PENERAPAN PROSEDUR PRA OPERATIF DAN KEJADIAN KOMPLIKASI PASCA ODONTEKTOMI DI RUMAH SAKIT GIGI DAN MULUT UNIVERSITAS GADJAH MADA PROF. SOEDOMO YOGYAKARTA

IBNU RUSDIARTO, Dr. drg. Dibyo Pramono, S.U., MDSc.; dr. Hanevi Djasri, MARS.

2018 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang. Kualitas pelayanan dalam konsep clinical governance merupakan fokus dari semua kegiatan. Gigi molar ketiga impaksi merupakan masalah yang sering menimbulkan gejala klinis, sementara tindakan odontektomi merupakan tindakan dengan kategori high volume, high cost dan high risk. Tingginya kejadian komplikasi pasca odontektomi memerlukan upaya untuk menurunkan angka kejadiannya sebagai wujud peningkatan kualitas pelayanan. Tahap pra operatif merupakan salah satu tahapan penting dalam proses penatalaksanaan tindakan bedah odontektomi gigi molar ketiga impaksi. Penatalaksanaan tahapan-tahapan tindakan odontektomi yang sesuai standar prosedur operasional dapat mengurangi angka kejadian komplikasi pasca odontektomi Tujuan. Penelitian ini bertujuan untuk mengetahui hubungan antara penerapan prosedur pra operatif sesuai standar dan kejadian komplikasi pasca odontektomi gigi molar ketiga rahang bawah impaksi di RSGM UGM Prof. Soedomo, Yogyakarta. Metode. Jenis penelitian yang dilakukan adalah analitik dengan rancangan retrospective cohort study. Direkrut dua kelompok subyek yang menjalaniperawatan dengan tahap p ra-operatif sesuai standar (kelompok terpapar) serta kelompok subjek yang menjalani perawatan dengan tahap pra-operatif tidak sesuai standar (kelompok tidak terpapar) dan kemudian diamati kejadian komplikasinya sebagai luaran klinis. Hasil. Prosedur pra operatif yang sesuai standar berhubungan dengan penurunan kejadian komplikasi pasca odontektomi gigi molar ketiga rahang bawah impaksi di RSGM UGM Prof. Soedomo, Yogyakarta. Kejadian komplikasi pada kelompok terpapar 13,7% dan pada kelompok tidak terpapar 41,9%. Uji statistik dengan multiple logisctic regression test menunjukkan nilai p = 0,000 (+- = 0,05) dan OR = 4,961 (CI 95% = 2,930 -8,400).

Background. Quality of service in the concept of clinical governance is the focus of all care activities. Impacted mandibular third molar is a problem that often shows clinical symptoms, while odontectomy is a treatment with high volume, high cost and high risk category. The high incidence of post-odontectomy complications requires efforts to reduce the incidence rate as an effort to improve the quality of care. The preoperative stage is one of the important stages in the process of surgical management of mandibular third molar odontectomy. Management of odontectomy that comply with standard operational procedures may reduce the incidence of post-odontectomy complications. Objective. The aim of this study was to determine the relation between the implementation of preoperative procedures that comply to the standard and the incidence of post mandibular third molar odontectomy complications in RSGM UGM Prof. Soedomo, Yogyakarta. Method. The design of this research was analytic study with retrospective cohort study design. Two group of subject was taken and then classified into group of subjects, group of subjects undergoing treatment with preoperative stage that comply to standard (exposed group) as well as group of subjects undergoing treatment with pre-operative stage that do not comply to standard (unexposed group) and then the incidence of complication will be observed as rhe clinical outcome. Result. Preoperative procedures that comply to standard decrease the incidence of post mandibular third molar odontectomy complication at RSGM UGM Prof. Soedomo, Yogyakarta. Complication rate in the exposed group is 13,7% and in the unexposed gr oup is 41,9%. Multiple logistic regression test shows that p value is 0,000 (+- = 0,05) and odd ratio is 4,961 (CI 95% = 2,930-8,400).

Kata Kunci : clinical governance, prosedur pra operatif, luaran klinis, komplikasi, odonektomi, clinical governance, pre operative procedure, clinical outcome, complication, odontectomy.