Analysis on the Implementation of Nutrition Services in Tugurejo General Hospital Semarang

Abstract

ABSTRAK

Gizi merupakan faktor penting dalam upaya perawatan dan penyembuhan pasien. Hasil evaluasi Unit Litbang Gizi RSUD Tugurejo pada tahun 2011 menunjukkan bahwa sisa makan pasien masih di bawah Standar Pelayanan Minimal. Tujuan penelitian ini adalah melakukan analisis terhadap implementasi pelayanan gizi di RSUD Tugurejo Semarang. Penelitian dilakukan secara kualitatif dengan informan utama 4 ahli gizi, 8 pramumasak dan 8 pramusaji. Informan triangulasi adalah Kabid Penunjang, Ka. Instalasi Gizi, Ka. Ruang Perawatan dan 6 orang pasien dari kelas 1, 2 dan 3 dengan diit biasa dan diit khusus. Pengumpulan data melalui indepth interview, focus group discussion dan observasi. Pengolahan data dengan metode content analysis. Hasil penelitian menunjukkan bahwa implementasi pelayanan gizi belum optimal. Komunikasi kebijakan pelayanan gizi belum jelas dan konsisten. Sumberdaya belum mencukupi dengan latar belakang pengetahuan dan ketrampilan kurang mendukung. Usulan sarana terpenuhi namun tidak tersedia tepat waktu. Petugas menunjukkan sikap kurang mendukung kegiatan pengolahan dan distribusi diit. Tugas dan wewenang kurang dipahami oleh pramusaji, SOP kurang jelas dan kurang dipahami oleh petugas serta mekanisme pertanggungjawaban tugas distribusi diit belum berjalan. Pasien menyatakan bahwa makanan sudah baik, alat makan lengkap dan bersih namun belum mendapatkan penjelasan tentang diit yang diberikan. Hasil observasi menunjukkan bahwa sisa nasi, lauk nabati dan sayur pasien masih cukup banyak. Disimpulkan bahwa implementasi pelayanan gizi belum optimal berkaitan dengan komunikasi kebijakan tidak jelas/tidak konsisten, tugas, wewenang, SOP dan mekanisme pertanggungjawaban tugas tidak jelas/tidak dipahami oleh petugas. Disarankan kepada rumah sakit untuk mengevaluasi kebijakan, memperbaiki hubungan antar petugas dengan family gathering/outbond dan koordinasi serta menata ulang tupoksi SDM.

Kata kunci : Implementasi, Pelayanan Gizi, Rumah Sakit

ABSTRACT

Nutrition was an important factor for patient care and cure. Results of an evaluation by nutritional research and development unit of Tugurejo district general hospital (RSUD) in 2011 indicated that food remains of patient were still below the minimal standard of service. Objective of this study was to analyze the implementation of nutritional service in the RSUD Tugurejo Semarang. This was a qualitative study with 4 nutritionists, 8 cook assistants, and 8 waitresses as main informants. Triangulation informants were a head of supporting unit, a head of nutritional installation, a chief of nursing room, and 6 patients from 1,2,3 classes with ordinary and special diet. Data were collected through in-depth interview, focus group discussion, and observation. Content analysis was applied in the data management. Results of the study showed that nutritional service implementation was not optimal. Nutritional service policy communication was not clear and consistent. Human resources were insufficient, and they had inadequate educational and skill backgrounds. Facilities were sufficient, but it was not provided on time. Workers did not fully support processing and diet activities. Tasks and responsibilities were not understood by waitresses. Standard operating procedure (SOP) was not clear, and it was not understood by the workers. Job responsibility mechanism of diet distribution was inadequate. Patients stated that the food was good, utensils were complete and clean. They did not get explanation regarding diet that they had received. Results of the observation showed that rice remains and vegetable site dish of the patients were sufficient. In conclusion, the implementation of nutritional service was not optimal. It was related to unclear or inconsistence of policy communication, task, authority, and SOP. The workers did not understand the job responsibility mechanism. Hospital workers are suggested to evaluate the policies, to improve relationship among workers by conducting family gathering or outbound, to coordinate and re-arrange functional main tasks (tupoksi) of human resource.

Keywords : Implementation, nutritional service, hospital