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Dokumentasi keperawatan merupakan bukti dari pelaksanaan keperawatan yang menggunakan metode proses keperawatan, berisi tentang catatan respon pasien terhadap tindakan medis dan tindakan keperawatan serta merupakan indikator mutu asuhan keperawatan. Agar pelayanan keperawatan berkualitas maka perawat diharapkan dapat menerapkan asuhan keperawatan dengan pendokumentasian yang benar.
Penelitian ini bertujuan untuk menganalisis kelengkapan dokumen asuhan keperawatan terkait dengan faktor individu, faktor organisasi dan faktor psikologis, menggunakan metode kualitatif dengan teknik pengumpulan data observasi dan wawancara mendalam. Observasi memungkinkan peneliti mengamati langsung tantangan perawat dalam melengkapi dokumen pengkajian, diagnosa keperawatan, rencana tindakan, implementasi, evaluasi dan catatan keperawatan.
Hasil penelitian menunjukkan bahwa secara umum pengisisan kelengkapan dokumentasi asuhan keperawatan di rumah sakit Santo Antonio masih di bawah standar Depkes. Perawat sudah menyadari pentingnya pendokumentasian asuhan keperawatan. Kendala yang dihadapi antara lain kurangnya tenaga dan kurangnya fasilitas yang ada seperti petunjuk teknis pengisian dokumentasi asuhan keperawatan. Selain itu, belum pernah dilakukan pelatihan terkait dengan pendokumentasian asuhan keperawatan. Perawat memanfaatkan hasil dokumentasi sebagai materi komunikasi kemajuan kondisi pasien, namun dokter belum memanfaatkan secara maksimal hasil dokumentasi yang dibuat oleh perawat.
Saran dari penelitian ini adalah agar pihak manajemen memenuhi jumlah tenaga, mengadakan pelatihan dan seminar, membuat petunjuk teknis pengisian dokumentasi asuhan keperawatan, menerapkan supervise berjenjang serta membuat lembar catatan pasien yang terintegrasi dari seluruh tenaga kesehatan. Saran untuk Kemenkes adalah mengembangkan peraturan yang memberikan pemisahan yang jelas antara tugas dokter dan tugas perawat.
Nursing documentation is an evidence of the implementation of nursing, using the nursing process method, which is contains the report of the patients’ response to the medical and nursing care also an indicator of the nursing care quality. In order to support the nursing care quality, the nurse should applied itself with proper documentation.
The aim of this research is to analyze the completion of the nursing care document, in relation to the individual, organizational, and psychological factors by using qualitative methods such as observation and in-depth interviews. This study is allow to observed nurses challenges to complete the document, diagnose, treatment planning, implementation, evaluation and medical record.
The study revealed that nursing care document completion in Saint Antonio hospital is still below standard even the nurses realized the importance of documenting nursing care. Challenges were found are the nurses work load, no technical guideline for completing the nursing document, no trainings and no workshops for the nurses. Nurses are going to use the results of the documentation to discuss the progress of patient’s condition, but clinicians do not use it as expected.
The study suggests the management to increase the number of personnel, to held trainings and seminars for nurses, to develop technical guideline for nursing documentation, to implement head nurse’s supervision and also create an integrated record sheet based on various personal’s health. Recommendation for Ministry of Health is to provide regulation of clear duty of nurses and doctors.
Kata Kunci : Lean; Non Value Added; Proses pelayanan; Value Added; Waste.
The service process of old patient at outpatient poly services in Rumah Sakit Jantung Dan Pembuluh Darah Harapan Kita related to waiting time examination of the patients, it has not reached the target of minimum service standards for hospital less than 60 minutes. This resulted in services being inefficient. Lean method is a method that is expected to improve efficiency in service process on old patients at outpatient general services. Qualitative research by using the principles of Lean Thinking to illustrate the process flow patient service on old patients at outpatient general services, calculated cycle time and lead time and analyzed waste that occurs. The results of the study are described in the current state value stream mapping showed that 12% of the total time required for value added activities, while 88 % of total service time is the time spent on non-value added activities (Waste). Proposed improvements with Lean methods can reduce non-value added activity presentation.
Keywords: Lean; Non Value Added; Process service; Value Added; Waste
Kata kunci : Pasien rujukan JKN, optimalisasi pelayanan, konsep lean, waktu tunggu.
The phenomenon of high rates of referral of patients received by the hospital in theera of National Health Insurance resulted in a buildup of patients treated at the hospital . Oneconcept that can be used in the era JKN to be able to provide quality care for the patientsreferral to be more effective and optimal, cost efficiency and also oriented to value althoughwith limited budgets and resources faced by hospitals is to apply the concept of Lean inhealthcare.This study shows that the decisive factor is not optimal patient care referral JKN inpolyclinic are caused by long waiting time for medical record file, long waiting timespecialist doctors, and patients who accumulate and clump waiting queue. Based ReferralSystem Characteristics WHO, lack of human resources in medical records, physicianprofessionalism, lack of cooperation and communication pre references, completeinfrastructure facilities and supporting resources are inadequate, and incomplete applicationSIMRS also lead to non-optimal patient care referral JKN in polyclinic. Based on the CurrentState Value Stream Mapping, value added activities in the service only 7.32 % to 17.75 %,while the non-value added activity reached 82.25 % to 92.6 %. By cutting the service flow,eliminate waste were found, and implementation tools of Lean 5S, Visual Management, ErrorProofing , and Heijunka expected at Estimate Future State Value Stream Mapping will resultin reduced service time to 87 minutes , and increase value added activities until 34.95 % .
Key word : referral patient of JKN, optimization services, lean concept, waiting time.
Penelitian ini bertujuan untuk mengetahui hubungan bauran pemasaran (product, price, place, dan promotion) dan pemasaran spiritual (rabbâniyyah, al-insâniyyah, al- wâqi’iyyah, dan akhlâqiyyah) terhadap loyalitas pasien di Rumah Sakit Sari Asih Ciledug Tahun 2023 serta mengetahui pengaruh secara langsung dan secara tidak langsung dari variabel-variabel yang digunakan. Adapun dua variabel yang dicurigai berpengaruh terhadap loyalitas pasien rumah sakit bersertifikasi syariah adalah bauran pemasaran dan pemasaran spiritual dan dimediasi oleh kepuasan. Penelitian dilakukan di Rumah Sakit Sari Asih Ciledug yang telah tersertifikasi syariah sejak tahun 2018. Penelitian ini merupakan penelitian kuantitatif dengan pendekatan cross sectional. Pengumpulan data mengunakan kuesioner dengan jumlah responden sebanyak 145 pasien rawat inap dan diolah menggunakan SmartPLS 3. Semua variabel lolos dalam uji outer model, kemudian hasil dari inner model adalah adanya hubungan yang signifikan antara bauran pemasaran dengan loyalitas p-value 0,049 (p-value <0,05) dan kepuasan pasien p-value 0,003 (p- value <0,05) secara langsung serta loyalitas pasien dimediasi oleh kepuasan pasien p- value 0,026 (p-value <0,05). Sedangkan, pada pemasaran spiritual tidak terdapat hubungan yang bermakna terhadap loyalitas pasien secara langsung p-value 0,931 (p- value >0,05) dan bernilai negatif. Namun, hubungan pemasaran spiritual dengan kepuasan dan hubungan pemasaran spiritual yang dimediasi oleh kepuasan pasien menunjukkan hasil yang signifikan terhadap loyalitas dengan nilai p-value 0,000 (p-value <0,05). Terdapat hubungan antara kepuasan dengan loyalitas pasien di Rumah Sakit Sari Asih Ciledug p-value 0,000 (p-value <0,05). Semakin baik kepuasan pasien, maka akan meningkatkan loyalitas. Implikasi dalam penelitian ini dapat menjadi acuan dalam membangun loyalitas pasien dan memaksimalkan pemasaran di rumah sakit bersertifikasi syariah. Kata kunci: Bauran Pemasaran, Pemasaran Spiritual, Rumah Sakit Syariah, Kepuasan dan Loyalitas
The purpose of this study is to determine the relationship between marketing mix (product, price, place, and promotion) and spiritual marketing (rabbâniyyah, al- insâniyyah, al-wâqi’iyyah, and akhlâqiyyah) on patient loyalty at Sari Asih Ciledug Hospital in 2023, as well as to determine the direct and indirect effects of the variables used. The two variables suspected to influence patient loyalty in a sharia-certified hospital are marketing mix and spiritual marketing, mediated by satisfaction. The research was conducted at Sari Asih Ciledug Hospital, which has been sharia-certified since 2018. This study is a quantitative research with a cross-sectional approach. Data collection was done using a questionnaire with 145 inpatient respondents and analyzed using SmartPLS 3. All variables passed the outer model test, and the results of the inner model showed a significant relationship between marketing mix and loyalty with a p-value of 0.049 (p- value <0.05), as well as patient satisfaction with a p-value of 0.003 (p-value <0.05) directly, and patient loyalty mediated by patient satisfaction with a p-value of 0.026 (p- value <0.05). On the other hand, there was no significant direct relationship between spiritual marketing and patient loyalty with a p-value of 0.931 (p-value >0.05), and it had a negative value. However, the relationship between spiritual marketing and satisfaction, as well as the relationship between spiritual marketing mediated by patient satisfaction, showed significant results on loyalty with a p-value of 0.000 (p-value <0.05). There is a relationship between satisfaction and patient loyalty at Sari Asih Ciledug Hospital with a p-value of 0.000 (p-value <0.05). The better the patient satisfaction, the higher the loyalty. The implications of this study can serve as a reference for building patient loyalty and maximizing marketing in sharia-certified hospitals. Key words: Marketing Mix, Spiritual Marketing, Shariah Hospital, Satisfaction and Loyalty
