Penerapan protokol persiapan pasien dalam pemeriksaan CT abdomen pada kasus susp. ca gaster

Abstract

Background: Gastric cancer (Ca Gaster) is one of the leading causes of cancer-related mortality worldwide, with an increasing incidence trend in Indonesia. Abdominal CT examination plays a crucial role in establishing diagnosis and determining disease staging; however, image quality is highly dependent on the optimal implementation of patient preparation protocols.

Purpose: To evaluate the implementation of patient preparation protocols in abdominal CT examinations for gastric cancer cases at Bhayangkara Hospital Palembang, focusing on identifying barriers, assessing compliance with Standard Operating Procedures (SOP), and examining their impact on diagnostic image quality.

Method: The abdominal CT examination was conducted on January 24, 2025, at the Radiology Department of Bhayangkara Hospital Palembang, involving radiologists and radiographers selected through purposive sampling. The research object encompassed all stages of patient preparation in abdominal CT examinations for gastric cancer cases. Using a descriptive qualitative phenomenological approach, data were collected through semi-structured interviews, observations, and document analysis, then analyzed using the Miles and Huberman model. Validation was performed through source and method triangulation as well as member checking with informants.

Results: The implementation of patient preparation protocols included essential stages such as fasting, administration of contrast media, patient education, and body positioning. In practice, these were hindered by limited educational resources, technical equipment issues, and suboptimal inter-staff communication, which potentially reduced diagnostic image quality and increased the workload of healthcare personnel.

Conclusion: Patient preparation protocols were carried out in accordance with SOP guidelines through fasting, contrast administration, education, and body positioning. Nevertheless, limitations in educational media, technical equipment disturbances, and inadequate interprofessional communication remain challenges, potentially compromising diagnostic image quality. These findings emphasize the need for synergy between technical and humanistic aspects as the foundation for developing strategies to enhance patient education, strengthen cross-professional communication, and improve supporting facilities to reinforce the quality of radiology services.

Suggestion: Enhancing patient education with interactive visual media, strengthening cross-professional communication through digital systems, and providing adequate technical facilities are required. Periodic evaluation of SOPs and the development of digital technology-based approaches are expected to support adaptive, effective, and patient-safety-oriented radiology protocols.

Keywords: Abdominal CT; Education; Gastric cancer; Image quality; Patient preparation protocol

Pendahuluan: Kanker lambung (Ca gaster) merupakan salah satu penyebab utama kematian akibat penyakit kanker di dunia, dengan tren kejadian yang terus meningkat di Indonesia. Pemeriksaan CT abdomen berperan penting dalam menegakkan diagnosis dan menentukan stadium penyakit, namun kualitas citra sangat bergantung pada penerapan protokol persiapan pasien yang optimal.

Tujuan: Mengevaluasi penerapan protokol persiapan pasien pada pemeriksaan CT abdomen untuk kasus kanker lambung di RS Bhayangkara Palembang, dengan fokus pada identifikasi hambatan, tingkat kesesuaian terhadap Standar Operasional Prosedur (SOP), serta dampaknya terhadap kualitas citra diagnostik.

Metode: Pelaksanaan CT abdomen pada 24 Januari 2025 di Instalasi Radiologi RS Bhayangkara Palembang dengan partisipan radiolog dan radiografer yang dipilih melalui purposive sampling. Objek penelitian mencakup seluruh tahapan persiapan pasien pada pemeriksaan CT abdomen untuk kasus kanker lambung. Menggunakan pendekatan kualitatif deskriptif fenomenologis, data dikumpulkan melalui semi-structured interview, observasi, dan analisis dokumen, kemudian dianalisis dengan model Miles dan Huberman serta divalidasi melalui triangulasi sumber dan metode serta member check kepada informan.

Hasil: Penerapan protokol persiapan pasien mencakup tahapan penting seperti puasa, pemberian media kontras, edukasi, dan pengaturan posisi tubuh. Pada pelaksanaannya terkendala oleh keterbatasan sarana edukasi, gangguan teknis peralatan, serta komunikasi antarpetugas yang belum optimal, yang berpotensi menurunkan kualitas citra diagnostik dan meningkatkan beban kerja tenaga kesehatan.

Simpulan: Penerapan protokol persiapan pasien telah dilakukan sesuai pedoman SOP melalui tahapan puasa, pemberian kontras, edukasi, dan pengaturan posisi tubuh. Namun, keterbatasan media edukasi, gangguan teknis peralatan, serta komunikasi antar tim medis yang belum optimal masih menjadi kendala, sehingga berpotensi menurunkan kualitas citra diagnostik. Temuan ini menegaskan perlunya sinergi aspek teknis dan humanistik sebagai dasar pengembangan strategi peningkatan edukasi pasien, komunikasi lintas profesi, serta fasilitas pendukung untuk memperkuat mutu layanan radiologi.

Saran: Perlunya peningkatan edukasi pasien dengan media visual interaktif, penguatan komunikasi lintas profesi berbasis sistem digital, serta penyediaan fasilitas teknis yang memadai. Evaluasi berkala terhadap SOP dan pengembangan pendekatan berbasis teknologi digital diharapkan mendukung protokol radiologi yang adaptif, efektif, dan berorientasi pada keselamatan pasien.