Tatalaksana Overcrowding di Instalasi Gawat Darurat (IGD): Integrative Literature Review

RAMADIN, Intansari Nurjannah, S.Kp., M.N.Sc., Ph.D. ; Ema Madyaningrum, S.Kep., Ns., M.Kes., Ph.D.

2023 | Tesis | MAGISTER KEPERAWATAN

Latar Belakang: Overcrowding, waktu tunggu lama, dan antrian menjadi masalah umum di Instalasi Gawat Darurat (IGD). Tinjauan tatalaksana yang efektif dalam mengatasi overcrowding sangat dibutuhkan.

Tujuan: Tujuan penelitian ini adalah untuk mengetahui tatalaksana overcrowding di IGD melalui pendekatan integrative literature review.

Metode: Metode penelitian yang digunakan yaitu integrative literature review. penelitian dilakukan dalam kurun waktu 3 bulan, yaitu bulan Mei-Juli 2023. Proses pencarian literatur dilakukan pada database jurnal, meliputi PubMed, Google Scholar, Scopus, dan EBSCO-MEDLINE. Peneliti menggunakan beberapa alat bantu untuk membantu proses penelitian, meliputi Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) dan The Crowe Critical Appraisal Tool (CCAT).

Hasil: Terdapat dua tema utama dalam mengatasi overcrowding di IGD, meliputi strategi berbasis dalam rumah sakit (inhospital) dan berbasis luar rumah sakit (outhospital). Strategi inhospital terdiri dari 11 bagian, meliputi rapid assesment, LEAN methods, telemedicine, penambahan staf, strategi penjadwalan, strategi forecasting, queue management, emergency short stay unit, optimalisasi organisasi, bed intervention, dan four-hour rule/national emergency access target (NEAT). Sedangkan strategi outhospital, terdiri dari ambulance diversion dan peneyediaan layanan gawat darurat ketika acara publik.

Kesimpulan: Terdapat dua tema utama yaitu strategi di rumah sakit (inhospital strategy) dan di luar rumah sakit (outhospital strategy).

Background: Overcrowding, long waiting times, and queues are common problems in Emergency Rooms (ERs) globally. A review of management that is effective in overcoming overcrowding is urgently needed.

Purpose: The aim of this study was to determine the strategy of overcrowding in the emergency room through an integrative literature review approach.

Method: The research method used is integrative literature review. The research was conducted over a period of 3 month, namely May-July 2023. The literature search process was carried out on journal databases, including PubMed, Google Scholar, Scopus, and EBSCO-MEDLINE. Researchers use several tools to assist the research process, including the Preferred Reporting Items for Systematics Reviews and Meta-Analyses (PRISMA) and the Crowe Critical Appraisal Tool (CCAT).

Result: There are two main themes in dealing with overcrowding in the emergency room, including inhospital and outhospital based strategies. The inhospital strategy consist of 11 sections, including rapid assessment, LEAN methods, telemedicine, staff additions, scheduling strategies, forecasting strategies, queue management, emergency short stay units, organizational optimization, bed intervention, and four-hour rule/national emergency access target (NEAT). Meanwhile, the outhospital strategy consists of ambulance diversion and the provision or emergency services during public events.

Conclusion: There are two main themes, namely strategies in the hospital (inhospital strategy) and outside the hospital (outhospital strategy).

Kata Kunci : Instalasi Gawat Darurat, IGD, Manajemen, Overcrowding, Emergency Room, ER, Management