ABSTRAK
Karya ilmiah akhir ini merupakan laporan praktik residensi keperawatan medikal bedah yang terdiri dari pengelolaan kasus stroke hemoragik dan 30 kasus resume dengan pendekatan Model Adaptasi Roy MAR , penerapan evidence based nursing EBN untuk skrining penegakan diagnosa gangguan menelan pada pasien stroke fase akut dan melakukan proyek inovasi tentang pemberdayaan caregiver pada pasien stroke dengan edukasi terstruktur. Perilaku maladaptif paling banyak terdapat pada mode fisiologis dengan masalah keperawatan resiko ketidakefektifan perfusi jaringan serebral. Pengkajian dengan pendekatan MAR bisa diterapkan pada pasien dengan gangguan neurologi di ruangan. The Barnes-Jewish Hospital Stroke Dysphagia Screen BJH-SDS bisa diterapkan dengan memiliki sensitivitas 100 dan spesivisitas 100 . Budaya pengembangan intervensi keperawatan berdasarkan EBN diharapkan bisa terus terbangun di tatanan klinik. Pada inovasi keperawatan terdapat peningkatan rata-rata pengetahuan dan ketrampilan caregiver setelah pemberian edukasi terstruktur pValue

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ABSTRACT
This final scientific paper is a report of medical surgical nursing of residency practice which consists of the management of cases of hemorrhagic stroke and 30 cases of resume with the approach Roy rsquo s Adaptation Model RAM , the application of evidence based nursing EBN to screen for enforcement diagnosis of swallowing disorders in stroke patients in the acute phase and undertake innovation projects on empowering caregivers in stroke patients with a structured education. Maladaptive behavior are most numerous in the physiological mode with nursing problems ineffectiveness risk of cerebral tissue perfusion. RAM assessment approach can be applied to patients with neurological disorders in the hospital. The Barnes Jewish Hospital Dysphagia Stroke Screen BJH SDS can be applied with a sensitivity of 100 and specificity of 100 . Cultural development of nursing interventions based EBN is expected to continue to awaken in order clinic. On the innovation of nursing there is an average increase knowledge and skills caregiver after administration of structured education pvalue