Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAK Analisis Praktik Residensi Keperawatan Medikal Bedah pada Pasien Gangguan Sistem Neurologi dengan Kasus Cedera Kepala Menggunakan Pendekatan Model Adaptasi Roy di Rumah Sakit Cipto MangunkusumoJakarta Megawati SibuloJanuari 2018 AbstrakPraktek residensi keperawatan kekhususan neurologi dalam penerapannya sebagai Clinical Care Manager CCM dimaksudkan sebagai pemberi perawatan langsung direct care , konsultan, edukator, kolaborator, dan pembuat keputusan klinis dalam memberikan asuhan keperawatan Model Adaptasi Roy pada pasien dengan gangguan sistem neurologi, berperan sebagai mentor coach dan peneliti researcher dalam penerapan Evidence Based Nursing EBN . Selain itu, spesialis keperawatan berperan sebagai pemimpin leader dalam penerapan proyek inovasi. Penerapan model adaptasi Roy pada pasien cedera kepala dan 30 pasien lainnya dengan berbagai gangguan sistem persarafan. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologi, yaitu risiko ketidakefektifan perfusi jaringan serebral. Intervensi keperawatan berupa cerebral management dan cerebral perfusion promotion bertujuan meningkatkan adaptasi pasien dalam memperbaiki perfusi jaringan serebral. Pada penerapan EBN dengan menggunakan format Neurogenic Bowel Dysfunction NBD score terhadap 14 pasien dalam menilai gangguan defekasi pasien menunjukkan sensitifitas terhadap kejadian gangguan defekasi pada pasien. Program inovasi penerapan media edukasi melalui video diharapkan dapat meningkatkan kesadarn diri pasien dan keluarga terhadap kejadian stroke berulang dan membantu mempermudah perawat dalam melakukan edukasi. ABSTRACT Analysis of Medical Surgical Nursing Residency Practice on NeurologicalSystem Disorders with Head Injury Case Using Roy Adaptation Model Approach at Cipto Mangunkusumo Hospital in Jakarta Megawati SibuloJanuary 2018 AbstractThe practice of nursing residency of neurological specificity in its application as Clinical Care Manager CCM are intended as a direct care provider, consultant, educator, collaborator, and clinical decision maker in providing Roy Adaptation Model nursing care in patients with neurological system disorders, mentors coach and researchers in the application of Evidence Based Nursing EBN. In addition, nursing specialists serve as leaders in implementing innovation projects. Applying Roy 39 s adaptation model to head injury patients and 30 other patients with various neural system disorders. The most maladaptive behavior is the physiological adaptation mode, ie the risk of perfusion of cerebral tissue perfusion. Nursing interventions of cerebral management and cerebral perfusion promotion aim at improving adaptation of patients in improving cerebral tissue perfusion. In the application of EBN using the format of Neurogenic Bowel Dysfunction NBD score of 14 patients in assessing defective disorder patients showed sensitivity to the incidence of defective disorders in patients. The innovative application program of educational media through video is expected to increase patient and family awareness of recurrent stroke incidents and help facilitate the nurse in doing the education.Keywords Defecation disorders, NBD score, neurological system disorders, head injury, Roy 39 s Adaptation Model. "

"ABSTRAK Keperawatan menurut Mc Mahon merupakan terapi yang melibatkan tiga 3 komponen yaitu partnership, intimate dan reciprocity disetiap tindakan keperawatan. Begitu juga yang harus dilakukan oleh perawat ners spesialis atau perawat lanjutan. Pelaksanaan praktik residensi keperawatan khususnya neurologi dilakukan sebagai bagian dari proses untuk mencapai pendidikan perawat ners spesialis. Perawat ners spesialis dalam memberikan asuhan keperawatan harus memiliki tujuh kompetensi yaitu memberikan pelayanan langsung, konsultasi, kepemimpinan, kolaborasi, pendidikan, penelitian dan pengambil keputusan yang mengedepankan etik. Rangkaian pendidikan spesialis keperawatan ini adalah mengelola kasus utama, menyusun kasus resume yang dilaporkan sebanyak 30 pasien dengan gangguan neurologi, melakukan Eviden based Nursing EBN latihan Menelan dengan madu pada pasien disfagia serta melakukan inovasi membuat video edukasi. Kasus terbanyak selama praktik adalah stroke dan diagnosis keperawatan terbanyak yaitu resiko ketidakefektifan perfusi jaringan serebral, gangguan mobilisasi dan gangguan pemenuhan kebutuhan personal hygine.. Rekomendasi: analisis lebih dalam tentang latihan menelan dengan madu dan analisis kognitif, afektif dan psikomotor yang diperoleh saat menggunakan video edukasi pada pasien ABSTRACT Nursing in Mc Mahon say that nursing is a therapy that involves three 3 components of partnership, intimate and reciprocity in every action of nursing. So also must be done by a specialist nurse nurse or advanced nurse. Implementation of nursing residency practices, especially neurology is done as part of the process to achieve specialist nurse education. The role of nurse specialist in providing nursing care should have seven competencies that is to provide direct services, consultation, leadership, collaboration, education, research and decision makers that put ethics forward. This series of nursing specialist education is managing the main case, compiling 30 reported cases of patients with neurological disorders, performing an Evidence based Nursing EBN and innovating with patients with neurological disorders. The most cases during the practice were stroke and the most common nursing diagnoses were the risk of perfusion of cerebral tissue, impaired mobilization and impaired fulfillment of personal hygine needs. EBN is a swallowing exercise with honey and the implementation of group innovation to make educational videos to increase self awareness and family against the risk of recurrent stroke. Recommendations deeper analysis of swallowing exercises with honey and cognitive, affective and psychomotor analyzes obtained when using educational videos in patients"

"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."

"Karya ilmiah akhir ini merupakan laporan praktik residensi keperawatan medikal bedah yang terdiri dari pengelolaan kasus stroke hemoragik dan 30 kasus resume dengan pendekatan Model Adaptasi Roy MAR , penerapan evidence based nursing EBN untuk skrining penegakan diagnosa gangguan menelan pada pasien stroke fase akut dan melakukan proyek inovasi tentang pemberdayaan caregiver pada pasien stroke dengan edukasi terstruktur. Perilaku maladaptif paling banyak terdapat pada mode fisiologis dengan masalah keperawatan resiko ketidakefektifan perfusi jaringan serebral. Pengkajian dengan pendekatan MAR bisa diterapkan pada pasien dengan gangguan neurologi di ruangan. The Barnes-Jewish Hospital Stroke Dysphagia Screen BJH-SDS bisa diterapkan dengan memiliki sensitivitas 100 dan spesivisitas 100 . Budaya pengembangan intervensi keperawatan berdasarkan EBN diharapkan bisa terus terbangun di tatanan klinik. Pada inovasi keperawatan terdapat peningkatan rata-rata pengetahuan dan ketrampilan caregiver setelah pemberian edukasi terstruktur pValue.

---

This final scientific paper is a report of medical surgical nursing of residency practice which consists of the management of cases of hemorrhagic stroke and 30 cases of resume with the approach Roy rsquo s Adaptation Model RAM , the application of evidence based nursing EBN to screen for enforcement diagnosis of swallowing disorders in stroke patients in the acute phase and undertake innovation projects on empowering caregivers in stroke patients with a structured education. Maladaptive behavior are most numerous in the physiological mode with nursing problems ineffectiveness risk of cerebral tissue perfusion. RAM assessment approach can be applied to patients with neurological disorders in the hospital. The Barnes Jewish Hospital Dysphagia Stroke Screen BJH SDS can be applied with a sensitivity of 100 and specificity of 100. Cultural development of nursing interventions based EBN is expected to continue to awaken in order clinic. On the innovation of nursing there is an average increase knowledge and skills caregiver after administration of structured education pvalue."

"Praktik residensi merupakan praktik profesi untuk membentuk perawat spesialis. Tujuan praktik residensi adalah memberikan gambaran praktik residensi keperawatan medikal bedah pada pasien dengan gangguan neurologi dengan pendekatan teori keperawatan Model Adaptasi Sister Callista Roy, penerapan evidence based nursing dan penerapan proyek inovasi keperawatan. Praktik residensi ini dilakukan selama dua semester di RSUP dr. Cipto Mangunkusumo dan RSP Otak Nasional.Hasil praktik didapatkan adanya asuhan keperawatan lanjut menggunakan Model Adaptasi Roy (1 kasus kelolaan utama dan 30 kasus resume), dilaksanakan penerapan praktik berdasarkan bukti menggunakan format BBS untuk pengkajian keseimbangan pada pasien stroke, serta penerapan proyek inovasi dengan pemberian edukasi perawatan pasien post kraniektomi berbasis media audiovisual (video) bagi pasien dan care giver.

---

Practice residency is a profesional practice to form specialist nurses. The purpose in practice residency is give the description residency practice medical surgical nursing for neurology distrubance patient using Roys Adaptation Model, implementation evidence based nursing and nursing innovation project. This practice residency is done in two semester in RSUPN dr. Cipto Mangunkusumo and RSP Otak Nasional.The result is advance nursing care in the neurologi area using Roys Adaptation Model (1 main case and 30 cases of resume), application of evidence-based practice, the BBS format is used for assessing balance in stroke patient, and implemented the innovation project is the Education of Post Craniectomy Care Using Audiovisual Media (Video) for Patient and Care Giver."

"Program spesialis keperawatan medikal bedah khususnya neurologi dimaksudkan untuk menjadikan seorang perawat spesialis neurosains yang berperan dalam praktik keperawatan berupa pemberi asuhan keperawatan lanjut, melakukan pembuktian ilmiah dan agen pembaharu. Asuhan keperawatan dilakukan pada kasus pasien dengan cedera kepala dan 31 pasien dengan gangguan neurologis dengan pendekatan Model adaptasi Roy (RAM). Perilaku maladaptif paling banyak terganggu pada mode fisologis dengan diagnosis penurunan kapasitas adaptif intrakranial. Evidence Based Nursing dilakukan dengan menerapkan sistematik oral care pada 12 pasien gangguan neurologis dengan hasil yang signifikan (p value 0,004). Program inovasi menerapkan pemberdayaan caregiver pasien stroke dengan hasil perbedaan pengetahuan dan keterampilan caregiver melalui edukasi dan demonstrasi (p value <0.005). Pengkajian perilaku dan stimulus pada RAM perlu diterapkan pada pengkajian pada pasien gangguan neurologis. Intervensi keperawatan diharapkan berbasis pada evidence based nursing. Pemberdayaan caregiver pada pasien gangguan neurologis khususnya stroke perlu dilakukan sejak dini untuk menyiapkan caregiver dalam merawat pasien gangguan neurologis.

---

Nurse specialist program of medical surgical nursing especially neurological nurses proposed neuroscience nurse specialist play role in nursing practice as advanced nursing care providers, conduct scientific evidence and innovator. Roy adaptation model approach was used in the nursing care of the head injury patients and 31 patients of neurological disorders cases. Decreased intracranial adaptive capacity was the most often of nursing diagnosis enforced which was caused maladaptive behavior in physiological mode. Evidence based nursing was implemented by practice systematic oral care in 12 neurological disorders patients that showed oral assessment score differed significantly (p value 0,004). Role as an innovator was implemented by engage caregiver empowerment through education and demonstration in stroke patients that showed there was differences in the knowledge and skills of the caregivers (p value <0.005). Roy adaptation model can be one effective approach for the assessment of the neurological disorders patients. Nursing interventions are expected to always be based on evidence based nursing. Early caregiver empowerment in neurological disorders patients especially stroke is required to set up the caregivers in caring of the patients."

"Pasien dengan kasus cedera/trauma spinal memerlukan perawatan yang komprehensif dan mungkin akan membutuhkan waktu yang lama untuk pasien dapat beradaptasi dengan perubahan-perubahan yang terjadi pada dirinya. Selama pasien menjalani masa perawatan di rumah sakit, asuhan keperawatan yang tepat diberikan kepada pasien adalah dengan model konsep teori adaptasi Roy. Asuhan dengan pendekatan model adaptasi ini menjadi pilihan yang sesuai untuk kasus-kasus perawatan jangka panjang sehingga pasien dapat menjalani kehidupan lanjutan pasca perawatan dengan baik, mengembalikan kemandirian, kepercayaan diri terutama konsep gambaran diri dan status peran di masyarakat. Perawat dengan pendidikan spesialis harus mampu menjalankan berbagai peran terutama sebagai Clinical Care Manager, dengan demikian peningkatan layanan keperawatan di rumah sakit dapat dicapai dengan lebih optimal dan memberikan kepuasan pelanggan. Adapun pasien dengan masalah neurologis yang menjalani perawatan jangka panjang, immobilisasi dan disabilitas akan beresiko besar terhadap kejadian thrombosis vena dalam, dengan demikian perlu adanya suatu model asesmen penilaian resiko sehingga pencegahan dan tatalaksana terhadap kondisi tersebut dapat dilakukan lebih dini agar pasien terhindar dari komplikasi perawatan dan meningkatkan keselamatan pasien selama perawatan di rumah sakit. Laporan analisis praktek ini membahas mengenai asuhan keperawatan pada pasien dengan cedera spinal dengan menggunakan pendekatan model konsep adaptasi Roy, resume 30 kasus pasien dengan gangguan neurologis di RSCM dan RS PON Jakarta, laporan praktik keperawatan berbasis fakta yaitu model asesmen resiko kejadian thrombosis vena dalam dan inovasi keperawatan. Diharapkan laporan karya ilmiah akhir ini dapat menjadi salah satu informasi untuk pengembangan pendidikan keperawatan spesialis terutama perawat yang memberikan layanan kepada pasien dengan gangguan neurologis.

---

Patients with spinal injuries or neurological disorders require comprehensive care and it may take a long time for the patient to adapt with the changes. During the patient's stay in the hospital, appropriate nursing care should be given to the patient, using the Roy adaptation theory concept model. This model is one of the best appropriate nursing care approach for long-term care cases so that patients can lead a good post-treatment life, restore independence, self-confidence, especially the concept of self-image and role status in society. Nurses with specialist education must be able to carry out various roles, especially as a Clinical Care Managers, thus improving nursing services in hospitals can be achieved more optimally and provide customer satisfaction. As for patients with neurological problems who undergo long-term care, immobilization and disabilities will be at great risk for the incidence of deep vein thrombosis, thus it is necessary to have a risk assessment model so that prevention and management of these conditions can be carried out earlier to avoid complications of treatment and improve patient safety during hospitalization. This practice analysis report discusses nursing care in patients with spinal injuries using Roy's adaptation concept model approach, resumes of 30 cases of patients with neurological disorders at RSCM and PON Jakarta Hospital, reports on fact- based nursing practice, namely a model of risk assessment for deep vein thrombosis and innovation. nursing. It is hoped that this final scientific paper report can be one of the information for the development of specialist nursing education, especially nurses who provide services in neuro care unit."