HUBUNGAN KEPATUHAN PELAKSANAAN CLINICAL PATHWAY DENGAN OUTCOMES PASIEN STROKE NON HEMORRHAGE DI RSUD WATES KULON PROGO

WIDI ASTUTI, Savitri Citra Budi, S.K.M., M.P.H.

2016 | Tugas Akhir | D3 REKAM MEDIS SV

Latar Belakang: Clinical pathway atau jalur klinis merupakan suatu standar yang digunakan untuk menstandarisasi pelayanan medis pada pasien. Selain itu clinical pathway juga berguna untuk menjaga mutu pelayanan medis pasien.Indikator mutu pelayanan kesehatan tidak terlepas dari outcomes pasien. RSUD Wates Kulon Progo mulai mengimplementasikan clinical pathway pada bulan Oktober 2015, pada penyakit stroke non hemorrhage, diare, pneumonia dewasa, hernia inguinal lateral dan section caesarean elective. Berdasarkan hasil wawancara studi pendahuluan, kasusstroke non hemorrhage di RSUD Wates Kulon Progo termasuk dalam 10 besar penyakit, membutuhkan biaya perawatan yang tinggi, dan merupakan penyakit yang berisiko. Evaluasi dilakukan terhadap pelaksanaan clinical pathway termasuk kepatuhan pelaksanaan clinical pathway.Dari latar belakang tersebut peneliti ingin mengetahui hubungan kepatuhan pelaksanaan clinical pathway dan outcomes pasien stroke non hemorrhage. Tujuan: Menganalisis hubungan kepatuhan pelaksanaan clinical pathway dengan outcomes pasien stroke non hemorrhagedi RSUD Wates Kulon Progo. Metode: Jenis penelitian yang digunakan dalam penelitian ini adalah penelitian survei dengan pendekatan kuantitatif dan rancangan cross-sectional.Pengumpulan data dilakukan dengan studi dokumentasi pada 38 lembar clinical pathways dan berkas rekam medis. Hasil: Angka kepatuhan pelaksanaan clinical pathway pada 3 bulan pertama pelaksanaan clinical pathway adalah 14 patuh dan 24 belum memenuhi target kepatuhan sebesar 80%.Rata-rata kepatuhan secara keseluruhan 72,92%. Dari 38 pasien tersebut 36 sembuh dan 2 meninggal >48 jam. Hasil uji hubungan dengan uji fisher pada program statistik R menunjukkan p value sebesar 0,522, lebih besar dari nilai Alfa sebesar 0,05. Kesimpulan: Tidak terdapat hubungan yang signifikan antara kepatuhan pelaksanaan clinical pathway dengan outcome pasien stroke non hemorrhage di RSUD Wates Kulon Progo. Kata kunci: kepatuhan,clinical pathways, outcomes, stroke non hemorrhage.

Background: clinical pathway is a standard used for medical service in patients. Besides clinical pathway also useful to prevent the quality of patients medical service. Quality of health service cannot be separated from patients outcomes. RSUD Wates Kulon Progo start attempt implementation of clinical pathway in October 2015 in diseases stroke non hemorrhage, diarrhea, pneumonia adult, hernia inguinal lateral, and caesarean elective. According to the interview in the study introduction stroke non hemorrhage at RSUD Wates Kulon Progo including in the case of 10th top diseases, high cost care and high risk. The evaluation is done with the clinical pathway, including the obedience of clinical pathway implementation. From the background researchers want to know relations of clinical pathway implementation obedience with outcomes of stroke non hemorrhage patients. Objective: To analyze relations obedience of clinical pathway implementation with outcomes of stroke non hemorrhage patients in RSUD Wates Kulon Progo. Methods: The kind of research which use in this research is survey research with kuantitative approach and design cross-sectional. Data collection was done by study documentation in 38 sheets of clinical pathways and medical record. Results: The number obedience of clinical pathway implementation from on the first 3 month of clinical pathway implementation is 14 obedient and 24 do not yet fulfill the target of obedience by 80 percent. The average frequency of obedience as a whole is 72,92%. From 38 patients, 36 were cured and 2, died after 48 hours. The result ofrelations eksperimen by fisher test on program statistic R, p value show 0,522. It is higher than Alfa, 0.05. Conclusion: There was no correlation of obedience of clinical pathway implementation with outcomes of stroke non hemorrhage patients in RSUD Wates Kulon Progo. Keywords: obedience, clinical pathway, outcomes, stroke non hemorrhage. 

Kata Kunci : kepatuhan, clinical pathway, outcomes, stroke non hemorrhage