PENERAPAN RONDE KEPERAWATAN BERBASIS TEORI BOYKIN & SCHOENHOFER TERHADAP KUALITAS ASUHAN KEPERAWATAN DAN KEPUASAN PASIEN DI RUANG RAWAT INAP RSKB COLUMBIA ASIA PULOMAS

Abstrak

Pendahuluan: Kualitas asuhan keperawatan yang optimal tetap menjadi tantangan di berbagai fasilitas kesehatan global. Data WHO (2021) menunjukkan tingkat kepuasan pasien bervariasi dari 34,4% (India) hingga 92,37% (Swedia). Di RSKB Columbia Asia Pulomas, sistem CEMPIA mencatat 445 keluhan dari 33.858 respons periode April 2023-Maret 2024, mayoritas terkait komunikasi terapeutik dan sikap perawat. Ronde keperawatan berbasis teori Boykin & Schoenhofer (Nursing as Caring) menekankan hubungan empatis dan perhatian holistik yang berpotensi transformatif, namun belum pernah diimplementasikan secara sistematis dengan framework teoritis caring di rumah sakit tersebut. Tujuan: Menganalisis efektivitas implementasi ronde keperawatan berbasis teori Boykin & Schoenhofer terhadap peningkatan kualitas asuhan keperawatan dan kepuasan pasien di ruang rawat inap RSKB Columbia Asia Pulomas. Metode: Penelitian kuantitatif dengan desain quasi-experimental menggunakan nonequivalent control group pretest-posttest design dilaksanakan di ruang rawat inap RSKB Columbia Asia Pulomas. Sampel mencakup perawat pelaksana dan pasien rawat inap yang memenuhi kriteria inklusi, dibagi menjadi kelompok intervensi (penerapan ronde keperawatan berbasis Boykin & Schoenhofer dengan integrasi konsep 4P Matron Nurse) dan kelompok kontrol (perawatan standar). Instrumen penelitian menggunakan kuesioner tervalidasi untuk mengukur kualitas asuhan keperawatan dan kepuasan pasien. Intervensi dilakukan melalui ronde keperawatan terstruktur yang menekankan presence (kehadiran autentik), komunikasi empatis, dan perhatian holistik terhadap dimensi fisik, emosional, spiritual, dan psikososial pasien. Analisis data menggunakan uji paired t-test untuk perbandingan pre-post dalam kelompok dan independent t-test untuk perbandingan antar kelompok, dengan tingkat signifikansi α=0,05. Hasil: Kelompok intervensi menunjukkan peningkatan signifikan pada skor kualitas asuhan keperawatan (p<0,001) dan kepuasan pasien (p<0,001) dibandingkan kelompok kontrol. Pendekatan caring yang mengintegrasikan presence (kehadiran aktif dan sadar perawat), komunikasi empatik terstruktur, dan asesmen holistik kebutuhan pasien terbukti efektif meningkatkan kualitas interaksi perawat-pasien. Analisis menunjukkan pembentukan hubungan saling percaya yang memperkuat keterlibatan pasien dalam proses penyembuhan. Dimensi emosional dan psikososial pasien yang sebelumnya terabaikan menjadi terintegrasi dalam ronde keperawatan, menciptakan pengalaman perawatan yang lebih bermakna bagi pasien. Kesimpulan: Implementasi ronde keperawatan berbasis teori Boykin & Schoenhofer efektif meningkatkan kualitas asuhan keperawatan dan kepuasan pasien secara signifikan. Pendekatan caring yang humanistik dan holistik mentransformasi ronde keperawatan dari prosedur klinis rutin menjadi praktik keperawatan yang menekankan kehadiran manusiawi mendalam. Model ini dapat diadopsi sebagai best practice untuk meningkatkan kualitas pelayanan keperawatan di rumah sakit, dengan rekomendasi pengembangan program pelatihan berkelanjutan untuk internalisasi nilai-nilai caring dalam praktik keperawatan profesional.

Introduction: Optimal nursing care quality remains a persistent challenge in healthcare facilities globally. WHO data (2021) shows patient satisfaction rates varying from 34.4% (India) to 92.37% (Sweden). At RSKB Columbia Asia Pulomas, the CEMPIA system recorded 445 complaints out of 33,858 responses during April 2023-March 2024, predominantly concerning therapeutic communication and nurse attitudes. Nursing rounds based on Boykin & Schoenhofer's theory (Nursing as Caring) emphasize empathic relationships and holistic attention with transformative potential, yet had never been systematically implemented with a caring theoretical framework at this hospital. Objective: To analyze the effectiveness of implementing nursing rounds based on Boykin & Schoenhofer's theory on improving nursing care quality and patient satisfaction in the inpatient ward at RSKB Columbia Asia Pulomas. Methods: This quantitative study employed a quasi-experimental design using nonequivalent control group pretest-posttest design conducted in the inpatient ward at RSKB Columbia Asia Pulomas. The sample included staff nurses and inpatients meeting inclusion criteria, divided into an intervention group (implementation of Boykin & Schoenhofer-based nursing rounds with integration of 4P Matron Nurse concept) and a control group (standard care). Research instruments used validated questionnaires measuring nursing care quality and patient satisfaction. The intervention was implemented through structured nursing rounds emphasizing presence (authentic attendance), empathic communication, and holistic attention to patients' physical, emotional, spiritual, and psychosocial dimensions. Data analysis utilized paired t-tests for within-group pre-post comparisons and independent t-tests for between-group comparisons, with significance level α=0.05. Results: The intervention group demonstrated significant improvements in nursing care quality scores (p<0.001) and patient satisfaction (p<0.001) compared to the control group. The caring approach integrating presence (active and conscious nurse attendance), structured empathic communication, and holistic assessment of patient needs proved effective in enhancing nurse-patient interaction quality. Analysis revealed the formation of trusting relationships that strengthened patient involvement in the healing process. Emotional and psychosocial dimensions of patients, previously neglected, became integrated into nursing rounds, creating a more meaningful care experience for patients. Conclusion: Implementation of nursing rounds based on Boykin & Schoenhofer's theory effectively and significantly improves nursing care quality and patient satisfaction. The humanistic and holistic caring approach transforms nursing rounds from routine clinical procedures into nursing practice emphasizing profound human presence. This model can be adopted as best practice to enhance nursing service quality in hospitals, with recommendations for developing continuous training programs for internalization of caring values in professional nursing practice.