Analisis Faktor Kriteria Klinis Pasien dalam Tahap Terminal di RS Dr. Moewardi Surakarta Tahun 2018

Resia Perwirani, Hosizah Hosizah

Abstract


Abstract

Dr. Moewardi Surakarta Hospital has program to improve quality of patient services in terminal conditions. Based on observations, NDR (Net Death Rate) of 67.43‰ far exceeds the Ministry of Health's efficient number of <25‰. In accordance with Kepmenkes 812 of 2007 and PAP7, PAP7.1 SNARS standards for terminal services, terminal patients must be assessed to take care patient's needs. Good assessment must be based on clinical sign of terminal patients. The purpose of research to determine the clinical sign of terminal patients. The study was conducted at the Medical Record Unit of Dr. Moewardi Hospital on July - August, 2019. This research is quantitative with a cross-sectional approach. The instrument was a checklist based on CriSTAL theory. Sample was selected 344 medical records by random sampling method, processed by a factor analysis method to confirm the CriSTAL theory with a model construct consisting of five observable variables and five latent variables using SmartPLS 3.0. The results of analysis state that it is necessary to modify the model by eliminating factors that do not meet the requirements. Clinical Criteria of Terminal Patients are formed from 3 latent variables, namely Clinical deterioration criteria, Findings of Physical Weakness, and Abnormal ECGs, and 34 observable variables namely patient admission via IGD, Behavioral alteration / disability, history of hospitalization and history of ICU.

Keywords: factor analysis, clinical sign of terminal stage patients, CriSTAL

 

Abstrak

RS Dr. Moewardi Surakarta mempunyai program kerja meningkatkan kualitas pelayanan pasien dalam kondisi terminal. Berdasarkan hasil observasi, angka NDR (Net Death Rate) sebesar 67,43‰ jauh melampaui angka efisien Kementerian Kesehatan sebesar <25‰. Sesuai Kepmenkes 812 tahun 2007 dan Standar PAP7, PAP7.1 dalam SNARS tentang pelayanan dalam tahap terminal, pasien dalam kondisi terminal wajib dilakukan asesmen yang memperhatikan kebutuhan pasien. Assesment yang baik wajib didasarkan pada kriteria klinis pasien tahap terminal. Tujuan penelitian ini adalah untuk mengetahui kriteria klinis pasien dalam tahap terminal di RS Dr. Moewardi Surakarta tahun 2018. Penelitian dilaksanakan di unit Rekam Medis RS Dr Moewardi Surakarta bulan Juli – Agustus 2019. Jenis penelitian kuantitatif dengan pendekatan cross sectional. Instrumen penelitian berupa checklist yang dibuat berdasarkan teori CriSTAL. Sampel 344 rekam medis diambil secara acak, data diolah dengan metode analisis faktor untuk mengkonfirmasi teori CriSTAL dengan konstruk model terdiri dari lima variabel observable dan lima variabel laten menggunakan SmartPLS 3.0. Hasil analisis faktor menyatakan perlu modifikasi model dengan mengeliminasi faktor yang tidak memenuhi persyaratan. Kriteria Klinis Pasien Terminal terbentuk dari tiga variabel laten yaitu Kriteria perburukan klinis, Temuan Kelemahan Fisik, dan Abnormal EKG, serta 34 variabel observable yaitu cara masuk pasien melalui IGD, Behavioral alteration/disability, riwayat rawat inap dan riwayat ICU.

Kata Kunci : analisis faktor, kriteria klinis pasien terminal, CriSTAL


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