THE APPLICATION OF CLOSE SUCTION TO HELP INEFFECTIVENESS OF AIRWAY CLEARANCE IN PATIENTS WITH VENTILATOR IN THE INTENSIVE CARE UNIT

Introduction: Endotracheal tube in patients with ventilator is a foreign thing in respiratory tract secretions that can increase the production of the airway and cause airway clearance ineffectiveness problems that require suction action. The close suction technique is used in patients who are using ETT type. Close suction system is one of technique suction that applied without opening the ventilator connector in patients with ventilator in Intensive Care Unit. The purpose of this case study is to evaluate breath sounds, RR, SpO2 before and after implementation of technique close suction in patients with ventilator in the Intensive Care Unit of Dr Mohammad Soewandhie Hospital Surabaya. Method: Research method was a case study in patients with early pulmonary edema eclampsia who use a ventilator. The instrument used is the observation sheet. Result: The results of the case study showed before the close suction action Ronchi breath sounds in the right lung field left, RR 27 x / min, and SpO2 90%. After applying technique close suction action on the first day with the results of SpO2 95%, RR 22 x / min, still no sound Ronchi in both lung fields, day 2 with the results of SpO2 97%, RR 20 x / min, there was the sound of a smooth Ronchi left lung, day 3 with the results of the oxygen saturation of 100%, RR 18 x / min and vesicular breath sounds. Discussion: Based on these results it can be concluded that the provision of closed suction system technique is effective in addressing the problem of ineffectiveness airway clearance. However, in patients with pulmonary infection that uses a ventilator with thick secretions should be given nebulizer prior to close suction action. Key words: closed suction system, ineffective airway clearance, ventilator, intensive care uni

Identifikasi Tindakan Aff Sheath Radialis Dan Aff Sheath Femoralis Masa Inflamasi Pada Post Cateterisasi Jantung Di Ruang ICCU Rsud Dr.Mohamad Soewandhie Surabaya

Kateterisasi jantung merupakan prosedur diagnostik invasive dimana menggunakan satu atau lebih kateter dimasukkan kedalam jantung dan pembuluh darah tertentu untuk mengukur tekanan dalam berbagai ruang jantung, rnenentukan saturasi oksigen dalam darah dan yang paling banyak dilakukan adalah untuk menentukan derajat penyempitan pada arteri koroner. Di RSUD dr. Moh Soewandhie tahun 2014  sebagian  besar post cateterisasi jantung  dilakukan aff sheath radialis dari pada aff sheath femoralis. Di ruangICCURSUD dr. Moh Soewandhie  tahun 2014, aff sheath femoralis lebih sering terjadi hematom, perdarahan, inflamasi pada luka dan membutuhkan penekanan yang lama. Tujuan penelitian ini menganalisa Perbedaan Masa Inflamasi Pada Tindakan Aff Sheath Radialis Dan Aff Sheath Femoralis Post Cateterisasi Jantung Di Ruang Iccu Rsud Dr.Mohamad Soewandhie SurabayaPenelitian ini menggunakan desain penelitian cross secsional dengan metode observasi dengan populasi pasien Post Cateterisasi Jantung Di Ruang ICCU di  RSUD Dr Mohamad Soewandhie Surabaya, dengan jumlah sampel 30 responden dibagi 15 responden diberi aff sheath radial, 15 responden diberi  aff sheath femoral, dan 15 responden sebagai control diberi selimut kain. Analisa data dengan uji statistik Mann Whitney U TestBerdasarkan perhitungan koefisien, Mann Whitney U Test Asymp, Sig(2-tailed)=0,002 dengan uji statistik SPSS didapatkan hasil p=0,002 < 0,005 yang berarti ada perbedaan Masa Inflamasi Pada Tindakan Aff Sheath Radialis Dan Aff Sheath Femoralis Post Cateterisasi Jantung Di Ruang ICCU RSUD Dr.Mohamad Soewandhie Surabaya.Masa inflamasi pada pasien post Cateterisasi Jantung di berikan aff sheath radialis sebagian besar baik,  pada aff sheath femoralis didapat hasil sebagian besar cukup. Sehingga aff sheath radialis yang paling efektif  dibandigkan aff sheath femoralis.Kata kunci : Aff Sheath Radialis,  Aff sheath  Femoralis, Masa inflamasi

Latihan Fisik Terarah Penderita Post Sindrom Koroner Akut dalam Memperbaiki Otot Jantung

Background: One of cardiovascular disease and very scary is acute coronary syndrome (ACS). It is currently one of the leading causes of death in developed and developing countries, including Indonesia. SKA can be either acute myocardial infarction, including ST-segment elevation MI (STEMI) and non- segment elevation MI (NSTEMI), and unstable angina. Globally become the fi rst cause of death in developing countries, replace mortality due to infection. Systematic eff ort is needed and intensively to prevent the increasing cases of illness, among others with cardiac rehabilitation. One of cardiac rehabilitation can be done is directed physical exercise.Objectives: To determine the eff ect of derected physical exercise on the function of cardiac muscle, assessed based on the results of blood pressure, pulse and ECG.Methods: The study uses a quasi-experiment design, the research subjects totaling 64 people divided into intervention group as 32 peoples and control group of 32 peoples, carried out in hospital cardiac clinic Siti Khodijah Surabaya.Results: Wilcoxon test and Mann Whitney test, obtained results there is a significant influence on tension with p-value of 0.001 (p 0.05), there is no signifi cant eff ect on the change of the pulse with the p-value of 1.000 (p 0.05), and signifi cantly infl uence changes in EKG with P-value 0.000 (P 0.05). The results of the Nagelkerke test and Chi-square, obtained results physical exercise directed has contributed to the tension of 16.4%, OR = 9.552, while the ECG changes of 47.0%, OR = 27.617.Conclusions: Physical exercise directed has a signifi cant eff ect on blood pressure and EKG, where the directional physical exercise has a more signifi cant eff ect on blood pressure than the ECG.Key word: Physical exercise directed and Coronary acute syndrome (ACS

The Implementation Of The Guided Walking Imagery Relaxation On The Decreasing Human Chest Pain Scale By Acute Coronary Syndrome Medical Diagnose In Intensive Care Unit Room Of Siti Khodijah Hospital, Sepanjang

Introduction: Acute coronary syndrome is a blood flow hindrance in the coroner artery that supplies blood to the cardiac muscle. A number of first time symptom in heart disease showed the sudden death patients. Other symptom are pain in the chest felt like being pressured, its felt until on the left shoulder and neck such as being choked. called "Boro". The consequence is leaving his wife for several months even years. Objective: This research purpose is how to identify the implementation of guided walking imagery relaxation on the decreasing of the pain scale on the human chest of acute coronary syndrome patients. Method: The research design uses the case study style of research. The case study style of research is the design which describes one fact to answer one or more phenomena. The case study in this research tests the implementation of a procedure. This case study research was applied by giving the intervention or treatment and then observed the result for the final step.Results:The research goal showed that after the implementation of the guided imagery, the researcher gained the result from the first patient who had a pain scale, the therapy that was proposed could decrease the pain scale until reach the low scale of pain, while the second patient with the high pain scale could not continue the therapy and had to be helped by collaborative treatment by the other medical team. Conclusion: The conclusion that could be obtained is the guided imagery could decreasing the pain on human chest for the medium scale, while this therapy cannot be continued for the high pain scale patients.   Keywords: Guided Walking Imagery Relaxation, human chest pain, Acute coronary syndrom

The determinants of patient care manager role and the implementation of COVID-19 clinical pathway: a cross-sectional study

Objective This study aims to determine the factors associated with patient care manager role and the implementation of the clinical pathway among nurses in private hospitals. Methods This study was conducted from January–July 2021 using the cross-sectional approach. The sample consisted of 168 nurses working in a private hospital in Surabaya City, East Java, Indonesia. Meanwhile, the data were collected using the Patient Care Manager Role Scale (PCMRS) and analyzed by multiple logistic regression to find the correlation between the variables. Results A higher percentage of nurses namely 64.3% had compliance in COVID-19 clinical pathways with an average PCMRS score of 27.81 ± 2.43. Nurses with a high-level patient care manager role level had a significant compliance risk with odds ratio [OR] 440.137, 95% confidence interval [CI] [51.850–3736.184], and p-value = 0.000 compared to those with a low role. Conclusion The role of patient care manager and compliance with COVID-19 clinical pathways correlated significantly. Based on the results, several actions are needed for the early identification of patient service managers’ roles to ensure compliance with COVID-19 clinical pathways and reduce the number of cases in Indonesia