FAKTOR FAKTOR YANG MEMPENGARUHI KETEPATAN PELAKSANAAN JADWAL OPERASI ELEKTIF PADA PASIEN OBSTETRI DAN GINEKOLOGI DI RUMAH SAKIT SARDJITO, YOGYAKARTA

LANI MUNAWIR HOLIS, dr. H Risanto Siswosudarmo, SpOG(K); dr. Rukmono Siswishanto, M.Kes, Sp.OG(K)

2018 | Tesis-Spesialis | OBSTETRI DAN GINEKOLOGI

Latar belakang: Ketepatan pelaksanaan jadwal operasi masih menjadi perhatian dalam upaya meningkatkan kinerja rumah sakit. Pelaksanaan jadwal operasi jam pertama dituntut untuk tepat waktu karena mempengaruhi ketepatan jadwal operasi selanjutnya. Tujuan: Mencari tahu faktor faktor yang mempengaruhi ketepatan pelaksanaan jadwal operasi elektif. Bahan dan cara kerja: Penelitian ini dilakukan di Gedung Bedah Sentral Terpadu RS Sardjito dari bulan Oktober 2017 sampai dengan bulan Februari 2018 dengan melibatkan semua operasi obstetri dan ginekologi yang memenuhi kriteria inklusi dan eksklusi. Keterlambatan operasi didefinisikan sebagai keterlambatan melakukan insisi lebih dari 30 menit dari jadwal operasi. Data diolah dengan paket program statistika dalam komputer. Chi square test, risiko relatif, analisis regresi logistik dan t-test dipakai untuk analisis statistika. Hasil: Sebanyak 145 operasi kasus obstetri dan giekologi yang memenuhi kriteria inklusi di masukan ke dalam penelitian. Sebanyak 93,1% operasi mengalami keterlambatan lebih dari 30 menit. Waktu kedatangan residen anestesi, waktu mulai pembiusan, dan jenis anestesi mempengaruhi ketepatan pelaksanaan jadwal jam operasi. Analisis regresi logistik menunjukan bahwa waktu kedatangan residen anestesi sesudah pukul 8 memiliki kecenderugan untuk terlambat operasi 11,99 kali dibanding waktu kedatangan residen anestesi sebelum pukul 8. Penggunaan jenis pembiusan regional + kombinasi memiliki kecenderungan untuk terlambat sebesar 17,44 kali dibandingkan dengan anestesi umum. Kesimpulan: Sebagian besar operasi mengalami keterlambatan lebih dari 30 menit. Waktu kedatangan residen anestesi dan jenis pembiusan adalah dua faktor yang mempengaruhi ketepatan pelaksanaan jadwal operasi. Kata kunci: Ketepatan jadwal operasi, waktu kedatangan residen anestesi, jenis anestesi.

Background: Timeliness of scheduled operation is one of the determinant factor for hospital performance and its efficiency. The first scheduled operation must be timeline because the next operation should also be timeline. Delayed first operation will result in the next delay. Objective: To find out factors influencing timeliness of scheduled operation. Materials and method: Study was conducted in Central Operating Theatre of Sardjito Hospital from October 2017 to February 2018. All obstetric and gynecological cases meeting the inclusion and exclusion criteria were recruited. Delayed operation was defined as starting incision 30 minutes beyond the scheduled time i.e., 8 o�clock a.m. Data were processed with data processing program in the computer. Chi square test, relative risk, logistic regression and independent sample t-test were used for statistical analysis. Results: A total of 145 cases meeting the eligibility criteria were processed and analyzed. As much as 93.1% of all operations were delayed more than 30 minutes. Bivariate analysis showed that the arrival of anesthetic residents, starting time and type of anesthesia were three dominant factors contributing to the delay of timeliness of scheduled operation. Logistic regression, however, showed that the arrival of anesthetic residents after 8 o�clock resulted in the risk of delay 11.99 folds compared to the arrival before 8 o�clock. Type of anesthesia (regional + combination) gave rise to risk of delay 17.44 folds compared to general anesthesia. Conclusion: The majority of scheduled operations were delayed more than 30 minutes. The delayed arrival of anesthetic residents and type of anesthesia were two dominants factor influencing the delayed timeliness of scheduled operation. Key words: Timeliness of scheduled operation, arrival of anesthetic residents, type of anesthesia.

Kata Kunci : Ketepatan jadwal operasi, waktu kedatangan residen anestesi, jenis anestesi.