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Layanan unit Hemodialisa sebagai layanan unggulan masih bermasalah pada komitmen dan komunikasi kepemimpinan keperawatan. Penelitian ini betujuan untuk menjelaskan faktor kepemimpinan : komunikasi dan komitmen dalam upaya pelayanan keperawatan yang bermutu di Unit Hemodialisa di RS Tipe B. Penelitian ini dilakukan secara kualitatif dengan metode wawancara mendalam dan observasi. Subjek penelitian terdiri dari 11 orang yaitu 3 orang informan utama (1 perawat kepala ruang dan 2 perawat) dan 8 orang informan triangulasi (1 dokter penanggung jawab unit hemodialisa, 4 perawat dan 3 pasien). Observasi dilakukan dengan menggunakan check list atau daftar tilik. Hasil penelitian menunjukkan faktor komunikasi yang terdiri dari fungsi instruksi, konsultasi, partisipasi, delegasi dan pengendalian sudah dilakukan oleh pimpinan. Fungsi instruksi dilaksanakan dengan memberikan arahan tetapi strategi tidak disampaikan. Fungsi konsultasi sudah dilaksanakan tetapi masukan tidak direspon oleh kepala ruang. Fungsi delegasi sudah dijalankan dari kepala ruang kepada kepala tim. Fungsi partisipasi sudah dilaksanakan. Fungsi pengendalian dilaksanakan dengan pengawasan langsung tetapi belum ada mekanisme monitoring dan evaluasi . Untuk faktor komitmen, yang sudah dilakukan adalah komitmen untuk menjadi teladan dan pemberian motivasi sedangkan komitmen untuk melakukan monitoring dan menjalankan SOP belum dilaksanakan. Pelayanan keperawatan sudah dirasakan cukup baik oleh pasien dan kolaborasi antar petugas medis sudah berjalan dengan baik tetapi belum ada penjaminan mutu pelayanan keperawatan. Sarana dan prasarana sesuai persyaratan dari Depkes dan Pernefri belum dipenuhi. Simpulan, faktor komunikasi kepemimpinan belum semuanya dilaksanakan oleh pimpinan keperawatan. Komitmen untuk menjadi teladan dan memberikan motivasi sudah dilaksanakan. Komitmen untuk melaksanakan SOP serta melakukan monitoring dan evaluasi belum dilaksanakan. Saran, kepemimpinan keperawatan agar meningkatkan fungsi komunikasi, pelaksanaan SOP serta melakukan monitoring dan evaluasi sebagai bentuk upaya penjaminan mutu pelayanan keperawatan. Haemodialysis unit service as an eminent service had been still a problematic in nursing leadership commitment and communication. This study objective was to explain the factors of leadership : communication and commitment to quality nursing care effort in Haemodialysis Unit at the Type B Hospital. The research was conducted in-depth qualitative interviews and observation. Research subjects consisted of 11 people : 3 key informants (1 head room nurse and 2 nurses) and 8 triangulation informants (1 physician responsible hemodialysis unit, 4 nurses and 3 patients). Observations carried out by using a check list.The results shows that the communication factors consists of instruction, consultation, participation, delegation and controlling functions have been done by the head room nurse. The instruction function has been implemented by providing direction but the strategy has not been delivered yet. Consulting function has been already implemented but the suggestion has not been responded by the head room nurse. Delegation function has been functioning from the head room nurse to the team head nurse. Participation function has been implemented. Controlling function has been carried out under the direct supervision but there have been no monitoring and evaluation mechanisms. Commitment factor has been a model and a motivation, while the commitment to monitor and to do using SOP has not been implemented. The nursing care has been perceived quite well by patients and collaboration among medical officers has been good but there has no assurance of quality nursing care. Facilities and infrastructures according to the requirements of the Department of Health and Pernefri have not been fulfilled. Conclusion, leadership communication factors have not all done by nursing leadership. Commitment to be a model and and a motivation have been implemented. Commitment to implement the SOP and conduct monitoring and evaluation have not been conducted. Suggestions, nursing leadership should improve the functioning of nursing leadership communication, implementation of SOPs and conduct monitoring and evaluation as an effort to guarantee quality of nursing care

Analysis of Leadership s Factors in Nursing Care Quality Effort at Hemodialysis Unit of B Class Hospital