Strategi peningkatan mutu pelayanan keperawatan berbasis persepsi pasien rawat inap di RSU Dokter Soedarso Pontianak
MUHAEMENON, Sri Werdati, SKM.,M.Kes
2004 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang Penelitian : pelayanan kesehatan di RSU Dokter Soedarso Pontianak berdasarkan self assessment oleh tim akreditasi RSU Dokter Soedarso pada tahun 2000 untuk lima (5) pelayanan dasar berada pada rata-rata skor 69,6% dengan skor terendah pada pelayanan keperawatan yakni 52%. Dalam Indikator pelayanan RS didapatkan data penurunan BOR, tingginya angka NDR dan GDR serta pasien pulang atas permintaan sendiri dalam 5 tahun terakhir. Pada Indikator mutu pelayanan keperawatan didapatkan data angka kejadian dekubitus sebesar 13,02% dan phlebitis sebesar 0,87% pada tahun 2003. Metode Penelitian : Penelitian non eksperimental dengan jenis penelitian deskriptif analisis. Follow Up penelitian dilakukan studi kualitatif dengan Strategi QA; Pendekatan Aspek Kepuasan Pasien untuk menyusun draft peningkatan mutu pelayanan keperawatan dengan tool brainstorming, multi-voting, fishbone dan house of quality. Unit analisis adalah pelayanan rawat inap RSU Dokter Soedarso Pontianak dengan populasi pasien rawat inap dan berkas rekam medisnya (Proportional Stratified Sampling) dan karyawan RS (Purvosive Sampling). Penelitian ini mengukur mutu pelayanan keperawatan dengan menggunakan instrumen Evaluasi Penerapan Standar Asuhan Keperawatan di RS yakni Instrumen A dan B (Depkes RI, 1997). Pengolahan data primer dilakukan dengan analisis matriks prestasi-kepentingan, analisis persentase dan diagram cartesius. Hasil Penelitian; mutu pelayanan keperawatan rawat inap di RSU Dokter Soedarso Pontianak dipersepsikan “cukup baik†dari persepsi pasien (74%) dan dokumentasi penerapan SAK (58,54%). Dengan analisis matriks-prestasi kepentingan, pelaksanaan pelayanan keperawatan (3,70) belum memenuhi harapan pasien rawat inap terhadap mutu pelayanan keperawatan (4,59). Dalam menyusun draft upaya peningkatan mutu pelayanan keperawatan, didasarkan hasil analisis didapatkan variabel mutu pelayanan keperawatan yang perlu dipertahankan prestasinya adalah komunikasi perawat, dan variabel yang perlu ditingkatkan prestasinya adalah ketanggapan dan kemampuan perawat.
Background: Based on self assessment in the year of 2000 by Dr. Soedarso general hospital accreditation team for 5 (five) basic services, health service of hospital was in the average score 69.6% with lowest score on nursing service 52%. Hospital service indicator in five years showed the decreasing of hospital BOR, the high number of NDR and GDR, and forced returned. Nursing health quality indicator in the year 2003 showed number of decubitus was 13.02% and number of phlebitis was 0.87%. Method: This was non experimental study with descriptive analysis. The study was followed up by quantitative study with assessment quality strategy, patient satisfaction aspect approach to arrange nursing service quality increasing by tool brainstorming, multi-voting, fishbone, and house of quality. Analysis unit of the study was inpatient service in Dr. Soedarso general hospital Pontianak by inpatient population and medical record total quality management, and quality function deployment. Analysis unit of the study was inpatient service in Dr. Soedarso general hospital, i.e. inpatient population, and bundle of medical record (proportional stratified sampling) and hospital staff (purposive sampling). Nursing service quality was measured by A and B nursing care standard implementation evaluation instrument (by Department of Health, Republic Indonesia). Primary data processed by matrix analysis of achievement and importance, percentage analysis, and cartecius diagram. Result: The perception of inpatient nursing service quality in Dr. Soedarso General Hospital Pontianak was good, it was referred to patient perception (74%) and nursing care standard implementation document (58.54%). Matrix analysis of achievement importance and nursing service implementation is not complying with inpatient request and nursing service quality (4.59). The arrangement outcome of improvement effort draft for nursing service quality that is based on analysis result was the nursing service quality variable that needs in continuum quality performance of nurses communication, actually responsiveness and nurse skill must be improved.
Kata Kunci : Manajemen Rumah Sakit, Mutu Layanan, Strategi Peningkatan, Persepsi Pasien, nursing service quality, patient perception, nursing care
