Pendahuluan:perforasi ileum merupakan suatu kegawatdaruratan dalam sistem gastrointestinal. Perforasi ileum terjadi akibat tumor ileum. Tujuan:untuk menampilkan asuhan keperawatan, penerapan evidence based nursing dan proyek inovasi. Peran perawat spesialis sebagai pemberi asuhan keperawatan lanjut, edukator, advokat, konselor, kolaborator, pembaharu dan peneliti. Metode:karya ilmiah ini menggunakan pendekatan studi kasus. Hasil: ada 1 kasus utama yaitu perforasi massa ileum dan 30 kasus resume sistem gastrointestinal dan hepatobilier. Ada 2 pasien dilakukan penerapan evidence based nursing practice mengunyah permen karet. Adanya efektifitas dari pemberian mengunyah permen karet untuk meningkatkan motilitas usus. Program inovasi kelompok berupa panduan peningkatan pemulihan setelah operasi enhanced after recovery surgery pada pasien yang menjalani pembedahan sistem pencernaan berupa pemberian maltodekstri sebelum operasi yaitu berjumlah 2 pasien, dan mobilisasi dini post operasi berjumlah 4 orang serta mengunyah permen karet setelah operasi berjumlah 2 orang. Kesimpulan: perilaku maladaptif pasien Tn.SMS yaitu gangguan body image. Mengunyah permen karet dapat meningkatkan motilitas usus, pemberian maltodektsrin pre operasi dapat mengurangi mual dan muntah serta nyeri post operasi dan mobilisasi dini 2 jam post operasi dapat mengurangi nyeri bahu pasien.

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Analysis of Medical Surgical Nursing Residency Practice and Case Study of Nursing Care Delivery on Patient with Perforated Ileal Mass Using Roy Adaptation Model RohmaniJuly 2018 Introduction: ileal perforation is an emergency in the gastrointestinal system. Perforation of ileum occurs due to ileal tumors. Purpose: to present nursing care, the application of evidence-based nursing and innovation projects. The role of specialist nurse as a nursing care nurse, educator, advocate, counselor, collaborator, reformer and researcher. Method: This paper uses a case study approach. Results: There were 1 major cases of ileal mass perforation and 30 cases of gastrointestinal and hepatobilier resume systems. There were 2 patients conducted the application of evidence based nursing practice chewing gum. The effectiveness of chewing gum to increase bowel motility. The group innovation program is an enhanced after recovery surgery guideline for patients undergoing gastrointestinal surgery in the form of preoperative maltodextrine, 2 patients, and postoperative early mobilization of 4 people and chewing gum after surgery of 2 people. Conclusion: maladaptive behavior of patient of Mr.SMS are body image disorder. Chewing gum can improve bowel motility, preoperative maltodextrine administration may reduce nausea and vomiting and postoperative pain and early mobilization 2 hours postoperatively may reduce shoulder pain of the patient. Key words: Roy adaptation model, Tumour of Ileum, Chewing Gum, Maltodextrin, D early mobilization, Enhanced recovery After Surgery.