Nursing Knowledge about Model of Professional Nursing Practice:
Team at USU Hospital
Wid
y
a Handa
y
ani
1
, Rahmitha Sari
1
, Diah Arruum
2
1
USU Hospital Nurses, Jl. Dr. Mansyur No 66, Universitas Sumatera Utara, Medan, Indonesia
2
Lecturer of Nursing Faculty, Jl. Prof. T. Maas No.3,Universitas Sumatera Utara, Medan, Indonesia
Keywords: Knowledge, Team Model, Nurse
Abstract: The team model is one of the Professional Nursing Practice Methods (MPKP) by a group of nurses in
providing nursing care to a group of patients. The focus of this research on 4 components namely definition,
nursing care planning, nursing tasks, and implementation of team models. The purpose of this study was to
identify the nurse's knowledge of the team's nursing practice model. Descriptive design with the number of
nurses 77 people each consisting of head nurse, team leader, and associate nurse. Total sampling technique.
The result of the research showed that the knowledge of the Associate nurse was 67,2% in the less category,
the knowledge of the team leader was 81,8% in enough category, and the knowledge of the head nurse in
the good category was 80%. It shows that the higher the nurse's position the better the nurse's knowledge.
However for the knowledge on the implementation of the team model is in the category less for each level
of position. It is necessary to socialize the knowledge of the team model and the application of the model to
support comprehensive communication and care and services that reflect the patient.
1 INTRODUCTION
Hospitals have responsibility in efforts to improve
the quality of health services. One of the efforts of
the hospital is the approach of Professional Nursing
Practice Model (MPKP). (Sitorus, 2000) stated that
the implementation of MPKP can improve the
quality of nursing care in the hospital. (Wan, 2011)
described the model of professional nursing care can
improve patient satisfaction.
Model of Professional Nursing Practice (MPKP)
is nursing care system to patients by applying the
principles suitable to standard, easy to implement,
efficient and effective (Nursalam, 2007). MPKP
consists of various models such as team model.
Team models are needed to be able centralize
services to patients, reduce coordination and
communication problems (Babiker et al, 2014).
The implementation of MPKP aims to ensure
adequate communication between nurses and health
teams, continuous nursing care, patient safety, and
improved nursing care services in accordance with
standards. The Service focus on patients with
standard of care and patient care of the National
Standard Accreditation of Hospital edition I. (JCI,
2017)
Kasim's result research said better the application
of team methods will be better service quality and
documentation of nursing care. Seeing the
importance of the team model to the patient, then a
nurse must have prior knowledge in implementing
the provision of nursing care in the form of
professional nursing care.
According to (Notoatmodjo 2010) Knowledge or
cognitive is a very important domain for the
formation of one's actions. (Eizenberg, 2010) stated
the high knowledge and experience of nurse work
will improve the nurses' professional skills.
American Nurse Association (ANA) mentions
professional standards of nurses is good knowledge.
Therefore, the first step to achieve the team model
application required good knowledge. In this study
knowledge includes on the definition, planning,
team tasks, implementation. So the possibility of
nurse knowledge about MPKP Team not be known.
It is expected with good knowledge then the
implementation of MPKP in University Of north
Sumatera Hospital will be more optimal.
This study aimed to identify the nurse's
knowledge about the model of professional nursing
practice team in inpatient room of University of
Sumatera Utara Hospital
Handayani, W., Sari, R. and Arr uum, D.
Nursing Knowledge about Model of Profesional Nursing Practice: Team at USU Hospital.
DOI: 10.5220/0010078105470552
In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramification Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages
547-552
ISBN: 978-989-758-449-7
Copyright
c
 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
547

2 METHOD
The study was conducted using descriptive method
which aimed to identify the nurse's knowledge about
the professional nursing practice model of the team.
Total sampling technique with a total of 77 nurses.
The data collection process was carried out in
May 2018 by first obtaining approval for research
and permission from the ethical commission on
health research. The data were collected using a
research questionnaire containing questions related
to team methods.
Next, data analysis is done quantitatively, presented
in the form of frequency distribution tables and
percentages. From the data obtained description of
Nurse Knowledge Level about professional nursing
practice of team model.
3 RESULT AND DISCUSION
3.1 Result
From 77 nurses inpatient room of RS USU which
become respondent of research, got the characteristic
of respondent like in table below. From the table
shows that the largest number of nurses in the room
Mahogany (22.1%) is class 3, based on the nurse
position of the majority of nurses (79.2%), Based on
gender of all nurses in the hospital inpatient room of
USU hospital (100%). Based on marriage status, the
majority of nurses are married (68.8%), based on
tribe, the majority is bataknese (66.2%), based on
the last Education majority of nursing D3 (57.1%),
based on employment status majority employee
status Civil Affairs (87%), based on information
received on the MPKP majority stated that they had
received information about MPKP (53.2%) and the
average age of nurses inpatient room is 30 years.
Characteristic of Nurses f %
Work Unit
Cendana
Meranti
Mahoni
Maternitas
Child
16
13
17
15
16
20,8
16,9
22,1
19,5
20,8
Total 77 100
Position
Head nurse
Team leader
Associate nurse
5
11
61
6,5
14,3
79,2
Total 77 100
Gender
Male 0 0
Female 77 100
Total 77 100
Marriage status
Married
Single
53
24
68,8
31,2
Total 77 100
Tribe
Bataknese
Minangnese
Javanese
Malay
Karonese
Others
51
5
15
1
1
4
66,2
6,5
19,5
1,3
1,3
5,2
Total 77 100
Education
D3
Ners
S2
44
30
3
57,1
39
3
Total 77 100
Employment status
PNS
Non PNS
67
10
87
13
Total 77 100
Information
Yes
No
41
36
53,2
46,8
Total 77 100
Experience
Head Nurse
< 5years
≥ 5 years
Team Leader
< 5years
≥ 5 years
Associate Nurse
< 5years
≥ 5 years
4
1
8
3
60
1
5,2
1,3
10,4
3,9
77,9
1,3
Total 77 100
Age, Mean = 30 years old
Based on the table 2 characteristics of nurse
education level with n = 77 inpatient nurses at USU
Hospital showed that head nurse education level was
60% Ners, team leader 63.6% Ners, associate nurse
65.6% D3 Nursing. In detail can be seen in table 2
below:
Table 2. Frequency distribution of Nurse Education based
on occupation in inpatient room University of Sumatera
Utara Hospital, n= 77 Mei 2018
Education Level f %
Head Nurse
‐ D3
‐ Ners
‐ S2
0
3
2
0
60
40
ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramification Researches
548

Total 5 100
Team Leader
‐ D3
‐ Ners
‐ S2
4
7
0
36,4
63,6
0
Total 11 100
Associate nurse
‐ D3
‐ Ners
‐ S2
40
20
1
65,6
32,8
1,6
Total 61 100
Based on table 3, all head nurses get 100%
information, team leader is 72.7%, associate nurse is
45.9%.
Table 3. Data Distribution Information about MPKP in
Inpatient room University Of Sumatera Utara Hospital, n
= 77 Mei 2018
Nurse information f %
Head nurse
‐ Yes
‐ No
5
0
100
0
Total 5 100
Team Leader
‐ Yes
‐ No
8
3
72,7
27,3
Total 11 100
Associate nurse
‐ Yes
‐ No
28
33
45,9
54,1
Total 61 100
Table 4 shows that level of head nurse
knowledge is good at 80%, the level of the team
leader is 81.8% while associate nurse are less than
67.2%.
Table 4. Distribution of Nurse Knowledge Level about
MPKP Team in inpatient room University of Sumatera
Utara Hospital n= 77 Mei 2018
Nurse’s Knowledge f %
Associate nurse
‐ Good
‐ Enough
‐ Less
1
19
41
1,6
31,1
67,2
Total 61 100
Team Leader
‐ Good
‐ Enough
‐ Less
0
9
2
0
81,8
18,2
Total 11 100
Head Nurse
‐ Good
‐ Enough
4
1
80
20
‐ Less 0 0
Total 5 100
Table 5 shows that majority of the head nurse
have goodh knowledge for definition at 100%, Good
knowledge in Nursing Care Planning and nurse duty
at 60%, and enough category in team model
implementation at 72.7%.
Table 5. Knowledge Frequency Distribution Head Nurse
about MPKP Team in Inpatient Room University of
Sumatera Utara hospital n= 5 Mei 2018
Knowledge of Head Nurse f %
Definition of MPKP
‐ Good
‐ Enough
‐ Less
5
0
0
100
100
100
Total 5 100
Nursing Care Planning
‐ Good
‐ Enough
‐ Less
3
2
0
60
40
0
Total 5 100
Nurse duty
‐ Good
‐ Enough
‐ Less
3
2
0
60
40
0
Total 5 100
Team Model Implementation
‐ Good
‐ Enough
‐ Less
4
1
0
80
20
0
Total 5 100
Table 6 shows that majority of the team leaders
have enough knowledge for definition at 72,7%,
Enough knowledge in planning and nurse duty at
63.6%, and science team leader for execution of
team model at category less namely 72.7%.
Table 6. Knowledge Frequency Distribution of Team
Leaders about Team MPKP in inpatient room University
Of Sumatera Utara Hospital n= 11 Mei 2018
Knowledge of Team Leader f %
Definition of MPKP
‐ Good
‐ Enough
3
8
27,3
72,7
Total 11 100
Nursing Care Planning
‐ Good
‐ Enough
4
7
36,4
63,6
Total 11 100
Nurse Duty
‐ Good
‐ Enou
g
h
2 18,2
Nursing Knowledge about Model of Profesional Nursing Practice: Team at USU Hospital
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‐ Less
7
2
63,6
18,2
Total 11 100
Team Model Implementation
‐ Good
‐ Enough
‐ Less
3
8
0
27,3
72,7
0
Total 11 100
Table 7 shows that associate nurses have
knowledge that they are less than 42.6%,
knowledge for nursing care planning at 42.6% and
nurse duty at 62,3%, and associate nurse knowledge
for team model implementation at less category
91.8%
Table 7. Knowledge Frequency Distribution of Associate
Nurse about Team MPKP in inpatient room University Of
Sumatera Utara Hospital n= 61 Mei 2018
Knowledge of Associate Nurse f %
Definition of MPKP
‐ Good
‐ Enough
‐ Less
18
17
26
29,5
27,9
42,6
Total 61 100
Nursing Care Planning
‐ Good
‐ Enough
‐ Less
10
25
26
16,4
41
42,6
Total 61 100
Nurse Duty
‐ Good
‐ Enough
‐ Less
7
16
38
11,5
26,2
62,3
Total 61 100
Team Model Implementation
‐ Good
‐ Enough
‐ Less
0
5
56
0
8,2
91,8
Total 61 100
3.2 Discussion
Based on the research which is analized about
knowledge definition, planning, nurse duty, model
execution. Nurses have potential to improve their
knowledge so be able do practice as good as
possible. (Donaldson dan Risjord, 2010).
Based on result about MPKP team for head nurse
knowledge is 80% good category. Head nurse is key
position to set and manage nursing service in
inpatient room. So that understanding of definition
and MPKP concept must be better. The result is
found that knowledge head nurse in inpatient room
University of Sumatera Utara Hospital part of in
good categoty that good in knowledge MPKP about
definition, nursing care planning, nurse duty. Team
models are needed to be able centralize services to
patients, reduce coordination and communication
problems. (Babiker, 2014)
Based on quentionere about knowledge is gotten
that all head nurse answered clearly about
definition component namely: definition of team
model, qualifications of team leader, the sense of
weighing in nurse and in the patient's bed, the pre
and post confrence understanding, team member
replacement, the subjective data understanding,
Situation concept, Background, Analysis,
Recommendation (SBAR) and priority of nursing
problem. This shows that the basic concept of
knowledge MPKP a head nurse should be good
considering the head nurse is the highest leader in
the inpatient room so as to be able to delegate tasks
to team leader and associate nurse as subordinate.
(Ferguson, 2009) stated Role of team leader
necessitated staff development and support to
enhance clinical leadership skills involved in this
new role, and main gains achieved with team
nursing for patients were more contact with nurses,
better quality care in a safer environment and for
less skilled and less experienced nurses, better
support and direct supervision. ANA mentioned
professional standard nurses are good knowledge, is
expected able to achieve a good application as well.
However, head nurse knowledge in execution of
team model most of them at sufficient category. It
mean head nurse didn’t understand and having
experience in execution of team model. It was
suitable with (Notoatmojo,2010) who said that
experience is period of time who were undergone by
people in doing job that impact on improving
understanding and skill in the area. While period of
work the head nurse majority less than 5 years. If
head nurse has good knowledge in the team model
application, so nursing care can be achieved.
Therefore, good application knowledge supports
service applications.
This can be proven by FGD results in March
2018 at USU Hospital that the application of team
model has never been done. If we look at the
question items of knowledge in the application of
the team model it can be seen that most of them
head nurse don’t understand about priorities which
is discussed during post confrence.
Post conference is an activity undertaken by
associate nurse to deliver nursing care reports to the
team leader. Aplication team model a head nurse
must be supported by good knowledge so that
ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramification Researches
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process of post conference can be done better. At
item question about Nursing Care Standards (SAK)
as the guidance of a team leader in the
implementation of pre conference also majority
answer wrong, this is reflected in the room that
obtained in implementing nursing care a team leader
not yet use SAK as regularity in doing action plan
of nursing.
Nurse’s knowledge in aplication of conference
team, started from hand over, pre conference,
nursing care, post conference, nursing round.
(Marquis and Huston, 2010) mentioned that
function of management useful as nurse role model,
The head nurse should be use his/her knowledge in
patient management. It's means the head nurse can
act as role model in team application, so is needed
knowledge in applying team model in the room.
The nurse who work under head nurse is a team
leader. Team leader is a nurse who responsible to
lead associate nurse in doing nursing care in the
inpatient room and direct responsible to head nurse
in report the result of management patient. At team
model the team leader hold a very important role in
managing care and guiding staff.
Based on the result research about knowledge of
team leader is found that most of them at enough
category was 81.8% from definition knowledge,
nursing care management, and nurse duty, and there
was no result good category. It can be seen at item
question about planning what must be made by a
associate nurse, team leader and head nurse can be
answered exactly by team leader.
But, team leader knowledge in management of
team model most of them at less category. Based on
question in aplication team model can be seen that
team leader most of them didn’t know the priorities
discussed during post conference. At team model
application a team model is leader of post
conference that aims to evaluate action plans that
have been implemented and evaluate patient
progress. This is the same thing with head nurse,
where the knowledge of head nurse still lacking.
Another question that can not be known team leader
is about assessment of patient dependency level.
While the knowledge result of team leader about
the implementation of model at less category.
indicating that the team still lacks knowledge of the
subject. It can be seen on the item about priorities
discussed during post conference many team leader
do not know this, as well as the question items about
assessment of dependence level patient. It was
according with theory is forward by (Notoatmodjo,
2016) where between knowledge, understanding and
application must be suitable.
Many factor can be caused low team leader
knowledge. This MPKP Definition is basic
knowledge must be has by a team leader about team
MPKP. Knowledge about MPKP definition and
planning nursing care interpreted as a reminder of
MPKP theories that have been learned previously
both from education and from experience.
When team leader knowledge about MPKP
definition is good, so interpreted team leader on do
nurse duty has good duty in team work model.
Interpreted is ability explain corectly about the
object be known and be able to interpret material
correctly. In this good understanding the
implementation of team model as an application will
also increase. Applications were defined as ability to
use the material that had been learned in the actual
situation or true condition.
Thus the research result to associate nurse
knowledge is gotten most of them at less category
was result 67.2%. It can be seen in the knowledge of
definitions, planning, nurse assignments and model
execution. The lack of knowledge on associate nurse
can be seen in nurse knowledge questionnaire about
the execution of team model. It was means that
associate nurse less understood about the execution
of team model.
The team method is method of giving nursing
care, a professional nurse lead a group of nursing
staff in providing nursing care to a group of clients
through cooperative and collaborative efforts
(Douglas, 1992). The team method is based on the
belief that every member of the group has
contribution in planning and providing nursing care
so that it raises a high sense of responsibility.
(Sitorus, 2006)
Head nurse knowledge, team leader, and
associate nurse is very needed to provide nursing
care who comprehensif, because team method is
shape good comunication between team to reach
goals together. If reviewed based on knowledge
about execution of team model, for each level it can
be proved that knowledge of the three levels in
execution of team model has lower percentage
value. In addition, the higher the nurse position so
the higher knowledge was had. Thus it can be stated
that knowledge is very important in supporting the
achievement of optimal nursing care. This means
that placing the position of the USU Hospital is
appropriate, that a head nurse must be at least Ners.
Nursing Knowledge about Model of Profesional Nursing Practice: Team at USU Hospital
551

4 CONCLUSIONS
The higher of position nurse so the higher
knowledge which was had. All nurses stated that
knowledge in the application of team models was in
the less category. Recommendations from the results
of this study are necessary to socialize the MPKP
Team and Applications at USU Hospital to support
comprehensive communication and patient center
care.
ACKNOWLEDGEMENTS
Acknowledgment is given to research institute (LP)
USU and all the nurses in Inpatient room during this
research.
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