Work motivation and self efficacy are psychological factors that play an important role in reducing burnout. The aim is to minimize the occurrence of burnout among nurses in their performance.The purpose of this study is to determine the significance of the relationship between work motivation and self efficacy with the level of burnout among nurses. This research is quantitative in nature with a cross-sectional approach. Data collection was conducted using questionnaires administered to 98 respondents from the total population. The instruments used included a work motivation questionnaire (ERG), a general self-efficacy scale (GSES), and a Maslach Burnout Inventory (MBI). The data collected was processed using Spearman's test and ordinal logistic regression. Results researchers found that respondents who reported high work motivation numbered 89 respondents with a percentage of (90.8%), self-efficacy among nurses also showed a high category in 90 respondents with a percentage of (91.8%), and the majority of burnout levels were in the low category range of 65 respondents with a percentage of (66.4). Statistical tests showed a relationship between work motivation and burnout levels with a p-value of 0.000 (a = -0.358), and showed that there was a relationship between self-efficacy and burnout levels with a p-value of 0.013 (a = -0.250). Furthermore, multivariate statistics found that work motivation was the dominant factor influencing burnout with a p-value of 0.012 (E = -2.030). Conclusion there is a significant relationship between work motivation and self-efficacy with the level of burnout among nurses. Nurses with high work motivation and self-efficacy tend to have lower levels of burnout. Work motivation is a dominant factor in influencing burnout.

Nursing services are a fundamental part of the hospital service system because nurses interact frequently with patients, particularly in inpatient rooms. The quality of nursing services significantly impacts patient satisfaction. This study aims to determine the relationship between the quality of nursing services and patient satisfaction in the inpatient rooms of UMMI Hospital Bogor. This study used a correlational analytical research design with a cross-sectional approach. The population in the study were 1,944 inpatients at UMMI Hospital Bogor. The sample calculation used the Slovin formula with a simple random sampling technique and obtained 332 respondents. The research instrument for the quality of nursing services was based on the five dimensions of SERVQUAL (tangible, reliability, responsiveness, assurance, and empathy) and a patient satisfaction questionnaire. Data analysis was performed univariately and bivariately using the Chi-Square Test statistic. The results showed that the majority of respondents rated the quality of nursing services as good, namely 214 people (64.5%), while respondents who rated the quality of nursing services as poor were 118 people (35.5%). Patient satisfaction results revealed that of the 332 respondents, the majority (230 people or 69.3%) expressed satisfaction, while 102 (30.7%) expressed dissatisfaction. The statistical test results showed a p-value of 0.000 (p < 0.05). The conclusion of this study is that there is a significant relationship between the quality of nursing services and patient satisfaction in inpatient wards. Therefore, continuous improvement in the quality of nursing services is necessary to enhance patient satisfaction and the quality of hospital services.

This study is intended to analyze the implementation of the value for money approach in assessing financial performance at RSUD Kota Tangerang during the period of 2022–2024. The research employs a descriptive quantitative approach using secondary data derived from budget realization reports. This analysis carried out using three main ratios: economy, efficiency, and effectiveness. The findings show that the hospital’s financial performance is categorized as economical, as reflected by economy ratios under 100% throughout the observed year. In terms of effectiveness, performance was considered effective in 2022 and 2023 but declined in 2024, indicating that the revenue target was not fully achieved. Meanwhile, efficiency performance remains suboptimal, as efficiency ratios exceed 100%, suggesting that the costs incurred are higher than the revenue generated. Overall, the hospital demonstrates the ability to manage its budget economically and achieve revenue targets, but still faces challenges in improving resource efficiency. Therefore, efforts are needed to optimize cost management and enhance service productivity to achieve a balance among economy, efficiency, and effectiveness in line with the value for money principles.

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.

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.

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.

Sectio caesarea is a common surgical procedure to deliver a baby when normal delivery is not possible or risky. Postoperatively, patients often experience acute pain that can interfere with the recovery process. The benson relaxation technique is a nonpharmacological method that has been shown to be effective in reducing pain through a relaxation and patient confidence approach. This study uses a case study approach on Mrs. T, a post-sectio caesarea patient at Harapan Bunda Hospital, Batam City. Nursing care is carried out comprehensively for three days, including assessment, diagnosis, intervention, implementation, and evaluation. The main intervention was the administration of benzone relaxation techniques for 10–15 minutes every day. After three days of applying the Benson relaxation technique, Mrs. T's pain intensity decreased from a scale of 6 (moderate pain) to a scale of 2 (mild pain). Patients show increased comfort, ability to be active, and decreased expressions of pain such as grimacing. These results support previous findings that benzon relaxation is effective as a nonpharmacological therapy in reducing postoperative pain. This technique can be a safe and easy-to-apply alternative in nursing practice, especially for post-sectio caesarean patients.

The implementation of Hospital Management Information Systems (HMIS) has become a strategic imperative to enhance operational efficiency amidst the ongoing global digital health transformation era. This study aims to analyze the determinants of successful HMIS implementation and its impact on service efficiency and patient outcome quality. Employing a narrative review approach with thematic synthesis of literature from PubMed, Scopus, and ScienceDirect databases between 2016-2026, the study evaluates the relationship between technology investment and organizational performance. The synthesis results indicate that while HMIS significantly reduces administrative burdens and medication errors, a "digital paradox" exists where technical efficiency may disrupt interpersonal interactions between healthcare providers and patients if systems are not user-centered. Key success factors include data interoperability (HL7/FHIR standards), human resource readiness, and governance policy support. This study concludes that a patient-centered efficiency model is the fundamental basis for ensuring technology investments yield sustainable added value within the healthcare delivery system.

This study examines the importance of legal protection for healthcare workers in medical services, particularly in the Central Surgical Installation of the Regional General Hospital of Mataram City, which involves high medical risks. The background of this research is based on the increasing potential for medical disputes and the vulnerability of healthcare workers to legal claims due to discrepancies between medical outcomes and patient expectations. The objective of this study is to analyze the implementation of legal protection and identify the challenges faced in practice. The research employs a descriptive method with a qualitative approach, utilizing interviews, observations, and documentation studies. The findings indicate that legal protection has been implemented through standard operating procedures, informed consent, and internal hospital policies in accordance with applicable laws and regulations. However, its implementation remains suboptimal due to several constraints, including limited legal awareness among healthcare workers, inadequate legal assistance systems, and increasing public demands. The study implies the need to enhance legal education for healthcare workers and strengthen the role of hospitals in providing effective legal protection to support professional and safe healthcare services.

Aggressive behavior is one of the manifestations commonly found in individuals with mental disorders, and this can potentially cause harm both to themselves and to their surroundings. To address this condition, one non-pharmacological approach that can be implemented is the use of Mozart classical music therapy. This study aims to evaluate the impact of Mozart classical music therapy on patients who have the potential to exhibit violent behavior at Aceh Mental Hospital. The research activities were conducted from July 2 to 5, 2025. The research design adopted in this study is pre-experimental using the One group pretest-posttest Design method. The study subjects consisted of 15 inpatients who had been identified as being at risk for violent behavior, with sample selection carried out through purposive sampling. The findings of the study showed that the average score of signs and symptoms before the intervention was 5.73, with a score range of 3 to 8. After the intervention in the form of Mozart classical music therapy, the average score of signs and symptoms decreased significantly to 1.60, with a range between 1 and 2. Statistical analysis using the Wilcoxon Signed Rank test showed a Z value of -3.437 with a significance level of P = 0.000 (P < 0.05). Based on these results, it can be concluded that Mozart classical music therapy has a significant effect in reducing the risk of violent behavior in patients. Therefore, Mozart classical music therapy is recommended as an effective supportive intervention and can be routinely integrated into psychiatric care rooms.

Preoperative anxiety can lead to increased blood pressure, accelerated heart rate, and bleeding. One of the non-pharmacological interventions that can be provided is dhikr therapy, particularly tahlil dhikr (repeated recitation of La ilaha illallah). This study aims to determine the effect of tahlil dhikr on reducing anxiety in preoperative patients. This research is a quantitative study with a quasi-experimental design, using a one-group pretest-posttest approach. Data collection was conducted from May 22 to May 27, 2025, at Meuraxa Hospital. The population in this study consisted of 270 patients scheduled for surgery at Meuraxa Hospital, Banda Aceh, with a sample of 73 respondents selected through random sampling. The research instruments used were the Standard Operating Procedure (SOP) for Tahlil Dhikr Therapy and the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire, which had a Cronbach’s Alpha score between 0.6 – 0.7 and was considered reliable with a result > 0.6. The results showed a decrease in the intensity of anxiety after the administration of tahlil dhikr. Data analysis using the Wilcoxon Signed-Rank Test showed a p-value = 0.000 (≤ 0.05), indicating a significant effect of tahlil dhikr on reducing preoperative anxiety among patients at Meuraxa Hospital, Banda Aceh. The study recommends the integration of tahlil dhikr as an alternative method for reducing anxiety in preoperative patients.

The quality of nursing services is not solely determined by nurses’ technical competence in providing clinical care, but is also influenced by their ability to establish therapeutic communication with patients. Therapeutic communication is a professional interaction process aimed at helping patients understand their health conditions, express their feelings, and develop a trusting relationship with nurses. Effective communication between nurses and patients can increase patients’ comfort during hospitalization and may influence their level of satisfaction with the nursing services provided. This study aimed to determine the relationship between nurses’ therapeutic communication and patient satisfaction in the inpatient ward of Grha Permata Ibu Hospital in 2025. This study used an observational analytic design with a cross-sectional approach. The sample consisted of 182 patients selected using a purposive sampling technique. Data were collected using a therapeutic communication questionnaire and the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) to assess patient satisfaction with nursing care. Data analysis was conducted using the Spearman Rank correlation test to determine the relationship between the two variables. Most respondents assessed nurses’ therapeutic communication as good (87%). However, the majority of patients reported poor satisfaction levels (79.7%). The results of the Spearman Rank analysis showed a Sig. (2-tailed) value of <0.001 with a correlation coefficient of rs = −0.438, indicating a statistically significant relationship with a moderate correlation strength between nurses’ therapeutic communication and patient satisfaction. There is a significant relationship between nurses’ therapeutic communication and patient satisfaction in the inpatient ward of Grha Permata Ibu Hospital.

This study aims to analyze The Responsibility of the Regional General Hospital (RSUD) TC. Hilers Maumere regarding the practice of burning medical waste and to examine its conformity with the provisions of Law Number 17 of 2023 concerning Health and other regulations related to hazardous waste management. Medical waste management is an important issue because improper handling may cause environmental pollution and pose serious risks to public health. This research employs an empirical legal research method with a descriptive approach, examining how the law operates in society through field data collection and analysis of relevant legal regulations.The results show that RSUD TC. Hilers Maumere implements a waste management system that includes the separation of household waste, liquid waste, and hazardous and toxic waste (B3). Medical waste is categorized and packaged according to its type, weighed, temporarily stored in medical waste storage facilities, and then destroyed using an incinerator or transported by authorized third parties. However, the practice of burning medical waste must be strictly supervised to prevent environmental impacts and potential legal violations. Therefore, stronger supervision, compliance with medical waste management standards, and the implementation of firm legal responsibility are necessary to protect public health and environmental sustainability.

Law Number 17 of 2023 concerning Health (the 2023 Health Law) serves as a fundamental regulation governing various aspects of health services in Indonesia, including the operations of private hospitals. For private hospitals whose shares are listed on the Indonesia Stock Exchange (IDX), the implementation of the 2023 Health Law has brought significant changes in both legal and operational dimensions. This study aims to examine the legal aspects of implementing the 2023 Health Law on the operations of IDX-listed private hospitals. Employing a normative legal research method with statutory and conceptual approaches, this study analyzes relevant regulations and doctrines. The results indicate that the 2023 Health Law expands the scope of hospitals' legal liability, comprehensively regulates the obligations and rights of both hospitals and patients, and imposes stricter sanctions for violations. Furthermore, the implementation of this regulation impacts the business and financial aspects of listed private hospitals, including expansion opportunities, shifts in cost structures, and stock market responses. However, challenges remain in its application, such as diverse interpretations of certain provisions and hospitals' readiness to comply with the established requirements.

Tuberculosis (TB) remains a significant health issue in Indonesia, with the number of cases not showing a decline. Pediatric pulmonary tuberculosis is one of the leading causes of morbidity and mortality. In 2018, the number of TB cases in Aceh reached 41,595, with Aceh Utara having the highest number at 4,819 cases, followed by Bireuen with 3,636 cases, while Sabang recorded the lowest at 272 cases. The primary risk factor for pulmonary tuberculosis in children is a history of contact with adult TB patients, as children's immune systems are still weak, allowing the bacteria to enter their bodies easily. This study aims to examine the history of TB contact in children at the Pediatric Clinic of Cut Meutia General Hospital. The research used a descriptive observational design, with 105 respondents, and data was collected from medical records. The results showed that the majority of respondents were toddlers (47.6%), most were male (54.3%), and 58.1% had good nutritional status. A significant percentage of respondents (77.1%) had a history of contact with TB patients, and 83.8% did not receive BCG vaccination. These findings highlight that contact with TB patients is a key factor in the transmission to children.