Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.2. April 2023. Page.168-175 168 Team Work, Openness of Communication and Working Period for Reporting Patient Safety Events at the Regional General Hospital dr. ISKAK Tulungagung Dara Benedicta Antoninda1*, Indasah2 1 Universitas Airlangga, Indonesia 2 Institut Ilmu Kesehatan STRADA Indonesia, Kediri, Indonesia *Corresponding author: daraantoninda@gmail.com ABSTRACT Background: In 2021 RSUD Dr. Iskak Tulungagung again adopted a patient safety culture measure that was implemented for all hospital staff from several sources as the first step in a good patient safety program. Nurses are a component of human resources (HR) in the hospital health care system, who work directly on the front lines and have more time to deal with patients. Purpose: The purpose of this study is to analyze the influence of team work, communication openness and tenure on patient safety incident reporting at dr. ISK Tulungagung. Methods: The type of research conducted in this activity is an observational study with a cross- sectional design and using logistic regression statistical tests. The sample in this study were 406 respondents. Results: Based on the characteristics of the respondents, it showed that there were 304 female nurses and 102 male nurses. The longest working period was 6-10 years, namely 196 people. The results of the descriptive analysis show that the value of team work is 85%, the value of open communication is 83% and the cultural value of reporting patient safety incidents is 94%. Meanwhile, based on the statistical test results, the p-value is 0.001 <0.05; p-value 0.001 <0.05; and a p-value of 0.000 <0.05. Conclusion: Thus showing that there isThe Influence of Team Work, Open Communication and Working Period on Reporting of Patient Safety Incidents at the Regional General Hospital dr. ISK Tulungagung. Keywords: incident reporting, nurses, patient safety Received February 10, 2023; Revised March 12, 2023; Accepted April 3, 2023 DOI: https://doi.org/10.30994/jnp.v6i2.364 The Journal of Nursing Practice, its website, and the articles published there in are licensed under a Creative Commons Attribution-Non Commercial- ShareAlike 4.0 International License. https://thejnp.org/ mailto:daraantoninda@gmail.com https://doi.org/10.30994/jnp.v6i2.300 Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.2. April 2023. Page.168-175 169 BACKGROUND According to the Regulation of the Minister of Health of the Republic of Indonesia number 1691/MENKES/PER/VIII/2011 "Hospital patient safety is a system where hospitals make patient care safer which includes risk assessment, identification and management of matters related to patient risk, reporting and analysis incidents, the ability to learn from incidents and their follow-up and implementation of solutions to minimize risks and prevent injuries caused by mistakes resulting from carrying out an action or not taking the action that should have been taken”. The hospital is a primary health care facility. Thus the hospital must be able to provide integrated health services to patients as service users. Building a patient safety movement in hospitals is a top priority in hospital services. will benefit various parties, both hospitals and patients as users of health services (KKPRS, 2015) Data on patient safety in the world still shows problems in the world of health. The Institute of Medicine (IOM) in 2008 reported the number of Unexpected Events (KTD) in hospitals in the United States, namely 1.5 million patients were injured per year from medication errors, and 7000 of them were reported to have died (Webair et al., 2015). In addition, based on the results of research in Arab countries 2. Considerable data is also shown by world health institutions where there are a large proportion of medical errors and problems in patient care (Aspend, 2017). Data in America shows that 1.5 million people are injured each year and the average patient who is hospitalized has one error every day. experience estimating that an average of 10% of all inpatient visits creates some form of unwanted harm, reports from developing countries also show a 77% rate in cases of adverse events (Aspend, 2017) The safety culture system contained within the organization can be positive by there is open communication based on organizational values and beliefs as well as perceptions that are supported by members of the organization or individuals within an organization (Hammer et al., 2011). The Institute of Medicine (IOM) states that the biggest challenge is in building a work safety culture where a mistake is seen as an opportunity to improve service quality and prevent patient safety incidents (Doweri, 2015). The motivation for reporting patient safety incidents that is carried out with full honesty and without a culture of blame (Blame Free Culture) is a form of patient safety culture (Mark, 2011). A reporting system that prioritizes learning from mistakes and improving service systems is the basis of a safety culture (Reason, 1997). The most dominant dimension of improving patient safety culture is organizational learning/continuous improvement (Abood & El-Magd, 2018). Based on the results of a preliminary study at Dr. Iskak Tulungagung is known in the period 2018-2020 there were several reports of incidents that occurred. From patient safety incident reporting data and data from patient safety culture survey results in the previous year, in 2021 RSUD Dr. Iskak Tulungagung again adopted a patient safety culture measure that was implemented for all hospital staff from several sources as the first step in a good patient safety program. Nurses as a component of human resources (HR) in the hospital health care system, who work directly on the front line and have more time dealing with patients, without neglecting the role of other workers. Nurse performance is influenced by 3 variables, namely individual variables, organizational variables and psychological variables. Individual variables, consisting of abilities, skills, knowledge, demographics and family background, psychological variables consisting of perceptions, attitudes, motivation, personality and learning. Meanwhile, organizational variables consist of resources, rewards, workload, structure, supervision and leadership (Rahmatia, 2020). https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.2. April 2023. Page.168-175 170 Thus the implementation of patient safety incident reporting in hospitals is to design jobs with due regard to human factors. This means that in the arrangement, taking into account length of work, team work and openness of communication. METHODS The type of research conducted in this activity is observational research, namely observational research (survey) that tries to find a description of the variables without intervening in the research target. The design used is cross-sectional, that is, the researcher only makes observations and measures variables at a certain time. Measurements of unlimited variables must be at the same time, but have the meaning that each subject is only subjected to one measurement, without follow-up or repeated measurements (Saryono & Anggraeni, 2012). Samples were taken by simple random sampling technique. The number of samples in this study were 406 respondents. Statistical test using logistic regression,According to Ghozali (2018) logistic regression analysis is a regression that tests whether there is a probability of occurrence of the dependent variable that can be predicted by the independent variable. RESULTS 1. Characteristics of Respondents Table 1. Characteristics of Nurses Based on Gender No Characteristics f % 1. Gender a. Woman 304 75% b. Man 102 25% Total 406 100% Based on the table above, it shows that the majority of nurses are female, with 304 respondents (75%), while male nurses are 102 respondents (25%). 2. Characteristics of Respondents a. Characteristics of Team Work Variables Table 2. Characteristics of Variables Based on Team Work No Characteristics f % 1. Team Work a. Enough 345 85% b. Not enough 61 15% Based on the table above, it shows that the majority of nurses have adequate team work with a percentage of 85%. b. Characteristics of Communication Openness Variables Table 3. Variable Characteristics Based on Open Communication No Characteristics f % 1. Communication openness https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.2. April 2023. Page.168-175 171 a. Enough 337 83% b. Not enough 69 17% Based on the table above, it shows that the majority of nurses have sufficient openness of communication with a percentage of 83%. c. Characteristics of Patient Safety Event Reporting Variables Table 4. Characteristics of Patient Safety Event Reporting Variables No Characteristics f % 1. Patient Safety Incident Reporting a. Positive 382 94% b. Negative 24 6% Based on the table above, it shows that the majority of nurses have a positive Patient Safety Incident Reporting culture with a percentage of 94%. d. Characteristics of Variables Based on Working Period at dr.Iskak Hospital Table 5. Characteristics of Nurses Based on Years of Service at dr.Iskak Hospital No Characteristics f % 1. Years of service a. 1-5 years 150 37% b. 6-10 years 196 48.3% c. >11 years 60 14.7% Total 406 100% Based on the table above, it shows that the majority of nurses have worked for 6-10 years with 196 respondents (48.3%), while working for 1-5 years with 150 respondents (37%) and with working experience >11 years with 60 respondents (14, 7%). 3. Statistic test Model df Sig Exp(B) Team Work 1 001 5,291 Communication Openness 1 001 3,200 Years of service 1 .000 1,666 a. Analysis of the Influence of Team Work on Reporting of Patient Safety Incidents Based on the results of the Logistic Regression analysis, it shows that the p-value is 0.001 <0.05, so H1 is accepted, so it is concluded that there is an influenceThe Influence of Team Work on Reporting of Patient Safety Events at Dr.Iskak Hospital Tulungagung https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.2. April 2023. Page.168-175 172 b. Analysis of the Effect of Openness of Communication on Reporting of Patient Safety Incidents Based on the results of the Logistic Regression analysis, it shows that the p-value is 0.001 <0.05, so H1 is accepted, so it is concluded that there is an influenceThe Effect of Openness of Communication on Reporting of Patient Safety Incidents at Dr.Iskak Hospital Tulungagung c. Analysis of the Effect of Working Period on Reporting of Patient Safety Events Based on the results of the Logistic Regression analysis, it shows that the p-value is 0.000 <0.05, then H1 is accepted, so it is concluded that there is an influenceThe Influence of Working Period on Reporting of Patient Safety Incidents at dr.Iskak Tulungagung General Hospital DISCUSSION a. Identifying Team Work, Communication Openness and Working Period According to (Zulkifli, 2019) Team work is the foundation of the success of an organization, with the same vision and mission, a team work will have high loyalty at work. If there is no team work in a team, it will be fatal to the work being done. Based on the results of the study, it was shown that the majority of nurses at Dr. Iskak Tulungagung General Hospital had adequate team work with a percentage of 85%, with good team work it was hoped that all members in the team would have a sense of helping each other in work and a commitment to achieving a common goal is a characteristics of effective team work. According to research by research (Dewi Anggraeni, 2016) Individual openness to incident reporting is one of the indicators of patient safety culture that is incorporated into individual behavior. An attitude that does not support accident reporting to staff, especially nurses, hinders the creation of safe services, because the lack of accident reporting has an impact on hospitals that do not know the potential risks that can lead to errors. Based on the results of the study showed that the majority of nurses have sufficient openness of communication with a percentage of 83%. Thus it can be said that nurses at Dr. Iskak Tulungagung General Hospital point to high communication openness. Tenure of work is seen from how long the nurse has worked which is categorized into 3 categories namely 1-5 years, 6-10 years and more than 11 years. Based on the research, it showed that the majority of nurses at dr.Iskak Tulungagung General Hospital had a working period of 6-10 years with 196 respondents (48.3%), while a working period of 1-5 years was 150 respondents (37%) and a working period of >11 years was 60 respondents (14.7%). Based on research by (Zulkifli, 2019) which states thatWork experience plays a very important role in providing nursing care for nurses whose new working period must be obedient in providing nursing care, for senior nurses these nurses are used to and are calmer with the threats they get during their treatment period in health services. b. Identify Patient Safety Incident Reporting Patient Safety Culture A patient safety culture is said to be successful if all elements within the hospital apply a patient safety culture in their daily work (Reiling, 2009). Whereas Beginta (2012) said that the effort that can be made to improve safety culture is to encourage everyone to be responsible for safety for themselves, co-workers, patients and visitors, prioritizing safety and profit over profits and organizational goals. Patient safety culture is a major step in improving patient safety. According to PMK Number 1691 of 2011 it explains that building awareness of patient safety values, leading and supporting staff in implementing patient safety is an important part https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.2. April 2023. Page.168-175 173 of creating a patient safety culture. One of the points in patient safety culture is reporting the number of incidents in real time to correct them so that the same mistakes will not be repeated.This is supported by research conducted by (Jeffs, Law, & Gr, 2007) reporting is an important element of patient safety. Adequate information in reporting will be used as material by the organization in future learning. Organizations learn from previous experiences and have the ability to identify risk factors for incidents to occur so as to reduce or prevent incidents from occurring. Based on the results of the study showed that the majority of nurses had a positive Patient Safety Incident Reporting culture with a percentage of 94%, thus it can be concluded that nurses at dr.Iskak Hospital have a good patient safety incident reporting culture. c. Analyzing the Effect of Team Work, Open Communication and Working Period on Reporting Patient Safety Events at the Regional General Hospital dr. ISK Tulungagung According to (Top & Tekingunduz, 2014) Aspects of cooperation in a team can be an indication of a positive patient safety culture. The results of this study are in line with the results of research by Najjar, Nafouri, Vanhaecht and Euwema (2015) at the Palestine Hospital showing that patient safety culture on the dimension of nurse work teams between uni within the hospital is in the positive category of 73%. According to researchers, teamwork that has been formed in an organization cannot be separated from the support from the organization and the systems contained in an organization. Hospital management has an important role in developing a solid team in providing nursing services. Based on the results of the study, it showed that the p-value was 0.001 <0.05, so H1 was accepted, so it was concluded that there was an influence of team work on patient safety incident reporting at Dr. Iskak Tulungagung General Hospital. A positive patient safety culture has the characteristics that there is communication built with a sense of mutual openness, transparency by all employees and reflects patient safety. In addition, open communication is a component of patient safety culture.Based on the results of the study, it showed that the p-value was 0.001 <0.05, so H1 was accepted, so it was concluded that there was an effect of openness of communication on the reporting of patient safety incidents at Dr. Iskak Tulungagung Hospital. Thus it can be said that openness of communication is an important element of patient safety. Without open communication, it will be fatal to patient safety. Based on the results of the study, it showed that the p-value was 0.000 <0.05, so H1 was accepted, so it was concluded that there was an effect of working period on reporting of patient safety incidents at dr.Iskak Hospital, Tulungagung. This is supported by research (Zulkifli, 2019) which states thatWork experience plays a very important role in providing nursing care for nurses whose new working period must be obedient in providing nursing care, for senior nurses these nurses are used to and are calmer with the threats they get during their treatment period in health services. This is in accordance with the opinion (Astriana, 2018) which states that the longer a person's working period, the competence, skills, expertise and experience gained will increase. Thus the competence for the work done will be better because there is support from the period of work itself. So it can be concluded that the longer the working period, the more it will determine the quality of the work performed. CONCLUSION a. 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