GAMBARAN PELAKSANAAN PENGISIAN CLINICAL PATHWAY PASIEN STROKE NON HAEMORRHAGE DI RUMAH SAKIT UMUM DAERAH WATES

DEFIANA RAHMAWATI, Savitri Citra Budi, S.K.M., M.P.H.

2016 | Tugas Akhir | D3 REKAM MEDIS SV

Latar Belakang : Berdasarkan Peraturan Presiden Republik Indonesia Nomor 12 Tahun 2013 tentang Jaminan Kesehatan, clinical pathway digunakan sebagai alat pengontrol tarif yang ditetapkan pada sistem INA-CBGs. Stroke atau cerebral infarction merupakan gangguan neurologis yang paling banyak terjadi dan menjadi masalah paling utama penyebab gangguan gerak dan fungsi tubuh pada orang dewasa. Pengkajian standar pelayanan yang baik, jelas dan berkelanjutan dalam kegiatan pelayanan rawat inap pasien stroke sangat diperlukan agar dapat diketahui mutu pelayanan rawat inap pasien stroke. Tujuan : Mengetahui gambaran pelaksanaan clinical pathway pasien stroke non haemorrhage di Rumah Sakit Umum Daerah Wates. Metode : Penelitian deskriptif kualitatif dengan rancangan studi kasus. Teknik pengumpulan data menggunakan wawancara, observasi, dan studi dokumentasi. Hasil : Pelaksanaan pengisian clinical pathway pasien stroke non haemorrhage di RSUD Wates mulai diterapkan pada bulan Oktober 2015. Clinical pathway pasien stroke non haemorrhage disusun oleh komite medis bersama pemberi pelayanan medis berdasarkan Panduan Praktik Klinis. Berdasarkan analisis kepatuhan yang dilakukan pada tiga bulan pertama menunjukkan persentase kepatuhan terhadap clinical pathway pasien stroke non haemorrhage sebesar 36,84%. Kendala yang dialami antara lain kurangnya jumlah SDM, tidak tersedianya alat penunjang CT Scan, belum ada SOP tertulis, pendokumentasian pelayanan yang belum lengkap di rekam medis, dan belum ada tempat khusus untuk menyimpan clinical pathway. Upaya yang sudah dilakukan yaitu penambahan tenaga di bagian farmasi, menggunakan pihak ketiga untuk memenuhi pelayanan CT Scan. Kesimpulan : Kepatuhan pelaksanaan clinical pathway pasien stroke non haemorrhage masih rendah sehingga diperlukan evaluasi dan perbaikan dalam pelaksanaannya.

Background: Based on the Presidential Decree of the Republic of Indonesia Number 12 in 2013 about Health Insurance, clinical pathways are used as controlling the cost assigned in INA-CBGs system. Stroke or cerebral infarction is a neurological disorder that is the most common and most important problem causes movement disorders and body function in adults. Assessment of service standards, good, clear and sustainable at the activities in caring of stroke patients is indispensable in order to know the quality of inpatient care of stroke patients. Objectives: To describe the implementation of clinical pathways of stroke non haemorrhage patients at Wates local public hospital. Methods: The study used descriptive qualitative and case study design. The technique of collecting data using interviews, observation and documentation. Results: Implementation of filling the stroke non haemorrhage clinical pathways in patients at Wates local public hospital was started in October 2015. Stroke non haemorrhage clinical pathway composed by a medical committee with local medical services based on Clinical Practice Guidelines. Based on the analysis compliance performed at the first three months shows the percentage of compliance with clinical pathways stroke non haemorrhage patients is 36.84%. It showed that the problem in the implementation are the shortage of human resources, lack of supporting tools CT Scan, there are no written standard operating procedures, incomplete documentation of services in the medical record, and there no special place for storing clinical pathways. Efforts that have been made are addition of personnel in the pharmacy, use third parties to meet the service CT Scan. Conclusion: Compliance the implementation of stroke non haemorrhage clinical pathways is still low so that need evaluation and improvement in its implementation.

Kata Kunci : pelaksanaan, pengisian, clinical pathway, stroke non haemorrhage