The Relationship Nurse Behavior with Ability in Implementing Patient Safety in the Emergency Room of Prof. Dr. Hi. Aloei Saboe Hospital City Gorontalo

. Patient safety is very important. The behavior and abilities of nurses play an important role in the implementation of patient safety. This study aims to determine the relationship nurse behavior with the ability in implementing patient safety in the emergency room at Prof. Dr. Hi. Aloe Saboe hospital. The research method uses quantitative analytic observation with a cross sectional design. A sample of 28 respondents was taken with a total sampling technique. Data obtained by observation and analysis of Chi Square test (α = 0.05). The result showed that the behavior of nurses was good is 11 (68.8%) the behavior of nurses were not good is 9 (75%). The results of the analysis test p = 0.024 so it was concluded that there was a relationship between the behavior of nurses and the ability of patient safety in hospitals .


INTRODUCTION
Regional General Hospital (RSUD) Prof Dr Aloei Saboe was built in 1926 and has been used since 1929 under the name of Gorontalo Municipal General Hospital. On September 17, 1987 changed its name to Prof. General Hospital. Dr. H. Aloei Saboe Gorontalo which was taken from the name of a pioneer of regional independence who was immortalized as an award for his service in the health sector and was determined based on the Decree of the Mayor of Gorontalo City No. 97 of 1987. On August 31, 1995 the Regional Government Level II (Mayor of the Gorontalo Level II KDH Madya) proposed an increase in the class of Prof. Regional General Hospital. Dr. H. Aloei Saboe from class C Plus to class B Non Education. Currently Prof Dr Aloei Saboe Hospital is the largest hospital in Gorontalo Province and is a referral center for health services in Gorontalo Province with a plenary level of accreditation.

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safety. Unsafe behavior, forgetfulness, lack of attention or motivation, carelessness, and the ability to ignore and maintain patient safety are all at risk of error and will cause injury to the patient, in the form of Near Miss (Near Injury) or Adverse Events. /KTD) further error reduction can be done by modifying the behavior. Nurses must involve psychological, affective and do things that prioritize patient safety (Lombogia et al., 2016In Baihaqi & Etlidawati, 2020 Indonesian hospitals have not reported a lot of patient safety incident data, not many hospitals in Indonesia have done. KKP-RS stores data by type of incident from September 2006-2012 by type of incident; KTD cases were 249 reports, and KNC cases were 283 reports. Based on the professional unit causing the case; nursing 207 reports, pharmacy 80 reports, laboratory 41 reports, doctors 33 reports and infrastructure 25 reports. Provincial data with the highest data were in Banten with 125 reports, Jakarta with 105 reports and the lowest in Riau with 5 reports, while in Jambi 1-6 incidents of patient safety incidents occurred in one year. Based on hospital ownership; Government 108, private sector 290 reports, TNI/Polri 9 reports.
Based on the results of the study by means of observation in the emergency room at RSUD Prof. Dr. Hi. Aloei Saboe Gorontalo City there are 28 nurses with 12 male nurses and 16 female nurses. Based on patient safety results, it is known the accuracy of patient identification, increased effective communication, increased safety of medicines that must be observed, reducing the risk of infection related to health services, reducing the risk of patient injury due to falls, in implementing patient safety goals where 16 nurses have behaved well by implementing patient safety goals and where 12 nurses are found to be partially able to apply patient identification accuracy, increase effective communication, increase drug safety Drugs that must be observed, can only be partially applied from the patient safety target.
Based on patient safety incident data at Prof. Hospital. Dr. Hi. Aloe Saboe received patient safety incidents in 2020-2018 with 13 cases of KNC type, 1 KTD, 5 KTC, and 16 KPC cases

METHODS
This research has been carried out in the emergency room of RSUD Prof. Dr. Hi. Aloei Saboe in Gorontalo City. The research design carried out in this study used quantitative methods. Dr. Hi. Aloei Saboe Gorontalo City, totaling 28 respondents, the researcher stated that the entire population will be used as a research sample using the Total Sampling sampling technique where all the population is used as a sample of 28 respondents

Univariate Analysis
Univariate analysis based on nurse behavior

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Based on table 1. The distribution of frequency based on the behavior of nurses, the most in this study was the behavior of good nurses as many as 11 respondents (42.9%). And the behavior of nurses was not good as many as 16 respondents (57.1%). Based on table 2. The distribution of patient safety frequency of the most respondents in the study was the high patient safety of 16 respondents (57.1%). And low safety 12 respondents (42.9%). Based on table 1. It was found that the behavior of nurses was not good and patient safety was high as many as 5 respondents (31.2%). Compared to the nurse's behavior is not good and patient safety is low as many as 9 respondents (75%). While the behavior of nurses is good and patient safety is high as many as 11 respondents (68.8%). Compared with good nurse behavior and low patient safety as many as 3 respondents (25%). The results of statistical tests obtained p value = 0.024 with < 0.005, it can be concluded that there is a relationship between nurse behavior and the ability to carry out patient safety in Emergency room at RSUD Prof. Dr. Hi. Aloei Saboe Gorontalo City.

The Behavior of Nurses in Implementing Patient Safety in the Emergency Room at RSUD Prof. Dr. Hi. Aloei Saboe
Based on the results of research that has been obtained in 28 respondents, the most in this study were good nurse behavior as many as 16 respondents (57.1%). While the behavior of nurses who are not good as many as 12 respondents (42.9%). It is said that the behavior of nurses is good seen from the results of research observations where one of them is that nurses always use at least 2 ways to identify patients, nurses always identify patients before administering drugs or taking blood. medicinal benefits. While it is said that the behavior of nurses is not good, the nurse explains to the patient about the type of drug, the benefits of the drug, side effects, contraindications and drug dosage, the nurse provides an explanation of nursing care to the patient's family or patient. Nurses Bantu (2014) 3 with the title; "The Relationship between Nurse Knowledge and the Application of Identify Patient Correcly at Ratatotok Buyat Hospital, Southeast Minahasa Regency". This study concludes that most have good knowledge about identify patient correctly. According to researchers, identifying patients correctly is the main foundation in preventing patient safety incidents from occurring. It can be seen from the observations and questionnaires that have been carried out by the researchers showing that more than half of the nurses who work in the acute room of Prof. Kandou Manado correctly identifies patients, but there are still some nurses whose behavior is forgetful, fatigued and requires emergency actions that are required to act quickly so that patient identification is not good with the installation of wristbands inefficient.

Variable
Based on the results of the study, the highest number of nurses' behavior was good, 16 respondents (57.1%). And the behavior of nurses is not good as many as 12 respondents (42.9%). So it can be concluded from research and theories that support that the behavior of good nurses is more than the behavior of bad nurses. It is said that nurse behavior is good seen from the results of research observations where one of them is that nurses always use at least 2 ways to identify patients. administering drugs or taking blood. and before administering drugs, nurses already know the types of drugs, the effects of drugs and the benefits of drugs.

Patient safety in the emergency of patient safety in the IGD room of the hospital Prof. Dr. Hi. Aloei Saboe
Based on the results of the study, it was found that the most patient safety in this study was high patient safety as many as 16 respondents (57.1%). While patient safety is low as many as 12 respondents (42.9%). It is said that safety is not good as seen from the observation that effective communication and effective hand hygne are still lacking. While patient safety is good, it is observed that patient identification, drug safety (high alert), and the risk of falling are better done by nurses. The results of the study are supported by research by Nurmalia, (2013)4 about the effect of mentoring programs on the application of patient safety culture. 52.2% of nurses have a negative safety culture. The expected patient safety culture in hospitals is a positive safety culture which is characterized by a good flow of information and a communication process related to learning during adverse events, having committed leaders and responsible executives and an approach to not blaming and not giving punishment. on the reported incident.
Based on the results of the study, the highest patient safety in this study was high patient safety as many as 16 respondents (57.1%). While patient safety is low as many as 18 respondents (42.9%). So it can be concluded from research and theories that support that patient safety is not good as seen from the observation that effective communication and effective hand hygne are still lacking. While patient safety is good, it is observed that patient identification, drug safety (high alert), and the risk of falling are better done by nurses.

Bivariate analysis
The Relationship between Nurse Behavior and Ability in Implementing Patient Safety In the ER room, Prof. RSUD Prof. Dr. Hi. Aloei Saboe Gorontalo City The results showed that the behavior of nurses was not good and patient safety was high as many as 5 respondents (31.2%). Compared to the nurse's behavior is not This is supported by the theory put forward by Nurjannah (2015)5 who argues that hand hygiene is an action taken by nurses to wash their hands in situations including before touching the patient, before performing clean/aseptic procedures, after contact with the patient's body fluids, after touching the patient. , and after touching equipment around the patient as a way to reduce or prevent nosocomial infections. In line with research conducted by Yudianto 2005 In Kesrianti et al., 2014)6 stated that several factors that have a relationship with communication when nurses carry out handovers are characteristics of gender, knowledge, attitudes, availability of procedures, leaders and colleagues.
The nurse's behavior is not good with low patient safety with a total of 9 respondents (75%) from the observations based on the nurse's questionnaire providing an explanation of nursing care to the patient's family. The procedural policy was developed in order to make the process of identification, location, labeling, and storage of drugs that need to be observed.
Drug storage is an activity to store and maintain by placing received pharmaceutical supplies in a place that is considered safe from theft and physical disturbances that can damage the quality of drugs. Drug storage aims to maintain the quality of pharmaceutical preparations, avoid irresponsible use, maintain availability, and facilitate search and control (Satibi, 2015). This research is in line with the results of Amril's research. (2005In Hia, 20197 entitled Factors related to the behavior of nurses in carrying out documentation of nursing care in the inpatient installation of RSUD Pariaman, it was found that the behavior of nurses in carrying out documentation of good nursing care was 62.9%. The results of bivariate analysis, which showed that there was a significant relationship with the behavior of nurses in carrying out documentation of nursing care were knowledge, workload, nursing SOPs. This research is in line with (Haritsa & Haskas, 2021)8 evaluation of the implementation of patient safety (patient safety) at the public hospital in the Labuang baji area, Makassar. The results of the study obtained on the implementation of patient safety showed that drug safety had been implemented quite well, it was known that from 70 respondents, 66 respondents (94.3%) had done drug safety is good, while those who do not practice drug safety are 4 respondents (5.7%). Based on the results of observations, it was found that respondents had implemented drug safety quite well, this was because the results of observations at Labuang Baji Hospital found that there were several respondents who did not include the name of the drug that needed to be alerted (High

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Alert) and the drug was not closely monitored. . However, there are some respondents who have carried out drug safety where respondents have given labels in the form of writing the patient's name, age, and room number, storing drugs and other electrolyte fluids separately from patient services. Nurse behavior is good with high patient safety with a total of 11 respondents (68.8%) from the observations obtained based on the questionnaire nurses always use at least 2 ways to identify patients (name and medical record number), nurses perform a five moment procedure to reduce the risk of infection related to health services.
According to Ridelberg, Roback, and Nilsen (2014)9. Factors that influence the implementation of patient safety include patient factors, staff and individual factors, team factors, technology factors, work environment factors, organizational and management factors and institutional context factors. Hand washing is the most important health procedure that everyone can do to prevent the spread of germs. In line with the research conducted by Sunarti Swastikarini, the analysis of factors related to the implementation of patient identification accuracy by the implementing nurse. Based on the results of the research that has been carried out, it is found that the level of knowledge of implementing nurses regarding the implementation of patient identification in the inpatient ward of RS X is mostly high (76.5%). The results of this study are supported by Bantu research (2014)10 it is known that 75% of nurses have good knowledge about the accuracy of patient identification. Bawelle (2013) in his research, it was found that nurses' knowledge about patient safety was good (90.8%). This shows that the level of knowledge of nurses about patient safety is good.
In line with research conducted by Edisyah Putra Ritonga on the implementation of five moment hand hygiene in the inpatient ward of a Medan city private hospital, several studies reported that hand hygiene compliance was still low. A study observed the hand hygiene compliance of inpatient nurses who had facilities such as a sink, drying tissue, alcohol-based solutions, and recommendations for hand washing that were posted on the walls in every room. Based on the results of the study, it was found that the majority of the implementation of five moment hand hygiene was not good, namely as many as 23 respondents (59%) and the minority of the implementation of five moment hand hygiene was good, namely as many as 16 respondents (41%). According to the researcher's assumption, the level of knowledge of nurses in the implementation of hand washing is still not good, this is due to the education level of the respondents, namely from the results of the study that the majority of respondents' education is D-III nursing, namely 33 respondents (84.7%) and the minority of respondents' education is SI Nursing, namely as many as 6 respondents (15.3%). According to the researcher, the higher the respondent's education, it will affect the respondent's knowledge. This is in accordance with Notoadmojo's (2012)12 theory that one's knowledge is influenced by one's education.
Nurse behavior is good with low patient safety totaling 3 respondents (25%) from the observations obtained based on the patient identification questionnaire, nurses always do when taking blood and other specimens for clinical trials, nurses apply the initial assessment process for the risk of falling patients and reassess them. patients when indicated changes in condition or treatment.
The patient identification process needs to be carried out from the beginning of the patient's admission to the hospital, which will then always be confirmed in all processes at the hospital, such as before administering drugs, blood or blood products, before taking blood and other specimens for examination. This is done so that there is no patient identification error which can later be fatal if the patient receives a medical procedure that is not in accordance with the patient's condition, such as giving the wrong medicine, taking wrong blood and even taking medical action (Permenkes RI, 2017)13.
In line with the research conducted by Sunarti Swastikarini, the analysis of factors related to the implementation of the accuracy of patient identification by the implementing nurse. %). The results of this study are supported by Bawelle (2013) it was found that 93.2% of implementing nurses had a good attitude in implementing patient safety. Attitude is a reaction or response of someone who is still closed to a stimulus or object. Attitude is said to be a function of humans such as perception, motivation and thinking that shows relationships, even to a certain extent their behavior can be predicted (Bawelle, 2013). of course automatically manifested in an action (overt behavior). Nurse behavior regarding patient safety is an important thing that must be done by a professional nurse in a hospital. Good nurse behavior is certainly related to patient safety. The results of the analysis test showed p = 0.024 where it was said that there was a relationship between nurse behavior and patient safety. Where H0 is rejected and H1 is accepted so it can be concluded that there is a relationship between nurse behavior and patient safety in hospitals.

CONCLUSION
Based on the results of the research, the researchers concluded that: Most of the respondents in the ER Prof. Dr. Hi. Aloei Saboe Gorontalo City has good behavior as many as 16 respondents (57.1%). While the behavior of nurses was not good as many as 12 respondents (42.9%) Most of the respondents in the ER Prof. Dr. Hi. Aloei Saboe Gorontalo City with high patient safety as many as 16 respondents (57.1%) while low patient safety as many as 12 respondents (42.9%) The results of statistical tests using the Chi-square test, obtained p value = 0.024 which means less than (α = 0 ,05). Where the significance value of 0.05 indicates a relationship in this study.