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The completeness of nursing care documentation serves as a primary indicator of hospital service quality and remains a critical component of patient safety, clinical communication, and legal accountability. Despite its importance, empirical evidence from various healthcare facilities indicates that nursing records are frequently suboptimal, incomplete, or inconsistent. This study aims to analyze the complex interrelationships between burnout and coaching on the completeness of nursing care documentation, specifically examining the role of nursing competence as a mediating (intervening) variable at the Dr. Chasbullah Abdulmadjid General Hospital in Bekasi City. Utilizing a quantitative research framework with a cross-sectional design, this study sampled practicing nurses stationed across inpatient and intensive care units. Primary data were gathered through a validated, structured questionnaire designed to measure psychological burnout, the frequency of clinical coaching, perceived professional competence, and the objective completeness of documentation. The data were subjected to rigorous analysis using Structural Equation Modeling–Partial Least Squares (SEM-PLS) to test the hypothesized pathways within the conceptual model. The results demonstrated that burnout exerts a significant negative influence on both nursing competence and the quality of documentation, suggesting that emotional exhaustion hinders professional performance. Conversely, systematic coaching was found to have a significant positive impact, directly improving both competence levels and documentation adherence. Critically, the analysis confirmed that nursing competence acts as a vital intervening variable; it effectively mediates and strengthens the influence of both burnout reduction and coaching interventions on the overall completeness of nursing care records. This study concludes that proactive burnout management and the institutionalization of structured coaching programs are essential strategic priorities. By addressing these factors, hospital management can enhance individual nurse competence, thereby ensuring high-quality, comprehensive nursing documentation that supports patient safety and institutional integrity.

Effective communication is essential for teamwork effectiveness in healthcare, particularly in inpatient units where patient care requires coordination among multiple professionals. Internal data from Hospital X showed that more than 50% of medical incidents in the last two years were related to miscommunication among healthcare workers. In addition, the 2024 employee satisfaction survey reported that workplace communication satisfaction was only 62%, below the hospital target of 75%. This study aimed to examine the influence of effective communication on teamwork effectiveness with interprofessional collaboration as an intervening variable at Hospital X.This study used a quantitative cross-sectional design involving 226 healthcare workers, including doctors, nurses, and medical support staff. Data were analyzed using the Three-Box Method and PLS-SEM. The findings revealed that effective communication significantly influenced teamwork effectiveness both directly and indirectly through interprofessional collaboration. Interprofessional collaboration also acted as a significant mediating variable between communication and teamwork effectiveness. These results indicate that communication is a key foundation for strengthening collaboration and improving teamwork in hospitals. Therefore, hospitals should enhance communication training and interprofessional collaboration programs to improve healthcare quality and patient safety

Hospitals play a strategic role in improving public health through professional, safe, and high-quality healthcare services. In modern healthcare organizations, service quality is not only determined by medical facilities and technology but also by the quality of human resources, particularly healthcare workers who directly interact with patients. This study aims to analyze the influence of authentic leadership on healthcare workers’ performance and hospital service quality. The study employed a quantitative explanatory research design involving 120 healthcare workers in a hospital setting. Data were collected using questionnaires and analyzed through multiple linear regression analysis. The findings demonstrate that authentic leadership has a positive and significant effect on healthcare workers’ performance, with a regression coefficient value of 0.648 and a significance level of 0.000. Furthermore, authentic leadership indirectly influences hospital service quality through healthcare workers’ performance, with an indirect effect value of 0.521. These findings indicate that leaders who demonstrate honesty, transparency, integrity, and interpersonal support are able to create a healthy work environment that enhances healthcare workers’ motivation, responsibility, and professionalism. Consequently, improved employee performance contributes to better hospital service quality, particularly in responsiveness, empathy, and communication with patients. This study highlights that authentic leadership is an effective leadership approach for strengthening healthcare human resources and improving hospital service quality in contemporary healthcare organizations.

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.

This study aims to investigate the influence of academic qualifications, managerial capabilities, and Perceived Organizational Support (POS) on emotional exhaustion and its implications for employee productivity at Sunan Kudus Islamic Hospital. Using a quantitative approach, data were collected via a questionnaire from 138 respondents. Instrument evaluation procedures were conducted through validity and reliability tests, while hypothesis testing was analyzed using Structural Equation Modeling (SEM). The findings reveal that academic qualifications and POS have a significant negative effect on emotional exhaustion, indicating that increased intellectual competence and strong organizational support are effective in reducing staff emotional exhaustion. Conversely, managerial capabilities were found to have no significant influence on emotional exhaustion. In the context of performance, the analysis results show that academic qualifications, managerial capabilities, and POS have a partial, positive, and significant effect on work productivity. Practically, this study suggests that hospital management prioritize human capital development and the strengthening of a supportive organizational climate to mitigate emotional exhaustion while accelerating operational efficiency in a sustainable manner.

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.

The premium healthcare industry in urban areas is experiencing increasing competition along with the increase in healthcare facilities and the increasing public demand for fast, comfortable, and quality medical services. In this context, Columbia Asia Pulomas Hospital is implementing an expansion strategy by increasing facility capacity, modernizing services, and adding a Center of Excellence (COE) as a service differentiation. This study aims to analyze customer retention strategies within the Balanced Scorecard (BSC) framework, focusing on the relationship between customer perspectives, internal processes, learning and growth, and their application to the financial perspective. The research method uses a document-based policy and strategy analysis approach, field findings, and a synthesis of Balanced Scorecard theory and patient experience.The analysis shows that customer retention during the expansion phase is influenced not only by clinical quality, but also by the assurance of doctor time in practice, speed of service, physical comfort, and digitization of queues and administration. The addition of a COE has been shown to increase the perception of service value and expand market share through service specialist differentiation. Within the BSC framework, the customer perspective serves as a leading indicator for achieving the financial perspective, where increased patient retention contributes to increased revenue, ROI growth, and long-term financial expectations. The research implications emphasize that strategies for strengthening human resources, modernizing internal processes, and service innovation are important foundations in ensuring successful hospital expansion and enhancing competitive advantage.

Post section caesarea (SC) and method of operative female sterilization (MOW) are surgical procedures that may cause various problems, such as pain, limited mobility, decreased muscle strength, and risk of postoperative complications. Physiotherapy management through exercise therapy is an important intervention to accelerate the recovery process. Objective this study aimed to determine the effectiveness of exercise therapy in improving the functional condition of patients post SC and MOW in Annisa Ward 32 A at PKU Muhammadiyah Karanganyar Hospital. Method: used was a case report on a 33-year-old female patient following SC and MOW procedures. The physiotherapy interventions included deep breathing exercises, active range of motion exercises of the extremities, light abdominal muscle contractions, gradual early mobilization, as well as breast massage and oxytocin stimulation. The results showed a reduction in pain from a scale of 4–5 to 2–3 based on the Numeric Rating Scale (NRS), improvement in mobility such as independent position changes, and increased activity tolerance, including sitting and walking with minimal assistance. In addition, the patient showed increased confidence in performing daily functional activities. Conclusion: exercise therapy has a positive effect on improving mobility, reducing pain, and accelerating functional recovery in post SC and MOW patients. Therefore, exercise therapy is recommended as an essential component of postoperative physiotherapy management to improve patients' quality of life.

This study examines the lived faith of Catholic migrants from East Nusa Tenggara (NTT) who have migrated to the Muslim-majority landscape of South Kalimantan, Indonesia. These migrants face a profound crisis of identity as they transition from a dominant religious environment to a marginalized minority status, necessitating a research objective that explores how their faith is reinterpreted amidst such socio-religious pressures. Employing a qualitative phenomenological-hermeneutical method, the research utilizes Paul Ricoeur’s threefold mimesis - prefiguration, configuration, and refiguration - as its primary interpretive framework. The findings reveal a significant narrative shift from an inherited “communal Catholic habitus” to a “refigured faith” characterized by personal agency and reflective commitment. This transformation is sustained through adaptive relational ethics, such as the sanctification of work and collaborative hospitality, which allow migrants to navigate their vulnerability. The study synthesizes these experiences to conclude that internal migration constitutes a vital locus theologicus, wherein the rupture of traditional religious structures does not erode faith but rather matures it into a more resilient, intentional, and relational existential orientation. Consequently, migration emerges as a transformative theological process that redefines the intersection of faith, culture, and minority existence in pluralistic societies.

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.

Prolonged outpatient waiting time remains a major challenge in public hospitals and reflects inefficiencies in service process management. Internal medicine clinics are characterised by high service complexity and patient volume, making them particularly vulnerable to process waste that contributes to extended waiting times. Objective: This study aimed to develop an outpatient service flow model based on the Lean Hospital approach to reduce waiting time in the internal medicine clinic of RSUD Balaraja. Methods: A qualitative case study design was employed. Data were collected through direct observation of outpatient service processes, document review, and Focus Group Discussions (FGD) with relevant stakeholders. Process analysis was conducted using Value Stream Mapping (VSM) to identify value-added and non–value-added activities, while Fishbone Diagram analysis was applied to explore the root causes of process inefficiencies. All findings were integrated to develop a future-state outpatient service flow model. Results: The findings indicate that prolonged outpatient waiting time is primarily influenced by inefficient service flow design, repetitive administrative processes, and weak coordination among service units. The proposed service flow model demonstrates a more streamlined, integrated, and patient-centred process, with potential reductions in waiting time through systematic waste elimination and process improvement. Conclusion: The Lean Hospital approach provides an effective framework for developing outpatient service flow models in public hospitals. The proposed model offers a practical basis for improving outpatient service efficiency in complex clinical settings such as internal medicine clinics.

This study aims to evaluate the determinants of organizational sustainability within the Doctor Peduli Foundation (doctorSHARE), specifically regarding its Floating Hospital program. Specifically, it examines the influence of stakeholder support and operational efficiency on organizational sustainability, while analyzing the role of organizational innovation as a mediating variable in ensuring the continuity of medical services in remote areas. Employing a quantitative approach with a survey method, data were collected from 81 respondents comprising staff and volunteers directly involved in the Floating Hospital's operations. Structural Equation Modeling (SEM) was utilized to analyze the data and test the proposed hypotheses.The results reveal that stakeholder support does not have a significant direct impact on either organizational sustainability or innovation performance. Conversely, operational efficiency emerged as a dominant factor with a significant positive influence. Furthermore, organizational innovation was found to play a crucial role as a mediator, strengthening the impact of operational efficiency on organizational sustainability.This study concludes that the sustainability of non-profit organizations such as doctorSHARE is determined more by management's ability to optimize internal resources efficiently and innovatively than by reliance on external support. Consequently, strengthening internal operational systems should be a primary strategic priority to ensure long-term organizational existence.

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 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.

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).

Background: Anxiety can affect physiological functions in patients prior to surgery, including increased heart rate and respiration, changes in blood pressure and temperature, relaxation of smooth muscles in the bladder, cold and clammy skin, and dry mouth, which may reduce the patient’s energy level. Psychologically, anxiety can lead to increased postoperative pain, delayed wound healing, increased physical disability, and decreased quality of life. One effective non-pharmacological intervention to reduce anxiety is Benson relaxation therapy. Objective: This study aimed to determine the effect of benson relaxation therapy on reducing anxiety levels in pre operative. Methods: This study used a case study design involving one preoperative patient with anxiety symptoms in the Teratai Ward of Prof. Dr. Margono Soekarjo Hospital, Purwokerto. Benson relaxation therapy was administered for 3 days, twice daily, with a duration of 15 minutes per session. Anxiety levels were measured using the Zung Self-Rating Anxiety Scale (ZSAS) before and after the intervention. Results: The patient showed a decrease in anxiety score from 55 (moderate anxiety) to 40 (mild anxiety) after receiving Benson relaxation therapy. Subjectively, the patient reported feeling calmer, more accepting, and motivated. Objectively, there was a reduction in heart rate and physical signs of anxiety. Conclusion: Benson relaxation therapy is effective in reducing anxiety levels in preoperative patients. This intervention can be used as a non-pharmacological alternative to support psychological recovery of pre-operative patients.

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.