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"Keselamatan pasien merupakan indikator kualitas pelayanan yang berdampak pada kepuasan pasien. Ketidakpatuhan terhadap penerapan keselamatan pasien dapat menimbulkan insiden keselamatan pasien. Pelaksanaan penerapan keselamatan pasien yang belum optimal berkaitan dengan human error (beban kerja, pemanfaatan waktu dan sumber daya manusia, dan pembagian beban kerja yang belum sesuai). Dibutuhkan kemampuan perawat primer/ketua tim sebagai lini terdepan dalam pemberian asuhan melalui pelaksanaan pendelegasian yang efektif. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara pelaksanaan pendelegasian dengan penerapan keselamatan pasien. Rancangan penelitian adalah penelitian kuantitatif dengan pendekatan cross sectional pada 160 perawat pelaksana yang diambil secara total sampling pada salah satu rumah sakit di Jakarta. Analisis dilakukan dengan uji chi square dan regresi logistik ganda.  Hasil penelitian menunjukkan ada hubungan antara pelaksanaan pendelegasian dengan penerapan keselamatan pasien (p 0,001; OR 4,302 2,215-8,356). Bidang Keperawatan membuat perencanaan capaian indikator mutu melalui pelaksanaan SKP yang belum optimal.  Kepala ruangan melakukan monitoring dan evaluasi terhadap  pelaksanaan pendelegasian yang dilakukan perawat primer/ketua tim.

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Patient safety is an indicator of service quality that has an impact on patient satisfaction. Non-compliance with the application of patient safety could lead to incidents of patient safety. The implementation of patient safety that is not optimal is related to human error (workload, utilization of time and human resources, and the division of workload that is not appropriate). It takes the ability of the primary nurse / team leader as the frontline in providing care through the implementation of effective delegation. This study aims to identify the relationship between the implementation of delegation and the application of patient safety. The study design was a quantitative study with a cross sectional approach. The samples were taken on 160 nurses with a total sampling method at one hospital in Jakarta. The analysis was done by chi square test and multiple logistic regression. The results showed that there was a relationship between the implementation of delegation and the application of patient safety (p 0.001; OR 4.302; CI 2.215-8.356) Director of Nursing makes planning the achievement of quality indicators through the implementation of patient safety goals that is not optimal The head manager monitoring and evaluation implementation of the delegations carried out by the primary nurse / team leader."

"Latar Belakang:Mortalitas dan morbiditas pasien di rumah sakit masih tinggi akibat kurangnya keselamatan pasien. Strategi terpenting untuk meningkatkan keselamatan pasien adalah denganmembangun budaya keselamatan pasien. Tujuandari penelitian ini adalah untuk mengukur pengaruh model budaya positif keselamatan pasien “IDA” terhadap pelaksanaan keselamatan pasien di rumah sakit. Metode.Design adalahaction riset yang terdiri dari: Tahap pertama adalah identifikasi masalah, tahap kedua adalah pengembangan model, tahap ketiga evaluasi efektivitas model. Data dikumpulkan secara kuantitatif dan kualitatif. Kualitatif dengan FGD dan wawancara pada 26 pimpinan dihasilkan empat tema. Penelitian kuantitatif dengan menggunakan instrumen safety attitude questionnaire, quality and safety self efficacy scale, hospital survey on patient safety culture, safety motivation questionnaire scale, safety consciousness scale, dan kuesioner pelaksanaan keselamatan pasien. Tahap dua pengembangan model hasil dari elaborasi tiga teori dan penerapannya dilaksanakan pada 192 orang perawat pelaksana dan 18 orang kepala ruangan di tiga rumah sakit yang telah terakrediatsi paripurna. Tahap tiga diukur efektivitas model pada pelaksanaan keselamatan pasien pada 192 responden kelompok intervensi dan 191 responden kelompok kontrol, sampel diambil dengan cluster random sampling. Hasil Penelitian: Model budaya positif keselamatan pasien “IDA” berpengaruh terhadap dimensi individu: pengetahuan perawat, sikap, motivasi, kesadaran, safety self efficacydan pelaksanaan keselamatan pasien (p<0,05) dan terhadap dimensi individu kepala ruangan: pengetahuan dan sikap kepala ruangan (p<0,05). Pengaruh positif juga terhadap dimensi organisasi dan dimensi lingkungan. Sebagai dampaknya maka terdapat perbedaan secara bermakna pada sasaran keselamatan pasien sebelum dan setelah dilakukan intervensi model “IDA”. Model “IDA” juga diukur efektivitasnya terhadap kelompok kontrol dan semua variabel berbeda bermakna (p<0,05). Kesimpulan dan Saran: model “IDA” berpengaruh terhadap perilaku keselamatan pasien dan capaian sasaran keselamatan pasien oleh perawat. Model “IDA”perlu diterapkan dirumah sakit agar keselamatan pasien tercapai.

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Background: The mortality and morbidity of patients in the hospital are still high due to the lack of patient safety. The most important strategy for improving patient safety is to build a culture of patient safety. The purpose of this study was to measure the effect of a positive culture model of patient safety "IDA" on the implementation of patient safety in hospitals. Method.Design is an action research consisting of: The first stage is problem identification, the second stage is the development of the model, the third stage is the evaluation of the effectiveness of the model. Data were collected quantitatively and qualitatively. Qualitative with FGD and interviews with 26 leaders resulted in four themes. Quantitative research using the instrument safety attitude questionnaire, quality and safety self-efficacy scale, hospital survey on patient safety culture, safety motivation questionnaire scale, safety consciousness scale, and patient safety implementation questionnaire. The second stage of the development of the model results from the elaboration of three theories and its application was carried out on 192 implementing nurses and 18 heads of rooms in three hospitals who had been fully accredited. Stage three measured the effectiveness of the model in the implementation of patient safety in 192 respondents in the intervention group and 191 respondents in the control group, the sample was taken by cluster random sampling. Results: The positive culture model of patient safety "IDA" affects the individual dimensions: knowledge of nurses, attitudes, motivation, awareness, safety self efficacy and implementation of patient safety (p <0.05) and on the individual dimensions of the head of the room: knowledge and attitude of the head. room (p <0.05). The positive influence is also on the organizational and environmental dimensions. As a result, there are significant differences in patient safety goals before and after the "IDA" model intervention. The effectiveness of the "IDA" model was also measured against the control group and all variables were significantly different (p <0.05). Conclusions and suggestions: the "IDA" model affects the implementation and achievement of patient safety goals. The "IDA" model needs to be applied in hospitals so that patient safety is achieved."

"Implementasi keselamatan pasien oleh perawat pelaksana di Indonesia masih rendah, sehingga penting dilakukan pelaksanaan supervisi oleh kepala ruangan. Penelitian ini bertujuan untuk mengidentifikasi hubungan pelaksanaan supervisi dengan implementasi keselamatan pasien di rumah sakit. Metode penelitian menggunakan pendekatan cross sectional. Sampel penelitian diambil menggunakan teknik total sampling terhadap 131 perawat pelaksana yang bekerja di ruang rawat inap. Alat pengumpulan data menggunakan kuesioner dengan 50 item. Data yang terkumpul dianalisis secara univariat dengan tendensi sentral dan proporsi serta analisis bivariat dengan uji spearman correlation. Hasil penelitian ini menunjukkan hubungan signifikan antara implementasi keselamatan pasien dengan pelaksanaan supervisi (p=0.001; r=0.290). Semakin baik kepala ruangan melakukan supervisi akan semakin baik perawat pelaksana melakukan implementasi keselamatan pasien, sehingga prinsip supervisi yang sudah baik harus dipertahankan bahkan ditingkatkan.

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The implementation of patient safety by primary nurse in Indonesia is still low, it is important to carry out supervision by the head nurse. This study aims to identify the correlation between the implementation of supervision and the implementation of patient safety in hospitals. The research method uses a cross sectional approach. The research sample was taken using a total sampling technique from 131 primary nurse who worked in the inpatient ward. The data collection tool used a questionnaire with 50 items. The collected data was analyzed univariately with central tendency and proportions and bivariate analysis with the pearson correlation test. The results of this study show a significant correlation between the implementation of patient safety and the implementation of supervision (p=0.001; r=0.290). The better supervision done by the head nurse makes the better implementation of patient safety by the primary nurse, so that the principles of good supervision must be maintained and even improved."

"No blaming culture merupakan bagian dari budaya keselamatan pasien. Penelitian ini bertujuan untuk mengidentifikasi hubungan no blaming culture dengan pelaksanaan keselamatan pasien oleh perawat di instalasi rawat inap, RSUP Fatmawati Jakarta. Metode penelitian ini menggunakan design deskriptif korelasi dengan pendekatan cross sectional. Sampel penelitian berjumlah 152 perawat, pemilihan sampel dilakukan dengan consecutive sampling. Instrumen penelitian terdiri dari 3 bagian kuisioner yaitu kuisoner data demografi, kuisioner no blaming culture dan kuisioner pelaksanaan keselamatan pasien. Analisis data menggunakan uji chi-square, yang menunjukkan ada hubungan yang bermakna antara no blaming culture dengan pelaksanaan keselamatan pasien oleh perawat di rumah sakit (p=0,003, CI: 1,376-5, 118). Penelitian ini merekomendasikan penerapan no blaming culture di RS dan diharapkan penelitian selanjutnya akan mengidentifikasi hal-hal yang dapat meningkatkan pelaporan kesalahan oleh di RS.

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No blaming culture is a part of patient safety culture. This study aims to determine the relationship of no blaming culture with patient safety implementation by nurses at inpatient installation in Fatmawati Hospital Jakarta. This study uses descriptive correlation design withcross-sectional. Sample was 152 nurses, which is selected by consecutive sampling.

This study uses 3 questionnaire namely demographic questionnaire, patient safety implementation questionnaire and no blaming culture questionaire. This study showed there was significant correlation between no blaming culture with patient safety implementation by nurses in hospitals (p = 0.003, CI 1,376-5,118).

This study recommended the implementation of ~uu blaming culture in hospital to increase patient safety and for further research it is expected to identify the way to improve error reporting by nurse."

"Berdasarkan penggalian data awal, iklim keselamatan kerja di PT XYZ belum terbentuk secara optimal, khususnya di Divisi Project Management (PM) dan Equipment Management (EM). Salah satu aspek penting yang diperlukan untuk membentuk iklim keselamatan kerja adalah peran dari manajemen atau pada perusahaan ini yaitu Divisi Safety, Health, and Environment (SHE). Diagnosa berikutnya menunjukkan para personil Divisi SHE memerlukan keterampilan taktik memengaruhi. Hasil ini menjadi acuan dalam penelitian untuk melihat hubungan antara taktik memengaruhi dan iklim keselamatan kerja, dengan menggunakan alat ukur influence tactics scale (Clarke & Ward, 2006) dan safety climate scale (Cheyne, Cox, Oliver, & Tomas, 1998). Influence tactic scale (tiga dimensi) memiliki koefisien reliabilitas (Cronbach's Alpha) sebesar .650 hingga .835 dan validitas (Corrected Item-Total Correlation) sebesar .247 hingga .708. Safety climate scale memiliki koefisien reliabilitas (Cronbach's Alpha) sebesar .862 dan validitas (Corrected Item-Total Correlation) sebesar .174 hingga .697. Hasil uji Kendall's Tau (τ) dari 28 orang partisipan teknisi di Divisi PM dan EM, menunjukkan salah satu dari tiga dimensi taktik memengaruhi (soft influence tactics) terbukti berkorelasi positif secara signifikan terhadap iklim keselamatan kerja (τ = .376, p < .05). Artinya, peningkatan perilaku taktik memengaruhi dapat mendorong peningkatan iklim keselamatan kerja. Selanjutnya, intervensi dilakukan melalui workshop 'effective influence communication'. Hasil uji evaluasi pengetahuan program workshop menggunakan Wilcoxon Signed Rank Test dari sembilan orang peserta, menunjukkan peningkatan pengetahuan yang signifikan pada para personil Divisi SHE setelah diberikan workshop 'effective influence communication' (Z = -2.536, p < .05).

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Based on the initial diagnosis, safety climate in PT XYZ has not been established optimally, especially in the Division of Project Management (PM) and Equipment Management (EM). One of the important aspects required to establish a safety climate is the role of management, or in this company is the Division of Safety, Health, and Environment (SHE). Subsequent diagnosis showed that influence tactics skills is required for the SHE Division personnel. This result is a reference in the study to see the relationship between influence tactics and safety climate, using influence tactics scale (Clarke & Ward, 2006) and safety climate scale (Cheyne, Cox, Oliver, & Thomas, 1998). Influence tactic scale (three dimensions) has reliability coefficient (Cronbach's Alpha) from .650 to .835 and validity coefficient (Corrected Item-Total Correlation) from .247 to .708. The safety climate scale used in this study has a reliability coefficient (Cronbach’s Alpha) of .862 and a validity coefficient (Corrected Item-Total Correlation) from .174 to .697. Correlation test was conducted using Kendall's Tau (τ) on 28 technicians of PM and EM Division, showing that one of the three dimensions in influence tactics (soft influence tactics), is positively and significantly correlated to the safety climate (τ = .376, p <.05). That is, an increase in influence tactics behavior can boost safety climate. Furthermore, intervention was conducted in the form of "effective influence communication" workshop. Knowledge evaluation result of the workshop program using Wilcoxon Signed Rank Test from nine participant showed a significant increase in knowledge among SHE Division personnel after the "effective influence communication” workshop was given (Z = -2.536, p < .05)."

"Pelaksanaan monitoring sangat penting dalam mewujudkan pelayanan keperawatan yang bermutu dan aman. Penerapan sasaran keselamatan pasien merupakan suatu proses asuhan keperawatan yang aman dengan menghindari, mencegah terjadinya KTD. Penelitian ini untuk mengidentifikasi hubungan pelaksanaan monitoring keselamatan pasien yang dipersepsikan oleh kepala ruangan dan ketua tim dengan penerapan sasaran keselamatan pasien pada perawat pelaksana di Instalasi Rawat Inap RSK Sitanala Tangerang. Desain penelitian ini adalah penelitian kuantitatif dengan pendekatan cross sectional. Sampel penelitian 11 kepala ruangan, 22 ketua tim dan 66 perawat pelaksana di Instalasi Rawat Inap RSK Sitanala Tangerang. Hasil membuktikan pelaksanaan monitoring keselamatan pasien terdapat hubungan yang bermakna dengan penerapan sasaran keselamatan pasien (p=0.005) nilai OR 13.3 (95% CI 2.08;84.99) berarti pelaksanaan monitoring keselamatan pasien yang dipersepsikan baik berpeluang 13.3 kali perawat menerapkan sasaran keselamatan pasien dengan baik dibandingkan dengan pelaksanaan monitoring yang kurang baik. Terutama pada tahap pelaksanaan dan tahap evaluasi (p < 0.05), dengan faktor yang paling berpengaruh adalah tahap pelaksanaan monitoring (p = 0.026) nilai OR 0.115 (95% CI 0.017 ; 0.776). Rekomendasi Kepala ruangan perlu meningkatkan fungsi pengendalian dengan melaksanakan program monitoring keselamatan pasien secara terus menerus oleh kepala ruangan dengan penerapan sasaran keselamatan pasien pada perawat pelaksana.

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Implementation of monitoring is very important in realizing a qualified and safe nursing service. Implementation of patient safety goals is a process of safe nursing care to avoid and prevent unwanted incidents. The purpose of this study was to identify the relationship of monitoring patient safety perceived by the room chief and team leader with the implementation of patient safety goals on operative nurses in the inpatient care facility of RS. This applied quantitative research design with cross-sectional approach. Sample of this research includes 11 room chiefs, 22 team leaders, and 66 executive nurses in the inpatient care facility of RSK SitanalaTangerang.

Results showed that implementation of monitoring patient safety related significantly to the implementation of patient safety goals (p = 0.005). Meanwhile, the OR values13.3 (95% CI 2:08; 84.99) implied that implementation of well monitoring patient safety had an opportunity 13.3 times higher for the nurse well implementing patient safety goals than implementation of poorly monitoring, especially in the actuating and evaluation stages (P <0.05), with the most influential factor of monitoring stage (p = 0.026, OR value 0.115 (95% CI 0.017; 0776)). It is recommended for the room chief to improve the function of control by continuous implementation of monitoring patient safety program and implemention of patient safety goal by nurses."

"ABSTRAKPembimbing klinik sangat berperan dalam proses pembelajaran mahasiswa yangmelaksanakan tindakan langsung kepada pasien di rumah sakit. Penelitian inibertujuan untuk mengidentiftkasi hubungan peran pembimbing klinik denganpelaksanaan keselamatan pasien oleh mahasiswa di rumah sakit. Respondenpenelitian sebanyak 196 mahasiswa tingkat akhir Stikes terdiri dari 38 mahasiswaNers, 56 mahasiswa D3 Keperawatan, dan 102 mahasiswa D3 Kebidanan. Semuamahasiswa melaksanakan praktik di rumah sakit yang sama. Desain penelitiancross seksional. Hasil penelitian dengan regresi logistik didapatkan ada hubunganbermakna antara peran pembimbing klinik dengan pelaksanaan keselamatanpasien yang dilaksanakan oleh mahasiswa setelah dikontrol dengan jenispendidikan (p = 0,02; CI=1,19-3,71). Rekomendasi dari hasil penelitian antaralain perlu ditingkatkan peran pembimbing klinik dan pelaksanaan keselamatanpasien oleh mahasiswa.

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ABSTRACTClinical instructor has an important role in student's learning process inimplementing direct intervention toward patient within the hospital. The purposeof this study is to determine thecorrelation between the role of clinical instructorand patient safety implementation by the studentin Karawang district hospital.This is descriptive correlational method which is recruited 196 students in theirfinal year in STIKES Kharisma Karawang as respondents. These respondentswere studying in bachelor nursing 38 students, diploma nursing 56 student anddiploma in midwifery program 102 student. The result shows significantcorrelation between the role of clinical instructor and patient safetyimplementation by the student where education as a confounding factor werecontrolled (p = 0,02; CI=1,19-3,71).It is recommended that training for clinicalinstructor in patient safety and evaluation."

"ABSTRAKRisiko kesalahan perioperatif sangat besar sehingga keselamatan pasien harus diupayakan. Fungsi Pengendalian kepala ruai1gan memastikan kelja sama tim sesuai tujuan perencanaan untuk meningkatkan kewaspadaan terhadap te1jadinya insiden atau kejadian yang tidak diharapkan.Penelitian ini be1tujuan untuk mengetahui efektifitas fungsi pengendalian kepala ruangan terhadap pelaksanaan keselamatan pasien perioperatif. Desain penelitian menggunakan preeksper;,nen dengan rancangan pretest-pastiest ·without control. Sampel yang digunakan 75 perawat pelaksana yang terlibat keperawatan perioperatif. Data analisis dengan Paired t test menunjukkan efektifitas fungsi pengendalian kepala ruangan P = 0,0001, (CI= 120,79-127,01) meningkatkan pelaksanaan keselamatan pasien perioperatif oleh perawat pelaksana P = 0,000 I, (CI 141,59-147, 15) setelah intervensi dengan tingkat hubunga1T sedang dan berkorelasi positif.Penelitian ini merekomendasikan monitoring- dan evaluasi pelaksanaan pengendalian kepala ruangan dan pengembangan model pengendalian yang lebih lengkap.

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ABSTRACT

The risk of errors in the perioperative period is very large so that patient safety should be supported and the team is obligated to cooperate in raising awareness toward the occurrence of the 1ncident or event that is not expected. Head nurse control function ensure appropriate planning objectives accomplished.

This research aims to know the effectiveness of the control function of the head nurse tO\;vard the implementation of perioperative patient safety. This research design using preexperiment with pretestposHest design without control. The sample size of 75 nurses that involved in perioperative nursing service. Data analysis using paired t test represent the effectiveness of the control function of the head nurse with p value = 0.000 I (CI = 120.79- 127.01) and the improve of implementation ofperioperative patient safety by nurses of post intervention that indicates positive correlation with p value = 0.0001 (CI = 141.59 - 147.15).

This research recommends there should be monitoring and evaluation of implementation of the control head room and a development model that is more complete control."

"Insiden keselamatan masih terus terjadi, praktik kolaborasi yang dipengaruhi oleh kompetensi IPCP dapat mengoptimalkan pelaksanaan keselamatan pasien di ruang rawat inap. Penelitian ini bertujuan untuk mengidentifikasi hubungan kompetensi IPCP perawat dengan pelaksanaan keselamatan pasien di ruang rawat inap. Penelitian ini menggunakan metode cross sectional di Rumah Sakit tipe A Jakarta Pusat. Sampel dalam penelitian ini berjumlah 158 yang terdiri dari clinical care manager, ketua tim, dan perawat pelaksana yang bertugas di ruang rawat inap. Hasil penelitian ini didapatkan bahwa usia, jenis kelamin, tingkat pendidikan, lama kerja dan level kompetensi tidak menunjukkan hubungan yang signifikan (p>0,05) dengan pelaksanaan keselamatan pasien di ruang rawat inap. Sementara kompetensi IPCP perawat mempunyai hubungan yang signifikan melalui hasil analisis bivariat (p=0,000). Hasil persamaan regresi didapatkan setiap kerja sama perawat dalam tim bertambah 1 poin, maka pelaksanaan keselamatan pasien di ruang rawat inap akan meningkat sebesar 0.655 setelah dikontrol variabel umur, jenis kelamin, pendidikan, lama kerja, komunikasi dalam tim, peran dan tanggung jawab. Rekomendasi penelitian selanjutnya dapat di lakukan dengan melihat sampel yang sesuai dengan standar yaitu dengan tingkat pendidikan minimal profesi ners dengan menggunakan variabel pelaksanaan keselamatan pasien dengan melihat 6 sasaran keselamatan pasien di ruang rawat inap.

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Safety incidents are still happening, collaborative practices that are influenced by IPCP competencies can optimize the implementation of patient safety in inpatient rooms. This study aims to identify the relationship between the IPCP competence of nurses and the implementation of patient safety in the inpatient room. This study used a cross sectional method at type A Hospital, Central Jakarta. The sample in this study amounted to 158 consisting of clinical care managers, team leaders, and implementing nurses who served in the inpatient room. The results of this study found that age, gender, education level, length of work and level of competence did not show a significant relationship (p>0.05) with the implementation of patient safety in the inpatient room. While the IPCP competence of nurses has a significant relationship through the results of bivariate analysis (p = 0.000). The results of the regression equation showed that each time the nurse's cooperation in the team increased by 1 point, the implementation of patient safety in the inpatient room would increase by 0.655 after controlling for variables of age, gender, education, length of work, communication in the team, roles and responsibilities. Recommendations for further research can be done by looking at samples that are in accordance with the standard, namely with a minimum level of education for the nursing profession and using patient safety implementation variables by looking at 6 patient safety goals in the inpatient room."

"Pelaksanaan keselamatan pasien oleh mahasiswa masih belum optimal sehingga diperlukan peningkatan peran pembimbing klinik melalui penerapan quality circle. Tujuan penelitian ini untuk mengidentifikasi pengaruh penerapan quality circle dalam meningkatkan pelaksanaan keselamatan pasien mahasiswa (pengetahuan, sikap, dan tindakan). Desain penelitian menggunakan quasi experiment pre test and post test nonequivalent control group design dengan sampel 34 mahasiswa keperawatan kelompok intervensi dan 34 mahasiswa kelompok kontrol di dua rumah sakit yang berbeda. Intervensi dilakukan dengan diterapkannya quality circle oleh pembimbing klinik yang berfokus pada permasalahan keselamatan pasien. Teknik sampling menggunakan consecutive sampling. Hasil penelitian menunjukkan terjadi peningkatan yang bermakna pada pengetahuan dan tindakan keselamatan pasien mahasiswa (p<0,001; α=0,05). Kesimpulan penelitian ini menunjukkan terdapat pengaruh penerapan quality circle terhadap pelaksanaan keselamatan pasien. Rekomendasi penelitian ini adalah perlunya pemanfaatan dan pengembangan teknik problem solving quality circle untuk mengoptimalkan pelaksanaan keselamatan pasien.

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Implementation of patient safety by nursing students is still not optimal so that the necessary increase in clinical instructor role through the application of quality circles. The purpose of this study to identify the effect of the application of quality circles in enhancing the implementation of patient safety of students (knowledge, attitudes, and skills). Quasi-experimental research design using pretest and posttest nonequivalent control group design with a sample of 34 nursing students of intervention group and 34 students of control group in two different hospitals. The intervention is done with the implementation of quality circle by clinical instructor that focuses on patient safety issues. The results showed an increase was significant in nursing student?s knowledge and actions of patient safety (p <0.001; α = 0.05). Conclusions of this study shows there are significant effect of the quality circle on the implementation of patient safety. Recommendations of this study is the need to utilize and develop quality circle as problem solving techniques to optimize the implementation of the patient safety."