NURSE'S KNOWLEDGE LEVEL OF HANDLING EMERGENCY PATIENTS DUE TO TRAFFIC ACCIDENTS AT RSUD PARAPAT SIMALUNGUN REGENCY

Traffic accidents can cause loss of a person or disability as well as injuries that require immediate help, such as hard object trauma to the head which can cause nerve disorders, failure in an organ such as respiratory failure and kidney failure, loss of fluids and electrolytes in large quantities, bleeding, and trauma or injury to the musculoskeletal system. Hospitals as health care facilities that have health workers must be able to provide optimal health services, especially for patients who are in an emergency condition. Efforts to provide health services to emergency patients are basically able to prevent death or disability that may occur. A study was carried out on 32 respondents (nurses) which aimed to determine the level of knowledge of nurses about handling emergency patients due to traffic accidents at the Emergency Unit of Parapat General Hospital, where this research is descriptive in nature, and uses totally sampling (the whole population), namely totaling 32 people, and carried out using primary data obtained from distributing questionnaires. After data processing was carried out, it was found that the majority of respondents had sufficient knowledge, namely around 20 people (62,500%) and had good knowledge, around 6 people (18,750%), less knowledgeable, around 6 people (18,750%) based on the level of education, the majority of respondents had sufficient knowledge, namely around 20 people (62.500%) and good knowledge about 6 people (18.750%).


INTRODUCTION
According to WHO and UNICEF, accidents happen to young people aged 10-24 years and in 2020 this can be predicted to be the main factor of death and disability at a young age in the world, and mentions that around 260,000 children die and 10,000,000 others are injured by accident.Every six seconds one life becomes a victim of a road accident in the world.Road deaths can rival those from malaria and tuberculosis.In the case of accidents, it is stated that 9 out of 10 deaths occur in developing countries.
Travel safety has been ignored by politicians and decision makers in the world.In this case, it is difficult for developing countries to obtain the financial and material assistance they need in an effort to improve road safety.Accident rates in developing countries and rich countries are in stark contrast, when rich countries continue to reduce accident rates, the number of accidents in developing countries continues to increase.
Actually accidents can be anticipated properly.People know how to reduce the risk of death and accidents, but there is still a lack of political factors to take action.In industrialized countries the death toll from accidents has halved in the last 30 years, although the number of vehicles has continued to increase.The Commission for Global Road Safety says "the government of each country should act with motorcyclists, and action against drunk drivers, as well as driving training (Firmansyah, 2011) An emergency patient is a patient who due to a cause (traumatic illness, accident, anesthetic action) which if not immediately assisted will experience disability, loss of organs or death.In handling emergency patients, the most important thing for health workers is to protect the patient's life, reduce complications that will arise, relieve the victim's suffering and protect themselves from the possibility of transmitting infectious diseases from sufferers (Sudjito, 2003).
Every day emergency response can reduce the death toll by up to 50% if handled properly.However, the reality encountered in the field is that each hospital has different (various) handling of emergency victims, so they do not yet have uniformity in handling and preparedness.The success of everyday emergency management will have a very beneficial impact.
In accordance with the basic principles of biotics, the obligation to help emergency patients is included in the concept of beneficence.In the handling of emergency patients must pay attention to professional standards and standard operating procedures.Services for emergency patients must be carried out as soon as possible.considering the patient's soul may fail to be saved if treatment is too late.If the patient is unconscious and not accompanied by his family, the doctor has the right to decide which medical action to take without anyone's consent, according to the patient's medical needs.
In accordance with professional standards and standard medical operational procedures, the management of emergency patients can be carried out without informed consent from anyone.Health workers must do their best so that patients can survive and recover from emergencies.In KTD, as long as doctors and paramedics have adhered to the concept of professional standards and operational procedures, medical actions taken cannot be called malpractice, and health workers are protected from legal sanctions by applicable health regulations (Agatha, 2009) Therefore researchers are interested in conducting research on the level of knowledge of nurses in the emergency department of Parapat General Hospital in providing health services to emergency patients.So the researchers conducted a study with the title of the level of knowledge of nurses on the handling of emergency patients due to traffic accidents in the emergency department of Parapat General Hospital.

1.1.Formulation of the problem
The formulation of the problem in this study is how is the level of knowledge of nurses regarding the handling of emergency patients due to traffic accidents in the emergency unit of Parapat General Hospital.

2.1.Types of research
The type of research conducted by researchers is descriptive by using the entire sample (totally sampling).Descriptive research aims to do a description of the phenomena or conditions that are found and presented as is where researchers do not analyze how these phenomena can occur so that there is no need to do hypotheses (Sastroasmoro, 2008)

2.2.Research sites
The research was conducted at Parapat General Hospital which is located in the Lake Toba area, Girsang Sipangan Bolon District, Simalungun Regency.Where Parapat General Hospital has 32 nurses with the qualifications of 3 Bachelor of Nursing, 22 D-II Nursing, and 7 SPK people, where they have different years of service and different work experiences.Considering several reasons, the number of patients who need emergency services due to traffic accidents at the hospital is quite high and no research has been conducted on the level of knowledge of health workers (nurses) regarding the handling of emergency services due to traffic accidents.

2.3.Research time
The time for conducting the research was from April to May 2018.

2.4.Population
The population is all subjects or objects with certain characteristics that will be studied (Hidayat A, 2007).The population of this study were all nurses working at Parapat General Hospital, totaling 32 people.

2.5.Sample
In taking the sample, the researcher took the entire population by using the totality sampling method (the entire population), where the sample used was 32 people.

3.RESULTS AND DISCUSSION
From the list of frequency distribution tables obtained, the level of knowledge of nurses regarding the handling of emergency patients due to traffic accidents at the Emergency Unit of Parapat General Hospital can be concluded.

3.1.Knowledge level
Knowledge is the result of knowing, and this occurs after someone has sensed a particular object.Knowledge or cognitive is a very important domain in shaping one's actions (Notoadmojo, 2007).
Knowledge means everything that is known, intelligence or everything that is known regarding the matter (subject) (KBBI, 2009) From the results of the study it was found that the majority of respondents (nurses) who worked at the Emergency Unit of Parapat General Hospital had sufficient knowledge, namely around 20 people (62.500%) while they had good knowledge of about 6 people (18.750%) and 6 people with less knowledge (18.750%) .In this case nurses who are knowledgeable and less have the same weight, namely 6 people (18.750%).

3.2.Level of education
Education is an effort to develop personality and abilities inside and outside of school and lasts a lifetime.Education affects the learning process, the higher a person's education, the easier it is for that person to receive information.The more information you get, the more knowledge you get.However, it should be emphasized that people with low education do not necessarily have low knowledge either.
The level of one's education will affect the response to something that comes from outside.Highly educated people will respond more rationally to incoming information and will think about how far the possible benefits will be obtained from this idea.
Education is a process of changing the attitude and behavior of a person or group and also efforts to mature humans through teaching and training efforts, so it is clear that a vision of education can be pursued, namely to educate humans (Suriasumantri, 2001)

3.3.Years of service
Age affects one's comprehension and mindset.The older you are, the more your comprehension and mindset will develop, so that the knowledge you gain will improve.At middle age, individuals will play a more active role in society and social life and make more preparations for successful efforts to adjust to old age, besides that middle age will spend more time reading.
Two traditional attitudes regarding the course of development throughout life: 1.The older the wiser, the more information found and the more things done so as to increase knowledge.2. Unable to teach new skills because of physical and mental setbacks.It can be expected that 1Q will decrease with age, especially in some other skills such as vocabulary and general knowledge.Some theories argue that a person's IQ will decline quite quickly with age.

3.4.Experience
Experience as a source of knowledge is a way to obtain the truth of knowledge by repeating the knowledge obtained in solving problems encountered in the past.Information obtained from both formal and non-formal education can have a short-term impact (immediate impact) resulting in a change or increase in knowledge.
Experience can be obtained from one's own experience or that of others.Experience that can broaden one's knowledge which is the result of the touch of nature and the five senses.(Notoadmojo, 2003) The experience of an individual about various things is usually obtained from the environment in his development process, such as participating in educational activities such as seminars.

4.CONCLUSION
After conducting research on the level of knowledge on handling emergency patients due to traffic accidents at the Emergency Unit of Parapat General Hospital in 2012, it can be concluded that: 1. Based on the knowledge of nurses on handling emergency patients due to traffic accidents at the Emergency Unit of Parapat General Hospital, the majority have sufficient knowledge, namely 20 people or around 62,500% 2. Based on the level of education, it was obtained that the majority of nurses had sufficient knowledge of handling emergency patients due to traffic accidents at the Emergency Unit of Parapat General Hospital, namely 20 people or around 62,500%. 3. Based on years of service, it was obtained that the level of knowledge of nurses regarding the handling of emergency patients due to traffic accidents at the Emergency Unit of Parapat General Hospital was the majority knowledgeable enough, namely 20 people or around 62.500%.4. Based on the experience gained such as participating in training, the majority of nurses' knowledge regarding patient handling of emergency patients due to traffic accidents at the Emergency Unit of Parapat General Hospital is sufficiently knowledgeable, amounting to 21 people or around 65.625%.