EVALUASI TATA LAKSANA DIARE AKUT TANPA DEHIDRASI PADA ANAK BALITA DI RSUD PANEMBAHAN SENOPATI

IGNASIA NILA SIWI, Prof. dr. Sri Suparyati Soenarto, Sp.A(K)., Ph.D.; Patricia Suti Lasmani, S.Kep., Ns. MPH

2016 | Tesis | S2 Keperawatan

Latar belakang: Hasil wawancara dengan perawat di bangsal anak RSUD Panembahan Senopati didapatkan bahwa tatalaksana diare akut belum semuanya sesuai dengan panduan. Terdapat peningkatan data ketidaksesuaian indikasi rawat inap kasus diare pada anak yaitu 4,4% (2013) menjadi 9,7% (2015). Hasil wawancara didapatkan bahwa SPM belum diperbaharui. Tujuan: Mengevaluasi dan mengetahui penyebab ketidaksesuaian tatalaksana diare akut tanpa dehidrasi pada anak balita di RSUD Panembahan Senopati berdasarkan 8 indikator. Metode: Penelitian studi kasus dengan rancangan deskriptif eksplanatori terhadap tatalaksana diare akut tanpa dehidrasi pada anak balita di RSUD Panembahan Senopati. Sumber bukti yang digunakan adalah dokumentasi rekam medis pasien diare akut tanpa dehidrasi pada anak balita bulan Juni-Agustus 2016 sebagai data kuantitatif, diskusi kelompok terarah sebagai data kualitatif. Dan dilakukan triangulasi dengan cara observasi, wawancara. Hasil: Tatalaksana diare akut tanpa dehidrasi pada anak balita di RSUD Panembahan Senopati dapat disimpulkan baik. Terdapat 7 dari 8 indikator tatalaksana diare akut tanpa dehidrasi pada anak balita yang masih perlu ditingkatkan (n=30), yaitu 3% indikasi rawat inap tidak sesuai indikasi, 43% anamnesis tidak ada dokumentasi sesuai kriteria karena keterbatasan waktu tapi ditanyakan dan hanya data abnormal yang didokumentasikan, 3% pemeriksaan penunjang tanpa indikasi yang sesuai karena pertimbangan khusus, 27% tidak ada dokumentasi terapi rehidrasi karena keterbatasan waktu tapi diedukasikan, 23% tidak ada dokumentasi meneruskan makan dan/atau ASI karena keterbatasan waktu tapi diedukasikan, 13% diberikan antibiotik tanpa indikasi yang sesuai karena miss data, dan 90% tidak ada dokumentasi sesuai kriteria untuk edukasi kepada orang tua karena keterbatasan waktu. Kesimpulan: Tatalaksana diare akut tanpa dehidrasi pada anak balita di RSUD Panembahan Senopati dapat ditingkatkan melalui optimalisasi pendokumentasian rekam medis, pembaruan SPM, dan pemberian edukasi dengan leaflet.

Background: According to interviews with nurses in the pediatric ward Panembahan Senopati Hospital found that the management of acute diarrhea is not all in accordance with the guidelines. There is an increased mismatch of data indicative of inpatient cases of diarrhea in children is 4.4% (2013) to 9.7% (2015). The results of interviews showed that SPM has not been renewed. Objective: Evaluate and determine the cause of nonconformity management of acute diarrhea without dehydration among children in Panembahan Senopati hospitals based on 8 indicators. Methods: The study was a case study with explanatory descriptive of the management of acute diarrhea without dehydration among children under 5 in Panembahan Senopati hospitals. Sources of evidence used was documentation of medical records of patients from acute diarrhea without dehydration in children under five from June to August 2016 as quantitative data, FGD as qualitative data. And triangulation by means of observation, interviews. Results: The management of acute diarrhea without dehydration among children under five years in Panembahan Senopati hospitals was good. There are 7 of 8 indicators management of acute diarrhea without dehydration in children under five who still needs to be improved (n = 30), which is 3% indications hospitalization is not appropriate indication, 43% anamnesis no documentation according to the criteria because of time constraints but asked and only abnormal data documented, 3% of investigations without an appropriate indication for special consideration, 27% no documentation rehydration therapy due to time constraints but it was educated, 23% no documentation to continue eating and / or breastfeeding due to time constraints but it was educated, 13% are given antibiotics without an appropriate indication for miss of data, and 90% no appropriate documentation criteria for education to parents because of time constraints. Conclusion: Management of acute diarrhea without dehydration among children in Panembahan Senopati hospitals could be improved through the optimization of medical record documentation, updates SPM, and the provision of education with leaflets.

Kata Kunci : evaluasi, diare akut tanpa dehidrasi, balita, evaluation, acute diarrhea without dehydration, children under 5 years