PENERAPAN EDUKASI MODEL TEACH BACK PADA PASIEN DENGAN GAGAL JANTUNG KONGESTIF
Di Ruang Marwah – RS Muhammadiyah Lamongan
KARYA ILMIAH AKHIR NERS
MARLIANTI MUSLIMAH (NIM: 202110461011081)
PROGRAM STUDI PROFESI NERS FAKULTAS ILMU KESEHATAN
UNIVERSITAS MUHAMMADIYAH MALANG
TAHUN 2022
ii
PENERAPAN EDUKASI MODEL TEACH BACK PADA PASIEN DENGAN GAGAL JANTUNG KONGESTIF
Di Ruang Marwah – RS Muhammadiyah Lamongan
KARYA ILMIAH AKHIR NERS
Diajukan Kepada Universitas Muhammadiyah Malang Untuk Memenuhi Salah Satu Persyaratan Dalam Menyelesaikan Program Studi Profesi Ners
MARLIANTI MUSLIMAH (NIM: 202110461011081)
PROGRAM STUDI PROFESI NERS FAKULTAS ILMU KESEHATAN
UNIVERSITAS MUHAMMADIYAH MALANG
TAHUN 2022
iii
LEMBAR PERSETUJUAN
iv
LEMBAR PENGESAHAN
v
SURAT PERNYATAAN KEASLIAN TULISAN
vi
KATA PENGANTAR
Puji syukur kehadirat Allah SWT atas berkat rahmat dan karunia-Nya sehingga karya ilmiah akhir Ners ini dapat diselesaikan. Shalawat serta salam tidak lupa juga untuk diucapkan kepada Rasulullah Nabi Muhammad SAW berserta keluarga dan para sahabat Rasulullah yang telah mengajarkan nilai-nilai islam yang hingga kini masih dapat dinikmati oleh seluruh umat di seluruh dunia. Karya ilmiah akhir ners dengan judul “Penerapan Edukasi Model Teach Back Pada Pasien dengan Gagal Jantung Kongestif” merupakan salah satu syarat untuk mendapatkan gelar profesi Ners (Ns.) pada Program Pendidikan Profesi Ners Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang.
Bersamaan dengan ini perkenankanlah penulis mengucapkan terima kasih yang sebesar-besarnya dengan hati yang tulus kepada:
1. Bapak Dr. Yoyok Bekti Prasetyo, M.Kep., Sp.Kom selaku Dekan Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang
2.
Bapak Sunardi, S.Kep., Ns. M.Kep selaku Kepala Program Studi Pendidikan Profesi Ners Universitas Muhammadiyah Malang3.
Bapak Zaqqi Ubaidillah, S.Kep., Ns., M.Kep. Sp.Kep.MB selaku Dosen Pembimbing yang telah memberikan banyak sekali nasehat, motivasi, dorongan, bimbingan, serta masukan untuk menyelesaikan dan melengkapi penyusunan KIAN ini.4. Kepada staf dan seluruh dosen Fakultas Ilmu Kesehatan terkhusus Program Studi Pendidikan Profei Ners Universitas Muhammadiyah Malang yang telah mengajarkan dan membimbing saya banyak hal akan keilmuan keperawatan dan pengalaman akan kehidupan.
5.
Kepada Staf dan seluruh pembimbing lapangan RS Muhammadiyah Lamongan, UPT. Rehabilitasi Sosial Pasuruan, dan Puskesmas Kendalsari yang telah membimbing saya selama menyelesaikan pendidikan profesi.6. Kepada kedua orang tua saya, ayah saya Hardiansyah dan ibu saya tercinta Maria Ulfah, yang telah menjadi orang tua hebat dan telah memotivasi, menemani, memberikan kasih sayang, maupun doa yang senantiasa dipanjatkan. Tak lupa juga kepada adik-adik saya, M. Mahdiannoor, Nur Hamsyatun Fitria, M. Wildan Alghazali, M. Yazid Alkahfi, Ghaziya
vii
Hafidza Azzahra, M. Zaini yang menjadi sumber motivasi saya dalam pengerjaan KIAN ini.
7. Sahabat-sahabat saya, Munjiah Syaroh, bubuhan Exo Parody (Khaerunnisa, Sri Wahyuni, Nur Putri Lestari Sa’diyah, Khoyrum Ummami, Febrika Nur Hanifa, Sherina Kusramadhani), Nur Afifah Firdaus, Rahma Dewi Hariyandi yang telah memberikan banyak semangat, dukungan, motivasi, hiburan, dan mendoakan saya demi kelancaran KIAN saya. Semoga senantiasa dilancarkan urusannya dan dilindungi oleh Allah SWT.
8. Teman-teman Kelompok 4 khususnya, dan Ners 24 yang tidak bisa disebutkan satu persatu yang telah berjuang bersama dan memotivasi satu sama lain mulai dari awal masuk hingga sekarang dan seterusnya
Serta semua pihak yang telah memberikan kontribusi dan membantu dalam proses penyelesaian KIAN ini. Mohon maaf atas segala kesalahan dan ketidaksopanan yang mungkin telah saya perbuat. Semoga Allah SWT senantiasa memudahkan setiap langkah-langkah kita menuju kebaikan dan selalu menganugerahkan kasih sayang-Nya untuk kita semua. Aamin. Penulis menyadari masih banyak kesalahan dan kekurangan. Oleh karena itu, penulis mengharapkan saran dan kritik yang bersifat membangun demi perbaikan karya tulis ini.
Malang, 15 April 2022
Marlianti Muslimah
viii ABSTRAK
Penerapan Edukasi Model Teach Back Pada Pasien dengan Gagal Jantung Kongestif Di Ruang Marwah – RS Muhammadiyah Lamongan
Marlianti Muslimah1, Zaqqi Ubaidillah2
Latar Belakang: Gagal jantung merupakan penyakit yang bersifat progresif dengan angka mortalitas maupun morbiditas yang tinggi di berbagai negara termasuk di Indonesia. Menurut World Health Organization menyampaikan bahwa estimasi kematian pasien dengan penyakit kardiovaskular pada tahun 2019 sebanyak 32% dari total kematian secara global dan 38% diantaranya disebabkan oleh penyakit gagal jantung. Namun penyakit ini semakin bertambah tiap tahunnya dan berdampak dalam menimbulkan kasus kekambuhan (hospitalisasi kembali) hingga komplikasi yang cukup serius. Salah satu faktor yang menyebabkan komplikasi tersebut yaitu kurangnya manajemen kesehatan pasien. Oleh karena itu, dalam karya Ilmiah Akhir ini mengangkat masalah keperawatan manajemen kesehatan tidak efektif dan bertujuan untuk mengkaji faktor penyebab kekambuhan pasien serta menganalisis pemberian edukasi teach back pada pasien dengan gagal jantung kongestif yang menjalani perawatan di RS Muhammadiyah Lamongan.
Metode: Metode penelitian yang digunakan dalam penyusunan Karya Ilmiah Akhir ini menggunakan laporan studi kasus yang menganalisis suatu masalah keperawatan yaitu manajemen kesehatan tidak efektif dan menganalisis penerapan edukasi model teach back pada pasien dengan gagal jantung kongestif.
Hasil: Setelah dilakukan penerapan edukasi model teach back selama 5 hari berturut-turut didapatkan masalah keperawatan teratasi dan pasien serta keluarga mampu memberikan umpan balik atas edukasi kesehatan yang diberikan.
Diskusi: Masalah keperawatan manajemen kesehatan tidak efektif merupakan masalah yang sering muncul pada pasien dengan gagal jantung kongestif akibat kurangnya pengetahuan dan pemahaman pasien serta keluarga dalam perawatan diri hingga berakibat pada kekambuhan dan hospitalisasi kembali. Tindakan yang dilakukan oleh perawat yaitu pemberian edukasi kesehatan dengan model teach back yang berfokus pada pemahaman pasien mengenai materi yang diajarkan dan meminta pasien maupun keluarga untuk memberikan umpan balik, tidak cukup hanya dengan hal tersebut, beberapa rekomendasi tindakan yang dibutuhkan untuk pasien selain intervensi utama yaitu self-care management, family centered care, dan complementary therapy.
Kata Kunci: Asuhan Keperawatan, Pasien, Gagal Jantung Kongestif, Manajemen Kesehatan Tidak Efektif, Teach Back
1 Mahasiswa Program Studi Ners, Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Malang
2 Dosen Program Studi Ners, Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Malang
ix ABSTRACT
Implementation of Teach Back Model Education in Patients with Congestive Heart Failure in the Marwah Room – Muhammadiyah Hospital Lamongan
Marlianti Muslimah1, Zaqqi Ubaidillah2
Background: Heart failure is a progressive disease with high mortality and morbidity rates in various countries, including Indonesia. According to the World Health Organization, the estimated mortality of patients with cardiovascular disease in 2019 was 32% of the total deaths globally and 38% of them were caused by heart failure. However, this disease is increasing every year and has an impact in causing relapse cases (rehospitalization) to quite serious complications. One of the factors that cause these complications is the lack of patient health management. Therefore, in this final scientific paper, it raises the issue of ineffective health management and aims to examine the factors that cause patient recurrence and analyze the provision of re-education to patients with congestive heart failure who are undergoing treatment at Muhammadiyah Hospital Lamongan.
Methods: The research method used in the preparation of this final scientific paper uses a case study report that analyzes a nursing problem, namely ineffective health management and analyzes the application of teach back education models in patients with congestive heart failure.
Results: After applying the teach back model of education for 5 consecutive days, the nursing problems were resolved and the patient and family were able to provide feedback on the health education provided.
Discussion: The problem of ineffective health management nursing is a problem that often arises in patients with congestive heart failure due to lack of knowledge and understanding of patients and families in self-care, resulting in relapse and hospitalization. Actions taken by nurses are providing health education with a teach back model that focuses on the patient's understanding of the material being taught and asking patients and families to provide feedback, it is not enough just to do this, several recommendations for actions are needed for patients other than the main intervention, namely self-care management, family-centered care, and complementary therapy.
Keywords: Nursing Care, Patient, Congestive Heart Failure, Ineffective Health Management, Teach Back
1 Student of Nursing Study Program, Faculty of Health Sciences, University of Muhammadiyah Malang
2 Lecturer of the Nursing Study Program, Faculty of Health Sciences, University of Muhammadiyah Malang
x
DAFTAR ISI
PENERAPAN EDUKASI MODEL TEACH BACK PADA PASIEN DENGAN
GAGAL JANTUNG KONGESTIF ... i
PENERAPAN EDUKASI MODEL TEACH BACK PADA PASIEN DENGAN GAGAL JANTUNG KONGESTIF ... ii
LEMBAR PERSETUJUAN ... ii
LEMBAR PENGESAHAN ... iii
KATA PENGANTAR ... iv
ABSTRAK ... vi
ABSTRACT ... vii
DAFTAR ISI... viii
DAFTAR GAMBAR ... x
DAFTAR TABEL ... xi
BAB I ... 1
PENDAHULUAN ... 1
1.1 Latar Belakang ... 1
1.2 Perumusan Masalah ... 4
1.3 Tujuan Penulisan ... 5
1.3.1 Tujuan Umum ... 5
1.3.2 Tujuan Khusus ... 5
1.4 Manfaat Penulisan ... 5
1.4.1 Manfaat Bagi Peneliti ... 5
1.4.2 Manfaat Bagi Ilmu Keperawatan ... 5
1.4.3 Manfaat Bagi Pelayanan Kesehatan ... 6
BAB II ... 7
TINJAUAN PUSTAKA ... 7
2.1 Konsep Jantung ... 7
2.1.1 Anatomi Jantung ... 7
2.1.2 Fisiologi Jantung ... 10
2.2 Konsep Gagal Jantung Kongestif ... 14
2.2.1 Definisi ... 14
2.2.2 Manifestasi Klinis ... 15
2.2.3 Etiologi ... 17
2.2.4 Klasifikasi ... 17
2.2.5 Patofisiologi ... 19
2.2.6 Komplikasi ... 25
2.2.7 Faktor Risiko ... 25
2.2.8 Pemeriksaan Penunjang ... 26
2.2.9 Penatalaksanaan ... 27
2.2.10 Evidence Based Nursing ... 28
2.3 Konsep Edukasi Model Teach Back ... 29
2.4 Konsep Asuhan Keperawatan pada Pasien Gagal Jantung Kongestif ... 29
2.4.1 Pengkajian Pasien Gagal Jantung ... 29
xi
2.4.2 Diagnosa Keperawatan Gagal Jantung ... 33
2.4.3 Luaran Keperawatan (SLKI) ... 33
2.4.4 Intervensi Keperawatan (SIKI) ... 35
BAB III ... 37
LAPORAN KASUS KELOLAAN UTAMA ... 37
3.1.1 Pengkajian ... 37
3.1.2 Tindakan dan Terapi yang didapat ... 43
3.1 Analisa Data ... 43
3.2.1 Manajemen Kesehatan Tidak Efektif (0115) ... 43
3.2 Rencana Keperawatan ... 43
3.3 Implementasi ... 44
3.4 Evaluasi ... 44
BAB IV ... 46
ANALISIS SITUASI ... 46
4.1 Analisis Profil Pelayanan RS Muhammadiyah Lamongan ... 46
4.2 Analisis Masalah Keperawatan ... 46
4.2.1 Analisis Masalah Keperawatan Manajemen Kesehatan Tidak Efektif ... 46
4.3 Analisis Intervensi Keperawatan ... 47
4.3.1 Analisis Intervensi Edukasi Kesehatan dengan Model Teach Back terhadap Masalah Keperawatan Manajemen Kesehatan Tidak Efektif ... 47
4.4 Rekomendasi Terapi/Intervensi ... 49
4.4.1 Self-Care Management ... 49
4.4.2 Family Centered Care for Patient with Heart Failure ... 50
4.4.3 Complementary Therapy ... 51
BAB V PENUTUP ... 53
5. 1 Kesimpulan ... 53
5. 2 Saran ... 53
DAFTAR PUSTAKA ... 54
LAMPIRAN... 66
xii
DAFTAR GAMBAR
Gambar 2. 1 Anatomi Jantung ... 7
Gambar 2. 2 Lapisan Otot Jantung. ... 8
Gambar 2. 3 Katup Jantung ... 9
Gambar 2. 4 Fisiologi Jantung ... 11
Gambar 3. 1 Patofisiologi Gagal Jantung ... 21
Gambar 3. 2 Web of Cause Congestive Heart Failure ... 25
xiii
DAFTAR TABEL
Tabel 2. 1 Klasifikasi Gagal Jantung Menurut NYHA ... 18
Tabel 2. 2 Klasifikasi Gagal Jantung menurut ACCF/AHA 2013 ... 18
Tabel 2. 3 Luaran Keperawatan ... 34
Tabel 2. 4 SIKI (Intervensi Keperawatan) ... 35
54
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