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"Pada era globalisasi saat ini terdapat kecenderungan meningkatnya tuntutan dan dugaan kejadian kesalahan medik yang berbias ke malpraktik. Hampir setiap tindakan medik menyimpan risiko. Kesalahan medik dengan konsckuensi serius paling sering terjadi Salah satunya di Unit Gawat Darurat. Masalah asuhan klinis di Unit Gawat Darurat apabila tidak dikenali dan dipahami dengan baik dapat merugikan pasien, bahkan rumah sakit itu sendiri. Penelitian ini bertujuan untuk mendapatkan informasi mengenai pengetahuan, sikap, dan persepsi tenaga kesehatan terhadap kesalahan medik yang nantinya diharapkan dapat meminimalisasikan texjadinya kesalahan medik. Penelitian dilakukan di unit gawat darurat RS ”X” dengan 10 informan yang terdiri dari manager, kepala seksi, kepala ruangan, ketua kelompok perawat, dokter dan perawat pelaksana yang bertugas di unit tersebut. Metode penelitian yang digunakan adalah metode kualitatif yaitu wawancara mendaiam, obsen/asi, dan tclaah dokumen. Analisis data dilakukan dengan metode analisis isi (content anabzsis) yaitu membandingkan hasil penelitian dengan teori dalam kepustakaan. Hasil penelitian menunjukkan bahwa informan sudah mengetahui tentang pengertian kesalahan medik, sumber-sumber kesalahan medik, dampak kesalahan medik, dan upaya kesalahan medik, namun untuk tipe-tipe kesalahan medik informan belum mengetahuinya. Sikap informan terhadap kesalahan medik, informan menilai bahwa kesalahancadalah hal yang wajar. Kewlahan tidak texjadi apabila mengikuti prosedur dengan benar. SDM terampil dan fasilitas cukup memadai, hanya ruangan yang belum memadai dinilai sebagai sumber kesalahan medik. Kesalahan medik dapat bcrdampak positif dan negatiti Informan menilai sikap pimpinan dalam mengantispasi kesalahan medik kurang sesuai. Persepsi infomian tentang kesalahan medik menunjukkan bahwa kesalahan medik texjadi dikarenakan kasus sulit, pasien banyak, dan harus melakukan tindakan dengan cepat. Faktor manusia, komunikasi, pasien, merupakan sumbcij terjadinya kesalahan medik. Kesalahan medik bukan hanya bcrdampak pada pasicn, namun berdampak juga pada pemberi pelayanan. Upaya yang dilakukan untuk meminimalisasikan kesalahan medik dapat dilakulcan dengan pelatihan, refreshing keilmuan, kolaborasi sesama tim, memperbaiki komunikasi, dan melaksanakan tindakan sesuai SOP. Kesimpulan dari penelitian ini adalah pengetahuan, sikap, dan persepsi tenaga kesehatan di unit tersebut cukup baik namun tidak dibarengi dengan tindakan, sarana dan prasarana yang rnemadai, pengawasan yang memadai dari tim manajemen risiko, dan sistem rujukan pasien yang kurang baik sehingga menyulitl-can keluarga pasien. Mengingat bahwa salah satu usaha untuk meminimalisasikan kesalahan medik adalah dcngan rnembuat Iaporan insiden, maka disarankan tim manajemen risiko untuk secara intensif mensosialisasikan pelaporan insidcn dan menyediakan buku panduan mengenai bentuk~bentuk kesalahan yang harus dilaporkan dan pihak rumah sakit membuat kebijakan yang isinya adalah mernberikan jaminan tidak akan memberikan sanksi kepada yang melakukan kesalahan dan melaporkan kesalahan medik yang terjadi.

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In current globalization era there is tendency of increasing demand and medical error cases estimation that biased to malpractice. Almost all of medical action has risk. Medical error with serious consequence is the most frequent cases in Emergency Unit. If clinical upbringing cases in Emergency Unit not recognized and comprehended well would harm patient, stahl even the hospital. This research aim to gather information toward knowledge, attitude and health force assessment toward medical error that later would minimize medical error.

Research conducted in emergency unit of RS “X” with 10 informant that consist of manager, chief section, chief executive, nurse group leader, doctor and muse administrator that undertake the unit. Research method used is qualitative method that is circumstantial interview, observation, and document study. Data analysis conducted with content analysis method that is research result with bibliography theory.

Research result shows that informant has recognize about medical error interpretation, medical error sources, medical error impact, and medical error efforts, however for medic types informer not yet know it. Informant behavior toward medical error, informant assess that mistake is spontaneous. Mistake would not occur if following the right procedure, skilled SDM and adequate facility, only room that not yet adequate assessed as medical error source.

Medical error could affect positively and negatively. Informant assessed leader behavior in anticipating medical error less suitable. Informant assessment toward medical error shows that medical error occurs because of complicated cases, excessive patient, and act quickly. Human factor, communication, patient, is source of medical error. Medical error was not only affecting patient, but also affecting service giver. Efforts conducted to minimizing medical error could do by training, knowledge refreshing, team collaboration, fixing communication, and conduct act that appropriate with SOP.

Conclusion Hom this research is knowledge, attitude, and health force assessment in those unit is quite well but not along with action, adequate medium and infrastructure, adequate monitoring from risk management team, and patient reference system that less good so that complicate patient family. Considering that one of the efforts to minimize medical error is making incidental report, so that suggested risk management team intensively socialize incident report and providing guidance book toward fallacies that had to be reported and hospital that make policy, which has content of guaranteed would not give sanction to the one who do mistake and reporting medical error occurred."

"Contents : Key concepts in patient safety -- Keeping the patient safe -- Safety improvement is in professional practice -- Safety improvement is in systems -- Safety improvement is achieved within organizations -- Culture of safety in healthcare settings -- Why things go wrong -- What to do when things go wrong -- Safe patient care systems -- The use of evidence to improve safety."

"This compendium of case studies on patient safety - told from the perspective of the patient and family - illustrates 24 stories of preventable health care errors that led to irreparable patient harm. The reader is guided through a structured analysis of the events, eliciting lessons learned and strategies for preventing similar events in the future. Learning objectives for each case facilitate the reader's development of a set of core competencies related to improving safety and quality of health care.Contents"

"Latar belakang: Insiden kesalahan pemberian obat terjadi karena kurang pengetahuan, kurang pengalaman dan kurang ketelitian dalam pemberian obat. Penulisan manuskrip ini bertujuan mengidentifikasi hubungan efikasi diri dengan kesalahan perawat dalam pemberian obat di rumah sakit.Metode: Penelitian dengan desain deskriptif analitik cross sectional ini melibatkan 200 perawat. Pengambilan sampel dengan teknik proporsionate stratified random sampling. Data dikumpulkan menggunakan Skala Efikasi Diri dalam Pemberian Obat dan Skala Kesalahan Pemberian Obat.Hasil: Total efikasi diri perawat 74,4%, efikasi diri tertinggi adalah kompetensi klinis (79,16%) dan terendah komunikasi kolaborasi (70,83%) dan pengembangan profesional (70,83%). Faktor yang paling berpengaruh adalah unit kerja, pelatihan, kemahiran dan tanggung jawab profesional.Kesimpulan: Efikasi diri berhubungan dengan kesalahan pemberian obat (r= -0,295, p<0,001). Kesalahan pemberian obat disebabkan oleh berbagai faktor. Strategi yang diusulkan untuk mengurangi kesalahan adalah penghargaan kepada perawat yang melaporkan kesalahan, program pengembangan professional keperawatan melalui pelatihan, dan diskusi refleksi kasus, program bimbingan oleh preceptor dan model praktik keperawatan professional agar perawat mendapatkan dukungan dan bimbingan berkelanjutan tentang pemberian obat yang aman.

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Background: Incidences of medication errors occur due to lack of knowledge, lack of experience and lack of accuracy in drug administration. The writing of this manuscript aims to identify the relationship between self-efficacy and nurses errors in administering medication at the hospital.

Method: The study was a cross sectional descriptive analytic design involving 200 nurses. Sampling using proportional stratified random sampling technique. Data was collected using the Scale of Self-Efficacy in the Provision of Medication and MAE self-reported questionnaire.

Results: Total nurse self-efficacy was 74.4%, highest self-efficacy was clinical competence (79.16%) and lowest collaboration communication (70.83%) and professional development (70.83%). The most influential factors are work units, training, professional skills and responsibilities.

Conclusion: Errors in drug administration are caused by various factors. The strategies proposed to reduce errors are awards to nurses who report errors, nursing professional development programs through training, and discussion of case reflection, guidance programs by preceptors and professional nursing practice models so that nurses get ongoing support and guidance on safe drug administration."