Staffing characteristics and their associations with the severe maternal outcomes at Indonesian tertiary hospitals
Makhfudli Makhfudli 1, Ferry Efendi 1, 2 , Anna Kurniati 3, Retnayu Pradanie 1, Susy Katikana Sebayang 4
Abstract
Aim: Staffing is believed to have a profound influence on the reduction of maternal mortality and severe maternal morbidity. Our research aims to examine the relationship between staffing characteristics and severe maternal outcomes. Methods: We conducted a retrospective cross-sectional study analyzing the data of deliveries and staffing from the eleven maternity units at the tertiary hospitals in the Java region of Indonesia. Results: The present study revealed that staffing characteristics were significantly associated with severe maternal outcomes. Maternity units with a higher nurse to birth ratio reduced the odds of severe maternal outcomes by 52% (OR = 0.476; 95% CI: 0.307–0.739). However, admission to units with a higher midwife to birth ratio increased the odds of experiencing severe maternal outcomes by 1.8 times (OR = 1.809; 95% CI: 1.070–3.059). The likelihood of severe maternal outcomes in maternity units is reduced by 52% for every additional year of nursing experience (OR = 0.476; 95% CI: 0.304–0.745), and by 69% for every additional year of midwifery experience (OR = 0.313; 95% CI: 0.200–0.491). Conclusions: The findings signify the prominent role of healthcare workers in maternal healthcare at the tertiary level. A further study is recommended to provide more support for the evidence-based policy in relation to developing safe staffing standards within the maternal healthcare framework.
The Differences in the Stimulation and Personal Social Development of School-Aged Children between Children who Raised by their Grandparents and Parents Respectively
Anjar Ani, Praba Diyan Rachmawati, Ferry Efendi, Kristiawati, Laily Hidayati
Abstract
Introduction: Indonesia is a country that has a cultural feature related to child care. Grandparents can act as a parent because of unexpected factors such as t h e parents dying, accidents, illness, t h e p a r e n t s b e i n g dependent on drugs, imprisonment, studying abroad or t h e parents still b e i n g adolescents. The aim of this research was to determine the difference between the stimulation and personal-social development of school-aged children taken care of by their grandparents and parents respectively. Method: The sample used consisted of 20 children taken care of by their grandparents and 30 children taken care of by their parents in one of the Elementary Schools in Surabaya. The independent variable was stimulation and the dependent variable was personal-social development. The data was collected using a questionnaires t h a t w a s analyzed using ChiSquare and Spearman rho’s with significance ?<0.05. Results: The results showed there to be a significant difference in stimulation between grandparents and parents (p=0.007) and the same in personal social development between the grandparents and parents (p=0.000). There was no correlation between grandparent stimulation (p = 0.209) and parental stimulation (p= 0.244) with the personal social development of the school-aged children. Discussion: The personal social development of schoolage children who are cared for by their grandparents was lower than those cared for by their parents. However, there was no relationship between the stimulation carried out by the grandparents and the personal social development as well as the stimulation given by their parents on the personal social development. Further research is suggested to analyze the factors that influence the stimulation and personal-social development of school-aged children by comparing the results of the grandparents’ children and those of the parents.
The Implementation of Controlling in Nursing Care Management Regarding Ventilator-Associated Pneumonia Bundles on Post Heart Surgery Patient in Intensive Care Unit
Muhammad Hadi1, Amalia Amalia2, Rohadi Haryanto1, Ferry Efendi3, Nursalam3
Abstract
Control in the nursing care management for Ventilator-Associated Pneumonia (VAP) bundles of postcardiac surgery patients is related to using predetermined standards and actions taken to correct mismatches between standards and actual performance. The purpose of this study was to apply the identification of controls in the nursing care unit to the VAP collection in the intensive care unit. Design research using quasi-experiments before and after with the control group. The population in this study was nurses invited to pediatric Intensive Care Unit (ICU). The number of samples was 32 people, divided into two groups consisting of intervention and control, taken by purposive sampling technique and General Linear Model Repeat Measure (GLM-RM) analysis method. The results of this study were analyzed by the dependent t-test. Dependent t-test results obtained in the average VAP bundle before the intervention were 3.3462 and after the intervention were 3.8362 with an average change of 0.41707 andp-value (0,000) < (0.05).The application of controls in the nursing care management to the VAP bundle in accordance with the Standard Operational Procedure (SOP) emphasizes better accountability in providing nursing care to patients who are fitted with work safety and improves the actual performance of officers. Implement the control of a part of a continuous improvement strategy in quality control of special health services in relation to pneumatic infections installed in mechanical facilities in the Intensive Care Unit.