"Latar belakang: Empat puluh sampai enam puluh satu persen dari pelayanan di rumah sakit adalah pelayanan keperawatan yang diberikan pada rawat jalan dan rawat inap. Mutu asuhan keperawatan yang diberikan melalui pendekatan proses keperawatan merupakan barometer baik buruknya pelayanan kesehatan di rumah sakit. Proses keperawatan yang diterapkan sebagai pendekatan penyelesaian masalah di RSJHK Jakarta belum baik sekitar 50,5% (pengamatan Tim audit kep, 2000), yang menyebabkan masalah keperawatan klien diselesaikan tidak secara tuntas. Penelitian ini bertujuan memperoleh gambaran hubungan karakteristik perawat, karakteristik pekerjaan dan karakteristik situasi pekerjaan dengan pelaksanaan proses keperawatan di RSJHK Jakarta.
Disain dan metodologi. Penelitian ini termasuk jenis penelitian deskriptif analitik dengan desain cross sectional. Data yang digunakan adalah data primer dan responden. Sampel 134 perawat pelaksana. Pengolahan data dengan analisis univariat, analisis bivariat dengan Uji Chi Square Tingkat kemaknaan 95%.
Hasil. Didapatkan: umur rata-rata perawat 31 tahun, 79,1% perempuan, lama kerja rata-rata 8 tahun, 56% telah kawin, 91,8% dengan latar belakang pendidikan DIII Keperawatan dan seluruhnya telah mendapat pendidikan tambahan, 70,9% perawat dengan tingkat tanggung jawab perawat pelaksana, .88,8 % ada bimbingan teknis dari perawat senior dan 69,4% ada supervisi kepala ruangan dalam pelaksanaan proses keperawatan. Proses keperawatan belum termasuk kategori baik dengan cut off point 80% disebabkan oleh: belum mengikuti pelatihan pelaksanaan proses keperawatan, kurang pemahaman, kurang tenaga, beban kerja berat, proses keperawatan menyita waktu, tugas lain selain tugas pokok, tidak ada bimbingan, arahan, evaluasi dan umpan balik dari kepala ruangan. Analisis bivariat didapatkan 9 dari 10 variabel yang diteliti tidak berhubungan secara bermakna dengan pelaksanaan proses keperawatan, namun mempuayai hubungan yang positif dengan pelaksanaan proses keperawatan kecuali pendidikan formal dan tingkat tanggung jawab. Hal ini diasurnsikan karena tuntutan tugas terhadap sumberdaya keperawatan dengan tingkat pendidikan lebih tinggi tidak ada perbedaan dengan perawat dari latar belakang pendidikan yang lebih rendah, sehingga tidak ada tantangan untuk bekerja lebih baik. Demikian juga dengan tingkat tanggung jawab antara perawat pelaksana dan ketua tim, didapatkan tidak ada perbedaan tuntutan tanggung jawab dalam pelaksanaan proses keperawatan. Supervisi kepala ruangan berhubungan bermakna secara statistik dengan pelaksanaan proses keperawatan dengan a = 0,04.
Kesimpulan: Dari penelitian ini dapat disimpulkan bahwa pelaksanaan proses keperawatan di ruang rawat inap RSJHK Jakarta belum termasuk kategori baik (<80%). Pengkajian, Perencanaan dan Evaluasi berkisar antara 73% - 77% sedangkan diagnosa dan implementasi masing-masing 80,3% dan 89,4%. Persentase rata-rata proses keperawatan 78,2%, lebih tinggi dari hasil pengamatan tim audit keperawatan terhadap pelaksanaan proses keperawatan (50,5%) pada tahun 2000. Ditemukan supervisi kepala ruangan berhubungan bermakna secara statistik dengan pelaksanaan proses keperawatan pada a < 0,05.
Saran: Mengacu pada kesimpulan, peneliti menyarankan agar bidang keperawatan sebaiknya mengevaluasi kinerja kepala ruangan dalam pelaksanaan supervisi kegiatan pelaksanaan proses keperawatan yang dilakukan perawat pelaksana di ruang rawat inap RSJHK Jakarta. Agar kepala ruangan meningkatkan kegiatan supervisi berupa birnbingan, arahan dan evaluasi terhadap kegiatan pelaksanaan proses keperawatan yang dilakukan oleh perawat pelaksana.
Analysis of Factors Relate To the Implementation of Nursing Process in Inpatient Room of the Rumah Sakit Jantung Harapan Kita JakartaIntroduction: Forty to sixty one percent of hospital services are nursing services which is provided in to inpatients and outpatients. The quality of nursing care which is delivered by nursing process as an approach is a barometer of health services in the hospital. The nursing process as an approach to solve the nursing problem in the RSJHK Jakarta has done up to about 50.5% (Observation of the Nursing Audit Team, 2000) that may lead to incomplete solution of the client problems. The purpose of this study was to get the correlations of nursing, work and work-environment characteristics and the implementation of nursing process in the RSJHK Jakarta.
Design and Methodology: This study was the descriptive-analytic research with cross-sectional design. The data used were primary data. Sample involved 134 nursing staffs. The univariat and bivariat analysis were applied for this study. The level of significance was 95%.
Results: The average of age of the nurses was: 31 years, 79.1% of them were females, the average of work experience was 8 years, 56% were married, 91.8% educational background of the nurse were DIII of Nursing and all of them got extra education, 70.9% of them were nurses staff, 88.8% got technical guidance from senior nurses and 69.4% got supervision from Head Nurse in the implementation of nursing process. The nursing process does not at good category with cut off point 80% because-of: did not get nursing process training, lack of understanding about the nursing process, lack of nursing staff heavy work load, time-consuming, have extra duty other then nursing duty, no counseling, guidance, evaluation and feed-back from the Head Nurse. From Bivariat analysis 9 of 10 variables were not had a significant correlation with the implementation of nursing process, but have a positive correlation with implementation of nursing process except for formal education and level of responsibility. It was assumed that because of no difference between the duties of nursing staff with high and low level educational background, so there were not challenges for working better of them. Moreover, there were not differences between the responsibilities of nursing staff with team leader in concern of implementation of nursing process. Supervision of Head nurse has significantly correlation statistically with the implementation of nursing process which was; a = 0.04.
Conclusions: From this study there was a conclusion that the implementation of nursing process at Inpatients Room of RSJHK Jakarta was not in good category (<80%). Assessment, Planning and Evaluation range between 73% - 77%, diagnosis was 80.3% and evaluation was 84.9%_ Average percentage of the nursing process was 78.2%, it was higher than the Nursing Audit Team observation in the year 2000 that is just 50.5%. It was also found that supervision of the Head Nurse has a significant correlation statistically with the implementation of nursing process, which was a< 0.05.
Suggestions: Base on the conclusions, the researcher suggest that the Nursing Department should evaluate the Head Nurse performance of the head nurse in giving supervision to the nursing staffs in the implementation of nursing process at Inpatients Room of RSJHK Jakarta. There for, the Head Nurse should improve the activity in relation to the supervision of nursing staff in implementation of nursing process such as guidance, counseling, and evaluation."
