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"Latar Belakang:Mortalitas dan morbiditas pasien di rumah sakit masih tinggi akibat kurangnya keselamatan pasien. Strategi terpenting untuk meningkatkan keselamatan pasien adalah denganmembangun budaya keselamatan pasien. Tujuandari penelitian ini adalah untuk mengukur pengaruh model budaya positif keselamatan pasien “IDA” terhadap pelaksanaan keselamatan pasien di rumah sakit. Metode.Design adalahaction riset yang terdiri dari: Tahap pertama adalah identifikasi masalah, tahap kedua adalah pengembangan model, tahap ketiga evaluasi efektivitas model. Data dikumpulkan secara kuantitatif dan kualitatif. Kualitatif dengan FGD dan wawancara pada 26 pimpinan dihasilkan empat tema. Penelitian kuantitatif dengan menggunakan instrumen safety attitude questionnaire, quality and safety self efficacy scale, hospital survey on patient safety culture, safety motivation questionnaire scale, safety consciousness scale, dan kuesioner pelaksanaan keselamatan pasien. Tahap dua pengembangan model hasil dari elaborasi tiga teori dan penerapannya dilaksanakan pada 192 orang perawat pelaksana dan 18 orang kepala ruangan di tiga rumah sakit yang telah terakrediatsi paripurna. Tahap tiga diukur efektivitas model pada pelaksanaan keselamatan pasien pada 192 responden kelompok intervensi dan 191 responden kelompok kontrol, sampel diambil dengan cluster random sampling. Hasil Penelitian: Model budaya positif keselamatan pasien “IDA” berpengaruh terhadap dimensi individu: pengetahuan perawat, sikap, motivasi, kesadaran, safety self efficacydan pelaksanaan keselamatan pasien (p<0,05) dan terhadap dimensi individu kepala ruangan: pengetahuan dan sikap kepala ruangan (p<0,05). Pengaruh positif juga terhadap dimensi organisasi dan dimensi lingkungan. Sebagai dampaknya maka terdapat perbedaan secara bermakna pada sasaran keselamatan pasien sebelum dan setelah dilakukan intervensi model “IDA”. Model “IDA” juga diukur efektivitasnya terhadap kelompok kontrol dan semua variabel berbeda bermakna (p<0,05). Kesimpulan dan Saran: model “IDA” berpengaruh terhadap perilaku keselamatan pasien dan capaian sasaran keselamatan pasien oleh perawat. Model “IDA”perlu diterapkan dirumah sakit agar keselamatan pasien tercapai.

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Background: The mortality and morbidity of patients in the hospital are still high due to the lack of patient safety. The most important strategy for improving patient safety is to build a culture of patient safety. The purpose of this study was to measure the effect of a positive culture model of patient safety "IDA" on the implementation of patient safety in hospitals. Method.Design is an action research consisting of: The first stage is problem identification, the second stage is the development of the model, the third stage is the evaluation of the effectiveness of the model. Data were collected quantitatively and qualitatively. Qualitative with FGD and interviews with 26 leaders resulted in four themes. Quantitative research using the instrument safety attitude questionnaire, quality and safety self-efficacy scale, hospital survey on patient safety culture, safety motivation questionnaire scale, safety consciousness scale, and patient safety implementation questionnaire. The second stage of the development of the model results from the elaboration of three theories and its application was carried out on 192 implementing nurses and 18 heads of rooms in three hospitals who had been fully accredited. Stage three measured the effectiveness of the model in the implementation of patient safety in 192 respondents in the intervention group and 191 respondents in the control group, the sample was taken by cluster random sampling. Results: The positive culture model of patient safety "IDA" affects the individual dimensions: knowledge of nurses, attitudes, motivation, awareness, safety self efficacy and implementation of patient safety (p <0.05) and on the individual dimensions of the head of the room: knowledge and attitude of the head. room (p <0.05). The positive influence is also on the organizational and environmental dimensions. As a result, there are significant differences in patient safety goals before and after the "IDA" model intervention. The effectiveness of the "IDA" model was also measured against the control group and all variables were significantly different (p <0.05). Conclusions and suggestions: the "IDA" model affects the implementation and achievement of patient safety goals. The "IDA" model needs to be applied in hospitals so that patient safety is achieved."

"Contents : Key concepts in patient safety -- Keeping the patient safe -- Safety improvement is in professional practice -- Safety improvement is in systems -- Safety improvement is achieved within organizations -- Culture of safety in healthcare settings -- Why things go wrong -- What to do when things go wrong -- Safe patient care systems -- The use of evidence to improve safety."

"Tesis ini membahas mengenai kejadian tidak diharapkan (adverse event) yang tejadi di Unit Gavvat Darurat RS Bhineka Bakti Husada bulan Oktober-November 2009. Bertujuan untuk mengetahui faktor-faktor kontribusi yang mempengaruhi kejadian tidak diharapkan tersebut yang bennanfaat bagi rumah sakit untuk mengelola manajemen risiko dengan memberikan pelayanan yang aman danmengutamakan keselarnatan pasien Upaya maminirnalkan resiko akan melindungi rumah sakit dari tuntutan yang meninglcat terhadap rumah sakit akhir-akhir ini. Penelitian ini adalah penelitian kualitatif dengan desain deskriptif analitik. Kesimpulan penelitian memberikan gambaran factor kontribusi langsung maupun tidak langsung yang mempengaruhi kej adian tidak diharapkan Saran untuk rumah salcit untuk meningkatkan upaya pengelolaan manajemen risiko melalui peningkatan lrualitas pelayanan dan peran serta staf.

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The thesis works through the adverse event occuring in the Emergency Care Unit of Bhineka Bakti Husada Hospital in October - November 2009. It is purposed to find out the contribution factors having an affect on the adverse event which are advantageous for the hospital to handle risk management with giving secure service and accentuating its patients safety. The effort to risk will protect from the claims to the hospital which have beet increasing recently. This research is a qualitative research with analytically descriptive design Its conclusion describes either direct or indirect contribution factors which affect adverse event The suggestion for the hospital is to increase risk management effort with improving its quality and staff role."

"Pendahuluan: Keselamatan pasien merupakan suatu sistem yang menjamin pasien aman dari insiden. Perawat sebagai bagian dari sistem pelayanan kesehatan wajib menerapkan sasaran keselamatan pasien (SKP). Dibutuhkan instrumen yang bersifat proaktif mencegah insiden. Penelitian ini bertujuan untuk mengembangkan instrumen faktor prediktor kepatuhan perawat dalam melaksanakan SKP di rumah sakit. Metode: Tahap 1 merupakan pengembangan item instrumen dengan 3 fase: wawancara, expert judgement, dan uji keterbacaan. Tahap 2 yakni uji validitas dan reliabilitas instrumen dengan pendekatan cross sectional menggunakan dua analisis data, yakni Confirmatory Factor Analysis (CFA) dan regresi linier berganda. Partisipan dalam fase wawancara menggunakan perawat pelaksana dan perawat manajer. Uji validitas dan reliabilitas instrumen melibatkan perawat pelaksana dengan jumlah sampel 100 responden. Variabel dependen yakni kepatuhan perawat dalam melaksanakan SKP di rumah sakit. Hasil: Sebanyak 16 faktor dan 63 item dihasilkan dari tahap 1 penelitian. Uji CFA menyebutkan bahwa seluruh faktor, termasuk variabel kepatuhan perawat dalam melaksanakan SKP dinyatakan valid dan reliabel dengan model yang dinyatakan dalam rentang good fit hingga perfect fit. Hasil analisis regresi linier pada uji t menyimpulkan bahwa hanya delapan faktor yang memiliki pengaruh terhadap kepatuhan, antara lain: sarana prasarana, kesadaran diri, niat, professional habit, komitmen, imbalan, kepemimpinan, serta tuntutan dan reputasi rumah sakit. Pada uji f menyimpulkan bahwa semua faktor tersebut menghasilkan 51,1% potensial memengaruhi kepatuhan perawat. Saran: Manajer keperawatan rumah sakit direkomendasikan untuk menggunakan instrumen ini untuk memperkuat sistem pencegahan insiden oleh perawat pelaksana.

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Introduction: Patient safety is a system that ensures patients are safe from incidents. Nurses, as part of the health service system, are obliged to implement patient safety targets (SKP). We need instruments that are proactive in preventing incidents. This research aims to develop an instrument for predicting factors of nurse compliance when implementing SKP in hospitals. Method: Stage 1 is the development of instrument items with 3 phases: interview, expert judgment, and readability test. Stage 2 is testing the validity and reliability of the instrument with a cross-sectional approach using two data analyses, namely confirmatory factor analysis (CFA) and multiple linear regression. Participants in the interview phase were nurse practitioners and nurse managers. Testing the validity and reliability of the instrument involved implementing nurses with a sample size of 100 respondents. The dependent variable is nurses' compliance with implementing SKP in hospitals. Results: A total of 16 factors and 63 items were generated from phase 1 of the research. The CFA test states that all factors, including the nurse compliance variable in implementing SKP, are declared valid and reliable with the model stated in the range of good fit to perfect fit. The results of the linear regression analysis on the t test concluded that only eight factors had an influence on compliance, including: infrastructure, self-awareness, intention, professional habit, commitment, rewards, leadership, as well as hospital demands and reputation. The f test concluded that all these factors produced 51.1% of the potential to influence nurse compliance. Suggestion: Hospital nursing managers are recommended to use this instrument to strengthen the incident prevention system by implementing nurses."

"Keselamatan pasien di rumah sakit masih menjadi isu krusial yang mendunia, karena rumah sakit merupakan institusi jasa pelayanan yang mengupayakan kesembuhan pasien. Maka keselamatan pasien menjadi suatu keniscayaan, diharapkan tidak terjadi insiden keselamatan pasien (zero insiden). Salah satu cara untuk mengendalikan peningkatan angka insiden di rumah sakit adalah dengan memanfaatkan sistem pelaporan. Penelitian ini membahas mengenai gambaran pelaporan insiden keselamatan pasien di rumah sakit di Indonesia beserta faktor-faktor yang memengaruhinya, ditinjau dari faktor individu, organisasi, dan pemerintah. Tujuan penelitian ini adalah didapatkannya informasi mengenai faktor-faktor yang brpengaruh terhadap pelaporan insiden keselamatan pasien di rumah sakit di Indonesia. Penelitian ini menggunakan metode literature review dengan basis data Garuda Kemendikbud, Rama Kemendikbud, Directory of Open Acces Journals (DOAJ), Library UI, Science Direct, PubMed, ProQuest, dan Scopus. Hasil penelitian didapatkan bahwa rumah sakit di Indonesia sudah memiliki regulasi yang mengatur mengenai pelaporan insiden kselamatan pasien. Sistem pelaporan yang digunakan masih berbasis manual, dan praktik pelaporan belum bisa dikatakan sukses karena masih adanya budaya menghukum, jaminan kerahasiaan pelapor masih diragukan, pelaporan belum tepat waktu, dan umpan balik masi minim. Dari hasil penelitian juga diperoleh faktor yang dapat memengaruhi pelaporan insiden keselamatan pasien di rumah sakit adalah faktor individu (pengetahuan, ketakutan, beban kerja, dan motivasi), faktor organisasi (umpan balik, sistem pelaporan, kerahasiaan, sosialisasi dan pelatihan, serta budaya keselamatan), dan faktor pemerintah dalam hal kebijakan.

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Patient safety in hospitals is still a crucial issue worldwide, because hospitals are service institutions that seek to cure patients. So patient safety becomes a necessity, it is hoped that there will be no patient safety incidents (zero incidents). One way to control the increasing number of incidents in hospitals is to utilize a reporting system. This study discusses the description of patient safety incident reporting in hospitals in Indonesia and the factors that influence it, in terms of individual, organizational, and government factors. The purpose of this study was to obtain information about the factors that influence the reporting of patient safety incidents in hospitals in Indonesia. This study uses a literature review method with the Garuda Ministry of Education and Culture database, Rama Kemendikbud, Directory of Open Acces Journals (DOAJ), UI Library, Science Direct, PubMed, ProQuest, and Scopus. The results showed that hospitals in Indonesia already have regulations governing patient safety incident reporting. The reporting system used is still manual-based, and reporting practices cannot be said to be successful because there is still a punitive culture, guarantees for the confidentiality of whistleblowers are still in doubt, reporting is not timely, and feedback is still minimal. From the results of the study, it was also found that the factors that can affect the reporting of patient safety incidents in hospitals are individual factors (knowledge, fear, workload, and motivation), organizational factors (feedback, reporting systems, confidentiality, socialization and training, and safety culture), and government factors in terms of policy."

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"Institusi rumah sakit seperti rumah sakit didesak untuk mengevaluasi budaya keselamatan pasien mereka untuk meningkatkan keselamatan, kualitas perawatan, dan penyembuhan pasien. Tujuan dari penelitian ini untuk mendapatkan gambaran budaya keselamatan pasien di antara perawat rawat inap di rumah sakit Hermina. Penelitian ini menggunakan cross-sectional dengan metode deskriptif kuantitatif dengan analisis data univariat menggunakan penelitian menggunakan instrumen kultur keselamatan pasien rumah sakit oleh AHRQ. Hasil penelitian menunjukkan ada empat budaya yang kuat (lepas tangan dan transisi, persepsi perawat terkait dengan keselamatan pasien, pembelajaran organisasi, umpan balik dan komunikasi kesalahan), empat budaya menengah (pelaporan insiden frekuensi, dukungan manajemen keselamatan pasien, keterbukaan komunikasi, kerja tim dalam unit), dan satu budaya lemah (staf). Secara keseluruhan, penelitian ini menunjukkan bahwa gambaran budaya keselamatan pasien di rumah sakit Hermina adalah budaya sedang. Perbaikan Suggesterd diperlukan dalam setiap dimensi budaya keselamatan pasien terutama dalam budaya yang lemah.

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Hospital institutions such as hospitals are urged to evaluate their patient safety culture to improve patient safety, quality of care, and healing. The purpose of this study was to obtain a picture of patient safety culture among inpatients at Hermina Hospital. This study uses cross-sectional quantitative descriptive methods with univariate data analysis using research using hospital patient safety culture instruments by AHRQ. The results showed that there were four strong cultures (hands off and transition, nurses' perceptions related to patient safety, organizational learning, feedback and communication errors), four intermediate cultures (frequency incident reporting, patient safety management support, communication openness, teamwork in unit), and one weak culture (staff). Overall, this study shows that the culture of patient safety in Hermina Hospital is a medium culture. Suggesterd improvement is needed in every dimension of patient safety culture, especially in a weak culture."

"Membangun budaya keselamatan pasien merupakan langkah awal dalam pengembangan keselamatan pasien. Budaya keselamatan pasien di rumah sakit merupakan bagian dari budaya organisasi, sehingga pengkajian tentang budaya organisasi diperlukan untuk menjadi panduan dalam mengembangkan keselamatan pasien. Penelitian ini bertujuan mengetahui budaya keselamatan pasien di kalangan pemberi pelayanan di RSUD dr. H. Abdul Moeloek Provinsi Lampung dan mengidentifikasi profil budaya organisasi pada jajaran pimpinannya. Penelitian deskriptif dengan interpretasi dan analisis kualitatif ini mengambil subyek penelitian para pemberi pelayanan dan jajaran manajemen rumah sakit, dengan cara menyebarkan kuesioner dan melaksanakan Consensus Decision Making Group (CDMG). Instrumen penelitian menggunakan kuesioner AHRQ (Agency for Heath Research and Quality) membagi budaya keselamatan pasien menjadi 1.) Budaya Keterbukaan, 2.) Budaya Keadilan, 3.) Budaya Pelaporan, 4.) Budaya Belajar, 5.) Budaya Informasi. Sedangkan kuesioner Organization Culture Assesment Instrument (OCAI) menilai 6 kriteria budaya yaitu 1.) Karakter Dominan, 2.) Kepemimpinan Organisasi, 3.) Manajemen Karyawan, 4.) Perekat Organisasi, 5.) Penekanan Strategis, 6.) Kriteria Keberhasilan. Budaya organisasi terbagi menjadi Tipe Clan, Adhocrazy, Market dan Hierarki. Hasil penelitian mendapatkan bahwa budaya keterbukaan, terutama kerjasama dalam unit merupakan dimensi budaya keselamatan pasien yang terkuat dan dominan. Sedangkan respons non punitive dan pencatatan merupakan dimensi yang terlemah. Tipe budaya Hierarki didapatkan sebagai tipe budaya organisasi yang dominan sekaligus kuat untuk saat ini dan yang diharapkan. Hal ini menjadi panduan untuk memilih strategi peningkatan mutu melalui Competing Value Framework dalam rangka pengembangan dan peningkatan keselamatan pasien. Rencana tindak lanjut dibuat dan disepakati dalam Consensus Decision Making Group (CDMG) untuk membumikan unsur keselamatan pasien dalam visi dan misi organisasi serta penguatan budaya keselamatan melalui pelatihan keselamatan pasien bagi seluruh staf. Blamming culture harus secara perlahan dan signifikan segera dihilangkan dalam semua bentuk pelayanan di rumah sakit.

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Building a culture of patient safety is the first step in the development of patient safety. Culture of patient safety in hospitals is part of the culture of the organization, so that the assessment of organizational culture needed to be a guide in developing patient safety. This study aims to determine the patient safety culture among providers in dr. H. Abdul Moeloek Lampung and identify organizational culture profile in the ranks of leadership.

Descriptive study with qualitative interpretation and analysis of the study subjects took care providers and hospital management board, by distributing questionnaires and implement the Consensus Decision Making Group (CDMG). The research instrument used questionnaires AHRQ (Agency for Heath Research and Quality) dividing the patient safety culture to 1.) Cultural Openness, 2.) Cultural Justice, 3) Cultural Reporting, 4.) Cultural Learning, 5.) Cultural Information. While questionnaires Organization Culture Assessment Instrument (OCAI) assesses six cultural criteria, namely 1.) Dominant character, 2) Organizational Leadership, 3) Employee Management, 4.) Adhesive Organization, 5.) Strategic Emphasis, 6.) Success Criteria. Organizational culture is divided into Type Clan, Adhocrazy, Market and Hierarchy.

Results of the study found that a culture of openness, especially cooperation in the unit are the dimensions of patient safety culture is strongest and dominant. While the non-punitive responses and recording the weakest dimension. Type Hierarki culture obtained as the dominant type of organizational culture as well strong for the current and expected. It serves as a guide to select a quality improvement strategy through Competing Value Framework in order to develop and increase patient safety. Follow-up plan prepared and agreed in the Consensus Decision Making Group (CDMG) to ground elements of patient safety in the vision and mission of the organization and strengthening a culture of safety through patient safety training for all staff. Blamming culture must gradually and significantly soon be eliminated in all forms of service in hospitals."