ANALISIS KESESUAIAN PENILAIAN EARLY WARNING SCORE PASIEN DEWASA DENGAN RESPON EARLY WARNING SCORE DI RSUD WATES

R.ANGGONO JOKO P, Dr. Sri Setiyarini, S.Kp., M.Kes; Uki Noviana S.Kep.Ns.,M.NSc, Ph.D

2021 | Tesis | MAGISTER KEPERAWATAN

Latar belakang Sebelum mengalami penurunan kondisi klinis, pasien sering kali memperlihatkan tanda bahaya dini. RSUD Wates telah menerapkan pemantauan tanda bahaya dini kondisi pasien dengan menggunakan EWS. Selama pelaksanaan EWS di RSUD Wates, belum pernah dilakukan evaluasi pelaksanaannya. Penelitian ini bertujuan untuk mengetahui kesesuaian penilaian EWS dengan respon EWS. Metode Penelitian ini berupa diskriptif analitik dengan pendekatan crossectional. Dilakukan di bagaian Rekam medis RSUD Wates dengan populasi rekam medis pasien dewasa dari bulan 1 Mei 2019 sampai dengan 30 April 2020. Sampel diambil dengan teknik purposive dari 8 ruang rawat inap dewasa sampai memenuhi jumlah penghitungan sampel sebanyak 211 rekam medis. Data diambil menggunakan lembar observasi yang dibuat oleh peneliti. Peneliti juga melakukan wawancara dengan perawat senior menggunakan pedoman wawancara untuk mendapatkan data pendukung hasil observasi dari rekam medis Analisa data univareat dilakukan terhadap variable penilaian EWS dan respon EWS dengan distribusi frekuensi dan prosentase. Analisa bivareat menggunakan uji statistic chi-square dengan tingkat signifikan alfa (0,05). Data wawancara dilakukan analisis secara kuantitative dalam bentuk prosentase. Hasil Dari 221 rekam medis pasien didapatkan 2129 observasi. Penelitian ini menunjukkan sebagian besar penilaian EWS telah dilakukan sesuai dengan ketentuan 1.868 (87,7%) dan sebagian besar respon telah sesuai dengan ketentuan 1.499 observasi (70,4%). Terdapat hubungan signifikan antara penilaian dengan respon EWS (p=0,001; p<0,05). Nilai prevalensi sebesar 4,52 artinya penilaian EWS yang tidak sesuai beresiko mengalami respon EWS yang tidak sesuai 4,52 kali lebih tinggi. Kesimpulan Penilaian berhubungan dengan respon EWS. Selain peningkatan penilian EWS perlu diperhatikan kelengkapan pelaksanaan respon EWS di RSUD Wates seperti dibentuknya emergency medical team (EMT) serta adanya panduan respon pada kondisi perburukan pasien.

Background: Before deteriorating in clinical condition, patients often show early warning signs. RSUD Wates has implemented early warning sign monitoring. During the implementation of the Early Warning Score (EWS) at RSUD Wates Hospital, there has never been an evaluation of its implementation. This study aimed to determine the suitability of the EWS assessment with the EWS response. Methods: This research was an analytic descriptive study with a cross-sectional approach, conducted in the medical records section of Wates Hospital with a population of adult patient medical records from May 1, 2019 to April 30, 2020. Samples were taken using purposive technique from 8 adult inpatient rooms to meet the total sample count of 211 medical records. The data were collected using the observation sheet made by the researchers. Researchers also conducted interviews with senior nurses using interview guidelines to obtain supporting data from observations from medical records. Univariate data analysis was done on the EWS assessment variables and EWS responses with frequency and percentage distribution. Bivariate analysis used the chi-squared test with a statistical significance level of alfa (0.05). Interview data were analyzed quantitatively in the form of percentages. Results: From 221 patient medical records, 2,129 observations were obtained. This study shows most of the EWS assessments were done accordingly in 1,868 (87.7%) and most of the responses were in accordance with the provisions of 1,499 observations (70.4%). There was a significant relationship between the assessment and the EWS response (p = 0.001; p <0.05). A prevalence value of 4.52 means that an unsuitable EWS assessment has 4.52 times higher risk of experiencing an unsuitable EWS response. Conclusion: The EWS assessment is related to the EWS response. In addition to improving the EWS assessment, it is necessary to pay attention to the completeness of the implementation of the EWS response at Wates Hospital such as the establishment of the emergency medical team (EMT) and the existence of response guidelines in the event of a patient's deteriorating condition.

Kata Kunci : EWS, Penilaian EWS, Respon EWS, early warning signs, Early Warning Sign Assessment, Early Warning Sign Response