Factors Related to the Implementation of Infection Prevention Procedures on Normal Delivery Cares in Pati District (Study on Normal Delivery Care Trained Midwives) - Ulin Nafiah; Cahya Tri Purnami; Lucia Ratna Kartika Wulan (Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro, 2014)
AbstrakAKI di Kabupaten Pati tahun 2011 meningkat lagi menjadi 24 kasus (116.17/100.000 KH) dengan penyebab langsung kematian ibu masih saja didominasi oleh perdarahan 3 kasus (12.5%), infeksi 2 kasus (8.33%), hipertensi 8 kasus (33.33%), eklamsi 1 kasus. Tujuan penelitian adalah untuk menganalisis beberapa faktor yang mempengaruhi pelaksanaan tindakan pencegahan infeksi pada pertolongan persalinan oleh bidan desa pasca pelatihan asuhan persalinan normal di Kabupaten Pati.Jenis penelitian observasional dengan pendekatan cross sectional Populasi adalah seluruh bidandesa pasca pelatihan APN. Jumlah sempel 69 bidan desa pasca pelatihan APN dipilih secara purposive dengan kriteria inklusi. Pengumpulan data dengan kuesioner terstruktur dan observasi langsung. Data dianalisis secara kuantitatif dengan uji korelasi Chi-square dengan metode Yate Correction dan regresi logistik linear.Responden mempunyai pengetahuan baik (76,2%), responden mempunyai sikap baik (75,0%), responden mempunyai motivasi baik (71,4%), responden mempunyai persepsi terhadap supervisi baik (69,8%), responden mempunyai peralatan lengkap (70,8%), responden melaksanakan prosedur pencegahan infeksi dalam kategori baik (59,4%). Faktor yang mempengaruhi pelaksanaan prosedur pencegahan infeksi adalah pengetahuan (ρ = 0,001), sikap (ρ = 0,0001), motivasi (ρ = 0.004), supervisi (ρ = 0,046), peralatan (ρ = 0,008).Semua variabel (pengetahuan, sikap, motivasi, supervisi, dan peralatan) berpengaruh terhadap pelaksanaan prosedur pencegahan infeksi karena nilai signifikan dibawah 0.05 (p-value < 0.05) namun variabel yang paling berpengaruh adalah sikap (p-value = 0.000, Exp(B) =9.6000) dan pengetahuan (p-value = 0.001, Exp(B) = 6.400).Kepada Dinas Kesehatan dan organisasi IBI Kabupaten Pati untuk memberikan pembinaan agar lebih meningkatkan ketrampilan dan pengetahuan bidan desa yang terkait dengan tugas dan fungsi bidan lewat pelatihan-pelatihan, supervisi yang positif terutama tentang prosedur pencegahan infeksi pada pertolongan persalinan. AbstractMaternal mortality rate (AKI) in Pati district in 2011 increased to 24 cases (116.17/100000 live- births). Direct causes of maternal death were dominated by hemorrhage (3 cases or 12.5%), infection (2 cases or 8.33%), hypertension (8 cases or 33.33%), and eclamsia (1 case). Therefore, analysis of factors affecting the implementation of infection prevention actions in the delivery assisted by village midwives with post normal-delivery care (APN) training in Pati district was done. This was an observational study with cross sectional approach. The number of samples was 69 village midwives with post APN training. They were selected purposively according to the inclusion criteria. Data were collected through interview guided by structured questionnaire and through direct observation. Data were analyzed quantitatively by applying Chi Square test, Yate Correction, and linear logistic regression. Results of the study showed that respondents had good knowledge (76.2%), good attitude (75.0%), good motivation (71.4%), good perception on supervision (69.8%), complete instruments (70.8%), and good category for the implementation of infection prevention procedure (59.4%). Factors affecting the implementation of infection prevention procedure were knowledge (p= 0.001), attitude (p= 0.0001), motivation (p= 0.004), supervision (p= 0.046), instruments (p= 0.008). All variables (knowledge, attitude, motivation, supervision, and instruments) influenced the implementation of infection prevention procedure (p-value d” 0.05). However, the most influencing variables were attitude (p= 0.000, Exp(B) = 9.60) and knowledge (p= 0.001, Exp(B) = 6.40). Suggestions for district health office and IBI organization of Pati district are to give guidance to improve skills and knowledge of village midwives related to the job and function of midwives; it can be done through trainings, positive supervision mainly on infection prevention procedure in delivery assistance.