Hasil Pencarian  ::  Simpan CSV :: Kembali

"Pengukuran respons nyeri dengan konduktansi kulit menjadi perkembangan teknologiyang memberi kemudahan dalam penggunaannya. Bayi berat lahir rendah akanmengalami prosedur pengambilan darah berulang selama perawatannya di rumah sakit.Penelitian cross sectional ini bertujuan untuk melihat perbedaan respons nyeri dengankonduktansi kulit pada bayi berat lahir rendah terhadap prosedur invasif pengambilandarah vena, arteri, dan kapiler. Metode consecutive sampling mendapatkan sampelsebanyak 44 pada masing-masing kelompok. Pengukuran respons nyeri dilakukan padatiga menit sebelum, selama, dan tiga menit setelah prosedur. Penelitian ini menunjukkanperbedaan bermakna respons nyeri dengan konduktansi kulit sebelum, selama, setelahprosedur invasif pada masing-masing kelompok (p<0,001); terdapat perbedaan bermaknarespons nyeri dengan konduktansi sebelum, sebelum-selama, selama-setelah prosedurinvasif antara ketiga kelompok (p<0,001). Respons nyeri ditunjukkan dengan perubahantegangan (volt) secara real time, yang mampu mendukung tindakan keperawatan dalampengelolaan nyeri terhadap prosedur pengambilan darah di unit perawatan perinatologipada bayi berat lahir rendah.

---

Skin conductance measurement become technological advancement which provide ease

of use in assess pain. Low-birth-weight infants undergo repeated blood samping during

their hospital care. This cross-sectional study aimed to investigate differences pain

response with skin conductance in low-birth-weight infants towards invasive procedures

of venous, arterial and capillary blood sampling. Consecutive sampling method obtained

44 of samples in each group. Pain response measurements were taken at three minutes

before, during, and three minutes after procedure. This study showed significant

differences pain response with skin conductance before, during, after invasive procedures

in each group (p<0.001); and there was a significant difference pain response with

conductance before, before-during, during-after invasive procedure between groups

(p<0.001). Pain response indicated by changes in voltage in real time, which could

support nursing management of pain towards blood sampling in low birth weight infants

at perinatology unit"

"Bayi berat lahir rendah (BBLR) memiliki ukuran vena yang sangat kecil sehingga memiliki resiko dilakukan pemasangan akses intravena perifer dengan beberapa kali penusukan. Penelitian ini bertujuan untuk mengetahui dampak dari pemasangan akses intravena perifer berulang pada BBLR. Desain penelitian menggunakan cross sectional melibatkan 211 responden di salah satu rumah sakit rujukan di Jakarta dengan teknik consecutive sampling. Hasil uji korelasi Spearman menunjukan adanya hubungan yang bermakna antara pemasangan akses intravena perifer berulang pada BBLR dengan peningkatan nyeri, peningkatan frekuensi nadi, peningkatan frekuensi nafas, penurunan saturasi oksigen, penurunan suhu tubuh, durasi menangis bayi, keterlambatan terapi, durasi pemasangan dan tingginya biaya perawatan dengan nilai (p<0,001). Pada penelitian ini, sebagian besar responden memiliki usia gestasi 32-36 minggu, berat lahir 1501-2499 gram, dan berjenis kelamin laki-laki. Penelitian ini diharapkan dapat dijadikan landasan dalam pengembangan tindakan preventif untuk mengurangi dampak pemasangan akses intravena perifer berulang pada bayi berat badan lahir rendah.

---

Low birth weight babies (LBW) have a very small size of vein so that they have the risk to do peripheral intravenous access by multiple insertion. This research aims to determine the impact of multiple insertion on intravenous access to LBW. The research design uses a cross sectional  involving 211 respondents in a referral hospital in Jakarta with consecutive sampling. The Spearman correlation test results show that there is a significant relation between multiple insertion on intravenous parifer in LBW with increased pain, increased pulse frequency, increased breath frequency, decreased oxygen saturation, decreased body temperature, duration of crying babies, delay in therapy, duration of installation and high cost of treatment with value (p<0,001). In this research, most of respondent have gestational age about 32-36 weeks, 1501-2499 grams of birth weight, and male sex. This research is expected to be used as a basis for developing preventive measures to reduce the impact of the multiple insertion on peripheral intravenous access for low birth weight babies."

"

Pemasangan infus perifer merupakan tindakan yang dapat menimbulkan risiko komplikasi pada bayi berat lahir rendah (BBLR). Angka kejadian flebitis pada BBLR memiliki presentase yang variatif. Penelitian ini untuk menganalisis faktor-faktor risiko terhadap kejadian flebitis pada BBLR diperinatologi.  Desain penelitian ini cross sectional dengan melibatkan 126 BBLR yang memenuhi kriteria inklusi. Pemilihan sampel dengan tekhnik consecutive sampling. Pengambilan data dilakukan sejak BBLR mulai terpasang infus sampai infus dilepas dengan alasan tertentu. Instrumen yang digunakan adalah skala flebitis INS dan skala nyeri neonatus (NIPS). Variabel yang berhubungan dengan kejadian flebitis dengan analisis bivariat adalah pengalaman klinis pemasang infus < 2 tahun (0,01), penggunaan pompa infus (p=0.0198), lokasi pemasangan infus (p=0,019), berat badan lahir neonatus (p=0.025) dan pemberian total parenteral nutrition (p=0.01). Faktor risiko yang paling berhubungan dengan kejadian flebitis berdasarkan analisis multivariat adalah pengalaman petugas pemasang infus < 2 tahun  (OR=26,006). sehingga dapat dijadikan pertimbangan untuk meningkatkan kualitas perawat pemberi layanan di area perinatologi.

 

Kata Kunci: Infus perifer, BBLR, flebitis

 

 

---

Installation of peripheral infusion is an action that can cause a risk of complications in low birth weight babies (LBW). The incidence of phlebitis in LBW has a varied percentage. This study was to analyze risk factors for the incidence of phlebitis in LBW in clinical settings. The study design was cross sectional involving 126 LBW who met the inclusion criteria. Selection of samples by consecutive sampling technique. Data collection was carried out since the LBW started to infuse until the infusion was released for certain reasons. The instruments used were the scale of INS phlebitis and neonatal pain scale (NIPS). The variables associated with the incidence of phlebitis with bivariate analysis is clinical infusion installer <2 years (0.01), use of infusion pumps (p = 0.0198), location of infusion (p = 0.019), neonatal birth weight (p = 0.025) and total parenteral nutrition (p = 0.01). The risk factor most associated with the incidence of phlebitis based on multivariate analysis is the experience of infusion supervisors <2 years (OR = 26,006). so that it can be taken into consideration to improve the quality of care providers in the area of perinatology.

 

 

 

 

"

"ABSTRAKBBLR merupakan bayi dengan berat lahir rendah kurang dari 2.500 gram yang beresiko mengalami berbagai masalah kesehatan sehingga perawat perlu memberikan developmental care dengan pemberian posisi tidur yang sesuai dengan standar operasional prosedur. Penelitian ini bertujuan untuk mengetahui gambaran posisi tidur bayi berat lahir rendah di ruang perinatologi. Penelitian ini menggunakan desain deskriptif cross-sectional dengan sampel sebesar 30 BBLR. Instrumen observasi yang digunakan adalah “Infants Position Assessment Tool (IPAT).” Dengan menggunakan analisis univariat, didapatkan kesimpulan mayoritas responden dalam kategori berat bayi lahir rendah (60%) dan berat bayi lahir sangat rendah (33.3%). Jenis kelamin responden mayoritas perempuan (60%) dengan jenis kehamilan mayoritas dengan kehamilan tunggal (93.3%). berat bayi sekarang memiliki tingkat rata-rata 1593.93 gram (95% CI: 1420.33-1767.54) dan rata-rata usia gestasinya 32.57 minggu (95% CI: 31.29-33.85). Secara keseluruhan posisi tidur berada pada posisi tidur yang baik (53.3%). Hasil penelitian ini diharapkan dapat memberikan gambaran tentang pengetahuan perawat terkait pemberian posisi tidur BBLR.

---

ABSTRACTLow Birth Weight infant is an infant which has low birth weight less than 2,500 grams that has risk for various health problems. Therefore, nurses need to provide developmental care by giving sleeping position based on procedural operational standards. This study aimed to describe the sleeping position of low birth weight babies in perinatalogy. This study used cross-sectional descriptive designs included 30 low birth weight infants that were selected to be sample. It was used "Infants Position Assessment Tool” as an observation instrument. By using univariate analysis, it was concluded that most of respondents were low birth weight (60%) and very low weight infants (33.3%). Most of them were female (60%) and kind of pregnancy with single pregnancy (93.3%). Infants’ average weight rate was 1593.93 grams (95% CI: 1420.33-1767.54) with average age of 32.57 weeks gestation (95% CI: 31.29-33.85). Overall, infants were in a good sleeping position (53.3%). This results were expected to provide an overview of nursing knowledge related to the provision of LBW sleeping position.Keywords: LBW, LBW sleeping position"

"Di Indonesia proporsi Bayi Berat Lahir Rendah (BBLR) <2500 gram pada bayi umur 0-59 bulan masih cukup tinggi, yaitu 6,2% di tahun 2013-2018. Padahal kondisi BBLR memiliki risiko lebih besar untuk mengalami morbiditas dan mortalitas dari pada bayi dengan berat badan normal. Salah satu masalah terbesar yang sering dialami BBLR adalah peningkatan risiko untuk terserang infeksi maupun sepsis, sehingga obat yang paling banyak digunakan di unit perawatan intensif neonatus adalah dari golongan antibiotik. Oleh sebab itu, diperlukannya peran Apoteker dalam melakukan praktik profesi berupa Pemantauan Terapi Obat (PTO) dalam proses pengobatan agar dapat membantu dalam mengoptimalkan efek terapi dan meminimalkan efek yang tidak dikehendaki sehingga prognosisnya dapat menjadi lebih baik. Pelaksanaan PTO dilakukan pada tanggal 15-24 September 2020 bertempat di ruang perinatologi 2B di gedung bougenville RSUP Fatmawati berdasarkan laporan kasus yang bersifat kualitatif dengan melakukan pengamatan langsung atau observasi. Data yang diperoleh kemudian diidentifikasi terkait Drug Related Problems (DRPs) menurut Cipolle dan dianalisis rasionalitasnya pada domain antibiotik dengan metode Gyssens. Dari analisa yang dilakukan ditemukan beberapa masalah DRP menurut Cipolle yaitu terkait lama pemberian obat meropenem yang terlalu panjang; pemberian dosis yang terlalu rendah pada obat fluconazole dan ketorolac; pemilihan obat bactesyn yang tidak rasional; adanya interaksi obat fluconazole dengan omeprazole yang bersifat moderat, serta interaksi obat gentamicin dengan bactesyn yang bersifat minor jika digunakan secara bersamaan. Sementara hasil evaluasi menggunakan metode Gyssens pada penggunaan antibiotik menunjukkan obat meropenem termasuk kategori IIIa (penggunaan antibiotik terlalu lama); gentamicin termasuk kategori 0 (penggunaan antibiotika tepat/bijak); bactesyn termasuk katagori IVa (ada antibiotik lain yang lebih efektif) dan katagori IIa (penggunaan antibiotik tidak tepat dosis) apabila tetap dipertahankan penggunaannya.

---

In Indonesia, the proportion of Low Birth Weight Babies (LBW) <2500 grams in infants aged 0-59 months is still quite high at 6.2% in 2013-2018. In fact, LBW conditions have a greater risk of experiencing morbidity and mortality than babies with normal weight. One of the biggest problems that are often experienced by LBW is the increased risk for infection and sepsis, so the most widely drugs used in neonatal intensive care units are from the antibiotic class. Therefore, a pharmacist's role is needed in carrying out professional practice with Drug Therapy Monitoring (DTM) in order to help optimize the effect of therapy and minimize unwanted effects, so the prognosis can be better. The implementation of DTM was carried out on September 15-24, 2020 at the perinatology room 2B in the bougenville building of RSUP Fatmawati based on qualitative case reports by direct observation. Then the data was identified using the Drug Related Problems (DRPs) classification according to Cipolle and analyzed their rationality in the antibiotic domain using the Gyssens method. From the analysis conducted, it was found that several DRP problems were related to the the long duration of administration of meropenem; too low a dose of fluconazole and ketorolac; irrational choice of bactesyn; There is a moderate drug interaction between fluconazole and omeprazole, as well as a minor drug interaction between gentamicin and bactesyn when used concurrently. Meanwhile, the results of the evaluation using the Gyssens method on antibiotic use showed that meropenem was included in category IIIa (the use of antibiotic is too long); gentamicin was included in category 0 (the use of antibiotics is appropriate/wise); bactesyn was included category IVa (there are other antibiotics that are more effective) and category IIa (the use of antibiotics is not in the right dose) if its use is maintained."

"[ABSTRAKPengambilan darah vena merupakan prosedur yang menimbulkan nyeri pada bayiberat lahir rendah. Penelitian ini bertujuan mengidentifikasi perbandingan antaraPerawatan Metode Kanguru dan pemberian empeng terhadap respon nyeri selamapengambilan darah vena. Desain penelitian adalah eksperimen acak terkontrolpada 21 bayi berat lahir rendah dengan teknik consecutive sampling. Penilaianrespon nyeri menggunakan instrumen Premature Infant Pain Profile. Analisis uji tindependen menunjukkan bahwa terdapat perbedaan bermakna rerata respon nyeripada kelompok Perawatan Metode Kanguru (rerata = 8,94) dan pemberianempeng (rerata = 5,08) dengan p value = 0,005. Pemberian empeng dapatdijadikan sebagai intervensi keperawatan dalam asuhan atraumatik saat prosedurinvasif minor.

---

ABSTRACTVenous blood collection is the procedures which cause pain on low birth weightinfants. This study aimed to identify the comparison between Kangaroo MotherCare and pacifier for pain response during venous blood collection. The researchdesign was randomized controlled trial on 21 low birth weight infants withconsecutive sampling. Pain response was assessed by Premature Infant PainProfile instrument. Independent t-test analysis showed that there were significantdifferences in mean pain response between Kangaroo Mother Care group (mean= 8.94) and pacifier group (mean = 5.08) with p value = 0.005. Pacifier can beused as a nursing intervention in atraumatic care with minor painful procedures, Venous blood collection is the procedures which cause pain on low birth weightinfants. This study aimed to identify the comparison between Kangaroo MotherCare and pacifier for pain response during venous blood collection. The researchdesign was randomized controlled trial on 21 low birth weight infants withconsecutive sampling. Pain response was assessed by Premature Infant PainProfile instrument. Independent t-test analysis showed that there were significantdifferences in mean pain response between Kangaroo Mother Care group (mean= 8.94) and pacifier group (mean = 5.08) with p value = 0.005. Pacifier can beused as a nursing intervention in atraumatic care with minor painful procedures]"

"Penulisan karya ilmiah akhir ini bertujuan untuk mengaplikasikan teori Konservasi melalui pendekatan asuhan perkembangan dalam perawatan tiga bayi berat lahir rendah (BBLR) yang mengalami penundaan pemberian nutrisi enteral dini. Nutrisi enteral dini memfasilitasi adaptasi saluran cerna sehingga tercapai maturasi yang penting bagi penerimaan nutrisi enteral bayi selanjutnya. Penyebab penundaan pemberian nutrisi enteral dini pada BBLR ini adalah intoleransi minum dan perdarahan saluran cerna. Kebutuhan nutrisi BBLR tetap terpenuhi melalui pemberian secara parenteral. Adapun pendekatan asuhan perkembangan yang digunakan bertujuan agar energi yang dimiliki bayi dapat digunakan secara optimal untuk tumbuh dan berkembang melalui pencapaian konservasi, dalam hal ini konservasi energi. Selama menjalani perawatan, BBLR dalam uraian karya ilmiah akhir ini menunjukkan status oksigenasi yang baik, instabilitas suhu tidak terjadi, dan penurunan berat badan masih dalam kisaran rentang normal yaitu 10-15% dari berat badan lahir.

---

This scientific assignment aimed to applying the Conservation theory by approach of developmental care in nursing care of three cases of low birth weight (LBW) infants who experienced the delayed early enteral nutrition. Early enteral nutrition facilitated the adaptation of gastrointestinal tract in order to reach maturation which is important for LBW infants to receive enteral nutrition later. The causes of delayed early enteral nutrition in these LBW infants were feeding intolerance and gastrointestinal bleeding. Nutritional needs of these LBW infants was fulfilled by parenteral nutrition. The using of developmental care approach aimed to strive the energy of LBW infants could be optimally utilize for growth and development through attainment of energy conservation as one of conservation principles in Conservation theory. During treatments, LBW infants in this scientific assignment showed normal oxygenation status, stability of body temperature, and weight loss was still within normal range was 10-15% of birth weight."

"Latar Belakang: Bayi sangat prematur rentan terjadi retriksi pertumbuhan ekstrauterin yang berakibat gangguan neurodevelopmental. Hal ini dapat dicegah denganpemberian nutrisi parenteral agresif dini dan nutrisi enteral sesuai protokol nutrisibayi prematur. Tujuan pemberian nutrisi parenteral agresif dini adalah mencegahterjadinya katabolisme dan menjamin pertumbuhan yang sama dengan intrauteri.Pengukuran kecepatan pertumbuhan adalah salah satu metode pengukuranpertumbuhan untuk menilai status nutrisi pada bayi prematur. Nilai kecepatanpertumbuhan diukur pada usia 28 hari dikarenakan pada saat ini telah terjadipertumbuhan pesat setelah bayi kembali ke berat lahir.Tujuan: Mengetahui nilai kecepatan pertumbuhan usia 28 hari bayi sangat prematurdan atau bayi berat lahir sangat rendah serta faktor-faktor yang memengaruhinyasetelah mendapatkan protokol standar nutrisi bayi prematur yang berlaku di RSCM.Metode: Studi kohort prospektif dengan metode konsekutif sampling pada bayisangat prematur dan atau bayi berat lahir sangat rendah yang lahir di RSCM padabulan Februari sampai dengan November 2020.Hasil: Didapatkan 64 subjek penelitian yang diamati. Terdapat 33/64 (51,6%) subjekdengan transfusi berulang, 22/64 (34,4%) asidosis metabolik memanjang , 5/64(7,8%) EKN derajat II, 12/64 (18,8%) DAP Hs, 37/64 (57,8%) penyakit membranhialin derajat IV, 37/64 (57,8%) intoleransi minum, 55/64 (85,9%) SMK dan 9/64(14,1%) KMK. Rerata kecepatan pertumbuhan adalah 17,98 gram/kgBB/hari, SMK18,22 gram/kgBB/hari dan KMK 16,50 gram/kgBB/hari. Faktor yang palingmemengaruhi adalah asidosis metabolik memanjang dengan nilai p 0,01.Kesimpulan : Kecepatan pertumbuhan usia 28 hari bayi sangat prematur dan ataubayi berat lahir sangat rendah setelah mendapat protokol standar nutrisi bayiprematur RSCM adalah 17,98 gr/kgBB/hari. Asidosis metabolik memanjangmemengaruhi kecepatan pertumbuhan.

---

Background: Very preterm infants are susceptible to extrauterine growth restriction

resulting in neurodevelopmental disorders. This can be prevented by providing early

aggressive parenteral and enteral nutrition, aiming to prevent catabolism and ensure

similar intrauterine growth. Growth velocity is a growth measurement method for

assessing nutritional status in preterm infants, which is measured at 28 days of age

since it is the moment of rapid growth after the baby has returned to birth weight.

Aims : To determine the growth velocity at 28 days of age for very preterm and/or

very low birth weight infants and assess affecting factors in applying the standard

protocol of preterm infant nutrition in Cipto Mangunkusumo Hospital (CMH).

Methods: Prospective cohort study with consecutive sampling method on very

preterm and/or very low birth weight infants born in CMH since February to

November 2020.

Results: Among 64 subjects, the number of appropriate- and small-for-gestationalage

(AGA and SGA) were 55 (85.9%) and 9 (14.1%), respectively. The associated

conditions were as following; sepsis with repeated transfusions (33/64, 51.6%),

prolonged metabolic acidosis (22/64, 34.4%), grade II necrotizing enterocolitis (5/64,

7.8%), hemodynamically-significant patent ductus arteriosus (12/64, 18.8%), grade

IV hyaline membrane disease (37/64, 57.8%), and feeding intolerance (37/64,

57.8%). The mean growth velocity was 17.98 g/kg/day, specifically 18.22 g/kg/day

in AGA and 16.50 g/kg/day in SGA infants, respectively. The most influencing factor

in applying nutritional protocol was prolonged metabolic acidosis (p value = 0.01).

Conclusion: The growth velocity at 28 days of very preterm and/or very low birth

weight infants after receiving standard nutritional protocol for preterm infants in

CMH was 17.98 g/kg/day. Prolonged metabolic acidosis has significant influence on

growth velocity."

"

Abstrak

Bayi berat lahir rendah yang dirawat terpapar dengan berbagai kondisi yang menimbulkan ketidaknyamanan, sehingga dapat memicu respon stres dan gangguan pertumbuhan. Penelitian ini bertujuan untuk mengetahui pengaruh stimulus auditori murottal Qur’an terhadap kenyamanan dan berat badan pada BBLR. Desain penelitian menggunakan pendekatan uji klinis dengan randomisasi yaitu single blind randomized controlled trial secara paralel pada kelompok intervensi dan kontrol dengan melibatkan 52 responden BBLR sesuai kriteria inklusi (masing-masing kelompk 26 responden). Intervensi murottal Qur’an diberikan melalui speaker selama 20 menit/3 jam dengan frekuensi 4 kali setiap hari. Intervensi dilakukan selama 3 hari. Hasil penelitian menunjukkan ada perbedaan bermakna kenyamanan BBLR setelah intervensi murottal Qur’an hari pertama, hari kedua, dan hari ketiga antara kelompok intervensi dan kelompok kontrol (p=0,014; <0,001; <0,001) dan tidak ada perbedaan bermakna berat badan setelah intervensi murottal Qur’an hari pertama, hari kedua, dan hari ketiga antara kelompok intervensi dan kelompok kontrol (p=0,481; 0,481; 0,464). Stimulus auditori murottal Qur’an dapat membantu meningkatkan kenyamanan pada BBLR yang menjalani perawatan di rumah sakit sehingga dapat digunakan sebagai terapi suportif untuk meningkatkan  asuhan perawatan perkembangan pada BBLR dan prematur.

Kata kunci: Murottal Qur’an, Kenyamanan, Berat Badan, Bayi Berat Lahir Rendah    

---

Abstract

Low birth weight infants who hospitalized with various conditions which provoke discomfort. This discomfort could trigger stress and growth faltering. This study aimed to determine the influence of holy Qur’an recitation as auditory stimulus toward comfort and weight in low birth weight infants. This study design used clinical test approach with single blind randomized controlled trial in parallel among intervention and control groups with 52 low birth weight infants. The infants were randomly divided in two groups (n=26). Holy Qur’an recitation had given through speaker for 20 minutes/ 3 hours, 4 times a day. Intervention had given for 3 days. Result of this study showed there is significant difference in comfort of low birth weight infant after got holy Qur’an recitation in first, second, third days among intervention and control groups (p=0.014; <0.001; <0.001) and there is no significant difference in weight gain in first, second, and third days among intervention and control groups (p=0.481; 0.481; 0.464). Holy Qur’an recitation can help improve comfort level in low birth weight infants who hospitalized. Holy Qur’an recitation can used as a supportive therapy for increasing nursing care in development among low birth weight infants and premature infants.

Key Words: Holy Qur’an recitation, Comfort, Weight gain, Low birth weight infants

"

"Pemantauan Terapi Obat pada Neonatus Kurang Bulan, Bayi Berat Lahir Rendah, dan Sepsis di Ruang Neonatus Intensive Care Unit (NICU) RSUP Fatmawati Bulan September 2020.

---

Neonates, especially preterm infants have weak physical defenses and immature immune function, making them susceptible to bacterial invasion. One of the efforts to achieve the Sustainable Development Goals (SDGs), which is to reduce the incidence of neonatal mortality to 12 per 1,000 live births, it is necessary to collaborate between health workers in treating patients. Pharmacists in hospitals need to carry out their roles, one of which is by monitoring the therapy given. Data were collected directly by looking at the cardex and patient's medical records with the following criteria: less-month neonatal patients, receiving polypharmacy, patients with antibiotic therapy, and length of stay in the hospital ≥5 days. The data obtained were analyzed using the SOAP method and identified problems related to drugs. From the Monitoring of Drug Therapy (PTO), it was found that drug-related problems that occurred were dose mismatches and frequency mismatches, and analysis of the evaluation of antibiotic administration (EPA) with the Gyssens method found that the use of antibiotics was found in category IIIa, namely giving meropenem too long and category IIa, which was not the right dosage."