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"Mutu merupakan fokus sentral dari setiap upaya pelayanan kesehatan. Untuk menjamin bahwa pelayanan telah bermutu atau sesuai standar maka perlu dilakukan evaluasi, diantaranya dengan audit akreditasi rumah sakit. Perawat manajer adalah orang yang terlibat dalam akreditasi dan bertanggung jawab atas pengelolaan pelayanan keperawatan, sehingga tujuan pelayanan keperawatan yang bermutu tercapai. Banyak faktor yang berhubungan dengan kinerja perawat manajer. Gibson (1985), Ilyas (1999), dan Robbins (1996) mengemukakan bahwa kinerja berhubungan dengan pemahaman tentang tugasnya. Pengalaman tentang akreditasi merupakan stimulus untuk pemahaman dan perilaku (Thoha, 2000). Maka diasumsikan pemahaman tentang akreditasi dapat menyebabkan perilaku perawat manajer untuk melaksanakan tugasnya sesuai standar.Penelitian ini termasuk jenis penelitian deskriptif korelasional yang bersifat cross sectional, yang bertujuan mendapatkan gambaran bubungan antara pemahaman tentang akreditasi rumah sakit: bidang pelayanan keperawatan dengan kinerja perawat manajer. Populasi penelitian ini adalah semua perawat manajer fungsional (lower or first level managers), yang meliputi kepala ruangan 22 orang, wakil kepala ruangan 20 orang, kepala rawat jaga 13 orang, dan ketua tim keperawatan 141 orang. Sampel penelitian adalah total populasi, yaitu 193 orang. Data yang diperoleh adalah data primer, dikumpulkan melalui penyebaran kuesioner penelitian, yang validitas dan reliabilitasnya telah diuji sebelum penelitian di Rumah Sakit Persahabatan Jakarta.Hasil analisis univariat menunjukkan 49,7% perawat manajer di Rumah Sakit Fatmawati menilai kinerja mereka dengan kategori kurang, dan 50,8% mempunyai pemahaman tentang akreditasi dengan kategori kurang. Hasil analisis bivariat dengan uji Kai Kudrat, diketahui bahwa dari enam sub variabel pemahaman tentang akreditasi, dengan alpha 0,05 hanya satu variabel pemahaman yang berhubungan secara signifikan dengan kinerja perawat manajer, yaitu pemahaman tentang falsafah dan tujuan pelayanan keperawatan (p=0,011). Hasil analisis multivariat dengan uji regresi logistik ganda diketahui bahwa 69,95% variasi kinerja perawat manajer di Rumah Sakit Fatmawati secara signifikan dapat dijelaskan oleh variabel pemahaman tentang falsafah dan tujuan; jabatan; dan unit kerja, dengan nilai G= 48,569 dan nilai p = 0,0001. Dan variabel yang paling dominan berkontribusi dengan kinerja perawat manajer, adalah unit kerja, setelah dikoreksi variabel pemahaman tentang falsafah - tujuan, dan jabatan.Berdasarkan hasil penelitian, rekomendasi yang ditujukan kepada Direktur Pelayanan Medis dan Keperawatan, serta Kepala Bidang Keperawatan Rumah Sakit Fatmawati, adalah meningkatkan kinerja perawat manajer melalui peningkatan pemahaman dan keterampilan, serta sikap perawat manajer sesuai standar yang ditetapkan. Upaya yang dapat dilaksanakan diantaranya adalah melakukan pelatihan tentang akreditasi rumah sakit, khususnya tentang falsafah pelayanan keperawatan, visi, misi, dan tujuan pelayanan keperawatan, serta standar dan indikator pelayanan keperawatan bermutu. Rekomendasi kedua adalah agar diadakan lokakarya dan kerja kelompok keperawatan dalam rangka penyempurnaan uraian tugas, tanggung jawab, kewenangan, dan standar operasional prosedur untuk perawat manajer, sesuai falsafah, dan tujuan pelayanan keperawatan, terutama di Instalasi Rawat Jalan (IRJ), Instalasi Rawat Darurat (IRD), dan Instalasi Bedah Sentral (IBS).

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The Relationship between Understanding of Accreditation of Hospital and Nurse Managers Performance in Nursing Services at Fatmawati Jakarta Hospital in 2002"Quality is a central focus of each effort of health services. Evaluation, such as accreditation of hospital, has to be done to guarantee that the effort is qualified or in accordance with standard. A nurse as a manager is a person who is involved in accreditation and is responsible for nursing services so that objectives of qualified nursing services can be achieved. There are many factors that relate to managers performance. Gibson (1955), Ilyas (1999), and Robbins (1996) suggested that the performance related to the understanding of the duty. The experience of accreditation could be stimulus to understanding and behavior (Thoha, 2000). Then, it has been assumed that the understanding of accreditation encourage the managers to do the job based on the standard.This research is descriptive correlation design, which is cross sectional. It aims to obtain an illustration of the relationship between understanding of accreditation of hospital and nurse managers performance. Population of the research is all lower or first level managers that include 22 head nurses, 20 charge nurses, 13 nurse supervisors, and 141 heads of nursing team. Samples for this research are 193 persons (all of the population). The data obtained is primary data, which is gathered through distributing questionnaires. The validity and reliability of the questionnaires have been tested before the research at Persahabatan Jakarta Hospital.The result of univariat analysis shows that 49.7% nurse managers at Fatmawati Hospital evaluate that their performance is categorized less, and 50.8% managers have less understanding of accreditation. From the result of bivariat analysis with Chi-square test, it can be seen that among six sub variables of understanding of accreditation, with α =0.05 there is only one variable that deeply relates to nurse managers' performance. That is the understanding of philosophies and objectives of nursing services (p-0.011). The result of multivariate analysis with double logistic regression test shows that 69.95% variation of nurse managers? performance at Fatmawati Hospital can be explained significantly by variable understanding of philosophies and objectives; position; and units of work. The results are G=48.569 and p=0.0001. The variable that dominantly contributes to nurse managers' performance is unit of work after correcting variable of understanding of philosophies, objectives, and positions.Based on the results of the research, recommendations addressed to Director of Medical and Nursing Services along with Head of Nursing Department of Fatmawati Hospital are to increase nurse managers' performance through raising the understanding and skill, and standardizing managers' attitude. The efforts that can be done are training in accreditation of hospital, specifically about the philosophies of nursing services, vision, missions. The second recommendation is to perform workshops and team works of nursing in order to complete the details of duty, responsibility, authority, standard operational procedure of nurse managers, based on the philosophies and objectives of nursing services especially at out-patient clinics department, emergency and acute care department, and operating room department."

"Recent health service should ti-y to grant comprehensive service, in line with technology demand and society interest, clients have resumed to pay attention to profits of hospital providing qualified service, efficient cost and satisfaction to its clients. A hospital, if dose not pay attention to its client?s satisfaction, will diminish its clients and eventually will suffer a financial loss. One of many factors influencing client?s satisfaction is client-nurse communication.

The survey at Karya Bhakti Hospital, Bogor indicated that its clients have felt satisfied, yet they still have complaint on that the communication between nurses and clients in inpatient unit has not been active. In consequence, this research was to prove that there was a relation between nurse-client communication and a level of client?s satisfaction with the nursing service. The used method was descriptive correlation and the data collecting utilized cross sectional. The sample of research was 100 people who were patients of inpatient unit of Karya Bhakti Hospital, Bogor. The research was conducted in June and July 2001. The instrument of this research broke down into three part, namely: first client?s characteristics; second, nurses? communication toward client; and third, client?s satisfaction.

Characteristics of respondent were: age between 15-73 years old of age, mostly women educational level ranging from elementary to university, mostly from new patients who got service at first; and length of caring ranging from 3-12 days. The research was conducted at four inpatient units. The result of communication variable implied that the clients often got empathy, involved in planning and decision making lfl controlled caring process, entrusted and often got detail, systematic and transparent information as well as rewarding as an individu in nurse communication (Confirmation). The result finding at satisfaction level showed that the level of corespondent?s satisfaction was high enough. Their characteristic did not indicate a significant relation with the level of satisfaction There was a significant Connection between nurse-client COflhrfltiflication (confirmation) and client?s satisfaction on detail-systematic information granting (transparency) as well as attitude to appreciate client as an indivìdu (confirmation).

Based on the research, it is recommended that policy makers of the hospital should remain this achievement. And ¡t should be enhanced so the entire staffs of the hospital could run communication well and it could be remained by rewarding to executing nurse whom has carried his/her communication well, emphasizing to all hospital to do so. And they should establish teamwork that handles matter of communication in a hospital and compose a program which focuses on information restructuring such as health education through discharged planning that is adjusted with individual needs.

It is suggested that nurses should carry out nursing care using excellent communication. And create a program that control and facilitate communication program in environment of care. For further research, it is recommended that this result should be base of the following research using more complete method such as experiment equation or by direct-qualitative-interview on factors influencing clients? satisfaction. Due to the fact that this research had analyzed the content of communication, so the further research is recommended to ilivestigate some relations between nurse-client communication techniques and achievement of nursing service quality."

"ABSTRAKDelegasi keperawatan merupakan salah satu aktifitas kepala ruangan melaksanakan fungsi manajemen dalam pemberian pelayanan keperawatan. Mekanisme delegasi keperawatan yang efektif menjamin kualitas pendelegasian keperawatan. Penelitian ini bertujuan memperoleh model delegasi keperawatan yang efektif dan meningkatkan kualitas pendelegasian keperawatan kepala ruangan. Penelitian ini dilakukan tiga tahap yaitu tahap 1 identifikasi masalah melalui penelitian deskriptif kualitatif fenomenologi, tahap 2 pengembangan model, dan tahap 3 penelitian kuasi eksperimen pre-posttest control group design. Metode sampling tahap 1 dengan purposive sampling dengan 4 partisipan. Tahap 3 sampel dipilih secara probability sampling yaitu simple random sampling sejumlah 70 responden 35 responden kelompok intervensi dan 35 kelompok kontrol . Hasil penelitian tahap 1 didapatkan 5 tema yaitu proses kegiatan delegasi keperawatan belum sesuai prinsip, prosedur delegasi keperawatan tidak standar, kegiatan delegasi tidak terdokumentasi, perbedaan pemahaman antar partisipan tentang prosedur delegasi, dan belum ada penerapan penghargaan atau sanksi untuk proses delegasi yang telah dilaksanakan. Tema tersebut dikembangkan pada tahap ke 2 menjadi model delegasi keperawatan yang diberi nama lsquo;Relactor rsquo;. Di tahap ke 3 terbukti bahwa model delegasi keperawatan lsquo;Relactor rsquo; meningkatkan kualitas pendelegasian keperawatan p

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ABSTRACTNursing delegation becomes one of management function of head nurse 39 s activity in providing nursing care. The mechanism of effective nursing delegation assures quality of nursing delegation. This research aimed to discover effective nursing delegation model and improve quality of nursing delegation of head nurse. This study undergone 3 steps include step 1 problem identification through descriptive qualitative phenomenology research, step 2 model development, and step 3 quasi experimental research pre post test control group design. Sampling method of step 1 with purposive sampling involved 4 participants. Seventy respondents 35 respondents at each group had been collected by using simple random sampling probability sampling during step 3. Research result of step 1 obtained 5 themes, those were inappropriate nursing delegation process, unstandardized nursing delegation procedure, undocumented delegation activity, different understanding among participants about delegation procedure, and the absence of reward and punishment for implemented delegation. Those themes were developed at step 2 that hereinafter called nursing delegation model lsquo Relactor rsquo . Step 3 was successfully proved that there was significant influence of nursing delegation model lsquo Relactor rsquo toward quality of delegation. The study recommended that lsquo Relactor rsquo model can be applied in nursing service and be executed continuous monitoring to measure success."

"Peneitian ini bertujuan untuk mengetahui hubungan antara kinerja perawat pelaksana dalam melakukan asuhan keperawatan dengan kepuasan pasien. Penelitian dilakukan di Rumah Sakit Kepolisian Pusat Raden Sukanto Jakarta di 11 ruang rawat inap. Desain penelitian crass sectional, sampel diambil secara proporsionai random sampling dengan jumlah sampel 110 pasien. waktu pelaksanaan pada bulan Juni 2002. Data dianalisis dengan Chi-square untuk melihat hubungan antara variabel dependen dan independen, sedangkan untuk menilai kuatnya hubungan antara variabel dependen dan independen dilakukan dengan regresi holistik berganda dan untuk menentukan prioritas utama menggunakan diagram Kartesius. Hasil penelitian menunjukkan bahwa kinerja perawat nilai tertinggi pada tindakan keperawatan sebesar 83,6 %, kepuasan pasien menunjukkan hasil 19,1 % menyatakan puas. Hasil uji bivaiiat menggunakan Chi- square didapatkan bahwa ada hubungan antara pengkajian dengan kepuasan pasien ( Pv=0, 000), ada hubungan antara diagnosa keperawatan dengan kepuasan pasien (Pv= 0.000), ada hubungan antara rencana keperawatan dengan kepuasan pasien ( Pv 0,0001), ada hubungan antara tindakan keperawatan dengan kepuasan pasien ( Pv= 0,015) dan ada hubungan antara evaluasi dengan kepuasan pasien ( Pv 0,001). Hasil multìvariat menggunakan regresi logistik berganda menunjukkan bahwa diagnosa keperawatan paling dominan daiam menentukan kepuasan pasien dikontrol oleh pengkajìan dan jenis kelamin (Exp.B.= 18,58). Diagram Kailesius menunjukkan pengkajian merupakan priotitas utama. Untuk menindaklanjuti hasil penelitian disarankan untuk menyelenggarakan pelatihan proses keperawatan khususrrya pengkajian dan diagnosa keperawatan. Ditunjang dengan pelaksanaan supervisi serta penyempurnaan standar asuhan keperawatan dan standar operasional prosedur. Untuk peneliti lain penelitian ini merupakan data awal, untuk mendapatkan hasil yang Iebih objektif dikombinasi dengan wawancara dan observasi.

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The research was providing to obtain the correlation between the nurses performance in nursing care and patient?s satisfaction. The research was conducted at Rumah Sakit Kepolisian Pusat Raden Said Sukanto, the number of sample were 110 which were taken randomly from 11 wards. Research design was cross sectional, Was held in June 2002. Data was analysed by using Chi-square to identify correlation between dependent variable with independent variable. Kartesius diagram was applied to determine the main priority.

The result of research showed that the nurses performance?s score mostly in implementation 83,6%, the rate satisfied patienst were 19,1%. From the result of Chi-square test there was a significant distinction between assesment with patient?s satisfaction (Pv = 0,000); between diagnosis with patent?s satisfaction (Pv = 0,000), between planning with patient?s satisfaction (Pv = 0,0001); between implementation with patient?s satisfaction (Pv = 0,015); between evaluation with patient?s satisfaction (Pv = 0,001). The result of multivaziate shows that diagnosis is more dominance in decisirving patient?s satisfaction after controfled by assesment and sex. Kartesius diagram shows that assesment in the demain priority.

To follow up the result of this research, it is recommended to rm the nursing process training particularly on asscsment and nursing cIignosñ. In adition supervision is needed to, as well as revision on nursing care standard and operational standard procedure. For the researcher, this research is basic data for gating the more objective result combine with interview and observation."