Implementasi Early Warning Score pada Kejadian Henti Jantung di Ruang Perawatan Rumah Sakit Dr. Hasan Sadikin Bandung yang Ditangani Tim Code Blue Selama Tahun 2017

Abstract

Angka kejadian henti jantung di rumah sakit sangat bervariasi. Sebagian besar kasus henti jantung didahului oleh penurunan kondisi pasien yang digambarkan dengan gangguan parameter tanda vital. Keberhasilan Early warning score (EWS) dalam menurunkan angka kejadian henti jantung dipengaruhi oleh implementasi yang baik dari instrumen EWS sesuai dengan pedoman yang ditetapkan. Penelitian ini bertujuan melihat implementasi EWS di RSUP Dr. Hasan Sadikin Bandung. Penelitian bersifat deskriptif dengan desain potong lintang menggunakan data rekam medis pasien henti jantung di ruang perawatan yang ditangani oleh tim Code Blue selama tahun 2017, dan dilakukan pada bulan November 2018. Data EWS 6 jam sebelum dan saat henti jantung, serta tindak lanjut yang dilakukan setelah penilaian EWS dicatat. Didapatkan 87 data rekam medis henti jantung yang memenuhi kriteria inklusi dan tidak termasuk eksklusi. Di antaranya, 72% memiliki catatan EWS lengkap, 9% memiliki catatan EWS tidak lengkap, dan 18% tidak memiliki data EWS. Dari 63 data rekam medis yang memiliki data EWS lengkap hanya 21% yang mendapat tindak lanjut yang sesuai dengan standar prosedur operasional EWS. Simpulan penelitian ini adalah implementasi EWS di ruang rawat inap RSUP Dr. Hasan Sadikin belum cukup memuaskan. Tindak lanjut yang dilakukan setelah penilaian EWS belum sesuai dengan standar prosedur operasional EWS yang berlaku.

Implementation of Early Warning Score to Patients with In-Hospital Cardiac Arrest in Dr. Hasan Sadikin General Hospital Managed  by Code Blue Team

Incidence of in-hospital cardiac arrest varies greatly around the world. Most in-hospital cardiac arrests are preceded with physiological deteriorations that manifest as alterations in vital signs. The success of early warning score (EWS) in reducing the incidence of cardiac arrest is influenced by the good implementation of EWS instruments by ward staff in accordance with the guidelines The aim of this study was to assess to what degree EWS was implemented at Dr. Hasan Sadikin General Hospital Bandung. This was a cross sectional descriptive study on patients with in-hospital cardiac arrest managed by the code blue team during 2017 that was conducted in November 2018. EWS 6 hour prior to cardiac arrest event, EWS at the event, and action taken upon finding an abnormal value were obtained from medical records.  Eighty seven medical records were included. Of these, 72% medical records had complete EWS data, 9 medical records had incomplete EWS data, and 18% medical records had no EWS recorded. From those 63 medical records with complete EWS recorded, only 21% had been managed correctly according to the EWS guideline. This study concludes that the implementation of EWS in the wards of Dr. Hasan Sadikin General Hospital Bandung has not been completely satisfactorily. Actions taken after EWS assessment are still not accordance with the EWS guideline.