Strategi Administrasi dan Lingkungan Pengelolaan Limbah Medis Berdasarkan Kinerja Petugas di Puskesmas Kabupaten Jember

Abstract

Latar Belakang: Hasil survei dan data Dinas Kesehatan tahun 2021 menyatakan bahwa Puskesmas Kabupaten Jember memiliki perawatan rawat inap yang dapat menghasilkan timbulan limbah sebanyak 15-70,5kg setiap minggu. Pengelolaan limbah medis di Puskesmas Kabupaten Jember masih belum memenuhi standar mulai dari pemilahan hingga penyimpanan di tempat penampungan sementara. Permasalahan yang ditemukan, masih terdapat petugas Puskesmas yang membuang limbah medis tidak sesuai fungsinya, pengangkutan limbah medis tidak dilakukan 1x24 jam dan penyimpanan limbah medis di TPS lebih dari 2x24 jam. Pengelolaan limbah apabila tidak dilakukan dengan optimal dapat menimbulkan berbagai penyakit, terutama infeksi nosokomial. Pengelolaan limbah padat di Puskesmas harus dilakukan dengan benar, efektif dan memenuhi persyaratan sanitasi, sehingga perlu adanya strategi dalam pengelolaan limbah medis di Puskesmas.Metode: Penelitian ini merupakan penelitian kuantitatif. Jenis penelitian  analitik observasional dengan  desain  rancang cross sectional di 11 Puskesmas Kabupaten Jember. Populasi dan sampel sebanyak 90 responden yaitu petugas kebersihan, dokter, bidan, perwat, apoteker dan tenaga teknis kefarmasian (TTK), dengan mengamati variabel bebas sumber daya, kepemimpinan, struktur, design pekerjaan, imbalan dan variabel terikat yaitu pengelolaan limbah medis. Data  hasil  kuesioner dianalisis menggunakan uji Rank Spearman’s dan dianalisis menggunakan analisis SWOT. Hasil: Hasil analisis administrasi diketahui perlu adanya peningakatan pemanfaatan struktur organisasi mandiri, meningkatkan dan mengoptimalkan penambahan anggaran sarana dan prasarana, implementasi Dinas kesehatan membuat MOU dengan pihak ke 3 terkait pengelolaan limbah medis untuk wilayah kerja Puskesmas Kabupaten Jember. Hasil strategi lingkungan perlu adanya promosi peningkatan kinerja petugas guna meningkatkan PHBS lingkungan, Puskesmas memaksimalkan penyimpanan limbah medis guna meningkatkan kualitas penyimpanan dan mendesain ulang tempat penyimpanan sementara limbah medis.Simpulan: Sumber daya, kepemimpinan, desain pekerjaan dan struktur berhubungan dengan pengelolaan limbah medis sedangkan, imbalan tidak berhubungan dengan pengelolaan limbah medis. sumber daya, kepemimpinan, desain pekerjaan, struktur organisasi dan imbalan berperan penting dalam peningkatan kinerja pengelolaan limbah medis di Puskesmas Kabupaten Jember. ABSTRACT Title: Administrative and Environmental Strategy for Medical Waste Management Based on the Performance of Jember District Health Center OfficersBackground: Survey results and data from the Health Office in 2021 stated that the Jember Regency Health Center has inpatient care which can produce waste generation of 15-70.5kg every week. Medical waste management at the Jember Regency Health Center still does not meet the standards starting from sorting to storage in temporary shelters. Problems found, there are still health center officers who dispose of medical waste not according to its function, transportation of medical waste is not carried out 1x24 hours and storage of medical waste in TPS for more than 2x24 hours. Waste management if not done optimally can cause various diseases, especially nosocomial infections. Solid waste management at the health center must be carried out correctly, effectively and meet sanitation requirements, so it is necessary to have a strategy in managing medical waste at the health center.Method: This study is a quantitative study. Type of observational analytic research with cross sectional design in 11 health centers in Jember Regency. The population and sample were 90 respondents, namely janitors, doctors, midwives, nurses, pharmacists and pharmaceutical technical personnel (TTK), by observing the independent variables of resources, leadership, structure, job design, rewards and the dependent variable, namely medical waste management. The data from the questionnaire was analyzed using Spearman's Rank test and analyzed using SWOT analysis.Result: The results of the administrative analysis showed that it is necessary to increase the utilization of an independent organizational structure, improve and optimize the additional budget for facilities and infrastructure, implement the health office to make an MOU with a third party related to medical waste management for the Jember Regency Puskesmas work area. The results of the environmental strategy need to promote increased officer performance to improve environmental PHBS, Puskesmas maximize medical waste storage to improve storage quality and redesign temporary storage of medical waste.Conclusion: Resources, leadership, job design and structure are related to medical waste management whereas, rewards are not related to medical waste management. resources, leadership, job design, organizational structure and rewards play an important role in improving the performance of medical waste management in the Puskesmas of Jember Regency.