Ketidakpatuhan Penerapan Early Warning Score Dewasa Sebagai Risiko Kematian Di Ruang Rawat Inap Rsud Dr. Soedirman Kabupaten Kebumen

Ns. Purnomo Wahyudi, 3. Dr. Akhmadi, S.Kp., M. Kes., M. Kep., Sp. Kep.Kom. ; Dr. Sri Setiyarini, S. Kp., M. Kes.

2024 | Tesis | S2 Magister Keperawatan

Latar Belakang: Rumah Sakit (RS) berkembang dengan kemajuan ilmu pengetahuan dan teknologi, namun menghadapi tantangan salah satunya angka kematian tinggi. Implementasi Early Warning Score (EWS) sangat penting untuk efektivitasnya. 

Tujuan: Penelitian ini bertujuan untuk mengetahui risiko antara ketidakpatuhan penerapan Early Warning Score (EWS) dewasa dengan kematian di ruang rawat inap RSUD Dr. Soedirman Kabupaten Kebumen. 

Metode: Merupakan penelitian observasional analitik case control, menggunakan quota random sampling dengan total sampel 328 (82 kelompok kasus dan 246 kelompok kontrol). Analisis data menggunakan regresi logistic (95%CI).

Hasil: Penerapan EWS pada kelompok kasus dan kontrol, menunjukkan mayoritas penerapan EWS patuh (68,3%) dan sisanya tidak patuh (31,7%). Ketidakpatuhan EWS berisiko terhadap kematian (p=0,001, Adjusted OR=18,63, CI 95% 6,78-59,29). Faktor risiko kematian lainnya yang bermakna meliputi stroke, jantung, gagal ginjal kronis, sepsis, dan tingkat keparahan EWS. Variabel-variabel ini signifikan mempengaruhi kematian (Cox & Snell R Square=0,603).

Kesimpulan: Ketidakpatuhan dalam penerapan EWS dewasa di ruang rawat inap Rumah Sakit berisiko meningkatkan angka kematian pasien. Implementasi EWS sesuai SPO yang konsisten sangat penting untuk mengurangi angka kematian.

Background: Hospitals develop alongside advancements in science and technology; however, they face challenges, one of which is high mortality rates. The implementation of the Early Warning Score (EWS) is crucial for its effectiveness.

Objective: This study aims to determine the risk associated with non-compliance in the application of the Early Warning Score (EWS) for adults and its correlation with mortality in the inpatient wards of Dr. Soedirman District General Hospital, Kebumen.

Methods: This is an observational analytic case-control study, using quota random sampling with a total sample of 328 (82 in the case group and 246 in the control group). Data analysis was conducted using logistic regression (95% CI).

Results: The application of EWS in both the case and control groups showed that the majority complied with EWS (68.3%), while the rest did not comply (31.7%). Non-compliance with EWS was associated with an increased risk of mortality (p=0.001, Adjusted OR=18.63, 95% CI 6.78-59.29). Other significant risk factors for mortality included stroke, heart disease, chronic kidney failure, sepsis, and the severity level of EWS. These variables significantly influenced mortality (Cox & Snell R Square=0.603).

Conclusion: Non-compliance in the application of EWS for adults in hospital inpatient wards is associated with an increased risk of patient mortality. Consistent implementation of EWS according to standard operating procedures is crucial to reduce mortality rates.

Kata Kunci : Keywords: Early Warning Score (EWS), non-compliance, mortality risk, adult inpatient wards, District General Hospital.