Skripsi

Evaluation on the Adherence to Clinical Practice Guideline in the Management of Schizophrenia in RSCM Psychiatric Inpatient Units = Evaluasi Kesesuaian Pelayanan Berdasarkan Panduan Praktik Klinik untuk Orang dengan Skizofrenia di Ruang Rawat Inap RSCM.

Introduction Schizophrenia is amongst the most severe mental disorders which poses a long-term up to a lifetime risk. Comprehensive management strategies were established in clinical practice guidelines (CPG) by institutions, including RSUPN Dr. Cipto Mangunkusumo. However, with the low rate of remissions, the implementation of CPG in RSCM is questioned. This research will evaluate the guideline adherence in the management for people with schizophrenia (PWS) in RSCM. Method An observational, retrospective cross-sectional study will be conducted using the secondary data from medical records of PWS in the adult psychiatric units in RSCM. The data will be integrated into an evaluation form of guideline adherence and analysed in mixed methods. Result There are 52 (20.16%) hospitalised PWS out of 258 patients in the RSCM adult psychiatric unit in 2022. Out of 38 subjects, 23 (60.5%) patients were in the age range of 18-29, 29 (76.3%) were males, 33 (86.8%) were not married, 38 (100%) were aided by BPJS/JKN for their hospitalisation fee, 24 (63.2%) had comorbidities from axis III, 28 (73.7%) were not compliant to medication, and 2 (5.3%) experienced readmission within 30 days after discharge. After evaluating the adherence of their management to CPG, we found 37 (97.4%) were in full adherence, while 1 (2.6%) is partially adherence. However, among the 37 that were in full adherence, only 30 (81.1%) achieved all three criteria of the target outcome. Conclusion The schizophrenia management in the RSCM adult psychiatric unit was in good adherence to the CPG, wherein almost all patients were managed in full adherence.
Keywords: clinical practice guideline, guideline adherence, inpatient unit, schizophrenia


Latar Belakang Skizofrenia merupakan salah satu gangguan mental paling berat yang menimbulkan resiko jangka panjang. Tatalaksana yang komprehensif dikembangkan dalam panduan praktik klinis (PPK) yang ditetapkan oleh berbagai institusi, termasuk RSUPN Dr. Cipto Mangunkusumo. Namun, melihat rendahnya angka remisi, implementasi PPK di RSCM patut dipertanyakan. Penelitian ini akan mengevaluasi kesesuaian pelayanan berdasarkan PPK dalam pengobatan orang dengan skizofrenia (ODS) di RSCM. Metode Studi ini akan dilakukan dengan metode cross-sectional, observasional retrospektif menggunakan data sekunder dari rekam medis ODS di bangsal psikiatri dewasa di RSCM. Data tersebut akan diintegrasikan ke dalam formulir penilaian kesesuaian pelayanan berdasarkan PPK dan dianalisis dengan mixed method. Hasil Terdapat 52 (20.16%) ODS dirawat inap dari 258 pasien di bangsal jiwa dewasa RSCM di 2022. Dari 38 subjek, 23 (60.5%) pasien berada di kisaran umur 18-29, 29 (76.3%) adalah laki-laki, 33 (86.8%) belum menikah, 38 (100%) menggunakan BPJS/JKN untuk pembiayaan, 24 (63.2%) komorbid dengan kelainan dari axis III, 28 (73.7%) tidak patuh dengan pengobatan, dan 2 (5.3%) mengalami readmisi dalam 30 hari setelah pulang dari perawatan. Setelah mengevaluasi kepatuhan manajemen terhadap PPK, ditemukan 37 (97.4%) memiliki ketaatan penuh, sedangkan 1 (2.6%) ketaatan parsial. Namun, di antara 37 yang taat penuh, hanya 30 (81,1%) yang mencapai ketiga kriteria target luaran. Kesimpulan Pelayanan skizofrenia di bangsal jiwa dewasa RSCM memiliki ketaatan kepada PPK dengan baik, di mana hampir semua pasien ditangani dengan kepatuhan penuh.
Kata Kunci: kesesuaian pelayanan, panduan praktik klinik, rawat inap, skizofrenia