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Building a culture of patient safety is the first step in the developmentof patient safety. Culture of patient safety in hospitals is part of the cultureof the organization, so that the assessment of organizational culture neededto be a guide in developing patient safety. This study aims to determine thepatient safety culture among providers in dr. H. Abdul Moeloek Lampungand identify organizational culture profile in the ranks of leadership.Descriptive study with qualitative interpretation and analysis of thestudy subjects took care providers and hospital management board, bydistributing questionnaires and implement the Consensus Decision MakingGroup (CDMG). The research instrument used questionnaires AHRQ(Agency for Heath Research and Quality) dividing the patient safety cultureto 1.) Cultural Openness, 2.) Cultural Justice, 3) Cultural Reporting, 4.)Cultural Learning, 5.) Cultural Information. While questionnairesOrganization Culture Assessment Instrument (OCAI) assesses six culturalcriteria, 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, especiallycooperation in the unit are the dimensions of patient safety culture isstrongest and dominant. While the non-punitive responses and recording theweakest dimension. Type Hierarki culture obtained as the dominant type oforganizational culture as well strong for the current and expected. It servesas a guide to select a quality improvement strategy through CompetingValue Framework in order to develop and increase patient safety. Follow-upplan prepared and agreed in the Consensus Decision Making Group(CDMG) to ground elements of patient safety in the vision and mission ofthe organization and strengthening a culture of safety through patient safetytraining for all staff. Blamming culture must gradually and significantlysoon be eliminated in all forms of service in hospitals.Keywords: Organizational Culture, Patient Safety Culture, Patient safety,Cultural Hierarchy, RSUD dr. H. Abdul Moeloek
Abstrak
Keselamatan pasien menjadi penting karena masih tingginya angka KTD di rumah sakit secara global maupun nasional. Di RSUD Sele Be Solu pada tahun 2011,dari 1.560 pasien rawat inap penyakit dalam yang dilakukan pemasangan infus sebanyak 1,9% mengalami phlebitis. Di ruang rawat inap anak RSUD Sele Be solu, kejadian phlebitis setelah pemasangan infus kurang dari 3 hari ditemukan sebanyak 8 pasien (20%) dari 40 pasien anak dan ada 11 pasien (61,1%) dari 18 pasien anak setelah lebih dari 3 hari pemasangan infus. Selama ini belum pernah dilakukan penilaian budaya keselamatan pasien di Rumah sakit Sele Be Solu. Tujuan penelitian ini adalah untuk mengetahui hubungan frekuensi pelaporan KTD dengan budaya keselamatan pasien oleh perawat di RSUD Sele Be Solu. Metode kuantitatif dengan pendekatan cross sectional, populasi adalah seluruh perawat di instalasi rawat inap sebanyak 110 orang. Pengumpulan data dengan menyebarkan kuesioner.
Hasil penelitian ada hubungan antara frekuensi pelaporan KTD dengan feedback dan komunikasi terhadap kesalahan, (p value = 0,018) besarnya hubungan dua kali lebih besar dibandingkan dengan kerjasaman dalam unit. Kesimpulan dari penelitian ini adalah masih rendahnya tingkat pelaporan KTD di RSUD Sele Be Solu Kota Sorong. Saran kepada pihak manajemen agar segera membentuk komite keselamatan pasien di rumah sakit dan menerapkan standar keselamatan pasien sesegera mungkin/
Patient safety become an important issue because adverse events are still in a high level at hospital globally and nationally. In 2011, at Interna ward of Sele Be Solu Sorong hospital, from 1.560 patients which had i.v line attached by nurses, 1,9% patients were had phlebitis. While at the pediatric ward, phlebitis events after i.v line was attached less than three days, 8 patients was found (20%) from 40 patients, and there were 11 patients (61,1%) from 18 children after 3 days of i.v line was attached. The patient safety culture in Sele Be Solu hospital was never been assessed. The purpose is to discover the relationship between adverse events frequency report and patient safety culture by nurses at Sele Be Solu hospital. Quantitative method was used in this study with cross sectional approached, population were all nurses at inward installation, which are 110 people. Data was gathered with questionnaire which had filled by nurses.
The result is there are relationship between adverse events report frequency activity with feedback and communication to the false (p value=0,018) and the relationship are double amounts higher than teamwork in the unit. Conclusion is the report activity of adverse event at Sele Be Solu hospital Sorong is low. Suggest to the hospital management is to form patient safety committee at hospital and set the patient safety standard procedure immediately.
Pelaporan kesalahan pelayanan merupakan usaha untuk memperbaiki sistem pelayanan dalam mencapai pelayanan yang aman. RSUD Kab Bekasi dalam mengembangkan program keselamatan pasien sejak tahun 2009, yang terlihat dari laporan tahunan program keselamatan pasien, terdapat indikasi perlunya peningkatan kesadaran setiap personil dalam melaporkan kesalahan pelayanan, termasuk perawat pelaksana di unit rawat inap rumah sakit. Penelitian ini bertujuan untuk mengukur persepsi perawat pelaksana dalam melaporkan kesalahan pelayanan serta mencari hubungannya dengan budaya keselamatan pasien, gaya kepemimpinan, dan kerja tim. Penelitian dirancang dengan disain cross sectional dengan menggunakan kuesioner sebagai alat ukur. Pengambilan data dilakukan pada bulan November 2011.Responden merupakan keseluruhan perawat pelaksana di unit rawat inap RSUD Kab. Bekasi dan didapatkan 77 kuesioner yang dapat dianalisa. Data yang diperoleh dianalisa secara univariat dan multivariat dengan menggunakan metode component based structural equation modeling dengan aplikasi komputer SmartPLS. Hasil penelitian menunjukkan budaya keselamatan pasien, gaya kepemimpinan, kerja tim dan persepsi pelaporan kesalahan pelayanan oleh perawat dalam penilaian sedang. Didapatkan pula adanya pengaruh baik secara langsung maupun tidak langsung budaya keselamatan pasien, gaya kepemimpinan, dan kerja tim terhadap persepsi pelaporan kesalahan pelayanan oleh perawat. Total pengaruh sebesar 89%. Persamaan linier yang didapat dari penelitian ini adalah persepsi pelaporan kesalahan = 0,12.budaya keselamatan pasien + 0,30.kepemimpinan transaksional ? 0,22.kepemimpinan transformasional + 0,37.kerja tim + 0,26. Dari penelitian ini dapat disimpulkan perlunya peningkatan faktor-faktor yang terbukti memberikan pengaruh positif terhadap peningkatan pelaporan dapat menjadi dasar usaha perbaikan. Terdapat pula faktor-faktor lain yang tidak masuk dalam model penelitian ini yang mempengaruhi perawat dalam melaporkan kesalahan pelayanan yang masih perlu digali agar pelaporan kesalahan pelayanan di masa depan dapat meningkat.
Reporting errors is an attempt to improve the system in achieving a safe service. From a report in 2010 in RSUD Kab. Bekasi seen that the number of cases or incidents reported has increased, but still needs to improve awareness of any personnel, including nurse in inpatient units. The aim of this study is to measure the nurse?s perception in the reporting of sevice delivery errors and to find a relationship between the behavior to other factors: patient safety culture, leadership style, and team work. This study was using cross-sectional design by questionnaire as a measuring tool. Data was collected in November 2011 from the entire nurse at the inpatient unit of the hospital as respondens. There are 77 questionnaires that can be analyzed. The data obtained were analyzed using multivariate methods by component-based structural equation modeling with computer applications SmartPLS. The results of this study suggest patient safety culture, leadership style, teamwork and the perception of service delivery error reporting by nurses are in intermediate conditions. It was found that there are relationship obtained either directly or indirectly from patient safety culture, leadership style, and teamwork to service delivery error reporting by nurses. This research model can explain the real state of 89%. Linier equation from this model is reporting perception = 0,12.patient safety culture + 0,30.transactional leader ? 0,22.transformational leader + 0,37.team work+ 0,26. From this study it can be concluded that factors that are proven to provide positive influence of this research can be the basis of improvement efforts. In addition, there are other factors that are not included in this study that should be considered that better reporting of medical errors.
Patient safety culture (PSC) is the application of patient care systems in theorganization which are reflected in the attitudes, behaviors, skills,communication, leadership, knowledge, responsibility, and values that exist inhealth care workers. This study aims to determine the organizational behaviorbased on the characteristics of individuals, groups and organizations on patientsafety culture by nurses on inpatient units in Hermina Hospital Daan Mogot(HHDM). The design of this study using cross-sectional method with respondentsfrom all (111) nurses on inpatient units in HHDM. Questionnaire data wereanalyzed using univariate, bivariate and multivariate analyzes. The resultsshowed the characteristics of an individual, group characteristics andorganizational characteristics of the PSC in HHDM is good. Results PSCinpatient nurses HHDM shows good value. Responsibility to be the only variablethat did not match while the leadership were most associated with PSC.Keywords: patient safety culture, patient safety, organizational behavior,individual characteristics, group characteristics, organizationalcharacteristics, nurse.
