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"Kesehatan reproduksi merupakan hal yang penting untuk diperhatikan dalam meningkatkan kesehatan perempuan. Ners spesialis keperawatan maternitas memiliki peran dalam mencapai upaya tersebut. Laporan ini merupakan hasil analisis yang komprehensif tentang pelaksanaan praktek residensi Ners spesialis keperawatan matemitas pada masa childbearing dan non. childbearing. Fokus pelaporan adalah pada kesesuaian penerapan teori keperawatanself care Orem dan social support Marjorie A. Schaffer pada kasus ibu postpartum dengan IUFD. Masalah keperawatan yang muncul dikaitkan dengan penyesuaian diri klien secara fisik dan psikologis terhadap perawatan masa nifas dengan IUFD. Selama masa perawatan dan klien melalui proses berdukanya, diharapkan klien dapat melakukan perawata11 diri yang tepat secara bertahap dengan dukungan sosial dari tenaga kesehatan dan keluarga. Kelima kasus kelolaan mengalami proses berduka namun dengan dukungan dari tenaga kesehatan dan keluarga, diharapkan klien dapat menggali potensi yang dimiliki untuk melakukan perawatan diri seoptimal mungkin secara bertahap. Perbedaan yang terjadi pada klien adalah kemampuan masing-masing klien untuk memenuhi self carenya berbeda-beda, tergantung dari usia, dukungan sosial, toleransi terhadap nyeri dan motivasi diri klien. Kompetensi yang dicapai selama praktek residensi ini dapat meningkatkan pengalaman dan ketrampilan ners spesialis keperawatan maternitas."

"Laporan ini bertujuan untuk menganalisis tentang pengalaman praktik residensi spesialis keperawatan medika bedah dalam menjalankan peran perawat selama praktik keperawatan. Perawat berperan sebagai pemberi asuhan keperawatan, peneliti, pendidik dan innovator di RSUP fatmawati Jakarta. Sebagai pemberi asuhan keperawatan, penulis mengaplikasikan penerapan model self care Orem dalam memberikan asuhan keperawatan pada pasien dengan gangguan system musculoskeletal. Laporan analisis ini juga menerapkan praktik keperawatan berbasis bukti (Evidence Based Nursing) untuk mengurangi nyeri post operasi ORIF dengan menggunakan tehnik terapi music. Terapi music efektif diterapkan untuk mengurangi nyeri pasien post operasi ORIF. Peran perawat sebagai innovator mencoba menerapkan Clinical Practice Guideline (CPG) pada klien post operasi ektremitas bawah. Penerapan CPG ini melibatkan tim ruangan tempat lahan praktik. Rumah sakit sebagai institusi pelayanana kesehatan diharapkan dapat mengembangkan sumber daya perawat melalui pendidikan yang berkelannjutan, pelatihan dan pertemuan ilmiah khususnya dibidang ortopedi untuk meningkatkan pelayanan keperawatan yang berkualitas, cepat dan tepat.

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This report was aimed to analyze about the experience of specialist nursing practice residency medical surgical nursing in performing the role of nurses during the nursing practice. Nurse's role as provider of nursing care, researcher, educator and innovator in Fatmawati General Hospital Center Jakarta. As a provider of nursing care, the practician applied the model application Orem self care in providing nursing care to patients with f the musculoskeletal system disorder. The analysis report also implemented evidencebased nursing practice (Evidence Based Nursing) to reduce postoperative pain ORIF using music therapy techniques. Music therapy effectively applied to reduce postoperative pain patients ORIF. The role of the nurse as an innovator trying to implement Clinical Practice Guideline (CPG) on the client postoperative at lower extremity. This involves of the application of CPG team room where the place of practices. Hospital as an institution is expected to develop the service of health resources through continuing education nurse, training and scientific meetings in the field of orthopedics in particular to improve the quality of nursing services, progressive and accurately."

"Praktik residensi di ruang ortopedi untuk memberikan asuhan keperawatan pada gangguan muskuloskeletal menggunakan teori keperawatan Self Care Orems, menerapkan praktik keperawatan berdasarkan pembuktian, dan melakukan inovasi keperawatan. Kasus kelolaan utama pada gangguan sistem muskuloskeletal adalah osteomielitis kronis. Masalah keperawatan paling banyak adalah nyeri dan mobilitas fisik untuk universal self care requisites serta kurang pengetahuan untuk developmental self care requisites. Intervensi keperawatan berdasarkan pembuktian yang telah diterapkan adalah cold compression therapy yang dapat meningkatkan proses penyembuhan dengan indikator penurunan nyeri dan edema, serta peningkatan rentang gerak sendi. Inovasi keperawatan yaitu penggunaan Clinical Practice Guidline untuk melakukan asuhan keperawatan berdasarkan clinical pathway pada pasca ORIF ekstremitas bawah. Perawat dapat menerapkan teori Self Care Orems, cold compression therapy, serta melakukan kegiatan inovasi untuk meningkatkan kompetensi perawat dan kualitas pelayanan keperawatan.

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The advanced clinical practice in orthopaedic ward involved the planning of nursing care for musculoskeletal disorders patients with Orem?s Self Care theory, the implementation of evidenced based nursing practice, and the implentation of nursing innovations. The primary case management of the musculoskeletal system disorders is chronic osteomyelitis. Most nursing problems for the universal selfcare requisites are pain and physical mobility, while for the developmental self care requisites is knowledge deficit. The evidence based nursing intervention implemented was cold compression therapy. It can improve the healing process with the indicators of decreased pain and edema, and increased range of motion. The nursing innovation implemented was the use of Clinical Nursing Practice Guidline in giving nursing care based on the clinical pathways post-ORIF lower extremities. Nurses can apply the Orem?s Self Care Theory, cold compression therapy, and innovation activities to improve their competency and also quality of nursing services."

"Praktik Spesialis Keperawatan Medikal Bedah Kekhususan Respirasi di RSUP Perasahabatan Jakarta merupakan aplikasi peran dan fungsi sebagai ners spesialis dengan menerapkan Model Adaptasi Roy dalam memberikan asuhan keperawatan pada pasien dengan gangguan sistem respirasi baik pada pasien kelolaan utama maupun 30 pasien resume. Selain sebagai pemberi asuhan keperawatan peran perawat spesialis respirasi adalah menerapkan tidakan berbasis bukti ilmiah pada area respirasi yaitu dengan memberikan terapi suara berbasis alam dalam mengurangi kecemasan, agitasi, dan stress pada pasien terpasang ventilator mekanik. Peran selanjutnya dari perawat spesialis respirasi adalah melakukan inovasi melalui analisi situasi dan studi literature dalam hal ini adalah penerapan The Respiratory Distress Observation Scale (RDOS) dalam menilai risiko terjadinya distress pernapasan. Hasil praktik menunjukan bahwa teori Model Adapatasi Roy dalam memberikan asuhan keperawatan pada pasien dengan gangguan sistem respirasi dan suara berbasis alam cukup efektif dalam mengurangi kecemasan, agitasi, dan stress pada pasien terpasang ventilator mekanik. Serta RDOS dapat diterapkan pada pasien dengan gangguan respirasi dalam menilai risiko distress pernapasan.

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The Practice of Medical Nursing Specialists Specialized in Respiration in RSUP Perasahabatan Jakarta is the application of roles and functions as specialist nurses by applying Roy's Adaptation Model in providing nursing care to patients with respiratory system disorders in both the main managed patient and 30 resume patients. Aside from being a nursing care provider, the role of respiration specialist nurses is to apply scientific evidence-based nursing actions to the area of ​​respiration by providing nature-based sound terapi to reduce anxiety, agitation, and stress in patients with mechanical ventilators. The next role of respiration specialist nurses is to innovate through situation analysis and literature studies in this case is the application of The Respiratory Distress Observation Scale (RDOS) in assessing the risk of respiratory distress. Practical results show that Roy's adaptation theory in providing nursing care to patients with respiratory and natural-based sound disorders is quite effective in , agitation, and stress in patients with mechanical ventilators. As well as RDOS can be applied to patients with respiratory disorders in assessing the risk of respiratory distress."

"ABSTRAK Praktik residensi keperawatan medikal bedah merupakan bagian dari proses pendidikan yang berfokus pada pengembangan ketrampilan klinik, khususnya pada area respirasi di RSUP Persahabatan Jakarta. Peran yang diterapkan sebagai pemberi asuhan keperawatan, edukator, peneliti, dan inovator. Peran sebagai pemberi asuhan keperawatan dengan mengelola 30 pasien gangguan sistem respirasi dengan menggunakan pendekatan model konsep teori Virginia Henderson. Masalah keperawatan yang sering muncul yaitu ketidakefektifan bersihan jalan napas. Peran sebagai peneliti ditunjukkan dalam penerapan evidence based nursing practice berupa penerapan breathing retraining untuk mengurangi sesak napas pada pasien kanker paru. Dan peran sebagai inovator dan edukator yaitu melakukan pendidikan kesehatan dengan diskusi interaktif kelompok untuk meningkatkan pengetahuan dan motivasi serta telenursing dengan sms reminder untuk meningkatkan kepatuhan minum obat pada pasien tuberkulosis di poliklinik paru.ABSTRACT Residency practice is a part of clinical education in medical surgical nursing specialist programme, especially for respiratory nursing. It was conducted at Persahabatan Hospital Jakarta. Residents based their practice on Henderson Nursing Theory with role modes as care provider, educator, researcher, and innovator. Role as a care provider was held on 30 cases with Henderson theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. Role as a researcher was conducted through clinical research which investigates the effectiveness breathing retraining to minimize dyspnea. Role as an innovator that is conducted health education with interactive group discussion to increase knowledge and motivation, and telenursing with sms reminder to increase medication adherence in patient with tuberculosis.;Residency practice is a part of clinical education in medical surgical nursing specialist programme, especially for respiratory nursing. It was conducted at Persahabatan Hospital Jakarta. Residents based their practice on Henderson Nursing Theory with role modes as care provider, educator, researcher, and innovator. Role as a care provider was held on 30 cases with Henderson theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. Role as a researcher was conducted through clinical research which investigates the effectiveness breathing retraining to minimize dyspnea. Role as an innovator that is conducted health education with interactive group discussion to increase knowledge and motivation, and telenursing with sms reminder to increase medication adherence in patient with tuberculosis.;Residency practice is a part of clinical education in medical surgical nursing specialist programme, especially for respiratory nursing. It was conducted at Persahabatan Hospital Jakarta. Residents based their practice on Henderson Nursing Theory with role modes as care provider, educator, researcher, and innovator. Role as a care provider was held on 30 cases with Henderson theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. Role as a researcher was conducted through clinical research which investigates the effectiveness breathing retraining to minimize dyspnea. Role as an innovator that is conducted health education with interactive group discussion to increase knowledge and motivation, and telenursing with sms reminder to increase medication adherence in patient with tuberculosis.;Residency practice is a part of clinical education in medical surgical nursing specialist programme, especially for respiratory nursing. It was conducted at Persahabatan Hospital Jakarta. Residents based their practice on Henderson Nursing Theory with role modes as care provider, educator, researcher, and innovator. Role as a care provider was held on 30 cases with Henderson theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. Role as a researcher was conducted through clinical research which investigates the effectiveness breathing retraining to minimize dyspnea. Role as an innovator that is conducted health education with interactive group discussion to increase knowledge and motivation, and telenursing with sms reminder to increase medication adherence in patient with tuberculosis.;Residency practice is a part of clinical education in medical surgical nursing specialist programme, especially for respiratory nursing. It was conducted at Persahabatan Hospital Jakarta. Residents based their practice on Henderson Nursing Theory with role modes as care provider, educator, researcher, and innovator. Role as a care provider was held on 30 cases with Henderson theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. Role as a researcher was conducted through clinical research which investigates the effectiveness breathing retraining to minimize dyspnea. Role as an innovator that is conducted health education with interactive group discussion to increase knowledge and motivation, and telenursing with sms reminder to increase medication adherence in patient with tuberculosis."

"ABSTRAKKarya ilmiah akhir KIA merupakan analisis laporan praktik residensi keperawatan medikal bedah yang terdiri dari pengelolaan kasus gangguan sistem perkemihan dengan pendekatan teori Self Care Orem, penerapan evidence based nursing berupa pemijatan pada titik LI-4 untuk mengurangi nyeri kanulasi arteriovenous AV fistula dan melakukan proyek inovasi kelompok berupa tentang seminar sosialisasi konseling dan konselor keperawatan pada pasien gagal ginjal terminal. Pendekatan teori Self Care Orem meyakini bahwa perawatan diri pasien merupakan sesuatu yang dapat dipelajari dengan melibatkan kemampuan yang ada pasien sesuai kondisi penyakitnya. Pemijatan pada titik LI-4 efektif dalam mengurangi nyeri kanulasi AV-fistula pada pasien hemodialisis, mudah diaplikasikan dan tanpa efek samping sehingga dapat diaplikasikan perawat sebagai intervensi manajemen nyeri non farmakologis untuk mengurangi nyeri kanulasi AV-fistula. Seminar sosialisasi tentang konseling dan konselor keperawatan dapat meningkatkan pengetahuan dan motivasi dari perawat untuk mengembangkan diri dalam memberikan konseling kepada pasien gagal ginjal terminal.

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ABSTRACTThis final paper is an analysis report of residency medical surgical nursing practice consisting of case management of urinary system disorder with Orem Self Care approach, application of evidence based nursing using massage at LI 4 point to reduce pain in AV fistula cannulation, innovation projects on seminars about socialization of counseling and nursing counselors in end stage renal disease patients. The Orem self care approach believes that self care is something that can be learned by involving the patients existing abilities based on his illness. Massage at LI 4 point is effective to reduce pain of AV fistula cannulation in hemodialysis patients, easy to apply and without side effects, so it can applied by nurses as nonpharmacologic pain management interventions to reduce pain in AV fistula cannulation. Seminars about counseling and nursing counselors can improve the knowledge and motivation of nurses to provide a counseling to end stage renal disease patients."

"Praktik spesialis keperawatan medikal bedah merupakan rangkaian dari pendidikan ilmu keperawatan yang dilaksanakan dalam tatanan pelayanan kesehatan. Selama menjalani proses residensi, residen berperan menjadi Clinical Care Manager yang bertugas sebagai pemberi asuhan keperawatan, sebagai peneliti, konsultan keperawatan bagi staf keperawatan, serta pendidik. Guna mencapai peran tersebut, residen menerapkan teori keperawatan model adaptasi Roy sebagai alat untuk mempermudah pemberian asuhan keperawatan dalam membantu individu, baik dalam kondisi sakit maupun pada proses penyembuhan dan peningkatan pemeliharaan kesehatan di setiap mode fisiologis, konsep diri, fungsi peran dan interdependen secara sistematis. Pada kasus kelolaan dengan tuberkuloma paru diperoleh hasil bahwasanya ada perbaikan kondisi setelah pemberian asuhan keperawatan selama 15 hari dan hasil pada 30 kasus resume pasien dengan penyakit sistem pernapasan terbanyak adalah tuberkulosis paru. Penerapan Evidence Based Nursing menggunakan terapi Eye Movement Training (EMT) didapatkan hasil bahwa kelompok intervensi EMT memiliki nilai perubahan kualitas tidur rerata lebih tinggi sebelum dan sesudah diberikan terapi dibandingkan kelompok kontrol. Pada proyek inovasi, dilakukan program peningkatan kemampuan perawat dalam melakukan perawatan trakeostomi pada pasien dewasa dengan 6 elemen bundle trakeostomi diperoleh hasil bahwa perawat ruangan merasa materi yang diberikan sangat bermanfaat dan mampu laksana sehingga tindak lanjutnya adalah terbentuknya booklet perawatan trakeostomi dan teraplikasi dalam Electronic Medical Record (EMR).

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Medical-surgical nursing specialist practice is a series of nursing science education carried out in health care settings. During the residency process, the resident acts as a Clinical Care Manager in charge of providing nursing care, as a researcher, nursing consultant for nursing staff, and educator. In order to achieve this role, residents apply the Roy adaptation model nursing theory as a tool to facilitate the provision of nursing care in helping individuals, both in sickness and in the process of healing and improving health maintenance in each physiological mode, self-concept, role function and interdependence systematically. In the case of management with pulmonary tuberculosis, the results showed that there was an improvement in condition after providing nursing care for 15 days and the results in 30 cases of patient resumes with the most respiratory system diseases were pulmonary tuberculosis. The application of Evidence Based Nursing using Eye Movement Training (EMT) therapy found that the EMT intervention group had a higher mean sleep quality change value before and after therapy than the control group. In the innovation project, a programme to improve the ability of nurses to perform tracheostomy care in adult patients with 6 elements of the tracheostomy bundle was carried out. The results showed that the room nurses felt the material provided was very useful and applicable so that the follow-up was the formation of a tracheostomy care booklet and applied in the Electronic Medical Record (EMR)."