Residensi spesialis keperawatan medikal bedah merupakan bagian dari proses pendidikan ners spesialis, berfokus pada manajemen asuhan keperawatan pasien dengan gangguan endokrin menggunakan pendekatan teori Model Adaptasi Roy, edukasi; bimbingan dan konsultan, penerapan praktik keperawatan berdasarkan bukti dan pelaksanaan inovasi keperawatan. Masalah keperawatan umum pada 33 kasus kelolaan antara lain mode fisiologis: nutrisi kurang dari kebutuhan dan intoleransi aktivitas, mode konsep diri: resiko gangguan religiusitas dan cemas, mode peran: manajemen kesehatan diri tidak efektif. Edukasi manajemen diabetes diberikan kepada pasien dan keluarga, bimbingan dan konseling pada mahasiswa dan rekan sejawat tentang tekhnik penyuntikan insulin, disfungsi seksual pada diabetes dan manajemen luka. Intervensi keperawatan berdasar bukti telah diterapkan lokasi dan rotasi sistematis pada penyuntikan insulin yang dapat mengendalikan kadar glukosa darah dengan stabil, terdapat trend penurunan kadar glukosa darah dan tidak terjadi komplikasi penyuntikan. Inovasi keperawatan dilakukan pelatihan dan penerapan metode irigasi luka dengan tekanan 13 psi dan pengkajian luka menggunakan format CSSC-DFU sebagai kendali infeksi dan inflamasi. Hasil inovasi diperoleh peningkatan pengetahuan, sikap, psikomotor perawat dan ditindaklanjuti dengan revisi ulang SOP perawatan luka diabetes di RSUP Fatmawati Jakarta. Disarankan selanjutnya tetap melakukan strategi asuhan keperawatan dengan pendekatan multidisiplin, edukasi diabetes, penerapan peran perawat spesialis, terapi komplementer dan alternatif, perawatan di rumah dan masyarakat, pendekatan budaya dan spiritual, penyediaan fasilitas layanan bagi diabetes, dan menggunakan teori keperawatan lain sehingga klien mampu beradaptasi positif dengan diabetes di sepanjang hidupnya.

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Medical surgical nursing specialist residence is a part of nursing specialist study program, focused on endocrine disorder patient?s nursing care management by Roy Adaptation Model approach, education; supervision and consultant; evidence based nursing practice application and nursing innovation implementation. Common nursing problems on 33 cases are on physiologic mode: nutrition less than requirement and activity intolerance, self concept mode: risk of impaired religiosity and anxiety, role performance mode: ineffective self healthy management. A diabetes management education was provided to client and family. Diabetic sexual dysfunction; site and systematic rotation on insulin injection and wound management are shared and supervised to nursing student and nurses. An evidence based nursing intervention was applied by site and systematic rotation on insulin injection; it was controlled blood glucose by decreasing blood glucose trend without complication. A nursing innovation was implemented by clinical mentorship program and application of 13 psi wound irrigation and wound assessment by CSSC-DFU format as an infection and inflammation control, it?s show a cognitive; affective and psychomotor improvement, and revision of RSUP. Fatmawati Jakarta?s wound care standard operation procedure. Finally, nurse is suggested to give a nursing care with multidisciplinary approach, diabetes education, medical surgical nurse specialist role performance, complementary and alternative therapy, community; practice nursing and home-based nursing, cultural and spiritual approach, providing services for diabetes and using another nursing theory until the client is able to adaptive with diabetes for entire of his life.