vii

DAFTAR ISI

HALAMAN JUDUL ................................................................................................ i

HALAMAN PENGESAHAN .................................................................................ii

SURAT PERNYATAAN ...................................................................................... iii

PRAKATA .............................................................................................................. iv

DAFTAR ISI ..........................................................................................................vii

DAFTAR GAMBAR .............................................................................................. ix

DAFTAR TABEL .................................................................................................... x

DAFTAR LAMPIRAN ........................................................................................... xi

INTISARI ..............................................................................................................xii

BAB I PENDAHULUAN ................................................................................... 1

1.1. Latar Belakang ................................................................................. 1

1.2. Permasalahan Penelitian ................................................................... 4

1.3. Tujuan Penelitian .............................................................................. 4

1.3.1. Tujuan Umum ......................................................................... 4

1.3.2. Tujuan Khusus ........................................................................ 4

1.4. Manfaat Penelitian ............................................................................ 5

BAB II TINJAUAN PUSTAKA .......................................................................... 6

2.1. Ventilator-Associated Pneumoniae (VAP) ...................................... 6

2.1.1. Definisi Ventilator-Associated Pneumoniae (VAP) ............... 6

2.1.2. Insidensi dan Prevalensi Ventilator-Associated Pneumoniae

(VAP) di ICU .......................................................................... 8

2.1.3. Patogenesis Ventilator-Associated Pneumoniae (VAP) ....... 10

2.1.4. Mikrobiologi Ventilator-Associated Pneumoniae (VAP) ..... 13

2.1.5. Sumber Patogen VAP ........................................................... 15

2.2. Hubungan Lama Penggunaan Ventilator Mekanik dengan Jumlah

Kuman Penyebab Ventilator Associated Pneumonia (VAP). ........ 16

2.3. Lama Penggunaan Ventilator Mekanik di ICU .............................. 17

2.4. Hubungan Lama Penggunaan Ventilator Mekanik dengan Kejadian

Ventilator Associated Pneumonia (VAP). ...................................... 18

viii

2.5. Kerangka Teori ............................................................................... 21

2.6. Kerangka Konsep ........................................................................... 21

2.7. Hipotesis ......................................................................................... 22

BAB III METODE PENELITIAN ...................................................................... 23

3.1. Jenis Penelitian dan Rancangan Penelitian .................................... 23

3.2. Variabel dan Definisi Operasional ................................................. 23

3.2.1. Variabel Penelitian ................................................................ 23

3.2.2. Definisi Operasional ............................................................. 23

3.3. Populasi dan Sampel ...................................................................... 25

3.4. Instrumen Penelitian dan Bahan penelitian ................................... 26

3.4.1. Instrumen Penelitian yang dipakai : ...................................... 26

3.4.2. Bahan Penelitian ................................................................... 27

3.5. Cara Penelitian ............................................................................... 27

3.5.1. Cara penelitian VAP ............................................................. 27

3.5.2. Pemeriksaan spesimen sputum ............................................. 27

3.5.3. Pengambilan data lama penggunaan ventilator mekanik ...... 27

3.6. Tempat dan Waktu Penelitian ........................................................ 28

3.6.1. Tempat Penelitian ................................................................. 28

3.6.2. Waktu Penelitian ................................................................... 28

3.7. Analisa Hasil .................................................................................. 28

BAB IV HASIL PENELITIAN DAN PEMBAHASAN ..................................... 29

4.1. Hasil Penelitian............................................................................... 29

4.2. Pembahasan .................................................................................... 30

BAB V KESIMPULAN DAN SARAN ............................................................. 35

5.1. Kesimpulan ..................................................................................... 35

5.2. Saran ............................................................................................... 35

DAFTAR PUSTAKA ............................................................................................ 36

ix

DAFTAR GAMBAR

Gambar 2. 1. Patogenesis VAP (Kollef, 2005). .....................................................12

Gambar 2. 2. Proporsi Patogen penyebab VAP (Chastre dann Fagon, 2002). ......15

Gambar 2. 3. Sumber Patogen VAP (Joseph dkk., 2010) .....................................16

x

DAFTAR TABEL

Tabel 2. 1. Faktor Risiko VAP. ...............................................................................7

Tabel 2. 2. Patogen Penyebab VAP. .....................................................................14

Tabel 4. 1. Karakteristik Responden. ....................................................................29

Tabel 4. 2. Distribusi Frekuensi Pasien Berdasarkan kejadian VAP di ruang

ICU RSUD Kraton Pekalongan setelah pemakaian ventilator

mekanik ≥48 jam. ................................................................................30

xi

DAFTAR LAMPIRAN

Lampiran 1. Data Penelitian : Penggunaan Ventilator Mekanik pada Pasien

ICU RSUD Kraton Pekalongan Periode Oktober 2016 –

Desember 2017. ................................................................................ 40

Lampiran 2. Hasil Uji Statistik .............................................................................. 42

Lampiran 3. Ethical Clearance .............................................................................. 43

Lampiran 4. Surat Keterangan Perizinan Penelitian .............................................. 44

Lampiran 5. Foto Penelitian ................................................................................... 45

Lampiran 6. Hasil Uji Mikrobiologi dan Sensitivitas Antibiotik .......................... 46