Praktik klinik Keperawatan merupakan proses pembelajaran yang perlu mendapat perhatian dan upaya peningkatan agar menghasilkan lulusan D II] Keperawatan yang bermutu. Untuk mengetahui mutu proses praktik klinik dapat dilihat dad kemampuan pembimbing institusi dan instmktur klinik, penggunaan peralatan, pengunaan metode, penggunaan bahan dan Iingkungan praktik klinik.Tujuan penelitian adalah untuk memperoleh infomtasi tentang rendahnya mutu praktik klinik Keperawatan , populasi peneiitian adalah sernua Mahasiswa Akper Depkes Jambi tingkat H dan tingkat III yang telah mengikuti praktik klinik (total sampel). Penelitian merupakan penelitian kuantitatif dengan rancangan cross sectional data dikumpulkan melalui wawancara menggunakan kuesioner kepada responden mahasiswa tingkat II dan tingkat III.Hasil penelitian memberikan informasi bahwa sebagian besar pencapaian kompetensi kurang baik temtama unit mata ajaran Keperawatan Kesehatan Ibu (unit 214)) dan unit mata ajaran Keperawatan Kesehatan Anak (unit 321) serta Keperawatan Kesehatan Mental Psikiatri (unit 322). Kemampuan lnstruktur Klinik, penggunaan metode praktik , penggunaan bahan praktik dan lingkungan praktik sebagian besar kurang baik pada mala ajaran Keperawatan semua tingkat usia (unit 217), sedangkan kemampuan pembimbing institusi, penggunaan metode praktik dan lingkungan praktik sebagian besar kurang baik pada mata ajaran Keperawatan Medikal Bedah (unit 320), dan penggunaan peralatan praktik sebagian besar kurang baik pada mata ajaran Keperawatan Kesehatan Komuniti (unit 213), mata ajaran Keperawatan Medikal Bedah (unit 320) dan keperawatan Kesehalan anak (unit 321).Kesimpulan penelitian adalah bahwa di tingkat III kernampuan pembimbing institusi yang kurang baik merupakan faktor yang berhubungan dengan rendahnya pencapaian mutu praktik klinik, sedangkan di tingkat II faktor penggunaan metode, penggunaan bahan praktik dan pengunaan peralatan yang kurang baik secara bersama berhubungan dengan rendahnya mutu praktik.Kepada Kepala Pusat Pendidikan Tenaga Kesehatan Depkes RI disarankan agar pelatihan bimbingan klinik menjadi salah satu prioritas program, selain tetap memperhatikan alokasi anggaran untuk penambahan peralatan praktik. Disamping itu pengelola institusi Politeknik Kesehatan Depkes Jambi Jumsan Keperawatan agar melakukan pertemuan berkaia guna meningkatkan mutu proses praktik klinil.

Nursing Clinic practice is a leaming process that needs attention and improvement effort as to produce a qualified nursing diploma III graduate. ln order to lind the quality of clinic practice, it can be seen from the capability ofthe institution supervisor and clinic instructor, the use of tools, the use of method, the use of material and clinic practice environment.The purpose of this research is to gain information about the cause ofthe low quality of nursing clinic practice, the population of the research is all students on second and third grade of Nursing Academy Department of Health Jambi, who have passed through clinic practice, sampling was not done because all students on second and third grade become research respondent. The research is a quantitative research using cross sectional design; data is gained by interview lo students on second and third grade respondent by using questionnaire.The result of the research infomis that, most of competence achivement are not good enough, mostly in the subject of Mgjhgfs Health Nursing (unit 214) and, Paediatric Nursing (unit 321), and Psvchiatric Mental Nursing (unit 322). 'lite ability of clinic instructor, the use of practice method, practice material and practice environtment are not good enough, mostly in the subject All Ages Nging (unit 217), otherwise the ability of institution instructor, the use of practice method and practice environtment are not good enough, mostly in Surggg Medical Nursing (unit 320), while the use of pratice tools is mostly not good enough in the subject of Community Health Nursing (unit 213), Surgery Medical Nursing (unit 320), and Paediatric Nursing (unit 321)The conclusion of the research is that on the third grade, the ability of institution supervisor which is not good enough is a related factor with the low achievement of clinic practice quality, while on the second grade, factor of method using, practice material using, and tools using which are not good enough, have caused the low of clinic practice quality.The researcher suggested that the Head of Medical Staff Education Centre Department of Health Rl makes clinic guidance training to be one of program priority, and also keep giving attention to budget allocation to the practice tools addition. Moreover, the management of the institution Health Polytechnic Department of Health Jambi majoring in Nursing should hold liequent meeting as to improve the quality of clinic practice activity process.

Penerapan Pengembangan Manajemen Kinerja (PMK) bidan di puskesmas ini diharapkan dapat meningkatkan pengetahuan dan keterampilan bidan; kepatuhan penggunaan standar dalam melakukan pelayanan kebidanan; kemampuan manajerial pelayanan kebidanan; pelaksanaan monitoring kinerja; mutu asuhan kebidanan. Penerapan PMK ini diharapkan dapat berperan untuk tercapainya indikator Sistem Pelayanan Minimal (SPM) Kabupaten/Kota yang dilaksanakan bidan di sarana kesehatan, mengingat bidan sebagai ujung tombak pelayanan kesehatan dengan jumlah yang cukup besar (40%) dari seluruh kategori tenaga kesehatan. Dalam penerapan Pengembangan Manajemen Kinerja bidan di rumah sakit dan puskesmas diawali dengan pelatihan. Pelatihan ini ditujukan pada bidan koordinator, dengan harapan bidan koordinator dapat memberikan kiat-kiat dalam memberikan pengarahan, bimbingan, dan sekaligus menilai kinerja staf secara obyektif. Scsuai dengan Kepmenkes no. 8361Menkes/SKIVI12005, pada pelatihan tersebut ditekankan pada penguasaan lima komponen PMK yaitu standar, uraian tugas, indikator kinerja, sistem monitoring, dan Refleksi Diskusi Kasus. Penelitian ini dilakukan untuk melihat gambaran sejauh mana penerapan PMK bidan di Puskesmas dengan pendekatan sistem. Penelitian ini menggunakaii pendekatan kuantitatif dengan bidan yang telah mendapat pelatihan PMK dan telah menerapkan PMK bidan di puskesmas tempat bekerja yang berjumlah 33 orang dari lima puskesmas. Juga dilakukan pendekatan kualitatif melalui wawancara mendalam pada lima pimpinan dan bidan koordinator puskesmas yaitu di puskesmas Curup, Kampung Delima, Perumnas, Tunas Harapan, dan Sambirejo serta dilakukan telaah dokumen terhadap penerapan PMK bidan di puskesmas. Hasil penelitian antara lain: (1) Faktor masukan penerapan PMK bidan berupa uraian tugas, Standard Operational Procedure (SOP), pendidikan dan latihan, semua bidan puskesmas (100%) telah ada dan dilaksanakan dcngan baik, hanya variabel penerapan sistem penghargaan ada yang masih buruk di puskesmas (48.5%). (2) Faktor proses penerapan PMK bidan di Puskesmas berupa kegiatan pendokumentasian kegiatan dimana semua bidan (100%) telah melaksanakan dengan baik dan sesuai dengan telaah dokumen, sedangkan pemantauan dan pengendalian kegiatan umumnya sudah baik (66.7%), dan masih ada yang buruk (33.3%), pertemuan strategis umumnya juga sudah baik (72.7%) dan yang masih buruk (27.3%), kegiatan Refleksi Diskusi Kasus (RDK) umumnya sudah baik (63.6%) dan masih buruk (36.4%). (3) Faktor luaran penerapan PMK bidan di Puskesmas yaitu manajemen kinerja bidan umumnya sudah baik di puskesmas (57.6%), yang masih buruk (42.4%). Kesimpulan akhir dari penelitian ini adalah bahwa penerapan Pengembangan Manajemen Kinerja bidan di puskesmas umumnya sudah baik, hanya beberapa variabel saja penerapannya yang masih buruk dan perlu ditingkatkan lagi. O1eh karena itu, peneliti mencoba memberikan rekomendasi kepada: (1) Pemerintah Daerah untuk memberikan dukungan pelaksanaan setiap komponen program PMK bidan, menyetujui usulan program Dinas Kesehatan untuk melaksanakan pelatihan PMK kepada bidan yang belum mendapat pelatihan. (2) Kepala Dinas Kesehatan supaya melakukan tindak lanjut dari penerapan program PMK, seperti melakukan monitoring PMK setiap 3 bulan sekali, memberikan pelatihan penerapan PMK kepada bidan yang belum dilatih, dan diharapkan semua puskesmas di kabupaten Rejang Lebong dapat menerapkan PMK (3) Kepada Pimpinan Puskesmas supaya menyusun indikator kinerja bidan untuk keperluan monitoring dan penilaian kinerja, menilai kinerja bidan puskesmas minimal 1 tahun sekali dan memberikan penghargaan sebagai umpan balik.

The Application Of Management Performance Development o: Midwife in health center is expected improve the midwife's knowledge and skill; compliance of usage in midwifery service standard; ability of midwifery service managerial; execution of performance monitoring; midwifery care quality, while expectation of Development Of Management Performance contribute to reach a Minimum Service System indicator in the District City which is executed and midwife in health place, considering midwife as part of health service with high amount (40%) from all of health worker category. The Application Of Management Performance Development in hospitals and health centers started with training. This Training is addressed for the coordinator midwife in health center, while the expectation of the coordinator midwife is to give suggestions in guidance, teaching, tuition, and at the same time to assess stair performance objectively. According to Kepmenkes No. 836 / Menkes / SK / VI / 2005, this training emphasized five components: standard, job description, performance indicator, monitoring system, and reflection cased discussion (RCD). This research is done to give an assessment and to describe how far the application of Development Of Management Performance of midwife in Health Center is done. This research applying the quantitative method to midwife as respondents who work in a health center which have applied the Development Of Management Performance, they are 33 midwife from five health centers. This research is also done by a qualitative method through interview for five leaders of health center and midwife coordinator, such as Curup Health Center. Kampung Delima, Perumnas, Tunas Harapan, and Sambirejo and also analyze document for applying Development 0C Management Performance midwife in health center. Research results include: (I) Input factor for applying Development Of Management Performance midwife, such as job description, SOP, and training and fellowship for all of Health Center midwives (100%) arc done well available with duty in Health Center, but applying of appreciation system variable is not good (48.5%). (2) Process factor for applying Development of Management Performance Midwife in Health Center such as activity of documentation where all midwives (100%) have done this matter based on document study by Researcher, while monitoring activity generally is good (66.7%), the other is bad (33.3%), strategic meeting generally is so good (72.7%) and the other is bad (27.3%), Reflection Case Discussion (RCD) activity generally is good (63.6%) and the other is bad (36.4%). (3) Output factor for applying Development of Management Performance Midwife in Health Center that is midwife performance management generally is good in Health Center (57.6%), the other management is bad (42.4%). The conclusion of this research is that applying development of midwife performance management in health center generally is good, there just some variables which is bad. Therefore, researcher try to give recommendation for: (I) Local Government, giving support the application of Management Performance Development of midwife in health center, approve proposal of District Health Office program to doing Development Of Management Performance training for midwife who does not get training yet. (2) Head of District Health Office: should follow-up program of Management Performance Development, such as monitoring every 3 months once, doing training of Management Performance Development For midwife who have not been [rained yet, and expected that all health center in Rejang Lebong district can applying the Management Performance Development of midwife. (3) Health Center leader, monitoring and performance assessment minimally 1 year once to assess midwife performance in Health Center and give appreciation as feed back.