Pengaruh Kompetensi Guru Terhadap Komitmen Profesional Dan Dampaknya Pada Kinerja Serta Kepuasan Kerja Guru Matematika SMP Dan Mts

Penelitian ini bertujuan untuk memperoleh model hubungan kausalitas dari variabel-variabel kompetensi, komitmen profesional, kinerja dan kepuasan kerja guru matematika. Populasi dalam penelitian ini adalah seluruh guru matematika SMP dan MTs di Kabupaten Ponorogo yang berjumlah 262 orang. Sampel sejumlah 82 orang ditentukan melalui teknik two stage cluster random sampling. Instrumen penelitian ini adalah kuesioner dan lembar penilaian/observasi. Kuesioner digunakan untuk mengumpulkan data komitmen profesional dan kepuasan kerja guru matematika, sedangkan lembar penilaian/observasi digunakan untuk mengumpulkan data kompetensi dan kinerja guru matematika. Data yang diperoleh dianalisis dengan metode Structural Equation Modeling (SEM).Hasil penelitian menunjukkan bahwa: (1) terdapat pengaruh positif kompetensi terhadap komitmen profesional sebesar 15,9%; (2) terdapat pengaruh positif kompetensi terhadap kinerja sebesar 63,6%; (3) terdapat pengaruh positif komitmen profesional terhadap kinerja sebesar 15,9%; dan (4) terdapat pengaruh positif komitmen profesional terhadap kepuasan kerja sebesar 37,8%. Hasil-hasil penelitian di atas dapat mengkonfirmasi kesimpulan penelitian-penelitian sebelumnya

Baseline hospital performance and the impact of medical emergency teams: Modelling vs. conventional subgroup analysis

<p>Abstract</p> <p>Background</p> <p>To compare two approaches to the statistical analysis of the relationship between the baseline incidence of adverse events and the effect of medical emergency teams (METs).</p> <p>Methods</p> <p>Using data from a cluster randomized controlled trial (the MERIT study), we analysed the relationship between the baseline incidence of adverse events and its change from baseline to the MET activation phase using quadratic modelling techniques. We compared the findings with those obtained with conventional subgroup analysis.</p> <p>Results</p> <p>Using linear and quadratic modelling techniques, we found that each unit increase in the baseline incidence of adverse events in MET hospitals was associated with a 0.59 unit subsequent reduction in adverse events (95%CI: 0.33 to 0.86) after MET implementation and activation. This applied to cardiac arrests (0.74; 95%CI: 0.52 to 0.95), unplanned ICU admissions (0.56; 95%CI: 0.26 to 0.85) and unexpected deaths (0.68; 95%CI: 0.45 to 0.90). Control hospitals showed a similar reduction only for cardiac arrests (0.95; 95%CI: 0.56 to 1.32). Comparison using conventional subgroup analysis, on the other hand, detected no significant difference between MET and control hospitals.</p> <p>Conclusions</p> <p>Our study showed that, in the MERIT study, when there was dependence of treatment effect on baseline performance, an approach based on regression modelling helped illustrate the nature and magnitude of such dependence while sub-group analysis did not. The ability to assess the nature and magnitude of such dependence may have policy implications. Regression technique may thus prove useful in analysing data when there is a conditional treatment effect.</p

Hospital overnight and evaluation of systems and timelines study : a point prevalence study of practice in Australia and New Zealand

Background: Diurnal variation in the performance of rapid response systems has not been fully elucidated. Afferent limb failure (ALF) is a significant problem and is an important measure of performance of rapid response systems. Objective: To determine the diurnal variation in the detection and response to acute patient deterioration as measured by ALF, completeness of patient observations (Respiratory rate (RR); Pulse rate (PR) and Systolic blood pressure (SBP), and to explore the diurnal variation in the consequences of ALF in unanticipated admissions to the Intensive care unit (ICU) from the ward. Design, setting and participants: Point Prevalence study conducted on two days in 2012 in 41 ICUs in Australia and New Zealand, examining emergency (unanticipated) admissions to the ICU from the ward. Results: 51 patients from the ward were admitted as an emergency to the ICU following a rapid response team call, of whom 48 patients had complete datasets and were enrolled; 32 (67%) were men. The prevalence of ALF was 37.5% (18/48). Median age was 62.5 (IQR 51.5–74.0), Median APACHE II score was 21.0 (IQR 17–26). There was no diurnal variation in the prevalence of ALF (day 28% versus night 28%; p = 0.92), patient observations documented over time (p = 0.78 for RR, p = 0.95 for PR and p = 0.74 for SBP) or 28-day mortality (p = 0.24). There was a significant diurnal variation between the least recorded observation (SBP) and the most recorded observation (PR) (p < 0.01). ALF was more likely (day and night) if a complete set of observations had been taken (p < 0.01). Conclusion: The prevalence of ALF amongst patients admitted to the ICU from the ward is high. SBP is the least recorded patient observation. This study was unable to identify a diurnal variation in the prevalence of ALF, its consequences (i.e. mortality) and the completeness of patient observations. Observational studies with a larger sample are required to explore this important problem.5 page(s

Multi-Tiered Observation and Response Charts: Prevalence and Incidence of Triggers, Modifications and Calls, to Acutely Deteriorating Adult Patients.

BACKGROUND:Observation charts are the primary tool for recording patient vital signs. They have a critical role in documenting triggers for a multi-tiered escalation response to the deteriorating patient. The objectives of this study were to ascertain the prevalence and incidence of triggers, trigger modifications and escalation response (Call) amongst general medical and surgical inpatients following the introduction of an observation and response chart (ORC). METHODS:Prospective (prevalence), over two 24-hour periods, and retrospective (incidence), over entire hospital stay, observational study of documented patient observations intended to trigger one of three escalation responses, being a MER-Medical Emergency Response [highest tier], MDT-Multidisciplinary Team [admitting team], or Nurse-senior ward nurse [lowest tier] response amongst adult general medical and surgical patients. RESULTS: PREVALENCE:416 patients, 321 (77.2%) being medical admissions, median age 76 years (IQR 62, 85) and 95 (22.8%) Not for Resuscitation (NFR). Overall, 193 (46.4%) patients had a Trigger, being 17 (4.1%) MER, 45 (10.8%) MDT and 178 (42.8%) Nurse triggers. 60 (14.4%) patients had a Call, and 72 (17.3%) a modified Trigger. INCIDENCE:206 patients, of similar age, of whom 166 (80.5%) had a Trigger, 122 (59.2%) a Call, and 91 (44.2%) a modified Trigger. PREVALENCE and incidence of failure to Call was 33.2% and 68% of patients, respectively, particular for Nurse Triggers (26.7% and 62.1%, respectively). The number of Modifications, Calls, and failure to Call, correlated with the number of Triggers (0.912 [p<0.01], 0.631 [p<0.01], 0.988 [p<0.01]). CONCLUSION:Within a multi-tiered response system for the detection and response to the deteriorating patient Triggers, their Modifications and failure to Call are common, particularly within the lower tiers of escalation. The number of Triggers and their Modifications may erode the structure, compliance, and potential efficacy of structured observation and response charts within a multi-tiered response system

Narrativizing errors of care: Critical incident reporting in clinical practice

This paper considers the rise across acute care settings in the industrialized world of techniques that encourage clinicians to record their experiences about adverse events they are personally involved in; that is, to share narratives about errors, mishaps or 'critical incidents'. The paper proposes that critical incident reporting and the 'root cause' investigations it affords, are both central to the effort to involve clinicians in managing and organizing their work, and a departure from established methods and approaches to achieve clinicians' involvement in these non-clinical domains of health care. We argue that critical incident narratives render visible details of the clinical work that have thus far only been discussed in closed, paperless meetings, and that, as narratives, they incite individuals to share personal experiences with parties previously excluded from knowledge about failure. Drawing on a study of 124 medical retrieval incident reports, the paper provides illustrations and interpretations of both the narrative and the meta-discursive dimensions of critical incident reporting. We suggest that, as a new and complex genre, critical incident reporting achieves three important objectives. First, it provides clinicians with a channel for dealing with incidents in a way that brings problems to light in a non-blaming way and that might therefore be morally satisfying and perhaps even therapeutic. Second, these narrations make available new spaces for the apprehension, identification and performance of self. Here, the incident report becomes a space where clinicians publicly perform concern about what happened. Third, incident reporting becomes the basis for radically altering the clinician-organization relationship. As a complex expression of clinical failure and its re-articulation into organizational meta-discourse, incident reporting puts doctors' selves and feelings at risk not just within the relative safety of personal or intra-professional relationships, but also in the normative context of organizational coordination, accountability, planning and management.Critical incident reporting Adverse event Narrative Acute care Discourse genre Self identity

Additional file 1: of Diurnal variation in the performance of rapid response systems: the role of critical care services—a review article

Australian Commission on Safety and Quality in Health Care (ACSQHC) standards. (PDF 1013 kb

Relative risk posterior estimates and 90% credible intervals for temporal effect and covariates in the spatiotemporal model of FTR across LGAs of NSW over the study period (2002–2009).

<p>Note: Effects of year (linear and quadratic) were obtained where time was centred on the middle of study period (2005.5). Effect of SEIFA score was obtained for 10 unit increments in the raw scores varying from 816 to 1155 in NSW. Effect of distance travelled was obtained for square root of the raw values. Effect of gender was obtained for 10 unit increments in the percentage of females among all patients.</p><p>Relative risk posterior estimates and 90% credible intervals for temporal effect and covariates in the spatiotemporal model of FTR across LGAs of NSW over the study period (2002–2009).</p