The Nurse Performance of Ponkesdes in Giving Family Nursing Care
Luluk Fauziyah J
1
, Joni Haryanto
1
, Siti Nur Kholifah
2
1
Faculty of Nursing Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia
2
Poltekes Kemenkes Surabaya, Indonesia
Keywords: Nurse performance, Ponkesdes, Family Nursing Care.
Abstract: The performance of nurse in giving family nursing care as spearhead of health service is a very important
issue to be studied in order to maintain and improve the quality of health services. Nurse as health workers
in Ponkesdes carry out promotive services, preventive continuous. This study aims to identify a description
of the nurse performance of ponkesdes in providing family nursing care. This research used descriptive
research design with the number of samples of 101 nurses taken by using simple random sampling
technique and take sample using random number table. Data collection was done by using questionnaire of
demographic data and questionnaire picture of nurse performance in giving of family nursing care. Analysis
from the results of the study noted that the majority of respondents had a good performance in providing
nursing care as much as 79%. The standard of achievement in giving of family nursing care at least 90%.
Although the results of this study showed 79% of nurses had good performance but this value has not
reached the standard from Department of health. It is expected that the nurse be able to improve the
performance in giving family nursing care accordance with the standards set by (Department of health).
1 BACKGROUND
Pondok Kesehatan Desa (Ponkesdes) is a health
service located in village which is development of
Pondok Bersalin Desa (Polindes) as a network of
Puskesmas in order to get closer access and quality
of health service (PergubJatim, 2010) . Nurse of
ponkesdes has role, function and main task in
providing nursing care. The success of a Ponkesdes
in implementing family nursing care in health
services in perfect quality is influenced by many
factors one of them is Human Resources. Human
resources that can determine the quality of health is
the performance of nurses. The performance of
nurses as the spearhead of health services is a very
important issue to study in order to maintain and
improve the quality of health services. The
performance of a good nurse is a bridge in answer
assurance of health service quality that is given both
of sick and health patients. Main key in
improvement quality of health service is nurse has
high and good performance. However, complaints
were found related to the quality of health services
whose came from the performance of health workers
including nurse.
Performance is a result of work that is intended
to the task in an organization (Nursalam, 2014). The
performance of nurses is capability or learning
application that has been received during the
completion of nursing education program to give
services and responsible for health improvement,
and disease prevention and service to patient
(Wibrata, 2017).
Nurses as health workers in Ponkesdes have
duties and responsibilities according to the authority
of the Puskesmas. Poskesdes nurses have UKM
program (Public Health Enterprises) applied in
Puskesmas program by implementing promotive,
preventive service continuous without neglecting
curative and rehabilitative services as a whole and
integrated. Nursing care intended for individuals,
families, groups and communities through the
nursing process in order to make community be
independent in effort for their health.
East Java Government has run Ponkesdes since
2010 which aims to close health services to the
society. Society hope will be easier get access of
health service in caring for the family, one of the
main elements in the welfare of society is health.
From data taken in Wibrata research (2017) from
Health of Department in East Java there were 10%
J, L., Haryanto, J. and Kholifah, S.
The Nurse Performance of Ponkesdes in Giving Family Nursing Care.
DOI: 10.5220/0008327104770481
In Proceedings of the 9th International Nursing Conference (INC 2018), pages 477-481
ISBN: 978-989-758-336-0
Copyright
c
2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
477
(291) nurses who carry out activities as nurses
Ponkesdes, and the remaining 90% (2619) nurses
have not well performed as nurse Ponkesdes. This
problem will certainly obstruct health development
if not handled properly.
The results of reports in several Health
Department in Bangkalan District since Ponkesdes
run in 2009 obtained Ponkesdes nurse are more
oriented be Individual Health Business activities
(UKP), if compared to Public Health Enterprises
(SMEs). Employment data of Bangkalan Health
department in 2009 conducted on 99 nurses
Ponkesdes obtained most of the performance of
nurses in yellow category or quite were 47 people
(58%) and the performance of nurses in the red
category or less as many as 23 nurses (26%), there
are even 2 nurses (3%) did not have standard
performance so happened termination of
employment by personnel at the Bangkalan health
department.
The factors that influence nurse's performance
consist of 3 main factors: individual variable (ability
& skill, background of experience, demography),
psychology variable (perception, attitude,
personality, learning, motivation), organizational
variable (resource, leadership, structure, job design)
(Gibson, 2005) According to the results of the study
Performance of nurses in the implementation of
perkesmas is directly influenced by affection
factors, personal factors, and interaction factors
(Wibrata, 2017). Factors that obstruct the
implementation of family nursing is the inability of
ponkesdes officers in the filling cohort instrumentt,
the unavailability of nursing care format for the
patient, the community have not understood the
function of Ponkesdes. Non-technical constraints is
inadequate infrastructure facilities, operational
budget of Ponkesdes not available, standard salaries
of Ponkesdes officers are still below the District
Minimum Wage (UMK) in 2016 (Munir, 2016).
Nurse has not optimal performance of ponkesdes
in family can reduce the independence of families in
health care, and prevention of disease. As a result
the quality of public health declined, and hampered
health development. Because the family is a group
that has a very important role in Because family is a
group that has a very important role in developing,
preventing, adapting and fixing health problems
found in families (Azwar, 2007). The problem of
nurse performance of Ponkesdes if it is not handled
soon will have wide-ranging and dangerous effect
for long term. Not only for health agencies but also
the wider society.
The Efforts that need to be done in order to
improve the role and function of nurse in health care
service of family nursing care in Ponkesdes is to
improve the quality of nurses in Ponkesdes. To
improve the quality of nurses required changes in
nurse performance that begins with behavioral
change. The purpose of this study was the researcher
interested to do research nurse performance
Ponkesdes in giving nursing care of family in
Bangkalan regency.
2 METHODS
This research used descriptive design to know the
description of nurse performance in Ponkesdes
Kab.Bangkalan. The population of this study were
all nurses in Ponkesdes of Bangkalan regency. The
sample size for this study were 101 people.
Sampling was done by simple random sampling with
the formula of sample used slovin
Data collection tool was the form of
questionnaires prepared by the researchers by
referring to the concept of theory. Questionnaires
have been examined by experts and have been tested
outside of respondents of Ponkesdes Bangkalan
regency. The questionnaire consists of two parts,
namely the questionnaire demographic data and the
questionnaire description of nurse performance in
the provision of family nursing care. The nursing
performance questionnaire consisted of 30
statements using Guttman scale where the score 0-
15 was poor performance and the score 15-30 was
good performance (Arikunto, 2010).
Data analysis done starting from checking phase
completeness of identity of respondent data and
make sure all answer filled. The data obtained is
identified by the next data processed with
computerized program in descriptive test to know
the frequency, percentage of mean and standard
deviation.
This study has passed the ethical review
conducted by research Ethics Commission of
Faculty of Nursing Airlangga University with
number 727 KEPK dated January 10,2018
3 RESULTS
Based on the data of respondent's characteristic, the
majority of the education of nurse of ponkesdes are
DIII (75.8%), male majority (80.5%), madura
majority (70.8%), married majority (63.3%).
Based on the results of research on the performance
of nurse ponkesdes in Kab.Bangkalan divided into 2
categories that was good and bad. The result showed
that 80 respondents (71,4%) description of nurse
performance good and 21 respondents (28,6%) bad
performance picture.
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
478
The results of table 1 showed that the
performance of Ponkesdes showed that 80
respondents (79%) was good nurse performance and
21 respondents (21%) was poor performance.
Based on the results in the table 2, it was found
that 80 nurse (79%) had assessment family nursing
care, 69 nurse (69,7%) had diagnose family nursing
care, 84 people (85%) had Intervention family
nursing care, 79 people (80%) had Implementation
family nursing care, and 73 people (73,7%) had
evaluation family nursing care.
4 DISCUSSION
From the results of the study, the majority of
respondents (79%) got good performance while the
bad (21%). This achievement has not reached the
standard from Department of health, which provides
the terms of family nursing care based on the
research results of Munir's (2016), performance will
be good if supervision done routinely. According
Notoadmojo, (2010) the success of performance
determined by guidance of good supervision from
superiors to subordinates who asked the problems
and obstacles in the implementation to solve the
problems. Supervision is a component of
management functions to achieve results in
performance.
Nurse performance is a measure of success in
achieving the goal of nursing service. The nurse
performance of ponkesdes in the provision of family
nursing care is the application of the ability or
learning that has been received during the
completion of the nursing education program to
provide direct health services to the family (Ali,
2012)
According to Friedman (2003), family health
care function can be achieved from the ability of
families to understand and implement the five family
health tasks. This is very dependent on the role of
nurses in providing nursing care to the family, so
that the family expected to get coaching and
guidance in running the five functions of family
health care. Coaching and guidance to the family
greatly affects the achievement of family
independence to solve various health problems in the
family. This is because the family nursing care is a
series of transferred knowledge activities and the
ability of families to overcome existing health
problems by using various strategies to make
behavior change in a better direction. Strategies or
methods used include health education using verbal,
psychomotor (practice) and affective to see the
extent of family compliance doing activities to
overcome health problems in the family
Notoatmodjo (2010) stated that behavior change
strategy is to provide information about how to
avoid disease and increase the knowledge of society
Based on the result of Munir's research (2016), the
nurse's performance in nursing care can only be
given by the nurse minimum D-3 grade education.
Because in studying Diploma 3 Nursing, they
obtained the theory of nursing care. One type of
nursing care is family nursing care.
Family nursing care is a process or a series of
activities on nursing practice given directly to clients
/ families in various health care settings (IPPKI,
2017). Family nursing care is carried out based on
nursing orders or the authority of nursing services to
carry out nursing assessment to the family in health
facilities or ponkesdes which includes the client's
bio-psycho-social-cultural and spiritual status,
formulates a family nursing diagnosis related to the
phenomenon of non-fulfillment of basic human
needs, develop plans for simple and complex
nursing actions for individuals, groups and
communities in health facilities, implement nursing
actions that have been performed, document the
results of nursing performed (IPKKI, 2017).
Based on this research 79% of respondents have
done the assessment, but the performanced in this
family assessment has not reached the standard set
by the health of department (Fahriadi, 2015).
Assessment is the most important thing in doing
nursing care because in it series of data collection
Table1: Performance of Nurses in Family
Nursing Care in Ponkesdes Bangkalan Regency.
No
Performance
Frequency
Percentage
1
Good
80
79%
2
Bad
21
21%
Table 2: Nurse performance in giving
family nursing care in Ponkesdes Bangkalan
Regency.
No
Performance in
Family nursing care
No
1
Assessment
21
(21%)
2
Diagnose
32
(30,3%)
3
Intervention
16
(15%)
4
Implementation
22
(20%)
5
Evaluation
27
(27,7%)
The Nurse Performance of Ponkesdes in Giving Family Nursing Care
479
and will affect the next work that diagnosed until
evaluation. However, nursing diagnoses have
reached the density of 69.7% of respondents have
done. Nursing diagnoses will not work if the data
assessment is lacking or incomplete. Nursing
diagnoses are conclusions drawn from data collected
about the client. This indicates that if the assessment
is not done then the nursing diagnosis nonsense even
threaten client because the action did not in
accordance with the actual family conditions
therefore nurses must conduct a complete and
accurate assessment (ICN, 2013).
In this study obtained on the results of planning
and implementation also has not reached the
standards from department of health.
Implementation is the action or application of the
nursing care plan to achieve the expected goal. In
performing the action in accordance with the nursing
plan then required a sufficient number of nurses,
good knowledge and skills. The nurse who most
needed when the number of clients increases and the
client's condition decreases (Potter & Perry, 2005). It
is a component of nursing management that nursing
managers need to pay attention (Gillies, 2005). This
returns to the role of nursing managers to consider
the number of workers or nurses t be comparable
with the nurse's task, knowledge and skills of nurse
also improved through training and further
education.
Based on the results of this study nursing
evaluation has reached 73.7% of respondents, nurses
did evaluation actions compliance with the
standards. Nursing evaluation is a step to find out
whether the expected results have been achieved
(ICN, 2013). Results will be achieved if all nursing
care process activities from assessment to evaluation
are done correctly and appropriately. All nursing
care processes affect each other mutually, with this
all stages of nursing care must be in accordance with
the standards for achieved the best result.
5 CONCLUSIONS
The results showed that the nurse performance of
Ponkesdes in Bangkalan District showed that more
responden showed good nurse performance than
poor performance. It can be used as input for nurse
as efforts to improve the performance of nurses in
the provision of family nursing care in Ponkesdes. It
is expected that the next researcher can examine the
effect of nurse ponkesdes's performance in giving
family nursing care to independences of Family.
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