Efektivitas strategi synergized mentoring approach for reinforcement and training (SMART) dalam meningkatkan kompetensi perawat klinis di rumah sakit
DOI: https://doi.org/10.33024/hjk.v19i11.2231
Kompetensi Keperawatan Klinis Strategi Mentoring Synergized Mentoring Approach for Reinforcement and Training (SMART)
Abstract
Background: Nurse competency is a crucial factor in ensuring the quality of care and patient safety in hospitals. However, competency assessments in hospitals reveal a gap between competency standards and actual nursing practice, particularly for level 1 and 2 clinical nurses. This issue primarily relates to knowledge of safe medication administration, fluid and electrolyte needs, and wound care. Therefore, a systematic and sustainable development model is needed to improve nurse competency.
Purpose: To analyze the effectiveness of the synergistic mentoring, reinforcement, and training (SMART) approach in improving the competency of clinical nurses in hospitals.
Method: This study used a one-group pretest-posttest quasi-experimental design conducted for 4 weeks in a hospital in Central Java, with 33 nurses selected using a total sampling technique. The SMART intervention combined individual mentoring, bedside coaching, and reflective discussions. Nurse competency was measured using a validated knowledge instrument on safe medication administration, fluid and electrolyte needs, and wound care. Data were analyzed using the Wilcoxon Signed Rank Test.
Results: There was a significant increase in knowledge-based nursing competency from 57.6% to 93.9% (p < 0.001), particularly in fluid and electrolyte management and wound care. This increase has clinical significance as it has the potential to support safer nursing practice and reduce the risk of patient safety issues in inpatient wards. Medication administration did not show a significant increase.
Conclusion: The SMART strategy has proven effective in improving knowledge-based nursing competency in clinical nurses at levels 1 and 2 and has the potential to be implemented as a continuous development model to support service quality improvement and patient safety in hospitals.
Suggestion: Future research could use an RCT design with a follow-up period and combine knowledge measurement with direct observation of clinical skills to more comprehensively assess long-term effectiveness.
Keywords: Clinical Nursing Competency; Mentoring Strategy; Synergistic Mentoring Approach for Strengthening and Training (SMART).
Pendahuluan: Kompetensi perawat merupakan faktor penting dalam menjamin mutu pelayanan dan keselamatan pasien di rumah sakit. Namun, hasil asesmen kompetensi di rumah sakit menunjukkan masih adanya kesenjangan antara standar kompetensi dan praktik keperawatan aktual, khususnya pada perawat klinis level 1 dan 2. Permasalahan tersebut terutama berkaitan dengan aspek pengetahuan tentang pemberian obat secara aman, pemenuhan kebutuhan cairan elektrolit, dan perawatan luka. Oleh karena itu, diperlukan model pembinaan yang sistematis dan berkelanjutan untuk meningkatkan kompetensi perawat.
Tujuan: Untuk menganalisis efektivitas strategi synergized mentoring approach for reinforcement and training (SMART) dalam meningkatkan kompetensi perawat klinis di rumah sakit.
Metode: Penelitian menggunakan desain kuasi-eksperimen one-group pretest–posttest yang dilaksanakan selama 4 minggu di salah satu rumah sakit daerah Jawa Tengah, kepada 33 perawat dipilih menggunakan teknik total sampling. Intervensi SMART mengombinasikan mentoring individual, bedside coaching, dan diskusi reflektif. Kompetensi perawat diukur melalui instrumen pengetahuan tervalidasi pada aspek pemberian obat aman, cairan elektrolit, dan perawatan luka, sedangkan analisis data dilakukan menggunakan uji Wilcoxon Signed Rank Test.
Hasil: Peningkatan signifikan kompetensi perawat berbasis pengetahuan dari 57.6% menjadi 93.9% (p < 0.001), terutama pada aspek cairan elektrolit dan perawatan luka. Peningkatan ini memiliki makna klinis karena berpotensi mendukung praktik keperawatan yang lebih aman dan menurunkan risiko masalah keselamatan pasien di ruang rawat inap. Aspek pemberian obat menunjukkan peningkatan yang tidak signifikan.
Simpulan: Strategi SMART terbukti efektif dalam meningkatkan kompetensi perawat klinis 1 dan 2 berbasis pengetahuan dan berpotensi diterapkan sebagai model pembinaan berkelanjutan untuk mendukung peningkatan mutu pelayanan dan keselamatan pasien di rumah sakit.
Saran: Penelitian selanjutnya dapat menggunakan desain RCT dengan periode tindak lanjut serta mengombinasikan pengukuran pengetahuan dan observasi langsung keterampilan klinik untuk menilai efektivitas jangka panjang secara lebih komprehensif.
Kata Kunci: Kompetensi Keperawatan Klinis; Strategi Mentoring; Synergized Mentoring Approach for Reinforcement and Training (SMART).
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