Kolaborasi interprofesional (Interprofessional Collaborative/IPC) menjadi strategi untuk menjawab kebutuhan akan pelayanan kesehatan yang terpadu. Dalam terapi antibiotik, praktik IPC yang efektif dapat meningkatkan ketepatan peresepan dan penggunaan antibiotik yang berdampak pada penurunan kejadian resistensi antibiotik. Agar tercipta praktik IPC yang efektif, perlu dilakukan identifikasi permasalahan yang ada dari persepsi tenaga kesehatan yang terlibat dalam IPC. Penelitian ini bertujuan menilai persepsi tenaga kesehatan terhadap praktik IPC dalam terapi antibiotik di unit bedah ortopedi. Penelitian ini merupakan penelitian observasional dengan pendekatan cross-sectional. Persepsi tenaga kesehatan dinilai menggunakan kuesioner Collaborative Practice Assessment Tool (CPAT) yang terdiri dari 8 domain dengan total 53 item pernyataan. Penelitian melibatkan 47 responden tenaga kesehatan di unit bedah ortopedi. Hasil penelitian menunjukkan terdapat perbedaan persepsi yang signifikan antara perawat dan tenaga kefarmasian terhadap domain hambatan tim dalam kolaborasi. Pada domain kepemimpinan terdapat perbedaan yang siginifikan antara tenaga kefarmasian dan dokter. Penelitian ini menyimpulkan secara umum, tenaga kesehatan menilai praktik IPC sudah berjalan dengan baik (76,47% dari skor maksimum CPAT).Perawat menilai otonomi mereka dalam IPC masih terbatas ( 52% dari skor maksimum domain hambatan tim dalam kolaborasi), serta tenaga kefarmasian menilai masih adanya dominasi tenaga kesehatan lain dalam praktik IPC (72% dari skor maksimum domain kepemimpinan)
Clinical pathways can improve the quality of health services. The effectiveness and impact of implementing clinical pathways are controversial. The preparation of clinical pathways not only enacts therapeutic guidelines but requires mutual agreement in accordance with the roles, duties, and contributions of each profession in the team. This study aimed to investigate the perception of interprofessional collaboration practices and the impact of clinical pathway implementation on collaborative and Defined Daily Dose (DDD) prophylactic antibiotics per 100 bed-days in orthopedic surgery. The Collaborative Practice Assessment Tool (CPAT) questionnaire was used as a tool to measure healthcare’ perceptions of collaborative practice. The clinical pathway (CP) in this study was adapted from existing CPs published by the Indonesian Orthopaedic Association (Perhimpunan Dokter Spesialis Orthopaedi dan Traumatologi Indonesia, PABOI) and was commended by local domestic surgeons and orthopedic bodies. We then compared post-implementation results with pre-implementation clinical pathway data using ANCOVA to explore our categorical data and its influence towards CPAT response. ANOVA was then employed for aggregated DDD per 100 bed-days to compare pre and post intervention. The results showed that the relationships among members were associated with the working length. Six to ten years of working had a significantly better relationship among members than those who have worked one to five years. Interestingly, pharmacists’ leadership score was significantly lower than other professions. The clinical pathway implementation reduced barriers in team collaboration, improved team coordination and organization, and reduced third-generation cephalosporin use for prophylaxis in surgery (pre: 59 DDD per 100 bed-days; post: 28 DDD per 100 bed-days). This shows that the clinical pathway could benefit antibiotic stewardship in improving antibiotic prescription, therefore reducing the incidence of resistant bacteria.
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