“PENGELOLAAN SDM

KEPERAWATAN”
LESSON LEARN DARI ERA PANDEMIK

PERSPEkTIF DARI KOLEGIUM KEPEMIMPINAN & MANAJEMEN KEPERAWATAN

SERTA EVIDENCE BASED DI INDONESIA

Dr. Rr. Tutik Sri Hariyati, SKp.,MARS

 Curriculum Vitae
• Staf Pengajar FIK UI 1999-sekarang
• Skretaris Kolegium Kepemimpinan dan Manajemen Keperawatan Indonesia 2011-
sekarang
• Surveior & Pembimbing KARS
• Ketua Senat Akademik Faultas Ilmu Keperawatan UI
• Kompartemen Keperawatan PERSI 2013-sekarang
• Ketua Tim Pengembangan Manajemen Keperawatan/ TPMK FIK UI 2012- sekarang
• Manajer Umum (SDM, Keuangan, Fasilitas & Umum) FIK UI 2014-2017
• Tim Pengembangan, Konsultan dan Riset Sistem Informasi Keperawatan di RS
• Tim Pengembangan Jenjang Karir Keperawatan Indonesia-JICA 2013-2017
• Staf Ahli Riset DRPM UI 2007-2012
Latar Belakang
• Lonjakan pasien perlu diikuti dengan kesiapan
sumberdaya manusia, sarana dan prasarana
• Berdamai dengan Covid-19
• Dalam kondisi krisis ini, beberapa hal yang
harus menjadi pertimbangan adalah:
1. Keselamatan staff: perlu ditunjang dengan
kelengkapan APD
2. Jadwal dan lama tugas perawat: menjaga
keseimbangan tugas dan istirahat untuk
mencegah kelelahan, keselamatan pasien dan
perawat dan burn-out
• Metode penugasan dalam pemberian asuhan
keperawatan
REGULASI
• UU Keperawatan no 38 Tahun 2014
• PMK no 10 Tahun 2015 Tentang Standar Keperawatan di RS Khusus
• PMK no 49 Tahun 2013 Tentang Komite Keperawatan
• Permenkes no 34 Tahun 2017 Tentang Akreditasi RS
• PMK no 40 Tahun 2017 Tentang Jenjang Karir Keperawatan
• PMK no 26 Tahun 2019 tentang Pedoman implementasi UU Keperawatan
• Permenpan No 35 Tahun 2019 tentang Jabatan Fungsional Keperawatan
• PMK no 9 Tahun 2020 Pedoman Pembatasan Sosial Berskala Besar
Dalam Rangka Percepatan Penanganan Corona Virus Disease 2019
• STANDAR AKREDITASI NASIONAL RS 1.1
Tugas Kolegium Kepemimpinan & Manajemen
Keperawatan
Mengembang Menyusun ERA COVID-19
kan keilmuan standar
sesuai Pendidikan
kepakaran tinggi 14 Pengelola Prodi
keperawatan Peminatan Kepemimpinan
& Manajemen
Mengemban Menentukan Keperawatan 8. UNSIAH
gkan lingkup 9. UNJANI
1. UI
asuhan
kurikulum keperawatan 2. UNPAD 10 UNAND
pada cabang 3. UMJ 11.UNIMUS
4. STIKES CAROLUS
tugas ilmu 5. UNDIP 12. UM. BANJARMASIN
sebagai 6. USU 13 STIKES BALI
pengampu 7. UNAIR 14 STIKES KARYA HUSADA
cabang
disiplin ilmu
 LEARNING OUT 10 SKS yg Sama di Indonesia
COME Leadership
Manajemen Strategis
SCIENTIST; Manajemen Sumberdaya
Evidence Based Nurse Keperawatan
PENGELOLA Practice, periset yang
PELAYANAN mempu menggunakan hasil Manajemen Mutu
KEPERAWATAN: EBP dan Riset untuk Entrepreneurship
perbaikan pelayanan
entrepreneur, decision DAN
maker, intercollaboration, Praktik Pengelolaan Sistem dan
strategic planner, CHANGE LEADER,
manajemen Risk..etc
memimpin perubahan untuk
Pelayanan Keperawatan
pengembangan perbaikan
pelayanan keperawatan dan Dan MK INTI & Institusi
kesehatan

COVID-19
EVIDENCE BASED PENGELOLAAN SDM KEPERAWATAN

• GARDA TERDEPAN
• DURASI WAKTU TERLAMA
• 23/3/7 SIKLUS
• KOLABORASI & KOORDINASI
• SUPPORT APD
• SUPORT PSIKOLOGIS
Many Issues
• Nurses closed with patient, assisted with patients’ activities of daily living,
including offering nutrition and fluids, meeting elimination needs, providing
oral hygiene and skin care (Liu, 2020)
• Many hospitals suspended those rotations because of a shortage of masks,
gowns, and other medical supplies (Hart & Archives, 2020).
• The nursing manager must have competence in arranging nurse scheduling
and must be able to make modifications according to conditions (Wei et al.,
2020)
• In addition to providing care to patients, wearing PPE for long hours also led to
physical distress, especially for nurses who had to stay in the isolation wards
for entire shifts (Jaarsma et al., 2020).
• Many hospitals suspended those rotations because of a shortage of masks,
gowns, and other medical supplies (Hart & Archives, 2020)
• One-factor clusters infected of staff due to un-sufficient personal
protective equipment (Wei et al., 2020).
• Nurse has been exposed or who show symptoms will be required to go
into quarantine (Walton et al., 2020)
Pengelolaan SDM Keperawatan: Era
Pandemik Standar KKS
 KUALIFIKASI & KEWENANGAN
(UU Keperawatan, PMK 49 Th 2013, PMK 40 th 2017, KKS 13 dan
KKS 14)

• TETAP PERHATIKAN REGULASI: STR & SIPP

• UPAYAKAN TETAP PERHATIKAN SURAT
PENUGASAN KLINIS DAN RINCIAN
KEWENANGAN KLINIS- KKS 14
• PERAWAT PENANGGUNG JAWAB ASUHAN
KEPERAWATAN ADALAH PERAWAT KOMPETEN
DAN DIBANTU OLEH PERAWAT PELAKSANA,
ATAU RELAWAN (JIKA JUMLAH SUDAH TIDAK
MEMADAI
• BILA ADA BANTUAN SDM PERAWAT DARI
LUAR AREA, PASTIKAN STR
• RELAWAN DAN RELAWAN NON STR
DIBAWAH SUPERVISI PPJA
 KETENTUAN MANAJEMEN
KESELAMATAN STAF
(KKS 8.2)
• Keamanan Berangkat dan Pulang Shift,
antar Jemput atau Dormitory
• Perhatikan kewaspaan pada kesehatan
SDM Keperawatan
• Pemeriksaan Kesehatan: TTV sebelum bertugas
• Suport Makanan, Multivitamin
• Modifikasi Jam Dinas
• Tidak Long Shift
• Istirahat Saat shift
• Pemeriksaan Ulang
• Motivasi dan Penghargaan
• Jaminan pengobatan keterpaparan penyakit
PENGELOLAAN SDM KEPERAWATAN
DISKUSI  SUBMIT INTERNASIONAL NURSING
SCINECE

RS
FATMAWATI
RS KARYADI
RS SARDJITO
RS UNIVERSITAS
INDONESIA RS
PERSAHABATAN
RS JANTUNG HARAPAN KITA
TANGGAL KLASIFIKASI PASIEN JUMLAH JAM PERAWATAN TOTAL JUMLAH FAKTOR LOSS DAY
MINIMAL PARSIAL TOTAL INTENSIF MINIMAL PARSIAL TOTAL INTENSIF JUMLAH JAM TENAGA KOREKSI
KEBUTUHAN
TENAGA
DINAS PAGI DINAS SORE DINAS MALAM LIBUR
PERAWAT NERSPERAWAT D3 JUMLAH PAGI PERAWAT NERSPERAWAT D3 JUMLAH SORE PERAWAT NERS PERAWAT D3 JUMLAH MALAM PERAWAT NERSPERAWAT D3 JUMLAH LIBUR
21/03/20 30 30 0 0 0 30 4,3 1,2 1,4 6,8 1,8 1,0 2,7 1,1 0,6 1,7 1,1 0,6 1,7 0,4 0,2 0,7
22/03/20 27 27 0 0 0 27 3,9 1,1 1,2 6,2 1,6 0,9 2,5 1,0 0,5 1,5 1,0 0,5 1,5 0,4 0,2 0,6
23/03/20 27 27 0 0 0 27 3,9 1,1 1,2 6,2 1,6 0,9 2,5 1,0 0,5 1,5 1,0 0,5 1,5 0,4 0,2 0,6
24/03/20 32 32 0 0 0 32 4,6 1,3 1,5 7,3 1,9 1,0 2,9 1,2 0,6 1,8 1,2 0,6 1,8 0,5 0,3 0,7
25/03/20 27 27 0 0 0 27 3,9 1,1 1,2 6,2 1,6 0,9 2,5 1,0 0,5 1,5 1,0 0,5 1,5 0,4 0,2 0,6
26/03/20 27 27 0 0 0 27 3,9 1,1 1,2 6,2 1,6 0,9 2,5 1,0 0,5 1,5 1,0 0,5 1,5 0,4 0,2 0,6
27/03/20 27 27 0 0 0 27 3,9 1,1 1,2 6,2 1,6 0,9 2,5 1,0 0,5 1,5 1,0 0,5 1,5 0,4 0,2 0,6
28/03/20 27 27 0 0 0 27 3,9 1,1 1,2 6,2 1,6 0,9 2,5 1,0 0,5 1,5 1,0 0,5 1,5 0,4 0,2 0,6
29/03/20 27 27 0 0 0 27 3,9 1,1 1,2 6,2 1,6 0,9 2,5 1,0 0,5 1,5 1,0 0,5 1,5 0,4 0,2 0,6
30/03/20 27 27 0 0 0 27 3,9 1,1 1,2 6,2 1,6 0,9 2,5 1,0 0,5 1,5 1,0 0,5 1,5 0,4 0,2 0,6
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
 0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0
0 0 0 0 0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0

Table 1. Scheduling and Nursing Rostering in Patient Ward

*) PPE mandatory Correction
Category of Discussion Model Description

Scheduling Three Shift Morning (M), Afternoon (A) &

Evening(E) Shift, & Holiday (H)
Rostering Model Model 1 M,A,E, H, H
Model 2 M, M, A, A, E, E, H, H
Model 3 M, M, A, A, E, H, H
Time period of shift 7-8 hours (Full Time Equivalent/FTE)
3-4 hours with PPE ( average 3,5 hour) *)
Change over Model Model 1 Continuous shift
Model 2 14 days on duty, 14 quarantine days
Model 3 30 days on duty, 14 quarantine days
Model 4 30 days on duty in Covid-19 ward, then change in the
Non Covid-19 ward
Man Power Planning - Nursing Department, Nursing Committee & other
Team Department
 Table 2. Patient Category as Reference to Nurse Needs Formula
References Patients Category Description Total hours Patient
day
Guidance INA & Minimal Care Haemodynamic Low Monitoring Needed 1-2
Department Partial Care Haemodynamic Low Monitoring Needed 4
of Health, & Part of activity daily living took by nurse
2005
Total Care Haemodynamic High Monitoring Needed & 6-8
All activity daily living took by nurse

Intensive Care All activity daily living took by nurse, 12

Using monitoring Machine
Haemodynamic intensive monitoring
Health Workforce Easy condition Not required in patient -
Estimator on Moderate condition In patient care, without Oxygen therapy 3,66
Covid- 19 Heavy condition Oxygen required 4,66
(HWFE, WHO, 2020) Critical condition intensive care required including 14,81
mechanical ventilator
T

Table 3. Formula Nurse Man Power

*) https://www.nationalnursesunited.org/ratios
References Formula: Common Situation Covid-19 Era
Regulation: Guidance INA & A = (Total Patient X Total Hour per Patient Correction
Department of Health, 2005 day) 40-50%
Nurse Effective Hours Day
B = ( Total Holidays on the years) x A
Days Effective on the years
C = ( A + B) x 25%

Total Number = A + B + C

Indonesia Nurse to-Patient Emergency Care 1: 2 Correction

Staffing Ratio Intensive Care /ICU 1: 1 40-50%
High Care Unit/HCU 1:1 And
Neonatal Care : 1: 2 80-100%
Medical/Surgical Unit 1:5
Paediatric Unit 1: 4
 Table 3. Formula Nurse Man Power
*) https://www.nationalnursesunited.org/ratios
References Formula: Common Situation Covid-19 Era
California RN-to- Emergency care 1:2 No Information
Patient Staffing Intensive/Critical Care 1:1
Ratios *) Neonatal Care: 1: 2
Medical/surgical Unit 1:4
Well baby Nursery 1: 6
Post Partum Coupled 1:3
Paediatric Unit 1: 3
Health Workforce No information Moderate 1: 3
Estimator on Covid- Heavy 1: 0,9
19 Critical 1: 0,6
(HWFE, WHO,
2020)
 Table 4 Simulation Estimator Nurse

Formula Common situation Covid-19 with Correction

DEPKES FORMULA,2005 40-50%
20 patient- minimal 11 15
20 patient- moderate 21 30
10 patient- heavy 21 32
10 patient- critical 32 48
Total 85 124
STAFFING RATIO FORMULA (I) 40-505
20 patient- minimal 12 17
20 patient- moderate 16 22
10 patient- heavy 20 30
10 patient- critical 40 60
Total 88 129
STAFFING RATIO FORMULA (II) 80-100% *)
20 patient- minimal 12 24
20 patient- moderate 16 32
10 patient- heavy 20 40
10 patient- critical 40 80
Total 88 176
WHO, HWFE FORMULA
20 patient- minimal 20
20 patient- moderate 20
10 patient- heavy 33
10 patient- critical 50
Total 123
*) Hospital type A, large Hospital & decreased BOR, utilized nurse from other unit
 PEMBAGIAN DINAS
MISALKAN RUANG ISOLASI BERKAPASITAS 25 BED,

• 2 PASIEN INTENSIF CARE

• 3 PASIEN TOTAL CARE 24 PERAWAT + 1 KARU + 1 Clinical Care Manager/Nurse In-Charge (NI)
• 8 PASIEN PARTIAL CARE (sesuai PMK 56 1:1 u RS A,B)
• 15 PASIEN MINIMAL CARE
PENGORGANISASIAN
MODIFIKASI PEMBAGIAN DINAS DI RUANG ISOLASI
PEMBAGIAN DINAS PAGI
PAGI (40%)
1 Kepala Ruangan
SORE (25%)
1 Nurse incharge + 5 perawat
MALAM (25%)
1 Nurse Incharge + 2 perawat
LIBUR

1 Nurse Incharge + 8 perawat

JAM 07.30-11.30 JAM 11.30-15.30
1 KARU + Nursing In charge ikut melaksanakan Nursing In charge ikut DUTY OFF
1 Nursing Incharge: Ikut bantu di asuhan ke pasien melaksanakan asuhan ke pasien (10%)
Intensif care
1 HCA 1 HCA
Karu
2 Health Care Assistance/HCA Karu
07.30-11.30 11.30-15.30 15.30-19.30 19.30-23.30 23.30-03.30 03.30-07.30 2 perawat
2 psn Intensif 2 psn Nurse
Intensif & 2 psn Intensif & 2 psn Intensif 2 psn Intensif
Nurse 2 psn Intensif
dan 3 psn 3 psn Total : 2 3 psn Total : 2 & 3 psn Total : 3 psn Total : & 3 psn Total :
Incharge Incharge
toral: 2 prwt prwt prwt 2 prwt 2 prwt 2 prwt
8 Partial & 15 8 Partial & 15 8 Partial & 15
PPJA 1 PPJA 2
8 Partial & 15 8 Partial & 15 PPJA 3
8 Partial & 15 PPJA 4
Minimal: 1 prwt PPJA 1 PPJA 2
Minimal: 1 prwt Minimal: PPJA 3
1 prwt PPJA 4
Minimal: 2 Minimal: 2 prwt Minimal: 1 prwt (1prwt: 23 (1prwt: 23 (1prwt: 23
8 ps partial care 2 ps intensif care
8 ps partial(1prwt:
prwt (1prwt: care 4-5 (1prwt:223ps intensifpasien)
care pasien) pasien)
15 ps minimal care 3 ps total care3 ps total care
10 pasien)
15 ps minimal care
pasien) pasien)
1 perawat: 11-12 pasien 1 perawat: 2-3 pasien 1 perawat: 11-12 pasien 1 perawat: 2-3 pasien
2 relawan 2 relawan 2 relawan 2 relawan 2 relawan 2 relawan
Health Care Assistance 2 orang Health Care Assistance 2 orang
Kondisi pandemic tambah 2 relawan Kondisi pandemic tambah 2 relawan
 PEMBAGIAN DINAS
SORE JAM 19.30-23.30

JAM 15.30-19.30

Nurse Nurse
Incharge Incharge

PPJA 1 PPJA 2 PPJA 3 PPJA 1 PPJA 2 PPJA 3

2 ps intensif care 2 relawan 2 ps intensif care

3 ps total care 3 ps total care
2 relawan
8 ps partial care
1 perawat: 2-3 pasien 15 ps minimal care 1 perawat: 2-3 pasien
1 perawat: 23 pasien

Health Care Assistance 1 orang Health Care Assistance 1 orang

 Kondisi pandemic tambah 2 relawan Kondisi pandemic tambah 2 relawan

PEMBAGIAN DINAS
MALAM JAM 03.30-07.30

JAM 23.30-03.30

8 ps partial care
15 ps minimal careNurse Nurse
Incharge Incharge

PPJA 1 PPJA 2 PPJA 3 PPJA 1 PPJA 2 PPJA 3

2 relawan 2 ps intensif care 2 relawan 2 ps intensif care

3 ps total care 3 ps total care
8 ps partial care 8 ps partial care
15 ps minimal care 1 perawat: 2-3 pasien 15 ps minimal care 1 perawat: 2-3 pasien
1 perawat: 23 pasien
Health Care Assistance 1 orang Health Care Assistance 1 orang
Kondisi pandemic tambah 2 relawan Kondisi pandemic tambah 2 relawan
Continuing Professional Development
ZOOMINAR
PPNI ANZCA ( Australia & New Zealand College of anaesthetis, 2020)
 Upaya Manager Keperawatan Dalam Pengelolaan SDM-Pandemi Covid-19

The Nursing Department of the hospital

fully executed its functional authority to(Liu BERSAMA KITA BISA
et al., 2020)

• Allocate human recourses dynamically

• Manage a rostering staff
• Prepare a pre-service training
• Supervise the key working steps
• Deploy medical supplies positive
• Formulate incentive methods PERAWA PERAWAT PERAWAT
PENDIDIK
T RISET
• Strengthen to positive environment MANAJE
KLINIK

• The counselling model (Brinkman, 2019) R

PERAWA
• Strengthen to research based T
 Excell bisa di buka di
Simulasi 1
https://docs.google.com/spreadsheets/d/1onUW5HFFgnkcTippDyi2_RFYQ9jtebe0/edit#gid=193188690
References
• Hart, J., & Archives, S. J. (2020). Wisconsin ’ s nursing shortage in the spotlight as hospitals face influx of
COVID-19 cases. 19–21.
• Jaarsma, T., van der Wal, M., Hinterbuchner, L., Köberich, S., Lie, I., & Strömberg, A. (2020). Flexibility
and safety in times of coronavirus disease 2019 (COVID-19): Implications for nurses and allied
professionals in cardiology. European Journal of Cardiovascular Nursing, 147451512092102.
https://doi.org/10.1177/1474515120921027
• Li, N., Liu, T., Chen, H., Liao, J., Li, H., Luo, Q., Song, H., Xiang, F., Tan, J., Zhou, J., Hu, G., Yuan, Z., Peng, Y.,
& Luo, G. (2020). Management strategies for the burn ward during COVID-19 pandemic. Burns.
https://doi.org/10.1016/j.burns.2020.03.013
• Liu, Q., Luo, D., Haase, J. E., Guo, Q., Wang, X. Q., Liu, S., Xia, L., Liu, Z., Yang, J., & Yang, B. X. (2020a).
Articles The experiences of health-care providers during the COVID-19 crisis in China : a qualitative study.
The Lancet Global Health, 20, 1–9. https://doi.org/10.1016/S2214-109X(20)30204-7
• Liu, Y., Wang, H., Chen, J., Zhang, X., Yue, X., Ke, J., Wang, B., & Peng, C. (2020). Emergency management
of nursing human resources and supplies to respond to coronavirus disease 2019 epidemic *.
https://doi.org/10.3761/j.issn.0254e1769.2020.03
• Lucchini, A., Giani, M., Elli, S., Villa, S., Rona, R., & Foti, G. (2020). Nursing Activities Score is increased in
COVID-19 patients. Intensive and Critical Care Nursing, 102876. https://doi.org/10.1016/j.iccn.2020.102876