Pendokumentasian proses keperawatan merupakan suatu kegiatan yang sangat krusial, karena dapat menjadi bukti bahwa segala tindakan perawat telah dilaksanakan secara profesional dan legal sehingga dapat melindungi klien selaku penerima jasa pelayanan dan perawat selaku pemberi jasa pelayanan keperawatan. Kualitas pendokumentasian ini sangat tergantung pada kompetensi perawat pelaksana sebagai tenaga inti dan dapat dipengaruhi oleh berbagai faktor, yaitu dari perawat bersangkutan maupun supervisi kepala ruangan sebagai salah satu bentuk kegiatan manajerial.Sehubungan dengan hal tersebut, maka penelitian berupaya mengidentifikasi hubungan antara pemahaman perawat pelaksana tentang proses keperawatan dan persepsinya terhadap fungsi supervisi kepala ruangan, dengan tetap mempertimbangkan variabel karakteristik perawat pelaksana yang dapat mempengaruhi pemahaman dan persepsi yang terjadi.Penelitian ini dilaksanakan di RS. Karya Bhakti Bogor dan merupakan penelitian kuantitatif dan kualitatif dengan rancangan deskriptif korelasi dan bersifat cross sectional. Pada penelitian kuantitatif dilaksanakan dengan cara menyebarkan kuesioner kepada 91 responden perawat pelaksana yang bekerja di ruang rawat inap serta tidak memberikan perawatan intensif. Sedangkan penelitian kualitatif dilaksanakan melalui pelaksanaan diskusi kelompok terarah, dengan mengajukan empat pertanyaan terbuka kepada 10 responder. Hasil penelitian kuantitatif dianalisis secara univariat, bivariat dan multivariat. Berdasarkan analisis univariat diketahui bahwa secara rata-rata pemahaman perawat pelaksana terhadap proses keperawatan dan kompetensi mendokumentasikan proses keperawatan sudah cukup baik. Pemahaman ini tidak dipengaruhi oleh latar belakang pendidikan, jumlah pelatihan yang telah diikuti dan masa kerja. Terungkap pula bahwa perawat rata-rata mempersepsikan kepala ruangan masih belum cukup optimal dalam melaksanakan supervisi terhadap pendokumentasian proses keperawatan. Selanjutnya analisis bivariat memperlihatkan pertama, adanya hubungan bermakna yang sedang dan berpola positif antara pemahaman terhadap pendokumentasian proses keperawatan dengan kompetensi mendokumentasikan proses keperawatan. Kedua, adanya hubungan bermakna yang sedang dan berpola positif antara persepsi terhadap pengarahan sebagai salah satu fungsi supervisi dengan kompetensi mendokumentasikan proses keperawatan. Kemudian berdasarkan analisis multivariat diketahui bahwa variabel babas yang berhubungan paling erat dengan variabel terikat adalah variabel pemahaman terhadap proses keperawatan dan bimbingan sebagai salah satu bentuk fungsi supervisi. Namun diantara kedua variabel tersebut, variabel bimbingan memiliki kemampuan lebih besar dalam memprediksi kompetensi perawat dalam mendokumentasikan proses keperawatan, jika variabel lain dalam keadaan konstan.Sedangkan hasil penelitian kualitatif yang diperoleh melalui diskusi kelompok terarah menyimpulkan bahwa perawat pelaksana merasakan kompetensinya masih belum optimal, memerlukan tambahan pengetahuan baik melalui pendidikan formal maupun non formal. Selain itu supervisi kepala ruangan sangat diperlukan guna meningkatkan kompetensi perawat pelaksana dalam mendokumentasikan proses keperawatan.Adapun saran yang peneliti ajukan kepada kepala ruangan adalah mengoptimalkan pelaksanaan bimbingan kepada perawat pelaksana dan perawat pelaksana diharapkan meningkatkan pemahamannya terhadap proses keperawatan. Sub bidang keperawatan disarankan melakukan upaya-upaya yang dapat meningkatkan pemahaman proses keperawatan dan fungsi supervisi. Direktur rumah sakit dianjurkan untuk menyusun kebijakan yang berkaitan dengan sistem penghargaan terhadap kegiatan pendokumentasian dan supervisi serta pengaruhnya terhadap jenjang karir perawat. Selanjutnya kepada pihak pendidikan diharapkan agar lebih banyak memberikan latihan kasus. Peneliti lain seyogyanya memperdalam penelitian kualitatif jika ingin meneliti bidang yang sama.
Relationship between Understanding on Nursing Process and Function of Supervision with Competency to Document Nursing Process at Karya Bhakti Hospital BogorNursing process documenting is a crucial activity because it could be a proof that all nurses' actions have been done professionally and legally so it could protect client as service receiver and nurses as nursing service grantor. The quality of this documentation depends on executing nurses' competency as core personnel and could be influenced by same factors, namely the nurses themselves, or unit manager's supervisory as a managerial activity.Pertaining to the case above, the conductor of this research tried to identify relation between executing nurse's understanding on the nursing process and their perception to unit manager's supervisory function, yet the conductor still consider executing nurses' characteristic variable that could effect an understanding and perception that occurred.This research was carried out at Karya Bhakti Hospital Bogor and constitutes qualitative and quantitative research with descriptive correlation design and had cross sectional nature, The quantitative research was run by distributing questioner to 91 respondents of executing nurses who work at inpatient unit and they do not serve intensive nursing. Meanwhile the qualitative one was carried out through focused group discussion by presenting four open questions to 10 respondents.The quantitative research was analyzed in univariat, bivariat and multivariat way. Based on the univariat analysis, it was known that in average, executing nurses' understanding on nursing process and competency to document nursing process was good enough. This understanding was not influenced with educational background, number attaining that has been attended and tenure. And it was also disclosed that they percept unit manager less- enough-optimal in handling supervisory toward nursing process documentation. Further, bivariat analysis indicated first, there was a moderate and positive significant relation between understanding on nursing process documentation and competency to document nursing process. Second, there was a moderate and positive significant relation between perception on direction as one of supervisory function and competency to document nursing process. And then, based on multivariate analysis, it was comprehended that the independent variable most related with dependent variable understood of nursing process and guiding, as one of supervisory functions. Yet among the two variables, guiding variables had bigger ability in forecasting nurses' competency in documenting nursing process provided that the other variables were in constant situation.In the same time. the qualitative research that gained through focused group discussion concluded that executing nurses felt that the competency had not been optimal. It still needed extended knowledge either through formal education or non-formal one. Besides, the unit manager's supervisory was badly needed to improve executing nurses' competency in documenting nursing process.The researcher recommended that unit manager should optimize guiding implementation to the executing nurses, the executing nurses is expected to enhance their understanding on the nursing process. Sub nursing division should carry out some efforts to increase : understanding on nursing process and supervisory function. The director of the hospital is suggested to compose some policies in line with rewarding system to documentation and supervisory activities as well as their influence to nurses' career stage. And finally the education and training division in learning process should grant more cases training. And the further researcher should utilize and deepen qualitative research when they wish to conduct the same research. |
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