KAJIAN MANAJEMEN PENGELOLAAN LIMBAH PADAT MEDIS DI KLINIK INTI MEDIKA INSANI TANGERANG

ABSTRACTMedical waste carries a greater risk to health. Such as diarrhea, skin infections, dengue fever until hepatitis A, B, and C. Poor handling of waste will also pose a risk of nosocomial infection. To realize the quality of environmental health, it is necessary to set standards for environmental health quality standards and health requirements by implementing safeguards on waste and implementing waste reduction. The health facilities had produced more than 296.86 tons of medical waste every day. Only about 43% of health service facilities that carry out medical waste management have met the standards. Objective: To examine the management of medical solid waste management in Inti Medika Insani Clinic, Tangerang. Methods: This research is a type of descriptive qualitative research. The object of this research is the director of Inti Medika Insani Clinic, manager of Inti Medika Insani Clinic, nurses, staff in charge of waste, cleanig service. This research uses in-depth observation and interview methods. Data collection techniques in this study is use interview techniques conducted by telephone. Based on the results of the study, Inti Medika Insani Clinic had not yet carried out appropriate waste management. Klinik Inti Medika Insani did not have sanitation workers, there were no available budgets, facilities and infrastructure that were not yet maximal, and there was no policy, monitoring and supervision. ABSTRAKLimbah medis membawa resiko yang lebih besar terhadap kesehatan. Seperti diare, infeksi kulit, demam berdarah sampai hep atitis A, B, dan C. Penanganan limbah yang tidak baik juga akan menimbulkan resiko terjadinya infeksi nosokomial. Mewujudkan kualitas kesehatan lingkungan perlu ditetapkan standar baku mutu kesehatan lingkungan dan persyaratan kesehatan dengan melaksanakan pengamanan terhadap limbah dan penyelenggaraan pengurangan limbah. Banyaknya fasilitas kesehatan tersebut sudah menghasilkan limbah medis sebanyak lebih dari 296.86 ton setiap harinya. Hanya sekitar 43% fasilitas pelayanan kesehatan yang melaksanakan pengelolaan limbah medis yang sudah memenuhi standar. Tujuan: Untuk mengkaji manajemen pengelolaan limbah padat medis di Klinik Inti Medika Insani Tangerang. Metode: Penelitian ini merupakan jenis penelitian deskriptif kualitatif. objek dalam penelitian ini yaitu direktur Klinik Inti Medika Insani, manajer Klinik Inti Medika Insani, perawat, staff penanggung jawab limbah, cleanig service. Penelitian ini menggunakan metode observasi dan wawancara secara mendalam. Teknik pengumpulan data dalam penelitian ini yaitu dengan menggunakan teknik wawancara yang dilakukan melalui telephone. Berdasarkan hasil penelitian diperoleh bahwa klinik inti medika insani belum melaksanakan manajemen pengelolaan limbah yang sesuai. Dijelaskan bahwa di klinik inti medika insani tidak memiliki tenaga sanitasi, tidak tersedia anggaran, sarana dan prasarana yang belum maksimal, dan tidak adanya kebijakan, monitoring dan supervisi.

Tinjauan Kebutuhan Tenaga Kerja Petugas Rekam Medis Berdasarkan Metode Workload Indicator of Staffing Needs (WISN) di Klinik Rawat Inap Ramdani Husada

The medical record is one of the most important parts of a health service which must be supported by an adequate number of human resources, so it is necessary to calculate the exact workforce requirements. Medical record activities at Ramdani Husada Inpatient Clinic are not done by officers with medical record education qualifications but are carried out by officers with qualifications of high school education, midwifery diploma, and midwifery diploma. The research objective was to describe the need for medical record personnel based on the WISN (Workload Indicator of Staffing Need) method at the Ramdani Husada Inpatient Clinic. The research design used descriptive quantitative with a cross-sectional approach. The population and sample of the study were all officers who carried out medical record activities as many as 3 people including the clinic manager, head of administration, and administrative staff. The results showed that the available work time was 1,953 hours/year or equivalent to 117,180 minutes/year, the workload standard was not in accordance with the number of available officers, the allowance standard was 1.70 workers. So that the need for medical record officers based on the WISN method is 9 workers. Based on the research results, there is a gap between theory and practice, where the Ramdani Husada Inpatient Clinic does not use the WISN method or other methods for planning its workforce. It is suggested that the Ramdani Husada Inpatient Clinic do deeper planning related to the workforce, especially for medical record officers to increase work productivity and reduce the risk of fatigue in officers.

Nosokomiale Infektionen

In 21st century medicine, nosocomial infections still represent a common treatment risk. The author systematically explains the diverse requirements for a standard infection-preventive hygiene organisation in medical institutions and analyses the associated civil law and, in particular, criminal law liability risks. Both the requirements of § 23 of the Infektionsschutzgesetz and the obligation of medical facilities to inform patients about facility-specific increased infection risks exert considerable influence on questions of evidence under liability law. The author pays particular attention to the responsibility of clinic manager.

Influence of the awareness of COVID-19 pandemic on assisted reproductive technology clinic in Africa, South of the Sahara

Introduction: COVID-19 pandemic has taken the world by storm and consequently, various reproductive medicine societies had since issued guidelines based on best judgement for the safety of IVF patients and attending health staffs Objective: The objective of this study was to assess the opinions of IVF staff in sub-Sahara Africa on the awareness of COVID-19 on Assisted Reproductive Technology. The study also evaluated some of the measures that can mitigate the effects of the virus in IVF clinics. Methodology: Different cadres of staff at Nordica Fertility Center (NFC) in Lagos, Nigeria were interviewed. Those interviewed included the Medical Director, Clinicians/Gynecologists, Clinic Manager, Nurses, Embryologists, Counsellor, Business Developing Unit, Client Liaison Officers and Accounts Officer. Their responses were collated, and the key points were documented. Each staff in face mask was visited by one interviewer who observed all government-recommended sanitary precautions including wearing a facemask and maintaining social distance between her and the interviewee. Result: The response of the MD on the fate of IVF clinic in Africa within the next 6 months to 1 year of the Covid-19 pandemic was that the overall economy is a major determinant of the ability of clients to pay for IVF services. Infertile women would still want to have children but “how would they pay for the services?” since ART is not subsidized by the government but mostly paid as out-of-pocket expense in this part of the world. The main points were that IVF clinics are not immune to the economy and vaccine may or may not favor IVF, reasons being; The virus is about 5 months old hence still much to be discovered There is no solid evidence that the virus affects reproduction No evidence of mother-to-child transmission and The virus can survive in cold environment therefore, it could survive cryopreservation. The embryologist was of the opinion that IVF clinics in Africa need to understand the virus more to decide whether: Attend to COVID-19 patients or not and if so, how best to care for them Better prepare modalities of cryopreservation such as Appropriate equipment Batching gametes together with HIV or Hepatitis patients In same or separate equipment and Getting special cryo-tanks for Covid-19 patients. Embryologist agreed that clinics will be able to perform other adjunct fertility treatment such as Pre-implantation Genetic Diagnosis (PGD), dependent on clinics’ ability to have separate equipment for Covid19-positive and negative patients. Conclusion: Africa is not left behind in experiencing the effects of COVID-19 and ART, for which concerns for the survival of privately owned clinics to ensure and safeguard the health and safety of patients, staff and the unborn babies are expressed. As of now, no-one is sure of patients that are symptomatic and those not symptomatic, as testing in the country, just like in most parts of the world, are still inadequate. When a vaccine is available, it may be mandatory for every IVF patient to get a shot. The main points of other cadres of staff are discussed.

Factors Contributing to Delayed Health Seeking Behaviours Among Adolescents

BACKGROUND: Most adolescents for various reasons fail to go and seek for health care regarding health risks and challenges until they are faced with the complications. The socio-cultural belief concerning the causes of illnesses and its characteristic has correlation with the treatment seeking behaviour of an individual. OBJECTIVES: The study explored and described factors contributing to delayed health-seeking behaviours amongst adolescents in Kutlwanong clinic, North West Province. METHOD: This was a qualitative study designed using a phenomenological approach. Individual semi-structured in-depth interviews were audiotaped and transcribed verbatim. 8 Steps of Tesch’s inductive, descriptive open coding technique by Creswell was used followed by independent coding. Purposive sampling recruited fourteen participants aged 15–18 years. Trustworthiness criteria adhered to were credibility, dependability, transferability, and confirmability. Ethical clearance was sought with the University of Limpopo. RESULTS: Factors that negatively impact adolescents’ health-seeking behavior include the negative attitude of nurses and community, influenced by peers, shortage of medicine, lack of services throughout weekends, long queues, waiting times, distance, and lack of knowledge. Family planning and antenatal care were the common reason for seeking health care. CONCLUSION: Being aware of factors contributing to delay health-seeking behaviours will facilitate with setting future priorities to guard the health, well-being, and dignity of adolescents. The impacts of youth programs must be monitored on a regular basis to assess the needs and capabilities of specific facilities. Clinic manager to ensure compliance with the national core standards to meet adolescent’s immediate expectations.