Speech Text Group 7

The Impact of Evidace- Based Practice in Nursing: Improving Patient Safety

By :

Brigitta Wamis P 202241023

Siti Handayani 202241015

Riris Nur Hidayati 202241019

Chrishadi Yulian P 202241020

Program Studi S1 Ilmu Keperawatan Program Ekstensi

STIKes. St. Elisabeth Semarang

Tahun 2022 /2023

First of all, please allow me……………………………….

Good morning to everyone present here today. I feel honored and blessed to be given this
opportunity to give a speech on” the impact of evidence – based practice in nursing : improving
patient safety “ . I hope everyone learns something from this speech.

Dear guests,

Hospital patient safety and service quality: Surprising empirical evidence Everyone
would want to get quality health services and free from risk. The question is, how to choose
quality health services? Choosing a hospital service can be likened to choosing a restaurant. At
first we might be interested in trying a certain restaurant because it is visited by many people,
friendly waiters, fast food, large parking area, and comfortable place. The dimension of service
quality is of course important, but it becomes meaningless if the food turns out to be bad,
especially if afterwards it results in diarrhea, or even has to be treated in a hospital.

Choosing a hospital can be influenced by many factors: other people's suggestions,

reputable doctors, friendly nurses, fast service and comfortable physical buildings. The paradigm
of health service quality also starts from service excellence. In its development, these dimensions
are not enough. The hospital was chosen because of its excellent clinical services (clinical
excellence) and prioritizing patient safety. At this time the quality of health services has entered
the era of patient safety.

The problem of service quality and patient safety is increasingly developing into a serious
public health problem. Even though the patient naturally has a risk due to the disease he is
suffering from, the risk due to unwanted events will certainly worsen the patient's condition. It's
like having fallen, hit by a ladder anyway. The latest publication in America in 2011 showed that
1 in 3 patients who were hospitalized had an adverse event. The most common types are
medication errors, surgical and procedure errors and nosocomial infections (Classen et al., 2011).
The study at 10 hospitals in North Carolina found similar results. One in 4 hospitalized patients
experiences an adverse event, 63% of which can actually be prevented (Landrigan et al., 2010).
The frequency of adverse events is almost 10 times higher than the results of research in the
1990-2005 period. In fact, efforts to reduce adverse events in developed countries have been
slow.

How about in Indonesia? In Indonesia patient safety has become a serious concern. The
first study was conducted in 15 hospital inpatients with 4500 medical records (Utarini et al.,
2000). The results show that the incidence of adverse events varies greatly, from 8.0% to 98.2%
for diagnostic errors and 4.1% to 91.6% for medication errors. Since then, there has been
increasing evidence of patient safety in Indonesia. Considering the high number of adverse
events due to medical procedures at the hospital, the slogan "buy one, get one free" is not too
wrong. Instead of recovering from their illness and leaving the hospital immediately, some
patients actually get a bonus for unwanted events, ranging from the mild to causing disability and
death. The study of postoperative wound infections is one example of this slogan. Instead of
recovering and leaving the hospital immediately, the patient had to undergo longer treatment due
to a surgical wound infection. The results of several studies show the rate of postoperative
wound infection in hospitals in Indonesia ranges from 11.5% to 47.7% (Manuaba, 2006;
Priharto, 2005; Yulianto, 2007)

Since the declaration of the patient safety movement in 2005 by the Minister of Health of
the Republic of Indonesia, a voluntary accident reporting system has also been developed in
hospitals. Even though the number of reported adverse events was still relatively low, namely
only around 300 cases in 2009, this was quite encouraging as the beginning of the growth of a
hospital organizational culture that was oriented towards patient safety. Honorable guests,

In Indonesia, the quality of health and patient safety services has a strong legal basis.
Law (UU) Health no. 36/2009 mandates that safe, quality and affordable health services are the
government's responsibility and everyone's right (articles 5 and 19). Likewise, the Law on
Medical Practice (UUPK) No. 29/2004 and the Law on Hospitals (UURS) No. 44/2009
unequivocally state that the quality of service and patient safety is the basis and objective of
medical practice and hospital administration.

To conclude this speech, Service and patient safety in Indonesia are very dependent on
the mechanisms of internal regulation, co-regulation and meta-regulation. So that responsive,
each strategy needs to adopt the regulatory pyramid principle. For example, hospital
accreditation will be more responsive if starting from education about accreditation standards,
giving feedback positive feedback to the hospital, financial implications for achievement of
accreditation, granting of recognition by the association of houses sick, to the provision of
information to the public in order to get recognition from a wide audience.