Pengembangan Standar Operasional Prosedur (SOP) Persiapan Rujukan Kasus Pre eklampsia Berat/eklampsia oleh Bidan Desa di Kabupaten Pekalongan

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2016 ABSTRAK Miftachul Jannah Pengembangan Standar Operasional Prosedur (SOP) Persiapan Rujukan Kasus Pre eklampsia Berat/eklampsia oleh Bidan Desa di Kabupaten Pekalongan xv +98halaman +6 tabel+6 gambar+ 11 lampiran Angka Kematian Ibu di Kabupaten Pekalongan tahun 2014 mengalami peningkatan, penyebab kematian ibu tertinggi yaitu pre eklampsia berat/eklampsia dengan jumlah kasus 16 (41%). Dari kasus kematian tersebut masih ada bidan yang tidak memberikan penanganan persiapan rujukan karena belum memahami SOP. Tujuan penelitian mengembangkan SOP persiapan rujukan kasus pre eklampsia berat/eklampsia yang dapat dipahami serta mudah dilaksanakan oleh Bidan Desa di Kabupaten Pekalongan. Jenis penelitian kualitatif.Data kualitatif dikumpulkan dengan metode diskusi kelompok dengan metode Nominal Group Technique (NGT). Data tentang pemahaman terhadap SOP dikumpulkan dengan kuesioner terstruktur pada 77 bidan desa.Jumlah subjek kualitatif 5 orang bidan desa, 5 orang bidan PONEK dan 1 orang dokter spesialis. Instrumen pemahamantelah diujivaliditas dan reliabilitasnya.Analisis data secara deskriptif dan analisis isi. Hasil penelitian menunjukkan pemahaman bidan desakurang (29,9%), cukup (58,4%), danbaik (11,7%). Pemahaman yang kurang terdiri dari: tanda dan gejala, efeksamping MgSO4 dan penanganan awal pre eklampsia berat/ eklampsia pra rujukan. SOP yang baru lebih jelas dalam penilaian klinik dan pengelolaan pra rujukan dari informed consent sampai pasien mendapat perawatan di ruang IGD. SOP menggunakan bagan yang lebih sederhana. Disarankan kepada Dinas Kesehatan dan Organisasi IBI untuk Dapat menguji coba SOP dalam penanganan preeklamsia/ eklamsia sebelum melakukan rujukan oleh bidan untuk mengurangi AKI serta AKB. Kata kunci : Pre eklampsia berat/eklampsia, Standar Operasional Prosedur, Persiapan Rujukan Kepustakaan : 30 (1995-2014) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2016 ABSTRACT Miftachul Jannah Development of Standard Operating Procedure (SOP) of Severe Preeclampsia/Eclampsia Case Referral Preparation by Village Midwives in District of Pekalongan xv + 98 pages + 6 tables + 6 figures + 11 appendices Maternal Mortality Rate (MMR) in District of Pekalongan in 2014 increased. The highest main cause of maternal mortality was severe preeclampsia/eclampsia with number of cases were 16 persons (41%). Some of these mortality cases occurred because midwives did not manage referral preparation due to not understanding of Standard Operating Procedure (SOP). The aim of this study was to develop SOP of severe preeclampsia/eclampsia case referral preparation that was easy to understand and to implement by village midwives in District of Pekalongan. This was a qualitative study. Qualitative data were collected by conducting Focus Group Discussion using a method of Nominal Group Technique (NGT). Data of understanding SOP were collected using a structured questionnaire from 77 village midwives. Qualitative subjects consisted of five village midwives, five midwives of PONEK, and one specialist. Tests of validity and reliability for the research instrument were performed. Data were analysed using a descriptive method and content analysis. The results of this research showed that village midwives had lack of understanding (29.9%), enough understanding (58.4%), and good understanding (11.7%). Lack of understanding consisted of: signs and symptoms, side effect of MgSO4, and initial treatment of preeclampsia/eclampsia in pre-referral. A new SOP was clearer in clinical assessment and pre-referral management from asking for informed consent to obtaining treatment at an emergency room for a patient. SOP used a simple scheme. District Health Office and Indonesian Midwives Association need to test SOP in handling severe preeclampsia/eclampsia before referring by midwives to reduce MMR and Infant Mortality Rate (IMR). Keywords : Severe Preeclampsia/Eclampsia, Standard Operating Procedure, Referral Preparation Bibliography: 30 (1995-2014)