ANALISIS PENERAPAN KEBIJAKAN PENGGUNAAN ALAT PELINDUNG DIRI PADA TENAGA KESEHATAN DI RUANG INSTALASI GAWAT DARURAT RSU SOE

TAUFIK ABDULLAH, dr. Agus Surono M.Sc., Ph.D.,Sp.T.H.T.K.L(K)

2018 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Tenaga kesehatan, baik dokter maupun perawat yang bekerja di Instalasi Gawat Darurat (IGD) memiliki resiko tinggi tertular penyakit karena menangani pasien yang belum diketahui riwayat penyakitnya. Tindakan pencegahan melalui penggunaan Alat Pelindung Diri (APD) selama melakukan tindakan pada pasien dapat meminimalisir risiko penularan penyakit pada semua petugas kesehatan. Tujuan Penelitian: Untuk mengkaji penerapan kebijakan penggunaan APD pada tenaga kesehatan di ruang IGD RSU Soe. Metode Penelitian: Penelitian ini merupakan penelitian kualitatif dengan pendekatan studi kasus. Informan utama dalam penelitian ini terdiri dari 6 perawat dan 2 dokter. Keabsahan data menggunakan triangulasi, observasi dan telaah dokumen. Analisis data menggunakan model Creswell. Hasil: Komunikasi kebijakan APD dilakukan secara langsung oleh Komite PPI dan Penanggung Jawab K3 melalui sosialisasi, simulasi dan demosntrasi. Namun sosialisasi tidak dilaksanakan secara rutin. Isi kebijakan penggunaan APD sudah jelas dan konsisten. Sumber daya manusia (SDM) masih kurang dalam kuntitas dan kualitas. Tidak tersedia poster dan banner penggunaan APD di ruang IGD. Belum ada informasi mengenai data pelaporan dan pencatatan penyakit dan kecelakaan akibat kerja. Kewenangan yang diberikan kepada pelaksana kebijakan sudah cukup. Fasilitas APD belum lengkap. Sikap pelaksana kebijakan APD sangat mendukung. Belum terdapat Standar Prosedur Operasional (SPO) APD di ruang IGD. Pembagian tanggung jawab untuk menjalankan kebijakan penggunaan APD sudah jelas akan tetapi masih kurang dalam koordinasi. Kesimpulan: Hambatan penerapan kebijakan penggunaan APD yaitu komunikasi kebijakan yang tidak rutin disosialisasikan, kurangnya kualitas dan kuantitas SDM, fasilitas APD yang kurang dan tidak sesuai standar, dan SPO penggunaan APD yang belum didistribusikan ke ruang IGD dapat menpengaruhi penerapan kebijakan penggunaan APD. Diperlukan kerja sama antara pihak PPI da manajemen dalam meningkatkan keselamatan dan kesehatan kerja pada perawat dan dokter di ruang IGD.

Background: Health workers, both doctors and nurses, who are working in the emergency room, have a high risk of contracting a disease because they are dealing with an unknown patient with a history of a disease. Precautions through the use of Personal Protective Equipment (PPE) during the course of an action in patients can minimize the risk of disease transmission in all the health workers. Purpose: To examine the policy implementation of the use of PPE on the health workers in the Emergency Room (ER) of Soe Public Hospital. Methods: This study was a qualitative research with observational case study approach. The main informants in this study consisted of six nurses and two doctors. The validity of data used triangulation, observation, and document review. The data analysis used Creswell model. Results: The implementation of the policy of PPE had been socialized, simulated, and demonstrated. But, the socialization was not performed routinely. The content of the policy had been communicated clearly and consistently. The human resources were still inadequate in quantity and quality. No available posters and banners were found on the use of PPE in emergency rooms. No information was obtained regarding the report and record of occupational diseases and accidents. The empowerment given to the policy implementers was sufficient. The PPE facilities had not been completed yet. The attitude of the workers was supportive in implementing the policy of PPE. No available Standard Operating Procedure (SOP) of PPE was found in the emergency room. The division of the responsibility to carry out the policy of the use of PPE was obvious but still inappropriate in coordination. Conclusions: a number of hindrances in implementing the policy of the use of PPE was found, namely; the communication of the policy which was nonroutinely socialized, the lack of quality and quantity of human resources, the lack of PPE facilities and unsuitable standards, and the SOP of the use of PPE which had not been distributed to the ER that potentially can affect the implementation of PPE policy. The cooperation between the IPC committee and the management of the hospital is required in order to enhance the occupational safety and health of nurses and doctors in the ER.

Kata Kunci : kebijakan alat pelindung diri (APD), tenaga kesehatan, instalasi gawat darurat, personal protective equipment (PPE) policy, health workers, emergency room (ER)