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"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.

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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.

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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."

"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 klinik lanjut selama praktek residensi keperawatan pada sistem neurologi dimaksudkan untuk mampu memberikan asuhan keperawatan, menerapkan Evidence Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Peran pemberi asuhan keperawatan dilakukan dengan menggunakan model adaptasi Roy pada pasien dengan cedera kepala dan 30 pasien lainnya dengan berbagai gangguan sistem persarafan. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologi, yaitu ketidakefektifan perfusi jaringan cerebral. Intervensi keperawatan berupa manajemen edema cerebral ditujukkan untuk meningkatkan adaptasi pasien dalam meningkatkan perfusi jaringan cerebral. Penerapan EBN skrinning tool Trunk Impairment Scale. Program inovasi keperawatan berupa edukasi terhadap perawat dalam manajemen pasien pasca craniotomy dengan protokol ERAS.

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Advanced clinical practice during the nursing residency practice in the neurological system is intended to be able to provide nursing care, implement Evidence Based Nursing (EBN) and be able to act as an innovator in the treatment room. The role of nursing caregivers was carried out using Roy's adaptation model in patients with head injuries and 30 other patients with various nervous system disorders. The most maladaptive behavior is physiological adaptation mode, namely ineffective cerebral tissue perfusion. Nursing intervention in the form of cerebral edema management is intended to improve patient adaptation in increasing cerebral tissue perfusion. Application of the EBN screening tool Trunk Impairment Scale. Nursing innovation program in the form of education to nurses in post-craniotomy patient management with the ERAS protocol."

"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."

"Praktik klinik lanjut selama praktek residensi keperawatan pada sistem neurologi dimaksudkan untuk mampu memberikan asuhan keperawatan, menerapkan Evidance Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Peran pemberi asuhan keperawatan dilakukan dengan menggunakan mode adaptasi Roy pada pasien dengan Guilain Bare Syndrome dan 30 pasien lainnya dengan berbagai gangguan sistem persyarafan. Perilaku maladaptive paling banyak adalah model adaptasi fisiologis, yaitu penurunan kapasitas adaptif intracranial. Intervensi keperawatan berupa manajemen peningkatan tekanan intracranial. Penerapan EBN latihan core stability pada keseimbangan duduk pada pasien stroke menunjukkan pasien dapat memeprtahankan keseimbangan duduk. Program inovasi keperawatan berupa penerapan manajemen ERAS pada pasien pasca kraniotomi diruang ICU, HCU dan rawat inap.

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Advance clinical practice during the nursing residency practice in the neurological system is intended to be able to provide nursing care, implement Evidance Based Nursing (EBN) and able to act as an innovator in the treatment room. The role of nursing caregiver was perfomed using Roy’s adaption mode in patients with Guillain-Barre Syndrome and 30 other patients with various nervous system disorders. The most maladaptive behavior is a physiological adaption model, namely a decrease in intracranial adaptive capacity. Nursing intervention in the form of management of increased intracranial pressure. The application of EBN core stability exercises to sitting balance in stroke patients shows the patient can maintain a sitting balance. Nursing innovation program in the form of application of ERAS management to post-craniotomy patients in ICU,HCU and inpatient rooms."

"Peran perawat spesialis neurosains dalam praktik keperawatan antara lain sebagai pemberi asuhan keperawatan lanjut, melaksanakan pembuktian ilmiah, pendidik, advokat, kolaborator, dan agen pembaharu. Asuhan keperawatan lanjut dilaksanakan pada pasien dengan kasus tumor otak dan 30 pasien gangguan neurologi menggunakan pendekatan model adaptasi Roy. Perilaku maladaptif paling banyak terganggu pada mode fisiologis dengan diagnosis ketidakefektifan perfusi jaringan serebral. Penerapan Evidence Based Nursing berupa latihan Range of Motion (ROM) pasif bilateral ekstremitas atas pada dua pasien stroke akut dengan hemiparese menunjukkan hasil peningkatan fungsi ekstremitas atas dan Activity of Daily Living (ADL). Program inovasi pengembangan media edukasi perawatan pasien kraniotomi pengangkatan tumor menunjukkan peningkatan pengetahuan pasien secara signifikan (p=0,038) dan memudahkan perawat dalam memberikan edukasi secara efektif.

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The role of nurse specialist in nursing practice consist of advanced nursing care providers, conduct scientific evidence, educator, advocat, collaborator, and change agent. Advanced nursing care is done by Roy Adaptation Models approach on brain tumor and 30 other neurological disorders patients. Maladaptive behavior at most in a physiological mode with ineffective cerebral perfusion nursing diagnosis.

Evidence Based Nursing was performed by applying bilateral passive Range of Motion (ROM) of upper extremity at two acute stroke patient with hemiplegi and it showed an increase in function of upper extremities and the activity of daily living. The innovation programme by develop an education media for caring patient with craniotomy removal tumor showed significant increase in patient knowledge (p=0,038) and help nurses to give an effective education."

"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."