Acute Coronary Syndrome (ACS) is a cardiac emergency condition that requires fast and precise action while a pre-hospital delay in a patient to come to the ED is still common. This pre-hospital delay is related to the socioeconomic and knowledge factor. The purpose of this study is to determine the relationship of socioeconomic and knowledge with the prehospital delay of ACS patients to come to Integrated Heart Service in Emergency Department of Sanglah General Hospital, Denpasar. This research is a quantitative research with cross-sectional design and purposive sampling as data collection technique with 292 patients. The results showed that 55.8% of patients have low socioeconomic status and there are 71.6% of patients who do not know ACS. The pre-hospital delay, in this case, is associated with low socioeconomic status and knowledge of ACS so that health workers need to provide counseling to patients and families about ACS signs and symptoms, healthy lifestyles, and the importance of coming to the emergency department when signs of ACS are felt.

Background: Shift work is a way to maintain proper health care daily at hospital. Shift work may affect fatigue level of nurse and work related stress in Emergency Room (ER) nurses. Generally there are two types of shift work, such as two and three division time a day. The three-division time shift includes 6-6-12 shift and 7-7-10 hours shift, and two-division time includes 12-12 hours shift. Lack of studies discusses about shift work on fatigue and work related stress in ER nurses.Objective: The aim of this study was to identify the differences of the effects between 6-6-12 shift, 7-7-10 shift, and 12-12 shift on fatigue and work related stress, and determine the dominant indicator influencing fatigue and work related stress in emergency nurses at the hospitals in Badung and Denpasar regency, Bali Indonesia.Methods: This was an observational analytic study with cross sectional approach. Purposive sampling was done to recruit 102 nurses from eight emergency departments at Badung and Denpasar regency. Occupational Fatigue Exhaustion Recovery (OFER) questionnaire was used to measure fatigue, and Expanded Nursing Stress Scale (ENSS) questionnaire was used to measure work related stress. Univariate analysis was used to analyze demographic characteristics of each ER. Kruskall-Wallis test with post hoc Mann Whitney were used to determine the different score of fatigue and work related stress between each group, and Structural Equation Modeling (SEM) was used to identify contribution of fatigue toward work related stress of ER nurses. Results: There were significant difference of the effect of shift work on fatigue, between 6-6-12 shift and 12-12 shift with p = 0.037, and between 7-7-10 shift and 12-12 shift with p = 0.003; and significant difference of the effect of shift work on work related stress, between 6-6-12 shift and 12-12 shift with p = 0.474, and between 7-7-10 shift and 12-12 shift with p = 0.128. SEM results show that fatigue contributed about 61% to increase work related stress in ER nurses.Conclusion: There was significant difference of the effects on fatigue between two and three-division time of shifts, and there was no difference of the effect on work related stress for each group. Fatigue statistically increased work related stress in ER nurses.

Acute Coronary Syndromes is the leading cause of short-term and long -term mortality.An aggressive treatment approach has the potential to change the prognosis of patients with ACS, although its depends on risk factors. There are several risk scores such as Thrombholysis in Myocardial Infarction (TIMI), Global Registry of Acute Coronary Events (GRACE), and Killip. The aim of this study is to analyse the differences of correlation of TIMI, GRACE, and Killip risk scoresas predictor Length Of Stay patientswith Non St-Elevation Myocard Infarction ACS.The method of this study utilized an analytic observational design with the cohort retrospective. The research was conducted at RSUD Dr.Iskak Tulungagung used 98 samples of medical records patient with NSTEMI ACS in the past 8 months (January-August 2017). The data collection techniques was completing risk score of TIMI, GRACE, and Killip and Length of Staypatient in ICCU ward. The results and analyse of Spearman Rank showed that TIMI has p = 0,000 r = 0.466, GRACE p = 0,000 r = 0.598, and Killip p = 0,000r = 0.441 (p < 0,05), so that it can be said that there was significant differences between the risk score of TIMI, GRACE and Killip as predictor prognosis patient with NSTEMI ACS. It can be concluded that the TIMI, GRACE and Killip risk scores have correlationas predictor prognosis patient with NSTEMI ACS,which is GRACE risk score has superior to TIMI and Killip.

Saat ini keselamatan pasien (patient safety) menjadi isu penting dalam pelayanan farmasi karena tidak dapat dipungkiri bahwa kesalahan pengobatan kerap terjadi di rumah sakit. Kesalahan pengobatan yang sering terjadi adalah kesalahan peresepan yang merupakan tahap awal proses pelayanan farmasi. Kesalahan peresepan berpotensi fatal bila terjadi di ruang perawatan intensif disebabkan karena kondisi pasien yang kritis, banyak komplikasi dan polifarmasi. Salah satu upaya pencegahan kesalahan peresepan adalah dengan pendampingan apoteker di ruang perawatan. Tujuan penelitian untuk mengetahui pengaruh pendampingan apoteker saat visite dokter terhadap kesalahan peresepan di ruang perawatan intensif. Penelitian ini adalah penelitian kuasi eksperimental dengan desain one group pre-post test. Pengambilan data secara prospektif dilakukan selama bulan April-Mei 2015 terhadap 110 sampel resep. Skrining resep dilakukan apoteker depo untuk mencatat kesalahan peresepan pada lembar observasi. Kesalahan peresepan didefinisikan sebagai kesalahan dalam proses penulisan resep. Kesalahan penulisan yang dimaksud adalah informasi resep yang tidak lengkap/tidak ditulis dan informasi resep yang tidak sesuai kesepakatan. Analisa perbedaan kesalahan peresepan sebelum dan dengan pendampingan apoteker menggunakan uji Mann-Whitney. Hasil penelitian menunjukkan bahwa ada perbedaan bermakna antara kesalahan peresepan sebelum dan dengan pendampingan apoteker (p<0,05). Juga terdapat korelasi negatif yang bermakna antara frekuensi rekomendasi pendampingan apoteker dan frekuensi kesalahan peresepan (r=-0,638; p<0,05). Artinya kegiatan pendampingan apoteker perlu ditingkatkan sebagai awalan implementasi farmasi klinik dan proses kolaborasi antara dokter dan apoteker. Hal tersebut tentu saja membutuhkan dukungan sistem manajemen rumah sakit agar komunikasi interpersonal diantara profesi lebih mudah terwujud. Kata kunci: Farmasi klinik, kesalahan peresepan, one group pre-post test, pendampingan apoteker

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