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DOMINANT FACTORS AFFECTING NURSE PERFORMANCE IN GENERAL

WARDS: A SYSTEMATIC REVIEW

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 DOMINANT FACTORS AFFECTING NURSE PERFORMANCE IN
GENERAL WARDS: A SYSTEMATIC REVIEW

Achmad Masfi1, Aulia Rahman1, Sarifudin1

1Faculty of Nursing Universitas Airlangga

Campus C Mulyorejo, Surabaya, Indonesia 60115

auliarahmanfattan@gmail.com

ABSTRACT
Introduction: The main problem of nurse performance in nursing services is the
lack of highly educated nurses, inadequate capacity, many nurses were rude (less
friendly to the patient). The purpose of this study was to determine the dominant
factors affecting nurse performance in general wards. Methods: This study was
used a systematic review design. A literature search conducted through several
major databases such as ProQuest, ScienceDirect, Eldoxea, Medline, and Google
Scholar by entering keywords Nurse Performance, Job Satisfaction of Nurse,
Factors Effecting Performance of Nurse. Researcher found only 15 articles with a
sample of study were 2017 nurses in general wards of hospital. The inclusion
criteria was 1) Case Control /Cross Sectional design 2) Sampling taken with
random sampling technique 3) Non Experiment 4) The number of samples > 50
respondents. Results: The result showed from the 15 articles, there are three
factors that are often used by researcher as a variable to determine the factors
affecting nurse performance in general wards of hospital namely motivation as
much as 7 researchs, salary as much as 6 research, leadership as much as 5
research. These factors become dominant factors in this study to determine the
effect on the nurse performance in general wards of hospital. Discussion: So that
the dominant factor affecting the performance of nurse general wards hospital is
motivation, salary, and leadership.

Keywords: performance, nurse, general wards

INTRODUCTION
The main problem of nurse
performance in nursing services is
the lack of highly educated nurses,
inadequate capacity, many nurses
were rude and less friendly to the
patient. The problems were not just
about the attitude to the patient, but
also the high rates of nursing
workload, unclear rules and
regulations of the nurse (Aditama,
2003). Consumers still feel a lot of
deficiencies from nurse performance,
such as competitiveness and
competency that can not meet the
demand for healthcare services
(Department of Health RI, 2001 in
Sasono, 2016).
The previous study showed the
differences in the results of the
factors affecting nurse performance.
Mulyaningsih (2013) in her research
showed the demographic and
educational factors did not affect
nurse performance, while Rahmatina
(2015) and Nurbaya (2012) in their
study mentioned that educational
factors affecting nurse performance.
According to Jeles (2009)
nurse performance is an act done by
a nurse within an organization
according to their authority and
responsibilities, not violate the laws,
rules and norms and ethics, which is
a good performance will give
satisfaction to the service user. The
activities of a nurse is to collect data
about the health of the patient
(assessment), make a diagnosis
according to the science of nursing,
set nursing goals, implement nursing
actions and evaluation.
Many researchers doing
research about the factors
affectingnurse performance with
different variables and results. Their
research has many differences from
sample size and place of research is
influenced by various factors.
Based on the background
above, researcher conducted a
systematic review research about "
Dominant Factors Affecting Nurse
Performance in General Wards”.
METHODS
Systematic review is one of the
research methods that use a review,
study, structured evaluation,
classifying and categorizing of
evidence based had done before. The
steps and strategies for the
systematic review were highly
planned and structured so that this
method is different from the methods
which just used to show the literature
study (Tutik, 2013).
A literature search conducted
through several major databases such
as ProQuest, ScienceDirect, Eldoxea,
Medline, and Google Scholar by
entering keywords nurse
performance, job satisfaction of
nurse, factors effecting performance
of nurse. Data were collected at
Airlangga University in Surabaya
and 1254 articles have been found.
Then the number of the article is
minimized by the year 2012 - 2016.
This aims to maintain the currency of
writing based on the latest research
results, found 567 articles by
researcher. Researcher found only 15
articles with a sample of study were
2017 nurses in general wards of
hospital. The inclusion criteria was
1) case control/cross sectional design
2) sampling taken with random
sampling technique 3) non
experiment 4) the number of samples
> 50 respondents.
The result showed from the 15
articles, there are three factors that
are often used by researcher as a
variable to determine the factors
affecting nurse performance. The
purpose of this study was to
determine and analyze the dominant
factors affecting nurse performance
in general wards of hospital.
RESULTS AND DISCUSSION
Identification of factors affecting
nurse performance in general
wards of hospital
There was 15 articles has been
chosen as a sample of research and
53 variable found as the factors
affecting nurse performance.
Researchers only used 27 variables
as the factors affecting nurse
performance in general wards of
hospital namely 1) motivation, 2)
supervision, 3) awards, 4)
competency, 5) adversity quotient
(AQ), 6) quality management (TQM)
, 7) training, 8) education, 9) age, 10)
gender, 11) working period, 12) job
satisfaction, 13) leadership, 14) work
culture, 15) career development, 16)
compensation, 17) salary, 18)
discipline, 19) workloads, 20)
intensive, 21) facilities, 22) nurse
status, 23) type of hospital, 24)
experience, 25) time management,
26) sociodemographic, 27)
environment.
Identification of dominant factors
affecting nurse performance in
general wards of hospital
Researcher analyzed the
dominant factors affecting nurse
performance in general wards of
hospital from 27 existing variables.
Researcher identify, classify same
variable, and analyze the factors
which is more used from 15 samples
in order to examining the factors
affecting nurse performance in
general wards of hospital.
Table 3 shows from 15 studies,
variables which is significant with
the nurse performance in general
wards of hospital were 40 variables.
Researchers conducted the
identification and clustering the same
variables and 19 variables was
found: 1) motivation, 2) supervision,
3) awards, 4) Adversity Quotient
(AQ), 5) leadership, 6) training, 7)
education, 8) job satisfaction, 9)
work culture, 10) career
development, 11) discipline, working
period, 12) workloads, 13) facilities,
14) nurse status, 15) age, 16) time
management 17) experience, 18)
environment, 19) job satisfaction.
Analysis showed from 15
articles, there was three factors are
often used by researchers as variable
to determine the factors affecting
nurse performance in general wards
of hospital namely motivation as
much as 7 researchs, salary as much
as 6 researchs, leadership as much as
5 researchs. . These factors become
dominant factors in this study to
determine the effect on the nurse
performance in general wards of
hospital.
Motivation factor
There was 7 of 15 articles that
use motivation as a factor affecting
nurse performance in general wards
of hospital. Those articles include
article from Fergie Mandagi M
(2015), Endah Woro Utama (2013),
Sri Sugiyanti (2013), Inriyani
Matthew (2014), Sasono Mardiono
(2015), Tesfaye (2015), Agezegn
Asegid (2015).
Motivation affects nurse
performance in general wards of
hospital, this is consistent with
research by Indrawaty and Rattu
(2012) which mentioned that there
was a significant relationship
between motivation and nurse
performance in Irina general wards
of Binangkang Datoe Kotamobagu
City Hospital. Mahendra and
Brahmasari (2015) in their research
also mentined that there was a
significant relationship between
work motivation and nurse
performance in the general wards of
Menur Psychiatric Hospital
Surabaya. Research by Muttaqillah
(2015) mentioned that the motivation
from nurses to BLUD RSJA have a
positive effect inimproving nurse
performance.
Motivation inthe workplace
can be defined as an individual's
degree of willingness to exert and
maintain effort towards
organizational goals. Work
motivation is an internal process and
person receive certain stimuli from
the environment (Bennetts, 1999).
Motivation could push a nurse
to behave according to the goals that
wouldbe achieved. Motivation can
also make a nurse to predict the
behavior of what have to do in the
future. In this case the behavior of
the nurses will either come from that
nurse with good motivation. So if a
nurse has a good motivation to
achieve its goals, their performance
will increase. Thus, the more
motivation of individual nurses
increase, the more nurse performance
of individuals, groups and the
hospital improve.
Salary/incentive factor
There was 6 of 15 articles that
use salary as a factor affecting nurse
performance in general wards of
hospital. Those article include article
from Surya Darma Putra (2014),
Nurbayak (2012), Inriyani Mathius
(2014), Sasono Mardiono (2015),
Nebiat Negussie (2013), Agezegn
Asegid (2015).
Salary is one of the factors
which can affect the nurse
performance in general wards of
hospital. this is consistent with
research by Lande (2006), which
showed thatthe relationship between
incentive and nurse performance
when performing nursing care in
general wards. There was so many
nurses in general wards of Elim
Rantepao Toraja Hospitalare not
satisfied with theirincentive which
related to their poor performance in
performing nursing care.
Similarly with research by
Sitohang (2006) which mentioned
that the low performance of nurses to
do works it is because of low
incentives earned. It can be seen
from the nurses who always think to
get another job outside the hospital.
Emerging paradigm is the incentive
will automatically be always
accompanied by the increase in
productivity/performance.
Incentive or salary is one of the
factors that affect the level of
performance, and there are other
factors may also affect performance
such as conducive environment
(attitude and behavior of supervisor)
and the environmental characteristics
of nurse organization in the work can
also solve the problem and
management policies (Muhammad,
2003).
A good salary is a system that
is able to ensure the satisfaction of
the organization members. An
organization acquire, maintain and
employ a number of people with a
positive attitude and behavior, and
also those people work productively
for the benefit of the organization. If
the organization members was not
satisfied with their compensation, the
impact on the organization will be
very negative. This means that if
these grievances are not resolved
properly, it is natural that the
organization member want more
incentive.
There was 5 of 15 articles that
use leadership as a factor affecting
nurse performance in general wards
of hospital. Those article include
article from Sri Sugiyanti (2013),
Rahmatina Aulia (2014), Nurbayak
(2012), Sasono Mardiono (2015),
Agezegn Asegid (2015).
Leadership is a factor affecting
nurse performance in general wards
of hospital. This is consistent with
research by Ermina Rusilawati
(2009) which concluded that the
factors affecting the employee
perfomance at zainab Women and
Children's Hospital Pekanbaru, one
of the variable is leadership, with
coefficient value 0. 390. It means
leadership positively affects
employee performance. The results
of this study consistent with
Andreas’s opinion (2005: 15) which
explains that in the literature of
management and organization,
organizational culture and leadership
is seen as the two main variables that
affecting both the poor and the good
performance of employees. Strong
and adaptive organizational culture
and also transformational leadership
are two key variables whichrelated to
determine the level of employee
performance.Both of this evidence
showed the influence of leadership
on employee performance
improvement.
Organizational commitment is a
situation where an employee in favor
of an organization policies which
aim to maintain the work
productivity of organization
members although there are leader
commitments that states are less
good, but the fact remains
significantly affect the performance
of nurses. Thus, if the pattern of
leadership in improving performance
are less or no good, then the
performance will decrease because
leadership is a key in determining the
employee performance, including the
nurse performance in general wards
of hospital.
CONCLUSION
Factors that are often used by
researchers to determine the effect of
the nurse performance can be divided
into internal and external factors.
Internal factors including age,
gender, education, experience, time
management skills, and discipline.
While external factors including
motivation, leadership, salary,
training, facilities, nurse status,
workload, Adversity Quotient (AQ),
and environment. The dominant
factor affecting nurse performance
nurses in general wards of hospital
are external factors such as
motivation, salary, and leadership.
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