EVALUASI PENYIMPANAN DAN PEMUSNAHAN BERKAS REKAM MEDIS INAKTIF DI RSIA RESTI MULYA JAKARTA TIMUR

EKA PURWANTI, M. Syairaji, S.K.M., M.P.H.

2019 | Tugas Akhir | D3 REKAM MEDIS DAN INFORMASI KESEHATAN

Latar Belakang: Penyimpanan berkas rekam medis bertujuan untuk mempermudah dan mempercepat ditemukan kembali berkas. Berkas rekam medis yang sudah melewati masa inaktif akan dilakukan pemusnahan. RSIA Resti Mulya Jakarta Timur belum pernah melakukan evaluasi pelaksanaan penyimpanan dan pemusnahan berkas rekam medis inaktif. Tujuan: Mengetahui dan mengevaluasi pelaksanaan penyimpanan dan pemusnahan berkas rekam medis inaktif di RSIA Resti Mulya Jakarta Timur. Metode: Jenis penenelitian ini deskriptif dengan pendekatan kualitatif dan rancangan fenomenologi. Subjeknya yaitu empat petugas rekam medis dan satu koordinator rekam medis. Objeknya yaitu tempat penyimpanan berkas rekam medis inaktif. Pengambilan data menggunakan wawancara, observasi, dan studi dokumentasi. Uji Keabsahan data menggunakan triangulasi sumber dan teknik. Hasil: Penyimpanan berkas rekam medis inaktif disimpan di lokasi yang berbeda, berkas tersebut tidak disusun berdasarkan sistem penjajaran yang ada yaitu Terminal Digit Filing dan langsung dimasukkan ke dalam kardus dan karung. Selain itu pemusnahan yang dilakukan belum tepat karena dirobek dan digunting. Hal tersebut disebabkan karena belum tersedianya rak dan alat pemusnahan. Kesimpulan: Berdasarkan hasil wawancara dan observasi ditemukan ada beberapa kegiatan pelaksanaan dan pemusnahan berkas rekam medis inaktif yang belum sesuai dengan prosedur dan aturan yang berlaku. Hal tersebut karena kurangnya alat penunjang. Sarannya yaitu mempertimbangkan pengimplementasian solusi yang diberikan berupa menyediakan peralatan penunjang.

Background: The storage of medical record aims to facilitate in rediscovering documents quickly. The medical record documents that has passed the inactive period will be destroyed. Up until now RSIA Resti Mulya East Jakarta has never evaluated the storage and destruction of inactive medical record documents. Objective: To know and evaluate the procedure of inactive medical record records storage and destruction at RSIA Resti Mulya East Jakarta. Methods: This type of research uses descriptive with qualitative approach and phenomenological design. The subjects were four medical record officers and one medical record coordinator. The object was the inactive medical records storage. Data retrieval was used by interviews, observation, and documentation studies. Data validity was by source and technique triangulation. Results: Storage for inactive medical record was in a different location from the active medical record and these documents is not arranged based on the existing storage system Terminal Digit Filing and is directly inserted into boxes and sacks. Besides that the destruction that was carried out was not right because it was torn and cut. This is due to the unavailability of shelves and extermination tools. Conclusion: Based on the results of interviews and observation, it was found that there were several implementation and destruction activities of inactive medical record files that were not in accordance with the applicable procedures and regulation. This is because of the impeded of supporting devices. The advice given is implementing the existing solution which is providing supporting devices.

Kata Kunci : evaluasi, pemusnahan, penyimpanan, rekam medis inaktif