Background: Cytokine storm has been widely known to contribute to the development of the critical condition in patients with coronavirus disease 2019 (COVID-19), and studies had been conducted to assess the potential aspect of cytokine storm elimination by performing therapeutic plasma exchange (TPE). However, contradictory findings were observed. The objective of this study was to assess the association between TPE and the reduction of mortality of critically ill COVID-19 patients. Methods: A meta-analysis was conducted by collecting data from PubMed, Scopus, and Web of Science. Data on the mortality rate of critically ill COVID-19 patients treated with TPE plus standard of care and that of patients treated with standard of care alone were analyzed using a Z test. Results: We included a total of four papers assessing the association between TPE and the risk of mortality among critically ill COVID-19 patients. Our findings suggested that critically ill COVID-19 patients treated with TPE had lower risk of mortality compared to those without TPE treatment. Conclusion: Our study has identified the potential benefits of TPE in reducing the risk of mortality among critically ill COVID-19 patients.

Distribution of midwife practice pomegranate (quality of service) in Cirebon is difficult to know where the location of the practice because of the vast area of Cirebon. Then, the number of pregnant women who are less get help quickly (giving birth without medical assistance) because of ignorance location midwife practice pomegranate (quality of service) nearby. And the number of midwives pomegranate (quality of service) has not cooperated with the insurance BPJS to perform payment transactions. This study uses a clustering method, which can segment data clustering method, which is used to facilitate information retrieval midwife pomegranate (quality of service). Clustering methods have representation stage pattern, the selection traits or characteristics, pattern proximity, distance measurement, data obtained from IBI (Indonesian Midwives Association) and the tools used: phpMyAdmin, notepad ++, xampp, GoogleMapApi, Dreamwaver. This system can be expected to map the location of the practice of midwives pomegranate (quality of service) in the district of Cirebon, can find the nearest location midwife pomegranate (quality of service), can find pomegranate midwives who work with BPJS to perform payment transactions. Then, hopefully it can help people in handling pregnant women rapidly. And, is expected to reduce maternal and child mortality.

This study aims to identify problems and determine improvement strategies to overcome burnout nurses. The research method used is a case report to assess quality improvement with an 8-step approach to change starting from problems with observation and screening of burnout using the Maslach Burnout Inventory Human Services Survey (MBI-HSS), analysis using a fishbone approach, determining improvement strategies, implementing and program evaluation. The results showed that 55% of nurses experienced a decrease in self-esteem, but through the Empowerment Psychotherapy program: Three Good Things, which was carried out for two weeks, it was able to reduce the burnout level of nurses as assessed by the Mini Z burnout survey. In conclusion, Empowerment Psychotherapy: Three Good Things can overcome nurse burnout problems. It is recommended that the implementation of this program be carried out thoroughly in all work units. Keywords: Burnout Management, Nurses, Empowerment Psychotherapy, Three Good Things