Prevention and Control of Blood Stream Infection Using the Balanced Scorecard Approach

ABSTRACT: to obtain formulation of an effective and effcient strategy to overcome blood stream infection (BSI). Methods: operational research design with qualitative and quantitative approach. The study was divided into two stages. Stage I was an operational research with problem solving approach using qualitative and quantitative method. Stage II was performed using quantitative method, a form of an interventional study on strategy implementation, which was previously established in stage I. The effective and effcient strategy for the prevention and control of infection in neonatal unit Cipto Mangunkusumo (CM) Hospital was established using Balanced Scorecard (BSC) approach, which involved several related processes. Results: the BSC strategy was proven to be effective and effcient in substantially reducing BSI from 52.31o/oo to 1.36o/oo in neonates with birth weight (BW) 1000-1499 g (p=0.025), and from 29.96o/oo to 1.66o/oo in BW 1500-1999 g (p=0.05). Gramnegative bacteria still predominated as the main cause of BSI in CMH Neonatal Unit. So far, the sources of the microorganisms were thought to be from the environment of treatment unit (tap water flter and humidifying water in the incubator). Signifcant reduction was also found in neonatal mortality rate weighing 1000-1499 g at birth, length of stay, hospitalization costs, and improved customer satisfaction. Conclusion: effective and effcient infection prevention and control using BSC approach could signifcantly reduce the rate of BSI. This approach may be applied for adult patients in intensive care unit with a wide range of adjustment.
Key words: balanced scorecard, birthweight 1000-1999 g, bloodstream infection, neonates
Author: Rinawati Rohsiswatmo, Sarah Rafka, Putri M.T. Marsubrin
Journal Code: jpkedokterangg140283

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