Analisis Pelaksanaan Pendelegasian Kewenangan Klinis Perawat di Rumah Sakit
Abstract
This literature review aims to summarize the results of research regarding the implementation of delegation of clinical authority to nurses in hospitals. Literature search using five databases PubMed, ProQuest, ScienceDirect, Google Scholar and Wiley in the period 2013-2023. Nine studies were included in the review, where the effectiveness of the implementation of delegation of nursing authority could be hampered by three factors: 1) practice standards and policies (clarity of delegation standards, clarity of nurses' duties, transparent supervision); 2) delegation (delegator's fear of responsibility, burdensome delegation tasks, accountability, recognition of the delegate's efforts, education and learning opportunities, expertise, lack of positive incentives, communication and openness of information, trust); 3) situational obstacles (lack of resources, workload and fatigue, important tasks that are difficult to delegate). In conclusion, there are three factors inhibiting the effectiveness of delegation, namely: practice standards and policies, delegation, and situational obstacles.
Keywords: Delegation, Clinical Authority, Implementation, Nurse, Hospital
References
American Nurses Association. (2019). National Guidelines for Nursing Delegation. https://www.nursingworld.org/~4962ca
Atta, S. M., Ezz, N., & Fekry, E. (2019). Barriers of Effective Delegation as Perceived by Nursing Staff in a University Hospital. International Journal of Novel Research in Healthcare and Nursing, 6(3), 899–907. www.noveltyjournals.com
Baddar, F., Salem, O. A., & Hakami, A. A. (2016). Nurse Manager's attitudes and preparedness towards effective delegation in Saudi Hospitals. Health Science Journal, 10(2), 1-9. www.hsj.gr/archive
Benjamins, S. J., Damen, M. L. W., & Van Stel, H. F. (2015). Feasibility and Impact of Doctor-Nurse Task Delegation in Preventive Child Health Care in the Netherlands, a Controlled Before-After Study. PLoS ONE, 10(10), 1–18. https://doi.org/10.1371/journal.pone.0139187
Crevacore, C., Coventry, L., Duffield, C., & Jacob, E. (2022). Factors Impacting Delegation Decision Making by Registered Nurses to Assistants in Nursing in The Acute Care Setting: a Mixed Method Study. International Journal of Nursing Studies, Volume 136. https://doi.org/10.1016/j.ijnurstu.2022.104366
Dudley, N., Miller, J., Breslin, M. Lou, Chapman, S. A., & Spetz, J. (2021). The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study. Medical Care Research and Review, 78(1_suppl), 47S-56S. https://doi.org/10.1177/1077558720960902
Gillen, P., & Graffin, S. (2010). Nursing Delegation in the United Kingdom. OJIN: The Online Journal of Issues in Nursing, 15(2). https://doi.org/10.3912/ojin.vol15no02man06
Hidayat, A. T., Hariyati, R. T. S., & Nuraini, T. (2021). The Factor of Affecting Head Nurse’s Delegation: A Cross Sectional Study. Enfermeria Clinica, 31, S117–S121. https://doi.org/10.1016/j.enfcli.2020.12.004
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Kerzman, H., Van Dijk, D., Eizenberg, L., Khaikin, R., Phridman, S., Siman-Tov, M., & Goldberg, S. (2015). Attitudes Toward Expanding Nurses’ Authority. Israel Journal of Health Policy Research, 4(1), 1–8. https://doi.org/10.1186/s13584-015-0005-z
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Tompkins, F. (2016). Delegation in Correctional Nursing Practice. Journal of Correctional Health Care, 22(3), 218–224. https://doi.org/10.1177/1078345816654229
Wagner, E. A. (2018). Improving patient Care Outcomes Through Better Delegation-Communication Between Nurses and Assistive Personnel. Journal of Nursing Care Quality, 33(2), 187–193. https://doi.org/10.1097/NCQ.0000000000000282
Walker, F. A., Ball, M., Cleary, S., & Pisani, H. (2021). Transparent Teamwork: the Practice of Supervision and Delegation Within the Multi-Tiered Nursing Team. In Nursing Inquiry, 28(4). https://doi.org/10.1111/nin.12413
Whittemore, R., Chao, A., Jang, M., Minges, K. E., & Park, C. (2014). Methods for Knowledge Synthesis: An Overview. Heart and Lung: Journal of Acute and Critical Care, 43(5), 453–461. https://doi.org/10.1016/j.hrtlng.2014.05.014
Yoon, J., Kim, M., & Shin, J. (2016). Confidence in Delegation and Leadership of Registered Nurses in Long-Term-Care Hospitals. Journal of Nursing Management, 24(5), 676–685. https://doi.org/10.1111/jonm.12372
Atta, S. M., Ezz, N., & Fekry, E. (2019). Barriers of Effective Delegation as Perceived by Nursing Staff in a University Hospital. International Journal of Novel Research in Healthcare and Nursing, 6(3), 899–907. www.noveltyjournals.com
Baddar, F., Salem, O. A., & Hakami, A. A. (2016). Nurse Manager's attitudes and preparedness towards effective delegation in Saudi Hospitals. Health Science Journal, 10(2), 1-9. www.hsj.gr/archive
Benjamins, S. J., Damen, M. L. W., & Van Stel, H. F. (2015). Feasibility and Impact of Doctor-Nurse Task Delegation in Preventive Child Health Care in the Netherlands, a Controlled Before-After Study. PLoS ONE, 10(10), 1–18. https://doi.org/10.1371/journal.pone.0139187
Crevacore, C., Coventry, L., Duffield, C., & Jacob, E. (2022). Factors Impacting Delegation Decision Making by Registered Nurses to Assistants in Nursing in The Acute Care Setting: a Mixed Method Study. International Journal of Nursing Studies, Volume 136. https://doi.org/10.1016/j.ijnurstu.2022.104366
Dudley, N., Miller, J., Breslin, M. Lou, Chapman, S. A., & Spetz, J. (2021). The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study. Medical Care Research and Review, 78(1_suppl), 47S-56S. https://doi.org/10.1177/1077558720960902
Gillen, P., & Graffin, S. (2010). Nursing Delegation in the United Kingdom. OJIN: The Online Journal of Issues in Nursing, 15(2). https://doi.org/10.3912/ojin.vol15no02man06
Hidayat, A. T., Hariyati, R. T. S., & Nuraini, T. (2021). The Factor of Affecting Head Nurse’s Delegation: A Cross Sectional Study. Enfermeria Clinica, 31, S117–S121. https://doi.org/10.1016/j.enfcli.2020.12.004
Kementerian Kesehatan RI. (2019). Peraturan Menteri Kesehatan Republik Indonesia Nomor 26 Tahun 2019 tentang Peraturan Pelaksanaan Undang-Undang Nomor 38 Tahun 2014 tentang Keperawatan. Kementerian Kesehatan Republik Indonesia.
Kerzman, H., Van Dijk, D., Eizenberg, L., Khaikin, R., Phridman, S., Siman-Tov, M., & Goldberg, S. (2015). Attitudes Toward Expanding Nurses’ Authority. Israel Journal of Health Policy Research, 4(1), 1–8. https://doi.org/10.1186/s13584-015-0005-z
Khadim, H. A., Ali, A., Ijaz, M. S., & Rooman, N. (2018). Nurse Manager’s Attitudes and Preparedness Towards Effective Delegation in a Tertiary Care Public Hospital Lahore. National Journal of Health Sciences, 3(3), 99–106. https://doi.org/10.21089/njhs.33.0099
Motacki, K., & M. Burke, K. (2017). Nursing Delegation and Management of Patient Care Third Edition (Third Edit). Elsevier.
Muttaqin, G. F. (2018). Pengaruh Pendelegasian Wewenang terhadap Kinerja Organisasi. Jurnal Riset Akuntansi Terpadu, 11(2). http://dx.doi.org/10.35448/jrat.v11i2.4255
Nursing & Midwifery Council. (2018). The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates. Nursing & Midwifery Council United Kingdom. https://doi.org/10.4324/9781315135496-8
Pardede, M. J., Fitriani, A. D., & Hadi, A. J. (2020). Analisis Implementasi Manajemen Asuhan Keperawatan di Ruang Rawat Inap RSU. Mitra Sejati Medan. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 3(2), 93-99. https://doi.org/10.56338/mppki.v3i2.1077
Poeira, A. F., & Zangão, M. O. (2022). Construct of the Association between Sleep Quality and Perinatal Depression: A Literature Review. Healthcare (Switzerland), 10(7), 1–11. https://doi.org/10.3390/healthcare10071156
Pohan, V. Y., & Faozah, H. S. (2019). Gambaran Penerapan Model Delegasi Keperawatan Relactor (MDK’R’) pada Perawat Kepala Ruang. Urecol, 189–196. http://repository.urecol.org/index.php/proceeding/article/view/602
Presiden RI. (2014). Undang-Undang RI No.38 Tahun 2014 Tentang Keperawatan. Departemen Kesehatan RI.
Selpi, Narmi, & Narmawan. (2020). Hubungan Pendelegasian dan Supervisi dengan Semangat Kerja Perawat. Jurnal Keperawatan, 03(03), 17–22. https://doi.org/10.46233/jk.v3i03.243
Simamora, R. H. (2012). Buku Ajar Manajemen Keperawatan (Cetakan 20). EGC.
Tompkins, F. (2016). Delegation in Correctional Nursing Practice. Journal of Correctional Health Care, 22(3), 218–224. https://doi.org/10.1177/1078345816654229
Wagner, E. A. (2018). Improving patient Care Outcomes Through Better Delegation-Communication Between Nurses and Assistive Personnel. Journal of Nursing Care Quality, 33(2), 187–193. https://doi.org/10.1097/NCQ.0000000000000282
Walker, F. A., Ball, M., Cleary, S., & Pisani, H. (2021). Transparent Teamwork: the Practice of Supervision and Delegation Within the Multi-Tiered Nursing Team. In Nursing Inquiry, 28(4). https://doi.org/10.1111/nin.12413
Whittemore, R., Chao, A., Jang, M., Minges, K. E., & Park, C. (2014). Methods for Knowledge Synthesis: An Overview. Heart and Lung: Journal of Acute and Critical Care, 43(5), 453–461. https://doi.org/10.1016/j.hrtlng.2014.05.014
Yoon, J., Kim, M., & Shin, J. (2016). Confidence in Delegation and Leadership of Registered Nurses in Long-Term-Care Hospitals. Journal of Nursing Management, 24(5), 676–685. https://doi.org/10.1111/jonm.12372
