Staff Experiences in Managing Incidents in Nursing Homes: A Descriptive Qualitative Study.

Introduction: Adverse incidents in nursing home (NH) may occur as the result of inadequate monitoring for signs of unobservable initial complications, medical errors, improper nursing interventions, lack of communication, and inadequate reporting. Purpose: This study explores incident types, causes, handling, and documentation in Indonesian NHs through a qualitative approach. Patients and Methods: In-depth interviews were conducted with 23 NH staff members, including managers, nurses, and support staff. Results: Five themes and 17 sub-themes emerged, with falls and resident-to-resident abuse as common adverse incidents. Causes included older adults' conditions, environment, and misunderstanding. Follow-up action included first aid, hospital referrals, and assertive communication. Adverse incidents were actively reported through verbal and written reports or WhatsApp groups. Reports and documentation remain unstructured, however, as there were no standard operating procedures regarding incident reporting, documentation, and the types of adverse incidents that staff should report. Conclusion: Improvements in management, documentation, and reporting adverse incidents are highlighted in this research. Practitioners, nurses, and social workers should develop guidelines for handling, reporting, and documenting adverse incidents in NHs.

Psychometric properties of the Indonesian version of the nursing home survey on patient safety culture.

INTRODUCTION: The development of resident safety culture in nursing homes (NH) represents a major challenge for governments and NH owners, with a requirement for suitable tools to assess safety culture. Indonesia currently lacks suitable safety cultures scales for NH. OBJECTIVES: To evaluate the psychometric properties of the translated Indonesian version of the Nursing Home Survey on Patient Safety Culture (NHSOPSC-INA). METHODS: This study was a cross-sectional survey conducted using NHSOPSC-INA. A total of 258 participants from 20 NH in Indonesia were engaged. Participants included NH managers, caregivers, administrative staff, nurses and support staff with at least junior high school education. The SPSS 23.0 was used for descriptive data analysis and internal consistency (Cronbach's alpha) estimation. The AMOS (version 22) was used to perform confirmatory factor analysis (CFA) on the questionnaire's dimensional structure. RESULTS: The NHSOPSC CFA test originally had 12 dimensions with 42 items and was modified to eight dimensions with 26 items in the Indonesian version. The deleted dimensions were 'Staffing' (4 items), 'Compliance with procedure' (3 items), 'Training and skills' (3 items), 'non-punitive response to mistakes' (4 items) and 'Organisational learning' (2 items). The subsequent analysis revealed an accepted model with 26 NHSOPSC-INA items (root mean square error of approximation = 0.091, comparative fit index = 0.815, Tucker-Lewis index = 0.793, CMIN = 798.488, df = 291, CMIN/Df = 2.74, GFI = 0.782, AGFI = 0.737, p < 0.0001) and a factor loading value of 0.538-0.981. Expert feedback confirmed the relevance of the instrument items (content validity index [CVI] = 0.942). CONCLUSION: The modified NHSPOSC-INA model with eight dimensions (26 items) fits the data set in the context of Indonesian NH services. IMPLICATIONS FOR PRACTICE: The NHSPOSC-INA is a valid and reliable instrument for assessing staff perceptions of NH resident safety culture in Indonesia. The questionnaire can now be used to evaluate interventions for resident safety in Indonesian NH.

Self-efficacy and social support have relationship with academic burnout in college nursing students.

Objectives: To analyse the relationship of self-efficacy and social support with academic burnout of nursing students. Method: The correlational, cross-sectional study was conducted in August 2021 at the Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia, and comprised nursing students in the 4th and 6th semesters of their academic programme. Data was collected using self-efficacy and social support questionnaires as well as the Maslach Burnout Inventory-Student Survey. RESULTS: Of the 184 subjects, 160(87%) were females and 24(13%) were males; 98(43.3%) were from the 4th semester and 86(46.7%) were from the 6th; 66(36.4%) were aged 20 years, followed by 65(35.9%) aged 21 years; and East Java was the hometown for 163(88.6%) students. Self-efficacy (p=0.005; r=-0.205) and social support (p=0.000; r=-0.265) were significantly associated with academic burnout. CONCLUSIONS: Higher self-efficacy and social support levels may lead to lower academic burnout among nursing students.

Efforts to Improve the Safety Culture of the Elderly in Nursing Homes: A Qualitative Study.

Introduction: The attention to building a safety culture in nursing homes is relatively less when compared to hospitals. Good patient safety will improve the quality of health services and minimize incidents related to patient safety. This study aims to look at efforts that can be made to improve safety culture in nursing homes. Materials and Methods: The research design uses phenomenological qualitative with in-depth interviews. Purposive sampling was used with interpretive phenomenological analysis. Participants were 29 staff from four government and private institutions in East Java, Indonesia. Results: The sub-themes resulting from the research efforts to improve the safety culture of the elderly in nursing homes are the provision of new staff orientation, training, improvement of infrastructure, and procurement of security staff. Conclusion: The analysis shows that efforts to improve safety culture can be carried out with various strategies by paying attention to risk assessment steps, patient risk identification, and management, incident reporting, and analysis, the ability to learn from incidents and their follow-up, as well as implementing solutions to minimize risks and prevent them from occurring injury. Safety culture plays an essential role in improving the quality of care.

Determinant factors of low birth weight in Indonesia: Findings from the 2017 Indonesian demographic and health survey.

BACKGROUND: Low birth weight (LBW) is still a significant problem in Indonesia because it affects the growth and development of infants. It is also one of the factors that increase the risk of developing chronic disease later in life. PURPOSE: The study aimed to analyse the determinants of LBW in Indonesia. METHODS: This cross-sectional analytic study used secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). Data on the maternal factors (maternal age, frequency of antenatal care (ANC) visits, education, and maternal smoking status), children's birth order, and socio-demographic factors of the 14,239 respondents were examined. The association between LBW and the independent variables was analysed using bivariate analysis with a chi-square test (X2), followed by multivariate analysis in the form of binary logistic regression. RESULTS: LBW was identified in 960 infants (6.74%). Fewer than four ANC visits [AOR = 1.86; 95% CI = 1.44-2.42], uneducated mothers [AOR = 2.09; 95% CI = 1.00-4.37], and mothers who finished only primary school [AOR = 1.45; 95% CI = 1.05-2.00] were significantly associated with the incidence of LBW. CONCLUSIONS: This study revealed that the frequency of ANC visits was a dominant factor in the incidence of LBW. PRACTICE IMPLICATION: To reduce LBW in Indonesia, the government must increase ANC visits through health promotion programmes and maintain ANC facilities and quality.

Informal carer's knowledge of traumatic brain injury questionnaire: Initial development and validation.

AIM: To develop and psychometrically test the instrument for measuring the knowledge of traumatic brain injury of informal carers. DESIGN: Instrument development. METHOD: Focus group discussions were conducted among informal carers and healthcare specialists in March 2017. The content validity was determined by the mean of the item content validity index. A reliability test was performed by the Kuder-Richardson 20 and Pearson's correlation coefficient among 40 informal carers of patients with a traumatic brain injury in the rehabilitation medicine department of a tertiary hospital from August-September 2017. RESULTS: The final 34-item questionnaire covers the nature of traumatic brain injury, the consequences of traumatic brain injury, the rehabilitation process, and the role of the caregiver. The item content means ranged from 0.8-1.00, and the difficulty of knowledge items ranged from 0.18-0.98. The internal consistency reliability and correlation coefficient were 0.70 and 0.84, respectively.

Dietary Diversity and Associated Factors Among Children Aged 6-23 Months in Indonesia.

BACKGROUND: Optimum feeding practice is the key to determine development and growth among infants and young children. Dietary diversity is considered an indicator to assess nutritional adequacy. OBJECTIVES: This study aimed to determine the factors that associated with minimum dietary diversity types among children aged 6-23 months in Indonesia. METHODS: Secondary data analysis was carried out for this study using the Indonesian Demographic and Health Survey (IDHS) 2017. The study was conducted with inclusion criteria in women of childbearing age with ages ranging from 15 to 49 years, having children aged 6-23 months, and living with respondents (n = 4861). Data obtained using a questionnaire with cross-sectional design approach. Chi-square test, and logistic regression test were used to measure the determinants of minimum dietary diversity. RESULTS: The prevalence of children aged 6-23 months who received various foods was 3070 (63.15%) respondents. Age of child of 18-23 months [AOR = 5.88; 95% CI = 4.48-7.14], mother graduated from university level [AOR = 5.16; 95% CI = 2.07-12.89], access to maternal information on mass media (reading newspapers or magazines [AOR = 1.30; 95% CI = 1.10-1.55] and watching television [AOR = 1.56; 95% CI = 1.06-2.30]), and richest wealth quintile [AOR = 1.91; 95% CI = 1.32-2.75] significantly related to minimum dietary diversity in children aged 6-23 months in Indonesia. CONCLUSIONS: The current study revealed that minimum dietary diversity among Indonesian children remain related to education, mass media and socio-economic level. PRACTICE IMPLICATIONS: Pediatric nurses can play a critical role here by delivering the messages through educational outreach visits that focus on poor uneducated mother.

Determinants of early marriage among female adolescent in Indonesia.

BACKGROUND: While studies on reproductive health issues are discussed widely, until recently early marriage among adolescent has not received enough attention across stakeholders in Indonesia. This research aims to analyze the determinants of early marriage among female adolescents in Indonesia. METHODS: This study employs data from the Indonesia Demographic and Health Survey (IDHS) 2012 on females aged 15-19 years (n = 7207). The analytical methods used to determine factors of early marriage were chi-square and multiple logistic regression. RESULTS: The results from this research revealed that four determinants are significantly related to early marriage among female adolescent. Females who have not completed primary school tend to be involved in an early marriage more often than those who graduated from high school. Furthermore, underprivileged females tend to get married earlier than those with a high socio-economic status. Additionally, females living in rural areas are more prone to early marriage than those living in urban areas. Finally, well-informed females tend not to get married as early as females who do not have access to media information. CONCLUSION: A stakeholder policy is required that promotes the status of females by improving access to national education, particularly for females in rural areas and those who live in poverty. Marketing and advertising media campaign targeting adolescent are needed to ensure greater access to information.