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"ABSTRAK Keperawatan menurut Mc Mahon merupakan terapi yang melibatkan tiga 3 komponen yaitu partnership, intimate dan reciprocity disetiap tindakan keperawatan. Begitu juga yang harus dilakukan oleh perawat ners spesialis atau perawat lanjutan. Pelaksanaan praktik residensi keperawatan khususnya neurologi dilakukan sebagai bagian dari proses untuk mencapai pendidikan perawat ners spesialis. Perawat ners spesialis dalam memberikan asuhan keperawatan harus memiliki tujuh kompetensi yaitu memberikan pelayanan langsung, konsultasi, kepemimpinan, kolaborasi, pendidikan, penelitian dan pengambil keputusan yang mengedepankan etik. Rangkaian pendidikan spesialis keperawatan ini adalah mengelola kasus utama, menyusun kasus resume yang dilaporkan sebanyak 30 pasien dengan gangguan neurologi, melakukan Eviden based Nursing EBN latihan Menelan dengan madu pada pasien disfagia serta melakukan inovasi membuat video edukasi. Kasus terbanyak selama praktik adalah stroke dan diagnosis keperawatan terbanyak yaitu resiko ketidakefektifan perfusi jaringan serebral, gangguan mobilisasi dan gangguan pemenuhan kebutuhan personal hygine.. Rekomendasi: analisis lebih dalam tentang latihan menelan dengan madu dan analisis kognitif, afektif dan psikomotor yang diperoleh saat menggunakan video edukasi pada pasien ABSTRACT Nursing in Mc Mahon say that nursing is a therapy that involves three 3 components of partnership, intimate and reciprocity in every action of nursing. So also must be done by a specialist nurse nurse or advanced nurse. Implementation of nursing residency practices, especially neurology is done as part of the process to achieve specialist nurse education. The role of nurse specialist in providing nursing care should have seven competencies that is to provide direct services, consultation, leadership, collaboration, education, research and decision makers that put ethics forward. This series of nursing specialist education is managing the main case, compiling 30 reported cases of patients with neurological disorders, performing an Evidence based Nursing EBN and innovating with patients with neurological disorders. The most cases during the practice were stroke and the most common nursing diagnoses were the risk of perfusion of cerebral tissue, impaired mobilization and impaired fulfillment of personal hygine needs. EBN is a swallowing exercise with honey and the implementation of group innovation to make educational videos to increase self awareness and family against the risk of recurrent stroke. Recommendations deeper analysis of swallowing exercises with honey and cognitive, affective and psychomotor analyzes obtained when using educational videos in patients"

"Pasien dengan kasus tumor otak memerlukan perawatan yang komprehensif dan membutuhkan waktu yang lama untuk pasien dapat beradaptasi dengan perubahan-perubahan yang terjadi pada dirinya. Selama pasien menjalani masa perawatan di rumah sakit, asuhan keperawatan yang tepat diberikan kepada pasien adalah dengan model konsep teori adaptasi Roy. Asuhan dengan pendekatan model adaptasi ini menjadi pilihan yang sesuai untuk kasus-kasus perawatan jangka panjang sehingga pasien dapat menjalani kehidupan lanjutan pasca perawatan dengan baik, mengembalikan kemandirian, kepercayaan diri terutama konsep gambaran diri dan status peran di masyarakat. Perawat dengan pendidikan spesialis harus mampu menjalankan berbagai peran terutama sebagai Clinical Care Manager, dengan demikian peningkatan layanan keperawatan di rumah sakit dapat dicapai dengan lebih optimal dan memberikan kepuasan pelanggan. Laporan analisis praktek ini membahas mengenai asuhan keperawatan perioperative pada pasien dengan tumor otak, laporan praktik keperawatan berbasis fakta yaitu early mobilization dan resume pasien dengan gangguan neurologis di RS PON Jakarta,serta e handbook peran perawat perioperative dalam pembedahan spinal. Analisis praktik residensi ini dapat digunakan sebagai dasar perawat dalam latihan critical thinking, mengelola kasus sulit dan menerapkan asuhan keperawatan berbasis bukti.

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Patients with cases of brain tumor require comprehensive care and require a long time for the patient to adapt of the changes that occur. As long as the patient is undergoing treatment in the hospital, the appropriate nursing care is using Roy's adaptation teori concept model. Adaptation model approach is an appropriate choice for cases of long-term care so that patients can live a good post- treatment follow-up life, restore independence, self-confidence, especially the concept of self-image and role status in society. Nurses with specialist education must be able to carry out various roles, especially as Clinical Care Managers, thus improving nursing services in hospitals can be achieved more optimally and provide customer satisfaction. This practice analysis report discusses perioperative nursing care for patients with brain tumor, a fact-based nursing practice report, namely and resumes of patients early mobilization with neurological disorders at National brain centre Hospital Jakarta. E handbook about perioperative nursing at spinal surgery. This residency practice analysis can be used as a basis for nurses in critical thinking exercises, managing difficult cases and implementing evidence-based nursing care. Keywords: Brain tumor, Roy's adaptation model, early mobilization, E handbook about perioperative nursing at spinal surgery."

"Peran perawat spesialis diperlukan untuk peningkatan kualitas pelayanan asuhan keperawatan yang kompleks dan akurat sebagai pemberi asuhan keperawatan tingkat lanjut kasus neurosain, pendidik, advokat, serta agen pembaharu melalui penerapan evidence based nursing (EBN) dan proyek inovasi. Asuhan keperawatan tingkat lanjut menggunakan teori Adaptasi Roy yaitu pengelolaan pasien meningitis tuberkulosis sebagai kasus utama dan 30 resume gangguan sistem neurologi. Teori Roy banyak bertujuan meningkatkan perilaku adaptif dan mengubah perilaku inefektif. Diagnosis keperawatan yang paling banyak ditemukan pada pasien gangguan sistem neurologi adalah ketidakefektifan perfusi jaringan serebral dan hambatan mobilitas fisik. Penerapan EBN dilakukan pada pasien stroke yang mengalami disfagia. Pasien diberikan latihan menelan shaker exercise hasilnya menunjukkan peningkatan kemampuan menelan dan tidak terjadi aspirasi. Proyek inovasi kelompok menerapkan Pengembangan Media Edukasi Perawatan Pasien Brain Tumor Craniotomy. Penerapan proyek inovasi meningkatkan pengetahuan pasien, keterampilan pasien latihan napas dalam dan mobilisasi setelah operasi, dan menambah kepercayaan diri perawat saat memberikan edukasi. Pengalaman praktik residensi diharapkan menambah kompetensi dan peran perawat spesialis di lahan klinik.

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The role of nurse specialists is needed to improve the quality of complex and accurate nursing care services as providers of advanced nursing care in cases of neuroscience, educators, advocates, and agents of reform through the application of evidence based nursing (EBN) and innovation projects. Advanced nursing care uses Roy's Adaptation theory, which is the management of meningitis tuberculosis patients as the main case and 30 resumes of neurological system disorders. Roys theory aims to improve adaptive behavior and change ineffective behavior. The most common nursing diagnoses found in patients with neurological system disorders are ineffective perfusion of cerebral tissue and barriers to physical mobility.

EBN application is performed on stroke patients who have dysphagia. The patient is given training to swallow the exercise shaker, which results in increased swallowing ability and no aspiration. The group innovation project applies Development of Educational Media for Nursing Brain Tumor Craniotomy Patients. The application of innovation projects increases patient knowledge, the skills of patients in deep breathing exercises and mobilization after surgery, and increases nurse confidence when providing education. The residency practice experience is expected to increase the competency and role of specialist nurses on the clinic grounds."

"Perawat spesialis neurosains berperan dalam praktik keperawatan sebagai pemberi asuhan keperawatan lanjut pada sistem neurologi, menerapkan Evidence Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Peran dilakukan dengan pemberian asuhan keperawatan menggunakan Model Konsep Adaptasi Roy pada pasien dengan tumor otak khususnya pada tumor sellar region dan 30 kasus lainnya dengan berbagai gangguan sistem persarafan. Perilaku maladaptif paling banyak ditemui pada mode adaptasi fisiologi penurunan kapasitas adaptif intrakranial. Intervensi keperawatan manajemen peningkatan tekanan intraknial dan pemantauan status neurologis. Penerapan Evidence Based Nursing dilakukan dengan menerapkan 4AT sebagai screening delirium pada pasien stroke akut. Program inovasi keperawatan berupa manajemen ERAS pasca operasi craniotomy. Model Adaptasi Roy telah berpengaruh besar terhadap profesi keperawatan. Model ini adalah salah satu model yang sering digunakan dalam memandu penelitian, pendidikan dan praktik keperawatan

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Neuroscience specialist nurses play a role in nursing practice as providers of advanced nursing care in the neurological system, Implement Evidence Based Nursing (EBN) and are able to act as innovators in the treatment room. The role is carried out by providing nursing care using Roy's Adaptation Model in patients with brain tumors, especially in the tumor cellar region and 30 other cases with various nervous system disorders. The most maladaptive behavior is the physiological adaptation mode of decreased intracranial adaptive capacity. Nursing intervention management of increased intracnial pressure and monitoring of neurological status. The application of Evidence Based Nursing is carried out by applying 4AT as a delirium screening in acute stroke patients. Nursing innovation program in the form of ERAS management after craniotomy surgery. Roy's Adaptation Model has had a major influence on the nursing profession. This model is one that is often used in guiding nursing research, education and practice."

"Perawat spesialis neurosains berperan dalam praktik keperawatan sebagai pemberi asuhan keperawatan lanjut pada sistem neurologi, menerapkan Evidence Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Peran dilakukan dengan pemberian asuhan keperawatan menggunakan Model Konsep Adaptasi Roy pada pasien dengan tumor otak khususnya pada tumor sellar region dan 30 kasus lainnya dengan berbagai gangguan sistem persarafan. Perilaku maladaptif paling banyak ditemui pada mode adaptasi fisiologi penurunan kapasitas adaptif intrakranial. Intervensi keperawatan manajemen peningkatan tekanan intraknial dan pemantauan status neurologis. Penerapan Evidence Based Nursing dilakukan dengan menerapkan 4AT sebagai screening delirium pada pasien stroke akut. Program inovasi keperawatan berupa manajemen ERAS pasca operasi craniotomy. Model Adaptasi Roy telah berpengaruh besar terhadap profesi keperawatan. Model ini adalah salah satu model yang sering digunakan dalam memandu penelitian, pendidikan dan praktik keperawatan.

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Neuroscience specialist nurses play a role in nursing practice as providers of advanced nursing care in the neurological system, Implement Evidence Based Nursing (EBN) and are able to act as innovators in the treatment room. The role is carried out by providing nursing care using Roy's Adaptation Model in patients with brain tumors, especially in the tumor cellar region and 30 other cases with various nervous system disorders. The most maladaptive behavior is the physiological adaptation mode of decreased intracranial adaptive capacity. Nursing intervention management of increased intracnial pressure and monitoring of neurological status. The application of Evidence Based Nursing is carried out by applying 4AT as a delirium screening in acute stroke patients. Nursing innovation program in the form of ERAS management after craniotomy surgery. Roy's Adaptation Model has had a major influence on the nursing profession. This model is one that is often used in guiding nursing research, education and practice."

"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."