Analysis Of Nursing Supervision Function In Nursing Supervision Implementation


 

 
Corresponding author: 
Etik Kustiati 
etik.kustiati@yahoo.com 
South East Asia Nursing Research, Vol 2 No 3, September 2020 
ISSN:2685-032X 
DOI: https://doi.org/10.26714/seanr.2.3.2020.123-131  

 
 

 
 
 
 
 

 

Case Study 
 

Analysis Of Nursing Supervision Function In Nursing Supervision 
Implementation  
 
Etik Kustiati1, Vivi Yosafianti Pohan2, Tri Hartiti3 

1,2,3 Master of Nursing Program, Universitas Muhammadiyah Semarang, Indonesia 

 
Article Info  Abstract 

Article History: 
Submit August 30th, 2020 
Accepted Sept 29th, 2020 
Published Sept 30th 2020 
 
Keywords:  
Supervisory Function; 
Nursing Room; Nursing 
Supervision 

 Preparaing rooms for covid 19 patients must be supported by the availability 
of superior human resources and good nursing management functions. 
Nursing care given to Covid 19 patients must be complete and well 
documented. The quality of service needs to be monitored on an ongoing 
basis by optimizing the supervisory function of the head of the room and the 
orphans by means of nursing supervision. The purpose of this analysis is to 
determine the usefulness of the nursing room supervision function in this 
case by implementing nursing supervision. The use of the action method in 
this analysis aims to develop new skills or new approaches and be applied 
directly and studied the results. The assessment using eight nursing 
management functions carried out in Sulaiman 4 room Roemani 
Muhammadiyah Semarang Hospital found that the most priority problems 
were not optimal in the implementation of the supervisory activities of the 
head of the room and head of the team. The supervision activities in the 
Sulaiman 4 room have actually been carried out but have not been scheduled 
and well documented. Actions taken by refreshing the nursing supervision 
through Small Group Discus activities, preparation of supervision schedules 
and making supervision formats. Evaluation of the actions taken, SGD was 
attended by 19 participants consisting of 15 nurses Sulaiman 4 and four 
other inpatient heads, the supervision schedule was made according to the 
agreement of the Head of the Room and the Head of the Team. The direct 
supervision format was used in Sulaiman 4 room according to the 
predetermined schedule, namely on December 11, 2020. The results 
achieved from the supervision obtained a significant increase in the number 
of completeness of nursing documentation from 48.24% to 82.98%. 

 

INTRODUCTION  

Nursing is a form of professional service 
that is part of the health service system 
based on knowledge, this service is 
manifested in a comprehensive form of 
services including bio, psycho-social and 
spiritual guidance given to individuals, 
families and communities both in a healthy 

state and in a sick condition covering all the 
process of life from human birth to death. 1 

The activity of providing nursing services to 
individuals, families, groups or 
communities is the meaning of nursing, 
quality nursing management will produce 
quality nurses so that the nursing services 
provided will also be of quality. Because 

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Etik Kustiati / Analysis Of Nursing Supervision Function In Nursing Supervision Implementation 

good service quality is currently a top 
priority for community demands for health 
services. Good quality services will provide 
assurance to patients of protection and legal 
certainty for both patients and nurses 
themselves. Quality service quality will 
further improve the health status of 
patients.2 

One of the functions of nursing 
management, namely the supervisory 
function, plays a very important role in 
improving the quality of nursing services 
where through monitoring activities in this 
case is carried out by monitoring and 
evaluation through nursing supervision. 
Through supervision activities, it is 
expected to solve problems as soon as 
possible against deviations, mistakes and 
failures from the expected goals. In addition 
to being a means of problem solving, 
supervision activities are also an activity to 
guide and motivate. Through nursing 
supervision activities will increase the 
productivity of nurses.3,4 

Nursing management is a form of science 
and art in managing nursing resources that 
are dynamic, proactive, efficient, effective 
and rational in running an organization by 
implementing a nursing management 
process to achieve a goal and objectivity in 
nursing care and nursing services. Nursing 
management in which there are activities in 
the form of organization, workforce 
management, direction, supervision, care 
room management, logistics management, 
nursing quality assurance programs and 
programs, patient safety, is an integral part 
of providing services. Through this nursing 
management process the objectives of 
nursing services and the objectivity of 
nursing care in health facilities can be 
realized.5 

The supervisory function is an activity in 
nursing management that aims to find and 
correct important deviations in nursing 
care service activities in a health service. 
The implementation of supervision by 
means of supervision is planned in a 

systematic, measured, planned, and 
documented manner. The supervisory 
function in nursing management is 
indispensable to provide control and 
limitation for implementing nurses in 
providing nursing care to patients, so that 
the goal of achieving excellent and quality 
service can be achieved. Supervision as a 
form of the process of implementing the 
supervisory function in nursing 
management in its implementation remains 
oriented towards patient-focused services 
(Patient Center Care).6 

The supervisory function in this case is 
carried out by means of nursing supervision 
which is a very important managerial 
activity. Through supervision, the 
implementation of the supervision function 
can run well to improve service quality and 
performance. Regular and scheduled 
supervision will support planned activities 
and expected goals.5 

Nursing supervision is a continuous process 
of activities carried out by the leader with 
the aim of knowing the extent of the level of 
knowledge, skills, creativity and compliance 
with the procedures performed by the 
nurse under him. Nursing supervision is 
also useful for exploring the quality and 
ability of nurses through support, direction, 
observation, guidance, and motivation.7 

Nursing care is a series of activities to 
provide direct nursing practice to patients 
in various health facilities by referring to 
the existing rules of the nursing profession. 
Nursing care standards are one of the 
references of the quality of nursing care 
provided to patients. The quality and 
quality of a hospital is also supported by 
quality nursing care standards.8  

Nursing care standards according to the 
Ministry of Health of the Republic of 
Indonesia in 1998 include the stages of the 
nursing process, namely assessment, 
diagnosis, nursing planning, nursing 
implementation and evaluation.9 



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Etik Kustiati / Analysis Of Nursing Supervision Function In Nursing Supervision Implementation 

Nursing care standards can be used as a 
determinant of the success and quality of 
nursing care. The provision of quality 
nursing care must be in accordance with the 
established standards of the nursing 
profession. Nursing care services are used 
fairly, efficiently, effectively and safely for 
patients and nurses as satisfying service 
providers. Social, economic, cultural, 
religious, ethical and values aspects in 
society are considered and used to assess 
the quality of nursing services by using 
nursing care standards. Nursing care 
standards are also used to maintain and 
improve service standards in health 
facilities.10 

Roemani Muhammadiyah Semarang 
Hospital is a private hospital in the middle 
of the city of Semarang that provides health 
services that aim to improve health status 
and is always oriented to the interests of the 
community. The health services provided 
are always balanced with dedication to the 
surrounding community. RS. Roemani 
Muhammadiyah Semarang strives to create 
a solid organization and management 
oriented towards the quality of service for 
the community. So that the process of repair 
and improvement is carried out in various 
aspects of services and facilities and 
infrastructure. 

To realize an increase in the quality of 
service at the Roemani Muhammadiyah 
Hospital in Semarang, the field of care 
organizes nursing supervision. Nursing 
supervision carried out in the field of care is 
the supervision of nursing services in 
general and the area of supervision of all 
units under the field of care. Meanwhile, 
supervision of the treatment room has been 
carried out but the implementation has not 
been optimal. Supervision of the treatment 
room is only carried out once a month, there 
is also no implementation schedule and 
documentation of the implementation of 
supervision. 

 

METHODS 

The method used is the action method, 
which is a method that aims to develop new 
skills or new approaches and is applied 
directly and the results are reviewed. 
Where this analysis is prepared based on 
the assessment of eight nursing 
management functions, namely the function 
of organizing, personnel, directing, 
monitoring, care management, logistics 
management, quality assurance programs 
and patient safety. The results of the 
assessment in the Sulaiman 4 room based 
on the eight nursing management functions 
found five problems, namely: Not optimal in 
the implementation of supervision activities 
of the head of the room and the team head, 
the implementation of nursing care was not 
in accordance with the SPO, Lack of 
manpower needs, the number of 
completeness of documentation was still 
low, the drill was still low in The last three 
months. Of the five problems above, the 
priority order of the problems according to 
the HANLON theory and the joint agreement 
of the Head of Sulaiman Room 4 is that the 
problem of not optimal implementation of 
the supervisory activities of the head of the 
room and the team leader is considered 
very important and needs immediate 
resolution. From the problem that the 
implementation of the supervision activities 
of the head of the room and the head of the 
team has not been optimal, the action taken 
is to refresh again about the supervision 
through the Small Group discus activity, 
preparation of the supervision schedule 
according to the agreement of the Ka Ru and 
the Ka of the Sulaiman 4 room team, making 
the supervision format. The results of the 
actions carried out by SGD which were 
carried out on December 7, 2020, attended 
by 19 participants consisting of 15 nurses 
(Ka Ru, Team Head and implementing 
nurses), four other inpatient heads, the 
schedule for supervision of the Team 
Leader and Head of the Team was made on 
December 8, 2020, the format of nursing 
supervision which was immediately applied 
in Sulaiman Room 4 on December 11, 2020. 



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Etik Kustiati / Analysis Of Nursing Supervision Function In Nursing Supervision Implementation 

RESULTS 

Roemani Muhammadiyah Semarang 
Hospital is one of the health facilities that 
has a vision to create a global quality 
hospital by 2030 with the application of the 
latest technology based on Islamic values. 
Based on the results of the assessment 
carried out in Room Sulaiman 4, it has 
provided nursing services as required in the 
SNARS 1.0 Accreditation, but these efforts 
have not been running optimally, because it 
is still in the refinement stage. This can be 
seen from the results of the analysis of the 
problems found by students during the 
application practice, namely: 

1. Not yet optimal implementation of 
supervisory activities for the head of 
room and head of the team 

2. Implementation of nursing care is not 
in accordance with the SPO 

3. Lack of personnel needs 
4. The number of documentation 

completeness is still low 
5. Drill is still low in the last 3 months 

The problems found have been taken based 
on an agreement with Sulaiman 4 and the 
supervisor of Roemani Muhammadiyah 
Semarang Hospital, by sticking to the theory 
of applying the problem, namely the 
HANLON theory. Every intervention that is 
made and implemented is an effort that is 
considered the most effective in adjusting 
the needs of the problem and able to answer 
existing problems. Description of the 
discussion of the interventions carried out 
which is taken from the main problem, 
namely the not optimal implementation of 
the supervisory activities of the head of the 
room and the head of the team. 

Supervision is an active process of directing, 
guiding and influencing the results of 
individual task performance, in this case the 
nurse as an individual who is supervised. 
Direct supervision is carried out by the 
Head and Team Leader to find problems as 
early as possible so that the resolution can 
also be faster and more effective. 

Clinical Supervision needs to be carried out 
in a programmed, scheduled manner, and 
not to look for errors or deviations. 
Supervision is also carried out, especially in 
providing guidance and direction to 
improve the understanding of the nurse in 
carrying out their duties and 
responsibilities in providing services 

From the results of observations made by 
practical application students during the 
implementation of nursing clinical 
supervision activities in Sulaiman Room 4, it 
was found that the team had carried out 
supervision in accordance with the existing 
SPO of supervision. However, there are 
some things that need to be improved, 
namely when: 

Assessment 
The Head of the Room and the Head of the 
team are expected to be able to schedule a 
scheduled and continuous nursing 
supervision so that it can be known by all 
the nurses 

Preparation 
Before carrying out the scheduled 
supervision, the head of the room / head of 
the team should first orientate or convey the 
material about the supervision that will be 
carried out. 

Implementation 
The Ka Ru and the Ka of the team in carrying 
out the direction and guidance are expected 
to have the ability to express questions that 
lead to the nurse's awareness of the benefits 
that are obtained. Because whatever is done 
on the occasion of the team and the center 
of efforts to gain new awareness, insight and 
identify goals 

Evaluation 
When conducting the evaluation, it is 
expected that the Ka Ru and the Ka of the 
team will be able to carry out supervisory 
assessments, provide feedback and 
clarification as well as reinforcement on the 
achievement of the progress of the 



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Etik Kustiati / Analysis Of Nursing Supervision Function In Nursing Supervision Implementation 

implementing nurse and follow up for 
improvements. 

Nursing Supervision in room 4 Roemani 
Muhammadiyah Semarang Hospital in 
Sulaiman room has been carried out 
according to SPO standards. The Ka ru and 
Ka of the team already understood the 
refresh that was given as evidenced by the 
implementation of the supervision program 
in the Sulaiman 4 room which was held on 
December 11, 2020. The results of the 
discussion with the head of the Sulaiman 
Room 4 compiled a supervise format that 
was easy to use because it was in the form 
of a check list and clear assessment. The 
format also helps the Ka Ru and the Ka of the 
team in identifying missing scores, making 
it easier for the team and the team to 
supervise. 

PDSA Implementation of Supervision in 
Sulaiman 4 RS Roemani Muhammadiyah 
Semarang 

1. Supervision implementation data 
analysis 
Based on the results of interviews and 
observations in Sulaiman's room4, data 
on the implementation of supervision is 
still conditional at least once a month, 
there is already a Supervision SOP, but 
the implementation is not yet 
appropriate 

2. PDSA 
a) Plan 

Problem: Supervision of Head and 
Team Head is not yet structured and 
scheduled 

Purpose: Supervision of Ka Ru and 
Ka Teams is carried out in a 
programmed, scheduled, continuous 
and documented manner 

Actions: 
- Refresh Back about Supervision 

via SGD 
- Preparation of supervision 

schedules 

- Making supervision format 

b) Do 
- Implementation of SGD 

supervision 
- Socialization of Supervision 

Format 

c) Study 
- Observation of the 

implementation of supervision 
with an average result of 
supervision of 82.98% 

- The results of the discussion 
were also found that the 
supervision format created was 
feasible and easy to apply 

d) Action 
- SGD supervise to the Head, Head 

of the Team and the executive 
nurse in the Sulaiman Room 4 Rs 
Roemani Muhammadiyah 
Semarang 

- Preparation of supervision 
schedules 

- Develop Supervision Format 
- Perform tiered supervision 

From the explanation above, there is a 
correspondence between the theory of 
nursing management functions, especially 
the supervisory function, with the priority 
of the issues raised, namely the not optimal 
implementation of supervisory activities for 
the head of the room and the head of the 
team. Indeed, the supervisory function is 
very necessary because with supervision 
through supervision carried out by both the 
Head and the Team, a solution can be 
immediately sought for the problems found 
during supervision, one of which was found 
in the implementation of supervision in 
Sulaiman 4, namely regarding the 
completeness of documentation and 
implementation of Handover. 

Problems found during the implementation 
of the nursing management application in 
the Sulaiman 4 in addition to not optimal 



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Etik Kustiati / Analysis Of Nursing Supervision Function In Nursing Supervision Implementation 

implementation of the supervision of the 
head of room and head of the team, namely 

1. The implementation of nursing care is 
not in accordance with the SPO 
Implementation: Refresh nursing SPO 
by Room leader and Ka Team, by reading 
at least 1 SPO per Hand Over 

Evaluation: Implementation of SPO 
Refresh has been carried out starting 
December 9, 2020 

Appropriateness Theory: In accordance 
with nursing management theory and 
research results, Refresh SPO is needed 
so that the care provided is in 
accordance with the patient's needs. 

2. Lack of personnel needs 
Implementation: Optimizing existing 
nurses while waiting for the recruitment 
process to be completed and additional 
nurses can enter the Sulaiman 4 

Evaluation: The recruitment process has 
been carried out, registration starts on 
December 10 and 11, followed by a 
written test on December 14, 2020, it is 
hoped that the 3rd week of December 
can be oriented. 

Suitability Theory: Quality of nursing 
care, effective and efficient service 
according to nursing management 
theory and in accordance with the 
results of other research. 

3. The number of documentation 
completeness still low 
Implementation: 
a. Build a strong commitment from the 

head, team and nurse administrators 
to carry out complete nursing 
documentation 

b. Bed Teaching site filling out nursing 
documentation by Ka Ru and Ka 
Team. 

 

Evaluation: 
a. Joint Commitment to improve 

completeness of documentation, bed 
site teaching and refresher of SPO 
held on December 8, 2020 

b. The results of supervision carried 
out on December 11, 2020 on the 
completeness of RM documentation 
increased significantly by 82.98 

Conformity Theory: Completeness of 
documentation is very important in the 
nursing care process, therefore joint 
commitment and continuous evaluation 
monitoring of nursing documentation 
needs to be done, this is in accordance 
with the nursing management function 
in care management. The 
implementation of nursing care 
standards is the core of nursing practice, 
it needs to be supported by good nursing 
management functions in order to 
guarantee the quality of nursing 
services. 

3. Drill is still low in the last 3 months 
Implementation: Providing the best 
service in accordance with the SPO 

Evaluation: On the 8th it was opened. 
The isolation room with a capacity of 8 
beds, until December 16th, all beds were 
fully occupied. 

Conformity Theory. Quality services will 
certainly improve the quality of nursing 
care so that patients will feel satisfied with 
the services provided. In accordance with 
the Nursing Management Function in 
Nursing Quality Assurance. 

DISCUSSION 

Preparing rooms for Covid 19 patients must 
be supported by the availability of superior 
human resources and good nursing 
management functions. Nursing care given 
to Covid 19 patients must be complete and 
well documented. The quality of service 
needs to be monitored continuously by 
optimizing the supervisory function of the 



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Etik Kustiati / Analysis Of Nursing Supervision Function In Nursing Supervision Implementation 

head of the room and the orphans by means 
of nursing supervision. The implementation 
of nursing supervision of nursing care in the 
Covid 19 isolation service must be well 
scheduled and documented. 

The nursing management function is 
primarily a supervisory function with the 
priority of the issues raised, namely the not 
yet optimal implementation of the 
supervisory activities of the head of the 
room and the head of the team. In fact, the 
supervisory function is very much needed 
because with supervision through 
supervision carried out by both the Head 
and Team Leader, solutions can be 
immediately sought for problems found 
during supervision. One of the findings in 
the implementation of supervision in 
Sulaiman Room 4 was about the 
completeness of documentation and the 
implementation of Hand over. After 
carrying out nursing supervision actions 
that are scheduled and well documented, 
significant results are obtained, namely the 
completeness of documentation of 82, 98% 

Some of the results of research that have 
been conducted by other researchers 
related to supervision and its benefits are 
increasing nursing care and documentation 
aimed at achieving patient satisfaction 
levels. 

The results of other research can be 
concluded that Discharge planning is one of 
the indicators of sustainable nursing 
services which, if done properly by nurses, 
will be able to improve the quality of 
nursing services and patient satisfaction. 
One of the influencing factors is the 
leadership of the head of the room, 
especially in the function of directing the 
nurse when carrying out discharge 
planning. The directive function carried out 
by the head of the room is in the form of 
providing motivation, supervision, and 
conflict management.11 

Other research shows that more than half 
(53.3%) of the head of the room carried out 

the supervision and documentation which 
was done completely and incompletely, the 
same amount (50%) was carried out by the 
executive nurse. The results of bivariate 
analysis with chi-square were obtained (p = 
0.021), it can be concluded that there is a 
relationship between the supervision of the 
head of the room and the documentation of 
nursing care in the inpatient room of RSI 
Ibnu Sina Bukittinggi.12 Other research 
showed have difference in documenting 
nursing care before and after being given 
supervision with a P value of 0,000.13 

The other research concluded that the 
combination of the supervisory function in 
the nursing field and the training that the 
supervisor participated in had a significant 
relationship with the implementation of 
supervision by the supervisor. Supervision 
periodically and with effective supervision 
techniques improve the performance of 
nurses in nursing services.14 

Nursing supervision that is structured, 
scheduled and well-documented is very 
beneficial for improving the quality of 
hospital services. This is supported by 
several published research results. 

In fact, the supervisory function is very 
necessary because with supervision 
through supervision carried out by both the 
Head and the Team, a solution can be 
immediately sought for problems found 
during the implementation of nursing 
supervision. Through nursing supervision, 
the number of completeness of Medical 
Record documentation increased 
significantly from 24.48% to 82.98% 

Nursing SPO refresh needs to be done 
periodically. Its implementation requires 
monitoring and evaluation so that the 
nursing care carried out by the 
implementing nurse can be in accordance 
with the SPO determined by the hospital. 

Joint commitment both room leader, the 
Head of the Team and the implementing 
nurses to achieve an increase in the number 



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Etik Kustiati / Analysis Of Nursing Supervision Function In Nursing Supervision Implementation 

of documentation completeness. One of the 
monitoring and evaluation with supervision 
is able to increase the value of completeness 
of Medical Record documentation. 

The increase in the number of Covid 
patients is comparable to a full bed in the 
Covid room provided. Increasing BOR while 
still paying attention to the quality of 
nursing services will have an impact on 
patient satisfaction. Providing quality 
services can be done by means of 
supervision which can be carried out by the 
Head of the Room and the Head of the Team. 

CONCLUSION 

RS. Roemani Muhammadiyah Semarang is 
one of the hospitals in Semarang. Based on 
the results of the assessment carried out in 
Sulaiman Room 4, 3 problems in nursing 
management were formulated and the 
priority problems were as follows 

1. Not yet optimal implementation of 
supervisory activities for the head of 
room and head of the team 

2. Implementation of nursing care is not in 
accordance with the SPO 

3. Lack of personnel needs 
4. The number of documentation 

completeness is still low 
5. Drill is still low in the last 3 months 

There are five problems found, but based on 
the priority of the problem according to 
HANLON, namely the not optimal 
implementation of the supervisory 
activities of the head of the room and the 
head of the team, the solution is sought by 
implementing supervision in Sulaiman 4 
room as many as 9 implementing nurses 
with a value of completeness of 
documentation of 82.98%. This result 
significantly increased from the initial value 
before implementation by students of 
48.24%. The implementation of supervision 
has used a mutually agreed supervision 
format and according to the time set in the 
supervision schedule. The understanding of 
the head of the room and the head of the 

team on the implementation of supervision 
is very understood, they are able to carry 
out the briefing process and guidance to the 
nurse under him 

The recommendes Suggestions for the 
hospital is expected to continuously run 
programs that can improve the quality of 
hospital services. It is hoped that the 
hospital should improve the 
implementation of the management 
function of the head of the room, especially 
in the implementation of nursing 
supervision and it is hoped that the 
implementation of supervision can be 
carried out in stages and continuously. 

The head of the room and the head of the 
team are expected to be able to continue to 
motivate the nurse in charge to always 
improve the quality and run the program 
that has been compiled. 

Nurses are expected to realize the 
importance of the role of nurses in the 
success of health services by continuing to 
work on the programs that have been 
prepared. 

ACKNOWLEDGMENTS 

Special thanks to Dr. Ns Vivi Yosafianti 
Pohan, M.Kep , Dr. Tri Hartiti, SKM, M.Kep 
for the constructive criticism and advice for 
this Nursing Management Application 
Report. I would like to express my deepest 
gratitude to Universitas Muhammadiyah 
Semarang and RS Roemani Muhammadiyah 
Semarang for their assistance and 
cooperation. 

CONFLICTS OF INTEREST 

Neither of the authors has any conflicts of 
interest that would bias the findings 
presented here. 

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