Prevention of Nursing Interruption Disputes in Obstetrics and Gynecology Based on Nursing Process Reengineering

During the nursing administration process, including preparation, management, and documentation, there is a high proportion of work interruption that results in nursing administration errors that consequently affect the safety of patients, increase the occurrence of nursing risks, and cause adverse reactions. To investigate the impact of nursing on drug withdrawal disputes in obstetrics and gynecology and reduce medical disputes are of great importance. In this study, documents related to medical disputes are collected and linked to relevant professional information systems for data collection and consultation. The patients are divided into groups and treated with different nursing methods, and then the correlation between nursing methods and disputes in different groups is computed. The results show that, based on the proposed nursing process, medical disputes caused by the cessation of nursing can be effectively reduced. Compared with traditional nursing methods, when the proposed nursing procedures are followed, the dispute rate is reduced by more than 10% and the possibility of serious disputes is also reduced with a reduction rate of about 15%. This shows that, based on the proposed nursing process, reengineering can play an effective preventive role in stopping obstetrics and gynecology nursing disputes.

The Urgency of Restorative Justice on Medical Dispute Resolution in Indonesia

Medical disputes in Indonesia are regulated by a host of laws. The important question that needs to be asked, however, is whether those laws have guaranteed justice for patients and doctors. This study aims to analyze the urgency of restorative justice in medical disputes. It explores secondary data and is normative legal research. The data was gathered through library research consisting of data collection activities based on several publications. This study focuses on legal principles with a doctrinal approach. It concludes that restorative justice is urgent to use in medical, criminal, and civil cases. This is evident in the will of the Health Law which prioritizes mediation as the first mechanism before being brought to trial. Furthermore, the use of restorative justice in medical dispute resolution is driven by the presence of three conditions: First is structural challenges among law enforcers and their limited capabilities in dealing with complex medical cases; Second is the condition of Indonesian correctional institutions which is overburdened and unable to provide maximum output, and the third is the relatively low number of Indonesian health workers. (Sengketa Medis di Indonesia telah diatur dalam beberapa peraturan perundang-undangan. Namun, pertanyaan penting yang perlu diajukan yaitu apakah peraturan yang ada telah menjamin kedilan bagi pasien dan dokter. Penelitian ini bertujuan untuk menganalisis urgensi prinsip keadilan restoratif dalam penyelesaian sengketa medis. Penelitian ini merupakan penelitian hukum normatif yang mengkaji data sekunder. Pengumpulan data dilakukan dengan studi pustaka (library research), yaitu kegiatan pengumpulan data yang berasal dari berbagai literatur. Penelitian ini fokus pada asas-asas hukum dengan pendekatan dokrinal. Kesimpulan dari penelitian ini adalah bahwa prinsip keadilan restoratif penting diterapkan dalam kasus medis, pidana, maupun perdata. Ini misalnya dapat dilihat dari i’tikad baik dalam Hukum Kesehatan yang mempriorotaskan mediasi sebagai mekanisme pertama sebelum dibawa ke pengadilan. Dalam konteks sengketa medis, prinsip keadilan restoratif menjadi urgen untuk diterapkan sedikitnya karena tiga hal; pertama adalah tantangan struktural di kalangan para penegak hukum serta kemampuan mereka yang terbatas dalam menghadapi kasus medis yang biasanya kompleks. Kedua, kondisi lembaga pemasyarakatan Indonesia yang over kapastias sehingga tidak mampu memberikan output yang maksimal; dan ketiga adalah jumlah tenaga kesehatan di Indonesia yang relatif rendah.

A Cognitive Research on Doctor Metaphor and Doctor-Patient Relationship Metaphor

From the perspective of "conceptual metaphor" in cognitive linguistics, 11 kinds of doctor metaphors and 6 kinds of doctor-patient relationship metaphors are reached by a tentative study. Based on nearly 300 questionnaires and interviews with 20 doctors and patients, this paper discusses and analyzes: 1) the current situation of doctor-patient relationship; 2) the understanding of "doctor metaphor" and "doctor-patient relationship metaphor" from both perspectives of doctors and patients, and finds out the similarities and differences; 3) the collection of doctor's description of doctor occupation and patient's description of medical experience, and with the combination of 1) and 2), this paper suggests the measures to alleviate the medical disputes. Medical conflict is a perpetual and intricate social issue, which involves doctor, patient, hospital, government and etc. It is not supposed to be solved in a short time, whereas requires the endeavor of generation after generation.

Design and Implementation of Hospital Automatic Nursing Management Information System Based on Computer Information Technology

Clinical nursing work fails to integrate various nursing tasks such as basic care, observation of patients’ conditions, medication, treatment, communication, and health guidance to provide continuous and full nursing care for patients. Based on this, this paper uses the Internet of Things (IoT) technology to optimize the infusion process and achieve closed-loop management of medications and improve the efficiency and safety of infusion and medication administration by using a rational and effective outpatient and emergency infusion and medication management system. The system was built by applying wireless network, barcode technology, RFID, infrared tube sensing, and other technologies and was combined with actual nursing work to summarize application techniques and precautions. The application of this system will become a new highlight of medical informatization, improve patient experience, monitor infusion safety, enhance nursing care, reduce emergency medical disputes, improve patient satisfaction, and will create good social and economic benefits for the hospital.

Kedudukan Majelis Kehormatan Disiplin Kedokteran Indonesia dalam Penyelesaian Sengketa Medis antara Dokter dan Pasien

This article aims to analyze the position of the Indonesian Medical Discipline Honorary Council in the Settlement of Disputes between Doctors and Patients. Medical disputes due to alleged violations of medical discipline should be resolved through the Indonesian Medical Discipline Honorary Council, however currently there are still medical disputes that are reported to the court without going through the Indonesian Medical Doctors Honorary Council. This study uses a normative juridical research method with a statute approach and a conceptual approach. The results of this study are based on Article 66 paragraph (1) and paragraph (3) of Law Number 29 of 2004 concerning Medical Practices, there is still legal uncertainty regarding the resolution of medical disputes between doctors and patients, because the word "can" contained in paragraph (1) can mean that the complaint against the Indonesian Medical Discipline Honorary Council may or may not be made. Whereas in paragraph (3) it is stated that it is possible to resolve medical disputes through the courts, which can cause medical dispute resolution to be carried out through the courts.

Analysis of Medical Legal Order as A Basis For Settlement of Medical Malpractice Disputes

This study aims to determine whether the medical legal order can provide a solution for resolving medical disputes carried out by doctors against health service recipients in hospitals. The absence of a malpractice law creates confusion in decision making when doctors become involved in medical disputes. As primary legal material, is has a strong legal basis in making decisions on sanctions that can be imposed on doctors who commit malpractice by violating the professional code of ethics or working not according to standard operating procedures. The methods used are normative legar research methods and library legal research by conducting critical analysis on primary and secondy legal materials. The results of the study have shown that malpractice acts committed by doctors have a clear legal accountability mechanism ,as regulated in Health law number 36 of 2009, law number 29 of 2004 concerning medical practice.Administratively all forms of malpractice committed by docors can be threatened with criminal,civil,administrative sanctions an fines. At a more final level, administrative sanctions from malpractice acts committed by doctors can lead to on revocation of practice license.

The Influence Factors of Medical Disputes in Shanghai and Implications - From The Perspective of Doctor, Patient and Disease

Background Based on the cases collected in eight hospitals in Shanghai in recent three years, causes of medical disputes in Shanghai and influence factors of medical dispute levels were explored, and targeted suggestions were put forward. Methods Multistage sampling were used to collect 561 cases of medical disputes occurred in two Tertiary hospitals, two Secondary hospitals and four primary hospitals. The causes of medical disputes were analyzed by descriptive statistics and the factors affecting medical dispute were analyzed by means of one-way ANOVA and Logistic regression analysis. Results Factors of doctor and patient are involved in the causes of medical disputes, with 87.1% disputes related to doctors and 13.9% related to patients. The doctor’s factors include lack of communication (28.82%), low technical level (16.91%), lack of sense of responsibility (8.86%), defective case records (6.92%), imperfect operation (6.44%), inadequate experience (6.44%), inadequate condition evaluation (5.8%), irregular management process (4.03%), violation of diagnosis and treatment regulation (4.03%), misdiagnosis and mistreatment (3.54%), belated diagnosis and treatment (2.58%), postoperative complications (2.42%), equipment problems (1.13%), missed diagnosis (0.81%), poor condition monitoring (0.48%), unreasonable charge (0.48%) and poor service attitude (0.32%). The patient's factors include misunderstanding of medical behavior (43.48%), high expectation of prognosis (25%), bad attitude (13.04%), inadequate medical knowledge (7.61%), disturbance (6.52%), poor compliance (3.62%) and mistrust (1.09%). Among all medical disputes, there are 406 cases of level-4 medical disputes (78%), 95 cases of level-3 medical disputes (18%), 19 cases of level-2 medical disputes (4%), and no level-1 medical dispute. Meanwhile, the classification of diseases, treatment effect, doctors' violation of diagnosis and treatment regulation, and low technical level are the reasons for the level differences in medical disputes. Conclusions Factors of doctor in medical disputes in Shanghai mainly include inadequate communication and low technical level while the patient’s factors mainly contain misunderstanding of medical behavior and high expectation of the prognosis. Level-3 and 4 medical disputes take up the major part in all medical disputes. The classification of diseases, treatment effect, doctors' violation of diagnosis and treatment regulation, and doctor’s deficient technical level are high-risk factors requiring critical attention in medical disputes.

THE MANAGEMENT OF MEDICAL REPORT COMPLETENESS FOR THE LEGALITY OF MEDICAL RECORD DOCUMENTS AT RSUD KRMT WONGSONEGORO (RSWN) SEMARANG CITY

ABSTRACTBackground: Quality hospital services is reflected in the achieving of medical records. Improper medical record documentation would negatively affect the quality of service delivered to patients and it would disadvantage the hospital when medical disputes occur.Objective:Analyzing the management of medical record completeness at RSWN to guarantee the legality of medical record documents and its effect in supporting the completeness of medical record documents.Method:In this qualitative research, observation and interviews were conducted to 60 PJRM officers in the Arimbi ward, Banowati, Nakula I and Prabukresna. The obtained data were qualitatively and quantitatively analyzed based on several underlying theories.Results:The results showed that the completeness of some aspects includinghuman, money, method, material and machine elements was proper. The quantitative analysis showed 100%, while the qualitative analysis showed a percentage of 100% with the exception on the informed consent component with the potential for loss of 99%.Conclusions:The human element required periodic outreach to PPA. In the machine element, special computerswere needed for PJRM officers, and the importance of informed consent for patients undergoing hemodialysis to obtain medical records with strong legal force. Key Words :Management, Medical Record Completeness, Legality of Medical Records.

IMPLEMENTATION EFFECTIVENESS OF HOSPITAL RESPONSIBILITY TOWARDS MEDICAL DISPUTE PROCESS AT HOSPITAL X CIBINONG

Medical disputes that are rife in the medical world in Indonesia are a separate burden for medical personnel in carrying out daily practices, where the hospital as a place for medical personnel to work, should be responsible for medical personnel involved in medical disputes. The absence of sufficiently clear regulations governing the responsibility of hospitals in resolving medical disputes, makes medical personnel, in this case, the most disadvantaged part. The purpose of this study is to empirically determine the applicable laws and regulations regarding the responsibility of hospitals in the process of resolving medical disputes and the effectiveness of their implementation. The research method used is qualitative research with case study approach. Data sources are primary and secondary data. The data analysis subjects were informants, namely the director of medical services, the legal department officer and the public relations officer. The analysis tool uses interactive analysis. There were at least 4 laws and regulations related to hospital responsibility for medical personnel and implementation of regulations regarding hospital responsibility towards medical dispute process is 88%. The research found no guidelines for handling medical disputes. This study shows that the laws and regulations related to hospital responsibility and their implementation in the medical dispute resolution process have been implemented. The recommendation to Hospital X Cibinong is to make guidelines on the flow of medical dispute handling and provide education about health law to all hospital staff, especially medical personnel as parties most vulnerable to malpractice suits.