The Effectiveness of the 15 Psi Irrigation Technique in Wound Cleansing to Reduce the Number of Bacteria on Patients with Diabetic Foot Ulcers

The increasing population of diabetic patients leads to the increasing number of diabetic foot ulcer (DFU) cases. To avoid the expansion of the infection, the wound cleansing is conducted through the irrigation and pressure methods. The aim of this research was to identify the effectiveness of wound cleansing using 0.9% normal saline technique with the pressure of 15 Psi in reducing the number of bacteria. This research used the randomized control trial method with a double blind design which had been approved by the ethnical committee of Muhammadiyah University of akarta with the ethnical committee number 261/PMK-UMJ/IV/2017. There were as many as 31 samples in each group collected through consecutive sampling technique with randomization. It had been found that there was a signi fi cant difference in the number of bacteria before and after wound cleansing. Thus, it could be concluded that from the statistical test and clinical test, wound cleansing with normal 0.9% saline technique with the pressure of 15 Psi could decrease the number of bacteria in diabetic foot ulcers. Wound cleansing with 0.9% normal saline irrigation technique pressurized at 15 Psi was recommended as a safe wound cleansing method for diabetic foot ulcers.

The 2015 Nepal Earthquake Disaster: Is the Threat of Occurrence of Communicable Disease Epidemic Over?

This opinion paper highlights the state of public health assessment in evacuation centers following the 2015 Nepal earthquake. It also suggests an approach to reinforce risk assessment and surveillance of communicable diseases (CD) in remote Nepalese districts. A short surveillance research was conducted on outbreaks of infectious diseases in Nepal in the post-2015 earthquake in evacuation centers in Kathmandu and Dhading districts. In collaboration with the Nursing Association of Nepal (NAN), the researchers have established a monitoring and surveillance system, named ‘EpiNurse’ program, in remote Nepalese districts. Periodic shelter to shelter visits, CD risk assessment and relief needs inventory in local communities are implemented, whereas health events with a potential to cause a CD outbreak are being reported to governmental agencies and health clusters involved in post-disaster relief in Nepal. Several cases of diarrheal diseases were identi fied in Nepalese districts after the 2015 earthquake, suggesting the existence of potential risk for the occurrence of new CD epidemics. Onsite risk assessment and monitoring of the effectiveness of actions and interventions implemented, as well as improvement of risk communication between relief agencies should be expanded to less resourced districts to reduce the risk of CD outbreak occurrence.

Autolytic and Conservative Sharp Wound Debridement for Granulation Tissue on Unstageable Diabetic Foot Ulcer

Diabetic foot ulcer (DFU) is a condition of deep tissue damage associated with Diabetes Mellitus in the lower extremities. Conducted with quantitative research of single group method with pre and post test design approach, this research primarily aims to know the effectiveness of utilizing combination of Autolysis & Conservative Sharp Wound Debridement in preparing granulation on unstageable DFU. It involved 30 respondents in the wound care clinic as the research sample and used the Wound Bed Score observation sheets measured on days 1, 7 and 28. The data analysis to determine effectiveness before and after intervention was carried out using dependent t-test (paired t-test), whilst to test effectiveness of giving intervention after controlled confounder was performed by linear regression. Based on the characteristics of the respondent’s, it is revealed that most of them were female (83.3%) and have normal BMI (80%). The average age of the respondents were 55.43 years old with the duration of DM of 13.27 years with average blood sugar of 101.2 mg/dL. The highest mean difference was on the 1st day of the 28th. The statistical results of this study indicated that the mean difference values for day 1 and 7 were 0.133 (SD 1.19, p value = 0.546), mean difference of day 7 and day 28th grade was of 2.5 (SD 1.306, p value=0.0001) and mean difference between day 1 and day 28 was of 2.63 (SD 1.273, p value=0.0001). This research recommends that the further research use different research methods.

Post-Traumatic Stress Syndrome (PTSS) in Nurses Post-Earthquake Disaster in Indonesia

Post-traumatic stress syndrome (PTSS) may be experienced by individuals who were traumatized by unpleasant experiences, such as earthquakes, which occur suddenly, and are diffi cult to predict. This study is aimed to explore PTSS experienced by nurse survivor following earthquakes in several areas in Indonesia. A qualitative study was conducted to participants with the following criteria: nurses who were actively working in the primary level health care services (health centers) and had experienced PTSS as determined by screening results. The study was conducted in regencies/cities that have experienced earthquakes in West Sumatra, North Sulawesi, Yogyakarta, East Java, and Banten. Data were collected for 3 months, between September and November 2011. Participants were recruited through purposive sampling according to the inclusion criteria for PTSS screening (experienced 2-3 years of grief). Ten participants agreed to be interviewed. Data were analyzed by thematic analysis. Two main themes emerged consisting of physical and psychological responses of nurses. Trembling and being scared have been the consistent response up to several years after the incident. The results of the study can serve as source of information for developing nursing skills in the prevention and mitigation stage of disaster, as well as for the formulation of supportive policies.

The Correlation of Family Support and Social Support with the Adherence to Physical Exercise Among the Older persons with Hypertension

This study is to determine the correlation of family support and social support with the adherence to physical exercise among the older persons with hypertension. It was a descriptive analytical type of quantitative research with the cross-sectional approach. Data were collected from the working area of Tugu Community Health Center, Depok involving 108 older persons with hypertension. Two questionnaires were used to measure the characteristic of the respondents (questionnaire A) and family support, social support, and adherence to physical exercise (questionnaire B). The data analysis included univariate, bivariate, and multivariate correlations. There is a signi fi cant correlation of family support and social support with the adherence to physical exercise among the older persons with hypertension. Family support has the greatest in fl uence on the adherence to physical exercise among the older persons with hypertension (β coeffi cient value: 0.381). The older persons with hypertension need a strong support from the family or closest friends to improve the adherence to hypertension treatments, one of which is physical exercise. Family support has the major infl uence on the adherence to physical exercise among the older persons so that the development of communitybased and family-based nursing strategies through the empowerment of the older persons care groups and family empowerment is essential to be carried out.

Analysis of Nursing Behavior Factors in Documentation of Nursing Care in Emergency Unit Using Theory of Planned Behavior

The complicacy of emergency unit (EU) working environment will certainly affect the quality of health care, including inaccurate or incomplete documentation. Incomplete nursing documentation indicates that nursing care process is not working properly and continuously. Theory of Planned Behavior (TPB) has been widely used to describe nurse’s behavior and identify important factors that in fl uence them. The purpose of this study is to analyze factors related to nurse behavior in documenting nursing care in EU using TPB. The research is designed as observational analysis with cross sectional approach. Sample is emergency nurses at EU of Level II Hospital Dr. Soepraoen, Panti Waluya Sawahan Hospital, and Islamic Hospital. Sample of 45 Emergency Nurses and 341 documents were selected according to inclusion and exclusion criteria. The result of statistical analysis of partial least square shows that there is a signi fi cant correlation between attitude and intention, perceived behavioral control and intention, and intention and nursing documentation behavior, evidenced by each value of T-Statistic equal to >1.68. Conversely there is no relationship between subjective norms and intention in documenting nursing care and evidenced by the value of T-Statistics

Case report on the use of a honey on diabetic foot ulcer patients

This article describes four infected diabetic foot ulcer patients who were treated with honey dressing as fragmented therapy. Quantitative and qualitative descriptions of the ulcer-healing process were documented. All four ulcers showed positive wound contraction and reduction in size, and clinical signs of infection were absent at the end of the follow-up period. Moreover, surrounding skin maceration and trauma were absent in all wounds. Adequate moisture control was also achieved, evidenced by a healthy red granulating base and a thin layer of clear light exudate in all fours cases. These reports provide little evidence that the use of honey dressing is effective in combating wound infection. Honey dressing can be used to improve wound healing in chronic diabetic foot ulcers.

Effect of Nurse Performance in Patient Safety Target Based on Knowledge Management: SECI on Quality of Nursing Services

Appropriate knowledge management will improve nurse performance. There have been numerous studies on nurse performance, but studies on nurse performance of Knowledge management: SECI in Indonesia have not been widely reported and therefore researchers interested in conducting this study. This study aims at identifying the effect of performance in patient safety target based on Knowledge Management: SECI on the quality of nursing services in Jakarta Islamic Hospital of Pondok Kopi. The study employed quasi experimental design of pre and posttest with control group. The respondents were nurses who worked in the inpatient unit with a sample size of 24 respondents in the intervention group and 37 respondents in the control group. The instrument used to measure pre-posttest was patient safety developed by Nasution (2013) with validity value of 0.444-0.772 and reliability of Cronbach’s Alpha of 0.950; and the adverse events developed by the researchers. Intervention protocols in the form of performance in patient safety target based on Knowledge Management: SECI were given through training. The analysis employed statistical tests of Mann Whitney and Wilcoxon. The study found that there was a change in patient safety before and after intervention in the intervention group rather than in the control group. There were differences in the scores of patient safety/quality of nursing care after treatment in the intervention group and the control group. The study recommends regular training for nurses concerning performance in patient safety target based on Knowledge Management: SECI, and further studies in different hospitals.

Image of Nurses Perceived by High School Students in Yogyakarta City

Misperception of and misunderstanding about nurses among high school students will affect their interest in continuing their education to nursing department and will affect recruitment of nurse health personnel. This study aims at providing an illustration of image of nurse perceived by high school students in Yogyakarta city. It is a descriptive research using cross sectional approach involving 415 third grade students of Natural Science Program (IPA) in Yogyakarta City in January 2016. Data were collected using a questionnaire made by researchers by modifying the research of Seranath & Gunawerdana and questionnaire of May et al. Data were analyzed through univariate and bivariate analysis using chi square statistic test. The results of the study showed that of 415 respondents, 54.9% of respondents had high knowledge of nursing, 47% of respondents had positive perception of nurses, and 49.4% of respondents had interest in nursing. The results of statistical tests indicated that there is no correlation of students’ knowledge and perceptions of nurses with their desire to continue education to the department of nursing. Recommendations: It is necessary to improve public perception for the image of nurses by providing information to high school students about nursing and its employment prospects.

Nurse’s Expectations after the Enactment of Nursing Law No. 38 of 2014 Concerning Independent Nursing Practices in Yogyakarta Special Region Province

This study aims to identify nurses’ expectations after the enactment of Nursing Law Number 38 of 2014 concerning independent nursing practice in Yogyakarta Special Region Province. This research is a mixed methods research, in which basic data in the form of nurses’ level of understanding about Nursing Law were taken using quantitative approach, followed by collecting qualitative data in order to identify nurses’ expectations in conducting independent nursing practice. The sample of quantitative data were 282 nurses in 5 Regional General Hospital in the province, while qualitative data were taken from 10 respondents using Focus Group Discussion (FGD) method, the data were analyzed in three stages, which are data reduction, data presentation, and conclusion. The quantitative data were collected using a questionnaire from November 2015-January 2016 and analyzed using frequency table. In terms of quantitative data, nurses’ understanding about Nursing Law was mostly fair, or 69.1%. In terms of qualitative data, the nurses’ expectations of Nursing Law Number 38 of 2014 are covered in 8 themes, namely recognition of nurse profession, provision of collegial regulation, type of nursing competence test, application standard for Nurse Practise License/Surat Izin Praktik Perawat (SIPP), derivatives of Nursing Law, better system, addition of competency test materials, and better protection for nurses. The nurses expect the clarity of job description of independent nursing practice, uniformity of standard operating procedure to facilitate the process of applying independent nursing practice, more protected condition in carrying out independent nursing practice and recognition by other professions.