Tesis

Analisis Faktor-faktor Yang Berhubungan Dengan Kepatuhan Bidan Dalam Penerapan Kewaspadaan Standar, Studi di Puskesmas Pelayanan Obstetri Neonatal Emergensi Dasar, Kabupaten Bekasi = Analysis of Factors Associated With Midwives Compliance To Standard Precaution, A Study in Basic Emergency Obstetric-Neonatal Care Public Health Center, Bekasi District.

Latar Belakang: Bidan memiliki risiko tinggi tertularnya Healthcare-Associated Infections (HAIs) pada saat merawat pasien. Umumnya risiko penularan infeksi yang dihadapi bidan adalah pada saat kontak dengan darah dan cairan tubuh. Pada tahun 2015, terjadi 250 kasus kecelakaan kerja termasuk didalamnya kejadian tertusuk jarum. Metode: Jenis penelitian adalah deskriptif analitik dengan desain penelitian potong lintang dan jumlah sampel 130 orang. Pengumpulan data dilakukan dengan wawancara, kuisioner dan pengamatan, sedangkan data sekunder diperoleh dari profil Dinas Kesehatan Kabupaten Bekasi. Hasil: Sebanyak 73 (56,2%) responden patuh, sedangkan sisanya 57 (43,8%) responden tidak patuh. Rata-rata tingkat kepatuhan responden terhadap prosedur kewaspadaan standar sebesar 88,7% dengan tingkat kepatuhan responden tertinggi adalah kepatuhan dalam pembersihan lingkungan area kerja sebesar 89 (100%) responden dan tingkat kepatuhan terendah adalah kepatuhan terhadap penggunaan APD sebesar 52 (55,3%) responden. Faktor yang paling berhubungan secara signifikan dengan kepatuhan bidan dalam menerapkan kewaspadaan standar adalah usia > 40 tahun (OR = 2,64, IK 95% = 1,08-6,49), sarana prasarana lengkap di kamar bersalin (OR = 6,26, IK 95% = 2,74-14,30) dan poli KIA-KB (OR = 5,84, IK 95% = 2,56-13,32), peraturan dan SOP lengkap di poli KIA-KB (OR = 2,04, IK 95% = 1,01-4,13), masa kerja ≥ 5 tahun (OR = 4,92, IK 95% = 2,11-11,49), status kepegawaian PNS (OR = 3,21, IK 95% = 1,56-6,64) dan beban kerja rendah (OR = 2,95, IK 95% = 1,25-6,96), sedangkan faktor yang paling berpengaruh adalah sarana prasarana lengkap di kamar bersalin (OR = 5,46, IK 95% = 2,31-12,89) dan masa kerja ≥ 5 tahun (OR = 4,12, IK 95% = 1,6710,18). Kesimpulan: Ketersediaan sarana prasarana merupakan faktor paling dominan yang berhubungan dengan perilaku bidan terhadap kepatuhan penerapan kewaspadaan standar.
Kata Kunci: Bidan, darah dan cairan tubuh, Healthcare-Associated Infections (HAIs), kewaspadaan standar.


Background: Midwives have a high risk of contracting Healthcare-Associated Infections (HAIs) when treating patients. Generally, the risk of transmission of infections that the midwife encounters is at the time of contact with blood and body fluids. In 2015, there are 250 cases of occupational accidents including the incidence of needle puncture. Methods: The type of the study was analytic descriptive with cross sectional study design and total sample of 130 people. Data was collected by interview, questionnaire and observation, while secondary data was obtained from the profile of Bekasi District Health Office. Result: The result shows that 73 (56.2%) respondents are obedient, while the rest of about 57 (43.8%) respondents are not. The average level of compliance of respondents to standard awareness procedure is 88.7% with the highest number of compliance of about 89 (100%) respondents is in cleaning work area environment and the lowest one is adherence to use of Personal Protective Equipment (PPE) equal to 52 (55.3 %) of respondents. Factors significantly correlated with midwife adherence in applying standard precautions were age > 40 years (OR = 2.64, IK 95% = 1.08-6.49), complete infrastructure in the delivery room (OR = 6.26, IK 95% = 2.74-14.30) and maternal, child health and family planning (MCH-FP) poly (OR = 5.84, IK 95% = 2.56-13.32), complete rules and Standard Operating Procedures (SOPs) in maternal, child health and family planning (MCH-FP) poly (OR = 2.04, IK 95% = 1.01-4.13), duration of work ≥ 5 years (OR = 4.92, IK 95% = 2.11-11.49), employment status of civil servants (OR = 3.21, IK 95% = 1.566.64) and low work load (OR = 2.95, IK 95% = 1.25-6.96), with the most influential factors were complete infrastructure in the delivery room (OR = 5.46, IK 95% = 2.31-12.89) and duration of work ≥ 5 years (OR = 4.12, IK 95% = 1.6710.18). Conclusion: The availability of infrastructure facilities is the most dominant factor that relates to midwives behavior on compliance to standard precautions.
Keywords: Blood and body fluids; Healthcare-Associated Infections (HAIs); midwives; standard precautions.