Evaluasi Pelaksanaan Clinical Pathway Pasien Hyperbilirubinemia Neonatus di Rumah Sakit Hermina Pandanaran Semarang

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2018 ABSTRAK Edwin Sanjaya Evaluasi Pelaksanaan Clinical Pathway Pasien Hyperbilirubinemia Neonatus di Rumah Sakit Hermina Pandanaran Semarang xiv + 139 halaman + 5 tabel + 5 gambar + 6 lampiran Hyperbilirubinemia neonatus adalah suatu kondisi peningkatan kadar bilirubin dalam darah pada bayi baru lahir, baik oleh faktor fisiologik maupun faktor non-fisiologik, yang dapat menyebabkan kematian pada bayi. Lama rawat pasien hyperbilirubinemia neonatus di RS Hermina Pandanaran 4,3 hari (± 0,675) tidak sesuai dengan standar yang ditetapkan yaitu 3 hari. Tujuan penelitian ini adalah mengetahui alasan-alasan tenaga kesehatan melakukan atau tidak melakukan prosedur sesuai dengan clinical pathway. Jenis penelitian ini adalah kualitatif yang disajikan secara explanatory design. Pengumpulan data dilakukan dengan teknik wawancara mendalam dan observasi. Informan utama pada penelitian ini adalah 3 dokter spesialis anak dan 3 perawat pelaksana, dan Informan triangulasi yaitu manajer pelayanan medis, kepala instalasi dan kepala perawat ruang perinatologi. Analisis data dilakukan dengan metode content analysis. Hasil penelitian menunjukkan bahwa dari 10 kasus yang diamati, rata-rata kepatuhan sebesar 92,18% (±1,77). Pemeriksaan uji Coomb dan G6PD tidak dilakukan karena pemeriksaan tersebut tidak bisa dilakukan di RS Hermina Pandanaran dan hanya 70% dari dilakukan pemeriksaan ulang bilirubin total karena alasan biaya. Sosialisasi belum berjalan dengan baik karena baru dilakukan di awal saat masuk bekerja. Belum dilakukan pengecekan sarana dan prasarana secara rutin. Tidak ada tim dan Standar Operasional Prosedur untuk monitoring dan evaluasi pelaksanaan Clinical pathway. Disarankan agar pihak Rumah Sakit mensosialisasikan kembali Clinical Pathway yang telah disusun, membentuk tim monitoring dan evaluasi pelaksanaan Clinical Pathway dan membuat Standar Operasional Prosedur monitoring dan evaluasi Clinical pathway. Kata kunci : Clinical Pathway, Hyperbilirubinemia Neonatus Kepustakaan : 39 (1996 – 2015) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Hospital Administration 2018 ABSTRACT Edwin Sanjaya Evaluation of Clinical Pathway Implementation of Neonatal Hyperbilirubinemia Patients at Hermina Pandanaran Hospital in Semarang xiv + 139 pages + 5 tables + 5 figures + 6 appendices Neonatal Hyperbilirubinemia is a condition of high bilirubin levels in blood of a newborn baby due to both physiological and non-physiological factors that can cause death of newborn babies. The average length of stay of neonatal hyperbilirubinemia patients in Hermina Pandanaran Hospital was 4.3 days (± 0.675) higher than the standard (3 days). The purpose of this study was to identify the reasons of health workers to doing or to not doing a procedure in accordance with a clinical pathway. This was a qualitative study using an explanatory design. Data were collected by conducting indepth interview and observation. Main informants consisted of three pediatricians and three nurses. Informants for triangulation purpose consisted of a manager of medical service, a head of installation, and a chief nurse of a perinatology room. Furthermore, data were analyzed using a method of content analysis. The results of this research showed that the average adherence rate of 10 observed cases was 92.18% (± 1.77). Tests of Coomb and G6PD were not performed because these kinds of tests could not be conducted by the Hermina Pandanaran Hospital. In addition, there was only 70% of retesting total bilirubin due to funding reason. Socialization had not been well conducted because it was done at the first day of working. Means and infrastructure had not been checked routinely. There was no team and Standard Operating Procedure to monitor and evaluate the implementation of Clinical Pathway. The hospital management needs to re-socialize Clinical Pathway that has been arranged, to form a team of monitoring and evaluation the implementation of Clinical Pathway, and to arrange Standard Operating Procedure of monitoring and evaluation of Clinical Pathway. Keywords : Clinical Pathway, Neonatal Hyperbilirubinemia Bibliography: 39 (1996-2015)