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"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."

"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."

"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."

"Ruam popok merupakan masalah yang sering terjadi pada bayi prematur. Penelitian ini bertujuan untuk mengetahui pengaruh perawatan perianal dengan menggunakan tisu basah berbahan dasar air terhadap derajat ruam popok pada bayi prematur. Desain menggunakan uji acak terkontrol dengan pendekatan pre dan post test pada 40 responden dengan simple random sampling (n1=n2=20). Kelompok intervensi diberikan perawatan perianal dengan menggunakan tisu basah berbahan dasar air dan kelompok kontrol diberikan perawatan perianal dengan menggunakan kapas dan air. Perlakuan perawatan perianal dilakukan selama 4 hari. Penilaian kondisi kulit perianal dilakukan dengan menilai derajat ruam popok menggunakan Scoring System for Diaper Dermatitis Scale. Meskipun hasil penelitian menunjukkan tidak ditemukan perbedaan signifikan skor ruam popok antara kedua kelompok (p>0,01), perawatan perianal dengan menggunakan tisu basah berbahan dasar air cenderung lebih efektif dalam mempertahankan skor ruam popok setelah hari ketiga perlakuan. Pengamatan dengan waktu lebih lama dan jumlah sampel lebih besar dapat dilakukan untuk menilai pengaruh perawatan perianal terhadap skor ruam popok.

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Effect of perianal care using water-based wet wipes to degrees of diaper rash in premature infant. Diaper rash is a problem that often occurs in premature infants. This study aims to determine the effect of perianal care by using water-based wet wipes on the degree of diaper rash in premature infants. The design uses randomized controlled trials with a pre and post test approach on 40 respondents with simple random sampling (n1 = n2 = 20). The intervention group was given perianal care using water-based wet wipes and the control group was given perianal treatment using cotton and water. Perianal treatment is carried out for 4 days. Assessment of perianal skin conditions was carried out by assessing the degree of diaper rash using the Scoring System for Diaper Dermatitis Scale. Although the results showed no significant differences in diaper dermatitis scores between the two groups were found (p> 0.01), perianal treatment using water-based wet wipes more effective in preventing the occurrence of diaper rash in premature infants. Longer time observations and larger sample sizes can be done to assess the effect of perianal care on diaper rash scores.

"

"Bayi prematur rentan untuk mengalami ketidakstabilan fungsi fisiologis dan postur yang asimetris akibat imaturitas organ. Tujuan penelitian ini adalah untuk mengidentifikasi pengaruh modifikasi nesting dengan fiksasi terhadap fungsi fisiologis dan postur. Penelitian ini menggunakan desain randomized controlled trial dengan tipe cross over dilakukan disalah satu rumah sakit umum pusat di Jakarta, dengan melibatkan 32 bayi prematur yang memenuhi kriteria inklusi. Intervensi terdiri dari modifikasi nesting dengan fiksasi (A) dan kelompok kontrol menggunakan perawatan rutin (B). Hasil dari penelitian ini menunjukkan bahwa terdapat perbedaan bermakna saturasi oksigen, frekuensi nadi, dan postur pada kelompok intervensi (A) dibandingkan dengan kelompok kontrol yang hanya mendapatkan perawatan rutin (B) (P<0,05). Modifikasi nesting dengan fiksasi merupakan asuhan perkembangan yang efektif untuk memfasilitasi fungsi fisiologis dan postur simetris pada bayi prematur, sehingga perlu diaplikasikan di unit perawatan intensif neonatus.

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Preterm infant vulnerable to experience unstable physiological function and asymmetric posture due to organ immaturity. The objective of this study was to identify the effect of modification nesting with the fixation on physiological function and posture. This study using a randomized controlled trial conducted in a general hospital Jakarta, by involving 32 preterm infant who met the inclusion criteria. The intervention consisted of Modification nesting with fixation (A) and control group with routine care (B). The result of this study showed that significant difference between modification nesting with fixation group (A) to the control group (B) (p<0,05). Modification nesting with fixation is effective developmental care to facilitate physiological function and symmetrical posture in preterm infants. Therefore, the application of modification nesting with fixation is needed in the neonatal intensive care unit."

"Bayi prematur lahir dengan berbagai permasalahan kesehatan dan membutuhkan perawatan khusus yang dapat menyebabkan kecemasan dan stres orang tua. Kualitas asuhan keperawatan yang bermutu dengan menerapkan asuhan perkembangan dapat dinilai dengan kepuasan orang tua. Penelitian ini bertujuan mengetahui hubungan penerapan asuhan perkembangan yang dipersepsikan oleh perawat dengan kepuasan orang tua bayi prematur di ruang neonatus. Penelitian kuantitatif dengan desain cross sectional ini menggunakan sampel berjumlah 52 perawat dan 52 orang tua bayi prematur. Tehnik pengambilan sampel yang digunakan adalah consecutive sampling Data dikumpulkan menggunakan kuesioner dan dianalisis menggunakan pearson. Hasil analisis menunjukkan terdapat hubungan yang bermaksna antara penerapan asuhan perkembangan dengan kepuasan orang tua bayi prematur (p value <0,001, p<0,05). Penerapan asuhan perkembangan yang baik dapat meningkatkan kualitas perawatan terhadap bayi dan juga meningkatkan kepuasan orang tua. Asuhan perkembangan perlu diterapkan di ruang neonatus sebagai upaya meningkatkan asuhan keperawatan pada bayi dan kepuasan orang tua.

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Premature infants born with several of health problems and needs special care can cause anxiety and stress of parents. A qualified nursing care by implementing developmental care can be assessed through parent satisfaction of premature infants. This study aims to recognize the relationship of developmental care application perceived by nurse with parental satisfaction of premature infants in neonatus care unit. This quantitative study used cross sectional design. The sample included 52 neonatus nurses and 52 parents of premature infants used consecutive sampling method. Data were collected using a questioners and analyzed using Pearson.

The analysis results show that there is significant relationship between developmental care applications with parent satisfaction of premature infants (p value=<0,001, p<0,05). The application of developmental care in premature infants may improve the quality of care and increase parens satisfaction. Developmental care need to be implemented as an effort to improve nursing care of infants and parents satisfaction."

"Breastmilk is the best nutrition for infant but giving only breastmilk for preamature infants older than 2 weeks could not comply the needs and has to be fortified Human milk fortifier HMF is very recommended to fortify breastmilk In west Sumatera including DR M Djamil Hospital HMF was unreachable and expensive At certain hospital in Africa and several Hospital in United States they exclusively use fortified breastmilk with Post Discharge Formula PDF Objective To compare the weight gain among premature infants receiving fortified breastmilk with PDF and premature formula milk and also to observe the adverse event Methods A 4 weeks experimental study on premature infants gestational age ge 28 until 37 weeks who receive fortified breastmilk with PDF and some of them received premature formula milk acted as a control from March until December 2015 in DR M Djamil Hospital West Sumatera Results Data was obtained from 30 sample for each group intervention and control Sample baseline characteristic such as sex gestational age GA birth weight and previous illness history was indifferent statistically The mean of birth weight in control group was 1643 grams the mean of weight at the initial study was 1631 grams and the mean of birth weight at the end of study 4 weeks was 2573 grams The mean of birth weight in intervention group was 1682 grams the mean of weight at the initial study was 1722 grams and the mean of birth weight at the end of study 4 weeks was 2775 grams The mean of time to reach full feed condition initial study in control group was 14 days and 18 days in intervention group The mean of weight gain during 4 weeks was 958 grams in control group and 1053 grams in intervention group p 0 22 There was no adverse event found in infants received both breastmilk fortified with PDF and premature formula milk Conclusion It appears that weight gain of premature infants who receive breastmilk fortified with PDF is indifferent statistically compared with premature infants who receive formula milk There is no adverse event found in this study"

"ABSTRAKDisertasi ini membahas pengaruh asfiksia pada bayi prematur terhadap kualitas hidup anak usia 2-4 tahun, dengan desain kohort retrospektif. Data asfiksia diperoleh dari catatan medik RSUP Dr. Sardjito, sedangkan kualitas hidup anak dinilai menggunakan PedsQL. Analisis data menggunakan regresi cox.Hasil penelitian menunjukkan ada pengaruh asfiksia terhadap kualitas hidup anak dengan RR: 2,2 (CI: 1.19-4.08). Asfiksia berpengaruh pada fungsi fisik dengan RR: 2,4 (CI: 1.33-4.36) dan fungsi sosial RR: 2,4 (CI: 1.36-4.15) tetapi tidak bermakna pada fungsi emosi RR: 1.4 (CI: 0.86-2.29) dan fungsi sekolah RR: 1.2 (CI: 0.63-2.31).

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ABSTRACT

This dissertation discusses the association of asphyxia in premature infants to the quality of life of children aged 2-4 years with retrospective cohort design. Asphyxia data were obtained from the medical records of Dr. Sardjito hospital, while the quality of life of children data were assessed using PedsQL. Data were analyzed using Cox regression.

The results of study showed strong association of asphyxia to the quality of life of children with RR: 2.2 (CI: 1:19 to 4:08). Risk of asphyxia effects on physical function was RR: 2.4 (CI: 1:33 to 4:36) and on social functioning was RR: 2.4 (CI: 1:36 to 4:15). However, the risk was not significant to the emotional function with RR: 1.4 (CI: 0.86-2.29 ) and school functions RR: 1.2 (CI: 0.63-2.31)."

"Bayi prematur sangat rentan mengalami gangguan integritas kulit berupa lukatekan terutama pada telinga. Tujuan penelitian ini adalah untuk mengetahuiefektivitas penggunaan bantal kacang untuk pencegahan luka tekan grade I padatelinga bayi prematur. Desain penelitian ini menggunakan “quasi experimentposttest only with control group”, yang melibatkan 30 bayi prematur di ruangperinatologi. Hasilnya menunjukkan tidak ada perbedaan yang bermakna proporsikejadian luka tekan grade I pada telinga bayi prematur pada kelompok intervensidan kelompok kontrol (p value=0,65, α=0,05). Rekomendasi dari penelitian iniadalahperawatan dengan bantal tetap bermanfaat namun perlu dilakukanoptimalisasi alih baring.

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Preterm baby was very vulnerable to get skin integrity breakdown as pressure

ulcer particularly on the ear. The purposed of this study was to identify the

effectiveness using peanut pillow to prevent pressure ulcer on ears of preterm

baby. The design of this study was “experiment posttest only with control group”,

involving 30 preterm baby in the neonatology unit. The result showed there was

no significant differences proportion of pressure ulcer in the intervention group

and control group (p value=0,65, α=0,05). This study recommended that using

peanut pillow give the advantages but it is needed to optimize changing position."

"Pengontrolan suhu tubuh sangat penting pada bayi prematur karena fluktuasi suhu meningkatkan ketidakseimbangan tingkat metabolisme bayi baru lahir. Pengaturan suhu tubuh yang buruk menjadi sasaran faktor lingkungan yang dapat menyebabkan kehilangan panas yang cepat sehingga rentan terhadap peningkatan risiko morbiditas dan mortalitas akibat hipotermia. Tujuan dari penelitian ini untuk mengetahui penerapan teori Konservasi  Levine dalam mengatasi masalah risiko termoregulasi tidak efektif pada bayi baru prematur di ruang Perinatologi. Model Konservasi Levine berfokus pada peningkatan adaptasi dan mempertahankan integritas diri (wholeness) dengan menggunakan prinsip konservasi. Masalah risiko termoregulasi tidak efektif merupakan salah satu gambaran terganggunya konservasi energi mencakup ketersediaan dan pengeluaran energi bayi baru lahir dan menyebabkan terjadinya peningkatan konsumsi oksigen dengan mempertahankan fungsi normal termogenesis

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Body temperature control is very important in preterm infant because temperature fluctuations improve the balance. Poor body temperature regulation is the target of environmental factors that can cause rapid heat loss, making them susceptible to an increased risk of morbidity and mortality due to hypothermia. The purpose of this study was to determine the application of Levine's Conservation theory in overcoming the problem of ineffective thermoregulation risk in premature newborns in the Perinatology room. Levine's Conservation Model focuses on increasing adaptation and maintaining wholeness using conservation principles. The problem of the risk  ineffective thermoregulation is one of the features of the disruption energy conservation and energy expenditure of baby and causes an increase in oxygen consumption by maintaining normal thermogenesis function.

 

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