INTRODUCTION
The phenomenon of the use of information systems
and technology in human life is increasing sharply following the times (Jiang, 2020). The presence of information systems and technology has a major impact on
human life (Seymour et al., 2018). Human life becomes effective and efficient in
supporting work in all sectors including the health sector (Cooke & Bartram, 2015). The health sector has health workers where nurses are the largest health
workers, so that their role is very large as a contributor to the fulfillment
of the performance and quality of health services.
Nursing service is the provision of nursing care
as evidenced by documentation of nursing care (Kent & Morrow, 2014). Documentation of nursing care in Indonesia is regulated by PPNI based on
the provisions of shared standards. Standard guidelines are divided into three
standard sections on nursing diagnoses, nursing interventions and nursing
outcomes (M�ller-Staub et al., 2007). The standards in these guidelines have relevance in nursing care
services (Douglas et al., 2014).
The first guiding standard set by PPNI is the Indonesian Nursing Diagnosis
Standard or also known as the SDKI (Israfil & Making, 2019). The second
guiding standard is the Indonesian Nursing Intervention Standard or also known
as SIKI (Andriani et al., 2021). The third
guiding standard is the Indonesian Nursing Outcome Standard or also known as
the SLKI (Tamher et al., 2021). SDKI, SIKI and SLKI are commonly abbreviated (3S) in the standard guidelines
set by PPNI. The 3S is currently the guideline used by nurses in every health facility.
Guidelines for nursing care (3S) are nursing practice activities that are
provided which are strung and processed directly to service recipients
(patients) in the setting of health service facilities (Hicks et al., 2015). Nursing care
is a nursing process method applied by nurses in meeting patient needs
systematically scientifically (Salvador et al., 2022). The needs
of patients in nursing care are able to achieve or maintain optimal biological,
psychological, social and spiritual conditions for patients. The achievement of nursing care is passed from the process of assessing
patients, analyzing data, formulating diagnoses, planning and implementing and
evaluating them through SIMRS. Moreover, Health
information technology solutions are expected to enhance nurses� use of
knowledge, experience, and judgement in assessment of patient problems and
planning care strategies (Redley et al., 2022).
Optimal nurse satisfaction is proven through
documentation of optimal nursing care for nurses. Documentation of nursing care is the basics of
the responsibility of nurses in carrying out their duties between providers and
recipients of health services (Kusumaningrum & Sulistyowati, 2022). Optimization of nurse satisfaction is currently
developing through system support. information and technology in hospitals such
as SIMRS (Kusumaningrum & Sulistyowati, 2022). SIMRS supports nursing services widely which is considered the key to
increasing nurse satisfaction because nurses are the largest health workers in
health facilities.(2)
Previous research has shown that nurses'
satisfaction with paper-based documentation is poor. Dissatisfaction includes
inadequate information, unclear, incomplete or illegible data entry and missing
signatures (Adjorlolo & Ellingsen, 2013). Other studies have shown that paper-based documentation does not meet the
current health care requirements so that it is less satisfying for nurses. These
health care requirements include those related to patient safety, continuity of
care, legal evidence of the care process and or evaluation of the quality of
patient care.
Other studies have shown that electronic nursing
documentation can improve the quality of nursing services for inpatients and
stimulate nurse satisfaction Electronic documentation has the potential to
streamline processes, increase the accuracy and efficiency of nursing
procedures and reduce the risk of errors. Other studies have shown that 65- 75% of nurses
believe that electronic documentation increases the satisfaction and quality of
nursing services (Kusumaningrum & Sulistyowati, 2022).
Electronic documentation can reduce documentation
time and increase satisfaction for nurses in serving. Research shows that the
average score for nurse satisfaction and performance in electronic
documentation is effective in improving service quality. Other research results
show that electronic documentation time has an impact on reduced 60% of working
time per week compared to paper-based documentation. It
can be concluded that the application of digital-based information systems in
nursing (nursing documentation) can build nurse satisfaction in providing
services and the output has an impact on the quality of health services
although further research is needed.
The author conducted a preliminary study at Dian Harapan
Jayapura Hospital to several nurses. Based on a preliminary study conducted by
the author, the performance of nurses includes assessing patients, analyzing data,
formulating diagnoses, planning and implementing and evaluating them. The
process of recording nursing care documentation has implemented the SDKI, SLKI
and SIKI, but is still paper-based. This documentation starts from the physical
assessment stage, formulating nursing problems, determining nursing diagnoses,
interventions and implementation and evaluation. All these processes are
carried out with a checklist filling system of documentation sheets and entries
based on the results and evaluations that have been carried out. Preliminary
studies showed that nurses reported experiencing several complaints and
dissatisfaction during work and the performance of nurses was felt to be
experiencing obstacles. The obstacles felt by nurses in documenting their performance
(nursing care) felt burdened because there were so many.
Data based on preliminary studies conducted on committees and the field of
nursing inform that, facts about the design of nursing care documentation SDKI, SLKI, SIKI (3S) are not yet available either on a paper-based basis or
digitally, they are still in the process of compre- hensively compiling the
previous nursing care documentation. The author has an innovative design design
for nursing care documentation SDKI, SLKI, SIKI (3S) in SIMRS at
Dian Harapan Jayapura Hospital as a digital-based information system media in
nursing to support documentation of nurse performance so that it can form a
positive attitude, namely the satisfaction of performing nurses. Based on the
background explanation above, the writer is interested in conducting research
on the effect of the design of nursing care documentation of SDKI, SLKI, SIKI (3S) in hospital management information systems on nurse
satisfaction at Dian Harapan Jayapura Hospital. The
general objective of this study was to analyze the effect of the design of
nursing care documentation of SDKI, SLKI, SIKI (3S) in SIMRS on nurse satisfaction at Dian Harapan Jayapura
Hospital.
METHOD
The research
design used in this study is a research and development method, namely the
method used to produce a particular product (Creswell, 2010). In addition, the
research design is descriptive correlational research regarding the effect of
implementing a safety and health management system. work on the performance of
nurses. In the research and development method, researchers only carry out
research and information gathering, planning (planning), and model development
(develop preliminary form of product). These stages can be summarized in the
scheme below:
�
Figure 1. Research
steps
RESULTS
AND DISCUSSION
Table 1
Normality Test
The Kolmogorov-Smirnov number is higher than the
significance level of 5% (0.05) so it can be concluded that the data on the
design variable for the 3S nursing care documentation design in SIMRS and the
nurse satisfaction variable are normally distributed.
Table 2
Linearity Test
The significance value of deviation from linearity in this research data is
higher than the significance level of 5% (0.05), so it can be concluded that
the data on the design variable for the 3S nursing care documentation design in
SIMRS and the nurse satisfaction variable have a significant linear
relationship.
Graphic 1. Heteroscedasticity Test
Graphic 1 shows that
the distribution of points on the scatterplot is seen randomly and is spread
both above and below zero on the Y axis. It can be concluded that there is no
heteroscedasticity in this regression model. A good regression model is a model
that does not occur heteroscedasticity where there is an inequality of variance
from the residuals of one observation to another observation between the 3S
nursing documentation design design variables in SIMRS and the nurse
satisfaction variable.
Table 3
Hypothesis Testing the Effect of 3S Nursing Documentation Design in SIMRS
on Nurse Satisfaction
The significance value of 0.000
is smaller than the probability value of 0.05, so that the hypothesis is
accepted (Ha), it can be concluded that there is an effect of 3S nursing care
documentation design in SIMRS on nurse satisfaction.
Table 4
D1etermination Test
The value of
R2 or Rsquare is 0.308 or 30.8%, this means that the
independent variable of 3S nursing care documentation design in SIMRS affects
the dependent variable of nurse satisfaction by 30.8% and the rest is
influenced by other variables not included in this study. (85)
Discussion
The results
of the analysis of this study indicate that the design of the 3S nursing care
documentation design in SIMRS at Dian Harapan Jayapura
Hospital has a good category with a percentage of 77%. While 23% of respondents
stated that the design of the 3S nursing care documentation in SIMRS was not
good.
The design
that the researcher made consisted of the SDKI, SLKI and SIKI. The SDKI is a
standard nursing diagnosis developed by PPNI and is a combination of nursing
diagnoses based on NANDA, ICNP and Carpenito. Nursing
diagnoses in the SDKI contain 148 diagnoses with diagnostic labels based on
NANDA for 2015-2017. Display of the SDKI design which includes 148 nursing
diagnoses can be understood and accepted by nurses during the second stage of
socialization of model development. This is indicated by the high results of
the study, 77% of nurses said it was good.
The
appearance of the SLKI is similar, where nurses feel that the design of the
SLKI is included in a good category. SLKI is an Indonesian nursing outcome
standard that includes observable and measurable parts such as responses to
nursing interventions on perceptions (patients, families and communities) about
their general condition and behavior. Nursing outcomes direct the status of
nursing diagnoses after the implementation of nursing interventions. The final
result of nursing intervention is an indicator or criterion for problem recovery
outcomes.
The
intervention design, in this case SIKI, is also in a good category. SIKI is an
Indonesian standard of nursing intervention which is categorized the same as
the group in the SDKI. Consisting of the SIKI taxon, namely 5 categories, 14
subcategories and 623 nursing interventions. SIKI is all nursing
treatments based on knowledge and clinical judgment to achieve outcomes and
nursing actions. Nursing actions such as performance specific behaviors nurses
to implement. The SIKI is in line with the SDKI, where each nursing diagnosis
in the SDKI will have an intervention in the SDKI. The SDKI, SLKI and SIKI are
benchmarks for providing nursing care used in Indonesia. The technology
developed is part of the concept of Bureaucratic Caring theory in which
technology influences a person's decision making in his attitude towards
professionalism.
Users who
are human users have various stimuli in perceiving every
thing they find, including when dealing with something new, including
responses to a SIMRS design. This is in line with Input in Callista Roy's model
which identifies input as a stimulus, which is a unity of information,
materials or energy from the environment that can cause a response, which is
divided into three levels of focal stimulus, contextual and residual stimulus. Process
control. According to the Callista Roy model, it is a form of coping mechanism
used, divided into regulatory subsystems, namely chemical, nervous or endocrine
systems, brain and spinal cord which are transmitted as behavior or responses
and cognator subsystems related to brain function in
processing information, judgments and emotions. Output in Callista Roy's model
is an adaptation system is a behavior that can be observed, measured, or can be
expressed subjectively. The output of this system can be an adaptive response
or a maladaptive response. The output of a system is behavior. that
can be observed, measured or subjectively reported either from from inside or outside or is feedback to the system.
Nurse Satisfaction
The results of the analysis of
this study indicate that the satisfaction
of nurses at Dian Harapan Jayapura Hospital shows
that nurses' satisfaction with the design of
3S nursing care documentation in SIMRS has a satisfied
category with a percentage of 73%. While 27% of respondents
stated that they were not satisfied with the design
of the 3S nursing care documentation
in SIMRS. In line with the results of
this study, nurse satisfaction has not reached its maximum so
it requires correction for further improvement.
The Effect of 3S Nursing Documentation Design in
SIMRS on Nurse Satisfaction. The results
of the test
analysis show that the significance
value is p-value of 0.000 or less than
the probability value of 0.05 alpha.
This shows that the significance
of the effect
of the 3S nursing care documentation
design in SIMRS on nurse satisfaction, then the hypothesis
(Ha) is accepted. The results of the
analysis of this study concluded that there was
an effect of the 3S nursing
care documentation design in SIMRS on nurse satisfaction. Furthermore, the results of the
analysis of the percentage of the influence
of the 3S nursing care documentation
design in SIMRS on nurse satisfaction showed an Rsquare
value of 0.308. This shows that
the 3S nursing care documentation design in SIMRS has an effect of 30.8% on nurse satisfaction
and the rest
is influenced by other factors
or variables that are not included in this study.
CONCLUSION
The design of 3S nursing care
documentation in SIMRS at Dian Harapan Jayapura
Hospital was 73% in the good category. Nurse satisfaction with the design of 3S
nursing care documentation in SIMRS at Dian Harapan
Jayapura Hospital by 77% is in the satisfied category. There is a significant
effect of 30.8% between the design of the 3S nursing care documentation in
SIMRS on the satisfaction of nurses at Dian Harapan
Jayapura Hospital.
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THE INFLUENCE NURSING CARE DOCUMENTATION DESIGN SDKI, SLKI, SIKI
(3S) IN HOSPITAL MANAGEMENT INFORMATION SYSTEMS ON NURSE SATISFACTION