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"Kepatuhan perawat dalam melaksanakan praktik pencegahan dan pengendalian infeksi dipengaruhi oleh persepsi dan pengalaman dalam berinteraksi dengan IPCN. Studi ini merupakan studi kualitatif fenomenologi yang bertujuan untuk mengeksplorasi pengalaman perawat dalam berinteraksi dengan IPCN. Metode yang digunakan adalah wawancara secara mendalam terhadap 11 perawat dengan durasi 30-60 menit yang berasal dari 8 area pelayanan di rumah sakit. Wawancara direkam audio kemudian dibuat transkrip wawancara. Analisis tematik dilakukan dengan menggunakan lima fase analisis data kualitatif yaitu: compiling, diassembling, reassembling, interpreting dan concluding.Hasil penelitian menemukan bahwa perawat memiliki interaksi yang minimal dengan IPCN dan menemukan pelaksanaan tugas IPCN yang belum sesuai Peraturan Menteri Kesehatan. Penelitian ini merekomendasikan optimalisasi pemahaman perawat terhadap fungsi IPCN dengan melibatkan pihak manajemen, serta merencanakan pendidikan formal ners spesialis pengendali infeksi kepada IPCN untuk memaksimalkan asuhan keperawatan.

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Nurse experience in interacting with infection prevention and control nurse (IPCN). Nurse compliance in implementing infection prevention and control practices is influenced by perceptions and experiences in interacting with IPCN. This study is a phenomenological qualitative study that aimed to explore the experience of nurses in interacting with IPCN. The method used was in-depth interviews with 11 nurses, once for about 30-60 min, from 8 service areas in the hospital. Interviews were audio recorded and field note were made then transcripts of interviews were made. Thematic analysis was carried out using five phases of qualitative data analysis, namely: compiling, diassembling, reassembling, interpreting and concluding.

The results of the study found that nurses had minimal interaction with IPCN and found that the implementation of IPCN duties had not been maximized according to the Regulation of the Minister of Health. This study recommends optimizing nurses understanding of the functions of IPCN by involving management, as well as pursue formal education for infection control specialists to IPCN to maximize nursing care."

"diwujudkan melalui proses pendidikan berkelanjutan setelah magister keperawatan. Program praktik residensi ners spesialis keperawatan medikal bedah peminatan endokrin, bertujuan agar para residen memiliki tingkat kompetensi profesional, berpikir kritis dan reflektif serta komunikasi interpersonal yang lebih tinggi ketika dihadapkan pada situasi klinis yang kompleks. Praktik dilakukan di ruang gawat darurat, ruang intensif, rawat inap, dan rawat jalan RSUPN Dr Cipto Mangunkusumo Jakarta dengan mengaplikasikan teori Model Adaptasi Roy pada 30 kasus resume dan 1 kasus utama pada pasien diabetes melitus tipe 2 dengan komplikasi peripheral arterial disease dan ulkus kaki diabetik. Penerapan evidence based nursing Short Form Berg balance Scale telah terbukti sebagai alat skrining yang mudah, murah, hemat waktu dan memiliki reliabilitas Intraclass Correlation Coefisien yang baik untuk pengkaji keseimbangan dan resiko jatuh pada pasien DM yang sudah lanjut usia. Penerapan inovasi New Simulation Tools terbukti efektif mengurangi rasa takut pasien terhadap jarum suntik dan meningkatkan keterampilan menyuntik pada pasien yang baru pertama kali menerima terapi insulin.

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The nursing profession always develops following the latest science. This is realized through a process of continuing education after the master of nursing. The residency practice program for medical surgical nursing specialists specializing in endocrine, aims to make residents have a higher level of professional competence, critical and reflective thinking and interpersonal communication when faced with complex clinical conditions. The practice was carried out in the emergency room, intensive care unit, inpatient and outpatient care at RSUPN Dr Cipto Mangunkusumo Jakarta by applying Roy's Adaptation Model theory to 30 resume cases and 1 main case in patients with type 2 diabetes melitus with complications of peripheral arterial disease and diabetic foot ulcers. . The application of evidence-based nursing Short Form Berg balance Scale has been proven as a screening tool that is easy, inexpensive, time-saving and has good Intraclass Correlation Coefficient reliability for assessing balance and risk of falling in elderly DM patients. The application of the innovative New Simulation Tools has been proven to be effective in reducing patients' fear of needles and improving injecting skills in patients who are receiving insulin therapy for the first time."

"Kondisi menderita penyakit fisik menimbulkan permasalahan psikososial ansietas dan gangguan citra tubuh. Permasalahan psikososial ini menjadi faktor comorbid yang menambah berat kondisi fisik klien. Pelaksanaan tindakan ners spesialis didasarkan pada perilaku dan adaptasi sebagai mahluk yang holistik yang meliputi: Cognitive Behavioral Therapy CBT, Thought Stopping TS, Progressive Muscle Relaxation PMR dengan mempertimbangkan toleransi fisik klien. Tindakan ners spesialis Family PsychoEducation FPE pada keluarga dan Supportive Theraphy ST pada kelompok pelaku rawat care giver diberikan untuk memperkuat dukungan dari luar klien demi mempertahankan kelangsungan proses perawatan klien. Hasil: Pelaksanaan tindakan ners spesialis menunjukkan penurunan tanda dan gejala pada klien di semua aspek respons terhadap stresor. Penurunan yang paling besar terjadi pada kombinasi terapi CBT PMR FPE yang dilakukan pada klien dengan diagnosis ansietas pada aspek afektif sebesar 79.2 dan klien dengan diagnosis gangguan citra tubuh pada aspek perilaku sebesar 86.3 . Kesimpulan: Tindakan ners spesialis Cognitive Behavioral Therapy CBT, Thought Stopping TS, Progressive Muscle Relaxation PMR dengan mempertimbangkan toleransi fisik klien dan Family PsychoEducation FPE pada keluarga serta Supportive Theraphy ST pada kelompok pelaku rawat care giver dapat membantu penurunan respons klien terhadap stressor.

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Physical ilness could contribute to psychosocial problems such as anxiety and disturbed body image. This psychosocial problems became a comorbid factor which could make the clients health problems more serious. The implementation Cognitive Behavioral Therapy CBT, Thought Stopping TS, Progressive Muscle Relaxation PMR holistically applied by taking into consideration the physical tolerance of clients. The provision of Family PsychoEducation FPE for patient's family and Supportive Theraphy ST for patient's care giver by mental health psychiatric nurse specialist could empower client continuity of care sustainability. Result The combination CBT PMR FPE nurse specialist implementation have decreased the sign and symptoms up to 79.2 of efective aspect for clients with anxiety, and 86.3 of behavioral aspect for client who has disturbed body image. Conclusion It was conclude that the implementation of Cognitive Behavioral Therapy CBT, Thought Stopping TS, Progressive Muscle Relaxation PMR by taking into consideration the client's physical tolerance and Family PsychoEducation FPE for client's family and Supportive Theraphy ST for client's care giver can decrease patient's responses to stressors."

"Latarbelakang: Praktik Spesialis Keperawatan Medikal Bedah Kekhususan Endokrin di RSUPN dr. Cipto Mangunkusumo Jakarta merupakan kegiatan pembelajaran dalam mengaplikasikan peran dan fungsi Ners Spesialis. Belum ada Karya Ilmiah Akhir Spesialis (KIAS) yang menelaah pasien diabetes melitus dengan komplikasi selulitis dan Chronic Kidney Disease (CKD) dengan penerapan teori adaptasi Roy. Tujuan: KIAS ini bertujuan untuk menganalisis asuhan keperawatan pada pasien diabetes melitus yang mengalami selulitis dan CKD maupun resume 30 kasus. Metode: KIAS ini terdiri dari analisis kasus utama, resume 30 kasus, penerapan evidence based nursing dan proyek inovasi. Teori model keperawatan yang dipakai adalah teori adaptasi Roy. Hasil: Ners spesialis berperan tidak hanya dalam memberikan asuhan keperawatan langsung tetapi menerapkan intervensi berbasis bukti ilmiah pada area endokrin yaitu memberikan aplikasi pelembab mengandung urea, gliserin dan petrolatum untuk mengatasi xerosis dan fisura tumit kaki pasien diabetes melitus tipe 2. Selain itu, Ners spesialis juga melakukan inovasi melalui analisis situasi dan kajian literatur untuk mencegah kejadian hipoglikemia berat pada pasien diabetes melitus tipe 2 melalui penerapan Hy-Newss bundle. Kesimpulan: Teori model adaptasi Roy sesuai untuk diaplikasikan pada pasien dengan gangguan endokrin. Pemberian pelembab mengandung urea, gliserin dan petrolatum efektif untuk menurunkan skor derajat xerosis pada pasien diabetes melitus tipe 2. Hy- Newss dapat diterapkan sebagai alat skrining risiko terjadi hipoglikemia berat pada pasien diabetes melitus tipe 2.

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Background: Medical surgical nursing specialist practice in endocrine specific at RSUPN dr. Cipto Mangunkusumo Jakarta is a learning activity in applying the role and function of nurse specialist. There is no KIAS that examines diabetes mellitus patients with complications of cellulitis and Chronic Kidney Disease (CKD). Aim: This KIAS aims to analyze nursing care in patients with diabetes mellitus who have cellulitis and CKD or resume 30 cases. Method: This KIAS consists of main case analysis, 30 case resumes, application of evidence based nursing and innovation projects. The nursing model theory used is Roy’s adaptation theory. Results: Nurse specialist play a role not only in providing direct care but applying scientific evidence-based practice in the endocrine area, which is providing moisturizing applications containing urea, glycerin and petrolatum to treat xerosis and heel fissures in patient with type 2 diabetes mellitus. In addition, nurse specialist innovate through situation analysis and literature review to prevent the incidence of severe hypoglycemia in patients with type 2 diabetes mellitus through the application of Hy-Newss bundle. Conclusion: Roy’s adaptation model theory is suitable for application in patients with endocrine disorders. Moisturizers containing urea, glycerin and petrolatum are effective in reducing the degree of xerosis score in patient with type 2 diabetes mellitus. Hy-Newss bundle can be applied as a screening tool for the risk of severe hypoglycemia in patients with type 2 diabetes mellitus."

"Praktik Spesialis Keperawatan Medikal Bedah Peminatan Kardiovaskular di RS Jantung dan Pembuluh Darah Harapan Kita bertujuan untuk menerapkan dan mempraktikan peran dan fungsi sebagai calon ners spesialis dalam melakukan pengelolaan pasien gangguan sistem kardiovaskular menggunakan pendekatan model Konservasi Levine. Calon ners spesialis memberikan dan menganalisis komprehensif  kasus utama berupa pasien post ASD closure, mitral valve replacement (MVR), tricuspid valve repair (TVR) dengan penyerta hipertensi pulmonal. Capaian lain pada praktik residensi adalah memberikan asuhan keperawatan pada 30 kasus kardiovaskular yang dianalisis sebagai resume.. Peran lain sebagai calon ners spesialis adalah  menerapkan intervensi keperawatan berbasis bukti ilmiah (evidance based practice) berupa aplikasi cryoanalgesia berupa kompres es batu untuk mengurangi nyeri pasien yang menjalani punksi darah arteri untuk pemeriksaan analisa gas darah (AGD). Selain itu calon ners spesialis dituntut sebagai inovator yang memberikan ide dan gagasan untuk perubahan yang lebih baik yaitu dengan penerapan protokol GASAL Aweakening and Spontaneous Breathing Trial yang bertujuan untuk memberikan panduan perawat dalam menyapih pasien yang terpasang ventilator mekanik. Hasil praktik residensi menunjukan model Konservasi Levine terbukti efektif diterapkan pada pasien dengan gangguan kardiovaskular. Penerapan EBN terbukti efektif menurunkan nyeri pasien yang menjalani punksi arteri untuk pemeriksaan AGD. Kegiatan inovasi mendapat respon positif dan terbukti memiliki kemanfaatan bagi perawat dalam proses weaning pasien terpasang ventilasi mekanik.

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The Practice of Medical Nursing Specialist with Cardiovascular Specialization at National Cardiovascular Center Harapan Kita aims to implement and practice the role and function as a candidate for specialist nurses in managing patients with cardiovascular system disorders using the Levine Conservation model approach. The specialist nurse candidates provide and comprehensively analyze the main cases in the form of post ASD closure patients, mitral valve replacement (MVR), tricuspid valve repair (TVR) with pulmonary hypertension co-occurring. Another achievement in residency practice is providing nursing care for 30 cardiovascular cases which were analyzed as a resume. Another role as a candidate for specialist nurses is to apply evidence-based nursing interventions (evidance based practice) in the form of cryoanalgesia applications in the form of ice packs to reduce pain in patients undergoing arterial blood puncture for examination of blood gas analysis (AGD). In addition, prospective nurse specialists are required to be innovators who provide ideas and ideas for better changes, namely the application of the GASAL Aweakening and Spontaneous Breathing Trial protocol which aims to provide guidance for nurses in weaning patients who is attached to a mechanical ventilator. The results of the residency practice show that the Levine Conservation model has proven to be effective in applying to patients with cardiovascular disorders. The application of EBN has proven to be effective in reducing pain in patients undergoing arterial puncture for AGD examination. The innovation activity received a positive response and was proven to have benefits for nurses in the weaning process of patients with mechanical ventilation."

"Praktik Spesialis Keperawatan Medikal Bedah Peminatan Kardiovaskular di RS Jantung dan Pembuluh Darah Harapan Kita bertujuan untuk menerapkan dan mempraktikan peran dan fungsi sebagai calon ners spesialis dalam melakukan pengelolaan pasien dengan gangguan sistem kardiovaskular menggunakan pendekatan model self-care Orem. Calon ners spesialis memiliki target mengelola 30 kasus resume dan 1 kasus sebagai laporan kelolaan utama pada pasien dengan mitral regurgitasi dan hipertensi pulmonal. Peran lain sebagai calon ners spesialis yaitu menerapkan intervensi keperawatan berbasis bukti ilmiah (evidance based practice) dengan memberikan aromatherapy dalam mengurangi gangguan atau kesulitan tidur selama dirawat dirumah sakit. Selain itu calon ners spesialis dituntut sebagai inovator yang memberikan ide dan gagasan untuk perubahan yang lebih baik yaitu dengan melakukan pengembangan model handover terstruktur metode MDS-ECHO (Minimum Data Set for Effective Clinical HandOver) untuk meningkatkan kemampuan perawat dalam memberikan informasi penting kepada shift selanjutnya. Hasil praktik residensi menunjukan model self-care Orem terbukti efektif dan dapat digunakan untuk pasien dengan gangguan kardiovaskular. Praktik evidance based practice tidak diaplikasikan dikarenkaan kondisi pandemik yang semakin menyebar sehingga praktik diganti sebagai relawan COVID-19 di RS Universitas Indonesia. Kegiatan inovasi mendapat respon positif dan terbukti dengan peningkatan kemampuan handover dan kepuasan setelah menerapkan metode MDS-ECHO.

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Practice of Medical Nursing Specialist with Cardiovascular Specialy had done in National Cardiovascular Center Harapan Kita aims to implement and practice the roles and functions as nursing specialists to care patients with cardiovascular system disorders using the Orem self-care model approach. Nurse specialist have a target of managing 30 resume cases and 1 case as the main management in this report patients with mitral regurgitation and pulmonary hypertension. Another role as a nurse specialist is implementing evidence-based practice by providing aromatherapy in reducing sleep disturbances during hospitalization. In addition, prospective nurse specialists as innovators provide ideas by developing a structured handover model using the MDS-ECHO (Minimum Data Set for Effective Clinical HandOver) method to improve the ability of nurses to provide important information to the next shift. The results of the residency practice show that Orem's self-care model is effective and can be used for patients with cardiovascular disorders. The practice of evidence-based practice was not applied due to the increasingly widespread pandemic conditions, so the practice was replaced as a COVID-19 volunteer at the Universitas Indonesia Hospital. The innovation activity received a positive response and was proven by an increase in handover capability and satisfaction after applying the MDS-ECHO method."

"Ners Spesialis peminatan kardiovaskular didapatkan setelah melalui program praktik residensi keperawatan. Praktek residensi keperawatan terdiri dari 2 program yaitu praktek residen umum dan praktek residensi peminatan yaitu kardiovaskular. Kegiatan praktek residensi peminatan termasuk peran perawat sebagai pemberi asuhan keperawatan, peneliti, dan inovator. Peran pemberi asuhan keperawatan yaitu melakukan asuhan keperawatan pada 1 kasus utama dan 30 kasus resume pasien gangguan sistem kardiovaskular menggunakan model konservasi Levine. Peran peneliti adalah melakukan penerapan EBN yaitu akupresur terhadap kecemasan pasien preoperasi jantung. Hasil penerapan EBN; akupresur sebagai intervensi nonfarmakologi, nonivasif, mudah, sederhana dan aman dapat menurunkan kecemasan preoperasi jantung. Terakhir, peran inovator yaitu penggunaan skala Munro untuk mencegah kejadian perioperative related pressure injury pada pasien bedah jantung. Instrumen skala Munro sebagai pengkajian risiko pressure injury spesifik pada perioperatif, dilakukan 3 tahapan (preoperatif, intraoperatif, dan postoperatif), valid dan reliabel. Instrumen dapat digunakan sebagai bagian dari satuan intervensi pencegahan perioperative related pressure injury bersama dengan pengkajian kulit.

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Nurse Specialist in cardiovascular is obtained after going through a nursing residency practice program. Nursing residensy practice consists of 2 programs, namely general residency practice and specialization residency practice, namely cardiovascular. Specialization residency practice activities include the roel of nurses as nursing care providers, researchers and innovators. The role of nursing care provder is to manage nursing care in 1 main case and 30 resume cases of pastients with cardiovascular system disorders using Levine conservation model. The role of researcher is to implement EBN, namely acupressure on the anxiety of preoperative cardiac patients.

Results of the EBN application; acupressure as a non-pharmacological intervention, non-invasive, simple, easy and safe can reduce anxiety of preoperative cardiac. Finally, the rola of an innovator is the use of Munro scale to prevent perioperative related pressure injury in cardiac surgery patients. Instrument of Munro scale as an assessment of the risk of specific in perioperative pressure injury, carried out 3 stages (preoperative, intraoperative, dan postoperative), valid and reliable. Instrument can be used as bundle of an intervention for the prevention of perioperative related pressure injury along with skin assessment."

"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."