Analisis Penerapan Catatan Perkembangan Pasien Terintegrasi (Cppt) Di Rumah Sakit

Analysis of the Implementation of Integrated Patient Progress Notes (CPPT) in Hospitals

Abstract

Introduction: Integrated Patient Progress Notes (CPPT) are important components of medical records that document the development of patient care comprehensively and continuously by healthcare professionals. Proper implementation of CPPT supports communication between healthcare teams, improves patient safety, and ensures the quality of hospital services. However, incomplete documentation and inconsistent implementation remain challenges in healthcare facilities. Objective: This study aimed to analyze the implementation of Integrated Patient Progress Notes (CPPT) in hospitals based on completeness, accuracy, timeliness, and compliance with documentation standards. Methods: This study used a quantitative descriptive analytical design conducted in 2023. The sample consisted of 120 medical record documents and 60 healthcare professionals involved in CPPT documentation. Data were collected using observation sheets and questionnaires related to CPPT implementation. Data were analyzed using frequency distribution and Chi-Square analysis. Results: The results showed that 72.5% of CPPT documentation was categorized as complete, while 27.5% remained incomplete. Factors associated with CPPT implementation were healthcare professional knowledge (p=0.002), workload (p=0.008), and supervision (p=0.001). Conclusion: CPPT implementation in hospitals has been carried out adequately; however, improvement is still needed, particularly in documentation completeness, supervision, and healthcare professional compliance.