Penerapan Fungsi Manajemen Kepala Ruangan dalam Pengendalian Mutu Keperawatan

Abstract

ABSTRAK

Tujuan: Mengidentifikasi masalah penerapan fungsi pengendalian mutu dan mengembangkan solusi pemecahan masalah di ruang rawat inap. Metode: Metode yang digunakan analisis hasil dan gap implementasi menggunakan kajian literatur. Permasalahan dianalisis menggunakan diagramfishbone. Penyelesaian masalah menggunakan tools Plan Do Study Action (PDSA). Data diambil melalui wawancara terstruktur, survei, dan observasi lapangan pada 11 responden kepala ruangan dan 88 staf perawat pada tanggal 19-27 Oktober 2017. Data dianalisis secara deskriptif dengan melihat distribusi frekuensi persepsi kepala ruangan dan staf tentang pengendalian mutu dan pelaksanaan fungsi manajemen dalam pengendalian mutu. Hasil: Fungsi pengendalian mutu keperawatan belum dilaksanakan optimal pada tahap perencanaan, pemantauan dan tindak lanjut masalah (45,45%). Implementasi penyelesaian dalam bentuk sosialisasi dan workshop yaitu panduan, prosedur, kamus dan instrumen pemantauan indikator mutu keperawatan. Hasil evaluasi menunjukkan 62% Kepala Ruangan meningkat pengetahuannya tentang pengendalian mutu dengan rata-rata skor pre-post test meningkat 1,33 poin dari 6,10 menjadi 7,43. Survei pasca implementasi menghasilkan persepsi yang baik dari 86,67% Kepala Ruangan mengenai pengendalian mutu keperawatan. Diskusi: Program pengendalian mutu merupakan salah satu fungsi utama kepala ruangan. Rumah sakit telah memiliki program pengendalian mutu yang dipersyaratkan standar akreditasi rumah sakit, namun kepatuhan penerapannya masih perlu dipertahankan. Rumah sakit dipersyaratkan untuk dapat mempertahankan kepatuhan dan kesinambungan pengendalian mutu guna mengevaluasi proses kerja secara berkelanjutan. Kesimpulan: Sosialisasi mengenai penerapan pengendalian mutu keperawatan cukup efektif meningkatkan pengetahuan kepala ruangan dan tentang program mutu yang dipersyaratkan akreditasi rumah sakit. Pimpinan rumah sakit perlu memberi pengakuan, dukungan, dan motivasi bagi kepala ruangan penerapan pengendalian mutu keperawatan di ruangan rawat.

Kata Kunci: fungsi manajemen, mutu keperawatan, pengendalian mutu, perawat manajer.

IMPLEMENTATION OF MANAGEMENT FUNCTION OF HEAD OF WARD IN NURSING QUALITY CONTROL

ABSTRACT

Objective: To identify problems in implementing quality control functions and develop solutions to problems in the inpatient ward. Method: The research employed results analysis and implementation gap by using literature review. Problems were analyzed usingfishbone diagram. Problem were solved using Plan Do Study Action (PDSA) tools. Data were taken through structured interviews, surveys, andfield observations in 11 heads ofward and 88 nursing staff between 19 and 27 October 2017. Data were analyzed descriptively by identifying the frequency distribution of the perception of head nurse and staff regarding quality control and the implementation of management functions in quality control. Results: The function of nursing quality control was not optimally implemented at the stages of planning, monitoring and follow-up of the problem (45.45%). The solutions were implemented in the form of socialization and workshops, including guidelines, procedures, dictionaries and monitoring instruments for nursing quality indicators. The results of evaluation indicated that the average score of pre-posttest on knowledge about quality control increased by 1.33 points 6.10 to 7.43 in 62% of the Heads of Ward. The post-implementation survey produced a good perception in 86.67% of the Head of the Ward regarding the nursing quality control. Discussion: The quality control program is one of the primary functions of the head of ward. The hospital has had a quality control program that is required by hospital accreditation standards, but it should maintain the adherence of its application. Hospitals are required to maintain adherence and sustainability of quality control in order to evaluate the sustainable work process. Conclusion: The socialization of the application of nursing quality control is quite effective in increasing the knowledge ofthe head ofward. In regard to the program of quality required by the hospital accreditation, the board of hospital management should give recognition, support, and motivation for the heads of ward to implement nursing quality control in the nursing ward.

Keywords: management function, nursing quality, quality control, nurse- manager.