Reposisi dan Massage Menurunkan Derajat Dekubitus pada Pasien Immobilisasi dengan Gangguan Neurologis: Case Report

Stroke dan penyakit gangguan fungsi neurologis lainnya akan mengakibatkan berbagai macam gangguan fungsi tubuh seperti gangguan fungsi kognitif, sirkulasi, kekuatan otot, fungsi perifer, fisiologis yang akan berpengaruh pada sistem sensorik dan motorik penderitanya. Hal ini membuat pasien mengalami immobilisasi. Immobilisasi yang lama akan menimbulkan resiko kerusakan pada permukaan tubuh yang tertekan yang disebut dengan dekubitus terutama pada daerah-daerah yang menonjol. Oleh karena dilakukan pemberian tindakan reposisi dan massage untuk menurunkan derajat dekubitus pasien imobilisasi dengan gangguan neurologis. Penelitian ini merupakan penerapan Evidence Based Nursing Practice (EBNP) dengan pendekatan studi kasus yang melihat perubahan pada luka dekubitus yang terjadi setiap hari. Populasi dalam penerapan EBNP ini adalah seluruh pasien yang dirawat di Ruang perawatan Lontara 3 Neuro RS dr. Wahidin Sudirohusodo Makassar. Teknik sampling yang digunakan adalah purposive sampling, sampel ditentukan berdasarkan Number Needed to Treat (NNT) dari jurnal utama yang digunakan sebagai pedoman penerapan EBNP. Hasil implementasi EBNP ditemukan bahwa pemberian reposisi dan massage selama 7 hari dapat menurunkan ukuran diameter luka, memberikan perubahan warna mendekati warna kulit di sekitar, lebih cepat menurunkan derajat luka pada dekubitus derajat 1, dan lebih cepat menurunkan derajat dekubitus pada bagian Heel. Disimpulkan bahwa reposisi dan massage efektif dalam menurunkan dekubitus derajat 1 dan 2 pada pasien imobilisasi dengan gangguan neurologis di Ruang Lontara 3 Neuro RS dr. Wahidin Sudirohusodo Makassar. Sehingga perawat sebaiknya melakukan screening dekubitus dan jika ditemukan tanda-tanda dekubitus derajat 1 dan 2 sebaiknya dilakukan kombinasi reposisi tiap 2 jam dan massage 2 kali sehari minimal selama 7 hari. Stroke and other neurological dysfunction diseases will result in various kinds of bodily disorders such as cognitive impairment, circulation, muscle strength, peripheral function, physiological effects that will affect the sensory and motor systems. This makes the patient immobilized. Prolonged immobilization will pose a risk of damage to depressed body surfaces called pressure ulcers, especially on prominent areas. Therefore, the administration of repositioning and massage measures to reduce the degree of pressure ulcers of immobilized patients with neurological disorders. This research is the application of Evidence Based Nursing Practice (EBNP) with a case study approach that looks at changes in pressure ulcers that occur every day. The population in the application of EBNP is all patients treated in the Lontara 3 room Neuro at Hospital Dr. Wahidin Sudirohusodo Makassar. The sampling technique used is purposive sampling, the sample is determined based on the Number Needed to Treat (NNT) from the main journal that is used as a guideline for the implementation of EBNP. The results of the EBNP implementation found that the administration of repositioning and massage for 7 days can reduce the size of the wound diameter, provide color changes close to the color of the surrounding skin, more quickly reduce the degree of injury in pressure ulcerss 1 degree, and more quickly reduce the degree of pressure ulcers on the heel. It was concluded that repositioning and massage are effective in reducing pressure ulcers 1 and 2 in immobilized patients with neurological disorders in the Lontara 3 room Neuro Hospital Dr. Wahidin Sudirohusodo Makassar. So that nurses should do dekubituss and if there are signs of pressure ulcers 1 and 2 should be a combination of repositioning every 2 hours and massage twice a day for at least 7 days.

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Persepsi Perawat Tentang Evidence Based Nursing Practice (EBNP) di Rumah Sakit

Jurnal Endurance ◽

10.22216/jen.v4i3.4638 ◽

2019 ◽

Vol 4 (3) ◽

pp. 516

Author(s):

Reni Irmayanti ◽

Hema Malini ◽

Dewi Murni

Keyword(s):

Nursing Practice ◽

Evidence Based Practice ◽

Hospital Setting ◽

Sampling Technique ◽

Phenomenological Approach ◽

Evidence Based ◽

Purposive Sampling ◽

Service Unit ◽

Nurses Perceptions ◽

Evidence Based Nursing

Evidence-Based Practice is a systematic approach to improving the quality of nursing practiceby collecting the best evidence. The application of Evidence Based Nursing Practice (EBNP) in nursing services has focused on the hospital setting. The concept of EBNP is acceptable but difficult to implement, so it is necessary to study how nurses' perceptions of EBNP are. This study aims to explore nurses' perceptions about EBNP at Bukittinggi Hospital. Qualitative research design with a phenomenological approach. Data collection was carried out through in-depth interviews with six participants using purposive sampling technique. Criteria for inclusion in the sample are the head of the room or the team leader in the nursing service unit. Data were analyzed by the Colaizzi method. The results this research found four themes, (1) Lack of nurses 'understanding of EBNP, (2) Obstacles in EBNP implementation (3) Nurses' expectations in implementing EBNP, (4) Benefits in implementing EBNP. The conclusion this research is the lack of nurses 'understanding of EBNP, there are obstacles in implementing EBNP, nurses' expectations in implementing EBNP and the advantages in implementing EBNP Evidence-Based Practice adalah pendekatan sistematis untuk meningkatkan kualitas praktik keperawatan dengan mengumpulkan bukti terbaik. Penerapan Evidence Based Nursing Practice (EBNP) dalam pelayanan keperawatan telah difokuskan pada tatanan rumah sakit. Konsep EBNP dapat diterima namun sulit dalam implementasinya, sehingga perlu dikaji bagaimana persepsi perawat tentang EBNP. Penelitian ini bertujuan untuk mengeksplorasi persepsi perawat tentang EBNP di RSAM Bukittinggi. Desain penelitian kualitatif dengan pendekatan fenomenologi. Pengumpulan data dilakukan melalui wawancara mendalam kepada enam partisipan dengan teknik purposive sampling. Kriteria inklusi sampel adalah kepala ruangan atau ketua tim pada unit pelayanan keperawatan. Data dianalisis dengan metode Colaizzi. Hasil penelitian ditemukan empat tema yaitu (1) Kurangnya pemahaman perawat tentang EBNP, (2) Hambatan dalam penerapan EBNP (3) Harapan perawat dalam penerapan EBNP, (4) Keuntungan dalam menerapkan EBNP. Kesimpulan penelitian ini yaitu kurangnya pemahaman perawat tentang EBNP, terdapat hambatan dalam penerapan EBNP, harapan perawat dalam penerapan EBNP dan keuntungan dalam menerapkan EBNP

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Pressure ulcers: implementation of evidence-based nursing practice

Journal of Advanced Nursing ◽

10.1111/j.1365-2648.2004.03333.x ◽

2005 ◽

Vol 49 (6) ◽

pp. 578-590 ◽

Cited By ~ 59

Author(s):

Heather F. Clarke ◽

Chris Bradley ◽

Sandra Whytock ◽

Shannon Handfield ◽

Rena van der Wal ◽

...

Keyword(s):

Nursing Practice ◽

Pressure Ulcers ◽

Evidence Based ◽

Evidence Based Nursing

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TERAPI AKUPRESUR SEBAGAI EVIDENCE BASED NURSING UNTUK MENGURANGI NYERI DADA PADA PASIEN SINDROM KORONER AKUT

Journal of Health Education and Literacy ◽

10.31605/j-healt.v2i2.614 ◽

2020 ◽

Vol 2 (2) ◽

pp. 69-73

Author(s):

Irwan Kambu

Keyword(s):

Chest Pain ◽

Rating Scale ◽

Sampling Technique ◽

Complementary Therapy ◽

Pain Scale ◽

Evidence Based ◽

Visual Analog Pain Scale ◽

Purposive Sampling ◽

Coronary Syndrome ◽

Evidence Based Nursing

Abstrak Penyakit jantung koroner secara klinis ditandai dengan nyeri dada akibat sumbatan di arteri coroner. Akupresur merupakan bagian terapi komplementer yang mampu meningkatkan kadar endorfin untuk merangsang penurunan nyeri. Pelaksanaan evidence based nursing akupresur ini diberikan pada 8 pasien dengan teknik pemilihan purposive sampling. Instrument penerapan menggunakan skala penilaian nyeri visual analog scale. Penerapan akupresur diberikan selama 20 menit pada titik akupresur L14 dengan skala nyeri 0 sampai 5. Hasil dari 8 sampel yang diberikan akupresur semua pasien mengalami penurunan skala nyeri. Penekanan atau sentuhan pada titik akupresur dapat meningkatkan kadar endorfin dalam darah maupun sistemik. Endorfin merupakan opiat tubuh secara alami dihasilkan oleh kelenjar pituitary yang berguna untuk mengurangi nyeri, mempengaruhi memori dan mood yang kemudian akan memberikan perasaan relaks. Terapi akupresur terbukti mampu menurunkan nyeri sehingga bermanfaat untuk diterapkan pada pasien akut koroner sindrom dengan keluhan nyeri dada. Abstract Coronary heart disease is clinically characterized by chest pain due to a blockage in the coronary arteries. Acupressure is part of complementary therapy that is able to increase endorphin levels to stimulate pain reduction. The implementation of evidence based nursing acupressure was given to 8 patients with a purposive sampling technique. The application instrument uses a visual analog pain scale rating scale. The application of acupressure was given for 20 minutes at the L14 acupressure point with a pain scale of 0 to 5. The results of the 8 samples given acupressure all patients experienced a decrease in pain scale. Emphasis or touch on the acupressure point can increase blood and systemic endorphin levels. Endorphins are the body's opiates naturally produced by the pituitary gland which are useful for reducing pain, affecting memory and mood which will then relax. Acupressure therapy has been proven to reduce pain so it is useful to apply to acute coronary syndrome patients with chest pain.

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