Introduction: Nursing diagnosis is an important part of the nursing process and it influences the quality of nursing care. Accuracy in establishing nursing diagnoses is one of the factors that determines the accuracy of the nursing intervention program and the speed of healing of the patients. The Clinical Decision Support System is an information system built to assist health workers in making clinical decisions including the enforcement of nursing diagnoses. Through this systematic review, the author wants to explain the clinical decision support system as a tool to increase the accuracy of the enforcement of nursing diagnoses.Methods: The search for journals using the PICOT framework was conducted in the Scopus, Proquest, PubMed and Cinahl databases with a 10-year publication time limit (2008 - 2018). There were 8 international journals reviewed in full.Results: Generally the journals reviewed stated that the use of the Clinical Decision Support System in establishing nursing diagnoses has been shown to improve the accuracy of nursing diagnoses.Conclusion: This systematic review concludes that the use of clinical decision support systems can help nurses or nursing students in establishing accurate nursing diagnoses.

Introduction: Fasting is defined as the voluntary abstinence from eating for variable time intervals and it has been associated with potential beneficial impacts on human health. The study was to review the benefits of fasting on cardiovascular health in humans with or without cardiovascular disease.Methods: The databases search was done using the keywords ‘fasting’ and ‘cardiovascular system’ using Scopus, Science Direct and ProQuest, limited to between 2013 and 2019 for publication year. A total of 3.619 articles were obtained and 15 articles involving experimental and non-experimental studies were used as the reference material.Results: The findings showed that in people who are healthy, fasting can reduce the inflammatory markers (IL-1 & IL-6, TNF-α), the oxidative stress marker (Malondialdehyde), body weight, abdominal circumference, fasting blood glucose, LDL, triglyceride and blood pressure. In people at risk or with cardiovascular disease, fasting can reduce body weight, body mass index, abdominal circumference, fat percentage, blood pressure, triglyceride, the biomarker of inflammation (serum amyloid A), the biomarker of oxidative stress (protein carbonyl), the biomarker of endothelial dysfunction (asymmetric dimethylarginine) and increase the vascular endothelial growth factor.Conclusion: Based on these findings, fasting can improve the health condition of people at risk or with cardiovascular disease by improving the risk factors such as blood pressure, overweight and endothelial dysfunction. In people who are healthy, fasting can be used for the prevention of cardiovascular disease by helping to maintain their weight, blood pressure, LDL and triglyceride within the normal limits.

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Background: Prevention and control of infections is a priority in the current health sector, and prevention of infection is an indicator of the quality of services provided. Purpose: to examine the available evidence about the application of the Six Sigma method in the prevention and control of infections in hospitals. Method: The database used to identify suitable articles obtained from Scopus, Pubmed, Ebscohost and Summon was limited to the last 5 years of publication from 2014 to 2019, English, and fulltext articles. The literature review used the keyword "Six Sigma, Prevention Infection". In searching articles used "AND". Only 8 articles met the inclusion criteria. This review was from these 8 articles. Results: The application of the six sigma method provided a variety of benefits. Prevention and Reduction of decubitus ulcer infection, Central Line Related Blood Flow Infection, Surgical Site Infection, Ventilator Related Pneumonia, reduced the incidence of health related infections, reduced length of stay, increased health protection, reduced treatment costs and improved patient safety. Conclusion: the six sigma method is effective in preventing and controlling infection in hospitals. Recommendation: hospitals apply this method for approval and control of infection. Keywords: six sigma; infection; hospital ABSTRAK Latar belakang: Pencegahan dan pengendalian infeksi menjadi prioritas bidang kesehatan saat ini, dan mengurangi kejadian infeksi merupakan salah satu indikator kualitas layanan yang diberikan. Tujuan: untuk menguji bukti yang ada tentang penerapan metode six sigma dalam pencegahan maupun pengendalian kejadian infeksi di rumah sakit. Metode: database digunakan untuk mengidentifikasi artikel yang sesuai diperoleh dari Scopus, Pubmed, Ebscohost dan Summon terbatas untuk publikasi 5 tahun terakhir dari 2014 hingga 2019, bahasa inggris, dan fulltex article. Tinjauan literatur menggunakan kata kunci “ Six Sigma, Prevention Infection”. Dalam pencarian artikel menggunakan "AND". Hanya 8 artikel yang memenuhi kriteria inklusi. Ulasan ini berasal dari 8 artikel tersebut. Hasil: penerapan metode six sigma memberikan manfaat yang beragam. Pencegahan dan penurunan kejadian infeksi ulkus decubitus, Central Line Associated Blood Stream Infection, Surgical Site Infection, Ventilator Associated Pneumonia, menurunkan kejadian healthcare associated infections, mengurangi lama hari rawat, meningkatkan kepatuhan kebersihan tangan, mengurangi biaya perawatan dan meningkatkan keselamatan pasien. Simpulan: metode six sigma efektif mencegah dan mengendalikan infeksi di rumah sakit. Saran: rumah sakit menerapkan metode ini untuk pencegahan dan pengendalian infeksi Kata kunci: six sigma; infeksi; rumah sakit