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"Dampak dari penyakit kardiovaskular tidak hanya dirasakan oleh individu namun juga secara global. Pencegahan dan pengawasan perlu dilakukan untuk menurunkan beban yang dihadapi akibat penyakit kardiovaskular dengan pendekatan populasi dan individu. Perawat memiliki peran penting dalam hal promotif, preventif, dan rehabilitatif. Residen mengelola 31 kasus dengan menggunakan pendekatan teori Care, Core, dan Cure dalam memberikan asuhan keperawatan pada pasien dengan gangguan kardiovaskular sebagai cerminan dari peran ners spesialis sebagai pemberi pelayanan dan pendidik. Peran ners spesialis sebagai peneliti dijalani oleh residen dalam menerapkan tindakan keperawatan yang berbasis bukti atau Evidence Based Nurisng EBN berupa pengukuran keterlibatan pasien dengan Patient Activation Measure PAM. Sebagai inovator dan pemimpin kelompok, residen mengembangkan proyek membuat format perencanaan pemulangan pasien dengan pendekatan lima model.

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The impact of cardiovascular disease is not only felt by individuals but also globally. Prevention and supervision have to do to reduce the cardiovascular disease burden by population and individual approach. Nurses have an important role in promotive, preventive, and rehabilitative. Resident manages 31 cases using Care, Core, and Cure theory approaches in providing nursing care to patients with cardiovascular disease as a reflection of the role of specialist ners as service providers and educators. The role of a specialist ners as a researcher is undertaken by the resident in implementing Evidence Based Nursing EBN by measuring patient engagement with Patient Activation Measure PAM . As an innovator and community leader, the resident developed the project to make a discharge planning format using a five model approach."

"Ners spesialis merupakan perawat lulusan program spesialis keperawatan yang mempunyai keahlian khusus dalam asuhan keperawatan. Perawat spesialis keperawatan medikal bedah peminatan kardiovaskular harus mempunyai kompetensi keperawatan inti dan keperawatan berbagai masalah kardiovaskular. Pendidikan residensi spesialis dilakukan selama 2 semester dengan tujuan utama melakukan asuhan keperawatan medikal bedah khususnya sistem kardiovaskular dengan menggunakan pendekatan teori kenservasi Levine. Asuhan keperawatan pada 1 kasus utama post operasi total koreksi TOF dan 30 kasus resume yang terdiri dari 6 kasus besar gangguan sistem kardovaskular meliputi kasus sindrom koroner akut, kelainan katup jantung, kelainan pembuluh darah, gagal jantung, kasus bedah (katup, CABG) dan disritmia. model konsep konservasi Levine dapat diterapkan pada pasien gangguan sistem kardiovaskular untuk mempertahankan wholeness dan adaptasi. Pemberian ice cube absorption dapat mengurangi sore throat pasca ekstubasi pasien bedah jantung. Proyek inovasi penerapan Awakening and Spontaneous Breathing Trial (SBT) Protocol pada pasien pasca bedah jantung yang terpasang ventilasi mekanik dan sedasi. Protokol mudah dipahami dan membantu perawat dalam proses weaning ventilasi mekanik.

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Nurse Specialist is an advanced practice nurse and have special skill in nursing care, graduate from the nursing specialist program. Nurse Specialist medical surgical nursing in cardiovascular specialization must have core nursing competencies and nursing of various cardiovascular problems. Specialist residency education is carried out two semesters with the aim of providing medical-surgical nursing care, especially the cardiovascular system, using Levine's conservation theory approach. Nursing care of one main case in after total correction TOF and thirty resume cases consisting of six major cases of cardiovascular system disorders: acute coronary syndrome, heart valve disorders, blood vessel disorders, heart failure, surgical cases (valve, CABG) and dysrhythmia. Levine's conservation concept model can be applied to patients with cardiovascular system disorders to maintain wholeness and adaptation. Ice cube absorption can reduce sore throat after extubation of cardiac surgery. An innovation project for the application of the Awakening and Spontaneous Breathing Trial (SBT) Protocol in post-cardiac surgery patients who are mechanically ventilated and sedated. The protocol is easy to understand and helps nurses in the process of weaning mechanical ventilation."

"Penyakit kardiovaskular merupakan sekumpulan penyakit yang mempengaruhi sistem peredaran darah termasuk jantung dan pembuluh darah, disebabkan oleh banyak faktor yang mencakup penyakit bawaan dan didapat. Penyakit kardiovaskular yang disebabkan oleh aterosklerosis meliputi penyakit arteri koroner, penyakit arteri serebral, dan penyakit arteri perifer dengan dua komplikasi utama infark miokard dan stroke iskemik. Perawat spesialis memiliki peran penting sebagai pemberi asuhan keperawatan langsung, peneliti, dan inovator. Peran sebagai pemberi asuhan keperawatan langsung dijalankan dengan mengelola satu kasus utama tentang asuhan keperawatan pada pasien pascaoperasi CABG dengan Low Ejection Fraction, PMI, dan topangan IABP serta 30 kasus resume keperawatan. Peran sebagai peneliti dijalankan melalui penerapan EBN tentang penggunaan gel ice pack untuk mengurangi nyeri pada pasien pascaoperasi jantung yang menjalani chest tube removal. Peran sebagai inovator dijalankan dalam penyusunan proyek inovasi tentang penerapan FICA Spiritual Assessment Tool untuk memenuhi kebutuhan spiritual pasien dengan gangguan sistem kardiovaskular. Hasil analisis praktik residensi menunjukkan bahwa pendekatan teori model konservasi Levine dapat diterapkan dalam pemberian asuhan keperawatan pada pasien dengan gangguan sistem kardiovaskular, pengaplikasian gel ice pack dapat mengurangi nyeri saat dilakukan chest tube removal pada pasien pascaoperasi jantung, dan instrumen FICA Spiritual Assessment Tool mudah untuk diterapkan sebagai upaya pemenuhan kebutuhan spiritual pasien dengan gangguan sistem kardiovaskular.

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Cardiovascular diseases are a group of diseases that affect the circulatory system, including the heart and blood vessels, caused by many factors that include congenital and acquired diseases. Cardiovascular diseases caused by atherosclerosis include coronary artery disease, cerebral artery disease, and peripheral artery disease, with two major complications: myocardial infarction and ischemic stroke. Specialist nurses play an important role as direct nursing care providers, researchers, and innovators. The role of direct nursing care providers is carried out by managing a major case of nursing care for post-CABG patients with Low Ejection Fraction, PMI, and IABP support, as well as 30 nursing resume cases. The role of researchers is carried out through the application of EBN on the use of ice pack gel to reduce pain in post-cardiac surgery patients undergoing chest tube removal. The role of innovators is carried out in the preparation of innovation projects on the application of the FICA Spiritual Assessment Tool to meet the spiritual needs of patients with cardiovascular disorders. The results of the residency practice analysis show that Levine's conservation model theory approach can be applied in providing nursing care to patients with cardiovascular disorders, the application of ice pack gel can reduce pain during chest tube removal in post-cardiac surgery patients, and the FICA Spiritual Assessment Tool is easy to apply as an effort to meet the spiritual needs of patients with cardiovascular disorders."

"schemic Heart Disease merupakan salah satu penyebab kematian paling umum di dunia dan frekuensinya terus meningkat setiap tahunnya. Hal ini menjadi tantangan yang besar bagi seorang Ners dalam pelayanan kesehatan di Indonesia. Praktik ilmu keperawatan yang berkualitas harus diimbangi dengan pembuktian secara Evidence Base Nursing (EBN) karena EBN bisa menjadi landasan dalam melaksanakan peran pemberi asuhan, pendidik, peneliti, dan innovator yang profesional. Praktik residensi telah memberikan pengalaman dan menambah pengetahuan residensi tentang keperawatan kardiovaskular. Penerapan teori Lydia Hall: Care, Core, dan Cure dilakukan oleh residensi pada 30 kasus resume dan satu kasus kelolaan yaitu pada pasien dengan STEMI. Peran peneliti telah dilakukan dengan menerapkan EBN tentang penerapan Slow Deep Breathing Relaxation Exercise (SDBRE) setelah chest tube removal pada pasien yang menjalani CABG di Ruang Intermediate Ward Bedah. Penerapan SDBRE didapatkan efektif dalam menurunkan nyeri setelah chest tube removal. Peran Inovasi dilakukan dengan menyusun protokol Munro Scale untuk mencegah kejadian Perioperative Related Pressure Injury pada pasien Bedah jantung. Munro Scale didapatkan mampu mendeteksi adanya resiko Pressure Injury, mudah dipahami oleh perawat, dan mudah dilaksanakan oleh perawat kamar bedah dalam perawatan. Namun sebaiknya follow up pengkajian Munro Scale dilakukan di ruangan ICU bedah, IW Bedah, dan Rawat Inap.

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Ischemic Heart Disease is one of the most common causes of death in the world and its frequency continues to increase every year. This is a big challenge for a nurse in health services in Indonesia. Quality nursing practice must be balanced with Evidence Based Nursing (EBN) evidence because EBN can be the basis for carrying out the role of professional caregivers, educators, researchers, and innovators. Residency practice has provided experience and increased residency knowledge about cardiovascular nursing. The application of Lydia Hall's theory: Care, Core, and Cure was carried out by residencies in 30 resume cases and one managed case, namely in patients with STEMI. The role of researchers has been carried out by applying EBN regarding the application of Slow Deep Breathing Relaxation Exercise (SDBRE) after chest tube removal in patients undergoing CABG in the Intermediate Ward of Surgery. The application of SDBRE was found to be effective in reducing pain after chest tube removal. The role of innovation is carried out by compiling the Munro Scale protocol to prevent Perioperative Related Pressure Injury in cardiac surgery patients. The Munro Scale was found to be able to detect the risk of Pressure Injury, easily understood by nurses, and easily implemented by operating room nurses in treatment. However, follow-up studies of the Munro Scale should be carried out in the surgical ICU, IW Surgery, and Inpatient rooms."

"Praktik spesialis Keperawatan Medikal Bedah peminatan kardiovaskuler ini bertujuan untuk melakukan praktik dengan mengaplikasikan peran perawat melalui pendekatan Model Adaptasi Roy. Peran sebagai pemberi asuhan keperawatan diterapkan pada 30 orang pasien gangguan kardiovaskuler dan satu orang pasien kelolaan utama yaitu pasien post operasi Coronary Artery Bypass Graft (CABG). Peran sebagai peneliti dalam melakukan penerapan tindakan keperawatan yang berbasis pembuktian ilmiah (evidence based nursing practice) yaitu dengan membuktikan pijat kaki dan tangan sebagai salah satu teknik pengurangan nyeri dan respon fisiologis pasien post operasi CABG. Peran sebagai inovator melalui penyusunan pedoman intervensi keperawatan Sindrom Koroner Akut (SKA) yang bertujuan untuk memudahkan perawat dalam menentukan intervensi keperawatan, dan meningkatkan kualitas asuhan keperawatan. Hasil praktik ini menunjukan bahwa Model Adaptasi Roy efektif digunakan pada pasien gangguan kardiovaskuler, dan pijat kaki dan tangan efektif untuk mengurangi nyeri dan menstabilkan respon fisiologis pasien post CABG, selain itu buku pedoman intervensi pasien SKA dapat diterapkan perawat dalam melakukan asuhan keperawatan.

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Medical Surgical Nursing Practice specialist in cardiovascular aims to practice by applying the role of nurses through the Roy Adaptation Model approach. Role as nursing care was applied to 30 patients of cardiovascular disorders and a patient with postoperative Coronary Artery Bypass Graft (CABG) is the main case. Role as researcher was caried out by applying evidence based nursing practice to prove the foot and hand massage as a pain reduction techniques and physiological responses of patients post CABG. Role as an innovator through the development of guidelines for nursing interventions Acute Coronary Syndrome (ACS), which aims to facilitate nurses in determining nursing interventions, and improve the quality of nursing care. The results of this practice shows that Roy Adaptation Model effectively used on patients of cardiovascular disorders, foot and hand massage effectively to reduce pain and stabilize the patient's physiological response on patients of post CABG. In addition, the interventions guidelines Acute Coronary Syndrome (ACS) can be applied to nurses in performing nursing care."