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"Program spesialis keperawatan merupakan program pembelajaran dan praktik keperawatan yang bertujuan untuk meningkatkan kemampuan perawat dalam memberikan asuhan keperawatan berkualitas. Program spesialis dilakukan selama 2 semester dengan mengelola satu kasus utama dan 30 kasus dengan berbagai jenis kanker serta penerapan Evidence Based Nursing (EBN) dan proyek inovasi. Pelaksanaan selama 2 semester telah mampu mengelola satu kasus utama yakni klien Adenokarsinoma Laring stadium IV post tiroidektomi total dengan trakeostomi dan gastrostomi serta 30 kasus lainnya dengan variasi jenis kanker menggunakan teori adaptasi Roy. Pengelolaan kasus utama dan 30 kasus kanker lainnya dilakukan di ruang IGD, Lantai 4 dan 8 Gedung A RSUPN Dr. Cipto Mangunkusumo. Pelaksanaan EBN dilakukan dengan menerapakan distres thermometer dan problem list untuk mengkaji distres pada klien kanker. Proyek inovasi kelompok dilakukan dengan penerapan video edukasi efek samping mual muntah pada kemoterapi. Program spesialis keperawatan bermanfaat untuk meningkatkan kompetensi asuhan keperawatan yang berkualitas.

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Nursing specialist program is learning and practice program aimed at improving competence of nursing. This program conducted for 2 semester by managing one main case, 30 various cancer cases, evidence based nursing, and inovation project. During this program, specialist has been managing one main case toward client with adenocarcinoma larynx stage IV post total thyroidectomi, tracheostomy and gastrostomy and 30 various cancer cases using Roys Adaptation approach at emergency room and inpatient room (4^th and 8^th floor) of National Hospital Dr. Cipto Mangunkusumo. Evidence Based Nursing conducted by implementation of distress thermometer and problem list to assess distress in cancer client. Inovation project conducted with implementation of education video about nausea and vomiting side effect of chemotherapy. Nursing specialist program is useful to improve competence of Nursing in providing nursing care."

"Keperawatan adalah sebuah seni dan ilmu pengetahuan yang merupakan gabungan dari ilmu fisik, manusia, sosial dengan kompetensi klinis dan kualitas yang berpusat pada pasien. Adanya peningkatan teknologi dan promosi kesehatan, maka perawat diharapkan memberikan pelayanan yang lebih berkualitas. Tujuan dari praktik residensi untuk memperoleh gambaran analisis pelaksanaan dan pengalaman praktik residensi keperawatan medikal bedah peminatan onkologi dalam menjalankan peran professional selama praktik residensi di RSUPN dr. Cipto Mangunkusumo. Residensi dilaksanakan selama 2 semester baik di ruang rawat inap, rawat jalan dan IGD dengan memberikan asuhan keperawatan, penerapan EBN yoga untuk mengurangi fatigue dan Proyek inovasi Edukasi Penanganan Mual Muntah berbasis Video untuk meningkatkan pengetahuan  pada pasien yang menjalani  kemoterapi. Pemberian asuhan keperawatan dilakukan pada pasien 1 kasus kelolaan dengan Adenocarsinoma Recti Sigmoid dan 30 kasus keganasan lainnya dengan menggunakan pendekatan Teori Model Adaptasi Roy, yoga terbukti efektif dalam menurunkan fatigue dan edukasi Penanganan Mual Muntah berbasis Video terbukti dapat meningkatkan pengetahuan pasien. Praktek residen bermanfaat dan dapat meningkatkan pengetahuan, keterampilan dan kompetensi dalam menjalankan peran perawat professional.

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Nursing is an art and a science, which combination of knowledge from the physical sciences, humanities, and social sciences along with clinical competencies and quality patient centered care.The improvement of technology and health promotion, nurses are expected to provide better quality services. The aims of the residency practice is to obtain an analysis of the implementation and practical experience of residency oncology specialization medical nursing residency in carrying out professional roles during residency practice at RSUPN Dr. Cipto Mangunkusumo. Residency was held for 2 semesters both in the inpatient, outpatient and emergency room by providing nursing care, implementing EBN yoga to reduce fatigue and the Innovation Project Video-based Vomiting Nausea Education Education to increase knowledge in patients undergoing chemotherapy. The provision of nursing care was carried out on patients with 1 case of management with Adenocarsinoma Recti Sigmoid and 30 other cases of malignancy using Roys Adaptation Model Theory approach, yoga effective in reducing fatigue and Video-based Vomiting Handling education effective to increase patient knowledge. Resident practices are useful and can increase knowledge, skills and competencies in carrying out the role of professional nurses."

"Analisis praktik residensi merupakan laporan rangkaian kegiatan Ners SpesialisKeperawatan Medikal Bedah dengan penerapan Model Adaptasi Roy pada prosesasuhan keperawatan pasien gangguan sistem pencernaan, penerapan praktikkeperawatan berdasarkan evidence based serta melakukan inovasi keperawatan.Pengkajian kasus utama terhadap pasien karsinoma gaster dan 30 kasus resume pasienbedah digestif, gastrointestinal serta hepatobilier berfokus pada respon adaptif darimodel adaptasi Roy. Pelaksanaan evidence based dilakukan untuk mengelolakecemasan pasien sebelum menjalani operasi bedah digestif sebanyak 8 orang, denganintervensi mendengarkan Al-Qur`an Surah Al Waqi’ah dan terjemahannya selama 30menit. Program inovasi keperawatan dilakukan, terhadap 7 orang pasien yangdirencanakan menjalani operasi kolostomi berupa optimalisasi pemberian edukasimelalui media video. Kesimpulan: mendengarkan Al-Qur`an Surah Al Waqi’ah danterjemahannya dapat menurunkan tingkat kecemasan pasien sebelum operasi danedukasi melalui media video terhadap pasien yang akan menjalani operasi kolostomidapat meningkatkan pengetahuan pasien yang sangat memengaruhi terhadap keputusanpersetujuan pasien menjalani operasi.

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The residency practice analysis is a series of reports on the activities of Surgical

Medical Nursing Specialists with the application of Roy's Adaptation Model in the

nursing care process of patients with digestive system disorders, the application of

evidence-based nursing practices and nursing innovations. Major case studies of gastric

carcinoma patients and 30 cases of digestive, gastrointestinal and hepatobiliary surgery

resumes focused on the adaptive response of Roy's adaptation model. Evidence based

implementation was carried out to manage the anxiety of patients before undergoing

digestive surgery as many as 8 people, with the intervention of listening to Al-Qur'an

Surah Al Waqi'ah and its translation for 30 minutes. Nursing innovation program

carried out, for 7 patients who were planned to undergo colostomy surgery in the form

of optimizing the provision of education through video media. Conclusion: listening to

Al-Qur'an Surah Al Waqi'ah and its translation can reduce the level of patient anxiety

before surgery and education through video media for patients who will undergo

colostomy surgery can increase patient knowledge which greatly influences the decision

of consent for patients undergoing surgery."

"Keperawatan medikal bedah merupakan area praktik keperawatan pada orang dewasa yang mengalami perubahan fisiologis atau mempunyai resiko terjadi perubahan fisiologis, trauma atau kecacatan Tujuan dari penulisan Karya Ilmiah ini adalah menjabarkan analisis kegiatan praktik residensi keperawatan medikal bedah peminatan onkologi di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo dengan penerapan Model Keperawatan Adaptasi Roy dalam pemberian asuhan keperawatan pada kasus keganasan, melakukan aplikasi evidence based nursing (EBN), dan melaksanakan proyek inovasi. Praktik residensi dilaksanakan selama 2 semester dengan mengelola 30 kasus resume dengan berbagai jenis kasus keganasan dan 1 kasus utama (osteosarkoma). Penerapan evidence based nursing tentang auricular acupressure efektif untuk mengurangi konstipasi pada pasien kemoterapi dan pelaksanaan inovasi video edukasi meningkatkan pengetahuan pasien untuk manajemen mual muntah efek samping kemoterapi. Praktik residensi sangat bermanfaat untuk meningkatkan pengetahuan dan keterampilan klinik pada mahasiswa ners spesialis.

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Medical surgical nursing is an area of nursing practice in adults who have physiological changes or risk of physiological changes, trauma or disability. The aim of this writing is to describe the analysis of residency practice in medical surgical nursing especially oncology at Cipto Mangunkusumo National Center General Hospital with the application of Roys Adaptation Nursing Model in the provision of nursing care in malignancy cases, conduct evidence based nursing (EBN) applications, and implement innovation project. The residency practice is held for 2 semesters by managing 30 cases of resumes with various types of malignancy cases and 1 main case (osteosarcoma). The application of evidence based nursing auricular acupressure is effective for reducing constipation in chemotherapy patients and the implementation of innovative educational video projects increases the knowledge of patients to manage chemotherapy-induced nausea and vomiting. The residency practice is very useful for increasing clinical knowledge and skills of nursing specialist students"

"Praktek residensi keperawatan pada sistem neurologi dituntut mampu memberikan asuhan keperawatan secara komperhensif, menerapkan Evidence Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Pemberi asuhan keperawatan dilakukan dengan menggunakan pendekatan model adaptasi Roy pada pasien stroke hemoragik dan 30 pasien lainnya dengan berbagai gangguan system neurologi. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologi. Penerapan EBN Pelvis Stability Training (PST) pada lima pasien stroke menunjukkan keefektifan dalam  meningkatkan kontrol pergerakan, kekuatan otot panggul, kecepatan berjalan, dan ADL melalui kestabilan keseimbangan panggul pada pasien stroke. Program inovasi keperawatan berupa penerapan program pencegahan kejadian jatuh pada pasien neurologi di rawat inap.

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Nursing residency practice in the neurology system is demanded to be able to provide comprehensive nursing care, implementation of Evidence Based Nursing (EBN) and be able to act as an innovator in the treatment room. Nursing care was performed using Roy's adaptation model approach in hemorrhagic stroke patients and 30 other patients with various neurological system disorders. Maladaptive behavior is the most common mode of physiological adaptation. The implementation of EBN Pelvis Stability Training (PST) in five stroke patients showed effectiveness in increasing movement control, pelvic muscle strength, walking speed, and ADL through stability in pelvic balance in stroke patients. The nursing innovation program is in the form of a fall prevention program in neurology patients hospitalized."

"Praktek Spesialis Keperawatan Medikal Bedah merupakan proses penting dari pendidikan profesi dalam rangka mengaplikasikan ilmu dan peran perawat spesialis dalam memberikan asuhan keperawatan yang profesional kepada pasien. Dalam menjalankan praktek Praktek Spesialis Keperawatan Medikal Bedah, residen juga menerapkan  Evidence Based Nursing. Evidence Based Nursing yang dilakukan adalah dengan menerapkan intervensi Jacobson Progressive Muscle Relaxation, serta  menjalankan peran sebagai inovator di lahan praktek. Residen telah melakukan asuhan keperawatan pada pasien dengan HIV/AIDS, dengan 1 kasus kelolaan utama yang menggunakan pendekatan Teori Roy dan 30 kasus resume kelolaan menggunakan pendekatan  Teori Bandura untuk ruang rawat jalan pada kasus HIV. Dari hasil kelolaan kasus utama, pasien HIV yang dirawat di ruang rawat memiliki diagnosa keperawatan utama gangguan perfusi jaringan serebral sehingga intervensi utama keperawatan fokus pada manajemen tekanan intrakranial. Dari kasus resume rawat jalan, masalah keperawatan yang paling banyak ditemukan adalah ketidakpatuhan akan pengobatan, sehingga Intervensi keperawatan yang dilakukan adalah dengan melakukan proyek inovasi Counseling Minum Obat ARV yang berisikan konseling secara terstruktur pengobatan ART dalam upaya meningkatkan self confidence perawat serta meningkatkan kepatuhan pasien.

Kata kunci: HIV, teori Roy, teori Bandura, ketidakpatuhan, konseling, Jacobson Progressive Muscle Relaxation.

 

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Practice of Medical Surgical Nursing Specialist is an important process of professional education in order to apply the knowledge and role of specialist nurses in providing professional nursing care to patients. In carrying out the practice of Medical Surgical Nursing Specialist, the resident also applies Evidence Based Nursing. Evidence Based Nursing is carried out by applying the Jacobson Progressive Muscle Relaxation intervention, and playing the role of an innovator in the practical field. Resident has provided nursing care to patients with HIV / AIDS, with 1 main case managed using the Roy Theory approach and 30 cases managed resumes using the Bandura Theory approach for outpatient rooms in HIV cases. From the results of the main case management, HIV patients who were treated in the ward had a major nursing diagnosis of cerebral tissue perfusion disorders so that the main nursing interventions focused on the management of intracranial pressure. From outpatient resume cases, the most common nursing problem found was non-adherence to treatment, so that the nursing intervention was carried out by conducting the innovative ARV Medication Counseling project which contained structured counseling on ART treatment in an effort to increase nurses' self-confidence and increase patient compliance.

 

 

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"Praktik residensi keperawatan medikal bedah sistem muskuloskeletal merupakan program lanjutan pendidikan magister keperawatan yang berfokus pada konsep dan prinsip dasar medikal bedah dengan menerapkan ilmu dan tehnologi keperawatan untuk memenuhi kebutuhan pasien dewasa yang mengalami perubahan fisik dengan atau tanpa adanya gangguan struktural pada sistem muskuloskeletal. Salah satu model keperawatan yang dapat diterapkan untuk memenuhi kebutuhan pasien gangguan muskuloskeletal adalah pendekatan Teori Keperawatan adaptasi Roy. Pendekatan ini merupakan model asuhan keperawatan yang dapat membantu pasien beradaptasi dengan berbagai permasalahan yang ditimbulkan akibat gangguan sistem muskuloskeletal. Kegiatan lain dari praktik residensi adalah melakukan penerapan evidence based nursing (EBN) melalui intervensi program ambulasi pada pasien post operasi fraktur ekstremitas bawah yang merupakan salah satu kegiatan intervensi untuk membantu pasien meningkatkan kemampuan gerak. Selain itu kegiatan melalui aplikasi peran perawat dalam penerapan program enhanced recovery after surgery (ERAS) pada pasien operasi panggul menjadi proyek inovasi yang dapat dilaksanakan di ruang perawatan untuk mempercepat proses pemulihan, mengurangi lama rawat (LOS), mencegah terjadinya komplikasi serta menekan morbiditas dan mortalitas paska operasi.

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The practice of residency in medical surgical nursing of the musculosceletal system is an advanced program of nursing master education that focuses on the concepts and basic principles of medical surgery by applying nursing science and technology to meet the needs of adult patients who experience physical changes with or without structural disorders of the musculosceletal system. One of nursing model that can be applied to meet the need of patients with musculosceletal disorder is Roys Adaptation Theory approach. This approach is a model of nursing care that can help patient to adapt various problems caused by disorder of the musculosceletal system. Another activity of residency practice is implementing evidence based nursing (EBN) through ambulation program intervention in postoperative patients lower limb their mobility. In addition, activities through the application of the role of nurses in implementing of "enhanced recovery after surgery (ERAS)" program in hip surgery patients are innovative projects that can be implemented in the surgical ward to speed up the recovery process, reduce length of stay (LOS), prevent complication, also reduce post morbidity and mortality operation."

"Analisis praktik residensi keperawatan medikal bedah merupakan karya ilmiah akhir ners spesialis. Analisis ini terdiri dari asuhan keperawatan pada gangguan sistem neurologi dengan kasus utama meningoencephalitis tuberkulosis dan 30 kasus resume menggunakan pendekatan model adaptasi Roy, penerapan evidence based nursing tentang intervensi hemifield eye-patching, dan penerapan proyek inovasi tentang program pencegahan kejadian jatuh pada pasien dewasa di ruang neurologi. Teori model adaptasi Roy bertujuan untuk memodifikasi dan mengubah stimulus sehingga pasien dapat adaptif terhadap kondisi kesehatannya. Meningoensefalitis tuberkulosis adalah keadaan darurat neurologis yang merupakan bentuk paling parah infeksi oleh Mycobacterium tuberculosis. Hemifield eye-patching merupakan intervensi yang mudah digunakan dan terbukti dapat mengatasi pengabaian visuo-spasial pada pasien stroke. Proyek Inovasi program pencegahan kejadian jatuh dapat meningkatkan pengetahuan dan kesadaran perawat, pasien, dan keluarga dalam pencegahan kejadian jatuh.

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Analysis of medical surgical nursing residency practice is the final scientific work of nursing specialist. This analysis consisted of nursing care in neurological system disorders with major cases of tuberculosis meningoencephalitis and 30 cases resuming using Roy's adaptation model approach, applying evidence-based nursing about eye-patching hemifield interventions, and implementing an innovative project about falling fall prevention programs in adult patients in neurology ward. Roy's adaptation model theory aims to modify and change the stimulus so that patients can be adaptive to their health conditions. Tuberculosis meningoencephalitis is a neurological emergency that is the most severe form of infection by Mycobacterium tuberculosis. Hemifield eye-patching is an easy-to-use intervention and is proven to overcome visuo-spatial neglect in stroke patients. The Innovation project for the prevention of falls can improve the knowledge and awareness of nurses, patients and families in preventing falls."

"ABSTRAK Keperawatan respirasi merupakan salah satu area khusus dimana perawat memiliki peran dalam memberikan asuhan keperawatan berdasarkan kebutuhan pasien. Perawat spesialis respirasi memiliki peran lebih yang berbeda, dengan menerapkan konsep dan teori keperawatan dalam penanganan kasus pada pasien gangguan pernapasan. Peran ners spesialis sebagai klinisi ahli, pendidik, manajer kasus, konsultan, dan peneliti untuk merencanakan atau memperbaiki kualitas keperawatan bagi klien dan keluarganya. Teori keperawatan yang digunakan dalam merawat pasien (satu kasus kelolaan dan 30 kasus resume) dengan menggunakan model adaptasi Roy. Peran sebagai peneliti diterapkan dengan melakukan latihan breathing retraining pada pasien asma. Sementara peran untuk memperbaiki kualitas pelayanan salah satunya adalah menerapkan inovasi bagi pasien tuberkulosis dalam mencegah terjadinya putus obat.ABSTRACT Nursing respiration is one particular area where nurses have a role in providing nursing care based on the patient's needs. Respiratory specialist nurse has a more distinct role, to apply the concepts and theories of nursing in the handling of cases in patients with respiratory disorders. The role of specialist nurses as expert clinicians, educators, case managers, consultants, and researchers to plan or improve the quality of nursing for the client and his family. Nursing theory used in treating patients (one case of management and 30 cases of resume) using Roy adaptation model. Role as researchers applied by practicing breathing retraining in patients with asthma. While the role to improve the quality of service, one is applying innovation for tuberculosis patients in preventing drug withdrawal.;Nursing respiration is one particular area where nurses have a role in providing nursing care based on the patient's needs. Respiratory specialist nurse has a more distinct role, to apply the concepts and theories of nursing in the handling of cases in patients with respiratory disorders. The role of specialist nurses as expert clinicians, educators, case managers, consultants, and researchers to plan or improve the quality of nursing for the client and his family. Nursing theory used in treating patients (one case of management and 30 cases of resume) using Roy adaptation model. Role as researchers applied by practicing breathing retraining in patients with asthma. While the role to improve the quality of service, one is applying innovation for tuberculosis patients in preventing drug withdrawal."