An Analysis on Nurse Knowledge and Attitude on Pre-Hospital Ambulance Service Satisfaction in Bali, Indonesia

Info Abstract Article


Ambulance is one of EMS (Emergency Medical
Services) components which is available for 24 hours in hospital and public health center with inpatient facility and also used for prehospital patient service. According to Minister of Health Regulation of Republic of Indonesia 47, 2018 on emergency service that the ambulance is used for medical evacuation from incident or patient location to health service facility or referral between health facilities by maintaining the stability of patient's condition through resuscitation [1].

The ambulance service in its implementation
is not only used to help the victim who needs surgical emergency, but also patient who experiences medical emergency. The most frequent surgical emergency is trauma case or traffic accident. Based on the data in Bali, the total victim of traffic accidents keep increasing in these two last years. In 2018, there are 1.827 accident cases with the description of 497 victims died, 220 severe injuries, while the rest have minor injuries [2].
In 2019, Bali has recorded as many as 3.341 accident cases with the description of 420 victims died, 261 severe injuries, and 2.462 minor injuries. Through ambulance service, it is expected to offer an early treatment for accident victims optimally.
The quality of ambulance service has a great impact to the well-being and survival of emergency patients. The patient satisfaction is one of main metrics to do assessment on ambulance service [3]. The patient satisfaction is also a center part of health service giving which is aimed to improve the service quality [4]. The patient satisfaction on ambulance service is an essential quality indicator and can be used as an indicator to manage pre-hospital emergency service [5].
The most frequent problem which appears on pre-hospital service is the nurses who are on duty in ambulance [6].

Study Design
This

The Illustration of Pre-hospital Ambulance Service Satisfaction in Bali
The descriptive analysis displayed on

Satisfaction in Bali
The

Knowledge and Pre-hospital Ambulance Service Satisfaction in Bali
The nurse knowledge was one of nurse factors that could affect the service performed by the nurse [12]. The better nurse knowledge would determine the higher level of satisfaction level [13], [14]. nurse to provide a good nursing service [17].

Satisfaction in Bali
A good nurse attitude to deliver nursing service would improve patient satisfaction during the service [13], [14]. The similar research has also stated about positive attitude performed by the nurse to give nursing service could raise a positive effect on patient satisfaction [18]. The positive attitude owned by nurse relating to emergency service would affect greatly on patient in his emergency condition [19].
The relation between nurse attitude and pre-hospital emergency service might be existed, since due to the caring-based nursing service delivery, the nurse attitude to perform the service would indicate how far the nurse care to give nursing care intervention. The similar analysis has been stated by Rahayu & Sulistiawati (2018) in their research, the nurse attitude was related to caring behavior performed by the nurse [20] and then caring behavior would affect patient satisfaction [21]. The nurse who has a positive attitude on pre-hospital emergency service would show a good caring behavior during pre-hospital ambulance service, then, it could positively affect the satisfaction on pre-hospital ambulance service in Bali.

The Most Related Nurse's Factors to Prehospital Ambulance Service Satisfaction in Bali
The patient satisfaction was a multidimensional concept which was oriented on the interaction between ambulance nurse and patient handled [22]. professional communication [27]. Moreover, the good communication was significant for the quality of health service given to the prehospital ambulance patient, because this aspect could increase the patient satisfaction [18]. The positive nurse attitude on prehospital emergency service would also encourage the nurse to be more active in