Reni Sulung Utami
Department Of Nursing, Faculty Of Medicine, Diponegoro University

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The Challenges and Strategies to Improve Family-centered Round: A Literature Review Utami, Reni Sulung
Nurse Media Journal of Nursing Vol 2, No 1 (2012): (JUNE 2012)
Publisher : Department of Nursing, Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (163.857 KB) | DOI: 10.14710/nmjn.v2i1.3963

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The importance of family-centered care and the role of families in decision making are becoming more recognized today. Several studies have supported the implementation of family-centered care and its role in enhancing quality of care. Family-centered rounds are one of family centered model of care that brings together multidisciplinary team as well as family to discuss the patient’s condition and care management, coordinate the patient’s care management, and make decisions on care plan for the patient (Sisterhen et al., 2007, Aronson et al., 2009). As part of innovations to enhance family-centered care, family-centered rounds have been adopted and implemented in many hospitals. This model of rounds is popular and widely applied in the neonatal and pediatric intensive care unit (Aronson et al., 2009, Kleiber et al., 2006, Mittal et al., 2010). However, other units have also begun to implement it (Schiller and Anderson, 2003, Mangram et al., 2005). The benefits of family-centered rounds have been presented in several studies. They reported that family-centered rounds have been improved communication between staff and family members (Mittal et al., 2010, Jacobowski et al., 2010, Rosen et al., 2009, Vazirani et al., 2005), understanding of the patient’s care plan (Rosen et al., 2009), staff and family satisfaction (Rappaport et al., 2010, Rosen et al., 2009); and decreased need for care plan clarification (Rosen et al., 2009).
Sensitivity and Specificity of the Comfort Scale to Assess Pain in Ventilated Critically Ill Adult Patients in Intensive Care Unit Wahyuningsih, Indah S; Prasetyo, Awal; Utami, Reni Sulung
Nurse Media Journal of Nursing Vol 7, No 1 (2017): (JUNE 2017)
Publisher : Department of Nursing, Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (408.895 KB) | DOI: 10.14710/nmjn.v7i1.15126

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Background: Pain is a common phenomenon experienced by ventilated and critically ill adult patients. It is urgent to measure the pain among these patients since they are unable to report their pain verbally. Comfort Scale is one of the instruments used to measure pain in adult patients. The scale is used to measure pain among children patients with fairly high sensitivity and specificity.Purpose: This study aimed to examine the sensitivity and specificity of the Comfort Scale to measure pain in the ventilated critically ill adult patients in the ICU.Methods: This study employed a cross-sectional design with 66 ventilated adult patients in the ICUs of two hospitals in Semarang. The pain assessment was administered to the patients in 2 duplo periods by two observers comparing with the Comfort Scale and Critical Care Pain Observational Tool (CPOT) as a gold standard instrument during the pre and post positioning procedures. The data were analyzed using the receiver operating curve (ROC).Result: The results showed that in the pre-positioning procedure, the Comfort Scale had the sensitivity value of 69% and the specificity value of 81%. Meanwhile, in the post-positioning procedure, the values were decreasing (the sensitivity of 45%, the specificity of 67%). This indicated that the sensitivity value of the comfort scale decreased and could be interpreted that the ability of the instrument to detect pain remained low. Meanwhile, the decrease of the specificity value of the instrument between the pre and post administration was not far different, so it could be interpreted that the instrument can correctly identify the patient without pain.Conclusion: The Comfort Scale had a lower value of sensitivity and specificity in the post-positioning than that in the pre-positioning procedure. It is recommended that further studies should focus on the relationship between sedation and pain by using instruments of pain studies for adult patients (CPOT). Additionally, the hospital policy makers, that is Pain Task Force is expected to give education and training through workshops and seminars about the nurse skills in pain management on critical areas as part of the multidisciplinary team.
Perspektif Keluarga dan Perawat tentang Kemitraan Keluarga Dalam Merawat Pasien di Intensive Care Unit Ekowati, Sri Indah; Purnomo, Hery Djagat; Utami, Reni Sulung
Journal Center of Research Publication in Midwifery and Nursing Vol 2 No 2 (2018): Journal Center of Research Publication in Midwifery and Nursing
Publisher : STIKES Bina Usada Bali

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36474/caring.v2i2.44

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Perawatan pasien di Intensive Care Unit (ICU) tidak hanya melibatkan petugas kesehatan, tetapi juga memerlukan peran keluarga. Keluarga juga mengalami stres dan kecemasan selama menunggu pasien di ICU. Patient-Family Centered Care (PFCC) merupakan paradigma baru dalam pelayanan kesehatan yang menempatkan pasien dan keluarga sebagai fokus pemberian asuhan keperawatan. Kemiraan keluarga sangat berperan dalam merawat pasien di ICU. Penelitian ini bertujuan untuk mengeksplorasi perspektif keluarga dan perawat tentang kemitraan keluarga dalam merawat pasien di ICU. Desain penelitian adalah kualitatif dengan pendekatan fenomenologi intepretatif. Informan adalah 10 perawat ICU dan 10 keluarga pasien sesuai dengan kriteria inklusi dan ekslusi yang diambil dengan metode purposive sampling. Penelitian dilakukan di Rumah Sakit Umum Pusat di Kota Semarang pada bulan April sampai Mei 2018. Analisis data dengan teknik intepretative phenomenological analysis (IPA). Hasil penelitian menunjukkan 4 tema utama tentang makna kemitraan keluarga, bentuk kemitraan keluarga, pengaruh kemitraan keluarga, dan tantangan penerapan kemitraan keluarga di ICU. Kemitraan antara perawat dan keluarga diartikan sebagai keadaan dimana perawat sebagai sumber informasi tentang kondisi pasien, perawat memberikan dukungan dan menghargai keluarga, kolaborasi antara pasien dan perawat, partisipasi keluarga dalam memberi dukungan bagi pasien, keluarga bisa mengungkapkan perasaanya pada perawat. Kemitraan keluarga meningkatkan kenyamanan pasien, tetapi mempengaruhi pemberian asuhan keperawatan dan menambah beban kerja perawat. Perspektif keluarga tentang perawatan ICU dan ketidaksiapan perawat menjadi tantangan penerapan kemitraan keluarga di ICU. Kesimpulan dari peneliian ini adalah keluarga dan perawat memahami makna dan pengaruh kemitraan dalam merawat pasien di ICU, tetapi masih terdapat tantangan dan hambatan dalam penerapannya.
Critical Care Nurses’ Experiences of End-of-Life Care: A Qualitative Study Utami, Reni Sulung; Pujianto, Ahmat; Setyawan, Dody; Naviati, Elsa; Rochana, Nana
Nurse Media Journal of Nursing Vol 10, No 3 (2020): (December 2020)
Publisher : Department of Nursing, Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/nmjn.v10i3.31302

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Background: Patients admitted to the intensive care unit (ICU) may face terminal illness situations, which may lead to death. In this case, the role of critical care nurses shifts from life-sustaining to end-of-life care (EOLC). Nurses’ involvement in EOLC varies between countries, even in one country due to differences in religion, culture, organization, laws, cases and patient quality. In Indonesia, research on EOLC in ICU has not been carried out.Purpose: This study aimed to explore the experiences of critical care nurses in providing EOLC.Methods: A qualitative study with a phenomenological approach was conducted. Ten critical care nurses having the experiences of caring for dying patients were recruited through a purposive sampling technique for in-depth interviews. Manual content analysis was used to identify themes.Results: The results of the study found five themes, including the challenge of communication with the family, support for the family, support for the patient, discussion and decision making, and nurses’ emotions. Conclusion: Most of EOLC provided by critical care nurses was focused on the family. They had some challenges in communication and decision making. Nurses need to get training and education about how to care for patients towards the end of life.
Metode Penyapihan Ventilasi Mekanik Di Intensive Care Unit: Studi Literatur Sarinti, Sarinti; Utami, Reni Sulung; Prasetyo, Awal
Jurnal Smart Keperawatan Vol 3, No 1 (2016): Juni 2016
Publisher : Sekolah Tinggi Ilmu Kesehatan (STIKes) Karya Husada Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34310/jskp.v3i1.463

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Latar belakang : Pasien di ICU ( Intensive Care Unit ) yang membutuhkan bantuan ventilasi mekanik hampir mencapai 30% dari total pasien. Ventilasi mekanik yang digunakan dalam jangka panjang dapat meningkatkan resiko terjadinya mortalitas, dan ventilator associated pneumonia sehingga diperlukan perencanaan penyapihan yang tepat.  Tujuan : Studi literatur ini bertujuan untuk mengidentifikasi metode penyapihan pasien dari ventilasi mekanik di ICU. Metode : Penelusuran literatur dilakukan melalui database Google scholar dan Google search dengan menggunakan kata kunci weaning mechanical ventilation, weaning protocol, critical care nursing. Literatur yang digunakan dari tahun 1997-2015 dalam bentuk full text. Literatur yang sesuai kriteria inklusi dan eksklusi dianalisis secara narasi. Hasil: Penelusuran mendapatkan 7 artikel penelitian yang menunjukkan metode penyapihan pasien dari ventilasi mekanik. Metode penyapihan dari ke 7 artikel tersebut adalah metode protokol dan non protokol. Metode non protokol misalnya physician direct weaning ( PDW ) dan collaboration weaning plan ( CWP ). Metode penyapihan dengan protokol antara lain : nurse` protokol directed weaning ( NPDW ) dan protokol base weaning ( PBW ). Kesimpulan : Metode penyapihan protokol menunjukkan hasil lebih efektif dibandingkan metode non protokol. Kata Kunci: Penyapihan Ventilasi Mekanik, Protokol Penyapihan, Keperawatan Kritis Methode of Weaning from Mechanical Ventilation in Intensive Care Unit : Study Literature ABSTRACT Back ground : patients in the ICU who require mechanical ventilation assistance almost 30% of the total patients. Mechanical ventilation is used in the long term can increase the risk of mortality and ventilator associated pneumonia so that proper planning is necessary weaning. Objectives : the literature study aims to identify methods of weaning patients from mechanical ventilation in the ICU. Methods : the literature study search pass through by Google scholar and Google search using keywords weaning mechanical ventilation, weaning protocol, critical care nursing. Literature is used from the year 1997-2015 in the form of full text. Appropriate literature inclusion and exclusion criteria were analyzed narrative. Results : search get 7 articles studies showing methods of weaning patients from mechanical ventilation. Method of weaning to the article 7 is the method protocol and non-protocol. Methods of non protocols eg physician-direct weaning ( PDW ) and collaboration weaning plan ( CWP ). Methods of weaning protocols include: nurse` protocol directed weaning (NPDW) and protocols base weaning ( PBW ). Conclusion : the method of weaning protocol shows the results more effective than non - protocol methods Key word : weaning mechanical ventilation; weaning protocol; critical care nursing
Metode Penyapihan Ventilasi Mekanik Di Intensive Care Unit: Studi Literatur Sarinti Sarinti; Reni Sulung Utami; Awal Prasetyo
Jurnal Smart Keperawatan Vol 3, No 1 (2016): Juni 2016
Publisher : Sekolah Tinggi Ilmu Kesehatan (STIKes) Karya Husada Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34310/jskp.v3i1.463

Abstract

Latar belakang : Pasien di ICU ( Intensive Care Unit ) yang membutuhkan bantuan ventilasi mekanik hampir mencapai 30% dari total pasien. Ventilasi mekanik yang digunakan dalam jangka panjang dapat meningkatkan resiko terjadinya mortalitas, dan ventilator associated pneumonia sehingga diperlukan perencanaan penyapihan yang tepat.  Tujuan : Studi literatur ini bertujuan untuk mengidentifikasi metode penyapihan pasien dari ventilasi mekanik di ICU. Metode : Penelusuran literatur dilakukan melalui database Google scholar dan Google search dengan menggunakan kata kunci weaning mechanical ventilation, weaning protocol, critical care nursing. Literatur yang digunakan dari tahun 1997-2015 dalam bentuk full text. Literatur yang sesuai kriteria inklusi dan eksklusi dianalisis secara narasi. Hasil: Penelusuran mendapatkan 7 artikel penelitian yang menunjukkan metode penyapihan pasien dari ventilasi mekanik. Metode penyapihan dari ke 7 artikel tersebut adalah metode protokol dan non protokol. Metode non protokol misalnya physician direct weaning ( PDW ) dan collaboration weaning plan ( CWP ). Metode penyapihan dengan protokol antara lain : nurse` protokol directed weaning ( NPDW ) dan protokol base weaning ( PBW ). Kesimpulan : Metode penyapihan protokol menunjukkan hasil lebih efektif dibandingkan metode non protokol. Kata Kunci: Penyapihan Ventilasi Mekanik, Protokol Penyapihan, Keperawatan Kritis Methode of Weaning from Mechanical Ventilation in Intensive Care Unit : Study Literature ABSTRACT Back ground : patients in the ICU who require mechanical ventilation assistance almost 30% of the total patients. Mechanical ventilation is used in the long term can increase the risk of mortality and ventilator associated pneumonia so that proper planning is necessary weaning. Objectives : the literature study aims to identify methods of weaning patients from mechanical ventilation in the ICU. Methods : the literature study search pass through by Google scholar and Google search using keywords weaning mechanical ventilation, weaning protocol, critical care nursing. Literature is used from the year 1997-2015 in the form of full text. Appropriate literature inclusion and exclusion criteria were analyzed narrative. Results : search get 7 articles studies showing methods of weaning patients from mechanical ventilation. Method of weaning to the article 7 is the method protocol and non-protocol. Methods of non protocols eg physician-direct weaning ( PDW ) and collaboration weaning plan ( CWP ). Methods of weaning protocols include: nurse` protocol directed weaning (NPDW) and protocols base weaning ( PBW ). Conclusion : the method of weaning protocol shows the results more effective than non - protocol methods Key word : weaning mechanical ventilation; weaning protocol; critical care nursing
PENGALAMAN PASANGAN HIDUP DALAM MENDAMPINGI PENGOBATAN PASIEN MULTIDRUG RESISTANT TUBERCULOSIS (MDR TB) LIFE PARTNER'S EXPERIENCE IN ASSISTING TREATMENT OF MDR TB PATIENT Sakti Vivendi Rosa Widyastuti; Meira Erawati; Reni Sulung Utami; Nur Setiawati Dewi
Jurnal Keperawatan dan Kesehatan Masyarakat Cendekia Utama Vol 10, No 1 (2021): Jurnal Keperawatan dan Kesehatan Masyarakat Cendekia Utama
Publisher : STIKES Cendekia Utama Kudus

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31596/jcu.v10i1.696

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ABSTRAK Latar belakang: pasien Multidrug Resistant Tuberculosis (MDR TB)  merupakan orang yang resisten terhadap obat isoniazid dan rifampisin. Dukungan keluarga terutama pasangan hidup diperlukan ketika pasien MDR TB menjalani pengobatan. Pasangan hidup mempunyai peran penting dalam keberhasilan pengobatan. Tujuan: mengeksplorasi pengalaman pasangan hidup dalam mendampingi pasien yang menjalani pengobatan MDR TB. Metode: penelitian ini merupakan penelitian kualitatif dengan menggunakan pendekatan studi kasus untuk mengeksplorasi bagaimana pengalaman pasangan hidup pasien MDR TB dalam mendampingi dan mendukung pasien yang menjalani pengobatan MDR TB. Partisipan: pemilihan partisipan menggunakan purposive sampling yaitu pasangan hidup yang aktif mendampingi pasien MDR TB dalam menjalani pengobatan. Jumlah partisipan pada penelitian ini adalah tiga orang. Hasil: penelitian ini dapat dikategorikan menjadi dua tema yaitu tantangan dalam merawat pasangan yang menderita MDR TB dan pasrah dalam menjalani hidup. Kesimpulan: pasangan hidup pasien MDR TB memiliki sikap dan perasaan khawatir terhadap kepatuhan pengobatan pasangan, kecemasan jika pengobatan MDR TB tidak berhasil dan terjadi kekambuhan pada pasangan.Kata Kunci:Tuberkulosis resisten obat, Pasangan Hidup, Pendampingan, Pengobatan
Physical Function–Tardive Dyskinesia (PATD) on Critical Patients in Intensive Care Unit Heru Suwardianto; Selvia David Richard; Awal Prasetyo; Reni Sulung Utami
Jurnal Ners Vol. 12 No. 2 (2017): October 2017
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (21.312 KB) | DOI: 10.20473/jn.v12i2.4504

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Introduction: Critical patients are patients who potentially get reversible dysfunction in one or more life-threatening organs and require care in the Intensive Care Unit (ICU).Methods: The objective of this research is to analyse the physical function-tardive dyskinesia in critical patients with sedation in the ICU. The design of this research is cross-sectional. The population is all of the critical patients in the ICU of the Baptist Hospital in Kediri. The purposive sample population was 41 respondents based on the inclusion and exclusion criteria. The variables are ‘giving the sedation’ and ‘physical function-tardive dyskinesia’. The data was collected using a Motor Activity Assessment, and the Sedation Scale for Critically Ill Patients and Tardive Dyskinesia Screening.Results: The results showed that giving sedation can slow physical function in the form of motor activity; the response of noxious stimuli (7.3%), response to touch or calling name (19.5%) and an increasing score of agitation and co-operative (4.9%). Symptoms of tardive dyskinesia increased after sedation in the form of tongue protrusion (4.9%), lip-smacking, puckering and pursing (2.4%), and rapid movements of the arms and legs. The administration of sedation in the first 24-hours in ICU patients affects the physical function of the critical patients (p = 0.005). Conclusion: Giving sedation affects the patients’ physical functions. Therefore, the prevention of the effects of sedation and treatment during ICU is needed in order to avoid a decrease in the physical function of critical patients.
Efektivitas Model Suction Terbuka dan Tertutup Terhadap Kejadian Pneumonia Pada Pasien Yang Terpasang Ventilator Mekanik (VAP): Systematic Review Teguh Santoso; Reni Sulung Utami
Journal of Health (JoH) Vol 5 No 2 (2018): Journal of Health - July 2018
Publisher : LPPM STIKES Guna Bangsa

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (935.661 KB) | DOI: 10.30590/vol5-no2-p62-66

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Latar Belakang: Hisap lendir melalui pipa endotrakeal merupakan prosedur yang paling efektif untuk membersihkan lendir yang menumpuk pada saluran pernapasan pada pasein yang terpasang ventilator. Ada dua macam model hisap lendir, yaitu model hisap lendir terbuka dan tertutup. Tujuan: Untuk mengetahui efektivitas model hisap lendir terbuka dan tertutup terhadap kejadian ventilator associated pneumonia (VAP) pada pasien yang dirawat diruang intensif (ICU). Metode: Sumber data didapatkan dari PubMed, Ebsco, Proquest, dan Google Scolar periode tahun 2000 sampai dengan 2015 dengan mengunakan kata kunci: suctioning, open suctioning, closed suctioning, ventilator associated pneumonia, dan intensive care unit. Jurnal yang digunakan dalam penelitian ini adalah jurnal yang melakukan perbandingan antara model hisap terbuka dan tertutup, dilakukan pada manusia dengan desain prospektif kohort dan full text. Hasil: Dari 55 artikel ilmiah yang diidentifikasi hanya 4 yang dilakukan review. Artikel tersebut menjelaskan hubungan pemberian model hisap lendir terhadap kejadian VAP. Dimana dari 4 artikel tersebut seluruhnya menyatakan bahwa tidak ada hubungan signifikan secara statistic. Kesimpulan: Model hisap lendir terbuka dan tertutup dapat membantu sistem kerja pernapasan dan tidak menimbulkan terjadinya VAP pada pasien yang menggunakan ventilator.
Phisical Function (Motor Activity) Pada Pasien Kritis Dengan Sedation Di Intensive Care Unit Heru Suwardianto; Awal Prasetyo; Reni Sulung Utami
coba Vol 5 No 2 (2017): Mei 2017
Publisher : Akademi Keperawatan Dharma Husada Kediri

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (6.106 KB) | DOI: 10.32831/jik.v5i2.139

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Introduction: Critical patients are patients who potentially get reversible dysfunction in one or more life-threatening organs and require they require care in the Intensive Care Unit (ICU). Method: The objective of this research is to analyze the physical function-tardive dyskinesia on critical patients with sedation in ICU. The design of this research is crossectional. The population is all critical patients in ICU Baptist Hospital Kediri. The sample is 41 respondents based on the inclusion and exclusion criteria in the total sampling. The independent variable is giving the sedation and the dependent variable is physical function-tardive dyskinesia. The data was collected using observation sheets. Result: The result shows that giving a sedation can decrease the physical function in the form of motor activity; response of noxious stimuli (7.3%), response to touch or calling name (19,5%) and the incresing score of agitation and co-operative (4.9%). Symptoms of tardive dyskinesia increased after sedation in the form of tongue prostrusion (4.9%), lip smacking puckering and pursing (2.4%), and rapid movements of the arms and legs. Administration of sedation in the first 24-hour ICU patient affects the physical function of the critical patients (p = 0.005). Conclusion: Giving sedation affects the change of patiens’ physical funcion. Therefore, prevention on the effects of sedation and treatment during ICU is needed in order to avoid a decrease in the physical function of critical patients. Keyword: physical function, tardive dyskinesia, sedation, critical patient, ICU