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"Perawat memiliki potensi dalam pencegahan primer dan melakukan pendidikan di masyarakat, ietapi dalam implementasi beberapa program utama rencana aksi percepatan penurunan angka kematian ibu di Indonesia peran perawat hanyalah sebagai pendukung bahkan pelibatannya sangat minimal. Penelitian ini bertujuan mengoptimalkan kompetensi perawat dalam program perawat kesehatan masyarakat (Perkesrnas) terintegrasi pelayanan maternitas pada ibu hamil berisiko di Kabupaten Cianjur melalui pengembangan program pelatihan p~rkesmas maternitas. Penelitian tahap satu merupakan penelitian kualitatif fenomenologi. Penelitian tahap dua yaitu pengembangan program pelatihan dan modul perkesmas yang dilanjutkan dengan pelatihan pada 10 perawat puskesmasPenelitian tahap tiga, penelitian kuasi eksperimen menggunakan metode consecutive sampling dengan jumlah sampel 66 orang (33 orang kelompok intervePsi dan 33 orang kelompok kontrol). Hasil penelitian kualitatif teridentifikasi tiga tema dan lima subtema yang dinyatakan partisipan. Hasil penelitian kuantitatif membuktikan bahwa pelatihan modul perkesmas mampu meningkatkan pengetahuan, sikap, keterampilan dan kegiatan perawat dalam implementasi perkesmas dengan nilai kemaknaan 0,00. Implementasi modul mampu meningkatkan pengetahuan, sikap dan perilaku ibu hamil berisiko paska intervensi dengan nilai kemaknaan 0,00. Melalui analisis regresi logistik dibuktikan ada pengaruh variabel pengetahuan , sikap dan perilaku ibu hamil berisiko kelompok interverisi terhadap pemanfaatan fasilitas kesehatan. Kesimpulan bahwa melalui pelatihan perkesmas maternitas, perawat puskesmas mampu berkontribusi dalam pelayanan :maternitas pada ibu hamil berisiko.

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Nurses have a potential role in primary prevention and health education in community. However their role in the main programs in planning to reduce mother's death number in Indonesia is only as a supporter, and even gives a minimum involvement.

This research was aimed to optimize nurse's competencies in community health nurses program (perkesrnas) which is integrated with maternity nursing care for high risk pregnant women in Cianjur Region through maternity perkesmas training program development. First stage of this research was a phenomenological qualitative. The second one was perkesmas training and module development which was followed by training for 10 primary health service nurses. The last stage was a quasi experiment research using consecutive sampling method with 66 respondents (33 each for intervention and controlled groups).

From the qualitative research, it was identified three themes and five subthemes. Meanwhile, the quantitative research proved that perkesmas module training was able to enhance nurse's knowledge, attitude and skills in perkesmas program with 0.00 significance. Module's implementation enhanced knowledge, attitude and skills among high risk pregnant women with 0.00 significance. Logistic regression analysis proved the influence of knowledge, attitude and skills variables among high risk pregnant women in intervention group on health facility usage.

In conclusion, through perkesmas maternity training, primary health service nurses were able to contribute in maternity nursing care for high risk pregnant women."

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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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"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."

"Maternity nurses are authorized health workers that provide antenatal care, but their roles and function in antenatal care services are not recognized by the public. This research aims to reveal the experience of pregnant women during antenatal visits in private clinic maternity nursing. Six pregnant women selected using purposive sampling underwent an in-depth interview in this descriptive phenomenological study. Data were analyzed through thematic content analysis with Moustakas approach. Three themes were identified in this study: 1) women experience good communication with maternity nurses; 2) women receive family-centered nursing care; 3) the schedule, cost, facility, and types of service meet the participants’ needs. This study suggests for nurses to improve their competencies in delivering antenatal care according to clients’ needs."

"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."