Hubungan Mean Arterial pressure dengan kejadian Post Operative Nausea Vomiting pada pasien seksio sesarea dengan spinal anestesi di RSUD Sleman Yogyakarta

Latar belakang: Seksio sesarea adalah suatu teknik pembedahan untuk melahirkan janin melalui insisi pada dinding abdomen dan uterus. Seksio sesarea tentunya tidak terlepas dari tindakan anestesi. Anestesi spinal merupakan teknik anestesi terbaik bagi seksio sesarea, tetapi anestesi spinal juga memiliki kekurangan. Teknik anestesi spinal memiliki kekurangan seperti terjadinya bradikardi, apnoe, pernafasan tidak adekuat, nausea/ mual dan muntah, pusing kepala pasca pungsi lumbal, blok spinal tinggi atau spinal total, hipotensi. Hipotensi merupakan salah satu penyebab terjadinya mual muntah pada spinal anestesi. Tujuan: Diketahuinya hubungan MAP dengan kejadian PONV pada pasien seksio sesarea dengan spinal anestesi di RSUD Sleman Yogyakarta. Metode: Jenis penelitian ini merupakan penelitian observasional analitik dengan menggunakan metode kuantitatif menggunakan desain penelitian cross sectional. Sampel penelitian ini berjumlah 48 responden. Pengambilan sampel dengan consequtive sampling. Alat pengumpulan data yang digunakan pada penelitian ini adalah lembar observasi yang berisi tekanan darah dan mual muntah post operasi. Uji yang digunakan adalah uji spearman rank. Hasil: Hasil penelitian yaitu hipotensi 13 responden (27,1%), kejadian PONV 17 responden (35,4%). Dari uji statistik dengan uji sperman rank didapatkan hubungan bermakna yaitu p Value sebesar 0,004 ( p < 0,05), dengan keeratan sedang yaitu 0,405. Kesimpulan: Terdapat hubungan MAP dengan kejadian PONV pada pasien seksio sesarea dengan spinal anestesi di RSUD Sleman Yogyakarta. Kata kunci: Mean Arterial Pressure, Post Operative Nausea Vomiting, Spinal Anestes

Averrhoa carambola Benefits to Reduce Hyphertension

Hypertension is a common health problem in the community. Uncontrolled hypertension can lead to degenerative diseases, such as congestive heart failure, kidney failure, and vascular disease. Hypertension is called the "silent killer" because it is symptomatic that cause strokes and heart disease. Therefore, patients with hypertension should have adherence to effectively control and obtain regular double intervention either farmako and other alternatives such as complementary therapies. The purpose of this study was to determine the star fruit (Averrhoacarambola) as a complementary therapy is effective in reducing systolic and diastolic blood pressure in patients with essential hypertension. This study begins with empirical studies and phytochemical test on star fruit in a laboratory Pharmacy Polytechnic Bandung, and worthy of ethics and the MoU between the Ministry of Health Polytechnic Yogyakarta and Bandung. This research method using experimental design, the type of Quasi experimental, with "Pre-test and Post-test Control Group Design without" 80 respondents in Community Health Centre Sleman Yogyakarta and Sukajadi Bandung. The results of the analysis of different test by Mann-Whitney that there was no significant difference to the decrease in blood pressure between the groups and slices of star fruit juice in systolic blood pressure p = 0.197 (> 0.05) and diastolic p = 0.061 (> 0.05). Results Wilcoxcon analysis, significantly there is a decrease in systolic blood pressure p = 0.000 (<0.05) and diastolic p = 0.000 (<0.05) after given juice and slices of starfruit. Phytochemical screening observed in the flavonoid as an amplifier arrangement of capillaries, decrease the permeability and fragility of blood vessels, as well as having bioactive compounds such as diuretics which can promote blood circulation, and thus can reduce the risk of heart and cardiovascular disease as well as preventing hypertensive disorders. Starfruit juice as a complementary therapy known to be effective in lowering systolic and diastolic blood pressure in patients with essential hypertension.

PANCI TEKAN SEBAGAI ALAT STERILISASI ALTERNATIF PENGGANTI AUTOKLAF

Background : The result of infection control procedure survey in Puskesmas showed that there were the health worker’s practices that increased potentially for transmission of infection, not only for patients but also for health workers. Sterilization is an important component for annihilating all microorganism include spore. As a standard sterilizer, autoclave was rarely had by Puskesmas (13.3%). Press cooker has the same principle mechanism as autoclave, therefore it can be used to sterilizer. Objective :The purpose of this study was to investigate the press cooker effectiveness as sterilizer to sterilize Bacillus subtilis. Methods : This study used laboratory experimental with posttest only with control group design. The samples were 54 tubes of Bacillus subtilis bacteria. In first research, the samples were 30 tubes of Bacillus subtilis. The variable was ability for sterilizing Bacillus subtilis by press cooker in 15 minutes. In second research, the samples were 24 tubes of Bacillus subtilis. The variable was the need of time for sterilizing Bacillus subtilis by press cooker. The result of sterilization test for Bacillus subtilis can be observed by incubation bacteria tubes into incubato for 24 hours in 37°C. The media were sterile, if they were transparent. Results : The result was press cooker can sterilize all of the Bacillus subtilis (100%) like autoclave in 15 minutes. The Kappa’s coefficient showed there was very good coefficient (K > 0.75) between press cooker and autoclave as sterilizer. Press cooker can sterilize Bacillus subtilis in 1 minutes. There was not the significant difference of time between a press cooker an another for sterilizing Bacillus subtilis. Conclusion : Press cooker had the same effectiveness as autoclave in sterilizing Bacilus subtilis. Press cooker needs time 11 minutes for sterilizing. Keyword : Press cooker and autoclave, Sterilize, Bacillus subtili

THE RELATIONSHIP OF SPINAL NEEDLE INSERTION PARAMEDIAN AND MEDIAN TECHNIQUES WITH HEADACHE POST SPINAL ANESTESHIA AT RSUD SEKAYU MUSI BANYUASIN

Background: postoperative pain is likely to be caused by surgical incision, but the possibility of other causes should be consider, including complications from spinal anesthesia, where the most often complication complained by the patient is a headache. The use of spinal anesthesia paramedian and median techniques are both often used in surgery, leakage of liquor because the stabbing on the ligaments through, and the impact that often arise after spinal anesthesia is a headache. If there is no headache or patient condition the same as pre-surgical condition, it can be shortened hospitalization time, reduce costs and reduce the psychological stress. Research goal: To determine the relationship of spinal needle insertion paramedian and median techniques with headache post operation to the spinal anesthesia at RSUD Sekayu Musi Banyuasin. Research method: Analytic observational studies using cross-sectional study design. Sample in this research was 66 patients in the installation of operating room and in the ward, general hospital Sekayu Musi Banyuasin according to the inclusion and exclusion criteria. Data was analysis with statistical chi square test. Research result: Headache response in the group of spinal needle insertion with paramedian technique post spinal anesthesia was: no pain (75.8%), mild pain (21.2%), and moderate pain (3.0%). Headache response in the group spinal needle insertion with median technique post spinal anesthesia was : no pain (57.6%), mild pain (12.1%), moderate pain (21.2%) and severe pain (9.1%). Conclusion: There is relationship of spinal needle insertion paramedian and median techniques with headache post operation to the spinal anesthesia at RSUD Sekayu Musi Banyuasin. This was proven by Chi Square test which known X2 value in amount of 9,136 with significance is 0,028 (p<5%). Keywords: spinal anesthesia, paramedian and median techniques, pain. INTISARI Latar Belakang : Nyeri pasca operasi mungkin sekali disebabkan oleh luka operasi, tetapi kemungkinan sebab lain harus dipertimbangkan, diantaranya adalah komplikasi akibat pemberian spinal anestesi, dimana komplikasi yang paling sering dikeluhkan oleh pasien adalah nyeri kepala. Penggunaan spinal anestesi teknik paramedian dan median sama-sama sering digunakan pada tindakan operasi, kebocoran liquor karena penusukan pada ligamen yang dilalui, serta dampak yang sering timbul pasca tindakan anestesi spinal adalah nyeri kepala. Apabila nyeri kepala tidak terjadi atau kondisi sama seperti prabedah maka dapat dipersingkat waktu rawat di rumah sakit, mengurangi beban biaya dan mengurangi beban stress psikis. Tujuan Penelitian : Mengetahui Hubungan Penusukan Jarum Spinal Teknik Paramedian Dan Median Dengan Nyeri Kepala Post Operasi Pada Spinal Anestesi Di RSUD Sekayu Kabupaten Musi Banyuasin. Metode Penelitian : Penelitian mengunakan metode observasi analitik dengan desain penelitian cross sectional. Sampel dalam penelitian ini diperoleh sebanyak 66 pasien di ruang Instalasi Bedah Sentral dan ruang rawat inap RSUD Sekayu Musi Banyuasin sesuai dengan kriteria inklusi dan eksklusi. Analisis data dilakukan dengan uji statistik uji chi Square. Hasil Penelitian : Respon nyeri kepala pada kelompok penusukan jarum spinal teknik paramedian post spinal anestesi adalah: tidak nyeri sebanyak (75,8%), nyeri ringan sebanyak (21,2%) dan nyeri sedang sebanyak (3,0%).Respon nyeri kepala pada kelompok penusukan jarum spinal teknik median post spinal anestesi adalah: tidak nyeri sebanyak (57,6%), nyeri ringan sebanyak (12,1%), Nyeri sedang sebanyak (21,2%) dan nyeri berat sebanyak (9,1%). Kesimpulan : Ada hubungan penusukan jarum spinal teknik paramedian dan median dengan nyeri kepala post operasi pada spinal anestesi di RSUD Sekayu Kabupaten Musi Banyuasin. Dibuktikan uji Chi Square diketahui nilai X2 sebesar 9,136 dengan signifikan sebesar 0,028 (p<5%). Kata Kunci : Spinal Anestesi, Teknik Paramedian Dan Median, Nyeri

GYMNASTICS DIABETIC EFFECTIVE LOWERING BLOOD GLUCOSE LEVEL IN DIABETIC TYPE II PATIENTS

Introduction : WHO predicting global prevalence of diabetics tipe II increasing from 171 million people in 2000 to 366 million people in 2030, and Indonesia ranked fourth. Aerobic exercise and if the exercise is done three times a week can lower blood glucose levels in diabetic patients (Miharja, 2000 ). In doing physical exercise diabetic patient prefers doing gymnastics diabetic because it is done together with other diabetic patients so that more enjoyable. Results of research conducted in Puskesmas Jetis I Bantul showed 40 % of patients with diabetes mellitus type II in Puskesmas Jetis I Bantul follow gymnastics which was held Puskesmas every single week . 63 % of patients with diabetes mellitus type II exercise routine at home in the form of walking . ( Nurmalita , 2011). The aims of study to know the effectiveness of diabetes gymnastics lowering blood glucose, blood pressure and weight in patients with diabetic type II Methods: The study was Quasi experiment: non equevalen control group. 15 enrolled participants do gymnastics diabetics three times a week as a intervension group and 15 enrolled participants do gymnastics diabetics one week as a control group. Data were analyzed using unpaired t test and Mann - Whitney. Results: The mean decrease in blood glucose levels in the intervention group was 18.76 mg / dl (± 23.309) and the control group of 2.8 mg / dl (± 36.099), the results of Mann - Whitney was obtained p value = 0.032 (p 0.05). The mean weight loss of 0.8 kg in the intervention group (± 1.69) and the control group 0.2 Kg (± 4.039) test results Mann - Whitney was obtained p = 0.018 (p <0.05) Conclusion: Diabetic Gymnastics effective in lowering blood glucose levels, weight loss. Keywords; Diabetes Mellitus , Blood glucose level , Gymnastics diabetes , weight los

HUBUNGAN PENGETAHUAN DENGAN KEPATUHAN PELAKSANAAN ASSESMEN PRE ANESTESI DI INSTALASI BEDAH SENTRAL RSUD WATES

Latar Belakang: Tindakan persiapan pre anestesi pada dasarnya digunakan untuk menyiapkan pasien sebelum dilakukan tindakan anestesi, dampak yang ditimbulkan dari persiapan anestesi yang kurang matang dapat mengancam nyawa pasien dan bila berlanjut menyebabkan kematian. Hal ini bisa disebabkan karena mengabaikan SOP yang sering menyebabkan permasalahan hukum. Oleh karena itu pentingnya pengetahuan dan kepatuhan atau keterampilan didalam persiapan pre anestesi salah satunya dengan pengisian dokumen assesmen pre anestesi. Metode: Penelitian ini menggunakan jenis penelitian survei analitik desain cross sectional dengan Teknik consecutive sampling. Data yang diambil sebanyak 140 dokumen assesmen pre anestesi di Instalasi Bedah Sentral RSUD Wates. Instrumen penelitian yang digunakan adalah lembar kuesioner untuk pengetahuan perawat anestesi dan studi dokumen kepatuhan perawat anestesi tentang assesmen pre anestesi. Analisis yang digunakan uji Spearman’s Rank dengan tingkat kemaknaan 0,05. Hasil: Hasil penelitian menunjukkan sebagian besar pengetahuan tentang pengisian assesmen pre anestesi cukup (45,9%) dan sebagian besar patuh melakukan pengisian assesmen pre anestesi ada (57,9%). Sedangkan hubungan pengetahuan dengan kepatuhan kategori baik dan patuh (49,4%), pengetahuan baik dan cukup kategori kurang patuh masing-masing (53,1%). sedangkan pengetahuan kurang kategori patuh ada (43,8%). Berdasarkan hasil uji Spearman’s Rank diperoleh hasil nilai signifikansi p-value 0,033 (P< 0,05) dan nilai koefisien korelasi (0,180) yang menunjukan semakin baik pengetahuan maka, semakin patuh dalam melaksanakan assesmen pre anestesi. Kesimpulan: Ada hubungan pengetahuan dengan kepatuhan pelaksanaan assesmen pre anestesi. Kata Kunci: Assesmen Pre Anestesi, Kepatuhan, Pengetahuan

PENERAPAN PENDIDIKAN KESEHATAN DIET DIABETES PADA KELUARGA DENGAN KLIEN DIABETES MELITUS DI WILAYAH KERJA PUSKESMAS SEWON II

Pendidikan kesehatan diet diabetes memberi informasi tentang pola makan sehat untuk penderita diabetes melitus tipe 2 sesuai dengan pedoman diet 3J, yaitu jam makan, jumlah kalori, dan jenis makanan. Penerapan pendidikan kesehatan diet diabetes dilakukan pada dua keluarga dengan salah satu anggota keluarga merupakan penderita diabetes melitus di wilayah kerja Puskesmas Sewon II. Jenis penelitian yang digunakan adalah studi kasus. Subjek penelitian adalah dua keluarga yang memiliki anggota keluarga penderita diabetes melitus tipe 2, penderita pada kasus 1 berusia 49 tahun dan kasus 2 berusia 44 tahun. Instrumen penelitian yang digunakan berupa format pengkajian asuhan keperawatan keluarga, daftar rencana pilihan menu makanan, checklist jadwal disiplin diet, kartu kontrol gula darah, lembar balik, leaflet, dan easy touch GCU. Penelitian dilakukan dari bulan Mei-Juli dengan 8 kali kunjungan. Hasil penelitian menunjukkan bahwa pada kasus 1 kadar gula darah tidak stabil dan tidak patuh menjalankan disiplin diet sedangkan pada kasus 2 kadar gula darah stabil dan patuh menjalankan disiplin diet. Penerapan pendidikan kesehatan diet diabetes dan kontrol rutin kadar gula darah dapat meningkatkan motivasi penderita diabetes melitus tipe 2 untuk menjalankan kepatuhan disiplin diet diabetes. Kata Kunci : Diabetes Melitus, Diet, Kadar Gula Darah, Pendidikan Kesehata

HUBUNGAN PELAKSANAAN OPERASI DENGAN KEPATUHAN TIM OPERASI DALAM PENERAPAN SURGICAL SAFETY CHECLIST DI INSTALASI BEDAH SENTRAL RSKIA SADEWA YOGYAKARTA

Tindakan pembedahan bertujuan untuk menyelamatkan nyawa, namun dapat juga menimbulkan Kejadian Tidak Diharapkan (KTD), Kejadian Nyaris Cidera (KNC), baik cidera medis maupun komplikasi yang dapat membahayakan nyawa. Data kematian sebelum pengenalan Surgical Safety Checklist 3,7% menjadi 1,4%. Komplikasi bedah setelah penggunaan Surgical Safety Checklist secara keseluruhan turun dari 11% sampai 7% dan angka kematian menurun dari 1,5% menjadi 0,7%. Penelitian ini bertujuan untuk mengetahui hubungan pelaksanaan operasi dengan kepatuhan tim operasi dalam penerapan Surgical Safety Checklist di Instalasi Bedah Sentral RSKIA Sadewa Yogyakarta. Jenis penelitian ini adalah penelitian observasional dengan pendekatan cross sectional. Sampel dalam penelitian ini adalah kegiatan operasi bedah berjumlah 65 kegiatan. Tehnik sampling yang digunakan adalah accidental sampling. Analisa data menggunakan uji chi square. Sebagian besar tim operasi melaksanakan operasi elektif yaitu 36 kegiatan operasi (55,4%), tidak patuh dalam menerapkan Surgical safety checklist fase sign in yaitu 26 kegiatan (40%), tidak patuh menerapkan Surgical safety checklist fase time out yaitu 30 kegiatan (46,2%) dan tidak patuh menerapkan Surgical safety checklist fase sign out yaitu 31 kegiatan (47,7%). Hasil uji chi square didapat nilai signifikansi (p) 0,114 > 0,05. Tidak ada hubungan Pelaksanaan Operasi dengan Kepatuhan Tim Operasi dalam Penerapan Surgical safety checklist di Instalasi Bedah Sentral RSKIA Sadewa Yogyakarta. Kata kunci : Kepatuhan, Surgical Safety Checklis

HUBUNGAN KARAKTERISTIK PASIEN PRE-OPERASI LAPARTOMI DENGAN GENERAL ANESTESI TERHADAP TINGKAT KEEMASAN DI RUANG PERSIAPAN RS.RK. CHARITAS PALEMBANG

Background: Psychosocial problems especially fearand anxietyexperienced by every person always in the face ofanesthesia or surgery. Fear and anxiety that may be experienced patients are diagnosed by the physical changes such as increased blood pressure, pulse and respiration, hand movements are not controlled, moist palms, anxious, asks the same question repeatedly, difficultysleeping, frequent urination Objective: To determine the relationship of patient characteristics pre - laparotomy surgery with general anesthesia on the anxiety level of preparation in room of RK.Charitas Hospital Palembang Method: T h i s study was an observational cross - sectional study. The number of samples obtained as many as 42 people with thesampling technique used is accidental sampling. Data analysis using chi-square statistical test or Kolmogorov-Smirnov Test if the condition is not met with the 95% confidencelevel (a =0.05). Result: Laparotomy patient preoperative characteristics ofpatients with general anesthesia in the preparation of the majority of the male 54.8%, age ≤ 35 years and > 35 years, respectively 50%, had never undergone surgery 73.8%, and 83.3% advanced education. A total of 15 patients or 35.7% had severe anxiety levels, 14 patients or 33.3% had mild anxiety levels, and 13 patients or 31.0% had amoderate level ofanxiety. Conclusion: Characteristics of patients pre-surgery with general anesthesia laparotomy which have an influence on the level of anxiety is the experience ofsurgery (p = 0.020), and education (p = 0.030). While gender (p = 0.746) and age (p = 0.931) had no significant effect with the level ofpatient anxiety pre-surgery general anesthesia laparotom

PERBANDINGAN KEBERHASILAN PEMASANGAN LARINGEAL MASK AIRWAY (LMA) UNIQUE PADA UPAYA PERTAMA ANTARA TEKNIK STANDAR DIGITAL DENGAN TEKNIK JAW TRUST DI RSM “DR. YAP” YOGYAKARTA

ABSTRAK Keberhasilan pemasangan LMA sangat tergantung pada keterampilan petugas dan kedalaman anestesi yang dapat dinilai dari efek atau komplikasi yang terjadi pada saat pemasangan. Masih banyak diterapkan berbagai teknik pemasangan LMA Unique seperti teknik standar digital dan teknik jaw thrust. Berdasarkan teknik yang digunakan terdapat tindakan yang mengakibatkan pemasangan LMA harus diulang atau diperbaiki posisi LMA agar kepatenan jalan nafas dapat terjaga. Penelitian ini bertujuan untuk mengetahui perbandingan keberhasilan pemasangan LMA Unique pada upaya pertama antara teknik standar digital dengan teknik jaw thrust di RS Mata “Dr. YAP” Yogyakarta. Penelitian ini merupakan penelitian eksperimen untuk mengetahui perbandingan keberhasilan pemasangan LMA Unique pada upaya pertama antara teknik standar digital dengan teknikjaw thrust. Populasi dalam penelitian adalah semua pasien yang menjalani prosedur bedah elektif ASA I dan II yang dianestesi umum dengan menggunakan alat bantu napas LMA Unique. Pengambilan sampel dengan teknik purposivedidapatkan 60 orang. Analisa data menggunakan Uji Mann-Whitney.Keberhasilan pemasangan LMA Unique dengan teknik standar digital pada upaya pertama yang dinyatakan berhasil sebanyak 56,7%. Sementara sebanyak 43,3% mengalami perbaikan.. Keberhasilan pemasangan LMAUnique dengan teknik jaw thrust yang dinyatakan berhasil sebanyak 90,0%. Sementara yang tidak berhasil hanya 10.0%. Selain itu terdapat perbedaan keberhasilan pemasangan LMA Uniqueyang signifikan pada upaya pertama dengan teknik jaw thrust dengan teknik standar digital. Nilai Z hitung sebesar -2,762 dan nilai signifikansi p-value sebesar 0.006 (p<0.05). Angka mean rank keberhasilan pemasangan LMA Unique pada upaya pertama dengan teknik jaw thrust lebih tinggi dibandingkan dengan teknik standar digital. Terdapat perbedaan keberhasilan pemasangan LMA Unique yang signifikan pada upaya pertama dengan teknik jaw thrust dengan teknik standar digital.Angka keberhasilan pemasangan LMA Unique pada upaya pertama dengan teknik jaw thrust lebih tinggi dibandingkan dengan teknik standar digital. Kata kunci : LMA, standar digital, jaw thrust ABSTRAC The installation success of the LMA is highly dependent on the perpetrators skill and the depth of anesthesia that can be measured from the effects or complications that occur during installation. Based on the field practical experience, various installation techniquess of LMA Unique such as digital standard techniques and jaw thrust techniques are still widely applied. Based on the techniques used there are some actions that result the LMA installation must be repeated or improved in order the patency of the airway can be maintained. The aim of This study is to know the comparison of the installation success of LMA Unique at the first effort between digital standard techniques with jaw thrust techniques at the Eye Hospital of "Dr. YAP" Yogyakarta. This study is an experimental study to know the comparison installation success of LMA Unique at the first effort between digital standard techniques with jaw thrust techniques. The population in this study are all patients who undergo elective surgical procedure ASA I and II. They are all in general anesthetized using a ventilator LMA Unique. The techniques that is used to take the sampling is purposive techniques and it is obtained 60 people. The Data are analyzed using the Mann-Whitney test. 56.7% are considered succesful at the first effort of the LMA Unique installation with digital standard techniques. While 43.3% experience improvement. The installation success of LMA Unique with jaw thrust techniques that is considered successful are 90.0%. While only 10.0% are fail. In addition, there is a significant difference of the installation success at the first effort between jaw thrust techniques with digital standard techniques. This is evidenced by the Z value - 2.762 and the significance value of p-value 0.006 (p <0.05). The Success rate for LMA Unique installation at the first effort with jaw thrust techniques is higher than the digital standard techniques. There is a significant difference of the LMA unique installation success at the first effort between jaw thrust techniques with digital standard techniques. The Success rate for LMA Unique installation at the first effort with jaw thrust techniques is higher than the digital standard techniques. Keywords: LMA, digital standar, jaw thrus