Shodiqurrahman, Rizky and Dr. dr. Wisnu Barlianto, M.Si. Med, Sp A (K) and Ns. Suryanto, S,Kep., M.Nurs, PhD (2024) Studi Fenomenologi: Pengalaman Perawat Public Safety Center (PSC) 119 dalam Penanganan Kegawatdaruratan Saat Era Pandemi Covid-19 di Malang Raya. Magister thesis, Universitas Brawijaya.
Abstract
Pandemi virus corona secara signifikan berdampak pada sistem perawatan kesehatan. Pada Desember 2019, wabah menular dengan etiologi yang tidak diketahui terdeteksi di Wuhan, Provinsi Hubei, China. Telah diidentifikasi sebagai agen yang menyebabkan berjangkitnya virus corona baru, SARS-CoV-2. World Health Organization (WHO) menyatakan wabah virus corona SARS-CoV-2 sebagai darurat kesehatan masyarakat internasional yang mempengaruhi lebih dari 4,5 juta orang, yang telah menyebabkan lebih dari 14.510 kematian. Update kasus Covid-19 dunia yang dilaporkan hingga 28 Mei 2023, ada lebih dari 767 juta kasus yang dikonfirmasi dan lebih dari 6,9 juta kematian telah dilaporkan secara global. Di Indonesia total akumulatif terdapat kasus positif Covid-19 berjumlah 6.806.288 jiwa dan kematian akibat Covid-19 secara akumulatif terdapat 161.739 jiwa. Coronavirus sendiri merupakan sekumpulan virus yang berasal dari subfamili Orthocronavirinae dalam keluarga Corona viridae dan ordo Nidovirales. Tanda dan gejala pasien covid bervariasi, mulai dari tanpa gejala sampai dengan gejala berat. Tidak jarang pasien covid mengalami kondisi gawat darurat berupa sesak nafas hebat dengan penurunan saturasi yang beresiko pada kematian. Dengan banyaknya kasus gawat darurat pada pasien covid maupun kegawatdaruratan non covid di saat pandemi, dibutuhkan penanganan kegawatdaruratan yang tersistem mulai dari pra rumah sakit hingga di rumah sakit. Di Indonesia, terdapat sistem layanan gawat darurat yang disebut dengan Sistem Penanggulangan Gawat Darurat Terpadu (SPGDT). SPGDT merupakan suatu mekanisme pelayanan korban / pasien gawat darurat yang terintegrasi dan berbasis call center dengan menggunakan kode akses telekomunikasi 119 dengan melibatkan masyarakat. Layanan pra rumah sakit memiliki andil besar pada pasien kegawatdaruratan covid maupun non covid. Hal ini karena kegawatdaruratan sering terjadi di masyarakat sehingga masyarakat membutuhkan layanan ambulan untuk penanganan di lokasi kejadian dan saat merujuk ke fasilitas kesehatan yang memadai. Penanganan sistem penanggulangan gawat darurat terpadu secara peraturan dan undang-undang pun telah dicanangkan oleh pemerintah Republik Indonesia melalui Permenkes no.19 tahun 2016 dengan pertimbangan terkait peningkatan jumlah korban atau kecacatan hingga meninggal dan dalam rangka peningkatan mutu pelayanan dalam penanganan kegawatdaruratan. Maka dari itu untuk mendukung terlaksana SPGDT, dibentuklah Pusat Komando Nasional (National Command Center) yang bergerak di pemerintah pusat dan yang bergerak di ingkup pemerintahan daerah yaitu Pusat Pelayanan Keselamatan Terpadu/ Public Safety Center. Penelitian ini mengeksplorasi makna pengalaman perawat Public Safety Center (PSC) 119 dalam melaksanakan pelayanan gawat darurat pada era pandemi Covid-19 di Malang Raya. Tujuan dalam penelitian ini adalah mengeksplorasi perasaan perawat PSC, motivasi perawat PSC,hambatan perawat, tantangan perawat PSC dan harapan perawat PSC dalam pelayanan kegawatdauratan saat era pandemi di Malang Raya. Partisipan dalam penelitian ini terdiri dari 11 (Sebelas) orang dengan jenis kelamin laki – laki dan perempuan yang dipilih dengan metode purpossive sampling. Tekhnik pengambilan data dengan melakukan indeept interview atau wawancara mendalam. Penelitian menggunakan desain penelitian dengan pendekatan studi fenomenologis.Berdasarkan analisis data pada sebelas partisipan dengan metode Interpretative Phenomenological Analysis (IPA) ditemukan 12 (dua belas) tema sebagai berikut. (1) Perasaan sedih dan dilema menghadapi penurunan kondisi hingga kematian pada pasien, (2) Perasaan bangga melihat perbaikan kondisi pasien, (3) Perasaan khawatir tertular penyakit, (4) Bermanfaat dalam menolong pasien melewati pandemi, (5) Situasi memaksa - proses alami menghadapi kondisi pandemi, (6) Rasa tanggung jawab atas pekerjaannya, (7) Keterbatasan gerak saat menggunakan alat pelindung diri, (8) Keterbatasan sarana pelayanan dan fasilitas kesehatan, (9) Pengalaman menghadapi bermacam situasi kegawatdaruratan disaat pandemi, (10) Risiko penularan virus yang tinggi, (11) Peningkatan sarana-prasarana dan kualitas pelayanan kesehatan, dan (12) Peningkatan kapasitas keilmuan dan kompetensi personel PSC. Pada interpretasi tema hasil penelitian diatas, peneliti akan mendisikusikan tema hasil penelitian yang ditemukan kemudian membandingkannya dengan literatur dan hasil penelitian sebelumnya yang relevan. Pembahasan interpretasi tema hasil penelitian ini diuraikan berdasarkan tujuan khusus penelitian. Hal yang paling penting yang dapat diberikan dari penelitian ini yaitu dapat memberikan pelajaran kepada setiap tenaga kesehatan khususnya perawat PSC bahwa perawat mampu menangani setiap masalah kesehatan khususnya masalah Kesehatan gawat darurat - kritis seperti pandemi tetapi dibutuhkan kesiapan dari setiap perawat dan juga ketersediaan peralatan-peralatan medis yang memadai dalam menangani kondisi krisis kesehatan yang terjadi saat pandemi. Tetapi, tindak lanjutnya adalah diperlukan pelatihan khusus dan penatalaksanaan gawat darurat kondisi bencana dan pandemi. Diperlukan pelatihan untuk seluruh petugas di lingkup pra rumah sakit tidak hanya petugas medis tetapi juga petugas non medis. Kesimpulan dari penelitian ini yaitu (1) Tujuan khusus pertama terkait perasaan perawat PSC 119 dalam melaksanakan pelayanan gawat darurat saat era pandemi di Malang Raya dapat dijawab dengan tema 1, 2, dan 3 yaitu perasaan sedih dan dilema menghadapi penurunan kondisi hingga kematian pada pasien, perasaan bangga melihat perbaikan kondisi pasien, dan perasaan khawatir tertular penyakit. (2) Tema 4, 5 dan 6 telah mewakili tujuan khusus kedua yaitu motivasi perawat PSC 119 dalam melaksanakan pelayanan gawat darurat saat era pandemi di Malang Raya. Saat melakukan pelayanan kegawatdaruratan kepada pasien disaat pandemi Covid-19, motivasi perawat PSC yaitu bermanfaat dalam menolong pasien melewati pandemi, situasi memaksa - proses alami menghadapi kondisi pandemi, dan rasa tanggung jawab atas pekerjaannya. (3) Berikutnya tema 7 dan tema 8 juga telah menjawab tujuan khusus ketiga yaitu hambatan perawat PSC 119 dalam melaksanakan pelayanan gawat darurat saat era pandemi di Malang Raya. (4) Tema 9 dan 10 telah menjawab tujuan khusus penelitian keempat yaitu tantangan perawat PSC 119 dalam melaksanakan pelayanan gawat darurat saat era pandemi di Malang Raya. Tantangan yang didapati perawat PSC dalam melakukan pelayanan kegawatdaruratan yaitu pengalaman menghadapi bermacam situasi kegawatdaruratan disaat pandemi dan risiko penularan virus yang tinggi. (5) Tujuan kelima yaitu harapan perawat PSC dalam pelayanan kegawatdauratan saat era pandemi di Malang Raya. Harapan yang dimiliki tersebut terjawab dari tema 11 dan tema 12 yaitu peningkatan sarana-prasarana dan kualitas pelayanan kesehatan hingga peningkatan kapasitas keilmuan dan kompetensi personel PSC. Saran dari penelitian ini yaitu perlunya menyiapkan sistem manajemen dan kerjasama tim dalam setiap proses keperawatan kegawatdaruratan di pra rumah sakit khususnya dalam menangani pasien dengan berbagai kasus gawat darurat saat terjadi suatu wabah/pandemi Covid-19. Penelitian ini dapat menambah pengetahuan tentang proses pelayanan kegawatdaruratan pra rumah sakit yang dilakukan oleh personel PSC terkhusus tenaga perawat, sehingga dapat digunakan sebagai bahan kajian literatur. Perlunya menyiapkan sistem manajemen dan kerjasama tim dalam setiap proses keperawatan kegawatdaruratan di pra rumah sakit khususnya dalam menangani pasien dengan berbagai kasus gawat darurat saat terjadi suatu wabah/pandemi Covid-19.
English Abstract
Covid-19 pandemic has significantly impacted the healthcare system. In December 2019, an infectious outbreak of unknown etiology was detected in Wuhan, Hubei Province, China. It has been identified as the agent that causes the outbreak of the new coronavirus, SARS-CoV-2. The World Health Organization (WHO) declared the SARS-CoV-2 coronavirus outbreak an international public health emergency affecting more than 4.5 million people, which has caused more than 14,510 deaths. Update on world Covid-19 cases reported as of May 28 2023, there are more than 767 million confirmed cases and more than 6.9 million deaths have been reported globally. In Indonesia, the accumulative total of positive cases of Covid-19 is 6,806,288 people and the accumulative deaths due to Covid-19 are 161,739 people. Coronavirus is a part of group from Orthocronavirinae subfamily in the Corona viridae family and the Nidovirales order. Covid-19 has variations of signs and symptoms, from asymptomatic to severe symptoms. No often for Covid-19 patients, they have experience about emergency conditions such as severe shortness of breath with decrease saturation which carries a risk of death. With the large number of emergency cases in Covid-19 patients emergencies during the pandemic, systematic emergency management is needed from pre-hospital to hospital. In Indonesia, there is an emergency service system called the Integrated Emergency Management System (SPGDT). SPGDT is an integrated and call center-based emergency victim/patient service mechanism using telecommunications access code 119 with involvement of the community. Pre-hospital services have a big contribution to emergency patients with Covid-19 and those without. That is because emergencies often occur in the community, so people need ambulance services for treatment at the scene and when referred to adequate health facilities. The handling of an integrated emergency management system according to regulations and laws has also been launched by the government of the Republic of Indonesia through Minister of Health Regulation no. 19 of 2016 with considerations related to the increase in the number of victims or disability to death and in the context of improving the quality of services in handling emergencies. Therefore, to support the implementation of SPGDT, a National Command Center was formed which operates within the central government and which operates within the regional government sphere, namely the Integrated Safety Service Center/Public Safety Center. This research explores the meaning of the experiences of Public Safety Center (PSC) 119 nurses in carrying out emergency services during the Covid-19 pandemic era in Greater Malang. The aim of this research is to explore the feelings of PSC nurses, the motivation of PSC nurses, the barriers of nurses, the challenges of PSC nurses and the hopes of PSC nurses in emergency services during the pandemic era in Malang Raya. Participants in this research consisted of 11 (Eleven) people, male and female, who were selected using the purposive sampling method. The data collection technique is by conducting in-depth interviews. The research uses a research design with a phenomenological study approach. Based on data analysis on eleven participants using the Interpretative Phenomenological Analysis (IPA) method, 12 (twelve) themes were found as follows. (1) Feelings of sadness and dilemma in facing a decline in the patient's condition to death, (2) Feelings of pride in seeing the improvement in the patient's condition, (3) Feelings of worry about contracting the disease, (4) Useful in helping patients get through the pandemic, (5) Forced situations - process experience of facing pandemic conditions, (6) Sense of responsibility for one's work, (7) Limited movement when using personal protective equipment, (8) Limited means of health services and facilities, (9) Experience in dealing with various emergency situations during a pandemic, (10) Risk high transmission of the virus, (11) Improved facilities and quality of health services, and (12) Increased scientific capacity and competency of PSC personnel. In interpreting the themes of the research results above, researchers will discuss the themes of the research results found and then compare them with relevant literature and previous research results. Discussion of the interpretation of the themes of this research results is described based on the specific research objectives. The most important thing that can be given from this research is that it can teach every health worker, especially PSC nurses, that nurses are able to handle every health problem, especially emergency - critical health problems such as pandemics, but it requires readiness from every nurse and also the availability of medical equipment. adequate in dealing with the health crisis conditions that occurred during the pandemic. However, the follow-up requires special training and emergency management in disaster and pandemic conditions. Training is required for all pre-hospital staff, not only medical staff but also non-medical staff. The conclusions of this research are (1) The first specific objective regarding the feelings of PSC 119 nurses in carrying out emergency services during the pandemic era in Malang Raya can be answered with themes 1, 2, and 3, namely feelings of sadness and dilemma in facing a decline in the patient's condition to the point of death. Feelings of pride seeing the improvement in the patient's condition, and feelings of worry about contracting the disease. (2) Themes 4, 5 and 6 represent the second special objective, namely the motivation of PSC 119 nurses in carrying out emergency services during the pandemic era in Greater Malang. When providing emergency services to patients during the Covid-19 pandemic, the motivation of PSC nurses is to be useful in helping patients through the pandemic, emergency situations - the natural process of dealing with pandemic conditions, and a sense of responsibility for their work. (3) Next, theme 7 and theme 8 have also answered the third specific objective, namely the obstacles for PSC 119 nurses in carrying out emergency services during the pandemic era in Greater Malang. (4) Themes 9 and 10 have answered the fourth specific research objective, namely the challenges of PSC 119 nurses in carrying out emergency services during the pandemic era in Greater Malang. The challenges faced by PSC nurses in providing emergency services include experience in dealing with various emergency situations during a pandemic and the high risk of virus transmission. (5) The fifth goal is the hope of PSC nurses in emergency services during the pandemic era in Malang Raya. These hopes were answered from theme 11 and theme 12, namely improving the infrastructure and quality of health services to increasing the scientific capacity and competence of PSC personnel. The suggestion from this research is we are need to prepare a management system and team collaboration in pre-hospital emergency nursing process, especially when nurses try to handling patients with various emergency cases during a Covid-19. This research can increase knowledge about the pre-hospital emergency service process carried out by PSC personnel, especially nurses, so that it can be used as material for a literature review. It is necessary to prepare a management system and team collaboration in every pre-hospital emergency nursing process, especially in handling patients with various emergency cases during a Covid-19 outbreak/pandemic.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 0424160006 |
| Divisions: | S2/S3 > Magister Keperawatan, Fakultas Kedokteran |
| Depositing User: | soegeng sugeng |
| Date Deposited: | 05 Apr 2024 01:06 |
| Last Modified: | 05 Apr 2024 01:06 |
| URI: | http://repository.ub.ac.id/id/eprint/218060 |
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