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"Karsinoma kolorektal adalah salah satu masalah kesehatan yang sering terjadi di daerah perkotaan, karena masyarakat perkotaan cenderung beresiko lebih besar untuk mengalami karsinoma kolorektal yang berhubungan dengan usia, diet, dan gaya hidup modern. Jenis karsinoma yang paling sering dialami adalah adenokarsinoma rekti. Klien dengan adenokarsinoma rekti membutuhkan tindakan pembedahan kolostomi karena perlunya dibuat stoma sebagai pengganti fungsi anus. Klien dengan stoma beresiko mengalami komplikasi jika tidak dilakukan perawatan stoma dan perisromal dengan baik. Salah satu cara terbaik untuk pencegahan dini komplikasi adalah memberikan edukasi yang tepat pada klien dan keluarga mengenai perawatan stoma. Dengan demikian, tujuan penulisan ini adalah untuk melakukan analisis evidence based mengenai edukasi perawatan stoma dalam mencegah komplikasi gangguan integritas kulit peristomal. Hasil dari pemberian edukasi perawatan stoma pada pasien ini terbukti efektif dalam mencegah terjadinya komplikasi. Rekomendasi penulisan ini adalah agar perawat sangat perlu memberikan edukasi perawatan stoma sebagai upaya pencegahan dini komplikasi pasca pembedahan kolostomi.

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Colorectal carcinoma is one of the health problems that often occur in urban areas, because urban societies tend to be at greater risk for experiencing colorectal carcinoma associated with age, diet, and modern lifestyle. The most often experienced type of colorectal carcinoma is rectal adenocarcinoma. Clients with rectal adenocarcinoma require colostomy to create stoma that will be functioned like anus. Clients with a stoma have a risk of complications if the stoma or peristomal skin is not treated properly.

One of the best ways for early prevention of complications is to provide appropriate stoma care education to clients and their relatives. Thus, the purpose of this paper is to analyze the evidence based on stoma care education in preventing peristomal skin complications.

The result of stoma care education is effective in preventing the occurrence of complications. Then, recommendation of this paper is that it is necessary for nurses to educate clients about their stoma care as early prevention of post surgical complications colostomy."

"[Pengendalian TB paru di Kota Depok masih berorientasi pada pelaksanaan program pengendalian TB nasional, belum terintegrasi dengan pelaksanaan Perawatan Kesehatan Masyarakat sehingga klien TB belum mandiri melakukan perawatan TB. Model P2K3 dikembangkan berdasarkan integrasi model perawatan diri, model perawatan berbasis komunitas dan pendekatan perawatan yang berpusat pada klien. Penelitian ini bertujuan untuk mengetahui efektivitas model pemberdayaan perawat, kader, keluarga dan klien (P2K3) terhadap tingkat kemandirian klien dalam perawatan TB Paru, menggunakan desain kuasi eksperimen pre-post test pada dua kelompok. Penelitian dilakukan di 15 wilayah kerja Puskesmas di Kota Depok dengan kasus TB tertinggi. Penelitian terdiri dari tahap pengembangan model dan pengujian efektivitas model. Sampel diambil secara purposif sebanyak 108, terdiri dari 54 kelompok kontrol dan 54 kelompok intervensi. Hasil menunjukkan model P2K3 efektif untuk meningkatkan kemandirian klien TB Paru sebesar 40,2%. Penerapan model ini perlu didukung dengan kebijakan pelayanan kesehatan dari Dinas Kesehatan. Model P2K3 dan modulnya direkomendasikan digunakan oleh perawat di komunitas sebagai acuan pemberdayaan kader, keluarga dan klien TB Paru;

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Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients? self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients? self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model?s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients? level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients;Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients;Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients, Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients]"

"Stroke merupakan penyebab kedua kematian dan penyebab ketiga terjadinya kelemahan satu bagian tubuh dapat menyababkan adanya hambatan melakukan kemandirian aktivitas sehari-hari. Studi kasus ini bertujuan untuk mengevaluasi penerapan mobilisasi bertahap pada pasien stroke iskemik. Mobilisasi bertahap dapat dilakuan sejak pasien masih ditempat tidur dengan menguatkan otot ekstremitas yang mengalami kelemahan atau yang tidak mengalami kelemahan. Hal ini dapat dilakukan saat tirah baring, duduk di tempat tidur, dan turun dari tempat tidur hingga berjalan. Latihan yang diberikan akan berawal dari melakukan rentang pergerakan sendi secara aktif-pasif pada pasien dan kemudian dapat diikuti oleh mobilisasi bertahap. Intervensi ini dapat dilakukan dua kali sehari selama enam hari dengan bantuan perawat maupun mandiri dengan keluarga.  Pengukuran intervensi ini menggunakan kekuatan otot yang akan diukur setiap intervensi dan skala barthel indeks untuk tingkat kemandirian yang akan diukur sebelum intervensi dimulai dan sesudah intervensi selesai. Hari pertama nilai barthel indeks pasien 50 (ketergantungan pasial)  dan hari keenam nilai barthel indeks pasien 70 (ketergantungan minimal). Studi kasus ini menunjukkan bahwa latihan mobilisasi tertahap dapat meningkatkan tingkat kemandirian pasien. Mobilisasi bertahap dapat dilakukan sedini mungkin untuk meningkatkan kemandirian pasien dan aman untuk dilakukan oleh perawat dan keluarga.

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Stroke is the second cause of death and the third cause of weakness in one part of the body can cause barriers to independence in daily activities. This case study aims to evaluate the application of gradual mobilization in ischemic stroke patients. Gradual mobilization can be done since the patient is still in bed by strengthening the extremity muscles that experience weakness or those who do not experience weakness. This can be done when lying down, sitting on the bed, and getting out of bed until walking. The given exercise will begin with active-passive range of joint movement in the patient and can then be followed by gradual mobilization. This intervention can be done twice a day for six days with the help of nurses and independently with the family. The measurement of this intervention uses muscle strength to be measured for each intervention and a single scale index for the level of independence that will be measured before the intervention begins and after the intervention is completed. The first day the Barthel value of the patient index was 50 (pa- tient dependence) and the sixth day the value of the patient's index was 70 (minimal dependence). This case study shows that a stepped-up mobilization exercise can increase the patient's level of independence. Gradual mobilization can be done as early as possible to increase patient independence and be safe for nurses and families.

 

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"Tesis ini membahas tentang faktor-faktor penyebab ketidaklulusan uji kompetensi untuk sertifikasi tenaga kesehatan diploma tiga keperawatan. Penelitian yang dilakukan guna mendukung penyusunan tesis ini meliputi peserta uji kompetensi untuk sertifikasi tenaga kesehatan, pimpinan institusi pendidikan diploma tiga keperawatan dan para pejabat lembaga yang berperan dalam penyelenggaraan uji kompetensi untuk sertifikasi tenaga kesehatan yang berada di wilayah Kota DKI Jakarta. Penelitian dilakukan dengan menggunakan pendekatan postpositivist dengan metode kualitatif. Hasil penelitian menunjukkan beberapa faktor yang menyebabkan ketidaklulusan dalam uji kompetensi untuk sertifikasi tersebut meliputi faktor eksternal yaitu alat belajar meliputi soal uji kompetensi dan waktu serta faktor internal yang mencakup kecakapan nyata, sikap kedisiplinan dan penyesuaian diri.

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This thesis discusses about the factors that cause unsuccessful test of competence for certification of health workers diploma 3 of nursing. Research carried out to support this thesis include participants competency tests for certification of health workers, leaders of institution diploma 3 of nursing and agency officials involved in the implementation of the competency test for certification of health workers who are in the city of Jakarta. The study was conducted using postpositivist approach with qualitative methods. The results showed some of the factors that lead to failure in the competency test for certification include external factors is a learning tool covering about a competency test and time as well as internal factors that include real skill, discipline and attitude adjustment."

"Masyarakat perkotaan berisiko mengalami kecelakaan yang menyebabkan fraktur.  Peningkatan jumlah kendaraan  bermotor  dan  padatnya  populasi serta pola aktivitas masyarakat perkotaan yang serba terburu-buru menyebabkan fraktur seperti fraktur hip.  Salah satu upaya manajemen fraktur yaitu Total Hip Replacement (THR) yakni pergantian tulang  sendi  yang patah dengan protesis. Karya ilmiah ini disusun berdasarkan asuhan keperawatan yang dilakukan mahasiswa selama 3 minggu di lantai 4 Gedung A RS Ciptomangunkusumo Jakarta. Tulisan ini difokuskan pada pasien fraktur femur post Total Hip Replacement. Adapun teknik pengumpulan data yang digunakan meliputi wawancara, abservasi klien, catatan individu, rekam medik dan dokumentasi proses keperawatan yang dilakukan selama 4 hari (8-11 Mei 2019). Data yang telah dikumpul dianalisis untuk  melihat masalah keperawatan yang dialami klien serta meninjau keefektian intervensi edukasi pencegahan dislokasi yaitu memberikan pendidikan kesehatan kepada klien terkait hal apa yang perlu diperhatikan dan dihindari agar tidak terjadi dislokasi dan melakukan latihan kekuatan otot seperti : angkle pump, quad sets, glut sets, heel sets, dan short arc quad. Hasil yang didapatkan klien mampu melakukan latihan kekuatan otot dan mempercepat mobilisasi serta klien tidak terjadi dislokasi hip replacement. Latihan  kekuatan otot sangat bermanfaat untuk mencegah terjadinya dislokasi pada pasien post THR dan meningkatkan kekuatan otot dalam melakukan mobilisasi klien serta meminimalkan komplikasi dari fraktur. Dalam memberikan asuhan keperawatan pasien post THR perawat memberikan asuhan keperawatan dengan berulang kali dan menggunakan leflet agar klien mudah mengingat dan melakukannya kembali dan sebaiknya edukasi dilakukan saat pasien preoperasi dan post operasi THR.

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Urban communities are at risk of having an accident that causes a fracture. Increasing the number of motorized vehicles and the density of the population and the pattern of activities of urban communities that are in a hurry cause fractures such as hip fractures. One attempt at fracture management is Total Hip Replacement (THR), which is a broken joint replacement with a prosthesis. This scientific work was prepared based on nursing care carried out by students for 3 weeks on the 4th floor of Building A, Ciptomangunkusumo Hospital, Jakarta.

This paper focuses on femur fracture patients post Total Hip Replacement. As for the data collection techniques used include interviews, client attendance, individual records, medical records and documentation of the nursing process carried out for 4 days (8-11 May 2019). Data that has been collected is analyzed to see the nursing problems experienced by the client and review the effectiveness of dislocation prevention education interventions, namely providing health education to clients regarding what needs to be considered and avoided so as not to dislocate and do muscle strength training such as angkle pump, quad sets, glut sets, heel sets, and quad short arc.

The results obtained by the client are able to do muscle strength training and accelerate mobilization and the client does not have a hip replacement dislocation. Muscle strength training is very useful for preventing dislocation in post THR patients and increasing muscle strength in mobilizing clients and minimizing complications from fractures. In providing nursing care for post-THR patients nurses provide nursing care repeatedly and use leaflets so that clients are easy to remember and do it again and education should be done when the patient is preoperative and post-THR surgery."

"ABSTRAK Obstruksi usus merupakan penyakit yang dapat disebabkan karena adanya tumor atau kanker yang menghambat jalannya kandungan intralumen usus. Klien datang dengan keluhan mual dan muntah, distensi abdomen, tidak dapat BAB, disertai demam. Klien telah dilakukan operasi laparatomi eksplorasi dan ileostomi. Masalah keperawatan yang dialami klien setelah operasi yaitu ketidakseimbangan nutrisi kurang dari kebutuhan, nyeri akut, defisit volume cairan, dan kerusakan integritas kulit. Karya Ilmiah Akhir Ners ini bertujuan untuk menganalisis asuhan keperawatan yang dilakukan pada klien selama 4 hari. Intervensi keperawatan yang diberikan adalah pemberian nutrisi parenteral, pemberian foot massage, pemantauan cairan dan nutrisi, dan manajemen ileostomi. Setelah diberikan intervensi keperawatan klien mengalami perbaikan nutrisi dan mampu BAB, penurunan skala nyeri dari skala 6 menjadi 4, dan peningkatan pemahaman perawatan ileostomi. Asuhan keperawatan yang telah dilakukan terbukti dapat meningkatkan status kesehatan klien dengan obstruksi usus.

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ABSTRACT

Intestinal obstruction is a disease that can be caused by a tumor or cancer that inhibits intestinal content rsquo s activity. Client came with nausea and vomiting, abdominal distension, fecal impaction, accompanied by fever. The client was performed exploratory laparotomy and ileostomy. Nursing problems found in client after surgery are nutritional imbalance less than body need, acute pain, fluid volume deficit, and impaired skin integrity. The paper aimed to analyze the nursing care performed on client for 4 days. Nursing intervention provided were parenteral nutrition, foot massage, fluid and nutrition monitoring, and ileostomy care. After nursing intervention had been done, the client had improved nutrition and been able to defecate, decreased pain scale from 6 to 4, and improved understanding of ileostomy care. Nursing care that had been done proven to increase the health status of clients with intestinal obstruction. "