FAKTOR-FAKTOR YANG MEMPENGARUHI KEPATUHAN PETUGAS KESEHATAN DALAM PENERAPAN CUCI TANGAN DI POLI GIGI RSCM JAKARTA

sylvia fatridha situngkir, Dr.dr. Felix Kasim,M.Kes

2014 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Infeksi nosokomial adalah infeksi yang didapat atau timbul pada saat pasien dirawat di rumah sakit. Infeksi nosokomial sangat dipengaruhi oleh kebersihan tangan petugas kesehatan. Ketidakpatuhan petugas kesehatan dalam penerapan cuci tangan bisa meningkatkan angka infeksi nosokomial. Banyak sekali faktor yang mempengaruhi kepatuhan petugas kesehatan dalam penerapan cuci tangan seperti persepsi, profesi, beban kerja yang tinggi, kurangnya waktu untuk pelaksanaan cuci tangan, letak bahan cuci tangan yang sulit di akses, adanya iritasi kulit, kelompok kerja petugas kesehatan, dan pengetahuan tentang pentingnya cuci tangan. Tujuan: Untuk mengetahui hubungan faktor individu (pengetahuan, persepsi, dan profesi), ketersediaan fasilitas cuci tangan, dan beban cuci tangan terhadap kepatuhan petugas kesehatan dalam penerapan cuci tangan di poli gigi RSCM. Metode: Jenis penelitian ini adalah mixed method sequential explanatory research design dimana menggunakan kombinasi metode kuantitatif dan kualitatif. Pengumpulan dan analisis data kuantitatif diikuti dengan pengumpulan dan analisis data kualitatif. Data kuantitatif diperoleh dengan melakukan metode observasi dan penggunaan kuesioner, sedangkan data kualitatif diperoleh dengan melakukan Focus Group Discussion (FGD). Analisis data kuantitatif yang digunakan adalah analisis univariat dalam bentuk distribusi frekuensi, analisis bivariat dengan uji chi square dan analisis multivariat dengan uji regresi logistik. Sedangkan untuk analisis data kualitatif digunakan thematical analysis. Hasil dan pembahasan: Tidak ada hubungan antara pengetahuan mengenai cuci tangan (p= 0,17) dan profesi (p=0,225) dengan kepatuhan penerapan cuci tangan petugas kesehatan di poli gigi. Ada hubungan antara persepsi terhadap cuci tangan dengan kepatuhan penerapan cuci tangan petugas kesehatan di poli gigi (p=0,001). Ada hubungan antara ketersediaan fasilitas cuci tangan dengan kepatuhan penerapan cuci tangan petugas kesehatan di poli gigi (p=0,014). Ada hubungan antara beban cuci tangan dengan kepatuhan penerapan cuci tangan petugas kesehatan di poli gigi (p=0,07). Hasil FGD menunjukkan bahwa ketidakpatuhan cuci tangan disebabkan karena fasilitas cuci tangan yang tidak baik. Kesimpulan dan saran: Faktor yang paling mempengaruhi kepatuhan petugas kesehatan dalam penerapan cuci tangan di poli gigi adalah ketersediaan fasilitas cuci tangan dan diikuti dengan persepsi cuci tangan. Dibutuhkan penelitian lebih lanjut yang membandingkan tingkat kepatuhan petugas kesehatan dalam penerapan cuci tangan dengan menggunakan hand rub dan sabun cair.

of hospitalized patients. Nosocomial infection is strongly influenced by the health worker hand hygiene. Non-compliance of health workers in the implementation of hand washing can increase the rate of nosocomial infections. There are so many factors that affect adherence of health workers in the implementation of hand washing as perception, professional, high workload, lack of time for the implementation of hand washing, location of hand washing materials that are difficult to access, the presence of skin irritation, a working group of health workers, and knowledge of the the importance of hand washing. Objective: To determine the association of individual factors (knowledge, perception, and profession), the availability of hand washing facilities, and a load of washing their hands of health workers in the implementation of compliance washing hands in the dental outpatient clinic of Cipto Mangunkusumo Hospital. Method: This research is a mixed method sequential explanatory research design which uses a combination of quantitative and qualitative methods. Collection and analysis of quantitative data followed by the collection and analysis of qualitative data. Quantitative data were obtained by the method of observation and the use of questionnaires, while qualitative data is obtained by performing a Focus Group Discussion (FGD). Analysis of quantitative data used are univariate analysis in the form of frequency distributions, bivariate analysis with chi square test and multivariate analysis with logistic regression. As for the qualitative data analysis used thematical analysis. Result and discussion: There is no association between knowledge about hand washing (p = 0.17) and profession (p = 0.225) with the application of handwashing compliance officer in dental outpatient clinic. There were associations between the perceptions of washing hands with hand washing compliance application of health care workers in dental outpatient clinic (p = 0.001). There is an association between the availability of hand washing facilities with handwashing compliance application of health care workers in dental outpatient clinic (p = 0.01). There is an association between the load of washing hands with hand washing compliance implementation of health care workers in dental outpatient clinic (p = 0.07). FGD results showed that non-compliance due to hand washing facilities are not good. Conclusion and recommendation: The factors that most influence the adherence of health workers in the implementation of hand washing in dental outpatient clinic is the availability of hand washing facilities and followed by perception of hand washing. Further research is needed comparing the level of compliance of health care workers in the application of hand washing using hand rub and liquid soap.

Kata Kunci : infeksi nosokomial, cuci tangan, kepatuhan