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"Supervisi konsisten mempengaruhi kinerja perawat tetapi pelaksanaannya pada pelayanan keperawatan di Indonesia cenderung bersifat pengawasan dan kurang memberikan upaya-upaya untuk mendidik, memotivasi, melatih, dan memberi arahan. Model supervisi klinik educative, supportive and Administrative Cycle (ESA-C) dibuat untuk meningkatkan nilai positif dari supervisi. Model ini disintesa dari model supervisi Kadushin, Proctor dan mengintegrasikannya dengan teori interpersonal relationships Peplau serta nilai caratif Watson. Penelitian bertujuan menguji efektifitas model supervisi klinik ESA-C dalam meningkatkan kinerja perawat, menggunakan desain kuasi eksperimen pre-post test pada dua kelompok. Dua rumah sakit dirandom dari 5 rumah sakit umum, sampel diambil secara random sebanyak 90 perawat dan 270 pasien secara purposif. Hasil penelitian menunjukkan model supervisi klinik ESA-C mampu meningkatkan kinerja perawat secara signifikan (p Value < 0.05) pada dimensi task performance: keterampilan teknis sebesar 2%, pemberian edukasi 9%, pemberian dukungan emosionl kepada pasien 14%, dan contextual performance: pemberian bantuan bagi pasien dan keluarga 21%. Model ini disarankan digunakan pada pelayanan keperawatan terutama di rumah sakit dalam upaya meningkatkan kinerja perawat dalam memberikan asuhan keperawatan kepada pasien.

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Supervision is a consistent variable that affect to job performance. Unfortunately, the supervision that had done only just controlled rather than an effort to educating, coaching, directing, and nurse potential reinforcement. ESA-C clinical supervision model that developed is to eliminate negative side of supervision these times. Educative, supportive, and administrative cycle of clinical supervision model was a result from synthesize of Kadushin's, Proctor's, Heron's, Faugier's, and Experimental's models. The ESA-C model was synthesizing with interpersonal relationship from Peplau's and carative value from Watson's. ESA-C clinical supervision model use a group approach in an educative supervision and individual approach for supportive and administrative supervision.

The purpose of this research is to determine the effect of ESA-C clinical supervision model to increasing nurses' job performance. This research used quasi experiment design with intervention and control group. The sample of this research use a random method to 90 nurses (each group has 45 nurses) and 270 patients (each group has 135 patients).

The result of this research revealed that ESA-C clinical supervision model can increase nurses' job performance including task performance dimension (clinical skill, patient education, emotional support) and contextual job performance (assisting patient and the family). This research recommended the using of ESA-C model in hospital to increasing nurses' job performance in giving of nursing care to the patient."

"Sistem informasi keperawatan adalah salah satu elemen penting dalam pelaksanaan asuhan keperawatan. Sistem informasi keperawatan di Indonesia saat ini masih belum optimal dan umumnya masih bersifat manual. Riset dimulai dengan mengidentifikasi dan dilanjutkan pengembangan model sistem informasi manajemen keperawatan oleh Roro ("SIMPRO") yang disesuaikan dengan kondisi rumah sakit. Model "SIMPRO" yang telah dicustomization diujicobakan di dua rumah sakit dengan karakteristik yang berbeda yaitu rumah sakit swasta dan rumah sakit pemerintah. Setelah implementasi, dilaksanakan evaluasi dengan desain pre- post test without control group. Jumlah sampel dokumentasi yang digunakan untuk mengevaluasi kinerja "SIMPRO" adalah 219 dokumentasi dari setiap kelompok rumah sakit. Hasil riset menyampaikan ada perbedaan kinerja sebelum dan sesudah menggunakan "SIMPRO" yang diidentifikasikan dari perbedaan kualitas, kelengkapan, kesinambungan, bukti aspek legal dan fungsi membantu membuat keputusan (p=0.001). Ada perbedaan efisiensi waktu: baik di Rumah Sakit Ibu dan Anak Bunda Jakarta dan RS. Fatmawati (p= 0.01). Setelah menggunakan "SIMPRO" waktu yang diperlukan untuk melaksanakan dokumentasi di RS Fatmawati adalah 40.29 menit atau 25.27% dari total waktu dalam satu shift, sedangkan di RS Ibu dan Anak Bunda Jakarta membutuhkan waktu 24.62 menit atau 9.60% dari total waktu dalam satu shift. "SIMPRO" juga mempengaruhi efisiensi biaya, dimana dengan "SIMPRO" dokumentasi tidak setiap waktu harus dicetak. "SIMPRO" menjamin continuity of care dari asuhan keperawatan, sebagai bukti aspek legal, membantu mengambil keputusan dan meningkatkan keselamatan pasien. "SIMPRO" mengefisiensikan waktu dokumentasi sehingga waktu perawatan langsung ke pasien lebih optimal. "SIMPRO" juga meningkatkan edukasi kesehatan kepada pasien dan keluarga."Pada riset ini "SIMPRO" juga dapat meningkatkan peran manajer keperawatan dalam melaksanakan fungsi manajemen terutama pada peran pemberiaan motivasi, pengarahan, evaluasi dan monitoring terhadap pelaksanaan asuhan keperawatan. Dukungan aspek perawat, aspek manajemen dan teknik dapat mengoptimalkan kinerja "SIMPRO" sehingga dapat meningkatkan kualitas pelayanan keperawatan. Berdasarkan manfaat dari "SIMPRO", maka sistem ini dapat direkomendasikan untuk digunakan di setiap Rumah Sakit serta dapat mendukung peningkatan kualitas mutu pelayanan keperawatan dan kesehatan.

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Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects.;Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects.;Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects.;Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects."

"Sumber daya manusia keperawatan yang berkualitas merupakan kepribadian yang tidak cacat emosionalnya seperti kesalahan/kekurang telitian dalam pekerjaan, keterlambatan dalam menyelesaikan pekerjaan, semangat kerja yang buruk, bekerja secara asal-asalan dan kesal hati. Sebaliknya sumber daya manusia keperawatan yang berkualitas adalah perawat yang memiliki kegairahan dalam bekerja, kreatif, proaktif, mempunyai kehangatan dan mudah tersenyum, terkait dengan kompetensi perawat pelaksana didapatkan bahwa kompetensi inti yang dimiliki oleh perawat pelaksana adalah kepemimpinan, cara kerja, interpersonal/softskill, dan pengusaan lingkungan. Softskill sendiri dapat dikembangkan dan ditumbuhkan melalui berbagai cara, dan faktor yang dapat membentuk softskill diantaranya pelatihan, tantangan yang didapat, lingkungan, dan pendidikan. Penelitian ini bertujuan mengetahui efektifitas model Kepemimpinan Transformasional Kepala Ruang berbasis softskill, mendapatkan modul dan panduan panduan model yang terdiri dari panduan, modul dan portopolio model Kepemimpinan Transformasional Kepala Ruang berbasis softskill Metode yang digunakan dalam penelitian ini adalah action research dengan desain riset pengembangan dengan studi eksperimen kuasi, dengan menggunakan penilaian times series. Penelitian terdiri dari 3 tahap yaitu tahap studi pendahuluan, tahap pengembangan model, dan tahap implementasi model, alat ukur yang digunakan yaitu Kuesioner Transformational Leadership Questionnaire (TLQ) dan Nurse Soft skill Questionnaire (NSQ), panduan model yang terdiri dari panduan, modul dan portopolio model Kepemimpinan Transformasional Kepala Ruang berbasis softskill, pada tahap implementasi dilakukan sosialisasi, pelatihan, pendampingan penerapan panduan model yang terdiri dari panduan, modul dan portopolio model Kepemimpinan Transformasional Kepala Ruang berbasis softskill. Populasi dalam penelitian ini terdiri dari 18 kepala ruang yang ada dimasingmasing Rumah Sakit sebagai kelompok kontrol dan kelompok perlakuan (total sampel), dan 47 perawat pelaksana yang diambil secara random sampling. Hasil penelitian didapatkan panduan model yang telah divalidasi dan diuji keterterapannya oleh 2 orang pakar dan 2 orang praktisi, hasil implementasi model diperoleh adanya efektifitas model dalam meningkatkan softskill perawat pelaksana dalam hal kemampuan beradaptasi, berkomunikasi, bekerjasama tim, memecahkan masalah, percaya diri, disiplin dan teliti, didapatkan perbedaan kemampuan softskill pada bulan ke 1 dengan ke II, dan ke I dengan ke III setelah implementasi model. Model kepemimpinan transformasional kepala ruang berbasis soft skill sangat mungkin diterapkan ditatanan Unit perawatan di seluruh Rumah Sakit yang ada, untuk dapat menjawab tantangan dunia terhadap perbaikan sumber daya manusia melalui perbaikan kinerja dalam hal kemampuan interpersonal dan intrapersonal, kegiatan harian perawat kegiatan ini yang sering terbengkalai, portopolio lembar kerja yang sangat efektif dalam penerapan model.

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Human resources qualified nursing an emotional personality defects such as errors / lack of carefully situations in the work, the delay in completing the work, poor morale, work carelessly and bitter. Instead of nursing human resources are qualified nurses who have a passion for working, creative, proactive, have a warmth and an smiling, related to the competence of nurses found that the core competencies possessed by nurses is leadership, how to work, interpersonal / soft skills, and procurement environment. Soft skill can be developed and grown through a variety of ways, and the factors which may form such soft skills training, the challenge is to come, the environment, and education.

This study aims to determine the effectiveness of transformational leadership model of Head Room-based soft skills, gain module guides and guide model consisting of guides, modules and portfolio models Transformational Leadership Head Room-based soft skills. The method used in this study is an action research with research design the development of quasi-experimental studies, using the assessment times series. The study consisted of three phases: a preliminary study, the model development stage, and the implementation phase models, The instruments used Transformational Leadership Questionnaire (TLQ) and Nurse Soft skills Questionnaire (NSQ), guide model consisted of guides, modules and portfolio Transformational Leadership Model Head Room-based soft skills, at the implementation stage by socialization, training, mentoring guide application model consisted of guides, modules and portfolio models Transformational Leadership Head Room-based soft skills. The population in this study consisted of 18 head rooms in each of the existing hospital as a control group and the experimental group (total sampling), and 47 nurses were taken by random sampling.

The results was obtained the model guide has been validated and tested by 2 experts and 2 practitioners, the results obtained by the model of implementation effectiveness of the model in improving the soft skills of nurses in terms of adaptability, communication, team work, problem solving, self-confidence, discipline and meticulous, There were significant differences at 1st months and 2nd months, and 1st months and 3rd months after the implementation of the model. Transformational leadership model of head room-based soft skills are very likely applicable in care units of hospital, to be able to meet the challenges of the world to the improvement of human resources through improved performance in terms of interpersonal and intrapersonal skills, daily activities of the nurse's activities are often neglected, portfolio worksheet very effective in the application of the model."

"Kepemimpinan kepala ruangan sangat diperlukan untuk meningkatkan kinerja perawat pelaksana. Di Indonesia belum ada model kepemimpinan yang memiliki kekuatan optimal yang dilandasi oleh tingkat kepercayaan bawahan dan berbagai pihak yang diyakini dapat berfungsi efektif di terapkan diruang rawat, sehingga mampu menghasilkan kinerja organisasi yang baik dan layanan kesehatan yang berkualitas. Penelitian ini bertujuan untuk mengidentifikasi konsep dalam rangka pengembangan model kepemimpinan keperawatan di ruang rawat inap rumah sakit kelas A di Di Indonesia. Penelitian ini merupakan penelitian kualitatif dan kuantitatif dengan desain cross sectional. Jumlah sampel 6 informan pada penelitian kualitatif dan 450 responden kepala ruangan pada penelitian kuantitatif. Hasil penelitiain ini menunjukkan sintesa dari 5 model kepemimpinan dalam literatur yaitu model kepemimpinan efektif, tranformasional, transaksional, visioner dan servant leadership mendukung terbentuknya rancangan model kepemimpinan keperawatan Indonesia yang dapat merupakan altertnatif model kepemimpinan untuk diterapkan kepala ruang di rumah sakit kelas A di Indonesia. Perilaku kepala ruangan yang diharapkan adalah sebagai berikut : pelatih yang baik bagi karyawan, senantiasa menyediakan tantangan dan makna atas pekerjaan orang-orang yang dipimpin, membentuk tim dan bekerja dengan tim, mendefinisikan dan menyusun interaksi kelompok, mengorganisasikan kegiatan-kegiatan kelompok dalam rangka pencapaian tujuan organisasi, dan tahu keinginan bawahan.

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Leadership of head nurse is required to improve performance of nurses in the wards. In Indonesia, there is no leadership model that has optimum strength based on mutual trust of its followers, and other parties that can be effectively implemented in the wards, which then will produce good performance of organization and quality health service. This research was aimed at identifying concepts in order to develop a model of nursing leadership in the wards of type A hospitals in Indonesia. The research was a mixed method of qualitative and quantitative research with a cross sectional design. Six subjects were participated in qualitative research and 450 head nurse as subjects were included in the quantitative research.

The findings demonstrated that a synthesis of five leadership models in the literature, that are effective, transformational, transactional, visioner, and servant leadership models have supported the development of a draft of Indonesian nursing leadership model. This model is produced as an alternative model that can be implemented by head nurses in type A hospitals in Indonesia. The expected behavior of head nurse in this model are as a good coach for their followers, provide challenge and meaning toward the tasks /assigment of the followers, build a team and work with the team, define and develop group interaction, organize group activities in order to achieve the goals of organization, and alert of the followers expectation/wishes."

"Sistem informasi keperawatan adalah salah satu elemen penting dalam pelaksanaan asuhan keperawatan. Sistem informasi keperawatan di Indonesia saat ini masih belum optimal dan umumnya masih bersifat manual. Riset dimulai dengan mengidentifikasi dan dilanjutkan pengembangan model sistem informasi manajemen keperawatan oleh Roro ("SIMPRO") yang disesuaikan dengan kondisi rumah sakit. Model "SIMPRO" yang telah dicustomization diujicobakan di dua rumah sakit dengan karakteristik yang berbeda yaitu rumah sakit swasta dan rumah sakit pemerintah. Setelah implementasi, dilaksanakan evaluasi dengan desain prepost test without control group. Jumlah sampel dokumentasi yang digunakan untuk mengevaluasi kinerja "SIMPRO" adalah 219 dokumentasi dari setiap kelompok rumah sakit. Hasil riset menyampaikan ada perbedaan kinerja sebelum dan sesudah menggunakan "SIMPRO" yang diidentifikasikan dari perbedaan kualitas, kelengkapan, kesinambungan, bukti aspek legal dan fungsi membantu membuat keputusan (p=0.001). Ada perbedaan efisiensi waktu: baik di Rumah Sakit Ibu dan Anak Bunda Jakarta dan RS. Fatmawati (p= 0.01). Setelah menggunakan "SIMPRO" waktu yang diperlukan untuk melaksanakan dokumentasi di RS Fatmawati adalah 40.29 menit atau 25.27% dari total waktu dalam satu shift, sedangkan di RS Ibu dan Anak Bunda Jakarta membutuhkan waktu 24.62 menit atau 9.60% dari total waktu dalam satu shift. "SIMPRO" juga mempengaruhi efisiensi biaya, dimana dengan "SIMPRO" dokumentasi tidak setiap waktu harus dicetak. "SIMPRO" menjamin continuity of care dari asuhan keperawatan, sebagai bukti aspek legal, membantu mengambil keputusan dan meningkatkan keselamatan pasien. "SIMPRO" mengefisiensikan waktu dokumentasi sehingga waktu perawatan langsung ke pasien lebih optimal. "SIMPRO" juga meningkatkan edukasi kesehatan kepada pasien dan keluarga.?Pada riset ini "SIMPRO" juga dapat meningkatkan peran manajer keperawatan dalam melaksanakan fungsi manajemen terutama pada peran pemberiaan motivasi, pengarahan, evaluasi dan monitoring terhadap pelaksanaan asuhan keperawatan. Dukungan aspek perawat, aspek manajemen dan teknik dapat mengoptimalkan kinerja "SIMPRO" sehingga dapat meningkatkan kualitas pelayanan keperawatan. Berdasarkan manfaat dari "SIMPRO", maka sistem ini dapat direkomendasikan untuk digunakan di setiap Rumah Sakit serta dapat mendukung peningkatan kualitas mutu pelayanan keperawatan dan kesehatan.

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Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects."

"ABSTRAKBerbagai studi tentang Keselamatan Pasien (KP) menyatakan bahwa untuk memperbaiki upaya-upaya KP di RS perlu diketahui kondisi budaya/iklim KP di RS tersebut pada tahap awal, sebagai salah satu alat untuk memprediksi perhatian RS terhadap KP. Untuk itu, studi ini bertujuan mengembangkan model pengukuran Iklim KP (Patient Safety Climate) di RS Muhammadiyah-?Aisyiyah (RSMA) dengan nilai psikometrik yang baik. Disain studi ini adalah cross sectional, dan analisis model pengukuran dan struktural menggunakan Confirmatory Factor Analysis (CFA) dan Structural Equation Model (SEM) 2nd level, dengan program LISREL 8.50. Kuesioner disebarkan secara proporsional di 5 RSMA di lima provinsi di P. Jawa, selama bulan Januari-Juni 2011, dengan tingkat respon:1198 (79.8%), dan total kuesioner yang bersih (no-missing data): 936 (62.40%). Wawancara mendalam dilakukan dengan Direksi RSMA untuk konfirmasi hasil penelitian. Model pengukuran menghasilkan 3 variabel laten eksogen yang saling berhubungan yaitu Kepemimpinan Transformasional, Kesadaran Individual, dan Kerjasama Tim. Ketiganya berpengaruh langsung secara bermakna terhadap variabel laten endogen Iklim KP (α=0.05). Model pengukuran terbukti valid (t>1,96 SLF>0,70); reliabel (CR > 0.70, dan VE > 0.50), serta close fit (RMSEA= 0.047 < 0.08). Penelitian menunjukkan model pengukuran mempunyai nilai psikometrik yang baik dan dapat menggambarkan kondisi iklim KP RSMA. Kepemimpinan transformasional terbukti berpengaruh langsung terbesar (SLF=0,56) terhadap iklim KP. Penelitian ini merekomendasikan agar model yang diperoleh dapat digunakan di seluruh RSMA atau RS sejenisnya dan dapat menjadi salah satu dasar pengembangan model untuk jenis RS lainnya (pemerintah atau swasta lainnya).

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ABSTRACTThe recent studies of patient safety have witnessed a growing concern over the issues of patient safety culture/climate as the first step to improve patient safety efforts, and also becoming an assessment tool in predicting hospital commitment to patient safety. This study is aimed to develop a measurement model of patient safety climate in RS Muhammadiyah-?Aisyiyah (RSMA) with good psychometric scores. The study is using cross sectional design. The Confirmatory Factor Analysis (CFA) and Structural Equation Models (SEM) 2nd level with LISREL 8.50 version are carried out to analyse the measurement and structural model. The questionnaire distributed proportionally to all employees in the 5 RS Muhammadiyah-?Aisyiyah from five provinces in Java, during the months of January-June, 2011. The response rate is 1198 (79.8%) with the total number of no-missing data is 936 (62.40%). In-depth interviews with Directors of RSMA were also conducted to confirm the results. The measurement model consist of 3 latent exogen variables: Transformational Leadership; Individually Consciousness, Teamwork, which are significantly related each other and have significant impact to Patient Safety Climate. It is valid and reliable (α=0.05: t>1,96, SLF>0,70; CR=0.90>0.70, and VE>0.50), and also a close fit model (RMSEA = 0.047 <0,08). This research shows that the measurement model has good psychometric scores and describes well the patient safety climate condition in each RSMA. It is also proved that Transformational Leadership had a greater positive impact (SLF=0,56) directly to the Patient Safety Climate than other variables. This research recommends the developed model to be implemented in all RSMA hospitals and could be used as a reference to develop similar model for other kind of hospital (government or other private hospital)"