Field observation panel group 14

FIELD OBSERVATION PANEL

Tabaringan Health Center By : Group 14

GROUP

14

Muh. Asy Shidiq 110 2015 0003A. Muh. Yasser Mukti110 2015 0022Andira Ratu Nurrasyid 110 2015 0030Andi Aisya Zealand 110 2015 0051Nur Zamzam Azizah 110 2015 0059Amaliah Hakim 110 2015 0070Rifqy Aditya 110 2015 0078Rindang Cahyani Abas110 2015 0101Elsa Shafira Prasetyati 110 2015 0117Cindy Purnamasari 110 2015 0136Atika Rahmah Mustapa 110 2015 0147

LOCATION Located in JL.Tinumbu Lrg.154 No. 2 District Ujung Tanah Kelurahan Tabaringan. Located in the middle of Cidu’s Market. The health center start to give service at 8.00 am

FACILITIESThere are some facilities provided by the health center which are:• Bin• Satisfaction box• Benches • Toilets and wastafel • Parking lot

■Location : difficult access■The waiting room : shaky chairs■Late service■The parking lot■Insufficiency of facilities : the tools to clean

the tartar■Information about disease

Some the negative sides of the health center:

Patient Come

locket

BPJS (Jamkesmas,Jamkesda, dan

askes)

Service

Dental

Clinic

KIA/KB

ClinicPrescriptionpharmacyDone

General

clinicFurther ExaminationLa

boratoryResult

Counter. The first place that the patient attend when

Come to the health center

Before the patient choose whatTreatment do they want to get.

Firstly they have to do angeneral check up

Dental clinic

Action Room

Immunization (P2 Programme)

Patients can choose based on what they feel about the service of Tabaringan health

center

Doctor-Patient Interaction■ Doctor and patient interact closely. The doctors treat patients

kindly. The doctors are very friendly.■ For every actions that done by doctor towards patient, doctors

always ask for permission and also whether they are comfortable (hurt or not) during examination, (informed consent)

■ Based on the interview we did on a patient, he said that the doctor is very friendly. The doctors treat patient really well. As a result, the patients are comfortable and satisfied with the service.

■ E.g. dr. Ella said that there was a patient who wanted to pay due to high satisfaction.

■ Based on our observation, there were some nurse who sometimes did not help the doctor. The doctor seemed to work alone possibly due to there were so many patients coming that day. As a result, these nurse did not accompany the doctor in the room.

■ Based on an interview we did towards a nurse, she told us that the doctors were sometimes very discipline but it is only for the development of the health care. The doctors always give motivations to them so that they keep their good work and to minimalize mistake to the patient.

Doctor-Nurse Interaction

Cont..■The doctor treats the nurse not as a sub-ordinate rather

treats all staff equally as the one who serve the citizens.■However, generally, there is a good communication

between doctor-nurse. The doctor is open-minded towards the nurse about the health care. Mutual relation between doctor-patient seems good and they look quite close.

Cont..

■The relationship between doctors is close. ■The doctor educates all young doctors(coass) very well. ■E.g. the head of the health center act as a good leader.

She treats all the doctor as a friend/collages not as a sub-ordinate.

Doctor-Doctor Interaction

General Clinic■ Beneficence : the doctor has to do its job is to give the best service

to the patient. ■ Autonomy : the doctor have fulfilled to the patient autonomy,

which has given information to patient, although according to our observation the information that is given is still lacking.

■ Nonmaleficence : doctor have fulfilled this priciple, namely to provide what is best for the patient and notgive adverse effect to the patient

■ Justice : doctors also fullfilled this principle, that does not discriminate against patients based on social, racial, cultural, and economic, except old or disabled people who are prioritized so not required to queue

■ Autonomy :Based on the observation that we have done, the doctor in the dental clinic has fulfilled the right of the patient that is to know about the information about the patient’s disease. Because that is one of the patient’s right to have all of the information of his/her disease.Futhermore the final decision is in the patient it self, to do the suggestion from the doctor or not.■ JusticeThe doctor to her/his patient don’t dicriminate the patients based on the social, racial, etc. The doctor gave the same service to all of her patient.

Dental Clinic

cont..■ NonmaleficenceIn our observation we can’t see an emergency situation. So we can’t tell you that there is a priciple of nonmaleficence in the dental clinic.■ BeneficenceThe doctor in dental clinic do all of her best to give the treatment for the patient. She try to give more benefit to the patient than the bad one. She give the reference to the patient if she can’t to hadle the patient’s disease.

■ Beneficence1) Midwives have always tried to provide the best service, by trying to

maintain a state of vaccine2) Trying to contact the family of a baby who does not come a time

when the baby is immunized■ AutonomyBy explaining to patients about the KB’s tools that exist and also allow the patient to make the decision to chose his/her own tool that he/she wants and is best for him without intervening■ JusticeStill provide the same service to all patients without discriminating patients

KIA/KB

CLINICAL ETHICS OF JONSEN, SIEGLER DAN WINSLADE “FOUR BOX”

■ Medical indication : Tabaringan Health enter had been fulfilled this aspect, because the doctor had given the information about patient’s disease like indication, diagnosis, and prognosis

■ Quality of life : The quality of life is strongly related to the present and future conditions or treatments of the patients. Like all health centers, Tabaringan Health Center is only a small medical provider, only capable of treating minor injuries and providing consultation and medication. Even so, nearly all the patients that we encountered were satisfied with the services and treatments. Depending on the type of treatment they required, the patient’s quality of life can vary greatly. Some needs medical attention while some don’t. The overall treatment was also good. People who do get treated here are satisfied with treatments given by the doctors. However, some patients sometimes needed further medical attention, but the health center only have limited facilitiy to treat their diseases. Realizing this, they send these patients to counsel on hospitals where the facilities are more advanced and complete.

Cont..■ Patient preferrences : health officials have met this rule, because it has been

fully devolved health elections that will be taken by the patients themselves, but health officials suggest only selecting the best treatment that should be taken by patients

■ Contextual features: during our observations, the decision to entrust the family medicine doctor. later we also did not find any problems in the data source clinicians and nurses

Based on the observation we can conclude that the services provided by the health centeris good enough. However, the behaviour of the nurses needed improvement because they were lacking in discipline. Besides informed consent given by the doctor is still lacking. The employee who was in charge of the counter also needed disciplinary because they were once late. Interms of amenities, it still must add support facilities for patients. Because according to our observation, the seating that is provided by the health center is still not enough to accommodate the patients who come for treatment.

CONCLUSION

Thank You…