TINGKAT PENGETAHUAN PERAWAT DAN CEDERA KULIT AKIBAT PEREKAT MEDIS PADA PASIEN ANAK

Cita Wulan Pasa, Nani Nurhaeni

Abstract


Pengetahuan perawat mengenai cedera kulit akibat perekat medis atau medical adhesive-related skin injury (MARSI) dan cara mencegahnya sangat penting untuk mengurangi kejadian MARSI dan mencegah komplikasinya pada pasien anak karena mereka rentan terhadap cedera kulit berhubungan dengan lapisan kulit mereka yang tipis. Tujuan penelitian: Penelitian ini bertujuan untuk mengidentifikasi hubungan antara pengetahuan tingkat pengetahuan perawat dan kejadian MARSI pada pasien anak. Metode: Penelitian ini menggunakan mode kuantitatif korelasional dengan desain potong lintang. Total jumlah sampel partisipan ialah 153 perawat yang bekerja di rumah sakit tipe A di Jakarta dengan teknik pengambilan sampel probabilitas berupa simple random sampling. Kriteria inklusinya ialah perawat yang berpraktik di ruang rawat inap anak. Penelitian ini menggunakan instrumen penelitian berupa Kuesioner Pengetahuan Perawat tentang MARSI pada Anak dan Kuesioner Kejadian MARSI. Uji statistik menggunakan uji korelasional chi kuadrat. Hasil: Sebanyak 54,2% partisipan memiliki pengetahuan baik tentang kejadian MARSI pada pasien anak dan sebanyak 38,6% partisipan melaporkan adanya kejadian MARSI dalam batas rendah. Ada hubungan signifikan secara statistik antara tingkat pengetahuan perawat dan kejadian MARSI (p = 0,001). Diskusi: Perawat dengan tingkat pengetahuan yang baik terhadap kejadian MARSI seperti deteksi dini, pencegahan, dan penanganan memiliki kemampuan yang lebih baik pula untuk melaporkan adanya kejadian MARSI pada pasien anak, mengingat pasien anak memiliki sensitivitas kulit yang lebih dibandingkan individu dewasa. Simpulan: Penting bagi perawat untuk terus mengikuti penelitian dan pedoman praktik terkini dalam deteksi dini, pencegahan, dan penanganan MARIS untuk mencegah komplikasi yang lebih lanjut pada pasien. Institusi rumah sakit perlu membuat standar prosedur operasional terkait dengan teknik penggunaan dan pelepasan perekat medis yang sesuai dengan standar.

 Kata Kunci: kejadian MARSI pada anak, pencegahan, dan pengetahuan perawat

 

Nurses’ Level of Knowledge and Medical Adhesive-Related Skin Injury (MARSI) in Pediatric Patients

 

ABSTRACT 

Nurses’ knowledge of medical adhesive-related skin injury (MARSI) and its prevention is crucial to reducing the incidence of MARSI and preventing complications, particularly in pediatric patients who are more vulnerable due to the thinness of their skin. Research Objective: This study aims to identify the correlation between nurses’ level of knowledge and the occurrence of MARSI in pediatric patients. Methods: This is a quantitative correlational study with a cross-sectional design. The total sample consisted of 153 nurses working in an A-type hospital in Jakarta, selected using probability-based simple random sampling. Inclusion criteria included nurses practicing in pediatric inpatient wards. The study employed a Nurse Knowledge Questionnaire on Pediatric MARSI and a MARSI Occurrence Questionnaire. Data were analyzed using the Chi-square correlation test. Results: A total of 54.2% of participants demonstrated good knowledge regarding MARSI in pediatric patients, and 38.6% reported a low level of MARSI occurrence. A statistically significant correlation was found between nurses’ knowledge levels and the occurrence of MARSI (p = 0.001). Discussion: Nurses with higher levels of knowledge regarding MARSI—including early detection, prevention, and management—showed greater ability to report MARSI occurrences in pediatric patients, who are at increased risk due to their more sensitive skin compared to adults. Conclusion: It is essential for nurses to remain updated on current research and clinical guidelines related to the early detection, prevention, and management of MARSI to prevent further complications in pediatric patients. Hospitals should establish standard operating procedures concerning the appropriate application and removal of medical adhesives in accordance with best practices.

 Keywords: MARSI occurrence in children, prevention, nurse knowledge


References


Ahmad, M., Massi, G. N., Anindita, N., Goni, A., Talumepa, J. (2021). Faktor yang Berhubungan dengan Tingkat Pengetahuan Perawat tentang Kriteria Status COVID-19. Jurnal Ilmiah Kesehatan Pencerah, 10(2), 215–223.

Allen, A., Zana-Taïeb, E., Allen, A., Audeoud, F., Bouvard, C., Brandicourt, A., …, Zores-Koenig, C. (2023). Recommendations for use of adhesives on hospitalized newborns: A systematic review of the literature. Archives de Pédiatrie, 30(7), 486–492. https://doi.org/10.1016/j.arcped.2023.06.001

Audet, L.-A., Bourgault, P., & Rochefort, C. M. (2018). Associations between nurse education and experience and the risk of mortality and adverse events in acute care hospitals: A systematic review of observational studies. International Journal of Nursing Studies, 80, 128–146. https://doi.org/10.1016/j.ijnurstu.2018.01.007

August, D., Chapple, L., Flint, A., Macey, J., Ng, L., & New, K. (2021). Facilitating neonatal MARSI evidence into practice: Investigating multimedia resources with Australian Neonatal Nurses – A participatory action research project. Journal of Neonatal Nursing, 27(4), 291–297. https://doi.org/10.1016/j.jnn.2020.12.001

Barton, A., Broadhurst, D., Hitchcock, J., Lund, C., McNichol, L., Ratliff, C. R., Moraes, J. T., Yates, S., & Gray, M. (2024). Medical Adhesive-Related Skin Injury at 10 Years: An Updated Consensus. Journal of Wound, Ostomy, and Continence Nursing : Official Publication of The Wound, Ostomy and Continence Nurses Society, 51(5S Suppl 5), S2–S8. https://doi.org/10.1097/WON.0000000000001116

Berdyshev, E. (2024). Skin Lipid Barrier: Structure, Function and Metabolism. Allergy, Asthma & Immunology Research, 16(5), 445–461. https://doi.org/10.4168/aair.2024.16.5.445

Byrd, A. L., Belkaid, Y., & Segre, J. A. (2018). The human skin microbiome. Nature Reviews Microbiology, 16(3), 143–155. https://doi.org/10.1038/nrmicro.2017.157

Darling, H. S. (2020). Basics of statistics – 4: Sample size calculation (ii): A narrative review. Cancer Research, Statistics, and Treatment, 3(2), 817-828.

Jiao, Q., Zhi, L., You, B., Wang, G., Wu, N., & Jia, Y. (2024). Skin homeostasis: Mechanism and influencing factors. Journal of Cosmetic Dermatology, 23(5), 1518–1526. https://doi.org/10.1111/jocd.16155

de Faria, M. F., Ferreira, M. B. G., dos Santos Felix, M. M., Bessa, R. M. V., & Barbosa, M. H. (2022). Prevention of medical adhesive-related skin injury during patient care: A scoping review. International Journal of Nursing Studies Advances, 4, 100078. https://doi.org/10.1016/j.ijnsa.2022.100078

de Oliveira Marcatto, J., Santos, A. S., Oliveira, A. J. F., Costa, A. C. L., Regne, G. R. S., da Trindade, R. E., Couto, D. L., de Souza Noronha, K. V. M., & Andrade, M. V. (2022). Medical adhesive-related skin injuries in the neonatology department of a teaching hospital. Nursing in Critical Care, 27(4), 583–588. https://doi.org/10.1111/nicc.12621.

Duarte, A., Ferreira, L., & Cunha, M. (2021). Nursing care in the prevention of medical adhesive–related skin injuries: a scoping review . Millenium - Journal of Education, Technologies, and Health, 2(9e SE-Life and Healthcare Sciences), 101–112. https://doi.org/10.29352/mill029e.24981

Du, M., & Liu, M. (2024). Prevalence, Risk Factors, Causes, Assessments, and Prevention of Medical Adhesive-Related Skin Injury: A Scoping Review. Advances in Skin & Wound Care, 37(11&12), 1–10. https://doi.org/10.1097/ASW.0000000000000235

Fauziyah, N., Hariyati, R. T. S., Rachmi, S. F., Handiyani, H., & Simarmata, R. (2021). Hubungan Fungsi Manajemen Kepala Ruangan dengan Pelibatan Pasien (Patient Engagement) dalam Asuhan Keperawatan di Masa Pandemi Covid-19. Jurnal Kepemimpinan Dan Manajemen Keperawatan, 4(2), 121–134. https://doi.org/10.32584/jkmk.v4i2.1230

Fialho, L., Albuquerque, J., Pinho, A. S., Pereira, A. M., Monteiro, C., Oliveira, N., Ferreira, S., & Martins, M. C. L. (2024). Exploring innovative adhesive approaches to manage medical adhesive-related skin injuries (MARSI). International Journal of Adhesion and Adhesives, 130, 103636. https://doi.org/10.1016/j.ijadhadh.2024.103636

Frota, O. P., Pinho, J. N., Ferreira-Júnior, M. A., Sarti, E. C. F. B., Paula, F. M., & Ferreira, D. N. (2023). Incidence and risk factors for medical adhesive-related skin injury in catheters of critically ill patients: A prospective cohort study. Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses, 36(6), 997–1003. https://doi.org/10.1016/j.aucc.2023.02.005

Fumarola, S., Allaway, R., Callaghan, R., Collier, M., Downie, F., Geraghty, J., Kiernan, S., Spratt, F., Bianchi, J., Bethell, E., Downe, A., Griffin, J., Hughes, M., King, B., LeBlanc, K., Savine, L., Stubbs, N., & Voegeli, D. (2020). Overlooked and underestimated: medical adhesive-related skin injuries. Journal of Wound Care, 29(Sup3c), S1–S24. https://doi.org/10.12968/jowc.2020.29.Sup3c.S1

Hitchcock, J., Haigh, D. A., Martin, N., & Davies, S. (2021). Preventing medical adhesive-related skin injury (MARSI). British Journal of Nursing (Mark Allen Publishing), 30(15), S48–S56. https://doi.org/10.12968/bjon.2021.30.15.S48

Hofman, H., Duljic, T., Johansson, S., Kottner, J., Kinnaer, L.-M., Beeckman, D., & Eriksson, M. (2024). Patients’ experiences with the application of medical adhesives to the skin: a qualitative systematic review. BMJ Open, 14(10), e089773. https://doi.org/10.1136/bmjopen-2024-089773

Iswara, R. (2020). Hubungan Tingkat Pendidikan dan Pelatihan dengan Tingkat Pengetahuan Petugas Kamar Jenazah tentang COVID-19 pada Jenazah. Medica Hospitalia: Kendari.

Kelly-O’Flynn, S., Mohamud, L., & Copson, D. (2020). Medical adhesive-related skin injury. British Journal of Nursing (Mark Allen Publishing), 29(6), S20–S26. https://doi.org/10.12968/bjon.2020.29.6.S20

Kim, M. J., Jang, J. M., Kim, H. K., Heo, H. J., & Jeong, I. S. (2019). Medical Adhesives-Related Skin Injury in a Pediatric Intensive Care Unit: A Single-Center Observational Study. Journal of Wound, Ostomy, and Continence Nursing : Official Publication of The Wound, Ostomy and Continence Nurses Society, 46(6), 491–496. https://doi.org/10.1097/WON.0000000000000592

Kim, J., & Shin, Y. (2021). Medical Adhesive-Related Skin Injury Associated with Surgical Wound Dressing among Spinal Surgery Patients: A Cross-Sectional Study. In International Journal of Environmental Research and Public Health, 18(17), 9150. https://doi.org/10.3390/ijerph18179150

Kõrgemaa, U., Sisask, M., & Ernits, Ü. (2024). Nurses retrospective view on nursing education: A repeated cross-sectional study over three decades. Heliyon, 10(4), e26211. https://doi.org/10.1016/j.heliyon.2024.e26211

Li, Z., Tan, J., Yang, X., Zhou, H., Xu, X., Zhu, D., & Luo, J. (2025). Application of Best Evidence-Based in Neonatal Medical Adhesive-Related Skin Injuries. Journal of Biosciences and Medicines, 13, 320–329. https://doi.org/10.4236/jbm.2025.132024

Kurniasari, E. (2021). Hubungan Antara Lama Kerja Dan Tingkat Pendidikan Dengan Pengetahuan Tentang Fungsi Manajemen Pada Perawat Di Rumah Sakit Orthopedi Surakarta [Undergraduate thesis]. Program Studi Keperawatan, Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Surakarta, Jawa Tengah, Indonesia.

Maene, B. (2013). Hidden costs of medical tape-induced skin injuries. Wounds UK, 9, 46–50

Mohamed, R. A., Alhujaily, M., Ahmed, F. A., Nouh, W. G., & Almowafy, A. A. (2024). Nurses’ experiences and perspectives regarding evidence-based practice implementation in healthcare context: A qualitative study. Nursing Open, 11(1), e2080. https://doi.org/10.1002/nop2.2080

Noonan, C., Quigley, S., & Curley, M. A. Q. (2006). Skin integrity in hospitalized infants and children: a prevalence survey. Journal of Pediatric Nursing, 21(6), 445–453. https://doi.org/10.1016/j.pedn.2006.07.002

Novardian, Sulaeman, S., Purwati, N. H., & Sari, W. (2018). The Effectiveness of Skin Barrier on Medical Adhesive Related Skin Injury in Neonates at Perinatology Dr. Cipto Mangunkusumo Hospital Jakarta. Proceedings of the 1st International Conference of Indonesian National Nurses Association (ICINNA 2018), 187–192. 10.5220/0008222801870192

Oranges, T., Dini, V., & Romanelli, M. (2015). Skin Physiology of the Neonate and Infant: Clinical Implications. Advances in Wound Care, 4(10), 587–595. https://doi.org/10.1089/wound.2015.0642

Patra, S., Swain, M., & Konda, S. (2024). Medical Adhesives Related Skin Injury (MARSI): Nursing Expertise that Improves Patient Care and Comfort. International Research Journal of Multidisciplinary Scope, 05, 210–223. https://doi.org/10.47857/irjms.2024.v05i02.0409

Rudman, A., Boström, A.-M., Wallin, L., Gustavsson, P., & Ehrenberg, A. (2020). Registered Nurses’ Evidence-Based Practice Revisited: A Longitudinal Study in Mid-Career. Worldviews on Evidence-Based Nursing, 17(5), 348–355. https://doi.org/10.1111/wvn.12468

Schnelli, A., Steiner, L. M., Bonetti, L., Levati, S., & Desmedt, M. (2024). A bachelor’s degree for entering the nursing profession: A scoping review for supporting informed health care policies. International Journal of Nursing Studies Advances, 6, 100171. https://doi.org/10.1016/j.ijnsa.2023.100171

Versluijs, Y., Brown, L. E., Rao, M., Gonzalez, A. I., Driscoll, M. D., & Ring, D. (2020). Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale. Journal of Patient Experience, 7(6), 1211–1218. https://doi.org/10.1177/2374373520948444

Vieira, C. P. de B., Ferreira, P. de C., Araújo, T. M. E. de, Silva, F. J. G. da, Galiza, F. T. de, & Rodrigues, Á. S. O. (2020). Prevalence of friction injury and associated factors in elderly in intensive therapy. Texto & Contexto-Enfermagem, 29, e20180515.

Wei, M., Yang, D., Chen, L., Wu, L., Lu, M., Wang, J., & Qiu, T. (2023). The prevalence of medical adhesive-related skin injury caused by protective dressings among medical staff members during the 2019 coronavirus pandemic in China. Journal of Tissue Viability, 32(1), 69–73. https://doi.org/10.1016/j.jtv.2023.01.003

Wu, L., Deng, S., Yu, L., & Rong, H. (2023). Nurses’ knowledge, attitude and behaviour on medical adhesive related skin injury in neonatal department: A survey. Nursing Open, 10(7), 4713–4720. https://doi.org/10.1002/nop2.1721




DOI: http://dx.doi.org/10.32419/jppni.v10i1.587

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