PENGGUNAAN LEMBAR STABILISASI RUJUKAN UNTUK MENINGKATKAN KUALITAS RUJUKAN DI PUSKESMAS DAMPINGAN PROGRAM EMAS
STUDI DI KABUPATEN KARAWANG
Abstract
Dalam rangka meningkatkan kinerja pelayanan rujukan emergensi maternal dan neonatal secara konsisten dan berkesinambungan serta menurunkan kematian ibu dan bayi baru lahir, program EMAS (Expanding Maternal and Neonatal Survival) memperkenalkan penggunaan Lembar Stabilisasi Rujukan di Puskesmas. Pada daerah intervensi EMAS fase 1 dan 2 lembar stabilisasi rujukan Puskesmas telah digunakan dengan dukungan dari Dinas Kesehatan kabupaten terutama pada pukesmas full support dan sebagian di Puskesmas replikasi EMAS (Karawang dan Tangerang). Tujuan: Tujuan penelitian ini untuk mengetahui penggunaan lembar rujukan maternal dan kaitannya dengan output ibu. Metode: Disain penelitian yang digunakan cross sectional pada 39 kasus rujukan maternal di Karawang. Sebanyak 25 kasus rujukan diambil sebagai sampel dari Puskesmas Klari yang dirujuk ke RSUD karawang serta dilengkapi lembar stabilisasi kemudian dibandingkan dengan 14 kasus rujukan tanpa lembar stabilisasi yang ada RSUD Karawang. Kriteria inklusi yaitu melahirkan pada periode Januari-Juli 2016 dengan diagnosa preeklampsia, sedangkan kriteria eksklusi yaitu data output pasien tidak lengkap. Instrumen yang digunakan berupa lembar stabilisasi rujukan dan buku register rumah sakit. Data dianalisa menggunakan uji chi square. Hasil: Hasil penelitian menunjukkan dari 39 kasus rujukan, rujukan yang dilengkapi dengan lembar stabilisasi mempunyai output yang lebih baik dibandingkan yang tidak. Dari 25 rujukan yang dilengkapi dengan lembar stabilisasi sebanyak 21(84%) pulang sehat, 3(12,0%) kasus nearmiss, dan 1(12,0%) kematian ibu. Sedangkan dari 14 rujukan tanpa lembar stabilisasi didapatkan 0(0%) pulang sehat, 5(35,7%) kasus nearmiss, dan 9 (64,3%) kematian ibu. Ada hubungan signifikan antara lembar stabilisasi rujukan dengan output ibu (p=0,0005). Kesimpulan: Penggunaan lembar stabilisasi rujukan sangat membantu dalam pengambilan keputusan klinis yang cepat pada fasilitas dampingan Program EMAS di kabupaten Karawang. Lembar stabiliasasi maternal berisi informai lengkap mengenai identitas pasien, keadaan umum, komplikasi, tindakan pra rujukukan, diagnosa, identitas pengirim dan penerima, serta monitoring perjalanan. Tujuan akhir dari penggunaan lembar ini adalah membantu menurunkan kasus nearmiss dan kematian ibu.
References
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