Jenis nosokomial di Pusat Jantung Nasional Harapan Kita (PJNHK) yang angkanya paling tinggi pada Januari - Juni 2003 adalah pneumonia, terutama di ruang perawatan intensif. Penelitian ini bertujuan untuk menganalisis faktor karakteristik pasien (umur, penyakit penyerta, jenis ruang perawatan intensif, lama inap, lama pemakaian ventilator mekanik), serta mengetahui gambaran bakteriologis tangan perawat, dan udara ruang perawatan intensif pada terjadinya infeksi pneumonia nosokomial pada pasien.Penelitian dilakukan di ruang Intensive Cure Unit (ICU) dan Cardio Vascular Care (CVC) PJNHK dengan desain Potong Lintang (Cross Sectional). Populasi dan sampel adalah pasien yang menggunakan ventilator mekanika 48 jam. Data mengenai karakteristik pasien dan kejadian infeksi nosokomial Maret 2003 - Februari 2004 dianalisis dengan Uji x2 atau Uji Fisher Exact pada a= 0,05. Odds Ratio dihitung untuk melihat kekuatan hubungan. Data gambaran bakteriologis tangan perawat dan udara ruang perawatan intensif dikumpulkan pada Januari - Februari 2004. Garnbaran bakteriologis tangan perawat diukur dengan swab tangan kanan terhadap 20 perawat setelah mencuci tangan, Sedangkan bakteriologis udara ruang perawatan intensif diukur dengan liquid impinger.Jumlah pasien yang memenuhi syarat sebagai sampel adalah 76 orang. Prevalensi pneumonia nosokomial di antara pasien yang menggunakan ventilator mekanik ? 48 jam adalah 78,9%. Karakteristik pasien yang berhubungan dengan pneumonia nosokomial adalah jenis ruang perawatan intensif (p-),000), umur (p=x,024), dan interaksi umur jenis ruang perawatan intensif (p=0,006). Pemeriksaan swab tangan dengan hasil positif ditemukan pada 20% perawat. Jutnlah koloni kuman di kedua ruangan pada semua titik melebihi standard. Jenis bakteri yang ditemukan pada tangan perawat yaitu Stapliilococcus epider nidis dan Enterobacter aerogenes. Jenis bakteri udara yang ditemukan adalah Enterobacter aerogenes dan Enterobacter agglomerans.Karakteristik pasien yang paling berhubungan dengan pneumonia nosokomial adalah jenis ruang perawatan intensif. Kemungkinan tangan perawat dan udara ruang perawatan intensif merupakan jalur transmisi pneumonia nosokomial sangat kecil. Disarankan kepada PJNHK untuk meningkatkan perhatian pada pasien pengguna ventilator mekanik > 2 hari. Perlu dilakukan studi prospektif untuk mendapatkan hasil yang lebih baik.Daftar Bacaan : 59 (1971 - 2003)
Characteristics of Patients and Bacteriological Descriptions of Nurses's Hand and Air of Intensif Care Rooms in the Incidence of Nosocomial Pneumonia at National Cardiovascular Center Harapan Kita Jakarta 2003 - 2004Type of nosocomial whose rates was highest at National Cardio Vascular Centre (NCC) in January - June 2003 was pneumonia, especially in Intensive Care Room. This study was to analyze factors of patients' characteristics (age, other diseases, types of intensive care room, duration of hospitalization, duration of Mechanical Ventilator), and to obtain bacteriological descriptions of nurse?s hand, and air of intensive care room in the incidence of Nosocomial Pneumonia in the patients.The study was conducted in Surgical and Medical Intensive Care Services of P.TNHK using A Cross Sectional Study. Population and sample are the patients who using mechanical ventilator a 48 hours Data of patients' characteristics and incidence of nosocomial pneumonia on March 2003 - February 2004 was analyzed using xz Test or Fisher Exact Test (a = 0,05). Odds Ratio was counted to see the power of the relationship, Data of bacteriological descriptions of nurse?s hands and air of intensive care room were collected on January- February 2004. Bacteriological descriptions of nurse?s hand was measured by swabbing of right side of 20 nurses' hands after hand washing. Bacteriological descriptions of air of intensive care room were measured using liquid impinger.Number of patients who were eligible as samples were 76 patients. Prevalence of nosocomial pneumonia among patients using mechanical ventilator a 48 hours were 78,9%. Characteristics of patients which had significant association with nosocomial pneumonia were type of intensive care room (p-O,000), age (0,024), and interaction of age* type of intensive care room (p=0,006). Examination by hand swab with positive result were found in 20% of nurses. Number of colony of bacteria at two rooms on all of points were over standard. Species of bacteria which were found from nurses's hand were Staphilococcus epidermidis and Enterobacter aerogenes. Species of air bacteria were Enterobacter aerogenes and Enterobacter agglomerans.Characteristics of patients which have significant strong association with nosocomial pneumonia are type of intensive care room. There is a little possibility that nurses' hand and air of intensive care room are path of transmission of nosocomial pneumonia. It is suggested that NCC improve their noticement for patients who used mechanical ventilator > 2 days. Prospective study is suggested to obtain a better result.References : 59 (1971 - 2003) |
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