Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Analisis Kebijakan Outsourcing Penyelenggaraan Makan Pasien di Rumah Sakit Umum Daerah Sumedang

Prevalensi malnutrisi pasien rawat inap di rumah sakit cukup tinggi. Pelayanan gizi diharapkan dapat mengatasi terjadinya malnutrisi di rumah sakit. Penelitian ini bertujuan untuk melakukan analisis terhadap kebijakan outsourcing penyelenggaraan makan pasien di Rumah Sakit Umum Sumedang. Desain penelitian adalah mixed method dengan strategi concurrent embedded. Pengambilan sampel kualitatif dilakukan secara purposive sampling. Subjek penelitian adalah tim pelayanan gizi rumah sakit. Sampel kuantitatif menggunakan stratified simple random sampling, diperoleh jumlah sampel 154 pasien. Pengukuran status gizi pasien menggunakan subjective global assessment. Penelitian dilakukan pada bulan November sampai Desember 2012. Mekanisme penyediaan makan cukup terstruktur dan jelas, meskipun masih ada Standar Operasional Prosedur (SOP) yang belum dimiliki katering seperti SOP untuk menu pasien anak-anak, penyiapan logistik dan membersihkan peralatan makan pasien. Beban kerja karyawan katering sangat tinggi dan rangkap tugas. Tim Panitia Asuhan Gizi (PAG) khususnya perawat dan petugas gizi dapat bekerja lebih baik, namun belum memiliki perencanaan stratejik untuk pelayanan gizi. Kapasitas tim PAG dalam pelayanan gizi belum optimal. Terdapat peningkatan gizi buruk dari 1,9% sebelum perawatan menjadi 13% setelah perawatan. Simpulan, penyelenggaraan makan dengan sistem outsourcing belum berdampak pada peningkatan status gizi pasien, namun mekanisme layanan asuhan gizi dan penyediaan makan menjadi lebih jelas dan lebih baik.

The prevalence of malnutrition remains high in hospital inpatients. Nutritional services can overcome such problem. This study aimed to perform a policy analysis of food service outsourcing in Sumedang District Hospital. The design of this study was a mixed method using a concurrent embedded strategy. The purposive sampling was chosen for the qualitative study in which the hospital nutritionist team members became the subjects. The sampling for the quantitative study was performed using the stratified simple random sampling. About 154 patients were selected as subjects. The subjective global assesment was used as the instrument. The study was conducted from November to December 2012. The food service mechanism was well structured and clear even though there were missing Standard Operating Procedures (SOPs) such as SOPs for pediatric patient menus, logistic preparation, and patient meal equipment cleaning. Catering employees had a very high workload and were multitasking. The Nutrition Care Committee Team may work better. There was no strategic plan for nutrition services. The capacity of the team was not optimum in terms of nutritional care. The proportion of malnutrition increased from 1.9% to 13% after hospitalization when compared to the pre-hospitalization condition. In conclusion, the outsourcing system for food services has no impact on patients’ nutrition status; however, it is apparent that a clear and better mechanism of nutrition care and food provision is needed.