EVALUASI PELAKSANAAN PENCEGAHAN RISIKO JATUH OLEH PERAWAT DI RUANG RAWAT INAP ANAK

HERI SAPUTRO, Prof. dr. Yati Soenarto, Sp.A (K)., PhD; Patricia Suti Lasmani, S.Kep., Ns., MPH

2015 | Tesis | S2 Keperawatan

Latar Belakang: Jatuh dapat terjadi pada semua tipe institusi pelayanan kesehatan, serta pada semua populasi. Pada usia anak-anak, kejadian jatuh sering tidak dilaporkan karena sering dianggap sebagai masa perkembangan anak dalam hal belajar. Berdasarkan hasil studi pendahuluan, ditemukan beberapa pendokumentasian pencegahan risiko jatuh yang belum terisi, tidak terpasangnya tanda risiko jatuh, serta pagar pengaman tempat tidur yang tidak dinaikkan pada pasien anak yang memiliki risiko tinggi jatuh. Tujuan penelitian ini adalah mengevaluasi pelaksanaan pencegahan risiko jatuh oleh perawat di Ruang Rawat Inap Anak. Metode: Penelitian ini merupakan penelitian studi kasus dengan desain penelitiannya menggunakan single case (kasus tunggal). Sampel dipilih dengan menggunakan metode purposive sampling. Penelitian dilakukan di 9 ruang rawat inap anak RSUP Dr Sardjito. Pengumpulan data dengan menggunakan multisumber bukti yaitu studi dokumentasi, observasi dan wawancara kelompok (focus group interview). Analisis data dilakukan secara deskriptif eksplanatori untuk melihat pendokumentasian dan pelaksanaan pencegahan risiko jatuh oleh perawat, selanjutnya menganalisis hasil wawancara kelompok dengan menggunakan metode content analysis. Hasil: Ada beberapa pendokumentasian pencegahan risiko jatuh pada rekam medis yang masih kosong terutama pada evaluasi, selain itu didapatkan hanya sebanyak 52,8% pasien anak yang didekatkan dengan ruang jaga perawat dan sebanyak 36,1% ruangan dengan pintu yang terbuka pada pasien anak dengan risiko tinggi jatuh. Karakteristik ruangan seperti kelas perawatan, jumlah perawat dan BOR (bed occupation rate) tidak berpengaruh pada pelaksanan pencegahan risiko jatuh. Dari hasil diskusi kelompok didapatkan bahwa persepsi perawat terhadap pelaksanaan pencegahan risiko jatuh dipengaruhi oleh sarana dan prasarana (fasilitas), hand rails, keluarga/penunggu, individu perawat serta beban kerja perawat, sedangkan kinerja perawat dipengaruhi oleh motivasi, supervisi dan insentif/tunjangan. Kesimpulan: Pelaksanaan pencegahan risiko jatuh sudah dilaksanakan oleh perawat ruang rawat inap anak, walaupun masih ada beberapa yang masing belum dilaksanakan. Motivasi individu perawat, supervisi serta tunjangan/insentif turut berperan dalam pelaksanaan pencegahan risiko jatuh.

Background: Falls can occur in all types of health service institution, and in all populations. At the child age, fall events are often not reported because they are considered as a part of the child’s development period in learning. The preliminary study found several documentations of fall risk prevention which had not been filled, fall risk signs which had not yet been put, as well as safety fences which had not yet been raised around child patients whose fall risk was high. The objective of this research is to evaluate the implementation of fall risk prevention by the nurses in the Inpatient Rooms for Child Care. Method: This research has been a study case one with the single case design. The samples were selected by the method of purposive sampling. It was conducted in the 9 inpatient ward for child care in the Dr. Sardjito Central General Hospital. The data collection was assumed by multisource evidences, namely documentation study, observation and focus group interview. The data analysis was conducted by descriptive explanatory to see the documentation and implementation of fall risk prevention by the nurses, followed by analysis on the result of focus group interview by applying content analysis method. Result: There were several documentations of fall risk prevention in the medical records which were empty, especially in the evaluation. Besides, it was found that only 52.8% child patients were placed close to the nurse station and 36.1% rooms with opened doors for child patient with high fall risk. The characteristics of the rooms such as the class of care service, the number of nurses and bed occupation rate (BOR) didn’t affect the implementation of fall risk prevention. The result of group discussion found that the nurse’s perception toward the implementation of fall risk prevention was influenced by the infrastructures and facilities, hand rails, family/watchers, the individual of the nurses and their workloads, whereas the nurse’s work performance was influenced by motivation, supervision and incentives/allowance. Conclusion: The implementation of fall risk prevention had already conducted by the nurses in the inpatient rooms for child care, although there were several parts which had not yet been completed. The motivation of the nurse individuals, supervision, and incentives/allowance played a role in the implementation of fall risk prevention.

Kata Kunci : Pencegahan risiko jatuh, anak, evaluasi