Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Evaluasi Pelaksanaan Program Pelayanan Gizi Rumah Sakit Dengan Sistem Outsourcing Di Rsud Kabupaten Sumedang (Evaluation Implementation Nutrition Service Programs In Hospital Using Outsourcing In Sumedang District Hospitals )

Program Pelayanan Gizi Rumah Sakit dengan sistem outsourcing di RSUD Kabupaten Sumedang telah dilaksanakan sejak tahun 2003, namun mutu pelayanan gizi masih rendah. Penelitian ini bertujuan untuk mengevaluasi pelaksanaan program meliputi sumber daya, pelaksanaan kegiatan, mutu pelayanan gizi, faktor-faktor yang mempengaruhi keberhasilan pelayanan gizi dan manfaat dari pelaksanaan pelayanan gizi untuk pasien yang dirawat di ruang rawat inap. Penelitian ini dilakukan dengan metode campuran rancangan embedded konkuren. Pengambilan data dilakukan dengan melakukan wawancara mendalam kepada pihak-pihak terkait, observasi dan telaah dokumen terkait serta penilaian status gizi pasien selama perawatan. Aspek sumber daya menunjukkan bahwa jumlah tenaga distribusi makanan ruangan masih kurang, belum ada kepala pemasak, belum ada ahli gizi kepala dan terbatasnya fasilitas dapur dan jalan untuk distribusi makanan. Fungsi perencanaan, pengorganisasian, pengarahan dan pengawasan kegiatan asuhan gizi belum maksimal. Terdapat faktor penghambat keberhasilan pelayanan gizi yaitu terbatasnya SDM dan material; belum adanya struktur organisasi Tim Terapi Gizi (TTG) sehingga tidak jelas dalam pembagian tugas, pendelegasian wewenang dan koordinasi ditambah dengan kurangnya komunikasi, diseminasi, supervisi, monitoring dan evaluasi untuk kegiatan asuhan gizi pasien di ruangan. Mutu pelayanan makanan dan asuhan gizi masih rendah menyebabkan status gizi pasien cenderung mengalami penurunan. Faktor penunjang keberhasilan pelayanan gizi yaitu kebijakan, SOP dan komitmen. Pelaksanaan program Pelayanan Gizi Rumah Sakit dengan sistem outsourcing di RSUD Kabupaten Sumedang dapat ditingkatkan dengan penyediaan sarana dan prasarana yang memadai, penambahan SDM untuk kegiatan asuhan gizi pasien di ruangan, peningkatan fungsi manajemen pelayanan gizi oleh kepala unit gizi, pembentukan TTG serta perlu adanya supervisi dari pihak manajemen agar mutu pelayanan gizi menjadi meningkat.

Nutrition Service Programs in Hospital using outsourcing system in Sumedang District Hospital has been implemented since 2003, but the quality of nutrition services is still low. The objective of the study was to evaluate the implementation of the outsourcing system for nutrition service including resources, implementation, quality and the factors contributing to nutrition service. This study was performed using mixed methods with embedded concurent. Data were collected by in-depth interviews to the relevant parties, observation, as well as the study of relevant documents and evaluate the nutritional status. Based on the study, from the resources,it indicates that there were lack of staff for distributing the food, there was not chief of chef and nutritionist. The planning, organizing, directing and monitoring of nutrition service were not maximize. There were factors that inhibiting the implementation of the program, such as the limitation of human and material. There are no formal TTG organizational structure,which in turn it is not clear in the division of duties, delegation, and coordination. The lack of communication, dissemination, supervision, monitoring and evaluation of nutrition care for patients in the activities room are also inhibiting the program. Nutritional status of patients after treated by nutrition service is better than before. Nutrition Service Programs in Hospital using outsourcing in Sumedang district hospitals can be improved by increasing the availability of infrastructure, human resource for nutrition service especialy in ward, improving management process by head of nutrition services and supervision by manajer,finally,the better quality of nutrition service is achieved.