Analisis Faktor yang Berpengaruh terhadap Ketepatan dan Kelengkapan Pengisian Partograf oleh Bidan di Rumah Sakit Umum Daerah Provinsi Sulawesi Tenggara

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Sultina Sarita Analisis Faktor yang Berpengaruh terhadap Ketepatan dan Kelengkapan Pengisian Partograf oleh Bidan di Rumah Sakit Umum Daerah Provinsi Sulawesi Tenggara xv + 126 halaman + 15 tabel + 3 gambar Persalinan dengan komplikasi di RSUD Provinsi Sultra mengalami peningkatan dalam dua tahun terakhir yaitu tahun 2009 -2010. Penyebab dari komplikasi persalinan adalah Distosia, KPD, partus lama yang seharusnya dapat terdeteksi melalui penggunan partograf yang benar. Namun kenyataan menunjukkan belum semua bidan mengisi partograf dengan tepat saat mengobservasi persalinan. Penelitian ini bertujuan untuk menganalisis faktor-faktor apa saja yang berpengaruh terhadap ketepatan dan kelengkapan pengisian partograf oleh bidan di Kamar bersalin RSUD Provinsi Sultra. Jenis penelitian ini adalah observasional , dengan pendekatan cross sectional. Pengumpulan data melalui wawancara dengan kuesioner terstruktur dan chek list observasi partograf. Subyek penelitian adalah bidan pelaksana di Kamar bersalin RSUD Provinsi Sultra, yang berjumlah 39 orang. Hasil Analisis univariat menunjukkan lebih dari separuh responden berpengetahuan kurang baik (51,3%), mempunyai motivasi baik (51,3%) dan sikap baik (51,3%), persepsi reward dan punishment kurang baik (51,3%), persepsi supervisi kurang baik (56,4%), dengan ketepatan dan kelengkapan pengisian partograf tidak tepat (58,9%). Hasil uji Rank Spearman menunjukkan semua variabel berhubungan dengan ketepatan dan kelengkapan pengisian partograf oleh bidan yaitu pengetahuan (p=0,0001), motivasi (p=0,001), sikap (p=0,0001), reward dan punishment (p=0,005), supervisi (p=0,0001). Hasil uji multivariat menunjukkan variabel bebas yang berpengaruh terhadap variabel ketepatan dan kelengkapan pengisian partograf adalah supervisi dengan nilai (p=0,036). Disarankan bagi pihak RSUD Provinsi Sultra, Pihak manajemen RS perlu mempertimbangkan penghargaan bagi bidan yang selalu patuh dalam mengisi partograf, pemberian insentif sesuai dengan tugas dan tanggung jawab bidan, menerapkan sanksi bagi bidan yang sering lalai mengisi partograf, saling koordinasi dengan kepala ruangan untuk menyediakan formulir partograf sesuai kebutuhan.Supervisor perlu memberi arahan tentang pengisian partograf sebagai tugas mandiri bidan, bimbingan pada bidan tentang cara pengisian partograf yang benar, pembinaan bidan yang kurang mendukung pengisian partograf, serta melakukan evaluasi saat bidan mengobservasi persalinan. Pimpinan RS perlu menetapkan SOP partograf di Kamar bersalin agar bidan lebih konsisten terhadap ketepatan dan kelengkapan dalam mengisi partograf pada setiap melakukan asuhan persalinan. Kata kunci : Ketepatan partograf, (faktor individu, psikologis, organisasi), Kinerja bidan Bibliography : 49 buku, makalah 5, perundang-undangan 2 Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2012 ABSTRACT Sultina Sarita Analysis on Factors Related to the Completeness and Accurateness of Partograph Filling by Midwives at District Hospital of South East Sulawesi Province, 2011 xv + 126 pages + 15 tables + 3 figures Delivery process with complications at South East Sulawesi Province General Hospital (RSUD) increased in the last two years, 2009-2010. Causes of delivery complication were dystocia, CPD, and long labor process. Those causes could be detected if partograph was used correctly. In reality, not all midwives filled the partograph correctly when observing delivery process. The objective of this study was to analyze factors affecting the accurateness and completeness of partograph filling by midwives in the delivery room of RSUD South East Sulawesi province. This was an observational study with cross sectional approach. Data were collected through interview using structured questionnaire and check list of partograph observation. Study subjects were 39 midwives in the delivery room of RSUD of South East Sulawesi Province. Results of a univariate analysis showed that more than a half of respondents had insufficient knowledge (51.3%), had good motivation (51.3%) and good attitude (51.3%), perception on reward and punishment was not good (51.3%), perception on supervision was not good (56.4%), accurateness and completeness of partograph filling was not good (58.9%). Result of Rank Spearman test indicated that all variables were associated with accurateness and completeness of partograph filling by midwives: knowledge (p= 0.0001), motivation (p= 0.001), attitude (p= 0.0001), reward and punishment (p=0.005), supervision (p= 0.0001). Result of multivariate test indicated that supervision (p= 0.036) was the independent variable that affected accurateness and completeness of partograph filling. Suggestions for RSUD of South East Sulawesi Province were the hospital management has to consider giving reward to midwives who always obediently fill the partograph; incentive are given according to the job and responsibility of midwives; sanction is given to midwives who frequently forget to fill partograph; conducting coordination with chief of delivery room to provide partograph forms as needed. Supervisor should give explanation that filling partograph is an independent duty of each midwife; give guidance to midwives regarding the right way to fill partograph; conduct evaluation when midwives observe delivery process. Hospital leader should establish standard operating procedures (SOP) for partograph filling in the delivery room; the purpose of this is to make midwives to be more consistent in filling partograph accurately and completely for each delivery care. Key words : Accurateness of partograph, individual factor, psychological, organization, midwives work performance Bibliography : 49 books, 5 papers, 2 decrees