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"ICU sebagai bagian dari pelayanan Rumah Sakit RS harus mempertahankan mutu dan standarpelayanan. Dalam melayani pasien Jaminan Kesehatan Nasional, RS menggunakan tarif inaCBGs sistempaket menuntut RS melakukan kendali biaya dan mutu. Data bagian keuangan: banyak tagihan ICU,terutama yang berhubungan dengan pelayanan ventilator, dibayarkan dibawah tarif. Pada 2015 untukkelas III 30 kasus dibayarkan defisit. Tahun 2016 tarif baru diberlakukan. Hal tersebut menjadi dasarpenulis meneliti biaya satuan dan cost recovery rate CRR pelayanan ventilator dengan tarif lama danbaru. Populasi penelitian 4 pasien dengan diagnosis utama Respiratory Failure J969 , kode INA-CBG J-1-20-III. Penelitian melalui telaah biaya terkait pelayanan ventilator, didapatkan biaya langsung dan taklangsungdengan metode Step-down dan Relative Value Unit. Hasilnya per pasien: biaya satuan aktual BSA Rp8.522.431 dan biaya satuan normatif BSN Rp1.429.657. Perbandingan tarif 2011 didapatkanCRR dengan BSA 14.55 dan BSN 85.34 . Dengan tarif 2016 CRR dengan BSA 15.92 dan BSN93.38 . Untuk tarif BPJS 2014 CRR dengan BSA 10.62 kelas 1 , 9,11 kelas 2 , 7,59 kelas 3 .Untuk tarif BPJS tahun 2016 CRR BSA 16,86 kelas 1 , 14,45 kelas 2 , dan 12,04 kelas3 . Jikakapasitas dioptimalkan dengan rerata BOR, CRR BSN tarif BPJS2014 masing-masing sebesar62,30 kelas 1 , 53,41 kelas 2 , 44,50 kelas 3 . Dengan tarif BPJS2016 CRR BSN 98.84 kelas 1 ,84,72 kelas 2 , dan 70,60 kelas3 . BSA penggunaan ventilator yang sangat tinggi oleh karenarendahnya kunjungan pasien dan tingginya nilai biaya investasi. Tingginya biaya ini juga menunjukkansupport daerah masih dibutuhkan di RSUD Nunukan baik sebagai pengawas maupun pendukung finansialmelalui APBD.

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AbstrarctIntensive Care Unit as a part of hospital service, must maintain the quality and standard of services. Intreating patients of National Health Insurance hospitals use InaCBGs fare in package per diagnosisdemanding hospital to control cost and quality. Data from our financial division shown that many ICU rsquo sclaim were paid below fare, especially ventilator services claim. In 2015 for class 3 about 30 was paidbelow fare. In 2016 new list of fares was enacted. This become the main reason to find out how much theactual AUC and normative unit cost NUC and Cost recovery rate CCR ventilator service comparewith previous and recent fare. Population of this research are 4 patients with diagnosis Respiratory Failure J969 , INA CBG code J 1 20 III. The research through cost analysis due to ventilator service, find outdirect and indirect cost with step down and Relative Value Unit method. The results per patient are AUCRp8.522.431 dan NUC Rp1.429.657. Compare with 2011 fare CRR of AUC 14.55 and NUC 85.34 .Compare with 2016 fare CRR of AUC 15.92 and NUC 93.38 . Compare with BPJS2014 fares CRRof BSA 10.62 class 1 , 9,11 class 2 , 7,59 class 3 . Compare with BPJS2016 fares CRR of BSA16,86 class 1 , 14,45 class 2 , dan 12,04 class 3 . If capacity optimalize according with mean BOR,CRR of NUC of BPJS2014 each are 62,30 class 1 , 53,41 class 2 , 44,50 class 3 . With BPJS2016fares CRR of NUC are 98.84 class 1 , 84,72 class 2 , dan 70,60 class 3 . The AUC of ventilatorservice was very high mainly because of low patients visit and the investment cost is high. These highcosts shown that Nunukan Hospital still needs support from local government as owner and financialsupporter."

"Pasien-pasien di unit-unit perawatan intensif {ICU) lebih banyak mengalami cedera akibat adverse events hila dibandingkan dengan pasien-pasien yang bukan dirawat di ICU. Banyaknya prosedur yang dilakukan pada pasien-pasien dalam kondisi yang kritis serta banyaknya jumlah dan jenis obat yang digunakan dalam pelayanannya juga meningkntkan resiko yang lebih tinggi hilngga dibandingkan dengan pasien lainnya. Tingginya data mortalitas dan insiden di beberapa ICU rumah saklt umum pusat bantuan regional Departemen Kesehatan menunjukkan belum ada suatu analisis yang mendalam terhadap faklor-faktor penyebab yang berkaitan dengan adverse events di unit perawatan intensif (ICU) pada rumah sakit tersebut. Hasil penelitian didapatkan bahwa adverse events di unit perawatan intensif (ICU) pada !8 (delapan belas) rumah sakit umum di Indonesia yaitu sebesar 42,7 %. Faktor faktor tidak baik, prosedur tidak lengkap, kurangnya kelengkapan dan pemeliharaan alat, berkontribusi dalarn terjarlinya adverse events di ICU pada 18 nrumah sakit. Pemahaman staf dan perawat ICU terhadap patient safety di unit perawatan intensif (ICU) sangat kurang. Penyebab dari beban kerja perawat tidak sesuai yaitu sumber daya manusia yang terbatas, uraian tugas yang tidak jelas, rasio antara petugas dengan pasien tidak sesuai, mengetjakan pekexjaan yang bukan wewenangnya dan kurangnya pelatthan. Behan kelja perawat yang tinggi berdampak stress kerja perawat. Penyebab komunikasi yang karang baik yaitu masib adanya gap antara perawat senior dan perawat yunior dalam berkomunikasi, kepala unit tidak mengikuti morning briefingkomunikasi yang kurang antara tim klinis. Miskomu­nikasi juga menyebabkan terjadinya medication error di lCU. Peralatan kesehatan tidak lengkap dan tidak sesuai standar lCU, scrta tidak adanya prosedur tertulis tentang pemakaian alat. Pimpinan unit dan supervisi klinis belum menjalankan tugrumya dengan baik.Dari hasil penelitian ini disarankan kepada pihak rumah sakit untuk meningkatkan pengetahuan dan pemahaman perawat tentang patient safety, meningkatkan peranan kepala unit, kepala ruangan, komite keperawatan dan supervisi klinis, menetapkan standar prosedur asuhan keperawatan, prosedur pemakaian dan pemeliharaan alat serta prosedur komunikasi bagi perawat di ICU, menambab surnber daya manusia kesehatan {SDMK), meningkatkan pelatihan bagi perawat, menfasilitasi sistem infOnnasi kesehatan melalui Information Technology.

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Patients in intensive care units (lCUs) may be more likely than non-ICU patients to be injured by adverse events. The procedures performed on critically ill patients and the quantity and type of drugs used in their care may also increase their risk relative to non-ICU patients. The height data incident and mortality in some ICU aids centers publics hospitals regional Department of Public Healths show there is no an circumstantial analyses to factors cause of related to adverse events intensive care units ( ICU) at the hospital. It was found from the research that adverse events in intensive care unit (!CU) at 18 (eighteen) public hospitals in Indonesia that is 42,7 %. Factors like: inappropriate nurse work load poor communications, incomplete procedure Jack of equipment and conservancy of appliance, contribution in the happening of adverse events in ICU at 18 hospitals. Understanding of nurse and staff!CU to patient safety in intensive care unit ( ICU) hardly less. The cause of inappropriate nurse work load that is limited resource, breakdown of ill defined duty, ratio between officers with inappropriate patients, do work which not the authority and lack of training, High nurse work load affect stress working nurse. The cause of unfavourable communications that is still existence of gap between senior and junior nurses in communicating, lead unit don't follow morning briefing, communications which less between teams. Miscommunication also cause medication errors in ICU. Incomplete equipments and also procedure inexistence. Leader of unit and clinical supervise not yet implement the duty.From this research result suggested to the side of hospital for increasing knowledge and understanding of nurse concerning patient safety increase role of unit director, room director, treatment committee and clinical supervise, specify treatment upbringing procedure standard, usage procedure and conservancy of appliance and also communications procedure for nurse in ICU add health human resource, increase training for nurse, health information system facility through Information Technology {IT) in the form of white line as decision support system."

"Sistem pembayaran INA-CBG dalam JKN diduga meningkatkan kejadian readmisi, didefenisikan sebagai kasus rawat-inap kembali pasien dalam waktu kurang 30 hari dengan kondisi Sama (diteliti dalam 4 model readmisi yaitu CMG/Adjacent-DRG/Severity-Level/Diagnosis-Primer Sama), cara pulang rawatan sebelumnya sembuh, pada rumah sakit yang Sama. Hanya satu kasus readmisi dihitung dalam 30 hari dari tanggal pemulangan pasien pada rawatan pertama per-periode-kasus-readmisi. Desain penelitian potong-lintang dengan data sekunder klaim rawat-inap Rumah Sakit wilayah BPJS-Kesehatan Cabang Sukabumi terverifikasi, data tahun 2015.Kejadian readmisi didapatkan pada 11 dari 13 Rumah Sakit untuk keempat model readmisi diteliti, terbanyak pada Readmisi-CMG-Sama, dan paling sedikit pada Readmisi-Severity-Sevel-Sama. Variabel independen adalah kepemilikan RS, Kelas/Tipe RS, diagnosis klinis (CMG, jenis-rawat-inap, Severity-Level, Diagnosis-Primer), selisih biaya, dan LOS (Length of Stay). Analisis multivariat menunjukkan variabel diagnosis-primer (kategori-kronis) dan severit-level (kategori-akut) paling berpengaruh. Selisih biaya negatif dan LOS yang lebih rendah tidak terbukti memiliki risiko readmisi lebih tinggi.Diagnosis Congestive Heart Failure dan Typhoid Fever memiliki kekerapan readmisi tinggi sekaligus diagnosis dengan selisih biaya positif tertinggi. Diagnosis Chemoterapy Session for Neoplasm, Aplastic Anaemia (unspecified), dan End-stage Renal Disease perlu mendapat perhatian karena kekerapan readmisi tinggi dan selisih biaya minus tertinggi. Risiko biaya total lebih 2 kali dari biaya kasus original (initial-admission).

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The INA-CBG payment system in JKN is suspected to increase the incidence of readmission, defined as a case of patient re-hospitalization in less-than-30-days under the same conditions (studied in 4 readmission models of same- CMG/Adjacent-DRG/Severity-Level/Diagnosis-Primer), previous case recovered, at the same hospital. Only one case of readmission was calculated within-30-days from the date of discharge in the initial-admission per- readmission-case-periode. This is a cross-sectional study design with secondary data of verified-inpatient-claims of the Hospital of BPJS-Kesehatan-Sukabumi- Branch in 2015.

The incidence of readmission was found in 11 of the 13 Hospitals of all four models, mostly in the same-CMG-readmission, and at least at the same-severity- level-readmission. The independent variables are hospital-ownership, hospital- types, clinical-diagnosis (CMG, inpatient-type, Severity-Level, Primary- Diagnosis), cost-difference, and LOS (Length of Stay). Multivariate analysis shows the primary diagnosis-type (chronic-category) and severity-level (acute- category) most influential. A lower-negative-cost and lower-LOS are not shown to have a higher risk of readmission.

Diagnosis Congestive-Heart-Failure and Typhoid-Fever have high readmission frequency as well as diagnosis with the highest positive-cost-difference. Diagnosis of Chemotherapy Session for Neoplasm, Aplastic Anaemia (unspecified), and End-stage Renal Disease need attention because of high read-list-frequency and highest-minus-cost-difference. The total cost risk is more than 2 times the original-admissions cost."

"ABSTRACTIntensive Care Unit (ICU) merupakan salah satu pelayanan terpenting di rumah sakit karena itu perlu ditingkatkan dan dievaluasi secara berkala. Pengukuran kualitas pelayanan ICU di rumah sakit dapat dilihat dari tingkat kepuasan keluarga pasien yang menjaga pasien di ICU terkait. Pada penelitian ini tingkat kepuasan keluarga pasien akan dinilai terhadap pelayanan dokter, pelayanan perawat, biaya pelayanan kesehatan, pelayanan medis, pelayanan administrasi, dan fasilitas. Akan dianalisis perbedaan mean tingkat kepuasan antara pengguna BPJS dan non-BPJS dan perbandingan tingkat kepuasan keluarga pasien ICU antar rumah sakit tipe A di Jakarta, serta faktor-faktor demografi yang mempengaruhi tingkat kepuasan keluarga pasien ICU. Data diperoleh dari 150 responden pada 8 rumah sakit tipe A di Jakarta. Metode analisis yang digunakan adalah Uji Mann-Whitney, Partial Least Square (PLS), dan Net Promoter Score (NPS). Hasil analisis data menunjukkan bahwa tingkat kepuasan keluarga pasien ICU yang menggunakan BPJS berbeda dengan tingkat kepuasan keluarga pasien ICU yang menggunakan non-BPJS hanya pada tingkat pelayanan administrasi. Faktor yang mempengaruhi tingkat kepuasan keluarga pasien ICU terhadap perlakuan dokter dan perawat adalah lama waktu perawatan sedangkan adanya rujukan menjadi faktor yang mempengaruhi tingkat kepuasan keluarga pasien ICU terhadap biaya dan pelayanan administrasi. Rumah Sakit S menjadi rumah sakit yang diberi penilaian tertinggi secara keseluruhan oleh para responden.

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ABSTRACTIntensive Care Unit (ICU) is one of the best central services in the hospital that should be improved and evaluated periodicly. When measuring the ICU service in the hospital, patient family satisfaction level is one of the indicator. In this study patient family satisfaction level is rated by the doctor services, the nurse services, the medical services fee, the medical services, the administration services, dan facility. This study aimed to analysis the differences about mean of satisfaction level between patient with BPJS and Non-BPJS and to compare the ICU patient family satisfaction between the type A hospitals in Jakarta, also to identify factors that affect the patient family satisfaction level also. The collected data is 150 respondents from 8 type A hospitals in Jakarta. The methods that will be used in this study are Mann-Whitney Test, Partial Least Square (PLS), and Net Promoter Score (NPS). The results of this study claimed that the ICU patient family satisfaction level with BPJS is different with The ICU patient family satisfaction level with Non-BPJS towards the administration services only. The factor that give an affect to the ICU patient family satisfaction towards the doctor and the nurse services is the length of treatment while reference letter is the factor that affect the ICU patient family satisfaction towards the medical services fee and the administration services. Hospital S is the best hospital for the respondents."

"Penggunaan antimikroba yang tidak tepat di ruang ICU dapat meningkatkan terjadinya resistensi bakteri. Penelitian ini bertujuan untuk menganalisis rasionalitas/ketepatan penggunaan antimikroba dan faktor-faktor yang mempengaruhi rasionalitas/ketepatan penggunaan antimikroba tersebut di ruang ICU periode Januari ndash; Desember 2010 dengan menggunakan metode Gyssens.Penelitian dilakukan dengan desain potong lintang cross sectional, data retrospektif diambil dari kardeks obat dan data rekam medis pasien. Faktor-faktor yang paling dominan dalam mempengaruhi rasionalitas/ketepatan penggunaan antimikroba berdasarkan metode Gyssens dilakukan analisis multivariat dengan menggunakan regresi logistik ordinal.Penggunaan antimikroba di ruang ICU RSUP Fatmawati sebanyak 912 rejimen dari 410 pasien. Berdasarkan metode Gyssens, penggunaan antimikroba antimikroba empiris yang tidak tepat sebesar 596 rejimen 74,03 dan penggunaan antimikroba definitif yang tidak tepat sebesar 84 rejimen 78,51 . Rasionalitas/ketepatan penggunaan antimikroba empiris dipengaruhi oleh penyakit utama terkait infeksi, penyakit penyerta terkait infeksi dan dokter. Penggunaan antimikroba di ruang ICU RSUP Fatmawati tidak rasional/tidak tepat.

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Inappropriate use of antimicrobial in the intensive care unit can increase bacterial resistance. The aim of this research were to analyze the rationality of antimicrobial use and the factors that influenced the rationality of antimicrobial use in the Intensive Care Unit during the period of January to December 2010 based on the Gyssens's method.This research was a cross sectional study with retrospective datas taken from patient rsquo s medicine orders and medical records. The factors that most influenced the rationality of antimicrobial use based on the Gyssen rsquo s method were analyzed using ordinal regression logistic. There were 912 regimens of antimicrobial use from 410 patients in the Intensive Care Unit of Fatmawati hospital.Using the Gyssens rsquo s method, there were 596 inappropriate empiric antimicrobial regimens 74,03 and 84 inappropriate definitive regimens 78,51 . The rationality of empiric antimicrobial use was influenced by the infection as the main disease presentation, the infection as the supplementary factor to the disease presentation and clinician rsquo s choice.The use of antimicrobial in the Intensive Care Unit at Fatmawati hospital was inappropriate."

"ABSTRACTPurposesVascular surgery (VS) has a higher perioperative mortality than other types of surgery. We compared different scores for predicting mortality in patients admitted to the intensive care unit (ICU) after open VS.MethodsPatients admitted to the ICU after open VS from 2006 to 2013 were included. We calculated the Acute Physiology and Chronic Health Evaluation (APACHE), Simplified Acute Physiology Score (SAPS), Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) and Preoperative Score to Predict Postoperative Mortality (POSPOM). We performed multivariate logistic regression to assess independent factors with the calculation of odds ratios (ORs) and 95% confidence intervals (CIs). We tested the predictive ability of the scores using the area under the receiver operating characteristics curve (AUROC).ResultsA total of 833 consecutive patients were included. Hospital mortality was 5,1% (1,3% after intermediate-risk and 8,4% after high-risk surgery). In the multivariate analysis, the age (OR 1,04, 95% CI 1,01-1,08, p = 0,013), smoking status (OR 2,46, 95% CI 1,16-5,21, p = 0,019), surgery risk (OR 2,92, 95% CI 1,058,08, p = 0,040), serum sodium level (OR 1,17, 95% CI 1,10-1,26, p < 0,001), urea (OR 1,01, 95% CI 1,01-1,02, p = 0,001) and leukocyte count (OR 1,05, 95% CI 1,01-1,10, p = 0,009) at admission were considered independent predictors. Hematocrit (0,86, 95% CI 0,80-0,93, p < 0.001) was considered an independent protective factor. The AUROC of our model was 0,860, compared to SAPS (0,752), APACHE (0,774), POSPOM (0,798) and POSSUM (0,829).ConclusionThe observed mortality was within the predicted range (1-5% after intermediate-risk and > 5% after high-risk surgery). POSSUM and POSPOM had slightly better predictive capacity than SAPS or APACHE."

"Beban kerja mental perawat dipengaruhi oleh faktor internal dan eksternal perawat. Faktor internal meliputi karakteristik individu dan motivasi perawat, serta faktor eksternal yang meliputi organisasi dan pekerjaan perawat. Tujuan penelitian ini untuk mengidentifikasi faktor yang paling berhubungan dengan beban kerja mental perawat saat berinteraksi dalam asuhan keperawatan di ruang perawatan intensif. Penelitian ini merupakan penelitian kuantitatif dengan pengumpulan data menggunakan kuesioner dan pendekatan Cross Sectional. Analisis data menggunakan Chi-Square dan regresi logistik ganda. Pengambilan sampel dalam penelitian ini menggunakan total population sampling dan melibatkan sampel sebanyak 129 perawat pelaksana yang bekerja di ruang perawatan intensif. Hasil uji regresi logistik menunjukkan bahwa faktor motivasi merupakan variabel yang paling berpengaruh terhadap beban kerja mental perawat dibandingkan variabel lainnya p=0,022; ?=0,05. Rumah sakit dapat mengoptimalkan dan melakukan resosialisasi regulasi pemberian reward bagi perawat, serta membuat program pengembangan kompetensi dan soft skill perawat.

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The mental workload of nurses is influenced by internal and external factors. Internal factor are nurse individual characteristic and motivation, also external factor such as organization and nurse task. The aim of this research is to identify the factors most closely related to the mental workload of nurses during interactions in nursing care in intensive care unit. This research is a quantitative research with data collection with questionnaire using Cross Sectional approach. Data analysis using Chi Square and multiple logistic regression. Sampling in this study used total population sampling and involved a sample of 129 implementing nurses working in the intensive care unit. The result of logistic regression test shows that motivation factor is the most influential variable to the mental workload of the nurse compared to other variables p 0,022 0,05 . Hospitals can optimize and resocialization regulation of reward for nurse, and make competence development program and soft skill of nurse. "

"Latar Belakang: Delirium adalah perubahan status mental berupa gangguan atensi, kesadaran, dan kognisi yang akut dan fluktuatif. Referensi standar mendiagnosis delirium pada anak dan dewasa menggunakan kriteria DSM-5 atau ICD-10. Populasi anak memiliki tahap perkembangan dan gambaran gejala delirium yang berbeda dibandingkan dewasa sehingga diagnosis delirium anak mengalami keterbatasan dan membutuhkan kemampuan klinis dan kompetensi. Telah dikembangkan instrumen pCAM-ICU untuk membantu diagnosis delirium anak usia minimal lima tahun yang memiliki sensitivitas dan spesifisitas yang tinggi. Saat ini pelayanan kesehatan anak di Indonesia belum memiliki instrumen membantu diagnosis delirium dalam Bahasa Indonesia. Oleh karena tingginya kebutuhan pelayanan, maka dilakukan validitas isi dan reliabilitas konsistensi internal instrumen pCAM-ICU versi Bahasa Indonesia Metode: Dilakukan proses forward translation dan back translation hingga didapatkan instrumen pCAM-ICU versi Bahasa Indonesia. Uji validitas isi pCAM-ICU versi Bahasa Indonesia melibatkan 10 orang ahli di Ilmu Kesehatan Jiwa dan Ilmu Kesehatan Anak yang pernah menangani kasus delirium pada anak dan remaja. Uji reliabilitas konsistensi internal dilakukan pada 30 pasien anak yang berusia 5 – 17 tahun di layanan RSCM. Penelitian ini merupakan penelitian potong lintang dengan membandingkan pemeriksaan pCAM-ICU dengan kriteria DSM-5. Hasil: Instrumen pCAM-ICU versi bahasa Indonesia memiliki nilai I-CVI dan S-CVI sebesar 1,00 pada uji validitas isi dan Cronbach’s alpha keseluruhan 0,959 pada uji reliabilitas konsistensi internal. Instrumen pCAM-ICU versi Bahasa Indonesia memiliki nilai sensitivitas 85% (95% CI, 68-100%) dan spesifisitas 96% (95% CI, 86-100%) Simpulan: Instrumen pCAM-ICU versi Bahasa Indonesia dinilai valid dan reliabel dalam membantu penegakkan diagnosis delirium pada anak minimal usia lima tahun.

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Background: Delirium is defined as an acute and fluctuating altered mental status in the form disruption of attention, consciousness, and cognition. DSM-5 and ICD-10 criteria are used as a standardized reference to diagnose delirium. Pediatric population has a different developmental stage and clinical manifestation compared to adult population, hence diagnosing delirium in pediatric population is limited and requires further clinical skill and competence. pCAM-ICU has been developed to help diagnosing delirium for children at least 5 years old with high sensitivity and specificity. Pediatric healthcare service in Indonesia does not have an instrument to help diagnosing delirium in Bahasa Indonesia. Due to the need of such instruments, content validation and internal consistency reliability test for Indonesian version of pCAM-ICU is carried out.

Methods: Forward translation and back translation is carried out to obtain the Indonesian version of pCAM-ICU. Content validity of Indonesian pCAM-ICU involves 10 experts in Psychiatry and Pediatric who have managed delirium cases in children and adolescent. Internal consistency reliability test is done to 30 pediatric populations from the age of 5-17 years old in RSCM. This research is a cross sectional research which compares pCAM-ICU with DSM-5 criteria.

Results: Indonesian version of pCAM-ICU has I-CVI and S-CVI score of 1,00 at content validity test and overall Cronbach’s alpha of 0,959 for internal consistency reliability test. Indonesian version of pCAM-ICU has 85% (95% CI, 68-100%) sensitivity and 96% (95% CI, 86-100%) specificity.

Conclusion: Indonesian version of pCAM-ICU is considered valid and reliable to held diagnosing delirium in children of at least 5 years old."

"Kemampuan berpikir kritis sangat diperlukan dalam memberikan asuhan keperawatan, khususnya di ruang intensive care. Penelitian ini bertujuan untuk mengidentifikasi faktor yang mempengaruhi kemampuan berpikir kritis perawat di ruang intensive care. Desain penelitian yang digunakan adalah deskriptif korelasi, dengan pendekatan cross sectional dengan melibatkan 112 orang perawat yang diambil berdasarkan consecutive non probability sampling. Pengumpulan data dengan menggunakan kuesioner dengan analisa univariat, bivariat dan multivariat.Hasil penelitian menunjukkan faktor yang mempengaruhi kemampuan berpikir kritis adalah umur, pengalaman klinis, level kompetensi, motivasi dan ketidakrutinan dalam kerja (p = 0.000-0,05). Variabel yang paling berpengaruh adalah ketidakrutinan dalam kerja (p = 0,000). Faktor-faktor tersebut perlu mendapat perhatian pimpinan di rumah sakit dengan tetap melakukan evaluasi terhadap faktor lain sehingga dapat meningkatkan pelayanan asuhan keperawatan.

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Critical thinking skills are indispensable in providing nursing care especially in the intensive care unit. This study aims to identify factors that affect the ability of critical thinking in the intensive care nurses. The correlation descriptive study design, with cross sectional approach involving 112 nurses were taken by non probability consecutive sampling. The data collecting used questionnaires with univariate, bivariate and multivariate analyzes.

The results showed that the factor of affect the ability of critical thinking are age, clinical experience, the level of competences, motivation and unroutines in labor (p= 0,000 to 0,05). The most influential variable is unroutines in labor (p=0,000). These factors need an attention by hospital manager to keep evaluating the other factors in order to improve the nursing care services."