Evaluasi Program Pelayanan Obstetri Neonatal Emergensi Komprehensif (PONEK) Pada Penanganan Kasus Neonatal di RSUD dr. H. Soewondo Kendal

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Shinta Ayu Nani Evaluasi Program Pelayanan Obstetri Neonatal Emergensi Komprehensif (PONEK) pada Penanganan Kasus Neonatal Di RSUD dr. H. Soewondo Kendal xvii + 165 halaman + 16 tabel + 2 bagan + 18 lampiran RS PONEK 24 jam merupakan bagian dari sistem rujukan pelayanan kedaruratan maternal neonatal yang sangat berperan dalam menurunkan AKI dan AKB. PONEK RSUD dr. H. Soewondo Kendal yang dimulai tahun 2012 bermasalah dalam hal penanganan kasus neonatal. Maka perlu dilakukan evaluasi program Pelayanan Obstetri Neonatal Emergensi Komprehensif (PONEK) pada penanganan kasus neonatal di RSUD dr. H. Soewondo Kendal. Desain penelitian adalah kualitatif dengan pendekatan longitudinal. Informan utama yaitu Wadir Pelayanan, Kabid Pelayanan Medik, Ketua PONEK, Kepala Unit IGD, Dokter IGD, Bidan Pelaksana IGD, Kepala Ruang Perinatal, Dokter Spesialis Anak. Informan triangulasi 4 keluarga pasien neonatal. Data dikumpulkan dengan wawancara mendalam, observasi cheklist dan analisis dokumen. Pengolahan dan analisis data menggunakan content analysis. Hasil penelitian menunjukkan ketersediaan SDM belum sesuai pedoman dan belum semua mengikuti pelatihan, pencapaian kinerja perinatal standar masukan sejumlah 73%, obat-obatan neonatal khusus PONEK sudah tersedia, tidak tersedia anggaran khusus, SOP belum sesuai dengan pedoman, pelayanan kasus gawat darurat neonatal dan persiapan pengobatan definitif di IGD sudah sesuai standar, penanganan kasus gawat darurat neonatal di ruang tindakan belum sesuai dengan pedoman, perawatan intermediate dan intensif belum secara optimal dilaksanakan. Jumlah layanan kasus neonatal mulai bulan Januari sampai Juni 2015 sejumlah 482 kasus, dari 482 kasus terjadi 41 (8,5%) kasus kematian, 75 (15,6%) kasus pulang paksa, 2 (0,4%) kasus dirujuk dan 364 (75,5%) kasus sembuh. RS untuk menambah jumlah SDM dan meningkatkan kompetensi tim PONEK, melengkapi kekurangan prasarana sarana, menyediakan anggaran khusus PONEK, memperbarui dan melengkapi SOP, tim PONEK dapat selalu on site serta pengadaan sistem informasi PONEK. Kata kunci : Evaluasi Program, PONEK, Penanganan Kasus Neonatal Kepustakaan : 42 (1999-2015) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Shinta Ayu Nani Evaluation of Comprehensive Emergency Obstetric and Neonatal Care (CEmONC) Program in Handling Neonatal Cases at dr. H. Soewondo Public Hospital in Kendal xvii + 165 pages + 16 tables + 2 schemas + 18 appendices A Comprehensive Emergency Obstetric and Neonatal Care (CEmONC) hospital 24 hours is one of the referral systems of neonatal maternal emergency service and plays an important role in decreasing Maternal and Infant Mortality Rates. CEmONC at dr. H. Soewondo in Kendal began in 2012 had a problem in handling neonatal cases. Therefore, CEmONC at the hospital needs to be evaluated to solve the problem. This was a qualitative study using a longitudinal approach. Main informants consisted of deputy director of services, head of medical service department, head of CEmONC, head of emergency unit, physicians and midwives at emergency unit, head of perinatal unit, and paediatrician. Informants for triangulation purpose consisted of four families of neonatal patients. Data collection used indepth interview, checklist of observation, and document analysis. Data were analysed using content analysis. The results of this research showed that human resource was not in accordance with a guidance. Not all officers were trained. Achievement of perinatal performance was 73%. Neonatal medicines for CEmONC were available. Specific budget allocation was not available. Standard Operating Procedure (SOP) was not in accordance with a guidance. Neonatal emergency services and preparation of definitive treatment at emergency unit had met the standard. Treatment for neonatal emergency cases at a treatment unit had not been in accordance with a guidance. Intermediate and intensive treatments had not been optimally implemented. Number of neonatal cases from January to June 2015 were from 482 cases. Of the total cases, 41 (8.5%) were death cases, 75 (15.6%) were forced return cases, 2 (0.4%) were referred, and 364 (75.5%) were convalescent. The hospital management needs to add number of officers, to improve competency of the CEmONC team, to complete means, to provide specific budget for CEmONC, to improve and complete SOP, to ask the CEmONC team in order to be on site, and to provide a CEmONC information system. Keywords : Program Evaluation, CEmONC, Neonatal Case Management Bibliography: 42 (1999-2015)