Evaluasi praktik keperawatan berdasarkan kaidah asuhan keperawatan di Kabupaten Indramayu

RUSWADI, Indra, Prof. dr. Hari Kusnanto, DrPH

2010 | Tesis | S2 IKM-Kebijakan dan Manajemen Pelayanan Kesehatan

Latar Belakang: Keluarnya Keputusan Menteri Kesehatan No. 1239 Tahun 2001 tentang registrasi dan praktik perawat, walaupun memberikan kenyamanan pada perawat khususnya yang menjalankan praktik mandiri keperawatan ternyata masih juga belum memberikan kejelasan batasan kewenangan, perlindungan hukum yang pasti bagi tenaga perawat, belum lagi di berbagai daerah banyak perawat mengeluhkan mengenai semaraknya razia terhadap praktik mandiri perawat sejak pemberlakuan UU No. 29 Tahun 2004 tentang Parktik Kedokteran, Berdasarkan pengamatan peneliti, selama melaksanakan praktik mandiri keperawatan, tidak sesuai dengan standar profesi seperti melakukan pengobatan, menjahit luka dan tindakan invasif lainnya dan kurang memperhatikan pendokumentasian asuhan keperawatan dan ada pengaduan dari masyarakat mengenai perawat yang melakukan operasi di tempat praktiknya hal ini tentunya akan berdampak pada kewajiban perawat secara mandiri tidak terpenuhi. Tujuan: Untuk mengevaluasi dan mengidentifikasi kegiatan – kegiatan yang dilakukan oleh perawat di Kabupaten Indramayu berhubungan dengan pelaksanaan Praktik Mandiri Keperawatan Berdasarkan Kaidah Asuhan Keperawatan. Metode Penelitian: Penelitian ini adalah penelitian non eksperimen dengan pendekatan methode campuran (mix method) untuk mengidentifikasi dan mengevaluasi kejadian-kejadian atau kegiatan-kegiatan yang telah dilakukan perawat dalam melaksanakan Praktik Mandiri Keperawatan Berdasarkan Kaidah Asuhan Keperawatan dan menganalisis seberapa jauh keberhasilan perawat dalam pelaksanaan Praktik Mandiri Keperawatan dalam satu waktu. Metode pengumpulan data dilakukan secara kuantitatif dan kualitatif. Hasil: Ada hubungan yang signifikan antara faktor pemenuhan hak perawat, pemenuhan kewajiban perawat, pemahaman hukum kesehatan dan batas kewenangan dalam praktik mandiri perawat dengan implementasi praktik mandiri keperawatan berdasarkan kaidah asuhan keperawatan (p,0,05). Kesimpulan: Praktik Mandiri Keperawatan Berdasarkan Kaidah Asuhan Keperawatan Di Kabupaten Indramayu belum dilaksanakan secara optimal, hal ini dikarenakan kurangnya pengawasan baik yang dilakukan oleh Dinas Kesehatan Kabupaten Indramayu maupun Organisasi Profesi dalam hal ini Persatuan Perawat Nasional Indonesia (PPNI) Indramayu dan Persepsi atas hak dan pemahaman atas batas kewenangan perawat dalam praktik mandiri keperawatan merupakan faktor yang berpengaruh terhadap kemungkinan praktik mandiri keperawatan berdasarkan kaidah asuhan keperawatan. Saran: Perlunya pembinaan dan pengawasan langsung oleh Tim Khusus atau Komite yang dibentuk oleh Dinas Kesehatan Kabupaten yang berisi: dari unsur pemerintah) Dinas Kesehatan) dan para profesional (PPNI).

Background: The issue of the Minister of Health Decree No. 1239 of 2001 on the nurse registration and practice, although providing nurse facility especially for the independent nursing practice, does not give nay clear authority boundary and legal protection for nurses, not to mention that in various regions many nurses complain about the frequent raid against the independent nursing practices since the enactment of Law No. 29 of 2004 on Medical Practices. The researcher observed that the independent nursing practice is not in accordance with the professional standards as to treating, stitching and other invasive measures and is lack of attention to the documentation of nursing care. There are also complaints from the public about nurses who perform operations in their practice places. This will certainly affect the liability of independent nurse which is not fulfilled. Objective: The research aims at evaluating and identifying activities carried out by nurses in Indramayu District associated with the implementation of Independent Nursing Practice based on the nursing care. Method: The research applied a non-experimental method with mixed approaches (mixed method) to identify and evaluate the occurrences or activities that have been performed by nurses in implementing the independent nursing practice and analyze how far the nurses succeed in the implementation of independent nursing practice in a period of time. The data were gathered quantitatively and qualitatively. Result: There was a significant correlation among the factors of nurse right fulfillment, nurse obligation fulfillment, health law understanding and authority boundary in the independent nursing practice which implements the independent nursing practice based on the nursing care codes (p, 0.05). Conclusion: The Independent Nursing Practice based on the nursing care in Indramayu District has not been performed optimally. This is due to the lack of good supervision by Indramayu District Health Office and professional organization such as the Indonesian National Nurse Association (PPNI) of Indramayu. The perception on the nursing rights and understanding on the authority boundaries of nurses in the independent nursing practice are factors influencing the possibility of independent nursing practice based on the nursing care codes. Suggestion: It requires direct guidance and supervision by a special committee established by the District Health Office which contains: the government elements (Health Office) and professionals (PPNI).

Kata Kunci : Evaluasi,Praktik mandiri keperawatan,Persepsi atas hak perawat,Persepsi atas kewajiban perawat,Hukum kesehatan,Wewenang perawat, Evaluation, Independent Nursing Practice, Perception on Nurse Rights and Obligations, health law, nurse authority