EVALUASI SKALA NYERI DAN WAKTU TUNGGU PELAYANAN PASIEN RAWAT JALAN DENGAN PENDEKATAN FAST-TRACK MANAJEMEN NYERI AKUT PASCAOPERASI

Abstract

ABSTRACT

Outpatient services play an important role in monitoring patients after surgical procedures and managing acute pain. The Fast-Track Acute Pain Management protocol includes initial pain screening and assessment, prompt administration of analgesic interventions, monitoring of pain responses, and evaluation before discharge. This study aimed to analyze differences in Numeric Rating Scale (NRS) scores and waiting times between patients managed using the Fast-Track protocol and those receiving conventional care in the outpatient department of a private hospital in Bumiayu. An analytical observational study with a retrospective cohort design based on medical record audits was conducted. A total of 40 patients with post-procedural pain or pain following minor to moderate surgery were selected using total sampling and divided into a Fast-Track group (n = 20) and a conventional care group (n = 20). NRS scores were assessed at arrival (T0), 30 minutes after intervention (T1), and before discharge (T2). Data were analyzed using the Mann–Whitney U and Friedman tests. The results showed that NRS scores were lower in the Fast-Track group than in the conventional care group at T1 [3 (IQR 2–4) vs. 5 (IQR 4–6); p < 0.001] and T2 [1 (IQR 1–2) vs. 3 (IQR 2–4); p < 0.001]. Waiting time was also shorter in the Fast-Track group (18.5 ± 4.2 minutes vs. 42.1 ± 8.6 minutes; p < 0.001). The Friedman test demonstrated a significant decrease in NRS scores over time in both groups (p < 0.001). The Fast-Track protocol was associated with lower NRS scores and shorter waiting times than conventional care.

ABSTRAK

Instalasi rawat jalan berperan penting dalam pemantauan pasien pascatindakan bedah dan penanganan nyeri akut. Protokol Fast-Track Manajemen Nyeri Akut mencakup skrining dan penilaian nyeri awal, pemberian intervensi analgesik secara cepat, pemantauan respons, serta evaluasi sebelum pasien dipulangkan. Penelitian ini bertujuan menganalisis perbedaan skor Numeric Rating Scale (NRS) dan waktu tunggu pelayanan antara pasien yang mengikuti protokol Fast-Track dan pasien dengan alur pelayanan konvensional di Instalasi Rawat Jalan RS Swasta di Bumiayu. Penelitian menggunakan desain observasional analitik dengan pendekatan kohort retrospektif berbasis audit rekam medis. Sampel diperoleh melalui total sampling dan terdiri atas 40 pasien dengan keluhan nyeri pascatindakan atau operasi minor hingga sedang, yaitu 20 pasien kelompok Fast-Track dan 20 pasien kelompok konvensional. Skor NRS dievaluasi saat kedatangan (T0), 30 menit setelah intervensi (T1), dan sebelum pasien pulang (T2). Analisis menggunakan uji Mann-Whitney U dan Friedman. Hasil menunjukkan skor NRS kelompok Fast-Track lebih rendah dibandingkan kelompok konvensional pada T1 [3 (IQR 2–4) vs. 5 (IQR 4–6); p < 0,001] dan T2 [1 (IQR 1–2) vs. 3 (IQR 2–4); p < 0,001]. Waktu tunggu juga lebih singkat pada kelompok Fast-Track (18,5 ± 4,2 menit vs. 42,1 ± 8,6 menit; p < 0,001). Uji Friedman menunjukkan penurunan skor NRS yang signifikan pada kedua kelompok (p < 0,001). Protokol Fast-Track dikaitkan dengan skor NRS yang lebih rendah dan waktu tunggu pelayanan yang lebih singkat dibandingkan alur konvensional.