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Abstrak :
ABSTRAK
Mutu pMutu pelayanan keperawatan merupakan hal yang sangat penting dalam pelayanan kesehatan. Penerapan metode penugasan yang tepat diharapkan mampu mengurangi permasalahan mutu pelayanan keperawatan terutama yang terkait dengan kesalahan obat dan phlebitis. Penelitian ini bertujuan mengidentifikasi pengaruh penerapan MPKP terhadap pencapaian indikator mutu pelayanan keperawatan : phlebitis, kesalahan pemberian obat. Desain penelitian ini quasi exsperiment pre and post test control group desain. Pengamatan prosedur pemberian obat 404 prosedur, pemasangan infus 404 prosedur dipilih dengan consecutive sampling. Ada perbedaan yang signifikan kelompok yang menerapkan MPKP dengan kelompok yang tidak menerapkan MPKP terhadap kejadian kesalahan pemberian obat (p=0,00 ;OR =6,4;CI=2,81-14,75).Tidak ada perbedaan yang signifikan kejadian phlebitis pada kelompok yang menerapkan MPKP dengan kelompok yang tidak menerapkan MPKP (p=0,874). Perlunya evaluasi rutin tentang metode penugasan di ruangan, Desiminasi pengetahuan tentang metode penugasan dan upaya meningkatkan mutu pelayanan keperawatan di rumah sakit.

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ABSTRACT
The quality of nursing services is very crucial in health services. Application of nursing assignment methods is expected to reduce problems of service especially which associated with medication errors and phlebitis. This study aimed to identify influence of the application of Professional Nursing Practice Model on the achievement of indicators of nursing service quality: phlebitis and medication. This study design was quasi experiment using pre-post tests and control group. A number of 404 medication and infusion administrations were selected with consecutive sampling and then were observed. There was a difference incidence of medication errors between groups of which applying PNPM and control (p = 0,001; OR = 6,4; CI = 2.81 to 14.75). There was no difference on phlebitis case between 2 groups (p = 0.874). It is necessary to perform routine evaluation and to disseminate knowledge about methods of nursing assignment in order to improve quality of nursing service.

Abstrak :
Aktivitas perawat dalam memberikan asuhan keperawatan di rumah sakit masih belum sesuai dengan ruang lingkup keperawatan dan amanah undang-undang keperawatan. Perawat banyak melakukan aktivitas diluar tugas dan kewenangannya sehingga beban kerja perawat dan asuhan yang terlewatkan meningkat. Hal ini juga berpengaruh terhadap kepuasan pasien. Model ini dikembangkan melalui tahapan yaitu penelitian kualitatif deskriptif, observasi aktivitas perawat dan derivasi dari teori keperawatan yaitu teori Human Need dari Virginia Henderson teori Goal Attainment dari Imogene King dan teori Aktivitas dari Yurjo Engestrom. Penelitian ini bertujuan untuk menguji pengaruh model Alokasi Aktivitas Perawat (AAP) terhadap beban kerja, asuhan yang terlewatkan dan kepuasan pasien. Desain yang digunakan adalah Pra-Eksperimen (Pra-Experiment Design) tanpa control group dengan tiga kali pengukuran yaitu sebelum intervensi, setelah 1 bulan dan pengukuran 2 bulan setelah intervensi. Responden yang terlibat dalam penelitian terdiri dari 48 perawat pada dua ruangan intervensi. Pengukuran juga dilakukan pada pasien sejumlah 257 orang. Hasil penelitian menunjukkan bahwa model AAP diterapkan melalui asuhan keperawatan dan berpengaruh secara signifikan terhadap beban kerja (p-value 0,009), asuhan yang terlewatkan (p-value 0,001) dan kepuasan pasien (p-value 0,035). Model AAP mampu menurunkan beban kerja dari 66,89 menjadi 62,75 dari nilai tertinggi 100 (turun 6,2%), mampu menurunkan asuhan yang terlewatkan dari 25,56 menjadi 21,88 dari nilai tertinggi 100 (turun 14,4%) dan mampu meningkatkan kepuasan pasien dari 77,99 menjadi 82,60 dari nilai tertinggi 100 (naik 6%). Model ini disarankan untuk digunakan pada pelayanan keperawatan terutama di rumah sakit dalam upaya meningkatkan kualitas asuhan keperawatan. ......The nurse's activities in providing nursing care in the hospital are still not in accordance with the scope of nursing and the mandate of nursing law. Nurses do a lot of activities outside of their duties and authorities so that the workload of nurses and overlooked care increases. It also affects patient and family satisfaction. This study aims to test the effect of the Nurse Activity Allocation model on workload, missed care and patient satisfaction. The design used is a quasi-experiment without control with three measurements, namely before the intervention, after 1 month and measurement 2 months after the intervention. The respondents involved in the study consisted of 48 nurses in two intervention rooms. Measurements were also taken on 257 patients. The results showed that the AAP model can be applied through nursing care and has a significant effect on workload (p-value 0.009), missed care (p-value 0.001) and patient satisfaction (p-value 0.035). The AAP model was able to reduce the workload score from 66.89 to 62.75 (down 6,2%), was able to reduce missed care from 25.56 to 21.88 (down 14,4%) and was able to increase patient satisfaction from 77.99 to 82.60 ( up 6%) from the highest score 100. This model is recommended to be used in nursing services, especially in hospitals in an effort to improve the quality of nursing care.

Abstrak :
Latar belakang: Supervisi klinis merupakan komponen penting dari jaminan kualitas dan kerangka tata kelola klinis dalam organisasi perawatan kesehatan. Penelitian ini bertujuan mengembangkan model supervisi klinis menggunakan alat bantu teknologi informasi berbasis motivasi dan efikasi diri (TIME) terhadap kompetensi perawat dalam keamanan obat. Metode: Desain penelitian mixed methode riset (kualitatif dan kuantitatif). Sampel: Kepala ruangan, perawat primer dan perawat pelaksana sebanyak 132 perawat. Hasil: tahap 1: studi kualitatif didapatkan 7 tema. Dukungan dalam efektivitas model, tahap 2: pengembangan model supervisi klinis “TIME”, model dan kurikulum, buku kerja dan buku evaluasi. Sistem aplikasi supervisi klinis “TIME”. Hasil user acceptance test (UAT) nilai rata - rata keberterimaan pelaksanaan 86% yang berarti sangat diterima. Hasil menunjukan bahwa terdapat perubahan yang bermakna uji efektivitas model sebelum dan sesudah intervensi model dengan p value < 0,05. Setelah intervensi model kompetensi perawat dalam keamanan obat terdapat perbedaan yang bermakna antara kelompok intervensi dan kelompok kontrol terkait kompetensi perawat dalam keamanan obat dengan p value < 0,05. Terdapat hubungan antara karakteristik perawat dalam hal usia, tingkat pendidikan, masa kerja dan intervensi model terhadap kompetensi perawat dalam keamanan obat dengan p value < 0,05. Faktor yang paling dominan berpengaruh adalah intervensi model supervisi klinis “TIME” terhadap kompetensi perawat dalam keamanan obat dengan p value < 0,05. Kesimpulan: Model supervisi klinis “TIME” dapat diimplementasikan pada tatanan pelayanan keperawatan sehingga dapat meningkatkan kompetensi perawat dalam keamanan obat. ......Background: Clinical supervision is an important component of the quality assurance and clinical governance framework in healthcare organizations. This study aims to develop a clinical supervision model using information technology tools based on motivation and self-efficacy (TIME) on nurse competency in drug safety. Methods: Mixed method research design (qualitative and quantitative). Sample: Head of room, primary nurse and implementing nurse as many as 132 nurses. Result: stage 1: qualitative study found 7 themes. Support in the effectiveness of the model, stage 2: development of the “TIME” clinical supervision model, model and curriculum, workbooks and evaluation books. “TIME” clinical supervision application system. The results of the user acceptance test (UAT) average value of 86% acceptance which means very acceptable. The results showed that there was a significant change in the effectiveness test of the model before and after the model intervention with a p value <0.05. After the intervention of the nurse competency model in drug safety, there was a significant difference between the intervention group and the control group regarding nurse competence in drug safety with a p value <0.05. There is a relationship between the characteristics of nurses in terms of age, education level, years of service and model interventions on the competence of nurses in drug safety with a p value <0.05. The factor that has the most dominant influence is the intervention of the clinical supervision model "TIME" on the competence of nurses in drug safety with a p value <0.05. Conclusion: The "TIME" clinical supervision model can be implemented in nursing service settings so that it can increase nurse competency in drug safety.

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Latar Belakang: Perilaku caring perawat merupakan salah satu faktor penentu kepuasan pasien di RS. Tujuan: mengeksplorasi perilaku caring untuk mengembangkan model perilaku caring perawat berbasis budaya NTT, menguji pengaruh model terhadap perilaku caring perawat dan kepuasan pasien. Metode: Mixed Metode, terdiri dari tahap I eksplatory design dan tahap II quasy experiment pretest-posttest control group design. Partisipan penelitian tahap I terdiri dari 14 tokoh masyarakat, 11 orang pimpinan RS, 10 orang pasien, dan 5 orang perawat pelaksana. Pemilihan partisipan secara purposive. Pengumpulan data menggunakan pedoman wawancara mendalam dan FGD. Analisis data menggunakan pendekatan Colaizzi. Sampel penelitian tahap II adalah perawat dan pasien yang dipilih secara purposive. Penentuan besar sampel menggunakan rumus beda proporsi pada dua kelompok. Besar sampel perawat 120 orang dan pasien 360 orang. Pengumpulan data menggunakan kuesioner yang telah teruji validitas dan reliabilitasnya. Analisis data menggunakan uji independent sampel t- test dan General Linear Model Repeated Measure (GLM-RM). Hasil: Penelitian tahap I menghasilkan 3-4 tema untuk setiap kelompok partisipan dan menghasilkan Model Floramora Berbasis Budaya NTT. Flora singkatan dari Flores, Sumba, Timor, dan Alor, yang merupakan empat suku besar di NTT. Mora merupakan sejenis bunga yang melambangkan caring adalah kasih dan kebaikan yang diwujudkan melalui budaya 3H: Hase, Hakneter, Haktaek (Menyapa, Menghargai, Menghormati) pasien dan keluarganya, budaya 4N: Nawas, Nopil, Nezel, Nimil (Nalar, Nafsu/semangat, Naluri, Nurani), budaya Karawa ya ole atamu gai’mu kada manuwara gu ole atamu (melayani pasien seperti perawat ingin dilayani), budaya su’u papa suru, sa’a papa laka (berbagi kasih dan tanggung jawab), budaya Halon No Viar (Berharap dan Percaya). Hasil penelitian tahap II menunjukkan implementasi model Floramora berpengaruh signifikan terhadap peningkatan perilaku caring perawat dan kepuasan pasien (p 0,001<0,05). Kesimpulan: Model ini berpengaruh signifikan terhadap peningkatan perilaku caring perawat dan kepuasan pasien. Saran: Model ini dapat diterapkan di RS guna meningkatkan perilaku caring perawat dan kepuasan pasien.

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Background: Nurse caring behavior is a significant variable in the establishment of patient contentment within a hospital setting. Objective: To explore caring behavior, to develop a Model of nurse caring behavior based on NTT culture, to examine the effect of the Model on nurse caring behavior and patient satisfaction. Method: Mixed Method, consisting of stage I exploratory design and stage II quasy experiment pretest-posttest control group design. Phase I research participants consisted of 14 community leaders, 11 hospital leaders, 10 patients, and five nurses. Selection of participants purposively. Data collection used in- depth interviews and FGD guidelines. Data analysis used the Colaizzi approach. Phase II research samples were nurses and patients who were selected purposively. Determination of sample size using the formula of different proportions in the two groups. The sample size is 120 nurses and 360 patients. Data collection used a questionnaire that has been tested for validity and reliability. Data analysis used independent sample t-test and General Linear Model Repeated Measure (GLM-RM). Results: Phase I research produced 3-4 themes for each participant group and produced the Floramora Model Based on NTT Culture. Flora stands for Flores, Sumba, Timor and Alor, which are the four major tribes in NTT. Mora is a type of flower that symbolizes caring, namely love and kindness which is manifested through 3H culture: Hase, Hakneter, Haktaek (Greeting, Appreciating, Respecting) patients and their families, 4N culture: Nawas, Nopil, Nezel, Nimil (Reason, Lust or passion, instinct, conscience), culture of Karawa ya ole atamu gai'mu kada manuwara gu ole atamu (serving patients like a nurse wants to be served), culture of su'u papa suru, sa'a papa laka (sharing love and responsibility), culture of Halon No Viar (Hope and Believe). The results of the second phase of the study showed that the implementation of the Floramora model had a significant effect on increasing nurse caring behavior and patient satisfaction (p 0.001 <0.05). Conclusion: This model has a significant effect on improving nurse caring behavior and patient satisfaction. Suggestion: This model can be applied in hospitals to improve nurse caring behavior and patient satisfaction.

Abstrak :
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. ......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.

Abstrak :
Angka kejadian medication errors dalam proses medikasi masih sangat tinggi di seluruh dunia. Kesalahan dalam pemberian obat dapat dilakukan oleh setiap anggota tim kesehatan termasuk perawat. Teknologi informasi dapat digunakan untuk membantu mewujudkan proses pengobatan yang aman. Berbagai penelitian merekomendasikan penerapan teknologi informasi untuk meningkatkan keamanan dan keselamatan dalam proses medikasi oleh perawat. Banyak kendala yang dihadapi dalam mengadopsi dan menerapkan sistem medikasi berbasis teknologi informasi di rumah sakit. Penelitian ini bertujuan untuk menilai efektivitas penerapan sistem medication safety berbasis teknologi informasi di ruang rawat rumah sakit. Penelitian ini menggunakan pendekatan action research yang terdiri dari 3 (tiga) tahap, yaitu: tahap pertama identifikasi masalah dengan desain studi kualitatif, tahap kedua pemecahan masalah, dan tahap ke tiga uji coba dan evaluasi dengan disain kuasi eksperimen. Besar sampel 188 responden, 94 kelompok intervensi dan 94 kelompok kontrol. Intervensi berupa pelatihan, sosialisasi, pendampingan dan penerapan sistem medication safety keperawatan berbasis teknologi informasi. Hasil penelitian ada perbedaan yang efektivitas antara sebelum dan sesudah penerapan SMeSTa-Nurse. Ada perbedaan efektivitas sistem medikasi antara rumah sakit yang menerapkan SMeSTa-Nurse dengan yang tidak menerapkan. Ada perbedaan efisiensi waktu sistem medikasi rumah sakit yang menerapkan SMeSTa-Nurse dengan yang tidak menerapkan. Ada perbedaan efisiensi biaya sistem medikasi rumah sakit yang menerapkan SMeSTa-Nurse dengan yang tidak menerapkan. Ada perbedaan kepuasan perawat terhadap SMeSTa-Nurse antara rumah sakit yang menerapkan SMeSTa-Nurse dengan yang tidak menerapkan. Ada hubungan yang signifikan antara faktor pendidikan perawat dengan efektivitas penerapan SMeSTa-Nurse di rumah sakit. Hasil penelitian ini merekomendasikan untuk meningkatkan pendidikan dan pengetahuan perawat tentang medikasi berbasis teknologi, meningkatkan peran manajer keperawatan dalam implementasi sistem medikasi berbasis teknologi informasi dan penelitian selanjutnya tentang dampak penerapan sistem medikasi berbasis teknologi informasi terhadap angka mediation errors. ......The incidence of medication errors in the medication process remains exorbitant. Errors in drug administration can be made without exception by members of the health team, including nurses. Information technology can be used to help realize a safe treatment process because it is considered an innovation in improving safety in the process of administering drugs to patients. Various studies recommend the application of information technology to improve security and safety in the medical process by nurses. Many obstacles are usually encountered in adopting and implementing information technology-based medical systems in hospitals. This study aims to assess the effectiveness of the application of information technology-based medication safety systems in hospital wards. This study using an action research approach consists of three stages: problem identification with a qualitative study design; problem solving; and trial and evaluation with a quasi-experimental design. The data was collected from 188 nurses, 94 in the intervention group and 94 in the control group. Interventions were training, socialization, assistance, and application of information technology-based nursing medication safety systems. The results showed that there was a difference in the effectiveness of the application of SMeSTa-Nurse within groups and differences in the effectiveness of the medication system between groups. There was a difference in the time efficiency of hospital medication systems between groups and differences in the cost-efficiency of hospital medication systems between groups. There was a difference in nurse satisfaction across groups. There was also a significant relationship between nurse education factors and the effectiveness of implementing SMeSTa-Nurse in hospitals. The results of this study recommend increasing the education and knowledge of nurses, increasing the role of nursing managers in the implementation of information technology-based medication systems, and further research on the impact of implementing information technology-based medication systems on the number of mediation errors.

Abstrak :
Pendahuluan: Keselamatan pasien merupakan suatu sistem yang menjamin pasien aman dari insiden. Perawat sebagai bagian dari sistem pelayanan kesehatan wajib menerapkan sasaran keselamatan pasien (SKP). Dibutuhkan instrumen yang bersifat proaktif mencegah insiden. Penelitian ini bertujuan untuk mengembangkan instrumen faktor prediktor kepatuhan perawat dalam melaksanakan SKP di rumah sakit. Metode: Tahap 1 merupakan pengembangan item instrumen dengan 3 fase: wawancara, expert judgement, dan uji keterbacaan. Tahap 2 yakni uji validitas dan reliabilitas instrumen dengan pendekatan cross sectional menggunakan dua analisis data, yakni Confirmatory Factor Analysis (CFA) dan regresi linier berganda. Partisipan dalam fase wawancara menggunakan perawat pelaksana dan perawat manajer. Uji validitas dan reliabilitas instrumen melibatkan perawat pelaksana dengan jumlah sampel 100 responden. Variabel dependen yakni kepatuhan perawat dalam melaksanakan SKP di rumah sakit. Hasil: Sebanyak 16 faktor dan 63 item dihasilkan dari tahap 1 penelitian. Uji CFA menyebutkan bahwa seluruh faktor, termasuk variabel kepatuhan perawat dalam melaksanakan SKP dinyatakan valid dan reliabel dengan model yang dinyatakan dalam rentang good fit hingga perfect fit. Hasil analisis regresi linier pada uji t menyimpulkan bahwa hanya delapan faktor yang memiliki pengaruh terhadap kepatuhan, antara lain: sarana prasarana, kesadaran diri, niat, professional habit, komitmen, imbalan, kepemimpinan, serta tuntutan dan reputasi rumah sakit. Pada uji f menyimpulkan bahwa semua faktor tersebut menghasilkan 51,1% potensial memengaruhi kepatuhan perawat. Saran: Manajer keperawatan rumah sakit direkomendasikan untuk menggunakan instrumen ini untuk memperkuat sistem pencegahan insiden oleh perawat pelaksana. ......Introduction: Patient safety is a system that ensures patients are safe from incidents. Nurses, as part of the health service system, are obliged to implement patient safety targets (SKP). We need instruments that are proactive in preventing incidents. This research aims to develop an instrument for predicting factors of nurse compliance when implementing SKP in hospitals. Method: Stage 1 is the development of instrument items with 3 phases: interview, expert judgment, and readability test. Stage 2 is testing the validity and reliability of the instrument with a cross-sectional approach using two data analyses, namely confirmatory factor analysis (CFA) and multiple linear regression. Participants in the interview phase were nurse practitioners and nurse managers. Testing the validity and reliability of the instrument involved implementing nurses with a sample size of 100 respondents. The dependent variable is nurses' compliance with implementing SKP in hospitals. Results: A total of 16 factors and 63 items were generated from phase 1 of the research. The CFA test states that all factors, including the nurse compliance variable in implementing SKP, are declared valid and reliable with the model stated in the range of good fit to perfect fit. The results of the linear regression analysis on the t test concluded that only eight factors had an influence on compliance, including: infrastructure, self-awareness, intention, professional habit, commitment, rewards, leadership, as well as hospital demands and reputation. The f test concluded that all these factors produced 51.1% of the potential to influence nurse compliance. Suggestion: Hospital nursing managers are recommended to use this instrument to strengthen the incident prevention system by implementing nurses.