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"Praktek klinik lanjut selama praktek residensi keperawatan pada sistem neurologi dimaksudkan untuk mampu memberikan asuhan keperawatan, menerapkan Evidence Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Peran pemberi asuhan keperawatan dilakukan dengan menggunakan model adaptasi Roy pada pasien dengan tumor otak dan 30 pasien lainnya dengan berbagai gangguan sistem persarafan. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologi, yaitu ketidakefektifan perfusi jaringan cerebral.Intervensi keperawatan berupa manajemen edema cerebral ditujukkan untuk meningkatkan adaptasi pasien dalam meningkatkan perfusi jaringan ceredral. Penerapan EBN respiratory muscle training (RMT) pada tiga pasien stroke menunjukkan keefektifan RMT dalam meningkatkan fungsi pernafasan pasien stroke. Program inovasi keperawatan berupa penerapan program pencegahan kejadian jatuh pada pasien neurologi di rawat inap.

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Advance clinical practice in neurological system during residency period is proposed to be able to provide nursing care, implement the evidence based nursing (EBN) and be able to act as innovator in the treatment room. The role of nurse care provider was made using Roy`s adaptation model in patients with brain tumor and 30 other patients with various neural system disorders. The most maladaptive behavior is the physiological adaptation mode is the ineffective cerebral tissue perfusion, The nursing management intervention was cerebral edema management to improve patient adaptation in enchancing cerebral tissue perfusion. Implementation of EBN: respiratory muscle training (RMT) in three patients with stroke can improve the respiratory function of the stroke patients. Implementation of the fall prevention program can be used for prevent the patient`s fall risk."

"Praktik klinik lanjut selama praktek residensi keperawatan pada sistem neurologi dimaksudkan untuk mampu memberikan asuhan keperawatan, menerapkan Evidance Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Peran pemberi asuhan keperawatan dilakukan dengan menggunakan mode adaptasi Roy pada pasien dengan Guilain Bare Syndrome dan 30 pasien lainnya dengan berbagai gangguan sistem persyarafan. Perilaku maladaptive paling banyak adalah model adaptasi fisiologis, yaitu penurunan kapasitas adaptif intracranial. Intervensi keperawatan berupa manajemen peningkatan tekanan intracranial. Penerapan EBN latihan core stability pada keseimbangan duduk pada pasien stroke menunjukkan pasien dapat memeprtahankan keseimbangan duduk. Program inovasi keperawatan berupa penerapan manajemen ERAS pada pasien pasca kraniotomi diruang ICU, HCU dan rawat inap.

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Advance clinical practice during the nursing residency practice in the neurological system is intended to be able to provide nursing care, implement Evidance Based Nursing (EBN) and able to act as an innovator in the treatment room. The role of nursing caregiver was perfomed using Roy’s adaption mode in patients with Guillain-Barre Syndrome and 30 other patients with various nervous system disorders. The most maladaptive behavior is a physiological adaption model, namely a decrease in intracranial adaptive capacity. Nursing intervention in the form of management of increased intracranial pressure. The application of EBN core stability exercises to sitting balance in stroke patients shows the patient can maintain a sitting balance. Nursing innovation program in the form of application of ERAS management to post-craniotomy patients in ICU,HCU and inpatient rooms."

"Penyakit sistem saraf menjadi salah satu penyebab kematian tertinggi di tingkat global. Upaya tindakan pencegahan dan tatalaksana terus dikembangkan untuk mengatasi permasalahan ini. Perawat spesialis memiliki peran sebagai pemberi asuhan keperawatan langsung, menerapkan evidence base nursing dan melakukan inovasi keperawatan. Praktik residensi spesialis keperawatan medikal bedah telah dilaksanakan untuk mengaplikasikan peran tersebut. Peran sebagai pemberi asuhan keperawatan langsung dilakukan dengan memberikan asuhan keperawatan pada 30 kasus kelolaan resume dan kasus kelolaan utama tumor neuroendokrin hipofisis dengan pendekatan Model Adaptasi Roy. Peran sebagai peneliti dijalankan dengan melakukan penerapan rehabilitasi dini pada pasien tumor otak pasca pembedahan. Peran perawat sebagai inovator dilakukan dengan menyusun proyek inovasi tentang edukasi perioperatif berbasis digital pada pasien tumor otak yang akan menjalani pembedahan. Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy efektif digunakan untuk pasien dengan gangguan sistem saraf, rehabilitasi dini pada pasien tumor otak pasca pembedahan dapat mencegah terjadinya delirium pasca operasi, serta edukasi perioperatif berbasis digital pada pasien tumor otak dapat diterapkan untuk meningkatkan pengetahuan dan mengurangi kecemasan.

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Nervous system disease is one of the leading causes of death globally. Efforts to prevent and manage continue to be developed to overcome this problem. Specialist nurses have a role as direct nursing care providers, implementing evidence-based nursing and carrying out nursing innovation. The practice of medical surgical nursing specialist residency has been implemented to apply this role. The role as a direct nursing care provider is carried out by providing nursing care to 30 cases of resume management and primary management cases of pituitary neuroendocrine tumors with the Roy Adaptation Model approach. The role as a researcher is carried out by implementing early rehabilitation in post-surgery brain tumor patients. The role of nurses as innovators is carried out by compiling an innovation project on digital-based perioperative education in brain tumor patients who will undergo surgery. The results of the practice analysis show that the Roy Adaptation Model is effective for patients with nervous system disorders, early rehabilitation in post-surgery brain tumor patients can prevent post- operative delirium, and digital-based perioperative education in brain tumor patients can be applied to increase knowledge and reduce anxiety."

"Peran perawat spesialis neurosains dalam praktik keperawatan antara lain sebagai pemberi asuhan keperawatan lanjut, melaksanakan pembuktian ilmiah, pendidik, advokat, kolaborator, dan agen pembaharu. Asuhan keperawatan lanjut dilaksanakan pada pasien dengan kasus tumor otak dan 30 pasien gangguan neurologi menggunakan pendekatan model adaptasi Roy. Perilaku maladaptif paling banyak terganggu pada mode fisiologis dengan diagnosis ketidakefektifan perfusi jaringan serebral. Penerapan Evidence Based Nursing berupa latihan Range of Motion (ROM) pasif bilateral ekstremitas atas pada dua pasien stroke akut dengan hemiparese menunjukkan hasil peningkatan fungsi ekstremitas atas dan Activity of Daily Living (ADL). Program inovasi pengembangan media edukasi perawatan pasien kraniotomi pengangkatan tumor menunjukkan peningkatan pengetahuan pasien secara signifikan (p=0,038) dan memudahkan perawat dalam memberikan edukasi secara efektif.

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The role of nurse specialist in nursing practice consist of advanced nursing care providers, conduct scientific evidence, educator, advocat, collaborator, and change agent. Advanced nursing care is done by Roy Adaptation Models approach on brain tumor and 30 other neurological disorders patients. Maladaptive behavior at most in a physiological mode with ineffective cerebral perfusion nursing diagnosis.

Evidence Based Nursing was performed by applying bilateral passive Range of Motion (ROM) of upper extremity at two acute stroke patient with hemiplegi and it showed an increase in function of upper extremities and the activity of daily living. The innovation programme by develop an education media for caring patient with craniotomy removal tumor showed significant increase in patient knowledge (p=0,038) and help nurses to give an effective education."

"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."

"ABSTRAK Praktek klinik lanjut pada sistem neurologi dimaksudkan untuk mampu memberikan asuhan keperawatan, menerapkan Evidence Based Nursing EBN serta sebagai inovator. Peran pemberi asuhan keperawatan dilakukan pada pasien dengan meningitis TB dan 30 pasien dengan gangguan sistem persarafan menggunakan Model adaptasi Roy RAM . Perilaku mode adaptasi fisiologi paling sering mengalami perilaku maladaptif. Diagnosis keperawatan yang muncul yaitu gangguan mobilitas fisik dengan intervensi salah satunya berupa exercise therapy. Penerapan EBN Kegel rsquo;s exercise yang dilakukan dalam 1 pekan belum mampu mengatasi inkontinesia urin pada pasien stroke. Program inovasi penambahan format pengkajian neurologi berupa NIHSS, BBS, ISI, 3IQ, FAST, dan ANVPS mampu meningkatkan pengetahuan perawat mengenai format pengkajian selain dari format pengkajian yang telah ada di ruangan. Pengkajian perilaku dan stimulus pada RAM perlu diterapkan pada pengkajian pasien. Diharapkan kegel rsquo;s exericse tetap diajarkan pasien stroke yang mengalami inkontinensia urin dikarenakan perlu waktu yang cukup lama untuk mengatasi inkontinensia urin. Adanya format pengkajian neurologi tambahan dapat meningkatkan mutu pelayanan keperawatan. ABSTRACT Advanced clinical practice in the neurological system is intended to be able to provide nursing care, apply Evidence Based Nursing EBN as well as the role of an innovator. Nursing care roles were performed in patients with TB meningitis and 30 patients with impaired neural system using the Roy adaptation model RAM . The behavioral mode of physiological adaptation most often experiences maladaptive behavior. The emerging nursing diagnosis is impaired physical mobility with exercise theray intervention sould be applied. Application of EBN Kegel 39 s exercise performed on a week and showed that kegel 39 s exercise has not been able to cope with urinary incontinence. The innovation program for the addition of the neurological assessment format NIHSS, BBS, ISI, 3IQ, FAST, and ANVPS was able to increase the nurse 39 s knowledge of the assessment format apart from the existing assessment formats in the room. Assessment of behaviors and stimuli in RAM need to be applied to patient assessment. It is expected that kegel 39 s exericse still taught stroke patients who experience urinary incontinence due to long enough time to overcome urinary incontinence. The presence of additional neurological assessment formats can improve the quality of nursing services. "