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"Kejadian missed nursing care masih tinggi di seluruh dunia. Missed nursing care dapat berdampak terhadap kualitas asuhan keperawatan dan keselamatan pasien. Pengembangan profesional berkelanjutan perawat merupakan salah satu sarana bagi perawat dalam melakukan pembelajaran klinis di ruangan salah satunya sebagai upaya pencegahan missed nursing care di ruang rawat inap. Penelitian ini bertujuan untuk mengembangkan model pembelajaran klinis terhadap missed nursing care. Desain penelitian riset terdiri 3 tahap penelitian. Tahap 1 merupakan studi eksplorasi yang dilakukan dengan desain mixed methode dengan pendekatan kualitatif fenomenologi dan kuantitatif deskriptif cross sectional. Hasil tahap 1 didapatkan 7 tema, sementara hasil kuantitatif menunjukan gambaran missed nursing care dan faktor - faktor yang berkaitan pengembangan profesional berkelanjutan. Tahap 2 pengembangan model berdasarkan teori quality of health care model Donabedian, caring Swanson dan Social learning teori Bandura. Hasil pengembangan model tahap 3 didapatkan model yang meliputi 3 komponen yaitu Motivasi, Kepemimpinan dan Aktivitas pembelajaran klinis. Hasil penelitian tahap evaluasi didapatkan perbedaan yang signifikan kompetensi perawat dalam pencegahan missed nursing care sebelum dan sesudah implementasi model pembelajaran “MiLA” (p-value=0,001, α: 0,05). Model ini disarankan untuk digunakan sebagai salah satu upaya meningkatkan kualitas asuhan keperawatan, dan upaya pencegahan missed nursing care di rumah sakit.

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The incidence of missed nursing care is still high worldwide. Missed nursing care can impact the quality of nursing care and patient safety. Continuous professional development of nurses is one of the means for nurses to conduct clinical learning in the room, one of which is an effort to prevent missed nursing care in the inpatient room. This study aims to develop a clinical learning model for missed nursing care. The research design consisted of three stages of research. Phase 1 is an exploratory study conducted with a mixed-methods design with a phenomenological qualitative approach and cross-sectional descriptive quantitative. The results of stage 1 obtained seven themes, while the quantitative results showed an overview of missed nursing care and factors related to continuing professional development. Stage 2 model development is based on Donabedian's quality of health care model, Swanson's caring theory, and Bandura's social learning theory. The results of stage 3 model development obtained a model that includes three components, namely motivation, leadership, and clinical learning activities. The results of the evaluation phase of the study found significant differences in nurse competence in preventing missed nursing care before and after the implementation of the "MiLA" learning model (p-value = 0.001, α = 0.05). This model is recommended to be used in an effort to improve the quality of nursing care and prevent missed nursing care in hospitals."

"ABSTRAKDokter sebagai gate keeper di fasilitas kesehatan tingkat pertama FKTP , memerlukan kompetensi pelayanan komprehensif berpusat pada pasien, sebagai komponen utama pelayanan kesehatan primer, namun kemampuan dokter dalam pelayanan berpusat pada pasien di FKTP masih rendah. Optimalisasi implementasi sistem pelayanan kesehatan berjenjang dan program rujuk balik, merupakan program Jaminan Kesehatan Nasional yang keberhasilannya ditentukan oleh dokter di FKTP, oleh karena itu diperlukan terobosan pembelajaran dengan situasi nyata di tempat kerja, serta penilaian terstandar diperlukan untuk meningkatkan kompetensi dokter dalam pelayanan komprehensif berpusat pada pasien.Penelitian ini bertujuan membuat Model pembelajaran dan penilaian berbasis tempat kerja PPBTK untuk meningkatkan kompetensi pelayanan komprehensif berpusat pada pasien bagi dokter di FKTP. Desain penelitian adalah ldquo;Penelitian Tindakan rdquo; 4 tahap yaitu ldquo;Tindakan Diagnosis rdquo; dengan metode survei. responden terdiri 96 pasien, 56 dokter, dan 64 pendidik, bertujuan mendapatkan indikator pelayanan komprehensif berpusat pada pasien, ldquo;Tindakan Perencanaan rdquo; dengan metode Delphi, responden terdiri 2 orang ahli pendidikan kedokteran, 5 orang ahli pelayanan primer, bertujuan menyusun Model Pembelajaran dan Penilaian Berbasis Tempat Kerja PPBTK yang tervalidasi dengan expert judgment, ldquo;Tindakan Implementasi rdquo; sebagai uji coba model, dengan rancangan eksperimen kuasi, terdiri 13 dokter sebagai kelompok intervensi dan 12 dokter sebagai kelompok kontrol. ldquo;Tindakan Evaluasi rdquo; dengan metode Kirkpatrick untuk membuktikan efektivitas model.Sebanyak 33 indikator dinilai relevan untuk mengukur pelayanan komprehensif berpusat pada pasien, menjadi instrumen Self Assessment dan Direct Observation. Case-based Discussion yang teruji konsistensinya, menjadi instrumen penilaian pertemuan modifikasi Balint group. Kompetensi ranah kognitif, afektif dan psikomotor sebelum dan sesudah intervensi Model PPBTK berbeda bermakna p value < 0,05 . Hasil uji SEM-PLS menunjukkan model efektif untuk meningkatkan kompetensi pelayanan komprehensif berpusat pada pasien di FKTP. Kata Kunci. pelayanan berpusat pada pasien, pelayanan komprehensif,pembelajaran berbasis tempat kerja.

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ABSTRACTDoctors as gatekeepers at First Level Healthcare Facility FLHF require a patient-centered and comprehensive care competency. The patient-centered care competency is necessary to determine the optimization of referral program in the National Health Insurance program implementation. Thus, learning methods with real situations in the workplace and standardized assessment are also required. The study design was Action Research with 4 stages. The first stage was diagnosing action supported by survey method. This stage consisted of many respondents involving 96 patients, 56 doctors, and 64 lecturers. The determination of respondents in the first stage was aimed to obtain a patient-centered and comprehensive care indicator. Second stage namely planning action supported by Delphi method with 2 medical education experts and 5 primary care specialists as respondents. The determination of the respondents in the second stage was to develop Workplace-Based Learning and Assessment WPBLA Model validated with expert judgment. The third stage was taking action as the test model with a quasi-experimental design, consisting of 13 doctors as an intervention group and 12 doctors as a control group. The last stage was evaluating action measures with Kirkpatrick method purposed to prove the effectiveness of the model. As many as 33 indicators were assessed to be relevant for evaluating patient-centered and comprehensive care. Case-based Discussion which its consistency had been tested, functioned as instruments of Balint Group meeting modification. The cognitive, affective and psychomotor domains before and after the intervention of WPBLA Model was significantly different p value < 0.05 . The SEM-PLS test showed the WPBLA was effective in improving patient-centered and comprehensive care competency at FLHF. Keywords. comprehensive care, patient-centered care, workplace-based learning. "