Yuanita Ananda
College of Health Sciences Alifah Padang,Indonesia
Corresponding Author’s Email:yuanita_ananda88@yahoo.com
ABSTRACT
The report of the decrease of the number of patients in Dr. Rasidin Padang is based on the annual report on patient ward. This study aims to reveal the relationship between nursing service quality and the level of patients’ satisfaction in the inpatient care of Dr. Rasidin Padang. The experiment was conducted in an internal room at Dr. Rasidin Hospital from January to August 2017. This study shows that 170 people were got admitted to inpatient section during last two months. There were 63 samples and they were taken purposive sampling. The data were analysed after using univariate and bivariate Chi Square test with 95% confidence level. The result showed that more than half (65.1%) patients expressed discontent with the quality of nursing service, and more than half (69.8%) patients stated that the quality of nursing care is not satisfactory in 2017. Bivariate result shows that p value is 0.000. So, the relationship between the quality of nursing care and the level of patients’ satisfaction is very significant. The leadership of this hospital to evaluate the services is based on a predetermined standard. So, a refresher training for the nurses to improve the quality of service to the patients is needed.
Keywords : Quality of Care, Patient Satisfaction
INTRODUCTION
The hospital, as a health facility provides health services to the community, has a very strategic role in accelerating the improvement of public health status. The quality of nursing services as an indicator of the quality of health services is one of the factors which determines the image of healthcare institutions in the eyes of the public. This happens because nursing is the largest number of professional groups, the front and closest to the suffering, pain, and misery experienced by patients and their families (Nursalam, 2013).
Patient satisfaction is one of the goals for improving the quality of health services. It can be proved that patients who experience satisfaction with health services tend to adhere to advice and
are loyal or obedient to the agreed treatment plan. Conversely patients who do not feel satisfaction when using health services does not tend to adhere to treatment plans, do not adhere to advice or move to other health facilities (Imbalo, 2012).
Patient satisfaction with nursing services will have a positive impact on hospital service institutions. As a result, patients will tell stories everywhere and to everyone to disseminate all the good things so that the patient or community will play a role as a public relation officer from every good quality health service organization (Imbalo, 2012).
Based on a research study conducted by T. Sudian (2011) about the relationship of patient satisfaction to the quality of health services in the North Aceh District Cut Mutia Hospital states that there is a relationship between health services and the level of patients’ satisfaction. sudian states that there is a meaningful relationship between empathy and patient satisfaction from 60 respondents who have empathetic nature there are 42 people (70%) respondents experience satisfaction, and from 18 respondents (30%) who have a lack of empathy, patients are less satisfied with the quality of service.
According to research conducted on the relationship of nursing service quality and the level of satisfaction of patients in the Hospital of Dr. Rasidin Padang found 22 people (34.9%) were satisfied with the services provided by nurses, while 41 people or (65.1%) were dissatisfied with with that.
Regional General Hospital Dr. Rasidin Padang is a hospital located in Sei. Sapih Kec. Kuranji, Padang city, West Sumatra Province, Indonesia. Regional Umun Hospital Dr. Rasidin Padang is a class C hospital and this hospital is able to provide limited specialist medical services. The hospital also accommodates referral services from health centers and private practices with the scope of its work area.
Based on the annual report at Dr. Rasidin Padang, the highest number of patients is in the Inpatient Internal Room. In 2013 the number of patients was 1258 (12.58%), and in 2014 the number of patients was 1015 (10.15%) people, and in 2015 the number of patients was 1297 (12.97%) people, in 2016 from the last two months the number of patients treated as many as 170 (1.70%) people (RSUD).
The decrease in the number of visits is one of the symptoms of patient dissatisfaction with health services (Warouw, 2017). Research conducted by Muninjaya (2004) on the satisfaction of users of health services at Sanglah Denpasar Hospital as much as 84.96% said they were not satisfied with the perceived service performance, many customers commented on nurses who were not friendly and mischievous, nurses' rooms were not clean, visit schedule doctors who are not on time and inadequate parking facilities.
Based on data from the indicators of internal hospital inpatient services at Dr. Rasidin Padang in 2013, BOR of Internal Inpatient Rooms was 29, 42% and LOS was 3.7 days, in 2014 BOR was 21.32% and LOS 3, 4 days, in 2015 BOR was 22.80% and LOS 2-7 days, the data illustrates that the percentage of BOR and LOS value in the Internal inpatient Room of Dr. Rasidin Padang decreases from year to year.
Based on preliminary studies that researchers conducted on 10 patients in the internal inpatient room of Dr. Rasidin Padang found four patients (40%) were dissatisfied with the service that was still slow, and patients were not satisfied with the officer who ignored the patient's complaint, gave less attention and communication with the patient, Three patients (30%) said they were not satisfied with the facility which is incomplete and feels dissatisfied with officers who are less friendly. Three patients (30%) were not satisfied with the treatment room which was hot and lacked hygiene.
In connection with the above, the researcher is interested in conducting research on the "Relationship between the Quality of Nursing Services and the level of satisfaction of patients in the Inpatient Interne Room of RSUD Dr. Rasidin Padang.
RESEARCH METHODOLOGY
The type of research used is analytic description with a cross-sectional study design that measures independent variables (quality of nursing services) and dependent variables (level of patient satisfaction) at the same time. This research has been conducted in the Inpatient Room of Dr. Rasidin Padang. The population in this study were all patients treated in the Inpatient Room of Dr. Rasidin Padang. With a sample of 63 patients. The sampling technique was purposive sampling, the analysis in this study was univariate and bivariate analysis and data processing using a chi-square test.
RESULTS
The level satisfaction | F | % |
Dissatisfaction | 41 | 65.1 |
Satisfaction | 22 | 34.9 |
Total | 63 | 100.0 |
Based on table 1 there are 41 people (65.1%) respondents feel dissatisfied in nursing services in the Interne Inpatient Room RSUD DR. Rasidin Padang
Quality nursing | F | % |
Not quality | 44 | 69.8 |
Quality | 19 | 30.2 |
Total | 63 | 100.0 |
Based on table.2 there were 44 people (69.8%) said that the quality of nursing services was not qualified in the Interne Inpatient Room of RSUD DR. Rasidin Padang
Quality nursing | The level satisfaction | Total | P Value | ||||
Dissatisfactio n | satisfaction | ||||||
f | % | f | % | f | % | ||
Not quality | 38 | 86,4 | 6 | 13,6 | 44 | 100,0 | 0,000 |
Quality | 3 | 15,8 | 16 | 84,2 | 19 | 100,0 | |
Total | 41 | 65,1 | 22 | 34,9 | 63 | 100,0 | |
Based on table 3 it is known that the proportion of respondents who stated that the quality of nursing services was not more qualified stated that they were dissatisfied, namely, 38 (86.4%) compared to respondents who expressed satisfaction, namely 6 (13.6%). From the results of statistical tests (Chi-square) obtained a p-value of 0.000 (p <0.05) thus it can be concluded that there is a significant relationship between the quality of nursing services to the level of patient satisfaction in the Interne Inpatient Room of RSUD DR. Rasidin Padang.
DISCUSSION
Level of Patient Satisfaction
The results showed that more than half of 41 people (65.1%) stated that they were dissatisfied with the service in the Inpatient Room of RSUD DR. Rasidin Padang. The results of this study are also in line with the research conducted by Efendi (2013) on the relationship of service quality to the level of satisfaction in Hospital Dr. RSUD. Rasidin Padang. The results showed that 65.1% of patients stated that they were not satisfied with the services provided by nurses.
Patient satisfaction is a level of feelings that arises as a result of the performance of health services obtained after the patient compares them to what they expect (Imbalo, 2012). According to Imbalo (2012), patient satisfaction with nursing services will have a positive impact on hospital service institutions. As a result, patients will tell stories everywhere and to everyone to disseminate all the good things so that the patient or community will play a role as a public relations officer of every good quality health service.
According to the assumption, the researchers found that the number of patients who were dissatisfied with the quality of nursing services in the Inpatient Room of RSUD Dr. Rasidin
Padang, because of lack of security in hospitals such as many patients who lost valuable items, lack of hygiene of the hospital such as cleanliness and completeness of toilet facilities, facilities and infrastructure inadequate as there is no air conditioning so the patient feels hot, this condition needs a concern for hospital management, because if the patient is not satisfied it will affect the image of the hospital in the future. If the patient is not satisfied, then the patient will tell everywhere so that it can influence the visit of other patients to the hospital and thus it will reduce the patients’ visit to hospital. In this case, it is necessary to evaluate the hospital management on the quality of services provided by nurses to patients so as to increase patient satisfaction.
Quality of Nursing Services
The results showed that more than half that is 44 people (69.8%) respondents stated the quality of nursing services in the Inpatient Room of RSUD DR. Rasidin Padang is not satisfactory. The results of this study are in line with the research conducted by Alimarni (2008) on the relationship of dimensions of quality of nursing with the level of patient satisfaction in the inpatient installation of RSUD Padang in 2008. The results showed that more than half of 54.6% of patients stated poor quality of service.
Quality of nursing services is the suitability of health services with professional standards by utilizing existing resources well, so that all customers’ needs, goal and optimal health degrees can be achieved (Bustami, 2011).
The quality of nursing services that are not in accordance with patient expectations is expected to be an input for health service organizations to try to fulfill them. If the performance of health services obtained by patients in a healthcare facility is in line with their expectations, patients will always come to the healthcare facility. Patients will always look for health services at a facility whose health service performance can meet patient expectations (Imbalo, 2012).
According to the assumption, the researchers found that the number of patients who stated inadequate service in the inpatient Room of Dr. Rasidin Padang hospital, because officers give less attention to clients. The environment is not clean and basically hot. The quality of this service is very important to note because the quality of nursing services to patient satisfaction is an indicator of whether the quality of a hospital's service is good or not. If the patient feels well served then the patient will come back to the hospital and will also inform others about the quality of service they feel so that it will increase the number of patient visits.
The Relationship between the Quality of Nursing Services and the Level of Satisfaction
The results showed that the proportion of respondents who stated that the quality of non-quality nursing services stated more dissatisfaction, namely 38 (86.4%) are compared to respondents who expressed satisfaction, namely 6 (13.6%). Statistical test results (Chi-square) obtained p value = 0.000 (p <0.05). So, it can be concluded that there is a significant relationship between the quality of nursing services and the level of patient satisfaction in the Inpatient Room of RSUD DR. Rasidin Padang.
The results of this study are in line with the research conducted by Efendi (2013) on the relationship of service quality to the level of satisfaction in the Hospital of RSUD Dr. Rasidin
Padang. The results showed that there was a relationship between service quality and patient satisfaction. The results of this study are also in line with the research conducted by Alimarni (2008) on the relationship between the dimensions of quality of nursing and the level of patient satisfaction in the inpatient installation of RSUD Padang in 2008. The results showed that more than half 54.6% of patients stated poor quality of service.
According to Imbalo (2012) that new patients will feel satisfied if the performance of health services obtained is the same or exceeds their expectations and vice versa, dissatisfaction or feelings of disappointment of patients will arise if the performance of health services obtained is not in line with their expectations. Patient satisfaction is a level of patient feelings that arise as a result of the performance of health.
According to the assumption of the researcher, it is proven that the quality of service will affect the level of patient satisfaction, where if the patient feels good quality of service then the patient will feel satisfied with the service provided. Conversely, if the patient feels poor service quality, the patient will feel dissatisfied with the quality of the service provided. Thus, to improve patient satisfaction, the quality of care for nurses needs to be monitored both in terms of reliability, responsiveness to patients, assurance, empathy, and physical evidence. In this case, it is necessary to periodically evaluate the quality of services provided by nurses to patients so that it can be known about the quality of services provided by nurses to patients. There needs a role for nurses in improving the quality of nursing services to patients for the betterment.
CONCLUSION
More than half, namely 41 people (65.1%) patients stated that they were dissatisfied with the quality of nursing services at the Inpatient Room of RSUD Dr. Rasidin Padang.More than half that is 44 people (69.8%) patients stated that the quality of nursing services is not qualified in the Inpatient Interne Room of RSUD Dr. Rasidin Padang.There is a significant relationship between the quality of nursing services and the level of patient satisfaction in the Internal Inpatient Room of RSUD DR. Rasidin Padang (p value = 0.000).
REFERENCES
Alimarni, 2008. Hubungan Dimensi Mutu Keperawatan dengan Tingkat Kepuasan Pasien di Instalasi Rawat Inap RSUD Padang. (Skripsi)
Bustami M, (2012). Penjaminan Mutu Pelayanan Kesehatan & Akseptabilitasnya. Erlangga, Jakarta.
Efendi, R., Arifin, A. & Darmawansyah. (2013). The Relationship Of Health Service Quality With Outpatient Satisfaction At Aeng Towa Public Health Center Of Takalar Regency. Andalas Journal of Public Health, 5(2), pp 1-12.
Imbalo, S.P.(2006). Jaminan Mutu Pelayanan Kesehatan: Dasar-Dasar Pengertian dan penerapan, Kesaint Blanc. Bekasi, Indonesia.
Muninjaya, 2012. Manajemen Mutu Pelayanan Kesehatan. Jakarta : EGC
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