Analisis Kesenjangan Ketenagaan Perawat ICU Berbasis POSAC Dalam Meningkatkan Keselamatan Pasien Di RSI Siti Rahmah Padang

Abstract

Nurse staffing gaps in the Intensive Care Unit (ICU) may affect workload, continuity of nursing care, and patient safety. This study aimed to analyze ICU nurse staffing gaps using the POSAC approach—planning, organizing, staffing, actuating, and controlling—to improve patient safety at RSI Siti Rahmah Padang. A descriptive case study design was employed. Data were collected through field observation, document review, and literature review. The data were analyzed descriptively and thematically based on the five POSAC management functions. The findings showed that the ideal number of ICU nurses was 11, while only 9 nurses were available, resulting in a shortage of two nurses. Nurse distribution consisted of three nurses on the morning shift and two nurses on each of the afternoon and night shifts. Nursing services were supported by patient assessment, documentation, SBAR communication, shift briefings, handovers, and clinical supervision. However, several challenges were identified, including limited patient-monitoring equipment, hybrid documentation, inconsistent patient repositioning, and the need to strengthen the incident-reporting culture. The staffing gap may increase workload and the risk of missed nursing care, including delays in pressure injury prevention. Improvements are needed through staffing adjustment based on patient dependency and acuity, strengthening clinical supervision, improving equipment availability, conducting regular service audits, and developing a stronger patient safety culture. The POSAC approach may serve as a managerial framework for integrating the planning, implementation, and control of ICU nursing services.