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"Program spesialis keperawatan medikal bedah dengan kekhususan pada sistem muskuloskeletal ini bertujuan mengaplikasikan peran perawat sebagai pemberi asuhan, pengelola, pendidik, peneliti serta sebagai inovator. Peran sebagai pemberi asuhan dilakukan dengan mengelola sebanyak 30 pasien dengan masalah sistem muskuloskeletal dan satu sebagai kelolaan utama dengan kasus open fracture femur dengan pendekatan Need Theory Virginia Henderson. Peran perawat sebagai peneliti dilakukan dengan penerapan tindakan keperawatan yang berbasis bukti ilmiah atau Evidence-Based Nursing Practice yaitu dengan menerapkan skrining kinesiophobia (rasa takut akan gerakan / kembali cedera) pada pasien low back pain dengan the tampa scale for kinesiophobia. Peran sebagai pendidik sekaligus sebagai inovator dilakukan dengan mengembangkan program pendidikan dengan berbasis web yang bertujuan untuk meningkatkan pengetahuan dan kesiapan pulang pada pasien dengan rencana operasi total hip arthroplasty.

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The purpose of this medical-surgical nursing specialist program with a special focus on the musculoskeletal system is to apply the role of nurses as caregivers, managers, educators, researchers and as innovators. The role as a care givers is applies by managing 30 patients with musculoskeletal system problems and one as the main focuses of management, is a case with open fracture of the femur using Virginia Henderson's Need Theory approach. The role of nurses as researchers is explain by implementing scientific evidence-based nursing practices or Evidence-Based Nursing Practice, by applying kinesiophobia screening (fear of movement / reinjury) in low back pain patients with the tampa scale for kinesiophobia. The role as an educator as well as an innovator is implementing by developing a web-based educational program that aims to increase knowledge and readiness to go home in patients with total hip arthroplasty surgery plans."

"Part of the Pediatric Practice series, Pediatric Practice: Ophthalmology is filled with practical, clinically relevant guidance on the successful diagnosis and management of children with ophthalmic symptoms and diseases. The care of the patient forms the core of this book, which also provides perspectives on epidemiology, pathophysiology, and diagnosis that every pediatrician, pediatric resident, and nurse should be familiar with. Over 600 full-color clinical images and illustrations highlight the techniques, diseases, and disorders discussed throughout the book. The book is logically divided into three parts: the first section describes the examination techniques, instruments, and ancillary tests used for evaluation of pediatric eye disorders. The second section on symptoms provides a straightforward how-to approach based on specific clinical presentations allowing pediatricians to quickly evaluate and accurately diagnose a patient in the office. The third section on diseases follows the style of traditional medical textbooks, offering greater detail on treatment of disease while maintaining the book?s easy-to-absorb presentation."

"Untuk meningkatkan mutu pelayanan keperawatan yang berkualitas, tentu dituntut peran perawat yang memiliki kompetensi baik dari segi ilmu pengetahuan juga keterampilan dalam melakukan praktik keperawatan. Sebagai seorang pemberi asuhan keperawatan langsung seorang residensi berperan sebagai Clinical Nurse Spesialist, praktik ini dilakukan di Rumah Sakit Jantung Dan Pembuluh Darah Harapan Kita. Melalui praktik residensi peminatan kardiovaskuler diharapkan juga dapat menjadi konsultan keperawatan bagi staf keperawatan dan edukator bagi pasien, serta peneliti. Dalam perannya memberikan asuhan keperawatan langsung kepada 31 kasus pasien, sebagai seorang pendidik juga ditunjukkan melalui pelaksanaan Jurnal reading dan case report dengan rekan sejawat, dan sebagai seorang peneliti dilakukan dengan penerapan Evidence based Nursing (EBN) terapi suara alam untuk menurunkan kecemasan pada pasien preoperasi CABG, serta sebagai inovator bersama kelompok melaksanakan penerapan aplikasi 6MWD pada pasien gagal jantung. Hasil dari penerapan tersebut menunjukkan bahwa Teori Model Adaptasi Roy dapat diterapkan pada asuhan keperawatan pasien dengan gangguan kardiovaskuler dan terapi suara alam dapat diterapkan sebagai alternatif intervensi keperawatan dalam menurunkan kecemasan pasien preoperasi CABG, serta hasil dari penerapan aplikasi 6MWD dapat digunakan oleh perawat dalam merekomendasikan latihan fisik kepada pasien gagal jantung.

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To improve the quality of nursing services, of course, the role of nurses who have competence both in terms of science and skills in carrying out nursing practice is required. As a direct nursing care provider, a residency acts as a Clinical Nurse Specialist, this practice is carried out at Harapan Kita Heart and Vascular Hospital. Through the practice of cardiovascular specialization residency is also expected to be a nursing consultant for nursing staff and educators for patients, as well as researchers. In its role of providing direct nursing care to 31 patient cases, as an educator it is also shown through the implementation of Journal reading and case reports with colleagues, and as a researcher carried out by applying Evidence based Nursing (EBN) natural sound therapy to reduce anxiety in CABG preoperative patients, and as an innovator with the group implementing the application of 6MWD in heart failure patients. The results of the application show that the Roy Adaptation Model Theory can be applied to nursing care for patients with cardiovascular disorders and natural sound therapy can be applied as an alternative nursing intervention in reducing the anxiety of CABG preoperative patients, and the results of the application of the 6MWD application can be used by nurses in recommending physical exercise to heart failure patients."

"PURPOSE: The aim of this study was to determine the risk factors for anastomotic leakage after laparoscopic rectal surgery.METHODS: We conducted a prospective trial involving 395 patients with stage 0/I rectal carcinoma who underwent laparoscopic low anterior resection using a double stapling technique. Data concerning variables related to patient background, tumors and surgical factors were evaluated. The outcomes with respect to anastomotic leakage were recorded, and univariate and multivariate analyses were performed to identify relevant risk factors.RESULTS: The overall anastomotic leakage rate was 8.4%. A univariate analysis showed male gender (P = 0.006) and preoperative blood sugar level (P = 0.0034) to be significantly associated with anastomotic leakage. The variables of gender, preoperative blood sugar level, American Society of Anesthesiologists (ASA) classification (P = 0.15), transanal decompression tube (P = 0.06) and number of stapler cartridges used for rectal transection (P = 0.18) were selected for the multivariate analysis because of their P values being <0.2. The multivariate analysis identified male gender (odds ratio 4.12, P = 0.006) and the absence of a transanal decompression tube (odds ratio 3.11, P = 0.0484) as independent risk factors predicting anastomotic leakage.CONCLUSIONS: Male gender and the absence of a transanal decompression tube appeared to be independent risk factors for anastomotic leakage. Insertion of a transanal decompression tube may help prevent anastomotic leakage after low anterior resection, particularly in male patients."