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"Pendokumentasian asuhan keperawatan dalam pelaksanaannya merupakan hal yang rumit. Beberapa upaya telah dilakukan dalam mengatasi permasalahan pendokumentasian. Namun belum ada penelitian yang menggali pendokumentasian dikaitkan dengan integritas perawat. Tujuan penelitian mengeksplorasi pengalaman perawat dalam pendokumentasian asuhan keperawatan kaitannya dengan integritas. Penelitian kualitatif dengan pendekatan fenomenologi deskriptif melibatkan 10 perawat di salah satu RS pemerintah. Metode dilakukan dengan wawancara mendalam. Data dianalisis menggunakan analisis Colaizzi.Hasil penelitian mendapatkan tujuh tema meliputi 1) Menuliskan pendokumentasian asuhan keperawatan sesuai proses asuhan keperawatan, pendokumentasian terintegrasi oleh perawat yang berperan sesuai SPO, 2) Mendokumentasikan asuhan keperawatan  belum sesuai SPO dan pedoman pengorganisasian pelayanan keperawatan yang dipengaruhi oleh faktor dari SDM perawat, metode penugasan, dan, material RS, 3) Merasakan beragam perasaan senang jika berhasil mendokumentasikan dan beragam perasaan bersalah jika belum mendokumentasikan 4) Mendapatkan manfaat pendokumentasian asuhan keperawatan, 5) Mengalami hambatan dan upaya mengatasi hambatan dalam pendokumentasian asuhan keperawataan, 6) Memahami integritas dalam pendokumentasian sebagai kemampuan kognitif, memiliki prinsip nilai, kejujuran, bertanggung jawab, dapat diperhitungkan, sesuai SPO, berkomitmen, kompeten, konsisten, sesuai identitas diri dan mengimplementasikan asuhan yang aman 7) Mengharapkan perawat semakin pintar, terampil dengan pendidikan berkelanjutan, adanya sistem JCI, akreditasi menertibkan pendokumentasian dan pendokumentasian yang lebih spesifik dan terkomputerisasi  Secara umum belum semuanya partisipan melakukan pendokumentasian asuhan keperawatan secara berintegritas. Perawat perlu meningkatkan integritas dalam pendokumentasaian asuhan keperawatan. Perawat dapat melakukan pendokumentasian secara berintegritas harus didikukung oleh manajemen rumah sakit dan tim  keperawatan.

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Documentation of nursing care in its implementation is a complicated matter. Several efforts have been made in overcoming documentation problems. However, no research has been conducted to explore the documentation associated with nurse integrity. The purpose of the study explores the nurse`s experience in documenting nursing care in relation to integrity. Qualitative research with descriptive phenomenology approach involved 10 nurses in one of the government hospitals. The method is done by in-depth interviews. Data were analyzed using Colaizzi`s analysis.

The results of the study obtained seven themes including 1) Writing down the documentation of nursing care according to the nursing care process, integrated documentation by nurses who acted according to SPO, 2) Documenting nursing care not in accordance with SPO and guideline for organizing nursing services that were influenced by factors from nurses human resource, assignment methods, and, hospital material, 3) Feeling a variety of happy feelings when successfully documenting and varying feelings of guilt if it has not documented 4) Getting the benefits of nursing care documentation, 5) Experiencing obstacles and efforts to overcome obstacles in nursing care documentation, 6) Understanding integrity in documentation as an ability cognitive, has the principle of value, honesty, is responsible, can be calculated, according to SPO, is committed, competent, consistent, in accordance with self-identity and implements safe care 7) Expects nurses to be smarter, skilled with educators continuous, the existence of a JCI system, accreditation in order to document and more specific and computerized documentation In general, not all participants have documented nursing care with integrity. Nurses need to improve integrity in documenting nursing care. Nurses can document with integrity must be supported by hospital management and the nursing team."

"Managers are judged by the results they deliver, and more than anything else, those results hinge on the ability to delegate and supervise. You will be surprised at how efficient and easy to manage your team becomes when you master these essential skills.

This handy, pocket-sized guide reveals time-tested ways to boost the performance and productivity of your employees, including how to: ? Define work, assign it, and set measurable, targeted standards for performance

- Match skills to job requirements

- Use Management by Objectives to delegate longer-term tasks to trusted team members

- Monitor, control, and keep on top of projects with minimum effort

- Turn delegation into a teaching tool and build the confidence of your staff

- Provide useful feedback and elicit active participation

- Avoid reverse delegation

- Free up time for higher-level tasks only you can tackle

- And much more. Done right, delegation and supervision allow your employees to learn, grow, and become more capable. Your success will skyrocket as you increase the quality and quantity of results, and build the loyalty, involvement, and commitment of your people."

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ABSTRACTThis evidence-based text is the perfect resource for both practicing nurses and nursing students alike. Using the latest, most authoritative research, this book will help you identify priorities to accurately and effectively manage patient care. Content spans the areas of medication, patient safety, patient education, nursing diagnosis, and collaborative management and much more to equip you for success in all aspects of critical care nursing. This new edition also features new case studies, new QSEN-focused call-out boxes throughout the text, a complete digital glossary, and revised chapter summaries."

"Kinerja adalah penampilan hasil karya personel baik secara kuantitas maupun kualitas dalam suatu organisasi. Kinerja dapat merupakan penampilan individu maupun kelompok kerja personel. Pendokumentasian asuhan keperawatan merupakan bukti tertulis bahwa proses asuhan keperawatan telah dilaksanakan dalam asuhan keperawatan pasien di rumah sakit. Kinerja perawat pelaksana dalam pendokumentasian asuhan keperawatan merupakan masalah sebelum mereka menyadari faktor-faktor yang berhubungan dengan pendokumentasian asuhan keperawatan antara lain faktor umur, jenis kelamin, tingkat pendidikan, masa kerja, status perkawinan, supervisi, pelatihan, rasio tenaga, ada tidaknya kegiatan tidak langsung, pengetahuan dan sikap. Tujuan dari penelitian ini untuk mendapatkan gambaran informasi hubungan faktor-faktor karakteristik individu, supervisi, pelatihan, rasio tenaga, ada tidaknya kegiatan tidak langsung, pengetahuan dan sikap terhadap kinerja perawat dalam pendokumentasian asuhan keperawatan di unit rawat inap RSUD Dr. Achmad Muchtar Bukittinggi. Penelitian merupakan penelitian Non Experimental dengan disain Cross Sectional. Sampel berjumlah sebanyak 86 orang yaitu dengan menggunakan Purposive Sampel pada 4 uni rawat inap spesialis dasar yaitu unit rawat inap penyakit bedah, penyakit dalam, penyakit anak dan bayi serta penyakit kebidanan dan kandungan. Data yang diperoleh dianalisis dengan analisis univariat, bivaria dengan uji statistik Chi-Square dan Multivariat dengan uji regresi logistik dan tingkat kemaknaa = 0,05. Tampilan distribusi frekuensi dan persentase kinerja, proporsi kinerja kurang lebih besar dari proporsi kinerja baik. Variabel-variabel tingkat pendidikan, status perkawinan, supervisi, pelatihan dan tingkat pengetahuan secara statistik ada hubungan bermakna dengan kinerja. Sedangkan variabel-variabel umur, jenis kelamin, masa kerja, rasio tenaga, ada tidaknya kegiatan tidak langsung dan sikap secara statistik tidak berhubngan tetapi secara proporsional ada kecenderungan perbedaan. Selanjutnya analisis multivariate variabel supervisi merupakan variahel yang paling berhubungan dengan kinerja perawat dan dari hasil uji interaksi ternyata karakteristik individu tidak berperan sebagai variabel kontrol. Berdasarkan hasil penelitian ini, disarankan kepada penentu kebijakan di RSUD Dr. Achmad Muchtar Bukittinggi untuk dapat lebih meningkatkan kinerja perawat pelaksana yaitu agar lebih meningkatkan peran supervisor keperawatan seperti kepada ruangan,perawat pengawas dan bidang keperawatan dan bidang pendidikan dan penelitian serta meningkatkan pengetahuan dan ketrampilan perawat pelaksana dalam bidang asuhan keperawatan dan pendokumentasian asuhan keperawatan dan lebih sering menyelenggarakan pelatihan, diskusi dan seminar asuhan keperawatan.

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Factors Related to Nurse's Performance in Documenting Nursing Activities in In Patient General Hospital Dr. Ahmad Muchtar Bukittinggi Year of 2002Performance is a personnel's working performance whether in quality or quantity in an organization. Performance could be individual or group performing. Documentation of nursing activities is a written proof that nursing activities have been done. Nurse's performance in documenting nursing activities is a problem before they realize the factors that related to nursing activities documentation such as age, sex, education, experience, marriage status, supervision, training, human resources ratio, direct activities, knowledge, and attitude.

Objective of this study is to get some information about relation factors such as individual characteristics, supervision, training, human resources ratio, direct activities, knowledge, and attitude with nurse's performance in documenting nursing activities in in-patient ward in Dr. Ahmad Muchtar General Hospital.

This study is non-experimental with cross sectional design with 86 purposive sample taken from 4 in-patient ward specialist such as; in-patient ward surgery unit, internist, child and infant, and obstetric and gynecology. Data analyzed by univariate, bivariate by Chi-square test and multivariate by logistic regression and significance level oc = 0.005. Education level, marriage status, supervision, training, and knowledge variable statistically have significance relation with performance. Whereas sex, age, experience, human resources ratio, direct activities, and attitude, statistically not related but proportionally have differences. From multivariate analysis, supervision variable is the most related variable with nurse's performance and from interaction test; individual characteristics have no role as control variables.

This study recommend to the policy maker in Dr. Achmad Muchtar General Hospital, Bukittinggi to improve nurses performance by improving supervisor's role and improve knowledge and skill in documenting activities, carrying out training and discussion."

"Rumah Sakit sebagai suatu institusi pelayanan kesehatan masyarakat mempunyai sumber daya manusia (SDM) yang kualitasnya sangat berperan dalam menunjang pelayanan tersebut. SDM terpenting dalam Rumah Sakit adalah perawat, karena selain jumlahnya yang dominan perawat juga memberikan pelayanan 24 jam dalam sehari selama tujuh hari dalam seminggu, serta mempunyai kontak yang konstan dengan pasien. Oleh karena itu pelayanan keperawatan sebagai bagian integral dari pelayanan kesehatan jelas mempunyai kontribusi yang sangat menentukan kualitas pelayanan di Rumah Sakit. Mengingat bahwa di RS se kota Palu belum pernah dilakukan penelitian terhadap kinerja perawat, serta dengan mengacu kepada penelitian sebelumnya di tempat lain. Maka perlu dilakukan penelitian agar diperolehnya informasi bagaimana kepemimpinan yang mendorong iklim kerja dan motivasi serta dampaknya terhadap kinerja perawat di Rumah Sakit sekota Palu. Rancangan penelitian yang digunakan adalah cross sectional. Sampel penelitian adalah seluruh populasi pada setiap Rumah Sakit se kota Palu dengan total populasi sebesar 420 orang perawat yang mempunyai tugas dan tanggung jawab sebagai tenaga perawat pelaksana perawatan. Hasil penelitian menunjukkan bahwa kinerja perawat di Rumah Sakit se kota Palu, berdasarkan penilaian 360 derajat, lebih dari setengah yaitu 51,9 % kinerja perawat baik. Berdasarkan uji Kai Kuadrat didapat bahwa ada hubungan yang bermakna antara kepemimpinan dengan motivasi kerja, kepemimpinan dengan iklim kerja, iklim kerja dengan motivasi kerja, kepemimpinan dengan kinerja, iklim kerja dengan kinerja, dan motivasi kerja dengan kinerja perawat. Pada hasil analisa multivariat dengan uji Regresi Logistik Ganda, didapat adanya hubungan yang bermakna antara kepemimpinan dengan motivasi kerja, setelah dikendalikan oleh variabel tempat bertugas dan masa kerja. Antara kepemimpinan dengan iklim kerja, setelah dikendalikan oleh variabel umur. Antara iklim kerja dengan motivasi kerja setelah dikendalikan oleh variabel tempat bertugas. Antara Kepemimpinan dengan kinerja perawat, antara iklim kerja dengan kinerja perawat dan antara motivasi kerja dengan kinerja perawat setelah dikendalikan oleh variabel tempat bertugas, masa kerja dan jarak dari rumah ke Rumah Sakit. Sesuai dengan tujuan penelitian yaitu diperolehnya informasi mengenai hubungan antara kepemimpinan, iklim kerja dan motivasi kerja dengan dengan kinerja perawat di Rumah Sakit sekota Palu, setelah dikendalikan oleh faktor internal, ternyata yang paling berhubungan dengan kinerja perawat adalah motivasi kerja,setelah dikendalikan oleh variabel tempat bertugas, masa kerja dan jarak dari rumah ke Rumah Sakit. Penelitian ini menyimpulkan bahwa setelah dikendalikan oleh faktor internal terbukti ada hubungan antara kepemimpinan dengan motivasi kerja, kepemimpinan dengan iklim kerja, iklim kerja dengan motivasi kerja, Kepemimpinan, iklim kerja dan motivasi kerja dengan kinerja perawat dan faktor yang paling berhubungan dengan kinerja perawat adalah motivasi kerja. Penelitian ini menyarankan bahwa untuk meningkatkan kinerja perawat perlu meningkatkan motivasi kerja perawat dengan menciptakan iklim kerja yang mendukung dan menerapkan kepemimpinan yang sesuai dengan situasi dan kondisi perawat di Rumah Sakit.

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Quality of human resources in hospital has a critical rate in providing high quality of services. The important human resources at the hospital are nurses, in which the number of nurses is dominant. They provide services 24 hours in a day, and seven days in a week, also have constant contact to patients. So that, nursing service as integral part of health service, their contribution will determine the quality of service at the hospital.

Considering that throughout the Palu City Hospitals have not conducted the study yet on nurses' performance, and referring to other previous study in another places. So, it needed to conduct a study in order to obtain the information on how leadership encourages working environment and motivation, and its impact to the nurses' performance throughout the Palu City Hospitals.

The design study used was cross sectional. The sample in this study were entire hospitals throughout Palu City with the number of population are 420 nurses, whose task and responsibility to perform as implementers nurses. The result of this study showed that the nurses' performance throughout Palu City Hospitals, based on 360 degrees assessment, generally, where over than half showed, i.e., 51,9%, their performance was good.

Based on Chi Square Test, it obtained that there was significant relationship between leadership and working motivation, leadership with working environment, working environment with working motivation, leadership with performance, working environment with performance, and working motivation with nurses' performance.

The result on multivariate analysis by Multiple Logistic Regression Test, it obtained that there was significant relationship between the leadership and working motivation, after managing by the variable of working place and working length. Between the leadership and working environment, after managing by variable of age. Between working environment and working motivation, after managing by variable of working place. Between the leadership and nurses' performance, between working environment and nurses' performance, between working motivation and nurses' performance, after managing by variable of working place, working length and distance of house to the hospital.

Referring to the objective this study, i.e. it obtained information on .the relationship of working environment and motivation to nurses' performance throughout Palu City Hospitals, after managing by internal factor. The fact, that the most relationship to nurses' performance was working motivation, after managing by variable of working place, working length and distance of house to the hospital.

This study concludes that after managing by internal factor, there was evidence relationship between leadership and working motivation. Leadership, working environment and motivation with nurses' performance and the factor that the most relationship to nurses' performance was work motivation.

Considering to the result of this study, it recommended that in order to improve the nurses' performance it should increase the working motivation of nurses, by establishing working environment that support and apply the appropriate leadership, that correspond to situation and condition of nurses at the hospital."

"Mutu merupakan fokus sentral dari setiap upaya pelayanan kesehatan. Untuk menjamin bahwa pelayanan telah bermutu atau sesuai standar maka perlu dilakukan evaluasi, diantaranya dengan audit akreditasi rumah sakit. Perawat manajer adalah orang yang terlibat dalam akreditasi dan bertanggung jawab atas pengelolaan pelayanan keperawatan, sehingga tujuan pelayanan keperawatan yang bermutu tercapai. Banyak faktor yang berhubungan dengan kinerja perawat manajer. Gibson (1985), Ilyas (1999), dan Robbins (1996) mengemukakan bahwa kinerja berhubungan dengan pemahaman tentang tugasnya. Pengalaman tentang akreditasi merupakan stimulus untuk pemahaman dan perilaku (Thoha, 2000). Maka diasumsikan pemahaman tentang akreditasi dapat menyebabkan perilaku perawat manajer untuk melaksanakan tugasnya sesuai standar.Penelitian ini termasuk jenis penelitian deskriptif korelasional yang bersifat cross sectional, yang bertujuan mendapatkan gambaran bubungan antara pemahaman tentang akreditasi rumah sakit: bidang pelayanan keperawatan dengan kinerja perawat manajer. Populasi penelitian ini adalah semua perawat manajer fungsional (lower or first level managers), yang meliputi kepala ruangan 22 orang, wakil kepala ruangan 20 orang, kepala rawat jaga 13 orang, dan ketua tim keperawatan 141 orang. Sampel penelitian adalah total populasi, yaitu 193 orang. Data yang diperoleh adalah data primer, dikumpulkan melalui penyebaran kuesioner penelitian, yang validitas dan reliabilitasnya telah diuji sebelum penelitian di Rumah Sakit Persahabatan Jakarta.Hasil analisis univariat menunjukkan 49,7% perawat manajer di Rumah Sakit Fatmawati menilai kinerja mereka dengan kategori kurang, dan 50,8% mempunyai pemahaman tentang akreditasi dengan kategori kurang. Hasil analisis bivariat dengan uji Kai Kudrat, diketahui bahwa dari enam sub variabel pemahaman tentang akreditasi, dengan alpha 0,05 hanya satu variabel pemahaman yang berhubungan secara signifikan dengan kinerja perawat manajer, yaitu pemahaman tentang falsafah dan tujuan pelayanan keperawatan (p=0,011). Hasil analisis multivariat dengan uji regresi logistik ganda diketahui bahwa 69,95% variasi kinerja perawat manajer di Rumah Sakit Fatmawati secara signifikan dapat dijelaskan oleh variabel pemahaman tentang falsafah dan tujuan; jabatan; dan unit kerja, dengan nilai G= 48,569 dan nilai p = 0,0001. Dan variabel yang paling dominan berkontribusi dengan kinerja perawat manajer, adalah unit kerja, setelah dikoreksi variabel pemahaman tentang falsafah - tujuan, dan jabatan.Berdasarkan hasil penelitian, rekomendasi yang ditujukan kepada Direktur Pelayanan Medis dan Keperawatan, serta Kepala Bidang Keperawatan Rumah Sakit Fatmawati, adalah meningkatkan kinerja perawat manajer melalui peningkatan pemahaman dan keterampilan, serta sikap perawat manajer sesuai standar yang ditetapkan. Upaya yang dapat dilaksanakan diantaranya adalah melakukan pelatihan tentang akreditasi rumah sakit, khususnya tentang falsafah pelayanan keperawatan, visi, misi, dan tujuan pelayanan keperawatan, serta standar dan indikator pelayanan keperawatan bermutu. Rekomendasi kedua adalah agar diadakan lokakarya dan kerja kelompok keperawatan dalam rangka penyempurnaan uraian tugas, tanggung jawab, kewenangan, dan standar operasional prosedur untuk perawat manajer, sesuai falsafah, dan tujuan pelayanan keperawatan, terutama di Instalasi Rawat Jalan (IRJ), Instalasi Rawat Darurat (IRD), dan Instalasi Bedah Sentral (IBS).

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The Relationship between Understanding of Accreditation of Hospital and Nurse Managers Performance in Nursing Services at Fatmawati Jakarta Hospital in 2002"Quality is a central focus of each effort of health services. Evaluation, such as accreditation of hospital, has to be done to guarantee that the effort is qualified or in accordance with standard. A nurse as a manager is a person who is involved in accreditation and is responsible for nursing services so that objectives of qualified nursing services can be achieved. There are many factors that relate to managers performance. Gibson (1955), Ilyas (1999), and Robbins (1996) suggested that the performance related to the understanding of the duty. The experience of accreditation could be stimulus to understanding and behavior (Thoha, 2000). Then, it has been assumed that the understanding of accreditation encourage the managers to do the job based on the standard.This research is descriptive correlation design, which is cross sectional. It aims to obtain an illustration of the relationship between understanding of accreditation of hospital and nurse managers performance. Population of the research is all lower or first level managers that include 22 head nurses, 20 charge nurses, 13 nurse supervisors, and 141 heads of nursing team. Samples for this research are 193 persons (all of the population). The data obtained is primary data, which is gathered through distributing questionnaires. The validity and reliability of the questionnaires have been tested before the research at Persahabatan Jakarta Hospital.The result of univariat analysis shows that 49.7% nurse managers at Fatmawati Hospital evaluate that their performance is categorized less, and 50.8% managers have less understanding of accreditation. From the result of bivariat analysis with Chi-square test, it can be seen that among six sub variables of understanding of accreditation, with α =0.05 there is only one variable that deeply relates to nurse managers' performance. That is the understanding of philosophies and objectives of nursing services (p-0.011). The result of multivariate analysis with double logistic regression test shows that 69.95% variation of nurse managers? performance at Fatmawati Hospital can be explained significantly by variable understanding of philosophies and objectives; position; and units of work. The results are G=48.569 and p=0.0001. The variable that dominantly contributes to nurse managers' performance is unit of work after correcting variable of understanding of philosophies, objectives, and positions.Based on the results of the research, recommendations addressed to Director of Medical and Nursing Services along with Head of Nursing Department of Fatmawati Hospital are to increase nurse managers' performance through raising the understanding and skill, and standardizing managers' attitude. The efforts that can be done are training in accreditation of hospital, specifically about the philosophies of nursing services, vision, missions. The second recommendation is to perform workshops and team works of nursing in order to complete the details of duty, responsibility, authority, standard operational procedure of nurse managers, based on the philosophies and objectives of nursing services especially at out-patient clinics department, emergency and acute care department, and operating room department."