Inisiasi supervisi klinis praktik menyuntik aman bagi perawat baru melalui pendekatan kotter’s eight step plan
DOI: https://doi.org/10.33024/hjk.v20i4.2938
Clinical Supervision Needle Stick Injury Planned Change
Abstract
Background: Needlestick injuries (NSIs) among new nurses at Hospital X account for 67% of the total incidence of needlestick injuries (NSIs). Therefore, interventions are needed to improve knowledge and skills in safe injection practices from the beginning of their employment.
Purpose: To describe the implementation of Kotter's eight-step plan to optimize the role and function of nurse unit managers (NUMs) through clinical supervision in preventing needlestick injuries.
Method: This case report was conducted from May 27 to June 30, 2025, through interviews, observations of safe injection practices, and questionnaires. Data were analyzed descriptively, mapped using a SWOT analysis, and then root causes were identified and prioritized using an Ishikawa diagram. A plan of action (PoA) was developed based on nursing management functions and implemented in one inpatient unit as a pilot project. Evaluation of structure, process, and outcomes was conducted using a proctor model that encompasses the formative, normative, and restorative functions of clinical supervision.
Results: New nurses had low knowledge of NSI (3.1%) and limited adherence to safe injection practices (31.4%). The lack of supervision and suboptimal facilities for safe injection practices highlight the need to optimize the role of National Unity Health (NUM) in preventing CJS through the initiation of a clinical supervision program for safe injection practices. Implementation of the PoA has only reached 50% of the planned level, but evaluations indicate adequate structural readiness, despite limited implementation. Outcome evaluations confirmed that structured clinical supervision improves adherence, strengthens staff competency, and reduces the risk of CJS.
Conclusion: Implementation of stages 1–4 of Kotter's eight-step plan successfully initiated strengthening the NUM's driving function through clinical supervision in CJS prevention. Although implementation is only 50%, initial results demonstrate organizational readiness and the potential for improved nurse adherence and competency. The Kotter and Proctor model approach provides a foundation for sustainable change toward safer, higher-quality nursing practice.
Suggestion: Future research could expand all stages of Kotter's eight-step plan and use more robust designs, such as quasi-experimental ones, to evaluate the impact of clinical supervision on knowledge, practice adherence, and criminal justice system incidents.
Keywords: Clinical Supervision; Needle Stick Injury; Planned Change.
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