EVALUASI EFEKTIFITAS PROSEDUR CUCI TANGAN PADA OPERATOR PUNGSI LUMBAL DI BAGIAN NEUROLOGI RSUP R.D. KANDOU MANADO

EVALUATION OF EFFECTIVENESS OF WASHING PROCEDURE ON OPERATOR PUNGSI LUMBAL IN PART NEUROLOGY RSUP R.D. KANDOU MANADO

Abstract

Pendahuluan: Kebersihan tangan operator tindakan pungsi lumbal (lumbar puncture = LP) sangat penting. Edukasi prosedur cuci tangan operator LP di Bagian Neurologi RSUP Kandou Manado hanya dilakukan lewat sosialisasi dan pelatihan. Belum pernah dibuat evaluasi efektifitas prosedur yang dikerjakan tersebut. Tujuan: Penelitian ini ingin mengevaluasi apakah prosedur cuci tangan yang diajarkan selama ini memberikan hasil buruk, baik, atau sempurna. Metode: Kami mengembangkan cara evaluasi dengan sistem skoring. Komponen penilaian dibagi atas Kepatuhan Saat, Teknik, dan Efikasi. Selanjutnya dibuat Evaluasi Keseluruhan. Untuk Efikasi kami menggunakan simulasi kuman dengan losion fluoresen yang dapat dibilas air, Lumigerm® dan mengevaluasinya di bawah lampu ultraviolet oleh dua penilai. Diskusi: Didapatkan 28 subyek dengan 16 orang di antaranya perempuan (57,1%). Rerata usia 32,6 tahun (±SD 4,42). Paling banyak subyek duduk di semester 2 (7 orang, 25%). Seluruh subyek patuh melakukan cuci tangan sesuai saat, 22 subyek (78,6%) melakukan teknik cuci tangan dengan tepat, dan 21 subyek (75%) memiliki efikasi buruk. Daerah sela-sela jari dan punggung tangan kedua tangan adalah daerah yang paling tidak bersih setelah dicuci. Lamanya cuci tangan mungkin mempengaruhi efikasi. Kesimpulan: Untuk operator LP, prosedur cuci tangan dengan air mengalir perlu dimodifikasi dengan memperlama waktu cuci tangan dan memberi perhatian khusus pada daerah sela-sela jari dan punggung tangan.

Kata kunci: kebersihan tangan, pungsi lumbal, prosedur.

Abstract

Background: Lumbar puncture (LP) operator’s hand hygiene is important. Handwashing procedure education in LP operators in Neurology Department Kandou Hospital was just conducted using dissemination and training. There was no evaluation been made for that procedure yet. Aims: This study wanted to evaluate whether the handwashing procedure taught provided poor, good, or perfect result. Methods: We developed a scoring system for the evaluation. The components to be evaluated were divided to Adherence, Technique, and Efficacy. After that we do the overall evaluation. For efficacy we used germ simulation with water-washable fluorescent lotion, Lumigerm®, and evaluated it under ultraviolet lamp by two evaluators. Result: We find 28 subjects and 16 are female (57.1%). Mean age is 32.6 years old (±SD 4.42). Mostly, they are on the 2-nd semester (7 persons, 25%). All of them adhere to wash their hand accordingly, 22 subjects (78.6%) perform the handwashing technique correctly, and 21 subjects (75%) have poor efficacy. Interdigital and dorsal part of both of the hands are the the most unclean region after handwashing. Duration of handwashing may influence the efficacy. Conclusion: For LP operators, handwashing procedure with running water needs to be modified by prolonging the handwashing time and pay special attention to the interdigital and dorsal part of the hands.

Keywords: hand hygiene, lumbar puncture, procedure.