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"Pengelolaan logistik salah satu aspek kritis dalam penyediaan layanan kesehatan dan memiliki peran penting dalam meningkatkan kualitas perawatan, kepuasan pasien dan kepuasan perawat. Perbaikan suatu proses kegiatan sangat dibutuhkan untuk optimalisasi pengelolaan logistik keperawatan. Lean six sigma merupakan metodologi perbaikan yang dirancang untuk mengurangi variasi dalam suatu proses dan meningkatkan kemampuan proses dalam perbaikan. Tujuan : untuk mengidentifikasi pengaruh improvement pengelolaan logsitik dengan studi lean six sigma terhadap kepuasan perawat. Metode : Pre-experimental designs: One-group pretest-posttest design yaitu hanya menggunakan satu kelompok eksperimen, tanpa adanya kelompok kontrol. Variabel dependen diukur sebelum diberikan perlakuan dan kemudian diukur kembali setelah diberi perlakuaan. Tehnik sampling dengan nonpropability sampling khususnya purposive sampling, terdiri dari 1I6 responden, yang dibagi menjadi 10 sampel intervensi dan 106 responden yang diukur tingkat kepuasannya dengan kriteria inklusi kepala ruang, ketua tim, perawat pelaksana yang berdinas di ruang rawat inap dan rawat jalan. Hasil : Rata-rata kepuasan perawat dalam pengelolan logistik sebelum improvement dengan studi lean six sigma adalah 57.75% dan setelah improvement dengan studi lean six sigma adalah 80.51%. Hasil penelitian didapatkan nilai 0.001, sehingga dapat disampaikan ada perbedaan yang signifikan pada kepuasan perawat dalam pengelolaan logistik antara sebelum dan setelah improvement dengan studi lean six sigma. Kesimpulan : Improvement pengelolaan logistik dengan studi lean six sigma memberikan pengaruh terhadap kepuasan perawat dan bermanfaat dalam optimalisasi pengelolaan logistik keperawatan.

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Logistics management is one of the critical aspects in the provision of health services and has a vital role in improving the quality of care, patient satisfaction and nurse satisfaction. Repair a process of activity is needed to optimize the management of nursing logistics. Lean six sigma is an improvement methodology designed to reduce variation in a process and improve process capability for improvement. Purpose: To identify the effect of logistics management improvement with a lean six sigma study on nurse satisfaction. Method: Pre-experimental designs: One-group pretest-posttest design, that is, using only one experimental group, without a control group. The dependent variable was measured before being given treatment and then measured again after being given treatment. Sampling technique with non-probability sampling, especially purposive sampling, consisting of 1I6 respondents divided into ten intervention samples and 106 respondents whose satisfaction level was measured with the inclusion criteria of the head of the room, team leader, implementing nurse who served in inpatient and outpatient rooms. Results: The average satisfaction rate of nurses in logistics management before improvement with the lean six sigma study is 57.75% and after improvement with the lean six sigma study is 80.51%. The study's results obtained a value of 0.001, so it can be conveyed that there is a significant difference in nurse satisfaction in logistics management between before and after improvement with a lean six sigma study. Conclusion: Improvement logistics management with study lean six sigma affects nurse satisfaction and helps optimize nursing logistics management.

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"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."

"Kontribusi pelayanan keperawatan terhadap mutu pelayanan kesehatan tergantung dari manajemen keperawatan, dan salah satu ukuran keberhasilan pelayanan keperawatan, adalah seberapa besar produktifitas perawat dalam memberikan asuhan keperawatan yang baik kepada klien dan keluarganya. Untuk mencapai pertumbuhan produktivitas kerja yang optimal diperlukan beberapa faktor pendukung antara lain adalah adanya iklim kerja yang harmonis, etos kerja yang baik dan disiplin kerja yang tinggi. Penelitian ini bertujuan untuk melihat hubungan antara iklim kerja, etos kerja, dan disiplin kerja dengan produktivitas kerja para perawat pelaksana non militer di RSAL dr. Ramelan Surabaya. Desain penelitian menggunakan deskriptif korelatif, yang bertujuan untuk menganalisis hubungan antara variabel iklim kerja, etos kerja dan disiplin kerja dengan produktivitas kerja perawat non militer di RSAL dr. Ramelan Surabaya. Jumlah sampel 170 orang dari 302 populasi yang diambil dengan sistematis random sampling. Untuk mengetahui hubungan antara variabel independen dengan variabel dependen digunakan analisis data dengan uji univariat, bivariat dan multivariat. Dengan tingkat kepercayaan α=0,05, didapatkan hasil yang berhubungan signifikan dengan produktivitas kerja adalah iklim kerja (p=0,032), dimensi psikologis (p=0,00), dimensi sosial (p=0,012), etos kerja (p=0,035), disiplin kerja (0,038), kepatuhan terhadap waktu kerja (p=0,014), kepatuhan terhadap tata tertib (p=0,000), kepatuhan terhadap standart (p=0,024) dan kepatuhan terhadap atasan (p=0,014). Analisis multivariat menunjukan bahwa umur (p=0,000) merupakan variabel yang paling berhubungan dengan produktivitas kerja. Rekomendasi untuk kepala dan manajemen keperawatan RSAL dr. Ramelan Surabaya, perlu dikembangkan lebih lanjut standart kinerja dan standart asuhan keperawatan, standart disiplin kerja, pengembangan team sharing dan pemberlakuan sistem penghargaan yang adil bagi yang berprestasi dan hukuman bagi yang melanggar. Dengan dilaksanakan program ini, pada gilirannya diharapkan dapat meningkatkan produktivitas kerja, sebagai tujuan akhir dari persoalan manajemen, termasuk didalamnya manajemen keperawatan.

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Contribution of nursing service to the quality of health service depended upon nursing management, and one of the indicator of excellence in nursing is how much the productivity of the staff nurse in providing a good care to client and family. To achieve the optimal productivity growth needs some supporting factor includes conducive work, climate work, good work ethos and high discipline. This research aims at identifying the relationship between work climate, ethos, and discipline with work productivity of non military nurses at RSAL dr. Ramelan Surabaya".

The design of this research was a descriptive correlation. The number of sample was 170 of 302 total population, obtained through a systematic random sampling technique. The univariate, bivariate and multivariate analysis were utilized to identify the correlation between the independent and dependent variables.

Using the level of significance (α=0,05), the bivariate analysis identified a relationship between work productivity and work climate (p=0,032), psychological (p=0,00), and social dimensions (p=0,012), ethos (p=0,035), discipline (p=0,028), compliance to the schedule (p=0,014), local policy (p=0,00), standard (p=0,024) and direct superior (p=0,014).The multivariate analysis showed that age (0,000) represents most related to work productivity.

Recommendation is directed to the director and nursing manager at dr. Ramelan Surabaya Hospital, that performance of nursing care, work discipline standards and team building development, fair reward system for high work performance and penalty for low work performance need to be developed further. In turn, all components mentioned above will improve work productivity as a final goal of management especially nursing management. "

"Salah satu terapi mengatasi Perilaku Kekerasan, Halusinasi dan Harga Diri Rendah pada Skizofrenia adalah dengan melakukan terapi CBT dan REBT. Penelitian ini bertujuan mengetahui efektivitas CBT dan REBT terhadap klien Perilaku Kekerasan, Halusinasi dan Harga Diri Rendah di RS Dr. H. Marzoeki Mahdi Bogor. Desain penelitian quasi experimental pre-post test with control group. Sampel berjumlah 60 orang yang meliputi 30 orang kelompok intervensi dan 30 orang kelompok kontrol. Hasil penelitian menunjukkan penurunan tanda gejala klien Perilaku Kekerasan, Halusinasi dan Harga Diri Rendah lebih tinggi pada kelompok intervensi dibandingkan kelompok kontrol (p value<0.05). Terapi CBT dan REBT efektif menurunkan Perilaku Kekerasan sebesar 61 %, Halusinasi 52,1% dan Harga Diri Rendah 66,2%. Peningkatan kemampuan kognitif, afektif dan perilaku pada kelompok intervensi sebesar 74,53%. Terapi CBT dan REBT direkomendasikan diterapkan sebagai terapi keperawatan lanjutan dalam merawat klien Skizofrenia dengan Perilaku Kekerasan, Halusinasi dan Harga Diri Rendah.

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One of behavior therapy to overcome violence, hallucinations and Low Self- Esteem in Schizophrenia is to do a CBT and REBT. This study aims to examine the effectiveness of CBT and REBT Violence against the client behavior, hallucinations and Low Self-Esteem in RS Dr. H. Mahdi Marzoeki Bogor. Quasiexperimental research design pre-post test with control group. Samples numbered 60 people including 30 people the intervention group and 30 control group.

The results showed conduct client signs symptoms of decreased violence, hallucinations and Low Self-Esteem is higher in the intervention group compared to the control group (p value <0.05). CBT and REBT therapy effectively lowered by 61% Violent behavior, hallucinations 52.1% and 66.2% of Low Self-Esteem. Increased cognitive skills, affective and behavior in the intervention group at 74.53%. CBT and REBT therapy is recommended as a therapy applied in the advanced nursing care for schizophrenia clients with violent behavior, hallucinations and Low Self-Esteem."

"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."

"ABSTRAKNama Mahasiswa:AchirmanProgram Studi:Magister Kepemimpinan dan Manajemen KeperawatanJudul Tesis:Hubungan Fungsi Manajemen Kepala Ruang Dengan Kelengkapan Dokumentasi Pasien Resiko Jatuh Di Rumah Sakit Pusat Pertamina Jakarta Abstrak Pencegahan pasien risiko jatuh harus dilakukan dengan baik di rawat inap dan menjadi tanggung jawab perawat secara individu dan manajemen keperawatan terutama kepala ruangan dan harus terdokumentasikan. Penelitian ini membahas tentang hubungan fungsi manajemen kepala ruang dengan kelengkapan dokumentasi pasien risiko jatuh. Penelitian ini adalah penelitian analitik korelatif dengan metoda penelitian cross sectional yaitu menganalisis data hasil deskripsi fungsi manajemen kepala ruang dan pelaksanaan dokumentasi dan mencari hubungan antara variabel tersebut satu satuan waktu dan sampel dalam penelitian ini adalah perawat pelaksana sebanyak 109 orang dan 109 file pasien dengan risiko jatuh. Hasil penelitian menunjukkan bahwa dengan uji korelasi pearson untuk data numerik dan uji t-independent untuk data kualitatif serta uji regresi linear untuk multivariatnya. . Hasilnya adalah fungsi manajemen secara keseluruhan terdapat hubungan dengan kelengkapan dokumentasi tetapi kekuatannya sedang. p=0,002, r=0,288 . Fungsi manajemen yang ada hubungan dengan kelengkapan dokumentasi adalah pengorganisasian p=0,001, r=0,325 , pengaturan staf p=0,000, r=0,360 , pengarahan p=0,023, r=0,218 dan pengendalian p=0,015, r=0,233 . Faktor karakteristik yang ada hubungan dengan kelengkapan dokumentasi adalah jenis kelamin p=0,029 dan usia p=0,035, r=0,202 dan masa kerja p=0,78, r=0,169 . Pada pemodelan multivariat hanya sekali pemodelan karena setelah dimasukkan kedalam model multivariat hanya fungsi pengaturan staf yang p < 0,05. Sehingga fungsi manajemen yang paling dominan mempengaruhi kelengkapan dokumentasi adalah pengaturan staf p=0,045; B=0,131 Penelitian ini merekomendasikan untuk meningkatkan kelengkapan dokumentasi dengan menerapakan dokumentasi secara komputerisasi dan meningkatkan fungsi manajemen kepala ruang pada fungsi pengendalian dengan memasukkan unsur kelengkapan dokumentasi sebagai penilaian kinerja staf. Kata kunci : Fungsi manajemen, dokumentasi, pasien risiko jatuh

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ABSTRACT

AbstractPrevention of falls risk patients should do well in inpatient and are the responsibility of individual nurses and nursing management, especially the head of the room and must be documented. This study discusses the relationship head space management functions with complete documentation of the patient 39 s risk of falling. This research is an analytic study correlative to the method of cross sectional research is to analyze the data of the description of management functions of head space and the implementation of documentation and look for relationships between these variables one unit of time and sample in this study were nurses and as many as 109 people and 109 files of patients at risk of falls , The results showed that the Pearson correlation test for numerical data and independent t test for the qualitative data as well as linear regression to multivariat, The result is an overall management function there is a relationship with the completeness of the documentation but its power was. P 0.002, r 0.288 . Management functions in connection with the completeness of the documentation is organizing p 0.001, r 0.325 , staffing p 0.000, r 0.360 , direction p 0.023, r 0.218 and control p 0.015, r .233 . Characteristic factors in connection with the completeness of the documentation is gender p 0.029 and age p 0.035, r 0.202 and age p 0.78, r 0.169 . In multivariate modeling modeling only once because once incorporated into the multivariate model only functions that staffing arrangements..."