AbstrakKebijakan pusat pelayanan kesehatan masyarakat (puskesmas) sebagai Badan Layanan Umum Daerah (BLUD) diimplentasikan untuk meningkatkan kualitas pelayanan kesehatan dasar. Kebijakan BLUD puskesmas telah diterapkan di Kabupaten Gianyar sejak tahun 2010 dan berlaku pada puskesmas perawatan maupun nonperawatan. Pelaksanaan BLUD puskesmas tidak selalu meningkatkan mutu layanan. Penelitian ini bertujuan mengetahui gambaran mutu pelayanan puskesmas perawatan yang berstatus BLUD di Kabupaten Gianyar. Penelitian ini merupakan penelitian potong lintang dengan pendekatan kuantitatif dan kualitatif. Tempat dan waktu penelitian ini dilakukan di Kabupaten Gianyar, Agustus hingga Desember 2013. Data kuantitatif dikumpulkan melalui penyebaran kuesioner kepada 105 pengguna layanan di empat puskesmas yang dipilih dengan cara multistage random sampling. Data kualitatif dikumpulkan melalui wawancara mendalam kepada 13 penyedia pelayanan kesehatan yang dipilih secara purposive sampling. Data kuantitatif dianalisis secara deskriptif dan data kualitatif dianalisis dengan analisis tematik. Dari hasil penelitian, pelayanan di puskesmas perawatan berstatus BLUD di Gianyar dinilai kurang memuaskan karena keterbatasan peralatan medis dan kurangnya tenaga yang kompeten dalam pengelolaan keuangan. Pelatihan pengelolaan keuangan pada staf puskesmas dan perekrutan tenaga berlatar belakang akuntansi penting untuk dilakukan.Kata kunci: Badan layanan umum, implementasi, kebijakan, puskesmas AbstractThe policy of primary health care as local public service agencies (BLUD) was established to improve the quality of basic health care services. The public service agencies primary health care policy has been implemented to all primary health care in Gianyar district since 2010. The implementation does not always improving health service quality. This research was aimed to overview the quality of services in primary health care with general services agency status in Gianyar district. This research was a crosssectional study with mixed of quantitative and qualitative approaches.This research was conducted in Gianyar between August and December 2013. The quantitative data was collected through questionaire survey to 105 patients in four primary health care who were chosen with multistage random sampling technique. The qualitative data was collected through in-depth interviews to 13 health care providers in primary health care who were chosen with pusposive sampling. The quantitative data was analysed descriptively and the qualitative data was analysed using thematic analysis. The result of the study was primary health care quality in BLUD puskesmas with inpatient services was perceived as poor due to the limited availability of medical equipment and lack of staff who major in financial management. Training on financial management and recruitment of staff with accounting background should be conducted.Keywords: Public service agencies, implementation, policy, primary health care PendahuluanDi era otonomi, pemerintah daerah khususnya Pemerintah Kabup...

Background Maternal healthcare services in Indonesia have seen dramatic improvements over the past 25 years and yet there is still room for improvement. The perception, by the women, of the perinatal care provided, is a vital input to further improving these services. This study examines how the perinatal care provided is experienced by Japanese women in Bali, using an interview survey. Methods We conducted semi-structured interviews, from August to October 2017, with 14 Japanese women living in Badung Regency and Denpasar City in Bali Province, Indonesia to report their perception of the perinatal care they experienced during their pregnancies. The interview guide included among others, the reasons for choosing specific (perinatal care) health facilities and their satisfaction with their experience of using the antenatal, delivery, and postnatal care services. The data were analysed using the qualitative content analysis method. Results From the interview data, 12 categories across five themes were extracted. Participants reported experiencing various concerns during their pregnancies such as difficulty in obtaining perinatal care related information. From the beginning of their pregnancies, participants gradually established trusting relationships with midwives, but in many situations, they were disappointed with their childbirth experiences, as they felt that the care provided was not woman-centred. Through their own efforts and with the support of family members and other Japanese residents, many women were able to eventually regard their childbirth experiences as positive. Nevertheless, some women could not overcome their negative impressions even years after childbirth. Conclusions Participants desired close attention and encouragement from nurses and midwives. Our results suggest that Japanese women in Bali expected a woman-centred perinatal care and active support from nursing/midwifery staff during their pregnancies and postnatal care.

ABSTRAK Kepatuhan mencuci tangan perawat merupakan salah satu faktor yang mempunyai pengaruh besar terhadap pencegahan terjadinya infeksi rumah sakit. Perawat memiliki andil yang sangat besar terhadap terjadinya penyebaran infeksi rumah sakit karena perawat berinteraksi langsung kepada pasien selama 24 jam. Kegagalan dalam melaksanakan cuci tangan sebelum kontak dengan pasien dan selama perawatan pasien, dapat menyebabkan terjadinya infeksi rumah sakit. Dalam penelitian ini bertujuan untuk mengetahui hubungan antara karakteristik, pengetahuan dan motivasi perawat dengan kepatuhan mencuci tangan. Penelitian ini  adalah penelitian deskriptif  dengan menggunakan desain cross - sectional. Responden yang digunakan sebanyak 97 responden dengan tehnik proportionated stratified random sampling. Hasil penelitian menunjukkan bahwa ada hubungan yang signifikan antara karakteristik (umur) dengan kepatuhan cuci tangan (p=0,007, PR= 3,68), tingkat pendidikan dengan kepatuhan mencuci tangan (p=0,021, PR= 0,33), pengetahuan dengan kepatuhan cuci tangan (p=0,003, PR= 4,16) dan motivasi dengan kepatuhan cuci tangan (p=0,013). Untuk variabel yang tidak berhubungan dengan kepatuhan petugas mencuci tangan yaitu masa kerja dengan kepatuhan cuci tangan (p=0,139, PR= 2,04) dan jenis kelamin dengan kepatuhan perawat mencuci tangan (p=0,069, PR= 0,34). Simpulan yang diperoleh bahwa pengetahuan dan motivasi perawat di RSU Surya Husadha sangat signifikan terhadap kepatuhan perawat melakukan cuci tangan. Saran peneliti agar edukasi, bimbingan dan pengawasan kepada perawat tentang pelaksanaan cuci tangan terus ditingkatkan agar kepatuhan cuci tangan semakin baik sehingga  kejadian infeksi rumah sakit dapat dicegah. Kata kunci: Karakteristik, pengetahuan, motivasi, kepatuhan mencuci tangan.   ABSTRACT Nurse compliance in nurses washing their hands is one of the factors that has a major influence on the prevention of hospital infections. Nurses have a very large contribution to the spread of hospital infections because nurses interact directly with patients for 24 hours. Failure to carry out hand washing prior to contact with patients and during patient care, can cause hospital infections. In this study aims to determine the relationship between characteristics, knowledge and motivation of nurses with compliance to wash hands. This research is a descriptive study using cross-sectional design. Respondents used were 97 respondents with proportionated stratified random sampling technique. The results showed that there was a significant relationship between characteristics (age) with hand washing compliance (p = 0.007, PR = 3.68), level of education with hand washing compliance (p = 0.021, PR = 0.33), knowledge with compliance hand washing (p = 0.003, PR = 4.16) and motivation with hand washing compliance (p = 0.013). For variables not related to compliance with hand washing officers, namely the length of service with compliance with washing hands (p = 0.139, PR = 2.04) and gender with compliance with nurses washing hands (p = 0.069, PR = 0.34). Conclusions obtained that the knowledge and motivation of nurses at Surya Husadha General Hospital are very significant to the compliance of nurses doing hand washing. Researchers suggest that education, guidance and supervision of nurses on the implementation of hand washing continue to be improved so that compliance with hand washing is better so that the incidence of hospital infections can be prevented. Keywords: Characteristics, knowledge, motivation, hand washing compliance.

ABSTRAK Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) terdiri dari 12 indikator salah satunya adalah indikator penderita hipertensi berobat secara teratur. Kabupaten Badung sudah terindeks pra sehat namun menduduki peringkat kedua terendah capaian indikator hipertensi berobat secara teratur (24,52 %) se Provinsi Bali. Tujuan penelitian untuk mengetahui pelaksanaan (PIS-PK) pada indikator hipertensi di wilayah kerja Puskesmas Kabupaten Badung khususnya dari segi input, proses dan lingkungan. Desain penelitian yang digunakan adalah penelitian deskriptif kualitatif. Penelitian dilaksanakan di Puskesmas Kuta II dan Mengwi III pada bulan Maret – Juli 2020. Jumlah informan 20 orang dipilih dengan purposive sampling. Pengumpulan data dengan wawancara mendalam dan FGD, kemudian dianalisis tematik. Validasi data dengan triangulasi sumber dan peer debriefing. Hasil penelitian yaitu input : SDM yang bertanggung jawab yaitu pemegang program hipertensi; tidak ada dana khusus untuk mendukung PIS-PK pada indikator hipertensi; Sarana prasarana pendukung berupa tensimeter, pinkesga dan alat tulis; metode berupa kunjungan keluarga; sasaran yaitu keluarga. Proses : Perencanaan berupa pembuatan tim dan jadwal tindak lanjut; Implementasi dilakukan dengan kunjungan, posbindu dan program inovasi; Monev melalui rapat minilok, pelaporan via aplikasi KS dan laporan bulanan. Lingkungan internal dan geografi tidak mempengaruhi program. Faktor ekonomi akan mempengaruhi gaya hidup masyarakat. Faktor sosial budaya mempengaruhi pelaksanaan program. Kata Kunci: PIS-PK, Hipertensi, Puskesmas, Badung  ABSTRACT The Healthy Indonesia Program with the Family Approach (HIP-FA) consists of 12 indicators, such as an indicator of hypertension sufferers taking medical treatment regularly. Badung regency has indexed pre-healthy. Nevertheless, Badung Regency occupies the fourth position with the highest number of hypertension sufferers and ranks the second lowest achievement indicator of hypertension for regular treatment (24.52%). This study aims to determine the implementation (HIP-FA) of hypertension indicators in Badung District Health Center, especially in terms of inputs, processes and outputs. The research design uses a qualitative descriptive study. The investigation takes place in Kuta II and Mengwi II Health Center from March - July 2020. The number of  informants is 20 people that were selected through purposive sampling. The data was collected through in-depth interviews and FGD and analyze by thematic analysis. The data is validated by the triangulation of sources and peer debriefing. The research results which is the inputs: The HR responsible for the PIS-PK hypertension indicator is the holder of the hypertension program at the Public Health Center: There are no special funds to support PIS-PK on the hypertension indicators: Supporting equipment such as tensimeter, pinkesga and stationary: Method of family visit, the target is the family. Process: Planning in the form of team building and follow up schedule: The implementation is carried out by visiting Posbindu and innovation programs: M&E is conducted once and every 3 months through minilok meetings and reporting via the KS application and monthly reports. The internal environment and geography do not affect the program. Economic factors do not affect the implementation of the program but will affect people's lifestyles. Socio-cultural factors influence the implementation of the program. Keywords: HIP-FA, Hypertension, Primary Health Care, Badung

Latar belakang dan tujuan: Permasalahan yang sering terjadi pada lansia akibat proses degenerasi adalah gangguan fungsi kognitif dan gangguan keseimbangan.  Aktivitas fisik dipercaya dapat memperlambat penurunan fungsi kognitif dan gangguan keseimbangan pada lansia, namun belum pernah diteliti di Denpasar.  Penelitian ini bertujuan untuk mengetahui hubungan senam kesegaran jasmani dengan fungsi kognitif dan keseimbangan tubuh lansia.Metode: Studi potong lintang dilakukan pada 60 lansia yang dipilih dari kelompok lansia yang mengikuti senam dan lansia yang tidak mengikuti senam, secara proportional stratified random sampling. Data karakteristik lansia dikumpulkan melalui wawancara, fungsi kognitif diukur dengan menggunakan kuesioner MoCa-Ina dan keseimbangan tubuh diperiksa dengan Romberg Test. Analisis data meliputi analisis univariat, bivariat (chi-square test) dan multivariat (logistic regression) untuk melihat hubungan antara senam kesegaran jasmani dengan fungsi kognitif dan keseimbangan tubuh.Hasil: Proporsi fungsi kognitif normal pada lansia yang melakukan senam adalah 80% sedangkan pada lansia yang tidak melakukan senam adalah 20%. Proporsi keseimbangan tubuh lansia yang melakukan senam adalah 86,7% sedangkan pada  lansia yang tidak melakukan senam adalah 20,0%. Perbedaan-perbedaan proporsi ini bermakna secara statistik. Analisis multivariat menunjukkan variabel-variabel yang mempengaruhi fungsi kognitif adalah senam kesegaran jasmani dan hobi. Sedangkan variabel-variabel yang mempengaruhi keseimbangan tubuh lansia adalah senam kesegaran jasmani dan riwayat penyakit.Simpulan: Fungsi kognitif dan keseimbangan tubuh pada lansia secara signifikan berhubungan dengan senam kesegaran jasmani