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"[ABSTRAKPrevalensi pasien dengan gangguan sistem kardiovaskular semakin meningkat. Perawat diharapkan memiliki kontribusi dalam penanganan pasien dengan gangguan sistem kardiovaskular dengan menjalankan peran sebagai pemberi asuhan, pendidik, peneliti dan inovator. Praktik residensi spesialis keperawatan medical bedah yang telah dilaksanakan selama 1 tahun (2 semester) bertujuan untuk melakukan penerapan dan pendalaman pada peran-peran tersebut dengan pendekatan model 14 pemenuhan kebutuhan dasar manusia Virginia Henderson. Peran sebagai pemberi asuhan diterapkan pada 30 pasien dengan berbagai gangguan kardiovaskular dan satu pasien kasus kelolaan utama dengan NSTEMI. Peran sebagai pendidik dijalankan dengan pembimbingan perawat sejawat dan mahasiswa keperawatan. Peran sebagai peneliti dijalankan dengan menerapkan tindakan keperawatan berbasis pembuktian ilmiah (evidence-based nursing) yaitu tindakan dukungan sosial keluarga dan intimasi untuk menurun tingkat persepsi nyeri pada pasien infark miokard. Peran sebagai inovator dijalankan dengan menerapkan pengembangan media edukasi pada pasien dengan alat kesehatan yang dipasang dalam tubuh. Hasil analisis praktik menunjukan bahwa 14 KDM Henderson efektif digunakan sebagai pendekatan dalam asuhan keperawatan pada pasien dengan gangguan sistem kardiovaskular. Penerapan tindakan dukungan keluarga dan intimasi efektif dalam penurunan tingkat persepsi nyeri pasien infark miokard. Media edukasi berupa leaflet dapat meningkatkan pemahaman pasien dengan alat medis yang terpasang dalam tubuhnya.

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ABSTRACTThe prevalence of patients with cardiovascular disorders is increasing. Nurses are expected to contribute on management of patients with cardiovascular disorders by running their roles as a care giver, educator, researcher and innovator. Residency clinical practice of medical-surgical nursing specialist had been carried out for 1 year (2 semesters) and aimed to implement and explore these roles with 14 Basic Human Needs Virginia Henderson Model approach. The role as a care giver was applied to 30 patient with various cardiovascular disorders and a patient with NSTEMI as the primary case. The role as an educator was performed by educating patients, nurses, and nursing students. The role as a researcher was carried out by applying the evidence-based nursing, Family Social Support and Intimacy to Pain Perception on Patient with Acute Miocard Infarc. The role as an innovator was executed by applying the development of educational media in patients with medical devices implantated in the body. The analysis showed that the 14 basic human needs can be applied effectively in nursing care for patient with cardiovascular diseases. Social support and intimacy as effective to decrease pain perception on patient with myocardial infarction. In addition Media education in the form of leaflets can improve understanding of a patient with a medical instrument implantated in his body., The prevalence of patients with cardiovascular disorders is increasing. Nurses are expected to contribute on management of patients with cardiovascular disorders by running their roles as a care giver, educator, researcher and innovator. Residency clinical practice of medical-surgical nursing specialist had been carried out for 1 year (2 semesters) and aimed to implement and explore these roles with 14 Basic Human Needs Virginia Henderson Model approach. The role as a care giver was applied to 30 patient with various cardiovascular disorders and a patient with NSTEMI as the primary case. The role as an educator was performed by educating patients, nurses, and nursing students. The role as a researcher was carried out by applying the evidence-based nursing, Family Social Support and Intimacy to Pain Perception on Patient with Acute Miocard Infarc. The role as an innovator was executed by applying the development of educational media in patients with medical devices implantated in the body. The analysis showed that the 14 basic human needs can be applied effectively in nursing care for patient with cardiovascular diseases. Social support and intimacy as effective to decrease pain perception on patient with myocardial infarction. In addition Media education in the form of leaflets can improve understanding of a patient with a medical instrument implantated in his body.]"

"This authoritative, up-to-the-minute guide gives readers information on: conditions that lead to coronary artery disease, a guide to the bypass operation, the aftereffects, alternative treatments, medical tests, and much more."

"Perkembangan ilmu dan pengetahuan keperawatan semakin berkembang untuk meningkatkan pelayanan bagi pasien. Penyakit kardiovaskular merupakan penyebab utama kematian di dunia dan prevalensi nya yang tinggi menjadi perhatian dan tantangan bagi tenaga kesehatan dalam memberikan pelayanan kesehatan. Perawat spesialis dengan perannya sebagai pemberi asuhan, pendidik, peneliti dan inovator memiliki peran penting dalam pelayanan kesehatan khususnya pada penyakit kardiovaskular. Pelaksanaan praktik residensi bertujuan untuk mengaplikasikan peran perawat spesialis dengan menggunakan pendekatan Teori Model Adaptasi Roy. Peran sebagai pemberi asuhan dan pendidik diterapkan pada 31 psaien dengan berbagai kasus kardiovaskular baik medical maupun surgical. Peran sebagai pendidik juga diberikan kepada rekan sejawat dengan melakukan jurnal reading dan diskusi. Hasil analisis praktik menunjukkan bahwa teori Model Adaptasi Roy dapat diterapkan pada asuhan keperawatan pada pasien dengan gangguan sistem kardiovaskular. Peran sebagai peneliti dilakukan dengan penerapan terapi oksigen nasal kanul aliran rendah tanpa humidifikasi. Hasil penerapan didapatkan bahwa terapi oksigen nasal kanul aliran rendah tanpa humdifikasi dapat dijadikan alternative pemberian terapi oksigen. Peran sebagai inovator dijalankan dengan menyusun form skrining pasien yang memerlukan perawatan paliatif pada pasien gagal jantung, dengn hasil evaluasi didapatkan bahwa form layak untuk digunakan.

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The development of nusing science and knowledge is increasingly evolving to improve services for patients. Cardiovascular disease is the leading cause of death in the world and its prevalence is high. It's become concern and challenge for health workers in providing health services. Nurses Specialist with his role as caregiver, innovators, researchers and educators have an important role in health services especially in cardiovascular disease. Implementation practice residencies aim to apply the role of specialist nurses using Theory approach Model Adaptation by Roy. The role as a caregiver and educator was applied in 31 cases with various cardiovascular cases either medical or surgical. The role of the educator is also given to other nurses by journal reading and discussion. Practice analysis results showed that the Roy Adaptation Model can be applied on nursing care of patients with cardiovascular diseases. The role as a researcher executed by evidence-based nursing, low flow nasal cannula oxygen therapy without humidification could become alternative modality in oxygen therapy. The role as an innovator executed by created palliative screening for heart failure, with the evaluation showed that the form is acceptable."

"Penyakit kardiovaskular menjadi salah satu penyebab kematian tertinggi di tingkat global. Upaya tindakan pencegahan dan tatalaksana terus dikembangkan untuk mengatasi permasalahan ini. Perawat spesialis memiliki peran sebagai pemberi asuhan keperawatan langsung, menerapkan evidence base nursing dan melakukan inovasi keperawatan. Praktik residensi spesialis keperawatan medikal bedah telah dilaksanakan untuk mengaplikasikan peran tersebut. Peran sebagai pemberi asuhan keperawatan langsung dilakukan dengan memberikan asuhan keperawatan pada 30 kasus kelolaan resume dan kasus kelolaan utama ADHF dengan teori Model Adaptasi Roy. Peran sebagai peneliti dijalankan dengan melakukan edukasi self-care pasien gagal jantung menggunakan metode teach-back. Peran perawat sebagai inovator dilakukan dengan menyusun proyek inovasi tentang penggunaan Munro Pressure injury Risk Assessment Scale untuk mencegah kejadian Perioperative related Pressure injury. Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy efektif digunakan untuk pasien dengan gangguan sistem kardiovaskular, edukasi self-care pada pasien gagal jantung dengan metode teach-back dapat meningkatkan pengetahuan, efikasi diri dan kemampuan self-care. Selain itu Munro Pressure injury Risk Assessment Scale dapat diterapkan untuk mencegah kejadian Perioperative related Presure Injury.

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Cardiovascular disease is one of the leading causes of death globally. Efforts to carry out management and prevention are always being developed to overcome this problem. Nurse specialists have a role as direct nursing care providers, applying evidence-based nursing and carrying out nursing innovations. The residency practice of medical-surgical nursing specialists has been implemented to apply for this role. The role of a direct nursing care provider is carried out by providing nursing care in 30 resume cases and ADHF main cases with Roy’s Adaptation Model theory. The role of a researcher is carried out by conducting self-care education for heart failure patients with the teach-back method. The role of nurses as innovators is carried out by developing an innovative project, namely "Using the Munro Pressure Injury Risk Assessment Scale to Prevent Perioperative-Related Pressure Injury." The results of practice analysis show that the Roy Adaptation Model is effective for patients with cardiovascular system disorders, and self-care education in heart failure patients with the teach-back method can improve knowledge, self-efficacy, and self-care abilities. In addition, the Munro Pressure Injury Risk Assessment Scale can be applied to prevent perioperative-related Pressure injury events."

"Penyakit kardiovaskular menjadi salah satu penyebab kematian tertinggi di tingkat global. Upaya tindakan pencegahan dan tatalaksana terus dikembangkan untuk mengatasi permasalahan ini. Perawat spesialis memiliki peran sebagai pemberi asuhan keperawatan langsung, menerapkan evidence base nursing dan melakukan inovasi keperawatan. Praktik residensi spesialis keperawatan medikal bedah telah dilaksanakan untuk mengaplikasikan peran tersebut. Peran sebagai pemberi asuhan keperawatan langsung dilakukan dengan memberikan asuhan keperawatan pada 30 kasus kelolaan resume dan kasus kelolaan utama NSTEMI dengan teori Model Adaptasi Roy. Peran sebagai peneliti dijalankan dengan melakukan terapi pijat kaki pada pasien pasca bedah jantung. Peran perawat sebagai inovator dilakukan dengan menyusun proyek inovasi tentang penggunaan aplikasi 6MWD untuk perawat pada pasien gagal jantung. Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy efektif digunakan untuk pasien dengan gangguan sistem kardiovaskular, teknik pijat kaki pada pasien pasca bedah jantung dapat menurunkan kecemasan, Selain itu aplikasi 6MWD dapat digunakan dengan mudah oleh perawat pada pasien gagal jantung.

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Cardiovascular diseases are among the leading causes of death globally. Preventive measures and management strategies continue to be developed to address this issue. Specialist nurses play a role as direct care providers, implementers of evidence-based nursing, and innovators in nursing practice. The medical-surgical nursing residency program has been implemented to apply these roles. The role as a direct care provider was carried out by delivering nursing care in 30 managed case summaries and a primary managed case of NSTEMI using Roy's Adaptation Model. The role as a researcher was undertaken by conducting foot massage therapy for post-cardiac surgery patients. The role as an innovator was realized through the development of an innovation project involving the use of a 6MWD application for nurses in managing heart failure patients. The analysis of practice outcomes showed that Roy's Adaptation Model is effective for patients with cardiovascular disorders, foot massage techniques for post-cardiac surgery patients can reduce anxiety, and the 6MWD application can be easily used by nurses for heart failure patients."

"Penyakit kardiovaskular menjadi salah satu penyebab kematian tertinggi di tingkat global. Upaya tindakan pencegahan dan tatalaksana terus dikembangkan untuk mengatasi permasalahan ini. Perawat spesialis memiliki peran sebagai pemberi asuhan keperawatan langsung, menerapkan evidence base nursing dan melakukan inovasi keperawatan. Praktik residensi spesialis keperawatan medikal bedah telah dilaksanakan untuk mengaplikasikan peran tersebut. Peran sebagai pemberi asuhan keperawatan langsung dilakukan dengan memberikan asuhan keperawatan pada 30 kasus kelolaan resume dan kasus kelolaan utama NSTEMI dengan teori Model Adaptasi Roy. Peran sebagai peneliti dijalankan dengan melakukan terapi pijat kaki pada pasien pasca bedah jantung. Peran perawat sebagai inovator dilakukan dengan menyusun proyek inovasi tentang penggunaan aplikasi 6MWD untuk perawat pada pasien gagal jantung. Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy efektif digunakan untuk pasien dengan gangguan sistem kardiovaskular, teknik pijat kaki pada pasien pasca bedah jantung dapat menurunkan kecemasan, Selain itu aplikasi 6MWD dapat digunakan dengan mudah oleh perawat pada pasien gagal jantung.

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Cardiovascular diseases are among the leading causes of death globally. Preventive measures and management strategies continue to be developed to address this issue. Specialist nurses play a role as direct care providers, implementers of evidence-based nursing, and innovators in nursing practice. The medical-surgical nursing residency program has been implemented to apply these roles. The role as a direct care provider was carried out by delivering nursing care in 30 managed case summaries and a primary managed case of NSTEMI using Roy's Adaptation Model. The role as a researcher was undertaken by conducting foot massage therapy for post-cardiac surgery patients. The role as an innovator was realized through the development of an innovation project involving the use of a 6MWD application for nurses in managing heart failure patients. The analysis of practice outcomes showed that Roy's Adaptation Model is effective for patients with cardiovascular disorders, foot massage techniques for post-cardiac surgery patients can reduce anxiety, and the 6MWD application can be easily used by nurses for heart failure patients."

"Penyakit kardiovaskular menjadi penyebab kematian terbesar di seluruh. Komplikasi yang sering terjadi pada pasien penyakit kardiovaskular antara lain kebutuhan untuk hospitalisasi yang lebih lama, rehospitalisasi, penurunan kapasitas fungsional dan peningkatan biaya perawatan. Perawat spesialis mempunyai peran penting sebagai pemberi asuhan keperawatan, peneliti, dan inovator dalam menangani penyakit kardiovaskular tersebut. Peran perawat spesialis sebagai pemberi asuhan keperawatan telah dilaksanakan residen dengan mengelola 31 kasus pasien dengan gangguan kardiovaskular yang terdiri dari 1 kasus kelolaan utama dan 30 kasus resume menggunakan pendekatan teori keperawatan Model Adaptasi Roy (MAR). Kasus utama yang dikelola oleh residen adalah asuhan keperawatan pada pasien dengan Acute Decompensated Hart Failure (ADHF). Peran sebagai peneliti dilakukan oleh residen dengan melaksanakan penerapan EBN, yaitu pemberian terapi musik untuk menurunkan cemas pada pasien pasca bedah jantung. Peran sebagai inovator dilaksanakan oleh residen melalui proyek inovasi Aplikasi 6 Minute Walking Distance (6MWD) pada pasien gagal jantung. Hasil analisis praktik residensi ini menunjukkan bahwa MAR cocok dan efektif diterapkan pada pasien dengan gangguan sistem kardiovaskular, terapi musik klasik dapat menurunkan cemas pada pasien pasca operasi bedah jantung, dan aplikasi 6MWD dapat diterapkan untuk memudahkan perawat dalam mengkaji kapasitas fungsional dan merekomendasikan latihan fisik pada pasien gagal jantung.

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Cardiovascular disease is the leading cause of death worldwide. Common complications in patients with cardiovascular disease include the need for longer hospitalization, rehospitalization, decreased functional capacity, and increased costs of care. Specialist nurses have an important role as providers of disease care, researchers, and innovators in dealing with cardiovascular disease. The role of specialist nurses as providers of rescue care has been implemented by managing 31 cases of patients with cardiovascular disorders consisting of 1 primary care case and 30 resume cases using the Roy Adaptation Model (MAR) approach. The main case managed by the resident is nursing care for patients with Acute Decompensated Heart Failure (ADHF). The role as a researcher carried out by the resident implements the application of EBN, namely providing music therapy to reduce anxiety in patients after heart surgery. The role as an innovator is carried out by residents through the 6 Minute Walking Distance (6MWD) Application innovation project in heart failure patients. The results of this residency practice analysis show that MAR is suitable and effective for patients with cardiovascular system disorders, classical music therapy can reduce anxiety in post-cardiac surgery patients, and the 6MWD application can be applied to make it easier for nurses to assess functional capacity and recommend physical exercise in heart failure patients."