Hasil Pencarian  ::  Simpan CSV :: Kembali

"Karya Ilmiah Akhir ini bertujuan untuk menjelaskan seluruh rangkaian kegiatan praktik residensi keperawatan medikal bedah dalam memberikan asuhan keperawatan pada pasien dengan berbagai macam gangguan sistem persarafan dengan pendekatan teori Adaptasi Roy, kegiatan penerapan evidence based nursing practice berupa efektifitas penggunaan Patient Health Questionnaire 9 (PHQ-9) untuk skrining depresi pada pasien post cedera kepala dan kegiatan inovasi keperawatan berupa penggunaan Barthel Indeks untuk mengkaji status fungsional pasien. Seluruh rangkaian kegiatan tersebut diharapkan dapat meningkatkan kualitas asuhan keperawatan pada pasien neurologi dimasa yang akan datang.

---

The purpose of this final scientific report is to describe series of activities in clinical practice residency in medical surgical nursing in providing nursing care on patient with various neurological system disorders using Roy’s Adaptation theory. Another activities includes implementation of evidence based nursing practice on the effect of Patient Health Questionnaire 9 (PHQ-9) to screen the depression level on post head injury patients, and the innovation activity was on the use of Barthel index assessment to assess patient’s functional status. From those series activities, it is expected to improve nursing care quality on patient with neurological disorder in the future."

"Karya Ilmiah ini mengambarkan kegiatan praktik ners spesialis dalam memberikan asuhan keperawatan pada pasien dengan gangguan system persarafan dengan kasus utama pada pasien dengan stroke hemoragik. Pada praktik ini residen juga menerapkan evidence based nursing practice berupa masase abdomen pada klien stroke dengan konstipasi sehingga memperbaiki kondisi konstipasi dan frekuensi buang air besar serta menerapkan inovasi pengkajian menggunakan indek barthel untuk mengukur kemampuan fungsional paisen dalam melakukan aktivitas kehidupan sehari- hari.

---

The purpose of this final scientific report is to describe advance clinical practice activities in providing nursing care on patient with neurological system disorder with haemoragic stroke as the majority case. In this residency clinical practice, we tried to implement evidence based nursing practice on abdominal massage of stroke client who experience constipation. This intervention can decrease constipation and improve defecation, and the innovation activity was on the use of Barthel index assessment to assess patient’s functional status in performing their daily activities."

"Laporan ini adalah hasil analisis asuhan keperawatan dan peran perawat selama melaksanakan praktik residensi spesialis keperawatan medikal bedah dengan peminatan sistem muskuloskeletal. Penulis berperan sebagai pemberi asuhan keperawatan, peneliti, pendidik dan innovator di RSUP fatmawati Jakarta. Sebagai pemberi asuhan keperawatan, penulis mengaplikasikan penerapan model adaptasi Roy dalam memberikan asuhan keperawatan pada pasien dengan gangguan sistem musculoskeletal. Penerapan praktik keperawatan berbasis bukti mengujicobakan pengkajian resiko ulkus dekubitus dengan menggunakan skala Braden sebagai langkah perbaikan upaya deteksi dini ulkus dekubitus. Inovasi dilaksanakan dengan menerapkan pendidikan kesehatan terpadu berupa manajemen nyeri, konstipasi, ulkus dekubitus dan risiko jatuh pada pasien dengan gangguan sistem muskuloskeletal.

---

This report is the result of analysis toward nursing care and the role of nurses during the clinical practice on medical-surgical nursing residency with specialization in the musculoskeletal system. The author role as nursing care provider, researcher, educator and innovator in Fatmawati Hospital Jakarta. As a provider of nursing care, the authors applied the Roy Adaptation Model to provide nursing care in patients with musculoskeletal system disorders.

Application of evidence-based nursing practice applied by using the Braden scale as a pressure ulcer risk assessment to early detection of pressure ulcers. Innovation implemented by applying an integrated health education in management of pain, constipation, pressure ulcers and risk of falls in patients with musculoskeletal system disorders."

"Fraktur hip merupakan masalah pada gangguan system musculoskeletal yang lebih sering diderita oleh usia lanjut ketika penulis melaksanakan praktik residensi keperawatan. Penulis menggunakan pendekatan model adaptasi Roy dalam pemberian asuhan keperawatan kepada pasien dengan fraktur hip yang menjalani hemiarthoplasty, dan pada 33 pasien kasus resume gangguan system musculoskeletal lainnya. Melalui pendekatan adatptasi Roy, pasien mampu beradaptasi dengan masalahnya selama menjalani perawatan di rumah sakit. Hasil kegiatan praktik keperawatan berdasarkan pembuktian (evidence besed nursing) mengenai multi intervensi dalam pencegahan jatuh terhadap pasien, dihasilkan intervensi yang lebih baik dan mendukung upaya pencegahan pasien jatuh di rumah sakit. Pelaksanaan inovasi pendidikan kesehatan dengan media booklet mampu meningkatkan kepercayaan diri perawat dalam memberikan pendidikan kesehatan secara komprehensif kepada pasien.

---

Hip fracture is the most common disturbance in musculoskeletal system to older patient. Nurses have a role in giving nursing care using systemically Roy adaptation model in order to make hip fracture’s patient adaptation and integrated in managing his daily life condition. The purpose of practical residency in Medical Surgical Nursing Focusing on Patient with musculoskeletal disturbance is to analyze practical using Roy adaptation model in performing the role of care provider, innovator, facilitator, resource person, coordinator, and role model.

The result of the implementation of evidence besed nursing multi-interventions falls prevention can improve falls prevention programe on Fatmawati Hospital Jakarta. The result of the innovation program is guidance book (booklet) in musculoskeletal patient problem , that can improve nurse's confidence to give health education."

"Praktik klinik lanjut di ruang neurologi bertujuan memberikan asuhan keperawatan pada pasien gangguan neurologi khususnya spondilitis TB menggunakan teori keperawatan Model Adaptasi Roy, menerapkan paraktik keperawatan berdasarkan pembuktian dan melakukan inovasi keperawatan. Masalah keperawatan yang sering muncul akibat perilaku inefektif pada mode adaptasi fisiologis yaitu perfusi jaringan serebral tidak efektif, mode adaptasi konsep diri yaitu kecemasan, sedangkan mode fungsi peran yaitu pemeliharan kesehatan tidak efektif. Intervensi keperawatan berdasarkan pembuktian yaitu Pemakaian Bantal dekubitus untuk mencegah terjadinya ulkus tekan pada tumit. Inovasi keperawatan yaitu program bladder training pada pasien gangguan neurologis setelah pelepasan kateter. Perawat dapat menerapkan Model Adaptasi Roy, pemakaian bantal dekubitus untuk mencegah terjadinya luka tekan pada tumit dalam memberikan asuha keperawatan pada gangguan neurologi.

---

Advanced clinical practice on patient with neurogical system disorder specialy Spondylosis Tuberculluse using Roy’s Adaptation theory is implementataion of nursing practice based on evidence and implementation of nursing innovation. The most frequent nursing problem occurred was ineffective cerebral tissue perfusion caused by ineffective behaviour response on physical adaptation mode, anxiety from self-esteem mode. Ineffective self-care management was nursing problem from role function mode. Nursing intervention based on evidence based practice on Using heel pressure cushion to prevent heel pressure. Nursing innovation in this clinical practice was Bladder training programme for neurological system disorder. Nurse can implement Roy’s Adaptation Theory with using heel pressure cushion, and innovation activities in delivering nursing care on neurogical disorder"

"Sistem muskuloskeletal memberikan perlindungan terhadap organ vital tubuh gangguan pada sistem tersebut memberikan dampak serius bagi kondisi kesehatan seseorang kualitas hidup keuangan kenyamanan fisik dan kesehatan psikologis Penyakit dan cidera di Indonesia paling banyak merupakan kejadian patah tulang Pada kondisi patah tulang dapat mengakibatkan insufisiensi vaskuler dan kompresi saraf serta sindroma kompartemen Perawat spesialis medikal bedah berperan penting dalam penatalaksanaan asuhan keperawatan melalui pendekatan Model Adaptasi Roy pada kasus multipel fraktur dan sindroma kompartemen penerapan pemberian edukasi singkat dan latihan relaksasi nafas dalam sebagai upaya menurunkan nyeri pada klien post operasi ORIF Open Reduction Intra Fixation serta peran sebagai inovator melalui pengembangan program SBAR Situation Background Assessment Recommendation dalam handover perawat ruangan Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy sesuai dalam pengelolaan asuhan keperawatan pada multipel fraktur dan sindroma kompartemen Pemberian edukasi singkat dan latihan relaksasi nafas dalam mampu menurunkan tingkat nyeri secara efektif hingga hari ke 7 setelah operasi pemasangan ORIF Pengembangan program SBAR dilakukan melalui pembuatan panduan berdasarkan kasus yang sering terjadi di ruangan bedah orthopedi RSUP Fatmawati sehingga melalui panduan tersebut perawat dapat melakukan timbang terima menggunakan SBAR khususnya pada pasien dengan gangguan muskuloskeletal Kata kunci Model Adaptasi Roy fraktur multipel Edukasi singkat dan nafas dalam SBAR Depok 21 Agustus 2015 Mengetahui Suvervisor Utama Mahasiswa Dr Debie Dahlia S Kp MHSM Annas Sumeru.

---

The musculoskeletal system provides protection against the body 39 s vital organs disturbances in the system create serious implications for a person 39 s health condition quality of life financial physical comfort and psychological health Disease and injury in Indonesia mostly caused by incidence of fractures Fractures could possibly lead to vascular insufficiency and nerve compression as well as compartment syndrome Medical surgical nurse specialist plays an important role in the management of nursing care by Roy Adaptation Model approach in the case of multiple fractures and compartment syndrome the application of brief educational and breathing relaxation exercises to reduce pain level of patient attempt ORIF Open Reduction Intra Fixation as well as a role as innovator through the development of SBAR Situation Background Assessment Recommendation programs for nurse handover The results of the analysis of practices shows that Roy Adaptation Model fit in the management of nursing care in multiple fractures and compartment syndrome Giving a brief educational and breathing relaxation exercises able to effectively reduce pain until the 7th day after ORIF surgery SBAR program development is done through the creation of guidelines based on the case that often occur in orthopedic ward of RSUP Fatmawati so that through the guidance of nurses can using SBAR particularly in patients with musculoskeletal disorders Keywords Roy Adaptation Model multiple fracture brief educational and breathing relaxation exercise SBAR Depok 21 Agustus 2015 Mengetahui Suvervisor Utama Mahasiswa Dr Debie Dahlia S Kp MHSM Annas Sumeru."

"Karya tulis ilmiah ini merupakan gambaran tentang pelaksanaan praktek residensi keperawatan medikal bedah yang telah dilaksanakan selama dua semester. Tiga kegiatan utama yang telah dilakukan di antaranya melakukan asuhan keperawatan pada pasien dengan gangguan sistem perkemihan, praktek keperawatan yang berbasis dengan pembuktian, dan melakukan inovasi keperawatan. Asuhan keperawatan yang dilakukan pada pasien dengan gangguan sistem perkemihan menggunakan model konseptual comfort Kolcaba. Pengkajian pada comfort Kolcaba meliputi physical, psychospiritual, enviromental, dan sociocultural. Masalah keperawatan yang sering muncul pada pasien dengan gangguan sistem perkemihan adalah nyeri akut dan kronis, kelebihan volume cairan, keletihan, cemas, intoleransi aktifitas, pola napas tidak efektif, dan koping individu tidak efektif. Untuk mengatasi masalah tersebut telah dilakukan intervensi secara standart, coaching, dan comfort food the soul. Praktek keperawatan berbasis pembuktian dengan melakukan PFME untuk menurunkan inkontinensia urine pada pasien post TURP. Hasil menunjukkan ada penurunan kejadian inkontinensia urine sampai 0% setelah empat minggu. Inovasi dilakukan dengan melaksanakan inisasi dialisis dengan media booklet, leaflet, dan video untuk pasien yang menolak dilakukan dialisis. Hasil program inovasi menunjukkan adanya peningkatan kesiapan pasien dalam melakukan dialisis sebesar 75%. Disimpulkan bahwa model konseptual comfort Kolcaba dapat mengembalikan kondisi discomfort pasien menjadi comfort pada pasien dengan gangguan sistem perkemihan. Disarankan agar model konseptual comfort Kolcaba dapat diterapkan dalam pemberian asuhan keperawatan pada pasien dengan gangguan sistem perkemihan. PFME dapat dilakukan untuk menurunkan inkontinesia urine pasien post TURP sehingga dapat meningkatkan kualitas hidup pasien. Inovasi ini dapat dikembangkan guna mempersiapkan pasien dalam menjalani dialisis.

---

This scientific paper is an overview of the implementation of medical surgical nursing practice residency that has been carried out during two semesters. The three main activities that have been carried out were providing nursing care to patients with the urinary system disorders, had been evidence based nursing practices, and nursing innovation. Nursing care had been patients with urinary system disorders using a conceptual model of Kolcaba comfort. Assessment on comfort Kolcaba include physical, psychospiritual, enviromental, and sociocultural. Nursing problems that often occured in patients, were acute and chronic pain, fluid volume overload, fatigue, anxiety, activity intolerance, ineffective breathing pattern, and individual coping ineffective. To overcome these problems had been done in the standard intervention, coaching, and comfort food the soul. Evidence based nursing practice by doing PFME to reduce urinary incontinence in patients with post TURP.

The results showed there was a decrease in the incidence of urinary incontinence to 0 % after four weeks PFME. Innovation nursing was done by performing initiation of dialysis with media booklets, leaflets, and videos for patients who undergoing dialysis. The results showed an increase in program innovation readiness in dialysis patients by 75 %. It is concluded that the conceptual model of comfort Kolcaba can restore the patient's discomfort into comfort in patients with disorders of the urinary system. It is suggested that the conceptual model of Kolcaba Gomfort can in the provision to patients with the urinary system disordes. PFME can be done to reduce urinary incontinence post TURP patients so as to improve the quality of life of patients. Innovation of initiation of dialysis may be developed in order to prepare patients undergoing dialysis."

"Praktik Residensi Keperawatan Medikal Bedah merupakan suatu rangkaian kegiatan Pendidikan Ners Spesialis Keperawatan yang berfokus pada penerapan ilmu, riset dan teknologi keperawatan dalam memenuhi kebutuhan dasar pada pasien dewasa secara komprehensif. Kegiatan praktik residensi ini terdiri dari pemberian asuhan keperawatan pada pasien dengan gangguan sistem perkemihan menggunakan pendekatan model adaptasi Roy, dilaksanakan di RS Fatmawati Jakarta. Asuhan keperawatan utama dilakukan pada pasien Sindrom Nefrotik dengan Efusi Pleura dan Asites Moderat. Penerapan Evidence Based Nursing (EBN) berupa intervensi teknik needle bevel down dalam mengurangi waktu perdarahan post removal kanulasi fistula pada pasien hemodialisis. PD SMART MODUL merupakan proyek inovasi yang dilakukan residen berupa Peritoneal Dialysis Nurse Educator Guidance dalam upaya meningkatkan mutu pelayanan training pasien baru dan menurunkan risiko komplikasi CAPD.

---

Surgical Nursing Residency Practice is a series of Nursing Specialist Ners Education activities that focus on the application of nursing science, research and technology in meeting basic needs in adult patients comprehensively. This residency practice activity consists of providing nursing care to patients with urinary system disorders using the Roy adaptation model approach, carried out at Fatmawati Hospital. The main nursing care is carried out in patients with Nephrotic Syndrome with pleural effusion and moderate ascites. Application of Evidence Based Nursing (EBN) in the form of needle bevel down insertion interventions for hemodialysis patients in reducing post-removal fistula cannulation bleeding time. PD SMART MODUL is an innovation project carried out by residents in the form of Peritoneal Dialysis Nurse Educator Guidance in an effort to improve the quality of new patient training services and reduce the risk of CAPD complications."

"Asuhan keperawatan yang komprehensif memerlukan fungsi dan peran profesi ners spesialis untuk meningkatkan kualitas pelayanan di bidang keperawatan. Pendidikan profesi ners spesialis keperawatan medikal bedah peminatan imunologi melatih kompetensi dalam pengelolaan asuhan keperawatan kasus gangguan sistem imunologi HIV yang disertai infeksi oportunistik, melatih pengembangan intervensi keperawatan berbasis fakta ilmiah melalui implementasi Evidence based Nursing (EBN), melatih penyusunan dan pelaksanaan proyek inovasi keperawatan. Pengelolaan asuhan keperawatan pada 1 kasus utama pasien Efusi Pleura dengan TB Paru pada HIV dan 30 resume kasus HIV dengan infeksi oportunistik dimana presentase paling banyak ditemukan secara berurutan adalah Candidiasis oral, Diare, TB Paru, Pneumonia, TB limfadenopathy, Kondiloma akuminata, dan Anemia. Penerapan teori model adaptasi Roy pada asuhan keperawatan pasien HIV meningkatkan mekanisme koping yang adaptif dalam merespon perubahan stimulus mode adaptasi. Penerapan teori model kognitif sosial Bandura menekankan pengkajian pada faktor individu, perilaku dan lingkungan yang saling mempengaruhi dalam perawatan HIV/ AIDS. Sedangkan pada evaluasi implementasi EBN, didapatkan intervensi breathing exercise yang dapat meningkatkan kualitas tidur pasien HIV/AIDS secara efektif. Proyek inovasi VOSIL SPARTAN dilaksanakan sebagai upaya pencegahan infeksi oportunistik (IO) dan peningkatan perilaku hidup bersih sehat (PHBS) pada pasien HIV/ AIDS. Hasil inovasi keperawatan berupa edukasi memanfaatkan teknologi QR code meningkatkan pengetahuan dan sikap dalam pencegahan infeksi oportunistik dan PHBS secara efektif.

---

Comprehensive nursing care requires the function and role of the specialist nurse profession to improve the quality of services in the nursing field. Professional education for nurses specializing in medical surgical nursing specializing in immunology trains competency in managing nursing care in cases of HIV immunological system disorders accompanied by opportunistic infections, trains the development of nursing interventions based on scientific facts through the implementation of Evidence Based Nursing (EBN), trains the organization and implementation of nursing innovation projects. Management of nursing care in 1 main case of Pleural Effusion patient with Pulmonary TB in HIV and 30 resumes of HIV cases with opportunistic infections where the highest percentages found in sequence were Oral Candidiasis, Diarrhea, Pulmonary TB, Pneumonia, TB lymphadenopathy, Condyloma acuminata, and Anemia. The application of Roy's adaptation model theory to nursing care for HIV patients increases adaptive coping mechanisms in response to changes in adaptation mode stimuli. The application of Bandura's social cognitive model theory emphasizes the study of individual, behavioral and environmental factors that influence each other in HIV/AIDS care. Meanwhile, in the evaluation of EBN implementation, it was found that breathing exercise interventions could effectively improve the sleep quality of HIV/AIDS patients. The VOSIL SPARTAN innovation project was implemented as an effort to prevent opportunistic infections (OI) and improve clean and healthy living behavior (PHBS) in HIV/AIDS patients. The results of nursing innovation in the form of education utilizing QR code technology increase knowledge and attitudes in preventing opportunistic infections and PHBS effectively."

"Peran perawat spesialis neurosains dalam praktik keperawatan antara lain sebagai pemberi asuhan keperawatan lanjut, melaksanakan pembuktian ilmiah, pendidik, advokat, kolaborator, dan agen pembaharu. Asuhan keperawatan lanjut dilaksanakan pada pasien dengan kasus tumor otak dan 30 pasien gangguan neurologi menggunakan pendekatan model adaptasi Roy. Perilaku maladaptif paling banyak terganggu pada mode fisiologis dengan diagnosis ketidakefektifan perfusi jaringan serebral. Penerapan Evidence Based Nursing berupa latihan Range of Motion (ROM) pasif bilateral ekstremitas atas pada dua pasien stroke akut dengan hemiparese menunjukkan hasil peningkatan fungsi ekstremitas atas dan Activity of Daily Living (ADL). Program inovasi pengembangan media edukasi perawatan pasien kraniotomi pengangkatan tumor menunjukkan peningkatan pengetahuan pasien secara signifikan (p=0,038) dan memudahkan perawat dalam memberikan edukasi secara efektif.

---

The role of nurse specialist in nursing practice consist of advanced nursing care providers, conduct scientific evidence, educator, advocat, collaborator, and change agent. Advanced nursing care is done by Roy Adaptation Models approach on brain tumor and 30 other neurological disorders patients. Maladaptive behavior at most in a physiological mode with ineffective cerebral perfusion nursing diagnosis.

Evidence Based Nursing was performed by applying bilateral passive Range of Motion (ROM) of upper extremity at two acute stroke patient with hemiplegi and it showed an increase in function of upper extremities and the activity of daily living. The innovation programme by develop an education media for caring patient with craniotomy removal tumor showed significant increase in patient knowledge (p=0,038) and help nurses to give an effective education."