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All Journal INOTEKS : Jurnal Inovasi Ilmu Pengetahuan, Teknologi, dan Seni Jurnal Keperawatan Indonesia Nurse Media Journal of Nursing Jurnal Manajemen Keperawatan Jurnal Keperawatan Soedirman (The Soedirman Journal of Nursing) Jurnal NERS Jurnal Penelitian Kesehatan Suara Forikes Jurnal Keperawatan Padjadjaran Jurnal Kesehatan Vokasional Belitung Nursing Journal Jurnal Keperawatan Silampari Jurnal Keperawatan Muhammadiyah Jurnal Keperawatan Widya Gantari Indonesia Jurnal Persatuan Perawat Nasional Indonesia (JPPNI) Journal of Telenursing (JOTING) Jurnal Aisyah : Jurnal Ilmu Kesehatan Indonesian Journal of Global Health research Babali Nursing Research Jurnal Syntax Transformation Cendekia Medika : Jurnal Stikes Al-Ma`arif Baturaja MAHESA : Malahayati Health Student Journal Jurnal Keperawatan Wiyata Lentera Perawat DUNIA KEPERAWATAN: JURNAL KEPERAWATAN DAN KESEHATAN Journal of Pharmaceutical and Sciences. Indonesian Journal of Community Development Media Penelitian dan Pengembangan Kesehatan Holistik Jurnal Kesehatan Indonesian Journal of Global Health Research
Hening Pujasari
Department Of Nursing And Basic Nursing, Faculty Of Nursing, University Of Indonesia
Agriculture, Biological Sciences & Forestry Arts Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Optimizing Patient Distribution Through the Adaptation of the RAFAELA System by Strengthening the Role of Nurse Unit Managers to Achieve Equitable Nursing Workload Distribution Mikha Arisia Helen; Tuti Afriani; Hening Pujasari
Indonesian Journal of Global Health Research Vol. 8 No. 5 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i5.2434

Abstract

Increasing patient complexity and Bed Occupancy Rate (BOR) have contributed to higher nursing workload at X hospital. These conditions potentially lead to imbalanced workload distribution, nurse fatigue, and decreased quality of care and patient safety. This study aimed to optimize competency-based nurse staffing through the role of Nurse Unit Managers (NUMs) in managing nursing workload at X hospital. This study used a project improvement approach conducted during nursing management residency activities in inpatient units on the 5th, 10th, 11th, 12th, and 13th floors of X hospital from April to May 2026. Data were collected through observations, semi-structured interviews, and document reviews. Problem analysis was conducted using the POSAC approach and fishbone analysis. The intervention was implemented through competency-based staffing using the RAFAELA System as a nursing intensity measurement tool. Most patients had partial to total dependency levels with high clinical complexity. The nurse-to-patient ratio increased to 1:9–11 during full BOR conditions. Patient assignment was previously based on room location rather than patient complexity and nurses’ competency levels, resulting in workload imbalance. The implementation of competency-based staffing assisted NUMs in distributing patients more objectively according to patient complexity and nurses’ competencies. Competency-based nurse staffing optimization through strengthening the role of NUMs and utilization of the RAFAELA System has the potential to improve nursing service effectiveness, support patient safety, and create more proportional workload distribution.
Optimalisasi Kualitas Tidur Perawat Shift Malam melalui Strategic Napping: Studi Manajemen Keperawatan di Rumah Sakit Pendidikan Ilham Cahyo Nugroho; Hanny Handiyani; Hening Pujasari
Jurnal Keperawatan Widya Gantari Indonesia Vol 10 No 2 (2026): JURNAL KEPERAWATAN WIDYA GANTARI INDONESIA (JKWGI)
Publisher : Nursing Department, Faculty of Health, Universitas Pembangunan Nasional "Veteran" Jakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52020/jkwgi.v10i2.15533

Abstract

Sleep quality among nurses is an important aspect of patient safety, quality of care, and nursing workforce well-being, particularly among nurses working night shifts. This activity aimed to analyze the strategic role of nursing management in optimizing nurses’ sleep quality through the development of a strategic napping program in the inpatient wards of Hospital X. The activity used a case report approach based on nursing management practices and was conducted from April 21 to May 21, 2026. Data were collected through in-depth interviews with five Nurse Unit Managers (NUMs), workplace observations, and a researcher-developed assessment questionnaire administered to inpatient nurses. The questionnaire was developed to assess nursing management functions and the need for a strategic napping program. A total of 18 nurses participated from a population of 146 nurses across five inpatient wards. Data were analyzed descriptively and further examined using SWOT and fishbone analyses. The findings showed that 72.2% of respondents perceived nursing management functions supporting sleep quality as less effective, while all respondents reported a need for a strategic napping program. The main challenges included high workload, an imbalance in the nurse-to-patient ratio, limited rest time and facilities, and suboptimal fatigue management. The program was developed using Kotter’s Eight-Step Change Model, with interventions including sleep hygiene education, scheduled rest periods, and strengthened nursing management roles. Initial evaluation indicated staff acceptance and participation in the program, providing a foundation for continued development of sustainable fatigue management.
Strategi Manajemen Shift Work Disorder (SWD) untuk Perawat Rumah Sakit: Sistematik Review Rizany, Ichsan; Handiyani, Hanny; Pujasari, Hening; Erwandi, Dadan; Wulandari, Cicilia Ika; Gayatri, Dewi
Jurnal Kesehatan Vokasional Vol 9, No 2 (2024): May
Publisher : Sekolah Vokasi Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkesvo.93081

Abstract

Latar Belakang: Shift Worker Disorder (SWD) masih menjadi masalah sampai saat ini. Perkiraan prevalensi gangguan kerja shift (SWD) bervariasi antara 5 - 35,2%. Banyak dampak yang diakibatkan oleh SWD kepada perawat.Tujuan: Penelitian bertujuan melakukan analisis tentang strategi manajemen shift work disorder (SWD) untuk perawat di rumah sakit.Metode: l Desain penelitian ini adalah systematik review menggunakan diagram alur PRISMA. Peneliti menggunakan PICOs dan mencari artikel bahasa inggris yang diterbitkan dari tahun 2018 sampai dengan Maret 2023. Database yang digunakan meliputi ProQuest, MEDLINE, Embase, Scopus, PubMed, ClinicalKey Nursing, Science Direct, dan Taylor & Francis. Peneliti memanfaatkan tool Covidence untuk proses seleksi data sampai dengan ekstraksi serta menggunakan instrument the Joanna Briggs Institute (JBI) untuk mengevaluasi artikel.Hasil: Sepuluh artikel telah diidentifikasi dan dianalisis. Ukuran sampel dari studi dilaporkan berkisar dari 16 sampai dengan 4275 yang dilakukan di berbagai wilayah geografis. Perawat bisa melakukan manajemen stres, menerapkan sleep hygiene, dan terapi perilaku kognitif untuk mengurangi SWD. Manajemen jadwal dinas, dukungan social dan pengaturan cahaya lingkungan menjadi poin yang dapat diperhatikan di level organisasi oleh manajer rumah sakit dalam membantu mengurangi SWD.Kesimpulan: Strategi untuk manajemen SWD dapat melalui sleep hygiene, pengaturan cahaya lingkungan, terapi perilaku kognitif,  dukungan sosial, manajemen stres, dan penjadwalan dinas.
Effectiveness of Cancer Patient Navigator Program to Reduce Caregiver Burden: A Systematic Review Rikumahu, Marisco; Allenidekania, Allenidekania; Pujasari, Hening; Gayatri, Dewi
Jurnal Kesehatan Vokasional Vol 10, No 2 (2025): May
Publisher : Sekolah Vokasi Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkesvo.105240

Abstract

Background: Cancer is a major disease that significantly affects global public health. In Indonesia, the number of cancer patients continues to increase, requiring innovative approaches in the cancer care system.Objective: This study aims to evaluate the effectiveness of cancer patient navigator programs in reducing caregiver burden, particularly among cancer patients.Methods: This systematic review followed the PRISMA guidelines and used inclusion criteria that included full-text articles published in English and quantitative studies. Literature searches were conducted in various academic databases using relevant keywords.Results: Out of 3,583 records retrieved, 6 studies met the criteria for further analysis. The results also showed that patient navigator programs can significantly reduce caregiver burden through improved education, emotional support, and access to healthcare services.Conclusion: The implementation of cancer patient navigator programs in Indonesia has the potential to reduce caregiver burden and improve the quality of cancer patient care. Recommendations for further research and health policy are also included.
Readiness for the Implementation of A Mentorship Program in Nursing Practice: Perspectives of Nurse Managers, Mentors, and mentees Sitta Diani Fichara; Enie Novieastari; Hening Pujasari; Hanny Handiyani; Sarvita Dewi
Indonesian Journal of Global Health Research Vol. 8 No. 6 (2026): Indonesian Journal of Global Health Research: December 2026
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i6.2727

Abstract

Background: Men Mentorship is a professional development strategy that plays an important role in enhancing nurses' competencies, professionalism, and the quality of nursing care. However, the implementation of mentorship programs at Hospital X has not yet been optimal, highlighting the need to explore readiness for program implementation. This study aimed to explore readiness for mentorship program implementation from the perspectives of nurse managers, mentors, and mentees. This descriptive qualitative study involved 24 participants, consisting of 10 nurse managers, 6 mentors, and 8 mentees, who were recruited using purposive sampling. Data were collected through Focus Group Interviews using a semi-structured interview guide and analyzed using thematic analysis. The analysis generated six themes describing the understanding of mentorship, mentorship implementation, learning orientation, implementation barriers, implementation readiness, and mentors' perceptions of mentee characteristics. Nurse managers emphasized the importance of leadership support and organizational systems, including structured implementation, monitoring, evaluation, and standardization. Mentors highlighted readiness to perform the mentoring role through competence, experience, and commitment. Mentees emphasized learning needs, effective mentoring, adaptation to the work environment, and support from head nurses. Across all three groups, operational, organizational, and individual barriers were identified as challenges to mentorship implementation. Overall, readiness for implementation was perceived as a multidimensional process resulting from the synergy among individual preparedness, leadership support, and organizational support. Readiness for mentorship implementation requires alignment between individual, leadership, and organizational factors. Establishing a structured and standardized system while maintaining responsive mentoring based on mentees' needs may support sustainable implementation of mentorship in nursing practice. torship is a professional development strategy that plays an important role in enhancing nurses' competencies, professionalism, and the quality of nursing care. However, the implementation of mentorship programs at Hospital X has not yet been optimal, highlighting the need to explore readiness for program implementation. This study aimed to explore readiness for mentorship program implementation from the perspectives of nurse managers, mentors, and mentees. Methods: This descriptive qualitative study involved 24 participants, consisting of 10 nurse managers, 6 mentors, and 8 mentees, who were recruited using purposive sampling. Data were collected through Focus Group Interviews using a semi-structured interview guide and analyzed using thematic analysis. Results: The analysis generated six themes describing the understanding of mentorship, mentorship implementation, learning orientation, implementation barriers, implementation readiness, and mentors' perceptions of mentee characteristics. Nurse managers emphasized the importance of leadership support and organizational systems, including structured implementation, monitoring, evaluation, and standardization. Mentors highlighted readiness to perform the mentoring role through competence, experience, and commitment. Mentees emphasized learning needs, effective mentoring, adaptation to the work environment, and support from head nurses. Across all three groups, operational, organizational, and individual barriers were identified as challenges to mentorship implementation. Overall, readiness for implementation was perceived as a multidimensional process resulting from the synergy among individual preparedness, leadership support, and organizational support. Conclusion: Readiness for mentorship implementation requires alignment between individual, leadership, and organizational factors. Establishing a structured and standardized system while maintaining responsive mentoring based on mentees' needs may support sustainable implementation of mentorship in nursing practice.
Inisiasi pengelolaan alarm fatigue perawat melalui panduan manajemen alarm di ruang intensif Neni Widyaningsih; Hanny Handiyani; Hening Pujasari; Masfuri Masfuri
Hik Vol. 18 No. 11 (2025): Volume 18 Nomor 11
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v18i11.507

Abstract

Background: Alarm fatigue in nurses working in intensive care units is still a critical issue and priority in patient safety. Alarm fatigue is a condition when someone becomes insensitive to safety warnings due to receiving too many alarms. Alarm fatigue can be prevented by implementing effective alarm management. On the other hand, the current implementation of alarm management is still not optimal. Head nurses play an important role in efforts to prevent alarm fatigue incidents and oversee the implementation of alarm management and need direction in its implementation in intensive care units. Purpose: To initiate alarm fatigue management for nurses through alarm management guidelines in intensive care units. Method: A case report study according to Kotter's planned change stages was conducted at the University of Indonesia Teaching Hospital on April 22 - May 24, 2024. The research process included assessment, data analysis, action plan (PoA), implementation, and evaluation. Data collection was carried out through interviews, observations, and filling out questionnaires. Results: The priority problems obtained were the suboptimal planning function related to alarm fatigue management through alarm management and implementation through Kotter's theory which had only been carried out until the third stage. Conclusion: Planned changes can be made in the implementation of implementation in solving problems. The problem found was the suboptimal function of the head of the room in alarm management in the intensive care unit. The alarm management guide that has been created is expected to prevent the occurrence of fatigue alarms in nurses and provide quality services. Suggestion: The draft guide for managing nurse fatigue alarms through alarm management can be approved by the president director and applied in services in the hospital's intensive care unit. In addition, the hospital can organize training and education for nursing staff to improve understanding of fatigue alarms, effective alarm management, and conduct periodic evaluations.   Keywords: Alarm Management; Fatigue Alarm; Intensive Care Unit; Nurses.   Pendahuluan: Alarm fatigue pada perawat yang bekerja pada ruang intensif masih menjadi masalah yang kritis dan prioritas dalam keselamatan pasien. Alarm fatigue adalah kondisi ketika seseorang menjadi tidak peka terhadap peringatan keselamatan akibat menerima terlalu banyak alarm. Alarm fatigue dapat dicegah dengan menerapkan manajemen alarm yang efektif. Di sisi lain, penerapan manajemen alarm saat ini masih belum optimal. Head nurse memainkan peran penting dalam upaya mencegah kejadian alarm fatigue dan mengawasi pelaksanaan manajemen alarm dan membutuhkan panduan dalam pelaksanaannya di ruang intensif. Tujuan: Untuk menginisiasi pengelolaan alarm fatigue perawat melalui panduan manajemen alarm di ruang intensif. Metode: Penelitian case report sesuai tahapan perubahan terencana Kotter’s, dilakukan di Rumah Sakit Pendidikan, Universitas Indonesia pada tanggal 22 April – 24 Mei 2024. Proses penelitian meliputi pengkajian, analisis data, rencana tindakan/plan of action (PoA), implementasi, dan evaluasi. Data dikumpulkan melalui wawancara, observasi, dan pengisian kuesioner. Hasil: Prioritas masalah yang didapat yaitu fungsi perencanaan belum optimal terkait dengan pengelolaan alarm fatigue melalui manajemen alarm dan implementasi melalui teori Kotters, dilakukan baru sampai pada tahap yang ketiga. Simpulan: Perubahan terencana dapat dilakukan dalam pelaksanaan implementasi dalam menyelesaikan masalah. Permasalahan yang ditemukan yakni belum optimalnya fungsi perencanaan kepala ruangan dalam manajemen alarm di ruang intensif. Panduan manajemen alarm yang telah dibuat diharapkan dapat mencegah terjadinya alarm fatigue pada perawat dan memberikan pelayanan yang berkualitas. Saran: Draft pengelolaan alarm fatigue perawat melalui manajemen alarm dapat disahkan oleh direktur utama dan diterapkan dalam pelayanan di ruang intensif rumah sakit. Selain itu, pihak rumah sakit dapat menyelenggarakan pelatihan dan edukasi bagi staf perawat untuk meningkatkan pemahaman tentang alarm fatigue, manajemen alarm yang efektif, dan melakukan evaluasi secara berkala.   Kata Kunci: Alarm Fatigue; Manajemen Alarm; Perawat; Ruang Intensif.
Kesiapsiagaan puskesmas dalam menghadapi perubahan iklim yang berdampak pada kesehatan: A systematic review Epi Susanti; Krisna Yetti; Hening Pujasari; Dewi Gayatri
Hik Vol. 18 No. 11 (2025): Volume 18 Nomor 11
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v18i11.509

Abstract

Background: Climate change has the potential to significantly impact public health. Primary health facilities must be prepared to provide effective health services to address the health impacts of climate change. Purpose: To determine the preparedness of community health centers in facing climate change that has an impact on health. Method: The approach used is Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). The search format using Patient, Intervention, Comparison, Outcome (PICO) was formulated to facilitate the process of searching literature from databases. The databases used are ScienceDirect, Sage Journal and Scopus from 2020-2024. Researchers use the Mendeley application to detect duplication. Results: The final search results obtained 10 articles, from these articles were obtained preparedness efforts that can be carried out by health centers through routine training, building knowledge, attitudes, and practices of health workers, and building positive perceptions about preparedness. Health centers can respond to the impacts of climate change more effectively with the support of a structured framework. Conclusion: Increasingly extreme climate change has a significant impact on public health, thus requiring better preparedness from health facilities such as community health centers.   Keywords: Climate Change; Health Centers; Preparedness.   Pendahuluan: Perubahan iklim berpotensi m.emberi dampak besar bagi kesehatan masyarakat. Fasilitas kesehatan primer dituntut memiliki kesiapsiagaan untuk memberi pelayanan kesehatan yang efektif dalam merespon dampak kesehatan akibat perubahan iklim. Tujuan: Untuk mengetahui kesiapsiagaan puskesmas dalam menghadapi perubahan iklim yang berdampak pada kesehatan. Metode: Pendekatan yang digunakan adalah Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). Format pencarian dengan menggunakan Patient, Intervention, Comparison, Outcome (PICO) dirumuskan untuk memudahkan dalam proses pencarian literatur dari database. Database yang digunakan adalah ScienceDirect, Sage Journal dan Scopus dari tahun 2020-2024.  Peneliti menggunakan aplikasi Mendeley untuk mendeteksi Duplikasi. Hasil: Hasil akhir pencarian didapatkan 10 artikel, dari artikel tersebut didapatkan upaya kesiapsiagaan yang dapat dilakukan oleh puskesmas melalui pelatihan rutin, membangun pengetahuan, sikap, dan praktik tenaga kesehatan, serta membangun persepsi positif tentang kesiapsiagaan. Puskesmas dapat merespons dampak perubahan iklim secara lebih efektif dengan dukungan kerangka kerja yang terstruktur. Simpulan: Perubahan iklim yang semakin ekstrem menimbulkan dampak signifikan terhadap kesehatan masyarakat, sehingga menuntut kesiapsiagaan yang lebih baik dari fasilitas kesehatan seperti puskesmas.   Kata Kunci: Kesiapsiagaan; Perubahan Iklim; Puskesmas.
Pengembangan pedoman handover di ruang rawat inap rumah sakit Universitas Indonesia Helen Magdalena; Hanny Handiyani; Hening Pujasari; Roro Tutik Sri Hariyati; Erna Puspita Sari
Hik Vol. 19 No. 2 (2025): Volume 19 Nomor 2
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i2.848

Abstract

Background: The handover process in nursing care is very important because it is directly related to patient safety and continuity of care. A suboptimal handover can increase the risk of medical errors. Purpose: To develop handover guidelines in the inpatient ward of the University of Indonesia Hospital. Method: A case report study on the preparation of handover guidelines was conducted at the University of Indonesia Hospital on September 2 - October 2, 2024. This activity includes assessment, data analysis, action plan (Plan of Action/PoA), implementation, and evaluation. Data collection was carried out through interviews, observations, and questionnaires. The approach used to solve the problem through Kurt Lewin's theory of change. Results: Shows that the implementation of handover is not optimal with variations in methods used, including conferences and handovers at the bedside. The results of the study indicate that the implementation of the handover SOP has not been consistently adhered to by ward nurses and several factors such as time constraints and lack of supervision have a negative effect on the effectiveness of the handover. Conclusion: The implementation of handovers in inpatient rooms has not been optimal due to inconsistencies in the application of SOPs, time constraints, and lack of supervision. The development of handover guidelines with the Kurt Lewin change theory approach is a strategic step to improve the effectiveness and consistency of handovers. Wider dissemination of guidelines and regular monitoring are needed to ensure patient safety and the quality of sustainable nursing care. Suggestion: Handover guidelines need to be updated regularly based on scientific evidence (evidence-based practice) to remain relevant to developments in nursing science. Socialization and implementation activities of handover conferences and handovers at the patient's bedside need to be monitored and evaluated routinely to ensure their effectiveness in improving the quality of patient handovers.   Keywords: Handover; Guidelines; Development; Inpatient; Hospital.   Pendahuluan: Proses serah terima atau handover dalam asuhan keperawatan sangat penting karena secara langsung berhubungan dengan keselamatan pasien dan kontinuitas perawatan. Handover yang tidak optimal dapat meningkatkan risiko kesalahan medis. Tujuan:  Untuk mengembangkan pedoman handover di ruang rawat inap rumah sakit Universitas Indonesia. Metode: Penelitian case report mengenai pengembangan panduan handover, dilakukan di Rumah Sakit Universitas Indonesia pada 2 September – 2 Oktober 2024. Kegiatan ini meliputi pengkajian, analisis data, rencana tindakan plan of action (PoA), implementasi, dan evaluasi. Data dikumpulkan melalui wawancara, observasi, dan pengisian kuesioner. Pendekatan yang digunakan untuk menyelesaikan masalah melalui teori perubahan Kurt Lewin. Hasil: Menunjukkan bahwa pelaksanaan handover belum optimal dengan variasi metode yang digunakan, termasuk conference dan bedside handover. Hasil menunjukan bahwa pelaksanaan SPO handover tidak konsisten dipatuhi perawat ruangan dan beberapa faktor, seperti keterbatasan waktu dan kurangnya supervisi berpengaruh negatif terhadap efektivitas handover. Simpulan: Pelaksanaan handover di ruang rawat inap belum berjalan secara optimal akibat ketidakkonsistenan dalam penerapan SPO, keterbatasan waktu, dan kurangnya supervisi. Pengembangan panduan handover dengan pendekatan teori perubahan Kurt Lewin menjadi langkah strategis untuk meningkatkan efektivitas dan konsistensi handover. Sosialisasi panduan yang lebih luas dan monitoring berkala diperlukan untuk menjamin keselamatan pasien dan kualitas asuhan keperawatan yang berkelanjutan. Saran: Panduan handover perlu diperbarui secara berkala berdasarkan bukti ilmiah (evidence-based practice) agar tetap relevan dengan perkembangan ilmu keperawatan. Kegiatan sosialisasi dan implementasi handover conference serta bedside handover perlu dimonitoring dan dievaluasi secara rutin untuk memastikan efektivitasnya dalam meningkatkan kualitas serah terima pasien.   Kata Kunci: Handover; Pedoman; Pengembangan; Rawat Inap; Rumah Sakit.
Optimizing Nurse Performance in Elective Surgery Patient Preparation through a Lean Management Approach: A Quality Improvement Case Report Ika Chandra Nuryana; Hening Pujasari; Hanny Handiyani
Indonesian Journal of Global Health Research Vol. 8 No. 6 (2026): Indonesian Journal of Global Health Research: December 2026
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i6.2759

Abstract

Nurse performance in managerial functions is essential to effective elective surgery preparation, as process failures may compromise patient safety, operational efficiency, and service quality. At X hospital, 92 surgical delays due to patient unpreparedness were recorded from January to April 2026, indicating gaps in nurses’ planning, organizing, and controlling functions. To analyze the optimization of nurse performance in elective surgery preparation through a Lean Management approach in an inpatient surgical unit. A quality improvement case study integrated the POSAC management framework, Lewin’s Planned Change Model, and Lean Management. Data were collected through interviews, validated and reliable 1–5 Likert-scale questionnaires administered to 15 nurses, direct observation, and document review. Data were analyzed using Value Stream Mapping (VSM), 5-Why Analysis, Fishbone Diagram, and the USG Priority Matrix based on five Lean Thinking principles. Overall nurse managerial performance was categorized as good. SOP compliance had the highest mean score (4.27), while the nurse-to-patient ratio (2.67) and cross-unit coordination (3.20) were the lowest. VSM identified 23 preparation steps, with only 9 (39%) classified as value-added. Implementation of cross-unit SOPs, visual management, and digital preoperative education resulted in 0% preparation defects during 11 days of monitoring, a 53.85% reduction in surgical delays (13 to 6 cases), 75% checklist compliance, and 100% shift-briefing adherence. Lean Management can optimize nurse performance, reduce process defects, and strengthen patient safety in elective surgery preparation. Sustainability requires SOP legalization, hospital information system integration, and periodic audits.
Co-Authors Abdul Rahman, La Ode Achir Yani Agung Waluyo Agustine Ramie Aldri Frinaldi Allenidekania Allenidekania ANDI AMALIA WILDANI Andi Amalia Wildani Azizah, Yuni Bahrul Hayat Bahrul Hayat Bahrul Hayat, Bahrul Cahyantari Merduaty, Rona Chatarina Setya Widyastuti Cicilia Ika Wulandari Cori Tri Suryani Dadan Erwandi Desnita Fitri Devi Nurmalia Dewi Gayatri Dewi Gayatri Dewi Gayatri Dwi Asih Rohmawati Dyah Juliastuti Elly Nurachmah Ema Hikmah Enie Novieastari Enie Novietasari Epi Susanti Era Dorihi Kale Eric Umar Erna Puspita Sari Evi Setyowati Friska Friska Gayatri, Dewi Geri Donenberg Hana Mutiasari Hana Mutiasari Hanny Handiyani Hanny Handiyani Harpendewisasmita Harpendewisasmita Helen Magdalena Hulu, Soni Roy Kurniawan I Made Kariasa Ika Chandra Nuryana Ilham Cahyo Nugroho Imami Nur Rachmawati Joan Xaveria Mahulae Judith A Levy Juwi Athia Rahmini Kartika Mawar Sari Sugianto Keksi Girindra Swasti Khairunnisa, Riana Krisna Yetti Krisna Yetti Krisna Yetti Kristiawati Kristiawati Kuntarti La Ode Abdul Rahman Lasiyani, Ni Luh Lestari Hernawati Made Sumarwati Mary Ellen Mackesy-Amiti Masfuri Masfuri Mayanti Mahdarsari Mikha Arisia Helen Muhamad Rofi’i Muhamad Rofi’i Muhammad Koko Hartopo Mulyawan, Tara Mudita Nasri, Khairul Neni Widyaningsih Noraliyatun Jannah Novy Helena Chatarina Daulima Nugraha, Rudi Nunung Nurhayati Nunung Nurhayati Nunung Nurhayati Nurani, Tuti Puspita Eka Wuyung Putri, Tissa Aulia Rahma Marfiani Rahmini, Juwi Athia Ratna Sitorus Resa Ariansyah Rhomlah Rhomlah Ria Kodariah Rikumahu, Marisco Rio Verdiansyah Riska Adellia Rita Setianingrum Rizany, Ichsan Robert C Bailey Rohmawati, Dwi Asih Roro Tutik Sri Hariyati Rr Tutik Sri Hariyati Ruri Wulandari Saho, Musa Sali Rahadi Asih Sari, Uti Nilam Sarma, Eva Winda Sarvita Dewi Sarvita Dewi Sitta Diani Fichara Situmeang, Widiya Yulian Sri Herni Wigiarti Suci Sari Pratiwi Tissa Aulia Putri Titin Ungsianik Tuti Afriani Viesca Septianata Wildan Wildan Wiwik Antaroza Yati Afiyanti Yeni Rustina Yuliana Bernadetta Yuvensius Pili