Peningkatan Pencegahan Catheter Associated Urinary Tractus Infection Melalui Penerapan Hasil Pengembangan Bundle CAUTI Berbasis Proses Keperawatan

Abstract

CAUTI can be prevented by implementing proven evidence-based practices such as the CAUTI bundle. The research objective was to develop a nursing process-based CAUTI bundle for CAUTI prevention. The research design is a mixed method. The first stage was the observation of 50 nurses carrying out the CAUTI bundle on 53 patients for 1 month. Data were analyzed descriptively, continued with literature studies, conducted FGDs with 31 participants, consulted with 7 experts, compiled the nursing process-based CAUTI module bundle, and compiled the CAUTI SPO bundle. The second stage was a module trial with a one-group pre-post test design, which involved 51 nurses and 116 patients who had urinary catheters attached. Data were analyzed using the Wilcoxon signed rank test. The results of phase 1 research showed that the implementation of the CAUTI bundle before development was included in the sufficient category at 63.24%. The results of the second phase of the study, namely the implementation of the CAUTI bundle as a result of the development before socialization, were included in the sufficient category (60.12%), and after socialization, it was included in the good category (78.71%). The results of the development module trial showed a significant difference between before and after treatment with a p = 0.000. Each component of the CAUTI bundle is explained briefly about the concept, proper assessment, problems encountered, action plans, efforts to improve compliance, how to ensure the right actions are taken and how to take the right actions. The implementation of the CAUTI bundle as a result of this development involves nurses, PPI committee and management.

Keywords: CAUTI bundles; nursing process; CAUTI prevention

ABSTRAK

CAUTI dapat dicegah dengan menerapkan praktik berbasis bukti yang sudah teruji seperti bundle CAUTI. Tujuan penelitian adalah mengembangkan bundle CAUTI berbasis proses keperawatan terhadap pencegahan CAUTI. Desain penelitian ini adalah mixed method. Tahap pertama adalah observasi 50 perawat dalam melaksanakan bundle CAUTI  pada 53 pasien selama 1 bulan.  Data dianalisis secara deskriptif, dilanjutkan studi literatur, melaksanakan FGD dengan 31 partisipan, konsultasi dengan 7 pakar, menyusun modul bundle CAUTI berbasis proses keperawatan, dan menyusun SPO bundle CAUTI. Tahap kedua adalah uji coba modul dengan rancangan one-group pre-post test design, yang melibatkan 51 perawat dan 116 pasien yang terpasang kateter urin. Data dianalisis menggunakan Wilcoxon signed rank test. Hasil penelitian tahap 1 menunjukkan bahwa pelaksanaan bundle CAUTI sebelum pengembangan termasuk dalam kategori cukup 63,24%. Hasil penelitian tahap kedua yaitu pelaksanaan bundle CAUTI hasil pengembangan sebelum sosialisasi termasuk dalam kategori cukup (60,12%), dan sesudah sosialisasi termasuk dalam kategori baik (78,71%). Hasil uji coba modul hasil pengembangan menunjukkan perbedaan yang signifikan antara sebelum dengan setelah perlakuan dengan nilai p = 0,000. Setiap komponen bundle CAUTI dijelaskan tentang konsep secara singkat, pengkajian yang tepat, masalah yang dihadapi, rencana tindakan, upaya meningkatkan kepatuhan, cara memastikan tindakan yang tepat tetap dilakukan dan bagaimana cara melakukan tindakan yang tepat. Pelaksanaan bundle CAUTI hasil pengembangan ini melibatkan perawat, komite PPI dan pihak manajemen.

Kata kunci: bundle CAUTI; proses keperawatan; pencegahan CAUTI