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"Analisis praktik residensi keperawatan medikal bedah merupakan karya ilmiah akhir Ners Spesialis. Bertujuan untuk memberikan gambaran secara umum proses pelaksanaan praktik residensi keperawatan medikal bedah yang dilaksanakan dalam dua semester. Analisis ini terdiri dari kasus kelolaan utama pada gangguan sistem neurologi dengan kasus astrositoma dan 30 kasus resum menggunakan pendekatan model adaptasi Roy, penerapan evidence based nursing (EBN) dan proyek inovasi. pada kasus kelolaan masalah masalah ketidakefektifan perfusi cerebral teratasi dan pada 30 kasus resum diagnosa terbanyak yaitu risiko jatuh dan ketidakefektifan perfusi cerebral. untuk peneraan evidence based nursing tentang Tongue stretching exercises (TSE) pada pasien stroke dengan gangguan menelan dan terbukti dapat meningkatan gerakan lidah dalam proses menelan. Untuk proyek inovasi melakukan tatalaksana perawatan pasca stroke terkini. Banyak manfaat yang didapatkan selama proses praktik residensi diantaranya melatihan berpikir kritis dalam mengelola kasus sulit, melatih keterampilan praktik, dan menerapkan intervensi berdasarkan bukti ilmiah. Diharapkan bagi bagi perawat untuk memberikan intervensi keperawatan berdasarkan bukti ilmiah dan selalu berlatih dalam berpikir kritis agar memiliki tingkat sensitifitas dalam melihat fenomena masalah pada pasien.

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Analysis of practice medical surgical nursing residency is the final scientific work of Specialist Nursing. The aim is to provide an overview of the process of implementing medical surgical nursing residency practices that got in two semesters. This analysis consists of cases of major management in neurological system disorders with astrocytoma cases and 30 cases of rums using Roy's adaptation model approach, application of evidence based nursing (EBN) and innovation projects. The case of managed cerebral perfusion problems the problem is managed and in 30 cases the most common diagnoses are the risk of falls and the ineffectiveness of cerebral perfusion. For evidence based nursing information about Tongue stretching exercises (TSE) in stroke patients with swallowing disorders and is proven to increase tongue movement in the swallowing process. Innovation projects carry out the latest post-stroke care management. Many benefits got during the residency practice process include training critical thinking in managing difficult cases, practicing practical skills, and implementing interventions based on scientific evidence. Hope is expected for nurses to provide nursing interventions based on scientific evidence and always practice critical thinking in order to have a sensitivity level in seeing the phenomenon of problems in patients."

"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.

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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."

"Analisis praktik residensi keperawatan medikal bedah merupakan karya ilmiah akhir ners spesialis. Analisis ini terdiri dari asuhan keperawatan pada gangguan sistem neurologi dengan kasus utama toksoplasmosis ensefalitis dan 30 kasus resume menggunakan pendekatan model adaptasi Roy, penerapan evidence based nursing tentang latihan motor imagery untuk meningkatkan keseimbangan pasien stroke, penerapan proyek inovasi tentang edukasi berbasis audio visual (video) perawatan pasien post kraniektomi. Teori model adaptasi Roy bertujuan untuk memodifikasi dan mengubah stimulus sehingga pasien dapat adaptif terhadap kondisi kesehatannya. Toksoplasmosis ensefalitis merupakan salah satu kasus emergensi neurologi pada HIV yang memerlukan penatalaksanaan yang serius. Latiham motor imagery dapat meningkatkan keseimbangan pada pasien stroke, dapat dilanjutkan di rumah secara teratur oleh pasien untuk membantu proses rehabilitasi. Edukasi berbasis audio visual (video) perawatan pasien post kraniektomi dapat meningkatkan pengetahuan dan keterampilan pasien dan keluarga dalam merawat pasien post kraniektomi untuk mencegah terjadinya komplikasi dan membantu proses penyembuhan.

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Analysis of the practice of residency in medical surgical nursing is the final scientific work of specialist nurses. This analysis consisted of nursing care in neurological system disorders with the main cases of toxoplasmosis encephalitis and 30 cases of resumes using Roy's adaptation model approach, the application of evidence based nursing about motor imagery exercises to improve the balance of stroke patients, the application of innovation projects on audio-visual (video) based education treatment of post craniectomy patients. Roys adaptation model theory aims to modify and change stimulus so that patients can be adaptive to their health conditions. Toxoplasmosis encephalitis is one of the neurological emergency cases in HIV that requires serious management. Motor imagery exercises can improve balance in stroke patients, can be continued at home regularly by patients to assist the rehabilitation process. Audio visual (video) based care for post craniectomy patients can improve the knowledge and skills of patients and families in treating post craniectomy patients to prevent complications and help the healing process."

"Spesialis keperawatan medikal bedah(KMB)khususnya neurologi membentuk nersspesialis neurosains yang berperan dalam praktik residensi selama 2 semester di RSUP dr. Cipto Mangunkusumo dan RSP Otak Nasional untuk memberikan asuhan keperawatan lanjutan, melakukan Evidence Based Nursing dan penerapan inovasi. Asuhan keperawatan yang dilakukan pada satu kasus utama ensefalitis autoimundan 30 pasien resume dengan gangguan neurologis menggunakan pendekatan Model adaptasi Sister Callista Roy. Ensefalitis autoimun merupakan salah satu kasus emergensi neurologi yang memerlukan penata laksanaan cepat dan tepat agar gejala sisa yang ditimbulkan menjadi adaptif. Diagnosa keperawatan pada kasus resume yang terbanyak adalah ketidak efektifan perfusi jaringan serebral. Selanjutnya Evidence Based Nursing dilakukan dengan menerapkan sleep hygiene yang menunjukkan adanya peningkatan kualitas tidur yang signifikan pada 5 pasien stroke dengan insomnia(p value 0,00). Kompetensi ners spesialis yang harus dicapai secara berkelompok adalah penerapan inovasi berupa tata laksana perawatan stroke terkini dengan Constraint Induced Movement Therapy (CIAT), Tongue stretching exercises(TSE), Constraint Induced Movement Therapy (CIMT),sit to stand training(STS),mirror therapy(MT)dan sleep hygiene(SH) sebagai aktivitas intervensi terbaru dengan masalah gangguan bicara dan bahasa, kesulitan menelan, gangguan mobilisasi,dan gangguan tidur yang diaplikasikan dapat membantu untuk mencegah terjadinya komplikasi dan membantu proses penyembuhan.

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Surgical medical nursing specialists (KMB) especially neurology,form neuroscience specialists who play a role in the practice of KMB residency for 2 semesters at RSUP dr. Cipto Mangunkusumo and RSP National Brain to provide advanced nursing care, conduct Evidence Based Nursing and apply innovation. Nursing processwas performed in one major case of autoimmune encephalitis and 30 patients resumed with neurological disorders using the Sister Callista Roy model adaptation approach. Autoimmune encephalitis is one of the cases of neurological emergencies that requires prompt and precise management, than complication becomes adaptive. The nursing diagnosis in most resume cases is the ineffectiveness of cerebral tissue perfusion. Furthermore Evidence Based Nursing was carried out by applying sleep hygiene which showed a significant improvement in sleep quality in 5 stroke patients with insomnia (p value 0.00). Special nurses competencies that must be achieved in groups are the application of innovations in the form of the latest stroke care management with Constraint Induced Movement Therapy (CIAT), Tongue stretching exercises (TSE), Constraint Induced Movement Therapy (CIMT), sit to stand training (STS), mirrors therapy (MT)and sleep hygiene(SH) as the newest intervention activities with speech and language problems, difficultyswallowing, impaired mobilization, and insomniacan help to prevent complications and help the healing process."

"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. "

"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.

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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."

"ABSTRAK Praktik residensi keperawatan neurologi bertujuan menerapkan peran perawat spesialissebagai pemberi asuhan keperawatan, agen pembaharu dan melakukan pembuktian ilmiah. Peran pemberi asuhan keperawatan dilakukan dalam mengelola kasus strokehemoragik dan 30 pasien dengan berbagai gangguan neurologi menggunakan modeladaptasi Roy. Perilaku mal adaptif terbanyak adalah mode adaptasi fisiologidiantaranya ketidakefektifan perfusi jaringan otak, hambatan mobilitas fisik dan risikojatuh. Intervensi keperawatan yang diberikan adalah manajemen edema serebral,ambulasi dan pencegahan jatuh.Tujuan intervensi untuk meningkatkan adaptasi pasiendalam meningkatkan perfusi jaringan otak, mobilisasi dan pencegahan jatuh. PenerapanEvidence Based Nursing EBN pemberian Positioning in Neutral LiN pada 12 pasiengangguan saaraf pusat yang mengalami hambatan mobilisasi fisik untuk meningkatkanrentang gerak sendi bahu dan panggul. Program inovasi yang dilakukan adalahpembuatan video edukasi faktor risiko stroke berulang untuk meningkatkan kesadaran diri pasien dan keuarga. Rekomendasi perlu dilakukan penelitian lebih lanjut tentangpengaruh LiN terhadap dekubitus dan kualitas hidup pasien stroke. ABSTRACT AbstractThe practice of neurological nursing residency aims at applying the role of specialistnurse as nurse care provider, reforming agent and doing scientific proof. The role of nursing care providers was done in managing cases of hemorrhagic stroke and 30 patients with various neurological disorders using Roy 39's adaptation model. Most adaptive malevolent behavior is the mode of adaptation of physiology such as ineffective perfusion of brain tissue, physical mobility barriers and the risk of falling.The nursing orders provided are management of cerebral edema, ambulation and prevention of falls. The aim of intervention to improve adaptation of patients in improving brain tissue perfusion, mobilization and prevention falls. Application of Evidence Based Nursing EBN of Positioning in Neutral LiN administration in 12 patients with central nervous disorders who experienced physical mobilization barriersto increase the range of motion of the shoulders and hip joints. The innovation program undertaken is the production of educational videos of recurrent stroke risk factors to increase patient and family awareness. Recommendations need further research on the effect of LiN on decubitus and the quality of life of stroke patients."

"ABSTRAK Praktek klinik lanjut selama masa residensi keperawatan pada sistem neurologi dimaksudkan untuk mampu memberikan asuhan keperawatan, menerapkan Evidence Based Nursing EBN serta mampu berperan sebagai inovator di ruang perawatan. Peran pemberi asuhan keperawatan dilakukan dengan menggunakan model adaptasi Roy pada pasien dengan miastenia gravis dan 30 pasien lainnya dengan berbagai gangguan sistem persarafan. Perilaku maladaktif paling banyak adalah mode adaptasi fisiologi, yaitu risiko ketidakefektifan perfusi jaringan serebral. Intervensi keperawatan berupa manajemen edema serebral ditujukan untuk meningkatkan adaptasi pasien dalam meningkatkan perfusi jaringan serebral. Penerapan EBN: Functional Oral Intake Scale FOIS pada sembilan pasien disfagia sebagai bentuk evaluasi kemampuan makan pasien menunjukkan sensitifitas terhadap kejadian aspirasi dan perubahan kemampuan makan pasien. Program inovasi penerapan format pengkajian tambahan dapat digunakan sebagai alat bantu bagi perawat dalam menegakan diagnosa keperawatan.ABSTRACT Advanced clinical practice in neurological system during the nursing residency period is proposed to be able to provide nursing care, implement the Evidence Based Nursing EBN and be able to act as an innovator in the treatment room. The role of nurse care provider was made using Roy 39 s adaptation model in patients with myasthenia gravis and 30 other patients with various neural system disorders. The most maladaptive behavior is the physiological adaptation mode is the risk of ineffective cerebral tissue perfusion. The nursing management intervention like cerebral edema is aimed to improve patient adaptation in enhancing cerebral tissue perfusion. Implementation of EBN Functional Oral Intake Scale FOIS in nine dysphagia patients as a evaluation form for feeding ability patients showed a sensitivity to occurrence of aspiration and changes in the patient 39 s eating ability. Implementation of additional asessment form as a innovation program can be used as a tool for nurses in determine nursing diagnoses."