Development And Application Of ‘Relactor’ Nursing Delegation Modelin

Indonesia

ViviYosafianti Pohan 1, Agung Waluyo 2, Dewi Irawaty 3, Muchtarudin

Mansyur4
Student of Doctoral Program of Nursing University ofIndonesia
E-mail: vivi_yosaf@yahoo.com/ 08122890261

ABSTRACT
Introduction: Nursing care and service at inpatient ward had been widely
known vary. Beside being a caretaker in nursing care management, head
nurse with many responsibilities often leave the ward related to managerial
task.Therefore she needs to do nursing delegation well to assure nursing care
quality. To assure the function of service/nursing care run well, delegation is
necessary. Method: This research is descriptive-narrative and quasi
experiment research that aimed to build the development of Relactor nursing
delegation model, also identify differences of nursing delegation quality
between before and after the application of Relactor nursing delegation model
at inpatient ward. Result: The result of this research becomes basis
development of nursing delegation model in Indonesia. Conclusion: nursing
delegation model has been found developed and applied.

Keywords: application, development, Relactor nursing delegation model

INTRODUCTION Based on the existing

The pilot study by interviewing
and observing head nurses
revealed direct handover and
responsibility of nursing care from
head nurse of inpatient ward to
team leader then to nurses had
been simply and briefly carried
out. The process was alarming
enough because the tasks and
responsibility of head nurse quite
big. Good delegation method is
absolutely required to ensure the
quality of nursing service when
head nurse leftthe ward.
phenomenon, researcher
contended the absence of nursing
delegation model and good and
effective nursing delegation model
standard.
RESEARCH METHOD
This study used 2 methods
consists of : 1). descriptive-
narrative research; 2) quasi
experiment design with pre- post
test design with control group
approach. Descriptive-narative
research aimed to arrange
development of effective Relactor
nursing delegation model. Steps of
descriptive research were:
 2)

1) arrangingplan of nursing measurement were conducted

delegation model; 2) consultation within 2 weeks distance. Guna
and seminar; 3) arranging and melihat efektifitas model delegasi
module trial; 4) completion of the keperawatan, seperti skema
model; 5) application of Relactor berikut:
nursing delegation through
training program. The result of the The effectivity of the model can be
model can be seen below: seen at scheme below:

Respondents were trained for 3 Scheme 1 Research Design

days with 8 hours everyday before
the application of the model.
Respondents initially measured
(pre) before training. Henceforth
second and third (post 1 and post

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“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
Surabaya, December 6 th-8th, 2016
 A = Intervention group according to Tómasdóttir &
B = Control group
Geirsdóttir (1998) consisted of 31
O1 (A & B) = Nursing delegation before
intervention questions, and had reliability score
X1 = Intervention of the model alpha Cronbach r = 0,786, counted
X2 = without intervention of the model as reliable.
O2A and O3A = nursing delegation after 2
weeks and 4 weeks with Relactor
model
O2B andO3B = nursing delegation after 2 RESULT OF STUDY
weeks and 4 weeks without
intervention of the model Table 1

Head nurse and team leader

amount 70 respondents (each 35
respondents) at inpatient ward
Roemani Hospital Semarang and
Sultan Agung Hospital, were involved.
Total sampletechnique had been used
as sampling technique. Research
instrument used a questionnaire
based on theory from Potet (1984)
which developed by Tómasdóttir &
Geirsdóttir (1998). Analysis result of different nursing
Question about attitude and delegation by head nurse and team
readiness of head nurse and team leader in intervention and control
leader at delegation process, group at 2016 (n=70)
amount 31 questions, with 5
alternative answers : very agree, *p> 0,05
agree, doubt, disagree, and very
disagree, with score 1-5 that The result of analysis using
chosen by giving checklist sign (V) general model-mixed repeated
at most suitable alternative measure toward nursing
answer.Criteria for positive delegation of head nurse at two
statement were scored 5= very groups showed result p value =
agree, 4=agree, 3=doubt, 0.134 means there was no
2=disagree, and 1= very disagree. significant differences about
However negative statement were nursing delegation between two
scored vice versa.Trial run the groups can be seen at the picture
nursing delegation instrument below:

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Surabaya, December 6 th-8th, 2016
Table 2

Differences nursing delegation of

head nurse and team leader
between pre and post intervention
at 2016 (n = 70)

Mean SD T P value
test
Post1 0.143 3.0 0,003
- Pre 0.392 50
Post2 0,041 0.292 1.1 0,235
- Pre 98
Result test between post test
1 and pre test 1 showed there was
significant increase 0.143 with p-
value 0.003.While between post
test 2 and pre test showed
increase 0.041 means there was
no significant increase with p
value 0.235. The increasing of post DISCUSSION
test 2 compared to pre test was
less significant, as seen below: Developed and arranged
Relactor nursing delegation model
that has been applied at training,
should continually execute.
Problem identification that has
been executed before training,
helped researcher to decide
solution. Besides, initial

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measurement (pre test) that
showed p value > 0.05 means
there was no significant difference
about nursing delegation among
two groups.
Repeated training are
necessary to refresh the
knowledge so that capable
applying both former and newly
delivered method (Kalra & Bhatia,
2008). Hasnita (2006) interposed
that success of training shown by
assessment process of training
needs, aim, plan, action, and
evaluation of training.
Comprehensive method has
been used in the Relactor nursing
delegation training included
modul, lecture, discussion, and
role play. The method creates
condusive and comfort ambience
at training process.
Planning at the second step
used quantitative study with quasi
experimental design with pre test
post test control group design, also
used time series design for
evaluation. It means the repetitive
measurements were executed at
two groups before and after the
intervention (training). Repetitive
measurements enrich information
and be more sensitive for better
result. Different nursing
delegation between before and
after training revealed significant
increase with p value 0.003 at post
test 1 measurement with pre
test.Whereas post test 2
measurement with pre test
showed increase 0.041 means
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unsignificant increase with p value
0.235. The result showed that the
increasing of post test 2 compared
to pre test was less significant.
Different increase between 2 ndand
3rdmeasurement might caused by
time span influence. Longer time
span from the training, also much
workload of respondents, caused
them forget. This study suggests
continually control and evaluation
from managerial.
CONCLUSION
Based on the result of the study,
the conclusion can be formulated
as below:
1. Relactor nursing delegation
model which should
continually executed by head
nurse and team leader at
inpatient ward has been
arranged.
2. There was significant
difference about nursing
delegation which conducted
by head nurse and team
leader between before and
after the intervention.
This study suggests to determine
policy in the form a fixed
procedure for head nurse and
team leader. Besides, continuos
training and monitoring are
important to improve better
nursing care.
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