PENGARUH MOBILISASI PROGRESIF LEVEL I TERHADAP TEKANAN DARAH DAN SATURASI OKSIGEN PASIEN KRITIS DENGAN PENURUNAN KESADARAN
DOI:
https://doi.org/10.32584/jpi.v1i1.3Abstract
Abstrak
Pasien yang dirawat di ruang Intensive Care Unit (ICU) merupakan pasien kritis yang dalam keadaan terancam jiwanya karena kegagalan atau disfungsi pada satu atau multipel organ yang disertai gangguan hemodinamik. Pasien kritis dalam keadaan penurunan kesadaran memiliki keterbatasan dalam mobilisasi, yang berdampak terhadap tekanan darah dan saturasi oksigen yang tidak stabil. Salah satu intervensi yang dapat dilakukan untuk menangani hal tersebut dengan mobilisasi progresif level I berupa head of bed, ROM, dan rotasi lateral. Penelitian ini bertujuan untuk mengetahui pengaruh mobilisasi progresif level I terhadap tekanan darah dan saturasi oksigen pada pasien kritis dengan penurunan kesadaran di ruang ICU. Metode penelitian ini menggunakan pra eksperimental dengan rancangan pre-test and post-test one group design. Responden penelitian ditetapkan dengan non probability sampling dengan metode total sampling. Penelitian dilaksanakan di ruang ICU pada 15 responden yang terdiri dari 10 responden perempuan dan 5 responden laki-laki dan memenuhi kriteria inklusi. Uji dependent t-test menunjukkan ada pengaruh mobilisasi progresif level I terhadap tekanan darah sistolik (p = 0,024), tekanan diastolik (p = 0,002), dan saturasi oksigen (p = 0,000). Mobilisasi Progresif Level I dapat meningkatkan tekanan darah dan saturasi oksigen pada pasien kritis dengan penurunan kesadaran. Mobilisasi Progresif Level I dapat dijadikan salah satu intervensi keperawatan untuk meningkatkan tekanan darah dan saturasi oksigen pasien kritis dengan penurunan kesadaran dengan tekanan darah di bawah normal.
Â
Kata kunci: Mobilisasi progresif level I, tekanan darah, saturasi oksigen, pasien kritis.
Â
Abstract
The effect of progressive level I mobilization on blood pressure and oxygen saturation in critical patients with decreased awareness. Patients who are treated in the Intensive Care Unit (ICU) are critical patients who are in danger of failure or dysfunction in one or multiple organs accompanied by hemodynamic disturbances. Critical patients in a state of reduced consciousness have limitations in mobilization, which have an impact on blood pressure and unstable oxygen saturation. One intervention that can be done to deal with this is with progressive level I mobilization in the form of head of bed, ROM, and lateral rotation. This study aims to determine the effect of progressive level I mobilization on blood pressure and oxygen saturation in critical patients with decreased awareness in the ICU. This research method uses pre-experimental design with pre-test and post-test one group design. Research respondents were determined by non-probability sampling with total sampling method. The study was conducted in the ICU room in 15 respondents consisting of 10 female respondents and 5 male respondents and met the inclusion criteria. The dependent t-test showed that there was an effect of progressive level I mobilization on systolic blood pressure (p= 0.024), diastolic pressure (p= 0.002), and oxygen saturation (p= 0.000). Level I Progressive Mobilization can increase blood pressure and oxygen saturation in critical patients with decreased consciousness. Level I Progressive Mobilization can be used as one of the nursing interventions to increase blood pressure and oxygen saturation of critical patients with decreased consciousness with below normal blood pressure.
Â
Keywords: Progressive level I mobilization, blood pressure, oxygen saturation, critical patientsReferences
Almeida, M Pavan, Rodringues. (2009. The Hemodinamic, Renal Excretory and Humoral Changes Induced By Resting in the Left Lateral Position in Normal Pregnant Women during Gestation.
Pengaruh Stimulasi Snesori terhadap Nilai GCS pada Pasien Cedera Kepala di Ruang Neuro Surgical Critical Care Unit RSUP Dr. Hasan Sadikin Bandung. Jurnal Ilmu Keperawatan. 2015 September; III (2).
Hudak, Gallo. (2010). Keperawatan Kritis Pendekatan Holistik Volume 2. 6th ed. Asih Y, editor. Jakarta: ECG
Ignatius. (2012). Angka kematian pasien end stage renal disease di ICU HCU RSUP dr. Kariadi Semarang. Karya Tulis Ilmiah. Semarang: Universitas Diponegoro, Fakultas Kedokteran
Iyer V, dkk. (2009). Validity of the Four Score Coma Scale in the Medical Intensive Care Unit. Mayo Clinic Proc.
Kozier. (2009). Buku Ajar Praktik Keperawatan Klinis. 5th ed. Fruriolina A, editor. Jakarta: EGC
Olviani Y. (2015). Pengaruh Pelaksanaan Mobilisasi Progressive Level I terhadap Nilai Monitoring Hemodinamika Non Invasive pada Pasien Cerebral Injury di Ruang ICU RSUD Ulin Banjarmasin Tahun 2015. Diakses pada tanggal 12 September 2015
Ozyurex S, dkk. (2012). Respiratory Hemodinamic Response to Mobilization of Critically ill Obese Patients. Journal of Cardiopulmonary Physical Theraphy. 2012; 23 No. 1
Purnawan I. (2012). The Effect of Murotal Al-Quran stimulation to level of consciousness at hemorrhagic stroke patient in Goeteng Taroenadibrata Hospital Purbalingga. Laporan Penelitian Purwokerto: Universitas Soedirman, Lembaga penelitian dan pengabdian masyarakat
Rahmati A. (2016). Mobilisasi Progresif terhadap Perubahan Tekanan Darah Pasien di Intensive Care Unit (ICU). Jurnal Ilmiah Kesehatan Keperawatan. Diakses pada tanggal 12 Februari 2016.
Ratnasari P. (2012). Hubungan antara tingkat ketergantungan activity daily living dengan depresi pada pasien stroke di RSUD Tugurejo Semarang. Karya Ilmiah S1 Keperawatan. Semarang: Sekolah Tinggi Ilmu Kesehatan Telogorejo Semarang, Keperawatan; 2012
Regina E, Fernacche F, Freitas D. (2012). Effect of Passive Mobilization on Acute Hemodynamic Response in Mechanically Ventilated Patients. 24(1), 72-78
Rihiantoro T, Nurachmah E, Hariyati TS. (2008). Pengaruh Terapi Musik terhadap status hemodinamika pasien koma di ruang ICU sebuah rumah sakit di Lampung. Jurnal Keperawatan Indonesia. Diakses pada tanggal 12 Juli 2008
Setiyawan. (2016). Mean Arterial Non Invasive Blood Pressure (MAP-NIBP) pada Lateral Position Dalam Perawatan Intensif: Studi Literature. Universty Research Colloquium. 2016; 3
Sunaryo A, Redjeki IS, Bisri T. (2012). Perbandingan Validasi APACHE II dan SOFA scores untuk memperkirakan mortalitas pasien yang dilakukan di ruang perawatan intensive. Majalah Kedokteran Terapi Intensive. Vol. 2 No. Diakses 20 Januari 2012
Vollman KM. (2013). Understanding critically ill patients’ hemodynamic response to mobilization: Using the evidence to make it safe and feasible. Critical Care Nursing Quarterly. 2013 January; Vol. 36 No. 1, pp. 17-27
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
This work is licensed under a Creative Commons Attribution 4.0 International License.
