scholarly journals Pelaksanaan Discharge Planning pada Pasien Hipertensi di RSUD Panembahan Senopati Bantul

2020 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Sugino Sugino ◽  
Fatma Siti Fatimah ◽  
R Agus Siswanto
Keyword(s):  
Discharge Planning ◽  
Sampling Fraction

<p>Hipertensi merupakan penyakit tidak menular yang masih menjadi masalah dibidang kesehatan. Upaya penanganan hipertensi pada dasarnya sudah dijalankan dengan berbagai cara termasuk kegiatan untuk meningkatkan pengetahuan penderita hipertensi. Pengetahuan dapat ditingkatkan melalui komunikasi informasi edukasi. Salah satu yang biasanya dilakukan petugas kesehatan ditatanan pelayanan kesehatan adalah pelaksanaan discharge planing. discharge planning adalah perencanaan pulang, sejak pasien masuk rumah sakit sampai pasien pulang yang dilakukan oleh petugas Kesehatan. Penelitian ini merupakan penelitian deskriptif dengan pendekatan retrospektif. Populasi penelitian ini adalah rekam medis pasien hipertensi yang mendapatkan rawat inap dan dinyatakan pulang dari bulan Agustus sampai dengan bulan Oktober 2017. Besarnya sampel penelitian sebanyak 145 rekam medis. Besarnya sampel tiap bangsal menggunakan rumus sampling fraction cluster. Instrumen penelitian menggunakan lembar checklist pemberian Pendidikan kesehatan. Analisa data menggunakan deskriptif statistik. Hasil dan Kesimpulan: Hasil penelitian menunjukan program pendidikan kesehatan secara keseluruhan 145 (100%) dilaksanakan, sebagian besar menggunakan metode diskusi 145 (100%), respon pasien atau keluarga pasien hipertensi setelah diberi pendidikan kesehatan sebagian besar paham tapi tidak bisa menjelaskan sendiri 113 (77,93%), pemberi pendidikan kesehatan sebagian besar dilaksanakan oleh dokter 135 (93,10%), dan penerima pendidikan kesehatan terbanyak diterima oleh keluarga pasien hipertensi 122 (84,14%).</p><p>Kata Kunci: Discharge Planning, Hipertensi</p>

STUDI FENOMENOLOGI: DUKUNGAN PADA IBU DALAM PERAWATAN BAYI PREMATUR DI RUANG RAWAT INTENSIF NEONATUS

2019 ◽  
Vol 7 (3) ◽  
pp. 198-205
Author(s):  
Anafrin Yugistyowati
Keyword(s):  
Intensive Care ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Discharge Planning ◽  
Premature Baby ◽  
Field Note ◽  
Analyse Data ◽  
Using Data ◽  
Care Ward ◽  
Intensive Care Ward

Background: The premature birth of infants is a process that leads to physical unpreparedness, sources of stress, and traumatize effects for the parents. Mostly mothers showed unpleasant memories that interfered the parents’ ability to take care of their premature baby. Objective: This study aimed  to obtain in-depth understanding of mother’s support in neonatal  intensive care ward. Methods: This is a qualitative research using phenomenology approach involving eight participants. Data were collected through in-depth interview using data recording, interview protocol, and field note. Colaizzi method was used to analyse data. Results: Two research themes were gained from data analysis, the source and the type of support for mother with premature infants’ care. Conclusion: This study recommends for nurses to assist parents by discussing any problems and to facilitate bonding mother and baby through implementation continuum of discharge planning.   Keywords: Care for Premature Infants, Neonatal Intensive Care Ward, Supporting Mothers

The Institute for Healthcare Improvement–NeuroPoint Alliance collaboration to decrease length of stay and readmission after lumbar spine fusion: using national registries to design quality improvement protocols

2020 ◽  
Vol 33 (6) ◽  
pp. 812-821
Author(s):  
Scott L. Zuckerman ◽  
Clinton J. Devin ◽  
Vincent Rossi ◽  
Silky Chotai ◽  
E. Hunter Dyer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Length Of Stay ◽  
Discharge Planning ◽  
Lumbar Fusion ◽  
Nonparametric Tests ◽  
Learning System ◽  
Design Quality ◽  
Implementation Phase ◽  
Healthcare Improvement ◽  
The Impact

OBJECTIVENational databases collect large amounts of clinical information, yet application of these data can be challenging. The authors present the NeuroPoint Alliance and Institute for Healthcare Improvement (NPA-IHI) program as a novel attempt to create a quality improvement (QI) tool informed through registry data to improve the quality of care delivered. Reducing the length of stay (LOS) and readmission after elective lumbar fusion was chosen as the pilot module.METHODSThe NPA-IHI program prospectively enrolled patients undergoing elective 1- to 3-level lumbar fusions across 8 institutions. A three-pronged approach was taken that included the following phases: 1) Research Phase, 2) Development Phase, and 3) Implementation Phase. Primary outcomes were LOS and readmission. From January to June 2017, a learning system was created utilizing monthly conference calls, weekly data submission, and continuous refinement of the proposed QI tool. Nonparametric tests were used to assess the impact of the QI intervention.RESULTSThe novel QI tool included the following three areas of intervention: 1) preoperative discharge assessment (location, date, and instructions), 2) inpatient changes (LOS rounding checklist, daily huddle, and pain assessments), and 3) postdischarge calls (pain, primary care follow-up, and satisfaction). A total of 209 patients were enrolled, and the most common procedure was a posterior laminectomy/fusion (60.2%). Seven patients (3.3%) were readmitted during the study period. Preoperative discharge planning was completed for 129 patients (61.7%). A shorter median LOS was seen in those with a known preoperative discharge date (67 vs 80 hours, p = 0.018) and clear discharge instructions (71 vs 81 hours, p = 0.030). Patients with a known preoperative discharge plan also reported significantly increased satisfaction (8.0 vs 7.0, p = 0.028), and patients with increased discharge readiness (scale 0–10) also reported higher satisfaction (r = 0.474, p < 0.001). Those receiving postdischarge calls (76%) had a significantly shorter LOS than those without postdischarge calls (75 vs 99 hours, p = 0.020), although no significant relationship was seen between postdischarge calls and readmission (p = 0.342).CONCLUSIONSThe NPA-IHI program showed that preoperative discharge planning and postdischarge calls have the potential to reduce LOS and improve satisfaction after elective lumbar fusion. It is our hope that neurosurgical providers can recognize how registries can be used to both develop and implement a QI tool and appreciate the importance of QI implementation as a separate process from data collection/analysis.

The effectiveness of discharge planning and range of motion (ROM) training in increasing muscle strength of nonhemorrhagic stroke patients

2018 ◽  
Vol 2 (3) ◽  
pp. 57
Author(s):  
Mohamat Iskandar
Keyword(s):  
Muscle Strength ◽  
Range Of Motion ◽  
Rating Scale ◽  
Discharge Planning ◽  
Intervention Group ◽  
Sampling Technique ◽  
Control Group ◽  
Planning Program ◽  
Stroke Patients ◽  
Central Java

Background: Non-hemorrhagic stroke patients experience hemiparesis, an improper handling results in joint contractures. Discharge planning combined with a range of motion (ROM) training given to patients and their families are expected to improve muscle strength in patients after returning from the hospital. Aims: This study is to identify the effectiveness of discharge planning in increasing muscle strength. Methods: This is a quasi-experimental study with a pre-posttest design. A total of 34 respondents were selected by cluster random sampling technique, from RAA Soewondo Pati General Hospital of Pati, Central Java, Indonesia. The respondents were divided equally into two groups; an intervention group (N = 17) was given a discharge planning program together with stroke information and range of motion (ROM) training while the control group (N = 17) received a standard discharge planning available in the hospital. Further, Muscle Rating Scale (MRS) was employed to assess the muscle strength on the 2nd, 7th, and 14th day after discharge planning presented to the nonhemorrhagic stroke patients. Results: This present study clearly acknowledges the standard discharge planning program available in the hospital improve the muscle strength of the upper and lower extremity in the nonhemorrhagic stroke patients just 2nd day after the care (pretest), and the significant improvement was observed until the day 14. Moreover, combining the care with ROM training at the intervention group faster the recovery and the muscle strength improved significantly at the 7th day and continue increase at the day 14. Looking to the muscle strength since the 2nd day to the day 14, respectively the muscle strength of upper and lower limb at the control group improved at the point of 0.588 and 0.882, while at the group received the ROM training reached the value of 1.472 and 1.412. Conclusions: The ROM training combined to the current discharge planning program will faster the muscle strength recovery of the nonhemorrhagic stroke patients. This research provide insight how family plays important role to the success in monitoring the rehabilitation and recovery progress. 

Biochemical Markers in Patients with Readmission for Congestive Heart Failure

2018 ◽  
Vol 69 (7) ◽  
pp. 1687-1691
Author(s):  
Razan Al Namat ◽  
Mihai Constantin ◽  
Ionela Larisa Miftode ◽  
Andrei Manta ◽  
Antoniu Petris ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Rural Areas ◽  
Discharge Planning ◽  
Difficult Problem ◽  
Uncontrolled Hypertension ◽  
Medical Attention ◽  
Family Doctors ◽  
Increased Risk ◽  
Risk Patients

Repetitive or recurrent hospitalizations are a general major health issue in patients with chronic disease. Congestive heart failure, is associated with a high incidence and presence of early rehospitalization, but variables in order to identify patients at increased risk and also an analysis of potentially remediable factors contributing to readmission have not been previously reported and it remains still a difficult problem. We retrospectively assessed 100 patients aged between 48-85 years old, of which 75% were men, who had been hospitalized with documentation of congestive heart failure in St. Spiridon County Emergency Hospital. They were hospitalized between 2010-2017. Even if recurrent heart failure was the most common cause for readmission or rehospitalization, other cardiac disorders and noncardiac illnesses were also accounted for readmission. Predictive factors of an increased probability of readmission included prior patient�s medical heart failure history, heart failure decompensation precipitated or accelerated by an ischaemic episode, atrial fibrillation or uncontrolled hypertension. Factors contributing to preventable readmissions included noncompliance with medications or diet, inadequate discharge planning or follow-up, failure of both social support system and the seek of a promp medical attention when symptoms reappeared. We also identified an inappropriate colaboration with family doctors especially for the patients from rural areas. Patients were more likely to cite side effects of prescribed medications rather than nonadherence as a precipitating factor for readmission. Thus, we can appreciate that early rehospitalization in patients with congestive heart failure may be avoidable in up to 50% of cases. Identification of high risk patients is possible and also necessary shortly after admission in order to identify nonpharmacological interventions designed to decrease readmission frequency.

Diabetes Discharge Planning and Transitions of Care: A Focused Review

2019 ◽  
Vol 15 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Robin L. Black ◽  
Courtney Duval
Keyword(s):  
Patient Outcomes ◽  
Hospital Admissions ◽  
Discharge Planning ◽  
Medication Management ◽  
Hospital Readmissions ◽  
The United States ◽  
Transitions Of Care ◽  
Discharge Process ◽  
The Impact ◽  
Diabetes Patients

Background: Diabetes is a growing problem in the United States. Increasing hospital admissions for diabetes patients demonstrate the need for evidence-based care of diabetes patients by inpatient providers, as well as the importance of continuity of care when transitioning patients from inpatient to outpatient providers. Methods: A focused literature review of discharge planning and transitions of care in diabetes, conducted in PubMed is presented. Studies were selected for inclusion based on content focusing on transitions of care in diabetes, risk factors for readmission, the impact of inpatient diabetes education on patient outcomes, and optimal medication management of diabetes during care transitions. American Diabetes Association (ADA) guidelines for care of patients during the discharge process are presented, as well as considerations for designing treatment regimens for a hospitalized patient transitioning to various care settings. Results: Multiple factors may make transitions of care difficult, including poor communication, poor patient education, inappropriate follow-up, and clinically complex patients. ADA recommendations provide guidance, but an individualized approach for medication management is needed. Use of scoring systems may help identify patients at higher risk for readmission. Good communication with patients and outpatient providers is needed to prevent patient harm. A team-based approach is needed, utilizing the skills of inpatient and outpatient providers, diabetes educators, nurses, and pharmacists. Conclusion: Structured discharge planning per guideline recommendations can help improve transitions in care for patients with diabetes. A team based, patient-centered approach can help improve patient outcomes by reducing medication errors, delay of care, and hospital readmissions.

The Energy Response of Calorimeters

2018 ◽  
Author(s):  
Richard Wigmans
Keyword(s):  
Sampling Frequency ◽  
Integration Time ◽  
Signal Integration ◽  
Energy Response ◽  
Absorption Process ◽  
Active Materials ◽  
Unit Energy ◽  
Sampling Fraction ◽  
Signal Integration Time ◽  
Calorimeter Response

This chapter deals with the signals produced by particles that are being absorbed in a calorimeter. The calorimeter response is defined as the average signal produced per unit energy deposited in this absorption process, for example in terms of picoCoulombs per GeV. Defined in this way, a linear calorimeter has a constant response. Typically, the response of the calorimeter depends on the type of particle absorbed in it. Also, most calorimeters are non-linear for hadronic shower detection. This is the essence of the so-called non-compensation problem, which has in practice major consequences for the performance of calorimeters. The origins of this problem, and its possible solutions are described. The roles of the sampling fraction, the sampling frequency, the signal integration time and the choice of the absorber and active materials are examined in detail. Important parameters, such as the e/mip and e/h values, are defined and methods to determine their value are described.

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