RESEARCH

STUDY DESCRIPTIVE BETWEEN INDWELLING

URINARY CATHETER USE AND INCIDENCE OF
URINARY TRACT INFECTION IN ADULT CLIENT IN
SANGLAH HOSPITAL 2008
Supervisor: Widodo, MN
Sumardino, S.ST, M. Kes

Created by:
Nur Hanief M.B
P27220006058

The Polytechnic of Health of Surakarta

Nursing Major
2007/2008

LEGALIZATION SHEET

Study Descriptive Between Indwelling Urinary Catheter Use and Incidence

Of Urinary Tract Infection in Adult Client in Sanglah Hospital 2008

Legalized on
Date:
Place:

Acknowledge by,

Widodo, MN
NIP.

PREFACE
Thanks to God thats give me chance to finish this proposal research with title
Study Descriptive between Indwelling Urinary Catheter Use and Incidence of
Urinary Tract Infection in Adult Client in Sanglah Hospital 2008. This proposal
is arranged to fulfill the task of research subject in 4th semester.
In this chance, the researcher thanks to every body that helped the researcher
to finishing this proposal. The researcher realizes that without their help the
researcher wouldnt fine difficulties in doing this proposal. This proposal is far

from being perfect; however with the strong and hard working the researcher
could finish the duty.
As this proposal has been completed, the researcher thanks to:
1. Mrs. Rita Benya Adriani, S. Kp. M. Kes
As the director of Polytechnic of Health of Surakarta for giving chance to the
researcher to make the research proposal
2. Mr. Satino, SKM, MScN
As the Chief of Nursing Department of Polytechnic of Health of Surakarta and
as the lecture who had given direction, advice and support to the researcher.
3. Mr. Martono, SKep, Ns,. M. Pd
As the consultant who give guidance and advice to the researcher in making
this proposal
4. Mr. Widodo, MN
As the consultant, for his help, advice well and guide the researcher doing this
research proposal
5. Mr. Sumardino, S. ST, M. Kes
As the consultant, for his help, advice well and guide the researcher doing this
research proposal
6. My Beloved Family
Which give support of this compilation research proposal.
7. All people that helps the researcher in finishing this report that cant be
mentioned one by one
The researcher apologies for some limitations in this research proposal.
Therefore the researcher expects critics and suggestions that can make this
proposal worthy and give benefit for reader and especially the researcher.
Surakarta,
Researcher

2008

CONTENT LIST

LEGALIZATION SHEETi
PREFACE.ii
CONTENT LIST..iv
CHAPTER I: INTRODUCTION.1
A. Research background............1
B. Main problem............3
C. Goal Objective..3
D. Research Scope.4
CHAPTER II: LITERATURE REVIEW.5
A. Definition of Urinary Catheter.5
B. Type of Urinary Catheter.5
1. Indwelling Urinary Catheter5
2. Suprapubic Catheter6
3. External Condom Catheter..7

C. Indwelling Urinary Catheter Use in Elderly8

D. Definition of Urinary Tract Infections (UTIs).8
1. Classification of Urinary Tract Infections (UTIs)..10
2. Risk factors in Urinary Tract Infections (UTIs).11
3. Signs and Symptoms of Urinary Tract Infections (UTIs)..12
4. Complications of Urinary Tract Infections (UTIs).13
E. Theoretical Framework...14
F. Conceptual Framework...15
G. Operational Definition16
CHAPTER III: METHODOLOGY RESEARCH...17
A. Research Design.17
B. Population and Sample17
1. Research Population17
2. Sample18
3. Sampling18
C. Research Variable..19
D. Instrument Measurement20
E. Validity and Reliability..21
1. Validity..21
2. Reliability..22
F. Technique Data Collecting24
1. Processing the Data24
2. Data Analyze24
REFERENCE25

CHAPTER I
INTRODUCTION
A. Research background
Urinary tract infections (UTIs) are the most common type of nosocomial
(hospital-acquired) infections, accounting for 40% of all infections in hospitals
per year (Burke and Zavasky 1999). Center for Disease Control and National
Nosocomial Infections Study Report (1979) stated that the urinary tract is the
most common site of nosocomial infection, accounting for more than 40% of the
total number reported by acute-care hospitals and affecting an estimated 600,000
patients per year. According to Haley, Hooton, Culver (1975-1976), and Garibaldi,
Burke, Dickman, Smith (1974) Up to 25% of hospitalized patients have a urinary
catheter placed during their stay. The overall incidence of nosocomial UTI among
these patients is 3% to 10% (average, 5%) per day. According to Haley, Culver,
White, Morgan and Emori (1985) urinary tract infections account for up to 40% of
nosocomial infections, and urinary catheterrelated infection accounts for most
nosocomial UTIs.
Bryan and Reynolds (1984) stated that the case-fatality rate from UTIrelated nosocomial bacteremia is approximately 13%, with severely ill patients at
highest risk. Short-term catheterization may also be associated with fevers and
acute pyelonephritis, whereas long-term catheterization may be complicated by
catheter obstruction, urinary tract stones, and chronic renal inflammation.
Urinary Catheter use especially Indwelling Urinary Catheter (IUC) is thought
to be risk factor for developing nosocomial UTIs. One study by Gardam, Amihod,

Orenstein, Consolacion, and Miller (1998) showed that 2 of 24 (8, 3%)

consecutive patients in Emergency Department(ED) had a UTI prior to catheter
insertion, and 5 of 24(20, 8%) developed UTI during their hospital stay.
Johanson, Athlin, Frykholm, Bolinder, and Larson (2002) found that 38% of
elderly patients with hip fractures had positive urine cultures on admission
hospital.
Untreated UTIs can lead to acute or chronic kidney infections
(pyelonephritis), which could permanently damage kidneys. Children and older
adults are at the greatest risk of kidney damage due to UTIs because their
symptoms are often overlooked or mistaken for other conditions. Women who
have UTIs while pregnant may also have an increased risk of delivering low birth
weight or premature infants (Greinstein, 2007).
According to previous survey that has done in Sanglah Hospital at 2007,
said that hospitalized client who use Urinary catheter is 80% from hospitalized
client with urinary catheter. According to the explanation above, the researcher
wants to do research with title Study Descriptive between Indwelling Urinary
Catheter Use and Incidence of Urinary Tract Infection in Adult Client in Sanglah
Hospital.
B. Main problem
Base on the research background, this proposal puts main problem about
description between Indwelling Urinary Catheter Use and Incidence of Urinary
Tract Infection in Adult Client in Sanglah Hospital 2008.
C. Goal objective
1. General purpose
The general purpose of this research is to know about description
between indwelling urinary catheter use and Incidence of urinary tract
infection in adult client in Sanglah Hospital
2. Specific purpose
The specific purposes of this research include:

a. To describe Incidence of urinary tract infection in client with Indwelling

Urinary Catheter in adult client in Sanglah Hospital
b. To describe Incidence of urinary tract infection in age category in adult
client in Sanglah Hospital
c. To describe Incidence of urinary tract infection in sex category in adult
client in Sanglah Hoapital

D. Research scope
1. Setting
This research will be done in Sanglah hospital, Bali.
2. Time
This research will be done on Semester 5th
3. Respondent
This research will include adult client in Sanglah hospital 2008.
4.

Material

This research interrelated with Medical Surgical Nursing II, and Preoperative
Nursing, and Emergency Nursing.

CHAPTER II
LITERATURE REVIEW
A. Definition of Urinary Catheter
Urinary catheter is a plastic tube which is either inserted through a
patient's urinary tract into their bladder or attached to a male patient's penis.
(Wikipedia, the free encyclopedia, 2007). A balloon located at the end of the
catheter is usually inflated with sterile water to prevent the catheter from slipping
out. According to Greeinsten (2007) a urinary catheter is any tube system placed
in the body to drain and collect urine from the bladder.
B. Type of Urinary Catheter
According to Wikipedia, the free encyclopedia, (2007) the most common
type of urinary catheter are indwelling catheter, suprapubic catheter, and external
condom catheter.
1. Indwelling urinary catheters (Long-Term Use)
A catheter that is left in place for a period of time may be attached to a
drainage bag to collect the urine. Indwelling urinary catheters are often needed for
hospitalized patients; however, their use is often in inappropriate because up to
80% of patients with a nosocomial UTI has an indwelling urinary catheter,
(Krieger, Kaiser, and Wenzel, 1983).
During long-term use, the catheter may be left in place during the entire
time, or a patient may be instructed on a procedure for placing a catheter just long
enough to empty the bladder and then removing it (known as clean intermittent
self-catheterization). If temporary or long-term urinary collection is required,
options other than indwelling catheterization should be considered. Intermittent
catheterization, ie, inserting and removing a sterile or clean urinary catheter
several times daily, may reduce the risk of bacteriuria compared with an
indwelling catheter. Because the incidence of bacteriuria is about 1% to 3% per
insertion, however, most patients become bacteriuric within a few weeks.

Intermittent catheterization may also be associated with a lower risk of local and
systemic complications of bacteriuria, but further studies are needed to assess
these issues (Warren, 1997).
2. Suprapubic Catheters
A suprapubic catheter is basically an indwelling catheter that is placed
directly into the bladder through the abdomen. The catheter is inserted above the
pubic bone. This catheter must be placed by an urologist during an outpatient
surgery or office procedure (Greenstein, 2007). A suprapubic catheter may be
recommended in people who require long term catheterization, after some
gynecological surgeries, and in people with urethral injury or obstruction
(Greenstein, 2007).
3. External Condom Catheters
A condom catheter, which fits on the outside of the penis using adhesive,
can be used for short-term catheterizations in males. However, long-term
catheterization is not recommended because chronic use carries a significant risk
of urinary tract infection (Wikipedia, 2007).
Hirsh, Vainstein, Musher (1979) found that the risk of developing
bacteriuria in men wearing a condom catheter was approximately 12% per month.
The rate was substantially higher, however, in those who frequently manipulated
their catheters. In 2 parallel cohort studies that are Ouslanders, Greengold, Chen
(1987) in a Department of Veterans Affairs nursing home, the incidence of
symptomatic UTI was about 2.5 times greater in men with a long-term indwelling
catheter compared with those wearing a condom catheter. On the other hand,
Zimakoff, Stickler, Pontoppidan, Larsen (1996) in Denmark reported that the risk
of UTI was higher in hospitalized patients wearing condom catheters than in those
using indwelling catheters. In light of these conflicting data, a randomized trial
comparing the safety and efficacy of these 2 devices is much needed.
C. Indwelling Urinary Catheter Use In Hospitalized Client

There is general agreement that the use of IUCs is appropriate in specific

clinical situations. None-the-less, previous study have shown that when using
agreed upon definitions of appropriateness for IUC use, only about 50% of IUCs
were placed appropriately (Gokula, Hickner, and Smith, 2004 and Foxman, 2002).
D. Definition of Urinary Tract Infections (UTIs)
A urinary tract infection (UTI) is a bacterial infection that affects any part
of the urinary tract. Although urine contains a variety of fluids, salts, and waste
products, it usually does not have bacteria in it (Adult Health Advisor, 2007).
Whereas according to Greeinstein (2007) a urinary tract infection (UTI) is a
condition where one or more structures in the urinary tract become infected after
bacteria overcome its strong natural defenses. In spite of these defenses, UTIs are
the most common of all infections and can occur at any time in the life of an
individual. Almost 95% of cases of UTIs are caused by bacteria that typically
multiply at the opening of the urethra and travel up to the bladder (known as the
ascending route).
A urinary tract infection, or UTI, is an infection that can happen anywhere
along the urinary tract. The urinary tract includes the:
Bladder
Kidneys
Ureters -- the tubes that take urine from each kidney to the bladder
Urethra -- the tube that empties urine from the bladder to the outside.
(MediLine Plus, 2007)
From the explanation above, we can conclude that urinary tract infection is
infection that happens in urinary tract, and it caused of bacteria.
1. Classification of Urinary Tract Infections (UTIs) based on Greeinstein
(2007)

a. Primary or Recurrent UTIs. UTIs are classified as primary or recurrent,

depending on whether they are the first infection or whether they are repeat
events.
b. Community- or Hospital-Acquired. UTIs are also sometimes grouped according
to where they are acquired:

Community-Acquired Infections. Most UTIs are thought to develop in the

community at large.

Hospital-Acquired Infections. UTIs are also commonly acquired in the

hospital, often due to contaminated urinary catheters.

c. Uncomplicated and Complicated. UTIs are also sometimes further defined as

either being uncomplicated or complicated depending on the factors that
trigger the infections.

Uncomplicated infections are only associated with bacterial infection,

most often Escherichia coli (E. coli). They affect women much more often
than men.
Cystitis is the most common urinary tract infection and is sometimes

referred to as acute uncomplicated UTI. It occurs in the lower urinary tract (the
bladder and urethra) and nearly always in women. When infection spreads to the
upper tract (the ureters and kidneys) it is called pyelonephritis , or more
commonly, kidney infection.
When infection is limited only to the urethra, the infection is known as
urethritis. This is a common sexually transmitted disease in men.

Complicated infections, which occur nearly as often in men as women, are

also caused by bacteria but they occur as a result of some anatomical or
structural abnormality. Often they are associated with catheter use in the
hospital setting, bladder and kidney dysfunction, or kidney transplant
(especially in the first three months after transplant).

2. Risk Factors

Risk factors for nosocomial UTIs associated with catheterization include:

a.

Sex

Hazelett, Tsai, Gareri and Allen (2006) found that female elderly
patients were more susceptible to inappropriate IUC use than
their male. Only 25% male patients who developed a nosocomial
UTI had an IUC placed inappropriately, while 50% female
patients developed a nosocomial UTI associated with an
inappropriately placed IUC. UTIs are more rare in boys and
young men. In adult women, though, the rate of UTIs gradually
increases with age. Scientists are not sure why women have more
urinary infections than men. One factor may be that a woman's
urethra is short, allowing bacteria quick access to the bladder.
Also, a woman's urethral opening is near sources of bacteria from
the anus and vagina. Infections in Men
UTIs in men are often a result of an obstructionfor example, a
urinary stone or enlarged prostateor from a medical procedure
involving a catheter. The first step is to identify the infecting organism
and the drugs to which it is sensitive. Usually, doctors recommend
lengthier therapy in men than in women, in part to pevent infections of
the prostate gland.
Prostate infections (chronic bacterial prostatitis) are harder to cure
because antibiotics are unable to penetrate infected prostate tissue
effectively. For this reason, men with prostatitis often need long-term
treatment with a carefully selected antibiotic. UTIs in older men are
frequently associated with acute bacterial prostatitis, which can have
serious consequences if not treated urgently.
Age
Age is a significant factor for bacteriuria with older age being associated
with bacteriuria than the younger age, without regard to the sex, the risk of
catheter-associated

bacteriuria

increase

with

age,

(http://www.psmid.org.ph/vol22/vol22num2topic5.pdf.)
b.

Severe disease

ODonnel and Hofmann (2002) point out that 20-50% of nursing home residents
have asymptomatic UTIs, and this rises to 100% in patients with IUC. Several

factors predispose the elderly to UTIs including malfunction (e. g., enlarged
prostate gland, obstructions), chronic diseases (e. g., diabetes, cerebrovascular
disease, parkinsons disease and multiple sclerosis), and certain medications.

People with diabetes have a higher risk of a UTI because of changes

in the immune system. Any other disorder that suppresses the immune
system raises the risk of a urinary infection.
c.

The length of time of using Urinary catheter

Passage of organisms from the urine bag to the bladder (retrograde

contamination) that occurs in 1520% of patients with indwelling catheters
(i.e., those left in place for several days or weeks)
d. Improperly procedure
There is general agreement that the use of IUCs is appropriate in specific
clinical situations. None-the-less, previous study have shown that when
using agreed upon definitions of appropriateness for IUC use, only about
50% of IUCs were placed appropriately (Gokula, Hickner, and Smith,
2004 and Foxman, 2002).
e. Surgery
Patients undergoing major surgery are often catheterized and may remain so
for some time.
f.

Errors in catheter care and use of antibiotics.

g. Nutrition
3. Symptoms & Signs of UTIs from Wikipedia (2007)
For Bladder Infections

Frequent urination along with the feeling of having to urinate even though
little or

no urine actually comes out.

Nocturia: Need to urinate during the night.

Urethritis: Discomfort or pain at the urethral meatus or a burning sensation

throughout the urethra with urination (dysuria).

Cystitis: Pain in the midline suprapubic region.

Pyuria: Pus in the urine or discharge from the urethra.

Hematuria: Blood in urine.

Pyrexia: Mild fever

Cloudy and foul-smelling urine

Increased confusion and associated falls are common presentations to

Emergency Departments for elderly patients with UTI.

Some urinary tract infections are asymptomatic.

inability to fully empty bladder

soreness in lower abdomen, back, or sides

For Kidney Infections

The above symptoms.

Emesis: Nausea, Vomiting is common.

Back, side (flank) or groin pain.

Abdominal pain or pressure.

Shaking chills and high spiking fever.

Night Sweats.

Extreme Fatigue.

4. Complications
Untreated UTIs can lead to acute or chronic kidney infections
(pyelonephritis), which could permanently damage your kidneys. Young children
and older adults are at the greatest risk of kidney damage due to UTIs because
their symptoms are often overlooked or mistaken for other conditions. Women
who have UTIs while pregnant may also have an increased risk of delivering low
birth weight or premature infants (Greinstein, 2007).

Medical Complications of Urinary Tract Infections in Adults

Serious physical complications can occur in some cases, however, most

often in hospitalized patients. Obstruction and Widespread Infection; Kidney

Damage; Urge Incontinence; Kidney Stones.

Complications in Children with Urinary Tract Infections

Urinary tract infections are a major cause of hospitalization in children.
Untreated, they can be very serious, particularly in children under 4 years old.
Fortunately, with prompt treatment, childhood cases of upper urinary tract
infections rarely cause any serious consequences. Spread of Infection; Kidney
Scarring (Greenstein, 2007).

E. Theoretical framework

Type of Urinary Catheters

Age
Indwelling urinary catheter
Suprapubic catheter
External condom catheter
Sex

Improperly procedure

The length of time

Nutrition

Urinary Tract Infections

Surgery
Symptoms of infection
Disease

Nosocomial infection
Signs of infection

F. Conceptual Framework
Age
Urinary Tract Infections
Sex

G. Operational Definition
Definition operational variable represent the guide of how variables in
research will give the illustrations manifestly more instructing phenomenon at
problems to be checked.
No Variable Operational Parameter Instrument
Definition
1

Scoring

Measureme

Urinary

A urinary tract-Symptoms

nt
-Symptoms Urinary

Tract

infection

of

Infections (UTI)

of UTIs
is

a-

bacterial

Signs

ofQuestionnair Infections is

UTIs

valued with

-Signs

affects

any

UTIs:

the

Observation -Symptoms

of

Nominal

UTIs:Tract

infection that
part

Scale

urinary tract.

sheet

ofthe
statement:
of UTIs:
Yes: 1
No: 0
- Signs of
UTIs:
Yes: 1
No: 0

Age

Period since a

20-30 yearMedical

20-30 year:ordinal

people

31-40 yearrecord

was
born until now

31-40 year:

41-90 year

2
3

Sex

Gender

Male

Medical

41-90: 3
Male: 1

differences

Female

record

Female: 0

Nominal

based

on

genital

CHAPTER III
METHODOLOGY RESEARCH

A. Research Design
This research uses Quantitative Research. The quantitative approach is
measure of phenomena use numerical data test and examine cause and effect
relationship to produce the findings, (Burns and Grove, 1997). According to Carr,
1994 Quantitative research is more objective view and more reliable, because its
use questionnaire or measurement that have been tested for validity and reliability.
This research will use survey research method, which is take sample from
one population and use questionnaire and observation sheet as primer
measurement. (Singarimbun and Sofian, 1989). This research analyzes by using
cross sectional methods.

B. Population and Sample

1. Research Population
Population is the entire variable that is related to this problem, and it is being
researched (Pariani, 2001). Population is all of variable which is concerning
problem to be checked (Nursalam, 2000).

The populations of this research are client hospitalization with Indwelling

Urinary Catheter (IUC) in ICU IRD, Medical Surgical Ward and Ratna Ward
Sanglah hospital.
According to data that the researcher got in Sanglah Hospital, especially in
Emergency Department found 40 patients with Indwelling Urinary Catheter (IUC)
perday.
2. Sample
Sample is some of the population that is chosen by specific sampling and to
fulfill or representative population (Pariani, 2001). Sample is a part or the
representative of research subject who was researched. (Arikunto, 1998).
Based on Sugiyono, 2005, sample can be taken from population by using
Krejcie table. Krecjei do measurement of sample based on +.05 of population
proportion p with a 95% level of confidence.
From 40 populations, we can looking for kricjei table in population 40, and
will find sample needed is 36.
a. Inclusion Criteria
Inclusion criteria are research subject characteristics from a target population
and attainable that will be examined or sample characteristic that is proper
examined (Pariani, 2001).
The inclusion criteria of this research are:
1) Hospitalized client with Indwelling Urinary Catheter (IUC)
2) Hospitalized client =20 years old (adult client)
3) Hospitalized client that want to be the respondent
4) Hospitalized client in Medical Surgical Ward, ICU IRD, Ratna Ward in
Sanglah Hospital
b. Exclusion Criteria

An exclusion criterion is releasing subject from research because of various

causes. Equally, improper to be checked (not fulfill the inclusion criteria) at the
time of research take place. (Nursalam, 2000)
The exclusion criteria of this research are:
a. Hospitalized client without Indwelling Urinary Catheter (IUC)
b. Hospitalized client =<20 years old
c. Hospitalized client that doesnt want to be the respondent
d. Hospitalized client that doesnt live in Medical Surgical Ward, ICU IRD,
Ratna Ward in Sanglah Hospital.
3. Sampling
Technical sampling is method that is used to collect the sample, so it has
purposed to gat sample that appropriate with all of the object research, (Hadi,
1996). The technical sampling on this research is probability random sampling
technical. It is random sample if each individual on the population can be taken at
the same chance.

C. Research Variable
Variable is a criteria that is possessed by member of group (people, things,
situation) and different with possessing of this group (Rafli, 1985). This research
use one variable, which is Incidence of Urinary Tract Infection (UTI) that can
influenced by age and sex category.

D. Instrument Measurement
Instrument measurement of this research is questionnaire, that consist of 8
question based on signs and symptoms of Urinary Tract Infection. Questions in
questionnaire use closed question and checklist. Before that, the respondent was
given explanation and statement and was informed the way to answer or fill up
questionnaire sheet. The respondent is questioned to identification of answer: yes
or no toward the statements. The respondent just put sign on the each printed
column at the question item.

E. Validity and Reliability

1. Validity
Validity is the level of research instrument ability, its truly to measure
what is measured (Notoatmojo, 2002)
The research instrument can be valid, if it is able to measure something
that is measured. This research use external validity, if the result data instrument is
suitable with data or other information that touch research variable (Arikunto,
1998).
To check observation sheet validity, this research use correlation technique

Contingency Coefficient. Contingency coefficient is used to measure correlation

between variables with nominal scale (Sugiyono, 1999). This technique has
correlation with Chi quadrate that

Formula: C =

used in hypothesis test.

X2
N X2

Chi quadrate can be measured by formula:

X2 =

i 1

j 1

OP

ij

Eij

EPij

Note: O (Observation) = fo
E (Expactation) = fh
To make measurement easily, data can be placed in this table:
Var. B

Var. A total

Total

B1

(A1B1)

(A2B2)

(AkBk)

B2

(A2B2)

(A3B3)

(AkBk)

..

Br

(A1Br)

(A2Br)

(AkBk)

Total
3. Measure variable A related to variable B
4. Measure fh (Hoped frequency)
5. Measure chi square with formula above
6. Measure Contingency Coefficient with formula above
7. Test measurement result chi quadrate with table chi quadrate,
include dk and significant error
-

dk = (k-1) (r-1); k: total sample; r: total category var B

significant error = 0, 05

8. If the result: measurement result chi quadrate > table chi

quadrate Ho rejected, Ha accepted
If the result: measurement result chi quadrate < table chi quadrate
Ho accepted, Ha rejected (Sugiyono, 1999).
2. Reliability
Reliability test that will be used on this research is internal consistency.
Reliability test with internal consistency is done by try the instrument only do in
one time and than the result will be analyzed with certain technique. The result of
analyze can be used to predict reliability instrument. Reliability test instrument
can be done with split half technique from spearman brown (split half), KR. 20,
KT. 21 and Anova Hoyt (Sugiyono, 1999).
The formula KR. 20 (Kuder ricardson)
k
ri = (k 1)

st 2 piqi
st 2

Note:
ri

: Reliability of total instrument

: Number of item and instrument

pi

: Proportion the number of subject that answer on item 1

qi

: 1 pi

St2 : Total of variants

1. Table in KR- 20
No.

No. Item

Res

Xt

Xt2

Total x

(Total x)2

..

..

..............

Total

Total

Total

(Total Np)2

no.1

no.2

n
Np

Total Np

no.x

0, total 0, total .

0, total

no.1

no.2

no.x

1-p

1-p

...

1-p

pq

pq

..

..

pq

pq = ..

2. Measure total of variants

X=

xt

xt
n

; n = total of respondent

x2
St2 = n
3. Result of St2 converts to formula KR-20

R1 =

2
k St p1 q1

k 1
St 2

4. After that, we can decide reliability of instrument, which the highest

number is 1.

D. Technique Data Collecting

1. Processing the data on this research will be done with steps:

a. Coding
Coding is effort to clarify the answer. Clarification is done with sign each
answer with code (numeral) and then its entered on table sheet for facilitate to
read.
b. Tabulating
Tabulating is entering the data of research result to the table that
appropriate with criteria.
c. Editing
Editing is researching again about completeness of questionnaire and
observation sheet. Editing is done in the same place for processing the data. If
there are lacks, it can be completed soon.
2. Data Analyze
The technique of data analyze can be used as a method taking judgment to
overcome problems. The researcher use distribution frequency and crosstabs by
using SPSS 10.00.

REFERENCE

Adult Health Advisor. 2005.4: Bacteria in Urine, No Symptoms (Asymptomatic

Bacteriuria). Retrieved on 2007-08-25
Bryan CS, Reynolds KL. 1984. Hospital-acquired bacteremic urinary tract
infection: epidemiology and outcome. J Urol; 132:494-498
Burke JP and D Zavasky. 1999. Nosocomial urinary tract infections, in
Hospital Epidemiology and Infection Control, 2nd ed. Mayhall CG (ed).
Lippincott, Williams and Wilkins: Philadelphia, pp 173187.

Center for Disease Control. (1979). National Nosocomial Infections Study Report,
Atlanta: Center for Disease Control. 2-14.
Gardam

MA,

Amihod

B,

Oreinstein

P, Consolacion

N,

Miller

M.

1998.Overutilization of indwelling urinary and the development of

nosocomial urinary tract infections. Clinical Performance and Quality
Health Care, 6:99-102.
Garibaldi RA, Burke JP, Dickman ML, Smith CB. 1974. Factors predisposing to
bacteriuria during indwelling urethral catheterization. N Engl J Med;
291:215-219.
Garibaldi RA, Burke JP, Britt MR, Miller MA, Smith CB. 1980. Meatal
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Respondent Agreement
Surakarta,..2008
To: Research Respondent
In Sanglah hospital,
Surakarta

By respectful
Im sincerely on this letter:
Name

: Nur Hanief M. B

Institution

: Nursing Major of Health Polytechnic of Surakarta

NIM

: P27220006058

Address

: Letjend Soetoyo Street, Mojosongo, Surakarta

Im student in Nursing Major of Health Polytechnic of Surakarta that is doing

research with title Study Descriptive between Indwelling Urinary Catheter Use
and Incidence of Urinary Tract Infection in Adult Client in Sanglah Hospital 2008.
This research doesnt give bad effect to you as the respondent and Im promise
that I want to keep the secret of all information that you give for me and only used
it for this research. If you dont want to be the respondent, it doesnt threat for
you. And if you as the respondent want to back up, it doesnt matter for you. If
you want to be the respondent, I hope you sincerely this agreement letter.
Thanks for your attention and willingness as a respondent.

Sincerely Yours
(Nur Hanief M. B)

The Agreement Letter to Be a Respondent

Im sincerely on this letter explain that Im ready to be respondent on this
research that is doing by student of Nursing Major Health Polytechnic of
Surakarta with the title Study Descriptive between Indwelling Urinary Catheter
Use and Incidence of Urinary Tract Infection in Adult Client in Sanglah Hospital
2008. I realize that this research doesnt give bad effect and detriment for me, so
Im ready to be respondent on this research.

Surakarta,
2008

Respondent

QUESTIONNAIRE
Study Descriptive Between Indwelling Urinary Catheter Use and Incidence
Of Urinary Tract Infection in Adult Client in Sanglah Hospital 2008
Instruction:
1. Read identity of respondent and fill the data completely
2. Read question and answer it by put sign (check list) on the each printed
column at the question item
A. Respondents Identity:
Initial of respondent:
Age

Address

Marital status

Occupation

Educational level

Sex

Date of admission

B. Observation Sheet
NO
1.

OBSERVATION
The respondent feels dysuria (burning or pain on urination)

YES

NO

2.

There is blood in the respondents urine (hematuria)

3.

The respondent had urgency (sudden need to urinate)

4.

The respondent had nocturia (awakening during sleep to

urinate)

5.

The respondent had incontinence (loss of control)

6.

The respondent had back pain

7.

The respondent got fever

8.

Redness in pubic area