Analisis Perbedaan Upaya Pencegahan Infeksi antara Bidan Delima dan Non Delima dalam Asuhan Persalinan di Kabupaten Kulon Progo

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Munica Rita Hernayanti Analisis Perbedaan Upaya Pencegahan Infeksi antara Bidan Delima dan Non Delima dalam Asuhan Persalinan di Kabupaten Kulon Progo xiv + 121 halaman + 21 tabel + 6 gambar + 5 lampiran Praktik pencegahan infeksi oleh tenaga kesehatan masih bersifat selektif. Di Kabupaten Kulon Progo 44,4 % kematian bayi disebabkan oleh sepsis, 9 % kematian ibu disebabkan komplikasi demam nifas. Pertolongan persalinan 59 % dilakukan Bidan Praktik Swasta (BPS), dengan 47,8 % BPS telah berpredikat Bidan Delima yang seharusnya melayani dengan service of excellence. Studi pendahuluan menunjukkan Bidan Delima mengangap sepele dan merasa repot dengan pencegahan infeksi. Penelitian bertujuan untuk mengetahui perbedaan upaya pencegahan infeksi antara Bidan Delima dan non delima dalam asuhan persalinan. Penelitian ini merupakan penelitian observasional analitik komparatif dengan pendekatan cross sectional. Populasi adalah semua BPS di Kabupaten Kulon Progo sejumlah 90 BPS. Subjek terdiri dari 34 Bidan Delima dan 34 BPS non delima yang memenuhi kriteria inklusi dan ekslusi. Pengumpulan data dengan metode angket menggunakan kuesioner dan observasi dengan lembar observasi. Hasil penelitian menunjukkan dari 8 (delapan) variabel yang diteliti Bidan Delima mempunyai nilai yang lebih baik dibanding BPS non delima. Hasil uji beda menunjukkan ada perbedaan bermakna dalam pelaksanaan pencegahan infeksi (p = 0,003), ada perbedaan bermakna dalam hal pengetahuan (p = 0,037), sikap (p = 0,03), persepsi kepuasan pasien (p = 0,016), persepsi beban kerja (p = 0,027), dukungan organisasi profesi (p = 0,012). Tidak ada perbedaan yang bermakna dalam pelatihan pencegahan infeksi (p = 0,169) dan motivasi bidan (p = 0,325). Uji bivariat dengan stratifikasi umur menunjukkan ada 2 (dua) variabel yaitu pelaksaaan pencegahan infeksi dan persepsi kepuasan pasien yang tidak mempunyai perbedaan bermakna baik pada kelompok umur tua maupun umur muda. Direkomendasikan agar IBI menetapkan prosedur tetap pencegahan infeksi pada asuhan persalinan yang harus dipatuhi anggotanya dan melakukan pembinaan program Bidan Delima sebagai program unggulan untuk meningkatkan pelayanan BPS. Direkomendasikan kepada dinas kesehatan agar memfasilitasi penyelenggaraan pelatihan manajemen pencegahan infeksi dan bekerjasama dengan IBI melakukan pembinaan terhadap BPS tentang pentingnya pencegahan infeksi khususnya pada asuhan persalinan. Kata Kunci : Pencegahan Infeksi, Persalinan, Bidan Delima Kepustakaan : 42 (1996 – 2012) 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 Munica Rita Hernayanti Analysis on the Differences between the Infection Prevention Practice by Delima and Non Delima Midwives in Delivery Cares in Kulon Progo District xiv + 121 pages + 21 tables + 6 figures + 5 enclosures Infection preventive practice by health workers was still selectively done. In Kulon Progo district 44.4% of infant mortality was caused by sepsis, 9% by post-delivery fever complication. The majority of delivery assistance was done by private practice midwives (BPS). Almost a half (47.8%) of BPS had Delima midwives predicate. They should do their work with service of excellence. A preliminary study showed that Delima midwives did not take into account infection prevention and they felt that infection prevention was annoying. The study objective was to identify the infection preventive action difference between Delima and non Delima midwives in the delivery care. This was an observational analytic and comparative study with cross sectional approach. Study population was all 90 BPS in Kulon Progo district. Study subjects consisted of 34 Delima midwives and 34 BPS non Delima who fulfilled inclusion and exclusion criteria. Data were collected through survey using questionnaire and observation using observation sheet. Results of the study showed that Delima midwives had higher value on eight examined variables than non Delima BPS. Results of a difference test showed that there was a significant difference in the implementation of infection prevention (p= 0.003), knowledge (p= 0.037), attitude (p= 0.03), patient satisfaction perception (p= 0.016), perception on workload (p= 0.027), support from organizational profession (p= 0.012). There was no significant difference in infection preventive training (p= 0.169), and midwives motivation (p= 0.325). Results of bivariate test with age stratification showed that two variables namely implementation of infection prevention and patient satisfaction perception were not significantly different in both elder age group and young age group. Recommendation for IBI is to establish standard procedure of infection prevention in the delivery care. All members of IBI should obey this standard procedure. IBI should develop Delima midwives program as a superior program to improve BPS service. Recommendations for district health office are to facilitate training implementation on the management of infection prevention, to collaborate with IBI to do supervision to BPS focusing on the important of infection prevention especially in the delivery care. Key words : Infection prevention, delivery, Delima midwives Bibliography : 42 (1996-2012)