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"Kemampuan menghisap bayi prematur dapat ditingkatkan dengan pemberian stimulasi non nutritive sucking (NNS) dengan menggunakan empeng. Penelitian ini bertujuan untuk membuktikan pengaruh stimulasi NNS menggunakan empeng terhadap lama penggunaan sonde dalam pemberian minum bayi prematur. Desain penelitian menggunakan kuasi eksperimen dengan post test only with control group design denan sampel 20 responden untuk 2 kelompok yang dipilih secara purposive sampling di salah satu rumah sakit daerah di Tangerang. Pengumpulan data menggunakan kuesioner dan instrumen lembar observasi indikator pelepasan sonde dan dianalisis dengan independent t test. Hasil penelitian menunjukkan tidak ada pengaruh stimulasi NNS dengan menggunakan empeng terhadap lama penggunaan sonde dalam pemberian minum bayi prematur (p=0,379, α=0,05), namun, masa penggunaan sonde lebih pendek. Peneliti merekomendasikan agar stimulasi NNS dengan menggunakan empeng tetap dijadikan prosedur alternatif untuk meningkatkan refleks menghisap pada bayi prematur.

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An adequate sucking can be improved a premature infant's sucking reflex with non nutritive sucking stimulation (NNS) with pacifier. The purpose of this research was to identify the influence of NNS stimulation with pacifier towards the duration of gastric tube usage during premature infant feeding.

The design of this research was quasi experimental with post test only control group design with 20 respondents for two groups, then were chosen by purposive sampling in one of Tangerang District Hospital. The data were collected using a questionnaire and an observation form. Data were analized using independent t test.

The result of this research showed that there was no influence of NNS with pacifier towards the duration of gastric tube usage (p=0,379; α=0,05), however the duration of gastric tube usage was shortened. This research recommends that non nutritive sucking stimulation with pacifier is an alternative procedures to improve a premature infant's sucking reflex."

"[ABSTRAKPerawatan bayi prematur di unit perawatan intensifdapat menimbulkan stimulasi berlebihan bahkan stres fisik pada bayi akibat prosedur invasif yang rutin dilakukan.Studi fenomenologi ini bertujuan untuk mengetahui pengalaman perawat dalam mengambil keputusan etik untuk pelaksanaan tindakan invasif pada bayi prematur.Partisipan berjumlah 7 orang perawat di ruang perinatologi yang dipilih secara purposive sampling. Hasil penelitian mengidentifikasi empat tema: (1)masalah etik yang ditemui dalam pelaksanaan prosedur invasif, 2) kebutuhan perawat untuk mampu mengambil keputusan etik, 3) hambatan dalam mengambil keputusan, dan 4) perilaku etis saat pelaksanaan prosedur invasif. Penelitian selanjutnya diharapkan dapat mengevaluasi secara kuantitatif kemampuan pengambilan keputusan etik perawat dalam pelaksanaan tindakan invasif selama proses asuhan keperawatan pada bayi prematur.

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ABSTRACTThe treatmentof premature infants at intensive care units may give excessive stimulation even physical stress due toinvasive procedures. The aims of this phenomenological studyis to determine thenurses experiences in ethical decision making for the implementation of invasive procedure. The total of the participants is 7 nurses at perinatology unit which selected by purposive sampling. The results identified four themes: (1) ethical issues encountered in the implementation of invasive procedures, (2) nursing ability to make ethical decisions, (3) some common barriers in decision making, and (4) ethical behavior during the implemention of invasive procedures. Future studies are expected to evaluate quantitatively the ability of nurse ethical decision making in the implementation of invasive procedures during the nursing processfor premature infants.;The treatmentof premature infants at intensive care units may give excessive stimulation even physical stress due toinvasive procedures. The aims of this phenomenological studyis to determine thenurses experiences in ethical decision making for the implementation of invasive procedure. The total of the participants is 7 nurses at perinatology unit which selected by purposive sampling. The results identified four themes: (1) ethical issues encountered in the implementation of invasive procedures, (2) nursing ability to make ethical decisions, (3) some common barriers in decision making, and (4) ethical behavior during the implemention of invasive procedures. Future studies are expected to evaluate quantitatively the ability of nurse ethical decision making in the implementation of invasive procedures during the nursing processfor premature infants.;The treatmentof premature infants at intensive care units may give excessive stimulation even physical stress due toinvasive procedures. The aims of this phenomenological studyis to determine thenurses experiences in ethical decision making for the implementation of invasive procedure. The total of the participants is 7 nurses at perinatology unit which selected by purposive sampling. The results identified four themes: (1) ethical issues encountered in the implementation of invasive procedures, (2) nursing ability to make ethical decisions, (3) some common barriers in decision making, and (4) ethical behavior during the implemention of invasive procedures. Future studies are expected to evaluate quantitatively the ability of nurse ethical decision making in the implementation of invasive procedures during the nursing processfor premature infants., The treatmentof premature infants at intensive care units may give excessive stimulation even physical stress due toinvasive procedures. The aims of this phenomenological studyis to determine thenurses experiences in ethical decision making for the implementation of invasive procedure. The total of the participants is 7 nurses at perinatology unit which selected by purposive sampling. The results identified four themes: (1) ethical issues encountered in the implementation of invasive procedures, (2) nursing ability to make ethical decisions, (3) some common barriers in decision making, and (4) ethical behavior during the implemention of invasive procedures. Future studies are expected to evaluate quantitatively the ability of nurse ethical decision making in the implementation of invasive procedures during the nursing processfor premature infants.]"

"Masalah pemberian nutrisi merupakan salah satu yang sering terjadi pada bayi prematur disebabkan imaturitas sistem gastrontestinal dan menimbulkan peningkatan volume residual lambung. Memposisikan bayi pada posisi prone diketahui mempercepat penyerapan lambung, namun posisi prone mempunyai dampak negative meningkatkan abnormalitas postur, dan risiko sindrom kematian bayi mendadak. Salah satu alternatif yang dapat dilakukan adalah posisi quarter prone karena memiliki efektifitas yang sama dengan posisi prone tanpa efek samping yang merugikan. Penelitian ini bertujuan untuk mengidentifikasi pengaruh posisi quarter prone terhadap volume residual lambung bayi prematur. Penelitian ini menggunakan Randomized Control Trial RCT crossover design dengan 18 responden. Pemilihan sampel dengan simple random sampling. Hasil penelitian menunjukkan adanya pengaruh posisi quarter prone terhadap volume residual lambung bayi prematur dibandingkan dengan posisi supinasi p value 0,0001 . Pemberian posisi quarter prone efektif menurunkan volume residual lambung pada bayi prematur. Pemberian posisi ini dapat diterapkan sebagai salah satu tindakan keperawatan mandiri dalam mengoptimalkan pemberian nutrisi pada bayi prematur.

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The problem of nutritional management often occurs in preterm infants due to gastrointestinal immaturity lead increased residual volume. Positioning preterm infants on prone position considered to influence gastric emptying but prone position has a negative effect of increasing postural abnormalities, and risk of sudden infant death syndrome. An alternative can be done is quarter prone position because it has the same effectiveness with prone without adverse side effects. This study aims to identify the effect of quarter prone position on gastric residual. This research used Randomized Control Trial RCT crossover design simple random sampling with 18 respondents. The results showed the effect of quarter prone position on the gastric residual compared with supine position p 0.0001 . Positioned in quarter prone effective decreases gastric residual in preterm infants. It is suggested positioned in the quarter prone can be applied as one of independent nursing intervention in optimizing Nutritional management of the preterm infant."

"Bayi Prematur lahir disertai berbagai masalah kesehatan. Masalah yang sering terjadi adalah distress pernapasan dan lemahnya refleks hisap dan menelan yang mengakibatkan masalah pemberian nutrisi. Stimulasi NNS dan latihan oral motorik dapat membantu bayi prematur untuk meningkatkan kemampuan menghisap dan menelan. Penelitian ini menggunakan rancangan uji klinik acak terkontrol dengan menggunakan pendekatan pre dan post test control group. Sampel dalam penelitian ini berjumlah 26 bayi prematur yang dirawat di tiga RSUD di sekitar Kota Sukabumi. Sampel terbagi menjadi dua kelompok intervensi, masing-masing 13 responden untuk setiap kelompok. Hasil penelitian ini menunjukkan terdapat perbedaan bermakna rerata skor kesiapan minum sebelum dan setelah intervensi stimulasi NNS dan latihan oral motorik pada bayi prematur dengan pemasangan alat bantu napas NCPAP p0,05. Stimulai NNS dan latihan oral motorik dapat meningkatkan kesiapan minum pada bayi prematur dengan pemasangan alat bantu napas NCPAP yang ditandai dengan peningkatan skor kesiapan minum melalui oral, sehingga perlu diimplementasikan dalam pemberian asuhan keperawatan pada bayi prematur. Rekomendasi untuk penelitian selanjutnya adalah membandingkan stimulasi NNS, latihan oral motorik, dan gabungan dari kedua intervensi tersebut.

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Premature baby is born with various health problems. The most common problems are respiratory distress and poor suction and swallowing reflexes that lead to nutritional problems. NNS stimulation and oral motor stimulation can help premature babies to improve their ability to suck and swallow. This study used a randomized controlled clinical trial design using pre and post test control group approaches. The sample in this study amounted to 26 premature infants treated in three hospitals around the city of Sukabumi, 13 respondents for each intervention group.

The results of this study indicate that there is a significant difference mean of oral feeding readiness score before and after NNS stimulation and oral motor stimulation intervention in premature infant with NCPAP p 0.05 . Stimulation of NNS and oral motor may improve oral feeding readiness in premature infants with NCPAP characterized by increasing oral feeding readiness scores, so it needs to be implemented in nursing care in premature infants. The recommendation for further research is to compare NNS stimulation and oral motor exercise with a combination of both interventions."

"Bayi prematur sulit untuk mencapai kemampuan minum akibat imaturitas sistem pencernaannya. Kondisi ini menyebabkan perawatan yang lebih lama di rumah sakit. Penelitian ini bertujuan untuk mengetahui efektivitas gabungan stimulasi oromotor dan pemberian nonnutritive sucking terhadap kecepatan minum bayi mencapai fullfeed, peningkatan volume minum, peningkatan berat badan, dan kesiapan minum bayi prematur. Rancangan penelitian ini adalah randomized control trial dengan desain paralel yang melibatkan jumlah sampel sebanyak 52 bayi prematur. Responden yang mendapatkan stimulasi oromotor dan pemberian nonnutritive sucking sebanyak 26 bayi prematur (kelompok intevensi) dan yang mendapatkan perawatan rutin RS sebanyak 26 bayi prematur (kelompok kontrol). Hasil penelitian mengidentifikasi rerata kecepatan minum bayi mencapai fullfeed pada kelompok intervensi dan kontrol (10,04, 9,73, p<0,001), Peningkatan berat badan yang signifikan pada kelompok intervensi dan kontrol (2,392,2,204,p< 0,001), dan terdapat rerata peningkatan volume minum pada kelompok intervensi dan kontrol (33,65, 29,9, p<0,001). Intervensi stimulasi oromotor dan pemberian nonnutritive sucking dapat menjadi alterrnatif tindakan perawat untuk mengatasi masalah kesulitan minum pada bayi prematur.

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Premature babies find it difficult to achieve the ability to drink due to the immaturity of their digestive system. This condition leads to a longer stay in the hospital. This study aims to determine the combined effectiveness of oromotor stimulation and non-nutritive sucking on the speed of feeding babies to reach full feed, increasing drinking volume, increasing body weight and readiness to drink premature babies. The design of this study was a randomized control trial with a parallel design involving a sample of 52 premature infants. Respondents who received oromotor stimulation and nonnutritive sucking were 26 premature babies (intervention group) and 26 premature babies who received routine hospital care (control group). The results of the study identified that there was an increase in the speed of infant feeding reaching full feed in the intervention and control groups (10.04, 9.73, p<0.001), weight gain in the intervention and control groups (2,392.2,204, p<0.001), there was an increase in volume drinking in the intervention and control groups (33.65, 29.9, p<0.001). and an increase in drinking readiness after the intervention in the intervention and control groups showed an increase (10.04% ,9.73%). Oromotor stimulation and the provision of nonnutritive sucking can be an alternative action for nurses to overcome the problem of drinking difficulties in premature infants."

"Kelahiran prematur merupakan penyebab terbesar kematian bayi. Perawatan metode kanguru atau PMK merupakan salah satu perawatan yang efektif bagi bayi prematur. Tujuan penelitian ini adalah mengetahui pengaruh PMK terhadap respon fisiologis bayi prematur dan kepercayaan diri ibu dalam merawat bayi di dua rumah sakit di Jakarta. Desain penelitian adalah one-group pre dan post test. Pengambilan sampel dengan cara purposive sampling. Hasil uji statistik menunjukkan terdapat perbedaan bermakna pada suhu tubuh, frekuensi denyut jantung, saturasi oksigen bayi prematur, dan kepercayaan diri ibu dalam merawat bayi sebelum dan sesudah dilakukan PMK. PMK dapat diusulkan menjadi tindakan rutin di ruangan perinatalogi rumah sakit.

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The main cause of neonatal mortality is premature birth. Kangaroo mother care is one effective care for preterm infants. The purpose of the study was to identify the effect kangaroo mother care on physiological response of preterm infants and self confidence of mother caring infants in two hospitals in Jakarta. The study design was one-group pre and post test. The result of study was founded that the are significant differencies between before and after kangaroo mother care intervention on physiological infants and self confidence of mother. Based on this study, there were some recomendations including kangaroo mother care usage as a part of routine care in hospital."

"Pendahuluan: Prediksi persalinan preterm penting untuk menunda terjadinya kelahiran preterm dan merujuk ke fasilitas dengan perawatan neonatal intensif. Hal ini penting guna menurunkan mortalitas dan morbiditas neonatal. Beberapa metode untuk memprediksi persalinan preterm adalah menggunakan prediksi klinis yaitu indeks persalinan preterm atau prediksi biofisik dengan mengukur panjang servik. Tujuan: Membandingkan nilai risiko indeks persalinan preterm dan panjang servik terhadap kejadian kelahiran preterm pada kasus persalinan preterm tanpa ketuban pecah. Metode: Desain penelitian ini adalah case- control menggunakan data dari rekam medis, dilakukan di RS Dr. Cipto Mangunkusumo sejak Agustus 2013 ? Februari 2014. Semua pasien persalinan preterm tanpa ketuban pecah pada periode tersebut ditelusuri. Dilakukan pengamatan data demografik dan klinis, setelah itu dilakukan penilaian indeks persalinan preterm dan panjang servik. Kemudian selanjutnya pasien ditentukan apakah mengalami kelahiran preterm atau tidak. Hasil: Dari bulan Agustus 2013 - Februari 2014 terdapat 127 kasus persalinan preterm tanpa ketuban pecah, tetapi hanya 57 subjek penelitian yang memenuhi kriteria inklusi dan eksklusi. Karakteristik demografik dan klinis pada kelompok indeks persalinan preterm dan panjang servik tidak berbeda bermakna saat dibandingkan. Duapuluh dari 57 subjek mengalami kelahiran preterm (35.1%). Dari hasil analisis bivariat, variabel yang bermakna mempengaruhi kejadian kelahiran pretem adalah indeks persalinan preterm dan panjang servik. Pasien dengan indeks persalinan preterm ≥ 4 memiliki kemungkinan 4 kali lipat (OR = 4,024) untuk mengalami kelahiran preterm. Sementara itu, pasien dengan panjang serviks ≤ 25 mm memiliki kemungkinan hingga 38 kali lipat (OR = 38,00) untuk mengalami kelahiran preterm. Kesimpulan: Indeks persalinan preterm dan panjang servik merupakan variabel yang baik untuk menilai risiko terjadinya kelahiran preterm pada persalinan preterm tanpa ketuban pecah.

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Introduction: Prediction of preterm labor is important to delay the incident of preterm birth and refers to the facility with a neonatal intensive care. It is important to reduce neonatal mortality and morbidity. Several methods for predicting preterm labor are using clinical prediction : preterm labor index or biophysical prediction with measurement cervical length.

Objectives: comparing risk value of preterm labor index to cervical length on preterm birth incident in preterm labor without rupture of membrane cases.

Methods: the research was a case control study using data from medical records in Dr. Cipto Mangunkusumo hospital since August 2013 ? February 2014. All preterm labor without rupture of membrane cases were traced. Demographic and clinical data were observed. After that preterm labor index and cervical length were assessed. Then patients were determined whether they had experienced preterm birth or not.

Results: From August 2013 - February 2014 there were 127 cases of preterm labor without rupture of membrane, but only 57 research subjects who meet the inclusion and exclusion criteria. The demographic and clinical characteristics of the index group of preterm labor and cervical length did not differ significantly when compared. Twenty from 57 subjects were experience preterm birth (35.1%). From the results of the bivariate analysis, the variables that significantly affect the incidence of preterm birth are preterm labor index and cervical length Patients with preterm labor index ≥ 4 has a possibility of 4-fold (OR = 4.024) to experience preterm birth. Meanwhile, patients with a cervical length ≤ 25 mm have the possibility of up to 38-fold (OR = 38.00) to experience preterm birth.

Conclusions: Preterm labor index and cervical length is a good variable for assessing the risk of preterm birth in preterm labor without rupture of membrane cases."

"Pengosongan lambung merupakan masalah yang sering terjadi pada bayi prematur akibat imaturitas sistem gastrointestinal. Tujuan dari studi kasus ini adalah melakukan analisis penerapan Teori Konservasi Levine pada lima bayi prematur yang mengalami masalah pemenuhan kebutuhan nutrisi melalui pemberian posisi miring kanan, pronasi dan miring kiri bergantian selama tiga hari. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil penerapan intervensi pengaturan posisi pronasi dengan pendekatan Teori Konservasi Levine dapat menurunkan kejadian muntah, distensi abdomen dan pengeluaran residu lambung. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami masalah pengosongan lambung.

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Gastric emptying is a common problem in premature infants due to immaturity of the gastrointestinal system. The objective of this case study was to analyze the application of Levine's Conservation Theory to five premature infants who had problems in fulfilllment the nutritional needs through giving alternate position in the right lateral position, pronation and left lateral position for three days. Levine's Conservation Theory was used by applying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. The results showed that the implementation of pronation positioning using Levine's Conservation Theory can reduce the frequency of vomiting, abdominal distension, and gastric residual. Nurses can apply the intervention as a standard operating procedure in premature infants who experience gastric emptying."

"[ABSTRAKLatar belakang: Prematuritas merupakan salah satu kelainan yang masih menjadimasalah global. Kejadian prematuritas tidak hanya terjadi di negara berkembangtetapi juga di negara maju. Beberapa kondisi ibu hamil dapat memicu keadaanhipoksia dalam rahim sehingga menyebabkan kelahiran prematur. Keadaanplasenta menggambarkan kesejahteraan janin intra uteri. Kondisi hipoksia selulermemicu ekspresi HIF-1α yang menjadi faktor transkripsi bagi CA9 sebagaipenanda hipoksia. Penelitian ini bertujuan menganalisis pengaruh hipoksiaterhadap plasenta prematur.Metode: Sampel menggunakan plasenta prematur yang hipoksia (H) dan nonhipoksia(N) sebagai kontrol. Parameter yang dinilai adalah struktur histologisplasenta (Hematoksilin-Eosin), regulator hipoksia HIF-1α (imunohistokimia), danpenanda hipoksia CA9 (ELISA).Hasil: Penilaian struktur histologis menunjukkan adanya perbedaan jumlahpembuluh darah fetus antara kedua kelompok secara bermakna, dimana padakelompok hipoksia jumlah pembuluh darah fetus lebih banyak dibandingkankelompok non-hipoksia. Distribusi intensitas ekspresi HIF-1α kedua kelompokjuga berbeda bermakna. Rerata kadar CA9 kedua kelompok tidak berbedabermakna, namun terdapat kecenderungan rerata kadar CA9 kelompok hipoksialebih tinggi 28% dibandingkan yang non-hipoksia.Kesimpulan: Pengaruh hipoksia terhadap plasenta prematur pada tingkatmolekuler berupa stabilitas protein HIF-1α yang menyebabkan peningkatanjumlah pembuluh darah fetus dan terjadi kecenderungan peningkatan sintesisprotein CA9.

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ABSTRACTBackground: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein.;Background: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein., Background: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein.]"

"Bayi prematur berisiko tinggi mengalami sepsis neonatorum awitan lambat pada minggu-minggu pertama pasca kelahiran. Tujuan dari studi ini adalah mengaplikasikan Teori Konservasi Levine dalam menurunkan kejadian sepsis neonatorum awitan lambat pada bayi baru lahir prematur dengan pemberian oral care ASI. Proses asuhan keperawatan menggunakan pendekatan Teori Konservasi Levine berdasarkan empat konservasi yaitu konservasi energi, konservasi integritas struktural, konservasi integritas personal dan konservasi integritas sosial. Lima kasus terpilih menunjukkan masalah keperawatan gangguan pertukaran gas, pola nafas tidak efektif, defisit nutrisi, termoregulasi tidak efektif, risiko infeksi dan risiko gangguan perlekatan. Hasil implementasi pemberian oral care ASI dapat menurunkan kejadian sepsis awitan lambat, mempercepat bayi minum penuh dan mempercepat proses penyapihan alat bantu pernafasan. Intervensi ini dapat menjadi standar prosedur operasional bagi perawat dalam memberikan asuhan keperawatan pada bayi baru lahir.

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Premature infants are at high risk for late onset neonatal sepsis in the first few weeks after birth. The aim of this study was to apply the Levine rsquo s Conservation Theory to decrease the incidence of late onset neonatal sepsis in preterm newborns by oral care of ASI. The nursing care process uses the Levine rsquo s Conservation Theory approach based on four conservation, such as conservation of energy, conservation of structural integrity, conservation of personal integrity and conservation of social integrity. Five selected cases indicate nursing problems of gas exchange disorders, ineffective breathing patterns, nutritional deficits, ineffective thermoregulation, infection risk and risk of attachment disturbance. The results of ASI oral care implementation may decrease the incidence of late onset sepsis, accelerate full feed and accelerate the weaning process of respiratory aids. This intervention can be standard operating procedure for nurses in providing nursing care to newborns."