"Mutu merupakan fokus sentral dari setiap upaya pelayanan kesehatan. Untuk menjamin bahwa pelayanan telah bermutu atau sesuai standar maka perlu dilakukan evaluasi, diantaranya dengan audit akreditasi rumah sakit. Perawat manajer adalah orang yang terlibat dalam akreditasi dan bertanggung jawab atas pengelolaan pelayanan keperawatan, sehingga tujuan pelayanan keperawatan yang bermutu tercapai. Banyak faktor yang berhubungan dengan kinerja perawat manajer. Gibson (1985), Ilyas (1999), dan Robbins (1996) mengemukakan bahwa kinerja berhubungan dengan pemahaman tentang tugasnya. Pengalaman tentang akreditasi merupakan stimulus untuk pemahaman dan perilaku (Thoha, 2000). Maka diasumsikan pemahaman tentang akreditasi dapat menyebabkan perilaku perawat manajer untuk melaksanakan tugasnya sesuai standar.
Penelitian ini termasuk jenis penelitian deskriptif korelasional yang bersifat cross sectional, yang bertujuan mendapatkan gambaran bubungan antara pemahaman tentang akreditasi rumah sakit: bidang pelayanan keperawatan dengan kinerja perawat manajer. Populasi penelitian ini adalah semua perawat manajer fungsional (lower or first level managers), yang meliputi kepala ruangan 22 orang, wakil kepala ruangan 20 orang, kepala rawat jaga 13 orang, dan ketua tim keperawatan 141 orang. Sampel penelitian adalah total populasi, yaitu 193 orang. Data yang diperoleh adalah data primer, dikumpulkan melalui penyebaran kuesioner penelitian, yang validitas dan reliabilitasnya telah diuji sebelum penelitian di Rumah Sakit Persahabatan Jakarta.
Hasil analisis univariat menunjukkan 49,7% perawat manajer di Rumah Sakit Fatmawati menilai kinerja mereka dengan kategori kurang, dan 50,8% mempunyai pemahaman tentang akreditasi dengan kategori kurang. Hasil analisis bivariat dengan uji Kai Kudrat, diketahui bahwa dari enam sub variabel pemahaman tentang akreditasi, dengan alpha 0,05 hanya satu variabel pemahaman yang berhubungan secara signifikan dengan kinerja perawat manajer, yaitu pemahaman tentang falsafah dan tujuan pelayanan keperawatan (p=0,011). Hasil analisis multivariat dengan uji regresi logistik ganda diketahui bahwa 69,95% variasi kinerja perawat manajer di Rumah Sakit Fatmawati secara signifikan dapat dijelaskan oleh variabel pemahaman tentang falsafah dan tujuan; jabatan; dan unit kerja, dengan nilai G= 48,569 dan nilai p = 0,0001. Dan variabel yang paling dominan berkontribusi dengan kinerja perawat manajer, adalah unit kerja, setelah dikoreksi variabel pemahaman tentang falsafah - tujuan, dan jabatan.
Berdasarkan hasil penelitian, rekomendasi yang ditujukan kepada Direktur Pelayanan Medis dan Keperawatan, serta Kepala Bidang Keperawatan Rumah Sakit Fatmawati, adalah meningkatkan kinerja perawat manajer melalui peningkatan pemahaman dan keterampilan, serta sikap perawat manajer sesuai standar yang ditetapkan. Upaya yang dapat dilaksanakan diantaranya adalah melakukan pelatihan tentang akreditasi rumah sakit, khususnya tentang falsafah pelayanan keperawatan, visi, misi, dan tujuan pelayanan keperawatan, serta standar dan indikator pelayanan keperawatan bermutu. Rekomendasi kedua adalah agar diadakan lokakarya dan kerja kelompok keperawatan dalam rangka penyempurnaan uraian tugas, tanggung jawab, kewenangan, dan standar operasional prosedur untuk perawat manajer, sesuai falsafah, dan tujuan pelayanan keperawatan, terutama di Instalasi Rawat Jalan (IRJ), Instalasi Rawat Darurat (IRD), dan Instalasi Bedah Sentral (IBS).
The Relationship between Understanding of Accreditation of Hospital and Nurse Managers Performance in Nursing Services at Fatmawati Jakarta Hospital in 2002"Quality is a central focus of each effort of health services. Evaluation, such as accreditation of hospital, has to be done to guarantee that the effort is qualified or in accordance with standard. A nurse as a manager is a person who is involved in accreditation and is responsible for nursing services so that objectives of qualified nursing services can be achieved. There are many factors that relate to managers performance. Gibson (1955), Ilyas (1999), and Robbins (1996) suggested that the performance related to the understanding of the duty. The experience of accreditation could be stimulus to understanding and behavior (Thoha, 2000). Then, it has been assumed that the understanding of accreditation encourage the managers to do the job based on the standard.
This research is descriptive correlation design, which is cross sectional. It aims to obtain an illustration of the relationship between understanding of accreditation of hospital and nurse managers performance. Population of the research is all lower or first level managers that include 22 head nurses, 20 charge nurses, 13 nurse supervisors, and 141 heads of nursing team. Samples for this research are 193 persons (all of the population). The data obtained is primary data, which is gathered through distributing questionnaires. The validity and reliability of the questionnaires have been tested before the research at Persahabatan Jakarta Hospital.
The result of univariat analysis shows that 49.7% nurse managers at Fatmawati Hospital evaluate that their performance is categorized less, and 50.8% managers have less understanding of accreditation. From the result of bivariat analysis with Chi-square test, it can be seen that among six sub variables of understanding of accreditation, with α =0.05 there is only one variable that deeply relates to nurse managers' performance. That is the understanding of philosophies and objectives of nursing services (p-0.011). The result of multivariate analysis with double logistic regression test shows that 69.95% variation of nurse managers? performance at Fatmawati Hospital can be explained significantly by variable understanding of philosophies and objectives; position; and units of work. The results are G=48.569 and p=0.0001. The variable that dominantly contributes to nurse managers' performance is unit of work after correcting variable of understanding of philosophies, objectives, and positions.
Based on the results of the research, recommendations addressed to Director of Medical and Nursing Services along with Head of Nursing Department of Fatmawati Hospital are to increase nurse managers' performance through raising the understanding and skill, and standardizing managers' attitude. The efforts that can be done are training in accreditation of hospital, specifically about the philosophies of nursing services, vision, missions. The second recommendation is to perform workshops and team works of nursing in order to complete the details of duty, responsibility, authority, standard operational procedure of nurse managers, based on the philosophies and objectives of nursing services especially at out-patient clinics department, emergency and acute care department, and operating room department."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2002
