ABSTRAKSalah satu aspek sanitasi dalam upaya pengelolaan rumah sakit yang bersih dan sehat adalah dengan menggunakan alat pembersih udara di dalam ruang perawatan. Dengan turunnya angka populasi kuman diharapkan terjadi korelasi penurunan angka kejadian Infeksi Nosokomial, dengan demikian dapat menekan biaya pengeluaran pasien/keluarganya dan biaya operasional rumah sakit, sehingga pada akhirnya akan meningkatkan efisiensi dan memperbaiki citra rumah sakit.
Penelitian bertujuan untuk mengetahui gambaran, pengaruh dan efisensi alat pembersih udara `Enviracaire' terhadap penurunan jumlah koloni kuman per m3 udara serta kaitannya dengan insiden kejadian Infeksi Nosokomial di Ruang Perawatan Intensif Penelitian dilaksanakan di tiga Ruang Watsif (Perawatan Intensif) RSPAD Gatot Soebroto. Rancangan penelitian adalah Eksperimen Kuasi, dua ruangan sebagai perlakuan dan satu ruangan sebagai pembanding. Pengukuran jumlah koloni kuman dilaksanakan sepuluh kali sebelum dan sepuluh kali selama perlakuan dengan lama pengukuran 8 menit dan interval waktu 3 hari. Untuk menghindari kemungkinan adanya pengaruh cuaca dalam ruangan (suhu dan kelembaban) yang dapat mempengaruhi hasil penelitian dikendalikan dengan mengukur Index WBGT.
Hasil rata-rata pengukuran Index WBGT pada masing-masing ruangan yang diteliti sebelum dan selama dipasang alat 20,166 dan 20,163. Hasil uji Anova tidak menunjukkan perbedaan yang bermakna (p > 0,05). Dengan demikian terbukti bahwa variabel cuaca yang merupakan variabel pengganggu pada penelitian ini dapat terkendali. Hasil pengukuran jumlah koloni kuman per m kubik udara rata-rata sebelum dipasang alat di ruang perlakuan I, II dan pembanding masing-masing adalah 1466, 1471 dan 1467 koloni. Uji Anova dari ketiga ruang penelitian tersebut secara statistik tidak menunjukkan perbedaan yang bermakna (p > 0,05), Hasil pengukuran rata-rata jumlah koloni kuman per m3 udara selama dipasang alat di ruang perlakuan I, II dan pembanding masing-masing adalah 459, 436 dan 1456 koloni. Apabila dibandingkan dengan persyaratan Permenkes RI No. 9861 Menkes 1 Per 1 XI 1 1992, angka di ruang perlakuan I dan II dibawah Batas maksimum yang diperbolehkan (700 koloni per m3 udara). Setelah diuji dengan Anova dan t test secara statistik menunjukkan adanya perbedaan yang bermakna antara ruang perlakuan I dan ruang pembanding, ruang perlakuan II dan pembanding (p < 0,05). Sedangkan ruang perlakuan I dan ruang perlakuan II tidak berbeda secara bermakna (p > 0,05). Perbandingan rata-rata jumlah koloni kuman antara sebelum dan selama perlakuan didapatkan basil bahwa di ruang perlakuan I dan ruang perlakuan II secara statistik terdapat perbedaan yang bermakna (p < 0,05). Sedangkan di ruang pembanding secara statistik tidak terdapat perbedaan antara sebelum dan selama perlakuan (p > 0,05). Dengan melihat kecenderungan jumlah koloni kuman, ternyata alat pembersih udara `Enviracaire' efektif digunakan sampai minggu ketiga. Efisiensi alat selama penelitian + 70 % dalam kurun waktu satu bulan. Sedangkan besarnya pengaruh (kontribusi) alat pembersih udara dalam menurunkan jumlah koloni kuman sebesar 94,2%. Secara deskripsi penurunan jumlah koloni kuman diikuti oleh penurunan angka insiden kejadian Infeksi Nosokomial di Ruang Perawatan Intensif (dari 14,81% menjadi 6,25%). Untuk mengetahui lebih lanjut apakah ada korelasi antara pemasangan alat pembersih udara dengan penurunan angka insiden Infeksi Nosokomial diperlukan adanya penelitian lanjutan.
Disarankan bahwa untuk membantu menurunkan angka kejadian Infeksi Nosokomial menggunakan alat pembersih udara `Enviracaire', mengingat alat ini mempunyai potensi dan efisiensi yang baik untuk menurunkan jumlah koloni kuman di rumah sakit. Namun demikian alat ini harus dirawat dan dibersihkan filternya secara periodik paling lama 3 minggu sekali.
Daftar bacaan : 34 (1961 - 1996)
ABSTRACTThe Influence of Usefully Cleaned Air Conditioning System on Decreasing Germ Colonizations and Nosocomial Infection (Study Held in Icu of Center Army Gatot Soberoto Hospital, May-July Of 1997)One of sanitation aspect in accordance with environmental and healthful hospital which is carried out by mean of well-cleaned air conditioning system as used for wards.
Therefore, there's any expected decreations of correlation between the quantity germs and occurred Nosocomial Infection rate, billing to patients taken medical treatments and the operated cost for hospitalization, consequently could be decreased and develop efficiently medical service and also improve the hospital prestigious.
The examinations done to describe or indicate whether `Enviracaire' (cleaned air conditioning system) could possibly decrease the correlation between the quantity disease germ of a cubic meter air and occurred disease germ of Nosocomial Infection or not for Intensive Care Unit use. The examinations have been carried out in three different Intensive Care Unit of Center Army Gatot Soebroto Hospital . Quasi experiment, the designed examinations, consists of two medical treatment rooms and another one is used for comparison. The germ colonization are measured prior to ten times and ten times during the examinations treatments within each duration of eight minutes and three days intervals. WBGT Index is used to avoid possibilities of the rooms terrible weather (temperature and humidity) as it can effect changes in the result of examinations.
Each room indicated as result of WBGT Index measurement rate before and during setting devices at 20,166 and 20,163. Otherwise, the Anova examination was without result or unmeaningful comparison (p > 0,05). Thus, it proved that variable temperature and humidity, as terreby result of examination, can be overcame (everything is under control). As result of correlation result between germ colonies of a cubic meter air rate prior to setting devices at the first and second treatment room and each comparison are namely 1466, 1471 and 147 colonies. Otherwise, Anova examination of those all experimented rooms are without result or unmeaningful in statistically (P > 0,05). However, as result of correlation between germ colonies of a cubic meter air after setting devices at the first and second treatment room and each comparison room are namely 459, 436 and 1456 colonies. In comparison with the requirement ruling of Minester of Health RI No. 986IMenkes/Per/XI11922, the rate of first and second treatment rooms are under maximized control allowed (700 colonies of a cubic meter air). In statistically, the result of Anova and other tests indicated that there is a meaningful different between the first treatment room and comparison room and between the second treatment room and the comparison one (p > 0,05).
However, the first treatment room and the second treatment room have no meaningful difference (p > 0.05) In comparison with the quantity germ colonization rate between before and during carried out treatment indicated that the results of the first treatment room and the second treatment room, in statistically, there's a meaningful difference (p > 0,05), otherwise, in statistically, there's no difference between before and during the treatment done in the comparison room (p > 0,05). Having observed the result of `Enviracaire', more effectively useful until the third week. This device or instrument timing is efficiently used for researches approximately 70 %, otherwise the contribution of cleaning air device succeeded in reducing the quantity germ colonization of 94,2 %. Descriptively, decreasing germ colonization are following decreasing incidentally accured. Nosocomial Infection in ICU (from 14,81% reducing of 6,25 %). Following further information whether there's a correlation between setting cleaning air conditioning system off and occurred disease germ rate of Nosocomial Infection should be done.
Suggestion should be great done for reducing or decreasing occurred disease germ of Nosocomial Infection by mean of `Enviracaire', the well cleaning air system, in accordance with this potentially of device. However, this sophisticated facility or device should be kept cleaned and well maintained periodically at least three times a week of it's filter.
Bibliography: 34 (1.961 - 1996)
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