<![CDATA[ABSTRACT Implementation of hospitality care in the Emergency Department (ED) often faces hurdles due to high workloads and patient crowding. At RSUD Awet Muda Narmada, a low complaint handling score (3.61) indicates a gap in humanistic care despite serving 14,859 patients annually. This study aims to identify and synthesize the challenges of implementing hospitality care in the ED from the perspectives of both nurses and patients through a systematic review. This systematic review followed the PRISMA protocol. A comprehensive search was conducted across PubMed, ScienceDirect, ProQuest, and Semantic Scholar databases. Eleven primary studies were included for data synthesis, and four review studies were utilized as comparative literature. Data were analyzed using thematic analysis. Implementation challenges were categorized into three main domains: 1) Structural barriers, including overcrowding and missed nursing care; 2) Psychological barriers, including diminished empathy and cognitive overload due to work interruptions; and 3) Environmental barriers, including lack of privacy and information transparency for families. Nurses primarily emphasized emotional exhaustion, whereas patients highlighted a lack of respect for dignity and physical comfort. There is a discrepancy between nursing capacity and patient expectations driven by systemic failures. The development of an Emergency Hospitality Nursing Care model must integrate systemic support for nurses to reduce cognitive load while safeguarding patients' rights to communicative and dignified care. Keywords: Emergency Department, Hospitality Care, Humanistic Caring, Nursing Management. ABSTRAK Implementasi hospitality care di Instalasi Gawat Darurat (IGD) sering kali terbentur oleh tingginya beban kerja dan kepadatan pasien. Di RSUD Awet Muda Narmada, rendahnya skor penanganan pengaduan (3,61) mengindikasikan adanya kesenjangan dalam asuhan humanistik meskipun volume kunjungan mencapai 14.859 pasien per tahun. Penelitian ini bertujuan untuk mengidentifikasi dan mensintesis tantangan implementasi hospitality care di IGD dari perspektif perawat dan pasien melalui tinjauan sistematis. Tinjauan sistematis ini mengikuti protokol PRISMA dengan pencarian pada database PubMed, ScienceDirect, ProQuest, dan Semantic Scholar. Sebanyak 11 studi primer diinklusi untuk sintesis hasil, sementara 4 studi tinjauan digunakan sebagai literatur pembanding. Analisis data menggunakan teknik analisis tematik. Tantangan implementasi dikelompokkan ke dalam tiga domain utama: 1) Hambatan struktural mencakup overcrowding dan missed nursing care; 2) Hambatan psikologis meliputi penurunan empati dan beban kognitif perawat akibat interupsi kerja; serta 3) Hambatan lingkungan berupa minimnya privasi dan transparansi informasi bagi keluarga. Dari perspektif perawat, hambatan utama adalah kelelahan emosional, sedangkan pasien lebih menyoroti kurangnya penghargaan terhadap martabat dan kenyamanan fisik. Terdapat diskrepansi antara kapasitas perawat dan harapan pasien yang dipicu oleh kegagalan sistemik. Pengembangan model Emergency Hospitality Nursing Care harus mengintegrasikan dukungan sistem bagi perawat untuk mengurangi beban kognitif sekaligus menjamin hak pasien atas asuhan yang komunikatif dan bermartabat. Kata Kunci: Emergency Department, Hospitality Care, Humanistic Caring, Nursing Management.]]>
