ABSTRAK

Pelayanan keperawatan merupakan salah satu pelayanan yang berkontribusi

terhadap pencapaian kinerja rumah sakit baik secara individu maupun secara
organisasi. Rumah Sakit Umum Mitra Sejati telah mendapat uji akreditasi rumah
sakit terhadap seluruh anggota/staf keperawatan namun setelah berjalan satu tahun
sampai dengan sekarang, terjadi penurunan mutu pelayanan keperawatan yang telah
distandarisasi.
Penelitian ini bertujuan untuk menganalisis Hubungan Pengetahuan tentang
Akreditasi Rumah Sakit dan Karakteristik Individu dengan Kinerja Perawat di Rumah
Sakit Mitra Sejati, Medan. Jenis penelitian cross sectional pendekatan explanatory.
Populasi dalam penelitian ini adalah seluruh perawat berjumlah 186 orang dan
seluruh populasi dijadikan sampel. Data diperoleh dengan wawancara menggunakan
kuesioner, dianalisis dengan regresi logistik berganda pada pengujian =0,05.
Hasil penelitian menunjukkan bahwa secara statistik pengetahuan perawat
tentang akreditasi rumah sakit meliputi; (falsafah dan tujuan, administrasi dan
pengelolaan, staf dan pimpinan, fasilitas dan peralatan, kebijakan dan prosedur,
pengembangan staf dan pendidikan, evaluasi dan pengendalian mutu) dan
karakteristik individu (umur dan lama kerja) berhubungan signifikan dengan kinerja
perawat. Variabel umur memiliki hubungan paling kuat dengan kinerja perawat.
Disarankan kepada; (1) Pelayanan Keperawatan Rumah Sakit Mitra Sejati;
mengupayakan peningkatan pengetahuan perawat tentang stndar akreditasi rumah
sakit melalui peningkatan sosialisasi secara berkelanjutan dan melakukan evaluasi
pelaksanaan akreditasi rumah sakit terhadap kinerja perawat dalam memberikan
pelayanan keperawatan. (2) Perawat; mengupayakan peningkatan pengetahuan
tentang stndar akreditasi rumah sakit melalui pendidikan, pelatihan dan seminar.

Kata kunci : Pengetahuan Akreditasi, Karakteristik Individu, Kinerja

i
 ABSTRACT

Since the last four years (2011-2014), Mitra Sejati Hospital, located at Jl.
AHNasution, Medan, has rapidly improved its service quality, guided by
KARS(Hospital Accreditation Committee). This service quality has been recognized
andcertified by the government, and its classification has been increased.The
problem was that some of the nurses and midwives provided inadequateservices for
their patients. The average rate of their resignation reached to 30% in theperiod of
2012- 2014. The problem was that whether their resignation was correlatedwith their
work load because of accreditation movement along the year.We learned some
significant knowledge from 168 nurses/midwives aboutaccreditation and the
characters which were correlated with their performance. Theresearch was
explanatory survey with cross sectional design. The hypothesis was thatminimal
knowledge of accreditation or individual characters could influence
thequality of their performance which caused disappointment and resignation.The
result of Pearson correlation test showed that the correlations between theknowledge
of nurses/midwives and performance were 1) correlation
betweenadministrative knowledge and performance was at the correlation coefficient
of 0.486and the significance level of 0.000, 2) correlation between the knowledge of
facilitystandard and performance was at the coefficient of 0.1512 and the significant
level of0.020, and 3) correlation between nursing procedure standard at the
coefficient of0.568 and the significant level of 0.00. There was no
significance in Spearmancorrelation of the four variables of personal
characteristics on the variable ofperformance. The conclusion of the research
was that there was significant information whichproved that the resignation of
nurses/midwives could be correlated because of theirlack of knowledge of
accreditation or because of individual characteristics. However,they could still carry
out their services satisfactorily at the interval 4 of 5 possibilities.Keywords:
Knowledge of Accreditation, Individual Characteristics,Performance

Key words: Knowledge of Accreditation, Individual

Characteristics,Performance

ii
 KATA PENGANTAR

Segala puji dan syukur penulis panjatkan ke hadirat Tuhan Yang Maha Esa

atas segala nikmat, rahmat, dan karuniaNya, sehingga penulis dapat menyelesaikan

penelitian dan penyusunan tesis ini dengan judul " Hubungan Pengetahuan tentang

Akreditasi Rumah Sakit dan Karakteristik Individu dengan Kinerja Perawat

di Rumah Sakit Mitra Sejati, Medan Tahun 2014".

Penulisan tesis ini merupakan salah satu persyaratan akademik untuk

menyelesaikan pendidikan pada Program Studi S2 Ilmu Kesehatan Masyarakat Minat

Studi Administrasi Rumah Sakit, Fakultas Kesehatan Masyarakat Universitas

Sumatera Utara.

Penulis, dalam menyusun tesis ini mendapat bantuan, dorongan dan

bimbingan dari berbagai pihak. Untuk itu pada kesempatan ini penulis mengucapkan

terima kasih dan penghargaan kepada :

1. Prof. Subhilhar, Ph.D, Selaku Pejabat Rektor Universitas Sumatera Utara

2. Dr. Drs. Surya Utama, M.S, Dekan Fakultas Kesehatan Masyarakat Universitas

Sumatera Utara.

3. Prof. Dr. Dra. Ida Yustina, M.Si, Ketua Program Studi S2 Ilmu Kesehatan

Masyarakat, Fakultas Kesehatan Masyarakat Universitas Sumatera Utara.

4. Dr. Ir. Evawany Aritonang, M.Si, Sekretaris Program Studi S2 Ilmu Kesehatan

Masyarakat, Fakultas Kesehatan Masyarakat Universitas Sumatera Utara.

5. Dr. Drs. R. Kintoko Rochadi, M.K.M selaku Ketua Komisi Pembimbing dan dr.

Mhd. Arifin Siregar, M.S selaku anggota Komisi Pembimbing yang dengan penuh

iii
 perhatian dan kesabaran membimbing dan mengarahkan serta meluangkan waktu

untuk membimbing mulai dari proposal hingga penulisan tesis selesai.

6. Dr. Juanita, SE, M.Kes dan Siti Zahara Nasution, SKp, MNS selaku penguji tesis

yang dengan penuh perhatian dan kesabaran membimbing, mengarahkan dan

meluangkan waktu untuk membimbing penulis mulai dari proposal hingga

penulisan tesis selesai.

7. Para dosen dan staf di lingkungan Program Studi S2 Ilmu Kesehatan Masyarakat

Fakultas Kesehatan Masyarakat Universitas Sumatera Utara.

8. Segenap staf Program Studi Administrasi Rumah Sakit FKM USU yang telah

memberikan bantuan, kemudahan dan bimbingan dalam melaksanakan

pendidikan.

9. Dr. Parambir Singh selaku direktur utama RSU Mitra Sejati. Terima kasih atas

berbagai fasilitas, kemudahan dan semangat yang telah diberikan selama

pendidikan dan penyusunan tesis ini.

10. Manajemen RSU Mitra Sejati. Terima kasih atas dukungan, bantuan dan

kerjasama selama penyusunan tesis ini.

11. Para perawat, suvervisior dan kepala keperawatan RSU Mitra Sejati. Terima kasih

atas dukungan, bantuan dan kerjasama selama penyusunan tesis ini.

12. Ucapan terima kasih yang tulus dan ikhlas kepada keluarga Ibu dan Alm Ayah

yang tercinta Pirman Ginting, Abang, Kakak dan Adik tersayang yang telah

memberi dukungan moril, materi dan doa restu kepada penulis.

13. Teristimewa kepada Istri tercinta Erlina Br.Tarigan dan putra-putri ku tersayang

iv
 Florentina Mawarta Br.Ginting, Gabriella Anastasius Ginting, Nica Virginta

Br.Ginting dan Panta Pratama Ginting yang penuh perhatian, pengorbanan dan

kesabaran serta doa dan rasa cinta kasih yang dalam, setia menunggu, memotivasi

dan memberikan dukungan moril agar bisa menyelesaikan pendidikan ini.

Akhirnya penulis menyadari atas segala keterbatasan, untuk itu saran dan

kritik yang membangun sangat penulis harapkan demi kesempurnaan tesis ini dengan

harapan, semoga tesis ini bermanfaat bagi pengambil kebijakan di bidang kesehatan

dan pengembangan ilmu pengetahuan bagi peneliti selanjutnya.

Medan, Januari 2016

Penulis

Arih Ginting
127032049/IKM

v
 RIWAYAT HIDUP

Arih Ginting lahir pada tanggal 26-03-1973 di Gedung Johor Kecamatan

Namorambe, Kabupaten Deliserdang Sumatera Utara, anak Pertama dari Tiga

bersaudara dari pasangan Ayahanda Pirman Ginting (alm) dan Ibunda Rasita

Br. Karo.

Pendidikan formal penulis, dimulai dari pendidikan SDN No. 101804 Gedung

Johor selesai tahun 1986, Sekolah Menengah Pertama (SMP) Negeri 2 Deli Tua

selesai tahun 1989, Sekolah Menengah Atas (SMA) Swasta Raksana Medan selesai

tahun 1992, Fakultas Kedokteran Universitas Methodist Indonesia selesai tahun 2002.

Mulai bekerja sebagai tenaga dokter umum di RSU Mitra Sejati sejak tahun

2002 sampai tahun 2011. Pada tahun 2012 sebagai Wakil Direktur Pelayanan Medis

di RSU Mitra Sejati sampai tahun 2014.

Tahun 2012 penulis mengikuti pendidikan lanjutan di Program Studi S2 Ilmu

Kesehatan Masyarakat Minat Studi Administrasi Rumah Sakit Fakultas Kesehatan

Masyarakat Universitas Sumatera Utara.

vi
 DAFTAR ISI

Halaman

ABSTRAK
..................................................................................................................................
..................................................................................................................................
i
ABSTRACT
..................................................................................................................................
..................................................................................................................................
ii
KATA PENGANTAR
..................................................................................................................................
..................................................................................................................................
iii
RIWAYAT HIDUP
..................................................................................................................................
..................................................................................................................................
vi
DAFTAR ISI
..................................................................................................................................
..................................................................................................................................
vii
DAFTAR TABEL
..................................................................................................................................
..................................................................................................................................
ix
DAFTAR GAMBAR
..................................................................................................................................
..................................................................................................................................
x
DAFTAR LAMPIRAN
..................................................................................................................................
..................................................................................................................................
xi

BAB 1. PENDAHULUAN
....................................................................................................................
....................................................................................................................
1
1.1. Latar Belakang

vii
 ............................................................................................................
............................................................................................................
1
1.2. Perumusan Masalah
............................................................................................................
............................................................................................................
9
1.3. Tujuan Penelitian
............................................................................................................
............................................................................................................
6
1.4. Hipotesis
............................................................................................................
............................................................................................................
6
1.5. Manfaat Penelitian
............................................................................................................
............................................................................................................
7
............................................................................................................
............................................................................................................
BAB 2. TINJAUAN PUSTAKA
....................................................................................................................
....................................................................................................................
7
2.1. Kinerja.............................................................................................
.........................................................................................................
7
2.1.1. Pengertian Kinerja.................................................................
...............................................................................................
7
2.1.2. Faktor-faktor yang Mempengaruhi Kinerja...........................
...............................................................................................
7
2.1.3. Penilaian Kinerja...................................................................
...............................................................................................
8
2.1.4. Indikator Kerja.......................................................................
...............................................................................................
11
2.1.5 Kinerja Keperawatan ...........................................................
...............................................................................................
12
2.1.6 Evaluasi Kinerja Keperawatan ...........................................

viii
 ...............................................................................................
13
2.1.7 Self Assessment Pokja Keperawatan pada Program
Akreditasi 2007 ..................................................................
...............................................................................................
14
2.2. Akreditasi Rumah Sakit...................................................................
.........................................................................................................
17
2.2.1 Tujuan Akreditasi Rumah Sakit.............................................
...............................................................................................
17
2.2.2. Manfaat Akreditasi Rumah Sakit...........................................
...............................................................................................
18
2.2.3. Dasar Hukum Akreditasi Rumah Sakit..................................
...............................................................................................
19
2.2.4. Standar Penilaian Kinerja Perawat........................................
...............................................................................................
27
2.2.5. Kinerja Perawat Pelaksana....................................................
...............................................................................................
31
2.3. Pengetahuan.....................................................................................
.........................................................................................................
19
2.4. Karakteristik Individu......................................................................
.........................................................................................................
24
2.5. Keperawatan....................................................................................
.........................................................................................................
25
2.5.1 Pengertian Keperawatan........................................................
...............................................................................................
25
2.5.2 Pelayanan Keperawatan.........................................................
...............................................................................................
26
2.6 Rumah Sakit dan Pelayanan Kesehatan..........................................
.........................................................................................................
28
2.6.1 Rumah Sakit Umum...............................................................
.........................................................................................................
28

ix
 2.6.2 Pelayanan Kesehatan..............................................................
.........................................................................................................
29
2.7 Landasan Teori................................................................................
.........................................................................................................
31

BAB 3. METODE PENELITIAN

....................................................................................................................
....................................................................................................................
32
3.1 Jenis Penelitian
............................................................................................................
............................................................................................................
32
3.2 Lokasi dan Waktu Penelitian
............................................................................................................
............................................................................................................
32
3.2.1 Lokasi Penelitian
............................................................................................................
............................................................................................................
32
3.2.2 Waktu Penelitian
............................................................................................................
............................................................................................................
32
3.3 Populasi dan Sampel
............................................................................................................
............................................................................................................
32
3.3.1 Populasi
............................................................................................................
............................................................................................................
33
3.3.2 Sampel
............................................................................................................
............................................................................................................
33
3.4 Metode Pengumpulan Data
............................................................................................................
............................................................................................................
33
3.4.1 Data Primer

x
 ............................................................................................................
............................................................................................................
33
3.4.2 Data Sekunder
............................................................................................................
............................................................................................................
33
3.4.3 Validitas dan Reliabilitas
............................................................................................................
............................................................................................................
34
3.5 Variabel dan Definisi Operasional
............................................................................................................
............................................................................................................
35
3.5.1. Variabel Independen
............................................................................................................
............................................................................................................
35
3.5.2. Variabel Dependen
............................................................................................................
............................................................................................................
35
3.6 Metode Pengukuran
............................................................................................................
............................................................................................................
37
3.6.1 Metode Pengukuran Variabel Independen dan Dependen
..................................................................................................
..................................................................................................
37
3.7 Metode Analisis Data
............................................................................................................
............................................................................................................
41

BAB 4. HASIL PENELITIAN

....................................................................................................................
....................................................................................................................
43
4.1 Gambaran Umum Lokasi Penelitian
............................................................................................................
............................................................................................................
43
4.2 Analisis Univariat

xi
 ............................................................................................................
............................................................................................................
44
4.2.1 Karakteristik Individu
..................................................................................................
..................................................................................................
44
4.2.2 Pengetahuan tentang Akreditasi Rumah Sakit.......................
...............................................................................................
45
4.2.3 Kinerja...................................................................................
...............................................................................................
53
4.3 Analisis Bivariat..............................................................................
.........................................................................................................
57
4.3.1 Hubungan Pengetahuan tentang Falsafah dan Tujuan
dengan Kinerja.......................................................................
...............................................................................................
58
4.3.2 Hubungan Pengetahuan tentang Administrasi dan
Pengelolaan dengan Kinerja..................................................
...............................................................................................
58
4.3.3 Hubungan Staf dan Pimpinan dengan Kinerja......................
...............................................................................................
58
4.3.4 Hubungan Fasilitas dan Peralatan dengan Kinerja................
...............................................................................................
59
4.3.5 Hubungan Kebijakan dan Prosedur dengan Kinerja.............
...............................................................................................
59
4.3.6 Hubungan Pengembangan Staf dan Pendidikan dengan
Kinerja...................................................................................
...............................................................................................
60
4.3.7 Hubungan Evaluasi dan Pengendalian Mutu dengan Kinerja
...............................................................................................
60
4.3.8 Hubungan Jenis Kelamin dengan Kinerja.............................
...............................................................................................
60
4.3.9 Hubungan Umur dengan Kinerja...........................................

xii
 ...............................................................................................
61
4.3.10 Hubungan Pendidikan dengan Kinerja.................................
...............................................................................................
61
4.3.11 Hubungan Status Keluarga dengan Kinerja..........................
...............................................................................................
61
4.3.12 Hubungan Lama Kerja dengan Kinerja................................
...............................................................................................
62
4.4 Analisis Multivariat..........................................................................
.........................................................................................................
63
BAB 5. PEMBAHASAN....................................................................................
...............................................................................................................................
67
5.1 Hubungan Pengetahuan tentang Akreditasi Rumah Sakit dengan
Kinerja Perawat...............................................................................
.........................................................................................................
67
5.1.1 Hubungan Pengetahuan tentang Falsafah dan Tujuan
dengan Kinerja Perawat.........................................................
...............................................................................................
67
5.1.2 Hubungan Pengetahuan tentang Administrasi dan
Pengelolaan dengan Kinerja Perawat....................................
...............................................................................................
69
5.1.3 Hubungan Pengetahuan tentang Staf dan Pimpinan dengan
Kinerja Perawat.....................................................................
...............................................................................................
71
5.1.4 Hubungan Pengetahuan tentang Fasilitas dan Peralatan
dengan Kinerja Perawat.........................................................
...............................................................................................
73
5.1.5 Hubungan Pengetahuan tentang Kebijakan dan Prosedur
dengan Kinerja Perawat.........................................................
...............................................................................................
74
5.1.6 Hubungan Pengetahuan tentang Pengembangan Staf dan
Pendidikan dengan Kinerja Perawat......................................
...............................................................................................
76

xiii
 5.1.7 Hubungan Pengetahuan tentang Evaluasi dan Pengendalian
Mutu dengan Kinerja Perawat...............................................
...............................................................................................
77
5.2 Hubungan Karakteristik Individu dengan Kinerja Perawat.............
.........................................................................................................
79
5.2.1 Hubungan Umur dengan Kinerja Perawat.............................
...............................................................................................
79
5.2.2 Hubungan Lama Kerja dengan Kinerja Perawat...................
...............................................................................................
80
5.3 Kinerja Perawat ..............................................................................
.........................................................................................................
81

BAB 6. KESIMPULAN DAN SARAN.............................................................

...............................................................................................................................
83
6.1 Kesimpulan.......................................................................................
...........................................................................................................
83
6.2 Saran.................................................................................................
...........................................................................................................
84

DAFTAR PUSTAKA...........................................................................................
...............................................................................................................................
85

LAMPIRAN.........................................................................................................
...............................................................................................................................
88

xiv
 DAFTAR TABEL

No Judul Halaman
2.1 Standar Pokja Keperawatan.........................................................................
.....................................................................................................................
15
3.1 Metode Pengukuran Variabel Independen dan Dependen...........................
.....................................................................................................................
41
4.1 Distribusi Karakteristik Indidvidu Responden.............................................
.....................................................................................................................
45
4.2 Distribusi Responden Berdasarkan Pengetahuan tentang Falsafah dan
Tujuan..........................................................................................................
.....................................................................................................................
46
4.3 Distribusi Responden Berdasarkan Kategori Pengetahuan tentang
Falsafah dan Tujuan.....................................................................................
.....................................................................................................................
47
4.4 Distribusi Responden Berdasarkan Pengetahuan tentang Administrasi
Rumah Sakit.................................................................................................
.....................................................................................................................
48
4.5 Distribusi Responden Berdasarkan Kategori Pengetahuan tentang
Administrasi Rumah Sakit...........................................................................
.....................................................................................................................
48.................................................................................................................
4.6 Distribusi Responden Berdasarkan Pengetahuan tentang Staf dan
Pimpinan......................................................................................................
.....................................................................................................................
49

xv
4.7 Distribusi Responden Berdasarkan Kategori Pengetahuan tentang Staf
dan Pimpinan...............................................................................................
.....................................................................................................................
50
4.8 Distribusi Responden Berdasarkan Pengetahuan tentang Fasilitas dan.......
.....................................................................................................................
51
4.9 Distribusi Responden Berdasarkan Kategori Pengetahuan tentang
Fasilitas dan Peralatan..................................................................................
.....................................................................................................................
51
4.10 Distribusi Responden Berdasarkan Pengetahuan tentang Kebijakan dan
Prosedur.......................................................................................................
.....................................................................................................................
52
4.11 Distribusi Responden Berdasarkan Kategori Pengetahuan tentang
Kebijakan dan Prosedur...............................................................................
.....................................................................................................................
53
4.12 Distribusi Responden Berdasarkan Pengetahuan tentang Staf dan
Program Pendidikan.....................................................................................
.....................................................................................................................
54
4.13 Distribusi Responden Berdasarkan Kategori Pengetahuan tentang Staf
dan Program Pendidikan..............................................................................
.....................................................................................................................
54

4.14 Distribusi Responden Berdasarkan Pengetahuan tentang Evaluasi dan

Pengendalian Mutu......................................................................................
.....................................................................................................................
55
4.15 Distribusi Responden Berdasarkan Kategori Pengetahuan tentang
Evaluasi dan Pengendalian Mutu.................................................................
.....................................................................................................................
56

xvi
4.16 Distribusi Responden Berdasarkan Skor Kinerja........................................
.....................................................................................................................
57
4.17 Distribusi Responden Berdasarkan Kategori Kinerja..................................
.....................................................................................................................
57
4.18 Hubungan Pengetahuan tentang Akreditasi Rumah Sakit dan
Karakteristik Individu dengan Kinerja.........................................................
.....................................................................................................................
63
4.19 Hasil Uji Regresi Logistik Berganda...........................................................
.....................................................................................................................
66

xvii
 DAFTAR GAMBAR

No Judul Halaman

2.1 Kerangka Konsep Penelitian

......................................................................................................................
......................................................................................................................
31

xviii
 DAFTAR LAMPIRAN

No Judul Halaman

1 Kuesioner Penelitian
........................................................................................................................
........................................................................................................................

88

2 Uji Validitas dan Reliabilitas

........................................................................................................................
........................................................................................................................

93

3 Uji Univariat dan Bivariat

........................................................................................................................
........................................................................................................................

97
........................................................................................................................

4 Uji Multivariat
........................................................................................................................
........................................................................................................................

122

5 Surat izin penelitian dari Program Studi S2 IKM FKM USU Medan
........................................................................................................................
........................................................................................................................

123

6 Surat izin selesai penelitian dari Rumah Sakit Mitra Sejati, Medan

xix
 ........................................................................................................................
........................................................................................................................
124

5. Dokumentasi Penelitian
.........................................................................................................................
.........................................................................................................................
154

6. Surat Izin Penelitian dari Pascasarjana USU

.........................................................................................................................
.........................................................................................................................
155

7. Surat Izin Penelitian dari Dinas Kesehatan Kabupaten Kampar

.........................................................................................................................
.........................................................................................................................
156

154Kesehatan Kabupaten Kampar

156

xx