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"Insiden cedera tertusuk jarum suntik CJS pada mahasiswa keperawatan masih tinggi. Penelitian ini bertujuan menghasilkan Model Pembelajaran berbasis Keselamatan MPbK untuk membentuk perilaku mencegah CJS mahasiswa keperawatan di wahana praktik. Desain penelitian ini adalah quasi experimental pre and post-test with control group. Penelitian terdiri dari dua tahapan yaitu penyusunan dan pengujian MPbK. Penyusunan MPbK dilakukan berdasarkan hasil systematic review dan focus group discussion pada 10 pembimbing klinik. Pengujian MPbK dilakukan pada 165 mahasiswa praktik profesi keperawatan dengan membandingkan perubahan pengetahuan, sikap, dan intensi perilaku. Responden dikelompokkan dalam 4 kelompok yaitu 26 mahasiswa mendapatkan MPbK 1 intervensi individu reedukasi pengingat harian, intervensi kelompok, dan organisasi ; 72 mahasiswa mendapat MPbK 2 intervensi individu reedukasi dan organisasi , 31 mahasiswa mendapat MPbK 3 intervensi kelompok dan organisasi , dan 36 mahasiswa tanpa intervensi. Intervensi individu meliputi reedukasi dan pengingat harian pencegahan CJS melalui pesan singkat teks dan video. Intervensi kelompok meliputi pengingat dan contoh peran dari pembimbing klinik yang telah dilatih pencegahan CJS. Intervensi organisasi meliputi kontrak program keselamatan dan penyediaan fasilitas penunjang pencegahan CJS. Penelitian tahap 1 menghasilkan MPbK yang diuji pada penelitian tahap 2. Hasil uji GLM-RM pada penelitian tahap 2 didapatkan bahwa pengetahuan dan sikap mencegah CJS dapat ditingkatkan secara signifikan menggunakan MPbK 1, 2, dan 3 p

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Needle Stick Injury NSI incident in nursing student is constantly high. This research aimed to develop Safety based Learning Models MPbK in Indonesia to shape preventive behaviors of NSI among nursing students during clinical practices. Quasi experimental pre and post test design with control group was employed in this study. The study comprised two stages MPbK development and testing stages. The during the first stage, systematic reviews and a focus group discussion with 10 clinical instructors were conducted to generate MPbK. While, the testing stage was performed to measure the changes in students rsquo knowledge, attitudes, and intention before and after the implementation of MPbK. A sample of 165 nursing professional program students was selected for the second stage, dividing into 4 main groups 26 students participated in MPbK1 individual, group, and organizational interventions , 72 students participated in MPbK2 individual and organizational interventions , 31 students participated in MPbK3 group and organizational interventions , and 36 students received no interventions. Individual interventions comprised re education and daily reminders through short message and video. Group interventions included role model clinical instructors whereas organizational interventions were safety programs contract between the university and hospitals, along with the provision of appropriate infrastructure and facilities to promote safety. Results of GLM RM analysis demonstrated the use of MPbK1, 2, and 3 significantly increased the knowledge and atitudes of students p 0,001 , the intention of student behavior to prevent NSI can be increased, but not yet significan p 0,110 0,993 . NSI incidents can be reduced using MPbK1 zero incident . The study suggested nursing educational institutions, hospitals and nursing professional organizations to use MPbK as a reference to develop policies of NSI prevention."

"ABSTRAKTujuan penelitian ini adalah untuk mengembangkan model perilaku adaptasi pasien penyakit ginjal kronis pre dialisis serta mengidentifikasi efektifitas model terhadap respon adaptasi fisiologi, perilaku adaptasi psikologi, pengetahuan dan sikap. Penelitian ini merupakan riset development yang dilakukan dalam dua tahap. Tahap satu mengidentifikasi masalah melalui penelitian kualitatif dengan pendekatan fenomenologi deskriptif tentang pengalaman hidup pasien dengan penyakit ginjal kronis pre dialisis, dilanjutkan membuat solusi dengan mengembangkan model perilaku adaptasi pasien penyakit ginjal kronis pre dialisis. Penelitian tahap dua quasi eksperimen dengan desain pre-test-post-test with control group untuk melihat efektifitas model pada 70 pasien penyakit ginjal kronis pre dialisis 38 orang kelompok intervensi dan 32 orang kelompok kontrol . Hasil penelitian tahap satu berupa buku model dan panduan implementasi, materi pembelajaran perilaku adaptasi untuk perawat pelaksana, serta booklet perilaku adaptasi untuk pasien penyakit ginjal kronis pre dialisis. Hasil penelitian tahap dua membuktikan kelompok intervensi memiliki respon adaptasi fisiologi, perilaku adaptasi psikologi, serta pengetahuan dan sikap yang lebih baik dibanding kelompok kontrol. Kesimpulan hasil penelitian ini adalah model perilaku adaptasi pasien penyakit ginjal kronis pre dialisis efektif terhadap respon adaptasi fisiologi, perilaku adaptasi psikologi, pengetahuan dan sikap. Saran melakukan sosialisasi model, advokasi ke unit terkait, aplikasi dalam asuhan keperawatan pada pasien penyakit ginjal kronis pre dialisis. Kata kunci: model perilaku adaptasi, respon adaptasi fisiologi, perilaku adaptasi psikologi, penyakit ginjal kronis pre dialisis

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ABSTRACTThe purpose of this study is to develop a model of adaptation behaviors for patients with chronic kidney disease pre dialysis and identify the effectiveness of the model towards physiological adaptation response, psychological adaptation behavior, knowledge and attitude of the patients. The study is a development research done in two stages. Stage one is identification of the issues through qualitative study according to descriptive phenomenology approach related to patients rsquo life experiences with chronic kidney disease pre dialysis, continued by the development of a model of adaptation behaviors for patients with chronic kidney disease pre dialysis as a solution to the issue. Stage two is a quasi experiment according to pre test post test with control group design to observe the effectiveness of the model in 70 patients with chronic kidney disease pre dialysis 38 subjects in the intervention group and 32 subjects in control group . The result of stage one study is a model book and implementation guideline, adaptation behaviors learning material for caregiver nurse and basic adaptation behaviors booklet for patients with chronic kidney disease pre dialysis. The result of stage two study proved that the intervention group has a physiological adaptation response, psychological adaptation behavior, knowledge and attitude better than the control group. In conclusion, the constructed model of adaptation behaviors for patients with chronic kidney disease pre dialysis is effective towards physiological adaptation response, psychological adaptation behavior, knowledge and attitude of the patients. Suggestions for model dissemination, advocacy to related units, application in nursing care in patients with chronic kidney disease pre dialysis. Keywords Model of adaptation behaviors, physiological adaptation response, psychological adaptation behavior, chronic kidney disease pre dialysis"

"Salat fardu, sebagai ekspresi spiritual pasien Muslim, merupakan kewajiban perawat untuk membantunya. Tujuan penelitian ini adalah diperolehnya model Laras Fardu; menemukan masalah dan harapan perawat serta pasien dalam membantu memenuhi ibadah salat fardu pasien; serta mengidentifikasi efektifitas model tersebut kepada pasien DM tipe 2 dirawat dirumah sakit. Penelitian ini termasuk operational research, dilakukan tiga tahap. Tahap I menggunakan pendekatan fenomenologi kepada 8 partisipan perawat pelaksana, 4 menejer rumah sakit, dan 9 partisipan pasien DM tipe 2. Tahap II pengembangan model berdasar studi literatur, hasil tahap I dan konsultasi pakar. Tahap III adalah tahap persamaan standar dan validasi model dengan penelitian pre-posttest control group design, dengan consequtive sampling. Jumlah sampel 22 Perawat, diberikan sosialisasi dan pemberian modul, sebanyak 23 perawat diberikan modul saja dan sebanyak 23 perawat sebagai kelompok kontrol. Jumlah sampel validasi model adalah 81 pasien dilakukan asuhan keperawatan kelompok perawat kompetensi standar plus dan 82 pasien dilakukan asuhan keperawatan kelompok perawat kompetensi standar.Hasil penelitian tahap I ditemukan tema 1 Ketidaktahuan; 2 Ketidakmampuan; dan 3 Ketidakmauan, sebagai masalah pasien, dan tema Harapan Pasien; tema : 1 Kompetensi layanan keperawatan ibadah salat fardu; 2 Ketersediaan fasilitas; 3 Persepsi kendala; dan 4 Keterbatasan dukungan sebagai kendala perawat serta tema Layanan Keperawatan Islami sebagai harapan perawat. Telah diperoleh Model Laras Fardu beserta kelengkapannya. Pemberian sosialisasi dan modul layanan keperawatan ibadah salat fardu, atau modul saja efektif meningkatkan pengetahuan dan sikap perawat dalam layanan keperawatan ibadah salat fardu, namun tidak efektif meningkatkan motivasi perawat. Asuhan keperawatan oleh kelompok perawat kompetensi standar plus meningkatkan self-tarnscendence, kesejahteraan spiritual dan menurunkan persepsi stress pasien DM tipe 2 dirawat di rumah sakit, namun tidak memiliki efek terhadap kadar glukosa darah. Model ini terbukti efektif untuk meningkatkan self-transcendence, kesejahteraan spiritual dan menurunkan stress pasien, namun tidak efektif untuk perbaikan glukosa darah.

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Nurses are obligated to help fardu prayer as a spiritual expression of Muslim patients. The purpose of this research was to obtain the model of Laras Fardu find the problems and expectation of nurse and patient in helping to fulfill fardu prayer of the patients as well as to identify the effectiveness of the model to patients with type 2 diabetes treated in the hospital. This research was an operational research, conducted in three stages. Stage I used phenomenology approach to 8 participating nurses, 4 hospital managers, and 9 participants of type 2 DM patients. Stage II was a model development based on literature study, stage I result, and expert consultation. Stage III was the standard equation and model validation stage with pre post test control group design study, with consecutive sampling. Sample size was 22 nurses who received socialization and module, as many as 23 nurses received only module and 23 nurses as control group. The number of model validation samples was 81 patients who received nursing care from the nursing group with standard plus competencies and 82 patients received nursing care from a group of nurses with standard competence.

Stage I research found the following themes 1 Ignorance 2 Inability and 3 Unwillingness, as the patients 39 problem, and the Patient 39 s Hope theme. Themes 1 The competence of nursing care in helping fardu prayer 2 Availability of facilities 3 Perception of constraints and 4 Limitations of support as nurse constraints, as well as the theme of Islamic Nursing Services as nurse expectations. We have obtained the Fardu Laras Model and its accessories. Providing socialization and nursing care module to help fardu prayer, or module only, effectively improved nurse 39 s knowledge and attitude in nursing care to help fardu prayer, but not effective to increase nurse motivation. Nursing care by a group of nurses with standard plus competence improved self transcendence, spiritual well being, and lowered the perceived of stress in patients with type 2 diabetes treated in the hospital, but had no effect on the improvement of blood glucose levels. This model proves to be effective for improving self transcendence, spiritual well being and stress reducing patients, but not effective for the improvement of blood glucose. "

"Tingginya tingkat hunian rumah sakit telah mendorong kebijakan untuk memulangkanpasien secara dini. Risiko infeksi luka operasi tidak hanya terjadi selama perawatan dirumah sakit. Infeksi luka operasi dapat juga terjadi ketika pasien sudah pulang dari rumahsakit. Kesinambungan pelayanan perawatan diperlukan agar tidak terjadi infeksi lukaoperasi selama pasien membutuhkan perawatan. Tujuan penelitian adalahmengembangkan model sistem pelayanan keperawatan berkesinambungan pasien operasiuntuk peningkatan kepuasan dan menyingkatkan waktu penyembuhan luka operasi.Metode penelitian meliputi tahap satu dilakukan penelitian kualitatif melalui focus groupdiscussion dengan peserta perawat pelaksana, kepala ruangan, dan perawat manajer dirumah sakit umum daerah Karawang berjumlah 25 orang, wawancara mendalam terhadap8 partisipan, dan uji coba model dengan sampel sebanyak 140 orang di RSUD Karawangdan RSUD Bayu Asih Purwakarta. Pada tahap tiga dilakukan uji coba model denganmetode kuasi eksperimen. Hasil penelitian tahap satu adalah terdapat empat tema danenam subtema. Hasil penelitian tahap tiga adalah variable jenis luka operasi berpengaruhterhadap lama kesembuhan luka operasi. Lama kesembuhan luka operasi lebih cepat 5hari pada kelompok intervensi. Tingkat kepuasan kelompok intervensi lebih tinggidibandingkan dengan kelompok kontrol. Model sistem pelayanan keperawatanberkesinambungan pasien operasi sangat penting diterapakan pada pelayanankeperawatan untuk meningkatkan kepuasan pasien dan penyingkatan waktupenyembuhan luka operasi.

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The high level of hospital occupancy had prompted policies to repatriate patients early.Surgical site infection risk did not only occur during hospitalization, surgical site infectioncould also occur when the patient have been discharged from the hospital. Continuity ofcare intervention was required to avoid surgical wound infections as long as the patientneeded. Objective of this study was to explorer the existing situation of continuity ofnursing care sistem for surgical patient, especially monitoring service to prevent surgicalsite infection. Research method include the first stage was conducted qualitative researchthrough focus group discussion with the staff nurses, head nurses, and nurse managers inpublic hospitals Karawang area amounted to 25 people and test model with a sample of140 people in public hospital Karawang and public hospital Bayuasih. In the third phaseexperimental model was conducted with quasi experimental method. The result of thestudy was found 4 themes and 6 subthemes in continuity of care flow of surgical patient.Longer wound healing was 5 days faster in the intervention group. The level of satisfactionof the intervention group was higher than the control group. Continuity of care systemmodel in surgery patients was very important to be applied in nursing care to improvepatient satisfaction and shorten wound healing time."

"ABSTRAKAmbulasi pascaoperasi penting dilakukan untuk mempercepat pemulihan pada pasien fraktur ekstremitas bawah. Ambulasi pascaoperasi sesuai dengan waktu yang direkomendasikan dapat memberikan manfaat klinis dan mencegah komplikasi pascaoperasi. Studi ini bertujuan untuk menguji efektifitas program konservasi keperawatan terhadap kemampuan ambulasi pascaoperasi. Metode penelitian yang digunakan yaitu uji klinis dengan kontrol tanpa randomisasi. Program konservasi keperawatan dirancang berdasarkan Model Konseptual Levine, yang terdiri dari; manajemen energi, latihan nafas dalam, latihan kekuatan otot, latihan rentang pergerakan sendi, terapi latihan; ambulasi, pendidikan kesehatan dan pemberdayaan keluarga. Populasi dalam penelitian yaitu: fraktur pinggul, fraktur femur, fraktur tibia/ fibula, dan fraktur pergelangan kaki. Penarikan sampel secara convenience sebanyak 54 responden, 30 responden kelompok kontrol dan 24 responden kelompok intervensi. Primary outcome yang dinilai, yaitu kemampuan ambulasi; waktu ambulasi, kemampuan fungsional dan tingkat ketergantungan. Sedangkan, secondary outcome yang dinilai yaitu: tingkat kelelahan, tingkat nyeri, keyakinan diri, dan dukungan keluarga. Hasil penelitian menunjukkan bahwa penerapan program konservasi keperawatan efektif mempercepat waktu ambulasi, meningkatkan kemampuan fungsional, menurunkan tingkat ketergantungan, menurunkan tingkat kelelahan, menurunkan tingkat nyeri, dan meningkatkan keyakinan diri p

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ABSTRACTAbstract Postoperative ambulation is an essential intervention to facilitate recovery in patients with lower extremities fracture. Regular post operative ambulation may contribute to the positive clinical outcomes and prevent post operative complications. This study aimed to examine the effectiveness of Nursing Conservation Program towards ambulation ability in patients with lower extremities fracture. A non randomized control clinical trial design was used in this study. Nursing Conservation Program was designed based on Levine rsquo s Conceptual Model which consisted of energy management, deep breathing exercise, muscle strength exercise, range of motion exercise, exercise therapy ambulation, health education, and family empowerment. Population in this study were patients with hip, femur, tibia fibula, and ankle fracture. The samples were recruited using convenience sampling technique, yielding 54 respondents, 30 respondents were in the control group and 24 respondents were in the intervention group. Primary outcomes were included ambulation ability which consisted of time, functional ability, and dependency level. Meanwhile, secondary outcomes were assessed from the level of fatigue, pain level, self confidence, and family support. This study found that the application of Nursing Conservation Program was effective to accelerate ambulation time, enhance functional ability, reduce self dependency, fatigue and pain level, and increase self confidence p"

"Klien stroke dengan hipertensi dari tahun ke tahun terus meningkat, sehingga keadaanini menjadi hal penting untuk dikelola dengan baik. World Health Organisation bahwapada tahun 2030 ada 23,3 juta kematian oleh karena penderita penyakit Jantung danStroke dan berdasarkan hasil Riset Kesehatan Dasar 2013 penderita stroke yangterdiagnosa di Indonsia sebanyak 1.236.825 orang. Penderita stroke di rumah sakittempat dilakukan penilitian selama empat tahun terakhir mencapai 351 orang, sehinggaini memberikan gambaran bahwa stroke merupakan penyakit yang memerlukanperawatan dan pengobatan yang lebih serius. Tujuan penelitian ini adalah untukmengembangkan model perencanaan pulang klien stroke dengan hipertensi. Metode:riset operasiobnal dengan 3 tahap. Yaitu tahap 1, identifikasi alur dan masalah sertakebutuhan perncanaan pemulang klien, tahap 2 dikembangkanya draft model dan modulberdasarkan data dasar dari hasil tahap 1. Telaah literatur dan konsultasi pakar, tahap 3,validasi model dan modul dengan kuasi eksperimen. Data dikumpulkan menggunakanFGD Focus Group Discussion dan Wawancara Mendalam pada tahap 1 denganinforman penelitian 33 orang. Partisipan tahap 3 uji model adalah keluarga 21 sebelumdan 37 orang sesudah, klien 33 sebelum dan 37 orang sesudah, dan perawat 37 orangsebelum dan sesudah dilakukan intervensi model. Data dikumpulkan dengan pre posttest. Analisa data tahap satu dengan analisa konten dan tahap uji model denganmenggunakan SPSS. Hasil tahap satu didapat alur klien masuk sampai pulang,kebutuhan dan masalah dalam perencanaan pulang. Hasil uji coba model bahwakemandirian klien bermakna signifikan dengan Pvalue =0.00 lebih kecil dari Pvalue =0.05, kepuasan klien tidak signifikan karena Pvalue =0.40 lebih besar dari Pvalue =0.05, kepuasan keluarga bermakna signifikan karena Pvalue =0.025 lebih kecil dariPvaleu = 0.05, sementara hasil kepuasan perawat sangat bermakna signifikan denganPvalue = 0.00 lebih kecil dari Pvalue = 0.05. Disimpulkan bahwa model perencanaanpulang diperlukan untuk memberikan pelayanan perawatan dan pengobatan kepadaklien, dan dapat digunakan tenaga kesehatan untuk melaksanakan perawatan danpengobatan. Merupakan saran agar manajemen rumah sakit membuat kebijakan danmempersiapkan perangkat sehubungan pelaksanaan perencanaan pulang bagi klien.

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Stroke client with hypertension increasing from time to time, this condition need tomanage very well. Wod Health Organization mentioned on year of 2030 have 23.3million dead caused of blood hypertension, and based on resulted of Riset KesehatanDasar on 2013, the stroke case 1.236.825 or 7 of Indonesian population. Stroke casedata in the hospitals where this research been done for the last 4 years reach 351 people,which providing us with a focus that stroke is a disease that need a more serioustreatments. The objectives of the research is developt Discharge Planning stroke clients.Operation research was apply with 3 phase, and first phase is to identify the gate cliententered to hospital, need and problems that face in conduct Discharge Planning. Phasetwo is to developt model and modul draft of discharge planning, and phase three is tovalidate model and modul that developt. Phase one the data was collected by FocusGroup Discussion and indept interview with 33 nurses participant. Phase validatemodel and conternt analysis and phase 3 used computer. Phase 3 found that the resultsof the test for the model are client self-efficacy provide a significant value withPvalue=0,00 lower than Pvalue= 0.05, client satisfaction is not significant with Pvalue =0.40 higher than Pvalue = 0.05, family satisfaction provide a significant value withPvalue = 0.025 lower than the Pvalue= 0.05, while nurse satisfaction provide asignificant value with Pvalue = 0.00 lower than Pvalue = 0.05. The conclustion takenfrom this research is that discharge planning model is needed to provide care andmedication service to client and can be used by healthcare team to perform the treatmentand medication. It is suggested to the hospital management to create a policy andprepare the infrastructure related to the implementation of discharge planning model fora client."

"

Disertasi Keperawatan, 20 Juni 2019

Aliana DewiPengembangan Instrumen Pengkajian Psikososial Pasien Di Intensive Care Unit(ICU)AbstrakPasien di ruang Intensive Care Unit (ICU) mengalami masalah kesehatan baik fisikmaupun psikososial. Pengkajian psikososial merupakan aspek yang penting dalammengetahui kebutuhan dan masalah pasien sehingga memudahkan dalam memberikanterapi dan perawatan pada pasien di ICU. Sampai saat ini belum ada instrumen untukmengukur psikososial pasien. Tujuan penelitian ini adalah tersusunnya pengembanganinstrument pengkajian psikososial pasien di Intensive Care Unit. Penelitian inimenggunakan desain operational research dengan 3 tahapan. Tahap pertama yaitu dari 15partisipan didapatkan 5 aspek psikososial dengan 25 item pernyataan yaitu ansietas,depresi, keputusasaan, ketidakberdayaan dan deprivasi. Tahap kedua melakukankonsultasi dengan 11 pakar didapatkan 25 item pernyataan. Selanjutnya dilakukan ujivaliditas dan reliabilitas berdasarkan uji alpha cronbach didapatkan hasil untuk bahasa0, 997 dan untuk konten 0,976. Tahap ketiga dilakukan uji coba instrumen oleh 100 orangperawat dan didapatkan hasil 66% pasien mengalami masalah psikososial. Tersusuninstrumen pengkajian psikososial dengan 25 item pernyataan sehingga disarankaninstrumen pengkajian ini dapat menjadi instrumen dalam mengkaji pasien di ruang ICU.

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Disertasi Keperawatan, 20 Juni 2019

Aliana DewiDeveloping Psychosocial Assesment Instrument in Intensive Care Unit (ICU)AbstractIntensive Care Unit patients experience physical and psychosocial health problem.Psychosocial assessment is an important aspect to understand the need and patientproblems thus management and treatment in ICU are delivered easily. Nowdays, there islack of psychosocial assessment tools for ICU patients in Indonesia. The aim of thisresearch is to develop a psychosocial assessment tools for the intensive car unitpatients. This research used operational research design with 3 stages. First stage found 5(five) psychosocial aspect from 15 respondents including anxiety, depression, hopeless,powerlessness and deprivation. On the second stages, the aspect were reviewed by 11experts and found 25 items for psychosocial assessment tools. The validity and realibilityof the instrumenwere checked with alpha cronbach’s 0.997 and0.976 respectively for languages and content analysis.Furthermore, the instrumenwas usedto assess psychosocial aspect of ICU patient. Total of 100 nurses carry out theassessment and found that 100% patients were experienced psychosocial problems. Theinstrumenconsisted of 25 items statement to be used as a mean to assess psychosocialaspect of ICU patients.

"

"Disertasi ini membahas algoritme neuromuscular taping terhadap manifestasi klinis gangguan mikrosirkulasi pada kaki dabetik. Tahapan riset meliputi kajian literatur, faktor risiko neuropati kaki diabetik, uji diagnostik, standarisasi perawatan pencegahan neuropati kaki diabetik, standarisasi NMT FANI pada perawatan neuropati kaki diabetik dan pembentukan algoritme. Desain penelitian uji diagnostik dengan cross sectional, sedangkan uji efek NMT FANI terhadap kelembapan, suhu, kapiler lipatan kuku dan nyeri neuropati dengan desain eksperimental. Instrument menggunakan moisture meter skin, thermometer infrared, capiloroscopy, biothesiometer dan LANSS. Hasil uji diagnostik menunjukan moisture meter skin (sensitifitas, spesifisitas dan akurasi 74%); capilaroscopy (sensitifitas, spesifisitas dan akurasi 73%) baik dalam mendeteksi neuropati kaki diabetik. Uji thermograph menunjukan sensitifitas 73.07% dalam mendeteksi kelainan neuropati, spesifisitas 56.42% dan akurasi 59.03%. Uji thermometer gun menunjukan sensitifitas 56.66%, spesifisitas 53.67% dan akurasi 54.21% kurang baik dalam mendeteksi neuropati kaki diabetik. NMT FANI berpengaruh secara signifikan terhadap kelembapan kulit, kapiler lipatan kulit kuku dan derajat nyeri neuropati pada kaki diabetik (p value < 0.05), sedangkan pada suhu kaki tidak berpengaruh secara signifikan (p value > 0.05). Hasil akhir algoritme tersusun dari pengkajian awal dari hasil anamnesis faktor risiko, pemeriksaan fisik dan diagnostik serta tatalaksana NMT FANI. Indikator kelembapan kulit, perubahan struktur kapiler lipatan kuku kaki dan intervensi NMT FANI perlu dimasukan dalam tatalaksana kaki diabetik.

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This dissertation discusses the neuromuscular taping algorithm against the clinical manifestations of microcirculation disorders in the diabetic foot. The research stages included a review of literature, risk factors for neuropathy of diabetic foot, diagnostic tests, standardization of preventive treatment of diabetic foot neuropathy, standardization of NMT FANI in the treatment of diabetic foot neuropathy, and algorithm formation. The study design was a cross-sectional diagnostic test, while an experimental design was employed for the NMT FANI effect test on skin moisture, temperature, nail fold capillaries, and neuropathic pain. The instruments used were a skin moisture meter, infrared thermometer, capillaroscopy, biothesiometer, and LANSS. The diagnostic test results showed that the SC skin moisture meter (sensitivity, specificity, accuracy 74%) and capillaroscopy (sensitivity, specificity, accuracy 73%) were good at detecting diabetic foot neuropathy. The thermograph test shows a sensitivity of 73.07% in detecting neuropathic disorders, a specificity of 56.42% and an accuracy of 59.03%. The thermometer gun test showed a sensitivity of 56.66%, a specificity of 53.67%, and an accuracy of 54.21% that was not good at detecting diabetic foot neuropathy. NMT FANI had a significant effect on skin moisture, nail fold capillaries, and the degree of neuropathy pain in diabetic foot (p value < 0.05), while foot temperature did not significantly influence (p value > 0.05). The end result of the algorithm is composed of a preliminary assessment of the results of the history of risk factors, physical examination, diagnostic and management of NMT FANI. Indicators of skin moisture, changes in the capillary structure of the nail folds and NMT FANI interventions need to be included in the management of diabetic foot."

"Latar Belakang: Keselamatan pasien isu kritis pelayanan kesehatan di lingkungan sipil maupun militer di dunia untuk mencegah cedera dan komplikasi selama perawatan. Kepatuhan praktik keselamatan pasien kunci dalam pelayanan kesehatan yang aman dan efektif bagi militer yang sakit. Peran perawat di RS militer sangat penting dalam keberhasilan menjaga keselamatan pasien yang berdampak pada kesehatan militer. Tujuan: Menghasilkan Sistem Informasi Manajemen Compliance Pressure Keselamatan Pasien (SIM-CPKP) yang dapat diaplikasikan di RS militer dan pengaruhnya terhadap kepatuhan perawat dalam menjaga keselamatan pasien menurut Onion Model di RS militer Jabodetabek. Metodologi: Penelitian menggunakan desain research and development melalui tiga tahapan. Tahap pertama melibatkan 25 partisipan, kemudian mengembangkan model SIM-CPKP dengan aplikasi smartphone dan WEB. Tahap ketiga melibatkan 212 responden. Hasil: teridentifikasi lima tema merupakan dasar pengembangan model, terciptanya aplikasi smartphone dan WEB SIM-CPKP. SIM-CPKP dievaluasi berpengaruh terhadap peran perawat yang bekerja di RS militer pada pelaksanaan sasaran keselamatan pasien dan teridentifikasi adanya faktor confounding yang mempengaruhi perawat yang bekerja di RS militer pada pelaksanaan sasaran keselamatan pasien. Simpulan: SIM-CPKP berpengaruh terhadap kepatuhan perawat dalam menjaga keselamatan pasien menurut Onion Model di RS militer Jabodetabek. Saran: SIM-CPKP dapat diadopsi untuk meningkatkan kepatuhan perawat dalam menjaga keselamatan pasien menurut Onion Model di RS militer Jabodetabek.

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Background: Patient safety is an issue in healthcare in civilian and military settings worldwide to prevent injuries and complications that occur during treatment. The role of nurses in military hospitals in maintaining patient safety can have an impact on the safe efficiency of the military healthcare. Objective: To produce a Management Information System Compliance Pressure Patient Safety (MIS-CPPS) that can be applied in military hospitals and impacted on nurse compliance in maintaining patient safety according to the Onion Model in Jabodetabek military hospitals. Methodology: This study used a research and development design. The first stage involved 25 participants, then the development of a smartphone application and MIS-CPPS WEB. The last involved 212 respondents. Results: five themes were identified as base for model development, creation of a smartphone application model and WEB. MIS-CPPS has been shown to has impacted on nurses' roles in military hospitals in implementing patient safety goals and identified confounding factors that impacted nurses in military hospitals. Conclusion: MIS-CPPS has impacted on nurse compliance in maintaining patient safety according to Onion Model in Jabodetabek Military Hospitals. Suggestion: MIS-CPPS can be implemented to improve nurse compliance in maintaining patient safety according to Onion Model at the Jabodetabek Military Hospital."

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Nama	: Mira Asmirajanti
Program Studi	: Doktor Keperawatan, Fakultas Ilmu Keperawatan UI
Judul	: Sistem Nursing Activity Based Costing Mira (N-ABC Mira)

 

Aktivitas Perawat merupakan semua kegiatan pemberian asuhan keperawatan terhadap pasien yang dilakukan dan dicatat oleh perawat. Aktivitas perawat meliputi asesmen, penetapan diagnosis, pembuatan perencanaan, pelaksanaan tindakan dan evaluasi. Perawat, tenaga profesional di rumah sakit yang terus menerus bersama pasien, tetapi aktivitasnya belum dijadikan dasar dalam perhitungan poin penghargaan pada remunerasi. Pembiayaan aktivitas perawat dalam pemberian asuhan keperawatan masih menjadi permasalahan utama profesi keperawatan. Tujuan penelitian ini mengevaluasi sistem nursing activity based costing Mira (N-ABC Mira). Penelitian dilakukan di RSP Jakarta dan RSDK Semarang. Penelitian ini menggunakan desain penelitian operasional dengan tiga tahap penelitian. Tahap 1 mengidentifikasi aktivitas perawat berdasarkan dokumentasi asuhan keperawatan, kepuasan perawat dan faktor perancu melalui penelitian kuantitatif dengan studi cross-sectional dan penelitian kualitatif analisis dari fokus grup diskusi. Tahap 2 mengembangkan sistem nursing activity based costing Mira (N-ABC Mira). Tahap 3 evaluasi dan uji coba sistem N-ABC Mira menggunakan kuasi eksperimen dengan pendekatan pengukuran berulang sebelum implementasi, uji coba 1, uji coba 2 dan uji coba 3. Sampel penelitian kuantitatif sebanyak 226, 199, 161 dan 92 perawat pelaksana dengan masa kerja minimal 1 tahun yang diambil secara acak dan dokumentasi pasien dengan jumlah mengikuti sampel perawat pada tahun 2018 secara insidental dari bulan Juli - bulan Desember yang diambil dari 10 penyakit terbanyak. Data dikumpulkan dari dokumentasi hasil uji coba sistem N-ABC Mira dan kuesioner. Analisis data menggunakan  GLM RM, t-Test, Anova, Korelasi Pearson’s. Pada penelitian ini didapatkan bahwa sistem N-ABC Mira antara sebelum dan sesudah implementasi, aktivitas perawat berdasarkan dokumentasi asuhan keperawatan ada perbedaan yang bermakna (15.269, p=0.0001); ada perbedaan yang bermakna kepuasan perawat terhadap aktivitas perawat (6.657, p=0.0001); ada perbedaan yang bermakna kepuasan perawat terhadap pengambilan keputusan (2.999, p=0.0001) dan ada perbedaan yang bermakna kepuasan perawat terhadap poin penghargaan (6.585, p=0.0001). Sistem N-ABC Mira untuk Aktivitas perawat berdasarkan dokumentasi asuhan keperawatan dan kepuasan perawat terhadap aktivitas perawat; pengambilan keputusan serta poin penghargaan dipengaruhi oleh aspek perawat, dukungan manajemen dan dukungan tehnik. Kesimpulan dari implementasi sistem N-ABC Mira, yaitu terdapat perbedaan aktivitas perawat berdasarkan dokumentasi asuhan keperawatan dan kepuasan perawat terhadap aktivitas perawat, pengambilan keputusan serta poin penghargaan perawat sehingga dapat meningkatkan kepuasan perawat dan kepuasan pasien, sehingga merekomendasikan sistem N-ABC Mira untuk dapat digunakan di setiap rumah sakit.

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Name	: Mira Asmirajanti
Study Program	: Doctoral Nursing Doctoral, Faculty of Nursing Universitas Indonesia
Title	: Nursing Activity Based Costing Mira (N-ABC Mira) System

 

Nursing activities are all activities of giving nursing care to patients performed and recorded by nurses. Nursing activities include assessment, determination of diagnosis, planning, implementation of actions and evaluation. Nurses are professionals in the hospital whose presence is continuously on the patient's side, but their activities have not been used as the basis for calculating reward points for remuneration. Financing nursing activities in nursing care is still a major problem in the nursing profession. The purpose of this study is to evaluate the nursing activity based costing Mira (M-N-ABC) system. The study was conducted at the Jakarta Pelabuhan Hospital and Semarang RSDK Hospital. This research was conducted using operational research design with three research stages. Stage 1 is identifying nurse activities based on nursing care documentation, nurse satisfaction and confounding factors through quantitative research with cross-sectional studies and qualitative research through analysis of focus group discussions. Stage 2 is to develop a nursing activity based costing Mira (M-N-ABC) system. Stage 3 is evaluating and testing the Mira N-ABC system using quasi-experiments with repeated measurement approaches before implementation, trial 1, trial 2 and trial 3. Quantitative research samples were 226, 199, 161 and 92 nurses with minimum of 1 year work experience period taken randomly. Incidental numbers of patient documentation were included based on participating nurses in 2018 from July to December by taking 10 most frequent diseases. Data were collected from results documentation of the N-ABC Mira system trial and questionnaire. Data analysis was done using RM GLM, t-Test, Anova, Pearson's Correlation. In this study it was found that between before and after the implementation of the Mira N-ABC system, there were significant differences in nursing activity based on care documentation (15,269, p = 0,0001); there was also a significant difference between nurses’ satisfaction with nursing activity (6,657, p = 0,0001); In addition, there was a significant difference between nurses’ satisfaction with decision making (2.999, p = 0.0001) and also between nurses’ satisfaction with award points (6,585, p = 0,0001). Mira N-ABC system for nursing activities is proposed based on nursing care documentation and nurses’ satisfaction on nursing activities; Decision-making variables and award points were influenced by aspects of nurses, management support and technical support. The conclusion of the Mira N-ABC system implementation is that there are differences between nurse activities based on nursing care documentation with nurses’ satisfaction on nursing activities, decision making and nurse award points. The Mira N-ABC system is recommended for everyday usage in hospital to improve nurses and patient satisfaction.

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