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Diabetes mellitus is a chronic disease that requires long-term pharmacological therapy, increasing the risk of Drug Related Problems (DRPs). DRPs can affect the success of therapy, increase the risk of complications, and reduce the patient's quality of life. This article aims to identify the use of antidiabetic drugs, the characteristics of DRPs, and their clinical implications. The method used was a literature review of articles from 2016-2026 that are relevant to the analysis of DRPs in diabetes mellitus patients. The results of the study indicate that metformin is the most widely used antidiabetic drug, both as a single therapy and in combination. The dominant types of DRPs include drug interactions, inappropriate drug selection, inappropriate dosages, omissions from therapy, and use of drugs without indications. These DRPs can cause hypoglycemia, failure to achieve glycemic control targets, an increased risk of complications, and increased duration and cost of treatment. Based on the results of the study, it is concluded that DRPs remain a challenge in the management of diabetes mellitus therapy, requiring more optimal monitoring and an active role of pharmacists through medication review to improve the safety, effectiveness, and quality of treatment.

The development of Artificial Intelligence (AI) has driven significant transformation in hospital management, particularly in operational efficiency, service quality, and patient safety. This study aims to analyze the implementation of AI in hospital management based on recent scientific evidence from 2020 to 2026. The method used was a systematic review guided by the PRISMA 2020 framework. Literature was retrieved from PubMed, ScienceDirect, SpringerLink, Google Scholar, and ProQuest. From 360 identified articles, a stepwise selection process was conducted, resulting in 15 articles that met the inclusion criteria. The findings indicate that AI contributes to improved operational efficiency through patient flow optimization, operating room management, workforce scheduling, and electronic medical record management. AI also enhances service quality through predictive data analytics and supports patient safety through risk detection and early warning systems. In conclusion, AI has strong strategic potential to support modern hospital management. However, its implementation still faces several challenges, including human resource readiness, data security, algorithmic bias, system interoperability, and investment requirements. Therefore, AI implementation should be carried out in a planned, ethical manner and evaluated from a health economics perspective.

The implementation of Electronic Medical Records (EMR) has become an essential part of digital transformation in the healthcare sector, aiming to improve the quality, effectiveness, efficiency, and continuity of healthcare services. In Indonesia, the implementation of EMR is supported by the Regulation of the Minister of Health Number 24 of 2022, which mandates healthcare facilities to adopt electronic medical records. However, the implementation process is often challenged by various technical and non-technical factors that may affect its success. This study aims to analyze the success factors and barriers to EMR implementation in hospitals through a literature review approach. The research method used was a literature review by examining and analyzing 11 scientific articles obtained from Google Scholar and other relevant scientific sources. The findings indicate that the success of EMR implementation is influenced by three main aspects, namely human, organizational, and technological factors. Supporting factors include management commitment, user readiness, continuous training, availability of information technology infrastructure, system quality, and organizational support. Meanwhile, common barriers include limited digital literacy among healthcare workers, insufficient information technology personnel, unstable internet connectivity, system errors, inadequate facilities and infrastructure, budget limitations, and the absence of specific standard operating procedures. Furthermore, EMR implementation provides significant benefits, such as improving service efficiency, facilitating access to patient information, enhancing documentation quality, supporting communication among healthcare professionals, and increasing patient safety. Therefore, successful EMR implementation requires synergy between human resources, organizational readiness, and technological infrastructure to achieve optimal healthcare service delivery.

  Latar Belakang : Pelaksanaan keselamatan pasien sering mengalami hambatan karena perawat belum sepenuhnya menerapkan perilaku caring secara optimal. Hubungan interpersonal yang kurang baik antara perawat dan pasien dapat menyebabkan munculnya kesalahpahaman selama proses perawatan. Tujuan penelitian secara umum adalah untuk mengetahui hubungan antara perilaku caring perawat terhadap keselamatan pasien di Puskesmas Batu . Metode : Penelitian ini menggunakan metode kuantitatif dengan desain analitik korelasional dan pendekatan cross-sectional. Populasi penelitian adalah seluruh perawat yang bekerja di Puskesmas Batu sebanyak 30 orang. Teknik pengambilan sampel menggunakan total sampling.Analisis data dilakukan secara univariat untuk menggambarkan karakteristik responden dan distribusi variabel penelitian, serta analisis bivariat menggunakan uji Spearman Rank dengan tingkat signifikansi 95% (? = 0,05) Hasil : Hasil uji statistik di atas menunjukkan bahwa nilai P (value) = 0.000(< 0.05) dan memiliki nilai r (korelasi) sebesar 1.000 dari total sampel penelitian (n) sebanyak 30 orang responden yang menunjukkan bahwa ada hubungan antara perilaku caring perawat dengan keselamatan pasien. Perilaku caring perawat dengan keselamatan pasien memiliki nilai korelasi sebesar 1.000 yang menunjukkan bahwa arah korelasi positif dengan kekuatan sangat kuat.. Kesimpulan sebagian besar perawat di Puskesmas Batu memiliki perilaku caring dan penerapan keselamatan pasien (patient safety) pada kategori cukup, meskipun sebagian lainnya telah berada pada kategori baik.

Background: The application of ethical principles is an essential foundation in nursing practice, as nurses frequently encounter complex clinical situations that require a careful balance between professional demands, patient safety, and patient rights. Objective: This study aims to explore nurses' experiences in applying ethical principles within clinical nursing practice. Methods: This study utilized a qualitative design with a phenomenological approach. Participants were selected via purposive sampling based on their work experience in direct patient care. Data were collected through in-depth interviews and analyzed using thematic analysis. Results: The findings revealed four main themes: 1) patient autonomy and decision-making in care; 2) the interaction of beneficence, safety, and religious values in care; 3) justice and patient prioritization in care; and 4) effective communication and patient confidentiality. Conclusion: The application of ethical principles is influenced by knowledge, clinical reasoning, moral sensitivity, and teamwork. Continuous reinforcement of ethical education and organizational support are highly required to enhance the quality of nursing care services.

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.

Introduction: Febrile seizures are seizure episodes that occur due to an increase in body temperature above 38°C without evidence of central nervous system infection such as meningitis or encephalitis. In Indonesia, the prevalence of febrile seizures is approximately 2–5% among children aged 6 months to 3 years, and around 30% of these cases experience recurrence or recurrent febrile seizures. Therefore, an appropriate nursing care plan is required to manage patients with febrile seizures. Methods: This scientific paper employed a descriptive narrative method to illustrate the provision of nursing care to patients through the nursing process approach. The general objective of this study was to understand and implement nursing care for patients with febrile seizures. Results: The nursing diagnoses identified in patients with febrile seizures were hyperthermia, risk for injury, and knowledge deficit. Nursing interventions included hyperthermia management, safety management, and health education. Conclusion: After two days of nursing implementation, two nursing diagnoses were resolved and one was partially resolved. Discharge planning included monitoring the patient's condition, particularly for seizure signs, maintaining a safe environment, educating the family about injury prevention during seizures, and encouraging family members to continuously supervise the patient.

Agentic artificial intelligence (AI) systems capable of autonomous goal-directed behavior, multi-step planning, tool use, multi-agent coordination, and iterative self-correction represent a transition from passive clinical AI tools toward systems that can participate in complex healthcare workflows. However, empirical evidence remains fragmented across clinical decision support, patient monitoring, and administrative applications, and no systematic synthesis has evaluated which agentic principles have been technically demonstrated and which have accumulated sufficient evidence to support responsible clinical deployment. We conducted a PRISMA-informed systematic review of peer-reviewed empirical studies published between January 2025 and April 2026. Searches across five bibliographic databases and Google Scholar, supplemented by citation tracking, identified 443 unique records for screening, of which 25 met the predefined PICOS and quality appraisal criteria. Evidence was synthesized using an evidence-informed seven-principle framework derived from the integration of agentic AI, clinical AI, and healthcare governance literature. This framework provides a structured lens for examining how agentic principles are evaluated individually and in combination, enabling a deployment-readiness perspective that extends beyond capability-focused assessments alone. The evidence base was concentrated on technical capability principles, whereas human oversight, safety, compliance, and equity-related evaluation received comparatively limited attention. Most studies remained at the laboratory, benchmark, or proof-of-concept stage, and none reported demographic-stratified performance outcomes. Overall, the findings suggest a structural asymmetry in agentic healthcare AI: empirical research is advancing agentic capabilities more rapidly than it is generating evidence for the oversight, safety, equity, and governance mechanisms required for responsible clinical translation.

Adolescents face significant barriers in accessing reproductive health services due to fears of privacy breaches and social stigma. In primary healthcare facilities, healthcare professionals are often trapped in a dilemma between the obligation to maintain medical confidentiality based on professional ethics and national regulatory demands requiring parental involvement for underage patients. This study aims to analyze the practice of protecting adolescent patient data privacy at Mardi Saras Primary Clinic and identify the gap between practical implementation and the norms of medical ethics and applicable legal regulations. This study employs a socio-legal research method with a qualitative approach. Data were collected through in-depth interviews with doctors and nurses, observation of service procedures, and study of the clinic's Standard Operating Procedures. The results indicate that although Mardi Saras Primary Clinic has implemented basic confidentiality protocols such as closed consultation rooms, there are substantial weaknesses in informed consent management, which still heavily relies on parental presence for all adolescent cases. This practice is driven by healthcare professionals' fear of legal risks, thereby ignoring the principle of developing autonomy in adolescents. These findings indicate a disparity between rigid administrative compliance and the spirit of protecting adolescent health rights within national regulations. The implication of this study underscores the urgency of developing specific SOPs that are sensitive to adolescent rights, as well as the need for continuous training for healthcare professionals regarding the legal and ethical boundaries of maintaining confidentiality for underage patients without compromising legal safety aspects.

Introduction: Ramadan fasting is a religious practice observed by Muslims by abstaining from food and drink from dawn until sunset. These changes may increase the need for oral and dental healthcare. However, some Muslims still perceive that undergoing dental treatment while fasting may invalidate the fast, leading many patients to delay or avoid dental visits during Ramadan. Objective: This study aims to review and analyse various scientific literature regarding the safety and permissibility of dental procedures for patients who are observing fasting during Ramadan. Methods: This study used a narrative review method by searching scientific articles through PubMed, ScienceDirect, and Google Scholar databases using keywords relevant to the research topic. Articles were selected based on predetermined inclusion and exclusion criteria. Results: The review findings indicate that most dental procedures, such as local anaesthesia administration, scaling, restorative treatment, and tooth extraction, generally do not invalidate fasting as long as no material or fluid is intentionally swallowed. The use of suction devices, isolation of the treatment area, and proper scheduling of dental procedures are important factors in minimizing the risk of swallowing fluids during treatment. Conclusion: Most dental procedures can be safely performed on fasting patients while still considering both medical aspects and Islamic principles. Patient education regarding the safety of dental procedures during fasting should be improved to prevent delays in treatment and complications in oral health.

Telepharmacy is a digital-based pharmaceutical service innovation aimed at improving access to healthcare services and enhancing the quality of pharmaceutical care, particularly in areas with limited healthcare resources. This study aimed to evaluate the implementation of telepharmacy services at Sehat Plus Pharmacy based on the six healthcare quality dimensions established by the World Health Organization (WHO), namely safety, effectiveness, timeliness, efficiency, equity, and patient-centeredness, and to analyze their association with respondent characteristics. A quantitative descriptive-analytic study with a cross-sectional design was conducted. The study involved 35 respondents selected using a total sampling technique. Data were collected through a structured Likert-scale questionnaire and analyzed using univariate analysis and Spearman correlation tests with a significance level of α = 0.05. The results indicated that the overall implementation of telepharmacy services was categorized as very good (88.8%), with the safety dimension achieving the highest evaluation score among all quality dimensions. Most respondents were female and aged between 21 and 25 years. Statistical analysis revealed a significant association between age and perceptions of telepharmacy implementation (p = 0.004; r = -0.471), indicating a moderate negative correlation. In contrast, gender, educational level, and occupation showed no significant association with service implementation (p > 0.05). It can be concluded that telepharmacy services at Sehat Plus Pharmacy have met WHO healthcare quality standards and provide positive user experiences, while age remains an important factor influencing service perception and acceptance.

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

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.

Drug-Related Problems (DRPs) are common in patients with type 2 Diabetes Mellitus (T2DM) who receive combination therapy involving oral antidiabetic agents and insulin. This literature review aims to identify the main types of DRPs and the factors contributing to their occurrence based on recent studies from PubMed, ScienceDirect, ResearchGate, and Google Scholar. The most frequently reported DRP is drug interaction, followed by underdosing, overdosing, therapy without indication, untreated indications, adverse drug reactions, and patient-related problems such as non-adherence. Several factors contribute to the occurrence of DRPs, including polypharmacy, inappropriate dosing, the presence of comorbidities, limited patient knowledge regarding therapy, and inadequate clinical monitoring. These conditions may increase the risk of poor glycemic control and treatment failure. Therefore, effective management of DRPs is essential to improve therapeutic outcomes. The findings of this review emphasize the important role of pharmacists in conducting medication reviews, identifying DRPs early, and implementing appropriate interventions to enhance patient safety and optimize treatment in T2DM patients.

Drug-Related Problems (DRPs) are common in patients with type 2 Diabetes Mellitus (T2DM) who receive combination therapy involving oral antidiabetic agents and insulin. This literature review aims to identify the main types of DRPs and the factors contributing to their occurrence based on recent studies from PubMed, ScienceDirect, ResearchGate, and Google Scholar. The most frequently reported DRP is drug interaction, followed by underdosing, overdosing, therapy without indication, untreated indications, adverse drug reactions, and patient-related problems such as non-adherence. Several factors contribute to the occurrence of DRPs, including polypharmacy, inappropriate dosing, the presence of comorbidities, limited patient knowledge regarding therapy, and inadequate clinical monitoring. These conditions may increase the risk of poor glycemic control and treatment failure. Therefore, effective management of DRPs is essential to improve therapeutic outcomes. The findings of this review emphasize the important role of pharmacists in conducting medication reviews, identifying DRPs early, and implementing appropriate interventions to enhance patient safety and optimize treatment in T2DM patients.

Implementing Standard Operating Procedures (SOPs) for fall risk is a crucial component of pediatric patient safety in inpatient wards. However, nurses' implementation of SOPs is not always optimal, especially for patients at high risk of falling. Inappropriate SOP implementation has the potential to increase fall risk incidents in hospitals. To describe the results of observations of nurses implementing SOPs for fall risk and efforts to improve implementation through resocialization, supervision, and strengthening the oversight system. This case study is an observational study of nurses implementing SOPs for fall risk in the Alfarisi Ward, Jakarta Islamic Hospital, Sukapura. Observations were conducted on nurses providing nursing interventions to two pediatric patients: one with a low risk of falling and one with a high risk of falling. Activities included observation of nurses' practice, resocialization of SOPs for fall risk, three- day implementation supervision, development of a supervision schedule, and proposals for SOP revisions based on evidence-based practice. Data collection used observation sheets, fall risk assessment instruments, and nursing documentation. After three days of resocialization and supervision, the implementation of SOPs for fall risk in low-risk patients was in accordance with the SOPs. However, in high-risk patients, SOP implementation is still limited to displaying yellow triangle signs and locking bed rails, while other interventions have not been optimally implemented. These findings form the basis for developing a structured supervision schedule. Nurses' implementation of fall risk SOPs is optimal in low-risk patients, but not optimal in high-risk patients. Resocialization, ongoing supervision, developing a supervision schedule, and proposing SOP revisions are important strategies for improving nurse compliance and pediatric patient safety.

Implementing Standard Operating Procedures (SOPs) for fall risk is a crucial component of pediatric patient safety in inpatient wards. However, nurses' implementation of SOPs is not always optimal, especially for patients at high risk of falling. Inappropriate SOP implementation has the potential to increase fall risk incidents in hospitals. To describe the results of observations of nurses implementing SOPs for fall risk and efforts to improve implementation through resocialization, supervision, and strengthening the oversight system. This case study is an observational study of nurses implementing SOPs for fall risk in the Alfarisi Ward, Jakarta Islamic Hospital, Sukapura. Observations were conducted on nurses providing nursing interventions to two pediatric patients: one with a low risk of falling and one with a high risk of falling. Activities included observation of nurses' practice, resocialization of SOPs for fall risk, three- day implementation supervision, development of a supervision schedule, and proposals for SOP revisions based on evidence-based practice. Data collection used observation sheets, fall risk assessment instruments, and nursing documentation. After three days of resocialization and supervision, the implementation of SOPs for fall risk in low-risk patients was in accordance with the SOPs. However, in high-risk patients, SOP implementation is still limited to displaying yellow triangle signs and locking bed rails, while other interventions have not been optimally implemented. These findings form the basis for developing a structured supervision schedule. Nurses' implementation of fall risk SOPs is optimal in low-risk patients, but not optimal in high-risk patients. Resocialization, ongoing supervision, developing a supervision schedule, and proposing SOP revisions are important strategies for improving nurse compliance and pediatric patient safety.

An abstranct is a brief summary of a research article, thesis, review, conference proceeding or any-depth analysis of a particular subject or disipline, and is often used to help the reader quickly ascertain the paper purposes. When used, an abstract always appears at the beginning of a manuscript or typescript, acting as the point-of-entry for any given academic paper or patent application. Absatrcting and indexing services for various academic discipline are aimed at compiling a body of literature for that particular subject. Abstract length varies by discipline and publisher requirements. Abstracts are typically sectioned logically as an overview of what appears in the paper.

Malpractice in the health professions is one of the issues that can cause harm to patients, health professionals, and healthcare institutions. A lack of understanding among students as prospective health professionals regarding ethical aspects, legal principles, professional standards, and proper service procedures may increase the risk of malpractice. This Community Service activity aims to provide students of STIKES Pasapua Ambon with an understanding of the concept of malpractice, the factors causing malpractice, and preventive efforts through the implementation of professional ethics, compliance with standard operating procedures, effective communication, and the improvement of professional competence. The activity was carried out through counseling, educational sessions, interactive discussions, and guidance on health law for participants. The results of the activity indicate an increase in students’ knowledge and awareness of the importance of understanding the limits of professional authority, legal responsibility, and preventive measures to avoid malpractice in healthcare practice. This activity is expected to help develop future health professionals who are professional, ethical, and responsible in providing safe and high-quality healthcare services.

Uterine myoma is a benign smooth muscle tumor of the uterus commonly found in women of reproductive age and may cause symptoms related to mass effect and hematologic disturbances. We report the case of a 41-year-old woman presenting with progressive vaginal pain for 3 months, accompanied by low back pain and impaired daily activities, without vaginal bleeding, vaginal discharge, fever, or urinary or defecatory symptoms. Laboratory examination revealed severe microcytic hypochromic anemia with a hemoglobin level of 4.7 g/dL, while ultrasonography demonstrated a 9.93 × 10.32 cm mass described as symmetric, well circumscribed, and hyperechoic, leading to a working diagnosis of uterine myoma with anemia. The patient was managed with general condition monitoring, intravenous fluids, analgesics, transfusion of four units of packed red cells, and laparotomy as definitive intervention. Following transfusion and surgery, the hemoglobin level increased to 9.4 g/dL and subsequently to 11.0 g/dL, accompanied by improvement in postoperative symptoms and clinical condition. This case demonstrates that a large uterine myoma may present predominantly with pelvic pain and functional impairment in the absence of vaginal bleeding. A comprehensive approach involving systematic evaluation, preoperative correction of anemia, appropriate surgical intervention, and postoperative monitoring is essential to improve safety and clinical outcomes in patients with symptomatic pelvic masses.