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Needle Stick Injury (NSI) is a serious occupational hazard among healthcare workers due to the risk of transmitting bloodborne pathogens. A preliminary study at Puskesmas X found that 60% of healthcare workers had experienced NSI. This study aimed to analyze the relationship between work standards, skills, and training with the incidence of NSI among healthcare workers (nurses and midwives) at Puskesmas X, East Bolaang Mongondow Regency. An analytical observational study with a cross-sectional design was conducted. A total sampling technique was used, resulting in 37 respondents. Data were collected using a structured questionnaire and analyzed using statistical tests. The results showed majority of respondents were aged 26–34 years (67.6%), female (81.1%), and had experienced NSI (73.0%). Statistical analysis showed a significant association between work standards (p = 0.018), skills (p < 0.001), and training (p = 0.014) with NSI incidence. Poor work standards, inadequate clinical skills, and limited participation in training were strongly associated with higher rates of NSI. Community health centers are recommended to implement regular occupational safety training programs to improve the technical skills of healthcare workers.

Needle Stick Injury (NSI) is a serious occupational hazard among healthcare workers due to the risk of transmitting bloodborne pathogens. A preliminary study at Puskesmas X found that 60% of healthcare workers had experienced NSI. This study aimed to analyze the relationship between work standards, skills, and training with the incidence of NSI among healthcare workers (nurses and midwives) at Puskesmas X, East Bolaang Mongondow Regency. An analytical observational study with a cross-sectional design was conducted. A total sampling technique was used, resulting in 37 respondents. Data were collected using a structured questionnaire and analyzed using statistical tests. The results showed majority of respondents were aged 26–34 years (67.6%), female (81.1%), and had experienced NSI (73.0%). Statistical analysis showed a significant association between work standards (p = 0.018), skills (p < 0.001), and training (p = 0.014) with NSI incidence. Poor work standards, inadequate clinical skills, and limited participation in training were strongly associated with higher rates of NSI. Community health centers are recommended to implement regular occupational safety training programs to improve the technical skills of healthcare workers.

Background:Tuberculosis remains a serious public health challenge in Indonesia, including in Pekalongan City, which sees an annual increase in cases. The still high number of TB cases and deaths each year indicates that the program being implemented is not yet fully effective, therefore requiring active community involvement, increased capacity of health workers, and closer cross-sector integration. Aims: This activity aims to provide comprehensive community nursing care through a promotive and preventive approach, with an emphasis on identifying risky behaviors, knowledge deficits, and non-adherence to TB treatment. Method: The methods used included community assessment, establishing a community nursing diagnosis, planning education-based interventions, implementing outreach and simulation activities, and evaluating outcomes. Results: The results of the activity indicated that most people have limited knowledge about TB prevention, and that risky behaviors and non-adherence to therapy persist. Interventions, including group outreach, interactive discussions, and education on the importance of medication adherence, demonstrated increased knowledge and healthier behavior changes. Conclution: The conclusion of this activity emphasized the importance of the active role of community nurses in reducing TB transmission rates through educational approaches, active surveillance, and cross-sector collaboration. Recommendations focused on strengthening ongoing education and the involvement of families and community health workers in early detection and monitoring of TB patient therapy.

Background: The application of ethical principles is an essential foundation in nursing practice, as nurses frequently encounter complex clinical situations that require a careful balance between professional demands, patient safety, and patient rights. Objective: This study aims to explore nurses' experiences in applying ethical principles within clinical nursing practice. Methods: This study utilized a qualitative design with a phenomenological approach. Participants were selected via purposive sampling based on their work experience in direct patient care. Data were collected through in-depth interviews and analyzed using thematic analysis. Results: The findings revealed four main themes: 1) patient autonomy and decision-making in care; 2) the interaction of beneficence, safety, and religious values in care; 3) justice and patient prioritization in care; and 4) effective communication and patient confidentiality. Conclusion: The application of ethical principles is influenced by knowledge, clinical reasoning, moral sensitivity, and teamwork. Continuous reinforcement of ethical education and organizational support are highly required to enhance the quality of nursing care services.

The primary challenge faced by the community in Dewasari Village, Ciamis Regency, is the ineffective management of household organic waste, along with limited knowledge and skills in converting organic waste into value-added products. This community service program aimed to strengthen community capacity in developing smart environmental management through community-based Black Soldier Fly (BSF) maggot cultivation. The program was implemented through educational sessions, practical training on BSF maggot cultivation, community mentoring, and learning evaluation using a participatory approach involving the village government, community groups, and local youth. The results showed significant improvements in participants' knowledge and practical skills in managing organic waste, cultivating BSF maggots independently, and utilizing the harvested maggots as alternative livestock feed and an additional source of household income. The program also increased community awareness of the importance of sustainable and environmentally friendly waste management. Therefore, community-based BSF maggot cultivation can serve as an innovative solution for promoting smart, productive, and sustainable environmental management while strengthening community economic empowerment and improving household livelihoods in Dewasari Village.

This study aims to determine the effect of assertive leadership and self-actualization on the performance of nurses at Dr. Soekardjo Regional General Hospital in Tasikmalaya. The research design used in this study is a quantitative approach using a survey method. Research subjects: All 40 nurses working in the Melati ward were included as respondents. Research data were collected through the distribution of questionnaires to all respondents. The collected data were analyzed using a series of multiple linear regression tests, along with instrument validation and hypothesis testing. The results of the data analysis yielded the regression equation Y = 0.743 + 0.482X1 + 0.521X2 + e. Furthermore, the analysis indicated that assertive leadership positively contributes to improved nursing performance. Additionally, self-actualization also plays a role in supporting performance improvement. Simultaneously, both variables exert a significant influence on nursing performance. The coefficient of determination of 68.2% indicates that 68.2% of the variation in nurses’ performance can be explained by the two independent variables—assertive leadership and self-actualization—while the remainder is influenced by other factors outside the research model. These findings suggest that strengthening a more assertive and clear leadership style and fostering nurses’ self-actualization can serve as strategies for improving the quality of nursing care.

Nursing care in hospitals is still below the established standard of 80%, thus reflecting suboptimal nurse performance. This condition is thought to be influenced by factors such as rewards, workload, length of service and supervision. This study aims to analyze the relationship between rewards, workload, length of service, and supervision with nurse performance in the Inpatient Unit of Ratu Zalecha Martapura Regional Hospital. This study used a quantitative method with an observational analytical design using a cross-sectional approach. The study sample consisted of 152 nurses selected using cluster proportional random sampling technique. Data were collected using a questionnaire and analyzed using the chi-square test and multiple logistic regression. The results showed a significant relationship between rewards and nurse performance (p-value=<0.001), workload and nurse performance (p<0.001), and supervision and nurse performance (p-value=<0.001). Length of service did not show a significant relationship with nurse performance (p-value=0,968). Multivariate analysis showed that supervision was the most dominant factor related to nurse performance. Thus, compensation, workload, and supervision are related to nurse performance, while length of service is not related to nurse performance in the Inpatient Unit of Ratu Zalecha Regional Hospital, Martapura. The hospital is expected to improve supervision, workload management, and training and recognition for nurses to improve the quality of nursing services.

This study aimed to analyze the influence of workload and burnout on nurses’ sleep quality while controlling for age, gender, and education as potential confounding variables. A quantitative analytic study with a cross-sectional design was conducted among 156 nurses working in a private hospital in Depok City. Data were collected using a workload questionnaire, the Maslach Burnout Inventory (MBI), and the Pittsburgh Sleep Quality Index (PSQI). The data were analyzed using Chi-Square tests and multiple logistic regression. The findings showed that both workload and burnout had significant effects on sleep quality (p < 0.05), with burnout identified as the most dominant factor. Age and gender were also significantly associated with sleep quality, whereas education did not show a statistically significant effect. The regression model demonstrated excellent fit, indicated by a McFadden pseudo R² value of 0.908. These results suggest that occupational factors, particularly burnout, play an important role in determining nurses’ sleep quality. Therefore, effective stress reduction and workload management strategies are needed to support nurses’ well-being and improve sleep quality.

Background: Schizophrenia is a serious chronic mental disorder that can affect thinking, perception, feelings, and behavior. Patients with undifferentiated schizophrenia are at risk of experiencing the nursing problem of risk of violent behavior (RPK) due to their inability to control emotions and anger. Based on data from the medical records of RSJD dr. Amino Gondohutomo, Central Java Province, from August to October 2025, the risk of violent behavior was the highest nursing diagnosis in the Gatotkaca Ward, reaching 56.5%–77% of all inpatients. Objective: To perform nursing care on Tn. K with the main problem of risk of violent behavior due to undifferentiated schizophrenia at RSJD dr. Amino Gondohutomo, Central Java Province. Methods: This study used a descriptive method with a nursing process approach. Data collection was carried out through interviews, observation, documentation studies, and literature review. Nursing care was provided from November 18 to 22, 2025. Results: Assessment findings on Tn. K (19 years old) with undifferentiated schizophrenia and a history of physical abuse, parental rejection, and family violence revealed four nursing problems: risk of violent behavior (core problem), sensory perceptual disorder: auditory and visual hallucinations, self-concept disorder: low self-esteem, and self-care deficit. Implementation was carried out through nursing strategies (SP) 1 to 4 for risk of violent behavior (physical, medication, verbal, and spiritual control), SP 1 and SP 3 for self-care deficit, and SP 1 to SP 2 for sensory perceptual disorder: hallucinations. All implementation stages were optimally achieved. Conclusion: Nursing evaluation showed that the client was able to achieve cognitive, affective, and psychomotor goals in all implemented SPs. Collaboration with ward nurses was carried out to continue SP 3 and SP 4 for hallucinations and the entire low self-esteem intervention due to time constraints.

Having employees with OCB attitudes will have a positive impact on the ease of achieving organizational goals. OCB is the attitude of employees doing many things outside of their duties voluntarily. In contrast, OCB will influence each other with organizational commitment. Organizational commitment is a person's sense of comfort in being part of the organization. The growth of these two things is influenced by the leadership style, in this case, the transformational leadership style. Based on the preliminary survey results, it has been shown that OCB attitudes and organizational commitment are both influenced by leadership style. So, the researcher wants to see the effect of the three. This study uses multiple linear regression research with quantitative research and a questionnaire with a Likert scale. After the analysis had been conducted, the results were H1: Transformational Leadership had a significant effect on Organizational Citizenship Behavior (OCB) in X Hospital nurses, H2: Transformational Leadership has a substantial impact on organizational commitment in X Hospital nurses, and H3: Organizational Commitment had a significant effect on Organizational Citizenship Behavior (OCB) on nurses at Hospital X.

Introduction: Non-Hemorrhagic Stroke (NHS) or ischemic stroke is the most common type of stroke resulting from blood vessel blockage that inhibits oxygen supply to brain tissue. The prevalence of stroke in Indonesia was recorded at 10.9 cases per 1,000 population in 2013 and increased to 70 cases per 1,000 population (equivalent to 7.0%) in 2017. At RSUD dr. Soeselo, Tegal Regency, the prevalence of stroke cases was recorded at 647 people (3.74%) in 2023, 682 people (3.94%) in 2024, and 1,120 people (6.48%) in 2025. These cases frequently cause impairments in physical, emotional, cognitive, and social functioning, necessitating comprehensive care and management. Writing Method: This scientific writing used descriptive narrative methods through a nursing process approach, aiming to describe nursing care in patients with Non-Hemorrhagic Stroke. Results: Four nursing diagnoses were identified in Ny. M with Non-Hemorrhagic Stroke: ineffective cerebral perfusion risk, impaired physical mobility, knowledge deficit, and fall risk. Nursing interventions included intracranial pressure increase management, neurological monitoring, intravenous medication administration, mobilization support, health education, and fall prevention. Conclusion: After two days of nursing implementation, 2 nursing diagnoses were resolved and 2 others were partially resolved: ineffective cerebral perfusion risk via discharge planning delegated to the ward nurse, and impaired physical mobility with discharge planning including recommendations for gradual passive range of motion exercises and continued family involvement in patient care.

Adolescents face significant barriers in accessing reproductive health services due to fears of privacy breaches and social stigma. In primary healthcare facilities, healthcare professionals are often trapped in a dilemma between the obligation to maintain medical confidentiality based on professional ethics and national regulatory demands requiring parental involvement for underage patients. This study aims to analyze the practice of protecting adolescent patient data privacy at Mardi Saras Primary Clinic and identify the gap between practical implementation and the norms of medical ethics and applicable legal regulations. This study employs a socio-legal research method with a qualitative approach. Data were collected through in-depth interviews with doctors and nurses, observation of service procedures, and study of the clinic's Standard Operating Procedures. The results indicate that although Mardi Saras Primary Clinic has implemented basic confidentiality protocols such as closed consultation rooms, there are substantial weaknesses in informed consent management, which still heavily relies on parental presence for all adolescent cases. This practice is driven by healthcare professionals' fear of legal risks, thereby ignoring the principle of developing autonomy in adolescents. These findings indicate a disparity between rigid administrative compliance and the spirit of protecting adolescent health rights within national regulations. The implication of this study underscores the urgency of developing specific SOPs that are sensitive to adolescent rights, as well as the need for continuous training for healthcare professionals regarding the legal and ethical boundaries of maintaining confidentiality for underage patients without compromising legal safety aspects.

Nurse workload is the total number or volume of tasks that must be completed by nurses during their professional practice in hospitals, including both physical and mental responsibilities in providing nursing care to patients. Meanwhile, nurse burnout is a condition of emotional and mental fatigue experienced by nurses due to prolonged work pressure and the high intensity of emotional demands in the hospital environment. However, workload problems are still commonly found in hospitals, with one of the main contributing factors being work stress caused by excessive job demands and continuous pressure during work activities. The population in this study were outpatient, inpatient and emergency nurses at Ibnu Sina Islamic Hospital, Bukittinggi in 2025 This study used a quantitative method with a cross-sectional approach, analyzing the relationship between one variable and another. This study had 130 samples consisting of outpatient nurses, inpatient nurses, and emergency room nurses. Sampling was carried out using a total sampling technique. The results of this study indicate a significant relationship between workload and burnout at a significance level of 0.00 (≤ 0.05). There is a significant relationship between workload and nurse fatigue at Ibnu Sina Islamic Hospital Bukittinggi in 2025.

Work stress is a condition often experienced by nurses, especially those working in the Intensive Care Unit (ICU) due to the high demands of the job and the responsibility of caring for critically ill patients. Work stress that is not managed properly can have an impact on nurses' health, one of which is sleep quality. Poor sleep quality can reduce concentration and performance and increase work fatigue. This study aims to determine the relationship between work stress and sleep quality among nurses in the ICU of Ulin Regional General Hospital in Banjarmasin. This study uses a quantitative method with a cross-sectional design. The research sample consists of ICU nurses selected using total sampling technique. The research instruments used are the Expanded Nursing Stress Scale (ENSS) to measure work stress and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Data analysis was performed using statistical tests to determine the relationship between the two variables. The results showed that most nurses experienced moderate work stress. In addition, many nurses still had five to six hours of sleep per night and experienced sleep disturbances. The analysis results showed a significant relationship between work stress and sleep quality among ICU nurses.

Effective communication is essential for teamwork effectiveness in healthcare, particularly in inpatient units where patient care requires coordination among multiple professionals. Internal data from Hospital X showed that more than 50% of medical incidents in the last two years were related to miscommunication among healthcare workers. In addition, the 2024 employee satisfaction survey reported that workplace communication satisfaction was only 62%, below the hospital target of 75%. This study aimed to examine the influence of effective communication on teamwork effectiveness with interprofessional collaboration as an intervening variable at Hospital X.This study used a quantitative cross-sectional design involving 226 healthcare workers, including doctors, nurses, and medical support staff. Data were analyzed using the Three-Box Method and PLS-SEM. The findings revealed that effective communication significantly influenced teamwork effectiveness both directly and indirectly through interprofessional collaboration. Interprofessional collaboration also acted as a significant mediating variable between communication and teamwork effectiveness. These results indicate that communication is a key foundation for strengthening collaboration and improving teamwork in hospitals. Therefore, hospitals should enhance communication training and interprofessional collaboration programs to improve healthcare quality and patient safety

The completeness of nursing care documentation serves as a primary indicator of hospital service quality and remains a critical component of patient safety, clinical communication, and legal accountability. Despite its importance, empirical evidence from various healthcare facilities indicates that nursing records are frequently suboptimal, incomplete, or inconsistent. This study aims to analyze the complex interrelationships between burnout and coaching on the completeness of nursing care documentation, specifically examining the role of nursing competence as a mediating (intervening) variable at the Dr. Chasbullah Abdulmadjid General Hospital in Bekasi City. Utilizing a quantitative research framework with a cross-sectional design, this study sampled practicing nurses stationed across inpatient and intensive care units. Primary data were gathered through a validated, structured questionnaire designed to measure psychological burnout, the frequency of clinical coaching, perceived professional competence, and the objective completeness of documentation. The data were subjected to rigorous analysis using Structural Equation Modeling–Partial Least Squares (SEM-PLS) to test the hypothesized pathways within the conceptual model. The results demonstrated that burnout exerts a significant negative influence on both nursing competence and the quality of documentation, suggesting that emotional exhaustion hinders professional performance. Conversely, systematic coaching was found to have a significant positive impact, directly improving both competence levels and documentation adherence. Critically, the analysis confirmed that nursing competence acts as a vital intervening variable; it effectively mediates and strengthens the influence of both burnout reduction and coaching interventions on the overall completeness of nursing care records. This study concludes that proactive burnout management and the institutionalization of structured coaching programs are essential strategic priorities. By addressing these factors, hospital management can enhance individual nurse competence, thereby ensuring high-quality, comprehensive nursing documentation that supports patient safety and institutional integrity.

The implementation of Electronic Medical Records (EMR) is a key component of healthcare digital transformation, as mandated by the Minister of Health Regulation Number 24 of 2022. EMR is expected to enhance efficiency, accuracy, and the quality of nursing services. However, its implementation at M Hospital continues to face challenges, particularly in terms of infrastructure readiness and the digital literacy of nursing staff. This study aims to analyze the effects of infrastructure readiness and digital literacy on the implementation of nursing EMR, with perceived usefulness as an intervening variable. A quantitative cross-sectional design was employed, involving all nurses at M Hospital, with a total sample of 100 respondents using total sampling. Data were collected through structured questionnaires and analyzed using SEM-PLS. The results indicate that infrastructure readiness and digital literacy have both direct and indirect effects on EMR implementation through perceived usefulness (p < 0.05). Among the independent variables, infrastructure readiness demonstrates the strongest influence. These findings support existing theories and prior research. From a managerial perspective, the results highlight the importance of improving infrastructure to optimize EMR implementation. In conclusion, infrastructure readiness and digital literacy significantly influence the successful implementation of nursing EMR, with perceived usefulness acting as a key mediating factor.

Implementing Standard Operating Procedures (SOPs) for fall risk is a crucial component of pediatric patient safety in inpatient wards. However, nurses' implementation of SOPs is not always optimal, especially for patients at high risk of falling. Inappropriate SOP implementation has the potential to increase fall risk incidents in hospitals. To describe the results of observations of nurses implementing SOPs for fall risk and efforts to improve implementation through resocialization, supervision, and strengthening the oversight system. This case study is an observational study of nurses implementing SOPs for fall risk in the Alfarisi Ward, Jakarta Islamic Hospital, Sukapura. Observations were conducted on nurses providing nursing interventions to two pediatric patients: one with a low risk of falling and one with a high risk of falling. Activities included observation of nurses' practice, resocialization of SOPs for fall risk, three- day implementation supervision, development of a supervision schedule, and proposals for SOP revisions based on evidence-based practice. Data collection used observation sheets, fall risk assessment instruments, and nursing documentation. After three days of resocialization and supervision, the implementation of SOPs for fall risk in low-risk patients was in accordance with the SOPs. However, in high-risk patients, SOP implementation is still limited to displaying yellow triangle signs and locking bed rails, while other interventions have not been optimally implemented. These findings form the basis for developing a structured supervision schedule. Nurses' implementation of fall risk SOPs is optimal in low-risk patients, but not optimal in high-risk patients. Resocialization, ongoing supervision, developing a supervision schedule, and proposing SOP revisions are important strategies for improving nurse compliance and pediatric patient safety.

Pre-Conference and Post-Conference are part of the direction function in nursing management which play an important role in maintaining communication and coordination. However, their implementation in the Al-Ghifari Room at the Islamic Hospital Jakarta Sukapura has not run optimally. This scientific work aims to determine the application of Pre Conference and Post Conference in improving nursing care. The method used is an implementation study with a Plan of Action (POA) approach through education, roleplay and mentoring during January 15-17 2026. Data collection was carried out through observation and interviews. The implementation results show an increase in Pre Conference and Post Conference implementation from 50% on the first day to 83% on the third day. This shows that implementing Pre Conference and Post Conference in a structured manner can improve communication and coordination between nurses. It can be concluded that the implementation of the Pre Conference and Post Conference in the Al Ghifari room at the Islamic Hospital Jakarta Sukapura has increased.

Pre-Conference and Post-Conference are part of the direction function in nursing management which play an important role in maintaining communication and coordination. However, their implementation in the Al-Ghifari Room at the Islamic Hospital Jakarta Sukapura has not run optimally. This scientific work aims to determine the application of Pre Conference and Post Conference in improving nursing care. The method used is an implementation study with a Plan of Action (POA) approach through education, roleplay and mentoring during January 15-17 2026. Data collection was carried out through observation and interviews. The implementation results show an increase in Pre Conference and Post Conference implementation from 50% on the first day to 83% on the third day. This shows that implementing Pre Conference and Post Conference in a structured manner can improve communication and coordination between nurses. It can be concluded that the implementation of the Pre Conference and Post Conference in the Al Ghifari room at the Islamic Hospital Jakarta Sukapura has increased.