PENGELOLAAN LIMBAH PADAT INFEKSIUS RUMAH SAKIT (Studi Kasus di Rumah Sakit PT. Pupuk Kaltim)

Abstract

Pupuk Kaltim Hospital is a hospital center for health services for people in Bontang and its surroundings. It operates 100 beds with 68,6% BOR (bed occupation rate) and 457 incoming patients per day, using around 220 m3 water per day. Besides, it produces 87 kg solid waster per day, including 35,1 kiligram infectious solid waste, and also 172,8 m3 liquid waste per day. This research is aimed at identifying pathogen germs and normal flora in the air at producing working unit and other units related to patients, paramedics and visitors, as well as evaluating ang proposing for improvement in infectious solid waste management system and procedure. Evaluation was conducted by taking samples, analysing samples, and conducting laboratory analyses to infectious medical waste and air at producing unit and non-producing units. SWOT analysis was also done to evaluate system and procedure management by scoring and weighing the importance and urgency level of each aspect. The result shows that there are pathogen germs (Pseudomonas, Emterobacteri and Corynebacten) at the producing unit and in the air. They are also nosocomial germs. Most of them are found in the Treatment Unit. SWOT analyses show the following results : (a) Strength : the hospital nosocomial team is already exist, completed with incinerator and its management unit; (b) Weaknesses :, unskilled manpower, reliance on outsourcing manpower, and weak implementation of old standard; (c) Opportunities: regulation is in line with standard, and the fulfilment of national accreditation for hospital; (d) Thread: the community's demand on waste impact well hadling, and the usage of hospital facilities by outside parties, .while waste transportation route is the same with patients, paramedics and visitors route. Therefore it is recommended that there shoukd be continuous monitoring to pathogen germs and normal flora in the air, as well as accurate documentation on the amount of infectious medical waste at the producing units, improving and renewing management procedure to prevent the existence of pathogen and nosochomial germs, and increase of awareness on the possibility of HIV, Hepatitis and other viruses from spreading if the infectious solid waste management outside hospital is not carefully handled. Keyword : infectious solid waste, hospital, waste management 1) The Postgraduate Student on Environment Science Master of Diponegoro Universitas 2) The First Supervisor 3) The Second Supervisor Rumah Sakit Pupuk Kaltim merupakan rumah sakit rujukan dari pelayanan kesehatan di Bontang dan sekitarnya, mengoperasikan 100 tempat tidur dengan BOR (bed occupation rate) 68,6% serta pasien rawat jalan 457 orang/hari, dengan fasilitas pelayanan yang ada, menggunakan air rata-rata 220 m3/hari, menimbulkan limbah padat 87 kg/hari termasuk 35,1/ kg adalah limbah padat medis infeksius dan limbah cair 172,8 m3/hari. Penelitian ini bertujuan untuk mengidentifikasi kuman patogen dan flora normal di unit kerja penghasil dan unit lain yang berhubungan dengan pasien, petugas, dan pengunjung, serta mengevaluasi dan memperbaiki sistem dan prosedur pengelolaan limbah padat infeksius. Pendekatan evaluasi •dengan 'pengambilan sampel, analisis sampel, analisis laboratorium, sampah medis infeksius dan udara, di unit sumber dan unit lain non sumber. Analisis SWOT dilakukan untuk mengevaluasi sistim dan prosedur pengelolaan dengan scoring dan pembobotan tingkat kepentingan dan urgensinya. Hasil penelitian menunjukkan adanya kuman-kuman patogen (Pseudomonas, Enterobacteri, dan Corynebacten) di unit sumber dan udara, kuman¬kuman tersebut patogen, juga sebagai kuman nosokomial, kuman terbanyak terdapat di unit Perawatan. Hasil analisis SWOT pada sistim dan prosedur pengelolaan, kekuatannya: ada tim Nosokomial rumah sakit,sarana insinerator, dan sudah ada struktur organisasi pengelolaan, kelemahan : SDM yang belum terlatih, pengelola masih outsourcing, pelaksanaan prosedur yang belum memenuhi standar dan sudah lama digunakan, peluangnya : regulasi sesuai standar, akredetasi nasional rumah sakit terpenuhi,dan ancaman : tuntutan masyarakat untuk dampak limbah, pemanfaatan fasilitas oleh pihak Iain.Jalur pengangkutan limbah sama alur pengunjung, pasien , petugas. Rekomendasi penelitian ini adalah agar dilakukan pemantauan secara terus menerus terhadap kuman patogen dan flora normal udara, serta pencatatan jumlah .sampah medis infeksius di sumber, memperbaiki dan memperbaharui prosedur pengelolaan sehingga bakteri patogen dan nosokomial dapat dicegah keberadaannya,dan perhatian untuk penularan virus HIV, Hepatitis, dan penyakit virus lain, apabila pengelolaan limbah padat infeksius diluar rumah sakit tidak baik. Kata kunci: limbah padat infeksius, rumah sakit, pengelolaan limbah. Mahasiswa S2 Magister Ilmu Lingkungan Universitas Diponegoro, Semarang 2) Pembimbing I '3) Pembimbing II