Pengembangan Instrumen Pengelolaan seragam Perawat Mencegah Kolonisasi Bakteri Patogen

NI MADE ADI SUASTI, Dr. dr. Hera Nirwati, M. Kes., Sp.MK ; Khudazi Aulawi, S.Kp., M. Kes., MN.Sc., Ph. D

2020 | Tesis | MAGISTER KEPERAWATAN

INTISARI Latar belakang: Health care associated infections (HAIs) atau infeksi nosokomial merupakan infeksi yang terjadi di rumah sakit dan fasilitas kesehatan lainnya, dimana penyebab yang paling sering adalah bakteri patogen. Seragam perawat dapat menyimpan dan mentransfer bakteri sebagai sumber HAIs, sehingga pengelolaan seragam perawat terkait hal tersebut menjadi sangat penting. Di Indonesia belum ditemukan instrumen untuk mengukur pengelolaan seragam perawat terkait dengan kolonisasi bakteri. Oleh karena itu, diperlukan pengembangan instrumen pengelolaan seragam perawat beserta uji validitas dan reliabilitasnya agar diperoleh alat ukur yang baik. Tujuan: mengembangkan Instrumen Pengelolaan Seragam Perawat Mencegah Kolonisasi Bakteri Patogen, serta melakukan uji validitas dan reliabilitas, di Ruang Bedah dan Ruang Perawatan Penyakit Dalam Rumah Sakit Akademik UGM dan 21 rumah sakit lain di Pulau Jawa dan Bali Metode: Penelitian ini merupakan penelitian pengembangan instrumen berupa kuesioner Pengelolaan Seragam Perawat Mencegah Transmisi Bakteri, berisikan 5 item pergantian seragam, 2 item model seragam dan 4 item kebiasaan perawat mencuci seragam. Proses validitas isi dilakukan oleh 3 orang pakar. Uji coba instrumen melibatkan 7 orang responden di RSA UGM dan RSUD Wangaya Denpasar, sedangkan uji validitas konstrak dan reliabilitas instrumen dilakukan pada 233 subyek penelitian yang merupakan perawat di Ruang Bedah dan Penyakit Dalam Rumah Sakit Akademik UGM, serta 21 rumah sakit lainnya di pulau Jawa dan Bali. Subyek memberikan jawaban pada kuesioner, dan datanya dianalisis menggunakan SPSS versi 23. Hasil: Instrumen pengelolaan seragam perawat dikembangkan melalui beberapa langkah yaitu: literatur review, uji validitas isi, uji coba instrumen, uji validitas konstruk dan uji reliabilitas. Instrumen pengelolaan seragam yang dikembangkan dinyatakan valid dan relevan dari segi konsep berdasarkan penilaian pakar, dengan nilai CVI 1 (11 item). Tidak ada item yang dihilangkan, namun ada beberapa perubahan pada redaksi kalimat. Uji validitas konstrak dengan korelasi product moment didapatkan rentang nilai yaitu 0,335 - 0,645 dengan nilai kritik tabel 0,129 dalam taraf signifikansi < 0,05 sehingga instrumen dikatakan valid. Pada uji konstruk dengan analisis faktor didapatkan nilai KMO dan Bartlett�s test > 0,5 yaitu 0,628, dan p < 0,05 serta nilai anti-image correlation tiap item > 0,5 menunjukkan bahwa tiap item memiliki korelasi yang baik, sehingga dapat dilakukan analisis faktor. Pada analisis faktor didapatkan 3 komponen yang memiliki nilai eigenvalue > 1 dengan total varian kumulatif sebesar 53%. Tiga faktor atau konstruk yang terbentuk yaitu pergantian seragam 5 item, model seragam 2 item, dan cara perawat mencuci seragam 4 item. Kuesioner dinyatakan reliabel dengan nilai Cronbach alpha 0,657 dalam tingkat keandalan 0,6. Kesimpulan: Instrumen pengelolaan seragam perawat dinyatakan valid dan reliabel, sehingga dapat dipergunakan untuk mengukur pengelolaan seragam perawat hubungannya dengan kolonisasi bakteri patogen.

ABSTRACT Background: Healthcare-associated infections (HAIs) or nosocomial infections are infections that occur in hospitals and other health facilities, where the most common cause is pathogenic bacteria. Nurse uniforms can store and transfer bacteria as a source of HAIs, so the management of nurse uniforms in relation to this is very important. In Indonesia, no instrument has been found to measure the management of nurse uniforms related to bacterial colonization. Therefore, it is necessary to develop a nurse uniform management instrument and test its validity and reliability in order to obtain a good measuring instrument. Objective: To develop a nurses uniform management instrument prevent the colonization of pathogenic bacteria, as well as to test the validity and reliability in the Surgical Room and Internal Medicine Room at the UGM Academic Hospital and 21 other hospitals in Java and Bali. Methods: This research is an instrument of development research in form of a questionnaire for Nurse Uniform Management to Prevent Colonitation of Bacteria, containing 5 items of uniform change, 2 items of uniform models, and 4 items of habits of nurses washing uniforms. The process of content validation was carried out by 3 experts. The instrument trial involved 7 respondents at RSA UGM and RSUD Wangaya Denpasar, while the test of construct validity and instrument reliability was carried out on 233 research subjects who were nurses in the Surgery and Internal Medicine Room at UGM Academic Hospital, as well as 21 other hospitals on the island of Java and Bali. Subjects gave answers to the questionnaire, and the data were analyzed using SPSS version 23. Results: The nurse uniform management instrument was developed through several steps, namely: literature review, content validity test, instrument test, construct validity test, and reliability test. The uniform management instrument developed was declared valid and relevant from a conceptual perspective based on expert judgment, with a CVI value of 1 (11 items). There are no items that have been omitted, but there are some changes to the editorial of the sentence. The validity test of the construct with the correlation product-moment obtained a value range of 0.335 - 0.645 with a table critical value of 0.129 in the significance level <0.05, so the instrument was said to be valid. In the constructed test with factor analysis, the KMO and values were obtained Bartlett's test > 0.5, namely 0.628, and p <0.05 and the anti-image correlation value of each item> 0.5 indicated that each item had a good correlation so that analysis could be carried out. In the factor analysis, 3 components have an eigenvalue >1 with a total variance of 53%. Three factors or constructs are formed, namely the change of uniform 5 items, 2 items model of uniform, and the way the nurse washes of uniform 4 items. The questionnaire was declared reliable with a value of Cronbach alpha 0.657 at a reliability level of 0.6. Conclusion: The nurse uniform management instrument is declared valid and reliable so that it can be used to measure the nurse's uniform management in relation to the colonization of pathogenic bacteria.

Kata Kunci : bakteri patogen; pengelolaan seragam perawat; validitas dan reliabilitas, pathogenic bacteria; nurse uniform management; validity and reliability