Evaluasi efektivitas pelaksanaan Kepmenkes RI No. 1204/Menkes/Sk/X/2004 tantang Kesehatan Lingkungan Rumah Sakit di RSUD Jayapura
SUBROTO, Kingkin Wahyudi Eko, Ir. Darmanto, Dipl.PH, M.Sc
2009 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang: Rumah Sakit Umum Daerah (RSUD) Jayapura adalah rumah sakit terbesar di Papua dan sebagai rumah sakit rujukan, pelatihan serta pendidikan. Namun kondisi kesehatan lingkungan di RSUD Jayapura saat ini masih perlu mendapat perhatian. Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui bagaimana efektivitas pelaksanaan KepMenkes RI Nomor 1204/ Menkes/SK/X/ 2004 tentang Kesehatan Lingkungan Rumah Sakit dan mengetahui faktor-faktor apa saja yang menjadi kendala efektivitas pelaksanaannya. Metode: Penelitian ini menggunakan metode deskriptif dan rancangan penelitian studi kasus dengan pendekatan kualitatif-kuantitatif. Lokasi penelitian dilaksanakan di RSUD Jayapura. Subyek penelitian melibatkan Manajemen RSUD, Dinas Kesehatan, Dinas Kebersihan dan Bapeldalda Provinsi Papua serta Pasien dan Pengunjung RSUD Jayapura. Hasil: Hasil uji laboratorium menunjukkan bahwa parameter penyehatan air melampaui baku mutu yang dipersyaratkan, sedangkan hasil uji statistik menunjukkan bahwa ada tiga variabel yaitu kesehatan lingkungan, penyehatan air dan penyuluhan kesehatan lingkungan, nilai thitungnya (1,092, 0,269, 0,783) lebih rendah dari t-tabel (2,037) yang berarti tidak ada perbedaan signifikan. Sementara dari hasil penilaian berdasarkan Pedoman Penilaian KepMenKes menunjukkan perhitungan skor maksimal adalah 68,5% di bawah ketentuan standar persyaratan kesehatan lingkungan rumah sakit sebesar 75%. Kesimpulan: Berdasarkan hasil evaluasi, maka pelaksanaan kesehatan lingkungan rumah sakit sesuai Kepmenkes RI Nomor 1204/Menkes/SK/X/2004 di RSUD Jayapura secara keseluruhan dapat dikatakan belum sepenuhnya efektif. Faktor-faktor yang menghalangi efektivitas pelaksanaan KepMenKes No. 1204/Menkes/SK/X/2004 adalah: (1) Kurangnya komunikasi dan koordinasi antara manajemen dan bagian instalasi sanitasi (2) Tidak ada pembahasan usulan perencanaan (3) Kurang tersedia sumberdaya yang kompeten (4) Pendidikan pelaksana belum memenuhi persyaratan Kepmenkes (5) Tidak ada batas kewenangan contracting bagi bagian instalasi sanitasi (6) Minimnya pengawasan (7) Belum adanya prosedur kerja kesehatan lingkungan rumah sakit dan belum dimilikinya dokumen lingkungan
Background: Jayapura Hospital is the biggest hospital in Papua that functions as a referral, training and teaching hospital. However the condition of environmental health of Jayapura Hospital at present needs certain attention. Objective: The study aimed to find out the effectiveness of the implementation of the Ministry of Health Decree No. 1204/Menkes/SK/X/2004 about environmental health of hospital and identify factors that obstructed the effectiveness of the implementation. Method: The study used a descriptive method and case study design with quantitative – qualitative approach. Location of the study was Jayapura Hospital. Subject consisted of hospital management, health office, sanitation office, Council of Local Environment Impact Control Agency Regional of the Province of Papua, patients and visitors of Jayapura Hospital. Result: The result of laboratory test showed that parameter of water purification exceeded the standard quality specified, whereas the result of statistical test showed that there were three variables, i.e. environmental health, water purification and environmental health socialization which had no significant difference of which their t calculation (1.0925; 0.269;0.783) were lower than t-table (2.037). Meanwhile the result of evaluation based on evaluation guideline of the Ministry of Health showed the maximum Score was 68.5% below the standard of environmental health requirement of hospital which was 75%. Conclusion: Based on the result of evaluation on the implementation of environmental health of hospital according to the decree of the Ministry of Health No. 1204/Menkes/SK/X/2004 the implementation at Jayapura Hospital in general was still ineffective. Factors obstructing the effectiveness were: 1) lack of communication and coordination between the management and the sanitation installation; 2) absence of discussion on planning proposition; 3) limited competence of human resources; 4) education of staff in charge had not fulfilled the requirement of the Ministry of Health; 5) no limit of contracting authority at sanitation installation; 6) minimum supervision; 7) unavailability of hospital environmental health operating procedures and environment documents.
Kata Kunci : Evaluasi,Efektivitas pelaksanaan,Kesehatan lingkungan rumah sakit, evaluation, effectiveness of implementation, hospital environmental health
