PAPER

MANAGEMENT IN HOSPITAL NURSING

Group 3

Supervisor :

Putri Indah P.,S.Kep.,Ns.,M.Kep

The name of group :

Alvina Septia Ratri Kusuma (0119002)

Dewi Nur Kumala Indah (0119010)

Nuriyatul ilmiah (0119024)

Meyra Adelia Putri S (0119029)

Nur ailil (0119035)

Puji Sudarsono T.W (0119040)

NURSING SCIENCE STUDY PROGRAM

INSTITUTE OF HEALTH SCIENCE DIAN HUSADA

MOJOKERTO 2020

i
 STATEMENT SHEET

We hereby declare that:

We have a copy of this paper which we can reproduce if the submitted paper is
lost or damaged.
This paper is the work of our own and is not the work of other people except
those that have been written in the reference, and no one has made this paper for
us.
If in the future there is academic dishonesty, we are willing to receive sanctions
according to the applicable regulations.

NAME SIGHNITURE

Alvina Septia Ratri Kusuma

(0119002)

Dewi Nur Kumala Indah

(0119010)

Nuriyatul ilmiah (0119024)

Meyra Adelia Putri S (0119029)

Nur ailil (0119035)

Puji Sudarsono T.W (0119040)

ii
 INTRODUCTION

Praise continues to the compilers of the presence of God Almighty, for all His
grace and guidance that has been delegated to compilers so that they can complete
the paper entitled "Hospital Management System". The purpose and purpose of
preparing this paper is to fulfill the Nursing Management course assignments. In the
preparation of this paper, the compilers did not escape difficulties and obstacles, but
thanks to the assistance and guidance and cooperation, this paper could be completed
in accordance with the specified time.

All abilities and efforts have been made to the maximum, but the author
realizes that there are still many shortcomings. Therefore, the authors really expect
constructive criticism and suggestions in order to improve this paper. The author
hopes that this paper can be of use to readers, especially in the world of nursing.

Mojokerto, 27 September 2020

Author

iii
 DLISTS ARE CONTENTS

Contents
STATEMENT SHEET..................................................................................................................ii
INTRODUCTION......................................................................................................................iii
DLISTS ARE CONTENTS...........................................................................................................iv
CHAPTER I............................................................................................................................1
INTRODUCTION..................................................................................................................1
1.1. Background.............................................................................................................1
1.2. Purpose Of Writing.................................................................................................2
1.2.1. General Purpose..............................................................................................2
1.2.2. Specific Objectives...........................................................................................2
1.3. Benefits Of Writing.................................................................................................2
1.3.1. For the patient, it is.........................................................................................2
1.3.2. For Nurses.......................................................................................................2
1.3.3. For hospitals...................................................................................................3
1.3.4. For students.....................................................................................................3
CHAPTER II...........................................................................................................................4
LITERATURE REVIEW........................................................................................................4
2.1. Nursing Management..............................................................................................4
2.1.1. Definition of Nursing Management.................................................................4
2.2.2. Management Functions Management..............................................................5
2.2.3. Role of Manager..............................................................................................7
2.2.4. The Role of the Head of the Room..................................................................7
2.2.5. Functions of the Head of the Room.................................................................7
2.2.6. Head of Room as Nursing Manager.................................................................8
2.2.7. Number of Nurses............................................................................................9
2.2.8. Availability of Nursing Care Standards and Standard Operating Procedures
11
2.2.9. Method..........................................................................................................12
CHAPTER III.......................................................................................................................14
CLOSING.............................................................................................................................14

iv
 4.1. Conclusions...........................................................................................................14
4.2. Suggestions...........................................................................................................14
TABLE OF CONTENTS......................................................................................................15

v
 CHAPTER I

INTRODUCTION

1.1. Background

Managementis a science of how to use resources actively, innovatively,

creatively and rationally to achieve predetermined organizational goals.
Management includes coordination and supervision of staff, facilities and
infrastructure in achieving goals. Nursing management is the process of working
through members of the nursing staff to provide professional nursing care.
Professional nursing service requires professional nursing development. In
optimizing the role and management of nursing, it is necessary to have a
strategy, one of which is the hope of an optimal management factor and being
able to increase the effectiveness and efficiency of nursing services. An
organization in achieving its goals needs to be supported by the management of
factors, including Man, Money, Machine, Method, and Material. A balanced and
good management of the five factors will provide satisfaction to hospital clients
and customers. The five hospital standards must have been owned by an
accredited hospital.

In a hospital, the smallest service unit is a room which is a health service

where nurses can apply their knowledge and nursing care optimally. However,
without adequate governance, strong will and ability, as well as the active role of
all parties, professional nursing service will only become a theory. For this
reason, nurses need to strive for activities to organize the Professional Nursing
Practice Model, which is the arrangement of the nursing service delivery system
through the development of a nursing practice model.

One of the models of professional nursing practice is the position of a

nurse as a room head, team leader or executive nurse, in one part there needs to
be an understanding of how to manage and lead others in achieving the goals of
quality nursing care. The quality of good nursing care includes: fulfilling
established professional standards, resources for nursing care services are used
appropriately, efficiently, effectively, safely for patients and nursing personnel,
satisfying for patients and nursing staff as well as social, economic, cultural,
religious aspects society, ethics and values are considered and respected.
Managerial abilities can be possessed in various ways, one of which is to
improve skills through college which must be through practical field learning.

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1.2. Purpose Of Writing

1.2.1. General Purpose

After practicing nursing management at the hospital for 4 weeks, it is

hoped that students will be able to apply the concepts and principles of
nursing management to the health service unit in a real way in an effort
to improve the quality of nursing services.

1.2.2. Specific Objectives

After practicing nursing management at the hospital, students are able to

a. Collecting data and understanding data on problems in organizing

nursing care.

b. Organizing the implementation of nursing activities.

c. Carry out efforts to coordinate nursing activities.

d. Choose and apply the appropriate leadership style in the room.

e. Introducing useful small changes to the room.

f. Identify the problem that occurred.

g. Planning several alternative solutions to the problem.

h. Propose and apply these alternatives to nursing managers.

i. Evaluating the results of implementing alternative problem solving.

1.3. Benefits Of Writing

In the writing of this nursing management paper, several benefits are stated,

namely:

1.3.1. For the patient, it is

expected that the patient will experience optimal service, as well as

get comfort in providing nursing care so that optimal client satisfaction is
achieved

1.3.2. For Nurses

a. Achieving the optimal level of job satisfaction.

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 b. The development of good relationships between nurses and nurses,
nurses with other health teams, and nurses with patients and families.

c. Grow and maintain accountability and self-discipline of nurses.

1.3.3. For hospitals

a. Knowing the problems that exist in the care room related to the
implementation of professional nursing care.

b. Can analyze existing problems with the SWOT method and develop
a strategic plan.

1.3.4. For students

a. Can apply the knowledge that has been obtained while studying at
STIKES DIAN HUSADA MOJOKERTO.

b. Can develop knowledge in the field of nursing management learning.

c. Making students more independent in writing a paper and adding to

students' insight into knowledge in the field of nursing management.

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 CHAPTER II

LITERATURE REVIEW

2.1. Nursing Management

2.1.1. Definition of Nursing Management

Management is an activity that is very complex but regular, so that if

management is properly implemented it will achieve maximum activity
results. (Suyanto, 2008: 2). According to Harsey and Blanchard in Suyanto
(2008: 2), the notion of management is a process of carrying out activities to
achieve organizational goals through cooperation with others.

According to Taylor in Suyanto (2008: 2), management is likened to

a production machine that works efficiently and quickly produces maximum
products that require motivation and cooperation. Meanwhile, nursing
management refers to the understanding of management in general. Nursing
management is an effective use of time, because management is the
effective use of time, the success of the clinical nurse manager's plan, who
has a theory or systematic of principles and methods related to large
institutions and nursing organizations within it, including each unit. This
theory includes knowledge of the mission and goals of the institution but
may require development or refinement including the mission or objectives
of nursing departments. From a clear statement of understanding the nurse
manager develops clear and realistic goals for nursing services (Swanburg,
2000).

Nursing management is nursing service as a hospital management

sub-system which must get the same place and attention as other
management, so that the hospital can function as expected. The scope of
operational management and nursing care management is planning,
organizing, directing, and supervising nursing resources. Nursing
management functions are planning, organizing, directing, monitoring,
which must be carried out by managers in the form of supervision. The
supervision carried out by the nursing manager properly and continuously
can ensure that the provision of nursing care is in accordance with the
standards of nursing practice. Supervision of the head of the room as a
manager can affect the performance of the nurse. As we know that nursing
management is a special task that must be carried out by nursing managers
to plan, organize, direct and supervise existing resources, both resources and

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 funds so that they can provide effective nursing services to patients,
families, and communities.

2.2.2. Management Functions Management

functions are basic elements that will always exist and are inherent in
the management process which will be used as a reference by managers in
carrying out activities to achieve goals. There are 3 management functions,
namely:
A. Planning
Planning is thinking about what to do with the resources you have.
Planning is done to determine the overall goals of the company and
how best to meet those goals. Managers evaluate various alternative
plans before taking action and then see if the selected plans are
suitable and can be used to meet company goals. Planning is the most
important process of all management functions because without
planning other functions cannot run. Planning is a process of thinking
and determining carefully what will be done in the future in order to
achieve predetermined goals (Siagian, 1990).
 Planning objectives:
 Give direction to the organization
 Set realistic goals
 Ensuring the achievement of goals
 Increase efficiency
 Remove programs that are not useful
 Avoid duplication of efforts or programs
 Concentrating services that are urgent
 Increase coordination and communication activities
 Allows adaptation to changing work environment.
 Principles of planning
 Clear purpose
   Clear results to be achieved
 Simple
 Based on applicable policies and procedures
 Priority
 Active involvement
 Effective and efficient
 Flexible
 Ongoing
 Clarity of evaluation method
 Planning includes activities:
 Data collection:
Data about patients, employees / staff, leadership, equipment,
and nursing services.
 Environmental analysis

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 By using a SWOT analysis (Strength, Weaknes, Opportunities,
Treath).
 Organizing data
Select supporting and constraining data.
 Making plans
Determining the objectives / means to be achieved, a
description of activities, procedures, target time, person in
charge, objectives, costs, equipment, methods.

B. Organizing (Organizing)
Organizing is done with the aim of dividing a large activity into
smaller activities. Organizing makes it easier for managers to supervise
and determine the people needed to carry out the tasks that have been
divided. Organizing can be done by determining what tasks have been
divided. Organizing can be done by determining what tasks must be
done, who should do them, how the tasks are grouped, who is
responsible for the task, and at what level decisions must be made.
Organizing is the whole grouping of people, tools, tasks, authorities and
responsibilities in such a way as to create an organization that can be
moved as a unit in order to achieve predetermined goals.
 Organizing principles:
 Chain of command
In new construction, the patient room must have a minimum
area of 9.2 m2, different floor size and area depending on the
local hospital policy and the existing land, the size of the
different floors is the same as the single bed area. Toilet room,
bidet, locker, storage room, vestibule, room arrangement
should be at least 0.91 m2 including the side and foot of the
bed and walls. In the multiple bed room, the minimum floor
size is 1.22 m2, in the multiple bed area the patient room has a
minimum size of 80 feet, the same as the single bed size,
which is 9.29 m2.
 The nurse operator's station should lead to all rooms.
- In new construction, wastapel should be provided in each
patient room. the location of the wastapel should be close
to beds and washing equipment. Toilets should be designed
for one bed or two beds.
- The patient room has a window in the appropriate section.
- Each patient must be close to the toilet without having to
leave the room. One toilet is designated for four or more
patient beds. The toilet has a water closet and wastapel that
uses double acting doors.
- Each patient must be separate from the wardrobe, locker.

6
 - If there are many beds in the room, a barrier is needed to
maintain privacy
- For ventilation, the oxygen room, oxygen room, air
vacuum and electricity must comply with the standard.
 Room Design The
layout of the inpatient room should be adapted to the existing
structure, but circular or rectangular units may be most efficient by
placing the care station in the center. A design like this will provide
maximum observation to the client. besides that, it must have a
washtafel and can be combined into a meeting room and
communication room, and have an emergency exit.

2.2.3. Role of Manager

The role of manager can influence motivational and environmental

factors. But other factors may influence the dependency of the task,
particularly how managers work in an organization. In general, the
manager's role can be assessed by his ability to motivate and increase staff
satisfaction. Staff job satisfaction can be seen from the fulfillment of
physical and psychological needs, where these psychological needs can be
met through the role of managers in treating their staff. This can be instilled
in managers in order to create an atmosphere of openness and provide
opportunities for staff to carry out their duties properly.

Managers have five impacts on environmental factors in their

professional duties as discussed previously: Communication, Potential
Development, Wisdom, Salary and Wages, Working Conditions (Nursalam,
2002).

According to Rewland & Rewland (1997), there are twelve main keys
in job satisfaction, namely: input, manager-staff relations, work discipline,
work environment, adequate rest and food, discrimination, job satisfaction,
performance rewards, clarification of policies, procedures, and benefits,
opportunity gain, decision making, and manager style.

2.2.4. The Role of the Head of the Room

The responsibility of the head of the room according to Gillies (1994)

is that the role of the head of the room must be more sensitive to the hospital
budget and the quality of nursing services, be responsible for the results of
quality nursing services, and avoid nurse boredom and avoid the possibility
of throwing each other. error. The head of the room in a nursing room needs
to coordinate the activities of the unit which is his responsibility and to carry
out evaluation activities for staff work performance activities in an effort to
maintain the quality of nursing care provision. Various methods of

7
 providing nursing care can be selected according to the condition and
number of patients, and the education category and experience of staff in the
unit concerned (Arwani, 2005).

2.2.5. Functions of the Head of the Room

The functions of the head of the room according to Marquis and Houston
(2000) are as follows:

a. Planning

Starting with the application of philosophy, goals, objectives, policies,

and regulations, making short and long term planning to achieve the
vision, mission and goals of the organization, determining costs for
each activity, and planning and managing change plans.

b. Organizing

Includes forming a structure to carry out planning, determining the

most appropriate method of providing nursing care to patients,
grouping activities to achieve unit goals and performing roles and
functions in the organization and using power and authority
appropriately.

c. Workforce

The workforce arrangement starts from recruitment, interviewing,

seeking, and orientation of new staff, scheduling, staff development,
and staff outreach.

d. Direction

Covers responsibilities in managing human resources, such as

motivation for enthusiasm, conflict management, delegation,
communication, and facilitating collaboration.

e. Supervision: includes work performance, general supervision, legal

aspects of ethics supervision, and professional supervision. A manager
in carrying out these five functions will daily be engaged in various
fields of sales, purchasing, production, finance, personnel, etc.

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2.2.6. Head of Room as Nursing Manager

As a nursing manager, the job description of the head of the room according
to the Ministry of Health (1994) is as follows:
a. Carry out the functions of planning,include:    
- Planning the number and category of maintenance personnel, as
well as other personnel as needed.
- Plan the number of types of maintenance equipment needed.
- Plan and determine the types of nursing activities / care to be
held according to the patient's needs
b. Carry out the function of movement and implementation, including:
- Organize and coordinate all service activities in the ward.
- Compile and organize a list of service personnel for
maintenance and other personnel in accordance with the needs
and applicable regulations / regulations (monthly, weekly,
daily).
- Carry out orientation programs for one nursing staff or other
personnel who work in the ward.
- Provide direction and motivation to care personnel to carry out
nursing assistance according to standards.
- Coordinating all existing activities by working together as
parties involved in ward room services.
- Recognizing the types and uses of equipment items and making
efforts to procure them according to the patient's needs in order
to achieve optimal service.
- Arranging routine requests covering the need for tools, drugs,
and other materials needed in the ward.
- Organize and coordinate the maintenance of equipment so that it
is always ready to use. Responsible for the implementation of
equipment inventory.
- Carry out an orientation program for patients and families
covering hospital regulations, room rules, existing facilities and
how to use them.
- Accompany the doctor during mobile visits to examine patients
and record programs.
- Stratify patients and arrange care for the placement diruang
- level of emergency, injection and non injection, for the
provision of nursing care.
- Approach each patient being treated to find out the situation and
accommodate complaints and help solve ongoing problems.
- Maintain patient feelings in order to feel safe and protected
during the implementation of the service.
- Providing health education to patients / families within the limits
of their authority.

9
 - Maintain the feeling of officers in order to feel safe and
protected during the implementation of the service.
- Maintain and develop a data recording system for nursing care
services and other activities carried out appropriately and
correctly.
- Conducting good cooperation with heads of other inpatient
rooms, all section heads, heads of fields, heads of agencies, and
heads of UPF in hospitals.
- Creating and maintaining a good working atmosphere between
staff, patients and their families, so as to provide peace.
- Provide motivation for non-nursing staff in maintaining
cleanliness of the room and environment. From the results
above, it can be concluded that the nurse is satisfied with the
work of the nurs

2.2.7. Number of Nurses

a. Calculation of Nurses
Guidelines for calculating the needs of nurses and midwives
according to the directorate of nursing services, Directorate General of
Medical Services, Ministry of Health RI (2001) by paying attention to
existing work units in each hospital. Based on the patient classification,
the calculation method for hospitalization is based on the following:
- The level of dependence of the patient based on the type of case
- Average patients per day
- The number of treatments needed / day / patient
- Hours of care required / room / day
- Effective working hours per nurse or midwife are 7 hours/day
b. Classification of nursing care categories according to the Ministry of
Health 2005
 Minimal nursing care:
- Personal hygiene, bathing, changing clothes do it yourself.
- Eating and drinking is done by yourself.
- Supervised ambulation.
- Observation of vital signs was carried out every shift.
- Minimal treatment, stable psychological status.
 Nursing care is:
- Personal hygiene is assisted, eating and drinking is
assisted.
- Observe vital signs every 4 hours.
- Assisted ambulation, treatment more than once.
 Nursing care is rather heavy:
- Most of the activities are assisted.
- Observation of vital signs every 2 - 4 hours.

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 - Installed folley cateter, the intake output is recorded.
- Installed an infusion.
- Treatment more than once.
- preparation of treatment necessary procedures
 Maximum care:
- Nurses provide all activities.
- Position is adjusted, observation of vital signs every 2
hours.
- Feeding requires NGT, intravenous therapy.
- Use of suction.
- Restless / disoriented

There are 4 categories of patient dependence, each of which takes time:

 ü Minimum nursing care: 2 hours / 24 hours

 ü moderate nursing care: 3.08 hours / 24 hours
 ü rather heavy nursing care: 4.15 hours / 24 hours
 ü maximum nursing care: 6.16 hours / 24 hours

Number of hours of treatment

Effective hours per shift

11
2.2.8. Availability of Nursing Care Standards and Standard Operating
Procedures

1. Nursing Care Standards Theory Study (SAK)

According to Nursalam (2002), a standard is a valid statement, a

model arranged based on authority, habit or agreement regarding what
is adequate and appropriate, can be received properly. Nursing care
standards are norms or affirmations about the quality of a nurse's work
that is considered good, appropriate, and correct, which are formulated
as guidelines for providing nursing care and as a benchmark in
assessing the work performance of a nurse.

2. Standard Operational Procedures The procedure for

patient nursing actions based on the results of interviews with the

Head of the Room states that having Nursing Care Standards (SAK)
and Standard Operating Procedures (SOPs) are implemented optimally
in services.

3. Documentation System Documentation

is an authentic record in the application of professional nursing

care management. Professional nurses are expected to be able to face
demands of responsibility and accountability for all actions that are
carried out. Public awareness of the law is increasing so that complete
and clear documentation is needed.

Important components in documenting are communication, nursing

processes and standards of nursing care. Documentation activities
include documentation skills, skills to document the nursing process in
accordance with nursing care standards.

The objectives of the documentation system are as follows:

o Documenting nursing care
o Documenting nursing assessments
o Documenting nursing diagnoses
o Documenting nursing planning
o Documenting the implementation of nursing
o Documenting nursing evaluations
o Documenting logistics and drug management
o Documenting health education through home planning activities

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 o Support weigh receipt
o Documenting supervision activities
o Documenting case resolution activities through the nursing
round
The advantages of doing a documentation system are as follows:
o As a means of communication between nurses and other health
workers
o As legal documentation and has a legal value
o Improve the quality of nursing services
o As a reference for learning in improving nursing science
o Has the value of nursing research and development research.
o The weakness of the documentation system is that sometimes
there is no continuity
o between action and documentation.

2.2.9. Method

 The Nursing Assignment System The

Professional Nursing Care Model is a system (structure, process
and values) that allows professional nurses to manage the
implementation of nursing care, including the environment to support
the provision of care.
The nursing care model used functional methods. The functional
model is carried out by nurses in nursing care management based on the
task orientation of the nursing philosophy, the nurse carries out certain
tasks / actions based on the existing activity schedule (Nursalam, 2002).

The advantages of the functional method:

 Simple.
 Efficient.
 A skilled nurse for a specific task or job.
 It is easy to get job satisfaction for nurses after completing tasks.
 The shortage of skilled personnel can be replaced by less
experienced personnel for one simple task.
 Make it easy for the head of the room to supervise staff or students
who practice certain skills.

Disadvantages of the functional method:

 The patient gets lots of nurses.
 The needs of the individual patient are often overlooked.

13
  Individual patient care is often neglected.
 Service is intermittent.
 Overall job satisfaction is difficult to achieve.
 Based on the results of observations regarding the nursing care
model used today is the functional method, where as many as 80%
of nurses understand the method used.
 Job
descriptions Thedescriptions of each nurse in the Interna Melur room
are based on the 2005 Ministry of Health, as follows:
a. Head of the Inpatient Room.
The authority of the Head of the Inpatient Room regulates and
controls the activities of nursing service activities in the inpatient
room. The Head of the Inpatient Room has the following duties:
- Develop a plan for the needs of nursing personnel in the
inpatient room in coordination with the head of nursing.
- Arrange a schedule to keep a nurse (schedule service)
- Plan and facilitate the availability of facilities needed in the
room.
- Organize and coordinate all service activities in the inpatient
room through collaboration with other officers.
- Checking completeness of employment status inventory
- Orienting new employees who will work in the room
- Conducting performance appraisals for nursing personnel under
their responsibility
- Organize and control the cleanliness and order of the room
- Creating and maintaining a harmonious working relationship
with patients / clients and other health teams.
b. Implementing Nurse Inpatient
nurses Duties include:
- Maintaining the cleanliness of the ward and its environment
- Caring for new patients in accordance with applicable
procedures and regulations
- Maintain nursing and medical equipment to be ready for use
- Conduct nursing assessments and determine nursing diagnoses
within the limits of their authority
- Develop a nursing plan according to ability
- Carry out nursing actions to patients according to their needs
and limits and train / help patients to do motion exercises
- Taking emergency measures to patients (high fever, collapse,
bleeding, poisoning, stopping breathing and cardiac arrest)
according to the applicable procedures, then immediately
reporting the actions that have been taken to the doctor in the
ward / doctor on duty

14
- Carry out an evaluation of nursing actions according to his or
her limits and observe the patient's condition, then take
appropriate actions based on the results of these observations
within his limits

15
 CHAPTER III

CLOSING

4.1. Conclusions 

From the above explanation, the authors can conclude that the
function of the control / control in nursing management can run effectively by
implementing the existing processes and standards. The control function in
nursing management focuses on the duties of a leader in the supervision as well
as the object being supervised, to control things that are factors in controlling
the management system. The thing that greatly impacts the management
process is the discipline of the parties concerned

4.2. Suggestions

 Students Learn to understand the function of management well as a

capital to become a leader in room managerial systems and hospitals. Healthy
achievement without corruption

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 TABLE OF CONTENTS
https://www.academia.edu/10833181/MAKALAH_MANAJEMEN_KEPERAWATAN_APLIKASI
_MANAJEMEN_DI_RUANGAN (1,10,2020/19.00)

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