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"Karya ilmiah akhir ini disusun sebagai laporan dari praktik residensi spesialis keperawatan Maternitas yang berfokus pada penerapan teori keperawatan Need for Help Wiedenbach dan Comfort Kolcaba pada asuhan keperawatan ibu yang mengalami partus lama Tujuan penulisan laporan ini untuk memberikan gambaran pelaksanaan praktik Spesialis Keperawatan Maternitas dalam menjalankan perannya sebagai pemberi pelayanan keperawatan edukator konselor advokat pengelola kolaborator komunikator dan koordinator agen perubah dan peneliti dalam memberikan asuhan keperawatan pada perempuan sepanjang periode kehidupannya dengan menerapkan teori keperawatan Aplikasi teori keperawatan need for help Wiedenbach dan Theory of Comfort Kolcaba efektif dilakukan pada enam ibu dengan partus lama Aplikasi teori tersebut berhasil membantu menyelesaikan masalah keperawatan dan meningkatkan kenyamanan klien selama persalinan Setelah melaksanakan praktik residensi spesialis keperawatan maternitas penulis mampu mencapai target kompetensi dengan baik Kata kunci asuhan keperawatan partus lama teori keperawatan 'comfort' teori keperawatan 'need for help'

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This final scientific report aimed to report the clinical practice of maternity nursing specialist which focus on the application of Wiedenbach's theory of the need for help and Kolcaba's theory of comfort in the nursing care to clients who experience prolonged labour The purpose of this report is to describe the implementation of maternity nursing specialist practices in their role as care giver educator counselor advocate collaborator communicator coordinator innovators and researchers The competencies also achieved through application of nursing theory in the nursing care The application of Wiedenbach's theory of need for help and Kolcaba's theory of comfort in the nursing care was effective to resolve client's health problem and increased the comfort of the mother during labour After finishing residential practice of maternity nursing specialist the competencies was achieved with a good result Keyword nursing process nursing theory of comfort nursing theory of need for help prolonged labour "

"[ABSTRAKAngka kematian ibu saat ini masih tinggi yang disebabkan karena komplikasi pada kehamilan dan persalinan, oleh karena itu perlunya peran tenaga kesehatan yang terkait termasuk perawat maternitas untuk memberikan pelayanan kesehatan profesional. Perawat spesialis maternitas dituntut mampu menjalankan perannya secara komprehensif. Laporan ini bertujuan untuk menggambarkan praktik residensi ners spesialis maternitas meliputi asuhan keperawatan pada masa prenatal, intranatal, dan postnatal normal dan berisiko serta bayi baru lahir normal dan berisiko, serta perempuan dengan masalah reproduksi dan ginekologi. Residen juga melakukan asuhan keperawatan dengan focus penerapan teori need for help dan comfort pada ibu bersalin dengan persalinan memanjang. Hasil menunjukkan bahwa kedua model efektif dapat diterapkan pada keenam kasus ibu bersalin dengan persalinan memanjang. Pencapaian kompetensi perawat spesialis maternitas dilakukan dengan penerapan peran perawat secara komprehensif.

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ABSTRACTMaternal mortality rate is still high due to pregnancy and labor complication, therefore the role of health professionals including maternity nurses is needed to provide a professional health care. Maternity nursing specialists are demanded to be able to perform their roles comprehensively. This report aimed to describe the residency practice of maternity nursing specialist including nursing care of normal and high risk prenatal, intranatal, and postnatal as well as normal and high risk newborns, and women with reproductive and gynecological problems. Resident also performed nursing care focused on the application of Wiedenbach Need for Help and Kolcaba Comfort Theory on intrapartum mothers with prolonged labor. Results showed that both models could be applied effectively to the six cases of intrapartum mothers with prolonged labor. The achievement of maternity nursing specialist competencies was conducted by the implementation of the nurse's roles comprehensively., Maternal mortality rate is still high due to pregnancy and labor complication, therefore the role of health professionals including maternity nurses is needed to provide a professional health care. Maternity nursing specialists are demanded to be able to perform their roles comprehensively. This report aimed to describe the residency practice of maternity nursing specialist including nursing care of normal and high risk prenatal, intranatal, and postnatal as well as normal and high risk newborns, and women with reproductive and gynecological problems. Resident also performed nursing care focused on the application of Wiedenbach Need for Help and Kolcaba Comfort Theory on intrapartum mothers with prolonged labor. Results showed that both models could be applied effectively to the six cases of intrapartum mothers with prolonged labor. The achievement of maternity nursing specialist competencies was conducted by the implementation of the nurse's roles comprehensively.]"

"Persalinan kala dua memanjang merupakan kondisi yang memerlukan penanganan perawat agar tidak terjadi dehidrasi atau kelelahan pada ibu dan mencegah gawat janin. Penatalaksanaan keperawatan pada ibu yang mengalami persalinan kala dua memanjang dengan memberikan asuhan keperawatan secara fisik dan psikologis. Metode yang digunakan adalah studi kasus dengan fokus penerapan teori need for help Wiedenbach dan comfort Kolcaba pada asuhan keperawatan ibu yang mengalami persalinan kala dua memanjang. Aplikasi teori need for help Wiedenbach dan comfort Kolcaba efektif diterapkan pada kelima kasus yang berfokus pada masa intranatal baik secara fisik dan psikologis, mencegah dampak persalinan kala dua memanjang terhadap kondisi ibu dan janin serta mengkaji pernyataan klien tentang bantuan yang dibutuhkan kepada perawat. Dengan intervensi keperawatan yang sesuai dengan bantuan yang dibutuhkan klien maka masalah klien dalam keadaan emergency teratasi dan kebutuhan rasa nyaman dapat terpenuhi.

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Prolonged second stage of labor is a condition requiring nurse handling to avoid dehydration or fatigue of the mother and prevent fetal distress. Management of nursing in mother who experience prolonged labor by giving physical and psychological nursing care. The method used is case study with focus on the application of the theory of need for help Wiedenbach and comfort Kolcaba on nursing care in mother who experienced prolonged second stage of labor. The application of need for help Wiedenbach and comfort Kolcaba theories effectively applied to the five cases that focused on intranatal phase both physically and psychological, prevent the impact of prolonged second stage of labor in mother and fetus condition, as well as reviewing the clients statement about the assistance needed to the nurse. Appropriate nursing interventions can address client problems in an emergency and comfort needs can be met."

"Perawat spesialis maternitas berperan dalam menurunkan Angka Kematian Ibu AKI akibat komplikasi kehamilan dan persalinan. Salah satu peran perawat adalah memberikan asuhan keperawatan yang komprehensif dengan mengidentifikasi dan mengatasi masalah pasien perdarahan post partum dengan pedekatan teori keperawatan. Penerapan model need for help Wiedenbach diterapkan pada fase akut untuk mefasilitasi ibu mengatasi masalah perdarahan yang dialami dan teori self care Orem diterapkan pada fase pemulihan untuk memfasilitasi pasien meningkatkan kemampuan dalam merawat dirinya. Lima kasus kelolaan pasien memiliki masalah yang berbeda beda sesuai hasil pengkajian model need for help Wiedenbach dan self care Orem. Kasus yang dilaporkan adalah pasien perdarahan post partum akibat retensio plasenta dengan keluhan perdarahan aktif, lemas, pusing. Masalah keperawatan yang ditemukan pada fase akut adalah perdarahan, kurang volume cairan, resiko gangguan perfusi jaringan, kecemasan, sedangkan masalah keperawatan pada fase pemeliharaan adalah defisit perawatan diri, risiko cidera, nyeri, kecemasan, dan berduka. Intervensi keperawatan yang dilakukan pada fase akut adalah untuk mengatasi masalah kegawatan dengan menghentikan perdarahan dan resusitasi cairan. Sedangkan intervensi keperawatan pada fase pemulihan adalah untuk meningkatkan kemandirian pasien dalam melakukan perawatan dirinya. Evaluasi yang didapatkan adalah perdarahan teratasi dan pasien mandiri dalam melakukan perawatan dirinya

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The Final Report of residential of Maternity Nursing Specialist which focus on application Theori of need for Help Wiedenbach and Self Care orem of Women with Post Partum Haemorhagae AbstrackMaternity nursing specialists have role in reducing maternal mortality due to complication of pregnancy and childbirth. One of the nurses 39 roles is to provide comprehensive nursing care by identifying and resolving patient problems with postpartum hemorrhage using nursing theories. The application of "the need for help" Wiedenbach theory in the acute phase is to facilitate mother in overcoming the bleeding problem and "the self care" Orem theory is applied in the recovery phase to facilitate patient having self care. Five cases of postpartum hemorrhage patients have different problems according to the results of "the need for help" theory of Wiedenbach and "self care" theory of Orem.

Reported cases were postpartum hemorrhage patients due to placental retention with active bleeding, weakness and dizziness complaints. Nursing problems found in the acute phase are bleeding, lack of fluid volume and risk of tissue perfusion disorders, while the problems in the recovery phase are self care deficits, risk of injury, pain, anxiety and grief. In the acute phase, nursing interventions is conducted to overcome emergency problem by stopping bleeding and fluid resusitation. While in the recovery phase, the nursing interventions is conducted to facilitate patients in doing self care. Evaluation obtained is bleeding resolved and having self care patients. "

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Retensi urin postpartum merupakan ketidakmampuan mengosongkan kandung kemih secara spontan setelah melahirkan dengan residu urin lebih dari 200 ml. Komplikasi yang dapat terjadi yaitu distensi kandung kemih, kontraksi uterus terhambat, perdarahan, otot detrusor melemah, kateterisasi intermiten dan disfungsi berkemih permanen. Penatalaksanaan keperawatan pada retensi urin postpartum dengan memberikan asuhan keperawatan secara holistik menggunakan studi kasus dan penerapan teori keperawatan. Penerapan teori self care Orem dan comfort Kolcaba pada lima kasus retensi urin postpartum dengan membahas permasalahan yang dialami dan menguraikan peran perawat pada kasus tersebut, dengan tujuan kebutuhan kenyamanan dan kemandirian pasien dapat terpenuhi. Kejadian retensi urin dapat diatasi dengan menerapkan evidence based nursing practice kegel excercise dan bladder training. Studi kasus yang dilakukan pada lima ibu postpartum yang mengalami retensi urin didapatkan bahwa kegel exercise dan bladder training mampu mengatasi retensi urin secara signifikan, menurunkan tingkat nyeri, dan meningkatkan self care.

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Postpartum urinary retention is the inability to empty the bladder spontaneously after giving birth with more than 200 ml urine residue. Complications that can occur are distention of the bladder, obstructed uterine contractions, bleeding, weak detrusor muscles, intermittent catheterization and permanent voiding dysfunction. Nursing management in postpartum urinary retention by providing nursing care holistically uses case studies and the application of nursing theory. Application of self care Orem and Comfort Kolcaba theory in five cases of postpartum urine retention by discussing the problems experienced and outlining the role of nurses in the case, with the aim of comfort and independence of patients can be fulfilled. Urinary retention can be overcome by applying evidence based nursing practice kegel excercise and bladder training. Case studies conducted on five postpartum mothers who experienced urinary retention found that kegel exercise and bladder training were able to overcome urinary retention significantly, reduce pain levels, and improve self care.

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"[Karya ilmiah akhir ini disusun sebagai laporan dari praktik residensi spesialis keperawatan Maternitas yang berfokus pada penerapan teori keperawatan Need for Help Wiedenbach dan Comfort Kolcaba pada asuhan keperawatan ibu yang mengalami retensio plasenta. Tujuan penulisan laporan ini untuk memberikan gambaran aplikasi teori Wiedenbach dan Kolcaba pada kasus retensio plasenta serta memberikan gambaran pelaksanaan praktik Spesialis Keperawatan Maternitas dalam menjalankan perannya sebagai pemberi pelayanan keperawatan, edukator, konselor, advokat, pengelola, kolaborator, komunikator dan koordinator, agen perubah dan peneliti dalam memberikan asuhan keperawatan pada perempuan sepanjang periode kehidupannya dengan menerapkan teori keperawatan. Aplikasi teori keperawatan need for help Wiedenbach dan Theory of Comfort Kolcaba efektif dilakukan pada lima ibu dengan retensio plasenta. Teori keperawatan Need for Help dari Wiedenbach menjadi pilihan untuk kasus retensio plasenta diruang gawat darurat. Penekanan teori ini berdasarkan kebutuhan ibu harus segera dipenuhi yang sifatnya gawat darurat. Labor is a holistic event and Comfort is a holistic phenomenon. Kenyamanan adalah fenomena holistik dan kebutuhan dasar manusia. Oleh karena itu perawat berupaya mengatasi kelemahan teori need for help Wiedenbach dengan menggabungkannya dengan Theory of Comfort Kolcaba. Teori keperawatan ini untuk mengatasi ketidaknyamanan dari aspek fisik, psikospiritual, sosial dan lingkungan sehingga asuhan keperawatan secara komprehensif dapat diberikan. Theory of Comfort Kolkaba terintegrasi dalam penerapan teori need for help Wiedenbach pada asuhan keperawatan ibu dengan retensio plasenta., This final scientific report aimed to report the clinical practice of maternity nursing specialist which focus on the application of Wiedenbach’s theory of the need for help and Kolcaba’s theory of comfort in the nursing care to clients who experience retained placenta. The purpose of this report to provide an overview of the application and Kolcaba Wiedenbach theory in the case of retained placenta and describe the implementation of maternity nursing specialist practices in their role as care giver, educator, counselor, advocate, collaborator, communicator, coordinator, innovators and researchers. Application of nursing theory need for help Wiedenbach and theory of Comfort Kolcaba effectively done in five women with retained placenta. Nursing theory Need for Help from Wiedenbach be an option for retained placenta cases in emergency ward. The emphasis of this theory is based on the needs of the mother must be met emergency nature. Labor is a holistic event and Comfort is a holistic phenomenon. Comfort is a holistic phenomenon and basic human needs. Therefore, the nurse tried to address the weaknesses of the theory of the need for help Wiedenbach combine with theory of Comfort Kolcaba. This nursing theory to address the discomfort of physical aspects, phsycospiritual, social and environment so comprehensively nursing care can be given. Theory of Comfort Kolcaba integrated in the application of the theory of the need for help Wiedenbach nursing mothers with retained placenta .]"

"ABSTRAK Tingginya angka kematian ibu saat ini salah satunya disebabkan oleh adanya komplikasi pada saat kehamilan dan persalinan Ners spesialis keperawatan maternitas mempunyai peran penting dalam mencegah kematian baik ibu maupun janin Laporan ini bertujuan untuk memberikan gambaran pelaksanaan praktik ners spesialis keperawatan maternitas meliputi asuhan keperawatan pada masa prenatal intranatal postnatal dan bayi baru lahir normal dan berisiko serta mengenai masalah kesehatan reproduksi perempuan Residen juga memberikan asuhan keperawatan dengan focus penerapan teori need for help dari Wiedenbach pada ibu dengan terminasi kehamilan karena preeklamsia berat Hasil menunjukkan bahwa penanganan segera dan terminasi kehamilan sesuai dengan indikasi dapat mencegah komplikasi dan kegawatan pada ibu dan bayi serta mencegah terjadinya Sindrom HELLP dan Eklamsia Penerapan teori model keperawatan Need For Help efektif untuk diaplikasikan pada kasus terminasi kehamilan karena preeklamsia berat Pencapaian kompetensi perawat spesialis keperawatan maternitas dilakukan dengan penerapan peran perawat secara komprehensif.ABSTRACT One of the causes of high maternal mortality rate is the complications of pregnancy and labor A maternity nursing specialist has an important role to prevent maternal and fetal death This report aimed to provide an overview of the implementation of maternity nursing specialist practice including nursing care of normal and high risk prenatal intranatal postnatal and newborn as well as women rsquo s health Resident also provided nursing care focused on the application of Wiedenbach Need for Help Theory on mothers with pregnancy termination due to severe preeclampsia Results showed that the immediate management and pregnancy termination as indicated could prevent complications and maternal and infant distress as well as prevent HELLP Syndrome and eclampsia The application of Wiedenbach Need for Help Model Theory was effective to be applied on cases of pregnancy termination due to severe preeclampsia The maternity nursing specialist competencies were achieved by applying a nurse rsquo s roles comprehensively."

"Praktik residensi keperawatan maternitas diselenggarakan untuk menghasilkan perawat maternitas yang menguasai aplikasi teori keperawatan maternitas dan memiliki keterampilan khusus untuk melakukan perawatan maternitas baik di rumah sakit maupun di komunitas. Laporan residensi ini menjelaskan tentang pelaksanaan praktik residensi maternitas, peran dan fungsi perawat maternitas, pencapaian kompetensi praktik dan upaya untuk memodifikasi hambatan yang dihadapi. Laporan residensi ini fokus pada penerapan teori need for help Wiedenbach dan self care Orem pada ibu hamil dengan tuberculosis multi drug resistance. Perawat maternitas perlu meningkatkan pengetahuan dan keterampilan klinik secara berkelanjutan sehingga mampu meningkatkan kualitas asuhan keperawatan maternitas.

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Maternity nursing practice residency organized to produce nurse of maternity who master the application of nursing theory and have special skills to do a good maternity care in hospitals and in the community. This residency final report describes the implementation of the practice residency maternity, roles and functions of nurses maternity, the attainment of practice and attempts to modify the barriers. Focus of this final report is application of theory need for help Wiedenbach and self care Orem in pregnant women with tuberculosis multi drug resistance. Nurse maternity needs to improve knowledge and clinical skills on an ongoing basis to improve the quality of maternity nursing care. "

"Karya ilmiah akhir disusun sebagai laporan praktik residensi ners spesialis keperawatan maternitas yang menggambarkan pencapaian kompetensi ners spesialis keperawatan maternitas dengan fokus pada aplikasi teori keperawatan need for help dan symptom management pada ibu hamil dengan preeklampsia berat. Kompetensi ners spesialis keperawatan maternitas diwujudkan dengan penerapan peran dan fungsi perawat sebagai pemberi pelayanan keperawatan, advokat, manajer, rehabilitator, komunikator, edukator, kolaborator, dan agen perubah. Aplikasi teori keperawatan need for help Wiedenbach dan symptom management Humphreys pada ibu hamil dengan preeklampsia berat dapat mengatasi masalah keperawatan selama fase akut dan pemeliharaan.

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This final report is created as a report of maternity nursing specialist residency practice which describes the achievement of maternity nursing specialist’s competencies focused on the application of ‘need for help’ and ‘symptom management’ nursing theory to pregnant women with severe preeclampsia. The competencies of a maternity nursing specialist were actualized by the implementation of roles and functions as a nursing care provider, an advocate, a manager, a rehabilitator, a communicator, an educator, a collaborator, and a change agent. The application of Wiedenbach’s ‘need for help’ nursing theory and Humphreys theory of symptom management to pregnant women with severe preeclampsia could solve the nursing problems during acute and maintenance phase."

"Ketuban pecah prematur adalah suatu kondisi yang berhubungan dengan ketuban spontan pecah sebelum tanda-tanda persalinan aktif dibawah usia kehamilan 37 minggu. Ketuban pecah prematur dapat meningkatkan risiko komplikasi pada kesehatan ibu dan janin. Pengelolaan pada ibu hamil ketuban pecah prematur dengan mengaplikasikan teori Konservasi Levine dan Kenyamanan Kolcaba bertujuan untuk mempertahankan kehamilan sampai aterm dan mengatasi ketidaknyamanan. Pendekatan proses keperawatan mulai dari pengkajian sampai evaluasi  diterapkan  pada  kelima  ibu  hamil dengan  ketuban pecah prematur.  Beberapa  masalah keperawatan  yang  muncul  adalah  risiko  infeksi , risiko cidera  janin, kesiapan  peningkatan  kenyamanan, ansietas,  dan  peningkatan  support  sistem. Melalui  konservasi  energi,  konservasi  integritas  struktur,  konservasi  integritas personal dan konservasi integritas sosial kelima ibu hamil dengan ketuban pecah prematur dapat terhindar dari komplikasi  dengan  perawatan  konservatif.  Hasil  ini  dapat  digunakan  untuk  mengelola  ibu  hamil ketuban pecah prematur pada area maternitas.

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Preterm Premature Rupture of Membranes is a condition associated with spontaneous rupture before signs of active labor under 37 weeks of gestation. Premature rupture of membranes can increase the risk of complications in maternal and fetal health. Management of premature rupture of amniotic mothers by applying the theory of Levine Conservation and Comfort Kolcaba aims to maintain pregnancy to term and overcome discomfort. The nursing process approach from assessment to evaluation is applied to the five pregnant women with Preterm Premature Rupture Of Membranes. Some nursing problems that arise are the risk of infection, the risk of fetal injury, readiness for increased comfort, anxiety, and increased support for the system. Through energy conservation, structural integrity conservation, personal integrity conservation and social integrity conservation of five pregnant women with Preterm Premature Rupture Of Membranes can avoid complications with conservative care. This result can be used to manage pregnant women Preterm Premature Rupture Of Membranes in the maternity area."