Determinants of Clinical Privileged Implementation and Nurse Performance at Dr. Zainul Abidin Regional General Hospital in Banda Aceh

Clinical privilegeis the process of granting credentials to individuals within an institution to provide specific patient care services. This study aims to analyze the factors that influence the implementation of clinical privileges on nurse performance at Dr. Zainoel Abidin Regional General Hospital, Banda Aceh. The study design used a quantitative approach with a cross-sectional method with 122 nurse respondents. The independent variables included education level, length of service, management support, credentialing system, and job satisfaction, while the dependent variable was nurse performance. Data were collected using a structured questionnaire, then analyzed using bivariate tests (Chi-square) and multivariate logistic regression to determine the dominant factors. The results showed that most nurses had good performance (77.0%). Bivariate analysis showed that management support (p=0.005), credentialing system (p=0.002), and job satisfaction (p=0.012) were significantly related to nurse performance, while education (p=0.053) and length of service (p=0.660) did not show a significant relationship. In multivariate analysis, management support was the most dominant factor influencing nurse performance, with an odds ratio (OR) of 2.286, meaning nurses with good management support were 2.3 times more likely to demonstrate good performance than nurses with poor management support. The conclusion of this study confirms that the effective implementation of clinical privileges is strongly influenced by organizational factors, especially management support. Therefore, improving the quality of nursing management, strengthening the credentialing system, and increasing job satisfaction need to be prioritized in developing hospital policies to improve the quality of nursing services and patient safety.