The Effect of Strengthening Nurses' Clinical Roles on Service Quality in the Emergency Department

Authors

  • Frima Lestari Simanjuntak Universitas Muhammadiyah Jakarta
  • Harif Fadhlillah Universitas Muhammadiyah Jakarta
  • Eni Widiastuti Universitas Muhammadiyah Jakarta
  • Muhammad Hadi Universitas Muhammadiyah Jakarta

DOI:

https://doi.org/10.37287/ijghr.v8i4.1929

Keywords:

emergency department, nurses' clinical roles, service quality

Abstract

The Emergency Department (ED) is a service unit that requires nurses to possess strong clinical competencies to make rapid, accurate, and safe decisions. Strengthening nurses' clinical roles is an important factor in improving service quality, particularly in work environments characterized by high complexity and intense pressure. This study aimed to determine the effect of strengthening nurses' clinical roles on service quality in the Emergency Department of Awal Bros Panam Hospital (RSAB Panam). This study employed a quasi-experimental design with control and intervention groups. The study was conducted in the Emergency Department of RSAB Panam. The sample consisted of 32 emergency nurses who were divided into control and intervention groups, as well as patients receiving nursing care in the ED as respondents for service quality assessment. Total sampling was used for nurse participants. The intervention involved strengthening nurses' clinical roles based on Patricia Benner's theory through structured training, supervision, and clinical evaluationService quality was measured using the SERVQUAL instrument, which has demonstrated good validity (content and construct) and high reliability with Cronbach’s Alpha values >0.80. The data were analyzed using the Generalized Linear Model Repeated Measure. The results showed a significant effect of strengthening nurses' clinical roles on improving service quality in the ED. The Greenhouse–Geisser test indicated a p-value of 0.000, demonstrating a statistically significant change in service quality over time. The tests of between-subjects effects revealed a significant difference in service quality between the control and intervention groups with a p-value of 0.000. Improvements in service quality were more consistent in the intervention group compared to the control group. In conclusion, strengthening nurses' clinical roles has a significant effect on improving service quality in the Emergency Department.

References

Alligood, M.R. (2022). Nursing theorists and their work (10th ed.). Elsevier.

Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing practice . Prentice Hall.

Benner, P. (2021). From novice to expert: Excellence and power in clinical nursing practice (Revised ed.). Prentice Hall.

Chen, L., Wang, C., & Liu, Y. (2021). Emergency patient satisfaction and influencing factors: A cross-sectional survey in China. International Journal of Environmental Research and Public Health, 18 (16), 8575. https://doi.org/10.3390/ijerph18168575

Dewi, R., Sari, D., & Hidayat, A. (2022). Employment status and patient satisfaction with nursing services. Journal of Nursing Science, 10 (3), 201–209.

Emergency Nurses Association. (2021). Emergency nursing scope and standards of practice (3rd ed.). ENA.

Gilboy, N., Tanabe, P., Travers, D. A., & Rosenau, A. M. (2020). Emergency Severity Index (ESI): A triage tool for emergency department care (Version 4). Agency for Healthcare Research and Quality.

Gómez-Urquiza, J.L., De la Fuente-Solana, E.I., Albendín-García, L., Vargas-Pecino, C., Ortega-Campos, E., & Cañadas-De la Fuente, G.A. (2017). Prevalence of burnout syndrome in emergency nurses: A meta-analysis. Critical Care Nurse, 37 (5), e1–e9.

Handayani, S., & Yusuf, M. (2021). Work resilience of male nurses in emergency situations. Journal of Medical-Surgical Nursing, 5 (2), 134–141.

Hidayat, T., Sari, M., & Wulandari, R. (2024). Strengthening nurses’ clinical roles to improve service quality: A quasi-experimental study. BMC Nursing, 23(1), 112. https://doi.org/10.1186/s12912-024-0112-3

Kurniawan, A., & Siregar, T. (2021). Nurse education and the quality of nursing services based on SERVQUAL. Indonesian Nursing Journal, 24 (3), 165–173.

Lee, H.J., Kim, S.H., & Park, H. (2022). Clinical competency levels of emergency nurses in Southeast Asia: A regional analysis. Asian Nursing Research, 16 (2), 112–120.

Lestari, D., & Nugroho, H. (2023). Clinical experience and training as determinants of nursing care quality. International Journal of Nursing Practice, 29(4), e13145. https://doi.org/10.1111/ijn.13145

Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: Theory and application (10th ed.). Wolters Kluwer.

Notoatmodjo, S. (2020). Quality management of health services . Rineka Cipta.

Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64 (1), 12–40.

Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2021). Fundamentals of nursing (10th ed.). Elsevier.

Prasetyo, A., Nugroho, D., & Santoso, B. (2023). Factors influencing patient perceptions of service quality in emergency departments. Journal of Emergency Nursing, 49(2), 123–130. https://doi.org/10.1016/j.jen.2022.10.005

Putri, D., Suryani, M., & Handayani, R. (2021). Patient age characteristics and clinical response in the emergency department. Indonesian Nursing Journal, 24 (1), 44–51.

Rahmawati, F., & Prabowo, A. (2020). Evaluating clinical role interventions on emergency nurses' service quality. Journal of Nursing Studies, 14 (2), 55–63.

Saputra, R., Handayani, L., & Putra, Y. (2024). The impact of clinical competency training on nurses’ performance in hospital settings. Nurse Education Today, 134, 105678. https://doi.org/10.1016/j.nedt.2023.105678

Sari, M., & Pranata, L. (2021). Patient characteristics based on gender in the Emergency Department. Journal of Medical-Surgical Nursing, 5 (1), 56–64.

Shen, H. C., & Lee, L. T. (2020). The impact of nurse empathy on the quality of emergency care. Journal of Emergency Nursing, 46 (2), 187–194.

Wijaya, A., Putri, N., & Kurniawan, F. (2024). SERVQUAL dimensions and their relationship with nursing service quality in emergency care. Journal of Nursing Management, 32(1), 45–53. https://doi.org/10.1111/jonm.13921

World Health Organization. (2020). State of the world's nursing 2020: Investing in education, jobs and leadership . WHO.

World Health Organization. (2021). Emergency care systems for universal health coverage . WHO Press.

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Published

2026-05-04

How to Cite

Simanjuntak, F. L., Fadhlillah, H., Widiastuti, E., & Hadi, M. (2026). The Effect of Strengthening Nurses’ Clinical Roles on Service Quality in the Emergency Department. Indonesian Journal of Global Health Research, 8(4), 13–22. https://doi.org/10.37287/ijghr.v8i4.1929

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