PERSEPSI DOKTER PENANGGUNG JAWAB PELAYANAN (DPJP) DALAM PENERAPAN PEDOMAN PENGENDALIAN COVID-19 KEMENTERIAN KESEHATAN REPUBLIK INDONESIA PADA PELAYANAN KASUS COVID-19 DI RUANG RAWAT INAP RS PELNI

SHEIRA AURANI, Dr. dr. Andreasta Meliala, Dipl.PH. M.Kes

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Pertama kali ditemukan kasus Covid-19 di Tiongkok pada 31 Desember 2019 yang penyebarannya sangat cepat. Pada tanggal 11 Maret 2020, WHO menganggap kasus Covid-19 sebagai pandemi dunia. Di Indonesia sendiri kasus infeksi Covid-19 ditemukan pertama kali pada tanggal 2 Maret 2020. Dalam memberikan pelayanan pada kasus Covid-19, Kementerian Kesehatan Republik Indonesia (Kemenkes RI) telah mengeluarkan Pedoman Pencegahan dan Pengendalian Coronavirus Disease (Covid-19) yang telah mengalami revisi sebanyak 5 kali. Tanggal 10 Maret 2020 ditemukan kasus pertama dengan tersangka Covid-19 di RS PELNI dimana kasus Covid-19 merupakan kasus yang baru dan menjadi tantangan tersendiri bagi dunia medis khususnya DPJP sebagai pemberi asuhan kepada pasien. Oleh karena itu perlu dikaji lebih lanjut bagaimana persepsi DPJP untuk menerapkan pedoman tersebut dalam rangka penanganan pasien Covid-19. Metode: Penelitian ini adalah jenis penelitian deskriptif kualitatif dengan melihat proses kesesuaian dalam implementasi pedoman dan melihat bagaimana gambaran persepsi Dokter Penanggung Jawab Pelayanan Pasien (DPJP) dalam penerapan Pedoman Pencegahan dan Pengendalian Kemenkes RI pada pelayanan kasus Covid-19. Studi dilakukan dengan melihat penerapan selama periode pelayanan covid sejak Juli - Desember 2020. Semua DPJP yang melakukan pelayanan langsung kepada pasien terinfeksi Covid-19 yang mendapatkan perawatan di ruang rawat inap RS PELNI pada periode Juli-Desember 2020. Hasil: Dalam penelitian ini dilakukan terhadap 8 orang responden selaku DPJP dengan jumlah pasien sebanyak 1.382 orang pada periode Juli – Desember 2020. Karakteristik pasien covid-19 di RS PELNI bervariasi dan dalam memberikan asuhan pasien covid-19 DPJP perlu melakukan adjustment atas apa yang ada dalam pedoman Pencegahan dan Pengendalian Covid-19. Dari reviu data rekam medis ditemukan adanya variasi terkait dengen kesesuaian pemulangan pasien. Terdapat banyak faktor yang mempengaruhi timbulnya variasi dalam asuhan layanan pasien Covid-19. Berdasarkan data rekam medis dan hasil wawancara terhadap responden, didapatkan bahwa seluruh responden telah mengetahui, memahami dan menerapkan atas Pedoman Pencegahan dan Pengendalian Covid-19 Kemenkes RI. RS PELNI juga menyusun beberapa kebijakan dan panduan sebagai bentuk adaptasi atas kewaspadaan Covid-19. Kesimpulan: Pedoman Pencegahan dan Pengendalian Covid-19 Kemenkes RI tidak mengatur secara detail atas manajemen klinis pasien kasus Covid-19 sehingga DPJP perlu melakukan ádjustment sebagai bentuk variasi atas apa yang ada dalam pedoman Kemenkes RI sesuai dengan kebutuhan klinis pasien. RS PELNI telah menyusun beberapa kebijakan dan panduan sebagai bentuk adaptasi atas kewaspadaan Covid-19 yang bertujuan untuk memudahkan staf dalam melakukan kegiatan dan pelayanan

Background: The first case of Covid-19 was found in China on December 31, 2019, which spread very quickly. On March 11, 2020, WHO considered cases of Covid-19 a global pandemic. In Indonesia, the first case of Covid-19 infection was found on March 2, 2020. In providing services for Covid-19 cases, the Ministry of Health of the Republic of Indonesia has issued Guidelines for the Prevention and Control of Coronavirus Disease (Covid-19) which has experienced revised 5 times. On March 10, 2020, the first case was found with the suspect Covid-19 at the PELNI Hospital where the Covid-19 case was a new case and a challenge for the medical world, especially doctor as a care provider for patients. Therefore, it is necessary to study further how the perception of doctor is to apply these guidelines in the context of handling Covid-19 patients. Method : This research is descriptive research with a qualitative approach. The qualitative approach is carried out by observing and extracting data in depth to competent informants in their fields. The research will be carried out at PELNI Hospital, which is located at Jl. Aipda KS Tubun No. 92-94 Slipi Jakarta. The research subjects were main doctor (internal medicine specialists and pulmonary specialists) who provide direct care for adult COVID-19 patients undergoing treatment in the COVID isolation room at PELNI Hospital Jakarta in the period July-December 2020 Result : This study was conducted on 8 respondents as doctor in charge with a total of 1,382 patients in the period July until December 2020. The characteristics of COVID-19 patients at PELNI Hospital vary and in providing care for COVID-19 patients, the doctor needs to make adjustments to what is in the guidelines. Prevention and Control of Covid-19. From the review of medical record data, it was found that there were variations related to the suitability of patient discharge. There are many factors that influence the emergence of variations in the care of Covid-19 patient services. Based on medical record data and the results of interviews with respondents, it was found that all respondents knew, understood and applied the Covid-19 Prevention and Control Guidelines of the Indonesian Ministry of Health. PELNI Hospital has also developed several policies and guidelines as a form of adaptation to Covid-19 vigilance. Conclusion : The Indonesian Ministry of Health's Covid-19 Prevention and Control Guidelines do not regulate in detail the clinical management of Covid-19 patients, so the DPJP needs to make adjustments as a form of variation on what is in the Indonesian Ministry of Health guidelines according to the patient's clinical needs. PELNI Hospital has compiled several policies and guidelines as a form of adaptation to Covid-19 vigilance which aims to make it easier for staff to carry out activities and services

Kata Kunci : Infeksi Covid-19, Persepsi DPJP, Penerapan Pedoman Pengendalian dan Pencegahan Covid-19, Covid-19 Infection, Doctor Perception, Implementation of Covid-19 Control and Prevention Guidelines