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"Coronary Artery Bypass Graft (CABG) adalah tindakan yang dilakukan untuk mengatasi masalah pada arteri koroner klien dengan membuat jalur pintasan baru. Salah satu tujuan jangka panjang CABG adalah untuk meningkatkan kualitas hidup klien. Penelitian kualitatif dengan pendekatan fenomenologi ini bertujuan untuk menggambarkan pengalaman klien post CABG tentang perawatan yang diterimanya terhadap kualitas hidup dalam konteks asuhan keperawatan. Hasil penelitian mengidentifikasi 6 tema, yaitu 1) respon psikospiritual, 2) respon pemenuhan kebutuhan dasar, 3) kepuasan klien terhadap perawat, 4) kualitas hidup berubah, 5) jenis upaya klien, 6) sikap profesional perawat. Hasil penelitian ini dapat dijadikan acuan bagi perawat untuk merancang asuhan keperawatan pre dan post CABG yang sesuai dengan kebutuhan klien, bagi penelitian lanjut dapat dijadikan data dasar untuk penelitian terkait kualitas hidup secara kuantitatif.

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Coronary Artery Bypass Graft (CABG) was action to solve client with coronary artery problem by making new bypass. One of the long-range purposed of CABG was to improve the quality of client life. This qualitative research with phenomenology study approach aimed to describe post CABG client experience in care accepted against quality of life in nursing care context. Result of this research identify 6 themes, they are 1) psycho-spiritual responses 2) accomplishment of elementary requirement responses 3) client satisfaction on nurse 4) changes in quality of life 5) strive client types 6) professional attitude of nurse. Result of this research can be made as reference to nurse on pre and post CABG nursing care design as client need, for the next research can be made as basic data related to quality of life research quantitatively."

"Kegiatan residensi keperawatan medikal bedah peminatan kardiovaskular dilaksanakan selama dua semester berupa pengelolaan asuhan keperawatan pasien gangguan kardiovaskular secara holistik dan komprehensif dengan penerapan model Konservasi Myra Estrin Levine pada satu pasien kelolaan utama dan 30 pasien kelolaan lainnya. Tujuan dan hasil asuhan keperawatan pasien gangguan kardiovaskular adalah mengupayakan adaptasi untuk mencapai keutuhan (wholeness) dengan memfasilitasi konservasi energi, konservasi intgritas struktur, konsevasi integritas personal, dan konservasi integritas sosial. Praktik keperawatan terbaik berbasis bukti (evidence-based nursing practice) memberikan posisi lateral 30o setelah dua jam pasca bedah di ICU bertujuan untuk memenuhi kebutuhan ambulasi dini dan dihasilkan kestabilan hemodinamik. Peran perawat spesialis sebagai inovator dalam pelayanan keperawatan dengan mengoptimalkan asuhan keperawatan berbasis spiritual di unit perawatan intensif jantung dengan memfasilitasi penyediaan format pengkajian, format diagnosa keperawatan, dan format rencana intervensi spiritual. Inovasi optimalisasi asuhan spiritual mendapat respon, dukungan, dan apresiasi yang tinggi oleh para perawat di unit terkait dan ditingkat manajemen pelayanan keperawatan rumah sakit.

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Medical surgical nursing residency activities in cardiovascular specialization was did in two semesters by managing the nursing care of patients with cardiovascular disorders holistically and comprehensively using the application of Myra Estrin Levine Conservation Model in one major case and other 30 cases. The purpose and outcomes of cardiovascular disorders nursing care is adaptation to achieve integrity (wholeness) to facilitate the conservation of energy, conservation of structure integrity, conservation of personal integrity, and conservation of social integrity. The best evidence-based nursing practice giving the lateral position two hours post-surgery in the ICU aimed to meet the needs of early ambulation and resulting hemodynamic stability. The role of specialist nurses as an innovator in nursing services optimizing the spiritual-based nursing care in cardiac intensive care unit by facilitating the creating of assessment form, nursing diagnosis form, and spiritual intervention plan form. Innovation in spiritual care optimization got responses, supports, and good appreciations from the nurses in the related unit and hospital nursing care management level."

"Analisis laporan praktek residensi merupakan analisis yang dilakukan selama penulis menjalankan praktek residensi 1, 2 dan 3 di Rumah Sakit Jantung Pusat Nasional Harapan Kita Jakarta. Laporan berisi asuhan keperawatan kasus kardiovaskuler yang terdiri dari 1 kasus kelolaan utama, dan 30 kasus resume, dengan penerapan teori keperawatan model Imogene King, pembuatan Evidence Best Nursing serta pembuatan inovasi keperawatan. Tujuan analisis ini adalah untuk memberikan gambaran peran perawat dalam penatalaksanaan keperawatan selama praktik residensi spesialis keperawatan medikal bedah dengan penerapan teori Imogene King pada kasus kardiovaskuler di RS Jantung Harapan Kita Jakarta dan merupakan salah satu bentuk pertanggung jawaban terhadap pengelolaan kasus pasien Acut Decompensated Heart Failure /ADHF pada pasien Coronary Artery Disease /CAD. Teori Imogene King adalah teori pencapaian tujuan yang dapat digunakan pada pasien dengan kasus kardiovaskuler mulai tahap pengkajian, perencanaan, implementasi sampai dengan evaluasi dalam usaha mencapai kesembuhan dan mencegah kekambuhan yang melibatkan peran pasien dan keluarga. Pelaksanaan EBN (Evidence Base Nursing) dilakukan di unit intermediate bedah yaitu melatih pasien dengan Inspiratory Muscle Training / IMT dengan penggunaan spirometri untuk melatih otot-otot diafragma dan nafas dalam untuk memperbaiki ekspansi paru dan menaikkan kapasitas paru. Hasil analisa menunjukan terdapat peningkatan kapasitas paru dan penurunan angka kejadian ateletaksis pada pasien intervensi. Kegiatan inovasi dilakukan di unit kamar bedah yaitu membuat prosedur handover antar personal dalam intra-operatif dalam rangka patient safety. Hasil menunjukan perawat dapat menerima perubahan atau prosedur baru yang bertujuan mencegah kesalahan dalam melakukan hand over intra operatif antar personal.

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Analysis of residency practice reports is an analysis conducted during the authors activity residency practices 1, 2 and 3 at National Cardiovascular Center Harapan Kita Jakarta. The report contains nursing care of cardiovascular cases consisting of one main management case, and 30 cases of resumes, with the application of Imogene King's model nursing theory, make Evidence Best and Inovation of Nursing. The purpose of this analysis is to provide an overview of the role of nurses in nursing management during the residency practice of surgical medical nursing specialists with the application of the Imogene King theory in cardiovascular cases at National Cardiovascular Center Harapan Kita Jakarta. This is the one of responsibility for managing cases of Acut Decompensated Heart Failure / ADHF in Coronary Artery Disease / CAD. Imogene King's Theory is a theory of goal attainment that for patients with cardiovascular cases from assessment, planning, implementation to evaluation in an effort to achieve recovery and prevent recurrence admitted which involving the role of the patient and families. EBN (Evidence Base Nursing) is carried out in the intermediate surgical unit, which is to train patients with Inspiratory Muscle Training / IMT by using spirometry to train diaphragm muscles and deep breathing to improve lung expansion and increase lung capacity. The analysis showed that increase the lung capacity and decrease in the incidence of ateletaxis. Innovation activities made inter-personal handover intra-operative procedures in in the operating room. The result showed nurses accept new procedures to prevent of intraoperative handover personal errors."

"schemic Heart Disease merupakan salah satu penyebab kematian paling umum di dunia dan frekuensinya terus meningkat setiap tahunnya. Hal ini menjadi tantangan yang besar bagi seorang Ners dalam pelayanan kesehatan di Indonesia. Praktik ilmu keperawatan yang berkualitas harus diimbangi dengan pembuktian secara Evidence Base Nursing (EBN) karena EBN bisa menjadi landasan dalam melaksanakan peran pemberi asuhan, pendidik, peneliti, dan innovator yang profesional. Praktik residensi telah memberikan pengalaman dan menambah pengetahuan residensi tentang keperawatan kardiovaskular. Penerapan teori Lydia Hall: Care, Core, dan Cure dilakukan oleh residensi pada 30 kasus resume dan satu kasus kelolaan yaitu pada pasien dengan STEMI. Peran peneliti telah dilakukan dengan menerapkan EBN tentang penerapan Slow Deep Breathing Relaxation Exercise (SDBRE) setelah chest tube removal pada pasien yang menjalani CABG di Ruang Intermediate Ward Bedah. Penerapan SDBRE didapatkan efektif dalam menurunkan nyeri setelah chest tube removal. Peran Inovasi dilakukan dengan menyusun protokol Munro Scale untuk mencegah kejadian Perioperative Related Pressure Injury pada pasien Bedah jantung. Munro Scale didapatkan mampu mendeteksi adanya resiko Pressure Injury, mudah dipahami oleh perawat, dan mudah dilaksanakan oleh perawat kamar bedah dalam perawatan. Namun sebaiknya follow up pengkajian Munro Scale dilakukan di ruangan ICU bedah, IW Bedah, dan Rawat Inap.

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Ischemic Heart Disease is one of the most common causes of death in the world and its frequency continues to increase every year. This is a big challenge for a nurse in health services in Indonesia. Quality nursing practice must be balanced with Evidence Based Nursing (EBN) evidence because EBN can be the basis for carrying out the role of professional caregivers, educators, researchers, and innovators. Residency practice has provided experience and increased residency knowledge about cardiovascular nursing. The application of Lydia Hall's theory: Care, Core, and Cure was carried out by residencies in 30 resume cases and one managed case, namely in patients with STEMI. The role of researchers has been carried out by applying EBN regarding the application of Slow Deep Breathing Relaxation Exercise (SDBRE) after chest tube removal in patients undergoing CABG in the Intermediate Ward of Surgery. The application of SDBRE was found to be effective in reducing pain after chest tube removal. The role of innovation is carried out by compiling the Munro Scale protocol to prevent Perioperative Related Pressure Injury in cardiac surgery patients. The Munro Scale was found to be able to detect the risk of Pressure Injury, easily understood by nurses, and easily implemented by operating room nurses in treatment. However, follow-up studies of the Munro Scale should be carried out in the surgical ICU, IW Surgery, and Inpatient rooms."

"Ners spesialis merupakan perawat lulusan program spesialis keperawatan yang mempunyai keahlian khusus dalam asuhan keperawatan. Perawat spesialis keperawatan medikal bedah peminatan kardiovaskular harus mempunyai kompetensi keperawatan inti dan keperawatan berbagai masalah kardiovaskular. Pendidikan residensi spesialis dilakukan selama 2 semester dengan tujuan utama melakukan asuhan keperawatan medikal bedah khususnya sistem kardiovaskular dengan menggunakan pendekatan teori kenservasi Levine. Asuhan keperawatan pada 1 kasus utama post operasi total koreksi TOF dan 30 kasus resume yang terdiri dari 6 kasus besar gangguan sistem kardovaskular meliputi kasus sindrom koroner akut, kelainan katup jantung, kelainan pembuluh darah, gagal jantung, kasus bedah (katup, CABG) dan disritmia. model konsep konservasi Levine dapat diterapkan pada pasien gangguan sistem kardiovaskular untuk mempertahankan wholeness dan adaptasi. Pemberian ice cube absorption dapat mengurangi sore throat pasca ekstubasi pasien bedah jantung. Proyek inovasi penerapan Awakening and Spontaneous Breathing Trial (SBT) Protocol pada pasien pasca bedah jantung yang terpasang ventilasi mekanik dan sedasi. Protokol mudah dipahami dan membantu perawat dalam proses weaning ventilasi mekanik.

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Nurse Specialist is an advanced practice nurse and have special skill in nursing care, graduate from the nursing specialist program. Nurse Specialist medical surgical nursing in cardiovascular specialization must have core nursing competencies and nursing of various cardiovascular problems. Specialist residency education is carried out two semesters with the aim of providing medical-surgical nursing care, especially the cardiovascular system, using Levine's conservation theory approach. Nursing care of one main case in after total correction TOF and thirty resume cases consisting of six major cases of cardiovascular system disorders: acute coronary syndrome, heart valve disorders, blood vessel disorders, heart failure, surgical cases (valve, CABG) and dysrhythmia. Levine's conservation concept model can be applied to patients with cardiovascular system disorders to maintain wholeness and adaptation. Ice cube absorption can reduce sore throat after extubation of cardiac surgery. An innovation project for the application of the Awakening and Spontaneous Breathing Trial (SBT) Protocol in post-cardiac surgery patients who are mechanically ventilated and sedated. The protocol is easy to understand and helps nurses in the process of weaning mechanical ventilation."