Stres Kerja dan Keselamatan Pasien: Literature Review
Occupational Stress and Patient Safety: Literature Review
Abstract
Latar belakang: Stres yang berhubungan dengan pekerjaan adalah kondisi yang lazim dalam profesi keperawatan yang menjadi penyebab utama kesehatan dan keselamatan pada pasien. Stres kerja pada perawat merupakan masalah global dan nasional yang mesti menjadi perhatian guna menunjang proses asuhan keperawatan yang optimal sehingga aspek keselamatan pasien bisa terwujud.
Tujuan: Untuk mengidentifikasi secara terstruktur dan memberi gambaran secara detail berbasis bukti terkini terkait dengan model stres yang berhubungan dengan pekerjaan pada perawat dan keselamatan pasien di Rumah Sakit. Tujuan tersebut bisa tercapai dengan mengelola literatur review berdasarkan: Karakteristik stres kerja pada perawat, Faktor dukungan rekan kerja (Dokter, Perawat, Rekan lainnya), Faktor Beban Kerja, Karakteristik kondisi Pasien, Metode pengukuran tingkat stres, Faktor keselamatan pasien, dan Manajemen stres.
Metode: Kajian literatur menggunakan PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analysis). Adapun sumber literatur review yaitu berasal dari pencarian berbasis online melalui mesin pencarian google secara umum dengan memasukkan kata kunci jurnal bereputasi baik secara nasional maupun internasional, tetapi sebagian besar jurnal yang digunakan yaitu jurnal bereputasi internasional sebagai rujukan utama.
Hasil: Jurnal yang didapatkan sebagian besar berformat PDF yang didapatkan melalui jurnal yang diterbitkan oleh Pubmed, Proquest, Google scholar, Science direct: Elsevier, BMC, Health Affairs, Oxford Academic, John Wiley & Sons serta sumber lainnya berupa Peraturan Menteri Kesehatan Republik Indonesia. Jumlah Artikel yang di peroleh sebanyak 205, Jumlah artikel yang layak dan memenuhi kriteria inklusi dan ekslusi sebanyak 14. Sumber stres terdiri dari 8 (delapan) skala yaitu: kondisi pasien, konflik dengan dokter, lingkungan kerja, masalah dengan teman sebaya, masalah dengan pengawas, beban kerja, ketidakpastian tentang pengobatan, konflik dengan pasien atau keluarga pasien.
Kesimpulan: Stres kerja dikalangan perawat secara garis besar dan paling dominan dipengaruhi oleh lingkungan kerja, beban kerja, kondisi pasien dan perawat. Stres pada perawat dapat mendatangkan kerugian bagi suatu Rumah Sakit terkhusus pada pasien, karena dapat mengganggu proses asuhan keperawatan pada pasien dan pada akhirnya mempengaruhi keselamatan pasien. Adapun saran yang ditawarkan yaitu melakukan Manajemen pengelolaan stres yang komprehensif guna menunjang faktor keselamatan pasien.
References
Permenkes RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 4 Tahun 2018 Tentang Kewajiban Rumah Sakit Dan Kewajiban Pasien. Nomor 4 Tahun 2018 Indonesia: Menteri Kesehatan Republik Indonesia; 2018 p. 4.
World Health Organization. Global Health Observatory. 2017 [cited 2019 Mar 28]. Nursing and Midwifery. Available from: https://www.who.int/hrh/nursing_midwifery/en/
Permenkes RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 10 Tahun 2015 Tentang Standar Pelayanan Keperawatan Di Rumah Sakit Khusus. Nomor 10 Tahun 2015 Indonesia: Permenkes RI; 2015.
Permenkes RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 11 Tahun 2017 Tentang Keselamatan Pasien. Nomor 11 Tahun 2017 Indonesia: Permenkes RI; 2017.
Desmedt M, Blegen MA, Schubert M, Schwendimann R, De Geest S, Ausserhofer D. The association of patient safety climate and nurse-related organizational factors with selected patient outcomes: A cross-sectional survey. International Journal of Nursing Studies:Elsevier:Pubmed.gov. 2012;50(2):240–52.
Milutinovi? D, Golubovi? B, Brki? N, Prokeš B. Professional Stress and Health Among Critical Care Nurses in Serbia. Journal of Postgraduate Medicine: Arh Hig Rada Toksikol. 2012. p. 171–80.
Moustaka ?, Constantinidis TCC. Sources and effects of work-related stress in nursing. Health Science Journal. 2010;4(4):210–6.
Foureur M, Besley K, Burton G, Yu N, Crisp J. Enhancing the resilience of nurses and midwives: Pilot of a mindfulnessbased program for increased health, sense of coherence and decreased depression, anxiety and stress. Contemporary Nurse. 2013;45(1):114–25.
Büssing A, Falkenberg Z, Schoppe C, Recchia DR, Poier D. Work stress associated cool down reactions among nurses and hospital physicians and their relation to burnout symptoms. BMC Health Services Research. 2017;17(1):551.
Johnston DW, Jones MC, Charles K, McCann SK, McKee L. Stress in nurses: Stress-related affect and its determinants examined over the nursing day. Annals of Behavioral Medicine. 2013;45(3):348–56.
Dawson D, Rogers AE, Dorrian J, Lamond N, van den Heuvel C, Pincombe J. A Pilot Study of the Safety Implications of Australian Nurses’ Sleep and Work Hours. Chronobiology International. 2006;23(6):1149–63.
Drury V, Craigie M, Francis K, Aoun S, Hegney DG. Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: Phase 2 results. Journal of Nursing Management. 2014;22(4):519–31.
Han K, Trinkoff AM, Geiger-Brown J. Factors Associated with Work-Related Fatigue and Recovery in Hospital Nurses Working 12-Hour Shifts. Workplace Health & Safety. 2014;62(10):409–14.
Keykaleh MS, Safarpour H, Yousefian S, Faghisolouk F, Mohammadi E, Ghomian Z. The Relationship between Nurse’s Job Stress and Patient Safety. Open Access Macedonian Journal of Medical Sciences: National Center for Biotechnology Information, US National Library of Medicine. 2018;6(11):2228–32.
Burke RJ, Greenglass ER. Hospital restructuring, Work-Family Conflict and psychological burnout in nursing staff. Journal Psychology & Health. 2001;16(5):583–94.
Fernández-Castro J, Martínez-Zaragoza F, Rovira T, Edo S, Solanes-Puchol Á, Martín-del-Río B, et al. How does emotional exhaustion influence work stress? Relationships between stressor appraisals, hedonic tone, and fatigue in nurses’ daily tasks: A longitudinal cohort study. International Journal of Nursing Studies. 2017;75:43–50.
UK Health & Safety Executive. Managing the causes of work-related stress. A step-by-step approach using the Management Standards. Second edi. HSE, editor. United Kingdom: Health and Safety Executive; 2007. 1–70 p.
Gurses AP, Carayon P. Exploring performance obstacles of intensive care nurses. Applied Ergonomics. 2009;40(3):509–18.
Baum A, Singer JE, Baum CS. Stress and the Environment. Journal of Social Issues. 1981;37(1):4–35.
Mcvicar A. INTEGRATIVE LITERATURE REVIEWS AND META-ANALYSES Workplace stress in nursing: a literature review. Journal of Advanced Nursing. 2003;44(6):633–42.
Braithwaite M. Nurse burnout and stress in the NICU. Advances in Neonatal Care,National Association of Neonatal Nurses:Wolters Kluwer. 2008;8(6):343–7.
Morrison WE, Haas EC, Shaffner DH, Garrett ES, Fackler JC. Noise, Stress, and Annoyance in a pediatric intensive care unit. Critical care medicine. 2009;31(1):113–9.
Lin L, Liang BA. Addressing the nursing work environment to promote patient safety. Nursing forum. 2007;42(1):20–30.
de Almeida Vicente A, Shadvar S, Lepage S, Rennick JE. Experienced pediatric nurses’ perceptions of work-related stressors on general medical and surgical units: A qualitative study. International Journal of Nursing Studies. 2016;60:216–24.
Berland A, Natvig GK, Gundersen D. Patient safety and job-related stress: A focus group study. Intensive and Critical Care Nursing. 2008;24(2):90–7.
Vande Voorde KM, France AC. Proactive error prevention in the intensive care unit. Critical care nursing clinics of North America. 2002;14(4):347–58.
Johnston D, Allan J, Schofield P, Morrison K, Jones M, Johnston M, et al. Nursing stress and patient care: real-time investigation of the effect of nursing tasks and demands on psychological stress, physiological stress, and job performance: study protocol. Journal of Advanced Nursing. 2013;69(10):2327–35.
World Health Organization, Department of Human Resouces for Health, Office HPNN and M. A Global Survey Monitoring. Progress in Nursing and Midwifery. Geneva 27, Switzerland; 2010.
Williams AM. The delivery of quality nursing care: A grounded theory study of the nurse’s perspective. Journal of Advanced Nursing. 1998;27(4):808–16.
Duffy E, Avalos G, Dowling M. Secondary traumatic stress among emergency nurses: A cross-sectional study. International Emergency Nursing. 2015;23(2):53–8.
Cho E, Lee NJ, Kim EY, Kim S, Lee K, Park KO, et al. Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: A cross-sectional study. International Journal of Nursing Studies. 2016;60:263–71.
Litvak E, Buerhaus PI, Davidoff F, Long MC, McManus ML, Berwick DM. Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2005;31(6):330–8.
Odagiri Y, Shimomitsu T, Inoue S, Asaoka S, Aritake S, Ozaki A, et al. Factors Associated With Shift Work Disorder in Nurses Working With Rapid-Rotation Schedules in Japan: The Nurses’ Sleep Health Project. Chronobiology International?:The Journal of Biological and Medical Rhythm Research. 2013;30(4):628–36.
Dermody K, Bennett PN. Nurse stress in hospital and satellite haemodialysis units. Journal of Renal Care. 2008;34(1):28–32.
Elfering A, Semmer NK, Grebner S. Work stress and patient safety: Observer-rated work stressors as predictors of characteristics of safety-related events reported by young nurses. Ergonomics. 2006;49(5–6):457–69.
Elfering A, Grebner S, Leitner M, Hirschmüller A, Kubosch EJ, Baur H. Quantitative work demands, emotional demands, and cognitive stress symptoms in surgery nurses. Psychology, Health and Medicine. 2017;22(5):604–10.
Yana D. Stres Kerja pada Perawat Instalasi Gawat Darurat di RSUD Pasar Rebo Tahun 2014. Administrasi Rumah Sakit Indonesia. 2014;1(2).
Herqutanto, Harsono H, Damayanti M, Setiawati EP. Stres Kerja pada Perawat di Rumah Sakit dan Fasilitas Pelayanan Kesehatan Primer. eJournal Kedokteran Indonesia. 2017;5(1).
Dewi AC, Surono A, Sutomo AH. Stres kerja , usia , dan lama layanan dengan kelelahan kerja pada perawat di rumah sakit jiwa Grhasia Yogyakarta. BKM Journal of Community Medicine and Public Health. 2016;32(2):53–8.
Lazarus RS, Folkman S. Stress, Appraisal, and Coping. 1st ed. Goleman D, editor. New York: Springer Publishing Company, Inc.; 1984. 456 p.
Walker J, Payne S, Paula S, Jarrett N. Psychology for Nurses and the Caring Professions. third edit. Abbott P, editor. Vol. 3. New York: Open University Press; 2007. 288 p.
Gray-Toft P, Anderson JG. Stress Among Hospital Nursing Staff?: Its Causes and Effects. Social Science & Medicine. 1981;15(5):639–47.
Numerof RE, Abrams MN. Sources of stress among nurses: An empirical investigation. Journal of Human Stress. 1984;10(2):88–100.
Colligan M, Swanson N, Hurrell Jr J, Scharf Jr F, Sinclair R, Grubb P, et al. Stress at Work. National Institute for Occupational Safety and Health. United States: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES-Public Health Service-Centers for Disease Control and Prevention: National Institute for Occupational Safety and Health; 2014.
Hamaideh SH. Occupational Stress, Social Support, and Quality of Life among Jordanian Mental Health Nurses. Issues in Mental Health Nursing. 2011;33(1):15–23.
Dewe PJ. Identifying the causes of nurses stress: A survey of New Zealand nurses. Work and Stress. 1987;1(1):15–24.
French SusanE, Lenton R, Walters V, Eyles J. An empirical evaluation of an expanded Nursing Stress Scale. Journal of nursing measurement. 2000;8(2):161–78.
Stordeur S, D’hoore W, Vandenberghe C. Leadership, organizational stress, and emotional exhaustion among hospital nursing staff. Journal of Advanced Nursing. 2001;35(4):533–42.
Hersch RK, Cook RF, Deitz DK, Kaplan S, Hughes D, Friesen MA, et al. Reducing nurses’ stress: A randomized controlled trial of a web-based stress management program for nurses. Applied Nursing Research. 2016;32:18–25.
Tsai SL. Chinese nurse stress in taiwan, republic of China. Issues in Mental Health Nursing. 1993;14(3):275–85.
Yoon SL, Kim JH. Job-related stress, emotional labor, and depressive symptoms among Korean nurses. Journal of Nursing Scholarship. 2013;45(2):169–76.
Khamisa N, Oldenburg B, Peltzer K, Ilic D. Work related stress, burnout, job satisfaction and general health of nurses. International Journal of Environmental Research and Public Health. 2015;12(1):652–66.
Aiken LH, Sermeus W, Van Den Heede K, Sloane DM, Busse R, McKee M, et al. Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ (Online). 2012;344(7851):1–14.
Lu DM, Sun N, Hong S, Fan YY, Kong FY, Li QJ. Occupational Stress and Coping Strategies Among Emergency Department Nurses of China. Archives of Psychiatric Nursing. 2015;29(4):208–12.
Revicki DA, May HJ. Organizational characteristics, occupational stress, and mental health in nurses. Behavioral Medicine. 1989;15(1):30–6.
Guppy A, Gutteridge T. Job satisfaction and occupational stress in UK general hospital nursing staff. Work and Stress. 1991;5(4):315–23.
Aiken LH, Clarke SP, Sloane DM. Hospital staffing, organization, and quality of care: Cross-national findings. International Journal for Quality in Health Care: Oxford University Press. 2002;14(1):5–14.
Yoshizawa K, Sugawara N, Yasui-Furukori N, Danjo K, Furukori H, Sato Y, et al. Relationship between occupational stress and depression among psychiatric nurses in Japan. Archives of Environmental and Occupational Health. 2016;71(1):10–5.
Cohen, S., Kamarck, T., & Mermelstein R. Perceived Stress Scale (PSS) | Measurement Instrument Database for the Social Sciences. Journal of Health and Social Behavior. United States: The social psychology of health: Claremont Symposium on Applied Social Psychology. Newbury Park, CA: Sage; 1983. p. 385-396.
Cohen S, Kamarck T, Mermelstein R. A Global Measure of Perceived Stress. Journal of Health and Social Behavior. 1983;24(4):385–96.
Gray-Toft P, Anderson JG. The Nursing Stress Scale: Development of an instrument. Journal of Behavioral Assessment. 1981;3(1):11–23.
World Health Organization. Quality of Care: Patient Safety. 2002.
ICN. International Council of Nurses. 2012 [cited 2019 Apr 10]. p. 3 Patient Safety. Available from: https://www.icn.ch/sites/default/files/inline-files/D05_Patient_Safety_0.pdf
Aspden P, Corrigan JM, Wolcott J, Erickson SM. Patient Safety:: Achieving a New Standard for Care. Washington, DC: The National Academies Press; 2004. 550 p.
Grabans M. Lean Hospitals. Improving Quality, Patient Safety, and Employee Engagement. 3rd ed. Toussaint J, editor. Vol. 3. CRC Press: Taylor & Francis Group; 2016. 347 p.
Fabre J. Smart Nursing: Nurse Retention & Patient Safety Improvement Strategies. Second. Zuccarini M, editor. New York: Springer Publishing Company, Inc.; 2009. 230 p.
ICN. Tokyo Declaration on Patient Safety ( Finalised Draft ) [Internet]. 2018 [cited 2019 Apr 11]. p. 1–2. Available from: https://www.mhlw.go.jp/file/06-Seisakujouhou-10800000-Iseikyoku/0000204005.pdf
ICN. International Council of Nurses. 2019 [cited 2019 Apr 10]. Patient Safety. Available from: https://www.icn.ch/nursing-policy/icn-strategic-priorities/patient-safety
Hwang JI. What are hospital nurses’ strengths and weaknesses in patient safety competence? Findings from three Korean hospitals. International Journal for Quality in Health Care. 2015;27(3):232–8.
Carayon P, Alvarado CJ, Schoofs Hundt A. Work design and patient safety. Theoretical Issues in Ergonomics Science. 2007;8(5):395–428.
Nixon AE, Lanz JJ, Manapragada A, Bruk-Lee V, Schantz A, Rodriguez JF. Nurse safety: How is safety climate related to affect and attitude? Work and Stress. 2015;29(4):401–19.
KARS. Standar Nasional Akreditasi Rumah Sakit (SNARS Edisi 1). first edit. KARS, editor. 2017. 421 p.
Spence Laschinger HK, Leiter MP. The Impact of Nursing Work Environments on Patient Safety Outcomes. JONA: The Journal of Nursing Administration. 2006;36(5):259–67.
Litvak E, Long MC. Cost and Quality Under Managed Care?: Irreconcilable Differences? the American Journal of Managed Care. 2000;6(3):305–12.
Moreland JJ, Apker J. Conflict and Stress in Hospital Nursing: Improving Communicative Responses to Enduring Professional Challenges. Health Communication. 2016;31(7):815–23.
Khamisa N, Peltzer K, Ilic D, Oldenburg B. Effect of personal and work stress on burnout, job satisfaction and general health of hospital nurses in South Africa. Health SA Gesondheid. 2017;22:252–8.
Tyson PD, Pongruengphant R, Aggarwal B. Coping with organizational stress among hospital nurses in Southern Ontario. International Journal of Nursing Studies. 2002;39(4):453–9.
Jungwee P. Work stress and job performance. Perspectives on Labour and Income. 2007;8(12):5–17.
Zúñiga F, Ausserhofer D, Hamers JPH, Engberg S, Simon M, Schwendimann R. Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers’ Perception of Quality of Care? A Cross-Sectional Study. Journal of the American Medical Directors Association. 2015;16(10):860–6.
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