iii ABSTRAK
Menurut Global Report WHO (2014) bahwa jumlah penderita TB paru di dunia sebanyak 9 juta orang termasuk 1.1 juta orang diantaranya dengan HIV. Salah satu kendala yang dihadapi menyadari pentingnya keteraturan berobat selama enam bulan dengan strategi DOTS (Directly Observed Treatment Short-Course) dan manajemen yang baik dari seluruh fasilitas kesehatan baik primer maupun sekunder termasuk rumah sakit. RSUD Dr. Tengku Mansyur adalah rumah sakit pemerintah yang ada di Kota Tanjungbalai dengan kasus TB Paru BTA(+) Kategori 1 dari Form TB 03 pada tahun 2014 sebanyak 41 Orang. Pencapaian rumah sakit seperti Angka Kesembuhan/Cure Rate (61%), berhenti berobat/default (21,9%), meninggal dunia (2,4%), dan tidak ada tercatat statusnya (14,6%)
Jenis penelitian ini adalah penelitian kualitatif untuk menilai secara jelas dan mendalam pelaksanaan strategi DOTS di rumah sakit dilihat dari input, process, dan output. Informan penelitian berjumlah 8 orang sebagai informan kunci. Data diperoleh dari metode observasi, wawancara mendalam, dan dokumentasi yang diolah melalui teknik triangulasi sumber. Data dianalisis dengan reduksi data, display data, dan verifikasi data.
Hasil penelitian menunjukkan bahwa pelaksanaan strategi DOTS berlaku di rumah sakit sejak tahun 2005 sudah berjalan dengan baik, namun ada beberapa komponen input, process, dan output yang belum diimplementasikan. Tim DOTS sudah mencukupi namun masih ada yang belum mendapatkan pelatihan. Fasilitas belum memadai. Selain itu, penentuan penderita TB dilakukan dengan pemeriksaan rontgen diawal dan pemeriksaan dahak hanya PS (pagi, sewaktu). Sementara belum ada nota kesepakatan untuk pasien dan Pengawas Menelan Obat (PMO). Komitmen rumah sakit untuk memulangkan pasien ke puskesmas asal dan hasil umpan baliknya juga belum ada dilakukan.
Berdasarkan hasil penelitian, diharapkan kepada Direktur agar menyediakan ruangan khusus pelayanan TB dan penyelenggaraan KIE (Komunikasi, Informasi, Edukasi), mengirimkan tim DOTS secara bergantian untuk pelatihan, dan mengaktifkan peran PMKRS (Promosi Kesehatan Rumah Sakit). Kepada tim DOTS agar membuat nota kesepakatan dan identitas, melakukan rapat rutin, serta berkomitmen memulangkan pasien dan membuat umpan balik hasil rujukan. Kepada penanggungjawab TB agar lebih proaktif memonitoring peran PMO pasien dan keteraturan pasien TB menyelesaikan pengobatan.
Kata Kunci: Evaluasi, Rumah Sakit, Strategi DOTS, Tuberkulosis
iv
ABSTRACT
According to the WHO Global Report (2014) that the number of patients with Pulmonary Tuberculosis in the world are about 9 million people, including 1.1 million of them with HIV. One of the obstacles which is faced that to realize the importance of treatment regularity for six months with the Directly Observed Treatment Short-Course (DOTS) strategy and good management from all facilities in primary and secondary healthcare, including in hospitals. Dr. Tengku Mansyur Hospital is a government hospital in Tanjungbalai City with cases of Pulmonary Tuberculosis BTA(+) Category 1 of Tuberculosis Form 03 in 2014 are 41 people. The hospital achievement such as Cure Rate (61%), Default (21,9%), Died (2,4%), and no recorded status (14,6%).
This research was a qualitative research to assess clearly and in-depth implementation of the DOTS in hospital visits of input, process and output. The informants were 8 people as key informants. Data were obtained from observation, interview, and documentation, which were processed by resources triangulation. Data were analyzed by using data reduction, data display, and conclusion drawing.
The results showed that the implementation of the DOTS strategy has been applied in hospital since 2005, is running well. But there are some components of input, process, and output are not yet implemented. DOTS team are sufficient, but some of them haven’t trained. The facilities are inadequate. In addition, the determination of TB Patients are firstly with the X-Ray examination then sputum examination only PS (Morning, When). While, there is no memorandum of understanding for patients and drugs swallowing control (PMO). There haven’t been hospital commitment to repatriate patients to the origin public health service and also the results of the feedback.
Based on the research of the study, expected to the Director in order to provide tuberculosis service room and organizing KIE (Communication, Information, Education) room, sent DOTS team alternately for training, and activate the role of PMKRS (Hospital Health Promotion). To DOTS team in order to make a memorandum of understanding and identity, do regular meetings, as well as committed to repartriate the patients and make feedback from referral results. To Tuberculosis Program Leader in order to be proactive in monitoring the role of PMO and tuberculosis patients regularity complete their treatment.
Keywords: Evaluation, Hospitals, DOTS Strategy, Tuberculosis
