Abstract Book ICoHAP

st The 1 International Conference on Health Administration and Policy “Risk Management in Healthcare” ABSTRACT BOOK SAMBUTAN Prof. Dr. Moh. Nasih, SE., M.T., Ak., CMA. Rektor Universitas Airlangga Assalamualaikum wr. wb. Yang saya hormati, para peserta The 1st International Conference on Health Administration and Policy Yang saya hormati, bapak ibu hadirin sekalian, Manajemen risiko dalam pelayanan kesehatan sangat penting karena tidak hanya berkaitan dengan pencegahan financial losses namun juga berkaitan dengan keselamatan pasien. Kesuksesan manajemen risiko tidak lepas dari peran seluruh petugas kesehatan. Ada baiknya seluruh petugas kesehatan diberikan pelatihan terkait manajemen risiko sehingga ilmu yang didapatkan dapat diimplementasikan dalam untuk mencegah, merespon the unavoidable moments, dan melaporkan risiko-risiko yang ditemukan di instansi pelayanan kesehatan kepada risk manager. Risk manager pada umumnya merupakan orang yang telah berpengalaman menangani berbagai masalah di berbagai setting di bidang kesehatan. Individu tersebut diharapkan mampu mengidentifikasi dan mengevaluasi risiko yang selanjutnya akan ditindaklanjuti demi keselamatan pasien maupun petugas pelayanan kesehatan. Strategi-strategi manajemen risiko perlu untuk selalu di update, salah satunya melalui konferensi The 1st International Conference on Health Administration and Policy ini. Diharapkan dengan adanya kegiatan ini dapat meningkatkan pengetahuan dan kemampuan praktisi kesehatan maupun akademisi terkait risk management dan menurunkan angka kesakitan serta kematian di masyarakat. Hadirin sekalian, Demikan sambutan yang saya sampaikan. Apabila terdapat salah kata saya mohon maaf. Selamat mengikuti kegiatan ini, semoga semuanya dapat berjalan dengan lancar dan membawa manfaat bagi kita semua. Aamiin aamiin ya rabbal alamin.. Wa billahi taufiq wal hidayah Wassalamualaikum wr. wb. SAMBUTAN Prof. Dr. Tri Martiana, dr., M.S. Dekan Fakultas Kesehatan Masyarakat Universitas Airlangga Assalamualaikum Wr. Wb. Selamat pagi dan salam sejahtera untuk kita semua. Bapak ibu hadirin sekalian yang sangat saya hormati. Marilah kita panjatkan puji syukur kepada Allah SWT, atas nikmat dan hidayah yang diberikan kepada kita, sehingga pada hari ini kita masih diberikan kesempatan untuk dapat mengikuti seminar ini. Selamat datang kami ucapkan kepada seluruh peserta seminar yang hadir disini. Seminar kita hari ini mengambil topik “Risk Management in Health Care”. Mengingat bahwa setiap organisasi menghadapi tantangan unik, tidak ada peluru perak untuk solusi manajemen risiko. Oleh karenanya, hari ini kita mendengarkan bersama presentasi mengenai Penanganan Risiko di dalam dunia kesehatan, baik dalam segi finansial, klinis dan bagaimana cara mengevaluasi risiko yang sudah ada. Hadirin yang berbahagia sebelum kita mulai acara seminar, marilah sebagai pembuka kita baca basmalah bersama-sama. Bismillahirrahmanirrahim Atas terselenggaranya acara seminar ini, kami mengucapkan terima kasih atas dukungan Bapak Ibu semua, terutama: 1. Rektor Universitas Airlangga 2. Para pembicara dan moderator 3. Perusahaan sponsor 4. Para peserta seminar, talent training dan call for paper. Akhir kata, jika ada kekurangan dalam penyelenggaraan seminar ini, kami mohon maaf. Selamat mengikuti seminar, semoga bermanfaat untuk kemajuan kita semua. Wassalamualaikum Wr. Wb. SAMBUTAN Kolonel drg. Bima Pramundita, Sp.Prostho Ketua Umum Panitia The 1st ICoHAP Segala puji syukur senantiasa kita panjatkan ke hadirat Tuhan Yang Maha Esa, yang telah melimpahkan rahmat dan berkah-Nya kepada kita semua sehingga hari ini kita dapat dipertemukan untuk mengikuti acara Seminar Internasional 1st International COnferencen on Health Administration and Policy (ICOHAP) dengan tema “Risk Management In Healthcare”. Kami mengucapkan selamat datang pada pembicara, moderator, keynote speaker dan peserta seminar dimana kita memiliki kesempatan untuk berbagi informasi tentang berbagai strategi untuk meningkatkan pengetahuan kita dalam upaya melakukan manajemen risiko di pelayanan kesehatan. Seminar ICOHAP ini dapat terselenggara berkat bantuan dari berbagai pihak. Untuk itu pada kesempatan ini ijinkan kami megucapkan terima kasih kepada Dekan Fakultas Kesehatan Masyaratkat UNAIR beserta jajaran nya karena telah memberi kepercayaan kepada kami mahasiswa AKK 2017 untuk melaksanakan kegiatan ini, para nara sumber, Asosiasi Profesi (Ikatan Dokter Indonesia, PERSAKMI, IAKMI, PPNI), para sponsor yang berpartisipasi dalam kegiatan seminar ini, para peserta seminar atas partisipasinya, serta pihak lain yang tidak dapat kami sebutkan satu persatu. Penghargaan yang setinggi-tingginya kami sampaikan kepada segenap panitia yang telah bekerja keras demi suksesnya kegiatan ini. Kami menyadari bahwa penyelenggaran seminar ini masih banyak kekurangan baik dalam penyajian acara, pelayanan administrasi maupun keterbatasan fasilitas. Untuk itu kami mohon maaf yang sebesar-besarnya. Akhir kata semoga peserta seminar mendapatkan manfaat yang besar dari kegiatan ini sehingga mampu mewujudkan dunia pelayanan kesehatan yang semakin baik ke depan nya. Kami mengucapkan SELAMAT MENGIKUTI SEMINAR. Terima kasih. I. LATAR BELAKANG Risiko adalah kemungkinan/ancaman kerusakan, cedera, hilangnya tanggung jawab yang disebabkan oleh kerentanan dan yang dapat dihindari melalui tindakan pre-emptive. Interaksi manusia dengan sistem kesehatan menimbulkan ancaman bagi mereka terutama karena teknologi yang kompleks, prosedur yang sangat kompleks, permintaan yang tinggi pada layanan, tekanan waktu, harapan yang tinggi dari pengguna layanan, hierarkis oleh sifat pelatihan dan tanggung jawab. Ada banyak prioritas untuk organisasi perawatan kesehatan, seperti keuangan, keamanan dan yang paling penting adalah perawatan pasien. WHO memperkirakan bahwa di negara maju, 1 dari 10 pasien dirugikan saat menerima perawatan di rumah sakit. Terutama penyebab yang mendasari kesalahan medis adalah masalah komunikasi, aliran informasi yang tidak memadai, masalah terkait manusia, transfer organisasi pengetahuan, pola kepegawaian dan alur kerja, kebijakan dan prosedur yang tidak memadai dan kegagalan teknis. Mengingat bahwa setiap organisasi menghadapi tantangan unik, tidak ada peluru perak untuk solusi manajemen risiko. Namun, karena risiko pada pasien, staf, dan organisasi lazim dalam perawatan kesehatan, organisasi harus memiliki manajer risiko kesehatan yang memenuhi syarat untuk menilai, mengembangkan, menerapkan, dan memantau rencana manajemen risiko dengan tujuan meminimalkan paparan. Tantangan yang dihadapi oleh administrator yang harus ditangani dalam rencana penilaian risiko termasuk tetapi tidak terbatas pada keselamatan pasien, peraturan federal wajib, potensi kesalahan medis, kebijakan yang ada dan masa depan, dan undang-undang yang berdampak pada bidang kesehatan. Pemimpin organisasi harus menjadi "pemikir sistem" yang menuntut analisis mendalam tentang masalah keamanan, mengganti reaksi hukuman terhadap kesalahan dengan lingkungan terbuka dan secara proaktif mengatasi risiko apapun, akan ada peluang untuk membangun organisasi perawatan kesehatan yang lebih aman. Namun tidak ada ruang untuk perilaku nekat dalam lingkungan perawatan kesehatan. Bahaya karena tidak mempersiapkan potensi masalah dapat memiliki efek jangka panjang yang signifikan. Pengabaian rencana manajemen risiko komprehensif di tempat kerja dapat membahayakan perawatan pasien, meningkatkan risiko kewajiban, dan mengakibatkan kerugian finansial. Dengan demikian, potensi risiko harus dievaluasi dan diukur dalam hal potensi efek negatifnya. Berdasarkan penilaian risiko, rencana pengelolaan spesifik organisasi harus dikembangkan, dilaksanakan, dan dipantau. Untuk menghadapi tantangan ini, Fakultas Kesehatan Masyarakat Universitas Airlangga akan mengadakan konferensi internasional dengan tema "Manajemen Risiko dalam Perawatan Kesehatan". Konferensi yang akan diadakan adalah kesadaran universitas dan komunitas ilmiah untuk menyebarluaskan pengetahuan kepada masyarakat, termasuk akademisi dan praktisi di bidang kesehatan. Konferensi ini akan menampilkan pembicara yang kompeten di bidang masing-masing dari luar negeri serta di dalam negeri dan mengundang peserta untuk menyerahkan abstrak penelitian dan makalah ilmiah lainnya (panggilan untuk pengajuan abstrak). II. TUJUAN Konferensi internasional ini bertujuan untuk menyebarluaskan pengetahuan kepada masyarakat luas, khususnya di bidang ilmiah dan praktisi dalam pelayanan kesehatan. Hasil dari konferensi ini diharapkan dapat menjadi masukan bagi pembuat kebijakan dari berbagai tingkatan dalam merumuskan program untuk mendukung dan menerapkan manajemen risiko dalam pelayanan kesehatan. III. OUTPUT KEGIATAN Output dari konferensi ini adalah perumusan rekomendasi kebijakan untuk pihak terkait, terutama yang terkait dengan strategi untuk menerapkan manajemen risiko dalam pelayanan kesehatan serta publikasi materi konferensi, presentasi lisan dan poster. Artikel ilmiah yang dipilih akan terdaftar sebagai artikel terindeks Scopus. IV. WAKTU DAN TEMPAT 1. Waktu : Sabtu-Minggu, 1-2 September2018; Pukul 08.00-17.30 (GMT+7) 2. Tempat : Wyndham Hotel, Jl Basuki Rahmat 67-73, Embong Kaliasin, Genteng, Kota Surabaya, Jawa Timur 60271 V. PENYELENGGARA Kegiatan ini diselenggarakan oleh Program Magister Administrasi Kesehatan dan Kebijakan, Fakultas Kesehatan Masyarakat, Universitas Airlangga, dengan komposisi komite sebagai berikut: Steering Committee Dr. Djazuli CHalidiyanto, SKM, M.ARS Dr. Ernawaty, drg. M.Kes. Nuzulul Kusuma P., S.KM, M.Kes Organizing Committee Ketua Umum drg. Bima Pramundita, Sp.Prostho Wakil Ketua M. Maman Firmansyah, S.KM Sekretaris dr. Victoria Kusumo Bendahara dr. Wahidah Rachmaniyah Eska Distia P., S.KM Ketua 1 Ester Mariana, S.Kep, Ns. Ketua 2 Farouk Ilmid Davik, S.KM Ketua 3 Indra Dwi Cahyono, S.KM Koordinator Acara dr. Dwi Rahayuningtyas Koordinator Workshop dr. Nanda Aulya Ramadhan Koordinator Ilmiah dr. Candra Ferdian HAndriyanti Koordinator Exhibition Desiana Medya A. L., S.KM Koordinator Gathering drg. Prima Nerito, Sp.KGA. Seksi Transportasi dan Perlengkapan dr. Yulianto Hadi Nugroho Koordinator Konsumsi dr. Amelia SUSUNAN ACARA Sabtu, 1 September 2018 07.00 - 08.00 Pendaftaran 08.00 - 09.00 Pembukaan 09.10 - 09.40 Keynote Speaker: Prof. Dr. dr. Nila Djuwita F. Moeloek, Sp.M (K) (Menteri Kesehatan Indonesia) * “Building of Public Health and Productive Community” 09.40 - 10.00 10.00 - 10.10 10.15 - 12.45 12.45 - 14.00 Ethical Lecture dr. Poernomo Boedi Setiawan, Sp.PD,K-GEH, FINASIM * Ketua Ikatan Dokter Indonesia (IDI) Jawa Timur Coffee Break Session 1 : Risk Management Policy in Health Care Pembicara: 1. Widodo JP.dr., M.PH., Dr.PH (Universitas Airlangga) “Health Care Risk Management Policy in Indonesia” 2. Prof. Dr. Ing. Eko Supriyanto (Universiti Teknologi Malaysia) “Policy of Medical Device and Health Informatics Act to Manage Risk in Health Care” 3. Prof. Dr. Herkutanto, dr., SpF., SH., LL. M. (Universitas Indonesia) “Medicolegal Aspect in Health Care Risk Management” ISHOMA 15:50 - Selesai Session 2 : Financial Risk Management in Health Care Pembicara: 1. Wilailuk Wisasa, Bsc., M.Econ. (National Health Security Office, Thailand) “Financial Risk Management in Implementing Universal Health Coverage” 2. Prof. Dr. Fachmi Idris, dr., M.Kes (Direktur Utama BPJS)* “Indonesia Universal Health Coverage 2019 in Financial Risk Management of Providers, Threat or Opportunity?” Penutupan dan Coffee Break 08:00 - 16:00 Presentasi Poster 14.00 - 18.00 Presentasi Oral 19.00 - Selesai Gala Dinner 14.00 - 15.50 Minggu, 2 September 2018 07.00 - 08.00 Pendaftaran Keynote Speakers: 1. Dr. Ir. Tri Rismaharini, M.T (Walikota Surabaya)* “Surabaya City Government Policy Regarding Quality Improvement in Healthcare 08.00 - 09.00 Services” 2. dr. Dodo Anondo, M.PH (Ketua PERSI Jatim) “Optimizing Service Quality In Health Care” 09.00 - 09.15 Coffee Break Workshop Seminar Session 3 : Risk Management in Health Care Accreditation Pembicara : 1. Erin Lloyd (Consultan Ramsay Management) 09.15 - 12.00 “Risk Management Towards International Standard Accreditation” 2. Djoni Darmadjaja, dr SpB (KARS) “Risk Management in Achieving Plenary Hospital Accreditation (SNARS Edition)” 3. Dr. Tjahyono (Komisi Akreditasi FKTP, Kemenkes) “Concept and Implementation of Risk Management in Primary Health Care” 12.00 - 13.00 ISHOMA Workshop Parallel Akreditasi Rumah Sakit SNARS Edisi 1 Akreditasi FKTP “Program Pengendalian Resistensi “Plenary Accreditation Strategies” Antimikroba” 16.30 - 17.00 Pembicara : dr. Hari Paraton., Sp.OG (K) (Ketua komisi Nasional PPRA, Kemenkes) – “Antimicrobial Resistance Control Program", Ministry of Health)” – “Plan of Action Antimicrobial Resitance Control Program in Hospital” Diskusi Coffee Break Djoni Darmadjaja, dr SpB (KARS) – “Rational Antimicrobial Therapy in Hospital based on SNARS 1st Edition” – “Tools and Survey Antimicrobial Resitance Control Program Supporting Document in Hospital Accreditation” Diskusi 08:00 - 17:00 Presentasi Poster 13.00 - 17.00 Presentasi Oral 13.00 - 14.20 14.20 - 14.50 14.50 - 15.20 15.20 - 16.30 17.00 – Selesai Penutupan Pembicara: Dr. Tjahyono (Komisi Akreditasi FKTP, Kemenkes) “Primary Heath Care Accreditation: Strategy and Implementation” dr. Yaya Mulyana (Puskesmas Kediri – Perwakilan Puskesmas Dengan Akreditasi Paripurna) “Keysuccess Factors in Implementation of Accreditation Standards Towards Plenary Level” ABSTRACT ORAL PRESENTATION 145 DESCRIPTION OF ENVIRONMENTAL FACTORS ON FILARIASIS INCIDENCE IN WEST PASAMAN REGENCY Masrizal1, Dion Andhika P1, Randa Ilham1 1 Public Health Faculty, Andalas University [email protected] Background: Data from West Sumatera Provincial Health Office in 2016 it is known that West Pasaman Regency is one of the highest filarial endemic areas of 40 patients. The purpose of this research is mapping of vulnerability of filariasis incidence region based on environmental factor in Pasaman Barat Regency in 2017. Method: Descriptive research was conducted on 30 cases with measurement method toward environmental aspect variable that influence filariasis incidence. Sampling technique in total sampling, This study was conducted in March to January 2018. Analysis is univariate and spatial. Results: The result of this research is the occurrence of filariasis in West Pasaman Regency 2017 as many as 30 Cases Most mosquito breeding sites contained in the garden, Air temperature not eligible 93.3%, air humidity eligible 63.3%, and 100% eligible altitude. Areas with temperatures that are eligible for filariasis occur in Mount Tuleh, Talamau, Sasak Ranah Pasisie and Luhak Nan Duo Subdistricts. Areas with altitudes that qualify for filariasis occurrence are present throughout the District in Kab. Western Pasaman and eligible moisture that is in Ranah Batahan subdistrict, Sungai Beremas, Koto Balingka and Sungai Aur. Conclusion: Filariasis incidence in Pasaman Barat District in 2017 as many as 30 cases. The description of vulnerability mapping which is at risk for filariasis vulnerability is mosquito breeding place in the garden and river, air humidity and altitude. It is expected that the Health Office and Community Health Center to health promotion, and surveillance routinely to the community, especially on the plantation, moisture and altitude areas that qualify for filariasis and monitor the development of filariasis and prevent transmission to preventive and curative action right. Keywords: Filarial, Garden, Humidity, Altitude, Spatial, Temperature 150 ROLES OF GOVERNMENT IN THE IMPLEMENTATION OF PATIENT SAFETY INCIDENT REPORTING IN INDONESIAN HOSPITALS: A QUALITATIVE STUDY Inge Dhamanti 1, Sandra Leggat 2, Simon Barraclough 3 Faculty of Public Health, Universitas Airlangga, Mulyorejo-Surabaya, Indonesia 60115 2&3 School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, 3083 1 The Indonesian government has built the patient safety incident reporting system since 2005. After a decade, the national incident reporting rates showed very poor rates, especially if compared with other systems that were built around the same time. Despite the established national guideline, there is a gap in the implementation at district, provincial and national level. This study aimed to analyse how Indonesian government organisations implemented their roles according to the National Guideline. This study employed a qualitative method and NVivo 10 software is used to assist with managing the qualitative data analysis. The semi-structured interview was undertaken with 12 senior staff from 8 government organisations. The finding indicated that DHO and PHO responsibilities in patient safety have been clearly described in the National Guidelines, however, a gap was apparent in their implementation as the MDGs were the focus of most of their programs. DHOs and PHO also showed a lack of responsibilities in controlling health development programs’ role including patient safety program at their respective levels. At a national level, MOH and the National Committee showed a weak performance when monitoring and evaluating the work of other organisations who were implementing incident reporting. They also seemed to leave the incident reporting matter as exclusively the responsibility of hospitals and independent institutions. Keywords: patient-safety, government, roles, incident reporting 142 SATISFACTION VISITORS OF SIJUNJUNG HOSPITAL TO COMPREHENSIVE HANDLING COMPLAINTS 1 Isniati 1 Faculty of Public Health, Andalas University, Padang, Sumatera Barat Background : In Hospital and Community Health Service ( HCHS ) total reports complained it was 117.836 on 20162017. The number was increasing 1,656 ( 1.4 % ) from a year earlier and 116,180.On basic health services in England number of complaints report on 2016-2017 is 90,579, increased 8,020 ( 9.7 % ) compared to the previous year that 82,559. Methods : The methodology used is the mix method. The first phase of the research uses quantitative methods to know the level of satisfaction visitors in Sijunjung hospital, and first is a qualitative methodology using depth interview and focus group discussion to know complaints handling problems that is Sijunjung hospital. Result : The results of the study got that the level of satisfaction patients who constitute the main priority of in-patient is officer in units of roentgen of responsible for carrying out a life in accordance with their skills in (82.27 %) , outpatient are doctors in units of common ones (76.49 %) , and in the emergency department is cleaning officers responsible for the cleanliness of the environment the hospital (80.83 %). Conclusion : The results of the study quantitative obtained the result that more than half visitors Sijunjung hospital get good service. While the qualitative study shows that system handling complaints in Sijunjung hospital do not have standard procedure clearly that the handling of complaints is still not maximum. Keywords: The handling of complaints , health services , regional general hospital of Sijunjung 169 EVALUATION OF THE MEASLES SURVEILLANCE SYSTEM IN PROVINCIAL HEALTH OFFICE, EAST JAVA Eva Flourentina Kusumawardani1, Retty Yoshepine Sipahutar3, Margaretha Domingga1, Atik Choirul Hidajah2 1 Program Study Magister Epidemiology, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 2 Department of Epidemiology, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 3 Provincial Health Office, East Java, Indonesia [email protected] Introduction: Indonesia currently has double burden in health sector. Infectious and contagious diseases still require as a great attention. One of the diseases that remains the government’s concern is measles. This disease will be very dangerous when accompanied by complications of pneumonia, diarrhea, meningitis, can even cause death. The incidence of measles cases in Indonesia for age group <1 year was 48.9 per 100,000 people years, 1-4 years old was 36.6 per 100,000 people years, and the age of 5-14 years was 18.2 per 100,000 people years in 2007. There is an incresing cases in 2016, the number of incidence rate is 2.7 per 100,000 population and who died 5 people in most of islands in Indonesia. The total number of outbreaks was 115 times with total cases of 1,348 cases, 4 of whom died. The cases of measles in East Java provice have fluctuated, where the clinical cases in 2013 were 489 cases, in 2014 were 733 cases, increased by 2015 were 2,322 cases, and in 2016 decreased to 1,924 cases, but increased again until September 2017 to 3,064 cases. The frequent outbreaks of measles in East Java province prompted the need for evaluation of the measles case-based surveillance system. Objective: this study is to evaluate the case-based measles surveillance system in Provincial Health Office, East Java, Indonesia and identify gaps in its operation by input, process and output. Methods: We interviewed with immunization program holders in East Java Provincial Health Office and conducted a retrospective record review of measles case-based surveillance data from 2013 – 2017 and adapted the 2001 CDC guidlines on surveillance evaluation and the Framework for evaluating Public Health Surveillance Systems for Early Detection of Outbreaks, to assess the systems usefulness, representativeness, timeliness, stability, acceptability and data quality. Results: the evaluation of attribute surveillance that is simplicity attribute is not simple because of personnel surveillance is only 1 person with multiple tasks as a CRS manager and other tasks, flexibility attribute is flexible on CI and CKLB/K reporting format, but not flexible on CBMS. Data quality attributes, acceptability, sensitivity, positive predictive value, timelines are still in low category. While representativeness attributes and stability attributes are high category. Conclusion: this evaluation showed that the problems are on human resources, both in terms of quantity and understanding of officers about good measles surveillance, poor allocation of funds for training, and poor supporting infrastructure such as reagents and procurement of bulletins. Keywords: Measles, Case-Based, Surveillance, Evaluation, Provincial Health Officer, East Java 174 DETERMINANT OF INPATIENT CARE UTILIZATION AMONG ELDERLY IN INDONESIA 1,2 Haerawati Idris1, Nur Afni2 Department of health policy & administration, Faculty of Public Health, Universitas Sriwijaya [email protected] Backgrounds: The proportion of elderly increase throughout the world. The increase in aging population presents many challenges in public health. They have higher susceptibility of chronic disease, therefore the needs of health service is more larger. The aim of the study was to know the factors that influence the inpatient care among elderly in Indonesia. Methods: We used Indonesian Family Life Survey 2014 data which represented 83% population of Indonesia. We also used Andersen’s theory of health service utilization model. This study used cross sectional design. The samples were 5.325 respondents with age ≥ 60 years old. The analysis method were univariate analysis, bivariate analysis using chi-square test, and multivariate analysis using logistic regression test. Results: There were 222 respondents who got inpatient care (4.2%). The variables which were correlated significantly with inpatient care utilization were women (PR 1.42, 95% CI 1.09-1.83), middle-school education (PR 1.57, 95% CI 1.14-2.17), high education level (PR 2.29, 95% CI 1.32-3.98), Sumatera region (PR 2.42, 95% CI 1.46-3.99), urban area (PR 1.81, 95% CI 1.39-2.36), health insurance ownership (PR 2.29, 95% CI 1.75-2.99), low economy status (PR 2.33, 95% CI 1.40-3.87), middle economy status (PR 2.26, 95% CI 1.34-3.82), high economy status (PR 3.17, 95% CI 1.90-5.27), very high economy status (PR 5.18, 95% CI 3.68-9.33), sick perception (PR 0.59, 95% CI 0.46-0.77), smoking habit (PR 0.67, 95% CI 0.52-0.88), obesity (PR 2.11, 95% CI 1.53-2.91). Most dominant predictor of inpatient care utilization was very high economy status with PR 4.67 (95% CI 2.90-7.51) after controlling other variables. Conclusions: The high economy status would increase the number of inpatient care utilization. The elderly who have health insurance should get inpatient care utilization without getting financial problems. The government should ensure elderly people to have health insurance. Keywords: Utilization, elderly, inpatient care, Indonesia Family Life Survey 167 IDENTIFICATION OF PROBLEMATIC COMPETENCE OF THE MIDWIFE IN PREPARED COMMUNITY IN SURABAYA Ridzotullahmad Nurchakim1, Suryanto2, Chandra Kusumawardhani3 1,2 Master Program of Human Resource Development Postgraduate School of Airlangga University 3 Public Health Promotion & Empowerment Bureau Surabaya City Health Office [email protected] Competence has an important role in an organization which demonstrates the existence and capabilities associated with the knowledge, values, and skills integrated into the work. The implementation of competencies in Prepared Local Midwife (Indonesian: Bidan Kelurahan Siaga) is important in Prepared Community Program in Surabaya (Indonesian: Pengembangan Kelurahan Siaga Aktif). The achievement of Purnama and Mandiri Community in 2017 reached only 35 out of 154 urban communities (21.42%.). Suharto (2012) mentioned that midwives in the Prepared Community (Desa/ Kelurahan Siaga) mostly run administrative and normative functions, and lack of competence as facilitator of community empowerment. There was a need for evaluation, including the implementation of the competence of midwife in the City of Surabaya. The purpose of this study was to identify competencies of midwife and competencies problem involved in Prepared Community Program in Surabaya. This study applied descriptive analytical study design. The data collected by in-depth interview to the respective experts of community empowerment and government officials responsible for the Prepared Community Program in Surabaya, field observation to program implementation and secondary data such as supporting reports. The results indicated that there was a gap between actual competence with the standard competence of Prepared Midwife in the City of Surabaya, where the problematics competence were found in knowledge regarding community empowerment, negotiation ability, developing skills of others, doing strategic planning, and teamwork. Competence of the midwife became an important part to develop Prepared Community, yet problematic competence were stiil found among the midwife. Therefore this study suggests the need for interventions to improve competence, for instance by developing the competency model of local midwives. Keywords: Competence, Community Empowerment, Midwife of Prepared Community 171 DESCRIPTIONS OF PATIENTS DROP OUT OF TUBERCULOSIS TREATMENT WHO RETREATMENT AGAIN IN SURABAYA CITY Lutfi Fajar Nuraidah1 Faculty of Public Health, Airlangga University [email protected] 1 World Health Organization in 2015 stated that Tuberculosis (TB) is the world's number two killer. TB treatment’s done within 6 months and should be taken daily, it’s possible to drop out. This is dangerous because irregular treatment will have worse effect than not treated. In East Java in 2015 the rate of drop out was high at 948 cases and in Surabaya there were 120 cases drop out and only 22 people (18.3%) were treated again. The purpose of this study was to determine the factors of patients drop out TB treatment for re-treatment in Surabaya City. The method used is descriptive with qualitative approach. The Informant was the TB Program Manager and 7 TB patients who were treated again in Surabaya. The sampling technique used Purposive Sampling. The results explained that the cause of drop out was side effects of drugs, the prohibition from family and distance to health services. Treatment after drop out is mostly done by nonproductive age group caused they had more leisure time. Patients who re-treated more women because women are more concerned with health. The patients stated that the distance to health care services is now much closer than the previous treatment, making it easier for patient to access it. Patients also get encouragement from the family and from within themselves to do the re-treatment regularly. The conclusion of this research is patient decided to re-treatment because of motivation, age, gender, family support, distance to health service getting closer and visit from health worker. Keywords: TB, drop out, re-treatment 181 DETERMINANT OF INDEPENDENT NATIONAL HEALTH INSURANCE OWNERSHIP IN INDONESIA Bela Sari¹, Haerawati Idris² ¹ Public Health Faculty, Sriwijaya University ² Section of Health Policy Administration [email protected] The increasing of independent National Health Insurance (Jaminan Kesehatan Nasional, or JKN) membership is one of the indicators to achieve universal coverage. One of the challenges in extending such coverage is reaching it out to the informal sector. This study was aimed to analyze the determinants of independent national health insurance ownership in Indonesia. This study used cross sectional design and the data were derived from Indonesian Family Live Survey (IFLS) 2014. 6,888 individuals aged ≥40 years were the sample of this study. To analyze the data, chi square analysis and logistic regression were used. Based on the analysis, the respondent with independent national health insurance is 16.6%. The ownership of national health insurance is independently influenced by the following factors: age 40-55 (PR = 1.72 95% CI 1.41-2.09, p-value = 0.00), Sumatera island (PR = 7.67 95 % CI 5,55-10,59 pvalue = 0,00), high expenditure (PR = 2,26 95% CI 1,85-2,75 p-value = 0,00), history of chronic disease (PR = 1,33 95% CI 1,15-1,53 p-value = 0,00), middle education (PR = 2,21 95% CI 1.92-2,55 p-value = 0,00), and urban areas (PR = 1.79 95% CI 1.57-2.04 p-value = 0.00). Region is the most dominant variable related to national health insurance ownership (p-value = 0,000; Exp B = 7,39; 95% CI: 5,33-10,25). Independent national health insurance membership has not been maximal, yet. To increase this participation, the Social Security Administrator (Badan Penyelenggara Jaminan Sosial, or BPJS) has to approach each region with low national health insurance membership through counseling, socialization and education about registration and the benefits of national health insurance. Keywords: National Health Insurance Ownership, Informal Sector, Indonesian Family Life Survey (IFLS) 186 THE ROLE OF TRANSFORMATIONAL LEADERSHIP IN THE RISK MANAGEMENT OF PATIENT SAFETY Moeheriono1 Hang Tuah University Surabaya 1 Changes and dynamics in the healthcare industry tend to fluctuate dynamically and experience rapid changes, and require strong executive leadership manner (Transformational Leadership). This issue relates with the health industry that needs a high supervision of the leader so that employees do not make mistakes and create a maximum customer satisfaction for patient safety. For this reason, leaders are needed who can manage the risks and minimize them which disserve the patient. The role of transformational leadership must have: (1) Idealized Influence, a behavior that produces respect and subordinate trust. (2) Inspirational Motivation, a behavior that always provides challenges for the job of staff and takes into account the meaning of the work itself. (3) Intellectual Stimulation, practicing the innovation based on the development of science and being able to transform it into a productive performance. (4) Individualized Consideration, reflecting his/herself as a caring person in understanding and following up complaints, ideas, expectations, and any staff input. Keywords: Transformational Leadership, Risk Management, and Patient Safety 196 DETERMINANTS OF UTILIZATION HEALTH SERVICE BY PEOPLE WITH DISABILITIES IN PALEMBANG CITY 1,2 Haerawati Idris1, Tilla Sapitri2 Part of Administration & Health Policy, Public Health Faculty, Sriwijaya University [email protected] Background: Problem of people with disabilities become human rights issues. Stigma and discrimination from the public and health who served in health service can be a barrier for people with disabilities in utilization health service. This study wa aimed to determinants of utilization health service by people with disabilities in Palembang City. Method: The type of this research is descriptive analytics with cross sectional design. Samples used people with disabilities were 103 samples which selected by cluster random sampling. For analysis the data of this study was chi square and multiple logistic regression. Result: The results showed that 47,6% people with disabilities in Palembang city use of health service. There are five variables related to utilization of health service. Those variable are sex female (p value: 0,022; PR: 1,70; 95%CI: 1,09-2,66), high income (p value: 0,001; PR: 2,02; 95%CI: 1,37-2,97), access to health service is easy (p value: 0,004; PR: 0,52; 95%CI: 0,36-0,76), low costs of health service (p value: 0,009; PR: 0,56; 95%CI: 0,37-0,84) and positive attitude towards health services (p value: 0,000; PR: 2,95; 95%CI: 1,48-5,87). Positive attitude towards health services is the most dominant variable related to utilization of health service (p value: 0,010; ExpB(PR): 4,57; 95% CI: 1,43-14,56). There are four counfounding variables, those variable are disabilities, access to health service, health insurance and age. Conclusion: The utilization of health services by persons with disabilities in Palembang City has not been maximized, it is expected that government will review the existing infrastructure in health services so that the creation of situations and condition that are more people friendly with disabilities. Keywords: utilization, health service, people with disabilities 199 THE PERFORMANCE OF RELATION BETWEEN NURSE AND DISORDER MENTAL PATIENT’S FAMILY SATISFACTION AT RSJ ABEPURA, JAYAPURA CITY Martapina Anggai1 Faculty of Public Health Universitas Cendrawasih, Papua, Indonesia 1 The service and nurture of nursing which is given to medical patient is professional service. The image of mental hospital is influenced by the quality of service that is given by a hospital. The satisfaction of mental disorder patient’s family is influenced by facility which has provided in the hospital as well. The medical patient’s family would feel satisfy when they get the service which they expected in the previous time and the feeling of disappointed to the medical patient’s family would appear if the performance of the nurse is seen unexpected. This research is conducted to identify the relation between the performance of nurse and the family satisfaction of mental disorder or mental illness patient. This research is done use design cross sectional method. The samples that used are 30 people, consists of nurses and mental disorder patient’s families. Data analysis is used unvaried and bivariate Chi-Square. The result of this research is P value in the amount of 0,008, this statistic experiment result show that there is relation between nurse’s services quality and mental disorder patient’s family, because the value count is 0,05 which is concluded that nurse’s quality service has influence to mental disorder patient’s family in Abepura RSJ. Based on conclusion, expected to the hospital to improve the knowledge and skill of the nurse in serving the mental disorder patient in Abepura RSJ, provide good facility and to the government to legal the amendment about the mental disorder patients who are uncontrolled by hospital and social department of government who handle about it. Keywords: Kinerja Perawat, kepuasan keluarga 207 A MODEL SERVPERF IN SERVICE OF THE ACT OF SURGICAL PATIENTS BPJS NON ARMY AT THE INDONESIAN NAVAL HOSPITAL DR. RAMELAN SURABAYA Agusta Murpy Tarigan 1, Agus Subianto 2,Sudibyo3 1 Magister Administrasi Publik FISIP UHT 2 Magister Administrasi Publik FISIP UHT 3 Fakultas Kedokteran Gigi UHT [email protected] Medical treatment based health insurance for all groups the people in Indonesia the targets of the government to ensure equity health services, as the act of surgical patients social security agency (BPJS) non army at the Indonesian Naval Hospital (Rumkital) Dr. Ramelan Surabaya point apply services excellent. This research aims to review and analyze factors that supports and impede in the act of the dissection of health service patients BPJS non army in Rumkital. Methods used in this research is qualitative. Research results in terms with a model the quality of services SERVPERF. Based on the results of their services with regard to the act of the dissection of years 2015-2016 shows that there has been the trend of increased the number of the act of operation of especially on a major and the particulars of, that this is true because the hospital can be respond to trust that the community in the sense of components Rumkital is able to provide a the best services for patients health management agency BPJS non army and so as to give of satisfaction with the provision of services by the hospitals. Science and technology as well as the future development of the demands the best services fit with public demand, hence the hospitals need to do to improve the manpower and the availability of infrastructure worthy of an international with hospitals. The act of the dissection factors model health service patients BPJS non army in Rumkital show that the services the act of the dissection in patients given as a and were not refer on the model SERVPERF, the act of the dissection model health service patients BPJS non army in Rumkital Dr. Ramelan Surabaya with the assessment of 10 indicators covering tangibles; realibility; responsivenes; assurance; empathy; expertise; outcome product; price and promotion. Keywords: SERVPERF, BPJS non army, The act of surgical services 213 THE ADAPTATIONS OF TECNOLOGY DUTIES AND TECNOLOGY UTILIZZATION TOWARD EMPLOYEE PERFORMANCE (STUDY TO THE ADMISNITRATION EMPLOYEE OF CENDERAWASIH UNIVERSITY AT JAYAPURA CITY) Michael Weyai1 Faculty of Public Health Universitas Cendrawasih, Papua, Indonesia [email protected] 1 This research will be retest chain of technology performance to predict the utilization as a variable mediator between adaption duties with individual performance which appear by information technology. The differences in the sample and instrument aspect that is used to measure the research variable. The main problem of this research, is there any influence of adaption factor to technology duties toward the utilization to the employee in the University of Cenderawasih Jayapura. The second, is the utilization become variable mediator between duties adaption technology to performance. This research use descriptive qualitative method by spread the questionnaire to 71 respondents who work in the University of Cenderawasih Jayapura. The technique analysis is used quantitative analysis technique with regression double analysis to find the influence from each independent variable toward dependent variable. The result of the research shown that adaption factor of technology duties have influence to utilization (t count = 6666, p= 0,000, utilization have influence to employees performance in the University of Cenderawasih Jayapura (t count= 8.047, p=0,000) and utilization can become mediator variable between adaption duties technology toward performance (t count = 5.371; p=0.000). Keywords: Adaption factor, adaption duties technology, utilization, individual performance, mediator variable 219 THE STUDENTS’LOW AWARNES THROUGH THE IMPLEMENTATION OF SCHOOL RULE AND TEACHER PARTICIPATION IN SELF AND ENVIRONMENT IN SMA TARUNA BAKTI WAENA Karel Batmanusi1 Faculty of Public Health Universitas Cendrawasih, Papua, Indonesia [email protected] 1 The aim of the research is to investigate the implementation of the rule in SMA Taruna Bakti Waena through self awarness of students to keep the healty life for themselves and the school environment. Besides that, to find the approach model and founding from the school in order to make the students’ awareness and their environment. Thus, the students’ awareness would become their personality as nation generation who has Indonesian character as the motto of this school itself “Pro Eklesia Et Patria” (Love Church and nationality). This research is development research which involve the students from the first grade to third of SMA Taruna Bakti Waena Jayapura. This research product the model approach in the form of rule which actualize based on students ‘age “adolescent” to build the students’ character. Keywords: School Law, Model Approach and Founding, students’ Awareness, Self and Environment Health 227 BACTERIAL MAPPING AND ANTIBIOTIC SENSITIVITY IN ORTHOPAEDIC INFECTION Luh Gede Djatu Anggitadewi1, Komang Agung Irianto S. 1,2, Luh Ade Wilan Krisna3 1 Surabaya Orthopaedic and Traumatology Hospital, Surabaya, Indonesia 2 Medical Faculty, Airlangga University/Orthopaedic Department Soetomo General Hospital, Surabaya, Indonesia 3 Technology of Medical laboratory Department, Polytechnic of Health Denpasar, Bali, Indonesia Background: Nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients where a large number of drugs are administered to the patient. This fact leads to the generation of antibiotic resistant pathogens. The emergence of resistant pathogens and their negative impact on patient survival and healthcare costs need the evaluation of antimicrobial susceptibility in order to control infection. Aims: this study was conducted to determine the antimicrobial susceptibility patterns among common nosocomial pathogens in Surabaya Orthopaedic and Traumatology Hospital (SOTH). Methods: A retrospective study was conducted in Surabaya Orthopaedic and Traumatology Hospital (SOTH) during 2016 - 2017. The clinically suspected laboratory samples were collected from the 87 patients and subjected to testing an antibiotic sensitivity. All bacteria were identified by standard microbiologic methods (CLSI), and their antibiotic susceptibility testing was performed using disk diffusion method. Results: In 2016, the proportion of infections caused by gram negative bacteria, amount to 52.6% (10 of 19 cases). There were 6 patients with chronic osteomyelitis treated in SOTH during 2016, that are treated at other healthcare facilities prevously. We found, total 5 out of 8 musculoskeletal infections cases caused by gram positive bacteria (62.5%) which the type of bacteria most commonly found on the culture is a Staphylococcus non haemolyticus. As many as 5 out of 19 (26,3 %) cases in SOTH musculoskeletal infections caused by multi-drug resistant microorganism (MDRO), and Cefixime was the most effective oral antimicrobial for gram negative isolates (100%), while Amoxycillinclavulanic acid and Cefprozil (75%) were the most efficacious antimicrobials for gram positive. In 2017, we found changes in the proportion. Gram positive bacteria dominated for the caused of infection (73,3%). There were also 0,4% increasing amount of infection cases that was caused by multi drug resistant microorganism, 8 from 30 cases (26,7%). Conclusion: The most frequent found on the culture is Staphylococcus non haemolyticus in 2016 and Staphylococcus aureus in 2017. In 2016, Cefixime was the most effective oral antimicrobial for gram negative isolates (100%), while Amoxycillin-clavulanic acid and Cefprozil (75%) were the most efficacious antimicrobials for gram positive. But changes were found in 2017. Cefixime has no longer effective (0% sensitivity). Oral antibiotic sensitivity had been swiftly change to clindamycin (87,5%) and levofloxacin (90,9%). We detected increasing amount musculoskeletal infection that caused by of multi drug resistant microorganism. Keywords: Antimicrobial pattern, nosocomial infection, antibiotic 228 THE RELATIONSHIP BETWEEN BODY POSTURE AND OTHER FACTORS WITH THE INCIDENCE OF CARPAL TUNNEL SYNDROME IN PACKING WORKERS IN THE KUJANG CIKAMPEK FERTILIZER FACTORY Savitri PA 1, Septiani Fany 2, Farsida3,Oktarina4 Medical teacher,faculty of medicine University of Muhammadiyah Jakarta 2 Medical teacher,faculty of medicine University of Muhammadiyah Jakarta 3 Medical teacher,faculty of medicine University of Muhammadiyah Jakarta 4 Medical teacher,faculty of medicine University of Muhammadiyah Jakarta 1 Background: Carpal Tunnel Syndrome (CTS) is a syndrome caused by the Nervus Medianus depressed inside the carpal tunnel of the wrist with the symptoms of pain, numbing and tingling in the fingers and hands in the area of innervation of the nervus medianus. One of the factors increasing complaints of CTS is the increase of the activity that uses hands done in long periods of time and often found among the workers of the industry. Aims: To determine The relationship between body posture and other factors with the incidence of carpal tunnel syndrome in packing workers in the Kujang cikampek fertilizer factory. Methods: This study used cross sectional design by using primary data obtained from all respondents who filled out the questionnaire developed by Kamath and Stothard and phalen test, and using Rapid Entre Body Assessment (REBA) method to assess work attitude on bagging workers at PT. Pupuk Kujang Cikampek. Results: Workers with high working-risk attitude were 57 workers (56.4%) and other factors were 41-60 years old as many as 59 workers (58.4%), employment time >4 years were 65 workers (64.4%), IMT >25 as many as 53 workers (52,5%), and phalen test as many as 60 workers (59,4%) which is positive so that risk of having complaint CTS. Conclusion: This research indicates that the majority of workers in PT. Pupuk Kujang Cikampek had symptoms of CTS. Where the working period of work, body posture and IMT have a related with complaints of CTS. While the age and employment time is not related with this research. Keywords: body posturre, Carpal Tunnel Syndrome, Kamath and Stothard, phalen test,REBA 201 GIVING OATMEAL AS A PREVENTIVE EFFORT TO FIBROTIC MICE LUNG TISSUE FORMATION DUE TO CIGARETTE SMOKE EXPOSURE Farida Anggraini Soetedjo1 Medical Faculty, Wijaya Kusuma Surabaya University 1 Oatmeal has been known as a healthy food in heart disease and cholesterol. The content of β-glucan and avenanthramides in oatmeal are known having high antioxidant activities, the others β-glucan could work as an immunoregulator. Exposure to cigarette smoke in a long time period can cause oxidative stress and chronic inflammation that resulting in lung damage and fibrotic tissue formation. The presence of compounds that can work as immunoregulators and antioxidants is expected to reduce the formation of fibrotic tissue due to cigarette smoke exposure. Keywords: chronic inflammation, cigarette smoke exposure, fibrotic tissue, oatmeal 241 EVALUATION OF PURCHASING STRATEGY IN PROCUREMENT OF DIAGNOSTIC SUPPORTING TOOLS CT-SCAN IN PKU MUHAMMADIYAH BANTUL HOSPITAL Pajar Sigit Nugroho 1, Firman Pribadi 2 Master of Hospital Management-Universitas Muhammadiyah Yogyakarta, Indonesia 2 Master of Hospital Management-Universitas Muhammadiyah Yogyakarta, Indonesia 1 Background: a hospital in the rural area of Yogyakarta which has type C hospitals serve as referral hospitals so they must provide more complete health service facilities, such as laboratory services with higher specifications. The hospital is one of the private hospitals of Muhammadiyah Organisation, operating with the spirit of missionary, helper of the du'afa misery. Seven years ago this Hospital made a purchase of Radiology Supervision in the form of CT SCAN, but has never been evaluated from the purchase of the tool. The purpose of this study is to evaluate whether the decision is appropriate and how the future strategy so that the benefits of the tool can be maximized in terms of financial and hospital income. Methods: Measuring or computing the revenue components and cost components of the CT SCAN tool and then analyzed by the NPV and PBP methods to find out whether purchasing from the equipment is beneficial for the hospital. Then a comparison analysis of real income analysis in seven years with income that using unit cost calculations methods. Results: The results show that the losses from the utilization of CT SCAN from the initial purchase amounted to Rp1.241.264.799. The smallest losses are in 2016 with the number Rp7.181.630, with the number of patients examined CT SCAN as many as 1623 patients. Conclusions: The CT -SCAN used for seven years was not considered to have the maximum impact of hospital finance. Evaluations show a greater potential loss in 2018 if no pricelist changes are made. Keywords: Evaluation, Purchasing Strategy, Insourcing, CT-SCAN 240 DUAL EFFECTS OF MESENCHYMAL STEM / STROMAL CELL IN TUMOR ANIMAL MODELS: A SYSTEMATIC REVIEW FOR RISK MANAGEMENT THERAPY OF STEM CELL IN CANCER PATIENTS Pratika Yuhyi Hernanda1 Medical Genetics Laboratory, Department of Biomedicine, Medical Faculty, Wijaya Kusuma University Surabaya [email protected] 1 Several studies have reported the Mesenchymal Stem Cell (MSC) MSC effects triggered tumor growth and several other studies reported evidence of anti-tumor role in MSC. .However, the direct anti-HCC effects of MSC have hardly been studied in patients, but have been extensively investigated in tumor animal models .We therefore performed a systematic review and meta-analysis of animal studies evaluating the effects of MSC on tumors, especially solid tumors. Method: We collected the relevant studies by searching ProQuest, PubMed Publisher, and GoogleScholar. Studies were included according to the following inclusion criteria: Mesenchymal Stem/Stromal Cell, tumor, and xenograft /animal study. A meta-analysis was performed for the outcome measures: tumor growth (inhibit or promote tumor growth), source of MSC used and phase of MSC delivery (co-culture/post tumorigenesis). The search resulted in 440 references, of which 53 could be included in the review.The study characteristics of the included studies varied considerably. All of the studies reported outcomes related to tumor growth. Of these 53 experiments, 28 (53%) showed a significant decrease of tumor growth and 25 (47%) experiments showed a significant increase of tumor growth. Conclusion MSC appears to have a dual effect in animal models, therefore we call for caution using MSC in tumor / cancer patients. There are variations in experimental condition and method. Although the intrinsic limitations of animal studies, this systematic review could provide an important reference for future preclinical animal trials and may give contribution for risk management therapy of stem cell in cancer patients. Keywords: Mesenchymal Stem/Stromal Cell, Tumor, Animal Study, Risk Management 252 IMPROVING APPOINTMENT KEEPING OF HIV POSITIVE CLIENTS AT MOROTO REGIONAL REFERRAL HOSPITAL (RRH), UGANDA Geofrey Ssekalembe1,2 , Brian Lwanga3, Sri Surmami4, Setya Haksama4 1 Epidemiology Student, Faculty of Public Health Universtas Airlangga, 2 Data officer, Moroto RRH USAID-SUSTAIN Project. 3 Clinical Care Coordinator, Moroto RRH USAID-SUSTAIN Project 4 Lecturer, Faculty of Public health Universtas Airlangga [email protected] Background: The ART clinic at Moroto RRH serves seven districts in the Karamoja region and has been supported by Strengthening Uganda's Systems for Treating AIDS Nationally (SUSTAIN) project since 2011. Currently, it has enrolled over 1,000 patients on HIV care, however appointment keeping still remains a challenge. SUSTAIN however initiated a Quality Improvement (QI) project in April 2017 towards improving appointment keeping of HIV positive patients. This QI project rose as a result of a very low patient appointment keeping (below 50%) and more so had further declined in March to 45% from 47.6% in February. The specific objectives of this project are to streamline clients’ appointment process with in the implementation period, to increase awareness of clients about the importance of keeping appointments, to increase staff knowledge and practices about the appointment system. Materials and Methods: A comparison analysis study has been made for a period of three months since the QI interventions and the last three months before the project. The number of patients who kept their appointment is compared to those that were given appointment. Results: Improvement since the start of this QI project as evidenced in the preceding months of April (79.5%), May (81.5%) and June (83.7%) as compared to the previous months of January (41.6%), February (47.6%) and March (45%). It is projected to be 100% in August 2017 and onwards keeping other factors constant. Conclusions: Interventions to improve this are; conducting routine intensive adherence counselling and health talks by the counselors to ignite a sense of appointment keeping, initiating mobile services to communities through patients’ team leaders, issuing two-month supplies of ARV drugs to stable clients, harmonizing appointment dates for clients from the same family and Village to encourage collective support and also provide food to clients on clinic days to encourage them keep their appointments since it’s on record that they appear when there is food to be served. Keywords: Appointment keeping, ARVs, ART, Viral Load 254 IDENTIFICATION OF BREAST CANCER USING MATLAB Maslihah1, Endang Noerhartati2, Lestari Retnawati1 Informatic Engineering, Universitas Wijaya Kusuma Surabaya, Surabaya,Indonesia 2 Agroindustrial Technology, Universitas Wijaya Kusuma Surabaya, Surabaya,Indonesia [email protected]; [email protected] 1 Cancer is one of the main causes of death. According to Basic Health Research 2007, in Indonesia, 70 percent of cancer cases are found at an advanced stage. As a result, survival rates are low and absorb large budgets. Early diagnosis of the breast is one of the efforts to minimize malignant cancer. Therefore in this activity research was carried out with the title "Identification of breast cancer using Matlab" as the development and application of science and technology that has a purpose: facilitate the user / patient to detect breast cancer and further minimizing the occurrence of delays in diagnosis and this supports the government program stated in the RI Minister of Health Regulation No. 34 of 2015 concerning "Breast Cancer and Uterine Cancer Prevention". The output of this study in the form of "breast cancer identification application using Matlab" and the output of this application is a statement of "Cancer and Not Cancer". In this study an analysis of the design of breast cancer identification using Matlab and system-making method is carried out by using the Neural Network Back Propagation {BJST}. Keywords: Matlab, artificial neural networks, breast cancer, and Neural Network Back Propagation 251 THE IMPORTANCE OF INDONESIAN FOOD ALTERNATIVE (IFA) SORGHUM FOR HEALTH 1 Endang Noerhartati1 Department of Agroindustrial Technology, Universitas Wijaya Kusuma Surabaya, [email protected] Sorghum as an Indonesian Food Alternative (IFA) has the potential to support healthy food. The purpose of this research is to explore the potential of sorghum based on the parts that can be processed as alternative foods. This study consisted of 3 stages: 1) research on sorghum rice processed into "nasi", 2) sorghum flour processed into "cookies", and 3) bran sorghum processed into "sticks", each research used 2 factors sorghum varieties: V1 (red sorghum / Sorghum bicolor) and V2 (white sorghum / KD 4). Observations include organoleptic aspects, chemical aspects, and physical aspects. Data analysis included: physical aspects with descriptive analysis, organoleptic tests were performed using Friedman test, while chemical tests were carried out using analysis of variance, followed by the Duncan test of 5%. The results showed that product formulations had been successfully obtained for alternative foods, including physical, organoleptic and chemical aspects. Sorghum is also considered healthier because it is gluten free, it contains anti-oxidants, tannins, a low glycemic index, and high fiber. Keywords: Sorghum, Indonesian Food Alternative, Healthy food, and Free Gluten 215 FALL PREVENTION AND ITS CHALLENGES IN ASIAN COUNTRIES: A SYSTEMATIC REVIEW Rohana O Damanik12, A Achadi1 Faculty of Public Health, Indonesia University 2 Jati Padang General Hospital, Jakarta [email protected] 1 Background: As the second leading cause of death, fall brings humiliation to health care provider and also a serious threat to hospital patient safety. This paper review articles and journals containing hospital patient fall in Asia, to describe its prevention and challenges in Asian countries. Materials and Methods: Electronic search was conducted in Proquest, PubMed and Google Scholar scientific databases. Using systematic review, we included those studies conducted on patient fall in hospital. Our search yielded 14 relevant papers with 7 countries included. Results: Causes of fall vary in different age group. Fall risks reduced by adoption of a comprehensive assessment tool and the use of multidisciplinary actions. Barriers to fall prevention includes lack of staff’s knowledge and care giver support . Conclusion: Fall Prevention Programme (FPP) proved to be effective in some countries. On the other hand, some also meet similar challenges. We suggest that research in more countries are needed to build sustainable approach of FPP. 255 LONG-TERM INDUCTIONOF PATENT EXTRACT OF TUMERIC (curcuma domestica) AND SOURSOUP LEAVES (Annona muricata L) AGAINST HISTOPATHOLOGICAL RENAL CHANGES IN MALE MICE Muhammad Farid Rizal1,Retina Yunani2, Endang Noerhartati3 Faculty of Veterinary Medicine, Universitas Wijaya Kusuma Surabaya, 2 Departemen Clinical Pathology Veterine, Universitas Wijaya Kusuma Surabaya, 2 Department of Agroindustrial Technology, Universitas Wijaya Kusuma Surabaya, [email protected] 1 Increasingly community’s awareness about the use of herbal products as relatively safe medicines, it demands a lot of research that to find out the quality and safety of a patent herbal medicine product or non-patent herbal medicine product. The research aims to determine changes in post-induced male mice (Mus musscullus) with patent extract of turmeric rhizome and patent extract of soursop leaves within 6 weeks. Type of the experimental research with complete randomized design. The sample used 150 grams of patent turmeric extract and 150 grams of soursop leaf extract. The method of research: on this study used 3 treatment groups and 9 repetition. Group P0: 9 mice given distilled water during 6 weeks. Group P1: 9 mice given turmeric extract during 6 weeks. P2: 9 mice given soursop leaf extract during 6 weeks. The parameters observed were histopathological changes of renal organs, data obtained were analyzed descriptively to determine changes in renal histopathology of mice. The results of the study: Observation of histopathological features of P0 group had picnosis necrosis, inflammatory cell and vascularity infiltration, in P1 and P2 groups found inflammatory cell infiltration, necrosis of cariolysis and renal cells had begun to develop fibrosis. Conclusion: Long-term induction of the patent extract of turmeric rhizome (Curcuma domestica) and soursop leaves (Aanonna muricata L) cause damage to renal cells of male mice. Keywords: extract patent, tumeric , Soursoup leaves, Renal histhopatological 259 RELATIONSHIP OF AVAILABILITY OF HEALTH PERSONNEL WITH MORTALITY AND MORBIDITY NUMBERS IN EAST JAVA INDONESIA 1 Septa Katmawanti1, Siti Nurochmah1 and Muhammad Ainurrochman1 State University of Malang, Semarang street number 5th, Malang, Indonesia [email protected] Health workers in East Java Province are the second largest number of health workers in Indonesia after Central Java Province with a total health workforce of 69,405 people by 2015. Viewed in general the picture of health services in East Java Province is quite good in terms of its achievement as in infant mortality rate (IMR), but should also be improved in some indicators such as maternal mortality rate (MMR) and overall morbidity for evaluation purposes. This research is a correlation research to see the presence or absence of correlation between variables due to the availability of health personnel (X) with dependent variable (Y1) mortality rate and (Y2) morbidity number in East Java Province. Keywords: Health workers availability, mortality, morbidity, health services 267 ANALISA PENYESUAIAN TARIF PEMERIKSAAN DI INSTALASI LABORATORIUM RUMAH SAKIT EM TAHUN 2018 Novita A1, Sulistiadi W1, Aulina PY1 Progran Studi Administrasi Rumah Sakit Fakultas Pasca Sarjana Universitas Respati Indonesia 1 The increasing the number of hospitals made the competition more increasing. Therefore need the concept more clearly to predict bussiness and growth faster and survive. Laboratory services as a part of hospitals services must improve the quality with affordable cost. Examination rates has never changed since 2013 and unit cost should be analize and re-evaluate it was still relevant and up-to-date.The purpose of this research is to know unit cost of each test and determine alternative rates. This research is case study using a descriptive quantitative approach during May until July 2018 in EM Hospitals. Number of samples of unit cost analysis are entire population of the examination in 2017 with a consecutive sampling technique of 96 samples to know ability and willingness of patient to pay. The result of study indicate that the applicable rates is still appropriate, however some rates below unit cost and CRR < 100%. To increase revenue can be proposed through rates increase because 96% of rates are still below the competitors. The increasing varies from 10% to 50%, but 7 types of examination are proposed still using current rates and 1 type of examination is proposed new lower rate. It takes various efforts to increase the number of laboratory examinations. Keyword : hospital rates, unit cost, CRR, ability to pay 273 COMPARISON ANALYST BETWEEN REAL COST AND INA-CBGS COST IN TOTAL KNEE REPLACEMENT AT SENTRA MEDIKA CISALAK HOSPITAL 2018. Wahyu Eko Widiharso1 Postgraduate Program Hospital Administration Universitas Respati Indonesia 1 Background: As an implementation of healthy regulation no 36, 2009, government formed health insurance named BPJS. But in the real situation, BPJS rate has changed several times from health minister regulation (permenkes no. 59) in 2014 to regulation no. 64 in 2016. Since then INA-CBG’s rate Total Knee Replacement for private hospital type B has decreased.. In one year, there were 60 cases of TKR. Objection: To analize the real cost of Total Knee Replacement surgery compare to Ina-CBG’s rate in Sentra Medika Cisalak Hospital 2018. Method: The research is done by using descriptive, quantitative and qualitative research and also case study project. This research is to describe the real cost by checking patient’s billing. Result: The most influence component on the real cost is implant cost (60%), surgery room cost (23,6%), and others (9,4%). On Kolmogorov-Smirnov shows that real cost and INA-CBG’S rate data are not distributed normally (p>0’05). On correlation test between real cost and INA-CBG’s rate using Mann Whiteney shows the result P = 0,0001 or P < 0,05 which there’s significant difference between real cost and INACBG’s rate. On Spearmann correlation test, we can get conclusion that there are four cost components that has p<0, 05, so the correlation among implant cost, surgery room cost, other cost (component cost) compare to real cost. With the real cost per case Rp. 43.578.533,2 and INA CBG’S rate per case Rp. 35.432. 963,7, so the difference cost is Rp. -8.145.569,6. Total real cost and INA-CBG’s rate is Rp. 2.614.711.990,00 and Rp. 2.125.977.820,00, and deficit Rp. -488.734.170,00. Conclusion/advise: The real cost of Total Knee Replacement in Sentra Medika Cisalak Hospital is higher than INA CBG’s rate. So it needs to done a cost evaluation especially implant cost and surgery room cost using clinical pathway. To be advised, the hospital should back to use health minister regulation no.59 in 2014. Keywords: Real Cost, Total Knee Replacement, INA CBG’S rate) 293 THE ROLE OF PUSKESMAS LEADERSHIP ON THE IMPLEMENTATION OF EARLY WARNING ALERT AND RESPONSE SYSTEM (EWARS) DENGUE HEMORRHAGIC FEVER (DHF) IN TRENGGALEK REGION Setya Haksama, M. Farid Dimyati Lusno, Ririh Yudhastuti, Abdul Hakim Zakkiy Fasya Faculty of Public Health, Universitas Airlangga Dengue hemorrhagic fever (DHF) is found in tropical and sub-tropical regions as a major health problem in Trenggalek with cases that remain higher and are in the top 5 Regions in East Java Province with 1,159 cases of DHF. An effort to reduce the DHF case in Trenggalek Regency is needed, one of which is to optimize the Early Warning Alert and Response System (EWARS) instrument by analyzing the leadership role in the Puskesmas. It was a quantitative study carried out in a cross-sectional manner in 6 Puskesmas based on mountainous, urban and coastal conditions selected based on DHF cases in 2017 to March 2018. The number of respondents 37 people consisted of P2DHF health center and jumantik cadres who were taken purposive sampling. The results showed that the leadership role had a value of 3.35 "excellent" category; leadership social responsibility has a value of 3.36 in the "excellent" category; Leadership concern has a value of 3.09 in the "average" category, and the condition of the EWARS report has a value of 2.26 in the "poor" category. The recommendation given is that the head of the puskesmas: 1). Active and routine in conveying the importance of the EWARS program, 2). program training on cadre training and try to budget for the provision of incentives, and 3). Pay attention to the implementation and effectiveness of EWARS with continuous monitoring. The main thing in an effort to optimize EWARS with the development of the information technology based on mobile and desktop applications that can help speed and accuracy of reporting data. Keywords: Leadership, Early Warning Alert and Response System (EWARS), Dengue Haemorrhagic Fever (DHF), Puskesmas 295 THE EFFECT OF INTRINSIC AND EXTRINSIC FACTORS ON PATIENT FALL INCIDENT AT PGI CIKINI HOSPITAL Trigono A.1 ,Winner2 PGI Cikini Hospital, Jakarta 2 Master of Hospital Administration Study Program, Universitas Respati Indonesia 1 Falls are most injury causing patient safety incident at PGI Cikini Hospital. This study is aimed to investigate the intrinsic and extrinsic factors affecting the fall incidents at PGI Cikini Hospital. This is a cross sectional study on secondary data of medical records of 85 patients who underwent admission on the period of January 1 st, 2016 to December 31st, 2017. We investigate the effects of intrinsic variables, which are patient’s age, history of falling, the presence of more than one diagnosis, walking aid necessity, gait/balance disturbance, and mental status; and extrinsic variables, such as intravenous devices attached, tube shaped medical devices attached, and the source unit of patient admission; to the fall incident. On the final model of multivariate test, we found that the fall incident at PGI Cikini Hospital is affected by patient mental status of not awaring his/her physical limitations, as the most dominant factor (p = 0,001; OR = 45,50; 95% CI: 5,098 - 406,050) and patient admitted from the outpatient clinic (p = 0,038; OR = 3,21; 95%CI: 1,067 - 9,657). Eventhough the other variables which were found to be statistically insignificant, it did not indicate that the fall incident is not affected by the variables, but rather it showed that those variables are already intervened as the formal patient fall prevention procedure at PGI Cikini Hospital. At PGI Cikini Hospital, the future interventions for fall incident prevention program are patient and family education in order to ensure they aware of the patient’s physical limitation thus encourage them to cooperate with hospital staffs in the fall prevention measns and the establishment of fall risk assessment for patient sourcing from outpatient clinics prior to admission. Keywords: intrinsic factor, extrinsic factor, fall incident, patient safety 313 ENVIRONMENT FACTORS (GOVERNMENT POLICY) THAT AFFECT PUBLIC HEALTH CENTER’S PERFORMANCE: A CASE STUDY OF PUBLIC HEALTH CENTER IN THE NATIONAL HEALTH INSURANCE ERA 1 Evi Derma Sastiva1,Afrizal2 , Hardisman3, Hefrizal Handra4 Faculty of Medicine, Andalas University, Padang, Indonesia, 1Faculty of Sociology, Andalas University, Padang, Indonesia, 1Faculty of Medicine, Andalas University, Padang, Indonesia, 1Faculty of Economy, Andalas University, Padang, Indonesia [email protected] Background: Health development is an integral part of national development. Public Health Center (PHC) as a place that facilitates the first level of health services still faced various problems, which is still faced high maternal, infant, and toddler mortality. The high mortality rates indicate that the standard of success of the program is still low even though more people need high quality service and fast along with the enactment of National Health Insurance (NHI) system per January 1, 2014. This study aims to analyze the environment factors (government policy) that affect the performance of PHCs. Materials and Methods: The research method used is qualitative method with case study approach. Case study approach is used to specifically identify the input factors that affect the performance of PHCs so that the researchers get a clear description from different points of view. The object of this research is 5 PHCs in Padang City. Data obtained by in-depth interview, questionnaire, and FGD. Results: PHCs haven’t had high quality yet. This is shown from the findings of research that the environmental factor that feel its influence in PHCs is the NHI Law which requires all residents to be NHI participants. Conclusions: Environment factors (government policy) at PHCs II (Andalas and Lubuk Buaya PHC) are better than PHCs I (Bungus, Lubuk Begalung, and Ambacang). Keywords: Environment, Government Policy, NHI, PHC, Performance. 314 INPUT FACTORS (HUMAN RESOURCES) THAT AFFECT PUBLIC HEALTH CENTER’S PERFORMANCE: A CASE STUDY OF PUBLIC HEALTH CENTER IN THE NATIONAL HEALTH INSURANCE ERA 1 Evi Derma Sastiva1 Faculty of Medicine, Andalas University, Padang, Indonesia and Widyaiswara Ahli Madya in community sports health center and Health Training, West Sumatera Province. [email protected] Background: Health development is an integral part of national development. Public Health Center as a place that facilitates the first level of health services still faced various problems, which is still faced high maternal, infant, and toddler mortality. The high mortality rates indicate that the standard of success of the program is still low even though more people need high quality service and fast along with the enactment of National Health Insurance system per January 1, 2014. This study aims to analyze the input factors (Human Resources) that affect the performance of PHCs. Materials and Methods: The research method used is qualitative method with case study approach. Case study approach is used to specifically identify the input factors that affect the performance of PHCs so that the researchers get a clear description from different points of view. The object of this research is 5 PHCs in Padang City. Data obtained by in-depth interview, questionnaire, and FGD. Results: PHCs haven’t had high quality yet. This is shown from the findings of research that: Human Resources in the implementation of PHCs program have not a sufficient quantities and types; Conclusions: Input factors at PHCs II (Andalas and Lubuk Buaya PHC) are better than PHCs I (Bungus, Lubuk Begalung, and Ambacang PHC). Keywords: Human Resources, Input, NHI, PHC. 248 LOW FREQUENCY ULTRASONIC WAVE TO KILL METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) IN VITRO WITH THE CHANGES OF MORPHOLOGICAL SHAPE AND CELL COLOR AS INDICATORS Mas Mansyur1, Edi Widjajanto2,5, Sumarno Reto Prawiro3,5, Erni Yudaningtyas4 1. Biomedical Department and Biomolecular Research, Faculty of Medicine, University of Wijaya Kusuma, Surabaya, Indonesia. 2. Department of Clinical Pathology, Faculty of Medicine, Brawijaya University, Malang, Indonesia. 3. Department of Microbiology, Faculty of Medicine, Brawijaya University, Malang, Indonesia 4. Department of Electrical Engineering, Faculty of Engineering, Brawijaya University, Malang, Indonesia 5 dr. Saiful Anwar Public Hospital, Malang, Indonesia Introduction: MRSA is Staphylococcus aureus which is immune to antibiotic type meticillin. This bacteria is multiresistant to antibiotics which is hard to kill compared to gram negative bacterias. MRSA is an important cause of nosocomial infection including Skin and Soft Tissue Infections. Aim: To find the effect of low frequency ultrasonic wave exposure to kill MRSA with the changes of morphological shape and cell color. Materials and Methods: 100 ml MRSA suspension exposed by an ultrasonic wave with frequency 21, 22, 23, ... 30 kHz and a power of 2 watts for 2 minutes. The macroscopic observing the percent of MRSA deaths after 24 hours, using a Quebec colony counter. Microscopic observation using SEM was performed to understand changes in morphology of MRSA cells, and colour change with gram staining. The efffect was found using ANOVA (α = 0,05) and the regression equation using MINITAB 16.0 program. Result: There was significantly difference between the low frequency ultrasonic wave with: death percentage of MRSA (p = 0,002) with optimum frequency is 26 kHz, change of MRSA morphological shape (p = 0,004) and change of MRSA color (0,021). The death of MRSA happened necrotically, the shape of MRSA cell changed from round to not round. The change of the shape happened due to mechhanical stress, cavitation, and chemical effect, also the combination of all. The broken MRSA wall caused the change of cell color from purple to pink. Conclusions: There is an significant effect between low frequency ultrasonic wave with death percentage of MRSA, changes of MRSA shape, and change of MRSA cell color. The death of the cell happened necrotically, which marked by the change of morphological shape and cell color. The change of the shape happened due to mechanical stress, cavitation, and chemical effect. Keyword: Cavitation, mechanical stress, SEM, ultrasonic wave 316 WILLINGNESS TO PAY FOR MATERNITY WAITING HOMES IN RURAL INDONESIA Arlina Dewi1,, Supriyatiningsih2, Sri Sundari3, Dianita Sugiyo4, Ralph. J. Lellee5 Master of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia 2,3 School of Medicine, Medicine and Health Sciences Faculty, Universitas Muhammadiyah Yogyakarta, Indonesia 4 School of Nursing, Medicine and Health Sciences Faculty, Universitas Muhammadiyah Yogyakarta, Indonesia 5 Muenster University Hospital, Germany [email protected] 1 Distance to a health care facility has long been discussed as a key barrier to maternal health care utilization in rural areas. Maternity Waiting Homes (MWHs) has been proved to reductions in maternal mortality. The objective of this study to investigate the pregnant women’s Willingness to Pay (WTP) toward the maternity waiting homes (MWHs). The cross-sectional study was conducted in two rural areas in South Sulawesi, Indonesia. The data were collected through survey which was distributed to pregnant women and their families. A total of fifty-one pregnant women and forty-nine families participated in the study as two groups of respondents. For the results of this study, there were 66.7% of pregnant women agreed if they should stay at MWHs. For a group of pregnant women, the amount of WTP which was capable to be paid was 100.000 IDR in a month. Moreover, for a group of family, the amount of WTP which they could pay for staying at MWH was 200.000 IDR in a month. The pregnant women’s acceptance to stay in MWH are good, but their willingness to pay are still very low. Key words: maternal waiting home, WTP, rural 317 EVALUATION OF RECREDENTIAL AND CREDENTIAL IMPLEMENTATION FOR GENERAL DOCTORS IN RPAU DR. HARDJOLUKITO Dyah Ayuning Tyas1, Elsye Maria Rosa2 Master of Hospital Management, Post Graduate Program, Universitas Muhammadiyah Yogyakarta, Indonesia 2 Master of Hospital Management, Post Graduate Program, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] 1 Credentialing is a process to achieve the standard as an effort to promote patient safety. The doctor must have a good competency and accountability so they can provide professional and high quality services. There was no clear study and evaluation in RSPAU Hardjolukito regarding the sustainability of the credentialing process from the beginning, especially for general practitioners. Researcher used a case study design with descriptive qualitative approach. Researchers used qualitative research to obtain descriptive data in oral and written form. This research was conducted at RSPAU Dr.Hardjolukito in June 2018. The credentialing process at the Harjolukito Hospital were often confused with the employee recruitment process. Implementation of credential process, written clinical authority, professional development, audit system, professional discipline and sanctioning reflect a better performance of the medical committee. Evaluation for the future is in line with the credential model "delineation of clinical privilege". This model is based on the credential triangle process consisting of clinical privileges, white papers, and peer groups, with the output is clinical appointments. The system of credentials in hospitals used "delineation of clinical privilege" model was very possible to be implemented because various elements that were needed have been found in the medical profession in Indonesia. Key words: credentialing, general physician 318 IMPLEMENTATION OF BUNDLE CATHETER ASSOCIATED URINARY TRACT INFECTION (CAUTI) Elsye Maria Rosa 1, Ani Syafriati 2, Novita Kurnia Sari3 Lecturer of Master Hospital Management, Post Graduate Program of Universitas Muhammadiyah Yogyakarta. 2 Student Master of Nursing, Post Graduate Program of Universitas Muhammadiyah Yogyakarta. 3 Lecturer of Master of Nursing, Post Graduate Program of Universitas Muhammadiyah Yogyakarta. [email protected] 1 One of achievements patient safety to reduce risk of CAUTI in hospitals by managing, preventing and controlling with using CAUTI bundle. Nurses for 24 hours at hospital accompany patients to monitor if CAUTI occurs in patients who use a catheter more than 48 hours. Purpose of this study was to analyze the comparison of CAUTI prevention in the intervention group and control group after development CAUTI (Post-test only) bundle in RSUD Sejiran Setason Muntok. This research used a true experimental quantitative method (post-test only). It was carried out for 2 weeks used consecutive sampling. It found that 64 respondents used urine catheters in six inpatient rooms of RSUD Sejiran Setason Muntok. After that it divided into two groups, 3 rooms with 32 respondents were intervention groups and 3 rooms with 32 respondents were the control group. Non-parametic test results of the Mann-Whitney Test were significant difference between intervention groups given Bundle CAUTI and control group, with a significance of 0.001 <0.05. In conclusion, level of CAUTI prevention conducted by nurses in intervention group that given CAUTI Bundle was different from the control group. It causes was a different nurse's compliance in implementation prevention of CAUTI Keyword : Infection control, Bundle CAUTI, Catheter urine 319 COMPARISON OF HEALTH WORKER PERFORMANCE IN EXPANDING MATERNAL AND NEONATAL SURVIVAL (EMAS) PROGRAM HOSPITAL AND NON PROGRAM Nannyk Widyaningrum1, Arlina Dewi2, Supriyatiningsih3 Master of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia 3 School of Medicine, Medicine and Health Sciences Faculty, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected]; [email protected]; [email protected] 1,2 The national program EMAS is based by the magnitude of maternal and infant mortality rate in Indonesia. According to 2010 civil census, over 30% deaths happen in women younger than 20 and older than 35. The implementation should be supported by good health worker performance so that the reduction of mortality rate can achieve the targets. The purpose of this study was to determine the difference of health worker performance in EMAS program hospital and Non-EMAS program hospital. The research type was quantitative with difference test analysis. The research samples came from 2 hospitals, consisting of 30 health workers from EMAS program hospital and 30 health workers from Non-EMAS program hospital. The data was collected using questionnaire and the data analysis used Mann Whitney test. The result of the difference test on 5 performance factors showed that 3 factors, i.e. ability, attitude and facility and infrastructure in EMAS program hospital had better scores than Non-EMAS program hospital. However, 2 other factors didn’t show any difference, i.e. motivation and leadership. There was significant difference in attitude (p<0,05). The performance of hospital with EMAS program was different in terms of attitude from hospital without EMAS program. Keywords: EMAS Program, Health Worker Performance 320 IMPLEMENTATION OF VIDEO IN IMPROVING SAFE SURGERY CHECKLIST (SSC) COMPLIANCE IN CENTRAL SURGICAL INSTALLATION OF HOSPITAL IN YOGYAKARTA Nova Maryani1, Elsye Maria Rosa2 Master Student of Hospital Management-Universitas Muhammadiyah Yogyakarta, Indonesia 2 Lecturer of Hospital Management-Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] 1 The surgical services field was a part that often causes unexpected events, both medical injuries and complications due to surgery. The objective of this study was to further evaluate the effectiveness of video use in an effort to increase compliance with the Safe Surgery Checklist. Research methods with qualitative methods, depth interviews, and coding. From the 4 subjects conducted by the depth interview that representing the population, it was found that Safe Surgery Checklist is not just a routine. SSC can minimize mortality and postoperative complications. An interesting and informative video facilitates understanding and reminders of SSC implementers. Video can also be a training medium for teams that will enter the operating room and carry out operations. Videos are useful in increasing understanding and reminders of SSC implementers. Keyword: Safe Surgery Checklist, Video, Surgery Installation 321 THE ROLE OF ACCREDITATION IN IMPLEMENTATION OF PATIENT SAFETY CULTURE OF FIRDAUS CLINIC YOGYAKARTA Novera Wardalia1, Arlina Dewi2 Student Master of Hospital Management, Post Graduate Program, Universitas Muhammadiyah Yogyakarta 2 Lecturer of Master Hospital Management, Post Graduate Program, Universitas Muhammadiyah Yogyakarta [email protected] 1 In Indonesia the level of undesirable events in 2007 was 46.2% and in 2010 increased to 63%, so patient safety was an important factor to pay attention. Firdaus Clinic is primary health care that are preparing the process of clinic accreditation, improvement of various systems, including patient safety. Study purpose:to determine the percentage change in the dimensions of patient safety achieved after, compared to before the application of accreditation documents. Quantitative descriptive research with questionnaire that consist of 12 dimensions from AHRQ (Agency for Healthcare Research and Quality) at 2004 which has been translated. Taken secondary data before the application of accreditation documents on October 2017, primary data on July 2018 after that. The result, an enhancement in the 10 dimensions of patient safety culture after the application of clinic accreditation documents. The highest change(44%) in the dimension of feedback and communication, there wasn’t change in the dimension of perception about patient safety, and a decrease in the dimension of frequency of reported events (6%). Overall 12 dimensions, the average change increased by 20.2% after the application of accreditation documents. So, the application of clinical accreditation documents can improve patient safety culture. Keywords: Clinic accreditation, patient safety culture 322 THE ROLE OF ACCREDITTATION ON MEDICAL RECORDS COMPLETENESS AT FIRDAUS CLINIC 1,2 Renata Nurul Setyawati1 ,Arlina Dewi2 Master of Hospital Management, Post Graduate Program, Universitas Muhammadiyah Yogyakarta. [email protected] The incompleteness of medical record (MR) filling is a problem for many health care facilities. A retrospective cohort study was performed to assess the role of accreditation in MR completeness at Firdaus Clinic. A total of 320 MR registered during November 2016-July 2018. The assessment based on Minister of Health Regulation No.269/MENKES/PER/III/2008, education and monitor of drug side effects. The result divided into initial phase after accreditation commitment (phase 1), preparation phase (phase 2), final phase (phase 3), and improvement phase (phase 4). Each phase showed in 6 months except phase 4 in 3 months. There were 29% of MR complete proofed. The records filled complete in the section of date and time, identity, history and treatment. The lowest percentage showed in vital sign, education and monitoring drug side effects. In phase 2, there is a decrease on vital sign, physical examination and education. In phase 3, there is an increase in physical examination and education. In phase 4, there is an increase in vital sign and education. Enhancement of health worker behavior to fulfill MR needs to be done by continue to improving the quality of performance. Keywords: medical record, accreditation phase 323 SAFETY CULTURE OF PRIVATE PRIMARY CARE: A PILOT STUDY IN YOGYAKARTA Yuyun Pramayanti1, Wiwik Kusumawati2 and Merita Arini3 Master of Hospital Management, Post Graduate Programme, Universitas Muhammadiyah Yogyakarta, Indonesia 2 Master of Nursing, Post Graduate Programme,, Universitas Muhammadiyah Yogyakarta, Indonesia 3 School of Medicine, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] 1 Patient safety is an important but neglected issue in primary health care. The lack of research on safety culture in primary health care compared to hospitals and finding out how start-up clinic implements safety culture who has not been accredited, became the objective in this study. This research is a mixed methods research. The research quantitatively used patient safety culture questionnaire, adopted from AHRQ and qualitatively used deep interview. In order to conduct and analyse both of quantitative and qualitative methods, the researcher deployed sequential explanatory method. From 12 dimension of patient safety, three dimensions in high score, 7 dimensions in medium score, but two dimensions were reporting system and punishment in low score. The major themes based on the deep interview conducted were the comprehension of patient safety culture of all staff and stakeholders, the implementation of patient safety programme, and management support. We concluded that accreditation is a sustaining factor that can be used as a framework for shaping patient safety culture. Patient safety is not a simple technique to gain quality in healthcare. We need continuous, multifaceted, and comprehensive approach to establish and maintain the implementation of safety culture. Keywords: Patient Safety, Primary Health Care 324 THE EVALUATION OF IMPLEMENTATION CLINICAL PATHWAY IN PNEUMONIA CASE IN INTERNA WARD OF YOGYAKARTA PUBLIC HOSPITAL Zariat Primatama1, Merita Arini2, Arlina Dewi3 Master of Hospital Management, Postgraduate Program of Universitas Muhammadiyah Yogyakarta, Indonesia 2 School of Medicine, Medical and Health Science Faculty of Universitas Muhammadiyah Yogyakarta, Indonesia 3 Master of Hospital Management, Postgraduate Program of Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] 1 Clinical pathways is a method for improving both of quality and health care cost. We aim to evaluate the implementation of CP pneumonia in interna ward of a public hospital in Yogyakarta, Indonesia. Research conducted by mix method and case study approach. The total sampling of Pneumonia medical records (January-March 2016, n=12) were analized descriptively by ICPAT (The Integrated Care Pathway Appraisal Tool). Qualitative samples were providers (n=15) that involved in the implementation and obtained by purposive sampling technique. The result show that the completeness fullfillment of the CP form was 0%. Based on ICPAT, content and quality of dimension 1 (is it true a CP) was moderate, content and quality of dimension 2 (documentation) was low, content and quality of dimension 5 (maintenance) was low, content and quality of dimension 3 (development) was moderate, content of dimension 4 (implementation) was moderate and quality was good, content of dimension 6 (organizational role) was good and quality was moderate. The barriers implementation were the evaluation and socialization of CP was not well programmed, CP does not become a single documentation, and lack of ownership. In conclusion, compliance of CP implementation should be improved with multifaceted organizational and individual approach. Keywords: ICPAT, Clinical Pathway, Pneumonia 354 THE EFFECT OF WORKLOAD AND MOTIVATION ON EMPLOYEE PERFORMANCE IN THE ERA OF NATIONAL HEALTH INSURANCE IN DEPARTMENT OF OPHTHALMOLOGY AT RSUPN DR. CIPTO MANGUNKUSUMO / RSCM KIRANA Widya P Sari13, J. Ilyas1, Sarah Amini3 Student of Hospital Administration Master Program, Faculty of Public Health, University of Indonesia, Depok, Indonesia 2 Scientific Lecture, Faculty of Public Health, University of Indonesia, Depok, Indonesia 3 Human Resources Division of Department of Ophthalmology, RSUPN Dr.Cipto Mangunkusumo/RSCM Kirana, Salemba, Indonesia [email protected] 1 Background: In 2014, Indonesia started the National Health Insurance and the management was carried out by the Badan Penyelenggara Jaminan Sosial (BPJS). Since then, many health service settings have changed and various related parties effected, including Human Resource Management (HRM). Workload and Motivation are some of the issues. Method: The research was conducted in quantitative methode, using SPSS to determine the variable linkages through multiple linear regression analysis, and in-depth interview with respondence. Result: The results of the test of the variable workload on employee performance shows a significance value of 0.026 <0.05, and motivation variable on employee performance shows a significance value of 0.187 <0.05, meaning that there is an relation between workload on employee performance and there's no relation between motivation on employee performance in the Department of Ophthalmology. Conclusion: The increase in the number of patients and the changing regulation of health services influenced the workload and the motivation of employees. Strategies should be made by Department of Ophthalmology for the employees to be more comfortable at work. 362 STRATEGY IN ACHIEVING HEALTH CARE FINANCE SUSTAINABILITY IN ASIAN COUNTRIES: A SYSTEMATIC REVIEW Lenny O. Sitorus1,2, J. Ilyas1 Fakultas Kesehatan Masyarakat, Universitas Indonesia 2 Rumah Sakit Umum Daerah (RSUD) Jati Padang, Jakarta [email protected] 1 Background: Universal Health Coverage (UHC), as the embodiment of right to health, has become priority for countries. Moreover, Health Care Finance Sustainability is needed to achieve it. This paper review journals highlighting Health Care Finance Challenges in Asia and strategy to reduce the problems. Materials and Methods: Electronic search was conducted in Proquest, SAGE and J-Store databases. Using systematic review, we search scholarly journals and dissertations related to Health Care Finance Strategy. We found 23 relevant papers with 12 countries included. Results: Every countries face cost escalation in providing health care services. The strategy to reduce the costs categorized into medication control, payment method, financial control, benefit package control and technology implementation strategy. Conclusion: Some countries are proven successful in reducing health care costs. This can be a lesson for others. We suggest further research in more countries to have comprehensive strategies. 370 ANALYSIS OF HOSPITAL PHARMACIST CREDENTIALS IN YOGYAKARTA REGION 1,2,3 Andyazgo MS Isnandi1,, Sabtanti Harimurti2, Irma Risdiana3 Master of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] Competent health professional such as doctors, nurses, pharmacists and others will improve the patient safety. To assess the competence of health professional can be measured by credentials. The purpose of this study is to analyze the pharmacist credential system in Indonesia, especially the pharmacist credential system in the Yogyakarta area hospital. The qualitative study was conducted in Yogyakarta, Indonesia. The data were collected through in-depth interview which was attended by representative of the professional organization and collected through focus group discussion which was attended by pharmacists working in hospitals in Yogyakarta. A total of one representative of the professional organization and fifteen pharmacists participated in the study as two groups of respondents. For the results of this study, currently known there is no specific law enforcement regulation related to the credential system for pharmacists. The credential system becomes a hospital requirement after the accreditation and fulfillment of administrative requirements of accreditation become the main motivation to implement pharmacist credentials. Pharmacist has the needs of improving the credential system both in theory and application. Expectations of pharmacist practitioners on the process of ideal pharmacist credentials are possible with supporting elements of professional organization. Key words: patient safety, pharmacist credential, accreditation 369 COMPENSATION, CARIER DEVELOPMENT, AND JOB SATISFACTION AS THE ANTECIDENT OF NURSE TURN OVER 1,2 Nur Hidayah1, Hana Rizka Ananda2 Master of Hospital Management, Postgraduate Program, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] Shortage of professional nurse in a hospital is threaten service quality and patient safety. In-adequate compensation, no career development, and dissatisfaction can increase turnover intention. Increasing the resilience of professional nurses better than recruiting new nurses from an economic perspective. The research analyzed the effect of compensation and carrier development on job satisfaction and the impact on turnover intention of nurses in a private hospital in Yogyakarta, Indonesia. A quantitative research design with cross sectional approach used. The sampling technique was simple random sampling. The samples consist of 47 nurses who made a self-reported by filling out the questionnaire. Data analysis used Partial Least Square. The study found that compensation and career development had direct and significant effects on Turnover Intention. Moreover, compensation and career development also had indirect and significant effects on Turnover Intention through job satisfaction as the intervening variable. Keywords: compensation, career, satisfaction, nurse turnover intention 368 THE POTENTIAL OF PRIVATE PRACTITIONERS ON THE PRESUMPTIVE TUBERCULOSIS CASES DETECTION IN SURABAYA, 2018 1 Chatarina U. W1*, Hari Basuki N1, Muhammad Atoillah I.1 Lecturer of Epidemiology Master Degree Program, Faculty of Public Health Universitas Airlangga, Surabaya Indonesia [email protected] Background: One of the performed efforts to improve and accelerate the finding of a TB case earlier was through the involvement of the private sector, which was known by the term of Public-Private Mix (PPM). Private Practitioners had the great potential in helping the TB control program, particularly in the acceleration of the case finding because most of presumptive TB cases came to seek medication at an early stage to private practitioners. With the importance and the high potential of private practitioners in the process of finding TB cases at an early stage, then it was necessary to consider and learn how big the potential of the private practitioners and what factors that influenced it as the aims of this study. Method: Observational Research with the cross-sectional study designed in 3 months (June-August 2018), the population was the private practitioners in the East Surabaya with the number of sample about 80 private practitioners, which was taken using a simple random sampling technique. The data collection was performed with structured questionnaires and analysed using the chisquare test. Results: This study showed that private practitioners found more cases of presumptive TB to be on men (65.6%), on practitioners ractice with the age group < 40 years (68%) and the private practitioners who had the average number of patients per day ≤ 15 (53.2% ). Private practitioners stated that if they found cases of TB suspects, they would take care themselves (38.5%), they would suggest checking their sputum to the Community Health Centres (21.2 % ), and suggested for the presumptive TB to get the x-ray photos first (23.5%.). Most of the private practitioners (77.5 %) who sent TB suspects to Community Health Centres had not used a special form. 77.4 % of presumptive TB cases found by private practitioners were definitely diagnosed with TB. There is associated between the sex of private practitioners with the finding of presumptive TB (OR = 2.91 95% CI 1.14<OR<7.39), and between the number of patients per day in the practice with the finding of presumptive TB (OR = 6,17 95% CI 2.05<OR<18.58). Conclusion: The potential of private practitioners in detection of TB suspects was still low and affected by sex and the number of patients per day. We recommend that the TB program provides all private practitioners with information about the DOTS strategy by training. Keywords: private practitioners, potential, TB suspects 379 TRAINING OF URINARY CATHETER INSERTION IN INCREASING NURSE KNOWLEDGE IN PKU MUHAMMADIYAH BANTUL HOSPITAL Ratri Primadiati1, Elsye Maria Rosa2 Student of Master Hospital Management, Post Graduate Program, Universitas Muhammadiyah Yogyakarta. 2 Lecturer of Master Hospital Management, Post Graduate Program, Universitas Muhammadiyah Yogyakarta [email protected] 1 Urinary catheter insertion is the most common cause of bacteriuria. The risk of bacteriuria in the catheter is estimated at 5% to 10% per day. UTI is the cause of >30% of all healthcare associated infections. At least 80% of UTIs by invasive procedures or urinary tract equipment are usually catheterized. Knowledge level of each nurse is different, it is a factor causing of urinary catheter installation quality. This study purpose was to analyze installing urinary catheters knowledge before and after training. This research is an quasi experimental study that used a quantitative method (one group pretest-posttest design). The total population was 186 nurses and a sample of 52 people, with Simple Random Sampling technique. Univariate and bivariate data analysis using paired t test analysis. The results showed that the knowledge of urinary catheter insertion prior to training was mostly in enough category of 36 respondents (69,2%). Nurses’ knowledge about urinary catheter placement during training was mostly in the good category with 42 respondents (80,8%). The Wilcoxon Test results were 0.000 <0.05. There is a difference in urinary catheters insertion knowledge before and after training at PKU Muhammadiyah Bantul Hospital. Keywords : training, urinary catheter insertion, nurse knowledge 392 RISK MANAGEMENT OF OCCUPATIONAL HEALTH AND SAFETY ON NURSING IMPLEMENTATION AT EMERGENCY DEPARTMENT OF SURABAYA "X" HOSPITAL Nurhayati Saridewi1, Mulyono1 Department of Occupational Health and Safety, Public Health Faculty, Universitas Airlangga, Mulyorejo Street, Surabaya, Indonesia [email protected], [email protected] 1 Nurses as health care workers with the highest number in hospitals are at risk of having work accidents and occupational diseases. This study aims to identify risks, analyze risks, evaluate risks and make recommendations for controlling occupational health and safety risks in the implementation of nursing at the "X" Hospital emergency department. The research method used was observational and cross sectional. The risk management process refers to AS / NZS 4360: 2004 standards. Risk identification through observation and interviews with nurses in emergency departments, documentation studies and making hazard identification with Job Safety Analysis. Risk analysis with semi-quantitative analysis uses the formula from William T Fine in the form of valuation of Consequence, Exposure and Probability. The highest residual risk value is 90 substanstial categories, namely at the risk of being pierced by a needle that has been used in patients when inserting needles in an infusion that has an impact on contracting a patient's disease. Risk management has been implemented, but improvements are still needed. The recommendations given are periodic health screening programs, regular exercise programs, supervision of the use of Personal Protective Equipment (PPE), as well as creating occupational safety and health guidelines for nurses in emergency departments. Keywords: risk management, occupational health and safety, nursing implementation, emergency department 396 RISK ASSESSMENT AND RISK CONTROL IN CENTRAL STERIL SUPPLY DEPARTMENT AT HOSPITAL “X”, SURABAYA CITY Yulia Purnawati1, Mulyono2 Occupational Health and Safety Department, Public Health Faculty, Airlangga University 2 Occupational Health and Safety Department, Public Health Faculty, Airlangga University [email protected], [email protected] 1 The Central Sterile Supply Department (CSSD) is an infection control unit and plays a role in suppressing infections. Every steps of work in the sterilization process there are potential hazards that can cause work accidents and occupational diseases. Therefore, it is necessary to conduct a risk assessment to determine the dangers of Central Sterilized Supply Department (CSSD). The purpose of this study is to conduct a risk assessment and control efforts at the Central Sterilized Supply Department, X Hospital in Surabaya City. This research was conducted by observational with cross sectional design. Observations and interviews were conducted to employees and supervisors. Research variables are type of work, potential hazard, hazard risk, risk assessment, risk control. The results of the identification of hazards, showed that there are 17 potential hazards that can cause 22 risks. Risk assessment carried out obtained a risk level of 50% substantial, 27% priority 3 risks and 23% acceptable risks. Some risk control has been carried out, but it is less than optimal so that there is still the potential risk of hazard. The conclusion is that 50% substantial and 27% priority 3 risks so overall control efforts need to be done as soon as possible to reduce the risk. The advice can be given is the realization of risk control, risk assessment regularly, procurement of PPE in accordance with the work conditions and safety inspections directly. Keywords : risk assessment, CSSD, hazard, PPE 413 RELATIONSHIP BETWEEN MONOTOMY MOVEMENT AND TIME PRESSUREWITH BURNOUT DISEASE OF WORK COMPLAINT ONBAG CONVECTION WORKER Puji Astusi 1, Muhammad Rizky F.2, Friska Ayu3 Bagian Prodi S2 Keperawatan Fakultas Keperawatan dan Kebidanan Universitas Nahdlatul Ulama Surabaya 2 Bagian Prodi S1 Ilmu Kesehatan Masyarakat Fakultas Kesehatan Universitas Nahdlatul Ulama Surabaya 3 Bagian Prodi D4 Kesehatan dan Keselamatan Kerja Fakultas Kesehatan Universitas Nahdlatul Ulama Surabaya [email protected] 1 Baggage handling workers in Tanggulangin still found problems related to burnout disease of work, among others, there are 3 workers (30%) in the cutting section stated burnout disease of work and 7 workers (70%) in sewing section stated burnout disease of work (Primary Data, 2018). Complaints of burnout disease of work commonly complained of pain in the shoulders and back, headache, and the body felt shaky, this study aims to analyze the relationship between monotomy movement and time expossure with burnout disease of work complaint in the bag convection.The design of this research is analythic with cross sectional approach and the population of this research are 45 people and the sample are 40 respondents taken with accidental sampling technique with independent variable that is monotomy movement and time expossure and dependent variable that is burnout disease of work complaint. The instrument of this study used REBA and RULA questionnaries, as well as subjective questionnaries of burnout disease of work/IFRC.The result showed that most of the workers had medium category monotomy movement (70%), time expossure during 6,963 hours and medium category of burnout disease of work complaint (67,5%). The result of Spearman Rank Test shows that the relationship of monotomy movement and time expossure with burnout disease of work complaint has P-Value equal to 0,001<α = 0,05 so there is a relationship between monotomy movement and time expossure with burnout disease of work complaint.The conclusion of this study is the higher the rate of monotomy movement and time expossure then also the higher of burnout disease of work complaint. The suggestion for the owner is to redesign the work environment and add ventilation, AC, or exhaust fan. It is recomended for workers to stretch the muscles before working and make good use of rest time. Keywords: Burnout Disease of Work 393 THE EFFECT MANUAL HANDLING ON LOW BACK PAINT COMPLAINTS IN CONVENTIONAL BAGS TANGGULANGIN Permadina Kanah Arieska, Faizatus Sholihah, Wiwik Afridah Universitas Nahdlatul Ulama Surabaya [email protected] Low back pain is one of the muscolesceletal disorders in the back of the body that can occur in the workplace both in the formal and informal sectors. One worker at risk is a bag worker who works with manual handling. This study aims to determine the effect of manual handling execution on low back pain complaints on production workers in convection bag area Tanggulangin Sidoarjo. The design of this study is an analytical survey with cross sectional design and this population as much as 52 people and a sample of 46 respondents. Sampling technique of this research is cluster sampling with independent variabel of manual handling implementation and dependent variable that is low back pain complaint. Instruments in study is LMM observation sheet and questionnaire of VAS pain with using is Spearman Rank Test. Spearman Rank test results showed the influence of manual handling implementation of low back pain P-value 0,007 <α = 0,05, so there is a significant influence between the implementation of manual handling of low back pain complaints. The concluded of this study is the higher the implementation of manual handling will be followed the higher complaints of lower back pain workers.advice for the owners is to redesigning work environment and give a handle on the material to be lifted by the worker. And sugestions for workers is to control the movement, pay attention to the correct way of lifting, sitting position to stretch the mucles. 388 RELATION OF REPETITIVE MOTION FREQUENCY AND LENGTH OF WORK BY HAND WITH CARPAL TUNNEL SYNDROME COMPLAINTS (Case Study in Bag Convection Workers at Tanggulangin) Wiwik Afridah, Nurachmawati Meindah Sari , Agus Aan Adriansyah Department of Public Health, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] Bag convection workers at Tanggulangin in the production process are found to do in repetitive motion and length of work by hand who causing Carpal Tunnel Syndrome (CTS) complaints. This study aims to analyze the relation between the repetitive motion frequency and length of work by hands with CTS complaints on bag convection workers. The design of this study is an analytical survey with cross sectional. The population of this study is 45 people with a sample of 41 respondents. Sampling technique is using Simple Random Sampling. The research instrument used carpal tunnel syndrome questionnaire, observation sheet, and stopwatch. Data analysis conducted by Kendall Tau statistic test. The results of research showed that almost all (75.6%) convection bag workers experienced repetitive movements >10 movements/min, most (73.2%) using hands with working length >4 hours/day, and almost half (41.5 %) have complaints of severe CTS. Kendall Tau test result shows that there is a significant correlation between frequency of repeated movement with CTS complaint (0,016 <0,05) and there was significant correlation between length of work using hands with CTS complaint (0,001 <0,05). The higher the frequency of repetitive motion and length of work by hand, the more likely it is to increase carpal tunnel syndrome complaints. Bag convection workers over limit the frequency of repetitive motion and length of work by hand and stretching on the sidelines of work so as not to endanger health and not harm the company in terms of cost and work time in the future. Keywords: Carpal Tunnel Syndrome 385 DOES E-HEALTH REDUCE PATIENT DELAYS IN HEALTHCARE?: A CROSS SECTIONAL STUDY AT OUTPATIENT OF WONOKROMO PUBLIC HEALTH CENTER IN SURABAYA Nurul Jannatul Firdausi 1, Niken Maretta Fikasari 1, Puji Astuti2 Public Health Program, Health Faculty, Universith of Nahdlatul Ulama Surabaya 2 Master of Nursing Program, Nursing and Midwifery Faculty, Universith of Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] 1 Abstrak: Wonokromo Public Health Center (PHC) has been using E-Health since 2014 but the problem of waiting time in outpatient still occurs. The aims to determine relationship between registration method and queuing time at outpatient of Wonokromo PHC. Study design was analytic observational with cross sectional approach. Population was patient visited to outpatients which visit rates each month were 2902 patient. Study was conducted in May 2018 and involved 70 respondents . Respondents were selected using simple random sampling technique. Data analysis used chi square test. E-health users were 42.9%. Average of total time by E-health users were 43 minutes 14 seconds. Average of waiting time 39 minutes 31 seconds to entered into outpatient room. Queue time for E-health users in outpatient (33.3%) was more than the standard time (≤ 25 minutes). The registration method and queu time were significantly and fairly strong (p-value 0.001 <α = 0.05; C = 0.326). Patients using manual registration method had queue time of 2.82 times longer than those using e-health registration method (OR = 2.82). Registration by E-health shortens queue time in outpatient. The main reason for the long queue times for E-health users is to wait for enter to outpatient room. Keywords: E-Health, Queue, Public Health Center, Outpatient 417 IDENTIFICATION DISASTER WILDFIRE MANAGEMENT OF HAJI SURABAYA GENERAL HOSPITAL Muslikha Nourma Rhomadhoni, Trendyk Rojab Ashari, Khairiyatul Afiyah Department of Public Health, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] Wildfire is an uncontrollable fire that extends and can cause damage. incidence of loss of life and property. Wildfire incidents can occur anywhere including in Haji General Hospital building Surabaya. Hospitals categorized in class 9a buildings must meet technical specifications such as those described in Mentei PU Regulation no. 26 PRTM2008. The researcher aims to identification the application of wildfire disaster management in the hospital. This research method is descriptive qualitative research with observasional Researcher will conduct observation, interview with respondent from hospital side and learn through available document. The results of this study found that the hospital already has and implement SOP for wildfire prevention, wildfire prevention facilities, life-saving infrastructure, wildfire prevention personnel, wildfire fighting education and training, wildfire inspection and maintenance equipment. The conclusion from the research that the management of fire prevention at Haji Surabaya General Hospital is appropriate. It is advisable for hospitals to fulfill wildfire extinguishers and inadequate lifesaving facilities, providing educators with wildfire fighting training twice a year. Keywords: Wildfire Management 409 THE EXPERIENCE OF TYPE 2 DIABETES MELLITUS PATIENTS ON BPJS PROLANIS IMPLEMENTATIONS Rusdianingseh, Nety Mawarda Hatmanti Universitas Nahdlatul Ulama Surabaya [email protected]; [email protected] The Chronic Disease Management Program (PROLANIS) is a management of chronic diseases including diabetes mellitus and hypertension in patients who are participants of BPJS Health to prevent complications, improve quality of life and fund health insurance effective and efficient. This study aims to determine the meaning of the experience of type 2 diabetes mellitus patients on BPJS Prolanis implementations. This study uses qualitative research methods with descriptive phenomenological study approach. Data collection was conducted by in-depth interviews with seven participants. Data collected in the form of interview records and field notes. The results of verbatim transcripts were analyzed using the Colaizzi method. The result of this research is to produce seven themes: understanding about prolanis BPJS, physical response to BPJS prolanis, psychosocial response to BPJS prolanis, adjustment of participant schedule, participant difficulties in the implementation of BPJS prolanis activities, family support for participants in projected BPJS and health personnel support (nursing services). Keywords: Experience, type 2 diabetes mellitus, BPJS Prolanis 386 RELATION OF ILLUMINATION WITH EYES FATIGUE TOWARD SANDAL WORKER WEDORO HOME INDUSTRY, WARU, SIDOARJO Islachul A’mal1, Handayani2, Permadina Kanah Arieska1 Public Health Program, Health Faculty, University of Nahdlatul Ulama Surabaya 2 Medical Program, Medical Faculty, University of Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] 1 Eyes fatigue or astenopic often occur in some industrial or company. Generally, eyes fatigue happen because of the illumination not appropriate with the standard. The objectives of this research are to know the illuminate condition, worker’s eyes fatigue, and analyze the relation of illumination with eyes fatigue to sandal worker Wedoro home industry, Waru, Sidoarjo. This research used method analitical survey with cross sectional study. Technical to took the samples use total sampling. The populations and the samples are 40 workers. The variables are illumination and eyes fatigue. Instruments of this research are lux meter and subjective fatigue quetionnaire. This reasearch used chi square test. The results with chi square test showed, signification or sig (2-sides) 0,021 < α (0,05). Based on the results, the hipotesist unacceptable and it explain there was a relation between illumination with eyes fatigue to sandal worker Wedoro home industry, Waru, Sidoarjo. The conclusion, (82,1%) workers have eyes fatigue because of the illumination unappropriated with the standard. The solutions to solve the problem, an industrialist need to make batter condition on working area with add more lamps and subtitute a part of the roof with more transparent. Keywords: illumination, eyes fatigue, home industry 420 RISK ASSESSMENT IN LAUNDRY WORKER AS A CONTROL OF ACCIDENT AND OCCUPATIONAL DISEASES AT HOSPITAL “X” SURABAYA 2018 Siti Asiah1, Mulyono2 Departement of occupational health and safety, Public Health Faculty, Airlangga University, Surabaya, Indonesia 2 Departement of occupational health and safety, Public Health Faculty, Airlangga University, Surabaya, Indonesia [email protected], [email protected] 1 Laundry workers at the hospital are at risk of exposure infectious blood and bloody fluids, needle stick injuries, and non-ergonomic working position. The main aim of this study was to conduct risk assessment on laundry workers as an effort to control accidents and occupational diseases in RS. X Surabaya. This research was an observational study with cross sectional and descriptive analysis. The subjects were 38 laundry workers. Primary data were collected by JSA (Job Safety Analysis) worksheet then performed risk assessment by determining Likelihood (L), Consequence (C), and Exposure (E). The results of the study there were found 47 risk, with priority 1 level 4 (8.51%), substantial level 21 (44.69%), priority 3 level 11 (23.40%) and acceptable level 11 (23.40%). Risk controls that have been implemented by the hospital are to engineering control, standard operating procedures, and provide personal protective equipment for work. The recommended of this study are to conduct inspection of worker compliance in the use of personal protective equipment, how to set up ergonomic working position and periodic health inspection. Keyword: Laundry worker, risk assessment, risk control. 416 RELATIONSHIPBETWEEN STRESS AND WORK PRODUCTIVITY OF EMPLOYEE IN BAG CONVECTION IN KEDENSARI VILLAGE Nur Hidaayah 1, Henggar Kusuma Putra 2, Nurul Jannatul Firdausi3 1 Bagian Keperawatan Universitas Nahdlatul Ulama Surabaya 2 Prodi S1 Ilmu Kesehatan Masyarakat Universitas Nahdlatul Ulama Surabaya 3 Bagian Prodi S1 Ilmu Kesehatan Masyarakat Universitas Nahdlatul Ulama Surabaya [email protected] The results of the initial survey conducted by researchers on 10 workers, as many as 70% of workers experienced burnout and 50% workers experienced uncomfortable complaints in the work caused by the target work and a cramped working environment. Complaints of saturation and uncomfortable in work caused by job target and cramped working environment cause symtptoms of work stress felt by convection workers. The ains of study is of this research is to ascertain relation of stress and work productivity of employe in bag convection in Kedensari Village, Tanggulangin Subdistrict, Sidoarjo Regency. Analytical survey method with sample cross sectional design, the study involved 39 workers responden of 42 workers population of convection. Independent variable of work stress, dependent variable of work productivity. The instrument used the questionnaire of stress and the observation sheet with spearman rank correlation test. The test result of spearman rank correlation test, it is known that the significance value or sig (2tailed) equal to 0.001 with significance level a 0.05. Obtained sig (2-tailed) 0.001 a 0.05 which means H0 is rejected and indicates that there is a relationship between job stress with work productivity at the convection bag employee in Kedensari Village, Tanggulangin District, Sidoarjo Regency. Conclusion from the researcher that the increasing level of work stress will increase the productivity of work produced by workers. It is advisable to the owners of the company to better monitor and pay attention to the work process of its workers in order to reduce the level of worker's perceived stress and the creation of a comfortable work process. Keywords: work stress 398 THE RELATIONSHIP BETWEEN WORKLOAD WITH WORK STRESS ON VACCINATION SERVICE OFFICER IN SURABAYA FIRST CLASS OF PORT HEALTH OFFICE (KKP) 1 Yanis Kartini 1, Hafifatus Sa’diyah 2, Nurul Jannatul Firdausi2 Departement of Nursing and Midwifery, Nahdlatul Ulama University, Surabaya, Indonesia 2 Departement of Public Health, Nahdlatul Ulama University, Surabaya, Indonesia [email protected], [email protected], [email protected] The increased patient visits will have an impact toward workload of the officer. This research aims to analyze the relation between workload with work stress on vaccination service officer in Surabaya first class of Port Health Office (KKP). The research design used analytic observational with cross sectional approach. Populations of this research are all of vaccination officer in KKP which divided in 2 place for 14 respondents at KKP Perak and 20 respondents in KKP Juanda with simple random sampling technique. Instrument of data collection using questionnaire and observational sheet. Data were analyzed used chi-square test with α = 0,05. The result showed almost all of respondents have low workload (91,2%) and most (73,5%) have low work stress. Chi-square tests result has significance of Fisher’s exact test 0,014 < 0,05 meaning H0 rejected, so that it can be concluded that there is a significant relation between workload with work stress on vaccination officer. The conclusion of this research is the lower workload of officers the higher worker’s stress and otherwise. So need for effective self management if there is a high workload so that it can be controlled effectively and still provide good service and maintain the comfort of patients. Keywords : Workload, Work Stress, Vaccination Service 382 RELATION BETWEEN WAITING TIME OF PRESCRIPTION SERVICE AND SATISFACTION OF BPJS OUTPATIENTS AT INSTALLATION PHARMACY 1 OF ISLAMIC HOSPITAL JEMURSARI SURABAYA Muhmmad Fakhri1, Ima Nadatien2, Agus Aan Adriansyah1 Public Health Program, Health Faculty, University of Nahdlatul Ulama Surabaya 2 Stratum of Nursing Program, Nursing and Midwifery Faculty, Universith of Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] 1 The waiting time for prescription service did not meet the requirements of Minimum Service Standard (MSS) with obtained value of 75.43% causing patients complaint at the hospital. Aim of this study is to know the relationship between waiting time of prescription service and satisfaction of BPJS outpatients at Installation Pharmacy 1 of Islamic Hospital Jemursari Surabaya. This study used an analytical survey design with cross sectional approach. Instrument used in this study are questionnaire and checklist sheet. The population of outpatients were 9,280 with 99 outpatient BPJS were studied. The variables study were waiting time and patient satisfaction. Data analysis using chi square test with Alpha 0.01. The result showed, almost all respondents (80.8%) satisfied with the prescription service on Installation Pharmacy 1 Islamic Hospital Jemursari Surabaya. Almost all respondents (90.8%) received non-prescribed prescriptions with waiting time not meet the requirements of Minimum Service Standard (MSS). Based on Chi-square test analysis obtained significant value of 1,000 which mean there is no significant relationship between waiting time for prescription service and satisfaction of outpatients BPJS in Islamic Hospital Jemursari Surabaya. The conclusion of this study is the closer of waiting time for prescription service meets the requirement of the standard will get satisfaction of respondent more. However, there are some of outpatients who feel satisfied even the waiting time for prescription service is not meets the requirement of MSS. Suggestion for the hospital, the additional service counters especially for outpatients who leave the medicine on that day therefore the service will not slow down on the next day. Keywords: waiting time, patient satisfaction, installation pharmacy 383 THE EFFET OF WORK POSITION AND MONOTON MOVEMENT TO MUSCULOSKELETAL DISORDER (MSDS) COMPLAINT AT PETIS WORKER IN SEKARDANGAN AREA SIDOARJO 2018 1 Friska Ayu 1, Anisgupta Larasaty Favurita2 Bagian Prodi D4 Kesehatan dan Keselamatan Kerja Fakultas Kesehatan Universitas Nahdlatul Ulama Surabaya 2 Public Health Program, Health Faculty, University Of Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] Material manual handling (MMH) such as work position and monoton movement can caused sress into physical condition of workers, if done repeatedly will cause of MSDs. Petis worker is the one of occupation or work has risk of Musculoskeletal Disorder (MSDs) disability. The aims research is to know the effet of work position and monoton movement with Musculoskeletal Disorder (MSDs) complaint at petis worker in Sekardangan area Sidoarjo. Design of this research using cross sectional study with 30 of sampel was taken by accidental sampling. Primary data was collected from observation and interview with respondent. The work position was collected was observed by RULA, monoton movement was observed by RUBA, and Musculoskeletal Disorder (MSDs) complaint was observed by NBM. Analysis data using chi-square and logistic binary regression with significant score α = 0,05. This research showed a majority of workers have MSDs complaint, based on chi-square it show there is effect between work position with MSDs complaint (0,037) and there is effect between monoton movement and MSDs complaint (0,031). Analysis data using logistic binary regression show there is no effect between work position (0,231) and monoton movement (0,196) with MSDs complaint. Recommended for the owner of petis factory worker organizing like job rotation every 3 months to decrease Musculoskeletal Disorder (MSDs) complaint which resulted work position dan monoton movement. Keywords : work attitude, monoton movement, and musculoskeletal disorder (MSDs) complaint 381 RELATIONSHIP OF PPE AND SMOKING WITH THE INCIDENCE OF ARY SYMPTOMS IN VEHICLE PAINTING WORKERS AT PENGENAL STREET SURABAYA Farah Saraswati1, Nurul Kamariyah2, Satriya Wijaya1 Departement of public Health Program, Nahdlatul Ulama Surabaya University 2 Faculty of Teacher Training Education, Nahdlatul Ulama Surabaya University [email protected], [email protected], [email protected] 1 Acute Respiratory infection (ARI) is a public health problem that has a big impact because it can be a trigger for the development of more dangerous diseases. The purpose of this study was to analyze the relationship of PPE and smoking with the incidence of ARI symptoms in vehicle painting workers at Pengenal Street Surabaya. The research design was analytical with cross sectional approach. The study was conducted 41 vehicle painting workers at Jalan Pengenal Surabaya. The sample used is 39 samples with Simple Random Sampling technique. Instruments using the APD questionnaire, smoking and symptoms of ARI. Data analysis using SPSS program with chi square test, found value of E <5 in table so that result is fisher's exact test. The results showed almost all workers did not use PPE (84.6%) and most workers smoked (61.5%) while working. Most of the workers had ARI symptoms (64.1%). Obtained pvalue of APD (0,016) and smoking (0,019) <α, which means H 0 rejected, there are significant relation between APD (0,016) and smoking (0,019) with incidence of ARI symptoms in vehicle painting workers at Pengenal Street Surabaya. The conclusions of the study, there are the relationship of PPE and smoking with the incidence of ARI symptoms in vehicle painting workers at Pengenal Street Surabaya. Suggestions for workers are motivated their self and need to access them from the environment and colleagues to always use PPE and not smoke while working. For the owner of the workshop about providing PPE masks and posters about PPE, the dangers of smoking and the dangers of ARI. Keywords: PPE, smoking, symptoms of ARI, vehicle painting. 384 RELATION OF SERVICE WAITING TIME WITH BPJS PATIENT SATISFACTION IN ON OUTPATIENT IN RUMAH SAKIT ISLAM AHMAD YANI SURABAYA Agus Aan Adriansyah1, Veronica Juniarti Putri1, Firdaus2 Departement of Public Health, Health Faculty, Nahdlatul Ulama Surabaya University, Jemur Sari Street 51-57, Surabaya, Indonesia 2 Diploma of Nursing Program, Nursing and Midwifery Faculty, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] 1 Satisfaction has high relation with quality service in hospital. The effort which could did to make increasing patient's satisfaction is improve the service waiting time. Aimed of this research is to analyze the relation of service waiting time with patient's BPJS satisfaction on care polyclinic in Rumah Sakit Islam Ahmad Yani Surabaya. This research used design analytical survey with cross sectional study. The populations in this study amounted to 226 with samples are 88 respondents. The sampling technique used stratified sampling. The instruments used questionnaires and observation sheet with chi square test. The results showed, most (69.3%) of BPJS patients were satisfied. While in waiting time, almost all of them (97.7%) have service waiting time are not appropriate with the standard (≥ 60 minutes). The result of chi square test showed, there was no significant relation between service waiting time and patient satisfaction with fisher's exact test value 1,000 (> 0,05). Conclution of this research is service waiting time not be a reason of patient's satisfaction. Base on this study, the researcher recommended to minimize the service flow, to improve the service quality especially on the tangible dimension, repair the registration machine and placement of officers around the registration machine. Keywords: Service waiting time, patient satisfaction, BPJS 390 SYSTEM ANALYSIS OF HEALTHCARE-ASSOCIATED INFECTIONS (HAIS) SURVEILLANCE IN RSUD SIDOARJO Dwi Handayani1, Nailul Masruroh2, Umdatus Soleha3 Department of Public Health, Nahdlatul Ulama Surabaya University, Jemur Sari Street 51-57, Surabaya, Indonesia 2 Department of Public Health, Nahdlatul Ulama Surabaya University, Jemur Sari Street 51-57, Surabaya, Indonesia 3 Bachelor of Nursing Program, Nursing and Midwifery Faculty, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] 1 Healthcare-associated Infections (HAIs) is an important problem worldwide. The impact that can be generated from HAIs is increasing morbidity and mortality, increasing health costs. Problem HAIs in RSUD Sidoarjo is also still often found. Efforts to control HAIs through surveillance activities become an important thing to do, considering the incidence of HAIs is one of the benchmarks of Minimum Service Standard hospital. The purpose of this study is to determine the workflow, identify problems and provide the alternative solution related to problem HealthcareAssociated Infections (HAIs) surveillance in RSUD Sidoarjo. This study is a qualitative research with observational design, in RSUD Sidoarjo year 2018. Data obtained from in-depth interview and FGD with PPI team. Data in this study was analyzed descriptive and presented narrative. Results showed that the workflow of HAIs Surveillance in RSUD Sidoarjo are collecting of data patient and collecting the supporting data, processing and data analysis, and dissemination the information. The problem of HAIs surveillance in RSUD Sidoarjo are number of IPCN is not proportional to the number of beds, data collection often occurs processing delays and data analysis has not been carried out epidemiologically (based on the variables of place and person), and no feedback has been made. The resulting information is limited to the percentage of infections. HAIs surveillance system in RSUD Sidoarjo implementation is still not optimal, because there are problems in the input, process and output components. Alternative solution from this study is that leaders need to add full-time IPCN in accordance with the regulations of the Minister of Health of the Republic of Indonesia and need to establish a reminder and monitoring system for data collection to avoid delays in collecting data. Keywords: Surveillance, Healthcare-Associated Infections, System approach (input, process, output) 397 FACTORS WHICH HAS RELATION WITH SICK BUILDING SYNDROME (SBS) COMPLAINT TO THE WORKERS IN PT. X AT GRESIK ON 2018 1 Lutfatin Taufiqoh 1, R. Khairiyatul A2, Friska Ayu1 Nahdlatul Ulama Surabaya University, Jemur Sari Street 51-57, Surabaya, Indonesia 2 Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] Sick Building Syndrome (SBS) complaint is one of the complaints related to working environtment conditions such as poor ventilation system and the hot working environment resulting from the production machines. These conditions can be caused discomfort and reduce the health condition of the workforce. This gripe is caused by several factor like as individual factor, work factor, and environment factor. The aims from this study is to analysis the factors which has relation between Sick Building Syndrome (SBS) complaint to the workers in PT. X at Gresik on 2018. This research used analytical survey with cross sectional study, with 40 respondent was taken by total population. Independent variabel are individual factor (age, smoke habit) work factor (work’s period, length of work, work’s shift) and Sick Building Syndrome complaint. Information about characteristicresponden was taken by interview to the worker’s and sick building syndrome complaint. Results of the Chi-Square test showed, there was a relation between individual factor age (p=0,009), smoke habit (p=0,0162), and work faktor like as work’s period (p=0,006), leght of work (p=1,000), and work’s shift (p=0,522) with Sick Building Syndrome complaint to the workesr in PT. X, at Gresik on 2018. The conclution of this research is there are therelationship between, smoking habit, and work period with Sick Building Syndrome (SBS) complaint to the workers in PT. X at Gresik on 2018. Suggested to the workforce to do relaxational and the began to feel Sick Building Syndrome (SBS) complaints and to reduce smoke habit to make health. Keywords: sick building syndrome, age, smoke habit, work’s period. 389 RELATIONSHIP THE QUALITY OF HEALTH SERVICES WITH INTEREST OF RE-VISIT ON OUTPATIENT IN GENERAL POLYCLINIC IN RUMAH SAKIT ISLAM AHMAD YANI SURABAYA Farida Umamah1, Nurvah Lifia Muhamad2, Agus Aan Adriansyah2 Diploma of Nursing Program, Nursing and Midwifery Faculty, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia 2 Departement of Public Health, Health Faculty, Nahdlatul Ulama Surabaya University, Jemursari Street 51-57, Surabaya, Indonesia [email protected], [email protected], [email protected] 1 Interest in patient visits in a hospital is closely related to the quality of health services. Quality of health services that are not in accordance with the expectations of patients is a problem that leads to complaints of patients in a hospital. The purpose of this research is to know the relation of quality of health service with interest on outpatient visit at RSI Ahmad Yani Surabaya. The research used analytic observational survey, cross-sectional method, and research instrument in the form of questionnaire. Sample of 80 out of 390 patient population in Outpatient Installation at Polyclinic RSI Ahmad Yani Surabaya. The independent variable is the quality of health service, the dependent variable is the interest of the patient's re-visit. Analysis in this research using chi-square test. The results showed almost all respondents assessed that the quality of health services in accordance with what they expect in the Outpatient Installation service in the polyclinic of RSI Ahmad Yani Surabaya. The interest of the visit shows that almost all respondents are interested to return to the outpatient installation at RSI Ahmad Yani Surabaya, H1 is accepted, meaning there is no relation between quality of health service with interest of outpatient visit in RSI Ahmad Yani Surabaya. It is advisable for hospitals to add comfortable and ergonomic waiting chairs as well as improvement of RSI Ahmad Yani Surabaya facility. Keywords : Quality of health service, outpatient, interest of re-visit 421 EFFECTIVENESS OF BREAST MILK PUMPS: CASE STUDY ON WORKING MOTHERS Uke Maharani Dewi, Yunik Windarti Universitas Nahdlatul Ulama Surabaya The breastfeeding mother who returns to work after childbirth has the responsibility to complete exclusive breastfeeding for six months. The way it is done is the expression of breast milk in the workplace. Limited time for breastfeeding expression among busy jobs needs to be supported by efficient and effective breastfeeding pumps. The purpose of this study was to compare the volume of breast milk expressed (VBM) with manual (MP) and electric pumps (EP). The study lasted for two months (September-November 2017) by using purposive sampling as much as 40 respondents. The criteria for respondents used in this research were working mothers who were expressing breast milk at work at 09.00-10.00 WIB (after breakfast), data taken as much as five days milking mother's milk, the length of time milking mother's milk was 30 minutes , infants aged 1-6 months, babies are given breast milk only without other complementary foods. The specified job criteria are mothers who work outside the home (separate from their babies) for a maximum of ten hours. Statistical analysis showed there is a difference in the volume of breast milk (p = 0.01 <0.05). Several factors that influence differences in breast milk volume include: maternal age (p = 0.023), parity (p = 0.016), type of work (p = 0.044), previous breastfeeding experience (p = 0.037), infant age (p = 0.261). In accordance with the results of this study, mother was working with a limited time to express breast milk can choose to use the electric pump. Some of the complaints as a result of the use of breast milk pump can be used as consideration in choosing a breast milk pump. Things to consider to minimize the complaints against the usage breast milk pump is understanding right about the use, care and alternative solutions in handling complaints can be extracted from the experience of other users or from the research results. Keywords: working mother, breast milk pump, breast milk volume. 402 RELATIONSHIP OF JOB FACTORS WITH EXCELENCE SERVICES (SERVICE EXCELLENCE) EMPLOYEES AT THE HEALTH CENTER WONOKROMO SURABAYA Umdatus Soleha, Qoni’ Rizqiyati Sa’idah , Muslikha Nourma Romadhoni Department of Public Health, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] Puskesmas Wonokromo strives to provide quality health services. Based on the preliminary survey conducted on 10 people, 50% of patients complained about the lack of clarity of information about the patient's disease, 40% of patients complained about the speed of health center staff service is less effective and less friendly in providing services, 50% of patients state complaints about inadequate physical facilities. The research method uses quantitative methods with a Cross Sectional approach. The population is 36 employees, a sample of 33 employees of the Wonokromo Surabaya Health Center. Data collection with questionnaires and observation of service delivery of employees to patients using checklish sheets, with Spearman rank correlation test. The test results show there is a significant relationship between the variety of skills (p = 0.016), task identity (p = 0.016), feedback (p = 0.016), with a significant level of α = 0.05, so H0 is rejected meaning there is a relationship between skills, task identity, feedback with Excellence service. While the results of the test of task significance (p = 0.103), autonomy (p = 0.103) with a significant level of α = 0.05, H0 was accepted, meaning that there was no relationship between task significance, autonomy and Excellence service of Wonokromo Surabaya Health Center employees. The conclusions from the study are that the higher the level of expertise, task identity, good feedback can improve Excellence service. It is recommended that the Wonokromo Surabaya Public Health Center to establish internal agreements related to the added value of each element of service in standard operating procedures so that the creation of Excellence services Keywords: service excellence, employee, occupational factors Puskesmas 425 RELATIONSHIP OF MOTIVATION AND JOB SATISFACTION WITH EMPLOYEE PERFORMANCE OF INSTALLATION UNIT NGAGEL PDAM SURYA SEMBADA SURABAYA CITY Habibah Faiqotun Ni'am1, Fritria Dwi Anggraini2, Nur Amin3 Program Studi S1 Ilmu Kesehatan Masyarakat Fakultas Kesehatan Universitas Nahdlatul Ulama Surabaya 2 Program Studi DIII Kebidanan Fakultas Keperawatan dan Kebidanan Universitas Nahdlatul Ulama Surabaya PROGRAM STUDI ILMU KESEHATAN MASYARAKAT FAKULTAS KESEHATAN UNIVERSITAS NAHDLATUL ULAMA SURABAYA [email protected] 1, 3 Performance is result of work achieved someone according to the task and responsible has been determined in the company. Low of employees performance caused some factors like motivation and job satisfaction. This research was conducted to determine relationship of motivation and job satisfaction with employee performance of Installation Unit Ngagel PDAM Surya Sembada Surabaya City. The design of this research is analytic research with cross sectional approach. Population in this research si employees of Installation Unit Ngagel PDAM Surya Sembada Surabaya City, in June 2018 amounted to 97. The sample size is 43 samples with simple random sampling method. Data were collected through questonnaires and camera. Data analysis was done with rank spearman correlation. Result of research showed almost entirely (90,7%) respondent have high motivation, almost entirely (88,4%) respondent have high job satisfaction, and high performance (88,4%). The result of rank spearman correlation obtained relationship between motivation with employees performance with ρ value 0,011, and there is no significant between job satisfaction with employees performance with ρ value 0,546. Conclusion of this research is there is significant relationship between motivation with employees performance and there is no significant relationship between job satisfaction with employees performance. Suggestions for companies about motivation and job satisfaction so that produce high performance for example reward for employees achievement and infrastructure adequate for employees. Keywords: motivation, job satisfaction, employee performance 410 STUDY OF PATIENT’S HOSPITALIZE SATISFACTION WITH HOSPITAL CONSUMER ASSESSMENT HEALTHCARE PROVIDERS AND SYSTEM (HCAHPS) APPROACH IN ISLAMIC HOSPITAL SITI HAJAR SIDOARJO Dewi Ratna Sari 1, Eppy Setiyowati 1, Muslikha Nourma Rhomadhoni2 Public Health Program, Health Faculty, Universith of Nahdlatul Ulama Surabaya 1 Master of Nursing Program, Nursing and Midwifery Faculty, Universith of Nahdlatul Ulama Surabaya 2 Occupational Health and Safety Diploma, Health Faculty, Universitas of Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] 1 The level of patient / family satisfaction of inpatients in 2017 at the Siti Hajar Islamic Hospital in Sidoarjo has not met the target, because it has not reached 90%. Hospital Consumer Assessment The Healthcare Providers And System (HCAHPS) is a method of measuring patient satisfaction based on all aspects of the hospital. The research objective was to describe the satisfaction of inpatients through the HCAHPS approach at the Siti Hajar Islamic Hospital in Sidoarjo. This type of research is quantitative descriptive. The population was 690 inpatients. Patients taken as many as 77 respondents. The sampling technique in this study uses simple random sampling. Data processing techniques and data analysis were performed using descriptive statistical tests. The variables of this study are patient satisfaction through the Hospital approach Health Assessment Provider And System Healthcare (HCAHPS). The results showed patient satisfaction based on HCAHPS indicators that met the target of achieving patient satisfaction at the Siti Hajar Sidoarjo Islamic Hospital by 90%, namely only in the component of physician communication that is 90.9%. Whereas those who did not meet the target achievement of patient satisfaction at the Siti Hajar Sidoarjo Islamic Hospital were the drug information component of 48.1%. The conclusion is that meeting the target of patient satisfaction at the Siti Hajar Islamic Hospital in Sidoarjo is only the component of physician communication. Whereas those who have not met the target are the drug information component. For the hospital, it is expected that the results of the drug information component can be used as a concern to apply the information points of the drug, which not only convey the time to take the medicine but also the type of drug, function, and side effects. Keywords: Patient Satisfaction, HCAHPS, Descriptive statistical test 394 RELATIONSHIP OF MARKETING MIX WITH OUTPATIENT VISIT IN ISLAMIC HOSPITAL OF SITI HAJAR SIDOARJO Satriya Wijaya, Elsa Eka Favilda, R.Khairiyatul Afiyah Universitas Nahdlatul Ulama Surabaya The decreasing number of outpatient visit level 1 in RSI Siti Hajar Sidoarjo from 2014 - 2017 becomes a problem for hospital. In addition, there is competitive competition with hospitals and other health care facilities in the market. The condition of the decrease in the number of patient visits can be viewed from the marketing mix. This study was conducted to determine whether there is a relationship between the marketing mix (marketing mix) with outpatient visits in Islamic Hospital Sakit Islam Siti Hajar Sidoarjo. The research design used analytic survey method with cross sectional design. The population was 225 patients, so the sample size was 88 patients. The sampling technique using simple random sampling technique. Instruments in this study using questionnaires. The analysis used binary logistic regression test with α = 0,05. Based on the result of marketing mix research in Siti Hajar Sidoarjo Islamic Hospital (71.6%) is good enough and outpatients often visit less when compared with outpatients who do not visit frequently. Statistical test using binary logistic regression test obtained 0,040 significant level <0,05 between marketing mix with outpatient visit. This means there is a relationship between the marketing mix with outpatient visits at the Islamic Hospital Siti Hajar Sidoarjo. The conclusion in this study is the better the marketing mix, the more frequent outpatient to visit. Advice for hospitals to maintain relationships between hospitals and customers and maintain the quality of hospital services. Keywords : Marketing Mix, OutPatient, Hospital 391 RELATIONSHIP OF PERSONAL HYGIENE WITH THE INCIDENCE OF PEDICULOSIS CAPITIS IN FEMALE STUDENTS OF ISLAMIC BOARDING SCHOOL AL-HALIM MIFTAHUL ULA, NGANJUK REGENCY Novera Herdiani1, Allif Fahriyani Masiha1, Fritria Dwi Anggraini2 1 Public Health Program, Health Faculty, University of Nahdlatul Ulama Surabaya 2 Program Studi D3 Kebidanan Fakultas Keperawatan dan Kebidanan Universitas Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] Incidence of pediculosis capitis is quite high, but still often overlooked because it is considered mild and low mortality. One of the factors is personal hygiene. The purpose of this research was to analyze the relationship of personal hygiene with the incidence of pediculosis capitis in female students of Islamic boarding school Al-Halim Miftahul Ula, Nganjuk Regency. The research design was analytical with cross sectional approach. The samples are 56 female students of Al-Halim Miftahul Ula, Nganjuk with Simple Random Sampling technique. Research instruments are questionnaire and observation sheet. The research used chi square test, however in the table is encountered the value of E<5, so we read fisher's exact test result ρ=0.003, ρ < α=0.05 which means that H0 is rejected, there is a relationship between personal hygiene with the incidence of pediculosis capitis with contingency coefficient 0,298 which means the strength of the relations enough. The conclusion, there is a relationship between personal hygiene with the incidence of pediculosis capitis in female students of Islamic Boarding School Al-Halim Miftahul Ula, Nganjuk. The solutions are more maintain personal hygiene, as well as it does the eradication of pediculosis capitis simultaneously on all students and is done routinely. Keywords: pediculosis capitis, personal hygiene, Islamic boarding school 401 THE EFFECT OF WORKING PERIOD, USED OF PPE AND SMOKING HABITS AGAINST SYMPTOMS OF ACUTE RESPIRATORY INFECTION IN LABOR AT PT. X GRESIK IN 2018 Merry Sunaryo1, Mamluatul Humaidah1, Ima Nadatien2 1 Public Health Program, Health Faculty, University of Nahdlatul Ulama Surabaya Stratum of Nursing Program, Nursing and Midwifery Faculty, Universith of Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] 2 Acute Respiratory Infection (ARI) is a health problem affected by several factors such as research, used of PPE, and smoking habits. The longer a person works the more often exposed to the dangers posed by unsafe working environment conditions. Smoking habits can also aggravate the condition of ARI. The reaserch was conducted to determine the effect of working period, used of PPE and smoking habits against symptoms of ARI in labor at PT. X Gresik in 2018. This research uses analytical survey with cross sectional approach. The population is 59 labors with sample 52 sample. The technique used is simple random sampling. This research used binary logistic regression test with independent variable of work period, use of personal protective equipment and smoking habit and symptom of ARI as its dependent variable. Instruments used is a questionnaires. The result of this research is known as 28 labors have a symptom of ARI. The result of binary logistic regression test showed that the working time> 5years (0,017), smoking habit of active smokers category (0,016) and passive (0,017) had value <α (0,05). While the use of Categories APD often (0.777) and rare (0.825) has a value> α (0.05). The conclusion of this study is the working period and smoking habits have an influence on the symptoms of ARI in labor at PT. X Gresik. It is recommended that the company not only provide health checks but also conduct communication, information, and education activities regularly. In addition, there is a need for vigilance for workers with a working life> 5 years to always maintain the condition of the body and a healthy lifestyle. Keywords: Work Period, Smoking Habit, Symptoms of Acute Respiratory Infection (ARI) 429 THE INFLUENCE OF ORGANIZATIONAL PRIDE ON THE PERFORMANCE OF LECTURERS IN HEALTH AT THE NAHDLATUL ULAMA UNIVERSITY IN SURABAYA Ima Nadatien, Seger Handoyo, Widodo J. Pudjiraharjo, Yusti Probowati Universitas Nahdlatul Ulama Surabaya [email protected] Pride is needed in individual motivation and performance, because a person will respond to profitable identities, which are relevant to developing members' psychological sense in the organization, as identification or commitment (Tyler & Blader, 2003). Unusa is a college concentrating on health education programs. Data from Unusa regarding the dharma of conducting research and community service in 2014, found that out of 117 lecturers who had carried out the research, the number had only reached 42.7%, community service was 44.4%. Demonstrating the performance of Unusa lecturers is not optimal. Research objectives, to prove the influence of Organizational Pride on the Performance of Unusa Lecturers. Observational research design, type of explanatory research, using a cross sectional approach. Respondents were 105 lecturers. Independent variables are Organizational Pride. Dependent variables are Lecturer Performance (task performance, contextual performance, adaptive performance, counterproductive work behavior). Data analysis used linear regression test, α = 0.05. The results of the study prove that Organizational Pride influences Lecturer Performance (p = 0.002; b = 0.301). This study shows that Pride of the Organization can play a role in encouraging the increase of Lecturer Performance. The higher the Pride of the Organization ultimately increases the Lecturers' Performance. Efforts to strengthen the pride of the lecturers, individually and in institutions are carried out through training and SGD (Small Group Discussion) with routine. Finally, it will improve and strengthen the sense of love, belonging and loyal to optimize the performance of the tridharma. Keywords: Organizational Pride, Lecturers’ Performance 399 RELATIONSHIP OF WAITING TIME IN SERVICE SYSTEM WITH SATISFACTION QUALITY OF OUTPATIENT SERVICE PATIENT RSU HAJI SURABAYA 1 Wesiana Heris Santy 1, Herdiani Hamdari2, Nurul Jannatul Firdausi 2 Nursing Program, Nursing and Midwifery Faculty, Universitas of Nahdlatul Ulama Surabaya 2 Public Health Program, Health Faculty, University of Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] Waiting time for services is a problem that is still often found in health care practices. Patient waiting time in health services is one of the important things in determining the quality of health services. the achievement of waiting time for outpatient services over the past three years has always experienced a decline which resulted in customer satisfaction with waiting times decreasing. Observational analysis type research with cross sectional approach. The population in this study were 504 people conducted in June 2018 with a total of 155 respondents. The sampling technique uses simple random sampling. Data analysis uses the chi-square test. Almost all (96.7%) have nonstandard time (> 40 minutes). The total time for all services is unproductive 139.52 minutes. The average waiting time in the service system is 152.06 minutes. Most (62.6%) respondents said they were not satisfied. Based on the five dimensions of service quality, the level of satisfaction of outpatients is in the unfavorable category in the tangible dimension. The existence of a relationship between waiting time for patient care in outpatients with satisfaction of the quality of outpatient services at Surabaya Haji Hospital, indicated by the value of P-Value = 0.007. Keywords: Waiting time, outpatient service, satisfaction of service quality 411 FACTORS RELATED TO WORK FATIGUE ON THE OPERATOR OF THE INSTALLATION UNIT NGAGEL 1 PDAM SURYA SEMBADA SURABAYA 1,2 Isna Fitri Nur Rohmah1, Nur Amin2 Public Health Program, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected] , [email protected] Work fatigue is one of the health and safety issues that become a risk factor for work accident. There are several factor causing work fatigue such as nutritional status, nutrient intake, work load and work shift. The purpose of this study to know the relationship of nutritional status, nutrient intake, work load and work shift with work fatigue. This research uses analytic observational with cross sectional approach. Sample 41 with total sampling method. The variables of this research are nutritional status, nutrient intake, work load, work shift and work fatigue. The instrument of this research use interview sheet and questionnaire. The result of statistic test shows that most operators have low work fatigue level at (58.5%), normal category nutrition status (70.7%), light category workload (61,0%), protein intake (53,7%), carbohydrate intake category deficit (51,2%), fat intake category deficit (43,9%) and shift work at shift time III (36,6%). The result of Spearman test showed that work shift (p-value = 0,000) has correlation with work fatigue while nutritional status (p-value = 0,735), carbohydrate intake (p-value = 0,986), fat intake (p-value = 0,742), protein intake (p-value = 0.426), workload (p-value = 0.426) has no relation with work fatigue. Suggestions from this research are there is a need for a canteen in the installation environment to meet deficit nutritional intake and conduct seminars on nutrition every year. Key word : Work fatigue, Operator, Nutritional status, Nutrient intake, Work load, Work shift 400 ANALYSIS OF THE MARKETING MIX RELATIONSHIP TO THE LOYALTY OF PATIENTS IN THE STREET SERVICE UNIT KARTINI HOSPITAL YEAR 2018 Enrico Adhitya Rinaldi Magister Study Program Hospital Administration Universitas Respati Indonesia The hospital is one of the public health service facilities which has a very important role in improving public health. The level of satisfaction of service to customers is an effort to provide services so that they can meet the needs and desires of customers and the accuracy of their delivery to synergize with customer desires. This research method uses a quantitative approach and this research is a descriptive analytic research method using cross sectional design. The sampling technique uses purposive sampling method. The sample of this study were patients at the Hospital Outpatient Clinic. Kartini, numbering 100 respondents. The results of this study indicate that the product marketing mix correlation with patient loyalty has a p value of 0.002 which means there is a significant correlation between the product marketing mix and patient loyalty. The correlation between Price's marketing mix and patient loyalty was positively weak and statistically significant. Place marketing mix with patient loyalty, obtained p value 0.004 shows that there is a significant correlation between Place marketing mix and patient loyalty. Promotion marketing mix correlation with patient loyalty through statistical analysis obtained p value 0.003, so there is a significant correlation between Promotion marketing mix and patient loyalty. People marketing mix with p value 0.008 shows that there is a significant correlation between the People's marketing mix and patient loyalty. Physical Evidence has a positive positive correlation (r = 0.477, p = <0.005). Bivariate analysis was conducted to determine the correlation of marketing mix Physical Evidence on patient loyalty to get a correlation coefficient (r) of 0.477 which means that the correlation between the marketing mix Physical Evidence and patient loyalty is a medium and meaningful positive correlation. Process marketing mix with p <0.004 shows that there is a significant correlation between Process marketing mix and patient loyalty. Suggestions to the management of Kartini Hospital in order to add superior products so that it can be a characteristic for the Outpatient Poly Hospital of Kartini Hospital, such as equipping specialist doctors who do not yet exist so that they can provide complete patient services. Keywords : Marketing, Patient Loyalty, Outpatient 161 THE ROLE OF PATIENT SATISFACTION IN ESTABLISHING PEOPLE EQUITY AMONG MEDICAL STAFF: EXPERIENCE FROM INPATIENT ROOM OF ISLAMIC HOSPITAL IN SURABAYA 1 Sendhi Tristanti Puspitasari1 Public Health Department, Faculty of Sport Science, Malang State University [email protected] Background: Patient satisfaction is the major indicator of quality of care provided by a health facility. While, people equity is a concept of human resource management to improve performance in the organization. This study aims to examine the associated between patient satisfaction and people equity among medical staff especially in inpatient room of Islamic Hospital in Surabaya. Method: This study used primary data through survey on 70 medical staffs (nurses, midwifes) and 128 patients, and secondary data from report in department of public relation, medical services and human resources. The present study focused on the measurement of people equity, the assessment of patient satisfaction and how these influenced the people equity. Questionnaire that used in this study adopted RATER dimension (reliability, assurance, tangible, empathy, responsiveness). Results: The study found that 3 inpatient room (Muzdalifah, Arofah, Shofa) did not meet the 3 elements of people equity (Alignment, Capabilities, Engagement). Patient satisfaction has been achieved well in inpatient room of Islamic Hospital in Surabaya, except on aspect of tangible especially on room cleanliness still relatively low. People equity of medical staff has strong relevance and is directly proportional to patient satisfaction at inpatient unit of Islamic Hospital in Surabaya. Conclusion: Internalizing an organizational culture is essential to harmonize the goals, vision and mission between hospital and staffs. This study recommends that there should be a more serious evaluation of the cleanliness of all service units in Islamic Hospital in Surabaya. Keywords: patient satisfaction, people equity, human resources management STUDY ABOUT THE MANAGEMENT OF MEDICAL WASTE AND GARBAGE IN KWAINGGA PUBLIC HOSPITAL, DISTRICT KEEROM, JAYAPURA Hesty Tumangke, Melkior Tappy, Agus Zainuri Universitas Cendrawasih, Papua, Indonesia Kwaingga Public Hospital is categorized as type C hospital because there are several aspects need to be improved for management and quality in order to fill the standard from Ministry of Health. Especially for a medical waste, there was a problem for incinerator, so the medical waste must be burn once in every two weeks. Hospital staff said that this incinerator has potential to explode due to bad structure. This incinerator was bough in 2012. Also there is hospital wastewater treatment plant which bough in 2013. This study aimed to observe the management of medical waste and daily waste in Kwaingga Public Hospital. This study is qualitative study where the population is all staffs that work in Kwaingga Public Hospital, and the study sample is six Hospital staffs including hospital director, planning division, treasurer, and hospital sanitarians. They have been deep interviewed and recorded. Study also took visual documentation for the condition of incinerator, landfill and wastewater treatment plant. There are 20 trashes distributed in hospital for daily waste and it is end in a small landfill in hospital backyard. This managed by 10 cleaning services and the staffs said that that number is still inadequate. Sanitarian staffs are six and they all have background health sanitation diploma, but they still have overload tasks and they don’t get any training for development yet, the last training was in 2012. For medical waste, there are incinerator, wastewater treatment plant, Septic tank, filtration for wastewater, and an old incinerator; there is no machine for destroyed needles. Unfortunately, the incinerator was rarely to use since its structure is bad and has potential to explode and there is operational cost issue; they said diesel cost is expensive. Similarly, wastewater treatment plant is rarely used due to electricity cost spending; it only runs if the wastewater is full. Therefore, the medical waste burned manually including needles. THE DRUGS MANAGEMENT IN ABEPURA PUBLIC HOSPITAL IN JAYAPURA Sarce Makaba, AL Rantetampang, Hesty Tumangke Universitas Cendrawasih, Papua, Indonesia Medicine is crucial part in healthcare for curative act and recovering period among patients, so drugs must be available in hospital for adequacy and variety in order to create good healthcare. Therefore, drugs must be manage effectively and efficient. This study aims to observe drugs management in public hospital including medicine planning, procurement, storage, and medicine distribution. This study is descriptive research with qualitative method. The study site is Pharmacy Instalation in Abepura Public Hospitalin 2012 with total informants; 8 people that involved in medicine management in hospital. Research instrument is using interview guideline and observation form. Data has been analyzed with Content Analysis. The result shows that in Abepura Public Hospital, drugs planning using consumption method and adjusted with available fund, where funding for drugs is 2.4% from hospital budget. Medicine planning has conducted at installation pharmacy division with director agreement. Procurement has done with tender and auction . There is no delay for payment in procurement process and there is no error an invoice in ordering drugs. Drugs storage use FIFO/FEFO system. Not all drugs have stock cards for every drug item. There is no expire drugs, and the percentage of stock out is 4.1 %. Value of final stock is 8% and drug distributions use floor stock system and individual prescription order system. Drugs that empty replaced with another drugs with same indication with physician agreement or drugs taken in pharmacy outside the hospital. Keyword : Drugs management, Pharmacy Installation, hospital ANALYSIS OF PLANNING, BUDGETING, AND FORECASTING IN IMPROVING QUALITY OF SERVICES AT PKU MUHAMMADIYAH YOGYAKARTA HOSPITAL 1 Nurul Anisa1,, Firman Pribadi1 Master of Hospital Management - Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] A proper planning, budgeting, and forecasting process can be obtained by comparing and analyzing the actual costs with budgeted costs. This can provide information for management to identify deviations that occur from planned activities so as to improve the efficiency and utility of the company's budget system. The budget has a very close relationship with management, especially in relation to planning, coordinating work, monitoring work, and evaluating work. The purpose of this study is to know how the planning, budgeting, and forecasting improve the quality of services at RS PKU Muhammadiyah Yogyakarta. The study used a qualitative research with a case study approach. Data collection techniques in this study are using depth interviews, questionnaires, and supporting data. The subject were the budgeting team at PKU Muhammadiyah Yogyakarta Hospital. The planning and budgeting process at PKU Muhammadiyah Yogyakarta Hospital is done with a bottom up system, based on reference from the previous year, and also considering that it can improve service quality. Forecasting is not running optimally yet, so it needs improvement to face off obstacles so the planning, budgeting, and forecasting process can run more optimally in the future. Key words : planning, budgeting, forecasting, quality of service FACTORS INFLUENCE ON HEALTH OF DEVELOPMENT FOR HUMAN RESOURCES ECONOMIC IN THE JAYAPURA DISTRICT Septevanus Rantetoding Universitas Cendrawasih, Papua, Indonesia This study aims to examine and analyze (1) Influence of Health Development of the Human Resources Economic in Jayapura District; and (2) Influence of Human Resources, Health Care Effort and Improvement of Health Status of the Human Resource Economics in Jayapura District. This research was conducted through a survey of the implementation of health development in order to improve implementation of Human Resource Economics. Eksplanatif design selected for this study to test the hypothesis in structural equations to analyze the influence of the factors of health development in the context of economic development of human resources. Thus, this study used quantitative and qualitative methods, is testing the hypothesis by using empirical data and primary data for the purpose of development theory and explain the research problem that has been proposed by previous researchers. The analysis used to answer the problem and prove the hypothesis is a descriptive analysis and SEM (Structural Equation Model). The results showed that Critical Ration (CR) and Probability (Prob): (1) Of the three (3) variables tested as factors influencing the Human Resource Economics in Jayapura District, produce that Human Resources (coëficient his regression of -3.383 and -2729, Probability is 0,000 and 0,006), Budget (CR it amounted to 2,332 and 2,406, Probability is 0,020 and ,016) and Infrastructure (CR of 3.416 and 2.508, Probability is 0,000 and 0,012) in Health positive and significant effect on the efforts of Health Services and Improved Health Status in Jayapura. (2) The Human Resources (CR by -0.802 and Prob. O,423), Budget (CR is regression of -1.146 and Probability is 0,252), and Infrastructure (coëficient her by -0.787 and Probability is 0,431) in Health Economics indirect effect on Human Resources in Jayapura District, but through the variable effort between the Health Care and Health Status Improvement in Jayapura that need to be optimized. (3) Health Care Efforts (CR of 4,895 and Prob. Is 0,000), and Health Status Improvement (CR his regression of 2.062 and Prob. 0,039) directly influence the Human Resource Economics in Jayapura District. The Implication is studi if Health Resource (Human Resource, Budget, Infrastructure) effect is Health Care Efferts and Health Status Improvement, and then three and five not effect to Human Resources Economic, but Human Resources, Budget, Infrastructure is health sector Not effect to Human resources Economic in Jayapura District. Keywords: Health Development and Human Resources Economic. THE INFLUENCE OF EFFECTIVE LEADERSHIP, WORKLOAD AND MOTIVATION TO THE NURSES PERFORMANCE IN APPLICATION OF PATIENT SAFETY IN INPATIENT ROOM PKU MUHAMMADIYAH BANTUL HOSPITAL 1 Ika Yulia Puspita Harsanti1,, Nur Hidayah1 Master of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] One of the efforts to improve the quality of hospital services is through improving performance in the application of patient safety. Nurses are health workers who held key of success on patient safety. Effective leadership from the head nurses, workload and work motivation of nurses is considered to be an important factor in improving nurses performance in implementing patient safety. Quantitative research with cross-sectional design. Knowing effective leadership, workload and motivation for 76 nurses in the performance of patient safety in the inpatient rooms of PKU Muhammadiyah Bantul Hospital during July to August 2018. Data analysis using multiple logistic regression. All variables tested are effective leadership, workload, and work motivation have an influence on the performance of nurses in the application of patient safety in the inpatient room of PKU Muhammadiyah Bantul Hospital. Motivation is the most influential on the performance of nurses in the application of patient safety. Key words: Effective leadership, workload, motivation, performance, patient safety APPLICATION OF COOPERATIVE LEARNING METHODS FOR INCREASING HAND HYGIENE KNOWLEDGE AND ACCURACY AT EMERGENCY INSTALLATION OF WONOSARI STATE HOSPITAL, YOGYAKARTA, INDONESIA Rinaldi Sahputera1, Merita Arini2, Kusbaryanto3 Student of Master Hospital Management, Post Graduate Program, UniversitasMuhammadiyah Yogyakarta 2 Lecturer of Medical Education, Faculty of Medicine and Health science, Universitas. Muhammadiyah Yogyakarta 3 Lecturre of Master Hospital Management, Post Graduate Program, Universitas Muhammadiyah Yogyakarta. [email protected] 1 Hand washing with soap is the cheapest and most effective health intervention to reduce the risk of transmission of Healthcare Associated Infections (HAIs). However, the implementation of hand hygiene (HH) usually low. This study aims to improve the knowledge and accuracy of the HH procedure improvement by using cooperative learning methods at the Emergency Installation of Wonosari Regional Hospital. This research is a quantitative research with Quasi-Experiment by pre-test and post-test design. There were 30 healthcare workers (HCW) obtained with the total sampling technique. Univariate and bivariate data analysis using paired t-test analysis. The results showed that there were differences in knowledge before and after being given training with a significant value of 0.002 (p <5%). There were differences in the accuracy of HH procedure before and after being given training at emergency installation with a significant value of 0.002 (p <5%). Our study suggests the need for continuity evaluation and innovative activities to refresh the knowledge and skills of HCW in order to improve their behavior on HAIs prevention. Keywords: hand hygiene, Healthcare Associated Infections PATIENT SAFETY CULTURE (CASE STUDY) AT PKU MUHAMMADIYAH BANTUL HOSPITAL Ajeng Titi Probo Rahayanti1, Arlina Dewi2 Master of Hospital Management, UniversitasMuhammadiyahYogjakarta 2 Master of Hospital Management UniversitasMuhammadiyahYogjakarta [email protected] 1 Patient safety culture is a system that can give safe feeling trough the patients, to avoid incidents such as adverse event, near misses,and medical error. The objective of this study to know and to explore implementation dimension of patient safety culture at PKU MuhammadiyahBantul Hospital. The cross sectional study was conduct and collected through Questioner using MAPSaF (Manchester Patient Safety Framework )that consist of 10 elements of question& 24 aspects towards 67 nursesof PKU Muhammadiyah Bantul Hospital. There were 5 maturity levels that can describe patient safety culture, such as Pathologic, Reactive, Calculative, Proactive & Generative. For the result of the study, there were 7 questions are in proactive level, such as commitment extend to repair sustainable, priority given to patient safety, evaluation an incident and best practices, learning and effective change, management civil and safety issues, education and training staff and cooperation team.There are 1 question are in Calculative level which is communication of patient safety issues.The last level is Generative,there are 2 questions such as a system error and the responsibility of individuals and recording of an incident and best practices. Key words: Patient Safety Culture, MAPSaF THE INFLUENCE OF DETERMINANT BEHAVIOR ON NURSE COMPLIANCE USING PERSONAL PROTECTIVE EQUIPMENT AT PRIVATE HOSPITAL IN YOGYAKARTA 1,2,3 Baik Dysa Garudiwati1,, Wiwik Kusumawati2, Merita Arini3 Master of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] Healthcare workers compliance of using Personal protective equipment (PPE) is important to prevent Healthcare Associated Infections (HAIs). This research used a mixed method with the sequential explanatory approach. Quantitative research was carried out first by distributing questionnaires to assess behavioral determinants based on Lawrence Green theory and observations to assess compliance on PPE use then proceed with qualitative research using the in-depth interview method. Data analysis uses multiple logistic regression analysis and a constant comparative method. Statistical results show that the factors influencing the use of PPE are knowledge p = 0.038; OR = 2.119, supervision p = 0.044, OR = 4.050 and motivation p = 0.046; OR 1.022. The dominant factor that mostly influences compliance with PPE is supervision. This result also supported by the result of qualitative research which explains that the use of PPE at Private Hospital in Yogyakarta is related to support management which one of them is supervision. Keywords: behavior, compliance, personal protective equipment EFFECT OF SERVICE QUALITY AND REFERRAL SYSTEM IN ACCREDITED COMMUNITY HEALTH CENTER Santika Afrianingtya Putri1,, Sri Sundari2, Mahendro Prasetyo Kusumo3 Master of Hospital Management, UniversitasMuhammadiyah Yogyakarta, Indonesia [email protected] Community Health Center is a gatekeeper in health services in Indonesia. The quality of health services at the Community Health Center has to increase. Referral system is a manifestation of the implementation of health services that regulate the transfer of tasks and responsibilities of health services. All health centers in Sleman, Regency have been accredited, but there are still many referrals to hospitals. Work assessment of a hospital or health care provider facility can be measured from the quality of service, a high level of performance is considered to increase patient satisfaction. This type of research uses a quantitative approach. Data analysis in this study uses correlation and regression analysis. The study population was all patients who were referred from the first health care center to the hospital, with a sample of 100 people. The results of this study indicate that there is a positive influence between the quality of service with the reference number, with the value of P value 0.005 by looking at P value <0.05. The conclusion of this study is that there is a relation between service quality and referral system. Key words: Service quality, community health center, referral system THE EFFECTIVENESS OF SIMULATION OF USING PERSONAL PROTECTIVE EQUIPMENT (PPE) TO INCREASE KNOWLEDGE AND COMPLIANCE OF USING PPE OF NURSES IN HEMODIALYSIS UNITS Fathimatuzzahro1, Winny Setyonugroho2, Ekorini Listyowati3 1,2,3 Master of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] Healthcare Associated Infections (HAIs) or Nosocomial Infection is infections obtained by patients or hospital workers. Some factors that cause HAIs are high-risk actions such as surgery, hemodialysis, lack of universal precaution like using Personal Protective Equipment (PPE). Aim: to know the effectiveness of simulation use of PPE to knowledge and compliance of use PPE in nurses in hemodialysis units. The type of research used was mixed methods. Population consisted of all nurse in hemodialysis units and used totally sampling. Nurses’ knowledge before simulation majority was categorized as sufficient (66,6%) and after the simulation, it was categorized as good (100%). Nurses’ compliance before the simulation was categorized as non-compliant (100%) and after the simulation, it was categorized as compliant (66,6%). The effectiveness of the simulation was analyzed using Wilcoxon test, obtained the results for the knowledge of pre-post simulation value of Sig.0,046 and the compliance of pre-post simulation value of Sig.0,046. The obstacles in the use of PPE include the lack of special PPE training, monitoring and evaluation that have not been carried out properly, and the availability of PPE that is not sufficient. Conclusion: The simulation of PPE use is effective in increasing knowledge and compliance of the PPE use. Keyword: Personal Protective Equipment (PPE), Knowledge, Compliance PLANNING, BUDGETING AND FORECASTING AT PKU MUHAMMADIYAH BANTUL HOSPITAL Devi Suryandari1,, Firman Pribadi2 Master of Hospital Management, Post Graduate Program of Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] 1 The importance of a careful planning in the preparation of budgeting and appropriate estimation is used to improve the performance of budget management in hospitals, especially in the field of accounting management, where the budget control system is a common tool used in controlling costs and improving performance. This is a way to allocate resources to have strategic business objectives and plan actions to help meet strategic goals. The purpose of this study was to determine the process of planning, budgeting and estimation at PKU Muhammadiyah Hospital in Bantul.This research is a qualitative research with a case study approach. The subject of this study was a team that was directly related to budget preparation at PKU Muhammadiyah Hospital in Bantul. Information about the planning, budgeting and estimation process is obtained through in-depth interviews. Qualitative data is analyzed using coding.Based on the results of interviews supported by previous theories and research shows that planning, budgeting and estimating activities at PKU Muhammadiyah Hospital Bantul have run quite well where the hospital has planned budgeting based on short-term plans, long-term plans, and several studies before budgeting. Whereas in the process of preparing the Hospital using a program that is sufficient to support the budgeting process to run effectively, supported by budgeting parties who have good quality and quantity that supports the creation of good PPE. Key words: planning, budgeting, estimation KEY BEHAVIORAL INDICATORS OF COMMUNITY HEALTH CENTER EMPLOYEES Verani Dwitasari1, Qurratul Aini2 Master of Hospital Management, Post Graduate Program, UniversitasMuhammadiyah Yogyakarta, Indonesia 2 Master of Hospital Management, Post Graduate Program,Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] 1 Performance measurement needs to be done, not only by assessing theresults, but also by assessing whether process is running optimally. One of the measuring tools that can be used to assess the performance process is Key Behavioral Indicators. This study aimed to measure the performance of community health center employees using Key Behavioral Indicators. This research used descriptive survey method with a quantitative approach. The data were collected through questionnairesdistributed to 40 employees of community health center as respondents. Data were analyzed using descriptive method which followed by multiple linear regression test. The mean value of employee performance is 3.95. From the simultaneous F test, the value of F count is 0.245 (F count < F table) with sig. 0.053 (p>0.05). From the partial t testobtained the significance value of gender, age, profession, and period of workis >0.05, while the level of education variable is 3.139 with sig. 0.003 (p<0.05).The result can be concluded that the level of employee performance has met the expectations. From the characteristics of respondents, only education levels have a positive and significant effect on employees performance. Keywords: performance measurement, Key Behavioral Indicators EVALUATION OF UNFEASIBLE PAYMENT CLAIM OF NON PSYCHIATRY IN 2016 IN PROF DR. SOEROJO MAGELANG MENTAL HEALTH HOSPITAL Eti Kurniyawati1, Firman Pribadi2 1Magister of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia 2,Lecture Master of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] Participant of National Health Insurance are already served in Prof Dr. Soerojo Magelang Mental Health Hospital but there are still claims that are not paid. Case in this research is about non psychiatry unfeasible payment claim in 2016.This research’s aim is to find out about the factors that cause non psychiatry unfeasible claim in January until December 2016.This research is an exploratory case study with single holistic case study design with analyzing data from one hospital.The result show up to 235 cases are dominated by one episode treatment. Unfeasible claim has not handled yet on spesific way, so that we need settlement policies and process for unfeasible payment claim that are set by the leader. Keyword(s): unfeasible payment claim, National Health Insurance THE INFLUENCE OF LEADERSHIP AND MOTIVATION TO NURSES PERFOMANCE IN PRATAMA YOGYAKARTA HOSPITAL 12 Citra Perwita Sari1, Qurratul Aini2 Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] Hospital services require comprehensive and professional performance of nurses in improving hospital quality, several factors that influence it are good leadership and motivation. The service quality of Yogyakarta Primary Hospital is still not in line with expectations, which means that some nurses' performance needs to be improved. Type of quantitative research with a cross-sectional approach. The study sample consisted of 58 nurses, determination of sampling with total sampling. The data were collected through a questionnaire that has been tested for validity and reliability. The questionnaire consists of 60 questions. Data analysis uses multiple linear regression. For the result of this study, leadership t test 2.768 with a significance level of 0.008 indicating that leadership influence the performance of nurses. Motivation t test 6.336 with a significance level of 0,000 indicates that motivation influence the performance of nurses. Adjusted R2 value of 0.472, F value of 26.515, significance of 0.000 shows leadership and motivation have a positive and significant influence on nurse performance. Leadership and motivation have an influence contribution of 47.2%, while the remaining 52.8% is explained by other factors not examined in this study. Keyword: Leadership, Motivation, Performance ANALYSIS OF UNIT COST ON ROUTINE HEMATOLOGY EXAMINATION WITH ACTIVITY-BASED COSTING METHOD AT HERMINA YOGYA HOSPITAL 1, 2, 3 Ainal Fadly1,, Firman Pribadi2, Mariska Urhmila3 Master of Hospital Management, Universitas Muhammadiyah Yogyakarta, Indonesia [email protected] Hospital is an institution that provides healthcare service comprehensively in various departments. One of them is laboratory unit. Analysis of unit cost is needed to calculate the cost of each unit in departments to determine the cost of various services in hospital. We would like to find the unit cost of routine hematology examination with Activitybased Costing (ABC) method, and to compare the result with the real cost that the hospital applies. This is a qualitative study with a case study design. Data were obtained from interviews, observations, documents, and medical records. Analysis of the cost was conducted with ABC method, and then be compared with the real cost that the hospital applies.The unit cost of routine hematology examination using ABC method is Rp. 90.147, while the real cost is Rp. 83.756. The difference is Rp. 6.391. The unit cost based on ABC method is higher than the real cost applied by the hospital. The ABC method gives more accurate cost because of the overhead costing is charged into each activity related to the routine hematology examination. This finding should be a concern to the hospital, giving them insight about cost containment process, which in turn may yield more profit. Key words:unit cost, real cost, ABC method, routine hematology examination LEAN HOSPITAL APPROACH TO IDENTIFY CRITICAL WASTE IN THE OUTPATIENT PHARMACY UNIT IN WATES STATE HOSPITAL Ika Mira Puspita Sari1, Firman Pribadi1 Master of Hospital Management, Post Graduate Program of Universitas Muhammadiyah Yogyakarta. [email protected] Many pharmacy units have the service problem with long waiting time. This shows that there are still waste (everything that has no value added). This research purpose to identify critical waste, root cause of critical waste, and to provide improvements suggestions to minimize critical waste in the outpatient pharmacy unit in Wates State Hospital. This research is case study with a qualitative approach. The stages of the research are the observation of service processes mapped through value stream mapping, questionnaires to obtain critical waste, interviews with the 5why method to find out the root of the critical waste and to provide suggestions for improvement. The results of value stream mapping showed ratio value added to waste for non-concoction prescription services is8,6% while concoction prescription services is 7.6%. Waste waiting is a critical waste accounting for 24.4%. The root causes of waste waiting are the length of use of SIMRS servers, limited number of human resources and is influenced by layout factors and the flow of service process. Proposed improvements include short, medium and long term proposals. Keywords: Lean Hospital, Outpatient Pharmacy Unit, Waste Waiting THE EFFECT OF ETHANOLIC EXTRACT OF MANGOSTEEN PEEL (Garcinia mangostana L.) TO THE MOTILITY, VIABILITY OF EPIDIDYMAL SPERMATOZOA AND THE LEVEL OF MDA AND SOD OF EPIDIDYMAL SPERM IN WISTAR RATS WHICH ARE EXPOSED BY CIGARETTE SMOKE Mas Loegito1, Djanggan Sargowo2, Aucky Hinting3, Aris Widodo4 Biomedic Department, Medicine Faculty of Wijaya Kusuma University Surabaya 2 Cardiology Department, Medicine Faculty of Brawijaya University Malang 3 Andrology Department, Medicine Faculty of Airlangga University Surabaya 4 Pharmacology Department, Medicine Faculty of Brawijaya University Malang 1 Background: The aim of this research was to know the effect of ethanolic extract of mangosteen peel (Garcinia mangostana L.) to the motility and viability of epididymal spermatozoa and the level of MDA and SOD of epididymal sperm in wistar rats which were exposed by cigarette smoke. According to the results of phytochemical analysis shown that ethanolic extract of mangosteen peel (Garcinia mangostana L.) contained alpha mangostin, gamma mangostin, 8hidroxicuadraxanthon, and Smeathxanthon which could be used as antioxidants (Yung et.al. 2007). Some kinds of compounds in cigarette smoke were nitrogen, O*-, OH*-, HOO*-, CO*-, CO2, NO*-, H2S, Tar, nicotine, and metal which could affect the reproductive system (Halliwell and Gutteridge, 2007). Methods: Twenty adult wistar rats were divided into five treatment groups, i.e. negative control group (C-) which was not treated, positive control (C+) which was exposed by cigarette smoke 63 mV, the group which was given ethanolic extract of mangosteen peel of 125 mg/Kg BW and cigarette smoke 63 mV (M1R), the group was given ethanolic extract of mangosteen peel of 250 mg/Kg BW and cigarette smoke 63 ml (M2R), and the group which was given the ethanolic extract of mangosteen peel 500 mg/Kg BW and cigarette smoke 63 mV. Exception the control group (C-), so each treatment was exposed by cigarette smoke and given ethanolic extract of mangosteen peel for 30 days. Results: The result of the treatments showed that the average number of motility of spermatozoa in control (C-) = 98,3 ±3,03; group (C+) = 82,5 ± 1,5; group (M1R) = 86,75 ± 1,74; group (M2R) = 84,15 ±2,15; group (M3R) = 82,55 ± 2,67. The average number of viability of spermatozoa in control (C-) =123,45 ± 2,105; group (C+) = 91, 2 ± 3,44; M1R =108,65 ± 5,036; M2R = 87,55 ± 0,914; M3R = 82,55 ± 3,36. The number of epididymal spermatozoa motility between treatments was not significantly different with p = 0,358> 0,05, but the number of spermatozoa viability between groups was significantly different with p = 0,048 < 0,05. The average of epididymal sperm MDA level in control (C-) = 0,458 ± 0,07; group (C+) = 0,602 ± 0,119; group M1R = 0,360 ± 0,093; group M2R = 0,294 ± 0,123; M3R = 0,208 ± 0,084. The average of epididymal sperm SOD level in control (C-) = 0,547 ± 0,165; group (C+) = 0,228 ± 0,1059. group M1R = 0,329 ± 0,179; group M2R = 0,3999 ± 0,765; group M3R = 0,5167 ± 0,2976 spermatozoa between treatments was significantly different with p = 0,048 < 0,05. The level of MDA between treatments was significantly different with p = 0,002 < 0,05, and the level of SOD between treatments was significantly different with p = 0,042 < 0,05. Conclusion: It was concluded that there was an effect of ethanolict extract of mangosteen peel (Garcinia mangostana L.) to the number of motility and viability of epididymal spermatozoa and the level of MDA and SOD of epididymal sperma in wistar rats which were exposed by cigarette smoke 63 mV. Keyword: wistar rat, cigarette smoke, mangosteen peel extract, motility, viability, MDA and SOD ABSTRACT POSTER PRESENTATION 125 DESCRIPTION OF LEADERSHIP EFFECTIVENESS OF THE HEAD IN PRIMARY CARE IN BONTANG CITY HEALTH OFFICE BASED ON HERSEY - BLANCHARD SITUATIONAL LEADERSHIP THEORY Zennidar Aulia Nashira¹, Ernawaty ² ¹ Master of Health Administration and Policy Interest in Health Services Management Studies Public Health Faculty, Airlangga University, Surabaya ²Lecturer at Public Health Faculty, Airlangga University, Surabaya [email protected] Leadership is an important factor for organizations, especially health care organizations. The style of leadership is the means by which people influence others. Leadership training at primary care in Bontang City Health Office needs to be consulted with the help and service of Puskesmas employees. This study aims to determine the picture of leadership effectiveness in 7 primary care in Bontang City Health Office. Quantitative research type with descriptive approach. The population of this research is all primary care leaders in Bontang City Health Office 7 people. Technique of collecting data in cross sectional, and total population are 7 people head of primary care in Bontang City Health Office. Data analysis used descriptive analysis to describe leadership effectiveness with Hersey - Blanchard theory approach. The result of the research show leadership style situational S1 or directing of 15 points, S2 or coaching by 28 points, S3 or supporting in amount of 34 points, and S4 or delegating equal to 7 points. The majority of primary care leaders use situational leadership style S3 or supporting in moving their subordinates where the number of S3 is 34 from total value 48, and dominant leadership style is S3 (supporting) 57%, followed by S2 (coaching) equal to 43%. The results showed that most primary care leaders have leadership style S3 or supporting where the level of readiness of employees in the position of moderate (low directions and high supportive). The leadership style at this stage encourages individuals or groups to share ideas and simultaneously facilitate work with the spirit they show. To improve the performance motivation of Puskesmas employees, the primary care leadership still maintains open communication and tends to be a good listener and ready to assist followers, and maintain the quality of relationships between individuals or groups. Keywords: leadership effectiveness, primary care, situational leadership theory 98 EVALUATION OF PROGRAM FOR SUPERVISION AND EXAMINATION OF PEOPLE IN THE FRAMEWORK OF THE PUBLISHING ISSUES OF THE SICK PEOPLE IN THE HEALTH KOREA OF MANOKWARI PORTS Yohana Yosevine Usmany1, Nila Farah2, Yohanes Rapa’ Patari3 and Dr.Ernawaty, drg. M.Kes4 Magister program of Health Administration Interest in Health Care Management, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia 2 Magister program of Health Administration Interest in Health Care Management, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia 3 Head of Port Health Office, Brawijaya 22 Road, Manokwari, Indonesia 4 Lecturer of Faculty of Public Health, Universitas Airlangga, Mulyorejo Street, Surabaya, Indonesia, [email protected] 1 Inspection and supervision of sick person transport permit in the form of direct examination of the sick includes the determination of infectious or non-communicable diseases, and then assessing whether or not a sick person traveling is carried out in order to be alert as early as possible from the spread of the disease which is very possible to occur PHIEC (Public Health Emergency of International Concern). This study aims to evaluate the implementation of surveillance and examination of the sick based on the Regulation of the Minister of Health No. 356 / MENKES / PER / IV / 2008 at the Manokwari Port Health Office. This research is an evaluation research using qualitative descriptive method. The subjects of the study were the family, decision makers at the Manokwari port health office and the shipping company that were always associated with referral referral. Supervision of a sick person's transport permit in 2016 of 973 patients consisting of 339 men and 634 women. Keywords: Evaluation, Supervision and Inspection of the Sick, Issuance of Transportation Permit for Sick People 134 IMPLEMENTATION OF COMPREHENSIVE EMONC QUALITY INDICATOR DATA TO INCREASE MATERNAL NEONATAL SAFETY AT AIRLANGGA UNIVERSITY HOSPITAL SURABAYA Farouk Ilmid Davik1, Muhammad Ardian2, Muhammad Arief 3, Nyoman Anita D.4 Master Student of Administration and Health Policy, Faculty of Public Health, Arilangga University 2 Medical Service Manager of Airlangga University Hospital, Surabaya, Indonesia 3 Resident of Obstetric and Gynecology Department Faculty of Medicine of Airlangga University – Dr. Soetomo General Hospital Surabaya, Indonesia 4 Lecture Faculty of Public Health, Airlangga University 1 Background: Comprehensive Emergency Obstetric and Newborn Care (EmONC) at Airlangga University Hospital is a comprehensive service provided for pregnant women and infants to prevent morbidity and mortality. The quality of the comprehensive EmONC service can be enhanced by a standardized WHO quality indicator evaluation. Objective: To assess the quality of service of comprehensive EmONC at Airlangga University Hospital Surabaya. Method: Qualitative descriptive study using comprehensive EmONC indicator at Airlangga University Hospital Surabaya in January - September 2017. Result: During the period from January to September 2017, 8 indicators of Function Signal of comprehensive EmONC in Airlangga University Hospital functioned at 100%. The percentage of vaginal labor was 70.2% -83.7%. Percentage of caesarean section was 16,3% -29,8%. Direct obstetric case fatality rate 0%. Intrapartum and very early neonatal death 1-1,4%. Indirect cause of death 1 patient from severe SLE. Exclusive breastfeeding percentage 57.5% -75%. Use of postpartum IUD in Maternity Room 11.9% -51.2%. The incidence of rupture of the perineum gr III was 5.9%. Performance of monitoring tool for maternal response performance: Obstetric neonatal emergency response 40%, emergency trolleys list 94.1%, active placental management 100%, post partum bleeding management 100%, severe preeclampsia / eclampsia management 100%, Maternal sepsis management 100%, labor stalled 62.5%. Performance of neonatal response monitoring apparatus: emergency neonatal response 67%, neonatal resuscitation 100%, neonatal sepsis management 100%, steroid administration to prevent premature complications 100%, initial breastfeeding and exclusive breastfeeding 88%, kangaroo treatment method 88%, neonatal treatment with low birth weight 67%. Achievements of clinical monitoring instruments in hospitals: clinical performance and evaluation 100%, customer feedback 50%. Achievement of infection prevention monitoring tool 100%. Conclusion: EmONC Airlangga University Hospital is fully functional. The assessment of the quality of the EmONC service based on the quality indicators of EmONC has largely met the set targets. Several quality indicators have not reached their targets such as the high presentation of abdominal delivery, low initial breastfeeding coverage, and the high incidence of rupture of the perineum gr 3. Keywords: EmONC, Airlangga University Hospital, Quality indicator. 75 CORRELATION ANALYSIS BETWEEN THE TOTAL OF EMPLOYEE OF TYPE X AND Y TOWARD PERFORMANCE AND CORRELATION BETWEEN INDIVIDUAL CHARACTERISTIC AND TYPE OF EMPLOYEE IN PRIMARY HEALTH CENTER IN PONOROGO REGENCY Desiana Medya A.L 1, Risya Wisdyastuti 1, Sinta Dewi Lestyoningrum 1, Ernawaty 2 Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 2 Lecturer of Departement of Administration and Healt Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 1 This research departs from insufficient performance (presented by the value of IKM) of many Primary Health Center in Ponorogo Regency. As the organization in providing health services, human factor holds important role as input, process and output as well. Individual characteristic, in reality, has correlation with performance namely motivation. One of famous motivation is Theory of X and Y by Douglas Mc. Gregor A. Therefore, according to the theory of X and Y, the research had been conducted to observe the employee in Primary Health Center in Ponorogo Regency. The design of research is cross sectional descriptive. This design is a quantitative research measuring type of employee in 24 Primary Health Center in Ponorogo Regency with 770 total of employee. Data sampling process had been done in January-April 2018. From the descriptive analysis, it can be pointed out that Primary Health Centre in Ponorogo Regency : 1) 54% of Primary Health Centre with performance above the average has Type of Y (employee) larger than the other Primary Health Centre, 2), 73% of Primary Health Centre with under performance of average has Type of Y fewer than other Primary Health Centre, 3) 54% of Primary Health Centre with performance above the average, has Type of X fewer than other Primary Health Centre, 4) 55% of Primary Health Centre with below average of performance, has Type of X larger than other Primary Health Centre. The researcher also made a test of correlation between some individual variable and type of employee. According to the crosstab result, it can be pointed out that there is correlation between type of employee and some variables which are variable of work satisfaction, suitability of profession, profession, length of working, sufficient income and age. This research is expected to support the head of Primary Health Centre in considering management technique, motivation technique, communication in organization, management of employee’s social interaction, and development of management guideline in establishing appropriate culture in Primary Health Centre in order to escalate working performance. 115 CORRELATION BETWEEN LEVELS OF EDUCATION AND PATIENT SATISFACTION TOWARD PHARMACEUTICAL SERVICE Vica Aulya Rivera1, Juliyana Puspa Sari2, Mohd Syaiful Johan3, Nyoman Anita Damayanti4 1 Student of Health Policy Administration Program Study, Faculty of Public Health, Airlangga University, Indonesia 2 Student of Health Policy Administration Program Study, Faculty of Public Health, Airlangga University, Indonesia 3 Hospital Selamat, Johor, Malaysia 4 Lecturer of Health Policy Administration Program Study, Faculty of Public Health, Airlangga University, Indonesia [email protected] The long waiting time of pharmaceutical service at Gotong Royong Hospital Surabaya has caused many patients to make complaints. It affects patients’ satisfaction toward pharmaceutical services. One of the factors affecting satisfaction is consumer behavior including patient’s levels of education. This research aims to analyze the correlation between levels of education and patient satisfaction. Samples, as many as 54 outpatients who received pharmaceutical services at Gotong Royong Hospital Surabaya, were selected accidentally. The data were analyzed by chi-square test. The findings of this research indicated a significant correlation between the levels of education and patient satisfaction towards pharmaceutical services; it was shown from p-value of 0,004 in which most of respondent who expressed dissatisfaction were at the levels of education of high school or equivalent (69,2%) and bachelor’s degree (66,7%). The conclusion of this research is that there is a significant correlation between the levels of education and patient satisfaction toward pharmaceutical service at Gotong Royong Hospital. Keywords: levels of education, patient satisfaction, pharmaceutical service 135 ASSOCIATION BETWEEN SITUATION, BACKGROUND, ASSESSMENT, AND RECOMMENDATION (SBAR) COMMUNICATION AND TEAMWORK IN THE INTENSIVE CARE UNIT: A SYSTEMATIC REVIEW Wahidah Rachmaniyah1, Bima Pramundita2 Department of Health Administration and Management, Faculty of Public Health, Universitas Airlangga, Surabaya 60286, Indonesia; Citra Medika Hospital, Sidoarjo, Indonesia 2 Department of Health Administration and Management, Faculty of Public Health, Universitas Airlangga, Surabaya 60286, Indonesia; Dr. Ramelan Marine Hospital, Surabaya, Indonesia 1 Background: This article is an attempt to provide a systematic review of the association between situation, background, assessment, and recommendation (SBAR) communication and teamwork in the intensive care unit. SBAR communication is a structured, short, clear and easy to understand communication method consisting of situation, background, assessment, and recommendation. SBAR communication we need an impact analysis in teamwork in providing health services in hospitals, especially in Intensive Care Unit. Objectives: To describes the association between SBAR communication and teamwork in the intensive care unit that is used as a consideration in improving services in the Intensive Care Unit. Methods: Searching the results research articles was via Pubmed, ScienceDirect, Ebsco, Proquest, and Web science in accordance with the criteria. To analysis of this article, review was by using a measurement tool to assess systematic reviews (AMSTAR), and each research article was being compared and concluded similarities between the research article. Results: The majority of studies focus was on providing an idea, that SBAR communication was a communication to be effective and efficient for health workers to convey the patient's current condition. The SBAR communication minimizes the occurrence of errors in providing nursing care and treatment in patients (patient safety). SBAR communication provides structured information that was easy to understand. SBAR communication makes the point or core of information to be conveyed more accurately. These conditions make the instruction in teamwork becomes more leverage to be implemented so that nursing care was given safer, especially in intensive care unit. Conclusion: Based on the results, this study suggests that association between SBAR communication and teamwork in the intensive care unit was significant. We need the implementation of SBAR communication in the intensive care unit to improve service quality and prevent misinformation. Keywords: SBAR communication, Teamwork, Intensive care unit 124 STAFFING MANAGEMENT USING NURSING ACTIVITIES SCORE (NAS) IN THE INTENSIVE CARE UNIT: SYTEMATIC REVIEW Yunita Selly Santoso1, Ahmad Zainur Ridla2, Stefanus Supriyanto3, Fis Citra Ariyanto4 Department of Health Administration and Management, Faculty of Public Health, Universitas Airlangga, Surabaya 60286, Indonesia, email: [email protected] 2 Faculty of Health, University of Technology Sydney, Sydney, Australia 3 Department of Health Administration and Management, Faculty of Public Health, Universitas Airlangga, Surabaya 60286, Indonesia 4 Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia 1 Background: This article is an effort to provide a description of the Systematic Review on staffing using Nursing Activities Score (NAS) in the Intensive Care Unit (ICU). The complexity of admitted patient and high cost of care make the quality of care and patient safety as a priority in the ICU. It can be adjusted based on measured by the nursing workload. The Nursing Activities Score is one of available tool that able to forecast/determine/calculate the number of nursing staff in the ICU. Objectives: (This study) aims to describe the workload of nurses using NAS, exploring the correlation between the workload of nurses with quality of care. Methods: Database searched was conducted to retrieve relevant literature from the following databases Medline, Pubmed, ScienceDirect, Cinahl and Proquest. Results: The majority of studies focus on providing an overview of the nurse's workload in the ICU of each shift. The condition was influenced by the clinical characteristics of the patient, the number of patients, the surgeon, and the patient who died. The calculation of the nurse's workload was used to plan the number of nursing staff in the ICU. Conclusion: The evidence suggests that NAS can be used to calculate the workload of nurses and is useful in planning the number of nursing staff in the ICU. Keywords: Nursing activities score, Nurse workload, Staffing 94 PATIENT SAFETY REPORTING SYSTEM (PSRS), IMPORTANCE KEY FOR IMPLEMENTATION OF RISK MANAGEMENT IN HEALTH SERVICE Eska Distia Permatasari1, Sinta Dewi Lestyoningrum1, Mohd Adnin Zakaria2, Djazuly Chalidyanto3 Magister Program, Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Jl.Mulyorejo Kampus C Unair, Surabaya, East Java, Indonesia 2 Hospital Kajang, Selangor, Malaysia 3 Magister Program, Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Jl.Mulyorejo Kampus C Unair, Surabaya, East Java, Indonesia [email protected], [email protected] 1 The safety of health care is now a major global concern. Patient safety is used to perform risk management and improve service quality. Every year, an inadmissible number of patients suffer injuries or die because of unsafe and poor quality health care. Most of these injuries are avoidable. However, there have been limited systemic in the safety of health care globally to avoid and manage risk factors in medical services. We need patient incident reporting to determinant how can incident occured and find root cause of incident so organizations can improve their performance. This research is a literature review which uses an meta-sintesis approach. This systematic review is conducted in articles published in the SAGE Publisher from 2011 to 2018. The search terms or keywords used are "incident reporting" or "patient safety" or "risk management". The number of articles obtained after the screening process based on the inclusion criteria is as many as 26 articles. Global Assessment shows that incident reporting is important to do as risk management activity in health service. The way that can be used to discipline the reporting of patient safety incident is implementation of Patient Safety Reporting System (PSRS). Keywords: incident reporting, patient safety, risk management 117 ASSOCIATION BETWEEN OPERATIVE DURATION AND HOSPITAL COST IN APPENDICITIS: A SYSTEMATIC REVIEW Bima Pramundita1,2, Wahidah Rachmaniyah1,3 Department of Health Administration and Management, Faculty of Public Health, Universitas Airlangga, Surabaya 60286, Indonesia 2 Dr. Ramelan Marine Hospital, Surabaya, Indonesia 3 Citra Medika Hospital, Sidoarjo, Indonesia 1 Background: This article is an attempt to provide an overview of the systematic review on the Association between Operation Duration and Hospital Cost in Appendicitis. The duration of Appendicitis surgery affects the length of stay of patients because indirectly the duration of surgery affects the risk of patients experiencing postoperative infections. Thus, it takes this analysis to be a consideration of hospitals in policy making. Objectives: To describes the association between operative duration and hospital costs in appendicitis that are used as a consideration in making policy. Methods: Searching for the research results via Pubmed, Sciencedirect, Proquest, Ebsco, and Web science according to criteria. Analysis of this article review using tools a measurement tool to assess systematic reviews (AMSTAR). Results: The majority of studies focus on providing an illustration that was important in identifying the diagnosis of Appendicitis by their standards and classification. Each grade of Appendicitis has different duration of operation, the higher the grade the longer the duration of operation performed because the level of difficulty of surgery was also increasing. The condition was aligned with the increase in hospital costs that must be borne by the patient. Based on these data can be made policy in improving services, especially in providing information to patients related to the diagnosis of patients Appendicitis and treatment. Conclusion: The evidence suggested that association between operative duration and hospital cost in appendicitis was significant. It is necessary to make standard in giving education to the patient so that they are sure to do appendicitis operation on Grade I so that the cost will be more effective. Keywords: Operative duration, hospital cost, appendicitis 136 ANALYSIS STRATEGIC OF MANAGEMENT OF THE CAPITATION FUND THE WARRANTY HEALTH NATIONAL (JKN) IN PUBLIC HEALTH CENTER OF KARANGKETUG PASURUAN CITY Martha Wahani Patrianty ¹, Tito Yustiawan ², Ratna Dwi Wulandari 3 ¹Student Master of Administration and Policy Health, Faculty Health Society, University Airlangga ²Department of Administration and Policy Health, Faculty Health Society, University Airlangga ³Departement of Administration and Policy Health, Faculty Health Society, University Airlangga [email protected] Introduction: Public Health Center of Karangketug has doing management of capitation fund since 2014. The over time budget calculation (SILPA) of capitation fund is relatively large with the number of fluctuating membership in each year. Research this aim for do analysis strategy of management fund capitation of Warranty Health National (JKN). Intervention: Analysis strategic was used was analysis of The Strength Weakness Opportunities Threats (SWOT). Type research descriptive qualitative. Collecting data using method interview repeating. Result: On internal external matrics, obtained values EFAS matrix of 2,96 and value IFAS matrix of 2,87. Of value matrix the position is hold and maintain. There are 3 (three) analyzes the resulting strategy that is SO1 strategy (improvement effort cooperation and coordination cross sector in technical of management of fund capitation JKN), SO2 strategy (improvement monitoring efforts and internal evaluation) and strategy WO2 (improvement competence treasurer of JKN through training and guidance technical). Discussion and Conclusion: Public Health Center of Karangketug located on position strategic, hold and maintain. It is show that management of capitation fund of JKN that has been held could maintained, but need development and repair related procedure and policy. Keywords: analysis of strategy, capitation fund, Warranty Health National (JKN) 114 INFLUENCE PROCESS VARIABLE EUROPEAN FOUNDATION FOR QUALITY MANAGEMENTOF SERVICE QUALITY IN THE INPATIENT UNIT SURABAYA ISLAMIC HOSPITAL Dor Valda Aritonang1, Farouk Ilmid Davik2, Thinni Nurul Rochmah3 Master Student of Administration and Health Policy, Airlangga University 2 Master Student of Administration and Health Policy, Airlangga University 3 Lecture Faculty of Public Health, Airlangga University [email protected] 1 Patient safety is freedom for patients from unwanted losses or potential health hazards associated with. Peraturan Menteri Kesehatan No. 129 / Menkes / SK / II / 2008 on minimum service standards for hospitals, that figure should incidents of 0% (zero accident).While the Inpatient Unit of Surabaya Islamic Hospital has a patient safety incident cases of higher than other units. Therefore, analysis of process variable influence of services quality in the Inpatient Unit Islamic Hospital Surabaya is a common goal in this study using the European Foundation for Quality Management (EFQM).This research is a analytic approach withcross-sectional design intended for nursing staff as respondents who totaled 53 people. The research variables consisted of five variables: the service process are systematically designed and managed, the service process is done accurately using innovation to meet the needs of patients and stakeholders,service was designed and developed based on the needs and expectations of the patient, the service is generated and given to the patient, improvement and management of the relationship with patients. Results showed that the D sub-process has the most influence on the service quality with Exp (B) 0.009. For A sub-process has a value of Exp (B) 0.017, B sub-process has great value Exp (B) 0.059, C sub-process has a value of Exp (B) of 0,020, and E sub-process have influence value of 0.047. Exp (B) shows a large influence on the dependent variable in thisresearch.Hence the advice that can be given to the Inpatient Unit is to improve the quality of service so that the future can be oriented hospital on Total Quality Management (TQM) and the main hospital became the people's choice. Keywords: EFQM, services, Inpatient Unit 77 HUBUNGAN EMPLOYEE ENGAGEMENT TERHADAP KINERJA KARYAWAN (Studi Pada Tenaga Perawat Ruang Rawat Intensif Rumah Sakit swasta di Surabaya) Victoria Theresa Kusumo 1, Amelia 2, Nyoman Anita Damayanti 3 Master Student of Administration and Health Policy, Airlangga University 2 Master Student of Administration and Health Policy, Airlangga University 3 Lecture Faculty of Public Health, Airlangga University 1 Employee performance is one of the important factors of company's success. To create a high performance is not easy, the entire workforce in the company must engage and work together to achieve goals. Employee engagement is a positive thing with the characteristic spirit, dedication, and loving work in the company. Not only makes employees have high loyalty, employee engagement also makes employees contribute more to the company through increased performance. The main purpose of this research is to know how employee engagement level of employee performance happened, and to know the influence of employee engagement towards employee performance at Premier Surabaya Hospital. This research uses descriptive method. The sampling technique used was census / total sampling with the total sample of 50 intensive inpatient nurses of Premier Surabaya Hospital. Keywords: employee engagement, employee performance 76 THE EFFECTIVENESS OF HAND HYGIENE CAMPAIGN TO IMPROVE 5 MOMENTS HAND HYGIENE COMPLIANCE ON NURSES AT HOSPITAL IN SURABAYA Amelia 1, Victoria Theresa Kusumo 2, Djazuly Chalidyanto 3 Master Student of Administration and Health Policy, Airlangga University 2 Master Student of Administration and Health Policy, Airlangga University 3 Lecture Faculty of Public Health, Airlangga University 1 Background : Health care associated infections (HAIs) remain a major concern in hospitals all over the world, not only because they increase morbidity and mortality but also because they can be prevented. Hand hygiene has been described as starting point in all infection control program. Therefore, the compliance of health care workers to 5 moments hand hygiene during patient care needs to be improved to minimize HAIs. Purposes : To analyze the effectiveness of 5 moments hand hygiene campaign on nurses. Methods : Quantitative research with One – Group Pretest-Posttest Design. This study was conducted at private hospital in Surabaya within 3 months. Initial measurements were made in the first month, the campaigns were held in the second month, post campaign evaluation were made in the third month. Population of this study is all the nurses on the intensive care unit (18), emergency unit (18), Azalea ward (16), and Bugenvile ward (17). The sampling technique is total sample. The campaigns are carried out with posters and socialization to all nurses. Results : Hand hygiene compliance was improved from 74.6% to 95% for the first moment, second moment improved from 91.3% to 92.5%, third moment improved form 94% to 97.5%, fourth moment improved from 78.8% to 95%, and fifth moment improved from 79.5% to 95%.The result of the study showed significant improvement in hand hygiene before and after campaign with p value = 0.046. Conclusion : It can be concluded that hand hygiene campaigns are very effective to improve 5 moments hand hygiene compliance. To maintain the hand hygiene compliance, continuous observation and campaign is required. Keywords: 5 Moments Hand Hygiene, Hand Hygiene Compliance, Hand Hygiene Campaign 127 WASTE MANAGEMENT IN THE SUKODONO VILLAGE, PANCENG DISTRICT, GRESIK REGENCY Angelina Tulus, Steven, Silvia Haniwijaya Tjokro, Mujtahidah Department of Public Health, Medical Faculty Of Widya Mandala Catholic University Surabaya, Indonesia [email protected] Rural areas in Gresik Regency have not been touched by the waste management system implemented by the government of Gresik Regency, one of them is Sukodono Village, Panceng District. The waste problem is seen as an unresolved problem. Most communities manage waste by individual patterns of household garbage collecting without being sorted out first and then burned. Seeing the problem, the researcher hopes to give recommendation and can find a way to apply the solution in improving waste management of community based household in Sukodono Village. The nature of this research is analytic survey, the research is directed to connect between the level of knowledge, attitude about waste management, infrastructure facilities and the role of community leaders with the behavior of garbage disposal in the community of Sukodono Village. This analysis applied a random sampling technique with 170 respondents. The data were analyzed by cross sectional study. The results showed that the related factors is infrastructure with p = 0,000; r = 0.324 and the role of community leaders with p = 0,000; r = 0.301. Seeing the related factors then made a program to solve the problem, namely by counseling and forming of garbage bank. From this activity, 15 people (62,5%) changed from burning all waste to not burning and from garbage bank activity simulated in one week of gathering got every RT in Sukodono village participated and collected 11kg Bak, 3kg Kardus, 23kg Plastic, and 1kg Kresek and formed the management of “Bank Sampah Berkah Desa Sukodono” so that this Garbage Bank can continue and develop. Keywords: Waste Separation, Infrastructure Facility, Community Leader, Garbage Bank 80 EFFECT OF THE JOB STRESS IN THE HOSPITAL ON EMPLOYEE JOB PERFORMANCE Mery1, Silvia Haniwijaya Tjokro2, Djazuly Chalidyanto3 Master Student of Administration and Health Policy, Airlangga University 2 Master Student of Administration and Health Policy, Airlangga University 3 Lecture Faculty of Public Health, Airlangga University 1 Rural areas in Gresik Regency have not been touched by the waste management system implemented by the This study aims to reveal the impact of job stress on employee performance. Job stress is one of the most important workplace health risks for employees and job performance have deep impact on the patient safety and the services that we apply toward the customer (patient). Aspects of work stress consisting of work load, working relationship, ambiguity and role conflict, employment relationships, career development and employee health status. In the other hand performance indicators based on Chester I Barnard (1938) performance. This research is an observational research with cross sectional design. Respondents in this study were 53 hospital personnel who directly conducted simple random sampling. The data were analyzed by using Spearman Rank, to see if there was any correlation between work stress and staff performance. The results showed that job stress has correlation toward job performance. Career development have influence toward job performance with p < 0,05; correlation coefficient = 0.848, ambiguity and role conflict with p < 0,05; correlation coefficient = 0.739, work load with p < 0,05; correlation coefficient = 0.469, working relationship with p < 0,05; correlation coefficient = 0.377, and health status with p < 0,05; correlation coefficient = 0.539. This finding implies that job stress has influences on employees’s job performance. The labor and management of the hospital should keep trying to make the work atmosphere more comfortable so as to improve its performance. Base on the research above, we can conclude that there is correlation between work stress on employee performance in hospital. Keywords: job performance, job stress 139 TRAINING NEEDS ANALYSIS FOR NUTRITION PROGRAM MANAGER AT COMMUNITY HEALTH CENTERS IN ORDER TO INCREASE EMPLOYEE CAPACITY 1 Novianti Indah Fatmawati¹, Panjumi Khorida¹, Nyoman Anita Damayanti2 Postgraduate Student of Health Policy and Administration Study Program, Faculty of Public Health, Universitas Airlangga, Mulyorejo Street Campus C, Surabaya, Indonesia ²Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Mulyorejo Street Campus C, Surabaya, Indonesia [email protected] One of the mechanisms that can be pursued in realizing a professional Human Resources is through learning and development of Human Resources. Nutrition Program Manager at Community Health Centers are required to become professional personnel so that Community Nutrition Program which is one of main program of Community Health Centers can run well. This study aims to determine the index of knowledge, attitude and skill of Nutrition Program Manager and to develop training needs for Nutrition Program Manager in Kediri District Health Office. The sample in this research is the total population that is all of 37 Nutrition Program Manager of Community Health Centers. Data collection was done by filling out questionnaires and scores which then carried out the analysis of training needs. Officers are said to need training if the index of knowledge, attitude and skills are included in the less category that is <0.75 and it is said that it does not need training if the knowledge index, attitude and skill are good category that is ≥ 0.75. In terms of knowledge there are 9 officers (24,4%) who have less knowledge, in terms of attitude there are 4 officers (10,8%) have attitude which less and skill 23 officers (62,2%) have less skills. Based on the above, it can be concluded that the Nutrition Program Manager of Kediri Health Office still needs training to improve skill, improve knowledge and improve work attitude. Keywords: Attitude, Knowledge, Nutrition Program Manager, Training Needs Analysis, Skill 71 IS PUBLIC HEALTH CENTER READY TO FACE ACCREDITATION? An Analysis Study of Readiness For Change Towards Public Health Center Accreditation In Indonesia Vidya Nurmala1, Linta Meyla Putri2, Riski Dwi Prameswari2 , Krisbianto2, Ernawaty3, S. Supriyanto3, Nuzulul Kusuma Putri3 1 Magelang District Health Office, Indonesia 2 Magister of Administration and Health Policy, University of Airlangga, Mulyorejo, Surabaya, Indonesia 3 Faculty of Public Health, University of Airlangga, Surabaya, Indonesia [email protected] Public Health Center is the main sector in providing basic health services to the community in Indonesia, which includes individual health care and community health care. To provide quality of services, public health center must be standarized by an independent institution. In 2015 there are only 37.93% of 23 Public Health Center in Magelang District said that they are ready to follow the accreditation. The purpose of this research is to analyzed readiness for change of Public Health Center in Magelang District towards accreditation. The research is an observational with cross sectional design. Research used simple ramdom sampling technique with 23 samples of Public Health Center in Magelang District. Data analyzed using multiple regression test. Readiness for change were influenced by change content, change process, change context and individual attribute. The most influential change content is the administrative system (β = 0.201), the most influential change process is job involvement (β = 0,194), the most influential change context is the District Health Office support (β = 0,167) and the most influential individual attribute is perception of accreditation by health workers (β = 0.147). The result of the research shows that to improve the readiness for change of Public Health Center, it needs intensive facilitation by District Health Office and other stakeholders, commitment development, perception improvement and job involvement for Public Health Center employees towards accreditation. Keywords: readiness for change, public health center, accreditation 91 EFFORTS TO IMPROVE COORDINATION MECHANISM BASED ON TYPE OF DEPENDENCY BETWEEN WORKS UNIT ON THE MANAGEMENT OF PHARMACEUTICAL SUPPLIES IN dr. SOEBANDI JEMBER REGIONAL HOSPITAL 1 Yeni Farida Istanti1, Rofida Lathifah1, Wiwik Supartiwi1 , Thinny Nurul R2, Djazuly Chalidyanto2 Magister of Administration and Health Policy, University of Airlangga, Mulyorejo, Surabaya, Indonesia 2 Faculty of Public Health, University of Airlangga, Surabaya, Indonesia [email protected] One of the functions of the hospital pharmacy installation is to maintain the availability of medicines through good planning so that the provision of drugs to be effective and efficient. Based on data at pharmacy installation of dr. Soebandi Jember hospital experienced an increase in direct drug spending expenses in 2011 to 2013 from 1.94% (2011), 3.36% (2012), and 6.35% (2013). This study aims to provide recommendations on policies, pathways and efforts to improve coordination mechanisms based on the type of dependence on work units in the effectiveness and efficiency of drug supply management in pharmacy installation of dr. Soebandi Jember hospital. This is an observational descriptive study. Located in the dr. Soebandi Jember hospital. The unit of analysis in this study is a work unit that has a role in the process of medical supplies management in the hospital with 40 respondents consisting of Head of Pharmacy Installation, Procurement Officer, Committing Officer, Receiver Committee, Head of Finance, head of service unit and officer management of hospitals involved in drug management. The instruments used in this study are indepth interviews and documents review related to the process of managing medical supplies in pharmaceutical installations dr. Soebandi Jember hospital as well as the process of payment of drugs in pharmaceutical installation dr. Soebandi Jember hospital. The recommendations for this study were developed through Focus Group Discussion (FGD). The result of this study is the policy about the management of drug supply in pharmacy installation of dr. Soebandi Jember hospital which consists of policy of planning, acceptance, ordering, storage, distribution, inventory, use, expiration of drug expiry, and drug payment. The next recommendation is the flow of drug supply management and drug payment. While the last recommendation is about improving the coordination mechanism based on the type of dependence among the work units involved in the process of managing the stock of drugs. Keywords: Policy, Coordination Mechanism, Type of Dependency 109 ER TEAM’s PERFORMANCE to IMPROVE QUALITY of EMERGENCY SERVICES 1 Linda Sutrisno1, Reyni Kumampung1,Titin Ekowati1, Widodo J.Pudjirahardjo2 Student Master Program of Administrationand Health Policy, Faculty of Public Health, Airlangga University 2 Faculty of Public Health, University of Airlangga, Surabaya, Indonesia [email protected] Background: The hospital is a health care institution that organizes the complete individual health care that provides inpatient care, outpatient, and emergency room. One of the problem that exist in ER IbnuSina Hospital Gresik is the high number of false cases of emergency, it is feared could affect the quality of emergency care in the ER. The purpose was to measure the performance of the emergency room team with NBNQA to increase the quality of service in case of emergency in ER IbnuSina Hospital Gresik. Methods: This study used descriptive quantitative. The population of the study was all ER team includes nurses, doctors, and head of installation and obtained samples as many as 30 people. The samples obtained by total sampling technique. Data collected by questionnaire of MBNQA and analyzed by descriptive statistics, percentage or exposure using word or phrase. Independent variable was ER team performance and dependent variable was quality of emergency services. Results: The results consist of seven parts: the calculation of ER team performance by using the seven criteria of MBNQA. Conclusions: it was recommended to the ER team to improve the quality of emergency services. We gave recommendation to the hospital to provide an opportunity to the ER’s staff with a good performance in order to continue their education to the higher level and made special policies to open department outpatient after hours to reduce the number of false emergency. Keywords: ER (Emergency Room), Team, Quality, Services, MBNQA (Malcolm Baldrige National Quality Award) 70 ORGANIZATIONAL COMMITMENT AND ORGANIZATIONAL CITIZENSHIP BEHAVIOR (OCB) CORRELATE WITH EMPLOYEES PERFORMANCE ON MUHAMMADIYAH HOSPITAL 1 Muryani1, Candra Ferdian Handriyanto1,Nyoman Anita Damayanti2 Student Master Program of Administrationand Health Policy, Faculty of Public Health, Airlangga University 2 Faculty of Public Health, University of Airlangga, Surabaya, Indonesia Human resources has an important role to achieve organization goals, including in hospital. Employee with outstanding performance can make organization reach their goal effectively and efficienlty. Factors that may affect the employee performance are commitment to organization and Organizational Citizenship Behavior (OCB). This research aim to analyze the correlation of organizational commitment and OCB with employee performance on Muhammadiyah Hospital. This is an analytic cross sectional research with simple random sampling method. Primary data was taken using questionnaire from 80 employees. Data was analyze using SPSS with regression test. The results show that organizational commitment and OCB correlate with employee performance on Muhammadiyah Hospital (p = 0.021). Employee with high organizational commitment and OCB has high performance. To improve the performance of Muhammadiyah Hospital employees, hospital management need to maintain and enhance the commitment of the employee to the organization and drive their sense of Organizational Citizenship Behavior. Organizational commitment can make employee stay loyal to hospital and work hard while OCB make employee do more than the job they were told. Thus, hospital goals can be achieved. Keywords: Organizational Commitment, Organizational Citizenship Behavior, Employees Performance 74 THE EXISTENCES OF JOB SATISFACTION RELATED GENDER IN TURNOVER TENDENCY OF HEALTHCARE WORKERS 1 Candra Ferdian Handriyanto1, Muryani1, Pavel Rysanek2, Nuzulul Kusuma Putri3 Student Master Program of Administrationand Health Policy, Faculty of Public Health, Airlangga University 2 Klinikum Chemnitzer, Germany 3 Faculty of Public Health, University of Airlangga, Surabaya, Indonesia Healthcare workers tend to work in high workload with different working hours of other jobs. Work-life balance is commonly identified as major issues among healthcare workers. Healthcare workers in hospital commonly are women with dual roles. It leads to high turnover tendency due to several dimensions of satisfaction toward their working life. This study analyzes how gender diversity in workplace will determine job satisfaction and turnover tendency of health workers. We surveyed 178 respondents in a hospital (N = 340) which selected by simple random sampling. Job satisfaction dimensions in each group were analyzed as exposure variables in linier regression for turnover intention. Our findings show that female worker tend to leave their current jobs due to unsatisfied condition of pay and communication. The pay satisfaction of female workers is related to the demographic variables that correlate with family economic demands. In the other hand, female worker with different education will have different satisfaction toward communication in workplace. Both variables do not determine turnover intention among male workers. Male workers who have willingness to resign are they who unsatisfied with the nature of work. These results show that gender satisfaction differential existed in affecting the turnover intention among health workers. Keywords: communication, gender, healthcare, nature of work, pay 79 JOB DESIGN AND TRAINING AS A SOLUTION TO OVERCOME THE DECREASE OF FOOD TIME DELIVERY ON PATIENTS IN RSUD dr. H. MOH. ANWAR SUMENEP Dhody Rofsanjani 1, Sigit Lesmonojati2, Totok Wahyudi3 Djazuli Chalidyanto4 Master Student of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga 2 Director of Bondowoso Bhayangkara Hospital 3 Master Student of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga 4 Lecturer of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga [email protected] 1 Introduction: The success of hospital meals can be due to the timely feeding of patients. Based on data on timeliness of feeding in patients in Nutrition Installation RSUD dr. H. Moh. Anwar Kab. Sumenep, there has been a decrease in the percentage of timely feeding in patients from September to December 2017. Aim of research is identify the causes of decreasing the timeliness of feeding in patients and provide an alternative solution of the human resource approach. Method: The type of research is observational with descriptive research design. This method is done by Cross Sectional approach. Data were collected through observation and interview. Data analysis is statistically descriptive. Results: The causes of the problem are the limited manpower, knowledge and ability of the officers, and the increase in the number of patients. Solutions that can be done through job design and training. Discussion and Conclusions: The main factors causing decreased timeliness of feeding in patients are the limited labor and the level of knowledge and ability of the officers. Solutions of the problems is job design (job enlargement and job enrichment) and conduct Training or internship related to catering so that can add insight and improve the skill of nutrition officer optimally. Keywords: Job design, training, feeding 141 ANALYSIS EFFECT OF EMPLOYEE SATISFACTION AND EMPLOYEE COMMITMENT ON ORGANIZATIONAL CITIZENSHIP BEHAVIOR (OCB) IN HOSPITAL OF BHAYANGKARA BONDOWOSO 1 Sigit Lesmonojati1, Nyoman Anita Damayanti2, Djazuly Chalidyanto3 Master Student of Health Policy and Administration, Faculty of Public Health, Airlangga University 2 Lecturer of Health Policy and Administration, Faculty of Public Health, Airlangga University 3 Lecturer of Health Policy and Administration, Faculty of Public Health, Airlangga University Bhayangkara Bondowoso Hospital is a hospital owned by the Police which has the main duty to provide health service plenary for Police and public in Besuki residency area. In carrying out these basic tasks, of course, required adequate human resources both in terms of quantity and quality. In order to evaluate human resource management in providing the best health service for the community, it is necessary to analyze the influence of employee satisfaction and work commitment to OCB so as to realize the improvement of service for hospital advancement in JKN era at this time. This is one of the indicators that affect the effectiveness of a hospital's performance. Job satisfaction and commitment of inpatient staff of Bhayangkara Bondowoso Hospital give influence to the creation of OCB. The more satisfied employees the better the level of OCB by 90.6%. The higher the level of employee commitment the better the OCB level of 71.9%. This is evidenced through research by sampling through the quisioner a number of 33 employees about the influence of job satisfaction and commitment to OCB. With correlation test of linear regression SPSS version 21 got significance influence of job satisfaction to commitment equal to F = 16,392; α = 0,000; Coefficients β = 0.588, the effect of job satisfaction on OCB is F = 12,454; α = 0.001; Coefficients β = 0.535, the influence of commitment to OCB is F = 19.025; α = 0,000; Coefficients β = 0.617. Keywords: job satisfaction, commitment, OCB, human resources 140 ANALYSES OF SEVERAL FACTORS THAT INFLUENCE THE WORK SATISFACTION OF THE EMPLOYEE AT SURABAYA PREMIER HOSPITAL Reyni Kumampung1, Linda Sutrisno 2, Nyoman Anita Damayanti 3 Student Master’s Program of Administration and Health Policy, Faculty of Public Health, University of Airlangga 2 Student Master’s Program of Administration and Health Policy, Faculty of Public Health, University of Airlangga 3 Lecturer of Health Policy and Administration, Faculty of Public Health, Airlangga University 1 Job satisfaction is important in human resource management, as it relates to organizational productivity, organizational citizenship behavior (OCB), customer satisfaction and loyalty. Aim: This research is based on Hygiene Herzberg Motivator theory with the aim to know the relationship of job satisfaction with motivation and hygiene factor and factors dominant influence on employee satisfaction at Premier Surabaya Hospital. Method: The research method used descriptive analytic with cross sectional design to 232 stratified samples from 586 employees of Premier Surabaya Hospital. Conclusion: The result is that there is a significant correlation between job satisfaction and company policy and administration, supervision, money and relationship with peers (hygiene factor) and achievement, recognition, responsibility and advancement (motivation factor). Keywords: Job satisfaction, Herzberg Theory 120 THE EFFECTIVENESS OF HEALTH PROMOTION TO IMPROVE DIABETES TYPE 2 PATIENT LIFESTYLE Noer Amalis Sholeha1, Riski Dwi Prameswari2,Krisbianto2,Linta Meyla Putri2,, Ernawaty3,S. Supriyanto3,Nuzulul Kusuma Putri3 1 Puskesmas Barengkrajan, Indonesia 2 Magister of Administration and Health Policy, University of Airlangga Mulyorejo Surabaya, Indonesia 3 Faculty of Public Health, University of Airlangga Surabaya, Indonesia [email protected] Diabetes Mellitus is a degenerative disease that its prevalence expected to increase in the next few years in Indonesia. Results of Riskesdas (2013) says that the prevalence of diabetes mellitus tends to be higher in urban than in rural areas. This is because in urban areas many people working as employees with lifestyle and poor diet as well as work stress experienced in the workplace. Patients with diabetes mellitus visit have increased in Puskesmas Barengkrajan.The purpose of this study is to analyze the effectiveness of health promotion to improve lifestyle in people with Diabetes Mellitus Type 2.This study uses the pre-experimental designs, using questionnaires HAPA through interview techniques. Indicator measured in HAPA focuses on intention and action planning. The population in this study included all patients with diabetes mellitus in Puskesmas Barengkrajan Sidoarjo. The sample size of patients in this study are patient with diabetes mellitus for one month period at Puskesmas Barengkrajan. Provision of health promotion to Diabetes Mellitus patients affect the lifestyle of patients. One indicator of lifesytle change is marked by changes in intention and action. Changes in action in the form of decreased blood sugar β (0,539) and altered intention β (0,307) marked with intention of patient to be willing to perform activities recommended by doctor in order to process of healing disease. Effective health promotion can improve lifestyle in type 2 Diabetes Mellitus patients characterized by changes in intention and action to change their lifestyle. Keywords: Lifestyle, Health Promotion, Diabetes Melitus, HAPA (Health Action Process Approach) 121 APPLICATION OF WORKLOAD INDICATORS OF STAFFING NEEDS (WISN) IN DETERMINING HEALTH WORKERS PLANNING IN JOMBANG ISLAMIC HOSPITAL Rofida Lathifah1,2, Yeni Farida Istanti1, Nanda Aulya Ramadhan1, Makhyan Jibril Al Farabi3, Nyoman Anita Damayanti1 1 Health Policy and Administration, Faculty of Public Health Airlangga University, Surabaya, Indonesia 2 Jombang Islamic Hospital 3 University College London, United Kingdom [email protected] As an effort to improve health service quality, Jombang Islamic Hospital sought to update staffing need for nurses and midwives against the existing workload as they are hospital staff whose gave direct service to patients. To support this decision, we used Workload Indicators of Staffing Need (WISN) method, a human resource management tool popularized by the World Health Organization. The study is a cross sectional survey involving observation and record review. There were seven units which included in the study. Rate ratio and proportions were calculated using Microsoft Excel. We measured the difference between the ideal number of nurse and midwife and current staffing levels then we gave recommendation for hospital based on the ideal WISN ratio. We found that nurses were short in 4 units (WISN ratio 0.56, 0.72, 0.96, 0.90) and excess in 2 units (1.48, 1.21). As for midwives, they were excess in all units (3 units; WISN ratio 8, 7.14, 1.89). The WISN results shows the inadequacies of existing staffing pattern. Therefore a new staffing pattern should be made. Keywords: hospital staffing, human resource management, midwife, nurse, WISN 113 EFFECTIVENESS OF HAND HYGIENE TRAINING ON EMPLOYEE’S COMPLIANCE HAND HYGIENE AT RUMAH SAKIT ISLAM SURABAYA Prima Nerito1, Boy Sandy Sunardhi1, Djazuly Chalidyanto 2 Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 2 Lecturer of Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia [email protected] 1 Hospital Associated Infection (HAIs) is still a problem in the world. One of the causes is the compliance of hand hygiene of health workers is still low. The spread of HAIs is 80% transmitted by hand. Non-medical personnel in hospitals are among the officers who are at risk of passing the pathogen through the hands, as non-medical personnel still have a great chance of being in one of 5 important moments of hand hygiene. Hand hygiene simulation is one type of training performed every shift change of non-medical personnel, in order to establish behavior and improve non-medical personnel compliance in hand hygiene. This research is descriptive research using questioner. The population is all RSIS employees in IGD, ICU and IRNA with a sample size of 40 people. Cross-tabulation analysis test to see the effectiveness of the training. The results obtained, the implementation of training hand hygiene appropriate at the input phase, process, output and outcome. From cross tabulation, it is found that there is relationship of input, process, output and outcome with effectiveness of hand hygiene training on RSIS employees. Keywords: hand hygiene, training effectiveness 143 CORRELATION OF OBLIGATION FACTORS WITH HAND HYGIENE FIVE MOMENTS OBEDIENCE TO HEALTH CARE WORKERS IN EMERGENCY ROOM OF PHC HOSPITAL SURABAYA Boy Sandy Sunardhi 1, Prima Nerito 1, Djazuly Chalidyanto 2 Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 2 Lecturer of Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia [email protected] 1 Each patient has the right to obtain safety during the hospitalization, one of which is to avoid the risk of HospitalAcquired Infections (HAI). The risk of Hospital-Acquired Infections (HAI) can be reduced through the implementation of hand hygiene five moments. The obedicene of health care workers in the implementation of hand hygiene five moments are still a problem for PHC Hospital Surabaya. Based on Monitoring and Evaluation Report of Hand Hygiene Audit Activities in Health Care of PHC Hospital Surabaya in 2017, service unit that has the lowest level of hand hygiene five moments obedience in 2017 is Emergency Room (ER) that is 24% (standard > 80%). This research aimed to analyze the correlation between obligation factors with hand hygiene five moments obedience to health care workers in ER of PHC Hospital Surabaya. This research was an observational descriptive study with cross sectional design. Questionnaires were distributed to 20 health care workers in ER of PHC Hospital Surabaya consisting of 16 nurses and 4 doctors. The result showed that the lower the assessment of health care workers about legitimacy of authority figure, personal responsibility, peer support and proximity of authority figure, then it tends to the lower of hand hygiene five moments obedience level. The conclusion of this research are legitimacy of authority figure, personal responsibility, peer support, proximity of authority figure have a correlation with hand hygiene five moments obedience to health care workers in ER of PHC Hospital Surabaya. Keywords: Obedience, hand hygiene five moments, health care workers, Emergency Room 87 IMPLEMENTATION OF MATERNAL REFERRAL SYSTEM IN PUSKESMAS GUNUNG ANYAR SURABAYA CITY Ester Mariana 1, Devita Tintasari 1, Juliyana Puspa Sari1, Pitra Aries1, Nyoman Anita Damayanti2 Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 2 Lecturer of Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 1 Implementation of the maternal referral system is still an unresolved problem in our health system. Weakness of health services that is felt is the implementation of inappropriate reference back. This is a problem that is not only financially harmful but also affects the quality of health services and will affect the achievement of performance in the health sector. Since 2014 BPJS has implemented a referral program as a cost-efficiency effort, but in its implementation is not as expected. This research uses descriptive research method that is implemented in Puskesmas Gunung Anyar Kota Surabaya 2018. Total sample are 16 respondents. Respondents are midwives of puskesmas and midwife in Puskesmas Gunung Anyar. Instruments in this study using questionnaires accompanied by interviews. Descriptive data analysis. Given the importance of maternal referrals, this study aims to determine the implementation of maternal referrals conducted at the Puskesmas Gunung Anyar. Result: Implementation of maternal referral at Puskesmas Gunung Anyar has been carried out according to standard procedure and according to medical indication and handling of delivery case, but standard procedure of receiving referral has not been done. The implementation of maternal referral at Puskesmas Gunung Anyar has been running well with some limitations, namely the lack of referral from hospital to Puskesmas, especially the administrative procedure. Suggestion: To implement a referral policy, the organization should establish a written procedure standard for return of referrals. Similarly, Puskesmas should establish standardized referral referral procedures from RS and standard referral return procedures to other Puskesmas, Pustu or midwife. Keywords: referral system, referral back 96 PUBLIC SOCIO-ECONOMIC PROFILE RELATIONSHIP WITH RISK OF HYPERTENSION DAN DIABETES MELLITUS PATIENTS IN SURABAYA IN 2015 Primayanti1, Warih Kusumaningtyas2, Nungky Taniasari3, Mochamad Imam Sudibyo4, Djazuly Chalidyanto5 1 Sub. Section Program, Information and Public Relations, Public Health Office of Surabaya 2 Postgraduate Student of Health Policy and Administration, Faculty of Public Health, Airlangga University Surabaya 3 Lecturer of Stikes RS Anwar Medika Sidoarjo 4 Vice Principal Public Relations of Insan Cendekia Mandiri Boarding School 5 Head of Health Policy and Administration Programs, Faculty of Public Health, Airlangga University Surabaya [email protected] Background: The quality of life of the patient is an important aspect in diabetes mellitus (DM) and hypertensions (HT) because poor quality of life will reduce the awareness of self-care that makes glycemic control worse, increases the risk of complications, and makes DM and HT worse both in the short and long term. Prevalence of diabetes mellitus in Indonesia based on Basic Health Research in 2013 has increased from 1.1% to 2.1%. Hypertension prevalence in Surabaya in 2015 is 6.1% while prevalence of diabetes mellitus is 3.35%. By 2015 the population of Surabaya is 2,848,583 inhabitants. Objective: To find out the correlation between socio-economic profile of patients with risk of hypertension and diabetes mellitus. Design: An analytical descriptive research with cross sectional study design was used in this research. Multistage random sampling was used to select the representative sample. There are 48 samples of diabetics and 48 samples with hypertensions. The data were collected through interviews using questionnaires. Results: The socio-economic profiles examined in this study are the profile of the economy, sex, and employment type of the participants. The results showed that from 96 of Hypertensions (HT) and Diabetes Mellitus (DM) patients, 21% of HP patients had economic profile with no income (E1), 60% of HP patients had economic profile with under of Minimum Wages (E2), and 19% of HP patients had economic profile with more than the same as Minimum Wages (E3). While in patients with DM showed 48% of participants have E1 profile, 40% of participants have E2 profile, and 12% of participants have E3 profile. While in the sex profile, 45% of women suffered from HP and 55% of women suffered from DM, while 61% of male suffered from HP and 39% of male suffered from DM. In the employment type profile in the HP patients as much as 10% with civil servants, the TNI, POLRI type, 25% with the housewives and not working type, 33% with company worker / labor / entrepreneur type, 0% with teacher / professional type, 10% with retired job type, and 2% with driver job type. By using chi-square calculation analysis with α = 0.01, showing the calculation value for economic profile has a result of 7.805; sex profile has a result of 2.33; and the employment type profile has a result of 12.19. The result of chi square calculation on the three profiles is greater than the value of chi table at 99% confidence level that is successively worth 9.21; 6.63; and 16.81. Conclusions: It was concluded that there was a relationship between the socio-economic profile of the patient and the risk of hypertension and diabetes mellitus. The socio-economic profile with economic, sex, and employment parameters has relevance to the illness suffered by the patient. Family members is expected to always give support to the patients either moral support, information, or funding. Patients with hypertension and type II diabetes mellitus are expected to always be motivated to improve self-awareness by striving to follow the control program of Non-Communicable Disease Risk Factors with emphasis on curative-promotive aspects in accordance with the results of the Surabaya City Government inventory program in 2015. Keywords: socio-economic, hypertension, diabetes mellitus 97 FINANCIAL RISK OF HOUSEHOLD: THE CHARACTERISTICS OF HEALTH ASSISTANCE FUND RECIPIENTS IN INDONESIA Nuzulul Kusuma Putri1, Anggun Wulandari2 Lecturer, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia 2 Student, Magister of Administration and Health Policy, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia [email protected] 1 Before national health insurance have been implemented since 2014, Indonesia was experienced with various scheme of health funding assistances for its citizens. The participants’ requirements were diverse depend on the each district government policy. This study aimed to analyzed in national level what is the specific existed financial risk of households that tend make them need a financial assistance in accessing healthcare services. We used data of Indonesian Family Life Survey (IFLS) from RAND Corporation in Santa Monica, USA. It is constructed based on financial variables that were combined from two data sets. There are 15,108 household were analyzed after processed in data cleaning. Our findings show that households which having risk to create debts in financing their daily needs are qualified to receive health assistance fund. The independency of household that observed through house ownership and other social funding assistances variables are also significantly related to citizen’s appropriateness as health assistance fund recipients. Surprisingly, household ability to paid debts that represents the improvement of family income is not related with the healthcare funding assistance. Keywords: financial risk, household, health insurance 107 IDENTIFICATION OF DRUG PRESCRIPTION ERROR IN MAWADDAH MEDIKA HOSPITAL WITH SIX SIGMA METHOD 1 Moh. Badrus Sholeh 1, Thinni Nurul R 2 Student, Magister of Administration and Health Policy, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia 2 Lecturer, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia [email protected] The hospital patient safety is a system to improve the patient care quality safer than before, including patient risk assessment, risk management, incident report and analysis, and solutions implementation to prevent incident. The patient safety incidents were significantly increased to 180% in the period 2014-2015 in Mawaddah Medika Hospital. The absence of in-depth analysis about the incident occurres in Mawaddah Medika hospital makes this research focus on the service process related to the incidents in order that the repetition of the next incident can be prevented, through six sigma methods. The method applies the quantitative method with observational descriptive study by using sigma method. At the define phase of six sigma, review of drug prescription error in Mawaddah Medika hospital were conducted. Incident reports that had occured from October 2015 until March 2016 were identified. After the incidents are analyzed for the risk grading. At the measure phase, the services related with those highest risk grading incidents are identified and measured as the service performance, with incident as the defect. And then every service is observed closely to measure whether there is any variation from the process or not. It also has been found that Mawaddah Medika hospital has lower sigma rate that conclude the hospital has less good quality. After each variations from the process is measured, the teams discuss to analyze root cause of potential incidents. After the root causes are identified, It goes to the improve phase. The recommendation for the improvement of programme was making to developed the hospital. Keywords: Patient Safety, drug prescription error, six sigma 84 THE OUTSTANDING TRANSFORMATIONAL LEADERSHIP IN TEACHING HOSPITAL OF UNIVERSITAS AIRLANGGA: DIRECTING HOSPITAL TOWARDS THE VISION AND MISION Nanda A Ramadhan1,2, Moh B. Sholeh1, Djazuly Chalidyanto1, Nasronudin2 1 Public Health Faculty, Universitas Airlangga 2 Teaching Hospital of Universitas Airlangga [email protected] Transformational leadership is defined as a method of leadership which a leader encourage teams to identify needed change, to shape the vision by inspiring and leading the change, and implementing the change in all of the members of a team. The leader serves as a role model for the members by inspiring them and rising their interest of projects and works. This method is able to promote the motivation as well as the job performance of each individuals, leading to enhancing the whole organization performance. On January 2016, the new CEO was inaugurated in Teaching Hospital of Universitas Airlangga (UNAIR Hospital). Immediately, the Director made several quick movements in order to identify the hospital governance problems of the hospital. Some problems causing less number of patient visit were financial, human resources, facilities, and infrastructure problems. Facing the problems, the CEO conveyed to all leaders if there are still many opportunities to improve the performance of UNAIR Hospital because it has the strength, among them 97% of human resources are still at productive age, the availability of sophisticated medical equipment and quite complete and the internal stakeholders come from various experts of academic disciplines that have accustomed to innovations. The external opportunity are the increasing number of population and the increasing income per capita resulting in modern health service facilities demand. UNAIR Hospital governance must focus to targeted market share, service effectiveness, cost competition, production capacity, financial position, service quality, human resource quality, and hospital image. To support the efforts, the hospital CEO set up an accreditation team, a quality team and a cost control team and set clear job descriptions on each of the human resources. Within a year, the UNAIR Hospital can pass national accreditation and be designated as teaching hospital and as type B hospital. During two years of his leadership, the other hospital indicators are also improved significantly. Transforming organizational culture is not easy but leaders can move the whole line to be able to change quickly and build a commitment to achieve targets that have been set. Keywords: Transformational, Leadership, Hospital, Vision, Mission 100 HOW TO INCREASE EARLY DETECTION OF HIGH-RISK PREGNANT WOMEN BY COMMUNITY AS AN EFFORT TO DECREASE MATERNAL MORTALITY RATE IN SURABAYA 1,2,3,4,5 M M Firmansyah1, N I Fatmawati2, N Farah3, N H Marada4 and N A Damayanti5 Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia [email protected] Background: Maternal Mortality Rate (MMR) is a component of health development index and quality of life index especially for women. Based on the report of maternal mortality from 38 in East Java in 2014-2016 showed surprising data that Surabaya listed as one of the regions that have a high number of maternal deaths. The number of maternal deaths in Surabaya in 2016 was 37 people. The cause of the majority of cases of maternal mortality can actually be prevented, and it is estimated that more than 40% of pregnant women have a risk of non-fatal obstetric abnormalities. Tenggilis Primary Health Care Surabaya in the year 2017 indicate that the target of 195 high-risk pregnant women only 179 were the result of early detection by the community and cadres. To see more in indirect factor, especially related to early detection of high-risk pregnant women by cadres and the community, it will use a comprehensive approach. Methods: This was an observational study with cross-sectional design. Independent variables in this study were age of pregnant women, pregnancy history, and history of miscarriage. While the dependent variable of this research is preliminary examination of high risk pregnant women by health cadres. The population of this study that all pregnant women who visited Tenggilis Primary Health Care during January - March of 2018 a total of 72 people. The number of samples in this study were 26 respondents with accidental sampling sampling technique. Results: Statistical results showed that age of pregnant women (p = 0.741), pregnancy history (p = 0.086), and history of miscarriage (p = 0.261) were not associated with preliminary examination of high risk pregnant women by health cadres. It is shown with p-value of each variable more than 0,05. Conclusion: Based on these results it can be concluded that in conducting preliminary examination (early detection) of high risk pregnant women, health cadres do not prioritize pregnant women who have risky age, poor pregnancy history, and pregnant women who have a history of miscarriage. Keywords: maternal age, pregnancy history, history of miscarriage, early detection, health cadres 130 DEVELOPING QUALITY INDICATOR IN CENTRAL STERILIZATION SUPPLY DEPARTMENT BASED ON LITERATURE REVIEW Widayanti 1, Prima Nerito 2, Djazuly Chalidyanto 3 Departement of Administration and Healt Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 2 Lecturer of Departement of Administration and Healt Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia [email protected] 1 Background: Healthcare associated infections (HAIs) are major threat to the patient safety care. Sterilization and decontamination of instruments and medical devices play a very important role in the prevention of HAIs. The Central Sterile Supply Department provides sterile medical devices or surgical instrument, proper sterilizations of instruments between patients is an essential action to reducing HAIs. The quality of sterilization products must be assessed by certain quality indicators. Lacks of standarization of Quality are major problem in developing countries include Indonesia. Methodes: Quality Indicators for sterilization in CSSD were developing by literature review. The main literature is National Indonesia Guidelines for CSSD , 2009, Revised WHO Manual and Guidelines for Desinfection and Sterilization 2016, dan Revised APSIC Guidelines For Desinfection and Sterilisation Of Instruments In Healthcare Facilities, 2017. Quality Indicator is developing in all cycle of process in CSSD, include input, process and output. In the approach to descriptive qualitative we present here, we begin with formulation of quality indicators, followed by a discussion of issues in qualitative data. Summarizing principles of good practice and providing sugestion for further reading and learning. Results : a total of 24 quality indicator were developed. These include 7 indicators for input, 10 indicators for process, and 7 indicators for output of CSSD. These Quality Indicators in CSSD can be evaluated in all sterilization process with controlling of this subject in evaluation and accreditation of hospital program. Conclusion : 24 indicators were developed for assesing the quality of CSSD based on study literature. Keywords: Quality Indicator, Sterilization practice, Central Sterile Supply Department 93 JOB SATISFACTION SURVEY IN PUBLIC HEALTH CARE Rokhmah Maulidina1, Widayati Yuli Arini2, Ernawati3 Student of Magister Administration and Health Policy, Airlangga Univerity, Surabaya 2 Student of Magister Administration and Health Policy, Airlangga Univerity, Surabaya 3 Lecture of Public Health Faculty, Airlangga University, Surabaya 1 Job satisfaction is a positive attitude of the workforce to its work, which arises based on an assessment of the work situation. Employees who are satisfied with their work prefer the work situation rather than dislike it. Job satisfaction is important in the organization. Cukir public health care has 35 employees of civil servants, and in the last three years the performance of public health care employees has decreased. The purpose of this study is to analyze employee job satisfaction and aspects that have the greatest contribution in forming employee job satisfaction at Cukir Public Health Center, Jombang District. This research is a descriptive research. The instrument used is Job Satisfaction Survey (Spector 1997). The sample in this study is all Civil Servants who work in Cukir public heath center that is as many as 35 people. The result showed that job satisfaction at Cukir Public Health Center was 71.4% felt satisfied and 28.6% were satisfied. While the dominant factor in forming employee job satisfaction is the dimension of the nature of the work with a mean value of 4.79 and the factor that has the least influence is the dimension of operational conditions. Keywords: job satisfaction, public health care 123 THE CORRELATIONS BETWEEN MARKETING MIX AND OUTPATIENTS LOYALTY IN PUSPA ANWAR MEDIKA CLINIC GRESIK 1 Devita Tintasari1,Fama Alburuda1, Nyoman Anita Damayanti2 Student of Magister Administration and Health Policy, Airlangga Univerity, Surabaya 2 Lecture of Public Health Faculty, Airlangga University, Surabaya The marketing mix is the core activity of the marketing system, the variable that can be controlled by the hospital to influence the patient's reaction. This marketing mix consists of products, places, people, processes and physical evidence. This objective of this research is to determine the relationship of marketing mix to loyalty of outpatients at Puspa Anwar Medika Clinic Gresik. This research was conducted at Puspa Anwar Medika Gresik Clinic. The type of research used is quantitative research using cross sectional study. The population is outpatient clinic at Puspa Anwar Medika Gresik Clinic with a large sample of 101 people. The statistical test used is chi square test. This research was conducted in November 2017. The results showed that there was a significant correlation between product marketing mix (p-value = 0,000), place (p-value = 0,000), people (p-value = 0,000), process (p-value = 0,001), and physical evidence (p-value = 0,000) with loyalty of inpatient at Puspa Anwar Medika Gresik Clinic. The conclusion of this study is the products, places, and physical evidences have a relationship with the loyalty of outpatients at Puspa Anwar Medika Gresik clinic. Keywords: Marketing mix, Loyalty, Patient 108 CORRELATION OF PATIENT SAFETY CULTURE AND INCIDENTS OCCURANCE IN HOSPITAL Risya Widyastuti1, Desiana Medya Arnani Landay1, Tito Yustiawan2 Magister Program, Departement of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Jl.Mulyorejo Kampus C Unair, Surabaya, East Java, Indonesia 2 Department of Administration and Health Policy, Faculty of Public Health, Universitas Airlangga, Jl.Mulyorejo Kampus C Unair, Surabaya, East Java, Indonesia [email protected] 1 Risk management related to patient safety is crucial and become global issue. The purpose of this study was to analyze the correlation between patient safety culture and patient safety incidents. This study conducted cross sectionally, involving 10 work units of Petrokimia Gresik Hospital with 145 respondents that were selected using stratified random sampling and using questionnaires adopted from AHRQ. Data were analyzed using descriptive statistics and spearman correlation test. This study found that overall patient safety culture in Petrokimia Gresik Hospital was high (mean=3.03±0.2). Furthermore, interesting results occurred in the dimensions of management support for patient safety (p=0.000, R=-0.976), and feedback and communication about error (p=0.025, R=-0.697). The results implied that more management support for patient safety and feedback and communication about error in the hospital will decrease the number of incidents. Morover, this case study also showed there was no significant correlation between patient safety culture and incidents occurance (p=0.176). To summarize, patient safety culture relatively insignificant to minimize number of patient incidents, and hospital management must emphasizing in giving more support, and providing feedback and communication in responding errors in hospital services delivery process. Keywords: patient safety culture, patient safety incidents 118 THE ROLE OF BREAST CARE NURSE IN BREAST CANCER PATIENT ADHERENCE ON SEEKING TREATMENT BEHAVIOR IN SURABAYA ONCOLOGY HOSPITAL: A PRELIMINARY STUDY 2 3 Dwi Rahayuningtyas1,2, M. Helmi Aziz3, Nanda Aulya Ramadhan2, Djazuly Chalidyanto2 1 Surabaya Oncology Hospital, Indonesia Department of Health Policy and Administration, Faculty of Public Health, Airlangga University, Indonesia Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Indonesia Background: Breast cancer is a cancer with the highest incidence rate among women worldwide. Women who are diagnosed with breast cancer need support from many people including health professionals, family members, friends and fellow breast cancer patients. The National Breast Cancer Centre (NBCC) guidelines for early breast cancer recommend that, in addition to the support provided by these people, women living in Australia also have access to support provided by breast care nurses. Breast care nurse is a novelty in Indonesia and there is no study describing the role of breast care nurse in Indonesia. The aim of this preliminary study is to describe breast care nurse role in breast cancer patient adherence on seeking treatment behavior in Surabaya Oncology Hospital, Indonesia. Method: This study is a retrospective case control study conducted in Surabaya Oncology Hospital. We analyzed data from medical records from the patients that were diagnosed with breast cancer and/or suspicious malignant tumor in their first medical appointment with breast care nurse or nurse from January 2017 – December 2017. A positive outcome was measured if the patients continued to seeking treatment, while negative outcome was the patients that stop to seeking treatment after the first appointment. Result: 423 patients were enrolled and analyzed in this study. Fisher's exact test comparing the rate of adhered patients to medical advice between patients educated by breast care nurse (85.3%) and patients educated by nurse (14.7%) showed that there is no meaning impact between the group (p value = 0.200). Conclusion: The preliminary results showed that breast care nurse had not a significant role in adherence on seeking treatment behavior of breast cancer patients in Surabaya Oncology Hospital, Indonesia. Keywords: Breast cancer, breast care nurse, breast cancer treatment, seeking treatment behavior 90 IMPLEMENTATION PREVENTION OF MOTHER TO CHILDREN (PMTCT) POLICY IN TENGGILIS HEALTH CARE SURABAYA 1,2, Widayati Yuli Arini1, Rokhmah Maulidina2, Nyoman Anita Damayanti3 Student of Magister Administration dan Health Policy, Public Health Faculty, Airlangga University Surabaya 3 Lecture of Public Health Faculty Airlangga University Surabaya [email protected] Prevention of Mother to Child Transmission (PMTCT) is in line with the general policy of Maternal and Child Health and is part of the effort to control HIV AIDS and Sexually Transmitted Infections in Indonesia through 4 (four) Prongs. The First Prong in PMTCT is counseling and testing service. In 2017, pregnant women testing HIV in Tenggilis Health Center as much as 75,03% from target 100%. Unattainable HIV testing targets for pregnant women are likely increase the cases of transmission HIV to child because pregnant women will not know the status of HIV disease in themselves and will be at risk of transmitting the virus to the fetus in the womb. This study aims to see the implementation of PMTCT policy in Tenggilis Health Center Surabaya. This research is an observational research with cross sectional approach. The data was collected by study literature about PMTCT policy and structured interview to programmer PMTCT, widfive coordinator and pregnant women who visited Tenggilis Health Center as many as 29 (twenty nine) pregnant women using Questionnaire through Socio Ecological Model (SEM). The results showed that the Surabaya Government has issued a policy about countermeasures HIV / AIDS in the form of local regulations Number 4 Year 2013, regulation of Mayor number 29 of 2015 and the mayor decision number 188.45 / 31 / 436.1.2 / 2010 but there is still no specific policy regulating the prevention Prevention of Mother to Child Transmission (PMTCT) and respondents are not yet aware of the policy. Tenggilis health care has implemented prevention policy of mother to child transmission HIV through 3 Prong according to the Prevention of HIV from mother to child (PMTCT) that is Prong 1, Prong 2 and Prong 3; Testing of HIV in pregnant women at Tenggilis health care was conducted by PMTCT team consisting of doctors, midwives, nurses and laboratory officers and integrated with ante natal care services but the partnership of testing HIV on pregnant women has not been established with independent midwives and private clinic which is network in Tenggilis health center area so that not all pregnant women do HIV testing. Therefore, it is necessary to strengthen the policy of PMTCT implementation in the local regulation of Surabaya City, Strengthening of network and improvement of partnership in Tenggilis Health Care area to conducting HIV testing on pregnant mother and PMTCT policy socialization to network of health center, religious leader, public figure, community and program targets. Keywords: PMTCT, HIV, AIDS, Policy 153 THE EFFECT OF WORK MOTIVATION ON ORGANIZATIONAL CITIZENSHIP BEHAVIOR OF THE EMPLOYEES Juliyana Puspa Sari1, Vica Aulya Rivera1, Nyoman Anita Damayanti2 Student of Health Policy Administration Program Study, Faculty of Public Health, Airlangga University, Indonesia 2 Lecturer of Health Policy Administration Program Study, Faculty of Public Health, Airlangga University, Indonesia [email protected] 1 Patient's dissatisfaction with the long waiting time of pharmaceutical service is assumed to associate with employee performance and work motivation in the medical support unit. To support employee performance, high work motivation is required. High work motivation can affect Organizational Citizenship Behavior (OCB). This research aims to analyze the effect of work motivation on Organizational Citizenship Behavior of Medical Support Unit employees at Gotong Royong Hospital Surabaya. The type of this research is observational research using crosssectional approach. The sample of this research is 35 employees of medical support units at Gotong Royong Hospital Surabaya. The data obtained were analyzed by simple regression analysis and t-test interpretation analysis; for each dimension of Work Motivation on OCB. The findings of this research indicated that work motivation had a nonsignificant correlation with organizational citizenship behavior (p-value = 0.078) and had an effect of 9.1%. The conclusion of this research is that work motivation has no significant correlation with OCB at Medical Support Unit of Gotong Royong Hospital Surabaya. Keywords: Work Motivation, Organizational Citizenship Behavior 99 FIVE DIMENSION LEVESQUE APPROACH (USING HUMAN RESOURCES SCORECARD) FOR EVALUATION OF HEALTH PROGRAM IN ELIMINATING MATERNITY SHAMAN (TBAs) Indra Dwi Chayono1, Nyoman Anita Damayanti2 Graduate Program of Health Administration and Policy Faculty of Public Health Airlangga University 2 Department of Health Administration and Policy Faculty of Public Health Airlangga University [email protected] 1 Data showed that maternal mortality rate in Bondowoso Regency Indonesia in 2016 was accounted to 195.81/100,000 live births (20 cases), meanwhile infant mortality rate was noted to 17.42/1,000 live births (187 cases). This study aimed to assess effectiveness of health program which named as “Stop Berduka” (Sinergi Total Pencegahan Bersalin di Dukun Bayi dan Selamatkan Ibu) or “Stop Grieving” in minimizing maternity shamans role which was initiated by The Health Office of Bondowoso Regency. Control Group Post test only design study was performed to identify how many maternity shamans that consistently handled delivery process for pregnant women in Bondowoso Regency. Three district areas were studied cross-sectionally as a pilot project of given program including Tlogosari, Sumberwringin, and Botolinggo. At the end of the year 2016, Tlogosari district had 21%, while Sumberwringin district had 4.74%, and Botolinggo district had 14.47% of pregnant women delivery process that were handled by maternity shamans. Subsequently, this study found that in May and June 2017 the role of dukun maternity was completely eliminated, since no woman gave birth using their services anymore, but in July until september there was again a case of shaman doing relief labor. From the results obtained in the evaluation of health service providers using the Human Resources Scorecard with a Levesque five-dimensional approach. Keywords: maternal mortality rate, maternity shaman, stop berduka, effectiveness, human resources scorecard, Levesque five-dimensional approach 116 RELATIONSHIP OF FAMILY SUPPORT TO ANTENATAL CARE (ANC) INSPECTION IN WORK AREA OF PUSKESMAS GUNUNG ANYAR SURABAYA 1 Fama Alburuda ¹ , Nyoman Anita Damayanti ² Student of Program of Health Administration and Policy Faculty of Public Health Airlangga University 2 Department of Health Administration and Policy Faculty of Public Health Airlangga University [email protected] One indicator of the level of health quality of a region is the Maternal Mortality Rate (MMR). The maternal mortality rate in Surabaya is still high. At 2016, AKI is 85.72 per 100,000 live births. Antenatal Care (ANC) is a pregnancy examination to optimize the mental and physical health of pregnant women, so as to be able to deal with labor. This study aims to analyze the relationship between family support for ANC examination in pregnant women in the work area Puskesmas Gunung Anyar Surabaya. This analytic observational study used cross sectional approach. The population of this study is pregnant women in 2018 in the work area Health Center Puskesmas Gunung Anyar Surabaya as much as 1089 respondents. Sampling was done by using Random sampling system to get 75 respondents. Collected data is processed statistically using Spearman test. Spearman test result with 95% confidence level, obtained p value <0,022. Based on the test results, the hypothesis proposed is accepted in other words there is a relationship between family support with ANC examination. Furthermore, the correlation coefficient (r) 0.264 shows that there is a positive correlation and a strong relationship between the function of family support with compliance ANC examination. Based on this research it is suggested that health practitioner give counseling to the nearest family, especially husband to actively participate in supporting pregnant mother to conduct pregnancy examination in health service. Keywords: Antenatal Care (ANC), Family Support, Maternal Mortality Rate (MMR) 154 HOW TO MANAGE DRUG LOGISTIC IN PUBLIC HEALTH CENTRE Agus Sulistyorini1, Totok Wahyudi2, Dhody Rofsanjani3, S. Supriyanto4, Ernawaty5 1 Public Health Office, Kediri District, East Java, Indonesia 2 Master Student of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga 3 Master Student of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga 4 Lecturer of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga 5 Lecturer of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga [email protected] Background : One of the obligations to ensure the availability of health services is drug logistics. Implementation of drug logistics at Public Health Centre must be effective and efficient. According to the data in 2014, the majority of Public Health Centre in Kediri district still had drug stockout condition and drug stagnation. The objective of the study is to analyze the management of drug logistics which includes selection, procurement, distribution, usage, support management, and the influence of drug logistics management on the availability of drugs in Public Health Centre. Method : This study uses primary data that is derived from in-depth interviews and filling checklists on available forms and secondary data from LPLPO data in Public Health Centre. Data presented in the form of descriptive, analytic and statistical test of linear regresi yield / show / bring up the dominant factor that influence the availability of drugs at Public Health Centre in Kediri district. Result : it showed that the dominant factor, the cause of drug availability is not optimal, was the demand of drug type (p = 0,005 and b = 0,691). Conclusion : The recommendations of the researchers were to formulate drug formularies at district level, validate drug planning proposals, rearrange the composition of the drug planning team and rearrange the drug procurement schedule. Keywords: Drugs Supply, Drug Logistic Management, Public Health Centre 155 IMPROVEMENT OF MOTHER VISIT TO POSYANDU USING IMPLEMENTATION SMS GATEWAY IN PUSKESMAS TENGGILIS Swasti Niramaya1 , Awliyana Rislaputri1, Nyoman Anita Damayanti2 , Tito Yustiawan2 Master Student of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga 2 Lecturer of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga [email protected] 1 Based on the results of the early survey on the mother & babies at the Posyandu Tenggilis, there was the biggest reason why they didn’t measure weight of her children in Posyandu is about lack of information related with Posyandu activities. The low participation of toddlers in Posyandu activities impacted on unmonitored growth and development by medical servant therefore many nutrition problems happened, especially lack of nutrients / malnutrition. Short Message Service (SMS) is one type of Instant Messaging (IM) that allows users to exchange short messages anytime. This application system utilizes SMS technology on mobile device as a reminder of Posyandu activity / schedule especially Kartu Menuju Sehat (KMS) for toddlers. Within this application is expected to be more convenience for medical servant or Posyandu officers to provide information and immunization schedule and useful as a monitoring of growth and development of toddlers. And also as a tools to record health services of toddlers then it can improve Posyandu or Puskesmas services towards the toddlers growth. Keywords: Ibu Balita, KMS, SMS Gateway 157 LEGAL STUDY ABOUT DOUBLE CLAIM IN HEALTH INSURANCE IN INDONESIA Hilda Yunita Sabrie1, Prawitra Thalib1, Zahry Vandawati1, Faizal Kurniawan1 1 Universitas Airlangga [email protected] Coverage or insurance is an agreement between the insurer and the insured that the insurer has an obligation to bear some or all of the risks of the insured, while the insured is obliged to pay the insurance premium that has been approved when the insurance agreement is closed. If the insured has an uncertain event then the insured is entitled to claim to the insurer. Specifically in filing health insurance claims there are several parties involved such as; the doctor and the hospital. This is because the doctor's and hospital's certificate is a letter that is needed by the insured as proof of health insurance claim submission. In practice the insurer will always ask to attach the original doctor or hospital letter, this is used to prevent the insured from submitting a double claim to another insurance company. But now with business reasons, many insurance companies receive certificates of doctors or hospitals in the form of photocopy. This policy will spur new issues that conflict with principles in insurance law. So that will have an impact on the legal protection for the insured and the insurer it self. To that this research needs to be studied more deeply. This research is normative legal research, which use legal method statute approach, conceptual approach, and case approach. Keywords: Health Insurance, Double Claim, insured, insurer 73 PATIENT SAFETY: IS IT IMPACT THE QUALITY OF HEALTH CARE SERVICES? (A SYSTEMATIC REVIEW) 1 Sinta Dewi Lestyoningrum1, Ratna Dwi Wulandari2 Magister Program, Departement of Health Policy and Administration, Airlangga University, Jl. Mulyorejo Kampus C Surabaya, East Java, Indonesia 2 Lecture, Departement of Health Policy and Administration, Faculty of Public Health, Airlangga University, Jl. Mulyorejo Kampus C Surabaya, East Java, Indonesia [email protected] This study reviews the literature on the patient safety that it can related and impact the quality of health care services. This study can support the researchers and health care service provider to develop models to improve the quality of services with managing their focus on patient safety. We conducted searches in online database with large repositories of research article or paper of academic studies, which written in English and accessible by the autors. The articles being reviewed are related with patient safety, quality of health care services, health management, human resource and organizational behavior. The literature was reviewed with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methods, and predefined string was used to extract 973 articles. The predefined articles were reviewed and checked carefully. The result of this study found factors in patient safety related and have an impact to quality of health care services. Keywords: patient safety, quality of health care services, health management, human resource and organizational behavior 105 AN EVALUATION 5 FACTORS OF JOB SATISFACTION IN RELIGION BASE HOSPITAL: A CROSS SECTIONAL STUDY AT MUHAMMADIYAH HOSPITAL IN TUBAN 1 Thiwit Nurul Huda1, Totok Wahyudi1, Djazuly Chalidyanto2 Magister Program, Departement of Health Policy and Administration, Airlangga University, Jl. Mulyorejo Kampus C Surabaya, East Java, Indonesia 2 Lecture, Departement of Health Policy and Administration, Faculty of Public Health, Airlangga University, Jl. Mulyorejo Kampus C Surabaya, East Java, Indonesia Background—Health service delivery is affected by many factors. Human resource is a vital component in delivering health services. The presence of highly qualified and motivated staff is a key aspect of health system performance. Job satisfaction of employees is highly important in building up employee motivation and performance which will increase productivity and efficiency. The objective of this study is to assess job satisfaction and many factors associated among employees in Muhammadiyah Hospital in Tuban, East Java, Indonesia. Materials and Methods— Muhammadiyah hospital is one of the islamic base hospital in Tuban. Cross sectional study was conducted among 127 employees in Muhammadiyah Hospital through a self-administered survey consisted of 25 questions including salary, supervision, opportunities for promotion, staff relationship, and working condition, which was analyzed with SPSS software. Multivariable logistic regression was used to assess associated factors of job satisfaction with 95% CI at p ≤ 0.05. Results—A total of 71 responses (n=18 (25,4%) male, n=53 (74,6%)) female) were collected for a total response rate of 56%. The result showed that majority of employees 74,6% (n=53) had been satisfied and 25,4% (n=18) of them had been dissatisfied with their job. The finding of this study indicated that only 57,7% (n=41) of responses had been satisfied with their salary. As 60,6% (n=43) of them had been satisfied to opportunities for promotion and supervision , and 73,2% (n=52) reported their satisfied for staff relationship. The majority score reported 85,9% (n=61) of responses had been satisfied in their working condition. The correlation between the different aspects of job satisfaction was found to be not significant. Gender differences, profession, and level of education were found to be significantly associated with job satisfaction. Conclusions—Majority of the study participants in our study were satisfied with their job. The most employee job satisfaction was attributed to working condition that they are currently doing, but only a half were satisfied with their salary. There is no correlation between 5 factors including salary, supervision, opportunities for promotion, staff relationship, and working condition with overall job satisfaction score. Keywords: Job satisfaction; Muhammadiyah hospital 163 THE ROLE OF COMMERCIAL HEALTH INSURANCE IN THE NATIONAL HEALTH WARRANTY PROGRAM Zahry Vandawati Chumaida1, Hilda Yunita Sabrie2, Widhayani Dian Pawestri3, Rizky Amalia4 1 Faculty of Law Universitas Airlangga, Jalan Dharmawangsa Dalam Selatan, Surabaya, Indonesia 2 Faculty of Law Universitas Airlangga, Jalan Dharmawangsa Dalam Selatan, Surabaya, Indonesia 3 Faculty of Law Universitas Airlangga, Jalan Dharmawangsa Dalam Selatan, Surabaya, Indonesia 4 Faculty of Law Universitas Airlangga, Jalan Dharmawangsa Dalam Selatan, Surabaya, Indonesia The National Health Insurance Program (JKN) organized by the Social Security Administering Body (BPJS) of Health is proclaimed by President Joko Widodo with the aim of the Indonesian people to get health careers in the implementation of this JKN, with the enactment of Law number 24 year 2011 on Indonesia Social Security Administering Agency (BPJS) has undergone a reformation in health financing by giving opportunity to Commercial Insurance to synergize JKN as partner by implementing Coordination of Benefit (COB) scheme. Participants / business entities that already have commercial health insurance are also required to join the mandatory insurance program organized by the government. In order to avoid double financing, the government cooperates with commercial insurance, through COB program so it can be avoided double cost. The issues raised are to know the role of private insurance companies to participate in the achievement of universal coverage in the era of National Health Insurance (JKN) in support of the Coordination of Benefit (COB) program. With the implementation of the National Health Insurance (JKN), every citizen will be guaranteed by the JKN program and for those who already have commercial health insurance, the guarantee will be considered a "top-up payer" or additional insurance. Research methods are normative (legal research / doctrinal research). This study analyzes the extent to which the role of commercial health insurance in succeeding National Health Insurance program launched by the government. Keywords: National Health Insurance, Role of Commercial Health Insurance 133 ANALYSIS OF FACTORS AFFECTING THE COMPLETENESS OF IMMUNIZATION BASIS FOR PREVENTING CHILD STUNTING IN PUSKESMAS TENGGILIS SURABAYA CITY Dilalatul Urfiah Muchlis1, Nyoman Anita Damayanti2 Policy Master of Health Administration program Interest in Health Care Management, Faculty of Public Health, Airlangga University, Surabaya, Indonesia 2 Lecturer, Faculty of Public Health, Airlangga University, Surabaya, Indonesia [email protected] 1 Background :According to Minister of Health No. 1995 / Menkes / SK / XII / 2010 on Standard Anthropometric Assessment of Nutritional Status of the Child, the understanding of short and very short is the nutritional status based on the index Length for by Age (PB / U) or Height by Age (TB / U) which is the equivalent term stunted (short) and severely stunted (very short). Short Toddlers (stunting) can be seen when a toddler has been measured length or height, and then compared to the standard, and the results were below normal. Method :This study was an observational analytic study using cross sectional design of the study wake. Analyze data are descriptive of univariate and bivariate analyzes. Samples were obtained by the technique of sampling was simple random sampling using a sample size calculation formula of Stanley Lemeshow. Logistic regression analysis using the SPSS 21. Results: Significance value of 1.000 where the value is greater than the confidence level α used is 0.05. It can be concluded that there is no significant influence on the completeness of basic immunization in preventing stunting in children under five. Conclusion:Results of research have shown that out of 26 respondents, 20 respondents (76.9%) complete their immunization status. From these results it can be seen that there is no significant influence on the completeness of basic immunization in preventing stunting in children under five. However, to prevent stunting among children under five in the region than respondents who essentially incomplete immunization status. Keywords: Immunization, Stunting 112 LEVEL OF PREGNANT WOMEN'S KNOWLEDGE ON HIGH-RISK OF PREGNANCY IN PUSKESMAS TENGGILIS SURABAYA CITY Nurhayati Marada1, Veby Andriani2, Nyoman Anita Damayanti3, Tito Yustiawan4 1 Magister program of Health Policy Administration Interest in Health Care Management, Faculty of Public Health, Airlangga University, Surabaya, Indonesia 2 Lecturer, Faculty of Public Health, Airlangga University, Surabaya, Indonesia, [email protected] Background: Maternal Mortality Rate (MMR) of East Java in 2016 based on district/city reports of 91.00/100,000 live births. The highest cause of maternal mortality in 2016 is Pre Eclipse, which amounted to 30.90% or as many as 165 people. While the smallest cause is infection of 4.87% or as many as 26 people. Objective: To find out the level of knowledge of pregnant women about the high risk of pregnancy at Puskesmas Tenggilis, Surabaya city, at good level, enough, less. Method: The type of this research is Quantitative Descriptive research with Cross Sectional approach. The number of samples were 26 pregnant women, with sampling technique using Exhaustive Sampling method. Result: The results showed that pregnant mother's knowledge about high risk of pregnancy was good as much as 9 respondents (34,6%), enough 10 respondents (38,5%) and less 7 respondent (26,9%). Conclusion: From the research that has been done can be known that pregnant mother knowledge about high risk of pregnancy at Tenggilis Public Health Center Surabaya most of which are knowledgeable enough that as many as 10 respondents (38,5%) from 26 respondents. Suggest: It is expected that health workers continue to work on counseling about high risk of pregnancy, especially in pregnant women at high risk by using media that is easy to understand by pregnant women. Keywords: Knowledge, Pregnancy, High Risk Pregnancy 129 RELATIONSHIP KNOWLEDGE WITH PREGNANT WOMAN'S BEHAVIOR IN THE USE OF VOLUNTARY COUNSELING AND TESTING SERVICES (VCT) IN PUSKESMAS TENGGILIS SURABAYA CITY 1 Veby Andriani1, Nurhayati Marada2, Nyoman Anita Damayanti3, Tito Yustiawan4 Magister program of Health Policy Administration Interest in Health Care Management, Faculty of Public Health, Airlangga University, Surabaya, Indonesia 2 Lecturer, Faculty of Public Health, Airlangga University, Surabaya, Indonesia, [email protected] Background: Number of HIV cases tended to increase by 2016 was reported as many as 41,250 cases. Number of AIDS cases in 2016 is also reported slightly increased from the year 2015 of 7 491 cases. HIV infection in pregnant women can threaten the mother’s life and can transmit the virus to her baby. More than 90% of HIV infected children are transmitted through mother-to-child transmission (MTCT). Result of Performance Assessment Indicators of Puskesmas Tenggilis on the achievement of pregnant women examined HIV at Tenggilis Health Center in 2017 equal to 75,03% from 100% target, visible still reducation of VCT service by group of pregnant women at Tenggilis Health Center. Objective: This study aims to determine the relationship between knowledge with the attitude of pregnant women in VCT services at Tenggilis Health Center Surabaya. Methods: The design of this study was cross-sectional, and the subjects of this study were 29 pregnant women who performed Antenatal Care at Puskesmas Tenggilis. Data analysis was done univariat and bivariate using Fisher test. Results: Result of analysis with Fisher test is ρ = 0,125 so ρ> 0,05 (no relation). Conclusion and Recommendation: There is no correlation between knowledge with attitude of pregnant mother in VCT service at Puskesmas Tenggilis, meaning there is no difference between the attitude of pregnant women whose knowledge is good or still less about HIV/ AIDS and VCT. It is hoped that the Puskesmas will do the empowerment of pregnant mothers through Maternal Care Movement activities and provide socialization about HAIV/ AIDS and VCT services and prevention of HIV/ AIDS transmission from mother to child. Keywords: Knowledge, Attitude, HIV/ AIDS, VCT 126 COORDINATION EFFECT OF IMPLEMENTING SYSTEM REFERRED MATERNAL TO HOSPITAL IN PUSKESMAS GUNUNG ANYAR SURABAYA Pitra Aries Wibowo1, Devita Tintasari1, Juliyana Puspa Sari1, Ester Mariana1, Nyoman Anita Damayanti2 1 Magister program of Health Policy Administration Interest in Health Care Management, Faculty of Public Health, Airlangga University, Surabaya, Indonesia 2 Lecturer, Faculty of Public Health, Airlangga University, Surabaya, Indonesia In 2014 the Government of Indonesia launched the JKN program, the important thing that is regulated is the patient referral system from the first health facility to the second health facility (continued). Puskesmas as the first health facility become the referring party to the hospital's advanced health facility. The high number of indications of high risk maternal patients make the puskesmas inadequate, so that the referral solution to the hospital should be done, in the hope that maternal mortality can be optimally suppressed. A common barrier that affects referrals is coordination and communication between puskesmas and hospital. This research used descriptive research method which was conducted at Puskesmas Gunung Anyar Surabaya in April - May 2018. Total sample were 16 respondents. Respondents are health center midwives at Puskesmas Gunung Anyar. Instruments in this study using questionnaires and interviews. Descriptive data analysis. The importance of referral system that begins with coordination, hence this research aim to know influence of coordination Puskesmas Gunung Anyar to referring mother deliver to hospital. Results: Obtained in the implementation of coordination and communication as the standard initial procedure referral system to maternity patients between Puskesmas Gunung Anyar to the hospital has not been appropriate, so that there is often a rejection of the hospital. Conclusion: In general, the implementation of maternal referral from Puskesmas Gunung Anyar has been running quite well with some drawbacks that are not yet compatible with referral procedures for coordination and early communication with the hospital. Suggestion: To optimize coordination and communication hence needed gathering forum together between Puskesmas Gunung Anyar with hospital to agree on effective and efficient comprehensive referral coordination system, such as communication procedure before referring, referral documentation and recording of coordination implementation. Keywords: referral system, coordination, communication, puskesmas 165 MEASURING JOB SATISFACTION OF HOSPITAL EMPLOYEE : A LITERATURE REVIEW 1 Nurhasmadiar Nandini1, Novia Handayani1, Naintina Lisnawati1, Agus Aan Adriansyah2 Faculty of Public Health, Diponegoro University, Tembalang, Semarang, Central Java, Indonesia 2 Faculty of Health, Nahdlatul Ulama University of Surabaya, Surabaya, East Java, Indonesia Hospital as an organization which sell service as its commodity always depend on the service quality, patient satisfaction and employee satisfaction. Employee satisfaction not only affect the work performance, but also the service quality and patient satisfaction. There were several and various method and instrument to measure employee satisfaction in hospital. This paper aimed to and identify advantages and disadvantages of those methods and instruments and compare it to develop a suggestion for more suitable instrument in hospital especially in Indonesia. This was literature review research by comparing several instruments and methods to measuring employee satisfaction in hospital. Result showed that there were several instruments with similar variables that used to measuring job satisfaction in regular institution and might be used to measure job satisfaction of hospital employee. However, there are several variables that important to be added in the instrument to measure job satisfaction of hospital employee, such as related to patient, work safety, and else. Also, it is needed to develop different specific question for specific job characteristic in hospital. Health professionals satisfaction should measured by different indicator with the employee in managerial area in hospital. Therefore, it could be concluded that it is needed to develop an instrument which able to capture and identify the job satisfaction both of health professionals and managerial staffs in hospital. Keywords: Measuring job satisfaction, hospital employee, literature review 89 INTERPERSONAL FACTOR ANALYSIS "SOCIAL ECOLOGICAL MODEL OF HEALTH BEHAVIOR" FAMILY SUPPORT IN UNDERFIVE CHILDREN VISIT TO INTEGRATED HEALTH CENTRE (POSYANDU) Richa Agustine Sundoko, Rokhmah Maulidina, Swasti Niramaya, Rohmah Alfi YL, Nyoman Anita Damayanti Department of Health Policy and Administration, Faculty of Public Health, Airlangga University [email protected] Family should weigh underfive children every month to the posyandu (Integrated Health Centre/IHC) to monitor their growth. Weighing coverage of underweight is still below target. The purpose of this study is to perform interpersonal factor analysis of underfive children visits at Posyandu Tenggilis Surabaya, East Java. The design of this study is descriptive, crosssectional study direction and data retrieval in May 2018 on 19 respondents mother of underfive children. The results show that regular visits to posyandu have higher frequency in good family support. Approach to family understanding and role is very important to increase family support on underfive children visits in posyandu. 132 ANALYSIS OF THE UTILIZATION OF SERVICE POST (POSYANDU) BY MOTHER WHO HAS TODDLER IN THE WORKING AREA OF PUSKESMAS TENGGILIS Rohmah Alfi Yafira Lukman1, Nyoman Anita Damayanti2 Health Policy and Administration Departement Faculty of Public Health Airlangga University 2 Mentor of Health Policy and Administration Departement Faculty of Public Health Airlangga University [email protected] 1 Posyandu is one of the health efforts that are sourced by the community, implemented by health cadres who have received education and training. This study aims to analyze the relationship between maternal education level, mother's knowledge, distance to posyandu, family support and cadre's role in informing posyandu on visitation level of mother to child to posyandu. The type of this research is quantitative research with cross sectional approach. The population in this study is all mothers who have children or children aged 0-59 months who reside in the work area of puskesmas tenggilis. Selection of sample by random sampling and taken to mother of toddler who come to puskesmas tenggilis through interview and filling questioner. Bivaritat analysis showed that posyandu distance with probability value 0.000 <0,05 was significant relation to visitation level of mother mother to posyandu. And maternal education, maternal knowledge, mother support work and cadre informant about the importance of posyandu have no relation with visitation level of mother mother to posyandu. And on multivariate analysis using multiple linear regression known that sig value. For mother education is equal to 0,919 (p> 0,05), hence hypothesis rejected mean maternal education variable do not influence significantly to visit mother to posyadu, sig value. For mother's knowledge is equal to 0,087 (p> 0,05), hence hypothesis rejected mean maternal knowledge variable do not influence significantly to visit mother to posyandu, sig value. For maternal employment is 0,594 (p> 0,05), hence hypothesis rejected mean maternal job variable do not significantly influence to mother visit to posyandu, for posyandu distance variable from data above show sig value. 0,001 (p <0,05), hence the accepted hypothesis meaning posyandu distance variable significantly influence to visit mother to posyandu, sig value. For family support is 0.636 (p> 0.05), hence the hypothesis is rejected means family support variable has no significant effect on mother visit to posyandu, and sig value. For cadre to inform about posyandu is equal to 0,020 (p> 0,05), hence hypothesis rejected meaning variable of cadre inform about posyandu not significantly influence to visit mother to posyandu. It can be concluded that the effect on the level of visit of the mother toddler to the posyandu is the distance from the mother toddler's house to the posyandu. Keywords: Education, Knowledge, Employment, Family Support, Distance to Posyandu, Attendance Level of Toddlers, Posyandu 170 HUBUNGAN TEAM EFFECTIVE DENGAN KEPATUHAN PELAKSANAAN HAND HYGENE DI RSIA PUSURA TEGALSARI Yulianto Hadi Nugroho1 Health Policy and Administration Departement Faculty of Public Health Airlangga University 1 Surveillance on nosocomial infection is one of the activities in Prevention and Infection Control Program (PPI Program) in hospital. Preliminary study shows the activity of recording and reporting of Hand Hygiene in PPI RSIA PUSURA Tegalsari was much lower than the minimum service standards, although trained PPI team was available. This indicates that the performance of surveillance of nosocomial infection has not run well. The purpose of this study is to identify, analyze, and determine the solution from the causes of the low performance of surveillance of Hand Hygiene in RSIA PUSURA Tegalsari. The study was conducted with a qualitative descriptive approach to study the documents, structurally interview, and observe with checklist. Problem searching was conducted using Focus Group Discussion with 30 workers, nurses of Infection Prevention Control Nurse (IPCN) and Infection Prevention Control Link Nurse (IPCLN) as participants. The results show most components of surveillance have not been executed properly according to the Technical Guidelines of the Ministry of Health Surveillance 2010. It is caused by the absence of policies for program socializing to PPI Team, lack of management support for the program and supporting facilities, as well as the lack of oversight of the implementation of Hand Hygiene surveillance program. The best solution is the establishment of an education program and continuous training for PPI team to improve the knowledge, skills, and attitudes to support the surveillance program of HAIs in RSIA PUSURA Tegalsari. 173 PHYSICIAN-INDUCED DEMAND: REVIEWING THE THEORY OF SUPPLY AND DEMAND IN HEALTHCARE Wulandari Berliani Putri1 Department of Public Health, Faculty of Medicine, Universitas Islam Indonesia [email protected]; [email protected] 1 Background: Healthcare expenditure has increased dramatically in the past decades around the world. Some argue that this is derived from the pharmaceuticals industry as well as physician-induced demand (PID), a demand in healthcare caused by doctors’ self-interests. Many studies tried to investigate how PID could increase the demand in healthcare, yet the result is erratic. The aim of this article is to analyze the determinants factor that influence the rise of healthcare expenditure. Method: Keywords searching through MEDLINE Ovid and EBSCO database and additional references from retrieved articles. Result: Determinants of demand in healthcare comprise of price, income, prices of other goods, tastes and lifestyles, population size and composition. If the price of a good or service decreases, the quantity of demand increases (law of demand). The higher the price the fewer can afford so this limits demand. PID hypothesis may contribute as it is derived from the asymmetry of knowledge between agent (doctor) and consumer (patient). However, most studies could not provide a detailed analysis whether patient treatment is based on PID or patient preference. Conclusion: In conclusion, PID is possible exist due to moral hazard which emerges from asymmetry information violation. Yet, many studies in PID have difficulty to distinguish between PID model and conventional supply and demand model. A growing demand in health care is caused by many factors such as the illnesses trends (chronic diseases), lifestyle changes, uncertainty area in medical knowledge, new and high technology in medical, health insurances, quality of care, and increased consumer expectation. Keywords: supply-demand determinants, health insurance, physician-induced demand, asymmetry information, moral hazard, healthcare expenditure 131 DESCRIPTIVE ANALYSIS OF MOBILE HEALTH SERVICES IN LESS DEVELOPMENT, BORDERLANDS AND ARCHIPELAGOES (DTPK) MARATUA ISLAND REGENCY OF BERAU PROVINCE OF EAST KALIMANTAN Nila Farah1, Yohana Yosevine Usmany2, Ratna Dwi Wulandari3 Magister program of Health Policy Administration Interest in Health Care Management, Faculty of Public Health, Airlangga University, Surabaya, Indonesia ²Magister program of Health Policy Administration Interest in Health Care Management, Faculty of Public Health, Airlangga University, Surabaya, Indonesia 3 Lecturer, Faculty of Public Health, Airlangga University, Surabaya, Indonesia, [email protected] 1 Introduction : Mobile health services are health services performed by the Health Services Team comprising provincial, district and district teams involving the sub-district health centers of Maratua District in order to improve access and availability of health services in remote and remote areas of Berau District, East Kalimantan Province. Where the type of health services include basic health services, emergency services, specialist health services, referral and evacuation health services and community empowerment. Priority issues that must be addressed at DTPK include access to quality health services, health personnel fulfillment followed by equitable distribution of human resources, and referral system in health facilities. Method: This study was conducted to find out the health status of the population residing in DTPK, with 120 respondents with simple random method. Data was collected by interviewing 120 respondents using questionnaires, randomly selected. Results and Discussion: The results of the study showed that 21.4% of respondents had communicable diseases, 54.2% of non-communicable diseases respondents, and others 24.4% of respondents. While among the respondents who experienced non-communicable diseases, 68% of them suffer from Hypertension and Diabetes Mellitus that is not known before, so never the previous health care provider. While the other 2% among respondents with non-communicable diseases require referral and evacuation health services. Conclusion: Overall mobile health services in the archipelago such as Maratua are very useful in bringing health care services closer to the community if done consistently and sustainably, using the island cluster approach by selecting and strengthening health facilities on Maratua Island into a referral health facility between health facilities on the surrounding island. Keywords: Health Service, in Less Development, Borderlines, Archipelagoes, Remote Areas 158 THE RELATIONSHIP BETWEEN MOTHER'S KNOWLEDGE OF VITAMIN A AND VITAMIN A COMPLIANCE IN INFANTS / TODDLERS AT TRENGGILIS HEALTH CENTER 1 Awliyana Rislaputri1, Nyoman Anita Damayanti2 Magister program of Health Policy Administration Interest in Health Care Management, Faculty of Public Health, Airlangga University, Surabaya, Indonesia 2 Lecturer, Faculty of Public Health, Airlangga University, Surabaya, Indonesia, [email protected] Background: Children need vitamin A intake is relatively higher than adults because vitamin A will be used for growth. Objective: to see if mother's knowledge about vitamin A is low so that Mother does not routinely check her child to get Vitamin A. Method: Using crossectional research design by looking at the relationship between mother / infant's knowledge about vitamin A and maternal obedience giving vitamin A to infant / toddler. Results and Discussion: Based on the results of the research, the knowledge of mother about Vitamin A was enough (85.7%) but maternal obedience to give low vitamin A (14.3%). After analyzed by using Pearson correlation, there was an inverse relationship between mother's knowledge of vitamin A and maternal obedience in giving vitamin A to their child but the relationship was not significant with p-value was 0.389. Conclusion: Vitamin A is one of the most important nutrients for children and adolescents so it is very important to remind mothers to provide vitamin A intake in children and adolescents to prevent unwanted disease. Recommendation: improving cooperation between all lines either from the health side or the Puskesmas, Kader, Ma and Mother as one part of the community. Keywords: Vitamin A, Knowledge, Compliance 216 CLINICAL PATHWAY IMPLEMENTATION - HOW MUCH ADVANTAGES DOES IT MAKE? A SYSTEMATIC REVIEW Via Dolorosa Halilintar1, Sherly Tandi Arrang2 Departemen of Pharmacology and Pharmacy, School of Medicine, Unika Atma Jaya Jakarta 2 School of Pharmacy, Unika Atma Jaya Jakarta [email protected] 1 Clinical pathways (CP) or Integrated Care Pathways (ICP) are guidelines used to conduct clinical interventions with evidence-based to apply to health-care facilities. Clinical pathways are used as standard clinicians in clinical practice. Several previous studies have shown CP or ICP as an instrument to control the quality and cost of primary health care for disease regimens with a high prevalence and cost. This systematic review is structured to see how much impact CP or ICP implementation has on clinical outcomes and costs. The literature search was conducted on the online database of PUBMED, ScienceDirect and Clinical Key. There are 16 journal articles that clearly and measurably describe the clinical outcomes and/or costs. Selected journals can explain the specific impact of CP / ICP implementation on specific diseases. Impact Implementation of CP / ICP in clinical outcomes consequently improving the quality of disease prognosis, simplification of the regimen, and decreased Length of Stay (LOS) in hospitalized patients. The decrease in treatment regimen cost after application of CP / ICP is varied between 6.8 - 42%. An assessment is required to see the relationship of CP / ICP implementation with Quality of life. 217 THE IMPORTANCE TO KNOWING RISK FACTOR OF ISCHEMIC STROKE AS RISK MANAGEMENT STROKE PATIENT: THE EFFECT SIZE RISK FACTORS OF ISCHEMIC STROKE Vema Aisya Rahma1, Nuke Amalia2 Biostatistics Department Faculty of Public Health Universitas Airlangga, Surabaya 2 Biostatistics Department Faculty of Public Health Universitas Airlangga, Surabaya 1 Stroke is the top ten causes of death in the world. The majority of strokes occur when blood vessels to the brain are called plaque. A stroke caused by lack of blood reaching is ischemic stroke. Therefore, risk factors for ischemic stroke need to be known as early as possible in order to decrease the incidence of ischemic stroke and appropriate precautions can be taken. The purpose of this study is to determine the risk factors for ischemic stroke. This study is a metaanalysis study from NELITI, ProQuest, Google Scholar, and Science Direct. We got five studies that related with this study. The analysis was performed on the same factors of each study to know the effect on ischemic stroke. These factors are diabetes mellitus, hypertension, gender, smoking and family history of stroke. One of five factors, sex, is not significant to occurrence of ischemic stroke. In this study found that significant risk factors with ischemic stroke is diabetes mellitus, hypertension, smoking and family history of stroke. Risk factors of hypertension have the largest contribution in the occurrence of ischemic stroke, this is indicated by the highest odds ratio value, so it is necessary to handle, control, and prevent hypertension. Keywords: ischemic stroke, risk factor, meta analysis 205 GAMBARAN GANGGUAN FUNGSI KOGNITIF PADA PASIEN STROKE DI POLI SYARAF RUMAH SAKIT ISLAM JAKARTA Fanny Septiani Farhan1, Melisa Ramadhani2 Departemen Biomedik Fakultas Kedokteran dan Kesehatan Universitas Muhammadiyah Jakarta 2 Program Studi Pendidikan Dokter Fakultas Kedokteran dan Kesehatan Universitas Muhammadiyah Jakarta 1 Latar Belakang : Stroke merupakan penyakit terbanyak ketiga setelah penyakit jantung dan kanker, serta merupakan penyakit penyebab kecacatan tertinggi di dunia. Data South East Asian Medical Information Centre (SEAMIC) diketahui bahwa angka kematian stroke terbesar terjadi di Indonesia yang kemudian diikuti secara berurutan oleh Filipina, Singapura, Brunei, Malaysia, dan Thailand. Kecacatan pasca stroke dapat berupa gangguan motoric, sensorik, otonom maupun gangguan kognitif. Gangguan kognitif yang diakibatkan oleh stroke dapat mengakibatkan gangguan, seperti gangguan bahasa, memori, visuospasial, atensi, orientasi kognisi dan emosi. Tujuan : Untuk mengetahui gambaran gangguan fungsi kognitif pada pasien stroke di Poli Syaraf RS Islam Jakarta periode September-November tahun 2015. Metode penelitian : Penelitian ini bersifat kuantitatif dengan desain potong lintang pada pasien stroke di poli syaraf di Rumah Sakit Islam Jakarta, Cempaka Putih pada bulan September-November tahun 2015 dengan menggunakan MoCA-INA (Montreal Cognitive Assessment Versi Indonesia) untuk mengetahui terganggua atau tidaknya fungsi kognitif responden. Analisis data dilakukan secara univariat dengan mendeskripsikan masing-masing variabel. Hasil : Hasil penelitian dari total 83 pasien stroke, stroke iskemik merupakan yang paling banyak diderita dengan 75 responden (90,4%) dan dengan total 76 responden (91,6%) positif mengalami gangguan fungsi kognitif. Untuk usia, range 55-64 tahun menjadi yang terbanyak dengan 29 responden ( 34,9). Berdasarkan kategori jenis kelamin, laki-laki lebih banyak dengan 47 responden (56,6%). Pada tingkat pendidikan SD merupakan yang tertinggi dengan total 22 responden (26.5%). Kesimpulan : Berdasarkan hasil penelitian ini, pasien stroke di Poli Syaraf Rumah Sakit Islam Jakarta Cempaka Putih, 76 responden (91,6%) positif mengalami gangguan fungsi kognitif. Pelayan Kesehatan diharapkan untuk melakukan screening rutin pemeriksaan fungsi kognitif untuk pasien stroke agar dapat mendiagnosis dini dan membantu pasien dalam mengatasi tanda-tanda dan gejala dari penurunan fungsi kognitif. Keywords: Stroke, Gangguan Fungsi Kognitif, MoCA-INA 237 FACTORS INFLUENCING CARPAL TUNNEL SYNDROME AMONG ‘OJEK’ DRIVER IN JAKARTA Fanny Septiani Farhan1, Aisyah Aftita2 Departement of Biomedic, Faculty of Medicine and Health, Muhammadiyah Jakarta University, Jakarta, Indonesia 2 Undergraduate program, Faculty of Medicine and Health, Muhammadiyah Jakarta University, Jakarta, Indonesia [email protected] 1 Background: Jakarta’s traffic was rank 12th of the worst in the world. To Avoid traffic jam, people used ojek, an alternative motorcycle transportation that continue growing in number every year. Ojek driver, is among the jobs at risk of Carpal Tunnel Syndrome (CTS). CTS has a multifactorial etiology involving systemic, anatomical, and ergonomic characteristics. The aim of this study is to investigate the influence of age, wrist posture and working hours of ojek drivers with symptoms of CTS. Methods: A cross sectional study was apply to identify factors associated with CTS symptoms among ojek driver in Jakarta. Data were obtained from interviewed and Tinnel test physical examination of the wrist. Results: 96 male ojek driver participants were recruited, 66,7% were aged ≥ 40 years old. 64,6% had wrist posture problems, 69,8% had > 8 hour working duration and 75% had CTS symptoms. Bivariate analysis showed statistically significant relation between age and wrist posture to the occurance of CTS. Conclutions: Appropriate health promotion programs focus on occupational health education and behavior should be implemented to reduce morbidity rates from CTS symptoms among ojek driver in Jakarta. Keywords: wrist, age, ojek driver, CTS 88 INTERNAL VS EXTERNAL DETERMINANT : THE MOST INFLUENTIAL INTENTION IN DIABETES MELLITUS FOLLOW UP Noer Amalis Sholeha1, Krisbianto2, Riski Dwi Prameswari2, Linta Meyla Putri2, Ernawaty3, S.Supriyanto3, Nuzulul Kusuma Putri3 1 Puskesmas Barengkrajan, Indonesia 2 Magister of Administration and Health Policy, University of Airlangga Mulyorejo Surabaya Indonesia 3 Faculty of Public Health, University of Airlangga Surabaya Indonesia [email protected] It is estimated that in 2030 people with Diabetes Mellitus in Indonesia will increase to a number of 21.3 million. Riskesdas in 2013 stated that the prevalence of Diabetes Mellitus in urban areas tends to be higher than in rural areas. Based on data from the Indonesian Central Bureau of Statistics the population of Indonesia with the prevalence of Diabetes Mellitus in urban areas was 14.7% and rural 7.2%. Diabetes Mellitus has psychological and behavioral content. When patients follow the doctor's instructions, they are faced with psychological conditions that are not easy, because patients must regularly go on a diet, exercise, medication, and sugar test. The purpose of this study was to determine the effect of internal and external factors on follow-up intention to treat type 2 diabetes mellitus. This study uses a pre-experimental design, using the HAPA questionnaire through interview techniques. HAPA indicators are internal factors (risk perception, outcome expectancies, self-efficacy) and external factors (social support from family and friends). The population in this study included all Diabetes Mellitus patients at Barengkrajan Sidoarjo Public Health Center in March and April 2016. The samples in this study were taken by purposive sampling, namely 1 month of Diabetes Mellitus patients found at Barengkrajan Health Center. The results of the study found that follow-up treatment for diabetes mellitus was influenced by internal and external factors. Internal factors that influence the intention include self efficacy β (0.337), risk perception β (0.339), outcome expectancy β (0.539). While external factors that influence intention are social factor β (0.307). The conclusion of this study shows that internal factors have more influence in the follow-up intention of diabetes mellitus treatment with the most influential factor is outcomes expectancy. Keywords: diabetes mellitus, intention, HAPA (Health Action Process Approach) 242 EVALUATING EFFICACY OF TEMPEH EXTRACT SUPPLEMENTATION ON OXIDATIVE STRESS BIOMARKERS AND CYTOKINES AMONG Rattus norvegicus INFECTED BY Mycobacterium tuberculosis Budhi Setiawan1, Lusiani Tjandra1, Kartika Ishartadiati2, and Sri Lestari Utami3 Department of Pharmacology, Medical Faculty University of Wijaya Kusuma Surabaya, Dukuh Kupang XXV/54, Surabaya, Indonesia 2 Department of Parasitology, Medical Faculty University of Wijaya Kusuma Surabaya, Dukuh Kupang XXV/54, Surabaya, Indonesia 3 Department of Biomedicine, Medical Faculty University of Wijaya Kusuma Surabaya, Dukuh Kupang XXV/54, Surabaya, Indonesia [email protected], [email protected], [email protected], [email protected] 1 The purpose of this study was to evaluate the efficacy of ethanolic tempeh extract on the biomarkers of oxidative stress and proinflammatory cytokines in experimental rat tuberculosis (TB). Thirty-five infected male rats were divided randomly into five groups. The first, second and third groups received the supplement at concentrations of 200, 400 and 800 mg/kg body weight respectively. The fourth group was the control group, and the fifth group was for histopathological confirmation. Total antioxidant capacity (TAC) and Malondialdehyde (MDA) levels were assessed using colorimetric method while C-reactive protein (CRP), tumor necrosis factor alpha (TNF α), interferon gamma (INF ɣ), interleukin (IL)-2, IL-6, and IL-10 were measured by Elisa method. There were no significant differences in the levels of MDA, CRP, TNF α, IL-2, IL-6, IL-10 at all concentrations in comparison with control. Tempeh extract provision increased levels of TAC at 200 (p = 0.011), 400 (p = 0.027), 800 (p = 0.029) kg/ body weight compared to control. At the concentration of 800 mg/kg body weight, the level of INF ɣ was lower than control (p = 0.0047). Supplementation of tempeh extract described no positive effect on oxidative stress biomarkers and proinflammatory cytokines in the animal model of tuberculosis. Keywords: Tuberculosis, tempeh extract, oxidative stress, cytokines 258 ANALYSIS OF RELATIONSHIPS IN DIABETES MELITUS TYPE 2 COMPLICATION WITH MEDICAL COST IN RUMAH SAKIT ISLAM JOMBANG Abdul Ghofir1,2, Sri Sundari1, Qurrotul Aini1 Master of Hospital Management, Universitas Muhammadiyah Yogyakarta 2 Rumah Sakit Islam Jombang [email protected] 1 Background: Since 2014 Indonesia has implemented National Health Insurance as a social insurance. The JKN payment scheme is no longer a fee for service but use Ina CBG's tariff scheme. Under the Ina CBG’s, the payment rate for DM type 2 patients is generalized (Rp 185,000 per visit) although DM patients with complications required higher cost. This study is intended to determine the relationship between DM complications with medical cost. Method: The research was done analytically and cross sectional. Secondary data is taken from medical record and details of patient care cost of DM JKN Non PBI at Outpatient Installation of Internal Disease RSI Jombang period 1 January 2014 to 31 December 2016 by total sampling method. A total of 818 samples met inclusion and exclusion criteria. The results were analyzed by chi square non-parametric test and spearman’s rho. Result: There was a significant correlation between medical cost and hospital visit in a year (p = 0.002). The highest average medical cost per visit was found in DM with macrovascular complications (Rp 226.727). While the average cost for DM with microvascular complications amounted to Rp 170.730 and with both complications of Rp 177.227. DM with no complications amounted to Rp 215.433. No significant correlation between DM complications with medical cost (p = 0.453). Conclusion: DM type 2 with complication needs higher cost but hospital was able to manage the cost efficiently at some point. But this may affect the quality of treatment. Government, hospital and physician must take further consideration. Keywords: Cost, Diabetes Complication, Ina CBG’s, JKN 268 ANALYSIS OF MEDICAL RESUME FILLING COMPLETENESS AND THE ACCURACY OF CODING DIAGNOSES AGAINST POTENTIAL RISKS OF BPJS CLAIMS AT INPATIENT INSTALASI OF RS dr M HASSAN TOTO BOGOR IN 2018 1 Ernie Burhanuddin1 Post Graduate Program Study of Hospital Administration Respati Indonesia University This research discussed about medical resume completeness and the accuracy of coding diagnoses against potential risks of BPJS claims at Inpatient Units of RS dr M Hassan Toto Bogor in 2018. This research used mix method approach with cross sectional design. This research found that there is still incompleteness in filling the medical record for secondary diagnostic variables 8,5 %, the signature of in charge physician variable 10,5%, and supporting examination variable 1,6 %. Inaccuracy of coding diagnoses on primary diagnostic 28,2%, secondary diagnostic 6,4% and procedur 6%. The risk of claims is delayed due to the incompleteness of medical resume amounting to Rp. 28.225.800,- in January,and obtained the difference in claims due to inaccuracy of Rp. 21.316.800,- in February and Rp 20,909.900,- in March. The results suggested that socialization of standar operational procedur,coding practice, reward dan punishment implementation, coding audit, coding team formulation, and continous evaluation by management. Key Word : Medical resume, Coding, BPJS Claim 269 PATIENT SAFETY CULTURE ANALYSIS IN IMPROVEMENT EFFORTS PATIENT SAFETY IN THE INPATIENT ROOM AT EVASARI AWAL BROS HOSPITAL IN 2018 Jufriza Fathoni Hospital Administration Study Program at Respati Indonesia University [email protected] Background: The safety culture of patients in the Evasari Awal Bros. hospital room has not gone well, marked by the many reports of patient safety incidents. Where RS Evasari Early Bros is a hospital that has been accredited plenary by KARS, which should apply the safety culture of patients with the maximum. This study aims to determine the status of patient safety culture in inpatient wards of Evasari Hospital Awal Bros Year 2018. Method: This research uses mixed methods research approach that is quantitative method with cross sectional approach and qualitative method with triangulation technique. Research subjects were medical and non-medical staff who worked more than 1 year in the inpatient room of 70 people. Measurement of patient safety culture using AHRQ (2004) questionnaire that was adopted from research of Puspitasari M. (2009). The questionnaire consisted of 12 dimensions (plus 2 additional dimensions) with 42 question items and completed with interview data with Hospital Hospital Patient team. Results and Discussion: The patient's safety culture status at Evasari Awal Bros Hospital was moderate culture category with an average positive perception of 57%. The greatest strengths are the dimensions of organizational learning and continuous improvement, the number of reported events and the cooperation within the unit. While the obstacles derived from the weakness of the staffing dimension, non punitive response to errors, Patient safety grade and handover and transition. Conclusions and Suggestions: The safety culture of patients in inpatient wards of Evasari Awal Bros is a moderate category, where improvement and improvement in various aspects need to be improved in order to achieve patient safety program objectives. Keywords: Safety Culture Patient, patient safety, patient safety incident. 266 READINESS ASSESSMENT OF ELECTRONIC MEDICAL RECORD IMPLEMENTATION IN KARTINI HOSPITAL JAKARTA 1,2,3 Yanuar Pribadi1, Sandra Dewi2 and Heru Kusumanto3 Department of Hospital Administration, Postgraduate Program, Respati Indonesia University, Jakarta, Indonesia 1 [email protected], [email protected], [email protected] Document management using computer / electronic based system in health sector that is becoming a global trend is electronic medical record (EMR), which is sub-system of health information, which is widely applied in Indonesia. This research uses quantitative research type with correlational research design. Quantitative research is done by distributing questionnaires to all EMR users consists of doctors, nurses, midwives, administrators, pharmacy staff, radiology staff, laboratory staff, and IT staff. The result of the research shows that the monitoring and reporting tools influence the readiness of the organization to apply EMR with monitoring tools as the most influential factor. Assessing the pre-implementation readiness of the EMR will help top management to choose whether to start implementing the EMR or apply a cheaper initial step, which will prepare the organization to anticipate changes. Readiness assessment of EMR implementation is a very important thing to do because the user is a very determining aspects of successful implementation of a system. From the user's answer and correlation test, the user is ready in the implementation of EMR and monitoring tools is useful in controlling EMR. However, prior to the implementation of EMR should be considered also the readiness of health facilities. Keywords : Electronic Medical Record, Readiness, Implementation, EMR Users, Quantitative 294 EFFECTIVENESS OF ADVANCED TRAINING FOR MIDWIVES TO DECREASE MATERNAL MORTALITY RATE Arif Setiawan1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Background. Maternal mortality rate in Indonesia is still high, based on the Indonesian Demographic and Health Survey data in 2015, the maternal mortality rate was 305 deaths in every 100,000 births. This number is still higher than Millennium Development Goals (MDGs) standard which is the maximum maternal mortality rate was 110 deaths in every 100,000 births. Midwives are one of the health workers who have contribute for reducing maternal and infant mortality. In addition to facilities, midwife's knowledge of maternal and child health, especially for cases of childbirth plays a major role in controlling maternal mortality. The topic for training were early detection preeclamsia and post natal bleeding treatment which is to reduce maternal mortality. Objective. This study aims to determine the effectiveness of advanced midwifery training to reduce maternal mortality. Method. The method used is by training, discussion and demonstration. Research respondents were midwives of the primary healthcare and independent practice midwives in the North Surabaya area. This type of research is descriptive with random sampling. Results. The results of ongoing training conducted in 2016 and 2017 have been proven to reduce maternal mortality in Surabaya. Keyword : Martenal mortality rate, midwives training,effectivity training 308 AFFECTIVE, SUSTAINABLE, AND NORMATIVE COMMITMENT: WHICH ONE IS CONTRIBUTED TO INCREASE THE PERFORMANCE? Case study in Cadre of Integrated Service Post in Sidotopo Wetan Primary Healthcare, Surabaya, Indonesia 1,2 Yeni Rahmah Husniyawati1, Fitri Widyacahya2, Ratna Dwi Wulandari3 Master Student of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 3 Lecturer of Health Policy and Administration Department, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia [email protected] Commitment is a determinant of great performance in work. There are three components of commitment such as affective, sustainable, and normative commitment. Cadre as the front liner in community empowerment has a task to increase participation of mothers in scale their toddlers at integrated service post near their house. The objective of this study was analyzed the relationship between commitment components and performance in aspect of increasing toddler’ mothers to integrated service post. This research was an analytic observational research with quantitative approach. Design is cross sectional. Sampling was done by using simple random sampling method. The finding showed majority of cadre had high level of affective commitment, and medium level of both sustainable and normative commitment. There was a relationship between sustainable commitment and performance (p=0.000), while affective and normative commitment did not have a relationship with performance. Therefore, it was necessary to increase sustainable commitment to obtain high performance of cadre. Eventually, this would give impact of high participation in mothers to let their toddlers scaling at integrated service post. Keywords: commitment, integrated service post, performance of cadre 332 THE PERSISTENCE OF MILK TEETH THAT LEADS TO POOR ORAL HYGIENE Anna Wijayanti Universitas Airlangga Persistence is a milk tooth that already exists today but is still in the mouth. This persistence usually occurs on days 6 to 12 years, when tooth changes to permanent teeth occur. Persistence is very important for permanent tooth growth and removing children to maintain the cleanliness of the oral cavity. Especially if the tooth has a carious consistency, the worse the cleanliness of the oral cavity. Doing more easily occurs in dental and oral diseases. Dental and oral diseases can change general health, but do not cause death directly. Dental and oral diseases can be another risk factor, deserving as a local infection, which means as a center or infection of one of the organs from the teeth. Choose one way of spreading germs from the center of infection to the organs of the body, through blood flow or lymphatics can also be from tonsillitis, pharyngitis, otitis media, bacteremia, toxemia, low body weight (LBW) and heart disease. Poor oral cavity conditions due to persistence, especially persistence with dental caries, function and activities of the oral cavity can affect nutritional status and also have an impact on quality of life. In childhood, this poor mouth condition can have an impact on growth and development of children and will significantly affect their lives later (Sheiham, 2005 WHO, 2007). Children with poor health conditions, 12 times more complete, including not being able to attend school compared to those who have good oral health. More than 50 million school hours per year are lost due to dental and oral diseases, which will have an impact on the appearance of children in school and their future success 307 THE INFLUENCE OF JOB DESIGN ON JOB INVOLVEMENT Fitri Widyacahya1, Yeni Rahmah Husniyawati2, Ratna Dwi Wulandari3 Graduate Student of Health Administration and Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 3 Lecture Faculty of Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia [email protected] 1,2 Job involvement is an important element for human resource management. Many factors could affect the job involvement which one of them was job design. Therefore this study was necessary to analyze the determinant of job design towards job involvement. Another objective was to analyze the dominant indicator in job design that affected job involvement. Data collection used the questionnaire for 62 permanent employees that had been calculated using simple random sampling in Undaan Eye Hospital, Surabaya. Analytical data used logistic regression test. The result showed there was significantly effect of job design towards employees’ job involvement. Other result indicated the feedback, one of indicators in job design, was very strong factor affecting towards job involvement. Thus, hospital management should pay attention job design to increase job involvement of its staffs. Keywords: autonomy, feedback, job design, job involvement, skill variety, task identity 395 HUBUNGAN TINGKAT PENGETAHUAN TERHADAP KUNJUNGAN ANTENATAL CARE Panjumi Khorida1, Novianti Indah Fatmawati2, Nyoman Anita Damayanti3 Postgraduate Student of Health Policy and Administration Study Program, Faculty of Public Health, Universitas Airlangga, Mulyorejo Street Campus C, Surabaya, Indonesia 2 Postgraduate Student of Health Policy and Administration Study Program, Faculty of Public Health, Universitas Airlangga, Mulyorejo Street Campus C, Surabaya, Indonesia ³Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Mulyorejo Street Campus C, Surabaya, Indonesia [email protected] 1 Maternal Mortality Rate in Indonesia is still quite high where the number tends to increase every year. The causes of AKI can be reduced and prevented through the provision of routine, quality and integrated pregnancy care to detect early abnormalities and complications. The level of knowledge has an important role to encourage mothers to be more active in examining their pregnancies to health workers. The purpose of this study was to determine the relationship between the level of knowledge of pregnant women on antenatal care visits at Gunung Anyar Surabaya Health Center in 2018. The data were taken observationally with a cross sectional approach. Total sample of 75 pregnant women, data analysis using chi square. The measurement results show that the relationship between the level of knowledge of pregnant women on antenatal care integrated p = 0.681 (> 0.05), and it can be concluded that there is no relationship between the level of knowledge of pregnant women on antenatal care visits. Keywords: Knowledge, Pregnant Mother, Antenatal Care. 408 RELATIONSHIP BETWEEN USE OF PPE(PERSONAL PROTECTIVE EQUIPMENT) WITH OCCUPATIONAL SAFETY AT GARBAGE WORKER IN TPS BRATANG SURABAYA 2018 Furqoniyah Nur Imamah1, Wesiana Heris S2, Merry Sunaryo3 Universitas Nahdlatul Ulama Surabaya [email protected] The garbage workers have a considerable potential hazard in the work process resulting in work accidents. Efforts to protect workers from occupational hazards risk by using Personal Protective Equipment (PPE). The purpose on this research is knowing relationship between use of PPE with occupational safety at garbage workers in TPS Bratang.The design of this research is an analytic survey using cross sectional method. The population of garbage workers in TPS Bratang are 89 people. The number of sample were 73 people taken by simple random sampling technique. The collection on research taken by questionnaires and observation. The analysis uses chi square test with significance level of 0,05.The research showed that most using of the PPE was poor (71,2%) and almost entirely occupational accident (91,8%). The result with chi square test obtained p-value 0.001 less than significance level (0.05) it’s mean there is a relationship between use of PPE with occupational safety at garbage workers in TPS Bratang Surabaya. The use of PPE for garbage workers should be used in order to protect themselves from the risks of working hazards. Use of personal protective equipment in the workplace is tailored to the hazard exposure encountered in the work area. Therefore, the garbage workers should work carefully and optimize the use of personal protective equipment while working. Keywords: Personal Protective Equipment (PPE), Occupational Safety, Garbage Workers 419 RELATIONSHIP BEETWEEN WORKING TIME AND BIORNOUT DISEASE OF WORK WITH WORK PRODUCTIVITY ON HOME INDUSTRY BAG CONVECTION IN TANGGULANGIN SIDOARJO AREA Uci Nur Alfu Laily1, Novera Herdiani2 Prodi Ilmu Kesehatan Masyarakat Fakultas Kesehatan Universitas Nahdlatul Ulama Surabaya 2 Bagian Prodi S1 Ilmu Kesehatan Masyarakat Fakultas Kesehatan Universitas Nahdlatul Ulama Surabaya [email protected] 1 Work productivity is a mental attitude that always looking for improvements to what already exists and expected to be implemented effectively and efficiently. Owners of the company do not think about the risks and conditions of workers, it make workers work longer and cause fatigue that makes the production process becomes slow, so it can harm the company. This type of research is an analytical survey using cross sectional. The population is 32 workers, and the sample size is 30 workers. The sampling technique is simple random sampling. Variables of work duration, work fatigue and work productivity were measured by questionnaires. The analysis used Chi Square test and Binary Logistic Regression with α = 0,05. Chi Square test results show that there is a relationship between the work duration and work productivity (0.02), while work fatigue and work productivity (0.03). Based on Binocene Logistic Regression test, there was no correlation between work duration and work productivity (0.99), whereas there was a relationship between work fatigue and work productivity (0.01). The conclusion of the research is the relationship between work fatigue with work productivity at home industry convection bag Tanggulangin Sidoarjo area. Suggestions for the company should improve supervision of each worker and pay attention to employee grievances and developments and pay attention to the design of the work environment such as seating in each type of ergonomic work and appropriate lighting in order for workers to work more comfortably. Keywords: work productivity 387 BOARDING TIMES IN EMERGENCY DEPARTMENT AND PATIENT SATIFACTION: A CROSS SECTIONAL STUDY FOR INPATIENT BOARDING PATIENT IN HAJJ HOSPITAL SURABAYA Uswatun Hasanah1, Nurul Jannatul Firdausi1, Khamida2 Public Health Program, Nahdlatul Ulama Surabaya University,Surabaya,Indonesia 2 Master of Nursing Departement, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] 1 Delays on transferring inpatient boarding patients in Emergency Department (ED) will be impact to continuity of care, increasing overcrowding in ED and patient disappointment. Delivery problem on inpatient boarding patient from ED also occured in Hajj Hospital Surabaya. The aims to analyze relationship of boarding time for inpatient boarding patient from ED and patient satisfaction in Hajj Hospital Surabaya. The design was observational with cross sectional approach. Population were 980 ED’s patient who decided to be hospitalized. The study involved 83 respondents selected by simple random sampling. The instrument were observational sheet and satisfaction questionnaire. Data analyzed by chi square test. The result included: the average boarding time was 142 minutes 25 seconds (minimum = 60 minutes; maximum = 290 minutes). Almost all respondents (81.3%) expressed satisfaction when boarding time being fast. Boarding time for inpatient boarding pating in ED was significantly related to patient satisfaction (p = 0.058 <α = 0.1). Faster patient transfer to inpatient increases patient satisfaction. The hospital need making attention to evaluate minimal standard of care for tranfer time, fixing the information of bed availability, and providing facility and service in good quality to increase satisfaction. Key word: Inpatient Boarding Patient, Boarding Time, Satisfaction 415 RELATION POSTURAL’S WORK AND LENGHT OF WORK WITH GRIPED OF MUSCULOSCELETAL DISORDERS (MSDS) TOWARDS A WORKER IN X INCORPORATED, GRESIK ON 2018 Fiqi inayatul aini1, Handayani2, Nur amin1 Public Health Program, Health Faculty, University of Nahdlatul Ulama Surabaya 2 Medical Program, Medical Faculty, University of Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] 1 Griped of Musculoskeletal Disorders (MSDs) are complaints of skeletal muscle due to unnatural work attitude over long periods of time which will cause very mild to very painful complaints. Aimed of this study is analysis the relation postural’s work and lenght of work with griped of musculosceletal disorders (MSDs) towards a worker in X Incorporated, Gresik on 2018. This study used analitical survey with cross sectional study, the populations of this study are 40 respondents and for the samples are 37 respondents. To take the samples used simple random sampling with independent variables are postural’s work and lenght of work. Dependent variable is MSDs griped. The instruments are use quastionnare and REBA evaluation form. Results of this study, almost all of a workers has griped risk middle musculosceletal (67,6%). Postural’s work almost all of them did risk high postural’s work (83,8%). And for the lenght of work almost all of them has time for work appropriated with a standart <8 haours everyday or 40 haours every week (62,2%). The results with chi square test portural’s work showed p-value 0,009 < 0,05, there was a relation between portural’s work with MSDs griped, between length of work p-value 1,000 > 0,05, there was no relation between lenght of work with MSDs griped. The conclusion of this study is lenght of work not be a causing of MSDs griped but portural’s work . Suggestion to X Incorporated to more care about postural’s work of worker with give some socialization and exercise to reduce the MSDs griped. Keywords: Portural’s work, lenght of work, musculosceletal disorders griped 403 RELATIONSHIP WORK POSITION WITH CUMULATIVE TRAUMA DISORDERS (CTDS) IN SANDALS INDUSTRY WORKERS AT WEDORO, WARU, SIDOARJO Elna Istiqomah Azha Zakia1, Siti Nurjanah2, Friska Ayu3 Departement uf Public Helath, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] Informal sector workers are at risk for occupational diseases such as CTD complaints. The results of the preliminary survey conducted at the study site found that as many as 7 workers complained of shoulder, wrist and neck pain that were the initial complaints of CTDs. The purpose of this research was to analyze the correlation between work position with Cumulative Trauma Disorders (CTDs) complaints on slippers industrial workers in Wedoro, Waru, Sidoarjo. The study design used an analytical survey with cross sectional design. The population of this study as many as 40 and the sample used as many as 37 workers taken by simple random sampling. The variables studied were work position and complaints of CTDs. Data related characteristics of respondents obtained from the observation and interview. Work position were assessed using REBA observation sheets and CTDs complaints were assessed using NBM interview sheets. Data analysis using chi square test. The results showed that work attitude in sandal industry workers almost entirely do not work ergonomic attitude, while those who have complaints CTDs almost all there are complaints of CTDs. The result of test analysis shows that there is a significant correlation between work position with complaint of CTDs with p-value value equal to 0,022 and has relationship strength equal to 0,425. The conclusions of the study were workers working with a non-ergonomic working attitude at risk for CTD complaints. It is suggested that industrial owners should supervise the work position / design of work stations by providing ergonomic chairs and tables. Keywords: Complaints Cumulative Trauma Disorders (CTDs) 424 ANALYSIS OF FACTORS AFFECTING SYMPTOMS OF OCCUPATIONAL CONTACT DERMATITIS TO TOFU INDUSTRIAL WORKERS IN JOGOROTO DISTRICT, JOMBANG REGENCY Umroh Mahfudzoh1 , Nur Hidaayah2, Merry Sunaryo3 Prodi Ilmu Kesehatan Masyarakat Fakultas Kesehatan Universitas Nahdlatul Ulama Surabaya 2 Ilmu Keperawatan Fakultas Keperawatan dan Kebidanan Universitas Nahdlatul Ulama Surabaya 3 Ilmu Kesehatan Masyarakat Fakultas Kesehatan Universitas Nahdlatul Ulama Surabaya [email protected] 1 Symptoms of occupational contact dermatitis, (DKAK) is a symptom of non-infectious skin disease caused or aggravated by a person's work due to contact with the material used. The purpose of this study is to analyze the factors that affect symptoms of occupational contact dermatitis work on tofu industry workers in the District Jogoroto, Jombang regency. The research method used an analytical survey with cross sectional design. The population of 50 industrial workers knows with a sample of 45 workers. Independent variable of prolonged contact, working period, Personal Hygiene and use of personal protective equipment (PPE), the dependent variable of occupational dermatitis symptoms. The instrument uses a questionnaire sheet using a regression logistic binary test with a coefficient level of less than 0.05. The results of the research test obtained contact time with the value of sig 0.001 = 0.05 which means H0 rejected indicates that there is influence, as well as other variables such as working period, personal hygiene and the use of personal protective equipment has no effect on Symptoms of occupational contact dermatitis. The conclusion of this research is that the longer the direct contact with the process of making the tofu, it will improve the Symptoms of occupational contact dermatitis on tofu industry workers in the district Jogoroto, Jombang. It is recommended to the owner of the company to pay more attention to the old process of contact, personal hygiene. As well as the use of personal protective equipment when engaging the making of tofu in order to reduce Symptoms of occupational contact dermatitis. Keywords: Symptoms of occupational contact dermatitis, Industrial Workers tofu, length of contact. 414 RELATIONSHIP OF DISCIPLINE AND EMOTIONAL INTELLIGENCE WITH EMPLOYEES PERFORMANCE OF PDAM SURYA SEMBADA CABANG NGAGEL SURABAYA 1 Dian Rosa Linda1, Puji Astuti2, Satriya Wijaya1 Department of Public Health, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia 2 Department of Nursing, Nahdlatul Ulama Surabaya University, Surabaya, Indonesia [email protected], [email protected], [email protected] One of the problems that can occur in an organization or company that is poor performance problems for example, not timely in completing tasks and job responsibilities work. The result of observation of preliminary data on PDAM Surya Sembada Surabaya employee was obtained 184 employees did not come to work without explanation, and 288 employees arrived late. The purpose of this study was to analyze the relationship of discipline and emotional intelligence with performance on PDAM Surya Sembada Surabaya.The design of this research is analytical with cross sectional approach. The population in this study is a production and maintenance workforce of 155 people. The sample size was 89 respondents taken by stratified random sampling technique. The data were collected using questionnaires. Data analysis using statistical test correlation rank spaerman with significance level of α 0,05.The results showed that employees of PDAM Surya Sembada Cabang Ngagel Surabaya, almost all (94.4%) had very high discipline, most (74.2%) had high emotional intelligence, and most (50,6%) had performance satisfying. Result of analysis test with rank spearman correlation obtained p-value 0,002 <α 0,05, hence there is correlation between discipline and employee performance. And p-value 0.001 <α 0.05, meaning there is a relationship between emotional intelligence with employee performance. In order to improve discipline and intelligence in the performance of employees should the company provide rewards in accordance with achievements in the workplace. Keyword : Employee Performance 426 ANALYSIS OF PATIENT SATISFACTION INDEX BPJS HOSPITALIZATION ON THE INSTALLATION PHARMACY IN GENERAL HOSPITAL SURABAYA HAJJ Hurratul Andawiyah 1, Permadina Kanah Arieska2 Public Health Program, Health Faculty, Universith of Nahdlatul Ulama Surabaya 2 Midwifery Study Program, Faculty of Nursing and Midwifery, Nahdlatul Ulama University Surabaya [email protected], [email protected] 1 Patient satisfaction is a very important factor in determining the success of the health service. The patient is a consumer of the resulting services. Complaints are common in hospital pharmacy including physical means less waiting room is comfortable, the least stock of drugs, and the length of the waiting time of the drug causing the patient's puasan against the pharmaceutical service. The purpose of the research is patient satisfaction index menganilisis BPJS hospitalization on the installation pharmacy in General Hospital of Hajj. Design research using the method of analytic observational. The population of the research was the entire patient BPJS inpatient general hospital Surabaya Hajj in a month that do drug-taking in pharmaceutical as much as 90. Patients taken samples as much as 74 respondents. Sampling techniques using simple random sampling. The variable index of patient satisfaction research is composed of dai 9 elements examined. the instrument uses a sheet of the questionnaire. Technical data pengelolahan and data analysis using descriptive statistics. The results showed that overall patient satisfaction index results in a pharmacy inpatient general hospital Surabaya Hajj was 2.96 value interval conversion 74 which means less service unit performance both with the quality of service this Result C. indicate that the patient's inpatient BPJS less satisfied of the service that is in the Public Hospital Pharmacy Haji Surabaya. The better the existing services in the pharmaceutical space then BPJS patient hospitalization Hajj General Hospital Surabaya will be satisfied. Therefore we recommend that you do the monitoring of service quality in pharmacy inpatient and improvement a priority issue in the short term. Keywords: Pharmacy, Patient Satisfaction Index 418 THE EFFECT OF PERCEPTION OF FACILITIES AND PRICES ON PATIENT SATISFACTION INPATIENT ROOM AROFAH RUMAH SAKIT ISLAM SURABAYA Durrotun Nafisah1, Nurul Kamariyah2, Novera Herdiani1 Department of Public Health, Nahdlatul Ulama University, Surabaya, Indonesia 2 Department of Nursing, Nahdlatul Ulama University, Surabaya, Indonesia [email protected], [email protected], [email protected] 1 Internal sector hospital is derived from effort provide supporting facilities. External sector provides facilities as expected and affordable cost by user which mean will lead to customer satisfaction. The purpose this study is identifies the effect of perception facilities and price on patien satisfaction at inpatient room Arofah. Design research is observational with cross sectional approach and patient population of arofah room 100 patients taken samples of 45 respondents. Sampling technique used by accidental sampling technique with independent variables of perception facilities and price to dependent variable of satisfaction. Technique data processing and analysis using Binary Logistic Regression. The results of study indicate almost all (93.3%) respondents perceptions facilities, good prices and express satisfaction the services provided by hospital. Binary Logistic Regression test result (>0,05) show that is no effect of perception facility and price on patient satisfaction. Research conclusions are perception of facilities and price do not affect patien satisfaction, this is because the respondents who becomes patient in Rumah Sakit Islam Surabaya has a factor other that can affect the variable perseption satisfation. Suggestion of research in hospital by conducting periodic evaluation, monitoring facilites and price for the visiting to be more comfortable and feel satisfied as expected. Keyword : Facilities Perseption, Price, Patient Satisfation 422 RELATION OF PSYCHOLOGICAL FAKCTORS WITH CONSUMER DECISION WITHIN CHOOSING BACK SERVICES GENERAL POLY OUTPATIENT ISLAMIC HOSPITAL OF SURABAYA Qithrotun Nada, Satria Wijaya, Firdaus Universitas Nahdlatul Ulama Surabaya The visit of the general poly outpatient Islamic Hospital of Surabaya for three years tended to decrease from 2015 to 2017. The purpose of this research is to analyses the correlation of psychological factor with consumer decision in choosing back services general poly outpatient Islamic Hospital of Surabaya. This research method used cross sectional approach. The study was conducted on general poly outpatient patient of Islamic Hospital Surabaya in May 2018. The study population was taken from the monthly average, the sample size was 99 from the purposive sampling technique. Data were collected using questionnaires. Data analysis were univariate and bivariate, use chi-square test with α = 0,05. The results of this study indicate that almost all respondents have good psychological factors (97%), almost all respondents re-choose services (96%). The result of chi-square test ρ = 0,004 so that ρ <α = 0,05 meaning there is correlation between psychological factor with consumer decision in choosing back services of general poly outpatient Islamic Hospital of Surabaya. The conclusion of this study is that consumers who have good psychological factors on the service will re-choose services. The advice given is to improve the behavior of general consumers Islamic Hospital of Surabaya. Keywords: Psychological factors, consumer decisions, hospitals 430 RELATION OF TOP MANAGEMENT SUPPORT WITH PERFORMANCE OF EMPLOYEE MANAGEMENT INFORMATION SYSTEM IN JEMURSARI ISLAMIC HOSPITAL Supratiwi Prameswari, Wiwik Afridah, Muslikha Nourma Rhomadhoni Universitas Nahdlatul Ulama Surabaya Performance Management information systems are the result of certain activities over a certain period of time by using the system to present information in support of management making decisions. The management information system at Jemursari Islamic Hospital has a dynamic change in needs in the process of inputting data by employees of Human Resources, and lack of control and monitoring activities related to employee data entry activities in the Hospital. The purpose of this research was to analyze the relation of top management support with performance of employee management information system in Jemursari Islamic Hospital. The design of this research is an analytical survey with a Cross Sectional approach. Population of 749 was carried out on employees at Jemursari Islamic Hospital. The sample size is 261 respondents with cluster sampling technique. This research instrument uses questionnaire sheets and interview sheets. Data analysis was performed using the Spearman Correlation test. The results obtained a significance of 0.001 <(α = 0.05) which indicates that H0 is rejected which means that there is a relationship between top management support and the performance of the Staffing SIM at Jemursari Islamic Hospital. The results of the calculation of the correlation is 0.209, which means that there is a weak relation and has a direction of relation that are unidirectional. Top management support positively affects the success of information management system in an agency then the role of Directors, Managers, Coordinators and staff are expected to contribute to each other and optimize the use of Civil Service License by maximizing the features of the Civil Service License. Keywords: Top Management Support, Management Information System, Hospital 427 RELATIONSHIP BETWEEN WORK PERIOD AND WORK POSITION WITS MUSCULOSKELETAL DISORDERS (MSDs) COMPLAINT ON WORKERS OF INSTALLATION UNIT PRODUCTION NGAGEL 1 PDAM SURYA SEMBADA SURABAYA Wildatus Sholihah1, Wesiana Heris Santy2, Novera Herdiani1 Public Health Program, Health Faculty, University of Nahdlatul Ulama Surabaya 2 Program Studi S1 Keperawatan Fakultas Keperawatan dan Kebidanan Universitas Nahdlatul Ulama Surabaya [email protected], [email protected], [email protected] 1 Musculoskeletal complaints are pain complaints, aches and pains in the muscle system caused by the muscles receiving static load repeatedly and continuously over long periods of time. This study was conducted to determine whether there is a relationship between work period and work possition Muskuloskeletal Disorders (MSDs) complaint on production workers Unit Installation of Ngagel 1 PDAM Surya Sembada Surabaya. The research design used analytic survey method with cross sectional design. The population is 45 workers, so the sample size is 40 workers. Sampling technique using simple random sampling technique. Methods variable work period, work possition using questionnaire, and complaints Muskuloskeletal Disorders using Nordic Body Map method (NBM). Analysis using Chi Square test and Binary Logistic Regression test with α = 0,05. Based on statistical test using Chi Square test obtained p value between working period and Muskuloskeletal complaints of 0,023. While p value between work possition and Musculoskeletal complaint is 0,001. Based on binary Logistic Regression test obtained p value between working period and Musculoskeletal complaints of 0.168. Whereas the p value between work possition and Musculoskeletal complaints is 0.002. The conclusions of the data are related and there is no relationship between the length of work and the Musculoskeletal complaints, whereas there is a correlation between work apossition and Musculoskeletal complaints. Suggestions for solution companies about working period and work possition with Musculoskeletal complaints can move older workers in lighter tasks, change tools or materials safely, stretch muscles, and train workers to better understand the environment and work tools. Keywords: Work Period, Work possition, Musculoskeletal Complaints INFLUENCING FACTORS ON THE BED TURN OVER ( BTO ) LEVEL ACCORDING TO NURSE ASSESMENT IN SUMBERREJO HOSPITAL Ani Pujiningrum1,Djazuly Chalidyanto2 Departement of Administration ang Public Policy,Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy,Airlangga University,Surabaya [email protected] 1 One indicator of hospital service in accordance with the Ministry of Health’s 2005 standards is BOR,AvLOS,TOI,and BTO.The Ministry of Health Standard in 2005 and the Minister of Health Regulation Number 1171/MENKES/PER/2011 the ideal BTO value is 40-50.From the BTO data of Sumberrejo Hospital,which was collected according to the daly census,it increased in 3 consecutive years,namely in 2015 amounting o 61,38, in 2016 amounted to 80,24 to 80,24 and in 2017 experienced an increase of 82,32. BTO numbers that did not meet the standard this has the potential to have an adverse impact on the patient’s health status. Effort to reduce the BTO number can be done by first knowing the cause. The purpose of this study was to analyze the causes of the high BTO in Sumberrejo Regional Hospital. Teh method of this research was observational research which was analytic.From this study as many as 57 nurses and midwives who served in Sumberrejo Hospital Servece Unit were taken by Strafield Random Sampling.The results that influence the height of BTO in Sumberrejo Hospital are the high number of patients who are admitted for hospitalization due to recovery, death or forced return in a relatively fast time (LOS) which is shortened, the implementation of service effectiveness and or the number of inadequate beds especially in the surgical treatment room. This inevitable height of BTO needs to be balanced with increased infection control so that patient safety is maintained. Key words : Bed Turn Over, Nurse, Hospital Quality THE DECREASING OF DIARRHEA INCIDENCE BASED ON THE NEED AND DEMAND ANALYSIS: AN EFFORT TO PARTICIPATE IN THE SUSTAINABLE DEVELOPMENT Afidah Andani, Thinni Nurul Rochmah Faculty of Public Health, Universitas Airlangga [email protected] Background: Related to the sustainable development goal 6 to ensure availability and sustainable management of water and sanitation for all, it becomes a serious problem especially in a remote area. It is still difficult to access water and sanitation. Then disease such as diarrhea gave huge impact to the community. The data showed that the diarrhea prevalence has been increasing in the last 3 years in the remote area of Amfoang Timur. Objective: this study aimed to compile environmental health effort to decrease the diarrhea prevalence based on the need and demand analysis. Study design: this study was a cross-sectional design, with quantitative approach. Samples 260 families were selected by systematic random sampling. The unit analysis of this study was remote area of Amfoang Timur, East Nusa Tenggara Province. Result: Respondents’ characteristics are mostly low education, low income, low awareness of environmental health, and large family member. The need and demand analysis showed that their willingness of having their own closet and clean water facilities are smaller than what they have done. The CLTS (Community Led Total Sanitation) has already changed their perception about having their own closet and clean water facilities. Conclusion: We conclude that the diarrhea prevalence is decreased by the environmental health effort. Keywords: Sustainable development, diarrhea incidence, environmental health, sanitation, need and demand EFFECTIVENESS OF THE MANAGEMENT FUNCTION OF THE PUSKESMAS NUTRITION POWER AGAINST THE IMPLEMENTATION OF THE BAD NUTRITION MANAGEMENT PROGRAM AT TULUNGAGUNG Mamik Hidayah1,Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Health can be created can not be separated from the intake of nutrients consumed. Good nutritional status is determined by the amount of food consumed. It is estimated that around 50 percent of Indonesia's population experience various malnutrition problems. In Tulungagung, the condition of malnourished children tends to increase the prevalence of malnutrition in 2015 was 0.075%, in 2016 was 0.08% and in 2017 was 0.08%. this figure is above the target set by the Tulungagung Health Office, which is 0.06%. Increasing the number of malnutrition is a threat to the health of children under five. The aim of this study was to evaluate the management function of implementing malnutrition prevention programs in Tulungagung District. This type of research is explanatory research with survey method and cross sectional approach. The population in this study is nutrition workers in TulungagungDistrict. The sampling technique in this study was the total sampling method. Instrument used by the questionnaire. From the results of the study, it can be concluded that one of the causes of the high prevalence rate of malnourished children under five is the lack of nutrition workers, so there needs to be additional nutrition workers in the Tulungagung district area. Keywords: management function, health center nutrition staff, malnutrition prevention program INFLUENCE OF MOTIVATION AND COMPETENCE TO EMPLOYEE PERFORMANCE IN RUMAH SAKIT UMUM DAERAH NGANJUK Siti Fatonah1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Hospital performance is very dependent on employee performance. In 2017 the hospital received patient complaints related to employee performance. this is a reference for hospitals to improve hospital performance through employee performance. Therefore efforts to improve employee performance continue to be made so that employees can provide the best performance for the hospital. The aim is to determine the influence of motivation and competency simultaneously and partially and the greatest influence on the performance of Rumah Sakit Umum Daerah Nganjuk employees. The number of samples is 85 employees, with census method. The analysis technique used is multiple linear regression. Based on the results of the analysis found that motivation and competence simultaneously and partially have a significant effect on the performance of Hospital employees. Among the two independent variables, motivation has the greatest effect on employee performance at the Hospital. Keywords: Performance, motivation, and competence. EVALUATION OF THE IMPLEMENTATION OF MALNUTRITION HANDLING PROGRAM AT PUBLIC HEALTH CENTER IN PANTOLOAN, PALU CITY 1 Miftahul Haerati Sulaiman1, Djazuly Chalidyanto2 Department of Administration and Public Policy, Public Health Faculty, Airlangga University, Surabaya 2 Lecturer of Public Health Faculty, Airlangga University, Surabaya [email protected] Malnutrition can inhibit physical growth, mental development, and intelligence of children. Cases of malnutrition in Palu City in 2016 reached 54 cases with the highest case found in Pantoloan Public Health Center that is as many as 11 cases. Therefore, it was necessary to evaluate the implementation of malnutrition handling program, in terms of input, process and output components. The type of this research is qualitative with case study approach on 8 informants selected by purposive sampling. Data collection was conducted by observation, in-depth interviews, and document studies. Validity test was done with source triangulation and technical triangulation. Data were analyzed with Miles and Huberman analysis model. The results showed that in the input components (the number of nutrition officers was still less and unavailability of Standard Operating Procedures (SOP) of malnutrition handling, while the infrastructure facilities have been fulfilled), the process components (organizing activities have not been implemented properly and implementation in the field there is still a problem that a delay in the distribution of supplementary food recovery, the coordination between the implementing team has not been optimal and the use of supplementary food recovery is not the right target), and the output components (malnourished toddlers have treated for 3 months, but there are still toddlers who do not increase their nutritional status). It was concluded that the implementation of malnutrition handling program was not optimal. Keywords: Evaluation, Program, Malnutrition, Public Health Center INCIDENCES OF MEDICATION ERROR BASED ON NURSES’ WORKLOAD AT INPATIENT UNIT OF SURABAYA HOSPITAL 1 Widy Try Windy1, Djazuly Chalidyanto2 Department of Administration and Public Policy, Public Health Faculty, Airlangga University, Surabaya 2 Lecturer of Public Health Faculty, Airlangga University, Surabaya [email protected] Medication error is an important issue in the world. Medication errors also included the most common serious problems of health field that occur and threaten the safety of patients even it can cause the death. The purpose of this study is to describe the incidences of medication error based on nurses’ workload at Inpatient Unit of Surabaya Islamic Hospital. This is an observational descriptive research with cross sectional approach. The respondents were 67 nurses. The data collections were conducted by questionnaires. Data analysis was conducted by cross tabulation. The results of this study are most of respondents were in the age range of 20-40 years old. Most of respondents were female. The last education of most of respondents was Diploma-III. Most of respondents have worked for more than 10 years. In overall of the rooms, the levels of nurses’ workload are moderate. The conclusion of this study is the incidences of medication error are more happening in the room with moderate level and light level of workload. Keywords: medication error, workload, nurse, inpatient, hospital IMPLEMENTATION OF NON CAPITATION FUNDS IN OBSTETRIC AND NEONATAL SERVICES AT FIRST LEVEL HEALTH FACILITIES OF MALINAU DISTRICT Nelly Yuliana, Ratna Dwi Wulandari Fakultas Kesehatan Masyarakat, Universitas Airlangga, Surabaya [email protected] There was changes of health insurance policy in Indonesia into the National Health Insurance (JKN) and there are dissatisfactions from midwives to that program especially in first level health facilities. This study was made to describe the implementation of the National Health Insurance policy and regulations. The research was conducted with descriptive design and a qualitative approach. This study compiled using information obtained from 26 informants associated with obstetric and neonatal health services in the region of Malinau district. The sampling technique in this study is using the purposive sampling methode. Based on this study, it is known that there are obstacles and barriers in the implementation of non capitation funds on obstetric and neonatal services at the first level health facilities. The conclusion that can be drawn of this study, there are still need a lot of improvements of the National Health Insurance policies and regulations either at a central or regional level so that the implementation could work well that will influence to decrease the maternal mortality rate and infant mortality rate significantly. To maximize the impact in the future, the socialization and reexamination procedures of the National Health Insurance implementation should be performed. Keywords: implementation, non-capitation funds, national health insurance, midwives, obstetric and neonatal services, first level health facilities, policy and regulations ANALYSIS OF THE RELATIONSHIP BETWEEN JOB SATISFACTION FACTORS AND TURN OVER RATE AT PT PGM Lilik Wijayati1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Introduction: Human resources are aspects that take a very important role in the success of a hospital service. The problem that often occurs in human resource management is employee turnover. Employee turnover at PT PGM in semester 1 of 2017 was 6.3%, semester 2 of 2017 was 6.7%, and semester 1 of 2018 was 6.4%, while the standard set by PT PGM was 5% per year. The high turnover can have a negative impact on the organization, both in terms of costs, resources and organization. Therefore an analysis of job satisfaction factors was carried out as one of the efforts to reduce employee turnover. Objective: the purpose of this study is to determine the relationship of job satisfaction factors with the desire for employee turnover. Method: This research is a type of analytic observational research with cross sectional design. The sample size in the study was 286 employees selected using propotional random sampling technique. Results: The results show that job satisfaction has a negative influence on employee turnover intention at PT PGM. 90% of employees choose to agree and strongly agree that dynamic factors such as incentives, respect for work and opportunities to develop abilities are the highest factors in job satisfaction. So it is recommended to increase dynamic factors to reduce employee turnover. Keywords: Turn over, job satisfaction, human resource. EFFORTS TO REDUCE PERINATAL DEATH CASES IN MANGGARAI, NTT Reinaldis Sara1, Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Introduction: Infant mortality in Indonesia is dominated by deaths in the perinatal period. Perinatal mortality rate in NTT in 2017 is 1300 per 100,000 births. Many factors influence this number, including diseases and development of maternal and fetal health and all matters related to health services both directly and indirectly. Therefore, special efforts are needed to reduce perinatal mortality rates in Manggarai district. Research Objectives: to make a program to reduce perinatal mortality rates in Manggarai district. Research Method: This research is descriptive research with cross sectional method. Data were collected from 22 health centers in Manggarai District, NTT. Data was taken by using interviews and observations to the midwives of the puskesmas. Results: From the results of this study it can be concluded that there is a relationship between the frequency of antenatal care and perinatal mortality and pregnant women who do antenatal care less than four times during the pregnancy. So it is necessary to conduct socialization activities by midwives to pregnant women patients regarding the importance of K4 in pregnancy, then collaborate with the PKK to socialize the importance of pregnancy examinations. Training is also needed for midwives to improve midwives' ability to handle pregnancy and birth with complications Keywords: Antenatal Care, Perinatal Death MATERNAL MORTALITY RATE RISK FACTOR ANALYSIS IN SIDOARJO REGENCY Sesotiyaningsih Madiyaning Utami1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Maternal Mortality Rate (MMR) is the number of maternal deaths due to pregnancy, birth up to 42 days after termination of pregnancy. The maternal mortality rate in Sidoarjo Regency is fluctuating and shows the highest status in 2017 with 82 per 100,000 live births. This figure has increased from the previous year, namely in 2015 was 72 and in 2016 was 66 per 100,000 births. It is necessary to analyze the increase in maternal mortality rates that occurred in Sidoarjo. The purpose of this study was to describe maternal deaths in Sidoarjo Regency and analyze risk factors for maternal deaths in Sidoarjo Regency. The study used descriptive descriptive approach with cross sectional method. The results of the study are the three main causes of maternal death in Sidoarjo Regency are heart disease, preeclampsia / eclampsia, and bleeding. Logistic regression analysis showed that the factors that influence maternal mortality were pregnancy complications (OR = 12,198, p = 0,010), labor complications (OR = 9,94, p = 0,020) and disease history (OR = 27,735, p = 0.011). Taken together, these three variables contribute to 64.3% of maternal deaths that occur in Sidoarjo Regency. Keywords: maternal mortality, pregnancy complications, labor complications ANALISIS INDEKS KEPUASAN MASYARAKAT (IKM) TERHADAP KUALITAS PELAYANAN DI PUSKESMAS TIUDAN Farida Handayani, Ratna Dwi Wulandari Program Studi S2 Administrasi dan Kebijakan Kesehatan, Fakultas Kesehatan Masyarakat, Universitas Airlangga [email protected] The public demand for the quality of public services is increasing and the Puskesmas is one of the health care facilities for the community. The purpose of this study was to analyze the quality of service at the Tiudan Health Center by using the Community Satisfaction Index (IKM) in accordance with the Minister of Administrative Reform Regulation No. 14 of 2017 concerning Guidelines for Preparing Community Satisfaction Surveys. The design of this study is quantitative descriptive. The variables of the research are community satisfaction with the service at the health center with subvariable requirements, procedures, time, costs / tariffs, product specifications, competency of officers, behavior of officers, handling complaints, suggestions and inputs as well as facilities and infrastructure. The study population was the visitors of Tiudan Health Center in June 2018. The random sampling method was 150 people with research instruments using questionnaires. The results of the study describe the Community Satisfaction Index (IKM) on the quality of health services in the element of service requirements 3.31 (Good), service procedures 3.36 (Good), service time 3.09 (Good), service costs 3.17 (Good), service specification products 3.28 (Good), competence of service personnel 3.32 (Good), behavior of service personnel 3.22 (Good), handling complaints, suggestions and input 3.19 (Good), and facilities and infrastructure 3, 16 (Good). Overall Community Satisfaction Index (IKM) of Tiudan Health Center is 3.20 with a conversion value of 80.02 including Good category. Keywords : Indeks Kepuasan Masyarakat , Kualitas Pelayanan, Puskesmas EFFORTS TO REDUCE STUNTING TODDLERS PREVALENCES IN SURABAYA Desy Puspitasari1, Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Stunting is a problem of chronic malnutrition caused by a lack of nutritional intake for a long time, which disrupts the growth of children. Based on the results of Nutrition Status Monitoring (PSG) in 2017 the prevalence of stunting in children under five in East Java was 26.7%. The prevalence rate has decreased from 2013 which was 32.7%. However, this figure is still higher than the standard set by WHO the maximum prevalence of Stunting in infants is 20%. This indicates that the prevalence of stunting occurring in East Java is still high. The purpose of this study is an effort to reduce the prevalence of stunting in infants in Surabaya. This research is descriptive research. Methods of data collection through interviews, observation and secondary data analysis. In an effort to reduce the prevalence of stunting in Surabaya, the health department carried out weighing activities every February and August, and carried out the movement of 'Guaranteeing Pregnant Women Nutritious enough for the First 1000 Days of Quality Life to Have a Happy Mother, Healthy Babies'. In addition, the health department also collaborates with all puskesmas and hospitals to conduct nutrition counseling on pregnant women and toddlers. Keywords : Stunting, malnutrition, Toddler LEVEL OF SATISFACTION OF HEALTH SERVICES AT SIWALANKERTO HEALTH CENTER Martha Ariana Wijayanti1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Patient satisfaction is one indicator that produces health services to the community. Health service satisfaction if there is one that matches or exceeds expectations. Patient satisfaction can also be an indicator of the success of health services. Patient complaints can be a reference for health centers in providing health services. The aim of this study is to find out the status of patient satisfaction, services can be improved and improved by health services. The design of this study is quantitative descriptive. The research variable is patient satisfaction with outpatient services at the primary health centre. The study population was visitors to the Siwalankerto Health Center in July 2018. The sampling method was random sampling. . Data collection starts from opening hours to completion. The results of the study were analyzed by comparing expectations and experiences that match the level of health of the patient. Patient satisfaction results are in accordance with the requirements, system, and procedures, costs, implementation costs, handling of facilities and facilities. Patients are satisfied with the service type product specifications. And patients with care and services at the Siwalankerto Health Center. Keywords: Patient Satisfaction, Health Services, Primary Health Centre NEONATAL COVERAGE PROGRAM ANALYSIS WITH COMPLICATIONS TREATED IN SUMENEP REGENCY Rani Romadaniyati1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 The neonatal coverage rate with complications handled is the coverage of neonates with complications that are handled definitively by competent health workers at the level of basic services and referrals in a work area for a certain period of time. Complicated cases handled are all cases handled without seeing the results live or die. This indicator shows the ability of health care facilities in handling neonatal emergency cases. However, the number of neonates with complications covered by Sumenep regency has decreased by 65.99% in 2015, 59.35% in 2016 and 50.95% in 2017. This figure is still far from the target of 95%. The purpose of this study was to analyze the causes of low rates of neonatal coverage with complications handled. This study uses a qualitative method. The research location was carried out in the work area of the Sumenep District Health Office. Data that has been collected through interviews and review of secondary data. then the data is analyzed by content analysis method. The result of this study were the factors causing the low coverage of neonates with complications handled were the low knowledge of mothers regarding the importance of health during pregnancy, lack of information from midwives on the importance of maternal and child health and also the lack of resources in carrying out the program. EVALUATION OF THE IMPLEMENTATION OF THE COVERAGE PROGRAM OF VISITING K4 PREGNANT WOMEN IN THE WORKING AREA OF HEALTH OF LUMAJANG DISTRICT Wahdatul Chizbiyah1, Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Background. Coverage of visits of pregnant women K4 is the coverage of pregnant women who have received antenatal care according to the standard at least 4 times in one work area in a certain period of time. The coverage of visits for pregnant women in K4 district in Lumajang continued to experience a decline in 2015 at 89.0% and in 2016 was 88.44%, this figure was further from the standard stipulated in the Republic of Indonesia Health Minister Regulation No. 741 of 2008 of 95%. Aim. to get more in-depth information about the Implementation of Minimum Service Standard Coverage of K4 Pregnant Women. Method. This study uses a qualitative method. The location of the study was carried out in the work area of the District Health Office. Data that has been collected through interviews and review of secondary data. then the data is analyzed by content analysis method. The results of this study indicate that the implementation of the K4 coverage program did not go well because of the lack of public knowledge about the importance of pregnancy health. Suggestions for this research are to train health center officers who are directly involved in antenatal care services, carry out data collection and activities of pregnant women, and conduct home and team visits in an integrated manner by involving cadres to recruit new pregnant women. Keywords: pregnant women, K4 program, health department MEDICATION ERROR IDENTIFICATION IN DISPENSING PHASE AT INPATIENT PHARMACY DEPOT GRESIK HOSPITAL Reviani1, Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Medication error is an incident that is detrimental to patients which can actually be prevented. Medication errors often occur in hospitals. The purpose of this study is to describe medication errors that occur in the dispensing phase in drug services at Gresik Hospital. This study was an observational study with a cross sectional study design on prescription data in inpatient Pharmacy Depo, Gresik Hospital Pharmacy Installation. The results showed that the potential for errors occurred because of the provision of incomplete etiquette, which was 61%. The conclusion of this study is that medication errors occur in the dispensing process due to incomplete etiquette administration. Keyword: medication error, dispensing, pharmacy ANALYSIS OF LOW PERFORMANCE OF CAMPLONG HEALTH CENTER AT SAMPANG DISTRICT Ariska Herlyawati1 ,Djazuly Chalidyanto2 Departement of Administration and Public Policy, Universitas Airlangga, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Universitas Airlangga, Surabaya [email protected] 1 Public Health Centers as public sector organizations that serve the health sector can not be separated from the community's assessment of the increasingly critical of its performance. One of the ways used by Health Office in assessing the success of Primary Health Centre is by conducting Primary Health Centre Performance Assessment. Camplong Health Center is one of the urban-type community health centers in Sampang Distric. Camplong Health Center performance assessment results in 2017 shows many program that not meet the standar, such as K4 programm for Maternal, Treatment for high risk Infant, and Health care for Toodler. The purpose of this research is to analyze the factors that are suspected to be the cause of the poor performance of the Camplong Health Center organization. This study is a qualitative research with in-depth interviews to program implementers in Health Center and informants triangulation Head of Primary Health Centre, Sub Division of Planning and Evaluation of Health Office, Head of Primary Health Service Section of Health Office. The result of the research shows the factors that cause the low performance of Camplong Primary Health Center are, the availability of the number and competency of health personnel are still lacking, the supervision process from the Head of Health Center is still not good, and still weak organizational culture at Camplong Community Health Center. To overcome this problem, it is suggested that Camplong Head of Primary Health Centre can change their leadership style and added several number of competence human resource. Keywords :Organizational Performance,Primary Health Centre, Public Service THE EFFECT OF GIVING ADDITIONAL EMPLOYEE INCOME TO THE DISCIPLINATION OF EMPLOYEES OF KEDIRI HEALTH OFFICE Dewi Kurniawati1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Minister of Home Affairs Regulation No. 59 of 2007 concerning Regional Financial Management specifically stated in article 39, which states that local governments can provide additional income to civil servants based on objective considerations by taking into account the regional financial capacity and obtaining approval from the DPRD. The additional income referred to in order to improve the welfare of civil servants based on workload, place of duty, working conditions, professional scarcity or work performance. Even in the Kediri City Government environment, starting from the end of 2017, the policy of giving additional income to civil servants has begun. The method of payment is adjusted to the level of attendance of civil servants through finger print attendance machines which are evaluated at the end of each month. This policy is given to improve the performance of civil servants in the Kediri City Government, especially the Kediri City Health Office. To see the effectiveness of this policy, it is necessary to evaluate whether this additional income has a positive effect on improving employee performance. The purpose of this study is: to analyze the effect of giving additional income to employees on employee performance, especially the discipline of employees at the City Health Office of Kediri. Method This type of research is descriptive which is intended to see the influence between variables studied using descriptive data analysis employee attendance before TPP is given with employee attendance after TPP is given through finger print results reports. The results of this study found that increasing employee income simultaneously has a positive and significant influence on employee performance, especially the level of employee discipline. Keywords: additional employee income, employee performance, employee discipline ANALYSIS OF RISK FACTORS THAT INFLUENCE MATERNAL MORTALITY IN SURABAYA Monica Ayu1, Setya Haksama2 Department of Administration and Public Policy, Airlangga University Surabaya 2 Lecturer on Department of Administration and Public Policy, Airlangga University Surabaya 1 Surabaya was ranked highest in East Java as a city with the highest maternal mortality compared to other districts. The number of maternal deaths was 39 deaths in 2014. Surabaya was ranked 22nd based on prevalence calculations. The purpose of this study was to determine the factors that most influenced maternal mortality in Surabaya which included anemia status, disease history, and history of complications. This type of research is a survey study with a case-control research design, that is one mother died looking for one mother who controls it with matching health visits equally more than the same as 4 visits. The number of respondents studied was 78 people. Data collection used is written interview technique, documentation and measurement method. The collected data were analyzed by chisquare analysis technique to determine whether there was any influence between the variables studied and maternal mortality, and multiple logistic regression analysis to determine the factors that most influenced maternal mortality in Surabaya. The results showed that based on multivariate analysis in the form of anemia status (p = 0.002; OR = 2.69), disease history (p = 0.001; OR = 3.81), and history of complications (p = 0.002; OR = 5.09 ) affect maternal mortality. The conclusion is that the factors that most influence the incidence of maternal mortality in Surabaya in 2018 after multiple logistic regression tests are a history of complications. It is recommended for husbands or other family members, must give a role to the mother at home to decide for themselves matters related to her pregnancy, including the decision to immediately check if there are symptoms of complications. Keywords: Maternal death, anemia status, disease, history of complications IMPLEMENTATION PROCESS OF THE ELDERLY HEALTHCARE CENTRE ON DECREASING THE PREVALENCE OF HYPERTENSION IN THE WORKING AREA OF KENDALSARI HEALTH CENTER MALANG Indana Tri Rahmawati1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Heatlhcare centre for the elderly is a development of government policy through elderly health services which is carried out through a puskesmas program involving the participation of the elderly, families, community leaders and organizations. This study aims to describe the implementation process of posyandu for the elderly to reduce the prevalence of hypertension in the work area of Kendalsari Malang Health Center. This type of research is evaluative research (evaluation study). The subjects in this study were 15 elderly posyandu. Determination of sampling by means of periodical accidental sampling. The informant was in charge of the Elderly Heatlhcare Centre Program, the respondents were active cadres and the elderly were met at the posyandu for the elderly at the time of the study. Data collection method by interview, observation and document review. Instrument used was questionnaire, checklist and monthly report of Kendalsari Health Center. The results of this study were the implementation stage of the posyandu for the elderly had been carried out at 54.36%. As many as 60.6% of the elderly said that there was no need to queue long at the Healthcare centre for the elderly. As many as 80.0% of elderly posyandu report the results of their activities to the puskesmas. The conclusion of this study is the implementation of the healthcare centre elderly implementation process in the working area of the Kendasari Health Center is quite sufficient. Keyword: elderly healthcare centre, hypertension, primary health care CAUSES OF LOW COVERAGE BEHIND OF PNEUMONIA BASED ON PROGRAM SUPERVISION MANAGEMENT ANALYSIS FACTORS AT PACARKELING HEALTH CENTER Dian Rakhminiar1 ,Suluh Rahardjo2, Djazuly Chalidyanto3 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Head Of Pacarkeling Health Center, Surabaya 3 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Background: Acute respiratory infections are known as one of the main causes of infant mortality in developing countries. Pneumonia as one of the acute lower respiratory infections mostly causes mortality in acute respiratory infections on toddlers. Pneumonia got less concerned than the other diseases in developing countries. According to WHO in 2008, toddlers infected with pneumonia in developing countries were 151.8 million cases each year and about 10% of them were severe pneumonia cases and need to be treated in hospital. the rate of pneumonia in toddlers in East Java is still high, whereas the number of findings is still low. The target of finding pneumonia for under-fives is 100%, while the discovery figure in the scope of the health center is 34% in 2015 and 78% in 2016. Although there has been an increase but still maintained the prescribed standards The aim of the study was to analyze the influence of supervision on the Invention of Pediatric Pneumonia program at Pacarkeling health center. Method: a descriptive study based on secondary data from Pacarkeling Health Center. The study was conducted by means of observation and interviews with related personnel. Results and Discussion: From this study found that the activity of the discovery of toddler pneumonia at Pacarkeling health center was not going well because there was no supervision and feed back given to the program. Lack of controlling causes the evaluation of activities not optimal so that they cannot make optimal improvements for the next activity. Keywords: Toddler pneumonia, health center EMPOWERMENT MOTHERS REDUCE A NUMBER OF EARLY CHILDHOOD CARIES INCIDENCES FOR A PRE-SCHOOL AGE (Study in a work area Telkomedika Health Center clinic Surabaya) Restika Anindya Pinasti Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] Treating dental caries in pre-school children (0-6 years) would increase growth rates and the quality of life of millions of children. In many countries, severe untreated dental caries is common in pre-school children. WHO has been made guidance The Global Goals for Oral Health 2020, in a purpose to minimize an effect oral disease and craniofacial effort of promotif emphasize and decrease a systematic disease affected manifest oral cavity with early diagnosis. So, the Oral Health Goals had stimulated awareness of the importance of oral health among national and local governments and acted as a catalyst securing resources for oral health in general. Among that rule, therefore Indonesia Health Ministry declared “Indonesia is carries free at 2030”, this research appointed the mothers decreasing a carries prevalence each of family especially children, with an observation method through cross sectional approach, which means a research did one moment and one time without a following stages. This researched conducted in Telkomedika Health Centre clinic Surabaya. The sample consist 50 mothers instantly 25-40 age that get a treatment in the clinic. Before the empowerment, most of respondents unknown about teeth and oral in which followed by old bad habits that make early childhood caries. The conclusion had shown mothers concerned and wanting to know the importance of maintaining dental and oral hygiene. Health promotion noted the mothers are the best teachers and supporters in promotion. Giving an example maintained dental hygiene, animation posters use and gift giving to the children whom cared is the best way to avoid caries in pre-school child teeth. Keywords: Empowerment, early childhood caries, the mothers, health promotion. HAND HYGIENE COMPLIANCE IN NURSES IN THE INPATIENT ROOM OF GATOEL HOSPITAL IN MOJOKERTO Anggraina Puspitasari, Djazuly Chalidyanto Departement of Administration ang Public Policy,Airlangga University, Surabaya Nosocomial infection is an infection that occurs in patients who are hospitalized or other health facilities, where the infection is not found or not during the incubation period when the patient is hospitalized. Nosocomial infections occur throughout the world in both developed and poor countries. This infection is one of the main causes of death and increased morbidity in hospitalized patients. Hand Hygiene has a great influence on the prevention of nosocomial infections in hospitals, and nurses have a large share because they interact with patients for 24 hours. The purpose of this study was to determine the factors that influence the level of compliance in the implementation of Hand Hygiene activities for nurses at the Gatoel Hospital in Mojokerto. The type of research used in this study is descriptive while the approach used is evaluation study. The sampling technique is total sampling that is taking all members of the population into samples. The results of this study found that the cause of adherence to hand hygiene nurses at Gatoel Mojokerto Hospital was still below the standard, namely 73% of the 100% standard was a lack of knowledge about the effects of hand washing and the absence of sustainable socialization. Nurses have not adhered to the implementation of hand hygiene activities properly and correctly and have not met the standard percentage of hand hygiene so that continuous socialization activities are needed and the installation of warnings on the importance of hand hygiene matches as many as five moments. Keywords: Hand hygiene, compliance, nurses, hand hygiene standards, five moments NURSE HAND HYGIENE COMPLIANCE DURING THE IMPLEMENTATION OF ACTION IN THE EMERGENCY DEPARTMENT Mardhina Ratna1 , Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Nosocomial infection is an infection obtained from hospitals, health facilities, health workers and other patients. One of the way to prevent the occurrence of nosocomial infection is by increasing compliance hand Hygiene. has set a standard of 100% compliance Hand Hygiene, but the number of compliance Hand Hygiene in the ED during January, February and March 2018 is 50%. Therefore, it is necessary to do an analysis to increase the Hand Hygiene compliance. The purpose of this study was to analyze nurses' compliance in washing hands in the Emergency Department. The method used is quantitative with a descriptive research design, which is a research method that is carried out with the main objective to make an overview or description of a situation. With a sample of 20 nurses which is total sampling. The nurse's Hang hygiene compliance rate before taking action is lower than after taking action. This is due to the lack of awareness and knowledge of nurses about the importance of hand hygiene. Key words: hand washing, nurses, Emergency Departement IMPLEMENTATION OF WHO MULTIMODAL HAND HYGIENE IMPROVEMENT STRATEGY TO REDUCE HEALTH CARE ASSOCIATED INFECTIONS AND VAP CAUSED BY MDRAB IN SILOAM HOSPITALS SURABAYA INDONESIA 1,2 Bernadetta Indah Mustikawati1, Niken Syitharini2 Quality and Risk Department, Siloam Hospitals Surabaya [email protected] Background: Siloam Hospitals Surabaya (SHSB) is a 160 bed private hospital in Surabaya, Indonesia with 2010 Average Length of Stay (ALOS) 9.52. In 2010, HAIs at SHSB rate was high (3.12%) and Hand Hygiene compliance in Health Care Workers (HCW) was low (73.34%). At the same time, SHSB had Multi Drug Resistant Acinetobacter Baumanii (MDRAB) outbreak in patients using ventilator in ICU with VAP rate 10.99/device days. Therefore, there was a need for quality improvement to reduce those HAIs rate and VAP rate caused by MDRAB, by using the WHO Multimodal Hand Hygiene Improvement Strategy to improve Hand Hygiene in healthcare workers. Purpose: To Improve HH compliance among HCW in Siloam Hospitals Surabaya from 73.34% to reach WHO standard of 85% and subsequently decrease HAIs and VAP caused by MDRAB in ICU. Methods: Program based on the WHO Multimodal, was implemented in 2010 in all departments, including: 1)System Change Initiatives: conducting HH policy review and ward infrastructure survey every 6 month, procuring budget for HH product, and evaluating staff’s tolerability and acceptability of Alcohol based hand rub. 2)Training and education: conducting regular mandatory training and induction program training for all staff, communicating with doctors via doctor’s forum and antibiotic stewardship case study, developing e-learning, validating process of staff’s HH training via staff’s portfolio and marking staff’s ID card with HH sticker. 3) Evaluation and feedback: conducting monthly HH compliance audit and reporting the result to governing body, providing feedback during monthly staff’s coordination meeting, and Infection Control committee meeting every 3 months, conducting external audit by ISO: 9001 and by Global Quality Development annually. 4)Reminders in the workplace: installing posters in public and point of care areas, HH reminder via paging system, and finger print attendance machine, production of International Patient Safety Goals Video and HH Leaflet. 5) Institutional Safety Climate for HH: declaring CEO support and commitment with official letter, implementing Quality Improvement program across Siloam Hospitals, establishing HH as Key Performance Indicator for all staff, and conducting HH Surveillance, promoting patient speak-up token in reminding doctors to perform hand hygiene. Result: We conducted monthly HH audit compliance since 2010 with total number of 31267 opportunities for hand hygiene during 2233 observation sessions in hospital wide. The overall hospital wide compliance with hand hygiene practices increased significantly from 73.34% in 2010 to 91.86% in 2014 (p<0.0001). The overall consumption of alcohol based hand rub increased in parallel from 16.8 L in 2010 to 34.55 L per 1000 patient-days in 2014 (p=0.002). HAIs rate decreased from 3.12 (2010) to 0.10 (2014) per 100 admission (p=0.02). VAP caused by MDRAB in ICU decreased from 10.99/devices days (2010) to 0% (2014) per 1000 devices-days (p=0.02). Hospital Average Length of Stay decreased from 9.52 in 2010 to 4.38 in 2014 Conclusions: Implementation of WHO Multimodal HH Improvement Strategy that is supported and committed by CEO and all hospital staffs, increased staff’s HH compliance and subsequently reduced HAIs rate in hospital wide and VAP caused by MDRAB in ICU. Keywords: WHO Multimodal, hand hygiene, hand hygiene strategy, HAIs Rate, VAP, MDRAB ABILITY TO CONTROL BLOOD SUGAR LEVELS OF TYPE 2 DIABETES MELLITUS PATIENTS THROUGH IMPLEMENTATION OF PROLANIS ACTIVITIES Dewi Kusumawati1, Djazuly Chalidyanto2 Departemen of Health Administration & Policy, Faculty of Public Health, 2 Lecture on Departemen of Health Administration & Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia [email protected] 1 Background: Data on International Diabetes Federation (IDF) shows the number of diabetics in Indonesia is currently estimated at 10 million, rangked seventh highest in the wordl and became number three killer in Indonesia. The prevalence of diabetes in Indonesia tends to increase, from 5,7% in 2007 to 6,9% in 2013. WHO data estimates that the number of patients with type 2 Diabetes Mellitus in Indonesia will increase significantly by 21,3 million in 2030. Type 2 Diabetes Mellitus is a chronic disease. The Indonesian government and health insurance (BPJS Kesehatan) form a programnationally, namely Chronic Disease Care Program [Program Pengelolaan Penyakit Kronis (PROLANIS)] which has the purpose of spesific examination of type 2 Diabetes Mellitus disease so as to prevent the emergence of disease complication. The purpose of study was to determinan the ability of type 2 Diabetes Mellitus patients to control blood sugar levels through the implementation of PROLANIS activities. Method: Research design using Descriptive with evaluative research approach. The sampling technique is Non Probability Sampling with Purpose Sampling, which is the respondent who arrives every month PROLANIS activities at least 3 consecutive months during the period January-May 2018 as many as 31 respondents. Result: The result of the study showed as many as 20 respondents (64,52%) were very good capable, 6 respondents (19,35%) were good and 5 respondents (16,13%) were not good. Conclusions: Based on these result it can be concluded that optimal PROLANIS activities give effect to the patient’s ability type 2 Diabetes Mellitus in controlling blood sugar levels. Key Word: PROLANIS, type 2 Diabetes Mellitus, blood sugar levels. EFFECTIVENESS OF HAND WASHING TRAINING BASED ON KIRKPATRICK LEVEL 2 THEORY ON NURSES AT DKT GUBENG POJOK HOSPITAL SURABAYA Ernawaty ¹, V A R Damayanti ² Faculty of Public Health, Universitas Airlangga [email protected]¹, [email protected] ² Hospitals to provide education and training staff potentially expose to direcly related to patients. One of education and training to provide by hospital which is hand washing. This study has been done because the number of hand washing disobedience in 2017 is still above 0%. The study has been done to analyze the elements of hand washing in nurses based on the training in DKT Gubeng Pojok Hospital Surabaya using the training effectiveness theory 2 Level Kirkpatrick. This research was descriptive, using a questionnaire to know the effectiveness of the training and the effectiveness of knowledge. The sample were a whole nurses all those participate of the training and nurses who did not participate in June 2017 at DKT Gubeng Pojok Hospital Surabaya and the number of respondents were 34 respondents. At the reaction level starting from the time of training until the trainer gets effective results. For the participant variables, there were 20 nurses from the total respondents who did not participated the training with the reasons of the training time. For learning level results, the knowledge and ability to remember the material of nurses who attended the training got good results with a score of 78.57 and 79.29, while for nurses who did not attend the training got good results with scores of 71 and 64. The conclusion of this study was from the identification of the first level get effective results, and the results of the comparison of the level of knowledge between the participating nurses and the nurses who did not participate in training received different grades. Researchers advise hospitals to be able to provide some other training needed by hospital employees. Keyword : Effectiveness Of Training, Hospital, Nurses. THE IMPORTANT OF LEAD AND SUPPORT STAFF ON PATIENT SAFETY IN RSUD KOTA YOGYAKARTA E Ernawaty, W Apriyani Faculty of publich Health Universitas Airlangga [email protected], [email protected] Back Ground: Patient safety affect everyone in the National Health Service. Building a safer culture depends on strong leadership and organisation's ability to listen and support all members of the healthcare team. The evidence available in indicates that the level of patient safety of an organisation can be improved if there is strong leadership from the top of an organization with clarity of vision and clear policies in relation to safety, balanced by demonstable implementation of best practice at service level. Research Method: This type of qualitative research with a case study approach on 6 informants used interview guidelines and a check list in the Minister of Health Regulation about leading and supporting staff in patient safety. Data analysis uses data reduction, data and conclusions. Result: The implementation of lead and support staff in the safety of patients RSUD Kota Yogyakarta is in accordance with the Peraturan Menteri Kesehatan about Patient safety because the hospital already has directors who are responsible for patient safety, in each installation there are drivers of patient safety, patient safety is a priority in the meeting agenda , there is training specifically conducted for hospital staff and all new employees and apprentices so that staff understand the importance of patient safety in hospitals and always respect every incident report. Conclusion: The implementation of leading and supporting staff in patient safety in RSUD Kota Yogyakarta is in accordance with the Peraturan Menteri Kesehatan about Patient Safety Key words: leadership, patient safety THE IMPORTANCE OF CORRECTLY IDENTIFYING THE PATIENT IN THE HOSPITAL Ernawaty, Widani Darma Isasih Faculty of Public Health, Universitas Airlangga [email protected], [email protected] Background: The hospital has an important role for people who offer and provide services with a variety of very complex components such as various types of drugs, tests, procedures, tools with technology, professional and nonprofessional personnel who are ready to serve 24 hours continuously to patients. All these components if not managed properly can potentially lead to errors when providing services to patients, thus threatening patient safety. Based on the results of a preliminary study in North Lombok District Hospital found several patients were not paired with identity bracelets and SOP identified patients who had not been distributed to officers, the patient identity bracelets were often erroneous, incomplete specific identification stickers, lack of commitment of officers. All of these problems can trigger incidents related to patient safety that can cause harm to patients and hospitals. Therefore, the researchers focused on the problem of research in implementing correctly identifying patients in a public hospital in the North Lombok district. Method: type of qualitative research with a total of 6 employees and the validity of the data using method triangulation and source triangulation. Results: SOPs are not channeled, human resources are still not maximal in correctly identifying, facilities and infrastructure are not sufficient in terms of quality and quantity. Conclusion: The implementation of identifying patients based on input, process and output has not been carried out. Keywords: patient identification, patient identity, patient safety. ANALYSIS OF FILLING COMPLETION OF MENUR HOSPITAL MEDICAL RECORD AT RUMAH SAKIT JIWA MENUR PROVINSI JAWA TIMUR Mumun Zurida Emilya1, Djazuly Chalidyanto2 Departement of Administration and Public Policy, Airlangga University, Surabaya 2 Lecturer on Departement of Administration and Public Policy, Airlangga University, Surabaya [email protected] 1 Background. The completeness of the medical record file is very important because it influences the service process carried out by medical personnel and affects the quality of the service of a hospital. The number of incomplete medical records in Rumah Sakit Jiwa Menur Provinsi Jawa Timur in 2017 is still high at 9.86%, while the standard set by the Ministry of Health is 100% complete medical record data. To reduce the number of incompleteness of medical records, it is necessary to analyze factors that affect the incompleteness of the medical record file, then make a proposal to solve it. The purpose of this study was to determine the factors that influence the incompleteness of inpatient medical record files at Rumah Sakit Jiwa Menur Provinsi Jawa Timur. Method: Analysis of the data used is qualitative analysis. The data taken are medical record files submitted from the inpatient unit to the medical record subdivision. The results showed that the cause of incomplete medical record files was the lack of socialization on filling in the medical record files, lack of policies regarding filling in medical record files, and lack of nurses' knowledge about the form of medical record files Keywords: medical records, hospital