An exploration of the factors that impact on clinical practices of Nurses in applying evidence-based practice

While healthcare institutions around the world strive to adopt evidence-based practice (EBP) as the new standard in best practice, the nursing profession still faces multiple barriers and limitations in implementation. The aim of this paper is to present the analysis of EBP from the perspective of nurses working within two major South Australian hospitals, assessing their implementation and beliefs and exploring avenues for further research-based upon their feedback. A descriptive survey using the EBP beliefs (EBP-b) and the EBP implementation (EBP-I) scales were developed by Melnyk and Fineout-Overholt. Nurses scored high in the EBP belief scale reflecting significant positive readiness towards EBP. A positive correlation was observed between EBP beliefs and implementation, yet implementation rates were very low. More research is needed to explore the reasons why implementation rates are so low amongst practising nurses to understand and address the root of this problem. Based on the evidence it appears that more research is needed to explore the reasons why implementation rates are so low amongst practising nurses to understand and address the root of this problem.

The Occupational Health Nursing Education Components Most Influenced by Informatics Technology Based on Gamification and Fogg's Models: a Case Study in Indonesia

The rapid development of informatics technology (IT) in healthcare in the digital era has not been in line with the development of industrial nursing informatics education in Indonesia. The discrepancy is disturbing the operational activities of nursing clinicians who stand between the need of client, business, and the quality of services. The objective is to explore the benefit to the largest components of education that have changed due to IT interventions. This research used the Case Study method. The instrument was a case management version of the American Board of Occupational Health Nursing (ABOHN). The purposive sampling population was 350 nurses and nursing students who filled a questionnaire based on the Likert Scale, focused on the influence of IT on OHN education. The supporting data was from 15 major campuses in Indonesia that have nursing majors and IT departments, also from ABOHN and other OHN international bodies. The data was processed by the Statistical Package for Social Sciences (SPSS) 25 version, in the table of Pearson Correlation. Gamification and Fogg's Behavior models were used to identify the influence of IT on OHN education. The data analysis showed a significant impact of IT on OHN education with a value of 0.782. The Influence of IT towards OHN learning materials based on Gamification and Fogg’s Models also showed of 9 OHN competency categories (100%), indicating the need for IT support was absolute. Case management result projected that the application of Gamification with Fogg's model with the application of IT on the OHN education proved the magnitude influence of IT on 8 components, i.e.: teaching methods, learning materials, learning methods, students’ learning interests, campus facilities, lecturer’s competencies, campus management, and the education curriculum. The IT intervention will simplify the OHN education system, provide more effective, and efficient OH nursing practice in the workplace.

Commentary on Letter to Editor regarding COVID-19 Pandemic: A SWOT Analysis of Indonesia’s Strategy

A SWOT Analysis of Indonesia’s Strategy

Microcontrollers Performance in Portable Electronic Stethoscope Design with a Disease Symptoms Detection Feature

One of the early examinations that is often done is to detect heart disease using a stethoscope. The electronic stethoscope consists of a membrane and tube from a conventional stethoscope coupled with a condenser microphone which is then connected to a computer. The purpose of this study is to analyze the comparison of two types of microcontrollers in the design of a portable electronic stethoscope equipped with a symptom detector. The research method used is instrumentation with 2 types of microcontrollers to design a heart sound detector. In processing the data to be displayed on the 16x2 Character LCD. Sending heart signal data for 60 seconds to produce BPM data which is processed using 2 different types of microcontrollers. The results of data collection on battery consumption of power usage on the AT mega 2560 resulted in an average saving of 0.11W. Therefore, it can be concluded that the two stethoscopes have a significant difference when compared, where the Arduino Mega 2560 is able to process data from heart signals faster than the AT mega 328P. The results of the research that have been carried out can be implemented using a system that strongly supports the needs when checking heart sound signals

Picture guided learning - A picture-based clinical skill teaching resource in undergraduate nursing in South Australia

A competent nursing graduate is required to perform psychomotor skills related to clinical procedures, articulate knowledge to support their activities, work in a team with efficient time management skills and have strategies to perform in the increasingly busy clinical environment and with complex patient acuity. Student Evaluation of Teaching data from an undergraduate nursing clinical subject 2014-2018 identified an inconsistency in clinical skill teaching/delivery by educators which needed to be addressed. This study aimed to evaluate the outcome of implementing the Clinical Skill Storybook as an additional teaching resource for students’ clinical skill development. A descriptive analysis approach was applied to summarise quantitative and qualitative subject evaluation data along with Clinical Skill Storybook evaluation questionnaires (2018-2020). Data analysis identified five themes: (1) Clinical Skill Storybook as a Learning Resource, (2) Self-directed learning and peer support, (3) Developing clinical skill competency, (4) Preparation for clinical placement, and (5) Maintaining teaching consistency. It was evident that the Clinical Skill Storybook provided an easy-to-follow visual guide which assisted students’ confidence and competence of skill development. The subject evaluation highlights that students were significantly more satisfied with the teaching resources than in previous years. The implementation of the Clinical Skill Storybook actively improved students’ skill acquisition, confidence, and readiness for placement. The findings indicated that picture-based resources such as the Clinical Skill Storybook are beneficial for nursing students’ clinical skill development. Further involvement with stakeholders such as clinical venues in developing the clinical skill storybook is planned for future exploration.

The Impact of Using Digital Filter and Analog Filter on Surface Electromyography Signal

Many accident cases result in humans having to going a surgery to save them, then performing muscle therapy to help the patient’s recovery after going through the post-surgery. The purpose of this therapy is the patient’s body to its normal state. Exoskeleton is an additonal clothing-like tool that aims to both protect and increase the wearer's abilities. Meanwhile electromyography (EMG) is a technique to evaluate and record the electrical activity produced by skeletal muscles. The purpose of this study was to analyze the differences in using of analog and digital filters on EMG, as well as the effect on the exoskeleton simulation. The method used in the main design consists of the myoware module, notch circuit, low pass filter, arduino uno, DAC module, teraterm software, and matlab. The intercepted signal was taken from the biceps using a disposable electrode (AG/AGCL.). The EMG signal tapped by the myoware module then is continued to another circuit, then was recorded on the Teraterm software, and analyzed in MATLAB. The voltage value on the analog filter is 1.541 Volt during relaxation and 2.086 Volt during contraction, while the digital filter that has passed through the DAC has a value of 41.8 mVolt during relaxation and 269.1 mVolt during contraction. The results of this study obtained that digital and analog filter values ​​have an average difference of 5 to 30. The conclusion of this research is that the tool can detect changes in the use of analog and digital filters. Therefore, in the future research, development can be made to compare other types of digital filters along with replacement to wireless systems. The benefit or purpose of this research is as a simulation of exoskeleton skeletal motion and to see the difference between the use of digital and analog filters.

Luxmeter Design with Proximity Sensor to Efficiently Test Light Intensity and Distance on Lamp Operation in Hospitals

The lighting of the operating/surgical site depends on the quality of the lighting from the overhead light source and the reflection from the curtain. Light measurement on the operating table is very necessary because it generates light that is irradiated into the cutting wound without dazzling the cutting surface so that pathological conditions can be recognized and must provide depth contrast and anatomical relationships, to ensure this proper calibration method is needed. Long-term use of medical devices can cause changes in accuracy. Therefore, the author makes a tool to measure the intensity of light which is equipped with a distance meter. The purpose of this study was to develop a measuring instrument for measuring the intensity of light in operating lamps, namely a luxmeter by making Luxmeter equipped with a TFT Display Distance Sensor. This tool uses an ultrasonic sensor HC-SR04 to measure the distance between the light source and the sensor module and the MAX44009 sensor to measure the light intensity of the operating lamp displayed on the TFT screen. Based on the module distance setting to the roll meter, the distance error value for the measurement of the Surabaya electromedical engineering workshop lamp at the 75 cm roll meter distance setting is 0.0127% for the 100 cm roll meter distance setting is 0.0045%. The error rate of the light intensity module on the results of the measurement of light intensity on the luxmeter by setting the roll meter distance of 75 cm between the tool and the lamp of the electromedical engineering workshop is getting an error value of 0.082% lux and for the light intensity on the results of the measurement of light intensity on the luxmeter with a roll meter distance setting of 100 cm between the tool and the lamp in the electromedical engineering workshop, that is, the error value of lux is 0.055%. The design of a luxmeter equipped with a proximity sensor can measure the intensity of light and the distance between the tool and the light source and can assist in the learning process with a more effective Luxmeter design that will assist electromedics in testing operating lamps in hospitals to be more efficient.

Design of Reflectance Pulse Oximeter and BPM using the Max30100 Sensor in Early Detection of Hypoxemia in Patients with Cardiovascular Disorders

Blood oxygen saturation meter is a tool used to monitor the state of oxygen saturation in the blood and also the patient's heart rate (BPM) and to assist in the physical assessment of the patient without going through blood gas analysis. Oxygen saturation measuring devices usually use the difference in the wavelengths of red and infrared led light that will be captured by the photodiode. The purpose of this research is to make a pulse oximeter equipped with a display of SPO2, BPM values ​​and an additional SP02 signal. The design of this measuring instrument uses the MAX30100 sensor, the minimum system circuit of Arduino ATmega328p and OLED (Organic Light-Emitting Diode). Data from the MAX30100 sensor enters the I2C pin on the minimum Arduino system, then the microcontroller is processed to produce the percentage of SPO2 value, BPM value, and SPO2 signal which is then displayed on the OLED. The test is done by comparing the module with standard measuring instruments which produces the largest % error of 0.81% for Spo2 and 0.87% for BPM. The error presentation is obtained from factor measurements, if there is finger movement it will cause a large error. From the results obtained, the tool is still feasible to use because in the "Guidelines for Testing and Calibrating Medical Devices" Ministry of Health RI 2001, the maximum limit in the pulse oximeter error tolerance is for Spo2 1% and BPM 5%.

Digital ECG Phantom Design to Represent the Human Heart Signal for Early Test on ECG Machine in Hospital

Electrocardiograph (ECG) is a diagnostic tool that can record the electrical activity of the human heart. By analyzing the resulting waveforms of the recorded electrical activity of the heart, it is possible to record and diagnose disease. Given the importance of the ECG recording device, it is necessary to check the function of the ECG recording device, namely by performing a device calibration procedure using the Phantom ECG which aims to simulate the ECG signal. The purpose of this research is to check the ECG device during repairs, besides that the Electrocardiograph (EKG) tool functions for research purposes on ECG signals or for educational purposes. Electrocardiograph (EKG) simulator or often called Phantom ECG is in principle a signal generator in the form of an ECG like signal or a recorded ECG signal. This device can be realized based on microcontroller and analog circuit. The advantage of this simulator research is that the ECG signal displayed is the original ECG recording and has an adequate ECG signal database. ECG This simulator also has the advantage of providing convenience for research on digital signal processing applications for ECG signal processing. In its application this simulator can be used as a tool to study various forms of ECG signals. Based on the measurement results, the error value at BPM 30 and 60 is 0.00% at the sensitivity of 0.5mV, 1.0mV, and 2.0mV, then the measurement results for the error value at BPM 120 are 0.33% and at the BPM 180 value, the error value is 0.22%. From these results, it can be concluded that the highest error value is at BPM 120 with sensitivities of 0.5mV, 1.0mV, and 2.0mV.

Nine Channel Temperature Data Logger in Measuring the Effectiveness of the Sterilization Process of Medical Instruments with Dry Sterilization

Measuring the temperature on the dry sterilizer is very necessary because the temperature inside the dry sterilizer has the possibility that the temperature is not the same as the temperature that has been set and is displayed on the display. If the temperature in the dry sterilizer does not match the standard setting temperature for the sterilization process, then the sterilization process is said to be imperfect The purpose of this study is to record and monitor whether the distributed temperature in the sterilization chamber corresponds to the setting temperature. The workings of the temperature data logger tool is that the type K thermocouple temperature sensor will detect the temperature which then enters the analog signal conditioning circuit which then enters the ATMegga 2560 which has been given a program and processed in such a way, then the temperature will be displayed on a 4x20 character LCD. Temperature measurement data will be saved to the SD Card every 10 seconds in the form of a TXT file. This research has been used to record 2 sterilizers and compared with the Madgetech OctTemp2000 data logger. Based on data measurements and comparisons, the average error was obtained at a temperature of 50ºC with the smallest error value of 0.7% and the largest value of 3.9%. At a temperature of 100ºC, the smallest error value is 1.6% and the largest is 10.5%. Then at a temperature of 120ºC the smallest error value is 0.0% and the largest is 8.5%. This research can be used to help analyze the distribution of temperature in a room. With these measurement results, it can be said that this study still has afairly high error value at several measurement points.