Abstract :

Clinical pathway (CP) is one of the requirements required in hospital accreditation standards. It has an important role in controlling quality, and costs and supporting patient safety, especially in cases that have the potential to consume large amounts of resources, one of which is a sectio cesarean (SC). Apart from being able to reduce maternal mortality due to normal childbirth, SC procedures can also cause post-operative injuries. This research explores the barriers and challenges to implementing the sectio caesarean clinical pathway among health workers in hospitals. This qualitative case study research recruited 10 informants consisting of 3 obstetricians, 2 executive nurses, the head of the inpatient room, the head of the operating room, the deputy director of medical services, and 2 patients who had undergone SC at the hospital purposively. In-depth interviews were conducted in March 2024 at a private hospital in Bandar Lampung, Indonesia. Thematic analysis was used for data analysis. Several themes emerged as obstacles to the implementation of CP SC in this research, namely: 1) individuals, 2) patients, 3) infrastructure, and 4) hospital management support. Apart from that, the challenges faced include the need to carry out socialization, monitoring, and evaluation activities, as well as collaborative activities between health workers and hospitals to share experiences to increase compliance in implementing CP SC. Hospital management is expected to provide regular outreach, training, and personal approaches to health workers regarding the implementation of CP SC. Collaboration between professionals and hospitals is also needed to share experiences regarding the implementation of sectio caesarean clinical pathways in hospitals.

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Keywords :

Challenges, Clinical pathway, health workers, hospital, sectio caesarea.

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