[Karya Ilmiah Akhir ini merupakan analisis dari rangkaian kegiatan praktik
residensi Ners Spesialis Keperawatan Medikal Bedah, dengan penerapan Model
The Dynamic Nurse - Patient Relationship Ida jean Orlando pada proses
keperawatan pasien gangguan sistem kardiovaskular, penerapan praktik
keperawatan berdasarkan pembuktian, dan melakukan inovasi keperawatan.
Pengkajian pasien dengan teori Ida Jean Orlando berfokus pada hubungan dan
reaksi antara perawat-pasien. Apa yang perawat dan pasien katakan dan
bagaimana pengaruhnya untuk kedua belah pihak. Tindakan keperawatan yang
dilakukan diperoleh dari pengalaman pasien yang sifatnya segera dan memerlukan
pertolongan cepat. Asumsi utama dalam teori Orlando terdapat tiga dari empat
konsep utama yaitu person (manusia), kesehatan dan keperawatan. Konsep
keempat, lingkungan tidak termasuk dalam teorinya. Kebutuhan untuk dibantu
(diagnosis keperawatan) yang umum terjadi pada pasien antara lain : penurunan
cardiac ouput, gangguan pertukaran gas, inefektif bersihan jalan napas, risiko
perdarahan, nyeri akut dan risiko infeksi. Pelaksanaan praktik keperawatan
berdasarkan pembuktian, dilakukan untuk pengelolaan nyeri pada pasien post
CABG. Intervensi dilakukan dengan memberikan terapi dingin (cold therapy)
dengan gel pack selama 20 menit, sebelum latihan napas dalam dan batuk efektif.
Pelaksanaan inovasi keperawatan berupa penyusunan format pengkajian
keperawatan, identifikasi masalah dan rencana tindak lanjut pasien dengan
gangguan sistem kardiovaskular di unit rawat jalan PJNHK., This scientific work is analysis from series of practice residency Nurse Medical Surgical Nursing Specialist by implementingThe Dynamic Nurse Patient Relationship model by Ida Jean Orlando s theory at nursing process with cardiovascular disorder implementation of nursing practical based on evidence and making innovation in nursing Assessment to patient with Ida Jean Orlando s theory was focusing on relationship and interaction between nurse patient What are the nurse and patient said and how they affect each other Nurse action that taken was obtained from patient experience with is urgent and need first aid The main assumption in Orlando s theory there are at least 3 out of 4 main concepts i e person human health and nurse The fourth concept is the environment was not included in his theory The need to get help diagnostic of nursing which generally happened to patient i e decreased of cardiac output impaired gas exchange ineffective airway clearance risk of hemorrhage acute pain and risk for infection Implementation of nursing practical based on evidence has to done to reducing patient pain Post CABG pain management after bypass surgery Intervention was done by providing cold therapy with gel pack up to 20 minutes before deep breathing exercise and cough Implementation of nursing innovation in form of preparation of nursing assessment formats for nursing problem identification follow up plan for patient with cardiovascular system disorder at outpatient unit in cardiovascular hospital Harapan Kita Jakarta ]