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"Penanggulangan tuberkulosis paru (TB) membutuhkan sistem pelayanan Keperawatan terpadu oleh perawat, Keluarga, dan Masyarakat. Untuk meningkatkan pelayanan dengan melibatkan tim partisipasi menggunakan model manajemen Pelayanan keperawatan dengan kerangka kualitas Malcolm Baldrige performance. Komunikasi dan pelaporan melalui aplikasi Android-mobile untuk meningkatkan akses dan kontrol. Studi ini menggunakan kuasi-eksperimental dengan pre dan post-tes desain yang melibatkan dua kelompok. Studi ini dilakukan di dua tempat yaitu puskesmas di Kabupaten Sidoarjo dengan kasus TB tertinggi. Penelitian ini terdiri dari studi eksploratif, pengembangan model dan pengujian efektivitas model. Sampel diambil secara purposive sebanyak 400 penderita TB, terdiri dari 200 responden dalam kelompok kontrol dan 200 responden dalam kelompok intervensi. Hasil penelitian menunjukkan bahwa model intervensi efektif dalam meningkatkan evaluasi diri pemeriksaan rutin hingga 86%, kepatuhan obat hingga 99%, kecukupan gizi menjadi 82%, batuk efektif hingga 88%, dan manajemen dahak menjadi 19%. Model ini perlu didukung oleh kebijakan perawatan kesehatan dari Dinas Kesehatan.

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Management of pulmonary tuberculosis (TB) requires an integrated nursing service system by nurses, family, and community participation. To improve participation team of family nursing services by using a quality-nursing care management model using Malcolm Baldrige's framework through an android-mobile application to prevent treatment interruption. This study used a quasi-experimental with pre and post-test design involving two groups. The study was conducted in two places that are clinics in Sidoarjo Regency with the highest TB cases. This research consisted of model development and testing the effectiveness of the model. Samples were taken purposively as many as 400, consisting of 200 respondents in control groups and 200 respondents in intervention groups. The results showed that the intervention model was valuable in increasing checkups routine up to 86%, medicine adherence up to 99%, nutrition adequacy to 82%, effective cough to 88%, and sputum management to 19%. This model needs to be supported by health care policies from the Public health Office."

"Tuberkulosis merupakan penyakit menular yang disebabkan oleh bakteri mycobacterium tuberculosis. Salah satu penyebab perburukan dan kematian pada pasien dengan tuberkulosis paru adalah adanya sepsis. Sepsis merupakan disfungsi organ mengancam nyawa yang disebabkan oleh disregulasi respon host terhadap infeksi. Syok sepsis akibat tuberkulosis dapat menyebabkan beberapa gejala yang umum pada tuberkulosis, seperti demam dan sesak napas hingga disfungsi multiorgan. Angka kematian yang tinggi dan kesalahan diagnosis sepsis pada tuberkulosis masih umum terjadi. Oleh karena itu, perawat berperan penting dalam pengenalan dini dan perawatan pada pasien dengan sepsis. Penulisan karya ilmiah ini bertujuan untuk memaparkan hasil praktik mengenai pemberian asuhan keperawatan pada pasien tuberkulosis paru dengan sepsis. Analisis asuhan keperawatan dilakukan pada pasien laki-laki berusia 49 tahun yang mengalami tuberkulosis paru disertai dengan sepsis di ruang rawat inap. Masalah keperawatan yang dapat diangkat pada kasus pasien dengan sepsis, antara lain bersihan jalan napas tidak efektif, ketidakseimbangan nutrisi: kurang dari kebutuhan tubuh, dan risiko syok. Penerapan intervensi pada karya ilmiah ini khususnya berfokus untuk menangani risiko syok dengan menggunakan bundel yang disertai dengan perawatan terperinci pada pasien. Intervensi diberikan selama empat hari kepada pasien. Intervensi yang diterapkan efektif dalam meningkatkan kondisi klinis pasien ketika dilakukan penerapan, namun tidak berdampak signifikan pada peningkatan kondisi klinis pasien secara kumulatif.

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Tuberculosis is an infectious disease caused by the bacteria mycobacterium tuberculosis. One of the causes of deterioration and death in patients with pulmonary tuberculosis is sepsis. Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response to infection. Septic shock due to tuberculosis can cause several symptoms common to tuberculosis, such as fever and shortness of breath to multiorgan dysfunction. The high mortality rate and misdiagnosis of sepsis in tuberculosis are still common. Therefore, nurses play an important role in early recognition and treatment of patients with sepsis. The aim of writing this scientific work is to present practical results regarding the provision of nursing care to pulmonary tuberculosis patients with sepsis. Analysis of nursing care was carried out on a 49 year old male patient who experienced pulmonary tuberculosis accompanied by sepsis in the inpatient room. Nursing problems that can be raised in cases of patients with sepsis include ineffective airway clearance, imbalanced nutrition: less than body requirements, and risk of shock. The implementation of interventions in this scientific work specifically focuses on managing the risk of shock using a bundle accompanied by detailed patient care. The intervention was given for four days to the patient. The intervention implemented was effective in improving the patient's clinical condition when implemented, but did not have a significant impact on improving the patient's clinical condition cumulatively."

"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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"[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.]"