UNISMUH PALUUNISMUH PALU

Journal of Public Health and PharmacyJournal of Public Health and Pharmacy

The government targets a significant reduction in antibiotic resistance by 2030 through wise antibiotic management, including implementing the Clinical Decision Support System (CDSS) for Health Providers in Non-Pneumonia acute respiratory infections (ISPA) and Non-specific Diarrhea in Primary Healthcare Centre (Puskesmas). However, the readiness and acceptance of Health Providers to CDSS need to be evaluated. This study evaluates the readiness and acceptance of doctors, nurses, midwives, pharmacists, and pharmacists assistants in Puskesmas using CDSS. The method used was a cross-sectional quantitative survey with snowball sampling of 185 respondents at the Probolinggo Puskesmas in July-August 2024. The questionnaire was developed based on a combination of the Technology Readiness Index and the Technology Acceptance Model (TRAM), and the data was analyzed using SEM-PLS (Structural Equation Modeling-Partial Least Squares). This study revealed that optimism contributed positively to the perception of ease of use (PEOU) and perception of benefits (PU) of CDSS. Innovation also contributed positively to PEOU, but not significantly to PU. Optimism increases PEOU and PU, while innovation only increases PEOU. Although innovation is insignificant to PU, it has a more significant impact on PEOU than optimism. These findings also show that PU affects the attitude of Health Providers to use CDSS (β = 0.286, p < 0.001) but does not directly affect behavioral intentions (β = 0.081, p = 0.250). PEOU significantly affected PU (β = 0.617, p < 0.001) and attitude (β = 0.661, p < 0.001). Attitudes towards CDSS greatly influenced the behavioral intentions of healthcare providers to use it (β = 0.851, p < 0.001), making it a strong predictor of CDSS adoption. The integration of TRI and TAM in predicting the readiness of Health Providers has proven helpful in understanding the factors of CDSS adoption in Puskesmas. These findings highlight the importance of training for health providers to improve CDSS readiness and acceptance. In addition, the results of this study can be the basis for policy development in implementing CDSS Primary Healthcare Centers to support a more rational use of antibiotics.

This study concluded that Health Providers at the Probolinggo Primary Healthcare Centers showed readiness and positive acceptance of CDSS.The study highlights the importance of providing training and technical support to enhance healthcare providers confidence in using CDSS and ensure seamless integration with existing digital systems.Overall, with the proper adjustments and support, CDSS has the potential to be an essential tool in improving the quality of primary health care and assisting in more rational antibiotic management.

Berdasarkan hasil penelitian ini, terdapat beberapa saran penelitian lanjutan yang dapat dilakukan untuk memperdalam pemahaman mengenai adopsi CDSS di fasilitas kesehatan primer. Pertama, penelitian lebih lanjut perlu dilakukan untuk mengidentifikasi faktor-faktor kontekstual spesifik, seperti infrastruktur teknologi yang tersedia dan budaya organisasi di puskesmas, yang dapat memengaruhi efektivitas implementasi CDSS. Kedua, studi kualitatif dapat dilakukan untuk menggali lebih dalam persepsi dan pengalaman para tenaga kesehatan dalam menggunakan CDSS, termasuk tantangan dan manfaat yang mereka rasakan secara langsung. Ketiga, penelitian intervensi yang melibatkan pengembangan dan pengujian strategi implementasi CDSS yang disesuaikan dengan kebutuhan dan karakteristik lokal dapat dilakukan untuk meningkatkan adopsi dan penggunaan CDSS secara berkelanjutan. Penelitian ini dapat mencakup pelatihan yang lebih intensif, penyediaan dukungan teknis yang memadai, dan pengembangan antarmuka pengguna yang lebih intuitif dan mudah digunakan. Dengan demikian, hasil penelitian ini dapat memberikan kontribusi yang signifikan dalam upaya meningkatkan kualitas pelayanan kesehatan dan mengurangi resistensi antibiotik di Indonesia.

  1. Barriers and facilitators to the uptake of an antimicrobial stewardship program in primary care: A qualitative... journals.plos.org/plosone/article?id=10.1371/journal.pone.0223822Barriers and facilitators to the uptake of an antimicrobial stewardship program in primary care A qualitative journals plos plosone article id 10 1371 journal pone 0223822
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