PENINGKATAN UPAYA PATIENT-CENTERED CARE (PCC) OLEH PERAWAT MELALUI OPTIMALISASI PERAN PERAWAT PENANGGUNG JAWAB ASUHAN (PPJA)

Pelayanan yang berpusat kepada pasien merupakan inti dari mutu pelayanan kesehatan di rumah sakit. Perawat memiliki peran penting dalam menjaga mutu kualitas asuhan pelayanan bagi pasien. Perawat Penanggung Jawab Asuhan (PPJA) harus memiliki kompetensi yang unggul agar dapat memberikan asuhan terbaik selama 24 jam bagi pasien. Pengabdian masyarakat ini bertujuan untuk meningkatkan pengetahuan perawat tentang konsep PCC dan peran PPJA. Metode yang digunakan dalam pengabdian masyarakat antara lain metode ceramah, tanya jawab dan pemodelan. Kegiatan pengabdian masyarakat ini dilakukan melalui Zoom CloudMeeting serta melibatkan 227 perawat dari beberapa rumah sakit. Melalui kegiatan abdimas ini diharapkan perawat PPJA mampu menerapkan asuhan keperawatan yang berpusat kepada pasien sehingga mutu layanan keperawatan semakin meningkat.Kata kunci: Mutu Keperawatan; Patient Centered Care; Perawat Penanggung Jawab Asuhan AbstractPatient-Centered Care (PCC) is the core of the quality of health services in hospital. Nurseshave an important role in maintaining the quality of service care for patients. Primary Nurseof care must have superior competence in order to provide the best 24 hour care for patients.This community service aims to increase nurse’s knowledge about the PCC concept and therole of Nurse in Charge. The methods used in community service include lecture, question andanswer and modelling methods. This community service though Zoom Cloud Meetings andinvolved 277 nurses from several hospital in Indonesia. Through this community serviceactivity, it is hoped that nurses will be able to implement the PCC to the patient so that thequality of nursing service will increase.Keyword: Nursing Quality; Patient-Centered Care, Primary Nurse

The Impact of Mindfulness-Based Stress Reduction Techniques on Nurse Burnout in an ICU

Practice Problem: Central Line Associated Bloodstream Infections (CLABSI) are a preventable hospital acquired infection which contributes to patient morbidity, mortality and rising healthcare costs. PICOT: The PICOT question that guided this project was: In adult inpatients with central venous catheters, does the use of a two-person dressing change team, compared to a single person procedure, decrease the rate of central line associated bloodstream infections over the course of 8 weeks? Evidence: The prevention of CLABSI is most effective when multifaceted line maintenance bundles are implemented and adherence to these bundles nears 100% (Schreiber et al. 2018). Intervention: A two-person, evidence-based dressing change procedure was implemented for all central line dressing changes, known as the sterile buddy. The role of this additional bedside nurse was to assist the dressing change through an extra set of hands and to provide real-time sterile technique feedback to the primary nurse. Outcome: The intervention did not lead to a statistically significant change in the rate of CLABSI, however there was a reduction in the overall number of observed CLABSI compared to both the prior year and the 6 months preceding to the intervention. Conclusion: The implementation of a sterile buddy was an effective intervention that resulted in a decline in the total of CLABSI, and although not statistically significant, resulted in an estimated cost savings of $56,000 when compared to the year prior and an estimated cost savings of $112,000 when compared to the 6 months preceding the intervention.

Development of a Culturally Specific Leadership Curriculum through Community-Based Participatory Research and Popular Education

Background: The purpose of this innovative capacity building pilot project was to develop, implement, and evaluate a nine-workshop curriculum, Rekki Lemnak [Thinking of] Parent Leadership, to prepare community and academic partners for community organizing within the Micronesian Islander community. The purpose of the partnership was to build team leadership and research capacity to lay a foundation for implementing a change in healthcare and school systems. Working collaboratively helped ensure access to shared leadership through the learning by doing approach, enabling a culturally responsive method to build a sustainable partnership. Approach: Community-based participatory research and Popular Education tenets and reflection were used as a guide in the development of the Rekki Lemnak [Thinking of] Parent Leadership curriculum. Nine workshops (two hours for eight workshops and three hours for one workshop) were held over a period of a year. Community and academic partners developed the learning objectives, capacity building topics, experiential activities, and an evaluation on the strengths and areas for improvement. The partnership consisted of seven Micronesian Islander parent leaders who are residents from the community at large, the Micronesian Islander Community organization including the Executive Director who is a community primary researcher and certified community health worker, and a Micronesian Islander-certified community health worker staff member, and the academic primary nurse researcher and another academic nurse researcher from Washington State University. A range from five to 10 partners with an average of eight attended the workshops, of which an average of five Micronesian Islander parent leaders attended the workshops. Community partners from the Micronesian Islander Community organization and the academic primary nurse researcher co-led four workshops. Community partners from the Micronesian Islander Community organization and MI parent leaders led two workshops respectively; academic nurse researcher partners led one workshop. Outcomes: We identified three main themes: initially shy and humble MI parent leaders who through their participation transformed to empowered voices, togetherness—coming from different Islands and academia, and the need for more outreach to Micronesian Islanders. Conclusions: Key elements of the Rekki Lemnak [Thinking of] Parent Leadership curriculum may be translatable to other community and academic partnerships. Culturally responsive research is more than a process in conducting a study. This requires an ongoing investment to establish and sustain authentic partnerships to conduct research with MI communities.

Understanding Nurse-led Case Management in Patients with Chronic Illnesses: A Realist Review

This realist review aims, with evidence from recent studies, to understand both how nurse-led case management interventions are implemented in the management of chronic illnesses, and in what circumstances these interventions are successful. The review followed the realist review methodology. From four electronic databases, twenty empirical and primary nurse-led case management intervention studies published between January 2011 and February 2020 were included. For each study, causality was explored, and findings were integrated. Three contexts, five mechanisms, and three major outcomes were found, and several context–mechanism–outcome strings were identified. Further analysis and synthesis of the studies showed that when duration of intervention, service delivery mode, and types of services are appropriate, as well as number of services with patients considering care is provided, case managment interventions change outcomes for patients with chronic illnesses. Finally, an explanatory conceptual framework based on the review results was developed to guide nurse managers and researchers.

Peningkatan Kemampuan Timbang Terima Pasien Melalui Budaya Komunikasi SITUATION, BACKGROUND, ASSESSMENT, RECOMMENDATION (SBAR) DI RS DI BEKASI

ABSTRAK Latar Belakang: Komunikasi tidak efektif dalam timbang terima dapat meningkatkan kejadian medication error, membahayakan pasien, memperpanjang proses perawatan, menurunkan kepuasan pasien, memperpanjang hari rawat pasien yang akan berdampak pada kurangnya mutu asuhan keperawatan yang diberikan pada pasien. Upaya meningkatkan mutu pelayanan salah satunya dengan menerapkan komunikasi Situation, Background, Assessment, Recommendation (SBAR). Komunikasi SBAR sudah mulai diterapkan pada kebijakan akreditasi rumah sakit, di beberapa rumah sakit masih ada yang belum menerapkan komunikasi SBAR. Tujuan: penelitian ini bertujuan mengidentifikasi perbedaan pengetahuan dan kemampuan perawat setelah pelatihan SBAR. Metode: pre-eksperiment dengan pre-post tanpa kelompok kontrol, sampel penelitian seluruh Perawat Primer dan Penanggung Jawab shift (n= 17). Pengukuran pengetahuan dengan melakukan tes tertulis sebelum dan sesudah pelatihan, dan untuk data kemampuan perawat timbang terima dengan komunikasi SBAR dilakukan pengamatan timbang terima sebelum dan sesudah pelatihan dengan menggunakan lembar observasi. Analisis data dengan uji t berpasangan dan uji Wilcoxon. Hasil: ada perbedaan yang bermakna rerata pengetahuan sebelum dan sesudah pelatihan (p-value <0,001), ada perbedaan yang bermakna rerata kemampuan perawat sebelum dan sesudah pelatihan komunikasi SBAR dalam timbang terima pasien antar shift (p-value <0,001). Kesimpulan: komunikasi SBAR efektif untuk meningkatkan sosialisasi, motivasi, mentoring, supervisi, serta pengembangan pendidikan yang berkelanjutan.Kata Kunci: Komunikasi, pengetahuan, SBAR, timbang terimaImprovement of the Handover Ability Through Situation, Background, Assessment, Recommendation (Sbar) Communication Culture in Hospital at Bekasi City ABSTRACTBackground: Ineffective communication in the handover can increase the incidence of medication errors, endanger the patient, prolong the treatment process, reduce patient satisfaction, extend patient care days which will have an impact on the lack of quality nursing care provided to patients. To improve quality of service, one of them is to apply SBAR communication. SBAR communication is already implemented in accreditation policy at hospital. Meanwhile, there are some hospital not yet implement it. Objective: this study was to identify differences in nurses’ knowledge and abilities after training. Methods: pre-experiment with pre-post without a control group, a sample of all Primary Nurse and Shift Guidance (n = 17), Measurement of knowledge by conducting a written test before and after training, and measurement of the ability to handover nurses with SBAR communication conducted handover observations before and after training using observation sheets. Data analysis by paired t-test and Wilcoxon test. Results: there were significant differences in the mean of knowledge before and after training (p-value <0.001), there were significant differences in the mean ability of nurses before and after SBAR communication training in the handover of patients between shifts (p-value <0.001). Discussion: SBAR communication must become a culture, its implementation needs managerial support and nurse commitment. Conclusion: communication with SBAR could improve effectively socialization, motivation, mentoring, supervision, and continuing education development.Keywords: Communication, knowledge, SBAR, handover

Dakwah bi al-Irsyãd untuk Memelihara Kesehatan Mental Spiritual Pasien di Rumah Sakit

This research was conducted on the basis of the fact the field that the maintenance of mental health inpatients spiritual through the spiritual guidance of Islam in the hospital neglected and not considered part of Islam (da’wa). It has violated the professional code of ethics, the rights of patients, and can cause a psychological impact to the theological to the patient. Research conducted at five hospitals namely Yarsi Pontianak General Hospital, Islamic Hospital Ibn Sina Yarsi Padang, Regional General Hospital R.Syamsudin, SH of Sukabumi, Regional General Hospital Al-Ihsan Baleendah, and Regional General Hospital Ujungberung Bandung . The purpose of this research is to find a model of preaching bi al-Irsyad for spiritual nurture mental health inpatients in hospitals which until now has not existed. The method used in this research is descriptive method with qualitative approaches and reseach and development. The source of the data in this study obtained from hospitalized patients, the patient's family, spiritual adviser, the primary nurse who had attended training, head of nursing, and head of spirituality. The data in this study were collected through observation, interview, and use documents. From the results of this study out that the construction of the model da’wa bi al-Irsyad can be conveyed through Spiritual Guidance Islam to maintain the mental health of spiritual in the hospital and consist of the seven components of the model, they are : rationale, vision, mission, goals and benefits, functionality, form of service and program guidelines, methods and techniques, guide services. The results of this study is important to be a source of da'wah guidance in hospitals and become an important study for the world of da'wah both academically and practically. This study also proposes two important recommendation. First, the next phase of research should be done to develop this model towards a model that is feasible and tested through further research. The second, collaboration of the parties ie UIN Sunan Gunung Djati in particular the Faculty of Da'wa and Communication, Majlis Ulama Indonesia, Institute of Health Sciences, and the hospitals to formulate policies in the maintenance of mental health spiritual patient and to quickly produce human resources that can fill the needs of aspects this. Penelitian ini dilakukan atas dasar kenyataan dilapangan bahwa pemeliharaan kesehatan mental spiritual pasien rawat inap melalui bimbingan rohani Islam di rumah sakit terabaikan dan dianggap bukan bagian dari dakwah Islam. Hal ini telah melanggar kode etik profesi, hak pasien, dan dapat menimbulkan dampak psikologis hingga teologis terhadap pasien. Penelitian diadakan di lima rumah sakit yaitu Rumah Sakit Umum Yarsi Pontianak, Rumah Sakit Islam Yarsi Ibnu Sina Padang, Rumah Sakit Umum Daerah R.Syamsudin, SH Kota Sukabumi, Rumah Sakit Umum Daerah Al-Ihsan Baleendah, dan Rumah Sakit Umum Daerah Ujungberung Kota Bandung. Tujuan penelitian ini adalah menemukan konstruk atau model dakwah bi al-Irsyãd untuk memelihara kesehatan mental spiritual pasien di rumah sakit yang sampai saat ini belum ada. Metode yang digunakan dalam penelitian ini adalah metode deskriptif dengan pendekatan kualitatif dan reseach and development. Adapun sumber data dalam penelitian ini didapat dari para pasien rawat inap yang beragama Islam, keluarga pasien, pembina ruhani, para perawat primer yang telah mengikuti pelatihan, Kabag Keperawatan, dan Kasubsi Kerohanian. Data dalam penelitian ini dihimpun melalui teknik observasi, wawancara, dan penggunaan dokumen. Dari hasil penelitian ini ditemukan bahwa konstruk model dakwah bi al-Irsyãd dapat disampaikan melalui Bimbingan Rohani Islam untuk memelihara kesehatan mental spiritual pasien di sakit dan terdiri dari tujuh komponen model yaitu : dasar pemikiran, visi misi, tujuan dan manfaat, fungsi, bentuk layanan dan panduan program, metode dan teknik, panduan layanan. Hasil penelitian ini penting untuk menjadi sumber panduan dakwah di rumah sakit dan menjadi kajian penting bagi dunia dakwah baik secara akademis amupun praktis. Penelitian ini juga mengajukan dua rekomendasi penting. Pertama, seyogyanya dilakukan penelitian tahap berikutnya untuk mengembangkan model ini kearah model yang feasible dan teruji melalui penelitian lanjutan. Kedua melakukan kerjasama antar pihak terkait yaitu UIN Sunan Gunung Djati khususnya Fakultas Dakwah dan Komunikasi, Majlis Ulama Indonesia, Akper/Stikes, dan pihak rumah sakit untuk merumuskan kebijakan dalam pemeliharaan kesehatan mental spiritual pasien dan untuk segera menghasilkan sumber daya manusia yang dapat mengisi kebutuhan aspek ini.

CAREGIVERS’ NEEDS IN CARING FOR RELATIVES WITH SCHIZOPHRENIA IN MEDAN INDONESIA: A PHENOMENOLOGICAL STUDY

Background: A caregiver is a primary nurse and has a major role in providing care for people with schizophrenia. Caring for those with schizophrenia for a long period of time is a challenge for families, especially caregivers. Various needs ought to be studied by nurses to assist caregivers in providing optimal care for family members who experience schizophrenia.Objective: This qualitative study aims to explore the needs of caregivers in treating schizophrenia at home.Methods: The method used in this study is the method of purposive sampling with the number of participants as many as 10 people with criteria: 1) have family members diagnosed with schizophrenia, 2) directly involved in home care patients, 3) caring for schizophrenia for more than one year, 4) willing to be a participant by signing informed consent, 4) being able to identify what is needed in treating schizophrenia. Colaizzi is used to analyze interview data.Results: The results of the study found four themes of caregiver needs in caring for schizophrenia patients at home, ly: 1) seeking information about schizophrenia, 2) sought schizophrenic relatives’ recovery, 3) looking for appropriate rehabilitation for relatives with schizophrenias, and 4) utilizing mental health facilities.Conclusions: It is expected that nurses have the knowledge and skills in identifying and helping families, especially caregivers, to meet unmet needs so they can optimize home care.