PELAKSANAAN STANDARD PRECAUTIONS OLEH PERAWAT DI RSUD BANGKA TENGAH

MANTO, Widyawati, SKp, M.Kes, Ph.D.; Christantie Effendy, SKp, M.Kes, Ph.D

2018 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang : Infeksi terkait layanan kesehatan (HAIs) merupakan masalah utama kesehatan global, yang menyebabkan jutaan pasien di seluruh dunia setiap tahunnya. HAIs memiliki implikasi serius bagi pasien dan sistem pelayanan kesehatan. Untuk mengatasi permasalahan tersebut upaya pencegahan dan pengendalian infeksi memainkan peran yang sangat penting. Salah satu strategi pencegahan dan pengendalian HAIs di rumah sakit adalah dengan penerapan Standard Precautions (SP) untuk memutus rantai penularan. Meskipun SP merupakan komponen inti dalam pencegahan HAIs namun secara universal kepatuhan pelaksanaanya oleh petugas kesehatan khususnya perawat masih suboptimal. Tujuan : Untuk mengeksplorasi gambaran pelaksanaan standard precautions oleh perawat. Metode : Penelitian kuantitatif dengan rancangan deskriptif. Penelitian dilakukan di RSUD Bangka Tengah. Jumlah sampel sebanyak 50 orang perawat. Penelitian dilaksanakan bulan April-Mei 2018. Alat ukur penelitian ini adalah kuesioner terstruktur dan lembar observasi. Cara pengambilan sampel dengan teknik sampling total. Data dianalisis menggunakan uji statistik deskriptif. Hasil : Gambaran pelaksanaan standard precautions (SP) di RSUD Bangka Tengah adalah pengetahuan SP dalam kategori cukup (68%) meliputi ruangan asoka (82%), flamboyan (69%), tulip (50%) dan strawbery (75%). Hambatan SP dalam kategori tinggi (56%) pada ruangan tulip (64%). Ketersedian fasilitas SP dalam kategori lengkap (52%) pada ruangan tulip (100%) dan strawbery (100%). Iklim keselamatan dalam kategori kurang baik (56%) pada ruangan asoka (73%) dan flamboyan (62%). Kepatuhan SP dalam kategori tidak patuh (64%) pada ruangan asoka (55%), tulip (79%), dan strawbery (75%). Gambaran komponen kegiatan SP meliputi tidak mencuci tangan sebelum kontak pasien (70%), salah mencuci tangan setelah kontak pasien (98%), perawat memakai cincin saat bekerja (60%), tidak merendam peralatan bekas pakai (100%), salah melakukan disinfeksi tingkat rendah (70%), melakukan recapping (74%), tidak menyarung jarum suntik dengan satu tangan (76%), dan penggunaan cairan pelarut untuk lebih dari 1 pasien (100%). Kesimpulan : Gambaran pelaksanaan SP di RSUD Bangka Tengah adalah pengetahuan kategori cukup, hambatan kategori tinggi, ketersedian fasilitas kategori lengkap, iklim keselamatan kategori kurang baik, dan kepatuhan SP dalam kategori tidak patuh.

Background: Healthcare Associated Infection (HAIs) is a major global health problem, which causes millions of patients in the world each year. HAIs has serious implications for patients and health care systems. To solve these problems, infection prevention and control plays a very important role. One of the strategies of HAIs prevention and control in hospitals is applying Standard Precautions (SP) to break the transmission chain. Although SP is a core component in the HAIs prevention however its universal implementation by health workers, especially nurses are suboptimal. Objective: To explore the description of the implementation of standard precautions by nurses. Method: This study was quantitative research with descriptive research design. This study was conducted at Bangka Tengah Hospital. Of the 50 nurses included as sample study. Study was conducted from April to May 2018. Study instrument was structured questionnaire and observation sheet. Total sampling method was used to collect sample. Data were analyzed with descriptive statistical test. Result: Description of standard precautions (SP) implementation in Bangka Tengah hospital consist of SP knowledge was fair category (68%) for Asoka room (82%), Flamboyant (69%), Tulip room (50%) and Strawbery room (75%). Then, obstacles of SP was in high category (56%) in the Tulip room (64%). While, availability of SP facilities was complete category (52%) for Tulip (100%) and Strawbery (100%) room. Insufficient safety climate (56%) were in Asoka (73%) and Flamboyant (62%) room. SP compliance for non-compliant category (64%) were in Asoka (55%), Tulips (79%), and Strawbery (75%) room. In addition, description of SP activity components were including unwashed hands before patient contact (70%), wrong hand washing after patient contact (98%), nurses weared ring while working (60%), did not soaked a used equipment (100%), wrong conducted low level disinfection (70%), recapping (74%), did not syringe by one hand (76%), and used solvent fluid for more than 1 patient (100%). Conclusion: Description of SP implementation in Bangka Tengah Hospital was including knowledge in moderate level, obstacle was high, availability of complete was complete, safety climate was poor, and SP compliance was not obey catagory.

Kata Kunci : Standar Precautions, Kepatuhan Standar Precautions, Faktor yang Mempengaruhi Kepatuhan Standar Precaution, Standard Precautions, Compliance with Standar Precautions,Factors influencing nurses compliance with standard precautions