The Relationship Between The Implementation of Patient Safety and The Quality of Nursing Services at Purwokerto Islamic Hospital

ABSTRACT

Background : Patient safety in drug administration is still a top global health priority because patient safety has become the most important indicator in the health care system for good and bad patient health.The lower the implementation of patient safety in administering medication, the better the quality of nursing services will be.Research Objective: To determine the relationship between the implementation of patient safety in administering inpatient medication and the quality of nursing services at RSI Purwokerto.Method: Quantitative methods were used with a correlational descriptive design with a crosssectional approach.The sampling technique was total sampling, totaling 90 respondents.Results: From this research, the results showed that there were 41 inpatient nurses (91.1%) who implemented patient safety in administering medication well, and 42 inpatient nurses (93.3%) who assessed the quality of nursing services at RSI Purwokerto as good .The results of the bivariate analysis showed that there was a significant relationship between the implementation of patient safety in administering medication and the quality of nursing services at RSI Purwokerto (p0.05).Conclusion: There is a relationship between the implementation of patient safety in inpatient medication administration and the quality of nursing services in hospitals.

INTRODUCTION
Medication errors are events that harm patients due to treatment carried out by health workers (human error) which can actually be prevented.Medication errors can be classified into dispensing errors, prescribing errors, and administration errors [2].In general, the factors that most often influence medication errors are individual factors, in the form of personal problems, inadequate knowledge about medications, and errors in calculating medication doses [9].
Currently, patient safety is still the main global health priority [11] because it has become the most important indicator in the health service system.The good and bad of patient health services implemented at the health service facility and can also be seen from the condition of the health service system implemented at the health service facility.The lower the number of medical errors that can be prevented from occurring, the better the quality of health facility services will be, and thus the public's trust in health service facilities will be higher.

ISSN: 2808-1021
Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30135 The aim to be achieved in this research is to determine the relationship between the implementation of patient safety when administering medication and the quality of nursing services at Purwokerto Islamic Hospital.

RESEARCH METHOD
This research is quantitative research, with a cross sectional approach.In this study there are two variables, namely the independent variable, namely the implementation of patient safety in administering medication and the dependent variable, namely the quality of nursing services.Example for this research there were 90 respondents who were inpatient nurses and inpatients at Purwokerto Islamic Hospital .The sampling technique used was total sampling.The data collection method uses a questionnaire.  2 , it shows that the majority of respondents were male (55.6%).Meanwhile, regarding age characteristics, the highest percentage is in the 36 -45 years old group (24.4%).Based on the research results, it shows that the majority of respondents were aged 36 -45 years (24.4%), which is the age most of them came to Purwokerto Islamic Hospital to get health services.

RESULT AND DISCUSSIONS
Based on the research results, it shows that the majority of respondents were male (55.6%).Male and female patients are relatively the same in feeling satisfaction in receiving health services at the hospital.This is in line with research [1] on gender on service quality tand there is no a relationship between type and satisfaction, meaning tthere is no significant difference between the total satisfaction of male and female respondents.

Bivariat
Table 3 Based on table 3, data was obtained regarding the implementation of patient safety when administering medicines, with 4 respondents (8.9%) in the Fairly Good category, and 41 respondents (91.1%) in the Good category.This is because implementing patient safety when administering medication is very important.The better the quality of nursing services, because the better the implementation of patient safety when administering medication to patients, the better the quality of nursing services.
The results of research conducted by [5] explain that when administering patient safety medication to respondents with a high patient safety culture, respondents will provide good service.Meanwhile, the implementation of providing patient safety medication to respondents with a low patient safety culture is inseparable from the respondents' low understanding.So the low understanding of respondents causes obstacles in implementing patient safety.Therefore, the implementation of medication administration for patient safety plays an important role in efforts to encourage the implementation of patient safety.Based on table 4, it is known that the assessment of the quality of patient service is poor (6.7%) with a total of 3 respondents.Meanwhile, patients rated the quality of nursing services as Good (93.3%) with a total of 42 respondents.
This is because nurses are guided by 4 aspects of the quality of nursing services, such as the reliability of nurses at RSI Purwokerto is good, the responsiveness of nurses at Purwokerto Islamic Hospital already has a good sense of responsiveness, the assurance at RSI Purwokerto is already kind, the nurses at RSI Purwokerto are empathetic and have a high sense of empathy.5, it can be seen that the implementation of patient safety in administering medication with the quality of nursing services at Purwokerto Islamic Hospital.The implementation of safety for patients administering medication received a poor category with the quality of nursing services being poor at 2.1% with the number of respondents being 5.Meanwhile, the implementation of patient safety for administering medication received the Good category with the quality of nursing services being good at 91.6% with a number of respondents being 90.Based on the results of the chi square test analysis showed that there was a relationship between the implementation of patient safety in administering medication and the quality of nursing services at the Purwokerto Islamic Hospital with a p value of 0.0021 (p <0.005).
The implementation of patient safety in administering medication was obtained in the Good category with good quality of nursing services (94.7%).Based on the results of statistical tests carried out using the chi square test, it was found that there was a relationship between the implementation of patient safety when administering medication and the quality of nursing services with a Fisher's Exact Test sign of 0.021 and a contingency coefficient value of 0.344.The closeness of the correlation is 0.344 with a closeness scale of 0.30 -0.49, which means the level of correlation is strong, meaning that the closeness means that the relationship between patient safety implementation of medication administration and the quality of nursing services itself is moderate.This is because implementing patient safety when administering medication is very important.Good means the quality of nursing services is bad, because the better the implementation of patient safety in administering medication to patients, the better the quality of nursing services, so the hypothesis is accepted with an OR value of 19.333.
In fact, the quality of nursing services can be achieved by increasing the implementation of patient safety practices, administering medication to nurses in accordance with what is expected.Where the results obtained are good quality of nursing services.This means that the treatment room remains clean and tidy.Reliability means that nurses are able to serve patients in accordance with applicable nursing service standards.Responsiveness (responsiveness) which means nurses handle nursing care problems quickly and responsively.Guaranteeing the certainty of meaningful behavior by nurses provides a sense of security and comfort to patients.Meaningful empathy nurses have shown empathy for patients in providing nursing services and care.
Implementing good patient safety practices in administering medicine will improve the quality of good nursing services.Likewise, if the implementation of patient safety when administering medication is not good enough, the quality of nursing services can also be considered not good enough.

1) Univariate Analysis  Characteristics of Nurse Respondents
Based on the results of research that has been conducted, of the 45 respondents there were 13 male nurses (28.9%) and 32 female nurses (71.1%).According to [7], the Southeast Asia region is still dominated by 79% of female nurses compared to only 21% of male nurses.The results of this research are in line with the theory expressed by [10] that women have advantages as nurses in treating patients and have persuasive abilities in communicating with patients, so that these abilities can be used to provide understanding to patients.In terms of age characteristics, there were 34 nurses aged 21-30 years (75.6%),11 people aged 31-40 years (24.4%).The results of this research are in line with research by [6] that nurses are at a productive age between 20-35 years.Meanwhile, in Indonesia the productive working age ranges from 15-64 years.
In terms of length of service characteristics, the majority of nurses at RSI Purwokerto worked for 1-10 years (91.1%), for 11-20 years (6.7%), and a small number for 21-30 years (2.2%).Length of time working affects a person's productivity [3].The longer the work period, the more abilities and skills will increase.So that experience will produce applications that lead to relatively permanent changes in behavior.
In terms of educational characteristics, the majority of respondents had a D3 education, 36 people (80.0%), 7 people had a bachelor's degree (15.6%), 1 person had a professional education as a nurse (2.2%), and 1 person had a master's degree (2.2%).The researcher's analysis shows that the level of nurse education still needs to be improved.This is in accordance with research conducted by [4]  Based on the research results, it shows that the majority of respondents were aged 36 -45 years, 29 respondents (24.4%), which was the largest age group who came to RSI Purwokerto to get health services.Based on the research results, it shows that the majority of respondents were male, 25 respondents (55.6%).Male and female patients are relatively the same in feeling satisfaction in receiving health services at the hospital.This is in line with [8] research that there is no relationship between gender and service quality, meaning there is no significant difference between the total satisfaction of male and female respondents.

2) Bivariate Analysis 1. Implementation of Patient Safety Implementation of Medication Administration
This is because the implementation of patient safety in administering medication really determines whether the quality of nursing services is good or bad, because the better the implementation of patient safety in administering medication to patients, the better the quality of nursing services will be.
The results of research conducted by [5], explain that implementing patient safety in administering medication to respondents with a high patient safety culture means that respondents will carry out services well.Meanwhile, the implementation of patient safety in administering medication to respondents with a low patient safety culture cannot be separated from the respondents' low understanding.So the low understanding of respondents causes obstacles in implementing patient safety.Therefore, the implementation of patient safety in drug administration plays an important role in efforts to encourage the implementation of patient safety.

Quality of Nursing Services at RSI Purwokerto
This is because nurses are guided by 4 aspects of the quality of nursing services such as the reliability of nurses at RSI Purwokerto is good, the responsiveness of nurses at RSI Purwokerto already has a good sense of responsiveness, assurance at RSI Purwokerto is good, empathy nurses at RSI Purwokerto already have a high sense of empathy.

CONCLUSION AND RECOMMENDATION
Purwokerto Islamic Hospital guided by 5 aspects of the quality of nursing services such as tangible space which means inpatient care is clean and tidy, reliability means the nurse is able to serve patients in accordance with applicable service standards in nursing practice, responsiveness which means the nurse is able to handle nursing care problems properly.Fast and responsive way, guarantee behavior meaningful guarantee _ nurse provide a sense of security and comfortable with the patient, meaning that the nurse has shown empathy for the patient in providing nursing services and care.
Nurses need to improve their implementation of patient safety.This is to improve the quality of nursing services in implementing patient safety.In order for the nursing sector to improve the implementation of nurse performance evaluations, it is necessary to hold a program to improve the implementation of patient safety for nurses such as training through workshops, seminars, etc. as well as carrying out regular monitoring of the implementation of nurse performance evaluations.patient safety.So that hospitals can carry out their obligations in treating patients professionally.

Table 2 .
of length of work at the Purwokerto Islamic Hospital, the highest percentage of nurses worked for a period of 1-10 years with a percentage of 41 respondents (91.1%).And in terms of characteristics of patient safety training, the highest percentage is that nurses have attended patient safety training with a percentage of 41 respondents (91.1%).Characteristics of the distribution of inpatient respondents at Purwokerto Islamic Hospital Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30 . Implementation of patient safety distribution for medication administration to inpatients at

Table 4 .
Distribution of Nursing Service Quality at Purwokerto Islamic Hospital

Table 5 .
relationship between the implementation of patient safety and administration of medication to inpatients with the quality of nursing services at Purwokerto Islamic Hospital Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30137 Based on table that Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30138 the majority of nursing staff are D3 Nursing.Even though most of the nurses at RSI Purwokerto have a D3 education, that doesn't mean they are no more professional than nurses with higher education.Regarding the characteristics of respondents who had attended patient safety training, 41 people (91.1%) had attended patient safety training and 4 people (8.9%) had never attended patient safety training.Through the training carried out, mastery of various skills and techniques for carrying out specific, detailed and routine work can be improved. Characteristics of Inpatient Respondents