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"Penerapan kepemimpinan dan budaya keselamatan pasien yang belum optimal dapat berdampak pada timbulnya insiden keselamatan pasien di rumah sakit. Penelitian ini bertujuan untuk diperolehnya model kepemimpinan kepala ruang untuk membangun budaya keselamatan pasien. Penelitian mixed methodini terdiri dari dua tahap. Tahap pertama adalah identifikasi masalah menggunakan metoda wawancara, FGD, studi literatur, studi dokumentasi, dan survey. Wawancara dilakukan pada delapan partisipan dan empat kali FGD pada 6-10 partisipan (FGD pimpinan rumah sakit, kepala ruang, ketua tim, dan kelompok perawat asosiet). Penelitian tahap kedua adalah pengembangan model dengan desain crosssectional. Sampel 210 perawat pelaksana dipilih secara acak sederhana dan data dianalisis dengan metode structural equation modeling (SEM). Hasil Confirmatory Factor Analysis menunjukkan dimensi dan indikator dari setiap variabel yang membangun model valid (nilai-t >1,96) dan reliabel (contruct reliability >0,70; variance extracted >0,50), serta kecocokan keseluruhan model adalah baik (RMSEA=0,065<0,08). Model struktural yang dihasilkan, adalah: Kepemimpinan kepala ruang berpengaruh langsung terhadap budaya keselamatan pasien.

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The implementation of leadership and patient safety culture which not optimal may have an impact on the growth of patient safety incidents in hospital. The aim of this study is obtaining leadership model of head nurse leadership to build the culture of patient safety. This mixed methods study consisted of two stages. The first stage is to identify the problem by depth interviews, focus group discussions, literature review, documentary studies, and surveys.

Interviews were conducted at eight participants, while the Focus Group Discussion (FGD) were carried four times at 6-10 participants (the head of hospital management, head nurse, team leader, and the group of nurse associate). The second stage of the study is the models development with cross sectional design. The 210 sample of nurses was collected by simple random sampling. Data that were found will be analyzed by Structural Equation Modeling (SEM).

The result of Confirmatory Factor Analysis has generate the dimensions and indicato rs of each variable, that support a valid (t-value >1,96) and reliable model building (contruct reliability >0,70; variance extracted >0,50), and also a good fit model (RMSEA = 0.065<0,08). Structural models were finally generated from this study: The leadership of head nurse directly affect patient safety culture."

"Kepala ruangan sebagai seorang manajer lini pertama harus menguasai manajemen keperawatan. Pengetahuan dan ketrampilan dalam mengelola ruang rawat inap diperoleh melalui berbagai upaya, diantaranya melalui pelatihan-pelatihan. Dalam rangka meningkatkan kemampuan kepala ruangan mengelola ruang rawat, pihak manajemen RSU Raden Mattaher Jambi telah mengadakan pelatihan manajemen keperawatan tahun 2000. Sejak saat itu belum pernah dievaluasi hasil pelatihan tersebut.Penelitian ini bertujuan untuk memperoleh data tentang kemampuan kepala ruangan mengelola ruang rawat inap yang dipersepsikan oleh perawat pelaksana dan diperolehnya gambaran kontribusi karakteristik perawat dengan persepsinya dalam menilai kemampuan kepala ruangan. Penelitian ini merupakan studi deskriptif dengan pendekatan cross sectional. Tempat penelitian Rumah Sakit Umum Raden Mattaher Jambi yang meliputi 14 ruang rawat inap.Hasil penelitian menunjukkan hanya 3 kepala ruangan dinyatakan mampu mengelola ruang rawat inap. Dari hasil penelitian juga diperoleh ada kontribusi yang bermakna antara sikap, kepentingan, pengalaman dan pengharapan perawat pelaksana, sedangkan motif tidak berkontribusi dengan persepsi perawat.Dari hasil penelitian terlihat bahwa perawat pelaksana belum melihat adanya perubahan yang berarti semenjak pelatihan manajemen keperawatan tahun 2000. Hasil penelitian ini merekomendasikan kepada pihak manajemen rumah sakit dimasa yang akan datang disarankan agar setiap bentuk pelatihan perlu diikuti dengan suatu pendekatan proses berubah sehingga hasil pelatihan dapat mencapai tujuan yang ditetapkan. Rekomendasi juga diberikan untuk para peneliti lain hendaklah sekaligus melibatkan faktor pada pemersepsi, faktor pada target dan faktor pada situasi secara terintegrasi dalam penelitian tentang persepsi.

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Abstract

A head nurse as a first line manager should be mastery in nursing management. The knowledge and skill to manage the ward are achieved through several efforts; one of the efforts is management training. Raden Mattaher Hospital is a district hospital, located in Jambi, in 2000 a management training was held in this hospital in order to increase the head nurse to management the ward.

The aim of this study was to evaluate the achievement of the training management based on staff nurses' perception. The method of the study was a descriptive, cross sectional design. The samples were obtained from fourteen wards. The questionnaires were used to obtain the data.

The results showed that fourteen there were three out of fourteen head nurses were able to manage the ward. There were also a contribution among nurses' attitudes, concerns, experiences and hopes in evaluating the head nurses' ability to manage the ward.

Based on the research result above, it is revealed that nurses do not see the significant changes since the training of nursing management in 2000 has been done. At this recommended in such training should be followed by a change process approach to in order to achieve the objectives of the training. Recommendation is also given to the other researcher to include other factors of people who perceive the Phenomena, target factor, and factor of situation which integrated in the research of perception."

"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."