Hasil Pencarian  ::  Simpan CSV :: Kembali

"Diabetes melitus merupakan penyakit kronis dan jumlah kejadian terus meningkat di seluruh dunia termasuk di Indonesia. Penerapan dari model keperawatan dibutuhkan untuk pencegahan dan pengelolaan diabetes. Pendekatan model adaptasi Roy diaplikasikan pada perawatan kasus pasien dengan diabetes. Evidence-based nursing dalam teknik penyuntikan insulin 900 dan dicubit dapat memberikan keselamatan dari kejadian hipoglikemi. Sebuah audiovisual sebagai media pendidikan kesehatan pasien, berjudul "Perawatan diri untuk pasien diabetes melitus" yang dibuat untuk sebuah proyek inovasi keperawatan berguna untuk meningkatkan pengetahuan pasien diabetes melitus.

---

Diabetes mellitus is a chronic disease and its prevalence is continusly increasing worldwide including in Indonesia. The implementation of nursing models required for its diabetes prevention and management. The Roy?s adaptation model approach was applied to the care of cases of patients with diabetes. Evidencebased nursing of 900 insulin injection technique and pinching could provide safety from the occurrence of hypoglycemia. An audiovisual as a patient health education media, titled "Self-care for Diabetes Mellitus Patients", which was created for a nursing innovation project were useful to improve knowledge among patient with diabetes mellitus."

"Diabetes Melitus merupakan penyakit metabolik kronis yang ditandai dengan hiperglikemia. Penyakit ini disebabkan defisiensi insulin absolut atau relatif atau keduanya yang dapat mengakibatkan komplikasi akut dan kronis. Penanganan Diabetes Melitus tidak hanya membutuhkan pendekatan medis, tetapi juga membutuhkan pendekatan multidisiplin termasuk pendekatan keperawatan. Salah satu pendekatan keperawatan yang digunakan adalah model adaptasi Roy. Pemanfaatan hasil-hasil penelitian sebelumnya sebagai dasar praktik evidence based nursing terkait edukasi insulin terlihat dalam peningkatan kemampuan penyuntikan insulin. Implementasi inovasi keperawatan tentang edukasi melalui audiovisual tentang perawatan diri bagi pasien diabetes juga terlihat dapat meningkatkan pengetahuan pasien diabetes tentang perawatan diri.

---

Diabetes mellitus is a chronic metabolic disorders that causes a hyperglycemia. Diabetes is caused by an absolute or relative insulin deficiency or both which could lead to acute and chronic complications. A medical approach is not the only approach used in the diabetes management. A multidisciplinary approach including nursing approaches have been considered useful in managing the diseases. The implementation of the Roy?s adaptation model in the nursing care of diabetic patients is one of the examples. Utilization of results from previous studies as the basis for the practice of evidence-based nursing about insulin education showed an increasing of patients? insulin injections ability. Whilst the implementation of a nursing innovation on patient?s knowledge about diabetes self-care."

"Diabetes melitus merupakan kelompok gangguan metabolik yang bersifat kronik yang ditandai dengan hiperglikemia yang disebabkan adanya kelainan sekresi insulin, resistensi insulin atau keduanya dan dapat mengakibatkan kerusakan jangka panjang atau kegagalan pada beberapa organ tubuh. Penanganan diabetes melitus tidak hanya melalui pendekatan medis tetapi perlu dilakukan secara multidisiplin yang sakah satunya melibatkan disiplin ilmu keperawatan. Pelayanan keperawatan yang dilakukan oleh ners spesialis dapat dilakukan dengan menerapkan teori model keperawatan seperti model konservasi Levine.Pemanfaatan hasil penelitian terdahulu sebagai dasar praktik evidence based nursing practice tentang edukasi nutrisi terlihat dapat meningkatkan kepatuhan pasien diabetes melitus dalam perencanaan makan. Inovasi keperawatan tentang edukasi pasien melalui media audiovisual perawatan diri pasien diabetes terlihat juga bermanfaat bagi pasien untuk peningkatan pengetahuan pasien tentang perawatan dirinya.

---

Diabetes Mellitus as a group of chronic metabolic disturbances which is identified with hyperglicemia caused by malfunction of insulin secretion or both which in long term could damages some parts of body. Diabetes Mellitus is not only managed through a medical approach. Nursing science approaches have been contributed to diabetes prevention and management. One of them is a theory of nursing based on Levine?s conservation.Results derived from previous research on patient?s adherence to diabetes diet were utilized as basis for a practice of evidence based nursing. Nursing innovation regarding patient education on self care delivered through an audiovisual showed improvement on patient's knowledge."

"[ABSTRAKGangguan pada sistem endokrin merupakan masalah kesehatan yang cukup tinggi di Indonesia, khususnya Diabetes Melitus (DM) tipe 2 dengan prevalensinya mencapai 2,1% dari total penduduk, dengan 60% dari total prevalensi adalah kasus neuropati. Kadar glukosa darah yang tidak terkontrol menyebabkan tingginya kejadian komplikasi DM baik akut maupun kronis. Pencegahan komplikasi tersebut memerlukan penanganan yang tepat dari berbagai multidisiplin ilmu, salahsatunya adalah peran perawat ners spesialis medikal bedah kekhususan endokrin sebagai praktisi keperawaan untuk ikut memberikan asuhan melalui berbagai pendekatan teori keperawatan seperti penerapan model adaptasi Roy secara holistik menggunakan pengkajian perilaku dan stimulus sehingga tercapai perilaku adaptif. Selain itu penerapan praktek keperawatan berbasis pembuktian ilmiah (evidence based nursing) seperti senam kaki diabetes dapat menjadi acuan intervensi dalam mencegah terjadinya polineuropati dan komplikasi lanjut seperti ulkus diabetik. Sebagai agen pembaharu/inovator, perawat spesialis juga membuat inovasi tentang self health assesment dan booklet sahabat diabetes bagi para diabetesi untuk meningkatkan promosi kesehatan terhadap pengelolaan dan penatalaksanaan DM.

---

ABSTRACTDisorders of the endocrine system is a health problem that is quite high in Indonesia, in particular diabetes mellitus (DM) type 2 prevalence was at 2.1% of the total population, with 60% of the total prevalence of neuropathy cases. Blood glucose levels are poorly controlled diabetes leading to high incidence of complications both acute and chronic. Prevention of these complications requires proper handling of various multidisciplinary, one of them is the role of medical-surgical nurse specialist nurses endocrine specificity as keperawaan practitioners to help provide care through a variety of approaches such as the application of nursing theory holistically Roy adaptation model uses behavioral assessment and stimulus in order to reach adaptive behavior, Besides the application of scientific evidence-based nursing practice (evidence-based nursing) such as diabetic foot gymnastics can be a reference for intervention in preventing the occurrence opolyneuropathy and further complications such as diabetic ulcers. As an agent reformer/innovators, nurse specialist also made innovations on health self-assessment and companion booklet diabetes for diabetics to improve health promotion for the management and treatment of diabetes., Disorders of the endocrine system is a health problem that is quite high in Indonesia, in particular diabetes mellitus (DM) type 2 prevalence was at 2.1% of the total population, with 60% of the total prevalence of neuropathy cases. Blood glucose levels are poorly controlled diabetes leading to high incidence of complications both acute and chronic. Prevention of these complications requires proper handling of various multidisciplinary, one of them is the role of medical-surgical nurse specialist nurses endocrine specificity as keperawaan practitioners to help provide care through a variety of approaches such as the application of nursing theory holistically Roy adaptation model uses behavioral assessment and stimulus in order to reach adaptive behavior, Besides the application of scientific evidence-based nursing practice (evidence-based nursing) such as diabetic foot gymnastics can be a reference for intervention in preventing the occurrence opolyneuropathy and further complications such as diabetic ulcers. As an agent reformer/innovators, nurse specialist also made innovations on health self-assessment and companion booklet diabetes for diabetics to improve health promotion for the management and treatment of diabetes.]"

"Praktik residensi keperawatan medikal bedah peminatan keperawatan endokrin merupakan kelanjutan dari pendidikan magister keperawatan yang dilaksanakan dalam rangka memberikan kesempatan dan pengalaman kepada residen perawat untuk menerapkan ilmu dan teknologi keperawatan khususnya memberi asuhan keperawatan lanjut dan kompleks dalam menyelesaikan permasalahan keperawatan endokrin pada fasilitas pelayanan kesehatan. Praktik klinik dilaksanakan di setting gawat darurat, perawatan intensif, rawat inap, dan rawat jalan di RSUPN Dr Cipto Mangunkusumo Jakarta. Penerapan teori Model Adaptasi Roy dilakukan oleh residen pada 30 kasus resume dan 1 kasus utama yaitu pada pasien SIDA on ARV, Diabetes mellitus tipe 2, Selulitis regio colli, Hepatitis C, Sirosis hepatis. Asuhan keperawatan berbasis bukti diterapkan berupa latihan Passive Stretching untuk menurunkan gula darah pada pasien yang tidak mampu melakukan latihan fisik mandiri. Inovasi pelayanan keperawatan dilakukan dengan menyusun media edukasi simulasi suntik insulin yang terdiri dari alat New Simulation Tools (alat peraga suntik insulin) video dan buku panduan edukasi suntik insulin (buklet) yang digunakan sebagai panduan dan media edukasi bagi perawat dalam memberikan edukasi suntik insulin, mengurangi rasa takut pasien terhadap penyuntikan, memberikan lebih banyak latihan, dan meningkatkan keterampilan penyuntikan insulin pasien.

---

The medical surgical nursing residency program specializing in endocrine nursing is a continuation of nursing master education which is carried out in order to provide opportunities and experience to nurse residents to apply nursing science and technology, especially providing advanced and complex nursing care in solving endocrine nursing problems in health care facilities. Clinical practice is carried out in emergency, intensive care, inpatient, and outpatient settings at Dr. Cipto Mangunkusumo Hospital Jakarta. The application of the Roy Adaptation Model theory was carried out by residents in 30 resume cases and 1 main case, namely in patients with SIDA on ARV, Diabetes mellitus type 2, Cellulitis regio colli, Hepatitis C, Cirrhosis hepatis. Evidence-based nursing care is applied in the form of Passive Stretching exercises to reduce blood sugar in patients who are unable to do independent physical exercise. Nursing service innovation is carried out by compiling educational media consisting of insulin injection simulation tools consisting of New Simulation Tools (insulin injection tool) videos and insulin injection education guidebooks (booklets) which are used as guidelines and educational media for nurses in providing insulin injection education, reducing patient fear of injections, providing more practice, and improving patient insulin injection skills."

"Ruang lingkup pelaksanaan program residensi adalah pencapaian kompetensi klinis dan penerapan peran ners spesialis dalam praktik keperawatan lanjut. Proses ini dilaksanakan dengan penerapan pendekatan teori Keperawatan Virginia Henderson pada sistem onkologi, penerapan Evidence Based Nursing terapi musik mengurangi nyeri kanker, dan penerapan inovasi protokol ERAS pada pasien mastektomi dan tiroidektomi di RSUP Cipto Mangunkusumo Jakarta. Pendekatan teori virginia Henderson sangat cocok diterapkan dalam memenuhi kebutuhan pasien dengan keganasan yang kompleks karena bersifat komprehensif dan holistik mencakup kebutuhan fisik, psikologis, sosial, dan spiritual. Penerapan evidence based nursing terapi musik menunjukan bahwa terjadi penurunan nyeri setelah diberikan terapi musik. Inovasi ERAS protokol menunjukan terjadi penurunan jumlah hari rawat dan berkurangnya komplikasi pasca bedah. Disarankan kepada perawat agar lebih mengembangkan penggunaan pendekatan teori Virginia Henderson dalam memenuhi kebutuhan pasien yang holistik dan menjadikan terapi musik sebagai alternatif pilihan dalam mengurangi nyeri kanker serta mengembangkan ERAS protokol pada pembedahan mastektomi dan tiroidektomi.

---

The scope of the implementation of the residency program is the achievement of clinical competencies and the application of the role of specialist nurses in advanced nursing practice. This process was carried out with the application of Virginia Henderson's Nursing theory approach to the oncology system, the application of Evidence Based Nursing music therapy to reduce cancer pain, and the application of innovation to the ERAS protocol in mastectomy and thyroidectomy patients at Cipto Mangunkusumo General Hospital, Jakarta.

The Henderson virginian theory approach is very suitable to be applied in meeting the needs of patients with complex malignancies because it is comprehensive and holistic including physical, psychological, social, and spiritual needs. The application of evidence based nursing music therapy shows that there is a decrease in pain after being given music therapy. The ERAS innovation protocol shows a decrease in the number of care days and a reduction in postoperative complications.

It is suggested to nurses to further develop the use of Virginia Henderson's theoretical approach in meeting patients' holistic needs and making music therapy an alternative choice in reducing cancer pain and developing ERAS protocols for mastectomy and thyroidectomy surgery."

"Gangguan pada system endokrin menimbulkan dampak yang kompleks pada system tubuh dan salah satunya adalah diabetes melitus (DM). Diabetes melitus merupakan penyakit kronis dan jumlahnya terus meningkat di seluruh dunia termasuk di Indonesia. Pencegahan komplikasi memerlukan peran dari berbagai multidisiplin ilmu, salah satunya perawat spesialis medikal bedah dalam memberikan asuhan keperawatan dengan menggunakan pendekatan model adaptasi Roy. Model adaptasi Roy dapat dijadikan dalam acuan dalam memberikan asuhan keperawatan yang holistik dan komprehensif dengan meminimalkan stimulus yang mempengaruhi adaptasi agar tercapai perilaku yang adaptif. Komplikasi kronik yang banyak terjadi adalah masalah kaki DM sehingga diperlukan pencegahan dengan melakukan praktek berdasarkan bukti (evidence based practice): pengaruh masase kaki secara manual terhadap sensasi proteksi, nyeri, dan Ankle Brachial Indek (ABI) pasien DM tipe 2. Peran perawat spesialis juga sebagai innovator untuk mengkaji pengetahuan pasien sebelum memberi edukasi dengan menggunakan format evaluasi edukasi sehingga dapat diketahui tingkat pengetahuan pasien. Perawat cukup memberi edukasi sesuai kebutuhan yang diperlukan pasien.

---

Endocrine system disorders create complex impacts towards body systems and one of those is Diabetes Mellitus. Diabetes mellitus is a choronic disease and its prevalence is continuously increasing worldwide including Indonesia. A multidisciplinary approach is essential to prevent DM complications and improve patient's quality of life. The medical surgical nurse specialist is expected to have a central role in diabetes care, and to perform nursing care based on Roy's adaptation model. Roy adaptation model can be utilized as a framework for nurses in providing a holistic and comprehensive nursing care by minimizing stimuli that affect patient's ability to become adaptive. Mostly chronic complication of DM is foot ulceration, so prevention with evidence based practice is needed: the effect of manual foot massage for protective sensation, pain, and Ankle Brachial Index (ABI) patient DM type 2. The medical surgical nurse specialist took park as the innovator to assess patient's knowledge before giving health education with evaluation format to see the level of patient knowledge. The nurse only educates the patient as needed."

"Penyakit endokrin merupakan penyebab kematian dengan angka yang cukup tinggi baik secara nasional maupun global. Hal ini menjadi tantangan bagi seluruh tenaga kesehatan khususnya bagi perawat spesialis medikal bedah peminatan endokrin dalam ikut membantu menurunkan tingkat komplikasi yang terjadi. Praktik ilmu keperawatan yang berkualitas berdasarkan evidence base nursing terbaru menjadi landasan dalam melaksanakan peran sebagai pemberi asuhan, peneliti, pendidik dan inovator. Praktik residensi perawat spesialis peminatan endokrin berlangsung dalam dua semester telah memberikan pengalaman dan kesempatan untuk menerapkan teori keperawatan secara menyeluruh dalam mengelola asuhan kepada pasien. Penerapan model teori adaptasi Roy dilakukan oleh residen terhadap 30 kasus resume dan satu kasus kelolaan utama yaitu pada pasien Diabetes Melitus type 2 dengan riwayat KAD, akut on CKD, hipertensi, dyslipidemia dan pankreatitis akut. Peran peneliti dilakukan dengan menerapkan evidence base nursing yaitu melalui inlows sixty second sebagai alat screening risiko terjadinya luka kaki pada pasien Diabetes Melitus. Inovasi pelayanan yang dilakukan residen adalah membuat alat simulation tool yaitu alat edukasi untuk pasien Diabetes Melitus yang menerima terapi insulin pertama kali. Protokol ini mampu memberikan panduan secara sistematis, mudah dipahami, serta mudah dilaksanakan oleh perawat kepada pasien sehingga diharapkan pasien dengan terapi insulin tidak merasa ketakutan saat mendapatkan insulin pertama kali.

---

Endocrine disease is a cause of death with a fairly high number both nationally and globally. This is a challenge for all health workers, especially for medical surgical specialist nurses specializing in endocrine in helping to reduce the rate of complications that occur. Quality nursing science practice based on the latest nursing evidence base is the cornerstone in carrying out the role as a caregiver, researcher, educator and innovator. The endocrine specialist nurse residency practice which takes place over two semesters has provided experience and opportunity to apply nursing theory as a whole in managing care for patients. Residents applied Roy's adaptation theory model to 30 resume cases and one main managed case, namely type 2 Diabetes Melitus patients with a history of DKA, acute CKD, hypertension, dyslipidemia and acute pancreatitis. The role of the researcher is carried out by applying evidence-based nursing, namely through sixty second inlows as a screening tool for the risk of foot injuries in patients with Diabetes Melitus. The resident's service innovation is to make a simulation tool, which is an educational tool for Diabetes Melitus patients who receive insulin therapy for the first time. This protocol is able to provide guidance in a systematic, easy to understand, and easily implemented by nurses to patients so that patients on insulin therapy are expected not to feel afraid when they get insulin for the first time."

"Karya Ilmiah Akhir ini merupakan laporan akhir setelah praktik residensi peminatan Keperawatan Medikal Bedah. Laporan akan menguraikan satu kasus utama dari pengelolaan terhadap 31 kasus yang dikelola, Evidence Based Nursing Practice (EBNP) dan Inovasi. Perubahan signifikan didapatkan pada hasil penerapan asuhan keperawatan menggunakan model adaptasi Roy, pasien mampu beradaptasi lebih baik terhadap masalah yang dihadapi tanpa tergantung pada keberadaan stimulus sebagai pencetus masalah. EBNP yang akan dilaporkan adalah penggunaan teknik relaksasi untuk mengatasi nyeri dan kecemasan post operasi gangguan muskuloskeletal, dengan hasil tindakan ini efektif untuk menurunkan nyeri tetapi tidak menunjukkan penurunan besar untuk kecemasan. Kegiatan inovasi yang dikerjakan yaitu program discharge planning untuk pasien perioperatif muskuloskeletal memberikan hasil yang baik dalam menurunkan kecemasan dan kepatuhan terhadap prosedur yang dijalankan.

---

This is a final report of Medical Surgical Nursing Specialist practice. It contains the explanation of one case of 31 managed cases, Evidence Based Nursing Practice (EBNP) and Innovation project. There is a significance outcomes after application of the Roy adaptation model in nursing care practice, patients could adapt better to the problems independently to existence of stimuli as the problem precipitator. The reported EBNP was implementation of relaxation technique for reducing musculoskeletal post operative pain and anxiety, this intervention was effective to reduce pain but not showing significant effect for anxiety. The innovation project, a discharge planning program for musculoskeletal perioperative patients showing a good result in reducing anxiety and promoting compliance to the procedure."

"Praktek residensi keperawatan pada sistem neurologi dituntut mampu memberikan asuhan keperawatan secara komperhensif, menerapkan Evidence Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Pemberi asuhan keperawatan dilakukan dengan menggunakan pendekatan model adaptasi Roy pada pasien stroke hemoragik dan 30 pasien lainnya dengan berbagai gangguan system neurologi. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologi. Penerapan EBN Pelvis Stability Training (PST) pada lima pasien stroke menunjukkan keefektifan dalam  meningkatkan kontrol pergerakan, kekuatan otot panggul, kecepatan berjalan, dan ADL melalui kestabilan keseimbangan panggul pada pasien stroke. Program inovasi keperawatan berupa penerapan program pencegahan kejadian jatuh pada pasien neurologi di rawat inap.

---

Nursing residency practice in the neurology system is demanded to be able to provide comprehensive nursing care, implementation of Evidence Based Nursing (EBN) and be able to act as an innovator in the treatment room. Nursing care was performed using Roy's adaptation model approach in hemorrhagic stroke patients and 30 other patients with various neurological system disorders. Maladaptive behavior is the most common mode of physiological adaptation. The implementation of EBN Pelvis Stability Training (PST) in five stroke patients showed effectiveness in increasing movement control, pelvic muscle strength, walking speed, and ADL through stability in pelvic balance in stroke patients. The nursing innovation program is in the form of a fall prevention program in neurology patients hospitalized."