Professional description of caregiver based on SNARS 1st edition in RSUD Makassar City

Lakka, Stella Bakti; Maidin, Alimin; Anggraeni, Rini; Irwandy
doi:10.1016/j.enfcli.2020.06.002
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      "titulo" => "Performance evaluation of patient safety committee in the regional general hospital of Makassar city"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Hospital Accreditation in Indonesia is carried out to assess hospital compliance with accreditation standards&#46; The accreditation standard for hospitals came in January 2018&#44; named National Standard for Accreditation of Hospitals Edition 1 &#40;SNARS Edition 1&#41; where the accreditation standard was new nationally in Indonesia<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">1</span></a> As a follow-up to this provision&#59; the hospital will do several things&#44; namely accrediting resources for professional and health workforce&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">2</span></a> The most influential thing in implementing home accreditation standards 2012 version of the illness&#44; especially in nursing care at Hermina Podomoro Hospital Jakarta is the integration of all health services&#44; especially the focus on patients&#44; then the patient&#39;s medical record file is integrated and documented all in the Integrated Patient Development Record &#40;CPPT&#41;&#46; Starting the patient came&#44; did the registration&#44; examination until the patient left&#46; Meanwhile&#44; all nursing actions are in nursing care&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">3</span></a> These six policies now play a role in the implementation of nursing care at the Hermina Podomoro Hospital in Jakarta based on 2012 hospital accreditation standards&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The quality of hospital services can be known from the professional appearance of hospital personnel&#44; the efficiency&#44; and effectiveness of services&#44; and patient satisfaction&#46; Patient satisfaction is determined by the overall service&#58; admission services&#44; doctors&#44; nurses&#44; food&#44; medicine&#44; facilities and equipment&#44; facilities and physical environment of the hospital and administrative services&#46; As health workers&#44; nurses and other health workers must have the right solution to provide better service than before so that patient satisfaction is achieved to the maximum&#44; by providing quality and quality services so that good job characteristics occur to patient satisfaction&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">5</span></a> The goal of this study is to know the picture of Professional Care Provider &#40;PPA&#41; in the inpatient installation of Makassar City Hospital in 2019&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Method</span><p id="par0015" class="elsevierStylePara elsevierViewall">The research method used in this study is a qualitative research method with a phenomenological approach which is a type of qualitative research to explore the phenomena&#44; reality&#44; and information and experience of an individual or group that appears about the implementation of SNARS edition 1 in Makassar City Hospital&#46; This research was conducted at Makassar City Hospital in March-May 2019&#46; Data collection methods used in this study are in-depth interviews &#40;in-depth interviews&#41;&#44; namely conducting a question and answer with informants and observations or observations&#46; The data analysis technique used in this research is descriptive analysis&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="par0020" class="elsevierStylePara elsevierViewall">According to hospital accreditation instruments issued by the Hospital Accreditation Committee &#40;KARS&#41; in 2018 that patients are the hospital&#39;s greatest responsibility and of course much-needed communication&#44; coordination&#44; and standardization of processes that will support professional care providers in implementing them to patients&#46; The results of this study will be discussed how the image of the Professional Care Provider &#40;PPA&#41; of care regulations&#44; care processes&#44; and patient care facilities that are part of a patient-focused service that is able to answer the research objectives&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Based on observations from researchers&#44; that there are regulations that have been implemented or implemented by the treatment room based on SNARS Edition 1 of 2018 and have been said to be 100&#37; Completely Fully complied based on the assessment method of SNARS accreditation&#46; The results of in-depth interviews that have been conducted&#44; it is known that the hospital set regulations for the provision of uniform care to patients&#46; From 3 informants interviewed said that there were regulations regarding uniform care at the hospital&#46; This was revealed from the results of the following interview&#58;<span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">There are regulations for the provision of uniform and integrated care set by hospitals for childcare namely service standards&#44; implementing competencies&#44; decrees&#44; etc&#46; There are regulations between service units&#44; such as decree&#44; etc&#46; Integrated patient discharge plans&#44; such as patients have gone home&#44; then there is written in the RM and given education drug problems that still exist and must be spent&#44; and if there are complaints can come to control again</span>&#8221;&#46;</p></span></p><p id="par0030" class="elsevierStylePara elsevierViewall">&#40;I5&#44; 41 Years&#41;<span class="elsevierStyleDisplayedQuote" id="dsq0010"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">The hospital establishes and provides regulations regarding uniform care and so far I have found SK&#44; etc&#46; There is a regulation that regulates services for all care integrated into surgical care&#44; especially now that it is SNARS accredited and it must be present and complete</span>&#8221;&#46;</p></span></p><p id="par0035" class="elsevierStylePara elsevierViewall">&#40;I7&#44; 32 Years&#41;<span class="elsevierStyleDisplayedQuote" id="dsq0015"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">There are regulations to work together to provide a uniform care process&#46; We make SPM every month&#44; there is a format given and there we can see how many doctors are today&#44; how many nurses are there are patients with Pleditis today</span>&#8221;&#46;</p></span></p><p id="par0040" class="elsevierStylePara elsevierViewall">&#40;I8&#44; 44 Years&#41;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The results of in-depth interviews that have been conducted&#44; it is known that the hospital set regulations that govern the method of giving instructions&#46; From 4 informants interviewed&#44; 2 informants said that there were regulations regarding the method of giving instructions and 2 other informants said that patients who were given treatment both in radiology and laboratory&#44; must be in accordance with clinical indications&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0020"><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">As far as I am there is a regulation regarding the method of giving instructions&#46; Especially now that the hospital has implemented SNARS Accreditation&#44; so it should be there</span>&#8221;&#46;</p></span></p><p id="par0050" class="elsevierStylePara elsevierViewall">&#40;I5&#44; 41 Years&#41;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The results of in-depth interviews that have been carried out&#44; it is known that the Hospital establishes the regulation of clinical and diagnostic actions that are requested&#44; carried out and received the results&#44; and stored in the patient&#39;s medical record file&#46; 3 informants interviewed said that there are regulations for every clinical action and written in the patient&#39;s medical record&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0025"><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">All clinical and diagnostic measures requested&#44; there must be regulation&#46; Can be seen in the RM for each treatment</span>&#8221;&#46;</p></span></p><p id="par0060" class="elsevierStylePara elsevierViewall">&#40;I1&#44; 44 Years&#41;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The results of in-depth interviews that have been conducted&#44; it is known that there is a Regulation directing dialysis patient care &#40;dialysis&#41; in Makassar City Hospital&#46; From 2 informants interviewed said that there were regulations regarding directing dialysis &#40;dialysis&#41; patient care in Makassar City Hospital&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0030"><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">Yes&#44; there are regulations regarding dialysis patients at this hospital&#46; Because we do care based on existing regulations</span>&#8221;&#46;</p></span></p><p id="par0070" class="elsevierStylePara elsevierViewall">&#40;I21&#44; 60 Years&#41;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The results of in-depth interviews that have been conducted&#44; it is known that the provision of care for all patients is integrated and coordinated between service units and is evidenced by the existence of CPPT&#46; From 7 informants interviewed&#44; 3 informants stated that there were regulations between service units for all patients integrated between service units&#44; and 4 informants stated that care plans were integrated and coordinated among service units&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0035"><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">There are regulations governing care that are integrated between service units</span>&#8221;&#46;</p></span></p><p id="par0080" class="elsevierStylePara elsevierViewall">&#40;I8&#44; 44 Years&#41;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The results of in-depth interviews that have been conducted&#44; it is known that HR at Makassar City Hospital has conducted EWS training as contained in regulations to improve the quality of hospitals that are undergoing SNARS accreditation&#46; Of the 11 informants interviewed&#44; as many as 7 informants stated that in this hospital there were regulations on the application of EWS&#44; and there was evidence of training in the medical record&#46; 3 informants said that the treatment carried out by the PPA was good and immediate action was taken against the patients concerned&#44; and 1 the informant felt that the PPA had not been able to deal with patients who had complaints&#44; and explained it in a language not understood by the patient&#39;s family&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0040"><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">There are regulations regarding the implementation of the early warning system &#40;EWS&#41;&#46; And of course there is also evidence of training and in RM</span>&#46;&#8221;</p></span></p><p id="par0090" class="elsevierStylePara elsevierViewall">&#40;I5&#44; 41 Years&#41;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The results of in-depth interviews that have been conducted&#44; it is known that the management of pain in some treatments have not been said to be good and not in accordance with existing standards in the hospital&#44; and providing education about pain management to patients has been carried out as needed&#46; From 7 informants interviewed&#44; 1 informant said that in providing pain management care based on nursing care standards&#44; 2 informants said that pain patients received services to treat pain as needed&#44; 3 informants said that PPA had provided treatment if the patient felt pain&#44; and 2 informants said that they were not satisfied with the PPA response to patients who experience pain&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0045"><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">Pain management performed by nurses here refers to the standard of nursing care used by nurses in pain management</span>&#8221;&#46;</p></span></p><p id="par0100" class="elsevierStylePara elsevierViewall">&#40;I1&#44; 44 Years&#41;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The results of in-depth interviews that have been conducted&#44; it is known that the care of high-risk patients and the provision of high-risk services is given based on clinical practice guidelines and legislation&#46; High-risk patient care and high-risk service delivery are provided based on clinical practice guidelines and legislation&#46; Of the 4 informants interviewed&#44; 3 informants said that there was always training conducted by staff on high-risk patients&#46; Evidenced by the training documents&#44; and 1 informant said that there are clinical therapy regulations for high-risk patients&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0050"><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">&#8220;<span class="elsevierStyleItalic">There is evidence of developing high-risk services into the hospital quality improvement program and evidence of the accreditation document is in the PMKP room itself</span>&#8221;&#46;</p></span></p><p id="par0110" class="elsevierStylePara elsevierViewall">&#40;I13&#44; 50 Years&#41;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">Efforts to ensure the quality of nursing care services in Makassar City Hospital in the field of nursing make the Quality Control and Improvement Program a guide in carrying out these quality control and improvement activities&#44; this is in line with research Nugraha&#44; Dewi A&#44; Listiowati E &#40;2014&#41; in which hospitals set policies on the use of drugs to watch out for such as the list of drug names for High Allert&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">6</span></a> Providing the most appropriate services in a hospital to support and respond to each patient&#39;s unique needs&#44; requires high-level planning and coordination&#46; When viewed between the previous SNARS accreditation and 2012 Accreditation&#44; both of them provide Patient Services based on the same regulations&#44; the same care process and the same facilities&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">4</span></a> The final part is the process of further intervention in the form of giving the patient&#39;s diet or providing education&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a> Professional competence in nursing practice is not only psychomotor and clinical diagnostic skills but also abilities in interpersonal and communication skills&#46; Registered nurses are expected to communicate in various formats and in all fields of practice&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">8</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">There is an individualized care plan for each patient created and documented that was described by the PPA team&#46; CPPT &#40;Integrated Patient Development Record&#41; contains the date of admission of patients&#44; hours of care&#44; what professions will later record the progress of patients&#44; as well as the names and signatures of the professions that record the progress of these patients during shift changes to be more coordinated&#46; Integrated patient development records &#40;CPPT&#41; can provide direction to the PPA team in communicating both with fellow teams and with patients&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">9</span></a> This is in line with Ryandini&#39;s research &#40;2018&#41; which says that the integrated and complete documentation in the Inpatient if done by the PPA team namely doctors&#44; nurses&#44; pharmacists&#44; nutritionists&#44; in accordance with standards set by the Hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a> The new paradigm in health care that Patient-Centered Care &#40;PCC&#41; is a form of health care where patients as the main service center in hospitals where approaches that involve patients and facilities are obtained&#46; This can be seen from the outcomes of better health services&#44; proper allocation of resources&#44; and achieving greater patient and family satisfaction&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a> This is in line with research by Nurlina&#44; Hadju&#44; &#38; Nontji &#40;2013&#41;&#44; where the availability of facilities in nursing care services is also sufficient because in each treatment room available Askep format&#44; complete SOP&#44; and other supporting facilities&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusion</span><p id="par0125" class="elsevierStylePara elsevierViewall">There is an individualized care plan for each patient created and documented that was described by the PPA team&#46; All patient care processes by PPA must be recorded in a patient medical record file in a coherent manner in accordance with the care journey experienced by patients in Makassar City Hospital&#44; starting from the Initial Assessment to the Resume Return&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This research was conducted to find out the description in Inpatient Installation of Makassar City Public Hospital in 2019&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The research method used in this study is a qualitative research method with a phenomenological approach at Makassar City General Hospital&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Some regulations have been carried out or implemented by the treatment room based on SNARS 1st Edition of 2018 and have been said to be 100&#37; fulfilled Complete for each element of assessment&#44; both regulation and documentation based on assessment methods from SNARS accreditation&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In improving the quality of the Hospital&#44; the hospital needs to run each service process properly by SNARS 1st Edition&#46;</p></span>"
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