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"Latar belakang: Karsinoma rektum merupakan salah satu keganasan neoplastik yang banyak terjadi pada bagian rektum dan umumnya terjadi pada negara maju yang terus menerus meningkat setiap tahunnya. Tujuan: menganalisis asuhan keperawatan pasien kanker rektum menggunakan pendekatan teori Peacefull End Of Life (PEOL). Metode: metode yang digunakan pada asuhan keperawatan ini yaitu case study, satu pasien dengan karsinoma rektum. Hasil: nyeri yang dirasakan pasien bersifat kronis dengan skala 5, fase kenyamanan: pasien mengalami keterbatasan dalam mobilisasi. Setelah dilakukan tindakan perawatan selama 7 hari, keluhan nyeri kronis tetap dirasakan pasien karena massa yang ada dibagian rektum tidak dapat dioperasi, namun selain penggunaan terapi opioid berupa Morfin MST 2x10 mg pasien juga diajarkan penggunaan terapi komplementer berupa terapi musik untuk mengurangi rasa nyeri. Kesimpulan: Penggunaan teori Peacefull End Of Life dapat digunakan dalam pengelolaan pasien dalam kondisi paliatif dan terminal yang bertujuan untuk meningkatkan kenyamanan serta mengurangi keluhan yang dirasakan pasien hingga akhir hidupnya.

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Background: Rectal carcinoma is one of the most common neoplastic malignancies that occurs in the rectum and generally occurs in developed countries which continues to increase every year. Objective: to analyze the nursing care of rectal cancer patients using the Peaceful End Of Life (PEOL) theoretical approach. Method: the method used in mental care is a case study, one patient with rectal carcinoma. Results: the pain felt by the patient is chronic with a scale of 5, the comfort phase: the patient experiences limitations in mobilization. After treatment for 7 days, patients still felt complaints of chronic pain because the mass in the rectum could not be operated on, but apart from the use of opioid therapy in the form of Morphine MST 2x10 mg the patient was also taught the use of complementary therapy in the form of music therapy to reduce pain. Conclusion: The use of the Peaceful End Of Life theory can be used in the management of patients in palliative and terminal conditions which aims to increase comfort and reduce complaints felt by patients until the end of their lives"

"Kanker paru masuk kedalam lima besar kanker terbanyak di Indonesia. Menurut data kanker paru mempunyai prognosis buruk meskipun sudah mendapat tatalaksana terapi kanker. Harapan hidup yang meningkat adalah tujuan terapi kanker paru. Pengenalan program paliatif dengan menerapkan teori keperawatan Peaceful end of life (PEOL) sangat aplikatif. Teori ini tidak hanya kanker paru namun juga penyakit keganasan yang lain. 30 resume kasus keganasan dibuat menggunakan teori PEOL, dengan berfokus dalam mengatasi nyeri, memberikan kenyaman, merasa bermartabat, di hargai, menyertakan keterlibatan dengan orang yang bermakna. Inovasi keperawatan yang dilakukan dengan mengembangkan media video dalam menunjang intervensi manajemen edukasi. Penerapan praktek klinik berbasis bukti ilmiah dalam merawat pasien luka kanker menggunakan green tea bag untuk mengontrol dan mengurangi bau. Tujuan laporan analisis praktek residensi adalah mendapat gambaran secara keseluruhan proses dari kasus kelolaa, 30 resume, EBN dan inovasi. Hasil dari laporan residensi dapat menjadi acuan dalam mengembangkan layanan asuhan keperawatan onkologi yang optimal.

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Lung cancer included in the top five most cancers in Indonesia. According to data, lung cancer has a poor prognosis even though has received cancer therapy. Increased life expectancy is the goal of lung cancer therapy. The introduction of palliative programs by applying the theory Peaceful end of life (PEOL) is very applicable. This theory is not only lung cancer but also other malignancies. 30 malignancy case resumes were created using PEOL theory, with a focus on reduce pain, providing comfort, feeling dignified, being valued, involvement with meaningful people. A breakthrough innovation by developing video media to support management of education. Application of evidence-based clinical nursing practice in treating malignant wounds using green tea bags to control and reduce odor. The purpose of the residency practice is to get an overall picture of the process of managed cases, 30 resumes, EBN and innovations. The results of the residency report can be a reference for nurse to develop their practice in oncology nursing care services."

"Praktik Residensi Keperawatan Medikal Bedah merupakan suatu rangkaian kegiatan megister dan Spesialis Keperawatan yang dilaksanakan di tempat pelayanan Kesehatan. Praktik residensi keperawatan medikal bedah berfokus pada penerapan ilmu, riset dan teknologi keperawatan dalam memenuhi kebutuhan dasar pada pasien dewasa dengan gangguan kardiovaskuler secara komprehensif. Praktik klinik keperawatan medical bedah peminatan kardiovaskuler dilaksanakan di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPHK) Jakarta, dengan pemberian asuhan keperawatan menggunakan pendekatan teori Virginia Henderson pada satu kasus kelolaan dengan diagnose medis UAP TIMI 2/7 GRACE 139 CRUSADE 57, AV Block derajat 1, LBBB ect NSTEMI Dengan Riwayat CABG x2 (SVG-OM, SVG-LAD) dan AVR mekanikAV block grade I dan 30 kasus resume. Penerapan Evidance Based Nursing (EBN) dengan menggunakan intervensi single session 20-minute mindful Breathing untuk mengurangi keluhan dyspnea pada pasien cute Decompensatio Heart Failure (ADHF). Residensi juga melakukan inovasi yaitu penerapan aplikasi assasement pressure injury pada pasien perioperative menggunakan Scale Munro sebagai instrument pencegahan terjadinya pressure injury pada pasien rencana operasi bedah jantung

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Medical Surgical Nursing Residency Practice is a series of activities for megisters and Nursing Specialists carried out in Health care facilities. The practice of medical surgical nursing residency focuses on the application of science, research and nursing technology in meeting the basic needs of adult patients with cardiovascular disorders in a comprehensive manner. Cardiovascular medical surgical nursing clinical practice is carried out at Heart and Vascular Hospital Harapan Kita (RSJPHK) Jakarta, by providing nursing care using the Virginia Henderson theoretical approach in one managed case with a medical diagnosis of UAP TIMI 2/7 GRACE 139 CRUSADE 57, AV Block degree 1, LBBB ect NSTEMI With History of CABG x2 (SVG-OM, SVG-LAD) and mechanical AVRAV block grade I and 30 cases resumed. Implementation of Evidence Based Nursing (EBN) using a single session 20-minute mindful breathing intervention to reduce complaints of dyspnea in cute Decompensation Heart Failure (ADHF) patients. The residency also made innovations, namely the application of pressure injury assessment applications in perioperative patients using the Munro scale as an instrument for preventing pressure injury in patients planning cardiac surgery."

"Karya Ilmiah Akhir ini merupakan laporan seluruh kegiatan praktik klinik residensi Ners Spesialis Keperawatan Medikal Bedah kekhususan kardiovaskular. Kegiatan praktik klinik meliputi pelaksanaan asuhan keperawatan pada pasien dengan masalah sistem kardiovaskular melalui pendekatan Comfort Theory Kolcaba, pelaksanaan praktik keperawatan berbasis bukti dan melakukan inovasi keperawatan. Asuhan keperawatan menggunakan Comfort Theory Kolcaba melihat pada status yang dialami oleh pasien terhadap comfort measures untuk memenuhi kebutuhan segera yang dikelompokkan dalam 3 jenis comfort, yaitu relief, ease, transcendence dan dalam 4 konteks pengalaman yaitu fisik, psikospiritual, sosial, dan lingkungan. Sehingga pemberian pelayanan keperawatan berdasarkan Comfort Theory Kolcaba lebih berfokus pada proses mengkaji kebutuhan kenyamanan klien, mengembangkan dan menerapkan intervensi keperawatan yang sesuai, dan mengevaluasi kenyamanan klien dan intervensi keperawatan yang telah diberikan. Praktik keperawatan berbasis bukti yang dilakukan adalah Spiritual Emotional Freedom Technique (SEFT) untuk menurunkan intensitas nyeri pasien pasca bedah jantung. Pelaksanaan inovasi keperawatan berupa penyusunan formulir pengkajian khusus mulut dan intervensi oral higiene pada pasien yang terpasang ETT dan ventilator di ICVCU Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita Jakarta.

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The final scientific paper is reporting of all activities of nurses specialist residency clinical practice Medical Surgical Nursing cardiovascular specificity. The Activities include implementation of clinical practice nursing care to patients with the cardiovascular system problems using Kolcaba’s Comfort Theory approach, the implementation of evidence-based nursing practice and innovation on nursing. Kolcaba’s Comfort Theory look at the status experienced by patients on comfort measures to meet the immediate needs are grouped the 3 types of comfort, which is a relief, ease, and transcendence in the context of the experience that is 4 physical, psikospiritual, social, and environmental. So the provision of nursing services by Comfort Theory Kolcaba more focused on the process of assessing the needs of the clients comfort, develop and implement appropriate nursing interventions, and evaluating the client's comfort and nursing interventions that have been given. Evidence-based nursing practice is carried Spiritual Emotional Freedom Technique (SEFT) to reduce post-cardiac surgery pain intensity. Implementation of nursing innovations in the form of the preparation of the mouth and form a special assessment of oral hygiene interventions in patients with ETT and ventilator installed in ICVCU of National Cardiovascular Center Harapan Kita Jakarta."

"Praktik keperawatan residensi yang dilakukan di Rumah Sakit Umum Pusat Persahabatan dengan kekhususan respirasi diharapkan dapat mengatasi masalah pernapasan. Selama proses residensi menerapkan intervensi berdasarkan evidence based nursing, mampu menjadi seorang Clinical Care Manager (CCM) sebagai konsultan staf keperawatan, dan memberikan terapi keperawatan yang profesional. Dalam memberikan asuhan keperawatan pada kasus kelolaan pasien dengan Bronkiektasis dan 30 kasus resume menggunakan teori Henderson 14 kebutuhan dasar manusia yang menunjukkan peran perawat sebagai pemberi asuhan keperawatan dalam membantu individu baik dalam keadaan sehat maupun sakit, melalui usahanya melakukan berbagai aktivitas guna mendukung kesehatan dan penyembuhan individu atau proses meninggal dengan damai. Masalah keperawatan yang banyak muncul yaitu tentang pemenuhan kebutuhan bernapas normal. Penerapan EBN cold application dan latihan napas dan batuk untuk menurunkan tingkat nyeri pada pasien terpasang chest tube. Pelaksanaan proyek inovasi pengembangkan video edukasi monitoring dan perawatan di rumah pasien terpasang WSD sebagai media self-management bagi perawat ruang rawat dan pasien yang terpasang WSD. Hasil analisis praktik residensi keperawatan didapatkan bahwa asuhan keperawatan menggunakan pendekatan teori Henderson bertujuan untuk membantu sesegera mungkin kemandirian pasien. Penerapan cold application dan latihan napas dan batuk dapat menurunkan skor nyeri pasien terpasang chest tube. Proyek inovasi video edukasi monitoring dan perawatan di rumah pasien terpasang WSD sebagai media self-management meningkatkan pengetahuan perawat dan kemandirian pasien.

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The practice of residency nursing conducted at RSUP Persahabatan with the specificity of respiration is expected to overcome respiratory problems. During the residency process apply interventions based on evidence-based nursing, be able to become a Clinical Care Manager (CCM) as a nursing staff consultant, and provide profesional nursing therapy. In providing nursing care in cases managed by patients with bronchiectasis and 30 resume cases using Henderson's theory 14 basic human needs that show the role of nurses as nursing care providers in helping individuals both in health and illness, through their efforts to carry out various activities to support the health and healing of individuals or the process of dying peacefully. Many nursing problems arise are about meeting the needs of normal breathing. Application of EBN cold application and breathing and coughing exercises to reduce pain levels in chest tube patients. The implementation of an innovation project to develop educational videos for monitoring and care at home of WSD-installed patients as a self-management medium for nurses, inpatient rooms and patients installed with WSD. The results of the analysis of nursing residency practice found that nursing care using Henderson's theoretical approach aims to help as soon as possible the independence of patients. The application of cold application and breathing and coughing exercises can reduce the pain score of patients attached to the chest tube. Educational video innovation project, monitoring and care at home installed with WSD as a self-management medium increases nurses' knowledge and patient independence."

"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."

"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."