ANALISIS FAKTOR - FAKTOR YANG BERHUBUNGAN DENGAN KINERJA PERAWAT PEGAWAI DAERAH DI PUSKESMAS KABUPATEN KUDUS

Abstract

The number of visiting patient to the Public Health Care Centers has been continuously decreasing which affected the income of the Health Care Centers. One of the priority services in the Health Care Centers is polyclinic services, and Nurses as paramedic officials have important roles in this services department. Therefore, the number of patients visiting the Centers is influenced by nurse performances. Status of nurses is categorized into 2 (two) groups : Civil Servant nurses and Non—Civil Servant Nurses (Local employees). In fact, the performance of non—civil servant nurses is less than that of civil servant nurses. The low performance of the non — civil servant is indicated by his or her poor discipline and weak implementation of the service standard operating procedure of the Health Care Centers. The objective of this research was to know the performance profile of non civil servant nurses in the District of Kudus and correlated factors influenced the performance. The research used was explanatory type using survey method of cross sectional approach. Research instrument used questionnaires to 25 respondents of non civil servant nurses from the Health Care Centers in District of Kudus. Focus Group discussion had been carried out involving 12 civil servant nurses and in-depth interview involving 3 (three) Heads of the Health Care Centers in District of Kudus. The primary and secondary data were processed and analyzed with qualitative and quantitative analysis with uni-variance and bi-variance methods using Spearmant rank test. The level of significant test was determined to be less than 0,05 (p < 0,05). The result shows that variables that correlate to performances are age (p-value : 0,028), income (p-value: 0,005), promotion opportunity (p-value: 0,004), leadership (p-value: 0,036), supervision (p-value: 0,013) and motivation (p-value: 0,000), and variable that does not correlate with performance is education (p-value: 0,426). From this research it can be drawn the following suggestions. To the Heads of the Health Care Centers, do not differentiate the non civil servant to civil servant nurses in the incentive and other facilities, opportunity attending education and training, and regular supervising. To the Heads of Local Health Services Office in District of Kudus, need to enforce the employee regulation in managing non civil servant nurses, to give opportunity to them attending education and training, to socialize the employee regulation to the Heads of the Health Care Centers. To the Government of the District of Kudus, to re-evaluate the rule that regulate the weighted point on the utilization of the health care center services, to enact policy in appointing civil servant candidates by prioritizing non — civil servant nurses who have outstanding performances. Kunjungan pasien di Puskesmas mengalami penurunan yang mempengaruhi pendapatan Puskesmas. Salah satu pelayanan unggulan di Puskesmas adalah bagian pengobatan, dimana perawat merupakan petugas paramedis paling berperan. Untuk itulah jumlah kunjungan pasien di Puskesmas dipengaruhi oleh kinerja perawat yang statusnya terdiri dad perawat Pegawai Negeri Sipil (PNS) dan Pegawai Daerah. Pada kenyataannya kinerja Perawat Pegawai Daerah lebih rendah dad pada perawat PNS. Rendahnya kinerja Perawat Pegawai Daerah ditunjukkan dengan rendahnya disiplin dan rendahnya tingkat kepatuhan perawat terhadap standar pelayanan di Puskesmas. Tujuan penelitian ini untuk mengetahui gambaran kineda Perawat Pegawai Daerah Kabupaten Kudus dan faktor — faktor yang berhubungan dengan kinerja. Jenis penelitian explanatory menggunakan metode survei dengan pendekatàn cross sectional. Instrumen penelitian menggunakan kuesioner pada 25 responden yaitu Perawat Pegawai Daerah di Puskesmas Kabupaten Kudus, Focus Group Discusion pada 12 Perawat Pegawai Daerah dan wawancara mendalam pada 3 Kepala Puskesmas Kabupaten Kudus. Data primer maupun sekunder diolah dan dianalisis dengan cara kualitatitf serta kuantitatif dengan metode univariat dan bivariat , menggunakan uji rank speannant Signifikansi ditentukan dengan nilai p < 0,05. Hasil penelitian menunjukkan bahwa variabel yang berhubungan dengan kinerja adalah umur (p-value : 0,028), pendapatan (p-value : 0,005), kesempatan promosi (p-value : 0,004), kepemimpinan (p-value : 0,036), supervisi (p-value : 0,013) dan motivasi (p-value : 0,000) dan variabel yang tidak berhubungan dengan kineda adalah pendidikan (p-value: 0,426) Disarankan kepada Kepala Puskesmas agar tidak membedakan Perawat Pegawai Daerah dan PNS dalam pemberian insentif dan fasilitas lainnya, memberikan kesempatan untuk mengikuti pendidikan dan pelatihan dan perlu adanya supervisi berkala. Bagi Dinas Kesehatan Kabupaten Kudus, perlu penegakan peraturan Kepegawaian dalam memperlakukan Perawat Pegawai Daerah, memberikan kesempatan untuk mengikuti pendidikan dan pelatihan, perlu adanya sosialisasi Peraturan Pegawai Daerah Kabupaten Kudus kepada Kepala Puskesmas. Bagi Pemerintah Kabupaten Kudus, agar meninjau kembali ketentuan yang mengatur pembobotan point penggunaan jasa pelayanan Puskesmas, diterbitkan kebijakan untuk mengutamakan perawat Pegawai Daerah yang berprestasi dalam pengangkatan Calon Pegawai Negeri Sipil.