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"Hepatitis B merupakan penyebab utama penyakit organ hati kronik dan dapat menyebabkansirosis, gagal hati dan karsinoma hepatoselular.Transmisi penularan hepatitis B dapatterjadi pada janin yang dikandungnya. Upaya pencegahan transmisi vertikal dapatdilakukan berupa skrining pada ibu hamil pada trimester pertama kehamilan sertapemberian imunoglobulin pada bayi setelah 12 jam kelahiran. Asuhan yang diberikankepada individu untuk pencegahan penyakit menular harus diberikan secara komprehensifdengan tujuan klien mampu beradaptasi terhadap penyakitnya dan memiliki perilaku yangbaik. Pengelolaan ibu hamil dengan hepatitis B menggunakan Teori Adaptasi Roy danHealth Belief Model (HBM) bertujuan untuk memberikan pengetahuan dan meningkatkanperilaku klien akan pencegahan penularan penyakit terhadap bayi dan keluarga lainnya.

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Hepatitis B is a major cause of chronic liver disease and can cause cirrhosis, liver failure

and hepatocellular carcinoma. As many as 240 million of them have chronic hepatitis B and

780,000 people have died due to acute and chronic complications of hepatitis B.

Transmission of hepatitis B can occur in the fetus it contains. The efforts to prevent vertical

transmission can be done in the form of screening in pregnant women in the first trimester

of pregnancy as well as giving immunoglobulins to infants after 12 hours of birth. The form

of nursing care given to individuals for the prevention of infectious diseases must be

provided comprehensively with the aim of the client being able to adapt to his illness and

have good behavior. The management of pregnant women with hepatitis B using Roy's

Adaptation Theory and the Health Belief Model (HBM) aims to provide knowledge and

improve client behavior regarding the prevention of disease transmission to infants and

other families."

"Praktik residensi keperawatan maternitas dalam pengelolan ibu postpartum dengan histerektomi atas indikasi plasenta akreta membutuhkan pengkajian dan intervensi keperawatans secara holistik sehingga dapat membantu pasien menangani setiap masalahnya serta kondisinya saat ini. Masalah yang sering muncul pada ibu postpartum bervariasi, baik fisik, psikologis, sosial dan spitirualnya. Masalah fisik dan psikologis adalah amsalah yang menonjol pada kasus ini dikarenakan adanya perubahan-perubahan dalam diri baik secara internal dan eksternal, terutama dengan kondisi histerektomi dimana penilaian atau persepsi ibu serta kondisi seksual akan mengalami perubahan sehingga diharapkan mampu beradaptasi dengan kondisi tersebut. Mendapatkan kenyamanan dalam menghadapi proses adaptasi juga merupakan salah satu usaha meningkatkan konsep diri ibu paska histsrektomi. Sehingga penerapan teori adaptasi Roy dan kenyamanan Kolcaba pada lima kasus ibu postpartum dengan histerektomi atas indikasi plasenta akreta mampu memberikan asuhan keperawatan yang komprehensif. Penerapan teori Roy dan Kolcaba mampu mengidentifikasi koping, stimulus, level dari kenyamanan pasien dan memberikan intervensi berbasis evidence based nursing practice yang sesuai dengan kebutuhan ibu postpartum dengan histerektomi.

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The practice of maternity nursing residency in the management of postpartum mothers with hysterectomy for placenta accreta indications requires holistic assessment and nursing interventions so that they can help patients deal with any problems and their current condition. Problems that often arise in postpartum mothers vary, both physically, psychologically, socially and spiritually. Physical and psychological problems are problems that stand out in this case due to changes in themselves both internally and externally, especially with the hysterectomy condition where the assessment or perception of the mother and sexual condition will change so that it is expected to be able to adapt to these conditions. Getting comfortable in the face of the adaptation process is also one of the efforts to improve the self-concept of the mother after hertectomy. So that the application of Roy's adaptation theory and Kolcaba's comfort in five cases of postpartum mothers with hysterectomy for placenta accreta indications was able to provide comprehensive nursing care. The application of Roy and Kolcaba's theory is able to identify coping, stimulus, level of patient comfort and provide evidence-based nursing practice-based interventions that are in accordance with the needs of postpartum with hysterectomy."

"Upaya untuk menurunkan AKI di Indonesia adalah menjamin setiap ibu mampu mengakses pelayanan kesehatan ibu yang berkualitas. Pada kondisi ibu dan janin dalam keadaan berisiko maka dilakukan tindakan bedah sesar untuk mencegah bahaya pada ibu dan bayi. Persalinan bedah sesar pada primipara memberikan efek baik fisik maupun psikologis. Peran ners spesialis keperawatan maternitas sebagai pemberi perawatan, pendidik, konselor, koordinator, advocate, agen pembaharu, peneliti, kolaborator sangat diperlukan dalam membantu pasien mengurangi efek yang terjadi. Tujuan dari penulisan ini adalah untuk memberikan gambaran tentang pelaksanaan praktik residensi Ners Spesialis keperawatan maternitas dengan berfokus pada aplikasi teori Self Care Orem dan Comfort Kolcaba pada ibu pasca bedah sesar primipara. Aplikasi teori ini telah membantu pasien memperoleh kenyamanan, menurunkan nyeri dan meningkatkan kemandirian pasien pasca bedah sesar melakukan perawatan diri dan bayi baru lahir.

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Efforts to reduce maternal mortality rate in Indonesia is to ensure that every mother is able to access quality maternal health services. On the condition of mother and fetus in risky circumstances, the action is taken of cesarean section to prevent harm mother and baby. Cesarean section delivery in primiparous provide both physical and psychological effects. The role of specialist nurses nursing maternity as a caregiver, educator, counselor, coordinator, advocate, agent reformer, researchers, collaborators is indispensable in helping patients reduce their effect.

The objective of this paper is to provide an overview of the implementation of specialist nurses practice nursing residency maternity by focusing on the application of the theory of Orem Self Care and Comfort Kolcaba maternal post cesarean section primiparas. Application of this theory has helped patients receive comfort and independence of postoperative cesarean perform self care and newborn. "

"Perawat sebagai pemberi asuhan mempunyai peran penting untuk dapat meningkatkan derajatkesehatan perempuan. Perawat menjalankan peran dan fungsi sebagai pemberi pelayanankeperawatan, konselor, advokat, educator, koordinator, pengelola, kolaborator, dan penelitidalam upaya meningkatkan kesehatan reproduksi perempuan, selama melaksanakan praktek baikdi rumah sakit maupun di komunitas. Salah satu masalah reproduksi pada perempuan adalahmolahidatidosa, teori yang diaplikasikan adalah fokus penerapan adaptasi Roy dan CaringSwanson pada ibu dengan post kuretase mola hidatidosa. Penerapan teori ini terbukti dapatmemberikan asuhan keperawatan pada klien secara komprehensif. Tujuan dari laporan ini adalahmemberikan gambaran tentang pelaksanaan praktik residensi ners spesialis dalam pengelolaankasus klien dengan mola hidatidosa, dan pelaporan evidence based practic nursing tentangSpiritual Emotional Freedom Technique, Pencapaian kompetensi Perawat Spesialis Maternitasdilakukan melalui peran perawat secara komprehensif.

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Nurses, as caregivers, have important role in improving woman's health standard. Either in the

hospital or in the community, nurses also serve as caretaker, counselor, advocate, educator,

coordinator, organizer, collaborator, and researcher in order to improve the woman's

reproduction health. One of the case in womans's reproduction health is hydatidiform mole,

This study used Roy and Caring Swanson adaptation. The theory was applied on posthydatidiform

mole curettage patients. The intervention was proven to be able to give the

nursing care comprehensively. The report aimed at describing the nursing residency specialist

practice in hydatidiform mole patient management. The achievement of maternity nursing

specialist was undergone through comprehensive nurse's roles."

"Saat ini profesi keperawatan telah mengalami perkembangan. Munculnya seorang perawat spesialis diharapkan dapat meningkatkan mutu pelayanan keperawatan dalam bidang kekhususannya, salah satu bidangnya yaitu keperawatan digestif. Program pendidikan spesialis keperawatan diadakan untuk memenuhi harapan tersebut. Penulisan KIAS bagi mahasiswa residen peminatan digestif, berisi tentang pengalamannya merawat 30 pasien dengan masalah sistem pencernaan menggunakan pendekatan teori model adaptasi Roy, penerapan intervensi keperawatan berdasarkan bukti ilmiah (evidence based practice), serta pelaksanaan proyek inovasi. Melakukan studi kasus dengan 30 pasien kelolaan menggunakan pendekatan teori model adaptasi roy, sesuai untuk digunakan pada pasien dengan kanker kolorektal. Penerapan evidence based nursing aromatherapy massage cukup efektif menurunkan kecemasan dan peningkatan kualitas tidur pasien pra-operasi kolorektal. Penerapan video edukasi efektif meningkatkan pengetahuan pasien pra-operasi kolostomi. Perawat yang berkompetensi massage diperlukan, agar ada alternatif intervensi keperawatan yang berkaitan dengan kecemasan dan kualitas tidur. Pemberian video edukasi stoma, diharapkan menjadi satu paket perawatan pasien stoma.

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Nowadays the nursing profession has developed. The emergence of a specialist nurse is expected to improve the quality of nursing services in their specialty areas, one of the fields being digestive nursing. Nursing specialist education programs are held to meet these expectations. The writing of KIAS for digestive resident students contains the experience of treating 30 patients with digestive system problems using Roy's adaptation model theory approach, the application of evidence-based nursing interventions, and the implementation of innovation projects. Conducted a case study with 30 patients under management using a theoretical approach to the Roy adaptation model, suitable for use in patients with colorectal cancer. The application of evidence based nursing aromatherapy massage is quite effective in reducing anxiety and improving sleep quality in colorectal preoperative patients. The application of educational videos effectively increases the patient's knowledge of pre-colostomy surgery. Nurses with competence in massage are needed, so that there are alternative nursing interventions related to anxiety and sleep quality. Providing stoma education videos, is expected to be a package of stoma patient care."

"Ners spesialis adalah pemimpin klinis dalam bidang praktik keperawatan. Pengetahuan dan keterampilan tingkat lanjut sebagai Ners Spesialis ini mencakup keahlian klinis,  evidence based nursing, kolaborasi, konsultasi, pendidikan, pendampingan, dan perubahan kepemimpinan. Ners spesialis bertanggung jawab untuk berkolaborasi dengan anggota tim perawatan kesehatan untuk merancang, mengimplementasikan, dan mengukur strategi perawatan berbasis bukti yang aman, efektif biaya, dan terbukti. Kegiatan yang dilakukan dalam menjalani praktik residensi Ners Spesialis Keperawatan Medikal Bedah peminatan respirasi terdiri dari mengelola kasus kanker paru menggunakan model adaptasi Roy, mengelola tiga puluh resume kasus, melaksanakan evidence based nursing (EBN) efektifitas Foot Reflexologi terhadap tingkat kecemasan dan perubahan fisiologis pada pasien yang akan dilakukan tindakan Bronkoskopi, serta melakukan penerapan inovasi keperawatan penggunaan Respiratory Distres Observation Scale (RDOS) untuk menilai berat ringannya dispnea pasien dengan gangguan pernapasan.

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Specialist nurses are clinical leaders in the field of nursing practice. Advanced knowledge and skills as Ners Specialists include clinical expertise, evidence based nursing, collaboration, consultation, education, mentoring, and leadership change. Specialists are responsible for collaborating with members of the health care team to design, implement, and measure evidence-based care strategies that are safe, cost-effective and proven. Activities carried out in undergoing residency practice Ners Medical Nursing Specialists Respiratory specialization surgery consists of managing lung cancer cases using Roy`s adaptation model, managing thirty case resumes, implementing evidence based nursing (EBN) Foot Reflexology effectiveness against anxiety levels and physiological changes in patients who Bronchoscopy will be carried out, as well as implementing nursing innovations using the Respiratory Distres Observation Scale (RDOS) to assess the mild severity of dyspnea in patients with respiratory disorders."

"Analisis praktik residensi merupakan laporan rangkaian kegiatan Ners SpesialisKeperawatan Medikal Bedah dengan penerapan Model Adaptasi Roy pada prosesasuhan keperawatan pasien gangguan sistem pencernaan, penerapan praktikkeperawatan berdasarkan evidence based serta melakukan inovasi keperawatan.Pengkajian kasus utama terhadap pasien karsinoma gaster dan 30 kasus resume pasienbedah digestif, gastrointestinal serta hepatobilier berfokus pada respon adaptif darimodel adaptasi Roy. Pelaksanaan evidence based dilakukan untuk mengelolakecemasan pasien sebelum menjalani operasi bedah digestif sebanyak 8 orang, denganintervensi mendengarkan Al-Qur`an Surah Al Waqi’ah dan terjemahannya selama 30menit. Program inovasi keperawatan dilakukan, terhadap 7 orang pasien yangdirencanakan menjalani operasi kolostomi berupa optimalisasi pemberian edukasimelalui media video. Kesimpulan: mendengarkan Al-Qur`an Surah Al Waqi’ah danterjemahannya dapat menurunkan tingkat kecemasan pasien sebelum operasi danedukasi melalui media video terhadap pasien yang akan menjalani operasi kolostomidapat meningkatkan pengetahuan pasien yang sangat memengaruhi terhadap keputusanpersetujuan pasien menjalani operasi.

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The residency practice analysis is a series of reports on the activities of Surgical

Medical Nursing Specialists with the application of Roy's Adaptation Model in the

nursing care process of patients with digestive system disorders, the application of

evidence-based nursing practices and nursing innovations. Major case studies of gastric

carcinoma patients and 30 cases of digestive, gastrointestinal and hepatobiliary surgery

resumes focused on the adaptive response of Roy's adaptation model. Evidence based

implementation was carried out to manage the anxiety of patients before undergoing

digestive surgery as many as 8 people, with the intervention of listening to Al-Qur'an

Surah Al Waqi'ah and its translation for 30 minutes. Nursing innovation program

carried out, for 7 patients who were planned to undergo colostomy surgery in the form

of optimizing the provision of education through video media. Conclusion: listening to

Al-Qur'an Surah Al Waqi'ah and its translation can reduce the level of patient anxiety

before surgery and education through video media for patients who will undergo

colostomy surgery can increase patient knowledge which greatly influences the decision

of consent for patients undergoing surgery."

"Pelaksanaan praktek klinik selama masa residensi Keperawatan Medikal Bedah peminatan Digestif bertujuan untuk mampu menampilkan peran perawat spesialis sebagai pemberi asuhan keperawatan lanjut, pendidik, advokat, konselor, kolaborator, pembaharu dan peneliti secara khusus pada keahlian Digestif. Peran pemberi asuhan keperawatan lanjut dilakukan dengan menggunakan Model Adaptasi Roy pada pasien dengan kanker pankreas dan 30 kasus pasien dengan masalah digestif lainnya. Salah satu karaktristik perawat spesialis adalah memberikan intervensi keperawatan berbasis bukti Evidence-based Nursing practice , yang dilakukan melalui penggunaan Animal Naming Test ANT untuk mengidentifikasi gangguan fungsi kognitif pada pasien sirosis hepatis yang sedang dirawat. Animal Naming Test ANT yang diterapkan pada 16 pasien sirosis telah berhasil mengidentifikasi lebih banyak pasien yang mengalami gangguan kognitif dibandingkan dengan asesmen klinis yang sudah ada di ruang perawatan. Inovasi dalam pelayanan keperawatan yang dilakukan melalui program inovasi kelompok berupa penerapan kegiatan ERAS yakni memberikan minuman karnohidrat Maltodextrin, mobilisasi dini dan mengunyah permen, terbukti berhasil meningkatkan pemulihan perawatan pasien pembedahan sistem pencernaan.

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The purpose of Clinical learning practice during Medical Surgical Nursing Residency Program, with specialisation in digestive, is to facilitate the student in developing capability to perform the roles of nurse specialist as advanced nursing care provider, educator, advocator, counselor, collaborator, innovator and researcher. Advance nursing care provider role is implemented by using Roy Adaptation Model on pancreatic carcinoma patiet and 30 other digestive cases. Evidence Based Nursing Practice as other character of nurse specialist practice was performed by applying animal naming test ANT to identify cognitive problem in hospitalized cirrhotic patients. It is based on the importance for nurse to recognize early cognitive dysfunction to provide better nursing care especially in latent asymptomatic hepatic encephalopathy that common happens in cirrhosis patient. ANT was tested on 16 hospitalized cirrhotic patients and succeeded in identifying more cirrhosis patient with cognitive dysfunction compared to available assessments in ward. The innovation program which was implementing ERAS activities carbohydrate loading, early mobilization and chewing gum have proven to be effective perioperative management in digestive surgery. "

"Analisis Praktik Residensi Keperawatan Medikal Bedah dan Studi Kasus Pemberian Asuhan Keperawatan Pada Pasien Akalasia Esofagus Dengan Pendekatan Model Adaptasi Roy Di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo Jakarta Abstrak Pendahuluan: Pelaksanaan praktek klinik selama masa residensi keperawatan peminatan digestif bertujuan untuk mampu menampilkan peran perawat spesialis sebagai pemberi asuhan keperawatan lanjut, pendidik, advokat, konselor, kolaborator, pembaharu dan peneliti. Peran pemberi asuhan keperawatan lanjut dilakukan dengan menggunakan Model Adaptasi Roy pada pasien Akalasia Esofagus dan 30 pasien lainnya. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologis dengan diagnosa keperawatan ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Intervensi keperawatan berupa manajemen nutrisi ditujukan untuk meningkatkan adaptasi pasien dalam mencapai status nutrisi. Evidence Based Nursing dilakukan dengan menerapkan pemberian minuman maltodekstrin pada pasien pra operasi elektif pada dua pasien untuk mengatasi mual, muntah dan nyeri pasca operasi, diperoleh hasil keluhan mual dan muntah tidak ada sama sekali pada 0-24 jam pasca operasi, sedangkan keluhan nyeri ringan masih dirasakan pada satu pasien. Program inovasi kelompok berupa penerapan protokol ERAS yaitu pemberian maltodekstrin pra operasi, mengunyah permen karet pasca operasi dan mobilisasi dini 2 jam pasca operasi terbukti efektif mengatasi keluhan mual dan muntah pasca operasi, meningkatkan motilitas usus dan mencegah nyeri bahu pasca operasi.

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Analysis of Medical Surgical Nursing Residency Practice and Case Study of Nursing Care Delivery on Achalasia Oesophagoes Using Roy Adaptation Model ApproachAbstractImplementation of clinical practice during the residency of digestive nursing aims to be able to showcase the role of specialist nurse as advanced nursing care provider, educator, advocator, counselor, collaborator, innovator and researcher. Role of specialist as advance nursing care provider was done by using Roy Adaptation Model on Achalasia Oesophagus and 30 other patients. Maladaptive behavior at most is a physiological adaptation mode with imbalanced nutrition: less than body requirement nursing diagnosis. Nursing outcome of nutrition management is aimed at improving patient adaptation in gaining nutrition status. Evidence Based Nursing was performed by applying preoperative oral carbohydrate loading to two patients undergoing laparoscopy cholesystectomy for relieving post operative nausea and vomiting. The innovation program was implementing ERAS protocol e.g preoperative oral carbohydrate loading, chewing gum and early mobilization proved effective as nursing intervention in pre and post operative management. "