PENERAPAN THE RECOGNITION OF STROKE IN THE EMERGENCY ROOM MENINGKATKAN KEMAMPUAN PERAWAT DALAM DETEKSI DINI STROKE: IMPLEMENTATION OF THE RECOGNITION OF STROKE IN THE EMERGENCY ROOM IMPROVES THE CAPABILITY OF NURSES IN EARLY DETECTION OF STROKE

Kristiyani Herda Rophi; Fitri Dia Muspitha

doi:10.47539/jktp.v7i1.381

Authors

Kristiyani Herda Rophi Jurusan Keperawatan, Poltekkes Kemenkes Jayapura, Kota Jayapura, Indonesia
Fitri Dia Muspitha Jurusan Keperawatan, Poltekkes Kemenkes Jayapura, Kota Jayapura, Indonesia

Keywords:

The Recognition of Stroke in The Emergency Room, deteksi dini, stroke

Abstract

Keselamatan pasien stroke sangat ditentukan dari cepat dan tepatnya penanganan awal. Tidak semua fasilitas kesehatan memiliki computed tomography scan (CT Scan) untuk penegakan diagnosis stroke. Tenaga kesehatan di puskesmas dapat menggunakan alternatif instrumen untuk screening stroke berupa sistem skoring, sehingga dapat memberikan tindakan segera untuk menurunkan kecacatan dan kematian akibat stroke. Penelitian ini bertujuan untuk mengevaluasi pengaruh penerapan the Recognition of Stroke in the Emergency Room (ROSIER) scale terhadap peningkatan kemampuan perawat dalam mendeteksi dini stroke. Penelitian ini merupakan quasi eksperiment dengan one group pre-post-test design yang dilakukan pada perawat dengan jadwal kerja di Unit Gawat Darurat (UGD) Puskesmas. Sampel penelitian berjumlah 34 perawat. Analisis data menggunakan uji Wilcoxon signed rank. Hasil penelitian menunjukkan adanya peningkatan rata-rata kemampuan deteksi dini stroke responden sebelum dan setelah penerapan ROSIER scale, dengan peningkatan sebesar 20,26 poin (8,09±5,02 dan 28,35±2,62). Pada pre-test sebanyak 34 responden (100%) berada pada kategori tingkat tidak mampu. Hasil post-test menunjukkan 32 responden (94%) pada tingkat mampu dan 2 responden (6%) pada tingkat cukup mampu. Ada pengaruh yang signifikan penerapan ROSIER scale terhadap peningkatan kemampuan perawat dalam deteksi dini stroke (p=0,000). ROSIER scale dapat dipertimbangkan penggunaannya sebagai instrumen deteksi dini stroke oleh tenaga kesehatan di setting pra-rumah sakit.

The speed and accuracy of initial treatment highly determine the safety of stroke patients. Not all healthcare facilities have computed tomography scans (CT scans) to diagnose strokes. Healthcare workers at community health centers (puskesmas) can use alternative instruments for stroke screening in the form of scoring systems, allowing for immediate action to reduce disability and death due to stroke. This study aims to evaluate the impact of implementing the Recognition of Stroke in the Emergency Room (ROSIER) scale on improving nurses' ability to detect strokes early. This research is a quasi-experimental study with a one-group pre-post-test design conducted on nurses working in the Emergency Unit of a community health center (Puskesmas). The study sample consisted of 34 nurses. Data analysis was performed using the Wilcoxon signed-rank test. The results showed an increase in respondents' average early stroke detection ability before and after the implementation of the ROSIER scale, with an increase of 20.26 points (8.09±5.02 and 28.35±2.62). In the pre-test, all 34 respondents (100%) were incapable. The post-test results showed 32 respondents (94%) in the capable category and two respondents (6%) in the fairly capable category. The ROSIER scale implementation has a significant impact on improving nurses' ability to early detect strokes (p=0.000). The ROSIER scale can be considered for use as an early stroke detection instrument by healthcare workers in pre-hospital settings.

Downloads

Download data is not yet available.

References

Albelbeisi, A. H., Albelbeisi, A., El Bilbeisi, A. H., Taleb, M., Takian, A., & Akbari-Sari, A. (2021). Public sector capacity to prevent and control of noncommunicable diseases in twelve low-and middle-income countries based on WHO-PEN standards: a systematic review. Health Services Insights, 14, 1178632920986233. DOI: https://doi.org/10.1177/1178632920986233

Alfira, N. (2019). Pengaruh penyuluhan metode FAST terhadap pengetahuan perawat dalam deteksi dini penyakit stroke di RSUD HA Sulthan Daeng Radja Kabupaten Bulukumba. Jurnal Ilmiah Kesehatan Diagnosis, 14(1), 58-61. DOI: https://doi.org/10.35892/jikd.v14i1.98

Avan, A., Digaleh, H., Di Napoli, M., Stranges, S., Behrouz, R., Shojaeianbabaei, G., Amiri, A., Tabrizi, R., Mokhber, N., Spence, J. D., & Azarpazhooh, M. R. (2019). Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: An ecological analysis from the Global Burden of Disease Study 2017. BMC Medicine, 17(1). https://doi.org/10.1186/s12916-019-1397-3 DOI: https://doi.org/10.1186/s12916-019-1397-3

Basyit, A., Sutikno, B., & Dwiharto, J. (2020). Pengaruh tingkat pendidikan dan pengalaman kerja terhadap kinerja karyawan. Jurnal Ema, 5(1), 12-20. DOI: https://doi.org/10.47335/ema.v5i1.44

Budiman, & Riyanto, A. (2013). Kapita Selekta Kuesioner Pengetahuan dan Sikap Dalam Penelitian Kesehatan. Jakarta: Salemba Medika.

Daud William Marihot Tua, & Ainun Mardhiyah. (2022). Pengaruh Tingkat Pendidikan Dan Pengalaman Kerja Terhadap Kinerja Karyawan Bagian Keperawatan Rumah Sakit Umum Daerah Padangsidimpuan. Jurnal Akuntansi, Manajemen Dan Ilmu Ekonomi (Jasmien), 2(3), 1–8. https://doi.org/10.54209/jasmien.v2i3.170 DOI: https://doi.org/10.54209/jasmien.v2i3.170

Dinkes Kota Jayapura. (2021). Profil Kesehatan Kota Jayapura Tahun 2021. Jayapura: Dinas Kesehatan Kota Jayapura

El Hajj, M., Abdo, R., Assaf, S., & Lahoud, N. (2023). Stroke Management in Developing Countries. In Handbook of Medical and Health Sciences in Developing Countries: Education, Practice, and Research (pp. 1-31). New York City: Springer International Publishing. DOI: https://doi.org/10.1007/978-3-030-74786-2_9-1

Ghofir, A. (2021). Tatalaksana Stroke dan Penyakit Vaskuler Lainnya. Yogyakarta: UGM PRESS.

Gibbons, I., & Williams, O. (2020). FAST or ROSIER to identify suspected stroke in the prehospital setting? Emergency Medicine Journal, 37(9), 587–588. https://doi.org/10.1136/emermed-2020-210497.2 DOI: https://doi.org/10.1136/emermed-2020-210497.3

H. Buck, B., Akhtar, N., Alrohimi, A., Khan, K., & Shuaib, A. (2021). Stroke mimics: incidence, aetiology, clinical features and treatment. Annals of Medicine, 53(1), 420–436. https://doi.org/10.1080/07853890.2021.1890205 DOI: https://doi.org/10.1080/07853890.2021.1890205

Han, F., Zuo, C., & Zheng, G. (2020). A systematic review and meta-analysis to evaluate the diagnostic accuracy of recognition of stroke in the emergency department (ROSIER) scale. BMC Neurology, 20(1), 1–10. https://doi.org/10.1186/s12883-020-01841-x DOI: https://doi.org/10.1186/s12883-020-01841-x

Harris, S., Rasyid, A., Kurniawan, M., Mesiano, T., Hidayat, R. (2022). Pengantar Stroke. Buku Ajar Neurologi Edisi Kedua Volume 1. Jakarta: Departemen Neurologi FK Universitas Indonesia.

Hasnah, F. (2020). Meta Analisis Faktor Risiko Penyakit Stroke Di Asia. Applied Microbiology and Biotechnology, 85(1), 2071–2079.

He, M., Wu, Z., Guo, Q., Li, L., Yang, Y., & Feng, J. (2012). Validation of the use of the ROSIER scale in prehospital assessment of stroke. Annals of Indian Academy of Neurology, 15(3), 191–195. https://doi.org/10.4103/0972-2327.99713 DOI: https://doi.org/10.4103/0972-2327.99713

Hidayatulloh, M. K. Y., Aftoni, A., & Hilmi, M. A. (2021). Pengaruh Locus Of Control Dan Pengalaman Praktik Kerja Lapangan Terhadap Kesiapan Kerja Siswa Smk Ypm 8 Sidoarjo. JoEMS (Journal of Education and Management Studies), 4(6), 21-28.

Kemenkes RI. (2019). Keputusan Menteri Kesehatan Republik Indonesia Nomor HK. 01.07/MENKES/394/2019 tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Stroke. Jakarta: Kementerian Kesehatan RI.

Kemenkes RI. (2019). Laporan Nasional Riskesdas 2018. Jakarta: LPB.

Kemenkes RI. (2019). Laporan Provinsi Papua Riskesdas 2018. Jakarta: LPB.

Lobo, Y. (2019). Hubungan Penerapan Metode Asuhan Keperawatan Profesional (MAKP) dengan Kinerja Perawat di Ruang Kelimutu, Ruang Komodo dan Ruang Anggrek RSUD Prof. Dr. WZ Johannes Kupang. Chmk nursing scientific journal, 3(2), 126-132.

Mendrofa, H. K., & Sagala, L. (2019). Pengaruh Pelatihan Dan Penerapan Model Metode Asuhan Keperawatan Profesional (Makp) Primary Nursing Terhadap Kualitas Asuhan Keperawatan Di Rumah Sakit Kota Medan. Indonesian Trust Health Journal, 2(2), 237–245. https://doi.org/10.37104/ithj.v2i2.40 DOI: https://doi.org/10.37104/ithj.v2i2.40

Mukhlis, M. (2021). Faktor-Faktor Yang Berhubungan Dengan Penerapan Sasaran Keselamatan Pasien Pada Perawat Di Instalasi Rawat Inap Rumah Sakit Umum Daerah Kota Langsa. Jurnal EDUKES: Jurnal Penelitian Edukasi Kesehatan, 4, 133-142.

Nor, A. M., Davis, J., Sen, B., Shipsey, D., Louw, S. J., Dyker, A. G., Davis, M., & Ford, G. A. (2005). The Recognition of Stroke in the Emergency Room (ROSIER) scale: Development and validation of a stroke recognition instrument. Lancet Neurology, 4(11), 727–734. https://doi.org/10.1016/S1474-4422(05)70201-5 DOI: https://doi.org/10.1016/S1474-4422(05)70201-5

Pasambo, Y., Karundeng, Y., Bobaya, J., Desyani, N. L. J., Sarimin, D. S., & Alam, S. (2023). Peningkatan Kapasitas Masyarakat Dalam Deteksi Dini Stroke Menggunakan “Metode Fast” Pada Masyarakat Dengan Risiko Tinggi Stroke. Jurnal Pengabdian Kepada Masyarakat Nusantara, 4(4), 3220-3226.

Pasaribu, F. R., & Perangin-angin, M. A. br. (2020). The Indonesian Journal of Health Science Volume 12, No.2, Desember 2020. The Indonesian Journal of Health Science, 12(1), 76–82. DOI: https://doi.org/10.32528/ijhs.v12i1.4859

Pemerintah RI. (2016). Peraturan Pemerintah Republik Indonesia Nomor 47 Tahun 2016 tentang Fasilitas Pelayanan Kesehatan. Jakarta: Kementerian Sekretariat Negara.

Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., ... & American Heart Association Stroke Council. (2019). Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 50(12), e344-e418. https://doi.org/10.1161/STR.0000000000000211 DOI: https://doi.org/10.1161/STR.0000000000000215

Prasetyo, E. (2018). Faktor-faktor yang Mempengaruhi Keterlambatan Pasien Stroke Akut Datang ke Lima Rumah Sakit Pemerintah di DKI Jakarta. Majalah Kesehatan Pharmamedika, 9(1), 040. https://doi.org/10.33476/mkp.v9i1.674 DOI: https://doi.org/10.33476/mkp.v9i1.674

Prihati, D. R., & Prasetyorini, H. (2023). Pemberdayaan Kader Kesehatan dalam Upaya Deteksi Dini Stroke dengan Metode FAST di Kecamatan Tugu. Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM), 6(6), 2291-2297. DOI: https://doi.org/10.33024/jkpm.v6i6.9764

Purnomo, R. T., Widjajanto, E., & Sulistyarini, I. (2017). Analisis Faktor-Faktor Yang Mempengaruhi Kejadian Stroke Akut Pada Pasien Stroke Yang Dibawa Ke Instalasi Gawat Darurat Rsi Klaten. Motorik, 12(24), 10–31.

Purrucker, J. C., Hametner, C., Engelbrecht, A., Bruckner, T., Popp, E., & Poli, S. (2015). Comparison of stroke recognition and stroke severity scores for stroke detection in a single cohort. Journal of Neurology, Neurosurgery and Psychiatry, 86(9), 1021–1028. https://doi.org/10.1136/jnnp-2014-309260 DOI: https://doi.org/10.1136/jnnp-2014-309260

Rachmawati, D. (2019). Peran Perawat dalam Assessment Pengenalan Dini untuk Meningkatkan Outcome Pasien Stroke di Instalasi Gawat Darurat. Jurnal Ners Dan Kebidanan, 6(2), 164–172. https://doi.org/10.26699/jnk.v6i2.ART.p164-172 DOI: https://doi.org/10.26699/jnk.v6i2.ART.p163-171

Rad, I. C., & Azimi, A. (2023). Recognition of Stroke in the Emergency Room (ROSIER) Scale in Identifying Strokes and Transient Ischemic Attacks (TIAs); a Systematic Review andMeta-Analysis. Archives of Academic Emergency Medicine, 11(1). https://doi.org/10.22037/aaem.v11i1.2135

Salsabila, A. N., & Dhamanti, I. (2023). Faktor-Faktor Yang Mempengaruhi Perawat Dalam Penerapan Keselamatan Pasien Di Rumah Sakit: Literature Review. Jurnal Ners, 7(1), 524–530. https://doi.org/10.31004/jn.v7i1.13740 DOI: https://doi.org/10.31004/jn.v7i1.13740

Setianingsih, Darwati, L. E., & Prasetya, H. A. (2019). Studi Deskriptif Penanganan Pre-Hospital Stroke. Jurnal Perawat Indonesia, 3(1), 55–64. https://doi.org/10.32584/jpi.v3i1.225 DOI: https://doi.org/10.32584/jpi.v3i1.225

Setiawan, P. A. (2021). Diagnosis dan tatalaksana stroke hemoragik. Jurnal Medika Hutama, 3(01 Oktober), 1660-1665.

Suprayitno, G., & Tasik, J. R. (2021). Efektivitas Pelatihan Bantuan Hidup Dasar terhadap Peningkatan Pengetahuan dan Keterampilan Tindakan Resusitasi Jantung Paru Mahasiswa Keperawatan. Jurnal Keperawatan Tropis Papua, 4(2), 68-74. http://jurnalpoltekkesjayapura.com/index.php/jktp DOI: https://doi.org/10.47539/jktp.v4i2.264

Sutarwi, S., Bakhtiar, Y., & Rochana, N. (2020). Sensitivitas dan Spesifitas Skor Stroke Literature Review. Gaster, 18(2), 186. https://doi.org/10.30787/gaster.v18i2.521 DOI: https://doi.org/10.30787/gaster.v18i2.521

Sweetasari, A. G. (2024). Gambaran Pengetahuan Peserta Pelatihan Deteksi Dini dan Tatalaksana Stroke Terkini Pada Tenaga Kesehatan di Puskesmas Wilayah Dinas Kesehatan Kota Cimahi. Jurnal Abdimas Kartika Wijayakusuma, 5(1), 174–182. https://doi.org/10.26874/jakw.v5i1.396 DOI: https://doi.org/10.26874/jakw.v5i1.396

Taukhid, M., Siswoaribowo, A., & Fuadah, D. Z. (2020). Pengaruh Pelatihan Skala Keseimbangan, Mata, Wajah, Tangan, Bicara (Kem-Watabi) Terhadap Kemampuan Psikomotor Kader Posyandu Lansia Dalam Skrining Stroke. Sebatik, 24(2), 267–275. https://doi.org/10.46984/sebatik.v24i2.1127 DOI: https://doi.org/10.46984/sebatik.v24i2.1127

Venketasubramanian, N., Yoon, B. W., Pandian, J., & Navarro, J. C. (2017). Stroke epidemiology in south, east, and south-east asia: A review. Journal of Stroke, 19(3), 286–294. https://doi.org/10.5853/jos.2017.00234 DOI: https://doi.org/10.5853/jos.2017.00234

WHO. (2018b). Noncommunicable Disease: Country Profile 2018. https://www.who.int/publications/i/item/9789241514620

Woszczyk, D., & Kłosiewicz, T. (2022). The clinical relevance assessment of ROSIER scale in emergency care. Medical Research Journal, 1–7. https://doi.org/10.5603/mrj.a2022.0040 DOI: https://doi.org/10.5603/MRJ.a2022.0040

Zulkifli. (2022). Pengaruh Edukasi Deteksi Dini Stroke dengan Metode Fast Terhadap Tingkat Pengetahuan Keluarga dengan Risiko Tinggi Stroke di Wilayah Kerja Puskesmas Suwawa Kabupaten Bone Bolango. Care Journal, 1(1), 20–26. https://doi.org/10.35584/carejournal.v1i1.22 DOI: https://doi.org/10.35584/carejournal.v1i1.22