Author(s):
Norman Dyanto, Diana Laila Ramatillah, Baharudin Ibrahim
Email(s):
normandyanto@gmail.com , diana.ramatillah@uta45jakarta.ac.id , baharudin.ibrahim@um.edu.my
DOI:
10.52711/0974-360X.2025.00248
Address:
Norman Dyanto1*, Diana Laila Ramatillah1, Baharudin Ibrahim2
1Faculty of Pharmacy, 17 Agustus 1945 Jakarta University, Jakarta 14350, Indonesia.
2Faculty of Pharmacy, Malaya University, 50603 Kuala Lumpur, Malaysia.
*Corresponding Author
Published In:
Volume - 18,
Issue - 4,
Year - 2025
ABSTRACT:
This study aims to determine the effectiveness of clinical pathway implementation in pediatric patients with acute diarrhea with mild-moderate dehydration on clinical outcomes by measuring the length of stay at North Jakarta Education Hospital. This study is a quantitative study using a retrospective cohort case study method. The samples in this study were pediatric patients with a diagnosis of acute diarrhea with mild-moderate dehydration who were hospitalized at the North Jakarta Education Hospital for the period January-December 2020 and January-December 2021 before and after the implementation of the clinical pathway, totaling 274 patients. The results showed that there were no differences in clinical outcomes before and after the clinical pathway for pediatric patients with acute diarrhea with dehydration; 270 patients (98.5%) went home and recovered, and 4 patients (2.5%) with worsening symptoms due to comorbidities suffered. Length of stay of pediatric patients with dehydration after clinical pathway showed no difference in length of stay compared to before clinical pathway implementation. Still, there was a slight reduction in the length of stay after implementing the clinical pathway. Based on the study's results, there was increased adherence to recommended medications such as zinc and antipyretic was decreased. It can be concluded that the application of the clinical pathway in inpatient patients with acute diarrhea with dehydration has increased the effectiveness of drug use as recommended, although not significantly change in clinical outcomes due to recovery rates. The results showed a no significant decreased in the length of hospital stay after the application of the clinical pathway, although a slight trend suggests for further investigation.
Cite this article:
Norman Dyanto, Diana Laila Ramatillah, Baharudin Ibrahim. Comparison of Clinical Outcomes of Hospitalized Pediatric Patients with Acute Diarrhea before and after Implementation of Clinical Pathway in The Hospital. Research Journal of Pharmacy and Technology. 2025;18(4):1731-8. doi: 10.52711/0974-360X.2025.00248
Cite(Electronic):
Norman Dyanto, Diana Laila Ramatillah, Baharudin Ibrahim. Comparison of Clinical Outcomes of Hospitalized Pediatric Patients with Acute Diarrhea before and after Implementation of Clinical Pathway in The Hospital. Research Journal of Pharmacy and Technology. 2025;18(4):1731-8. doi: 10.52711/0974-360X.2025.00248 Available on: https://rjptonline.org/AbstractView.aspx?PID=2025-18-4-39
REFERENCES:
1. Mohammed Sabah Otaiwi, Jawad K. Tarrad, Hadi F. AL-Yasari. Prevalence of E. coli serotypes among diarrheal patients in Hilla City, Iraq. Research J. Pharm. and Tech. 2019; 12(7): 3347-3349. doi: 10.5958/0974-360X.2019.00564.X
2. Ali, Manar and Genady, E.A. and Ahmad, S. and Alam, M.S. and Khan, S.A. and Abdi, S. and Harsoliya, M.S. Anti-diarrheal activity of medicinal plant growing in Jizan province (KSA) on wistar rats. Research Journal of Pharmacy and Technology. 2014; 7: 1456-1458
3. Menkes R.I. Peraturan Pemerintah Republik Indonesia nomor 47 tahun 2021 tentang Penyelenggaraan Bidang Perumahsakitan: Kementerian Kesehatan. 2021
4. Saliha Torche, Katiba Beroual, Mohamed Zaouani, Sofiane Boujellaba. Ethnobotanical Study of Medicinal plants used for Traditional Diarrhea Treatment in North-East Algeria. Research Journal of Pharmacy and Technology. 2024; 17(2): 811-9. doi: 10.52711/0974-360X.2024.00126
5. K. Ravishankar, K. Sudharani. Comparative in-vivo Study of Laxative, Anti-diarrheoal and Anti-emetic activity of Ethanolic and Ethyl Acetate Leaf Extract of Citrus limon in Rats and Chicks. Research Journal of Pharmacy and Technology. 2021; 14(6): 3045-0. doi: 10.52711/0974-360X.2021.00532
6. Syed Sagheer Ahmed, Chandra Prakash K, Saba Tabassum, Noor Salma, Ahalya Devi K H. Antidiarrhoeal Potential of various Solvent Extracts of Achyranthes aspera against three diverse diarrhoeal animal models. Research Journal of Pharmacy and Technology. 2021; 14(8): 4173-7. doi: 10.52711/0974-360X.2021.00722
7. Bhuvana.G.,LathaVenkatesan, Lizy Sonia A. Effectiveness of Clinical Pathway for Intra Uterine Insemination. Asian J. Nur. Edu. and Research. 2012; 2(3): 126-134
8. Eczema, P. Paediatric Eczema Nurse Practitioner Clinical Practice Guidelines. Melbourne: The Royal Children’s Hospital 2007, 1–81
9. Hanny, R. dan Waldi, N. Pelayanan Kesehatan Anak di Rumah Sakit. Indonesia: WHO. 2009; 434
10. Rivany, R. Indonesia diagnosis related groups. Kesmas Natl Public Heal J. 2009; 4(1): 3. https://doi.org/10.21109/kesmas.v4i1.194
11. Rajeswari U., LathaVenkatesan, Lizy Sonia A.. Effectiveness of Clinical Pathway for Parturient Mothers upon Knowledge and Practice of Nurses and Maternal Outcome. Asian J. Nur. Edu. and Research. 2012; 2(2): 90-95
12. K. M. Sathya Devi, Latha Venkatesan, Lizy Sonia. Effectiveness of Clinical Pathway for Postnatal Mothers with Vaginal Delivery upon the Knowledge and Practice of Nurses and Maternal Outcome. Asian J. Nur. Edu. and Research. 2012; 2(3): 165-170
13. Giannattasio, A., Guarino A. and Lo Vecchio, A. Management of children with prolonged diarrhea. Pubmed. 2016: 5-206. doi: 10.12688/f1000research.7469.1.
14. Ayesha Siddiqua, Ruba Khalid Abdullah, Najla Abdul Kareem. Impact of Clinical Pharmacist Intervention towards Polypharmacy in Elderly population-A Systematic Study. Research J. Pharm. and Tech. 2019; 12(6): 2621-2627. doi: 10.5958/0974-360X.2019.00439.6
15. Wissam Zam, Reine Dawod. Overview of the Probiotics’ role in Gastrointestinal disorders. Research J. Pharm. and Tech. 2020; 13(11):5557-5561. doi: 10.5958/0974-360X.2020.00970.1
16. Nyoman N.I. dan Meriyani H. Perbandingan penggunaan antibiotik tunggal dan kombinasi pada pasien pediatrik dengan gastroenteritis akut (GEA) di RSUD Wangaya Denpasar. Jurnal Ilmiah Medicamento. 2018; 4(1): 44-48. doi: https://doi.org/10.36733/medicamento.v4i1.882
17. Tambuwun, F., Yudi A. dan Wico I.. Hubungan sanitasi lingkungan dengan kejadian diare pada anak usia sekolah di wilayah kerja puskesmas bahu manado. J Keperawatan. 2015; 3-8. doi: https://doi.org/10.35790/jkp.v3i2.8035
18. Megawati, A., Sari, Della F. Rasionalitas penggunaan antibiotik untuk pengobatan diare pada pasien anak di instalasi rawat inap RSUD RAA Soewondo Pati. Cendekia Journal of Pharmacy. 2017; 2(1) . doi: https://doi.org/10.31596/cjp.v2i1.19
19. Suhesti, E., Janah N.E. dan Zakiudin, A. Asuhan keperawatan pada An.G dengan gangguan sistem pencernaan: gastroenteritis akut (GEA) di ruang anggrek I RSUD dr. Soeselo. Jurnal Mahasiswa Ilmu Farmasi dan Kesehatan. 2023; 1(4): 249-266. doi: https://doi.org/10.59841/jumkes.v1i4.293
20. Kementerian Kesehatan R.I. Pedoman Pengendalian Demam Tifoid. Kementerian Kesehatan R.I. 2006
21. Purba I.E. and Wandra T. Typhoid Fever Control Program in Indonesia: Challenges and Opportunities. 2016
22. WGO. World Gastroenterology Organisation practice guidelines: Probiotics and prebiotics. Arab J Gastroenterol. 2009; 10: 33–42. doi:10.1016/j.ajg.2009.03.001
23. Jacobs C., Manoppo J., Warouw S. Pengaruh oralit terhadap kadar natrium dan kalium plasma pada anak diare akut dengan dehidrasi. J e-Biomedik. 2013; 11: 15460. doi: https://doi.org/10.35790/ebm.v1i1.1609
24. Pauzin, M. Evaluasi skor dehidrasi modifikasi pada penderita diare akut. JST Kesehatan. 2014; 4(3): 277–82.
25. Ikatan Dokter Anak Indonesia (IDAI). Rekomendasi Praktik Pemberian Makan Berbasis Bukti pada Bayi dan Balita di Indonesia untuk Mencegah Malnutrisi. Jakarta. 2015: IDAI
26. Siswidiasari, A.. Profil terapi obat pasien rawat inap dengan diare akut pada anak di Rumah Sakit Umum Negara. Kim. 2012; 2: 183–90. doi:https://doi.org/10.24843/JCHEM.2014.v08.i02.p07.
27. Ristiawan, D., Rusnoto dan Hartinah, D. Hubungan antara lama perawatan dan penyakit yang menyertai dengan terjadinya infeksi sosokomial di RSI Sultan Hadlirin Jepara. JIKK. 2013; 4(1): 10-15. http://e-journal.stikesmuhkudus.ac.id/index.php/karakter/article/view/85
28. Rumokoy, R. Hubungan jumlah monosit dengan lama hari rawat pada anak penderita diare akut di RSUP. R. D. Kandou Manado tahun 2014. J eClinic. 2016; 4: 6–9. doi: https://doi.org/10.35790/ecl.v4i1.10826
29. Trisnowati, K.E. Kajian penggunaan antibiotik pada pasien diare akut di bangsal rawat inap. Jurnal Manajemen dan Pelayanan Farmasi. 2017; 7(1). doi: https://doi.org/10.22146/jmpf.363
30. Gustiana, D. Analisis hubungan lamanya diare dengan tingkat dehidrasi dan penurunan berat badan anak balita di RSUD Tugurejo Semarang. Text 2014. Semarang: STIKes Telogorejo.
31. Fadilah, N.F.N., Budi S.C. Efektifitas implementasi clinical pathway terhadap average length of stay dan outcomes pasien DF-DHF anak di RSUD Kota Yogyakarta. JKesV. 2018; 2(2): 175-181. doi: https://doi.org/10.22146/jkesvo.30333
32. Rutman L., Klein E.J., Brown J.C. Clinical pathway produces sustained improvement in acute gastroenteritis care. Pediatrics. 2017; 140(4). doi: 10.1542/peds.2016-4310