Electronic Theses and Dissertation

KEMENTERIAN PENDIDIKAN, KEBUDAYAAN, RISET DAN TEKNOLOGI
UNIVERSITAS SYIAH KUALA
FAKULTAS KEPERAWATAN
PROGRAM STUDI MAGISTER KEPERAWATAN

TESIS
17 Juni 2022

xiv Halaman + 5 BAB + 90 Halaman + 13 Tabel + 3 Gambar + 10 Lampiran

Zulfitri
NPM. 1712201010038

Analisis Determinan Pengambilan Keputusan Klinis Keperawatan Di Ruang Rawat Inap Bedah Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh

ABSTRAK

Keterampilan pengambilan keputusan klinis dapat membantu meningkatkan kualitas asuhan keperawatan. Situasi kesehatan yang sulit dan rumit akan meningkatkan kompleksitas masalah serta pentingnya pengambilan keputusan klinis oleh perawat. Namun sifat keputusan yang diambil sebagian besar masih tergantung dari kebiasaan praktik sehari-hari perawat. Tujuan penelitian ini adalah untuk mengetahui hubungan determinan; berpikir kritis, pengalaman klinis, advokasi dan otonomi dengan pengambilan keputusan klinis keperawatan. Jenis penelitian kuantitatif korelatif dengan desain cross sectional study. Jumlah sampel 152 responden, pengambilan sampel menggunakan teknik total sampling. Alat pengumpulan data menggunakan instrumen baku; California Critical Thingking Dispositions Inventory, Nursing Activity Scale, Protective Nursing Advocacy Scale versi Swedia dan Swedish Version of Melbourne Decision Making Questionnaire. Kuesioner didistribusikan secara online (google form). Analisa data menggunakan uji statistik deskriptif uji non parametric; chi-square test dan Regresi Logistik. Hasil penelitian ada hubungan berpikir kritis (p-value = 0,000), pengalaman klinis (p-value = 0,000), otonomi (p-value = 0,024) dan advokasi (p-value = 0,000) dengan pengambilan keputusan klinis keperawatan. Pengalaman klinis menjadi prediktor paling dominan dari determinan pengambilan keputusan klinis. Pengalaman klinis 11 kali lebih berpengaruh dalam pengambilan keputusan klinis dibandingkan dengan determinan berpikir kritis dan advokasi. Sebagai peran profesional, perawat menjadi bertanggung jawab untuk keputusan klinis yang lebih luas. Kompleksitas unit perawatan memungkinkan perawat menghadapi tantangan besar dalam memainkan peran serta fungsinya terutama dalam proses pengambilan keputusan klinis. Perawat akan terus dihadapkan dengan tuntutan untuk membuat keputusan klinis keperawatan, oleh karena itu, perawat diharapkan menjadi orang yang berpikir, mengambil keputusan, dan bertanggung jawab atas keputusannya.

Kata Kunci : berpikir kritis, klinis pengalaman, otonomi, advokasi, pengambilan keputusan klinis
Daftar Pustaka : 23 buku, 31 jurnal ilmiah dan 4 peraturan negara (2007-2021)

MINISTRY OF EDUCATION, CULTURE, RESEARCH AND TECHNOLOGY UNIVERSITAS SYIAH KUALA FACULTY OF NURSING MASTER PROGRAM OF NURSING SCIENCE THESIS June 17, 2022 xiv Pages + 5 CHAPTER + 90 Pages + 13 Tables + 3 Figures + 10 Appendices Zulfitri NPM. 1712201010038 Analysis of Determinants of Nursing Clinical Decision Making in the Surgical Inpatient Room at Regional General Hospital dr. Zainoel Abidin Banda Aceh ABSTRACT Clinical decision-making skills can help improve the quality of nursing care. Difficult and complicated health situations will increase the complexity of the problem and the importance of clinical decision making by nurses. However, the nature of the decisions taken is still largely dependent on the nurses' daily practice habits. The purpose of this study was to determine the relationship between the determinants; critical thinking, clinical experience, advocacy and autonomy with clinical nursing decision making. This type of quantitative research is correlative with a cross sectional study design. The number of samples is 152 respondents, sampling using total sampling technique. Data collection tools using standard instruments; California Critical Thinkking Dispositions Inventory, Nursing Activity Scale, Swedish version of Protective Nursing Advocacy Scale and Swedish Version of Melbourne Decision Making Questionnaire. The questionnaire was distributed online (google form). Data analysis used descriptive statistical test non parametric test; chi-square test and logistic regression. The results showed that there was a relationship between critical thinking (p-value = 0.000), clinical experience (p-value = 0.000), autonomy (p-value = 0.024) and advocacy (p-value = 0.000) with nursing clinical decision making. Clinical experience is the most dominant predictor of clinical decision-making determinants. Clinical experience is 11 times more influential in clinical decision making than the determinants of critical thinking and advocacy. As a professional role, nurses become responsible for broader clinical decisions. The complexity of the care unit allows nurses to face great challenges in playing their roles and functions, especially in the clinical decision-making process. Nurses will continue to be faced with demands to make clinical nursing decisions, therefore, nurses are expected to be people who think, make decisions, and are responsible for their decisions. Keywords : critical thinking, clinical experience, autonomy, advocacy, clinical decision making Bibliography : 21 books, 31 scientific journals and 4 state regulations (2007-2021)