Analysis of Factors Affecting Officer Behavior in Management of
Medical Waste in General Hospital Regional District Deli Serdang
Nurlisnawati, Syamsul Arifin
2
, Amir Husin
3
1
Program Study PSL USU, Universitas Sumatera Utara, Medan 20155, Indonesia
2
Faculty of Law, Universitas Sumatera Utara, Medan 20155, Indonesia
3
Faculty of Engineering, Universitas Sumatera Utara, Medan 20155, Indonesia
Keywords: Knowledge, Attitude and Action, Behavior.
Abstract: Health services shall be the right of every person guaranteed by the 1945 Constitution of the State of the
Republic of Indonesia which shall be realized with an effort to improve the highest degree of public health.
Hospitals as a means of health services, a gathering place for the sick and healthy people, or can be a place
of disease transmission and allow the occurrence of environmental pollution and health problems, so to
avoid risks and health problems need to organize the health of the hospital environment according to health
requirements by doing waste management or clinical and non-clinical waste both solid and liquid resulting
from hospital activities and other supporting activities so that hospital sanitation is maintained which is
supported by good officer behavior. Based on the above matters and in order to to examine more deeply
from the point of view of the behavior of medical personnel, the authors are interested in conducting
research with the title "Analysis of Factors Affecting Officer Behavior in Medical Waste Management at
Regional General Hospital Deli Serdang District". This research uses Multiple Regression Analysis tool
which operated through SPSS program. Respondents in the study were hospital medical personnel, as many
as 78 respondents. Methods of data collection through the distribution of questionnaires. The purpose of this
study is to analyze the factors that influence the behavior of officers in the management of medical waste in
RSUD Deli Serdang District. The results showed that partially as well as simultaneous variables
Knowledge, Attitudes and Action have a positive and significant impact on Medical Officer Behavior.
Furthermore the results of the Coefficient of Determination indicate that the variables Knowledge, Attitudes
and Actions have an effect of 74.90% of the Behavior variable so it can be concluded that the independent
variables have a strong degree of relationship with the dependent variable.
1 INTRODUCTION
Based on Law Number 44 Year 2009 on Hospital in
Article 1, it is explained that the hospital is a health
service institution that provides full range of
personal health services providing inpatient,
outpatient and emergency care services.
According to the MOH RI (2009) that the
hospital is a health facility for the gathering of the
sick and healthy people and can be a place of disease
transmission and allow the occurrence of
environmental pollution and health problems.
According to WHO (2000), the definition of a
hospital is a business state that provides lodging that
provides short and long-term medical services
consisting of observation, diagnostic, therapeutic
and rehabilitation for people suffering from illness,
injury and those who are willing to give birth and
are all affected by a safe environment. Chandra
(2007) said that the waste generated is a distinct
threat to environmental sustainability and for public
health if the effluent quality of hospital waste does
not meet the hospital waste requirements because it
contains various microorganisms causing human
diseases such as typhoid fever, cholera, dysentery
and hepatitis so that hospital waste must be
processed before discharge into the environment.
The Director General for PPM & PL (2002) said that
waste and hospital waste are all waste and waste
generated by hospital activities and other supporting
activities. In general, waste and hospital waste are
divided into two major groups, in general rubbishor
liquid waste or clinical and non-clinical waste.
Arifin (2008) says that hospital waste as well as
490
Nurlisnawati, ., Arifin, S. and Husin, A.
Analysis of Factors Affecting Officer Behavior in Management of Medical Waste in General Hospital Regional District Deli Serdang.
DOI: 10.5220/0009905100002480
In Proceedings of the International Conference on Natural Resources and Sustainable Development (ICNRSD 2018), pages 490-499
ISBN: 978-989-758-543-2
Copyright
c
 2022 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

other wastes will contain organic and inorganic
materials, whose levels of content can be determined
by commonly used water tests such as BOD, COD,
pH, microbiologic, and others. One of the activities
of hospital is sanitation of hospital so one of the
effort done by hospital for hospital sanitation service
is waste management (Nugroho and Trihadiningrum,
2007). Midwife practice, practice of doctors and
dentists, clinics, maternity homes also release little
infectious waste (infected B3) byproducts
(Permenkes RI, 2004). Waste management is one of
the strategic aspects of the hospital, because with
good waste management will create a good image
for the hospital so that knowledge, attitude, behavior
and behavior of medical personnel are needed.
Behavioral factors become the basis of successful
hospital waste management. This is in line with the
results of research from Okky Assetya Pratiwi, et al
(2013) indicates that liquid waste management
officers with good behavior will be able to
contribute and a considerable influence in the
management of liquid waste.
2 THEORETICAL STUDIES
Hospitals as a means of health improvement efforts
that carry out health services as well as educational
institutions of health and research personnel, it has a
positive and negative impact on the surrounding
environment so that the need for environmental
sanitation efforts of hospitals that aims to protect the
public and hospital officials will the danger of
pollution environment that comes from hospital
waste (Darmadi, 2008). Environmental problems are
closely related to the health world. To achieve a
healthy society needs a good environment as well. In
this case the hospital as a health facility must also
pay attention to the linkage. On the other hand, the
hospital can also be said to be a waste donor because
the waste comes from medical and non-medical
activities that are both dangerous and toxic
(Paramita, 2007). The same is also conveyed by
Sutarjo et al (2015) who said that the hospital is one
of the waste generators. To prevent outbreaks of an
infectious disease sanitation is a way of breaking the
chain from the source. Sanitation is a public health
effort that focuses on the mastery of various
environmental factors that affect the degree of health
(Arifin, 2008). The sanitation program in the
hospital consists of building and room sanitation,
food and beverage sanitation, water sanitation,
sanitary washing, insect and mouse control,
sterilization/disinfection, radiation protection,
environmental health counseling, nosocomial
infection control, and waste / waste management
(Adisasmito, 2009). Required policies according to
health and safety management by carrying out the
management and monitoring activities of hospital
waste as one of the important indicators that need
attention (Adhitama, 2006). OzderAclan, et al
(2013) says that the medical waste management of
hospitals is very important because medical waste
has various health risks for anyone so that
knowledge, attitude, behavior and behavior of
medical officers in the improvement.
2.1 Knowledge
According to Bachtiar et al (2008) knowledge is
formed by influenced by internal factors such as age
and intelligence and external factors namely
education, environment, experience, information,
and people who are considered important.
Knowledge and attitudes arise because of the
influence of the environment and or through the
learning process. Learning process will affect
learning outcomes in the form of changes in
knowledge and attitude (Notoatmodjo, 2007).
Soediharti (2012) said that the knowledge of nurses
in performing medical waste disposal determined the
level of education and age. Azwar (2005) says that
someone who has a good knowledge of waste
management will have good behavior as well.
Knowledge can be obtained from both formal and
non-formal education and requires a complex
cognitive process so that to know the level of
knowledge a person can be test or interview using a
questionnaire (Prawitasari, 2008). According to
Green (2001) that education is one of the actors who
became the basis for action and with a fairly high
education in expecting to have good knowledge.
2.2 Attitude
Attitude is a way of looking at life, a way of
thinking, feeling and acting. Therefore, attitude will
vary according to the pattern of his life. Azwar
(2003) argues that attitudes affect behavior through a
careful and reasoned decision-making process so
that a person will do an action if he or she is positive
and if they believe others want to do it. In another
section Allport (in Notoatmodjo, 2003) explains that
the attitude has three main components, namely: a)
Beliefs (beliefs), ideas and concepts of an object. b)
Emotional life or evaluation of an object and c)
tendency to act (tend to behave). Dayakisni and
Hudaniah (2003) say that the attitude of the
Analysis of Factors Affecting Officer Behavior in Management of Medical Waste in General Hospital Regional District Deli Serdang
491

individual is the beginning of the realization of
individual actions or behavior. Furthermore Yusran
(2008) said that a positive attitude is assessed as a
determinant of the level of compliance with
principles. Fauzul (2015) said that attitude is a very
important domain in shaping one's actions (overt
behavior). According Notoatmodjo (2007), that in
determining the whole attitude, knowledge,
thoughts, beliefs and emotions play an important
role. Measurement of attitude can be done directly or
indirectly. Directly can be expressed through the
opinion or statement of the respondent to an object,
while indirectly can be done with hypothetical
questions, then asked the opinion of the respondents
(Walgito, 2014).
2.3 Action
Attitudes will be reflected in the form of action but it
cannot be said that attitudes and actions have a
systematic relationship because it is influenced by
various other factors such as supporting factors and
drivers (Notoatmodjo, 2007; Siagian, 2004). Helwi
(2002) said that there is a significant relationship
between the actions of respondents with the behavior
of respondents to the handling of medical waste.
Notoatmodjo (2003) says that action is a movement /
action of the body after getting stimulus or
adaptation from within the body or outside the body
or the environment. The results of a study conducted
by Bachroen (2006) show that there are still some
officer actions that potentially increase the
transmission of the disease to themselves, the
patients served and the wider community, among
others (1) improper hand washing; (2) inappropriate
use of gloves; (3) unsafe resection of the syringe; (4)
safe disposal of sharp appliances; (5)
decontamination techniques and equipment
sterilization are less precise; (6) inadequate clean
room practices.
Figure 1: Thinking Framework.
2.4 Behavior
The behavior of officers involved in the liquid waste
management system is related to several factors,
namely predisposing factors, supporters and drivers
(Notoatmodjo, 2007). Nahampun (2009) said that
the predisposing factors and boosting factors or
drivers are the factors that influence the compliance
of officers in running the hospital waste water
management in accordance with the fixed
procedures. Furthermore, Nahampun (2009) said
that the rules that fall into the predisposing factors
affect the behavior of a person. Meanwhile,
according to Okky, et al (2013), that education,
knowledge, attitude, action, regulation and
supervision have significant relation with behavior
of waste management officer.
3 RESEARCH RESULT
Deli Serdang General Hospital is the only General
Hospital owned by the Government of Deli Serdang
Regency and is a Service Referral Center with Class
B Non-Education status under the Decree of the
Minister of Health of the Republic of Indonesia No.
405 / MENKES / SK / IV / 2008 dated 25 April
2008 and has achieved Full Accreditation of Service
16 Year 2011 according to SK Director of RSUD
Deli Serdang No: 800.110 / SK / I / 2011. On
December 30, 2016 graduated with a 4-star major
level of KARS with Number: Kars-Sert / 361 / X11 /
2016 as RSUD Type B based on Kepmenkes RI
Number: 405 / Menkes / SK / IV / 2008. RSUD Deli
Serdang is equipped with Facilities and
Infrastructure of Medical Service such as
Emergency Installation which consists of Intensive
Care / Intensive Care Unit (ICU, NICU and PICU),
Central Surgery Theater (IBS) / Central Operation
Theater (COT), Inpatient Installation, Outpatient
Installation (Outpatient Service in Polyclinic),
Medical Support Facilities and Infrastructure, Other
Infrastructure Facilities and Public Service Facilities
ICNRSD 2018 - International Conference on Natural Resources and Sustainable Development
492

3.1 General Characteristics of
Respondents
Table 1: Identify Respondents by Age.
No Description Amount %
1 < 20 Year - -
2 21 - 30 Year 11 14,10
3 31 - 40 Year 23 29,49
4 41 - 50 Year 30 38,46
5 > 51 Year 14 17,95
Total 78 100,00
Source: Primary Data Processed (2018)
Number of respondents with age ranged 41-50 years
more dominant as many as 30 people (38.46%).
Table 2: Identify Respondents by Status.
No Description Amount %
1 Married 75 96,15
2Not Married 3 3,85
Total 78
100,00
Source: Primary Data Processed (2018)
The number of respondents with married status is
more dominant as many as 75 people (96.15%).
Table 3: Identifiy Respondents by Sex:
No Description Amount %
1Man 55 70,51
2 Woman 23 29,49
Total 78
100,00
Source: Primary Data Processed (2018)
The number of respondents with male sex is more
dominant by 55 people (70,51%).
Table 4: Identifiy Respondents by Education.
No Description Amount %
1SD
- -
2SMP 5 6,41
3 SMA/SMU/SMK 12 15,38
4D3 20 25,64
5S1 39 50,00
6S2 2 2,56
7S3 - -
Total
78 100,00
Source: Primary Data Processed (2018)
Number of respondents with S1 education looks
more dominant as many as 39 people (50.00%).
3.2 Number of Medical Waste
Generated by Deli Serdang
Regional Hospital
Based on the data obtained that the volume of solid
medical waste generated in total averaged per day is
254,01 kg/day.
Table 5: Amount of Medical Waste Resulted.
Source : RSUD Deli Serdang (2018)
3.3 Implementation of Medical Waste
Management RSUD District Deli
Serdang
RSUD district Deli Serdang in its operational
activities produce medical waste with the following
processing stages:
1. Operational Engineering
In waste management at RSUD district Deli
Serdang, the process of sorting and collection is
done by officers from each unit (medical officer).
While the process of removal, transportation and
final disposal is done by waste (non-medical)
personnel.
a) Sorting
Segregation of waste is carried out by the
officer’s present in each waste generator unit
(unit officer). In the implementation, waste
sorting into two categories, namely medical
waste and non-medical waste. All waste
places owned by the hospital are
distinguished between medical waste and
non-medical waste. The plastic coating bag
used for medical waste is red. Plastic coating
bags are always installed and replaced every
day when the waste bin is emptied
b) Collection
The collection is distinguished in two
containers, namely for medical waste in the
form of a red covered bucket marked
"medical waste" lined with a yellow plastic
bag labeled "medical waste" and for non-
medical waste in the form of a gray-covered
tub. The medical waste site varies in addition
to the bucket form (bucket) as well as the
Analysis of Factors Affecting Officer Behavior in Management of Medical Waste in General Hospital Regional District Deli Serdang
493

form of the stepping stool and the plastic
waste place without lid. Hospitals use
medical waste containers made of strong,
lightweight, rustproof, water-resistant
materials, smooth surfaces on the inside, and
have a lid that is easily opened and closed
again. There is at least one waste place in
each installation room. Each medical waste
contained in a plastic bag as a medical waste
wrapper. Plastic bags are transported daily.
However, in reality there is still mixed waste,
whether it is medical waste in a non-medical
waste place or otherwise non-medical waste
discharged in medical waste. The behavior of
officers from each unit influences the
collection process.
c) Displacement
Moving is done by cleaning service, on
medical waste, waste is taken along with
yellow plastic bag without first tied directly
inserted into the open trolley. Unlicensed
plastic bags and open trolleys allow medical
waste to scatter especially when passing
uneven roads. While non-medical waste is
moved from the waste basin by pouring
directly into the drum, because it is not
coated black plastic bag then when moving
the waste there is the possibility of waste
scattered. Wastewater is also often used to
suppress waste so that more in the drum so
that the exterior of the waste tub becomes
dirty.
d) On Site Transportation
On site transport is the transport carried out at
the starting point to the temporary shelter.
Medical waste from each room is transported
by medical waste carts. Garbage carts used to
transport medical waste that has been
separated by non-medical waste. Medical
waste carts have a flat, watertight inner
surface, easy to clean and dry, medical waste
easily loaded and emptied. No sharp edges
can damage bags or containers during loading
or unloading. Medical waste carts are washed
3 days. Freight is made daily with a
frequency of 1x/ day. Transportation is done
by cleaning service, in handling the medical
waste the cleaning service is using Personal
Protective Equipment (APD) as complete as
rubber hands-on, mask cover nose,
hat/helmet, boots and special work clothes.
e) Temporary shelter
Medical waste originating from the medical
service unit, covers the wardinpatient,
outpatient and Emergency Unit (ER) are
accommodated in temporary shelters before
they are finally destroyed. The medical waste
is accommodated or packed in a plastic
bonded coating bag. Temporary shelter
locations of medical waste are located far
away from food and food storage locations.
The distance between the temporary shelters
and the food storage location and the food
storage ± 50 meters.Supplies for hygiene kits
(brooms, waste containers) protective
clothing, plastic coating bags for packing
medical waste in a sanitary room where the
site is close enough to temporary medical
shelter locations. The location or area of the
temporary shelter can be locked to prevent
unauthorized entry. The existing medical
waste at the temporary shelter is packed using
a plastic coating bag before being transported
by the carrier. Medical waste transport is
done by using open trolleys without drum to
the TPS (temporary shelter) near the
incinerator before being burned twice a day
that is in the morning and afternoon, while
transporting non-medical waste is done by
using sulo and trolley drum is brought to the
TPS hospitals 3 times a day that is in the
morning, afternoon, and evening. The path
used to transport waste in RSUD Deli
Serdang District is still the same as the
common path or path used for patients,
visitors, food delivered to patients, and
others. medical waste trolleys are not closed
and waste plastic bags are not tied up so that
germs present in medical waste can spread
when transport is made to people who can
cause nosocomial infections.
f) Off site transport
Offshore transport is the transport carried out
at the point of temporary shelter out of the
hospital. Medical waste in the shelter while
medical waste is transported out of the
hospital. Transportation of hospital medical
waste using vehicles where in the vehicle
there is no barrier or boundary to separate the
medical waste with other materials.
g) Final Disposal / Destruction
The final disposal of medical waste is carried
out by incinerator combustion and the ash of
combustion ash is taken by DKP once every
3 months, while non-medical waste from TPS
is taken by DKP 2 times a week. Incinerator
capacity owned by RSUD district Deli
Serdang is 1 m of medical waste transport
ICNRSD 2018 - International Conference on Natural Resources and Sustainable Development
494

per day in the morning is 3 trolley and lunch
is 1 trolley, so 1 trolley is inserted in
incinerator, after most of it burns and
becomes ash then the next result of transport
is just included in incinerator for burning.
Incinerator has capacities: 80 kg,
temperature: 800-13000
0
C, kerosene fuel,
working time regulation: 1 hour, electricity:
500W / 220W. Medical waste category of
sharp objects such as syringes, mess slides,
medicine bottles burned with a temperature
of 800-13000
0
C while the medical waste in
the form of cotton, kassa, plaster, hands-on
burned with a temperature of 500-8000
0
C.
The burning of medical waste is done 1 time
a week depending on the medical waste
generated a lot or a little. In one combustion
process conducted in one day, that is to enter
medical waste into the incinerator is done
once from all medical waste generated from
each installation room.
2. Management Unit
Waste management unit in Deli Serdang District
Hospital is Hospital Sanitation Installation. In
practice, hospital waste management is carried
out by all waste generating units in collaboration
with cleaning service and monitored by hospital
sanitation installations. Waste generating units as
waste sorting and collection, cleaning service as
waste removal, and sanitation personnel as
monitors and are responsible for the final
handling of medical waste.
3.4 Cross Tabulation Analysis
1. Knowledge Variable on Behavior Variable
The table shows that the calculated value of
Knowledge variables is 2,646 while the table is
worth 1.99. This means calculated> table that is
2.646> 1.99 so it can be concluded that the
variable Knowledge is positive and significant
effect on the variable Behavior.
Based on the result of Chi Square Test, the value
is 0.00 so p value is less than α = 0,05 so it can
be concluded that there is a significant
correlation between Knowledge to Behavior.
2. Attitude Variables on Behavior Variables
Based on the result of Chi Square Test, the value
is 0.00 so p value is less than α = 0,05 so it can
be concluded that there is a significant
relationship between Attitude to Behavior.
3. Variable Measures on Behavior Variables
Based on the result of Chi Square Test, the value
is 0.00 so p value is less than α = 0,05 so it can
be concluded that there is a significant
correlation between Measures to Behavior.
3.5 Hypothesis Testing
1. Test t (Partial Test)
a. Knowledge Variable (X
1
) to Behavior
Variable (Y)
Analysis of Factors Affecting Officer Behavior in Management of Medical Waste in General Hospital Regional District Deli Serdang
495

The table shows that the calculated value of
Knowledge variables is 2,646 while the table
is worth 1.99. This means t
calculated
>t
table
that is
2.646> 1.99 so it can be concluded that the
variable Knowledge is positive and
significant effect on the Behavior variable.
b. Attitude Variable (X
2
) to Behavior Variable
(Y)
The table shows that the calculated value of
Attitude variable is 3.038 while the table is
worth 1.99. This means t
calculated
>t
table
that is
3.038> 1.99 so it can be concluded that the
variable attitude is positive and significant
effect on the Behavior variable.
c. Action Variable (X
3
) to Behavior Variable
(Y)
The table shows that the calculated value of
the Action variable is 3.130 while the table is
worth 1.99. This means t
calculated
>t
table
that is
3.130>1.99 so it can be concluded that the
variable Action is positive and significant
effect on the Behavior variable.
2. F Test (Simultaneous Test)
The table shows that the F
hitung
of Knowledge,
Attitude and Action variable is 4.303 while F
tabel
is 2.73. This means F
calculate
>F
tabel
is 4.303> 2.73
so it can be concluded that the Knowledge,
Attitude and Action variable is positive and has a
significant effect on the Behavior variable.
3.6 Coefficient of Determination
(Adjusted R
2
)
Based on the table it can be concluded that the
variables Knowledge, Attitudes and Actions have an
effect of 74.90% against the Behavior variable,
while 25.10% influenced other variables that are not
examined. Since the R Square (R
2
) value is in the
interval 0.60 - 0.79 it can be concluded that the
independent variables have a strong degree of
relationship with the dependent variable
.
3.7 Discussion
The results of the study showed:
1. Of the total medical waste production, the
average 254,01 kg / day managed by RSUD
Distric Deli Serdang is 231.56 kg/day on
average, so the average of 22.45 kg of medical
waste is not managed every day. The cause is not
entirely medical waste managed because the
number of human resources management of
medical waste is still lacking because only
handled by 8 officers. A Head of Sanitation
Installation as responsible for the preparation of
hospital waste management plan is assisted by 1
coordinator in charge of monitoring the
implementation of waste management, 1
sanitation worker in charge of burning medical
waste, and 5 cleaning service personnel in charge
of transporting waste and if sanitation officer
unable to enter work then replaced by cleaning
service personnel. thus, causing shortage of
cleaning service personnel to collect medical
waste.
2. Based on the result of Chi Square Test, the
knowledge, attitude and action variable showed
that there was significant correlation with officer
behavior in medical waste management.
3. Knowledge has a significant effect on Behavior.
This is indicated by t test result with
t
calculate
(2.646)>t
table
(1.99). So the initial
hypothesis which states that there is a significant
influence of Knowledge Behavior to Behavior
proved true. This supports the results of a study
conducted by Sudiharti (2012) that Knowledge
has a positive and significant impact on
Behavior. The research results of Mary
Magdalene, Yunita Wungo, Eni Mahawati and
Eko Hartini (2013) also said that Knowledge has
a positive relationship to Medical Waste
Management Practice. This shows that the
knowledge of the respondents about garbage, the
type of garbage, the way of medical waste
ICNRSD 2018 - International Conference on Natural Resources and Sustainable Development
496

disposal is good. Respondents are able to do
waste sorting well. Factor of knowledge about
waste is very important to be implanted on every
officer who will do waste disposal hospital. One
of the efforts to increase knowledge by providing
training or counseling as a means of education,
especially nurses to behave throw away medical
waste in accordance with the place so as to
reduce the impact of work accidents and
nosocomial infections.
Table 6: Distribution of Medical Officer Knowledge in
Medical Waste Management.
Source: Primary Data Processed (2018)
4. Attitudes have a significant effect on Behavior.
This is indicated by t test result with
t
calculate
(3.038)>t
table
(1.99). So, the initial
hypothesis which states that there is a significant
effect of Attitudes toward Behavior attributes
proved true. This supports the results of research
conducted by Sudiharti (2012) that attitude has a
positive and significant effect on Behavior. The
research results of Mary Magdalene, Yunita
Wungo, Eni Mahawati and Eko Hartini (2013)
say that Attitudes have a positive relationship to
Medical Waste Management Practice. Based on
the results of research showed that the
respondents working in RSUD Deli Serdang
district have a good attitude towards the
management of waste/ medical waste by not
mixing between medical and non-medical waste.
The attendant's willingness to dispose of medical
waste in the hospital is done well. This is
influenced by the attitude of the officer to pay
attention to the specification of garbage dump,
the dangers of garbage and the special
supervision of the garbage management officer.
Table 7: Distribution of
Medical Officer Attitude in
Medical Waste Management.
Source : Primary Data Processed (2018)
5. Actions have a significant effect on Behavior.
This is indicated by t test result with
t
calculate
(3.130)> t
table
(1.99). So the initial
hypothesis which states that there is a significant
influence variable Measures against Behavior
proved true. This supports the results of a study
conducted by Komang Yudha Widiartha (2012)
which says that actions have a positive and
significant influence on Behavior. Based on the
results of research shows that the respondents
working in Deli Serdang District Hospital in the
implementation of waste management has a good
action on waste management/medical waste.
Officers have performed proper sorting and
collection of medical waste such as disposing of
medical waste in the medical waste bin,
installing and replacing the new plastic coating
bag afterthe bin has been emptied. Officers'
actions in sorting, collecting, sheltering and
transporting and destruction in the conduct of
medical waste management are as good as
collecting medical waste from any room with the
frequency of collecting from each room on a
regular basis, separating medical and non-
medical waste when collecting garbage from
every room by separating the medical and non-
medical waste collected from every room,
disinfecting and cleaning the trash after the bins
are emptied, disposing medical waste from every
room to temporary shelters
.
Table 8: Distribution of Medical Officer Action in
Medical Waste Management.
Source : Primary Data Processed (2018)
Analysis of Factors Affecting Officer Behavior in Management of Medical Waste in General Hospital Regional District Deli Serdang
497

4 CONCLUSIONS AND
SUGGESTIONS
4.1 Conclusion
a. Of the total medical waste production, the
average 254,01 kg/day managed by RSUD
district Deli Serdang is 231.56 kg/day on
average, so the average of 22.45 kg of medical
waste is not managed every day.
b. Knowledge variable (X
1
) partially have positive
value and have a significant effect to Behavior
Variable (Y).
c. Attitude Variables (X
2
) are partially positive and
have a significant effect on Behavior Variable
(Y).
d. Variable Action (X
3
) partially have positive
value and have a significant effect to Behavior
Variable (Y).
e. Knowledge Variables (X
1
), Attitude (X
2
) and
Action (X
3
) simultaneously have positive value
and have significant effect to Behavior Variable
(Y).
f. Coefficient of Determination indicates that
Knowledge (X
1
), Attitude (X
2
) and Action (X
3
)
have an effect of 74.90% on Behavior Variable
(Y), while 25.20% is influenced by other un-
researched variables. The independent variables
have a strong degree of relationship with the
dependent variable.
4.2 Suggestions
a. Management of RSUD Deli Serdang district is
expected to add cleaning service and incinerator
staff so that medical waste that have not
managed can be completely destroyed.
b. The management of RSUD district Deli Serdang
is expected to conduct training on the more
intensive medical and non-medical waste
disposal at least 1 year 2 times in 1 year so that it
can increase the medical officer knowledge about
waste disposal especially medical waste.
c. The management of Deli Serdang District
Hospital is expected to give warning to medical
officer who is known to have disposed of waste
that is not in accordance with the place that has
been provided in Deli Serdang District Hospital.
d. The management of Deli Serdang District
Hospital is expected to increase the procurement
of necessary facilities in the management of
medical waste such as increasing the number of
garbage bins, the procurement of plastic bags,
the procurement of waste transporting equipment
in the form of carts / trolleys and coordinating
with the officers who handle the medical waste
directly.
e. The management of RSUD district Deli Serdang
is expected to evaluate and improve the
fixedprocedures on medical waste management
so that the officers are nurses and garbage
managers.
f. For the next researcher is expected to examine
other variables such as facilities and
infrastructure, age, working period and others,
related to the behavior and with the number of
samples more so that can be obtained more
complete data in order to obtain the results of the
research more leverage.
REFERENCES
Adisasmito, W., 2009. Hospital Environmental Audit. PT
Raja Grafindo Persada. Jakarta.
Aditama, TY., 2006. Hospital Administration
Management. Publisher University of Indonesia.
Jakarta.
Arifin, M., 2008. Effect of Hospital Waste on Health.
FKUI.
Azwar, S., 2003. Human Attitudes Theory and
Measurement. Student Library. Jakarta, P.5-30.
Bachtiar, A., Milwati, S., Nisfadhila, C., 2008. Relation of
Islamic Knowledge Level with Attitudes of Sex
Teenagers in Madrasah Aliyah Negeri III Malang.
Health Journal 6(1): 23-32.
Chandra, B., 2007. Introduction to Environmental Health.
EGC. Jakarta.
Darmadi., 2008. Nosocomial Infection Problematic and
Control. Salemba Medika. Jakarta.
MOH RI., 2004. Decree of the Minister of Health of the
Republic of Indonesia Number 1204 Year 2004
regarding Health Hospital Environmental
Requirements. Jakarta: DG PPM and PLP.
_________., 2009. Environmental Health Requirements
for Hospital, Regulation of the Minister of Health RI
No. 1204/MENKES/SK/X/2004.Ministry of Health
RI.Jakarta.
Directorate General of PPM & PL and Directorate General
of Medical Services., 2002. Hospital Sanitation
Guidelines in Indonesia. Ministry of Health Republic
of Indonesia.Jakarta.
Hayat, F., 2015. Analysis of Practice Factors of Solid
Waste Medical Management at Cilegon City General
Hospital. Faletehan Health JournalVol. 3rd Edition 3.
Green, LW., Creature, MW., 2001. Health Promotion
Planing an Educational and environmental Approach.
Mayfield Publishing Company. Mountain New,
2ndEdition.
Helwi., 2002. Factors Affecting Officers Behavior Against
Medical Waste Management Haji Hospital Medan.
ICNRSD 2018 - International Conference on Natural Resources and Sustainable Development
498

Faculty of Public Health University of Sumatera
Utara. Medan.
Nahampun, HS., 2009. Description of Implementation of
Fixed Waste Management Procedures in Waste Water
Treatment Plant of Tangerang Regency General
Hospital. Faculty of Public Health University of
Indonesia. Depok.
Notoatmodjo, S., 2003. Introduction to Health Education
of Health Behavior Sciences. PT. Rineka Cipta.
Jakarta.
_____________., 2007. Health Promotion and Behavioral
Science. Rineka Cipta. Jakarta.
Nugroho, S., Trihadiningrum, Y., 2007. Study of Medical
Waste Management in RSUD dr. Soedono Madiun.
Proceedings of the National Seminar on Technology
Management V. MMT-ITS Study Program. Surabaya.
Paramita, N., 2007. Evaluation of Waste Controlof RSPAD
Gatot Subroto Jakarta. Diponegoro University.
Semarang.
Pratiwi, OA., Hasyim, H.,Sunarsih, E., 2013. Determinant
Analysis of Officer Behavior in Liquid Waste
Management Pet System at PT Pusri Palembang.
Journal of Public Health Sciences4(2).
Aclan, O., Teker, B., Eker, HH., Altindis, S.,Kocaakman,
M., 2013. Medical Waste Management Training for
Healthcare Managers A Necessity. Journal of
Environmental Health Science and Engineering11(1):
20.
Perwitasari, D., Anwar, A., 2008. Level of Risk for Use of
Personal Protective Equipment and Hygiene Officer at
Clinical Laboratory of Ciptomangunkusumo General
Hospital. Jakarta.
Siagian, SP., 2004. Motivation Theory and Its Application.
PT. Rineka Cipta.Jakarta.
Soediharti, S., 2012. Relationship Knowledge and
Attitudes with Nurse Behavior in Medical Waste
Disposal at PKU Muhammadiyah Hospital
Yogyakarta. Faculty of Public Health, University of
Ahmad Dahlan. Journal of KES MAS 6(1): 1 - 74.
Suseno, SU., Yudianto., Budijanto, D., Hardhana, B.,
Soenardi, TA., 2015. Health Profile of Indonesia Year
2014. Ministry of Health Republic of
Indonesia.Jakarta.
Walgito, B., 2004. Introduction to General
Psychology.Printing Andi. Jakarta.
WHO., 2014. Safe Management Of Wastes From Health-
Care Activities. Switzerland.
Yusran, M., 2008. Compliance with the implementation of
principles of infection prevention (universal
precaution) on nurses at AbdoelMuluk Regional
Hospital Bandar Lampung. Proceedings of the
National Seminar on Science and Technology II; 2008
November 17-18; University of Lampung
Analysis of Factors Affecting Officer Behavior in Management of Medical Waste in General Hospital Regional District Deli Serdang
499