IMPLEMENTATION OF INFORMATION SYSTEM APPLICATIONS NURSING MANAGEMENT IN

The Hospital Nursing Management Information System is very important in supporting operations, management and decision making. The management information system in hospitals is strengthened by Regulation of the Minister of Health of the Republic of Indonesia number 82 of 2013 concerning hospital management information systems. Decision making must be based on data and information entered in a valid information system. This study aims to determine the implementation of information systems at Sari Mutiara Hospital Lubuk Pakam. This study used qualitative analysis and interviewed users of hospital information system services consisting of 1 person in charge of providing information and handling hospital complaints, 1 non-medical officer, three executors and ten information users (patients). . The results of the study show that the benefits of a data-integrated and standardized information system with Ina-CBgs coding are very much needed in decision making. The results show that it is necessary to improve the facilities and infrastructure that support a stable internet network and the implementation and monitoring of evaluation of complaints from hospital information system administrators.


INTRODUCTION
The hospital is an integral part of a social and health organization with the function of providing plenary services (comprehensive), healing disease (curative) and disease prevention (preventive) to society, WHO (World Health Organization).The development of hospital service targets can be seen in how to build quality services that focus on patients and provide fast, precise, accurate and quality health services that can provide patient satisfaction.Hospitals with good quality are highly dependent on existing resources such as the services of doctors, nurses, staff/employees, infrastructure and hospital management.(Rensiner et al, 2018).The creation of comfort and satisfaction for patients seeking treatment at the hospital will increase visits, which will have an impact on increasing sources of income for the hospital.In an effort to improve service quality, coordination, efficiency, responsibility, and supervision, a Hospital Management Information System (Information System) is needed.Hospital Management Information System is one of the organizational resources to support the decision-making process at various levels of management.(Puspitasari, et al, 2017).It should be noted that creating the comfort and satisfaction of a patient seeking treatment at the hospital is an attraction and one of the benefits of increasing the source of income for the hospital itself.In an effort to improve 147 service quality, coordination, efficiency, responsibility, and supervision, a Hospital Management Information System (information system) is needed.The Hospital Management Information System is one of the organizational resources to support decision-making processes at various levels of management.(Puspitasari, et al, 2017).Good facilities and sources of information can certainly reduce uncertainty and prevent the risk of making wrong decisions.This is of course closely related to activities in the hospital, apart from serving the community on a daily basis as well as ensuring that data is obtained and processed properly.So we need a Hospital Management Information System (information system) whose goal is to produce information that is useful, precise and accurate and accessible to all parties involved in providing good health services.Information system is a system used to support operations, management in decision making.In its implementation it is strengthened by the Regulation of the Minister of Health of the Republic of Indonesia Number 82 of 2013 concerning Hospital Management Information Systems.The information system is an information communication technology system that processes and integrates the entire process flow of hospital services in the form of a network of coordination, reporting, and administrative procedures to obtain precise and accurate information, and every hospital is required to organize an information system.The benefits of information systems to improve the efficiency and performance of hospital services, it is necessary to evaluate the acceptance of information systems to be used as a reference for making policies related to users in using information systems.Evaluation of the information system is needed to find out the factors that influence employees to accept and use the information system, so that efforts can be made to increase the consistency and commitment of employees to use the information system.As time goes by, the population of Deli Serdang Regency is increasing, seeing the needs of the community, especially in the Lubuk Pakam area, the need for health services that have complete facilities.In 1987, health services such as hospitals were few, so the people of the Lubuk Pakam area had to go through a long journey to seek treatment at a hospital, one of which was a place for treatment at a hospital in the Medan city area.However, there are problems that arise in the implementation of the system, namely the low use of sustainable information systems.According to three Hospital staff at the Electronic Data Processing (EDP) installation, they explained that there were still staff who did not know and understand how to use the Hospital Management Information System, so that in applying the system many errors occurred, such as in registration services and billing systems.In this service, data duplication and inaccuracy of patient data often occur.And there are also installations that do not use the information system module provided by the hospital on a regular basis, such as in logistics and nursing installations.In the logistics installation the staff has used but not all the features used by this installation.Likewise with Nursing and for Nursing management in carrying out several activities and reporting they still use manual reports.Based on the results of interviews with the person in charge of implementing the information system at Sari Mutiara Lubuk Pakam Hospital stated that the Hospital seeks to carry out the mandate of laws and government policy regulations regarding the obligation of all hospitals to implement an information system as a basis for recording and reporting, so that it can become the basis decision making on the development and progress of the hospital.Even though currently it is still in the stage of repairing and perfecting the features, the implementation of the information system is still being carried out.
The results of initial interviews with three patients who visited the outpatient polyclinic stated the length of time the patient had to wait, starting with picking up the card, validating the health insurance membership data, then the status/medical card collection counter which had to be delivered to the intended poly.Approximately the time spent just to get a medical card is around 2-3 hours.Patient dissatisfaction is compounded by the attitude and behavior of health workers, delays in doctor services, doctors who are less communicative, and an uncomfortable environment due to the large number of patients queuing and not enough seats to queue.The problems experienced also occur at the pharmacy counter.After the patient has finished treatment at the outpatient polyclinic, the patient will queue again at the pharmacy counter.So that the time needed for one treatment at the poly spends 5-6 hours.Therefore, the implementation of an optimal information system is expected to help hospitals to streamline outpatient polyclinic treatment time.

Types of research
This study uses a type of qualitative research.Qualitative research is research conducted to obtain in-depth information or answers about one's opinions and feelings in order to get implicit things about one's behavior, motivations and beliefs.Qualitative research can be used to find out social interactions, for example by observation and interviews, so as to produce data that is more complete, sharp, and up to know the level of meaning of each behavior that appears.The descriptive research approach focuses on finding facts about the application of the Hospital Management Information System (information system) at Sari Mutiara Lubuk Pakam Hospital.

Research Place
This research was conducted at Sari Mutiara Hospital in Lubuk Pakam.The reason for choosing the location is because the use of information systems at Lubuk Pakam Hospital has not been maximized.

Research Informants Determination
of informants in qualitative research is not based on number but based on adequacy and suitability to reach data saturation.The selection of informants was carried out when researchers began to enter the field and during the research the researchers chose certain people who would provide information, then based on the information obtained from previous informants, researchers could determine other informants who would provide complete information.Therefore, the number of informants cannot be determined.The number of informants is considered to have been fulfilled if the information obtained has reached data saturation.Saturation occurs when in the data analysis process, researchers find patterns that are repeated many times so that new information is not found (Sugiyono, 2016).The determination of informants in this study used a purposive sampling technique, namely selecting informants according to the objectives and criteria previously set by the researcher, so that it is certain that the data obtained will be in accordance with the phenomenon under study (Saryono & Anggraeni, 2011).Informant inclusion criteria in this study were: 1 1.Data Integrity or Integration Integrity means unity.In the database context, the integrity object is data.So it can be concluded that data integrity is the integrity and unity of the data in the database so that the data can be a source of information that can be used.Today the development and progress of information technology is growing rapidly.Application systems in various fields are a must for an institution/company to utilize information as a basis for administration and data processing.Likewise with the Hospital.Hospitals get the attention of consumers to always improve medical services, reduce medical errors, provide access to timely information, and at the same time have to evaluate service activities and control operational costs.Because of that, it requires an integrated information system (Setyawan D, 2016).The information system used must provide convenience in operations and must be able to overcome the constraints of patient care in the hospital.This is in accordance with the results of interviews conducted with 5 informants about the benefits of information systems at Sari Mutiara Lubuk Pakam Hospital, as follows: Information 1 states:

Data Standardization
Information Systems is an integrated system starting from data collection, data processing, information storage, analysis and inference of information as well delivery of information needed for hospital needs.(Mitra et al., 2021).The application of the information system at Sari Mutiara Lubuk Pakam Hospital has not been fully integrated according to the module Information Systems and its features available.As per the results of the interview put forward by informant 1. Standardization of data is a coding system that is the same and standard that can be used for all parts of the hospital.Thus all parts of the hospital will use the same code to indicate the same type of item.Every health service facility, hospital or health center, must make coding policies and procedures in "The benefit of the information system at this hospital is that I feel my work is made easy...I don't have to write patient data in the registration book anymore like before.Now I only input it on the computer and the patient data is saved.Another benefit that I feel is that patient history data can be seen directly.
Information systems are very important in the health industry as a support for specialized health activities and services with a broad scope.Benefits in implementation Information Systems can increase access to information, increase the productivity of health service professionals, increase the efficiency and accuracy of codes and patient financial billing data, improve the quality of health services, improve clinical management in terms of patient diagnosis and treatment, reduce paper costs for medical records, minimize medical errors, improve patient safety, improve patient care outcomes and increase patient satisfaction (Fadilla & Setyonugroho, 2021).The implementation of the information system at Sari Mutiara Lubuk Pakam Hospital currently uses Klik-Medik in operating the information system.This information system has been integrated with sub-services needed by patients, although currently it is still limited to registration counters, outpatient polyclinics, and pharmacies.With Adaya Information Systems Patient medical records are well documented.(Sadriani Hade et al., 2019).Improving the quality of service can be done by implementing Information Systems which is influenced by several factors such as choosing the right hardware, the software used and the appropriate brainware (Nugroho & Ali, 2022).

Monitoring and Evaluation
Monitoring and evaluation is an activity carried out by organizational leaders to ensure that work can be carried out and completed according to plan in order to realize the goals that the organization wants to achieve.Monitoring is an effort that is carried out routinely to identify the implementation of various program components as planned, the time of program implementation as scheduled, and progress in achieving program objectives.(Jambago et al., 2022) Based on the results of interviews with informants: Report 1: "Monitoring and evaluation (monev) has not been carried out optimally.Currently, Standard Operating Procedures are still being refined for monitoring and evaluation.Monev that is currently being carried out is still

Sinaga, Adiansyah/Jurnal Mutiara Ners, Vol. 5 No. 2 Juli 2022 (P146-159)
In 1987, health services such as hospitals were few, so the people of the Lubuk Pakam area had to go through a long journey to seek treatment at a hospital, one of which was a place for treatment at a hospital in the Medan city area.Seeing the situation of health services in the Lubuk Pakam area was very little, in 1991 Mrs. Midwife Sauria and Mr. Drs.Wasington Purba agreed to establish a hospital in Lubuk Pakam.So that in 1990 the Tanjung Maternity Clinic was transferred to Sari Mutiara Lubuk Pakam Hospital which is located at Jl.Medan No.17 Lubuk which belongs to the Sari Mutiara Medan Foundation.by the Management of the Sari Mutiara Medan Foundation to strive to become a Class D General Hospital (Pratama).The management of the Sari Mutiara Medan Foundation together with the leadership of the Sari Mutiara Lubuk Pakam General Hospital from year to year have worked hard so that the Sari Mutiara b. Observation According to Marshall in Sugiyono (2016), observation is an activity carried out in the process of collecting data in a study which DOI : https://doi.org/10.51544/jmn.v6i2.4471© 2022 Jurnal Mutiara Ners.This is an open access article under the CC BY-SA license Website : http://e-journal.sari-mutiara.ac.id/index.php/NERS/indexPurba, Sinaga, Adiansyah/Jurnal Mutiara Ners, Vol. 5 No. 2 Juli 2022 (P146-159) DOI : https://doi.org/10.51544/jmn.v6i2.4471© 2022 Jurnal Mutiara Ners.This is an open access article under the CC BY-SA license Website : http://e-journal.sari-mutiara.ac.id/index.php/NERS/indexPurba,