Factors Related To The Standard Of Care And Installation Of A Dower Cateter In A Hospital

Background: Urethral catheter placement is a form of nursing care performed by nurses, a standard for catheter placement is required. Urinary tract infections often occur around 40% of all hospital infections each year. In addition, from some researchers, 80% of urinary tract infections occur due to the use of catheterization instruments, because almost 10% of all hospitalized patients, at Bantul Hospital in 2017 There are 21% of patients are infected with the urinary tract. Nurse compliance uses standards based on various factors. 
Research Objectives: To determine the factors associated with the participation of nurses in the implementation of the standard installation of urethral catheters 
Research Methods: Descriptive analytic research by discussing the cross-sectional study. The sample used was total sampling with a sample of 43 nurses according to inclusion criteria. Data collection tools using questionnaires and observation sheets. Chi-Square data analysis with α <0.05. 
Results: The gender of female respondents was 76.7%. Age of respondents received 18-40 years 76.7%. The level of knowledge of respondents in the good category is 65.1%. The attitude of respondents in the positive category was 83.7%. The working period of respondents <5 years 51.2%. There is a significant relationship to age with the implementation of the standard implementation of urethral catheters, (P = 0.003 with an OR value of 2.54). There is a significant relationship between knowledge and the implementation of standard urethral catheter placement (P = 0,000 with an OR value of 19.50). There is a significant relationship between attitude with the agreement on the implementation of the standard urethral catheter installation (P = 0.007 with an OR value of 0.361). There is a significant relationship between a work period and the implementation of the standard implementation of urethral catheters (P = 0,000 with an OR value of 20.40). 
Conclusion: There is a significant relationship between age, knowledge, attitudes, and years of service to the approval of nurses in the implementation of the standard installation of urethral catheters in care in Bantul Hospitall 
Keywords: Working period of a nurse, and catheter installation standards 
 


INTRODUCTION
Urinary tract infections are nasocomial infections that often occur around 40% of all hospital infections each year (Burke and Zavasky, 1999).
Additionally, from some researchers 80% of nosocomial UTI (urinary tract infections) occur after the use of instruments, especially catheterization (Asher, Oliver and Fry, 1986), because almost 10% of all hospitalized patients use a catheter, prevention of UTI infections is a major factor in reducing nasocomial infections, (Tietjen, 2005).
In developing countries the occurrence of nosocomial infections is high due to lack of supervision, lack of compliance with standards, poor prevention practices, inappropriate use of limited resources and overcrowded hospitals by patients (Sumaryono, 2005). Survey data conducted by AMRIN (Anti Microbal Resistance In Indonesia) research group, in Dr. Kariadi Semarang in 2002, the highest incidence was 11% Sugiono, (1999) in Kasmad, (2007).
Installation actions that are not good or not in accordance with the standards must be removed by providing quality services and good care. The results of previous studies that showed that catheter placement and dressing were not good or were not in accordance with fixed procedures, among others, there was still a long urethral catheter installation for more than 15 days Riyantinah (1999). In the research Ribek (2000) showed the compliance of nurses in the implementation of standards, one of which is the standard installation of urethral catheters not yet implemented 100% of nurses.
Catheterization is the act of inserting a rubber or plastic tube through the urethra and entering the bladder (Alimul, 2004 Age data is categorized into young and old.
Frequency distribution of categorization of respondent's age data can be seen in the table.
Based on the analysis results it is known that most respondents in the old category were 10 people (76.7%), while respondents in the young category were 33 people (23.3%).

b. Gender
The sex of the respondents consisted of men and women. The frequency distribution of obey disobey respondents' gender data can be seen in the following table. Based on the table above, it is known that the majority of respondents were female as many as 33 people (76.7%), while those who were male were 10 people (23.3%).

c. Years of service
The working period is grouped into <5 years (new) and> 5 years (old). The results of data analysis of the respondent's tenure are as follows.
Based on the results of the analysis, it is known that most of the respondents work only as many as 22 people (51.2%), while the rest have worked long time as many as 21 people (48.8%).

d. Knowledge
Knowledge level data is categorized into good and bad knowledge. The results of the analysis of respondents' knowledge level can be seen in  (2007) which states that the longer the service period of an officer the more his skills will be in obeying regulations.

CONCLUSION
There is a significant relationship between age, knowledge, attitude, and length of service of nurses' compliance in implementing the standard urethral catheter installation in Bantul Hospital.

SUGGESTION.
It is expected that efforts are needed to improve