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"Residensi Keperawatan Medikal Bedah diharapkan mampu menjadi seorang Clinical Care Manajer (CCM) yang bertugas sebagai konsultan keperawatan bagi staf keperawatan dan pemberi terapi keperawatan kepada pasien. Asuhan keperawatan pada kasus kelolaan pasien dengan TB paru klinis dengan efusi pleura dan 30 kasus resume menerapakan pendekatan dengan teori Roy Adaptasi Model (RAM). Dalam penerapan teori ini menunjukan peran perawat untuk membantu pasien dalam beradaptasi melalui stimulus yang diterima, memberikan intervensi baik secara regulator maupun kognator, sehingga pasien adaptif terhadap stimulus tersebut. Pada resume masalah keperawatan yang sering muncul yaitu masalah oksigenasi bersihan jalan nafas tidak efektif. Pada penerapan EBN Terapi Komplementer Acupressure Yuji, Nei Guan Dan Zongfu terhadap Penurunan Dyspnea pada Pasien Tb Paru Di Era Post Covid-19. Proyek inovasi Peningkatan Kemampuan Perawat Dalam Monitoring Pasien Terpasang WSD dan Edukasi Perawatan di Rumah dengan Video” di Rumah Sakit Umum Pusat Persahabatan, Jakarta. Hasil analisis praktik residensi keperawatan didapatkan bahwa asuhan keperawatan dengan menggunakan pendekatan teori Roy membantu pasien untuk beradaptasi terhadap stimulus untuk meningkatakan kesehatan individu. Pada penerapan EBN ada pengaruh Terapi Komplementer Acupressure Yuji, Nei Guan Dan Zongfu terhadap Penurunan Dyspnea pada Pasien Tb Paru. Proyek inovasi dapat meningkatkan pengetahuan perawat tentang Monitoring Pasien Terpasang WSD dan pengetahuan pasien tentang Edukasi Perawatan WSD di Rumah.

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The Medical Surgical Nursing Residency is expected to be able to become a Clinical Care Manager (CCM) who serves as a nursing consultant for nursing staff and provides nursing therapy to patients in the context of providing nursing care. Nursing care in cases managed by patients with clinical pulmonary TB with pleural effusion and 30 resume cases applied the Roy Adaptation Model (RAM) theory approach. cognator, so that the patient is adaptive to the stimulus. The resume founded nursing problem that often arises is the problem of ineffective airway clearance oxygenation. In the application of Yuji Acupressure Complementary Therapy EBN, Nei Guan and Zongfu on Reducing Dyspnea in Pulmonary TB Patients in the Post Covid-19 Era. An innovation project to Improve Nurses' Capabilities in Monitoring WSD Installed Patients and Home Care Education with Video” at the Persahabatan General Hospital, Jakarta. The results of the analysis of nursing residency practice found that nursing care using Roy's theoretical approach helps patients to adapt to stimuli to improve individual health. In the application of EBN there is an effect of Yuji, Nei Guan and Zongfu's Complementary Acupressure Therapy on Reducing Dyspnea in Pulmonary TB Patients. The innovation project can increase nurses' knowledge about WSD Installed Patient Monitoring and patient knowledge about WSD Care Education at Home."

"Asuhan keperawatan yang komprehensif memerlukan fungsi dan peran profesi ners spesialis untuk meningkatkan kualitas pelayanan di bidang keperawatan. Pendidikan profesi ners spesialis keperawatan medikal bedah peminatan imunologi melatih kompetensi dalam pengelolaan asuhan keperawatan kasus gangguan sistem imunologi HIV yang disertai infeksi oportunistik, melatih pengembangan intervensi keperawatan berbasis fakta ilmiah melalui implementasi Evidence based Nursing (EBN), melatih penyusunan dan pelaksanaan proyek inovasi keperawatan. Pengelolaan asuhan keperawatan pada 1 kasus utama pasien Efusi Pleura dengan TB Paru pada HIV dan 30 resume kasus HIV dengan infeksi oportunistik dimana presentase paling banyak ditemukan secara berurutan adalah Candidiasis oral, Diare, TB Paru, Pneumonia, TB limfadenopathy, Kondiloma akuminata, dan Anemia. Penerapan teori model adaptasi Roy pada asuhan keperawatan pasien HIV meningkatkan mekanisme koping yang adaptif dalam merespon perubahan stimulus mode adaptasi. Penerapan teori model kognitif sosial Bandura menekankan pengkajian pada faktor individu, perilaku dan lingkungan yang saling mempengaruhi dalam perawatan HIV/ AIDS. Sedangkan pada evaluasi implementasi EBN, didapatkan intervensi breathing exercise yang dapat meningkatkan kualitas tidur pasien HIV/AIDS secara efektif. Proyek inovasi VOSIL SPARTAN dilaksanakan sebagai upaya pencegahan infeksi oportunistik (IO) dan peningkatan perilaku hidup bersih sehat (PHBS) pada pasien HIV/ AIDS. Hasil inovasi keperawatan berupa edukasi memanfaatkan teknologi QR code meningkatkan pengetahuan dan sikap dalam pencegahan infeksi oportunistik dan PHBS secara efektif.

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Comprehensive nursing care requires the function and role of the specialist nurse profession to improve the quality of services in the nursing field. Professional education for nurses specializing in medical surgical nursing specializing in immunology trains competency in managing nursing care in cases of HIV immunological system disorders accompanied by opportunistic infections, trains the development of nursing interventions based on scientific facts through the implementation of Evidence Based Nursing (EBN), trains the organization and implementation of nursing innovation projects. Management of nursing care in 1 main case of Pleural Effusion patient with Pulmonary TB in HIV and 30 resumes of HIV cases with opportunistic infections where the highest percentages found in sequence were Oral Candidiasis, Diarrhea, Pulmonary TB, Pneumonia, TB lymphadenopathy, Condyloma acuminata, and Anemia. The application of Roy's adaptation model theory to nursing care for HIV patients increases adaptive coping mechanisms in response to changes in adaptation mode stimuli. The application of Bandura's social cognitive model theory emphasizes the study of individual, behavioral and environmental factors that influence each other in HIV/AIDS care. Meanwhile, in the evaluation of EBN implementation, it was found that breathing exercise interventions could effectively improve the sleep quality of HIV/AIDS patients. The VOSIL SPARTAN innovation project was implemented as an effort to prevent opportunistic infections (OI) and improve clean and healthy living behavior (PHBS) in HIV/AIDS patients. The results of nursing innovation in the form of education utilizing QR code technology increase knowledge and attitudes in preventing opportunistic infections and PHBS effectively."

"Praktik spesialis keperawatan medikal bedah merupakan rangkaian dari pendidikan ilmukeperawatan yang dilaksanakan dalam tatanan pelayanan kesehatan. Selama menjalani proses residensi, residen berperan menjadi Clinical Care Manager yang bertugas sebagai pemberi asuhan keperawatan, sebagai peneliti, konsultan keperawatan bagi staf keperawatan, serta pendidik. Guna mencapai peran tersebut, residen menerapkan teori keperawatan model adaptasi Roy sebagai alat untuk mempermudah pemberian asuhan keperawatan dalam membantu individu, baik dalam kondisi sakit maupun pada proses penyembuhan dan peningkatan pemeliharaan kesehatan di setiap mode fisiologis, konsep diri, fungsi peran dan interdependen secara sistematis. Pada kasus kelolaan dengan tuberkuloma paru diperoleh hasil bahwasanya ada perbaikan kondisi setelah pemberian asuhan keperawatan selama 15 hari dan hasil pada 30 kasus resume pasien dengan penyakit sistem pernapasan terbanyak adalah tuberkulosis paru. Penerapan Evidence Based Nursing menggunakan terapi Eye Movement Training (EMT) didapatkan hasil bahwa kelompok intervensi EMT memiliki nilai perubahan kualitas tidur rerata lebih tinggi sebelum dan sesudah diberikan terapi dibandingkan kelompok kontrol. Pada proyek inovasi, dilakukan program peningkatan kemampuan perawat dalam melakukan perawatan trakeostomi pada pasien dewasa dengan 6 elemen bundle trakeostomi diperoleh hasil bahwa perawat ruangan merasa materi yang diberikan sangat bermanfaat dan mampu laksana sehingga tindak lanjutnya adalah terbentuknya booklet perawatan trakeostomi dan teraplikasi dalam Electronic Medical Record (EMR).

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Medical-surgical nursing specialist practice is a series of nursing science education carried out in health care settings. During the residency process, the resident acts as a Clinical Care Manager in charge of providing nursing care, as a researcher, nursing consultant for nursing staff, and educator. In order to achieve this role, residents apply the Roy adaptation model nursing theory as a tool to facilitate the provision of nursing care in helping individuals, both in sickness and in the process of healing and improving health maintenance in each physiological mode, self-concept, role function and interdependence systematically. In the case of management with pulmonary tuberculosis, the results showed that there was an improvement in condition after providing nursing care for 15 days and the results in 30 cases of patient resumes with the most respiratory system diseases were pulmonary tuberculosis. The application of Evidence Based Nursing using Eye Movement Training (EMT) therapy found that the EMT intervention group had a higher mean sleep quality change value before and after therapy than the control group. In the innovation project, a programme to improve the ability of nurses to perform tracheostomy care in adult patients with 6 elements of the tracheostomy bundle was carried out. The results showed that the room nurses felt the material provided was very useful and applicable so that the follow-up was the formation of a tracheostomy care booklet and applied in the Electronic Medical Record (EMR)."

"Praktik keperawatan residensi yang dilakukan di Rumah Sakit Persahabatan dengan kekhususan respirasi diharapkan dapat mengatasi masalah pernapasan. Selama menjalani proses residensi, residen berperan menjadi seorang Clinical Care Manajer (CCM) yang bertugas sebagai konsultan keperawatan bagi staf keperawatan dan pemberi terapi keperawatan kepada pasien, sebagai peneliti serta pendidik dalam rangka pemberi asuhan keperawatan untuk meningkatkan mutu atau kualitas asuhan keperawatan. Dalam memberikan asuhan keperawatan, residen menerapkan model adaptasi Roy baik pada kasus kelolaan dengan diagnosa TB paru On OAT bulan ke-2 maupun pada 30 kasus resume, pada kasus resume ini didapatkan diagnosa medis terbanyak adalah kanker paru, diagnosa keperawatan terbanyak pola napas tidak efektif dan intervensi keperawatan yang paling banyak adalah manajemen airway. Penerapan model adaptasi Roy menunjukkan peran perawat sebagai pemberi asuhan keperawatan dalam membantu individu, baik dalam kondisi sakit maupun pada proses penyembuhan dan peningkatan pemeliharaan kesehatan di setiap mode fisiologis, konsep diri, fungsi peran dan interdependen. Selama melakukan asuhan keperawatan, masalah keperawatan yang banyak muncul yaitu pada mode fisiologis berupa masalah gangguan oksigenasi. Hasil analisis praktik residensi keperawatan didapatkan bahwa asuhan keperawatan menggunakan pendekatan model adaptasi Roy bertujuan untuk membantu individu sesegera mungkin beradaptasi terhadap stimulus baik stimulus internal maupun stimulus eksternal. Pada penerapan Evidence Base Nursing (EBN), residen melakukan penerapan foot massage yang bertujuan untuk mengurangi kecemasan dan parameter fisiologis pada pasien yang akan menjalani tindakan bronkoksopi. Hasil penerapan EBN menunjukan bahwa ada pengaruh pemberian foot massage dalam mengurangi kecemasan dan parameter fisiologis. Pada proyek inovasi, dilakukan program peningkatan kemampuan perawat dalam melakukan perawatan pada pasien yang terpasang WSD yang mencakup skrining awal, sebelum pemasangan WSD, saat pemasangan WSD, selama terpasang WSD, saat pencabutan dan perawatan luka WSD yang telah terstandar, berbasis bukti, sistematis dan terstruktur. Tujuan dari inovasi ini untuk meningkatkan kemampuan dan pengetahuan perawat dalam melakukan perawatan WSD dan terciptanya booklet sebagai pedoman standar intervensi perawatan WSD.

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Residency nursing practice carried out at Persahabatan Hospital with a respiratory specialty is expected to be able to overcome respiratory problems. During the residency process, the resident plays the role of a Clinical Care Manager (CCM) who serves as a nursing consultant for nursing staff and provides nursing therapy to patients, as a researcher and educator in the context of providing nursing care to improve the quality of nursing care. In providing nursing care, residents apply Roy's adaptation model both in cases managed with a diagnosis of pulmonary TB On OAT in the 2nd month and in 30 resume cases, in these resume cases the most medical diagnoses were lung cancer, the most nursing diagnoses were ineffective breathing patterns and The most common nursing intervention is airway management. The application of Roy's adaptation model shows the role of nurses as providers of nursing care in helping individuals, both in sick conditions and in the healing process and improving health maintenance in every physiological, self-concept, role and interdependent mode. During nursing care, nursing problems that often arise are in the physiological mode in the form of problems with oxygenation disorders. The results of the analysis of nursing residency practice showed that nursing care using the Roy adaptation model approach aims to help individuals adapt as quickly as possible to stimuli, both internal and external stimuli.

In implementing Evidence Base Nursing (EBN), residents apply foot massage which aims to reduce anxiety and physiological parameters in patients who will undergo bronchoscopy. The results of applying EBN show that there is an effect of giving foot massage in reducing anxiety and physiological parameters. In the innovation project, a program was carried out to increase the ability of nurses to provide care for patients with WSDs which included initial screening, before installing the WSD, during the installation of the WSD, during the installation of the WSD, during extraction and standard, evidence-based, systematic and structured WSD wound care. . The aim of this innovation is to increase nurses' abilities and knowledge in carrying out WSD care and to create a booklet as a standard guide for WSD care interventions.

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"Residensi spesialis keperawatan medikal bedah kekhususan respirasi melakukan proses pembelajaran dan manajemen asuhan keperawatan dilakukan dengan pendekatan proses keperawatan berdasarkan bukti-bukti ilmiah pada masalah kesehatan yang lazim terjadi pada usia dewasa baik yang bersifat akut dan kronik dengan penanganan konservatif maupun tindakan pembedahan dengan tetap berorientasi kepada upaya preventif, kuratif, dan rehabilitatif melalui tindakan keperawatan mandiri maupun kolaboratif. pemberi asuhan keperawatan dengan mengelola kasus pasien medikal bedah dan khususnya kasus pasien respirasi. Penerapan asuhan keperawatan menggunakan pendekatan teori model keperawatan model konseptual adaptasi yang dikembangkan oleh sister kalista roy. Calista roy mengembangkan konsep adapatasi dengam menggambarkan tingkat adapatasi sebagai kondisi proses kehidupan yang dapat berubah secara terus menerus dibangun dari stimulus fokal, kontekstual dan residual. Kasus bekas tuberkulosis mengalami berbagai gejala sisa dan komplikasi dapat terjadi pada paru dan bagian ekstrapulmonal dari thorax pada pasien yang dirawat atau tidak diobati. Diperkirakan 58 juta orang selamat dari tuberkulosis sejak tahun 2000, namun banyak dari mereka akan menderita post tuberculosis lung disease (PTLD). Latihan napas yang diberikan kepada pasien salah satunya dengan mindful breating, Latihan napas ini dilakukan pasien dengan bimbingan perawat dan focus terhadap pernapasannya sehingga menimbulkan perasaan tenang dan dampak dapat mengriangi sesak napas yang dirasakan. Inovasi keperawatan dengan mengembangkan video edukasi monitoring dan perawatan di rumah pasien terpasang WSD sebagai media self-management bagi perawat ruang rawat dan pasien yang terpasang WSD.

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Medical surgical nursing specialist residency specializing in respiration conducts a learning process and nursing care management is carried out with a nursing process approach based on scientific evidence on health problems that commonly occur in adults both acute and chronic in nature with conservative management and surgical procedures while remaining oriented towards efforts preventive, curative, and rehabilitative through independent and collaborative nursing actions. nursing care providers by managing medical surgical patient cases and especially respiratory patient cases. The application of nursing care uses a theoretical approach to the nursing model conceptual adaptation model developed by sister Kalista Roy. Calista Roy developed the concept of adaptation by describing the level of adaptation as a condition of a life process that can change continuously and is built from focal, contextual and residual stimuli. Cases of former tuberculosis have a variety of sequelae and complications can occur in the lungs and extrapulmonary parts of the thorax in treated or untreated patients. An estimated 58 million people have survived tuberculosis since 2000, but many of them will develop post- tuberculous lung disease (PTLD). One of the breathing exercises given to patients is mindful breathing. This breathing exercise is carried out by the patient under the guidance of a nurse and focuses on his breathing so that it creates a feeling of calm and the impact can relieve the shortness of breath that is felt. Nursing innovation by developing educational videos for monitoring and caring for patients with WSD installed as a self-management medium for ward nurses and patients with WSD installed."

"Praktek Spesialis Keperawatan merupakan sebuah proses penting dari pendidikan profesi dalam rangka mengaplikasikan peran seorang perawat spesialis yang memberikan dampak dalam upaya meningkatkan kualitas layanan keperawatan. Praktek ini dilakukan dan dikembangkan berdasarkan ilmu pengetahuan dan teknologi melalui penelitian yang berbasis fakta dan dengan pendekatan teori Henderson dan teori sosial kognitif Bandura di RS Persahabatan dan RS Fatmawati Jakarta. Tiga kompetensi yang harus dicapai dalam praktek residensi ini adalah memberikan asuhan keperawatan menggunakan pendekatan teori keperawatan, menerapkan implementasi keperawatan yang berbasis bukti ilmiah (evidence based nursing practice), dan melakukan proyek inovasi keperawatan yang berguna bagi lahan yang menjadi tempat praktek residensi. Mahasiswa residensi sebagai pemberi asuhan keperawatan telah memberikan asuhan keperawatan menggunakan pendekatan teori Henderson pada satu kasus kelolaan utama dan 30 kasus resume pasien HIV/AIDS dengan berbagai infeksi oportunitis. Tugas mahasiswa residensi sebagai peneliti telah mengaplikasi penerapan efektifitas terapi musik untuk menurunkan tingkat stes pada pasien dengan penyakit kronis dan hasil dari evidence based nursing ini menunjukkan bahwa terapi musik memberikan hasil yang signifikan untuk menurunkan tingkat stres pada pasien dengan penyakit kronis. Fungsi sebagai innovator, mahasiswa residensi telah melakukan inovasi yaitu pembuatan modul peer group dalam meningkatkan dukungan emosional dan kepatuhan minum obat pada ODHIV dan hasil penerapan proyek inovasi ini menunjukkan manfaat yang sangat signifikan bagi ODHIV dalam meningkatkan kepatuhan minum obat ART.

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Nursing Specialist Practice is an important process of professional education in order to apply the role of a specialist nurse which has an impact in efforts to improve the quality of nursing services. This practice is carried out and developed based on science and technology through fact-based research and using Henderson's theoretical approach and Bandura's social cognitive theory at Persahabatan Hospital and Fatmawati Hospital, Jakarta. The three competencies that must be achieved in this residency practice are providing nursing care using a nursing theory approach, implementing nursing implementation based on scientific evidence (evidence based nursing practice), and carrying out nursing innovation projects that are useful for the land where the residency practice takes place. Residency students as providers of nursing care have provided nursing care using Henderson's theoretical approach to one primary management case and 30 resume cases of HIV/AIDS patients with various opportunistic infections. The job of residency students as researchers has been to apply the effectiveness of music therapy to reduce stress levels in patients with chronic illnesses and the results of this evidence-based nursing show that music therapy provides significant results in reducing stress levels in patients with chronic illnesses. Functioning as innovators, residency students have innovated, namely creating a peer group module to increase emotional support and medication adherence for PLWHA and the results of implementing this innovation project show very significant benefits for PLWHA in increasing adherence to taking ART medication."

"[ABSTRAK Praktik residensi keperawatan medikal bedah peminatan sistem respirasi memiliki tujuan untuk menjalankan tiga peran ners spesialis. Peran sebagai manajer kasus, pemberi layanan dan inovator. Sebagai manajer kasus, residen mengelola kasus utama pasien tuberculosis dan diabetes mellitus, dan 30 kasus resume dengan menggunakan Teori Self-Care Orem. Masalah keperawatan utama yang paling sering muncul adalah ketidakefektifan bersihan jalan napas. Sebagai pemberi layanan, residen telah menerapkan intervensi keperawatan berdasarkan pembuktian yaitu oral hygiene dengan chlorhexidine 0,12% yang dapat mencegah terjadinya Ventilator Associated Pneumonia (VAP). Inovasi keperawatan yang dilakukan yaitu modifikasi Water Seal Drainage (WSD) 1 botol yang telah mendapatkan respon yang baik dari para ahli dibidangnya untuk meningkatkan keselamatan pasien dan keselamatan pekerja atau petugas kesehatan dalam proses asuhan keperawatan.ABSTRACT The purpose of medical-surgical nurse resident in respiratory system clinical practice is to perform three roles of a nurse specialist as a case manager, healthcare provider and innovator. As a case manager, the resident managed a case of Tuberculosis and Diabetes Mellitus patient, and 30 resume cases with Orem Self-Care theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. As a healthcare provider, the resident had applied an evidence-based nursing intervention that has been using chlorhexidine 0,12% in oral hygiene procedure that can prevent Ventilator Associated Pneumonia (VAP). As an innovator, resident had made a modification of one bottle water-sealed drainage that has received good response from the experts to increase patients and employers or healthcare provider safety during the nursing care process.;The purpose of medical-surgical nurse resident in respiratory system clinical practice is to perform three roles of a nurse specialist as a case manager, healthcare provider and innovator. As a case manager, the resident managed a case of Tuberculosis and Diabetes Mellitus patient, and 30 resume cases with Orem Self-Care theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. As a healthcare provider, the resident had applied an evidence-based nursing intervention that has been using chlorhexidine 0,12% in oral hygiene procedure that can prevent Ventilator Associated Pneumonia (VAP). As an innovator, resident had made a modification of one bottle water-sealed drainage that has received good response from the experts to increase patients and employers or healthcare provider safety during the nursing care process., The purpose of medical-surgical nurse resident in respiratory system clinical practice is to perform three roles of a nurse specialist as a case manager, healthcare provider and innovator. As a case manager, the resident managed a case of Tuberculosis and Diabetes Mellitus patient, and 30 resume cases with Orem Self-Care theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. As a healthcare provider, the resident had applied an evidence-based nursing intervention that has been using chlorhexidine 0,12% in oral hygiene procedure that can prevent Ventilator Associated Pneumonia (VAP). As an innovator, resident had made a modification of one bottle water-sealed drainage that has received good response from the experts to increase patients and employers or healthcare provider safety during the nursing care process.]"