bluuebunny/crossref_metadata_2025 huggingface dataset:
Formulation and Efficacy of Plaksha (Ficus lacor) Ointment in the Management of Non-Healing Ulcer
Authors: Changade Jayshree V. , Ulemale Anil H. , Jondhale P.B.
Published: December 2021

Chronic infected wound or non healing ulcer is commonly encountered problem faced in surgico-clinical cases. Wound healing property is most important pharmacological activity of Plaksh or Ficus lacor described by acharya Charaka and Bhavprakash, in an ancient compendia. A male patient aged 55 years, having non healing ulcer on right leg medially above the ankle joint due to trauma, reported to OPD. Wound was irregular with hyper keratinized edges, purulent discharge with foul smell, itching, redness and inflammation. Wound was cleaned with normal saline aseptically and ‘malhar’ or ointment which was prepared by using stem bark of Ficus lacor, was applied locally every day, for thirty days followed by alternate day for next fifteen days. ‘Malhar’ or ointment was prepared as per the formulation mentioned in ‘Ras tarangini’, an ancient compendia. Vitamin C, B complex and Zinc supplement was given orally. After forty five days, wound healed with healthy granulation tissue, purulent discharge and foul smell was totally absent .Bark contains phytochemicals like tannins, polyphenols caffiec acid. It possesses antioxident, anti-inflammatory, antibacterial, astringent activities. Caffeic acid have regulatory mechanism on glucose metabolism in diabetes.
Identification and Isolation of lupeol and β-sitosterol from
Iraqi Bauhinia variegata and determination the cytotoxic activity of the hexane extract of its leaves, stems and flowers
Authors: Mohammed Mais , Mahdi Monther F , Talib Bassma , Abaas Ibrahim S
Published: December 2021

Objective: Bauhinia variegata is evergreen small medicinal tree grows all over the world especially in the tropical regions. The aims of the study were detection, isolation quantification and identification of β-sitosterol and lupeol of Iraqi B. variegata stem using various chromatographic and spectroscopic methods, beside the cytotoxic investigation of hexane extract of different aerial parts. Methods: detection by GC mass spectroscopy, isolated by preparative TLC. The identification and the structural elucidation of isolated β-sitosterol and lupeol were performed by 1H nuclear magnetic resonance and FTIR. While the cytotoxic activity was performed against MCF-7 cells line. Results: Results highlighted that β-sitosterol and lupeol present in Iraqi B. variegata stem that confirmed by different chromatographic and spectroscopic analysis. Also the leaves extract has the superior action on MCF-7 cells followed by stem extract and end up by flower extract. Conclusions: The plant has a good content of both β-sitosterol and lupeol and the good cytotoxic action of aerial parts hexane extract confirm the successful plantation of B. variegata. These isolated compounds are a suitable candidate for further pharmacological study.
Extraction of Essential oils from Cymbopogon citratus using Organic solvents
Authors: B. Usharani
Published: December 2021

Essential oils are extracted from diverse plants and used in medicinal field for diverse conditions. The presence of unique aromatic compounds imparts aroma and medicinal values. Essential oil plays a vital role in pharmaceutical, cosmetics and also acts as rejuvenate. Though there are various plants from which essential oil are extracted, our study focuses on the extraction and comparison of the phytochemicals released from the fresh leaves of Cymbopogon citratus using two different organic solvents; (a). hexane (b) hexane and toluene in the ratio 1:1. Extraction was performed for 16 hours in Soxhlet extractor. The amount of oil obtained was weighed in both extractions and subjected to GC MS for phytochemical analysis. Results revealed that when the solvents hexane and toluene in the ratio 1:1 was used it gave a better yield of 3% from 5 gram of fresh leaves, while hexane yielded only 1.5%. The GC-MS analysis revealed that the compound released from both extractions are of diverse medicinal values and can be used in aromatherapy as rejuvenate. The compounds nerol (2,6 octadienal, 3,7 dimethyl.Z) and geraniol (2,6 octadienal, 3,7 dimethyl) are the common phytochemicals extracted .Nerol and geraniol are geometric isomers. Geraniol is reported as an efficient anticancer agent with additional properties of analgesic, antinflammatory and antiseptic values. Nerol is used as a fragrance. The compound 1 acetyl 4 hydroxy pyrrolidine 2 one is extracted when hexane and toluene were used for extraction in the ratio 1:1. It is reported to be anti-rheumatic and effective in the treatment of hips and joints. Hence it can be concluded that hexane and toluene in the ratio 1:1 can be used for extraction of oil considering its medicinal values and the increased % of extraction rather than using hexane alone.
Quản lý công tác giáo dục đạo đức thể thao cho vận động viên tại Trung tâm Huấn luyện thể thao Quốc gia Hà Nội
Authors: Đỗ Thị Thu Hương , Trần Khánh Đức
Published: December 2021

Trên cơ sở nghiên cứu thực trạng công tác quản lý giáo dục đạo đức thể thao cho vận động viên tại Trung tâm Huấn luyện thể thao Quốc gia Hà Nội, từ đó sẽ đề xuất các biện pháp quản lý công tác giáo dục đạo đức thể thao cho vận động viên Việt Nam trong thời kì hội nhập quốc tế, góp phần nâng cao thành tích, uy tín và th­ương hiệu của thể thao Việt Nam.
Biện pháp hình thành thói quen tự vệ sinh thân thể cho trẻ mẫu giáo 4 - 5 tuổi ở trường mầm non tỉnh Đồng Tháp
Authors: Ngô Thị Bình An
Published: December 2021

Những năm gần đây số lượng trẻ tuổi mầm non được đến trường ngày càng nhiều, bên cạnh đó các dịch bệnh ở trẻ em diễn biến ngày một đa dạng, phức tạp hơn, mà sức đề kháng của trẻ rất thấp, nên dễ nhiễm bệnh. Do đó, vấn đề hình thành cho trẻ có thói quen tự vệ sinh thân thể là rất cần thiết. Một số biện pháp được áp dụng như tăng cường rèn luyện ngoài tiết học, lồng ghép vào các hoạt động trong ngày, tổ chức hội thi cho trẻ tự thực hiện các thao tác vệ sinh đã mang lại hiệu quả khá tốt.
Nghiên cứu lựa chọn test đánh giá trình độ chuyên môn của nam sinh viên chuyên sâu bóng bàn chuyên ngành Giáo dục thể chất Trường Đại học Thể dục Thể thao Thành phố Hồ Chí Minh
Authors: Tô Thái Hà , Lê Thiết Can , Nguyễn Tiên Tiến
Published: December 2021

Bài viết sử dụng các phương pháp nghiên cứu khoa học thường qui tiến hành nghiên cứu lựa chọn test đánh giá trình độ chuyên môn của nam sinh viên chuyên sâu bóng bàn ngành giáo dục thể chất Trường Đại học Thể dục Thể thao thành phố Hồ Chí Minh.
Một số giải pháp cơ bản đào tạo người lao động đáp ứng nhu cầu xã hội tại tỉnh Đồng Tháp hiện nay
Authors: Trương Quang Khải , Phạm Ngọc Hòa
Published: December 2021

Bài viết nêu ra những thành tựu, hạn chế trong công tác đào tạo người lao động ở tỉnh Đồng Tháp; từ đó, đề xuất một số giải pháp cơ bản đào tạo người lao động đáp ứng nhu cầu xã hội tại tỉnh Đồng Tháp hiện nay.
Định lí điểm bất động cho ánh xạ hầu co-(ψ ,ϕ) tổng quát trong không gian b-mêtric
Authors: Nguyễn Thành Nghĩa , Nguyễn Trung Hiếu
Published: December 2021

Trong bài báo, chúng tôi giới thiệu khái niệm ánh xạ hầu co-(ψ ,ϕ) tổng quát trong không gian b-mêtric sắp thứ tự bằng cách bổ sung thêm bốn số hạng d(f2x,fx), d(f2x,y), d(f2x,fy) và d(f2x,x)+d(f2x,fy)2s thiết lập định lí điểm bất động cho lớp ánh xạ co này. Đồng thời, chúng tôi xây dựng một số ví dụ minh họa cho kết quả đạt được.
İLHANLI KOMUTANLARININ ANADOLU’DA HÜKÜMDAR OLMA ÇABALARININ OSMANLI’NIN KURULUŞU’NA ETKİSİ
Authors: ÖNEN Elif
Published: December 2021

Anadolu Selçuklu Devleti’nin kudretli Sultanı I. Alû’d-dîn Keykubad’ın korkusundan dolayı yıllarca Anadolu topraklarına yaklaşamayan İlhanlılar, Sultan’ın vefatı üzerine hemen harekete geçip, Anadolu’yu işgal etmeye başlarlar. İlhanlılar, bu işgal girişiminde tecrübesiz ve daha küçük yaşta olan Selçuklu Sultanı II. Gıyaseddin Keyhüsrev’i, 4 Temmuz 1243 yılında, Kösedağ Ovası’ndaki savaş meydanında zahmetsizce yenerek, büyük kıyımlarla Anadolu topraklarını kuşatma altına alırlar. Bu işgal sonucunda batı uç bölgesine doğru göç eden Türkmen aşiretleri, hem İlhanlı ordusuyla hem de İlhanlı hâkimiyeti altındaki Selçuklu Sultanının ordusuyla mücadele ederler. Ancak bu mücadelenin haricinde Anadolu’nun en uç sınır bölgesinde olan Osman Gazi de Alpleri ve Ahileri ile birlikte Bizans’a karşı gazâ hareketi başlatarak, burada beyliğini kurma çabası içerisine girer. Diğer taraftan İlhanlılar’ın içerisine düştüğü taht kavgaları, Anadolu topraklarındaki otoritesini zayıflatır ve buraya göndermiş olduğu kendi komutanları bile isyan ederek hükümdar olmaya çalışır. Böylece İlhanlılar’ın işgalleri son bulurken, Anadolu Selçuklu Devleti de yıkılmaya doğru sürüklenir. Öte yandan da Bizans’a yapmış olduğu gazâ hareketlerini başarıya ulaştıran Osman Gazi de Büyük Osmanlı İmparatorluğu’nun temellerini atar.
Relief of acute cough by cough syrup with mucoprotection
Authors: Mueck Tobias
Published: December 2021

Two randomised, blind, controlled, multicentre studies investigated the therapeutic effect of a chemical and mechanical barrier in the upper airways produced by polysaccharide-resin-honey based cough syrup in children with acute cough associated with a common cold. The mucoprotection led to a significant alleviation of the paediatric cough compared with carbocysteine syrup or placebo. The beneficial effect was especially apparent in children with severe cough and/or episodes of nocturnal coughing.
AGE-RELATED HEARING LOSS, TRADITIONAL COMPILATION
Authors: TEKİN DAL Bilgehan , GENÇ Gülsüm
Published: December 2021

The global population is gradually aging both domestically and abroad. Aging leads to a variety of anatomical and physiological changes occur in the auditory system. These changes cause hearing impairments that are called "age-related hearing loss.” Age-related hearing loss is a common chronic health condition that affects quality of life. There is no intervention available that prevents age-related hearing loss. However, there are intervention options that can improve daily life functions and well-being as well as decrease or compensate the negative effects of hearing loss. Thus, the importance of studies about age-related hearing loss has been progressively increasing.
MÜZİSYENLERİN AĞRI, POSTÜR, ÜST EKSTREMİTE FONKSİYONU VE ANKSİYETE DÜZEYLERİNİN İNCELENMESİ
Authors: KENDAL Kübra , ÇITAKER Seyit
Published: December 2021

Bu çalışma müzisyenlerde ağrı, postür, üst ekstremite fonksiyonları ve anksiyete düzeylerini incelemek amacıyla gerçekleştirildi. Çalışmaya 22 profesyonel müzisyen dahil edildi (ortalama yaş±SS (28,45±5,05 yıl), ortalama vücut kütle indeksi±SS (24,34±3,98 kg/m2)). Müzisyenlerin ağrı şiddeti Vizüel Ağrı Skalası (VAS) ile, postür Iphone uygulaması olan Posture Screen Mobile (PSM) ile, üst ekstremite fonksiyonları Kol-Omuz-El Sorunları Anketi (DASH) ile ve anksiyete düzeyi Beck Anksiyete Ölçeği (BAÖ) ile değerlendirildi. Değişkenler arası ilişki Spearman Korelasyon testi ile incelendi. Müzisyenlerin 20’si (%90,9) performans sırasında rahatsızlık hissettiği ve en çok rahatsızlık hissedilen bölgelerin boyun (%54,5), sırt (%50) ve bel (%40,9) olduğu belirlendi. VAS puanı 4,81±3,16, Anterior PSM derecesi 4,41±3,05, Posterior PSM derecesi 13,9±9,07, Sağ lateral PSM derecesi 21,92±7,43, Sol lateral PSM derecesi 22,5±7,94, DASH puanı 19,31±17,24 ve BAÖ puanı 12,56±9,07’ydi. VAS ile DASH arasında pozitif ve güçlü bir ilişki (r=0,76; p0,05) bulunmadı. Müzisyenlerde ağrı şiddetinin üst ekstremite fonksiyonelliği ve anksiyete ile ilişkili olduğu düşünülmektedir. Müzisyenlere daha iyi performans gösterebilmeleri için bütüncül yaklaşımlarla birtakım egzersiz ve pratikler önerilebilir.
"Obesity in the City" – urbanization, health risks and rising obesity rates from the viewpoint of human biology and public health
Authors: Kirchengast Sylvia , Hagmann Dominik
Published: December 2021

In 2007, for the first time worldwide, more people lived in urban conurbations than in rural settlement structures. This advancing urbanization has dramatically altered the living situation, the use of space, as well as human behavior along with the health situation and disease burden. This process began in Europe as early as the 19th century, while developing and emerging countries in particular are currently exposed to increasing urbanization. The burden of disease is clearly altered by living in a confined space, by environmental pollution in urban areas, the impossibility of producing food oneself, and being lost in an anonymous crowd. While city air made people “free” in medieval times, it often makes them “sick” today. Obesogenic environments represent a special problem in urban areas. A lack of physical activity, adverse dietary habits, and stressful and unsafe neighborhoods increase the risk of becoming overweight and obese in urban centers. Recently, modernization in rural areas and an adaptation to urban habits there increase the obesity rates in rural areas in high-income as well as low- and middle-income countries, too. Within cities, marked spatial differences in the prevalence of overweight and obesity occur. In Vienna, Austria, overweight and obesity rates during childhood and adolescence differ markedly between the individual Viennese districts. Highest overweight and obesity rates occur in districts characterized by a low socioeconomic status.
A short note on the BMI and on secular changes in BMI
Authors: Mumm Rebekka , Hermanussen Michael
Published: December 2021

Human size changes over time with worldwide secular trends in height, weight, and body mass index (BMI). There is general agreement to relate the state of nutrition to height and weight, and to ratios of weight-to-height. The BMI is a ratio. It is commonly used to classify underweight, overweight and obesity in adults. Yet, the BMI is inappropriate to provide any immediate information on body composition.

It is accepted that the BMI is “a simple index to classify underweight, overweight and obesity in adults”. It is stated that “policies, programmes and investments need to be “nutrition-sensitive”, which means they must have positive impacts on nutrition”. It is also stated that “a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions“. But these statements are neither warranted by arithmetic considerations, nor by historic evidence.

Measuring the BMI is an appropriate screening tool for detecting an unusual weight-to-height ratio, but the BMI is an inappropriate tool for estimating body composition, or suggesting medical and health policy decisions.
Stunting does not impair physical fitness in Indonesian school children
Authors: Scheffler Christiane , Hermanussen Michael
Published: December 2021

Background

Physical fitness is decreased in malnourished children and adults. Poor appearance and muscular flaccidity are among the first signs of malnutrition. Malnutrition is often associated with stunting.

Objectives

We test the hypotheses that stunted children of low social strata are physically less fit than children of high social strata.

Sample

We investigated 354 school girls and 369 school boys aged 5.83 to 13.83 (mean 9.54) years from three different social strata in Kupang (West-Timor, Indonesia) in 2020.

Methods

We measured height, weight, and elbow breadth, calculated standard deviation (SDS) of height and weight according to CDC references, and the Frame index as an indicator of long-term physical fitness, and we tested physical fitness in standing long jump and hand grip strength.

Results

Children of low social strata are physically fittest. They jump longer distances, and they have higher values in the Frame index. No association exists between height SDS and physical fitness, neither in respect to standing long jump, nor to hand grip strength.

Conclusion

Stunting does not impair physical fitness in Indonesian school children. Our results support the concept that SEPE (social-economic-political-emotional) factors are involved in the regulation of human growth.
Greater central adiposity resulting from increased market integration is associated with elevated C-reactive protein levels in older women from the Republic of Vanuatu
Authors: Mann Hayley , Pomer Alysa , Olszowy Kathryn , Sun Cheng , Silverman Harold , Dancause Kelsey , Chan Chim , Tarivonda Len , Taleo George , Kaneko Akira , Weitz Charles , Garruto Ralph , Lum Jefrey
Published: December 2021

Objective: We characterized the relationship between circulating C-reactive protein (CRP) levels and nine anthropometric measures of body fat to identify the best anthropometric predictors of CRP in Ni-Vanuatu women.

Sample and Methods: Anthropometric data and blood spot samples were collected from sixty-four Ni-Vanuatu female participants (age 35-78 years) on five islands with varying degrees of market integration, cultural change, and obesity. CRP concentration was determined with a high-sensitivity ELISA (hsCRP) assay and then compared to nine different anthropometric measurements.

Results: BMI was significantly correlated with CRP (p=0.047). Among the eight additional anthropometrics, the suprailiac skinfold (p=0.003) and waist-circumference (p=0.009) were better predictors of CRP than BMI. Moreover, our stepwise selection model indicated that the suprailiac skinfold explained ~14% of CRP level variance.

Conclusions: The BMI-CRP correlation coefficient for Ni-Vanuatu women falls within the range of previously reported values for East Asian populations with whom they share genetic ancestry. However, the best anthropometric predictors of CRP levels were waist circumference and suprailiac skinfold thickness. These measures capture central adiposity and are more closely associated with elevated CRP level and cardiovascular disease risk than fat distributed elsewhere on the body. Ni-Vanuatu in urban settings with high market integration are at greater risk for obesity, which is associated with elevated CRP levels. However, because nearly all Ni-Vanuatu still retain horticultural knowledge and land ownership, consumption of processed, imported foods is largely determined by degree of market integration and personal choice. Therefore, health interventions focusing on sustainable traditional food practices are feasible.
SIKAP PETUGAS TERHADAP PENGISIAN REKAM MEDIS RAWAT INAP DI RUMAH SAKIT SINAR HUSNI TAHUN 2017
Authors: Sabela Hasibuan Ali , W Siburian Melita
Published: December 2021

Rekam medis tidak hanya sekeda rmempunyai pengertian sebagai kegiatan pencatatan saja, akan tetapi mempunyai pengertian sebagai suatu system  penyelenggaraan rekam medis penelitian ini bertujuan untuk mengetahui bagaimana sikap petugas rekam medis tentang system pengisian di  Rumah Sakit Umum Sinar Husni Medan. Sikap petugas rekam medis adalah suatu kinerja secara kualitas dan kuantitas yang dicapai oleh petugas dalam melaksanakan tugasnya sesuai dengan tanggung jawab yang diberikan. Dalam mencapai kinerja yang maksimal diperlukan sistem reward sebagai dorongan atau motivasi seseorang dalam bekerja. Reward adalah insentif positif yang berupa penghargaan, anugerah, dan imbalan akibat hasil kerja yang baik yang dilakukan karyawan. Metode penelitian ini menggunakan kuantitatif. Populasi dalam penelitian ini adalah seluruh petugas rekam medis di unit rekam medis RSU SinarHusni Medan, sampel diambil menggunakan teknik total sampling berjumlah 6orang. Hasil Penelitian menunjukkan bahwa petugas  dengan kinerja yang sangatbaik 2 orang (33,3), petugas yang tetapi kinerja baik sebanyak 4 orang (66,7%). Untuk itu disarankan kepada perekam medis agar  lebih meningkatkan sikap petugas yang tercakup dalam penyelenggaraan pelayanan rekam medis di RSU Sinar Husni Medan.
ANALISIS SISTEM PELEPASAN INFORMASI REKAM MEDIS DALAM MENJAMIN ASPEK HUKUM KERAHASIAAN REKAM MEDIS DI RUMAH SAKIT IMELDA PEKERJA INDONESIA MEDAN TAHUN 2018
Authors: Purba Erlindai , Yulita Tania
Published: December 2021

Sarana pelayanan kesehatan bertanggung jawab untuk melindungi informasi kesehatan yang terdapat di dalam rekam medis terhadap kemungkinan hilang, rusak, pemalsuan dan akses yang tidak sah. Secara keseluruhan, keamanan (security), privasi (privacy), kerahasiaan (confidentiality) dan keselamatan (safety) adalah perangkat yang membentengi informasi dalam rekam medis. Jenis penelitian ini adalah deskriptif kualitatif. Sampel dalam penelitian ini yaitu Direktur Rumah Sakit, Kepala Rekam Medis Rumah Sakit dan Petugas Penyimpanan Rumah Sakit. Analisis data yang digunakan adalah distribusi frekuensi dan juga narasi dari hasil wawancara yang dilakukan. Dan dari hasil penelitian yang dilakukan di RSU Imelda Pekerja Indonesia Medan sudah optimal dan sudah melaksanakan SOP. Bagi instansi rumah sakit agar dalam menjaga kerahasiaan dan keamanan informasi pasien di RSU Imelda Pekerja Indonesia Medan, sebaiknya untuk pencatatan peminjaman atau untuk melakukan pelepasan informasi untuk pihak ke-3 dalam mendokumentasikan sebaiknya rumah sakit imelda medan menggunakan pendokumentasian terkomputerisasi agar lebih aman dan mudah untuk perhitungan data, pendokumentasian bertujuan sebagai bentuk bukti apabila terjadi tuntutan kelak.
ANALISIS DESAIN FORMULIR RINGKASAN MASUK DAN KELUAR PASIEN RAWAT INAP DI RUMAH SAKIT UMUM MADANI MEDAN TAHUN 2018
Authors: Syahputra Wiguna Ary , Soraya Matondang Siti
Published: December 2021

Formulir RM1 memiliki fungsi sangat utama yaitu mengetahui jenis pelayanan apa saja yang diberikan kepada pasien selama dirawat di unit pelayanan dari awal masuk hingga keluar rumah sakit. Oleh karena itu merupakan salah satu lembar rekam medis yang diabadikan, sehingga bahan yang digunakan harus diperhatikan dan butir data yang ada harus diisi selengkap mungkin. Berdasarkan survey awal yang dilakukan pada bulan November 2017 terhadap 1 DRM , diketahui bahwa belum pernah dilakukan adanya revisi terhadap formulir ringkaan masuk dan keluar. Tujuan umum dari penelitian ini adalah untuk menganalisa desain formulir ringkasan masuk dan keluar di rumah sakit umum madani medan tahun 2018.Jenis penelitian yang digunakan adalah deskriptif dengan pendekatan cross sectional. Objek dari peneliti ini adalah forrmulir ringkasan masuk dan keluar di rumah sakit umum madani medan. Subjek dari penelitian ini adalah petugas TPPRI, dokter, dan perawat.instrumen penelitian yang digunakan adalah kuesioner dan check list. Cara pengumpulan data yang digunakan adalah observasi dan wawancara.
ANALISA KEBUTUHAN RAK PENYIMPANAN BERKAS REKAM MEDIS RAWAT JALAN DI RUMAH SAKIT UMUM MADANI MEDAN
Authors: Andi Ritonga Zulham , Aisah Ritonga Nur
Published: December 2021

Rak penyimpanan merupakan salah satu peralatan rumah sakit yang berfungsi menyimpan dokumen rekam medis, dengan tersedianya rak penyimpanan dokumen rekam medis yang sesuai dengan kapasitas penyimpanan dokumen rekam medis maka tidak akan terjadi penumpukan dokumen di Lantai. Penelitian ini bertujuan untuk mengetahui perkiraan kebutuhan rak penyimpanan dokumen rekam medis rawat jalan di Rumah Sakit Umum Madani Medan Tahun 2018. Penelitian ini menggunakan metode deskriptif kuantitatif yaitu dengan memaparkan hasil penelitian apa adanya dan membandingkan dengan teori yang kemudian diambil kesimpulan. Waktu penelitian dilaksanakan pada bulan Oktober 2017-Januari 2018 di Rumah Sakit Umum Madani Medan. Populasi dan sampel  yang digunakan adalah rak penyimpanan dan dokumen rekam medis rawat jalan. Instrumen yang digunakan dalam pengumpulan data antara lain dengan observasi dan wawancara. Hasil penelitian ini menunjukkan bahwa jumlah kunjungan pasien rawat jalan di Rumah Sakit Umum Madani Medan dari tahun 2014 – 2016 sebanyak 52.439. Jumlah  rak penyimpanan rekam medis rawat jalan di Rumah Sakit Umum Madani Medan sebanyak 7 rak. Jika saat ini rumah sakit memiliki 7 rak file, maka rumah sakit perlu menyediakan 4 rak file lagi agar kebutuhan rak dapat tercukupi dan  dapat menampung semua berkas rekam medis pasien secara sistematis dan tidak menyulitkan petugas dalam proses penyimpanan dan pencarian berkas rekam medis pasien.
HUBUNGAN PEMBERIAN PENGHARGAAN (REWARD) DENGAN KINERJA PETUGAS REKAM MEDIS DI RSUP H.ADAM MALIK MEDAN TAHUN 2017
Authors: Simanjuntak Marta , Octaviana Caisara Dewi
Published: December 2021

Kinerja petugas rekam medis adalah suatu hasil kerja secara kualitas dan kuantitas yang dicapai oleh petugas dalam melaksanakan tugasnya sesuai dengan tanggung jawab yang diberikan. Dalam mencapai kinerja yang maksimal diperlukan sistem reward sebagai dorongan atau motivasi seseorang dalam bekerja. Reward adalah insentif positif yang berupa penghargaan, anugerah, dan imbalan akibat hasil kerja yang baik yang dilakukan karyawan. Metode penelitian ini menggunakan deskriptif kuantitatif. Populasi dalam penelitian ini adalah seluruh petugas rekam medis di unit rekam medis Rumah Sakit Umum Pusat Haji Adam Malik Medan ,sampel diambil menggunakan teknik total sampling berjumlah 84 petugas. Instrumen penelitian ini menggunakan lembar kuesioner dan dianalisis dengan menggunakan chi squaredengan tingkat signifikan P-value <0,032, bahwa ada hubungan reward dengan kinerja. Hasil Penelitian menunjukkan bahwa sistem penghargaan di Rumah Sakit Haji Adam Malik Medan biasanya disebut rumenerasi, dan hanya diberikan kepada pegawai PNS. Dan dari hasil pengolahan data didapat hasil bahwa petugas yang mendapatkan penghargaan berupa upah atau remunerasi dengan kinerja yang baik 44 orang (52,4%), dan petugas yang tidak mendapatkan penghargaan sebanyak 40 orang (47,6. Disarankan kepada direktur agar memberi penghargaan secara adil dan merata sesuai dengan kinerja petugas.
GAMBARAN SISTEM PENYELENGGARAAN REKAM MEDIS DI RUMAH SAKIT UMUM BUNDA THAMRIN TAHUN 2018
Authors: Andi Ritonga Zulham , Rusanti Sri
Published: December 2021

Dalam peningkatan mutu pelayanan kesehatan di fasilitas pelayanan kesehatan terutama rumah sakit harus tersedianya sistem penyelenggaraan rekam medis yang baik. Tercapainya tujuan penyelenggaraan rekam medis berhubungan dengan bagaimana rekam medis tersebut diselenggarakan. Penelitian ini bertujuan untuk mengetahui gambaran sistem penyelenggaraan rekam medis di Rumah Sakit Umum Bunda Thamrin.Jenis penelitian adalah survei yang bersifat deskriptif. Pengambilan data dilakukan bulan Juni 2018. Data primer diperoleh dengan cara pengamatan langsung terhadap proses pelaksanaan rekam medis, wawancara, serta observasi berkas rekam medis untuk melihat kelengkapan rekam medis. Data sekunder diperoleh dari telaah dokumen yang ada di Rumah Sakit Umum Bunda Thamrin. Hasil penelitian mengenai proses pengelolaan rekam medis adalah penerimaan pasien, sistem penamaan, pengambilan kembali rekam medis dan perencanaan rekam medis yang tidak aktif di Rumah Sakit Umum Bunda Thamrin sudah sesuai dengan Permenkes No. 269 tahun 2008 tentang Rekam Medis dan Petunjuk Pelaksanaan Penyelenggaraan Rekam Medis di Rumah Sakit. Yang belum sesuai yaitu jumlah tenaga yang masih kurang dan terutama yang latar belakang pendidikannya rekam medis, fasilitas ruangan yang kecil dan sempit, ruangan penyimpanan yang jauh dari tempat penerimaan pasien, jumlah rak penyimpanan berkas rekam medis yang kurang dan pengisian formulir yang belum lengkap. Disarankan untuk menambah beberapa orang tenaga rekam medis yang berlatar belakang pendidikan dari rekam medis, meningkatkan keterampilan/keahlian dari tenaga rekam medis terutama dalam pengolahan data medis, menambah ruangan untuk penyimpanan berkas rekam medis, menambah jumlah rak penyimpanan, mengisi formulir rekam medis dengan lengkap sehingga dapat lebih meningkatkan efisiensi sistem penyelenggaraan rekam medis di Rumah Sakit Umum Bunda Thamrin.
TINJAUAN KEPATUHAN DOKTER DALAM PENGISIAN DOKUMEN REKAM MEDIS RAWAT INAP DI RUMAH SAKIT UMUM IMELDA PEKERJA INDONESIA (RSU IPI) MEDAN TAHUN 2018
Authors: Simanjuntak Marta
Published: December 2021

Kelengkapan rekam medis merupakan hal yang sangat penting karena berpengaruh terhadap proses pelayanan yang dilakukan oleh petugas medis dan mempengaruhi kualitas dari pelayanan suatu rumah sakit tersebut. Rekam medis harus dibuat dengan lengkap setelah pasien menerima pelayanan. Penelitian ini bertujuan untuk mengetahui kepatuhan dokter dalam pengisian Catatan Perkembangan Pasien Terintegrasi (CPPT) pada berkas rekam medis rawat inap di Rumah Sakit Umum Imelda Pekerja Indonesia (RSU IPI) Medan Tahun 2018. Jenis penelitian yang dipakai dalam penelitian ini adalah penelitian deskriptif yang bertujuan untuk menggambarkan situasi yang ada ditempat penelitian dengan menggunakan metode observasi. Populasi pada penelitian ini adalah berkas rekam medis pada formulir Catatan Perkembangan Pasien Terintegrasi (CPPT) di periode Maret-Mei 2018 dengan jumlah 1518 berkas rekam medis. Sampel dalam penelitian ini adalah berkas rekam medis pada formulir Catatan Perkembangan Pasien Terintegrasi (CPPT) di Rumah Sakit Umum Imelda Pekerja Indonesia (RSU IPI) Medan berjumlah 94 berkas. Berdasarkan hasil dan pembahasan penelitian yang berjudul “Tinjauan Kepatuhan Dokter Dalam Pengisian Dokumen Rekam Medis Rawat Inap di Rumah Sakit Umum Imelda Pekerja Indonesia (RSU IPI) Medan Tahun 2018 ” khususnya pada berkas Catatan Perkembangan Pasien Terintegrasi (CPPT) dapat disimpulkan bahwa kepatuhan Dokter dalam mengisi Catatan Perkembangan Pasien Terintegrasi (CPPT) masih rendah.
ANALISIS KETIDAKLENGKAPAN DOKUMEN REKAM MEDIS MENURUT STANDAR AKREDITASI RUMAH SAKIT MKI 19.1 VERSI KARS 2012 DI RUMAH SAKIT UMUM IMELDA PEKERJA INDONESIA (RSU IPI) MEDAN TAHUN 2018
Authors: Simanjuntak Esraida , Napitupulu Bintang
Published: December 2021

Rumah sakit adalah institusi pelayanan kesehatan yang menyelenggarakan pelayanan kesehatan perorangan secara paripurna yang menyediakan pelayanan rawat inap,jalan dan gawat darurat. Salah satu meningkatkan mutu pelayanan dirumah sakit bisa dilihat dari kelengkapan pengisian berkas rekam medis. Tujuan dari penelitian ini adalah untuk menganalisis ketidaklengkapan dokumen rekam medis menurut standar akreditasi KARS versi 2012 pada MKI 19.1 di RSU Imelda Pekerja Indonesia Medan. Penelitian ini dilakukan pada bulan Juni 2018 dengan menggunakan teknik metode random samplingdimana populasi dipilih secara acak sebagai sampel. Jumlah populasi dalam penelitian ini adalah 440 berkas rekam medis pasien pulang, dan sampel yang digunakan dalam penelitian ini 81 berkas rekam medis pasien pulang dengan kelengkapan 66,67% pada fomulir dokumen pemeriksaan dan fomulir ketidaklengkapan 69,14% pada identifikasi pasien.Kesimpulan dari penelitian ini adalah ketidaklengkapan dokumen rekam medis pasien pulang yang tidak memenuhi standar MKI 19.1 terdapat pada fomulir mengidentifikasi pasien dan saran dalam penelitian ini agar petugas lebih meningkatkan evaluasi pada bagian monitoring dan assembling untuk melengkapi ketidaklengkapan dokumen rekam medis pada pasien pulangMeningkatkan evaluasi pada bagian assembling untuk melengkapi ketidaklengkapan dokumen rekam medis pada pasien pulang. Memberi sanksi apabila petugas belum lengkap mengisi dokumen rekam medis pasien pulang. Memberi Reward kepada petugas yang sudah melengkapi pengisian dokumen rekam medis dengan tepat waktu.
TINJAUAN PELAKSANAAN KARS 2012 MKI 16 BERDASARKAN SPO DI RSU IMELDA PEKERJA INDONESIA MEDAN TAHUN 2018
Authors: Sabela Hasibuan Ali , Kartika Pulungan Nidiya
Published: December 2021

Standar MKI 16 menjelaskan bahwa dokumen rekam medis harus dilindungi dari kehilangan dan kerusakan serta akses dan penggunaan oleh yang tidak berhak. Berdasarkan survey awal diketahui dari 23. 934 dokumen rekam medis  masih dijumpai 15% persentase berkas yang hilang dan rusak. Penelitian ini dilakukan untuk mengetahui pelaksanaan MKI 16 Berdasarkan SPO  di Rumah Sakit Imelda Pekerja Indonesia.Metode penelitian adalah deskriptif dengan metode observasi dan lembar cheklist. Pengumpulan data melalui observasi dan lembar cheklist terhadap SPO yang ada di Rumah Sakit Umum Imelda Pekerja Indonesia.Hasil penelitian ini menunjukkan bahwa kepatuhan petugas rekam medis terhadap standar prosedur operasional (SPO) MKI 16 sudah sesuai dengan pekerjaan yang dilakukan petugas rekam medis, namum petugas masih membiarkan DRM tercecer atau berserajan di lantai ruang filling. Sebaiknya perlu dilakukan untuk kerapian penyimpanan DRM petugas rekam medis agar lebih memperhatikan kerapian DRM rekam medis.
PERANCANGAN SISTEM INFORMASI PENDAFTARAN PASIEN RAWAT JALAN BERBASIS VISUAL BASIC DI RUMAH SAKIT IMELDA PEKERJA MEDAN
Authors: Sofyan  , Bahar Harahap Khatika
Published: December 2021

Rekam medis elektronik merupakan catatan rekam medik pasien seumur hidup dalam format elektronik tentang kesehatan seseorang yang dituliskan oleh satu atau lebih petugas kesehatan secara terpadu dalam tiap kali pertemuan anatar petugas kesehatan dengan klien. Tujuan penelitian ini adalah untuk mengetahui bagaimana perancangan sistem informasi pendaftaran pasien rawat jalan dirumah sakit imelda pekerja indonesia serta untuk mengetahui alur dan kurangan dalam pelaksanaan rekam medisyang terkomputerisasi. Jenis penelitian ini adalah STRADIS (Structur Analysis Design and implementation of Information System) bertujuan melakukan pengembangan tools dalam perancangan sistem dengan menggunaan Data Flow Diagram(DFD).Dalam melakukan penelitian, peneliti melakukan observasi terhadap alur pendaftarara pasien dan menggambil sampel sebanyak 20 pegawaipendaftaran pasien. Berdasarkan hasil penelitian yang dilakukan di RSU Imelda Pekerja Indonesia  pelaksanaan pendaftaran pasien rawat jalan masih belum bejalan dengan baik dilihat dari observasi yang dilakukan peneliti masih belum terlaksananya pemeberian nomor antrian setiap melakukan pendaftaran dan kekurangan lainya pada jaringan saat melakukan Proses penyimpanan atau pencarian. Kesimpulannya perancangan sistem informasi pendaftaran pasien rawat jalan dapat berjalan sesuai kebutuhan namun alur dan penggunaan kompueterisasi lebih diperhatikan sesuai kebutuhan rumah sakit.
TINJAUAN PENATALAKSANAAN PROGRAM INDONESIA SEHAT DENGAN PENDEKATAN KELUARGA (PIS-PK) PADA PUSKESMAS TEGAL SARI TAHUN 2019
Authors: Noviar Panggabean Terry
Published: December 2021

ABSTRAK

 

Di dalam hakekatnya pembangunan kesehatan merupakan berbagai usaha ataupun upaya yang dilaksanakan oleh setiap Individu Bangsa Indonesia dalam tujuan meningkatkan kesadaran masyarakat indonesia, kemauan, serta kemampuan hidup yang sehat bagi setiap individu Bangasa Indonesia agar terwujud tingginya derajat kesehatan masyarakat, yang juga merupakan suatu investasi bagi pembangunan sumber daya manusia yang produktif secara sosial dan ekonomis. Tujuan penelitian ini untuk mengetahui sejauh mana penatalaksanaan program indonesia sehat pada puskesmas tegal sari. Jenis penelitian menggunakan metode deskriptif.  Waktu penelitian dilakukan pada bulan Maret sampai Mei 2019 dan penelitian dilakukan di Puskesmas Tegal Sari Medan. Data dikumpulkan dengan menggunakan observasi. Hasil penelitian menunjukkan Data yang terkumpul hingga saat ini adalah 5.500 keluarga, dan data yang dientri dalam aplikasi keluarga sehat sebanyak 3.762 keluarga. Sedangkan banyak keluarga dalam area kerja Puskesmas Tegal Sari sebanyak 7.483 keluarga. Disarankan kepada pihak Puskesmas menambah jumlah SDM  dan Sarana dalam pengerjaan program ini, memperbaiki jaringan koneksi internet.

 

 

 

ABSTRACT

 

In the essence of health development is a variety of efforts or efforts undertaken by each individual nation of Indonesia in the goal of raising Indonesian society awareness, willingness, and healthy living ability for every Individuals of Indonesian nation to materialize the high degree of public health, which is also an investment in the development of human resources that are socially and economically productive. The purpose of this research is to know the extent of the management of healthy Indonesian programs at Puskesmas Tegal Sari. This type of research uses descriptive methods.  Research time is conducted in March to May 2019 and research conducted at the Puskesmas of Tegal Sari Medan. Data is collected using observation. The results of the study show that the Data gathered to date is 5,500 families, and the data that is included in the family application is as much as 3,762 families. While many families in the work area of Tegal Sari Puskesmas as much as 7,483 families. Recommended to the Puskesmas increase the number of human resources and facilities in the work of this program, repair the network Internet connection.
GAMBARAN SISTEM RUJUKAN TERINTEGRASI (SISRUTE) DI RSUD Dr. RM DJOELHAM BINJAI TAHUN 2019
Authors: Junita Bancin Lamtiur , Putri Nurul Arrizka , Rahmayani Nurul , Kharisma Ransiska , Purba Silvi Widya
Published: December 2021

Sistem Rujukan Terintegrasi (Sisrute) merupakan sebuah aplikasi untuk penyelenggaraan pelayanan kesehatan antar Fasilitas kesehatan.  Sisrute Pelayanan kesehatan tingkat rujukan terdiri atas fasilitas kesehatan sekunder dan tersier. Sisrute mempunyai fungsi dalam menbantu perumusan kebijakan strategis dan teknis dibidang kesehatan rujukan yang berkesinambungan dan mendukung penyelenggaraan pemerintahan daerah di bidang kesehatan. Adapun tujuan dari penelitian ini adalah untuk mengetahui alur Sisrute, kendala dan kelebihan dari aplikasi Sisrute di RSUD Dr.RM Djoelham Binjai. Jenis penelitian adalah penelitian deskriptif. Sumber data yang digunakan adalah data sekunder yang sudah ada di rumah sakit.  Dalam penelitian ini analisa data dilakukan secara deskriptif melalui observasi, penyajian dan penarikan kesimpulan, sehingga diperoleh gambaran tentang Sisrute. Aplikasi Sisrute sangat membantu percepatan pelayanan,  memudahkan informasi rujukan terkait kejelasan pasien dapat diterima oleh RS yang dirujuk, mudah melakukan konsultasi dalam penanganan pasien lebih terarah dan meminimalkan penolakan pasien dengan koordinasi dan komunikasi antara RSUD Dr. RM Djoelham Binjai dengan RS yang ingin dirujuk/RS penerima. Kendala penggunaan Sisrute yaitu:   Server Internet tidak stabil dan  data-data pasien yang dirujuk tidak lengkap sesuai dengan form yang ada di sistem sehingga menyulitkan RS penerima menerima jawaban. Kelebihan penggunaan Sisrute yaitu yaitu perujuk bisa mengetahui tujuan Rumah Sakit sesuai kebutuhan pasien, memastikan pasien sudah mendapatkan perawatan dari RS yang    dirujuk, perujuk bisa dapat kepastian terhadap pasien yang akan dirujuk.
RANCANGAN KEBUTUHAN RAK DAN LUAS RUANGAN PENYIMPANAN REKAM MEDIS DI RUMAH SAKIT PUTRI HIJAU
Authors: Satria Dewi Welly , Muthmainnah Siti
Published: December 2021

ABSTRAK

Rekam medis disimpan dalam ruang penyimpanan agar memudahkan dalam pengambilan dan pengembalian berkas rekam medis. Kunjungan pasien yang meningkat mengakibatkan penambahan ketebalan dan penambahan rekam medis baru, sehingga rak menjadi penuh mengakibatkan proses penyimpanan dan pengembalian  kembali menjadi terhambat dan mengakibatkan kerusakan fisik pada berkas rekam medis. Maka peneliti bertujuan untuk mengetahui kebutuhan rak dan luas ruangan penyimpanan rekam medis di Rumah Sakit Putri Hijau. Penelitian ini menggunakan metode deskriptif kuantitatif yaitu dengan memaparkan hasil penelitian apa adanya dan membandingkan dengan teori kemudian diambil kesimpulan. Subjek dalam penelitian ini adalah ruang penyimpanan berkas rekam medis, objek dalam penelitian ini adalah berkas rekam medis dan rak penyimpanan. Hasil penelitian ini menunjukkan bahwa jumlah rak penyimpanan berkas  rekam medis di Rumah Sakit Putri Hijau adalah 20 rak dengan luas ruangan 100 m2. Terdapat 15 rak dengan luas ruangan 75 m2 diruang aktif dan 5 rak dengan luas ruangan 25m2 diruang inkatif. Dengan luas ruangan aktif yang telah tersedia mampu menampung penambahan kebutuhan rak rekam medis  aktif sebanyak  2 unit,  sehingga dengan tercukupinya rak  penyimpanan rekam medis dapat memudahkan petugas dalam menyimpan dan mengembalikan berkas rekam medis pasien serta terjaga kerahasiaan dan terhindar dari kerusakan fisik dokumen rekam medis.

 

Kata Kunci : Rekam Medis, Rak Penyimpanan, Luas Ruangan.

 

ABSTRACT

Medical records are stored in a storage room to make it easier to retrieve and return medical record files. Increased patient visits result in increased thickness and addition of new medical records, so that the shelves become full resulting in the process of storage and return to be hampered and cause physical damage to the medical record file. Then the researchers aimed to determine the need for shelves and spacious medical record storage room at Putri Hijau Hospital. This research uses descriptive quantitative method that is by describing the results of the research as it is and comparing with the theory then conclusions are drawn. The subjects in this study were the medical record file storage space, the object in this study was the medical record file and storage rack. The results of this study indicate that the number of medical record file storage shelves at the Putri Hijau Hospital is 20 rack with room area of ​​100 m2. There are 15 shelves with a room area of ​​75 m2 in an active room and 5 shelves with a room area of ​​25 m2 in an inclusive room. With an active room area that is available to accommodate the need for additional active medical record shelves as much as 2 units, so that adequate storage of medical record shelves can facilitate officers in storing and returning patient medical record files and maintaining confidentiality and avoiding physical damage to medical record documents.
TINJAUAN PELAKSANAAN PEMELIHARAAN DOKUMEN REKAM MEDIS DI RUANGAN FILLING RUMAH SAKIT DR.PIRNGADI MEDAN TAHUN 2019
Authors: Simanjuntak Esraida , Shella Rizka Mei
Published: December 2021

Maintenance of medical record documents is a combination of various activities undertaken to maintain documents and production facilities including other production equipment or to repair them to a condition that is well accepted. Physical danger is damage to documents caused by sunlight, rain, flood, heat and humidity. Chemical hazard is document damage caused by food, beverages, and chemicals. Biological hazard is document damage caused by rats, cockroaches, and termites. The purpose of this study is to describe the implementation of maintenance of medical record documents in the room Dr. hospital filling Pirngadi Medan in 2019. This type of research is a description of the interview and observation methods. The place of research was conducted at Dr. Pirngadi Medan due to the inability of maintaining medical record documents. When the study was conducted in March-April 2019. Population and samples used were all medical record storage officers, amounting to 3 people. Based on the results of the study, there were still racks that used wood and did not use rool o'pack cabinets, there are damaged medical record documents that have not been replaced with new ones due to lack of cover inventory. The temperature and humidity of the room in the storage room are less controlled. The conclusion of this study is that the maintenance of medical record documents has not been carried out because the shelves are still made from wood and the lack of storage rack facilities make medical records documents partially placed under the floor. The suggestion from this research is that it is better to use a rool o'pack cupboard and keep the air conditioner on for 24 hours according to the theory.
PENGARUH PENYULUHAN KESEHATAN TERHADAP PENGETAHUAN PENCEMARAN SAMPAH MAKROPLASTIK DAN MIKROPLASTIK PADA MAHASISWA PRODI DIII PEREKAM DAN INFORMASI KESEHATAN STIKes IMELDA
Authors: Junita Bancin Lamtiur , Christy Johanna
Published: December 2021

Health education is one of the techniques to increase someone’s knowledge level due to the aim of improving knowledge and well understanding regarding microplastic and microplastic pollution. This research aimed to analyze the effect of health education towards the knowledge regarding macroplastic and microplastic pollution among students at the medical record and health major in the college of health sciences Imelda in terms of health education. This research used a quantitative approach with a Quasi-Experimental Study Design of a non-equivalent control group. The population was all the students with the medical record and health information major. The sampling technique used was purposive sampling, all the first-year students. The group of the sample consisted of two groups- the intervention and the control group. The intervention group consisted of 73 people who have given health education. Control group consisted of 73 people who have not given any health education. The statistic test used was the Wilcoxon test. The statistic result on the knowledge variable among the experiment group who had a good knowledge level refer to the pre-test score only 4.1 %. After given health education, the increasing number of people who had a good knowledge level (76.1%). The good knowledge level among the control group only showed 1.4% (pre-test and post-test). The result showed there was a significant increase after given health education among the experiment group (p=0.00). However, another result showed there was no significant difference among the control group (p=1.00). Health education towards macroplastic and microplastic pollution had a significant influence to the knowledge level for students. It is recommended for further research to examine the role of knowledge towards attitudes and behaviors or actions in the management of macro and microplastic waste pollution. Based on the results of the pre-test where respondents still have less and moderate knowledge while the issue of plastic waste in Indonesia requires full attention and more participation from the community from society, it is necessary to get the attention of educational institutions to further elaborate and educate students in pollution macro-plastic and microplastic waste.
GAMBARAN KARAKTERISTIK PETUGAS PENDISTRIBUSIAN BERKAS REKAM MEDIS RAWAT JALAN DI UPT RUMAH SAKIT KHUSUS PARU TAHUN 2019
Authors: Sabela Hasibuan Ali
Published: December 2021

One form of service at the hospital is the distribution of medical record files. Distribution is a process of delivering goods or services from producers to consumers and users, when the goods or services are needed. The purpose of this study was to determine the distribution of outpatient medical record files at the UPT Special Paru Hospital in 2019. This study used a descriptive research method with the aim of making an objective description or description of a situation with a total population of all medical record staff employees, namely 5 people and the sampling technique in this study is total sampling with the characteristics of all medical record officers. So the researchers analyzed the data starting from editing, coding, sorting, data entry, cleaning. The results of the study based on the majority of high school education were 3 people (60%) minority DIII medical records as many as 1 person (20%) and S1 education as many as 1 person (20%), based on the majority of 1-5 years working duration as many as 4 people ( 80%), and a minority of 6-10 years of work as many as 1 person (20%). So it can be concluded that the implementation of the distribution of outpatient medical record files is said to be sufficient, the length of the process of distributing medical record files and there are still a few medical record officers who are educated in DIII medical records and can be expected to improve the process of sending medical record files and the addition of officers with DIII medical record education.