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"Masalah pernapasan merupakan masalah krusial pada bayi prematur dan memerlukan penanganan segera. Pemberian asuhan keperawatan pada bayi prematur dengan gangguan oksigenasi dapat dioptimalkan melalui intervensi fasilitated tucking. Efek positif dari fasilitated tucking adalah mempromosikan bayi dalam kestabilan fungsi fisiologis, sehingga membantu proses oksigenasi bayi menjadi lebih baik. Penggunaan Teori Konservasi Levine dapat diaplikasikan dalam penerapan asuhan keperawatan yang menerapkan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Lima kasus terpilih menunjukkan masalah keperawatan pemenuhan gangguan oksigenasi. Praktik keperawatan berbasis pembuktian yang dilakukan melalui fasilitated tucking terbukti efektif terhadap laju perubahan yang konstan terhadap parameter fisiologis yaitu nadi dan saturasi oksigen. Intervensi fasilitated tucking berbasis teori Konservasi Levine dapat diterapkan dalam pemberian asuhan keperawatan yang berkualitas pada bayi prematur dengan gangguan pemenuhan oksigenasi.

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Respiratory distress is the crucial problem in preterm infants and appropriate management soon. Providing nursing care for preterm infants with impaired oxygenation fulfillment can be optimalized by applying fasilitated tucking intervention. Positive effect of fasilitated tucking can promoth physiological function stability, therefore it helps oxygenation process better. Levine's Conservation Theory was used by appliying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. Five cases were selected due to nursing problems in impaired oxygenation fulfillment. Evidenced done by doing fasilitated tucking effective for changes physiologic parameters constantly namely heart rate and oxygen saturation. Fasilitated tucking intervention with Levine's Conservation Theory can be applied for quality nursing intervention in preterm infants with impaired oxygenation fulfillment."

"Bayi prematur dengan alat bantu nafas ventilasi mekanik memerlukan tindakan bersihan jalan napas. Penelitian menggunakan quasy experiment pada dua kelompok A dan B untuk mengetahui perubahan saturasi sebelum, selama dan setelah tindakan bersihan jalan napas. Kelompok A open suction dan B closed suction masing-masing 30 dan 10 bayi prematur. Analisis menggunakan uji statistik repeated Anova yang dilanjutkan dengan post hoc paired wise comparison. Tindakan bersihan jalan napas menggunakan open suction nilai p kurang 0,001 secara statistik terdapat perbedaan rerata yang bermakna terhadap perubahan saturasi, sedangkan closed suction nilai p kurang 0,001 terdapat perbedaan rerata yang bermakna terhadap perubahan saturasi. Penggunaan alat pengisap lendir closed suction menunjukan keadaan saturasi oksigen lebih stabil, sehingga lebih disarankan untuk tindakan bersihan jalan napas pada bayi prematur. Penggunaan closed suction akan efektif pada keadaan sekret yang encer.

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Premature infant with a mechanical ventilation need airway clearance. The study used quasy experiment in two groups A and B to provide information before and after airway clearance. Group A open suction and B closed suction each of 30 and 10 premature infants. The analysis used the statistical repeated Anova test followed by post hoc paired wise comparison. Airway clearance using an open suction with p.value 0.001, statistically, there is a mean actually oxygen saturation, while closed suction p value of less than 0.001 is the average actually oxygen saturation. The used closed suction shows a more stable oxygen saturation state, more for airway clearance in premature infants. The use of the closed suction will be effective in the state of dilute secretions."

"Penulisan karya ilmiah akhir ini bertujuan untuk mengaplikasikan teori Konservasi pada pemenuhan kebutuhan psikologis orang tua dengan bayi prematur. Pemenuhan kebutuhan psikologis orang tua dapat dilakukan melalui komunikasi terapeutik, pendampingan keluarga dan pemberian pendidikan kesehatan, memfasilitasi ikatan dan kelekatan orang tua-bayi, perencanaan pulang, asuhan berpusat pada keluarga, serta pendekatan asuhan perkembangan. Pemenuhan kebutuhan psikologis dapat membantu orang tua dalam proses adaptasi dalam pencapaian konservasi, yaitu konservasi melalui integritas personal sosial untuk mengoptimalkan peran orang tua dalam meningkatkan tumbuh kembang bayi prematur. Selama memberikan asuhan keperawatan, orang tua menunjukkan kondisi psikologis yang stabil, komunikasi dan kontak fisik dengan bayinya, pengetahuan dan keterampilan orang tua meningkat, serta adanya keterlibatan dalam perawatan bayi di RS.

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This final scientific paper aims to apply the theory of Conservation of the psychological needs of parents with premature infants. The fulfillment of psychological needs can be done through therapeutic communication, family counseling and provision of health education, facilitating the bonding and parents-infant attachment, discharge planning, family centered-care, as well as developmental care approach. The existence of the psychological needs help parents in the process of adaptation through conservation achievement, in this case the conservation of social-personal integrity to optimize the role of parents in improving the growth and development of premature infants. During the nursing care, older people showed a stable psychological condition, communication and physical contact with the baby, the increase in parenting knowledge and skills, as well as involvement in the infant care in the hospital."

"Kesulitan menyusu merupakan masalah yang sering terjadi pada bayi prematur. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi oral pada bayi prematur melalui edukasi perencanaan pulang pada orang tua dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi dan menyusui tida efektif. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa pengetahuan dan keterampilan ibu menyusui bayi meningkat sehingga pemenuhan kebutuhan nutrisi bayi terpenuhi dan meningkatkan berat badan bayi melalui edukasi perencanaan pulang. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami kesulitan menyusu.

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Having difficulty in breastfeeding is a common problem on premature infants. The purpose of this study is to analyze the optimization of the oral fulfillment of nutritional needs in premature infants through discharge planning education for the parents using Levine rsquo s Conservation Theory. Five chosen cases shows the occurrences of nutritional deficit nursing problems. Levine rsquo s Conversation Theory approach is done using energy conservation principle, structural integrity conservation, personal integrity conservation, and social integrity conservation.

The research result from the intervention of discharge planning education with Levine rsquo s Conservation Theory could improve the mothers rsquo knowledge and skills so that the fulfillment of nutritional needs of the infants fulfilled and also increasing the infants rsquo weight. Nurse could make the intervention as a standard procedure for premature infants who experienced breastfeeding difficulty."

"Karya ilmiah ini merupakan analisis pelaksanaan praktik residensi keperawatan anak selama dua semester. Kegiatan utama yang dilakukan antara lain memberikan asuhan keperawatan pada bayi prematur dan praktik keperawatan berbasis pembuktian. Asuhan keperawatan pada bayi prematur menggunakan teori comfort Kolcaba. Diagnosis keperawatan yang sering muncul pada bayi prematur adalah nyeri prosedural, gangguan termoregulasi, nutrisi kurang dari kebutuhan tubuh dan risiko infeksi. Intervensi dengan teknik mengukur kenyamanan, edukasi pada orangtua, dan melalui tindakan menenangkan jiwa. Praktik keperawatan berbasis pembuktian dilakukan melalui facilitated tucking disertai "hadir-berbicara" untuk menurunkan skor nyeri prosedural. Hasil menunjukkan bahwa intervensi berbasis teori comfort Kolcaba efektif untuk meningkatkan kenyamanan. Disarankan agar teori comfort Kolcaba dapat diterapkan dalam pemberian asuhan keperawatan pada bayi prematur.

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This scientific paper is an analysis of the implementation of pediatric nursing practice residency during two semesters. Main activities were providing nursing care to premature`s infant and doing evidence based nursing practice. Nursing care had been premature`s infant using a Kolcaba comfort`s theory. Nursing problem usually occured in premature`s infant were acute procedural pain, ineffective thermoregulation, imbalanced nutrition: less than body, risk for infection. Intervention done by technical comfort measures, parent`s coaching, and comfort food the soul. Evidence done by doing facilitated tucking and "talking to-being with" to decrease score of acute procedural pain. The result showed the evidence based on Kolcaba comfort`s theory effective to increase comfort. It is suggested that Kolcaba comfort`s theory can applied in the provision of nursing care to premature`s infant."

"Bayi kurang bulan yang dirawat di rumah sakit seringkali mengalami nyeri yang disebabkan oleh prosedur diagnostik dan terapeutik. Tujuan dari studi kasus ini adalah memberikan gambaran aplikasi Model Konservasi Levine pada bayi kurang bulan dengan masalah nyeri. Model Konservasi Levine berfokus pada peningkatan adaptasi melalui prinsip konservasi untuk mencapai wholeness. Metode penelitian ini adalah studi kasus. Lima bayi kurang bulan yang mengalami masalah nyeri akut dirawat dengan pendekatan proses keperawatan berdasarkan teori Model Konservasi Levine. Masalah keperawatan lain yang ditemukan adalah pemenuhan nutrisi kurang dari keutuhan tubuh, risiko volume cairan kurang dari kebutuhan tubuh, risiko infeksi, ikterik neonaturum, gangguan pertumbuhan dan perkembangan risiko gangguan perlekatan orang tua dan bayi. Masalah-masalah tersebut dapat memperberat rasa nyeri dan menghambat proses adaptasi bayi kurang bulan dalam mencapai integritas diri.

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Preterm infants who is hospitalized, experience pain frequently that caused by diagnostic and procedure treatment. This study aim to describe the application of Levine’s Conservation Model in preterm infants who experienced pain. Levine's Conservation Model focuses on improving adaptation through conservation principles to achieve wholeness. This research method is case study with nursing process approach. Levine’s Conservation Model applied in five selected cases that have problem acute pain. The other nursing problems are nutrition less than body requirements, risk for deficient fluid volume, risk of infection, neonaturum icteric, impaired growth and development, risk of attachment disorder between parents and babies. All of the problems can aggravate pain and inhibit the process of adaptation in preterm infant to reaches wholeness."

"Bayi prematur membutuhkan asuhan perkembangan yang adekuat, namun di beberapa rumah sakit pelaksanaan asuhan perkembangan belum optimal. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan dengan penerapan asuhan perkembangan oleh perawat. Desain penelitian adalah cross sectional, jumlah sampel 82 perawat di ruang perawatan neonatus level I, II, III di RSAB Harapan Kita dan RSPAD Gatot Subroto. Instrumen yang digunakan adalah kuesioner. Data penelitian dianalisis multivariat dengan regresi linier ganda. Hasil analisis bivariat menunjukkan ada hubungan penerapan asuhan perkembangan dengan : usia nilai p=0,016, lama bekerja nilai p=0,001, riwayat pelatihan nilai p=0,011, dan efikasi diri nilai p=0,017. Hasil pemodelan multivariat : pelatihan NICU, lama bekerja, dan efikasi diri adalah faktor dominan yang berhubungan dengan penerapan asuhan perkembangan. Peneliti menyarankan pelayanan keperawatan dapat memfasilitasi penyediaan dana dan pelatihan untuk perawat di ruang neonatus.

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Premature infants need adequate care development, but in some hospitals the implementation of developmental care is not optimal. This study aims to identify factors associated with the implementation of developmental care by nurses. The study design was cross sectional sample of 82 nurses in neonatal care level I, II, III in RSAB Harapan Kita and Gatot Subroto Army Hospital. The instrument used was a questionnaire. Data were analyzed with multiple linear regression multivariate. The results of the bivariate analysis showed no association with the development of care implementation age p value 0.016, duration of work p value 0.001, history of training p value 0.011, and self efficacy p value 0.017. Multivariate modeling results NICU training, long work, and self efficacy is a dominant factor associated with the implementation of developmental care. Researchers suggest nursing services can facilitate the provision of funds and training to nurses in neonates."

"[ABSTRAKBayi prematur dapat mengalami hambatan kenaikan berat badan yang disebabkan oleh usia gestasi, penyakit penyerta, dan pengalaman nyeri atau stres. Hambatan kenaikan berat badan dapat diatasi dengan asuhan keperawatan yang tepat dalam pemenuhan kebutuhan nutrisi pada bayi prematur. Asuhan keperawatan dengan Model Konservasi Levine telah digunakan pada aplikasi praktik residensi di Ruang Neonatus Rumah Sakit Cipto Mangunkusumo dalam menganalisis kenaikan berat badan bayi prematur pada lima kasus terpilih mulai dari Bulan Maret-Mei tahun 2015. Analisis kasus didapatkan dari tahap pengkajian, tropikognosis, hipotesis, intervensi, dan evaluasi. Tropikognosis yang telah teridentifikasi yaitu risiko gangguan pemenuhan kebutuhan nutrisi. Intervensi telah dilakukan berdasarkan prinsip konservasi dan hasil evaluasinya yaitu bayi prematur mengalami kenaikan berat badan dengan konservasi energi. Kenaikan berat badan pada bayi prematur menunjukkan keberhasilan dari penerapan asuhan keperawatan berbasis Model Konservasi Levine.

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ABSTRACTThe preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine?s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine?s Conservation Model. ;The preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine?s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine?s Conservation Model. , The preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine’s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine’s Conservation Model. ]"

"ABSTRAKBayi prematur sangat sensitif terhadap stimulus nyeri. Tujuan dari studi kasus ini adalah menganalisis efektivitas penerapan asuhan keperawatan pada bayi dengan gangguan pemenuhan kebutuhan kenyamanan melalui intervensi stimulasi multisensori menggunakan model Comfort Kolcaba di ruang perinatologi. Lima kasus terpilih menunjukkan terjadinya gangguan kenyamanan dan nyeri akut pada bayi prematur akibat terpapar dengan prosedur invasif. Intervensi dilakukan dengan mengkaji skor nyeri, pemberian stimulasi multisensori, serta perlibatan orang tua dalam intervensi melalui sentuhan dan kontak kulit ke kulit. Intervensi keperawatan berdasarkan evidence based nursing melalui tindakan stimulasi multisensori dilakukan untuk menurunkan skor nyeri. Hasil menunjukkan bahwa intervensi berbasis teori Comfort Kolcaba efektif untuk meningkatkan kenyamanan. Disarankan agar teori Comfort Kolcaba dapat diterapkan dalam pemberian asuhan keperawatan pada bayi prematur.

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ABSTRACTPremature infants are particularly sensitive to pain stimulus. The purpose of this case study is to analyze the effectiveness of nursing care in infants with impaired fulfillment of comfort through multisensory stimulation intervention in the perinatology room using Comfort Kolcaba model. Five cases selected show disruption of comfort and acute pain in preterm infants from exposure to invasive procedures. The intervention is done by assessing pain scores, multisensory stimulation, as well as the involvement of parents in the intervention through touch and skin-to-skin contact. Nursing interventions based on evidence based nursing through multisensory stimulation measures taken to decrease the pain score. The results show that the theory-based intervention Comfort Kolcaba effective to increase comfort. Application of Comfort Kolcaba theory can be applied in the provision of nursing care in premature infants. ;;"

"Bayi prematur menghadapi banyak tantangan ketidakseimbangan cairan untuk bertahan di lingkungan ekstrauterin, sehingga membutuhkan pendekatan asuhan keperawatan yang komprehensif. Studi kasus ini menggambarkan proses keperawatan menggunakan model Konservasi Levine untuk merawat lima bayi prematur dengan ancaman keseimbangan cairan. Pengkajian mengidentifikasi triphocognosis meliputi risiko kekurangan volume cairan dan masalah cairan lainnya. Perawat anak merawat sesuai kompetensi, seperti pemantauan kesesuaian cairan masuk dan kebutuhan, pengurangan jumlah insensible water loss, blood management, dan peningkatan kemampuan minum melalui mulut. Intervensi membantu bayi prematur dan keluarga berhasil beradaptasi untuk mencapai wholeness. Penerapan model ini menyediakan pengalaman asuhan keperawatan yang komprehensif sebagai referensi untuk kasus serupa selanjutnya.

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Preterm infants faces many challenges of fluid imbalance for survive in the extrauterine environment. It needs comprehensive nursing care approach. This study describes a nursing process using Levine’s Conservation model to care five preterm infants with threat to fluids imbalance. The assessments identified triphocognosis including risk of deficient fluid volume and other related problems. Pediatric nurse care according to competencies, such as monitoring the suitability of fluid intake and requirement, reducing the amount of insensible water loss, blood management, and increased oral feeding ability. The interventions helped the preterm infant and family adapt successfully to achieve wholeness. This application of model provides a comprehensive nursing care experience as reference for future similar cases."