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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."

"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."

"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. ;;"

"[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. ]"

"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."

"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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"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.

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"Salah satu masalah yang dialami bayi prematur yaitu hipotermia dan dapatberdampak pada kematian bayi. Penelitian ini bertujuan untuk menganalisis efektivitas penggunaan lampu sorot dan PMK terhadap suhu tubuh bayi prematur di ruang Peristi RSUD Dr. Soesilo Slawi. Desain penelian yang digunakan dalam penelitian ini yaitu quasi experiment dengan pre-post test without control grup design pada 14 bayi prematur dengan teknik consecutive sampling. Analisis data menggunakan paired t test. Penelitian menujukkan adanya perbedaan yang bermakna antara selisih rerata suhu tubuh pada intervensi lampu sorot dan PMK yaitu pada intervensi lampu sorot 0,11°C dan intervensi PMK yaitu 0,65°C sehingga dapat disimpulkan PMK lebih efektif dalam meningkatkan suhu dibandingkan lampu sorot. Berdasarkan hasil ini maka PMK dapat direkomendasikan menjadi salah satu alternatif asuhan keperawatan dalam mengatasi suhu tubuh pada bayi prematur.

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One of the problems experienced by premature infant is hipothermia may have an impact on mortality. This study aimsed to analyze the effectiveness of the incandescent lamps and KangarooMother Care for the body temperature in premature infant. The study was quasi experimental with pre-post test without control group design consisted of 14 premature infants taken by consecutive sampling. Analysis result using paired t test showes significant difference in mean body temperature of incandescent lamps is 0,11 ° C and intervention KMC is 0.65 ° C so that it can be concluded KMC is more effective to increased the body temperature than incandescent lamps. Recommendation for the nursing care is KMC can be an alternative for nursing care in dealing with body temperature in preterm infants."