HEMODIALISIS DI FASILITAS KESEHATAN RAWAN BENCANA : ANALISIS KUALITATIF BERBASIS RESILIENT HEALTH SYSTEM WHO
DOI:
https://doi.org/10.31004/prepotif.v9i3.52173Keywords:
bencana, hemodialisis, ,Resilience, ,rumah sakitAbstract
Layanan hemodialisis (HD) merupakan layanan kritis yang sangat bergantung pada infrastruktur seperti air bersih bertekanan, listrik stabil, serta mesin reverse osmosis (RO), sehingga mudah terganggu saat bencana. Indonesia sebagai negara rawan bencana menghadapi tantangan besar dalam mempertahankan kesinambungan layanan HD. Penelitian ini bertujuan menganalisis ketangguhan layanan HD di fasilitas kesehatan rawan bencana berdasarkan kerangka Resilient Health System WHO dan menggali pengalaman subjektif pasien serta tenaga kesehatan mengenai gangguan layanan. Penelitian menggunakan desain kualitatif dengan pendekatan Interpretative Phenomenological Analysis (IPA). Informan terdiri dari 15 partisipan: enam pasien HD, tiga keluarga pendamping, empat perawat, satu dokter penanggung jawab, dan satu manajemen rumah sakit, yang dipilih melalui purposive sampling. Data dikumpulkan melalui wawancara mendalam, observasi non-partisipan, serta telaah dokumen. Analisis data dilakukan menggunakan thematic analysis Braun & Clarke. Hasil penelitian menunjukkan bahwa ketergantungan pada air, listrik, dan mesin RO menyebabkan penghentian layanan HD secara total saat bencana, dan tidak terdapat prosedur alternatif yang baku. Ketangguhan layanan lebih banyak bergantung pada adaptasi individu tenaga kesehatan, misalnya penjadwalan ulang pasien, koordinasi informal, dan prioritas pasien risiko tinggi. Sementara itu, SOP khusus bencana, rencana kontinjensi HD, sistem rujukan darurat, dan koordinasi lintas sektor belum berjalan efektif. Penelitian menyimpulkan bahwa ketangguhan layanan HD di Indonesia masih dominan berbasis improvisasi dan belum ditopang oleh ketangguhan sistemik sebagaimana direkomendasikan WHO. Penguatan rencana kontinjensi HD, sistem informasi rujukan, dan jaringan layanan antar fasilitas diperlukan untuk mewujudkan resilience by design.References
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