CD Disertasi

Model Pengelolaan Limbah Medis Padat di Puskesmas Kota Pekanbaru

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Background and Purpose: Covid-19 infectious medical waste generated by health facilities is an issue during this pandemic. Used masks, gloves, used syringes, used infusion sets, and used personal protective equipment include hazardous waste and toxic waste or waste. According to the Pekanbaru City Health Department, Pekanbaru generates an average of 42 tons of medical waste every month. Meanwhile, Puskesmas generates more than two tons of medical waste annually. To evaluate the environmental health performance of Puskesmas, the medical waste management system in Puskesmas needs to be monitored in addition to conducting qualitative and quantitative analysis of the system. There are 21 Puskesmas in Pekanbaru City that generated 4,142 kilograms of waste in 2021. In order for health services to run as efficiently as possible, it is necessary to pay attention to or evaluate waste management techniques that are in accordance with applicable regulations because the average health center manages waste independently or manually. The approach taken to obtain primary and secondary data in order to conduct monitoring activities in the form of measurements with measuring instruments, laboratory tests, recording conditions, and medical waste handling cases is the main method for data monitoring.The purpose of this research is to analyze the current condition of solid medical waste management in Pekanbaru City in terms of ecology, economy, and social to develop a solid medical waste management model for puskesmas in Pekanbaru City. Method: This research uses a mixed method approach, where the quantitative approach becomes the main data and serves to strengthen the data and information obtained with a qualitative approach. This research was conducted at all Puskesmas in Pekanbaru City, Riau Province, which amounted to 21 Puskesmas. Results and Discussion: Current existing conditions, most of the Pekanbaru City Health Centers have sufficient human resources, where all health centers have policies / SOPs related to solid medical waste management. For infrastructure facilities, it is still insufficient, but all puskesmas have sorted solid medical waste. Furthermore, temporary storage or waste storage is still a lot that is not feasible and some PHC environmental health programs are achieved which can manage solid medical waste properly. The results of bivariate analysis obtained p value 200 kg in 13 Puskesmas or 62.9%. Based on the amount of medical waste, this exceeds the capacity of the Puskesmas solid medical waste storage. Puskesmas waste management can be said to be good if it is able to manage solid medical waste starting from sorting waste routinely, collecting waste routinely, collecting waste routinely, transporting waste by third parties and disposing of waste. The health center must also have a warehouse/waste storage that is sufficient to accommodate the amount of waste in the health center. Barriers encountered in solid medical waste management are influenced by internal and external factors: Internal Factors. 1) Strengths: adequate land, adequate human resources, funds from BOK and BPJS, large amount of waste generated, and expansion of the scope of visits to health centers. 2) Weaknesses: lack of support from puskesmas management, low staff behavior in sanitation efforts at puskesmas, inadequate waste treatment facilities, and suboptimal budgeting for medical waste management. The alternative strategies needed at the Pekanbaru City Health Center are as follows: 1)Focus on developing a clinical waste management framework. 2) Budget for the purchase of medical waste treatment facilities. 3) maximize the role of sanitarians at puskesmas. 4) Supervision of medical waste in health centers. 5) Existence of regional regulation on solid medical waste management in Pekanbaru City. 6) Organizing medical waste management workshops at puskesmas. In more detail, the SWOT analysis and SWOT strategy can be explained as follows: 1) trength and Weakness Analysis: Internal aspects are the focus of this analysis. Since the level of strength can be determined by understanding each of these strengths and weaknesses, it is necessary to identify strengths and weaknesses. Activities are based on strengths, while management weaknesses limit and prevent them from reaching their full potential. Because of this weaknesses must not only be identified but also followed by management's willingness to accept having weaknesses. The linkage of the Puskesmas management system with the Regional Public Service Agency (BLUD) is the strongest point of this study. Puskesmas becomes a more technically and managerially independent institution with this BLUD status, including solid medical waste management at Puskesmas. In terms of the availability of infrastructure, personal protective equipment, environmental health officers, and other aspects that support solid medical waste management at Puskesmas, such as technology-based medical waste management information systems, this system allows BLUD to better manage solid medical waste. The weakness is the limited budget owned by the Puskesmas to be allocated by the Puskesmas to solid medical waste management. The number of activities carried out and the existence of priority programs make it sometimes difficult to allocate specifically to solid medical waste management at Puskesmas. This of course must be considered carefully so that it becomes a consideration in determining the novelty of the study. 2) Opportunity and Threat Analysis: Opportunities are things in the environment that are expected to help management, and threats are things that come from outside. Support obtained from the Pekanbaru City Health Office as the agency that oversees the Puskesmas. This support is carried out in order to realize the achievement of environmental health programs at the Puskesmas. Environmental health as an essential program at the Puskesmas has an important role in the Puskesmas. The novelty of this study is expected to get the support of the Health Office because it can facilitate the management of solid medical waste in all Puskesmas in Pekanbaru City. The threats that arise are the limited resources available at the Puskesmas, both human resources who use applications and technological resources due to the limited infrastructure at the Puskesmas. Then also the threat that can be seen is that the support from the Pekanbaru City Health Office cannot be a reference by the Puskesmas considering that the Puskesmas has its own authority over its institution. Based on the results of the SWOT analysis above, it can be concluded that the need for study renewal given the strengths of the Puskesmas then with opportunities in the form of support from the Pekanbaru City Health Office while still considering weaknesses and minimizing existing threats, the novelty in this study is a solid medical waste management model.
Conclusion: Based on the results of the study, with this model, it can make waste management more efficient and effective, and can utilize existing human resources and SDS in health facilities, especially Puskesmas. By using this model, it will simplify the process and be easier to monitor waste. In this model, it focuses on several main strategies, namely conducting routine roleplay in waste management, ensuring that all waste management activities are carried out according to SOPs and using complete PPE, monitoring the amount of waste collected regularly, and creating an Information System for Solid Medical Waste Management at Puskesmas Pekanbaru City (based on SWOT Analysis).

Bibliography: 47 (from 2012 to 2012)

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

2010341971

Penerbit

Pekanbaru : Universitas Riau – PASCASARJANA – Disertasi S3 Ilmu Lingkungan., 2023

Deskripsi Fisik

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Bahasa

Indonesia

ISBN/ISSN

-

Klasifikasi

2010341971

Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

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Subjek

PASCASARJANA (DISERTASI) ILMU LINGKUNGAN

Info Detail Spesifik

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Pernyataan Tanggungjawab

Mutia

Versi lain/terkait

Lampiran Berkas

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