PENGARUH MOBILISASI PROGRESIF LEVEL I: TERHADAP RISIKO DEKUBITUS DAN PERUBAHAN SATURASI OKSIGEN PADA PASIEN KRITIS TERPASANG VENTILATOR DI RUANG ICU RSUD Dr. MOEWARDI SURAKARTA

Abstract

Latar Belakang: Pasien kritis terpasang ventilator dengan masa rawat yang lama akan menyebabkan beberapa masalah kesehatan, salah satunya adalah resiko dekubitus. Immobilisasi dan ketidakstabilan saturasi oksigen dapat menyebabkan dekubitus. Pencegahannya dengan mobilisasi progresif level I yang tepat dan saturasi oksigen yang mencukupi pada pasien kritis. Metode: Penelitian ini menggunakan metode Quasy Experimental dengan design pretest dan posttest. Populasi adalah pasien kritis yang terpasang ventilator di ruang ICU RSUD Dr. Moewardi Surakarta. Teknik sampel menggunakan consecutive sampling. Sampel terdiri dari 30 pasien, masing – masing kelompok 15 pasien. Risiko dekubitus diukur dengan skala braden dan saturasi oksigen dengan oksimeter. Nilai skala braden <9 resiko sangat tinggi, 10-12 resiko tinggi, 13-14 resiko sedang, 15-18 resiko ringan dan >18 tidak berisiko. Pemberian mobilisasi proresif level I dilakukan setiap hari setiap 2 jam dan pada hari terakhir intubasi dilakukan observasi skor dekubitus oleh peneliti. Data dianalisis menggunakan Uji Mann Whitney. Hasil: Pada kelompok intervensi resiko dekubitus prepost test menunjukkan skor skala braden 13.53 menjadi 14.53. Kemudian pada kelompok kontrol resiko dekubitus prepost test menunjukkan skor skala braden 12.60 menjadi 11.00. Selain itu, pada kelompok intervensi tidak terjadi dekubitus dan pada kelompok kontrol didapatkan 4 pasien yang terkena dekubitus pada hari ketiga. Mobilisasi progresif level I secara signifikan dapat mencegah dekubitus (U=21;p= 0,00) dan meningkatkan saturasi oksigen lebih besar secara signifikan (U=28;p= 0,000). Kesimpulan: Mobilisasi progresif level I dapat mencegah terjadinya dekubitus dan mempertahankan nilai saturasi oksigen pada pasien kritis yang terpasang ventilator. Kata Kunci: Risiko Dekubitus, Saturasi Oksigen, Mobilisasi Progresif Level I, Pasien Kritis, Ventilator. Background: A prolonging hospitalization for critically ill patients with mechanical ventilation can lead to several health problems, one of them is risk of pressure ulcer, Immobilisation and insufficient oxygen saturation can cause pressure ulcer. The prevention of pressure ulcer is proper mobilisation and adequate oxygen saturation in critically ill patients. Methods: The study was a quasi-experimental pre-post test two group design, The populations were critically ill patients with mechnical ventilation in ICU at Moewardi Hospital of Surakarta, The samples were recruited by consecutive sampling technique, The samples were 30 subjects; 15 subjects each group, Risk of pressure ulcer was measured by Braden Scale and oxygen saturation was measured by oximeter, The scores of Braden Scale were <9 at extrimely high risk, 10-12 at high risk, 13-14 at medium high risk, and 15-18 at mild risk and >18 at no risk of pressure ulcer, Intervention of progressive mobility level I had been performed every 2 hours each day from admission to extubation by the researcher, Data were analyzed by Mann Whitney U. Results: The findings show Braden Scale scores at 13,53 (medium risk) at baseline and 14,53 (medium risk) at post test in intervention group, Braden Scale scores describe 12,60 (high risk) at baseline and 11,00 at post test in control group, Furthermore, there was no patient with pressure ulcer in the intervention group and 4 patients developed pressure ulcer since the third day after admission in the control group. Progressive mobility level I could significantly prevent pressure ulcer better in the intervention group than the control group (U=21; p=0,00), Oxygen saturation was a significantly greater increase in the intervention group than the control group (U=28,50; p=0,00) Conclusion: Progressive mobility level I can effectively prevent pressure ulcer and improve oxygen saturation in critically ill patients with mechanical ventilation. Keywords: Pressure Ulcer, Oxygen Saturation, Progressive Mobility Level I, Critical Patients, Mechanical Ventilation