Strengthening Conflict Management to Support Patient Safety In The Napza Rehabilitation Unit at RSKO Jakarta

Abstract

Conflict among patients in substance-use rehabilitation may compromise patient safety, therapeutic relationships, and continuity of care. This article reports a nursing-management residency project designed to strengthen the conflict-management system in the NAPZA Rehabilitation Unit at RSKO Jakarta. The project used a descriptive-analytic approach and a single-group program evaluation with knowledge measured immediately before and after the intervention. Assessment included observation, interviews/discussions, review of documents and incident records from 2023–2026, 5M/7M analysis, SWOT analysis, and Urgency, Seriousness, Growth (USG) prioritization. Thirteen nurses participated in the knowledge evaluation. The intervention combined a strengthened conflict-management guide, education, de-escalation training/simulation, a response pathway, a Post-Conflict Reconciliation Form, documentation, debriefing, and a monitoring plan. Patient conflict/fighting received the highest USG score of 15 (U=5, S=5, G=5). Mean knowledge scores increased from 41.8 before the intervention to 86.8 immediately afterward, a 45.0-point difference. These findings indicate an immediate improvement in knowledge but do not demonstrate improved clinical skills or a reduction in conflict incidents. Because the project had no comparison group and documented evidence of instrument validity and reliability was unavailable, the results should be interpreted cautiously. The program’s contribution is a context-specific, system-oriented package that links education with response procedures, reconciliation, documentation, and incident learning in NAPZA rehabilitation. Program sustainability should be evaluated through regular monitoring of safety indicators, adherence to response pathways, and conflict documentation.