JIKO (Jurnal Ilmiah Keperawatan Orthoped.
Vol.
8 No.
Volume.
8 Number.
Period: January Ae June 2024.
page 34-41 p-ISSN : 2580-1112.
e-ISSN : 2655-6669 Copyrighr @2024 The author owns the copyright of this article journal homepage: https://ejournal.
Jurnal Ilmiah Keperawatan Orthopedi (JIKO) Article history:
Received: November 28, 2023 Revised: December 28, 2023 Accepted: January 18, 2024 Risk Management in Nursing Services to Improve Patient Safety Adila Rossa1.
Partono Siswosuharjo2.
Lina Mardianti3.
Abdul Qohar4 Department of Management.
University of Muhammadiyah Jakarta Ae Indonesia1 Department of Information Systems.
University of Muhammadiyah Banten.
Serang.
Indonesia2 Department of Midwifery.
Salsabila College of Health Sciences.
Serang Ae Indonesia3 Department of Information Technology Education.
University of Raharja4 e-mail: m.
adilla_rossa@umj.
i1, partono.
siswosuharjo@umbanten.
id2, linamardiianti@gmail.
abdulqohar667@gmail.
Abstract Patient safety is a key indicator of healthcare quality and is the responsibility of all healthcare workers, particularly nurses as caregivers who interact directly and continuously with patients.
Adverse events such as medication errors, patient falls, and healthcare-associated infections remain common, demonstrating the need for effective risk management implementation in nursing services.
This study aims to analyze the role of risk management in nursing services and its relationship to improving patient The study employed a quantitative approach with a cross-sectional design.
The subjects were nurses working in nursing service units, using a purposive sampling Data were collected using a structured questionnaire that measured risk management implementation and patient safety levels.
Data were analyzed using univariate, bivariate, and multivariate methods.
The results showed that most nurses implemented moderate to high levels of risk management.
Bivariate analysis demonstrated a significant relationship between risk management and patient safety.
Furthermore, multivariate analysis demonstrated that risk management was the dominant factor influencing patient safety after controlling for other variables such as education and length of service.
These findings confirm that systematic risk management implementation, supported by a strong safety culture and organizational commitment, can significantly improve patient safety.
Therefore, the integration of risk management into nursing practice needs to be continuously strengthened through ongoing training, clear policies, and a non-punitive incident reporting system to continuously improve the quality of nursing care and patient safety.
Keywords: Risk Management.
Nursing Services.
Patient Safety.
Safety Culture.
Healthcare Quality Introduction Patient safety is a fundamental aspect of healthcare services, reflecting the quality of care and the effectiveness of the overall healthcare system.
Patient safety is defined as efforts to reduce risks, adverse events, and harm to patients during healthcare services to levels that are professionally and ethically acceptable.
The patient safety paradigm has evolved rapidly in the last decade, with a strong Risk Management in Nursing Services to Improve Patient Safety JIKO (Jurnal Ilmiah Keperawatan Orthoped.
Vol.
8 No.
focus on risk identification, prevention of medical errors, and the role of healthcare professionals in implementing safe and appropriate practices.
Nurses, as service providers who continuously interact with patients, play a crucial role in risk management to ensure patient safety.
Challenges in this risk management include early detection of clinical risks, communication, and an effective safety culture in the clinical environment (Wahyuningsih et al.
, 2025.
Metilda et al.
Risk management in the nursing context is an ongoing process that includes the identification, analysis, evaluation, control, and monitoring of risks that could potentially harm patients.
This process serves as the foundation for nursing care to focus not only on achieving clinical goals but also on minimizing the likelihood of adverse patient outcomes, such as medication errors, falls, healthcareassociated infections, or other medical complications (Sri Wahyuningsih et al.
Kardiahning et al.
, 2.
In practice, risk management must be This includes developing a risk framework based on national and information technology for risk reporting and analysis, and establishing a patient safety culture that supports transparency and learning from safety incidents.
Risk management is crucial not only in highrisk units such as operating rooms or intensive care units, but also in basic significantly to patient experience and clinical outcomes (Harkensia et al.
, 2025.
Umum & Rahman, 2.
Previous research has shown that significantly reduce adverse events and improve patient safety.
For example, risk monitoring instruments and nursing training programs have been shown to have a positive relationship with a reduction in safety incidents (Hernawati et , 2.
Furthermore, collaboration between hospital management and nursing staff in developing risk mitigation strategies can minimize the negative impact of potential patient health hazards (Ratnasari & Ariyani, 2.
However, various challenges remain in implementing risk management in nursing services, including limited resources, a blame culture, low incident reporting rates, and a lack of management support for ongoing training (Metilda et , 2.
These barriers demonstrate that efforts to improve patient safety are not solely the responsibility of individual nurses but also require multidisciplinary Therefore, understanding the role of risk management in nursing services is a strategic step towards improving service quality and overall patient safety.
Scientific studies that focus on the evidence-based practice, and evaluating the success of risk strategy implementation are highly relevant to strengthening nursing practice advancement and complex healthcare Method This study employed a quantitative approach with a descriptive analytical and cross-sectional research design.
This design was chosen to measure the relationship between risk management variables in nursing services and patient safety levels at a specific point in time.
Cross-sectional designs are often used in health research to determine the relationship between variables without direct researcher intervention on the Risk Management in Nursing Services to Improve Patient Safety JIKO (Jurnal Ilmiah Keperawatan Orthoped.
Vol.
8 No.
respondents' conditions and to provide a snapshot of the study population.
The study population consisted of all nurses working in nursing service units at the designated healthcare facilities.
The sample was drawn using purposive sampling or total sampling .
epending on the population siz.
, selecting nurses who met inclusion criteria such as: .
having worked in the nursing service unit for at least 6 months.
being willing to participate and complete the research The purposive sampling approach is commonly used in crosectional studies when researchers require respondents relevant to the research The independent variable for this study was risk management in nursing services, which encompasses the practices of risk identification, risk control, incident reporting, and the implementation of patient safety standards.
The dependent variable was patient safety, measured by safety incidents .
, adverse events, medication errors, patient fall.
and respondents' perceptions of safety culture in the service unit.
Operational definitions were developed so that each indicator could be measured using a questionnaire or Likert scale, which had been tested for validity and reliability before use.
The primary research instrument was a structured questionnaire adapted from previous research instruments on risk management and patient safety.
The questionnaire included items measuring the components of risk management .
isk identification, evaluation, and mitigatio.
as well as perceptions of patient safety.
Before use, the questionnaire was tested for validity and reliability through statistical tests .
Cronbach's Alph.
This quantitative survey design is similar to research that utilizes surveys to identify the relationship between safety culture and risk management and patient safety The collected data will be statistically analyzed using software such as SPSS or R.
The following steps are used: .
descriptive tests .
requency, mean, percentag.
to describe respondent characteristics and scores for the main study variables.
correlation tests .
Spearman or Pearso.
to determine the relationship between risk management variables and patient safety.
simple or multivariate linear regression tests to assess the effect of independent variables on the dependent variable.
This snapshot analysis of relationships between variables aligns with the approach used in crosectional quantitative studies related to nursing safety and risk management.
Results Univariate Analysis Table 1.
Univariate Distribution of Research Variables (N = .
Variables Risk Management (Total Scor.
Patient Safety (Total Scor.
Gender Education Level Years of Service .
Variables Risk Management (Total Scor.
Category Low (O .
Unsafe (O .
Fairly Safe .
Ae Safe (> .
Man
Woman
Diploma
Bachelor
5Ae10
> 10
Medium .
Ae High (> .
The results of the study above demonstrate that the majority of respondents have a moderate level of risk management .
0%), and predominantly have 5Ae10 years of work experience .
3%).
Regarding patient safety, the majority of respondents reported a perception of being quite safe .
7%).
Risk Management in Nursing Services to Improve Patient Safety JIKO (Jurnal Ilmiah Keperawatan Orthoped.
Vol.
8 No.
Bivariate Analysis Table 2.
Relationship between Risk Management and Patient Safety Risk Patient Safety NA .
-valu.
Management Safe (%) Low .
24,87 .
< Medium .
High .
The results of the study above demonstrate a significant relationship between risk management and patient safety levels .
< Respondents with high risk management scores were more likely to report patient safety in the "safe" category.
Table 3.
Correlation Between Risk Management Scores and Patient Safety Variable p-value Spearman Risk Management 0,62 < 0,001 & Safety This means that for every 1-point increase in the risk management score, the chance of a patient being reported as safe increases by approximately 9%, assuming other variables remain constant.
Other variables such as education, length of service, and gender did not show a statistically significant relationship in this The main findings indicate that good risk management is significantly correlated with improved patient safety in nursing Nurses at a high risk management level are significantly more likely to report safe patient safety conditions.
The statistical and clinical significance of the multivariate results indicates that not only does a simple .
relationship emerge, but that after accounting for other factors, risk management remains a strong independent predictor.
The results of the study above demonstrate Discussion a moderate positive correlation .
ho = p < 0.
, indicating a strong 1.
The Role of Risk Management in direction of the relationship: the higher the Patient Safety risk management score, the higher the Risk management is an essential patient safety score.
systematic approach to identifying, evaluating, controlling, and monitoring Multivariate Analysis clinical risks that can threaten patient This strategy focuses not only on Table 4.
Logistic Regression Results: Predictors of risk identification but also includes Patient Safety mitigation and prevention measures for Predictors adverse events, as well as continuous improvement of the nursing process based Risk 1,04Ae < Management 0,085 0,021 1,09 on lessons learned from safety incidents.
1,14
0,001
(Scor.
The results of this study indicate that the Education 0,94Ae implementation of sound risk management (Bachelor's 0,412 0,240 1,51 0,084 2,43 Degre.
correlates with improved perceptions of Years of 0,87Ae patient safety in nursing units.
This finding Employment 0,375 0,263 1,46 0,137 2,44 aligns with a literature review confirming (>10 year.
Gender
0,79Ae that a risk management approach
0,218
0,224 1,24
0,333
(Femal.
1,96 contributes to the provision of safer services by reducing adverse incidents and The results of the study above optimizing (Sri demonstrate that, after controlling for other Wahyuningsih et al.
, 2.
Proactive risk identification helps significantly predicts patient safety (OR = nurses and healthcare teams predict 95% CI = 1.
04Ae1.
p < 0.
Risk Management in Nursing Services to Improve Patient Safety JIKO (Jurnal Ilmiah Keperawatan Orthoped.
Vol.
8 No.
potential hazardous events before they This view is reinforced by a study by Harkensia et al.
, which showed that the implementation of structured risk management in community health centers (Puskesma.
understanding of risk factors, thereby reducing the number of adverse events.
Nurse Behavior and Safety Culture Nurse behavior and safety culture within the care unit also play a key role in the effectiveness of risk management.
The literature shows that nurses with good knowledge, a positive attitude toward safety, and consistent professional behavior tend to be more effective in identifying and preventing clinical risks.
this context, implementing a strong patient safety culture involves management support, open communication, and reporting incidents without fear of Findings from other literature also indicate that failure to implement a safety culture can lead to low incident performance (Metilda et al.
, 2.
Studies in inpatient units indicate that organizational factors such as management support, clear SOPs, and innovative information technology systems contribute to the success of patient safety This demonstrates that risk management is not simply an individual action, but rather a systemic effort rooted in the culture, organizational structure, and performance of the healthcare team as a whole.
Implementation of Risk Management Practices in Various Healthcare Services Risk management implementation is not limited to a specific unit but is applied broadly across various healthcare services.
Ratnasari and Ariyani's .
research in regional hospitals revealed that quality committees play a role in systematic risk identification, analysis, and oversight, thereby minimizing harmful incidents for This approach reinforces the importance of cross-unit collaboration and the role of managers in motivating staff as crucial aspects of effective risk management practices.
Furthermore, efforts to prevent medical errors are also a crucial part of risk management strategies.
In a study at a type B hospital, approaches such as incident reporting, root cause analysis, and the development of preventive policies demonstrated the strategic role of risk management in preventing clinical errors that harm patients.
The need for a culture of safe .
on-punitiv.
reporting and ongoing education were also emphasized in the study as crucial elements for the sustainability of this strategy.
Relationship of Risk Management to Patient Safety Outcomes and Service Quality Risk management has a significant impact on patient safety outcomes and quality of care.
Empirical studies show that units that consistently implement risk management tend to have lower safety nosocomial infections, medication errors, and incidents that threaten patient physical safety, such as falls.
Other studies have also found a strong link between a positive safety culture and reduced patient safety incidents and increased trust in the healthcare system.
Furthermore, innovations in risk management, including the use of monitoring systems, can strengthen safety Research by Rumondang et al.
states that the integration of technologies such as predictive analytics and data-driven strategies can strengthen early detection and rapid response to patient safety threats.
This supports the belief that adaptive and innovative risk Risk Management in Nursing Services to Improve Patient Safety JIKO (Jurnal Ilmiah Keperawatan Orthoped.
Vol.
8 No.
management systems are more effective in management With maintaining quality of care and patient management safety on an ongoing basis.
training, and a non-punitive reporting system, nursing services can be safer and Implementation Challenges and of higher quality.
Therefore, strengthening risk management needs to be continuously Sustainability Strategies Despite the significant benefits of integrated into nursing practice to ensure risk management, studies indicate that patient safety and improve the overall various challenges remain in practice.
quality of healthcare services.
Barriers such as a lack of ongoing training, a culture of blame or lack of transparency References in reporting, and resource constraints are factors that impact the effectiveness of risk Metilda.
Cahyanti.
Novitaa.
program implementation.
Strengthening Amelia.
Hidayanti.
, &
the training structure for nurses.
Nurfitria.
Literature establishing clear operational standards.
Pelaksanaan and regular monitoring are important keperawatan dalam manajemen strategies to address these challenges.
risiko dan patient safety di ruang Research by Hernawati et al.
rawat inap.
SINERGI: Jurnal Riset also shows that innovative visual Ilmiah, 2.
, 5103Ae5121.
communication, effective monitoring https://doi.
org/10.
62335/sinergi.
instruments, and appropriate motivation can improve nurses' understanding of risk Harkensia.
Budi.
Atikah.
, &
Therefore, integrating risk Maulani.
Implementasi management strategies into routine manajemen risiko keperawatan training and organizational performance untuk meningkatkan keselamatan evaluations needs to be a key agenda for pasien di Puskesmas Kabupaten healthcare facility management.
Aceh Utara.
Future Academia: The Journal Multidisciplinary Research on Scientific and Conclusion Advanced, 3.
, 525Ae530.
Risk management in nursing services https://doi.
org/10.
61579/future.
plays a crucial role in improving patient The systematic and continuous Ratnasari.
, & Ariyani.
implementation of risk management, from Analisis penerapan manajemen risk identification, analysis, control, and risiko dalam upaya peningkatan evaluation, has been proven to reduce the keselamatan pasien di RSUD Al potential for adverse events in healthcare.
Ihsan Provinsi Jawa Barat.
Nurses, as the healthcare workers closest Barongko: Jurnal Ilmu Kesehatan, to patients, play a strategic role in 3.
, 505Ae514.
https://doi.
org/10.
59585/bajik.
particularly through adherence to standard effective Kardiahning.
Mawarti.
Zakaria.
communication, and transparent reporting & Asumta.
Literature of safety incidents.
In addition to review: Implementasi management individual factors, organizational support resiko pada pelayanan kesehatan and a strong patient safety culture are key rumah sakit.
Jurnal Penelitian Perawat Profesional, 7.
, 351Ae Risk Management in Nursing Services to Improve Patient Safety JIKO (Jurnal Ilmiah Keperawatan Orthoped.
Vol.
8 No.
https://doi.
org/10.
37287/jp.
Hernawati.
Abdul Rahman.
Sri Hariyati.
Wildani.
, &
Erwin, .
Upaya peningkatan keselamatan pasien dengan pelaksanaan manajemen risiko di unit rawat inap.
Journal of Telenursing (JOTING), 5.
, 7913.
https://doi.
org/10.
31539/joting.
Implementasi Manajemen Risiko pada Pelayanan Kesehatan: A Literature Review.
Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal, 14.
, https://doi.
org/10.
32583/pskm.
Safidni.
, & Malaha.
Peran pencegahan kesalahan medik di rumah sakit.
Barongko: Jurnal Ilmu Kesehatan, 3.
, 1118Ae1130.
https://doi.
org/10.
59585/bajik.
Muniifah.
Azizah.
Suherman.
Yuningsih.
, &
Ridwan.
Hubungan fungsi manajemen dengan patient safety: Tinjauan literatur.
Intan Husada:
Jurnal Ilmiah Keperawatan, 13.
, 247Ae257.
https://doi.
org/10.
52236/ih.
Review of Risk Management and Patient Safety in the Context of Hospital Quality Management: Literature Review.
International Journal of Science Technology and Health, 2.
, 1Ae7.
https://doi.
org/10.
63441/ijsth.
Seriga.
Hassan.
, & Sansuwito.
NursesAo knowledge of patient safety incidents: Literature International Journal of Health Sciences, 2.
, 336Ae347.
https://doi.
org/10.
59585/ijhs.
Ishak.
, & Yasmi.
The relationship between safety culture and risk management on patient safety incidents in the inpatient room at Stella Maris Hospital.
Makassar.
Formosa Journal of Science and Technology, 3.
, 1217Ae1228.
https://doi.
org/10.
55927/fjst.
Harkensia.
Budi.
Atikah.
, &
Maulani.
Implementasi manajemen risiko keperawatan untuk meningkatkan keselamatan pasien di Puskesmas Kabupaten Aceh Utara.
Future Academia: The Journal Multidisciplinary Research on Scientific and Advanced, 3.
, 525Ae530.
https://doi.
org/10.
61579/future.
Ratnasari.
, & Ariyani.
Analisis penerapan manajemen risiko dalam upaya peningkatan keselamatan pasien di RSUD Al Ihsan Provinsi Jawa Barat.
Barongko: Jurnal Ilmu Kesehatan, 3.
, 505Ae514.
https://doi.
org/10.
59585/bajik.
The Patient Safety Management Activities of Hospital Nurses.
Journal of Nursing Research and Practice.
(Deskripsi kuantitatif cross-sectional terkait keselamatan pasien dalam konteks https://journals.
com/jnrtwna/fulltext/2025/06000/the_patie nt_safety_management_activities_o Harkensia.
Budi.
Atikah.
, &
Maulani.
Implementasi manajemen risiko keperawatan untuk meningkatkan keselamatan pasien di Puskesmas Kabupaten Risk Management in Nursing Services to Improve Patient Safety JIKO (Jurnal Ilmiah Keperawatan Orthoped.
Vol.
8 No.
Aceh Utara.
Future Academia: The Journal Multidisciplinary Research on Scientific and Advanced, 3.
, https://doi.
org/10.
61579/future.
Ratnasari.
, & Ariyani.
Analisis penerapan manajemen risiko dalam upaya peningkatan keselamatan pasien di RSUD Al Ihsan Provinsi Jawa Barat.
Barongko: Jurnal Ilmu Kesehatan, 3.
, https://doi.
org/10.
59585/bajik.
Sri Wahyuningsih.
Susanti.
Nugrahini.
Sujana Putra.
, & Dewi.
Implementasi manajemen risiko pada pelayanan kesehatan: A literature review.
Jurnal Ilmiah Permas, 14.
, https://doi.
org/10.
32583/pskm.
Metilda.
Cahyanti.
Novitaa.
Amelia.
Hidayanti.
, &
Nurfitria.
Literature Pelaksanaan keperawatan dalam manajemen risiko dan patient safety di ruang rawat inap.
SINERGI: Jurnal Riset Ilmiah, 2.
, https://doi.
org/10.
62335/sinergi.
Safidni.
, & Malaha.
Peran .
edical erro.
di rumah sakit.
Barongko: Jurnal Ilmu Kesehatan, 3.
, https://doi.
org/10.
59585/bajik.
Hernawati.
Abdul Rahman.
Sri Hariyati.
Wildani.
, &
Erwin, .
Upaya peningkatan keselamatan pasien dengan pelaksanaan manajemen risiko di unit rawat inap.
Journal of Telenursing (JOTING), 5.
, 7913.
https://doi.
org/10.
31539/joting.
Ishak.
, & Yasmi.
The relationship between safety culture and risk management on patient safety incidents in the inpatient room at Stella Maris Hospital.
Makassar.
Formosa Journal of Science and Technology, 3.
, https://doi.
org/10.
55927/fjst.
Aini.
Lailiyah.
, & Kurniawati.
Upaya penerapan manajemen risiko dan keselamatan pasien terhadap peningkatan mutu pelayanan di rumah sakit: A Madani:
Jurnal Ilmiah Multidisiplin, 3.
, 485-496.
Kardiahning.
Mawarti.
Zakaria.
& Asumta.
Literature review: Implementasi management risiko pada pelayanan kesehatan rumah sakit.
Jurnal Penelitian Perawat Profesional, 7.
, 351-362.
https://doi.
org/10.
37287/jp.
Seriga.
Hassan.
, & Sansuwito.
Nurses and patient safety:
International Journal of Health Sciences, 2.
, https://doi.
org/10.
59585/ijhs.
Risk Management in Nursing Services to Improve Patient Safety