ABSTRAK
Karya ilmiah akhir ini merupakan laporan praktik klinik lanjut keperawatan medikal bedah pada sistem neurologi yang terdiri dari pengelolaan kasus utama meningioma dan 30 resume menggunakan pendekatan Model Adaptasi Roy, penerapan Evidence Based Nursing (EBN) skrining kognitif Montreal Cognitive Assesment (MoCA), serta inovasi keperawatan pemberdayaan caregiver melalui edukasi terstruktur. Masalah keperawatan terbanyak akibat perilaku maladaptif pada mode fisiologis adalah risiko ketidakefektifan perfusi jaringan serebral, mode konsep diri yaitu cemas, mode fungsi peran adalah perubahan fungsi peran, dan mode interdependensi yaitu ketidakefektifan koping keluarga. Penerapan skrining fungsi kognitif MoCA lebih sensitif dan spesifik untuk mengidentifikasi gangguan fungsi kognitif pada pasien stroke. Pemberdayaan caregiver melalui edukasi terstruktur di rawat inap dapat meningkatkan pengetahuan dan keterampilan dalam merawat anggota keluarga pasien stroke, sehingga terjalin komunikasi, persiapan, dan kontiunitas perawatan sampai di rumah. Perawat diharapkan mampu menerapkan teori keperawatan, melaksanakan tindakan keperawatan berdasarkan EBN, dan melakukan inovasi untuk meningkatkan asuhan keperawatan yang berkualitas.

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ABSTRACT
This final scientific paper is a report of advanced clinical practice of medical surgical nursing in neurological which consists of the management of meningioma as main case and 30 summaries using Roy Adaptation Model approach, the screening cognitive Montreal Cognitive Assessment (MoCA) as the application of Evidence Based Nursing (EBN), and the caregiver empowerment through structured education as nursing innovation. Majority of nursing problems are due to the maladaptive behavior in physiological mode was risk for ineffective cerebral tissue perfusion, self-concept mode was anxiety, role function mode was ineffective role performance, and interdependence mode was ineffective family coping. The application of cognitive function screening MoCA was more sensitive and specific to identify cognitive function impairment in stroke patients. Caregiver Empowerment through structured education during hospitalization can improve knowledge and skills in caring for stroke family members, thus established communication, preparation, and continuity of care in their home. Nurses are expected to apply nursing theory, implement nursing interventions based on EBN, and make innovations to improve the quality of nursing care.