THE INFLUENCE OF TEAM WORK ENGAGEMENT ON THE PERFORMANCE OF MEDICAL DEVICE CALIBRATION

Medical devices that have been calibrated at the Primary Health Center in the work area of the Pasuruan District Health Office 10.02% and have been proposed in planning 21.17% in 2021. The purpose of this study was to analyze the effect of team work engagement on the performance results of medical device calibration at Pasuruan District Health Center. This type of research is analytic observational with a cross-sectional research design on 86 informants. Linear regression test was used to analyze the data. The results showed that the medical device calibration team at the Primary Health Center was at the team work engagement level of dedication and the results of medical device calibration performance were low (36.4%). The results of the analysis show that the effect of team work engagement has a significant effect on the management of preparing medical device calibration application letters. In addition, the results of the analysis of the effect of team work engagement showed a significant effect on the performance results of medical device calibration. Conclusion: There is an influence of team work engagement showing a significant effect on the performance results of medical device calibration. Recommendations for improving the results of medical device calibration performance at the primary health center in Pasuruan Regency were carried out through discussion and research by researchers.


INTRODUCTION
Calibration is a way to detect the accuracy and value of a device that is used to prove the feasibility of a device in accordance with national or international standard values.Calibration is a contributing factor related to medical device validation in patient safety incidents.Contributing factors here are factors that influence and play a role in developing and or increasing the risk of an event (Kemkes RI, 2015).
The positive influence between maintenance of haemodialysis equipment on the quality of patient service in the haemodialysis unit at Al Ihsan Bandung Hospital where calibration is one of the components in the maintenance activities of the equipment (Handari & Agusriani, 2019).In addition, the accuracy of central venous pressure measurement is influenced by, among others, improper calibration (Lesmana, 2018).
There are 33 primary health care in Pasuruan Regency with details of 17 units of Inpatien primary health care and 16 units of Outpatient primary health care (District Health Office, 2020).Medical devices that have been calibrated at the primary health care of the Pasuruan District Office Work Area in 2021 were found to have 10.02% calibrated medical devices and 89.98% uncalibrated medical devices at the primary health care in 2021.However, the medical devices that have been proposed in the planning of the Pasuruan District Health Office are only 21.17% in 2021.
In this study, the researcher proposes several hypotheses, namely the first hypothesis that there is a positive and significant effect of team work engagement on the management of the preparation of requests for calibration of medical devices at the primary health care at Pasuruan regency, and the second hypothesis that there is a positive and significant effect of team work engagement on the performance of medical device calibration.

METHOD
Analytical observational research with quantitative methods is the type of research used in this study.This type of research is quantitative research that uses statement and checklist tools to measure the variables studied.The design of this study is cross sectional because data collection is carried out once at a certain period of time and simultaneously on the variables studied.Data collection starts from December 2022 to June 2023.The research institution is the Primary health center at Pasuruan Regency and the Pasuruan District Health Office.The unit of analysis in this study was the primary health center at Pasuruan Regency.The research subject is the medical device calibration team at 33 primary health center at Pasuruan regency. 1 team consists of the Head of Primary health center, storage manager, and ASPAK application management officer.So that the informants of this research are the primary health center medical device calibration team of 86 informants.The initial stage is to measure the condition of the medical device calibration team at the primary health center from the variable level of Team Work Engagement, management of the preparation of medical device calibration requests, and the results of medical device calibration performance.Team work engagement is a state related to joint work, positive and satisfying and motivating in medical device calibration activities in which consists of 3 levels, namely team vigor, team dedication, team absorption.Then the researcher processed and analyzed the data on the informant's answers.Researchers analyzed the effect of team work engagement on the medical device calibration team at the Puskesmas on the management of the preparation of medical device calibration application letters.After that the researchers analyzed the effect of team work engagement on the performance results of medical device calibration at the primary health center.The measurement of team work engagement begins by gathering the medical device calibration team at the Puskesmas then the researcher explains that the opinions of all team members are important then the researcher explores the opinions of all team members using discussion and will be assessed by the researcher with the value of the answers given for each statement using the UWES scale (Table 1).Then the value of all components on team work engagement is composited and then made in the form of intervals from the median value of 49.38 as follows: a. Values 34-42 are said to be team work engagement level team vigor b.Values 43-54 are said to be team work engagement level team dedication c.Values 52-62 are said to be team work engagement level team absorption The third stage analyzes the results of the performance of medical device calibration seen from documents containing expenditures at the primary health center which are used as the basis for budget use including calibration of medical devices and a request letter for calibration of medical devices which is a submission letter from the primary health center to the testing institution to propose a medical device calibration and planning budget implementation documents.The analysis used interviews with a checklist guide with the answer choices of presence and absence.Then the value of all components in the performance results of medical device calibration is composited and then made in the form of an interval with a median value of 3.6 as follows: a.Value 0-2.9 then the performance is said to be less b.Value 3-6 then the performance is said to be good In the fourth stage, the data will be analyzed using SPSS using validity and reliability tests.For statistical analysis, researchers used descriptive analysis, cross tabulation test and linear regression test.

Validity and reliability test
Primary data collection was carried out through interviews with informants using a list of statements that had been provided where the research instrument was tested first in order to have validity and reliability in accordance with the requirements of the research instrument that had been determined and then statistically analyzed.The trial was conducted on 18 informants at 2 primary health center in Sidoarjo Regency, 2 primary health center in Jember Regency, 2 primary health center in Malang Regency, 2 primary health center in Bondowoso Regency, 2 primary health center in Trenggalek Regency, 2 primary health center in Pasuruan City, 2 primary health center in Malang Regency, 2 primary health center in Surabaya City, 2 primary health center in Mojokerto City.Validity test by calculating Pearson correlation and reliability test using Cronbach's alpha.The results of validity and reliability measurements are shown in Table 2 and Table 3.Based on the table above, the list of questions and checklists can be used for research because after the validity and reliability tests have proven to be valid and reliable.

Analysis Of Team Work Engagement In The Medical Device Calibration Team Of Primary Health Center At Pasuruan Regency
Team work engagement has 3 levels, namely team vigor, team dedication, and team absorption.An overview of team work engagement in the medical device calibration team of the primary health center at Pasuruan Regency can be seen in table 4.

Table 5 Recapitulation of Team Work Engagement Levels in the Primary Health Center at Pasuruan Regency Health Equipment Calibration Team in 2023
Team Work Engagement Level n % Team vigor 6 18,2 Team dedication 18 54,5 Team absorption 9 27,3 Total 33 100,0 Source: Data Processed in 2023 The recapitulation shown in table 5 explains that the level of team work engagement at each Primary Health Center was dominated by a team at the team absorption level of 27.3%, meaning that they are happy to be preoccupied with medical device calibration activities, immerse themselves in their work and find it difficult to leave medical device calibration activities.

Analysis of the Results of Performance Conditions for Calibration of Medical Devices In Primary Health Center At Pasuruan Regency
Performance itself is a variable that is able to describe the work results of the team in carrying out medical device calibration activities at the Primary Health Center.In this study, performance was explained through 2 indicators, namely the Budget Execution Document and the medical device calibration request letter.The results of the descriptive analysis regarding the performance results of medical device calibration at the Primary Health Center can be seen in table 6.The results of the study obtained information that the results of the performance calibration of medical devices at the Primary Health Center in Pasuruan Regency in 2023 were mostly in good condition (63.6%) but some were still in not good condition (36.4%).

Analysis of the Influence of Team Work Engagement on Performance Results of Medical Device Calibration at the Primary Health Center in Pasuruan Regency
The next step is to analyze the effect of team work engagement on the performance results of medical device calibration Table 8 shows that the largest percentage when team work engagement is at the level of team absorption and the results of good medical device calibration performance are 100%.After analyzing the relationship of team work engagement to the results of medical device calibration performance, we will then analyze the effect of team work engagement on the results of medical device calibration performance at the Primary Health Center in Pasuruan Regency which will be explained in the next paragraph.Table 9 can be analyzed that team work engagement significantly affects the performance of the results of medical device calibration activities at the primary health center in Pasuruan Regency.Team performance cannot be separated from how to relate to other colleagues, relate to superiors, follow organizational rules and policies, adhere to performance standards and often live in working conditions that are not ideal.However, a team that is already engaged will always be excited when it encounters difficulties and obstacles.To get the team to engage with medical device calibration activities, create a comfortable atmosphere by establishing clear procedures for carrying out medical device calibration activities at primary health center.
The team interaction process will be different in each primary health center because the various characteristics of the team and environment will influence it, but with clear and similar roles and procedures in the work area of the primary health center in Pasuruan Regency it will bring about teamwork involvement.Performance is a function of alignment, competency, engagement (Supriyanto, et al., 2021).A good and dynamic team must understand the vision, mission and procedures of medical device calibration activities, besides that they must be focused and engaged with the results to be achieved.So that the results of the calibration performance of medical devices get good results.Team work engagement affects the performance of medical device calibration activities, the higher the team work engagement, the better the performance of medical device calibration activities is 0.107 times.
To increase team work engagement with the results of medical device calibration performance, it is recommended that the medical device calibration team be made more focused on completing medical device calibration activities at the Primary Health Center, Increase the sense of unity in a work team and assume that through the team they will work better, members of the medical device calibration team strive not to feel any pressure at work, and develop a mature attitude for each team member in facing the changes and challenges they face.

LIMITATION OF THE STUDY
The researcher limited the research that analyzed the team work engagement of the medical device calibration team to the performance results of medical device calibration, which only reached the letter of submission for medical device calibration activities to the testing institution, not until the medical device calibration certificate was issued.

CONCLUSIONS AND SUGGESTIONS
Based on the results of the analysis the medical device calibration team at the primary health center is at the team work engagement level of absorption of 27.1%.Most of the performance results for the calibration of medical devices at Primary health Center are still not good.Team work engagement has a significant effect on the management of preparing calibration request letters and the results of medical device calibration performance at primary health center.
Suggestions for primary Health Centers Judging from the results of the research, it is necessary to immediately carry out training actions for equipment coordinators and immediately implement what is contained in the handbook on medical device calibration ETHICAL CONSIDERATIONS Scientific work obtained ethical approval from the Health Research Ethics Committee of the Faculty of Public Health, Airlangga University with No: 26/EA/KEPK/2023

Table 6
shows the performance of medical device calibration at the Primary Health Center in Pasuruan Regency in 2023 that on average the team has not made a medical device calibration request letter and then categorized into 2 categories which can be seen in table7