Objectives Autologous CD133+ bone marrow stem cells may improve cardiac function. This randomized, single‐blind clinical trial inquired whether a combined transepicardial and transseptal implantation of CD133+ stem cells during coronary artery bypass grafting (CABG) improve cardiac function with ejection fraction (EF) changes as a primary endpoint in patients with low EF. Methods Thirty patients with coronary heart disease and EF <35% were randomized to undergo CABG alone or CABG with transseptal and transepicardial implantation of CD133+. Cardiac function was evaluated using cardiac magnetic resonance imaging (MRI) before and 6 months after CABG. Results Preoperative EF was lower in the intervention group (25.88% ± 5.66%) than in the control group (30.18% ± 3.85%; P = .04). The adverse event incidence was similar between both groups. At 6 months, EF changes were significantly higher (8.69% ± 9.49; P = .04) in the CD133+ group than in the CABG‐only group. Compared to the control group, significant improvements were seen in the wall motion score index (P = .003) and scar size proportion (P = .047) in the CD133+ group. The quality of life (QOL), assessed by a 6‐minute walking test, showed considerable improvement in the CD133+ group compared to that in the control group (P = .03). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scale did not show improvement in the intervention group (P = .09, vs control). Conclusion Combined transepicardial and transseptal autologous CD133+ BMC implantation during bypass grafting improved cardiac function in low EF coronary artery disease patients.

Background: Cardiac surgery can elicit both physical and psychological responses. Prayer, exercise therapy, education, hypnosis, and music are expected to be able to overcome pain, anxiety, and immobilization in the cardiac surgery. This study was to create a smartphone-based peri-operative nursing intervention model that was able to reduce pain, anxiety, and increase early mobilization cardiac surgery patients.Design and Methods: This study consisted of three stages. The first stage was research and development, the second was true experimental design, and the third was cross sectional design. The samples size was 86 respondents. The intervention models for the treatment group comprised of a smartphone-based therapy of prayer, education, exercise, hypnosis, and music. The control group was given standard hospital intervention according to the clinical pathway.Results: The majority of respondents were adults, male, high school graduate in the treatment group and bachelor graduate in the control group, CABG type of surgery, and having pain history. The intervention had a significant effect on reducing pain scale and anxiety level as well as increasing early mobilization (p<0.05). The intervention had a direct effect on pain and anxiety, but it had no direct effect on early mobilization. However, it gave indirect effect on early mobilization that was mediated by anxiety.Conclusion: The models can be used by nurses to reduce pain, anxiety and to increase early mobilization on cardiac surgery patients.

AbstrakRemunerasi dapat memengaruhi motivasi pegawai sekaligus meningkatkan kinerjanya. Demikian halnya di rumah sakit sebagai institusi pelayanan kesehatan yang padat modal, sumber daya manusia serta padat ilmu dan teknologi. Penelitian ini bertujuan untuk menganalisis persepsi pegawai terhadap implementasi sistem remunerasi dan kinerja unit pelayanan bedah jantung dewasa (UPBJD) di rumah sakit. Penelitian ini menggunakan pendekatan mixed methods (kuantitatif dan kualitatif). Desain penelitian kuantitatif adalah potong lintang menggunakan instrumen kuesioner self-assessment. Sedangkan desain penelitian kualitatif adalah deskriptif, dilakukan melalui focus group discussion dan telaah dokumen pada data berupa buku jadwal, buku registrasi, catatan keperawatan, dan rekam medis. Pengambilan data dilakukan pada tahun 2013 di salah satu rumah sakit di Jakarta. Responden/informan adalah staf medis fungsional, perawat, dan petugas administrasi berjumlah 29 orang. Data dianalisis secara univariat (metode kuantitatif), dan content analysis (metode kualitatif). Hasil penelitian menunjukkan bahwa sebagian besar staf medik fungsional dan perawat tidak puas (71,2%) dengan beberapa hal dalam penerapan sistem remunerasi, seperti pada sistem penggajian dan penentuan grading. Terlihat kinerja unit pelayanan bedah jantung dewasa mengalami kenaikan setiap tahun sebelum dan setelah penerapan sistem remunerasi. Diharapkan agar rumah sakit ini dapat memperbaiki sistem remunerasi yang sesuai ketentuan kebijakan dan menyusun formulasi insentif dan bonus yang lebih sesuai dengan kondisi saat ini serta perlu dilakukan sosialisasi yang tepat dan evaluasi secara berkala. Penerapan Sistem Remunerasi dan Kinerja Pelayanan Implementation of Remuneration System and Service PerformanceTri Wisesa Soetisna*, Dumilah Ayuningtyas**, Misnaniarti*** system implementation and adult cardiac surgery services unit's performance at hospital. This study used a mixed method approach (quantitative and qualitative). Quantitative study design was cross-sectional using questionnaire for self-assesment. Meanwhile, qualitative study design was descriptive conducted through focus group discussion and document review on data in forms of schedule book, registration book, nursing notes and medical records. Data collection was conducted in 2013 at one hospital in Jakarta. Respondents/informants were functional medical staff, nurses, and administration staff amounted to 29 people. Data was analyzed using univariate and content analysis techniques. Results showed most functional medical staff dan nurse were unsatisfied (71.2%) with several things in remuneration system implementation, such as in payroll system and grading determination. However, adult cardiac surgery services unit's performance is increasing every year before and after the implementation of remuneration system. This hospital is expected to improve the remuneration system in accordance with policy and arrange incentive formulation that is more appropriate with current condition as well as followed with p...

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