A Study on the Calculation of the proper number of the SPMS safety managers and safety management ratio when introducing SPMS

Safety management in the shipping industry is based on an international regulation. It is International Safety Management Code (ISM-Code) which is a translation of SOLAS ‘74 Chapter IX. It stated that the objectives of the Code are to ensure safety at sea, prevention of human injury or loss of life, and avoidance of damage to the environment, in particular, to the marine environment, and to property.it is also requires commitment from top management to implementation on both company and on board. The implementation of the ISM-Code is expected to make the ship’s safety is more secure. The ISM-Code fulfillment refers to 16 elements, there are; General; Safety and Environmental Protection Policy; Company Responsibility and Authority; Designated Person(s); Master Responsibility and Authority; Resources and Personnel; Shipboard Operation; Emergency Preparedness; Report and Analysis of Non-conformities, Accidents and Hazardous Occurrences; Maintenance of the Ship and Equipment; Documentation; Company Verification, Review, and Evaluation; Certification and Periodical Verification; Interim Certification; Verification; Forms of Certificate. The responsibility and authority of Designated Person Ashore / DPA in a shipping company is regulated in the ISM-Code. So, it is expected that DPA can carry out its role well, than can minimize the level of accidents in each vessels owned/operated by each shipping company.Keywords : ISM Code, Safety management, Designated Person Ashore Manajemen keselamatan di bidang pelayaran saat ini diimplementasikan dalam suatu peraturan internasional yaitu International Safety Management Code (ISM-Code) yang merupakan penjabaran dari SOLAS 74 Chapter IX-Management for the safe operation of ships. Tujuan dari ISM-Code “The objectives of the Code are to ensure safety at sea, prevention of human injury or loss of life, and avoidance of damage to the environment, in particular, to the marine environment, and to property” dan ISM-Code menghendaki adanya komitmen dari manajemen tingkat puncak sampai pelaksanaan, baik di darat maupun di kapal. Pemberlakuan ISM-Code tersebut diharapkan akan membuat keselamatan kapal menjadi lebih terjamin. Pemenuhan ISM-Code mengacu kepada 16 elemen yang terdiri dari ; umum; kebijakan keselamatan dan perlindungan lingkungan; tanggung jawab dan wewenang perusahaan; petugas yang ditunjuk didarat; tanggung jawab dan wewenang nahkoda; sumber daya dan personil; pengopersian kapal; kesiapan menghadapi keadaan darurat; pelaporan dan analisis ketidaksesuaian, kecelakaan dan kejadian berbahaya; pemeliharaan kapal dan perlengkapan; Dokumentasi; verifikasi, tinjauan ulang, dan evaluasi oleh perusahaan; sertifikasi dan verifikasi berkala; sertifikasi sementara; verifikasi; bentuk sertifikat. Tugas dan tanggungjawab Designated Person Ashore/DPA didalam suatu perusahaan pelayaran, telah diatur di dalam ISM-Code. Sehingga diharapkan agar DPA dapat melaksanakan peranannya dengan baik, sehingga dapat menekan tingkat kecelakaan di setiap armada kapal yang dimiliki oleh setiap perusahaan pelayaran.Kata kunci : ISM Code, Manajemen keselamatan, Designated Person Ashore

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Lymph nodes detection and the mesorectal excision quality evaluation

Perspectives in Surgery ◽

10.33699/pis.2019.98.5.200-206 ◽

2019 ◽

Vol 98 (5) ◽

pp. 200-206

Keyword(s):

Lymph Nodes ◽

Neoadjuvant Therapy ◽

Quality Evaluation ◽

Rectal Resection ◽

Age Groups ◽

Cooperative Groups ◽

Mesorectal Excision ◽

Proper Number ◽

Before And After ◽

And Gender

ntroduction: Detection and examination of proper number of lymph nodes in patients after rectal resection is important for next treatment and management of patients with rectal carcinoma. There are no clear guideliness for minimal count of lymph nodes, variant recommendations agree on the number of 12 (10−14) nodes. There are situations, when is not easy to reach this count, mainly in older age groups and in patients after neoadjuvant, especially radiation therapy. As a modality for improvement of lymph nodes harvesting seems to be establishing of defined protocols originally designed for mesorectal excision quality evaluation. Methods: The investigation group was formed by patients examined in 2 three-years intervals before and after implementation of the protocol. Elevation in count of harvested lymph nodes was rated generaly and in relation to age groups and gender. Results: The average count of lymph nodes increased from 10 to 15 nodes, in subset of patients whose received neoadjuvant therapy from 7 to al- most 14 nodes. The recommended number of lymph nodes was obtained in all investigated age groups. By the increased number of lymph nodes, rises also possibility of positive nodes found, that can lead to upstaging of the disease, in subset of patients whose received neoadjuvant therapy it is more than 4%. Conclusion: Our conclusions show, that forming of multidisciplinary cooperative groups (chiefly surgeon-pathologist), implementation of defined protocol of surgery, specimen manipulation and investigation by detached specialists lead to benefit consequences for further management and treatment of the patients with colorectal cancer.

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