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Kata Kunci : Penapisan perawatan paliatif, kanker, perilaku.
Penelitian ini dilatarbelakangi kenyataan bahwa Instalasi Gawat Darurat merupakan suatu unit pelayanan di rumah sakit yang harus dapat memberikan pelayanan yang cepat dan tepat agar tujuan dari pelayanan gawat darurat dapat tercapai dan sekaligus memberikan kepuasan kepada pasien atau keluarganya.
Tujuan penelitian ini untuk mengetahui gambaran umum waktu tunggu persiapan operasi cito di IGD dan faktor-faktor yang berhubungan dengan waktu pelayanan terhadap pasien yang akan menjalani operasi cito.
Jenis penelitian ini merupakan studi kasus dengan pendekatan kualitatif. Data dan informasi mengenai proses pelayanan diperoleh melalui wawancara mendalam, fokus grup diskusi, observasi partisipatif dan telaah dokumen. Sedangkan data mengenai waktu pelayanan diperoleh melalui pencatatan waktu pelayanan mulai dari tahap penetapan operasi sampai saat dilakukan sayatan pertama di meja operasi.
Hasil penelitian menunjukkan bahwa waktu tunggu persiapan operasi cito di IGD RS Karya Medika I berhubungan dengan lamanya persetujuan operasi dari keluarga atau penanggung jawab biaya, ketidaksiapan SDM kamar operasi termasuk dokter operator dan dokter anestesi, serta keterbatasan peralatan operasi.
Untuk mempersingkat waktu pelayanan terhadap pasien yang akan menjalani operasi cito, RS Karya Medika I perlu menetapkan kebijakan tentang penanganan pasien operasi cito, memperbaiki manajemen SDM kamar operasi dan sistem pengadaan alat kesehatan.
The background of the research was the fact that Emergency Care Unit is a particular service unit in hospital which has to be able to respond quickly and effectively in order to achieve the goals of emergency care service and at the same moment to deliver satisfaction to the patients and their families.
The purpose of this research was to know the general picture about the waiting time of cito operations in the Emergency Departement and the factors associated with the time of service to patients who will undergo cito operations.
This type of research was a case study wih a qualitative approach. Data and information regarding the service process were obtained from indepth interviews, focus group discussion, participant observation and document review, while data regarding the service time was gained from recording and calculating the time taken starting from the moment of surgery decision until the moment of the first incision on the operating table.
The result from the research showed that waiting time for the preparation cito operation in the Emergency Departement at Karya Medika I hospital associated with informed concent from the family or the insurance, human resources, and the equipment of operation.
To minimize the waiting time for preparation cito operation in Emergency Departement, Karya Medika I Hospital need to establish policies regarding the handling of patients cito operations, to improve human resource management and procurement of medical equipment systems.
Appendicitis were majority in digestive surgery division. We found LOSwere varies ranging from 3 to 9 day, longer than 5 days in most cases. Theobjective is to determine factors contributed to LOS. Ressearch was performed to75 samples whom underwent open emergency appendicectomy taken from july toOctober 2014 at Hasan Sadikin General Hospital Bandung . LOS was thedependent variables. LOS determination were emerged from patientcharacteristics and health care provider characteristics. Statistical test was doneto all data results. The results showed that patient age, gender, diagnose,appendiceal orientation and positioning, length of the appendix, previous visitand pre hospital delay were not contributed to LOS more than 5 days. Emergingfrom health care provider characteristic, in hospital delay, time operation wasperfomed and operator were irrelevant to LOS, otherwise operating theathrretimestamp and post operative complication were found relevant to LOS more than5 days.This study also reveals that patient age and length of the appendixcontributed to the rate of post operative complication, that in turn indirectlycontributing to LOS more than 5 days. Suspicioulys that duration operation maycontribute to post operative complications.Similar study concluded pre hospitaldelay was highly significant predisposing to appendiceal perforation.