IMPLEMENTASI PATIENT SAFETY DI PELAYANAN POLIKLINIK GIGI DAN MULUT TERPADU RSUD DR. SOESELO SLAWI KABUPATEN TEGAL

FITRI NURSAPTI ARINI, Prof. dr. Adi Utarini, M.Sc., MPH, Ph.D; Dr. drg. Pipiet Okti K., MPH

2024 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Prevalensi masalah gigi dan mulut di Indonesia masih tinggi, tidak terkecuali di Kabupaten Tegal. Kasus kesehatan gigi dan mulut ini membutuhkan perawatan di fasilitas pelayanan kesehatan tingkat lanjut guna mendapatkan penanganan medis yang komprehensif. RSUD dr. Soeselo Slawi merupakan satu-satunya rumah sakit tipe B di Kabupaten Tegal yang menjadi rujukan kasus gigi dan mulut. Kunjungan poli rawat jalan gigi dan mulut RSUD dr. Soeselo Slawi mengalami penurunan selama pandemi Covid-19. Pandemi Covid-19 menimbulkan perubahan besar di bidang kedokteran gigi, utamanya pada keselamatan pasien (patient safety). Salah satu sasaran keselamatan pasien yang penting dan banyak terdampak selama pandemi Covid-19 yaitu pengurangan risiko infeksi terkait pelayanan kesehatan. Oleh karena itu, perlu mendesain ulang manajemen fasilitas kesehatan dan pelayanan poli rawat jalan gigi dan mulut RSUD dr. Soeselo dengan kondisi saat ini melalui benchmarking.

Tujuan: Penelitian ini bertujuan untuk menyusun perbaikan pedoman implementasi patient safety pada pelayanan rawat jalan di poli rawat jalan gigi dan mulut terpadu sesuai sasaran akreditasi rumah sakit.

Metode: Penelitian ini menggunakan metode kualitatif dengan jenis penelitian studi kasus, rancangan studi kasus tunggal deskriptif. Penelitian dilaksanakan di RSUD dr. Soeselo (inisiator) dan RS Akademik UGM (mitra benchmarking).

Hasil: Implementasi keselamatan pasien di RSUD dr. Soeselo Slawi tetap melaksanakan program keselamatan pasien sejak awal masa pandemi hingga pasca pandemi covid-19. Namun, beberapa program keselamatan pasien masih perlu evaluasi dan perbaikan. Evaluasi rutin pelayanan di poli rawat jalan gigi dan mulut RSUD dr. Soeselo perlu dilakukan untuk menjamin keselamatan penghuni rumah sakit. Fasilitas kesehatan dan keselamatan di poli rawat jalan gigi dan mulut terpadu ini belum sepenuhnya mengacu pada standar patient safety. Oleh karena itu, POA yang dapat dibuat meliputi sarana dan prasarana, SDM, penanggung jawab kegiatan, time line kegiatan, dan sumber pendanaan program.

Kesimpulan: Pelaksanaan implementasi patient safety terkait pengurangan risiko infeksi pada pelayanan rawat jalan poli gigi dan mulut terpadu di RSUD dr. Soeselo Slawi belum mengacu pada standar patient safety, evaluasi masih perlu dilakukan melalui pengelolaan dan penyelenggaraan program keselamatan pasien di ruangan, sosialisasi peraturan dan kebijakan, mekanisme pertanggungjawaban, pelaporan insiden keselamatan pasien dan pengawasan terhadap keterlibatan perawat, pelatihan, bimbingan dan motivasi karyawan, serta kelengkapan sarana prasarana dalam penerapan keselamatan pasien terkait pengurangan risiko infeksi.

Background: The prevalence of oral and dental health cases in Indonesia remains high, which includes cases in Tegal Regency. Oral and dental health health cases require treatment at advanced health care facilities for a comprehensive medical treatment. As the only type B hospital in Tegal Regency, RSUD dr. Soeselo Slawi has been a referral hospital for oral and dental health cases. Visits to dental and dental outpatient polyclinic at RSUD dr. Soeselo Slawi declined during the COVID-19 pandemic. The pandemic has caused major changes in the field of dentistry, especially in patient safety. One of the patient safety goals greatly affected during the COVID-19 pandemic is reducing the risk of infection related to health services. Therefore, it is necessary to redesign the management of health facilities and oral and dental health outpatient polyclinic services at RSUD dr. Soeselo with current conditions through benchmarking.

Objective: This study was aimed at developing guidelines for the implementation of patient safety in outpatient services in the integrated oral and dental health outpatient polyclinic according to hospital accreditation goals.

Methods: This study used a qualitative method with a case study research type, a single descriptive case study design. The study was conducted at RSUD dr. Soeselo (initiator) and RSA UGM (the benchmarking partner).

Results: Implementation of patient safety in RSUD dr. Soeselo Slawi has continued to carry out patient safety programs since the beginning of the pandemic until post COVID-19 pandemic period. However, several patient safety programs are subject to evaluation and improvement. Routine evaluation of services at the oral and dental health outpatient polyclinic at RSUD dr. Soeselo is a must to ensure the safety of the hospital occupants. The health and safety facilities at the integrated oral and dental health outpatient polyclinic have not complied with patient safety standards. Therefore, the PoA will include facilities and infrastructure, human resources, person-in-charge of activities, timeline of activities, and program funding sources.

Conclusion: Related to reducing the risk of infection, the implementation of patient safety in the integrated oral and dental health polyclinic for outpatient services at dr. Soeselo Slawi has not met the patient safety standards yet. Among the areas to improve include implementation management, dissemination of regulations and policies, evaluation, accountability mechanisms, patient safety incident reporting and monitoring of nurse involvement, training, employee guidance and motivation, as well as complete infrastructure in implementing patient safety associated with infection risk reduction.

Kata Kunci : Patient safety, Covid-19, pelayanan gigi dan mulut, benchmark, Patient Safety, COVID-19, oral and dental health services, benchmarking