Studi dokumentasi ketepatan skoring early warning score (ews) di rawat inap satu rumah sakit swasta Indonesia barat = documentation study of accuracy scoring early warning score (ews) in inpatient department of private hospitals in west of Indonesia

Halawa, Angellita and Mairuhu, Brigitta Armelia and Jahangmetan, Natalia Emerensia (2018) Studi dokumentasi ketepatan skoring early warning score (ews) di rawat inap satu rumah sakit swasta Indonesia barat = documentation study of accuracy scoring early warning score (ews) in inpatient department of private hospitals in west of Indonesia. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Early Warning Score (EWS) dikembangkan untuk memantau kondisi pasien yang memburuk dan telah diadopsi secara internasional (Mohammed, 2013). EWS adalah sistem penilaian berdasarkan pengamatan pada tanda vital yakni denyut jantung, tekanan darah, suhu, pernapasan, saturasi oksigen dan tingkat kesadaran, maka semakin tinggi EWS semakin tinggi perburukan kondisi pasien. Tujuan: mengidentifikasi demografi, ketepatan dan kategori skoring EWS. Desain: deskriptif kuantitatif dengan studi dokumentasi. Populasi: seluruh file pasien dewasa sebanyak 44 file dengan total sampling. Instrumen: lembar dokumentasi checklist berdasarkan acuan scoring Rumah Sakit Swasta Indonesia Barat. Hasil Penelitian: data demografi rentang usia 17 - 85 tahun dengan umur yang paling mendominasi adalah file pasien dengan umur 59 tahun (4 file) 9,0% dan didapatkan 44 diagnosa. Ketepatan skoring EWS banyak ditemukan pada shift malam mencapai 44.0% dan ketidaktepatan pada shift pagi 65.9%. Kategori EWS rendah banyak ditemukan, shift malam 41.2% tepat dan shift pagi 69.3% tidak tepat. Kesimpulan yang didapatkan dalam kategori kurang karena ketepatan pendokumentasian hanya mencapai 44.0% pada shift malam. Rekomendasi: melihat faktor -faktor yang memengaruhi ketidaktepatan atau melihat tingkat pengetahuan perawat dalam menentukan skoring EWS = Early Warning Score (EWS) was developed to monitor the condition of deteriorating and internationally adopted patients (Mohammed, 2013). EWS is an assessment system based on observations on vital signs of heart rate, blood pressure, temperature, respiration, oxygen saturation and level of consciousness, the higher the EWS the higher the deterioration of the patient's condition. The purpose: to identify demographic, accuracy and EWS scoring categories. Design: quantitative descriptive with documentation study. Population: All adult patient files are 44 files with total sampling. Instrument: checklist documentation sheet based on Private Hospitals in West of Indonesia scoring reference. Results: demographic data age range of 17 - 85 years with age most dominan is the file of patients with age 59 years old (4 files) reach 9.0%, and obtained 44 diagnoses. The accuracy of EWS scoring was found in the night shift reaching 44.0% and inaccuracy in the morning shift 65.9%. Low EWS categories are found, night shift 41.2% right and morning shift 69.3% is not right. The conclusions obtained in the category are less because of the accuracy of documentation of reaching night shift 44.0%. Recommendation: look at factors that influence inaccuracy or see the level of knowledge of nurses in determining EWS scoring.

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