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"[ABSTRAKLatar belakang: Hiponatremia pasca tindakan operasi mayor pada populasi anak merupakan gangguan elektrolit yang sering terjadi. Penggunaan cairan yang belum tepat sering menimbulkan peningkatan kejadian hiponatremia yang berhubungan erat dengan meningkatnya berbagai komplikasi seperti edema otak, kejang, bahkan kematian. Populasi anak merupakan risiko tinggi karena perbandingan jaringan otak dan tulang tengkorak yang lebih besar sehingga ruang yang tersedia saat terjadi edema otak lebih sempit.Tujuan: Mengetahui insidens hiponatremia pada anak pasca tindakan operasi mayor.Metode: Studi retrospektif potong lintang dilakukan terhadap anak usia 1 bulan hingga 18 tahun yang menjalani tindakan operasi mayor dan masuk ruang perawatan intensif. Penelusuran status medik sesuai kriteria inklusi dilakukan sampai jumlah sampel terpenuhi. Pencatatan terhadap subjek yang meliputi data praoperasi, intraoperasi, serta pemantauan pascaoperasi dilakukan. Subjek yang memenuhi definisi hiponatremia (<135 mEq/L) diklasifikasikan sesuai derajat hiponatremia dan dilakukan pencarian lebih lanjut terhadap komplikasi.Hasil : Studi dilakukan terhadap 90 subjek yang terdiri dari 56,7% lelaki, dengan 51,1% memiliki rentang usia 1 bulan hingga 4 tahun. Sebanyak 47,8% subjek menjalani tindakan laparatomi dengan berbagai indikasi. Hampir semua subjek (93,3%) mendapat cairan hipotonik pascaoperasi. Insidens hiponatremia pascaoperasi sebesar 28,9% dengan 11,1% diantaranya merupakan hiponatremia sedang-berat. Rerata kadar natrium pascaoperasi adalah 130,1 ± 4,1 mEq/L dengan rerata total cairan 79,8 ± 27,4 ml/kg. Sebesar 30,9% subjek yang mendapatkan cairan hipotonik pascaoperasi mengalami kejadian hiponatremia dengan rerata lama rawat 5,6 ± 4 hari. Terdapat 1/26 subjek yang mengalami komplikasi berupa kejang dan edema otak.Simpulan: Insidens hiponatremia pasca tindakan operasi mayor di ruang perawatan intensif hampir mencapai 30% dan sebagian besar mendapat cairan hipotonik pascaoperasi. Penelitian lebih lanjut perlu dilakukan untuk mengevaluasi pemberian cairan pascaoperasi yang tepat untuk mencegah hiponatremia.

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ABSTRACTBackground: Hyponatremia is commonly found post major surgery in pediatric population. The use of improper fluid often leads to increasing incidence of hyponatremia which causes complications such as cerebral edema, seizure, and death. Pediatric is a high risk population due to the large ratio between the brain tissue and skull, so that the availability space.Hyponatremia after major surgery in pediatric population is a common electrolyte disorder. The use of improper fluid often lead to increased incidence of hyponatremia which is closely linked to the increasing variety of complications such as cerebral edema, seizures, and even death. Pediatric is high risk population due to the larger comparison of brain tissue and the skull so that the space available in the event of brain edema narrower.Objective: To describe the incidence of hyponatremia in children after major surgery.Methods: A retrospective cross-sectional study was conducted on children aged 1 month to 18 years who underwent major surgery and entered the intensive care ward. The inclusion subjects was traced from medical records. The data was recorded from preoperative, intraoperative, and postoperative monitoring. Subjects who met hyponatremia (<135 mEq/L) were classified according to the severity of hyponatremia and its complications.Results: Ninety subjects were enrolled in this study (56.7% male, 51.1% age 1 month-4 years). There were 47.8% subjects underwent laparotomy with a variety of indications. Almost all subjects (93.3%) received postoperative hypotonic fluid. The incidence of postoperative hyponatremia was 28.9%, while 11.1% among them were moderate-severe hyponatremia. The mean postoperative sodium levels was 130.1 ± 4.1 mEq/L with a mean total fluid 79.8 ± 27.4 ml/kg. There were 30.9% subjects who received hypotonic fluids and experienced hyponatremia with a mean length of stay 5.6 ± 4 days. One of 26 subjects with hyponatremia suffered from seizures and brain edema.Conclusions: The incidence of postoperative hyponatremia in pediatric intensive care reached nearly 30%, and almost all of them received hypotonic fluid. Therefore, further research should be performed to evaluate the appropriate fluid in order to anticipating postoperative hyponatremia, Background: Hyponatremia is commonly found post major surgery in pediatric population. The use of improper fluid often leads to increasing incidence of hyponatremia which causes complications such as cerebral edema, seizure, and death. Pediatric is a high risk population due to the large ratio between the brain tissue and skull, so that the availability space.Hyponatremia after major surgery in pediatric population is a common electrolyte disorder. The use of improper fluid often lead to increased incidence of hyponatremia which is closely linked to the increasing variety of complications such as cerebral edema, seizures, and even death. Pediatric is high risk population due to the larger comparison of brain tissue and the skull so that the space available in the event of brain edema narrower.Objective: To describe the incidence of hyponatremia in children after major surgery.Methods: A retrospective cross-sectional study was conducted on children aged 1 month to 18 years who underwent major surgery and entered the intensive care ward. The inclusion subjects was traced from medical records. The data was recorded from preoperative, intraoperative, and postoperative monitoring. Subjects who met hyponatremia (<135 mEq/L) were classified according to the severity of hyponatremia and its complications.Results: Ninety subjects were enrolled in this study (56.7% male, 51.1% age 1 month-4 years). There were 47.8% subjects underwent laparotomy with a variety of indications. Almost all subjects (93.3%) received postoperative hypotonic fluid. The incidence of postoperative hyponatremia was 28.9%, while 11.1% among them were moderate-severe hyponatremia. The mean postoperative sodium levels was 130.1 ± 4.1 mEq/L with a mean total fluid 79.8 ± 27.4 ml/kg. There were 30.9% subjects who received hypotonic fluids and experienced hyponatremia with a mean length of stay 5.6 ± 4 days. One of 26 subjects with hyponatremia suffered from seizures and brain edema.Conclusions: The incidence of postoperative hyponatremia in pediatric intensive care reached nearly 30%, and almost all of them received hypotonic fluid. Therefore, further research should be performed to evaluate the appropriate fluid in order to anticipating postoperative hyponatremia]"

"Anak yang dirawat di ICU cenderung mengalami malnutrisi sejak masuk atau selama perawatan yang dapat memperberat penyakit dasar, memperpanjang lama rawat serta meningkatkan mortalitas. Baik underfeeding atapun overfeeding dapat terjadi di ICU Anak selama perawatan. Penelitian ini merupakan penelitian potong lintang, menggunakan data rekam medis. Selama 3 bulan penelitian. didapatkan 45 subjek penelitian. Dari 45 data pasien didapatkan 127 peresepan untuk menilai keseuaian peresepan dengan pemberian nutrisi pada pasien. Pemberian nutrisi pada pasien yang dirawat di ICU Anak merupakan hal yang sangat penting. Perlu perhitungan kebutuhan nutrisi yang cermat, pemberian nutrisi tepat yang sesuai kebutuhan pasien agar tidak terjadi malnutrisi yang lebih berat lagi.

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Children admitted to the Pediatric Intensive Care Unit (PICU) are at risk for poor and potentially worsening nutritional status, a factor that further increases comorbidities and complications, prolongs the hospital stay, increases cost and increases mortality. Both underfeeding and overfeeding are prevalent in PICU and may result in large energy imbalance. This was cross sectional study design, with 3 month consecutive sampling in PICU which met 45 patients as the subject and 127 prescription of nutrition. Nutrition support therapies in PICU is very important .Adequate nutrition therapy is essential to improve nutrition outcomes in critically ill children."

"Gangguan oksigenasi merupakan masalah yang sering dialami oleh pasien yang dirawat di ruang perawatan intensif anak. Oksigen merupakan kemponen yang penting dalam pembentukan energi sehingga gangguan oksigenasi dapat memengaruhi keseimbangan energi. Teori Konservasi Levine bertujuan untuk mempertahankan keutuhan pasien melalui empat prinsip konservasi yaitu konservasi energi, konservasi integritas strukrutal, konservasi integritas personal dan konservasi integritas sosial sehingga dapat diaplikasikan pada anak dengan gangguan oksigenasi. Salah satu intervensi keperawatan yang sesuai dengan prinsip konservasi energi pada pasien dengan masalah oksigenasi adalah pengaturan posisi lateral kanan. Tujuan dari karya ilmiah ini adalah memberikan gambaran mengenai aplikasi teori Konservasi Levine dalam pemenuhan kebutuhan oksigenasi dan pengaruh pengaturan posisi lateral kanan pada anak yang dirawat di ruang perawatan intensif. Asuhan keperawatan dengan pendekatan teori Konservasi Levine diberikan kepada lima anak yang terpasang ventilator. Proses keperawatan mulai dari pengkajian sampai evaluasi dilakukan berdasarkan empat prinsip konservasi. Evaluasi keperawatan menunjukkan adanya perbaikan kondisi pada beberapa pasien. Demikian halnya dengan pengaturan posisi lateral kanan dengan kemiringan 30° terbukti efektif meningkatkan saturasi oksigen pada anak yang terpasang ventilasi mekanik. Penulis merekomendasikan penggunaan teori Konservasi Levine dalam memberikan asuhan keperawatan kepada anak dengan gangguan oksigenasi di ruang perawatan intensif. Selain itu penulis merekomendasikan pengaturan posisi lateral kanan dengan kemiringan 30° untuk dapat diaplikasikan di ruang perawatan intensif anak serta dilakukan uji klinik lebih lanjut dengan sampel yang lebih besar sehingga dapat dijadikan dasar penyusunan standar operasional prosedur.

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Oxygenation impairment is one of the problems that is often experienced by patients treated in pediatric intensive care units. Oxygen is an important component in energy formation.  Oxygenation impairment can affect energy balance. Levine's Conservation theory focuses on maintaining patient wholeness through four conservation principles, namely conservation of energy, conservation of structural integrity, conservation of personal integrity, and conservation of social integrity so that it can be applied to children with oxygenation impairment. One of the nursing interventions that relate to the conservation of energy in patients with oxygenation impairment is the positioning with the right lateral position. The purpose of this scientific paper is to provide an overview of the application of Levine's Conservation theory in meeting oxygenation needs and the effect of right lateral position in children treated in intensive care units. Nursing care with the application Levine Conservation theory was given to five children who were on ventilators. The nursing process from assessment to evaluation was carried out based on four conservation principles. Nursing evaluation showed an improvement in the condition of several patients. Likewise, the right lateral position setting with a 30° tilt has shown to be effective in increasing oxygen saturation in children who are on mechanical ventilation. The author recommends the use of Levine's Conservation theory in providing nursing care to children with impaired oxygenation in intensive care units. In addition, the author recommends setting the right lateral position with a 30° tilt to be applied in the pediatric intensive care room and conducting further clinical trials with larger samples so that it can be used as a basis for compiling standard operating procedures."

"Lingkungan perawatan intensif anak dapat menjadi stimulus yang memengaruhi proses adaptasi anak maupun orang tua/wali. Orang tua akan mengalami tekanan psikologis yang berat seperti stres dan kecemasan. Asuhan keperawatan dengan pendekatan model adaptasi Roy diharapkan dapat membantu proses adaptasi orang tua ketika anak menjalani perawatan di ruang intensif. Tujuan karya tulis ilmiah ini untuk memberikan gambaran aplikasi teori model adaptasi Roy pada orang tua yang mengalami stres dan kecemasan di ruang perawatan intensif anak serta mengembangkan inovasi orientasi pasien baru melalui video untuk menurunkan stres dan kecemasan orang tua. Proses keperawatan digambarkan pada lima kasus dengan menggunakan model adaptasi Roy. Proses keperawatan yang khas pada model adaptasi Roy terdapat pada pengkajian yang dilakukan dua tahap yaitu pengkajian perilaku dan stimulus. Proses selanjutnya menyusun diagnosis, tujuan, dan implementasi keperawatan. Hasil evaluasi akhir diketahui empat dari lima orang tua memiliki respons konsep diri yang adaptif. Kecemasan orang tua menurun setelah mendapatkan video orientasi pada hari pertama anak dirawat. Oleh sebab itu, model adaptasi Roy dapat diaplikasikan pada orang tua yang mengalami stres dan kecemasan di ruang perawatan intensif anak. Inovasi video orientasi dapat dijadikan alternatif media penyampaian informasi yang konsisten kepada orang tua pada saat hari pertama anak dirawat di ruang intensif

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The paediatric intensive care unit can be a stimulus that influences the adaptation process of children and their parents or guardians. Parents will experience severe psychological pressure, such as stress and anxiety. Nursing care using the Roy adaptation model approach is expected to help parents' adaptation processes when children undergo treatment in intensive care. The aim of this scientific paper is to provide an overview of the application of Roy's adaptation model theory to parents who experience stress and anxiety in paediatric intensive care and to develop new patient orientation innovations via video to reduce parental stress and anxiety. The nursing process is described in five cases using Roy's adaptation model. The typical nursing process in the Roy adaptation model consists of an assessment carried out in two stages, namely behavioural and stimulus assessment. The next process develops a diagnosis, goals, and implementation of nursing. The final evaluation results showed that four out of five parents had an adaptive self-concept response. Parental anxiety decreased after receiving an orientation video on the child's first day of care. Therefore, Roy's adaptation model can be applied to parents who experience stress and anxiety in paediatric intensive care. The orientation video innovation can be used as an alternative medium for delivering consistent information to parents on the child's first day of care in the intensive care unit."

"Pembedahan dapat memicu respons stres metabolik yang dapat menimbulkan hiperglikemia. Mekanisme hiperglikemia pascaoperasi dihubungkan dengan resistensi insulin, peningkatan glukoneogenesis, dan glikogenolisis, serta penurunan glucose transporter-4. Hiperglikemia diduga sebagai respons adaptasi fisiologis “fight or flight” tetapi juga dikaitkan dengan peningkatan morbiditas dan mortalitas pascaoperasi. Risiko hiperglikemia pascaoperasi dan potensi bahaya yang ditimbulkan belum banyak disadari oleh para dokter. Penelitian ini bertujuan untuk mengetahui karakteristik pasien pascaoperasi di Pediatric Intensive Care Unit (PICU) di Rumah Sakit Ciptomangunkusumo, insidens hiperglikemia pada anak pascaoperasi, dan faktor-faktor yang memengaruhi hiperglikemia pascaoperasi. Penelitian ini merupakan suatu studi potong lintang terhadap 199 pasien di RSCM yang dirawat di ruang PICU pascaoperasi sepanjang Januari – Desember 2020. Data demografi serta gula darah pascaoperasi diambil dari rekam medis. Kejadian hiperglikemia pascaoperasi dalam 24 jam pertama adalah 42%. Faktor-faktor yang memengaruhi hiperglikemia pascaoperasi pada penelitian ini adalah usia > 60 bulan (rasio odds 1,92 (95% IK 1,08-3,41) p=0,025) dan median durasi operasi>5 jam (p=0,001)

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Surgery can trigger metabolic stress response that can lead to hyperglycemia. Mechanism of postoperative hyperglycemia is associated with insulin resistance, increased gluconeogenesis, and glycogenolysis, and decreased glucose transporters-4. Hyperglycemia is thought to be a physiological “fight or flight” adaptive response but also associated with increased postoperative morbidity and mortality. The risk of postoperative hyperglycemia and the potential dangers that it causes have not been widely realized by doctors. This study aims to determine the characteristics of postoperative patients at the Pediatric Intensive Care Unit (PICU) at Ciptomangunkusumo Hospital (RSCM), incidence of hyperglycemia in postoperative children, related factors of postoperative hyperglycemia. This study is a cross-sectional study of 199 patients at RSCM who admitted in PICU postoperative during January – December 2020. Demographic data and postoperative blood sugar were taken from medical records. The incidence of postoperative hyperglycemia in the first 24 hours was 42%. Related factors of postoperative hyperglycemia in this study were age > 60 months (Odds ratio 1,92 (95% CI 1,08-3,41); p=0,025 and median operative duration > 5 hours (p=0,001)."

"Bayi yang dirawat di unit perawatan intensif sangat mudah terpengaruh oleh lingkungan yang asing dan gangguan terhadap rutinitas harian normal mereka. Bahkan setelah tidak dirawatpun bayi-bayi ini akan menghadapi tantangan baru selama berbulan-bulan bahkan bertahun-tahun setelahnya. Baby liberation merupakan hasil adaptasi dari PICU liberation dan telah diidentifikasi sebagai strategi utama untuk mengurangi morbiditas dan meningkatkan hasil jangka panjang bagi para penyintas PICU. Teori Henderson bersifat fundamental memenuhi 14 kebutuhan dasar individu yang holistik dan komprehensif, teori ini sudah banyak dipakai di berbagai populasi individu namun belum pada ruang perawatan intensif anak. Tujuan penulisan karya ilmiah ini untuk memberikan gambaran aplikasi teori kebutuhan Henderson dalam asuhan keperawatan pada bayi sakit kritis sekaligus melihat efektivitas penerapan Baby Liberation Bundles Care untuk mendukung status fungsional bayi sakit kritis di ruang perawatan intensif anak. Terdapat lima kasus bayi yang mengalami masalah pada pemenuhan kebutuhan dasar dan diberikan asuhan keperawatan melalui pendekatan teori kebutuhan Henderson. Aplikasi teori kebutuhan Henderson cocok digunakan di PICU karena teori ini bersifat holistik dan komprehensif yang terdiri dari sembilan kebutuhan dasar fungsional tubuh dan lima kebutuhan dasar kenyamanan meliputi psikologis, sosial dan spiritual. Penerapan Baby Liberation Bundles Care efektif untuk mendukung status fungsional bayi sakit kritis dan diharapkan intervensi ini dapat diaplikasikan oleh perawat ruangan.

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Babies treated in intensive care units are easily affected by unfamiliar environments and disruptions to their daily normal routines. Even after not being cared for, these babies will face new challenges for months or even years afterward. Baby liberation is an adaptation of PICU liberation and has been identified as a key strategy to reduce morbidity and improve long-term outcomes for PICU survivors. Henderson's theory is fundamental in fulfilling 14 basic individual needs in a holistic and comprehensive manner, this theory has been widely used in various individual populations but not in pediatric intensive care unit yet. The purpose of writing this scientific work is to provide an overview of the application of Henderson's theory of needs in the care of critically ill babies and see the effectiveness of implementing Baby Liberation Bundles Care to support the functional status of critically ill babies in the Pediatric Intensive Care Unit. There were five cases of babies who experienced problems in providing basic needs and were given nursing care using Henderson's needs theory approach. The application of Henderson's needs theory is suitable for use in the PICU because this theory is holistic and comprehensive, consisting of nine basic functional body needs and five basic comfort needs including psychological, social and spiritual. The implementation of Baby Liberation Bundles Care is effective in supporting the functional status of critical babies and it is hoped that this intervention can be implemented by nursing staff."

"Bedah merupakan salah satu prosedur medis yang dilakukan secara manual dan menyebabkan banyak perlukaan dan berisiko tinggi menyebabkan infeksi Adanya infeksi harus ditangani dengan antibiotika empiris yang tepat dan rasional. Penelitian ini dilakukan untuk memperoleh data penggunaan antibiotika empiris pada pasien pascabedah di Ruang ICU RSAL Dr Mintohardjo selama periode 2012 2013 dan melakukan evaluasi kerasionalannya dilihat dari ketepatan pasien ketepatan indikasi ketepatan obat ketepatan dosis dan interaksi obat. Penelitian dilakukan dengan pengambilan data penggunaan antibiotik empiris dari rekam medis pasien pascabedah dengan metode retrospektif dengan desain cross sectional. Pengambilan sampel penelitian dilakukan dengan tekniktotal sampling. Populasi penelitian berjumlah 299 pasien dan 35 pasien diterima sebagai sampel penelitian. Pada penilaian terhadap jumlah pasien pascabedah terdapat 100 pasien mendapatkan terapi antibiotik tepat dengan kondisi pasien 11 43 pasien mendapatkan antibiotik sesuai indikasi 0 pasien mendapatkan antibiotik tepat obat 85 71 pasien sudah mendapatkan dosis yang tepat dan 51 43 pasien tidak mengalami interaksi obat. Sehingga dapat disimpulkan pengobatan antibiotik empiris pada pasien pascabedah di RSAL Dr Mintohardjo tidak rasional.

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Surgery is a manual medical procedure which causes many wounds and has a high infection risk Patient who has infection must be given antibiotic immediatelyand rationally. The aim of this study was to collect empiric antibiotics usage data in Intensive Care Unit of Naval Hospital Dr Mintohardjo 2012 2013 and to evaluate rationality of the administration through the appropriate patient appropriate indication appropriate drug appropriate dose and drugs interaction. This retrospective cross sectional study was done by collecting empiric antibiotics usage data from medical record of postoperative patients on 2012 2013 using total sampling. Population of study included 299 patients and 35 patients were accepted as samples of study. Appropriate assessment based on number of postoperative patients showed 100 appropriate patient 11 43 appropriate indication 0 appropriate drug 85 71 appropriate dose and 31 43 no drugs interaction. It was concluded that empirical antibiotic treatment in postoperative patients in Naval Hospital Dr Mintohardjo were irrational."

"Gangguan integritas kulit merupakan salah satu permasalahan yang dapat dialami oleh anak dengan penggunaan alat bantu napas invasif, yaitu endotracheal tube (ETT). Alat bantu napas memerlukan perekat medis untuk menjaga posisi dalam keadaan aman. Perekat ini dapat menimbulkan cedera kulit yang dikenal dengan medical adhesive related skin injury (MARSI). Tujuan penulisan karya ilmiah ini adalah untuk memaparkan pencegahan gangguan integritas kulit menggunakan profilaksis hidrokoloid dengan pendekatan teori Kolcaba. Asuhan keperawatan menggunakan teori Kolcaba dipaparkan dalam studi kasus lima orang anak dengan rawatan intensif anak. Aplikasi teori Kolcaba menciptakan kenyamanan dari empat aspek yakni fisik, psikospiritual, sosiokultural, dan lingkungan. Penerapan profilaksis hidrokoloid terbukti mampu mencegah kejadian gangguan integritas kulit (MARSI). Berdasarkan hasil ini, perawat dapat menerapkan aspek kenyamanan untuk memberikan asuhan secara holistik, termasuk untuk mencegah terjadinya cedera pada kulit.

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Impaired skin integrity is one of the problems that can be experienced by children using invasive mechanical ventilation, such as endotracheal tube (ETT). Endotracheal tube requires medical adhesives to maintain a safe position. These adhesives can cause skin injuries known as medical adhesive-related skin injury (MARSI). The purpose of this scientific paper is to explain the prevention of impaired skin integrity using hydrocolloid prophylaxis with the Kolcaba theory approach. Nursing care using Kolcaba's theory is reported in a case study of five children in pediatric intensive care. The application of Kolcaba's theory creates comfort from four aspects: physical, psychospiritual, sociocultural, and environmental. The application of hydrocolloid prophylaxis has been shown to prevent the occurrence of impaired skin integrity (MARSI). Based on these results, nurses can apply the comfort aspect to provide holistic care, including preventing skin injury."

"Nyeri merupakan salah satu gejala yang paling sering dialami oleh pasien anak di ruang perawatan intensif yang dilakukan prosedur tindakan pengambilan darah. Perawat perlu memberikan asuhan keperawatan dengan menitikberatkan pada kenyamanan anak selama prosedur tindakan pengambilan darah di rumah sakit karena kenyamanan adalah hal penting dalam kualitas hidup pasien anak. Tujuan karya ilmiah ini adalah untuk menganalisis penerapan Teori Kenyamanan Kolcaba dalam proses asuhan keperawatan pada anak di ruang perawatan intensif yang mengalami nyeri saat pengambilan darah melalui pemberian intervensi terapi musik. Metode karya ilmiah ini adalah studi kasus pada lima pasien anak yang dirawat di ruang perawatan intensif yang mendapatkan prosedur tindakan pengambilan darah. Terdapat lima kasus pasien anak yang terpasang ventilasi mekanik yang diberikan asuhan keperawatan dengan pendekan Teori Kenyamanan Kolcaba dengan intervensi kenyamanan yang berbasis bukti yaitu intervensi terapi musik. Hasil menunjukkan bahwa Teori Kenyamanan Kolcaba dapat diterapkan dalam asuhan keperawatan anak dan terapi musik  efektif dalam menurunkan nyeri  pada anak yang dilakukan tindakan pengambilan darah.

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Pain is one of the most common symptoms experienced by pediatric patients in intensive care unit who are undergoing blood collection procedures. Nurses need to provide nursing care with an emphasis on children's comfort during blood collection procedures in hospitals because comfort is important in the quality of life of pediatric patients. The aim of this scientific work is to analyze the application of Kolcaba's Comfort Theory in the care process for children in intensive care who experience pain when taking blood through providing music therapy interventions. The method of this scientific work is a case study of five pediatric patients treated in intensive care who received a blood collection procedure. There were five cases of pediatric patients on mechanical ventilation who were given treatment using Kolcaba's Comfort Theory approach with evidence-based comfort interventions, namely music therapy interventions. The results show that Kolcaba's Comfort Theory can be applied in childcare and music therapy is effective in reducing pain in children who undergo blood sampling."

"Pendahuluan: Hospitalisasi merupakan peristiwa yang membuat traumatik bagi anak, terlebih pada anak yang dirawat di ruang PICU. Anak yang dirawat di PICU berisiko tinggi mengalami kerusakan integritas kulit karena mengalami imobilitas dan terpasang banyak alat kesehatan. Tujuan studi kasus ini adalah untuk memberikan gambaran pencegahan risiko terjadinya kerusakan integritas kulit pada anak melalui pengkajian kulit dengan menggunakan instrumen Braden QD dengan pendekatan model konservasi Levine. Pengkajian dilakukan berdasarkan konservasi Levine terhadap lima kasus terpilih yang berisiko mengalami kerusakan integritas kulit. Hipotesis, intervensi dan respon organismik ditujukan untuk mencapai adaptasi serta membuat klien mencapai keutuhan (wholeness). Pengkajian dengan menggunakan instrument Braden QD terbukti efektif mencegah terjadinya cedera tekan.

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Background: Hospitalization has become a traumatic event particularly in pediatric patients in pediatric intensive care unit (PICU). Pediatric patients who were admitted in PICU have a risk for impaired skin integrity particularly for those who had immobility and under medical treatment devices. This case study aimed at describing the risk prevention of impaired skin integrity in pediatric patients by skin assessment using Braden QD Scale through a Levine Conservation Model approach. Skin assessment was performed based on this Levin s model amongst five selected cases which have the risk for impaired skin integrity. Hypothesis, intervention, and organismic response were addressed to achieve an adaptation and eventually reached the patients wholeness. The skin assessment using Braden QD Scale was effective in preventing the pressure injury."