Hospital Medan Research Articles

The Influence of Work Stress Compensation and Job Satisfaction on Nurse Turnover Intention at General Hospital Sinar Husni Medan

This study aims to determine Job Stress partially has a significant effect on Nurse Turnover Intention at Sinar Husni Medan Hospital, to determine Compensation partially has a positive and significant effect on Nurse Turnover Intention at Sinar Husni Medan Hospital, Job Satisfaction partially has a positive and significant effect on Nurse Turnover Intention at Sinar Husni Medan Hospital. The method used in this research is quantitative which analyzes and tests with data using numbers with instrument tools, classical assumption tests, multiple linear regression tests, hypothesis tests, and determination tests. Research results: Partially Job Stress is positive and significant to Turnover intention, partially Compensation has an effect on Turnover Intentuon, partially Job Satisfaction has a positive and significant effect on Turnover Intention, simultaneously Job Stress, Compensation and Job Satisfaction have a positive and significant effect on Turnover Intention.

Correlation Between Shoulder Pain Severity, Acromion Morphology, and Acromiohumeral Distance Using MRI: A Study at Haji Adam Malik Hospital Medan in 2022

Background: Studies have shown that rotator cuff tears (RCTs) are the most common cause of shoulder pain and restricted movement. The acromion is a posterior shoulder landmark. Specific acromion morphologies may predispose individuals to rotator cuff tears. Furthermore, studies have found a correlation between supraspinatus tendon tears and acromiohumeral distance. This study examines how shoulder pain assessed with American Shoulder and Elbow Surgeons (ASES) score relates to acromion morphology and acromiohumeral distance on MRI at Haji Adam Malik Hospital in 2022.Methods: This descriptive analytical study employed a cross-sectional approach. A total of 38 patients with a confirmed diagnosis of shoulder pain underwent shoulder MRI examinations and were assessed using the ASES score. Statistical analysis included assessing data normality and performing Spearman correlation analysis. Data were processed and analyzed using SPSS version 25.0.Results: In this study of 38 patients, most participants were women with an average age of 54.66 years. The most common acromion type was type 1 (flat), and the most frequent acromiohumeral distance category was normal. There was no correlation between acromion type and ASES scores, but a moderate correlation was found between the scores and acromiohumeral distance (p=0.016). A positive correlation was observed between type III acromion and ASES score. Conclusion: Shoulder pain based on ASES score has a moderate correlation with acromiohumeral distance and acromion type III variation has a positive correlation although there is no significant correlation was found between shoulder pain and acromion type.

Effectiveness of Propioceptive Neuromuscular Facilitation in Improving Walking Quality in Post-Stroke Patients at Haji General Hospital Medan

Nationally, the prevalence of stroke in Indonesia in 2018 was 10.9 per mile, an increase compared to 2013 which was 7 per mile. Stroke is the second leading cause of death and the third leading cause of disability in the world. Two-thirds of stroke events occur in developing countries. Weakness and decreased muscle strength in stroke sufferers occur on one side of the limb, however, in the trunk muscles, weakness occurs on both sides, resulting in limited trunk rotation and difficulty in maintaining balance and gait). Propioceptive Neuromuscular Facilitation (PNF) is a physiotherapy intervention method that can be used to improve the quality of walking in stroke patients. This method can improve proprioceptor function by stimulating it in muscles and tendons. PNF also improves muscle strength, flexibility, and balance). Description of respondent data was carried out using univariate analysis to determine the frequency of age, weight, height, gender, paralyzed side and Wisconsin values ??before and after the intervention for both groups. Bivariate test to compare the average WGS value after treatment with before treatment in both the PNF group and the conventional group and compare the average difference between the PNF group and the conventional group. The average value of the difference before and after the intervention in the PNF group was 1.75 with a standard deviation of ± 0.463, while in the conventional group the average value of the difference before and after the intervention was 0.63 with a standard deviation of ± 0.518. Statistical tests using the Wilcoxon rink test between the two groups obtained a p-value of 0.024, which is smaller than 0.05, which means there is a significant difference between the PNF intervention group and the Conventional intervention group.

031. Urine Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels as a Predictor of Early Acute Kidney Injury in Post Coronary Artery Bypass Graft (CABG) Patients in H. Adam Malik Hospital Medan

Background: One of the main complications after open heart surgery is acute kidney injury. Coronary Artery Bypass Graft surgery is one of the main factors in this complication. Currently, the use of serum creatinine as one of the diagnostic criteria for AKI is not sensitive for diagnosing AKI at an early stage. Elevated urine NGAL levels are more indicative of a renal damage process than an increase in circulation. An increase in NGAL levels in urine can occur 100 times faster than circulating NGAL. Thus our research aimed to view NGAL ability to predict AKI in CABG patient. Methods: This research is an observational study with cross-sectional data collection methods to find out whether NGAL can be a predictor of AKI in patients who have undergone CABG surgery. Results: The collection of research subjects was stopped when the number of samples had been reached so that this study was a cohort study with consecutive sampling techniques. In the results of this study, we obtained 31 research samples. In 31 research samples, it was found that the average age was 61.46 years with a standard deviation of 8.2 years. This study was dominated by male gender with a total of 20 people or 64% of the total sample. After CABG surgery, it was found that 4 patients had postoperative acute renal failure or 13.3% of the total sample. The sensitivity of the instrument is 100% with a specificity of 96%. The accuracy of the NGAL is 97.5%. Conclusion: NGAL is a useful parameter to predict AKI and would have significant advantage however further study with multi-center design would be necessary to validate these result.

The Effect of Complementary Acupressure Therapy on Nausea and Vomiting After Regional Block Anesthesia (Spinal Anesthesia) in the Recovery Room Imelda Indonesian Workers General Hospital, Medan

Postoperative nausea and vomiting is one of the side effects that often occurs in spinal anesthesia. Nausea and vomiting affect patient morbidity such as stress, discomfort, dehydration, prolonging treatment time and increasing treatment costs. This study aims to determine the effect of acupressure therapy on the incidence of nausea and vomiting after spinal anesthesia in the recovery room at the Imelda Workers Indonesia General Hospital, Medan. This type of research is quantitative research with quasi-experimental research methods. Data reports in the province of North Sumatra showed that there were 25,602 patients who underwent surgery. Meanwhile, at the Indonesian Umim Workers Hospital in Medan, data on surgical patients for January-March 2024 totaled 666 patients, and 250 patients had spinal anesthesia. This research was carried out in February - June 2024 at the Imelda Indonesian Workers General Hospital, Medan. The research sample was taken as many as 20 respondents. incidence of nausea and vomiting after spinal anesthesia at the Imelda Workers Indonesia General Hospital, Medan. Based on the characteristics of respondents based on age, they were in the age range of 36-40 years, namely 55%, based on gender, the majority of respondents were women, namely 60%, respondents based on smoking history were the majority 65%, the distribution of respondents with a history of nausea and vomiting was the majority 55% and the majority of respondents with nausea and vomiting were 60%. The recommendation for this research is that acupressure therapy can be applied in nursing practice so that patients are able to perform it independently. For the Imelda Workers Indonesia General Hospital, Medan, it is necessary to score the risk of nausea and vomiting in patients before surgery to minimize the incidence of post-operative nausea and vomiting.

The Effect of Occupational Safety and Health Counseling on the Use of Personal Protective Equipment at the Special UPTD of the Medan Hajj Hospital

The development of occupational safety and health science in the work environment can be seen with the development of advanced science and technology as well as the emergence of new innovations in the work environment and encouraging companies to improve the knowledge and skills of their human resources. The purpose of this study is to determine the Influence of Occupational Safety and Health Education (K3) on the Behavior of Using Personal Protective Equipment at the Special UPTD of Haji Medan Hospital. This research includes quasi-experimental research. This study uses a one group pretest and pottest design. The population in this study is emergency room nurses at the Special UPTD of Haji Medan Hospital which totals 50 nurses in June-August 2024. The sampling technique in this study is total sampling. The measuring tool in this study uses a univariate and bivariate distribution of non-parametric data with the Wilcoxon test. The results of the Wilcoxon statistical test of both knowledge and attitude obtained a P-value of 0.000. This means that at alpha 5% there is a significant difference in median score between before and after counseling. Meanwhile, in the aspect of action, there was an increase in the number of PPE users between before and after counseling. Because the results of Asymp.Sig of knowledge, attitudes and actions are less than 0.05, H0 is rejected so that there is an influence of occupational health and safety counseling (K3) on the behavior of using PPE. In conclusion, there is an influence of Occupational Safety and Health Counseling (K3) on the behavior of using personal protective equipment at the Special UPTD of Haji Medan Hospital. The suggestions are expected to increase the frequency of counseling and provide information on the importance of using personal protective equipment in the workplace, provide strict sanctions against nurses who do not use personal protective equipment at work, increase the frequency.

Analysis of Demographics Characteristics on Depression in Perimenopausal Staff at a Central General Hospital in Medan, Indonesia

Introduction/Objective Perimenopause is a period where the ovary gradually starts to produce less estrogen. One of the impacts that could happen during perimenopause is the onset of depression arising from hormonal and metabolic disorders due to the significant decrease of ovarium function and secretion of endogenous estrogen. This study was conducted to assess the factors related to depression in perimenopausal women. Methods A multivariate linear regression analysis with a cross-sectional design was conducted at a Central General Hospital in Medan, Indonesia, from October 2023 to January 2024. Subjects were perimenopausal female staff at the hospital who met the inclusion and exclusion criteria. Symptoms of depression were assessed using the Beck Depression Inventory-II (BDI-II) score. Data analysis was conducted using bivariate and multivariate tests with linear regression. Results A total of 111 subjects were included in this study. The median age was 48 years, and the median Body Mass Index (BMI) was 25. The mean depression score based on BDI-II was 12.96±7.084. Bivariate analysis showed significance on age, years of education, total monthly income, BMI, and number of pregnancies. Multivariate analysis showed that total monthly income had the highest correlation amongst other variables, followed by age, while the number of pregnancies had the lowest correlation. Conclusion In conclusion, there was a significance between depression and age, income, and number of pregnancies in perimenopausal staff. On the other hand, there was no significance between depression and years of education, BMI, marital status, and chronic disease.

Relationship of Stromal Tumor Infiltrating Lymphocytes (STILs) with Grading Histopathology in Penis Squamous Cell Carcinoma

ABSTRACT Background:Penile squamous cell carcinoma is the most common penile malignance found in the world. Assessment of stromal tumor infiltrating lymphocytes (STILs) associated with grading against penile squamous cell carcinoma can provide a potential prognostic picture and help determine the action. Method:Cross-sectional analytical study with 32 samples of histopathological preparations diagnosed as penile squamous cell carcinoma at H. Adam Malik Hospital Medan. The assessment of stromal TILs was carried out by assessing the number of lymphocyte inflammatory cells in the peritumoral stroma and then determined the assessment score, zero score no lymphocytes (minimum), score one found 0-10% lymphocytes (moderately), score two found 20-40% lymphocytes (massive) , score three found 50-90% lymphocytes. Grading assessments are categorized into grade I (well differentiated), grade II (moderately differentiated), and grade III (poorly differentiated). Result:The most grading found was grade II (43.8%) and the most STILs found were score three (50.0%). There is a significant relationship between grading and STILs in penile squamous cell carcinoma (p value=0.0001) i.e. the higher the STILs score , the lower the tumor grade. Conclusion:There is a relationship between STILs and histopathological grading in Penile Squamous Cell Carcinoma so that it can be used as an indikasi prognosis in patients with penile squamous cell carcinoma.

Frequency Distribution of Oncology Patients Who Come to Emergency Department at H. Adam Malik Hospital, Medan

A multidisciplinary approach is needed to comprehensively evaluate cancer patient’s condition and understanding patient demographic characteristics can improve health care by adapting to each patient's needs. This research is a descriptive observational study with a cross-sectional study design conducted at the Haji Adam Malik General Hospital in Medan on oncology patients who met the inclusion criteria. Data with a numerical measuring scale will be presented in mean+standard deviation (SD) and data with a categorical measuring scale will be presented in frequencies and percentages. The results showed that majority of patients were in 46–59 year age group as much as 32 patients (37.2%) and 58 patients (67.4%) were female. The highest level of education was found in 26 patients (30.2%) as bachelor, and 45 patients (52.3%) lived in Medan City. Most patients came to be treated at the surgical installation as many as 50 patients (25.6%). The research results found that majority of patients are in the age group 46-59 years, female, bachelor, domicile in Medan and are treated in surgical installation.

Mortality of Guillain Barre Syndrome and Myasthenic Crisis in Haji Adam Malik Central General Hospital Medan January 2021- December 2022

Introduction: Neuromuscular disorders are disorders of the neuro system that impact the muscular system. Among them are Guillain-Barré Syndrome and Myasthenic Crisis. Guillain-Barré syndrome is an autoimmune disorder of the nervous system that is polyradiculoneuropathic, characterized by weakness that radiates from the legs to the arms, torso, and face. Myasthenic crisis is a state of acute respiratory failure due to the exacerbation of Myasthenia Gravis. These two diseases are the most common types of neurodiseases found in hospital ICU patients. Objective: Determining the mortality rate of Guillain-Barré Syndrome and Myasthenic Crisis at Haji Adam Malik Central General Hospital Medan January 2021-December 2022. Methods : This study was a descriptive study with data obtained from medical records. The subjects were inpatients and outpatients with Guillain Barré Syndrome and Myasthenia Crisis, with as many as 129 patients. The subjects were selected by purposive sampling and met the inclusion and exclusion criteria. Results: A total of 40 Guillain-Barré Syndrome patients were studied, and 6 of them died. The majority were patients aged 36-50 years, and the male and female sexes were equally significant. A total of 89 patients with Myasthenic Crisis were studied, and 1 of them died, namely patients with the age category of 36-50 years and female. Conclusion: Guillain-Barré Syndrome mortality was 15%, and Myasthenic Crisis was 1.12% at Haji Adam Malik Center General Hospital Medan January 2021-December 2022. Keyword : Guillain-Barré Syndrome, Mortality, Myasthenic Crisis

Cesarean Scar Defect (Niche) Risk Factors: A Prospective Study on Indonesian Women

Introduction: Niche or cesarean scar defect is a complication of a cesarean section that has long-term implications for both obstetrics and gynecology. The rate of niche is believed to be increasing with the high number of cesarean sections. This study assesses the risk factors for niche development after cesarean section. Methods: A prospective cohort study was conducted on women who underwent cesarean section at the Haji Adam Malik General Hospital Medan between August 2020 and August 2022. Niche was assessed six weeks after cesarean section using transvaginal ultrasonography. The primary outcome was the presence of a niche. The antepartum, intrapartum and postpartum risk factors were analyzed for niche development. A logistic regression model was used to assess independent risk factors from the bivariate analysis. Results: There were 280 patients enrolled in this study. The prevalence of niche was 44.3% by using transvaginal ultrasound. There was no significant relationship between maternal age, gestational age, parity, nutritional status based on upper arm circumference, hypertension in pregnancy, anemia status, surgical indications, duration of surgery, volume blood loss, and puerperal infection to niche development (P > 0.05). The independent risk factors for niche development were Cervical dilatation > 4 cm (P = 0.035; RR = 1.75), locking suture technique (P = 0.015; RR = 13.81), non-closure vesicouterine folds (P = 0.04; RR = 0.14) and a retroflexed uterus (P = 0.001; RR = 0.039). Conclusion: Cervical dilatation > 4 cm, locking suture technique, non-closure vesicouterine folds, and a retroflexed uterus are risk factors for niche development after CS.

Pelayanan Pendaftaran Pasien Rawat Jalan di Rumah Sakit Elisabeth Medan

Abstract Hospital outpatient registration services are a phenomenon that refers to the actions or activities of a system within a hospital or health service facility which aims to maintain and improve health, prevent and cure disease and restore health. Outpatient care is a medical service provided to patients not in the form of inpatient care. This study aims to see an overview of outpatient registration services at Santa Elisabeth Hospital, Medan. This research uses a descriptive design with a quantitative approach. The sample in this study consisted of 30 patients. In this research, researchers collected data using a questionnaire. This research was conducted in June 2024. The data was analyzed univariably. The research results showed that there were 15 patients who received good and good service (50%), 10 patients received adequate service (33.33%) and 5 patients received poor service (16.66%). In this case, Santa Elisabeth Hospital Medan must continue to maintain good and friendly services and improve poor services.

Comparison of Posterior Tibial Slope and Outcomes of Pre and Post Total Knee Arthroplasty in Osteoarthritis Genu Patients at H. Adam Malik General Hospital Medan

Comparison of Posterior Tibial Slope and Outcomes of Pre and Post Total Knee Arthroplasty in Osteoarthritis Genu Patients at H. Adam Malik General Hospital Medan

Hubungan Kelengkapan Rekam Medis Dengan Keakuratan Kode Typhoid Fever Rawat Inap Rumah Sakit Santa Elisabeth Medan

The accuracy of the code is the accuracy in providing codes that are in accordance with the diagnosis of the disease and in accordance with the classification in ICD-10, which is useful to support the services and medical actions provided to patients. Completeness of medical records is the complete filling of medical records properly and correctly for medical services. The purpose of the study was to identify the relationship between the completeness of medical records and the accuracy of the typhoid fever code in hospitalization at Santa Elisabeth Hospital Medan in 2023. Analytic research design using a cross sectional approach. The population in the study were medical records of typhoid fever patients hospitalized at Santa Elisabeth Hospital Medan in 2023 as many as 214 medical records, the sample in the study was 66 medical records, the sampling technique was systematic random sampling. The instrument used was a checklist sheet. Data analysis using the Chi-square test. The results of this study obtained completeness of medical records with a complete category of 57 medical records (86.4%), the accuracy of the code with an accurate category of 51 codes (77.3%). Chi-square test results obtained p-value 0.023 (p0.05) indicates that there is a significant relationship between the completeness of medical records and the accuracy of the typhoid fever code inpatient Santa Elisabeth Hospital Medan.

Level of Psycoeducation Effectiveness on Adaptation Fracture Patients at Pirngadi Hospital Medan City

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Two thirds of injury cases in developing countries, including Indonesia, are still a major public health problem in all countries. In 2020 there were 152.256 injury cases in Indonesia (17.8%). Fractures cause a variety of negative effects, including psychological, social, and spiritual. A report from the Department of Health shows that 15 percent of fracture sufferers experience emotional stress and even depression. Psychological education helps in the treatment and reduction of depressive symptoms, which are part of the psychological response to disability. This research is to find out how well psychoeducation helps fracture patients adapt at Pirngadi Hospital, Medan City. This type of research is quasi-experimental with a pre-test-post-test design with control group. This research was carried out at Pirngadi Hospital, Medan City from 21 July to 23 August 2023. The study population included 67 patients who experienced grade 2 and 3 fractures. The sampling technique is non-probability sampling. The number of samples in this study was 16 people for the control group and 16 people for the treatment group. The research instrument has been tested for validity and reliability. Univariate analysis to describe research variables, while bivariate analysis with dependent t test to determine the mean differences in the treatment group before and after being given psychoeducation and in the control group at pre-test and post-test. The results of the study showed that there was a difference in the average adaptation of fracture patients who were given psychoeducational intervention compared to the group of patients who were not given intervention with p value = 0.000; 95% CI < alpha = 0.05. </em></p><p><em> </em></p></td></tr></tbody></table></div><strong><em>Keywords: Frakture, Injury Patient, Psychoeducation</em></strong>

Analisis Faktor-Faktor Penunjang Kesiapan Pelaksanaan Rekam Medis Elektronik

This study aims to analyze the factors that support the readiness to implement electronic medical records at the Royal Prima Medan General Hospital. The research method uses cross-sectional. The results of this study indicate that there is an influence of the perception of benefits on the readiness of the implementation of electronic medical records at the Royal Prima Medan Hospital with a p-value = 0.041, there is an influence of behavioral interest factors using the behavioral attention hospital management information system on the readiness for the implementation of electronic medical records at the Royal Prima Medan Hospital with a p-value = 0.000, there is an influence of the use of the hospital management information system on the readiness of submitting electronic medical records at the Royal Prima Medan Hospital with a p-value = 0.016. The conclusion is that there is an influence of the perception of benefits, behavioral interest, and use of information systems on the implementation of electronic medical records is a behavioral variable. Keywords: Readiness for Implementation, Electronic Medical Records, Hospital

Peran Rumah Sakit dalam Pencegahan dan Pengendalian Infeksi di Rumah Sakit

This study aims to determine the role of hospitals in preventing and controlling infections at Royal Prima Indonesia Hospital. The research method uses a cross-sectional study. The study results showed that the chi-square statistical test analysis of the role of hospitals in preventing and controlling infections at Royal Prima Medan Hospital showed a p-value = 0.283, which means the p-value> 0.05. In conclusion, there is no relationship between the hospital's role and the PPI team's compliance in preventing and controlling infections. Suggestions should be made so the hospital can provide ongoing training and education to improve compliance with standard precautions every three months. Keywords: Role of Hospitals, Prevention and Control of Infection

The Effect of Preoperative Oral Glucose Administration on Blood Glucose Levels in Diabetes Mellitus Patients in General Anesthesia Surgery

Background The administration of general anesthesia during surgery can trigger the body’s stress response causing changes in regular metabolic patterns that result in hyperglycemia and ketosis. The goal of this study is to investigate how preoperative oral glucose and non-glucose administration affect patients with diabetes mellitus with blood glucose levels during surgery under general anesthesia. Methods This is a single-blind, randomized controlled trial (RCT) being carried out by the Central Surgical Installation and postoperative recovery area at Haji Adam Malik General Hospital Medan. The study sample consists of 38 patients with diabetes mellitus who underwent electively scheduled laparotomies under general anesthesia and met inclusion/exclusion criteria. For treatment group participants, mineral water containing 50 grams of glucose was administered with 400 cc. Research hypotheses were assessed using the t-test, and significant findings had p-values equal to or less than 0.05 within a confidence interval of 95%. Results The study sample had a mean age of 50.1 ± 12.73 and showed a significant effect between glucose levels before (178.47) and after (163.78) administration of maltodextrin, with a P value (0.001). No side effects were observed during or after the post-operative evaluation process conducted in this study's participants. Conclusions Patients with diabetes mellitus experience a preoperative oral glucose-induced impact on blood glucose levels.

Initial Sofa Score and Mortality of Sepsis Patients in the Intensive Care Unit of Haji Adam Malik Hospital Medan: Does It Correlate?

Introduction: Sepsis is a life-threatening organ dysfunction or failure that is the primary cause of death in infectious disease. the Sepsis-3 Task Force recommends The Sequential (Sepsis-Related) Organ Failure Assessment (SOFA) Score as a means of Sepsis identification. Objective: To determine the correlation between sepsis patients’ deaths in the intensive care unit (ICU) of Haji Adam Malik Hospital Medan and their initial SOFA score. Materials and Methods: This study uses a cross-sectional study design and an observational analytical investigation. The sample for this study was sepsis patients who were treated in the ICU of Haji Adam Malik Hospital Medan in 2021-2022, and they were selected using the purposive sampling method. After calculating the Slovin formula, 61 samples are required. The researchers obtained the data from patient medical records. The analyses used are univariate and bivariate, with the Independent-T test and Fisher’s exact. Results: From 71 patients, there were 36 patients (50.7%) in the age group of 46-65 years old; 39 patients (54.9%) were male; 50 patients (70.4%) had comorbidities; and 50 patients (70.4%) had non-surgical disease. The average initial SOFA score was 9.89 ± 3.95, with mortality for sepsis patients in the ICU of 74.6%. The findings of the statistical analysis indicated a substantial difference (p<0.001) in the SOFA scores of those who survived and those who did not, as well as a significant correlation (p<0.001) between the initial SOFA score and mortality. Conclusion: There is a correlation between initial SOFA score and the mortality of sepsis patients in the ICU of Haji Adam Malik Hospital.

The Role Of Human Resource Management in Improving the Health Performance at the Malahayati Islamic Hospital Medan In 2024

Human resource management that has been applied in the management of the Islamic Malahayati Hospital is very good so that the Islamic Malahayati Hospital gets a different assessment compared to other hospitals in Medan which implemented the integrated ISO 9001;2008 management system. This study aims to determine how the existing resource management in the Islamic Malahayati Hospital. This type of research is a quantitative study with a cross-sectional study approach. The population in this study were all nurses at Islamic Malahayati Hospital as many as 190 civil servant nurses with a sample of 129 people. The sampling technique in this study used proportional random sampling. Data analysis was performed by univariate, bivariate with chi-square test and multivariate analysis with logistic regression. There is a relationship between recruitment and selection (p-value = 0.000), training and promotion (p- value 0.000), job appraisal, and salary management (p values = 0.000), with the performance of nurses at the Islamic Malahayati Hospital. Promotion and training have the greatest relationship with nurse performance with an OR value of 15,934. It is recommended to the hospital to increase the training and promotion of health workers, especially by involving more employees, in this case, nurses in training activities or increasing their capacity, and it is necessary to have a promotion or increase in positions that are in accordance with the work of nurses so that nurses are more active and more motivated in improving their performance while working in the hospital.