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"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."

"Pasien dengan kasus tumor otak memerlukan perawatan yang komprehensif dan membutuhkan waktu yang lama untuk pasien dapat beradaptasi dengan perubahan-perubahan yang terjadi pada dirinya. Selama pasien menjalani masa perawatan di rumah sakit, asuhan keperawatan yang tepat diberikan kepada pasien adalah dengan model konsep teori adaptasi Roy. Asuhan dengan pendekatan model adaptasi ini menjadi pilihan yang sesuai untuk kasus-kasus perawatan jangka panjang sehingga pasien dapat menjalani kehidupan lanjutan pasca perawatan dengan baik, mengembalikan kemandirian, kepercayaan diri terutama konsep gambaran diri dan status peran di masyarakat. Perawat dengan pendidikan spesialis harus mampu menjalankan berbagai peran terutama sebagai Clinical Care Manager, dengan demikian peningkatan layanan keperawatan di rumah sakit dapat dicapai dengan lebih optimal dan memberikan kepuasan pelanggan. Laporan analisis praktek ini membahas mengenai asuhan keperawatan perioperative pada pasien dengan tumor otak, laporan praktik keperawatan berbasis fakta yaitu early mobilization dan resume pasien dengan gangguan neurologis di RS PON Jakarta,serta e handbook peran perawat perioperative dalam pembedahan spinal. Analisis praktik residensi ini dapat digunakan sebagai dasar perawat dalam latihan critical thinking, mengelola kasus sulit dan menerapkan asuhan keperawatan berbasis bukti.

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Patients with cases of brain tumor require comprehensive care and require a long time for the patient to adapt of the changes that occur. As long as the patient is undergoing treatment in the hospital, the appropriate nursing care is using Roy's adaptation teori concept model. Adaptation model approach is an appropriate choice for cases of long-term care so that patients can live a good post- treatment follow-up life, restore independence, self-confidence, especially the concept of self-image and role status in society. Nurses with specialist education must be able to carry out various roles, especially as Clinical Care Managers, thus improving nursing services in hospitals can be achieved more optimally and provide customer satisfaction. This practice analysis report discusses perioperative nursing care for patients with brain tumor, a fact-based nursing practice report, namely and resumes of patients early mobilization with neurological disorders at National brain centre Hospital Jakarta. E handbook about perioperative nursing at spinal surgery. This residency practice analysis can be used as a basis for nurses in critical thinking exercises, managing difficult cases and implementing evidence-based nursing care. Keywords: Brain tumor, Roy's adaptation model, early mobilization, E handbook about perioperative nursing at spinal surgery."

"Program spesialis keperawatan medikal bedah khususnya neurologi dimaksudkan untuk menjadikan seorang perawat spesialis neurosains yang berperan dalam pemberi asuhan keperawatan lanjut, melakukan pembuktian ilmiah, dan agen pembaharu. Asuhan keperwatan yang dilaksanakan pada kasus stroke hemoragik dan 30 pasien dengan gangguan neurologis menggunakan pendekatan Model adaptasi Roy. Perilaku maladaptif yang paling sering ditemui pada mode adaptasi fisiologis adalah ketidakefektfan perfusi serebral. Intervensi keperawatan yaitu monitor tekanan intrakranial bertujuan untuk meningkatkan adaptasi pasien dalam meningkatkan perfusi jaringan cerebral. Penerapan EBN tentang penilaian kualitas tidur pada pasien stroke menggunakan Pittsburgh Sleep Quality Index. Tiga puluh pasien menunjukkan bahwa sebagian besar paien mengalami kualitas tidur buruk. Program inovasi keperawatan berupa penerapan perawatan pasca craniotomy di ruang NCCU, HCU dan rawat inap bedah saraf.

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The medical surgical nursing specialist program, especially neurology, is intended to become a neuroscience specialist nurse who plays a role in providing advanced nursing care, conducting scientific evidence, and a reforming agent. Nursing care was carried out in cases of hemorrhagic stroke and 30 patients with neurological disorders using the Roy adaptation model approach. The most common maladaptive behavior in physiological adaptation modes is cerebral perfusion ineffectiveness. Nursing intervention, namely intracranial pressure monitor, aims to improve patient adaptation in increasing cerebral tissue perfusion. The application of the EBN on sleep disturbance screening in stroke patients using the Pittsburgh Sleep Quality Index. Thirty patients indicated that most patients experienced poor quality sleep. Nursing innovation program in the form of post craniotomy care application in the NCCU, HCU and neurosurgery inpatients."

"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 cedera kepala 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 cerebral. Penerapan EBN skrinning tool Trunk Impairment Scale. Program inovasi keperawatan berupa edukasi terhadap perawat dalam manajemen pasien pasca craniotomy dengan protokol ERAS.

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Advanced clinical practice during the nursing residency practice in the neurological system is intended to be able to provide nursing care, implement Evidence Based Nursing (EBN) and be able to act as an innovator in the treatment room. The role of nursing caregivers was carried out using Roy's adaptation model in patients with head injuries and 30 other patients with various nervous system disorders. The most maladaptive behavior is physiological adaptation mode, namely ineffective cerebral tissue perfusion. Nursing intervention in the form of cerebral edema management is intended to improve patient adaptation in increasing cerebral tissue perfusion. Application of the EBN screening tool Trunk Impairment Scale. Nursing innovation program in the form of education to nurses in post-craniotomy patient management with the ERAS protocol."

"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."

"Program spesialis keperawatan medikal bedah khususnya neurologi dimaksudkan untuk menjadikan seorang perawat spesialis neurosains yang berperan dalam pemberi asuhan keperawatan lanjut, melakukan pembuktian ilmiah, dan agen pembaharu. Asuhan keperwatan yang dilaksanakan pada kasus stroke hemoragik dan 30 pasien dengan gangguan neurologis menggunakan pendekatan Model adaptasi Roy. Perilaku maladaptif yang paling sering ditemui pada mode adaptasi fisiologis adalah ketidakefektfan perfusi serebral. Intervensi keperawatan yaitu monitor tekanan intrakranial bertujuan untuk meningkatkan adaptasi pasien dalam meningkatkan perfusi jaringan cerebral. Penerapan EBN tentang penilaian kualitas tidur pada pasien stroke menggunakan Pittsburgh Sleep Quality Index. Tiga puluh pasien menunjukkan bahwa sebagian besar paien mengalami kualitas tidur buruk. Program inovasi keperawatan berupa penerapan perawatan pasca craniotomy di ruang NCCU, HCU dan rawat inap bedah saraf.

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The medical surgical nursing specialist program, especially neurology, is intended to become a neuroscience specialist nurse who plays a role in providing advanced nursing care, conducting scientific evidence, and a reforming agent. Nursing care was carried out in cases of hemorrhagic stroke and 30 patients with neurological disorders using the Roy adaptation model approach. The most common maladaptive behavior in physiological adaptation modes is cerebral perfusion ineffectiveness. Nursing intervention, namely intracranial pressure monitor, aims to improve patient adaptation in increasing cerebral tissue perfusion. The application of the EBN on sleep disturbance screening in stroke patients using the Pittsburgh Sleep Quality Index. Thirty patients indicated that most patients experienced poor quality sleep. Nursing innovation program in the form of post craniotomy care application in the NCCU, HCU and neurosurgery inpatients."

"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 cedera kepala 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 cerebral. Penerapan EBN skrinning tool Trunk Impairment Scale. Program inovasi keperawatan berupa edukasi terhadap perawat dalam manajemen pasien pasca craniotomy dengan protokol ERAS.

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Advanced clinical practice during the nursing residency practice in the neurological system is intended to be able to provide nursing care, implement Evidence Based Nursing (EBN) and be able to act as an innovator in the treatment room. The role of nursing caregivers was carried out using Roy's adaptation model in patients with head injuries and 30 other patients with various nervous system disorders. The most maladaptive behavior is physiological adaptation mode, namely ineffective cerebral tissue perfusion. Nursing intervention in the form of cerebral edema management is intended to improve patient adaptation in increasing cerebral tissue perfusion. Application of the EBN screening tool Trunk Impairment Scale. Nursing innovation program in the form of education to nurses in post-craniotomy patient management with the ERAS protocol."

"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."

"Program pendidikan ners spesialis keperawatan medikal bedah dilewati dengan mengikuti praktek ditatanan pelayanan dengan melakukan asuhan keperawatan (pengkajian, diagnosis, intervensi, implementasi dan evaluasi) yang menggunakan pendekatan teori model keperawatan. Selama proses praktik residensi yang dilakukan yaitu pengelolaan asuhan keperawatan pada gangguan sistem neurologi dengan kasus utama tumor otak dan dan 30 kasus resume yang menggunakan pengkajian dengan pendekatan model adaptasi Roy. Selain itu juga melakukan penerapan evidence based nursing tentang sit to stand training untuk meningkatkan keseimbangan pada pasien stroke dan penerapan proyek inovasi tentang tatalaksana perawatan pasien stroke terkini. Tumor otak merupakan jenis tumor yang paling banyak terjadi dari seluruh jenis tumor pada system saraf pusat. Sit to stand training dapat meningkatkan keseimbangan pada pasien stroke, dapat dilanjutkan dirumah secara berkelanjutan dirumah oleh pasien untuk membantu meningkatkan kemandirian pasien. Tatalaksana perawatan pasien stroke terkini dapat meningkatkan kemandirian pasien stroke serta mengurangi kecacatan akibat penyakit stroke serta menambah intervensi keperawatan berdasarkan evidence.

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Nursing medical specialist nursing medical education programs are bypassed by following the practice of service settings by conducting nursing care (assessment, diagnosis, intervention, implementation and evaluation) using a theoretical approach to nursing models. During the residency practice process, the management of nursing care for neurological system disorders with the main cases of brain tumors and 30 cases of resumes using assessments with Roy's adaptation model approach. It also implements evidence based nursing on sit to stand training to improve balance in stroke patients and the application of innovative projects on the management of stroke patients. Brain tumors are the most common type of tumors of all types of tumors in the central nervous system. Sit to stand training can improve balance in stroke patients, it can be continued at home continuously at home by patients to help improve patient independence. Current stroke patient care can improve the independence of stroke patients and reduce disability due to stroke and increase evidence-based nursing interventions."