Penerapan Checklist Instrumen Operasi untuk Meningkatkan Kepatuhan Perawat Melakukan Penghitungan Instrumen selama Operasi di Instalasi Kamar Bedah dan Anestesi RSUP Dr. Sardjito Yogyakarta

Retnaningsih, Khudazi Aulawi,S.Sp.,M.Kes.,MN.Sc.,Ph.D, Sutono,S.Kp.,M.Sc.,M.Kep

2022 | Skripsi | S1 ILMU KEPERAWATAN

Latar Belakang: Salah satu tugas perawat kamar operasi adalah melakukan penghitungan instrumen yang dipakai selama operasi. Ketidakpatuhan penghitungan instrumen selama operasi beresiko terjadi kehilangan instrumen, kemungkinan instrumen tertinggal di area operasi tanpa sepengetahuan tim operasi yang dapat membahayakan nyawa pasien. Tujuan Penelitian: Mengetahui pengaruh penerapan checklist instrumen operasi dalam meningkatkan kepatuhan perawat melakukan penghitungan instrumen selama operasi di Instalasi Kamar Bedah dan Anestesi RSUP Dr. Sardjito Yogyakarta. Metode: Penelitian ini menggunakan rancangan pra-pasca tes dalam satu kelompok (one-group pra-pasca test design). Populasi penelitian ini adalah semua tindakan operasi di Instalasi Kamar Bedah dan Anestesi RSUP Dr. Sardjito Yogyakarta dan perawat bedah yang berjumlah 60. Teknik pengambilan sampel menggunakan Accidental Sampling yang disesuaikan dengan kriteria inklusi dan eksklusi. Analisis data menggunakan uji univariat dan uji McNemar. Hasil: Kepatuhan perawat melakukan Surgical Safety Checklist (SSC) sebelum dan sesudah penerapan checklist instrumen operasi pelaksanaannya sudah baik pada saat (sign in), (time out), dan (sign out) seluruhnya 100% dilaksanakan, namun pada fase sign out masih ada item yang terlewat yaitu penghitungan instrumen yang dipakai selama operasi belum dilakukan secara benar dan belum konsisten. Kepatuhan perawat melakukan penghitungan instrumen selama operasi pada periode sebelum penerapan checklist instrumen operasi adalah 4 tindakan (7%) dinyatakan patuh dan 56 tindakan (93%) tidak patuh. Kepatuhan penghitungan instrumen selama operasi setelah penerapan checklist instrumen operasi meningkat menjadi 90% patuh dan 10% tidak patuh Kesimpulan:Terdapat pengaruh penerapan checklist instrumen operasi dalam meningkatkan kepatuhan perawat melakukan penghitungan instrumen selama operasi di Instalasi Kamar Bedah dan Anestesi RSUP Dr. Sardjito Yogyakarta dengan p=0,010.

Background: One of the duties of an operating room nurse is to calculate the instruments used during surgery. Non-compliance with instrument counting during surgery increases the risk of loss of instruments, and increases the possibility of instruments being left in the operating area unnoticed by the operating team which can endanger patients lives. Objectives: To determine the effect of applying a checklist of surgical instruments in increasing nurse compliance in calculating instruments during operations in the Operating Room and Anesthesia Installation of Dr. Sardjito Yogyakarta General Hospital. Methods: This study used a one-group pre-post test design. The population in this study were all operations in the Operating Room and Anesthesia Installation of Dr. Sardjito Yogyakarta General Hospital and surgical nurses totaling 60. The sampling technique used accidental sampling which was adjusted to the inclusion and exclusion criteria. Data analysis used univariate and McNemar tests with significance set as p<0.05 with 95% confidence interval. Results: Nurse compliance with the Surgical Safety Checklist in the period before and after the implementation of the operational instrument checklist was good when (sign-in), (time-out), and (sign-out) were all 100% implemented, but in the sign-out phase there were still items missed and the calculation of the instruments used during the operation was not done correctly nor consistently. Compliance of nurses performing instrument calculations during surgery in the period before the application of the operating instrument checklist involved 4 actions (7%) of compliance and 56 actions (93%) of non-compliance. Compliance with instrument counting during operation after implementing the operating instrument checklist significantly increased to 90% compliance and 10% non-adherence with p=0.010. Conclusion: There was a significant effect of applying a checklist of surgical instruments in increasing nurse compliance in calculating instruments during operations in the Operating Room and Anesthesia Installation of Dr. Sardjito Yogyakarta General Hospital.

Kata Kunci : penerapan cheklist instrumen operasi, kepatuhan perawat, perhitungan instrumen selama operasi / operating instrument checklist, nurse compliance, surgical instrument calculations