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Abstrak :
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. From the situational analysis at Emergency Care Unit at Fatmawati General Hospital it had been found that service time for patients who would undergo cito surgeries with the same diagnosis varied greatly. Therefore, the purpose of this research was to analyze service process for patients at Emergency Care Unit Fatmawati General Hospital who would undergo cito surgeries, which included the measurement of service time. This type of research was a case study with a qualitative approach. Data and information regarding the service process were obtained from in-depth interviews, 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 the patients were-delivered from the Emergency Care Unit to the cito surgery room. The result from the research showed that the service process varied immensely for patients who would undergo the cito surgeries with the process structure also varied. Nevertheless, there were several common stages of service which would have to be endured by the patients starting from the time the surgery was decided until the time the patient steps out from the Emergency Care Unit to the cito Surgery Room. Those stages were: surgery approval, room reservation, hematologic test, bleeding time and clotting time test, turning-in of surgery schedule, admission process and administration process. It had also been found that the average service time for patients who would undergo cito surgeries with the same diagnosis varied greatly. The variation of process structure resulted from the lack of clear comprehensive procedures for the service phase orders. For this reason the management of Emergency Care Unit Fatmawati General Hospital shall have to create a written procedure containing the service phase steps which have to be performed by the Emergency Care Unit attendants when delivering service to the patients undergoing cito surgeries. The large variation of service time was probably due to 2 type of factors. They were the patient factors and the service factors at the Emergency Care Unit. Included in the patient factors were gender, age and approval time for surgery, whereas included in the service factors were consultation time to other specialists, readiness of operator, readiness of cito surgery room and waiting time between various stages of service. To minimize the variation of service time for patients who will undergo cito surgeries with the same diagnosis, the management of Emergency Care Unit Fatmawati General Hospital shall have to improve coordination with other units. This can be achieved through existing regular meetings at the Fatmawati General Hospital.

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Penelitian ini dilatar belakangi oleh kenyataan bahwa Instalasi Rawat Darurat merupakan suatu unit pelayanan di rumah sakit yang harus dapat memberikan pelayanan yang cepat dan tepat agar tujuan pelayanan gawat darurat dapat tercapai dan sekaligus memberikan kepuasan kepada pasien atau keluarganya. Dan analisa situasi di IRD RSUP Fatmawati ditemukan bahwa waktu pelayanan terhadap pasien yang akan menjalani operasi cito dengan diagnosis yang sama sangat bervariasi. Tujuan penelitian ini adalah menganalisis proses pelayanan terhadap pasien LRD RSUP Fatmawati yang akan menjalani operasi cito, termasuk di dalamnya menghitung waktu pelayanannya. Janis penelitian ini merupakan studi kasus dengan pendekatan kualitatif. Data dan informasi mengenai proses pelayanan diperoleh melalui in-depth interview, sedangkan data mengenai waktu pelayanan diperoleh melalui pencatatan waktu pelayanan mulai tahap penetapan operasi sampai pasien keluar dari IRD menuju kamar operasi cito. Hasil penelitian menunjukkan bahwa proses pelayanan terhadap pasien yang akan menjalani operasi cito bervariasi dan urutan prosesnya pun bervariasi , namun ada beberapa tahap pelayanan yang harus dilalui oleh pasien sejak penetapan operasi sarnpai pasien keluar dari IRD menuju Kamar Operasi cito yaitu tahap persetujuan operasi, pemesanan ruang rawat inap, pemeriksaan darah Iengkap, pemeriksaan Bleeding Time dan Clotting Time, pengajuan jadwal operasi, pembuatan Buku Rawat dan penyelesaian administrasi. Ditemukan juga bahwa rata-rata waktu pelayanan terhadap pasien yang akan menjalani operasi cito dengan diagnosis yang sama sangat bervariasi. Bervariasinya urutan proses pelayanan disebabkan belum adanya prosedur tertulis yang jelas. Untuk itu manajemen lRD RSUP Fatmawati perlu membuat suatu prosedur tertulis yang berisi tentang urutan tahap pelayanan yang harus dilakukan oleh petugas IRD dalam memberikan pelayanan kepada pasien yang akan menjalani operasi cito. Besamya variasi waktu pelayanan kemungkinan disebabkan oleh 2 macam faktor yaitu faktor pasien dan faktor pelayanan di IRD. Termasuk dalam faktor pasien adalah jenis kelamin, umur dan waktu persetujuan operasi, sedangkan yang termasuk faktor pelayanan IRD adalah waktu konsul ke SMF lain, kesiapan operator dan kesiapan Kamar Operasi cito dan waktu tunggu diantara tahap-tahap pelayanan. Untuk memperkecll variasi waktu pelayanan terhadap pasien yang akan menjalani operasi cito dengan diagnosis yang sama, manajemen IRD RSUP Fatmawati perlu rnemperbaiki koordinasi dengan unitlbagian lain yang terkait melaiui rapat-rapat rutin yang sudah ada di lingkungan RSUP Fatmawati.

Abstrak :
Tingginya tingkat hunian rumah sakit telah mendorong kebijakan untuk memulangkanpasien secara dini. Risiko infeksi luka operasi tidak hanya terjadi selama perawatan dirumah sakit. Infeksi luka operasi dapat juga terjadi ketika pasien sudah pulang dari rumahsakit. Kesinambungan pelayanan perawatan diperlukan agar tidak terjadi infeksi lukaoperasi selama pasien membutuhkan perawatan. Tujuan penelitian adalahmengembangkan model sistem pelayanan keperawatan berkesinambungan pasien operasiuntuk peningkatan kepuasan dan menyingkatkan waktu penyembuhan luka operasi.Metode penelitian meliputi tahap satu dilakukan penelitian kualitatif melalui focus groupdiscussion dengan peserta perawat pelaksana, kepala ruangan, dan perawat manajer dirumah sakit umum daerah Karawang berjumlah 25 orang, wawancara mendalam terhadap8 partisipan, dan uji coba model dengan sampel sebanyak 140 orang di RSUD Karawangdan RSUD Bayu Asih Purwakarta. Pada tahap tiga dilakukan uji coba model denganmetode kuasi eksperimen. Hasil penelitian tahap satu adalah terdapat empat tema danenam subtema. Hasil penelitian tahap tiga adalah variable jenis luka operasi berpengaruhterhadap lama kesembuhan luka operasi. Lama kesembuhan luka operasi lebih cepat 5hari pada kelompok intervensi. Tingkat kepuasan kelompok intervensi lebih tinggidibandingkan dengan kelompok kontrol. Model sistem pelayanan keperawatanberkesinambungan pasien operasi sangat penting diterapakan pada pelayanankeperawatan untuk meningkatkan kepuasan pasien dan penyingkatan waktupenyembuhan luka operasi.

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The high level of hospital occupancy had prompted policies to repatriate patients early.Surgical site infection risk did not only occur during hospitalization, surgical site infectioncould also occur when the patient have been discharged from the hospital. Continuity ofcare intervention was required to avoid surgical wound infections as long as the patientneeded. Objective of this study was to explorer the existing situation of continuity ofnursing care sistem for surgical patient, especially monitoring service to prevent surgicalsite infection. Research method include the first stage was conducted qualitative researchthrough focus group discussion with the staff nurses, head nurses, and nurse managers inpublic hospitals Karawang area amounted to 25 people and test model with a sample of140 people in public hospital Karawang and public hospital Bayuasih. In the third phaseexperimental model was conducted with quasi experimental method. The result of thestudy was found 4 themes and 6 subthemes in continuity of care flow of surgical patient.Longer wound healing was 5 days faster in the intervention group. The level of satisfactionof the intervention group was higher than the control group. Continuity of care systemmodel in surgery patients was very important to be applied in nursing care to improvepatient satisfaction and shorten wound healing time.