Budaya Keselamatan Pasien dan Fenomena Underreporting Insiden Keselamatan Pasien di Rumah Sakit: Suatu Systematic Literature Review tentang Peran Just Culture, Dukungan Manajemen, dan Respons Nonpunitif
DOI:
https://doi.org/10.31933/ejpp.v6i2.1447Keywords:
Budaya Keselamatan Pasien, Just Culture, Underreporting, Pelaporan Insiden Keselamatan Pasien, Dukungan Manajemen, Respons Nonpunitif, Systematic Literature ReviewAbstract
Fenomena underreporting insiden keselamatan pasien masih menjadi tantangan utama dalam sistem keselamatan pasien di berbagai fasilitas pelayanan kesehatan. Rendahnya pelaporan insiden tidak hanya menunjukkan hambatan teknis, tetapi mencerminkan lemahnya budaya organisasi yang mendukung keterbukaan dan pembelajaran dari kesalahan. Menganalisis peran budaya keselamatan pasien, khususnya just culture, dukungan manajemen, dan respons nonpunitif dalam mengatasi fenomena underreporting insiden keselamatan pasien di rumah sakit melalui tinjauan literatur sistematis. Penelitian ini menggunakan desain Systematic Literature Review (SLR) dengan panduan PRISMA 2020. Pencarian literatur dilakukan pada lima basis data (Scopus, PubMed, ScienceDirect, Scite, Google Scholar) menggunakan kombinasi kata kunci terstruktur. Dari 500 artikel teridentifikasi, sebanyak 27 artikel memenuhi seluruh kriteria inklusi dan dianalisis menggunakan pendekatan sintesis naratif. Hasil sintesis menunjukkan bahwa just culture, dukungan manajemen, dan respons nonpunitif merupakan determinan organisasi yang secara sinergis berkontribusi dalam meningkatkan pelaporan insiden dan mengurangi fenomena underreporting. Penerapan just culture membangun persepsi keadilan dan keamanan psikologis; dukungan manajemen memperkuat komitmen organisasi; dan respons nonpunitif menghapus ketakutan tenaga kesehatan terhadap sanksi sebagai hambatan utama pelaporan. Upaya mengatasi underreporting memerlukan pendekatan sistemik yang mengintegrasikan transformasi budaya organisasi. Rumah sakit perlu mengembangkan kebijakan yang mendukung just culture, memperkuat komitmen pimpinan, dan menjamin bahwa pelaporan insiden dipandang sebagai sarana pembelajaran, bukan sebagai dasar pemberian sanksi.
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