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"Program spesialis keperawatan medikal bedah khususnya neurologi dimaksudkan untuk menjadikan seorang perawat spesialis neurosains yang berperan dalam praktik keperawatan berupa pemberi asuhan keperawatan lanjut, melakukan pembuktian ilmiah dan agen pembaharu. Asuhan keperawatan dilakukan pada kasus pasien dengan cedera kepala dan 31 pasien dengan gangguan neurologis dengan pendekatan Model adaptasi Roy (RAM). Perilaku maladaptif paling banyak terganggu pada mode fisologis dengan diagnosis penurunan kapasitas adaptif intrakranial. Evidence Based Nursing dilakukan dengan menerapkan sistematik oral care pada 12 pasien gangguan neurologis dengan hasil yang signifikan (p value 0,004). Program inovasi menerapkan pemberdayaan caregiver pasien stroke dengan hasil perbedaan pengetahuan dan keterampilan caregiver melalui edukasi dan demonstrasi (p value <0.005). Pengkajian perilaku dan stimulus pada RAM perlu diterapkan pada pengkajian pada pasien gangguan neurologis. Intervensi keperawatan diharapkan berbasis pada evidence based nursing. Pemberdayaan caregiver pada pasien gangguan neurologis khususnya stroke perlu dilakukan sejak dini untuk menyiapkan caregiver dalam merawat pasien gangguan neurologis.

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Nurse specialist program of medical surgical nursing especially neurological nurses proposed neuroscience nurse specialist play role in nursing practice as advanced nursing care providers, conduct scientific evidence and innovator. Roy adaptation model approach was used in the nursing care of the head injury patients and 31 patients of neurological disorders cases. Decreased intracranial adaptive capacity was the most often of nursing diagnosis enforced which was caused maladaptive behavior in physiological mode. Evidence based nursing was implemented by practice systematic oral care in 12 neurological disorders patients that showed oral assessment score differed significantly (p value 0,004). Role as an innovator was implemented by engage caregiver empowerment through education and demonstration in stroke patients that showed there was differences in the knowledge and skills of the caregivers (p value <0.005). Roy adaptation model can be one effective approach for the assessment of the neurological disorders patients. Nursing interventions are expected to always be based on evidence based nursing. Early caregiver empowerment in neurological disorders patients especially stroke is required to set up the caregivers in caring of the patients."

"ABSTRAK Analisis Praktik Residensi Keperawatan Medikal Bedah pada Pasien Gangguan Sistem Neurologi dengan Kasus Cedera Kepala Menggunakan Pendekatan Model Adaptasi Roy di Rumah Sakit Cipto MangunkusumoJakarta Megawati SibuloJanuari 2018 AbstrakPraktek residensi keperawatan kekhususan neurologi dalam penerapannya sebagai Clinical Care Manager CCM dimaksudkan sebagai pemberi perawatan langsung direct care , konsultan, edukator, kolaborator, dan pembuat keputusan klinis dalam memberikan asuhan keperawatan Model Adaptasi Roy pada pasien dengan gangguan sistem neurologi, berperan sebagai mentor coach dan peneliti researcher dalam penerapan Evidence Based Nursing EBN . Selain itu, spesialis keperawatan berperan sebagai pemimpin leader dalam penerapan proyek inovasi. Penerapan model adaptasi Roy pada pasien cedera kepala dan 30 pasien lainnya dengan berbagai gangguan sistem persarafan. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologi, yaitu risiko ketidakefektifan perfusi jaringan serebral. Intervensi keperawatan berupa cerebral management dan cerebral perfusion promotion bertujuan meningkatkan adaptasi pasien dalam memperbaiki perfusi jaringan serebral. Pada penerapan EBN dengan menggunakan format Neurogenic Bowel Dysfunction NBD score terhadap 14 pasien dalam menilai gangguan defekasi pasien menunjukkan sensitifitas terhadap kejadian gangguan defekasi pada pasien. Program inovasi penerapan media edukasi melalui video diharapkan dapat meningkatkan kesadarn diri pasien dan keluarga terhadap kejadian stroke berulang dan membantu mempermudah perawat dalam melakukan edukasi. ABSTRACT Analysis of Medical Surgical Nursing Residency Practice on NeurologicalSystem Disorders with Head Injury Case Using Roy Adaptation Model Approach at Cipto Mangunkusumo Hospital in Jakarta Megawati SibuloJanuary 2018 AbstractThe practice of nursing residency of neurological specificity in its application as Clinical Care Manager CCM are intended as a direct care provider, consultant, educator, collaborator, and clinical decision maker in providing Roy Adaptation Model nursing care in patients with neurological system disorders, mentors coach and researchers in the application of Evidence Based Nursing EBN. In addition, nursing specialists serve as leaders in implementing innovation projects. Applying Roy 39 s adaptation model to head injury patients and 30 other patients with various neural system disorders. The most maladaptive behavior is the physiological adaptation mode, ie the risk of perfusion of cerebral tissue perfusion. Nursing interventions of cerebral management and cerebral perfusion promotion aim at improving adaptation of patients in improving cerebral tissue perfusion. In the application of EBN using the format of Neurogenic Bowel Dysfunction NBD score of 14 patients in assessing defective disorder patients showed sensitivity to the incidence of defective disorders in patients. The innovative application program of educational media through video is expected to increase patient and family awareness of recurrent stroke incidents and help facilitate the nurse in doing the education.Keywords Defecation disorders, NBD score, neurological system disorders, head injury, Roy 39 s Adaptation Model. "

"ABSTRAK Praktek klinik lanjut selama masa residensi keperawatan pada sistem neurologi dimaksudkan untuk mampu memberikan asuhan keperawatan, menerapkan Evidence Based Nursing EBN serta mampu berperan sebagai inovator di ruang perawatan. Peran pemberi asuhan keperawatan dilakukan dengan menggunakan model adaptasi Roy pada pasien dengan miastenia gravis dan 30 pasien lainnya dengan berbagai gangguan sistem persarafan. Perilaku maladaktif paling banyak adalah mode adaptasi fisiologi, yaitu risiko ketidakefektifan perfusi jaringan serebral. Intervensi keperawatan berupa manajemen edema serebral ditujukan untuk meningkatkan adaptasi pasien dalam meningkatkan perfusi jaringan serebral. Penerapan EBN: Functional Oral Intake Scale FOIS pada sembilan pasien disfagia sebagai bentuk evaluasi kemampuan makan pasien menunjukkan sensitifitas terhadap kejadian aspirasi dan perubahan kemampuan makan pasien. Program inovasi penerapan format pengkajian tambahan dapat digunakan sebagai alat bantu bagi perawat dalam menegakan diagnosa keperawatan.ABSTRACT Advanced clinical practice in neurological system during the nursing residency period is proposed to be able to provide nursing care, implement the Evidence Based Nursing EBN and be able to act as an innovator in the treatment room. The role of nurse care provider was made using Roy 39 s adaptation model in patients with myasthenia gravis and 30 other patients with various neural system disorders. The most maladaptive behavior is the physiological adaptation mode is the risk of ineffective cerebral tissue perfusion. The nursing management intervention like cerebral edema is aimed to improve patient adaptation in enhancing cerebral tissue perfusion. Implementation of EBN Functional Oral Intake Scale FOIS in nine dysphagia patients as a evaluation form for feeding ability patients showed a sensitivity to occurrence of aspiration and changes in the patient 39 s eating ability. Implementation of additional asessment form as a innovation program can be used as a tool for nurses in determine nursing diagnoses."