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"ABSTRAKNama : Annisa Dea SariProgram Studi : Ilmu Kesehatan MasyarakatJudul : Analisis Kualitas Asuhan Keperawatan di Rawat Inap RS.Jantung danPembuluh Darah Harapan KitaPembimbing : dr. Agustin Kusumayati, M.Sc., PhdKualitas pelayanan di rumah sakit menjadi penting karena bila memiliki kualitas rendahmaka dapat membahayakan pasien. Perawat sebagai profesi yang 24 jam berhubungandengan pasien, turut menentukan mutu pelayanan. Depkes RI 2005 menyatakanpenerapan standar asuhan keperawatan untuk mengukur, memantau dan menyimpulkanapakah pelayanan sudah mengikuti persyaratan. Tujuan penelitian untuk melihatgambaran kualitas asuhan keperawatan melalui kinerja perawat. Pengukuran kualitasasuhan keperawatan dinilai melalui pelaksanaan asuhan dan pendokumentasi asuhan Muller-Staub, 2008 . Penelitian menggunakan desain deskriptf dengan cross sectionalstudy. Sampel penelitian menggunakan simple random sampling pada seluruh perawatdi rawat inap RSJPDHK sebanyak 159 orang. Pengumpulan data dilakukan melaluikuesioner dan observasi. Hasil penelitian yaitu sebanyak 56 perawat usia muda,57,2 pendidikan sarjana, 86,2 perawat perempuan, 57,2 pengetahuan baik tentangasuhan keperawatan, 64 perawat memiliki motivasi tinggi, 54,7 perawat memilikipersepsi positif, 66 perawat merasa beban kerja berat, 40,9 pelaksanaan asuhankeperawatan sesuai standard dan 63,5 pendokumentasian sesuai standar, hal inidipengaruhi oleh motivasi, pengetahuan dan beban kerja. Rekomendasi untukmanajemen keperawatan yaitu memberikan pelatihan tentang asuhan keperawatan,resosialisasi SPO pendokumentasian, bimbingan dan monitoring evaluasi penerapanstandar asuhan keperawatan.Kata Kunci : Kinerja perawat, pelaksanaan asuhan keperawatan, pendokumentasianasuhan keperawatan

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ABSTRACTABSTRACTName Annisa Dea SariStudy Program Public HealthTitle Analysis Quality Of Nursing Care On Inpatient Ward AtNational Cardiovascular Center Hospital Harapan Kita 2018Counsellor dr. Agustin Kusumayati, M.Sc., Ph.DQuality of health services in hospitals has become important considering that patientscould be endangered by poor quality services. As a profession which requires 24 hourscontact with the patient, nurses contribute to the quality of health services. The Ministryof Health of Indonesia 2005 stated that the purpose of applying the nursing carestandard is to measure, monitor, and conclude whether or not a service has been doneaccording to the requirements. The purpose of this study is to see and understand thequality of nursing care through the nurses rsquo performance. Nursing care qualitymeasurement is assessed through the implementation and documentation of care Muller Staub, 2008 . This study is a descriptive study using cross sectional studydesign. Samples are chosen through simple random sampling on all nurses of theinpatient care at RSJPDHK, which are 159 nurses. Data collection was done throughquestionnaire and observation. Results show 56 respondents are young adult, 57,2 are bachelor graduates, 86,2 female, 57,2 have good knowledge on nursing care,64 have high motivation, 54,7 have positive perception, 66 feel to have highworkload, 40,9 implemented nursing care according to standard and 63,5 documented according to standard. These results were affected by motivation,knowledge and workload. Recommendations for the nursing management are tofacilitate training on nursing care, resocialization of the documentation SPO, guidance,and monitoring and evaluation of the standard nursing care application.Keywords Nurse performance, nursing care implementation, nursing caredocumentation"

"ABSTRAKSosialisasi keselamatan pasien telah dilakukan secara rutin oleh rumah sakit, namun pengetahuan perawat tentang keselamatan pasien yang pada akhirnya akan mempengaruhi sikap keselamatan perawat masih belum optimal. Tujuan: Untuk mengidentifikasi dan menganalisis faktor-faktor yang mempengaruhi sikap keselamatan yang dimiliki oleh perawat. Metode: Penelitian kuantitatif dengan rancangan analitic-corelational dan pendekatan cross-sectional ini dilakukan pada 376 perawat yang diambil dengan menggunakan metode purposive sampling. Instrumen penelitian terdiri dari kepuasan kerja, beban kerja, stress kerja, fungsi manajemen kepala ruangan, kondisi kerja, dan sikap keselamatan perawat. Hasil uji validitas dan reliabilitas instrumen kepuasan kerja adalah 0,356-0,575 (Cronbach alpha's 0,724), beban kerja adalah 0,338-0,613 (Cronbach alpha's 0,736), stres kerja adalah 0,542-0,719 (Cronbach alpha's 0,756), fungsi manajemen kepala ruangan adalah 0,401-0,822 (Cronbach alpha's 0,760), kondisi kerja adalah 0,488-0,670 (Cronbach alpha's 0,767) dan sikap keselamatan adalah 0,300-0,827 (Cronbach's alpha 0,771) sehingga dikatakan valid dan reliabel. Hasil: Rata-rata perawat berusia 37 tahun, berjenis kelamin perempuan, masa kerja 12 tahun, jenjang karir PK II, berpendidikan DIII Keperawatan, bekerja di Unit Perawatan Intensif, bekerja 40 jam per minggu, kepuasan kerja sebesar 75,14%, pernah mengikuti pelatihan keselamatan pasien sebanyak 59,0%, memiliki beban kerja sebesar 69,41%, stres kerja sebesar 57,30%, kondisi kerja sebesar 76,00%, sikap keselamatan sebesar 80,46%, ada hubungan antara umur (p=0,001), pengalaman kerja (p=0,001), kepuasan kerja (p=0,001), jenis kelamin (p=0,025), jenjang karir perawat klinik (p=0,001), pelatihan keselamatan pasien (p=0,032), beban kerja (p=0,001), stres kerja (p=0,009), fungsi manajemen kepala ruangan (p=0,001), dan kondisi kerja (p=0,001) dengan sikap keselamatan perawat. Faktor yang paling mempengaruhi sikap keselamatan adalah beban kerja (Original Sample=-0,776), yang berarti setiap peningkatan beban kerja akan menurunkan 0,776 sikap keselamatan perawat. Kesimpulan: Ada hubungan antara usia, jenis kelamin, pengalaman kerja, jenjang karir, kepuasan kerja, pelatihan keselamatan pasien, beban kerja, stres kerja, fungsi manajemen kepala ruangan, kondisi kerja dengan sikap keselamatan, dan faktor yang paling memengaruhi sikap keselamatan adalah beban kerja. Rekomendasi yang diberikan adalah rumah sakit harus memperhatikan kepuasan kerja, beban kerja, stres kerja, kondisi kerja perawat, dan mengoptimalkan peran dan fungsi kepala ruang untuk meningkatkan sikap keselamatan yang dimiliki perawat.

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ABSTRACTPatient safety socialization has been carried out routinely by the hospital, but the knowledge of nurses about patient safety which in turn will affect the safety attitude of nurses is still not optimal. Objective: To identify and analyze the factors that influence the safety attitudes of nurses. Methods: This quantitative research with an analytic-corelational design and cross-sectional approach was conducted on 376 nurses who were taken using purposive sampling method. The research instrument consisted of job satisfaction, workload, work stress, head nurses management function, working conditions, and nurses safety attitude. The results of the validity and reliability test of the job satisfaction instrument were 0.356-0.575 (Cronbach's alpha's 0.724), workload was 0.338-0.613 (Cronbach's alpha's 0.736), job stress was 0.542-0.719 (Cronbach's alpha's 0.756), head nurse's management function was 0.401-0.822 (Cronbach's alpha 0.760), working conditions are 0.488-0.670 (Cronbach's alpha's 0.767) and nurse' safety attitude is 0.300-0.827 (Cronbach's alpha 0.771), so it was valid and reliable. Results: The average nurse is 37 years old, female, work period 12 years, career path PK II, Diploma in nursing, works in the Intensive Care Unit, works 40 hours per week, job satisfaction is 75.14%, has attended safety training patients is 59,0%, have a workload of 69.41%, work stress is 57.30%, work conditions are 76.00%, safety attitudes are 80.46%, relationships among age (p=0,001), work experience (p=0,001), job satisfaction (p=0,001), gender (p=0,025), clinical nuses career path (p=0,001), patient safety training (p=0,032), workload (p=0,001), work stress (p=0,009), head nurse's management function (p=0,001), and working conditions (p=0,001) with nurses' safety attitude. The factor that most influenced nurses' safety attitude was workload (Original Sample=-0,776), results showed that an increase in workload, 0.776 times will reduce the nurses' safety attitude. Conclusion: There was a relationship between age, gender, work experience, clinical nuses career path, job satisfaction, patient safety training, workload, work stress, head nurse's management function, and working conditions with nurses' safety attitude. The hospital need to pay attention for nurses' job satisfaction, work load, work stress, working conditions, and had to optimizing the head nurse's management function to improve nurses' safety attitudes."

"Latar belakang: Pelaporan Insiden Keselamatan Pasien (IKP) penting untuk memahami penyebab insiden dan meningkatkan keselamatan pasien. Tingkat pelaporan IKP oleh perawat di RSJPDHK tahun 2023 hanya 15,9%, menunjukkan masih banyak insiden yang tidak dilaporkan dan akan melemahkan kapasitas sistem pelaporan untuk mendorong pembelajaran. Penelitian terdahulu (2014-2023) mengidentifikasi bahwa faktor individu, psikologis, dan organisasi sebagai determinan penerapan pelaporan IKP.Tujuan: Mengetahui determinan individu, psikologis, dan organisasi yang berkaitan dengan penerapan pelaporan IKP oleh perawat di RSJPDHK tahun 2024.Metode: Penelitian kualitatif dengan desain studi kasus dilakukan pada bulan Juli – Oktober 2024. Penelitian ini melibatkan lima orang kepala unit kerja dan dua orang dari Komite Mutu melalui wawancara mendalam dan telaah dokumen.Hasil: Penerapan pelaporan IKP meningkat pada tahun 2022-2024, namun belum merata di seluruh unit kerja. Perawat yang rutin melaporkan IKP menunjukkan pengetahuan yang lebih baik dan motivasi yang lebih tinggi. Hambatan psikologis lebih sedikit dirasakan pada perawat yang aktif melapor. Determinan organisasi yang paling banyak mendapat respon negatif meliputi supervisi kepala unit, pelatihan, dan dukungan manajemen berupa champion keselamatan pasien.Kesimpulan: Akar permasalahan belum meratanya penerapan pelaporan IKP di RSJPDHK yaitu pelatihan yang belum efektif dan ketiadaan instrumen yang merinci pelaksanaan supervisi kepala unit dan uraian aktivitas champion keselamatan pasien.

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Background: Patient Safety Incident (PSI) reporting is crucial for understanding the causes of incidents, which serve as a basis for improving patient safety. The PSI reporting rate by nurses at National Cardiovascular Center Harapan Kita (NCCHK) in 2023 was 15,9%, indicating that many incidents remain unreported, which weakens the reporting system’s capacity to drive learning. Previous research (2014-2023) identified individual, psychological, and organizational factors as determinants of PSI reporting implementation.

Objective: To identify individual, psychological, and organizational determinants related to the implementation of PSI reporting by nurses at NCCHK in 2024.

Method: A qualitative study with a case study design was conducted from July-October 2024. The study involved five units head and two members from the Quality Committee through in-depth interviews and document reviews.

Results: The implementation of PSI reporting increased from 2022-2024 but remains inconsistent across all units. Nurses who regularly report PSI demonstrated better knowledge and higher motivation. Psychological barriers were less prominent among nurses who actively reported incidents. Organizational determinants receiving the most negative responses included unit head supervision, training, and patient safety champions.

Conclusion: The root causes are ineffective training, the absence of detailed instruments outlining unit head supervision and specific activities for patient safety champions."