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"Praktik residensi keperawatan medikal bedah yang dilakukan selama dua semester telah memberikan asuhan keperawatan pada pasien dengan gangguan respirasi, melakukan implementasi evidence based nursing dan dan proyek inovasi serta pengabdian masyarakat yang dilakukan di RSUP Fatmawati dan RSUP Persahabatan. Peran pemberian asuhan keperawatan pada kasus kelolaan utama yaitu PPOK eksaserbasi grup D dan 30 pasien resume menggunakan teori keperawatan self care Orem, teori ini digunakan karena masalah respirasi adalah masalah kronik, teori ini dapat diimplentasikan oleh perawat spesialis untuk meningkatkan perawatan diri pasien (self care) sesuai dengan kemampuannya untuk dapat meningkatkan kualitas hidup pasien. Implementasi EBN berupa balloon blowing exercise terbukti mampu mengurangi keluhan sesak napas pada pasien CLRD, mudah dilakukan, tidak memerlukan waktu lama, murah dan tidak menimbulkan efek samping. Penerapan proyek inovasi pengembangan self management: written action plan dengan media booklet terbukti dapat meningkatkan manajemen diri pasien PPOK. Booklet dapat membantu baik keluarga maupun pasien PPOK dalam mengetahui kondisi PPOK pasien serta melakukan manajemen yang tepat sesuai dengan kondisi pasien. Pengabdian masyarakat berupa edukasi kepada pasien TB Paru tentang TB Paru dan manajemen terapi pengobatannya terbukti dapat meningkatkan pengetahuan pasien, hal ini kemudian diharapkan dapat menurunkan angka putus obat pasien TB Paru.

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The medical surgical nursing residency practice which was carried out for two semesters has provided nursing care to patients with respiratory disorders, implemented evidence based nursing and and innovation projects as well as community service carried out at Fatmawati Hospital and Friendship Hospital. The role of providing nursing care in the main managed cases, namely COPD exacerbation group D and 30 patients resumed using Orem's self care nursing theory, this theory is used because respiratory problems are chronic problems, this theory can be implemented by specialist nurses to improve patient self care according to its ability to improve the patient's quality of life. The implementation of EBN in the form of balloon blowing exercise is proven to be able to reduce complaints of shortness of breath in CLRD patients, is easy to do, does not take long, is inexpensive and does not cause side effects. The implementation of self-management development innovation projects: written action plans with booklet media has been proven to improve COPD patient self-management. Booklets can help both families and COPD patients in knowing the patient's COPD condition and carrying out appropriate management according to the patient's condition. Community service in the form of educating pulmonary TB patients about pulmonary TB and management of treatment therapy has been proven to increase patient knowledge, this is then expected to reduce the dropout rate of pulmonary TB patients."

"Salah satu reaksi inflamasi yang ditimbulkan Mycobacterium tuberculosis yang masuk ke dalam alveoli adalah sekresi lendir yang berlebihan pada saluran napas. Penanganan dalam menurunkan produksi sputum pada pasien TBC dapat diberikan secara non farmakologi sebagai terapi pelengkap atau disebut juga terapi komplementer yaitu penggunaan minyak essensial untuk aromaterapi adalah Eucalyptus (minyak kayu putih). Tujuan penelitian ini untuk mengetahui efek aromaterapi Eucalyptus dalam menurunkan produksi sputum pada pasien paru. Penelitian ini menggunakan pendekatan quasi eksperimen dengan desain one group pretest-posttest design dengan jumlah 20 sampel dengan teknik non probability sampling dengan metode consecutive sampling. Analisis statistik menggunakan uji t-dependen yang bertujuan mengetahui adanya pengaruh intervensi aromaterapi Eucalyptus sebelum dan sesudah dilakukan intervensi untuk menurunkan produksi sputum pada pasien tuberkulosis. Hasil penelitian menunjukkan bahwa perbedaan signifikan jumlah produksi sputum antara sebelum intervensi, sesudah intervensi hari pertama, kedua dan ketiga dengan nilai p value 0,000. Perawat dapat memberikan aromatherapy Eucalyptus untuk menurunkan produksi sputum pada pasien TBC

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Residency nursing practices conducted at Persahabatan hospitals with respiration specificity are expected to address respiratory problems. In addition, during the residency process, they must have the ability to apply interventions based on evidence base nursing, expected to be able to become a Clinical Care Manager (CCM) who serves as a nursing consultant for nursing staff and a provider of nursing therapy to patients in order to provide nursing care to improve the quality or quality of nursing care. In providing care in cases of patients with drug-dropping pulmonary TB and 30 resume cases using Henderson's theory 14 basic human needs that demonstrate the role of nurses as nursing care providers in helping individuals both in health and sickness, through their efforts to carry out various activities to support the health and healing of individuals or the process of dying peacefully. The nursing problem that arises a lot is about the need for normal breathing. Application of EBN aromatherapy Eucalyptus in pulmonary TB patients who experience excessive sputum production due to inflammatory processes. Implementation of a booklet innovation project to prevent recurrence in COPD patients. Community service carried outis education about pulmonary TB treatment management to increase knowledge and compliance of patients and families to prevent drug dropouts. The results of the analysis of nursing residency practice found that nursing care using Henderson's theoretical approach aims to help as soon as possible the independence of patients. The application of Eucalyptus aromatherapy can reduce sputum production of sputum production in pulmonary TB patients. The self management: written action plan booklet innovation project can improve the self-management of COPD patien"

"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."

"Selang dada sering terpasang pada pasien yang telah dilakukan operasi jantung atau thorax yang berfungsi untuk memelihara fungsi kardiorespirasi dan stabilitas hemodinamik dengan mengalirkan udara, darah atau cairan yang berasal pleura dan mediastinal. Pencabutan selang dada merupakan prosedur yang menyakitkan yang dirasakan oleh hampir seluruh pasien. Tindakan pencabutan selang dada sering menyebabkan tarikan pada jaringan endotel yang melekat pada selang dada, merangsang saraf intercostal dan menginflamasi pleura. Berdasarkan evidence based kombinasi cold therapy dan terapi musik dapat mengurangi nyeri pada pasien saat pencabutan selang dada. Tujuan dari penerapan EBN ini adalah untuk mengetahui efektifitas pemberian kombinasi cold therapy dan terapi musik terhadap nyeri pada pasien yang dilakukan pencabutan selang dada. Jumlah sampel pada penerapan EBN ini adalah 20 orang dengan kriteria inklusi pasien berusia > 18 thn, terpasang selang dada (WSD), tidak ada gangguan pendengaran dan penglihatan, tidak ada gangguan mental, kesadaran compos mentis dan tidak terpasang ventilasi mekanik. Hasil penerapan EBN menunjukkan penerapan kombinasi cold therapy dan intervensi musik secara signifikan efektif terhadap nyeri pada pasien yang dilakukan pencabutan selang dada (P< 0.000, ?=0.05). Kombinasi cold therapy dan terapi musik dapat dijadikan pedoman dalam manajemen nyeri nonfarmakologis pada pasien yang dilakukan pencabutan selang dada.

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Chest tubes were often placed in patients who have undergone cardiac or thoracic surgery to maintain cardiorespiratory function and hemodynamic stability. Chest tube removal was a painful procedure that was felt by almost patients. Chest tube removal often caused a pull on the endothelial tissue attached to the chest tube, stimulating the intercostal nerves and inflaming the pleura. Based on evidence based the combination of cold therapy and music therapy could reduce pain in patients during chest tube removal. The purpose of this EBN application was to determine the effectiveness of providing a combination of cold therapy and music therapy on pain in patients with chest tube extraction. The sample size was 20 people with the inclusion criteria of patients aged> 18 thn, attached chest tube (WSD), no hearing and vision impairment, no mental disorders, compos mentis consciousness and not installed mechanical ventilation. The results of the application of EBN showed that the application of a combination of cold therapy and music intervention was significantly effective on pain in patients with chest tube removal (P < 0.000, ? = 0.05). The combination of cold therapy and music therapy can be used as guideline in nonpharmacological pain management chest tube removal."

"Ners spesialis merupakan perawat lulusan program spesialis keperawatan yang mempunyai keahlian khusus dalam asuhan keperawatan. Perawat spesialis keperawatan medikal bedah peminatan kardiovaskular harus mempunyai kompetensi keperawatan inti dan keperawatan berbagai masalah kardiovaskular. Pendidikan residensi spesialis dilakukan selama 2 semester dengan tujuan utama melakukan asuhan keperawatan medikal bedah khususnya sistem kardiovaskular dengan menggunakan pendekatan teori kenservasi Levine. Asuhan keperawatan pada 1 kasus utama post operasi total koreksi TOF dan 30 kasus resume yang terdiri dari 6 kasus besar gangguan sistem kardovaskular meliputi kasus sindrom koroner akut, kelainan katup jantung, kelainan pembuluh darah, gagal jantung, kasus bedah (katup, CABG) dan disritmia. model konsep konservasi Levine dapat diterapkan pada pasien gangguan sistem kardiovaskular untuk mempertahankan wholeness dan adaptasi. Pemberian ice cube absorption dapat mengurangi sore throat pasca ekstubasi pasien bedah jantung. Proyek inovasi penerapan Awakening and Spontaneous Breathing Trial (SBT) Protocol pada pasien pasca bedah jantung yang terpasang ventilasi mekanik dan sedasi. Protokol mudah dipahami dan membantu perawat dalam proses weaning ventilasi mekanik.

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Nurse Specialist is an advanced practice nurse and have special skill in nursing care, graduate from the nursing specialist program. Nurse Specialist medical surgical nursing in cardiovascular specialization must have core nursing competencies and nursing of various cardiovascular problems. Specialist residency education is carried out two semesters with the aim of providing medical-surgical nursing care, especially the cardiovascular system, using Levine's conservation theory approach. Nursing care of one main case in after total correction TOF and thirty resume cases consisting of six major cases of cardiovascular system disorders: acute coronary syndrome, heart valve disorders, blood vessel disorders, heart failure, surgical cases (valve, CABG) and dysrhythmia. Levine's conservation concept model can be applied to patients with cardiovascular system disorders to maintain wholeness and adaptation. Ice cube absorption can reduce sore throat after extubation of cardiac surgery. An innovation project for the application of the Awakening and Spontaneous Breathing Trial (SBT) Protocol in post-cardiac surgery patients who are mechanically ventilated and sedated. The protocol is easy to understand and helps nurses in the process of weaning mechanical ventilation."

"Penyakit kardiovaskuler menjadi perhatian dunia, Penatalaksanaan pada penyakit jantung adalah bedah jantung. Pasien yang menunggu operasi jantung biasanya mengalami kecemasan. Kecemasan preoperasi akan berdampak buruk pada intraoperasi dan post operasi yaitu pemberian dosis obat yang bertambah dan risiko infeksi. Salah satu intervensi untuk mengurangi kecemasan adalah dengan aromaterapi dan murattal alquran. Penelitian ini bertujuan menilai penerapan aromatherapy lavender dan murottal al-quran terhadap kecemasan pasien pre operasi bedah jantung  di RSJPD Harapan Kita Jakarta. Subjek penelitian sebanyak 30 orang dibagi menjadi kelompok intervensi sejumlah 15 orang dan kelompok kontrol 15 orang. Kelompok intervensi mendapat perlakuan aromaterapi dan murattal alquran sedangkan kelompok kontrol tidak mendapatkan intervensi. Penilaian kecemasan menggunakan Preoperative anxiety scale-7 (PAS-7). Uji statistik penelitian menggunkan analisis bivariat dengan uji paired t test dan independent t test. Hasil penelitian menunjukkan aromatherapy lavender dan murottal al-quran dapat menurunkan kecemasan (p-value 0,01) dibandingkan kelompok kontrol. Penerapan aromatherapy lavender dan murottal al-quran merupakan intervensi non-farmakologi dalam menurunkan kecemasan pasien pre operasi bedah jantung murah, efektif dan efisien, sederhana, mudah dalam penerapannya, tanpa risiko, tidak memerlukan pelatihan yang khusus, tidak memerlukan ruangan khusus, waktu penerapan yang bisa disesuaikan dengan kondisi pasien. Penelitian lanjutan bisa diterapkan pada waktu, cara pemberian, jumlah sampel lebih besar dan penyakit responden  yang berbeda.

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Cardiovascular disease is a worldwide concern. Management of heart disease is heart surgery. Patients awaiting surgery usually experience anxiety. Preoperative anxiety will have a negative impact on intraoperative and postoperative, namely the administration of increased drug doses and the risk of infection. One of the interventions to reduce anxiety is aromatherapy and murattal al-Qur'an. This study aims to assess the application of lavender aromatherapy and murottal al-quran to patient anxiety before heart surgery at RSJPD Harapan Kita Jakarta. Research subjects as many as 30 people were divided into an intervention group of 15 people and a control group of 15 people. The intervention group received aromatherapy and murattal al-Qur'an treatment, while the control group did not receive any intervention. Assessment using the Preoperative anxiety scale-7 (PAS-7). The statistical test of the study used bivariate analysis with paired t-test and independent t-test. The results showed that lavender aromatherapy and murottal al-quran could reduce anxiety (p-value 0.01) compared to the control group. The application of lavender aromatherapy and murottal al-Qur'an is a non-pharmacological intervention in reducing anxiety in preoperative cardiac surgery patients. It is cheap, effective and efficient, easy to implement, without risk, does not require special training, does not require a special room, and can be adapted to suit your needs. patient's condition. Follow-up research can be applied to the time, method of administration, larger sample size and different respondent's disease."

"Kecemasan dan nyeri merupakan masalah paling umum pada pasca operasi bedah jantung terbuka. Kedua hal tersebut akan menimbulkan efek negatif seperti meningkatkan penggunaan analgetik, komplikasi paru, gangguan tidur, waktu penyembuhan luka, lama serta biaya perawatan rumah sakit. Pranayama alternate nostril breathing merupakan terapi non-farmakologi yang dapat menurunkan kecemasan dan nyeri pasca bedah jantung. Evidence based nursing practice (EBNP) bertujuan menilai pengaruh pranayama alternate nostril breathing terhadap kecemasan dan nyeri pada pasien pasca bedah jantung. Subjek penelitian sebanyak 44 orang dibagi menjadi kelompok intervensi sejumlah 22 orang dan kelompok kontrol 22 orang. Kelompok intervensi mendapat perlakuan pranayama alternate nostril breathing sedangkan kelompok kontrol berupa relaksasi napas dalam. Penilaian kecemasan menggunakan The State-Trait Anxiety Inventory (STAI) sedangkan penilaian nyeri menggunakan Visual Analog Scale (VAS) 0-100 mm. Uji statistik penelitian menggunkan analisis bivariat dengan uji paired t test dan independent t test. Hasil penelitian menunjukkan pranayama alternate nostril breathing dapat menurunkan intensitas kecemasan dan nyeri pada kelompok intervensi (p-value <0,05) dibandingkan kelompok kontrol. Pranayama alternate nostril breathing merupakan intervensi non-farmakologi dalam menurunkan kecemasan dan nyeri pasien pasca bedah jantung yang bersifat sederhana, murah, efektif, efesien, dan fleksibel. Penelitian lanjutan perlu dilakukan dengan menggunakan sampel lebih besar serta instrumen penilaian kecemasan pasca operasi yang lebih spesifik.

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Anxiety and pain are the most common problems after open heart surgery. Both of them causes negative effects such as increasing the use of analgesics, pulmonary complications, sleep disturbances, wound healing time, hospital length of stay and cost. Pranayama alternate nostril breathing is a non-pharmacological therapy that can reduce anxiety and pain in post-cardiac surgery patients. Evidence based nursing practice (EBNP) aims to assess the effect of Pranayama alternate nostril breathing on anxiety and pain in post-cardiac surgery. The subjects were 44 people who divided into an intervention group of 22 people and a control group of 22 people. The intervention group received Pranayama alternate nostril breathing while the control group was get deep breathing relaxation. The State-Trait Anxiety Inventory (STAI) was used for anxiety assessment while the Visual Analog Scale (VAS) for pain assesment. The statistic test used bivariate analysis with paired t test and independent t test. Pranayama alternate nostril breathing could reduce the intensity of anxiety and pain in the intervention group (p-value <0.05) compared to the control group. Pranayama alternate nostril breathing is a non-pharmacological intervention for reducing anxiety and pain in post-cardiac surgery patients that is simple, inexpensive, effective, efficient, and flexible. Further research needs to be done using a larger sample and a more specific postoperative anxiety assessment instrument."

"Praktik residensi keperawatan medical bedah memberikan kesempatan kepada residen untuk mengimplementasikan fungsi implementator, educator, innovator dan peneliti asuhan keperawatan spesialistik pada gangguan kardiovaskular. Residen menerapkan proses keperawatan dengan pendekatan teori konservasi Levine pada 30 kasus kelolaan resume dan satu kasus kelolaan utama. Implementasi asuhan keperawatan berbasis bukti dengan intervensi akupresur pada acupoints Shenmen dan Yengchuan untuk meningkatkan kualitas tidur pada pasien acute coronanry syndrome. Sebagai inovator residen menginovasi awakening and spontaneous breathing trial protocol untuk memandu perawat dalam mengkaji kesiapan weaning ventilator pada pasien post operasi jantung yang tersedasi dan menggunakan ventilator. Akupresur pada acupoins Shenmen dan Yengchuan secara significant meningkatkan kualitas tidur pada kelompok intervensi (p = 0,009). Awakening and spontaneous breathing trial protocol mudah diterapkan sebagai prosedur pengakajian kesiapan weaning ventilator, mudah dipahami dan memberikan manfaat bagi perawat dan pasien.

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The practice of surgical and medical nursing residency provides an opportunity for resident to implement the functions of implementer, educator, innovator and researcher in specialistic nursing care in cardiovascular disorders.Resident applyed the nursing process using Levine's conservation theory approach by managing 30 resume cases and one main case. Implementation of evidence-based nursing care by applying of acupressure intervention on Shenmen and Yengchuan acupoints to improve sleep quality in patients with acute coronary syndrome. As an innovator, resident innovated the awakening and spontaneous breathing trial protocol to guide nurses in assessing weaning ventilator readiness in sedated and ventilated postoperative cardiac patients. Applying acupressure on the Shenmen and Yengchuan acupoints significantly improved sleep quality in the intervention group (p = 0.009). Awakening and spontaneous breathing trial protocols are easy to implement as a procedure to assess weaning ventilator readiness beside easy to understand and beneficial for nurses and patients."

"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."

"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 perawat sebagi pemberi asuhan langsung, peneliti dan inovator. Peran sebagai pemberi asuhan keperawatan langsung dilakukan dengan memberikan asuhan keperawatan pada 30 kasus kelolaan resume dan 1 kasus kelolaan utama Coronary Artery Disease, MR severe dengan teori Model Adaptasi Roy. Peran sebagai peneliti dijalankan dengan melakukan dan mengajarkan terapi komplementer untuk meningkatkan kualitas tidur pasien paska bedah jantung menggunakan teknik relaksasi benson. Peran perawat sebagai inovator dilakukan dengan menyusun proyek inovasi tentang pengkajian frailty untuk menilai kemampuan fungsional dan fungsi adaptasi pasien dengan gagal jantung sehingga dapat dilakukan tatalaksana lanjutan seperti rehabilitasi. Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy efektif digunakan untuk pasien dengan gangguan sistem kardiovaskular, teknik relaksasi benson pada pasien paska bedah jantung untuk meningkatkan kualitas tidur dan mengatasi nyeri. Selain itu pengkajian Frailty dapat diterapkan untuk menilai kemampuan fungsional dan adaptasi dan dilakukan tatalaksana rehabilitasi.

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Cardiovascular disease is one of the highest causes of death at the global level. Prevention and management efforts continue to be developed to overcome this problem. Specialist nurses have a role as providers of direct nursing care, implementing evidence base nursing and implementing nursing innovations. Medical surgical nursing specialty residency practice has been implemented to apply the role of nurses as direct care providers, researchers and innovators. The role as a provider of direct nursing care was carried out by providing nursing care to 30 cases managed by CV and 1 case managed by Coronary Artery Disease, MR severe using Roy's Adaptation Model theory. The role as a researcher is carried out by carrying out and teaching complementary therapy to improve the sleep quality of patients after heart surgery using the Benson relaxation technique. The role of nurses as innovators is carried out by preparing an innovation project regarding frailty assessment to assess the functional ability and adaptive function of patients with heart failure so that further management can be carried out such as rehabilitation. The results of the practice analysis show that the Roy Adaptation Model is effective for patients with cardiovascular system disorders, the Benson relaxation technique in post-cardiac surgery patients to improve sleep quality and overcome pain. Apart from that, frailty assessment can be applied to assess functional ability and adaptation and carry out rehabilitation procedures."