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"Masalah kesehatan yang paling sering dialami oleh bayi prematur adalah masalah sistem pencernaan sehingga peningkatan berat badan sesuai target tidak dapat tercapai. Tujuan dari studi kasus ini adalah melakukan analisis peranan jenis nutrisi terhadap peningkatan berat badan bayi prematur dengan masalah defisit nutrisi melalui pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa Teori Konservasi Levine mempengaruhi peningakatan berat bayi prematur. Bayi prematur yang diberikan ASI terjadi peningatan berat badan 10-15 gram per hari, sedangkan bayi prematur yang diberikan susu formula terjadi peningatan berat badan 5-10 gram per hari. Perawat anak dapat mengoptimalkan pemberian ASI kepada bayi prematur untuk meningkatkan berat badan.

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The most common health problems experienced by premature infants is the problem of the digestive system so that weight gain on target cannot be achieved. The purpose of this case study is to analyze the role of nutrients to premature infant weight gain with nutritional deficits through the Levine Conservation Theory approach. Five selected cases indicate a nutritional deficit nursing problem. The Levine Conservation Theory Approach is conducted using energy conservation principles, structural integrity conservation, conservation of personal integrity, and conservation of social integrity. The results of nursing care show that Levine Conservation Theory influences the weighting of premature infants. Premature infants given breastfeeding weight 10 15 grams per day, whereas premature infants given formula milk occured weight gain 5 10 grams per day. Child nurses can optimize breastfeeding for premature babies to gain weight."

"Pengosongan lambung merupakan masalah yang sering terjadi pada bayi prematur akibat imaturitas sistem gastrointestinal. Tujuan dari studi kasus ini adalah melakukan analisis penerapan Teori Konservasi Levine pada lima bayi prematur yang mengalami masalah pemenuhan kebutuhan nutrisi melalui pemberian posisi miring kanan, pronasi dan miring kiri bergantian selama tiga hari. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil penerapan intervensi pengaturan posisi pronasi dengan pendekatan Teori Konservasi Levine dapat menurunkan kejadian muntah, distensi abdomen dan pengeluaran residu lambung. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami masalah pengosongan lambung.

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Gastric emptying is a common problem in premature infants due to immaturity of the gastrointestinal system. The objective of this case study was to analyze the application of Levine's Conservation Theory to five premature infants who had problems in fulfilllment the nutritional needs through giving alternate position in the right lateral position, pronation and left lateral position for three days. Levine's Conservation Theory was used by applying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. The results showed that the implementation of pronation positioning using Levine's Conservation Theory can reduce the frequency of vomiting, abdominal distension, and gastric residual. Nurses can apply the intervention as a standard operating procedure in premature infants who experience gastric emptying."

"Intoleransi pemberian minum enteral merupakan masalah yang sering terjadi pada bayi berat lahir rendah. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi enteral pada bayi berat lahir rendah melalui pengaturan posisi dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil penerapan intervensi pengaturan posisi dengan pendekatan Teori Konservasi Levine dapat menurunkan kejadian desaturasi, distensi abdomen, dan frekuensi muntah. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi berat lahir rendah yang mengalami intoleransi pemberian minum enteral.

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Enteral feeding intolerance is a problem that often occurs in low birth weight infants. The objective of this case study was to analyze the optimization of the fulfillment of enteral nutrition in low birth weight infants through positioning with Levine`s Conservation Theory. Five cases were selected due to nursing problems in nutrition which is less than body requirements. Levine`s Conservation Theory was used by applying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. The results showed that implementation of positioning with Levine`s Conservation Theory can reduce the incidence of desaturation, abdominal distension, and frequency of vomiting. Nurses can make the intervention as a standard operating procedure in low birth weight infants who experience enteral feeding intolerance."

"Kesulitan menyusu merupakan masalah yang sering terjadi pada bayi prematur. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi oral pada bayi prematur melalui edukasi perencanaan pulang pada orang tua dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi dan menyusui tida efektif. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa pengetahuan dan keterampilan ibu menyusui bayi meningkat sehingga pemenuhan kebutuhan nutrisi bayi terpenuhi dan meningkatkan berat badan bayi melalui edukasi perencanaan pulang. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami kesulitan menyusu.

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Having difficulty in breastfeeding is a common problem on premature infants. The purpose of this study is to analyze the optimization of the oral fulfillment of nutritional needs in premature infants through discharge planning education for the parents using Levine rsquo s Conservation Theory. Five chosen cases shows the occurrences of nutritional deficit nursing problems. Levine rsquo s Conversation Theory approach is done using energy conservation principle, structural integrity conservation, personal integrity conservation, and social integrity conservation.

The research result from the intervention of discharge planning education with Levine rsquo s Conservation Theory could improve the mothers rsquo knowledge and skills so that the fulfillment of nutritional needs of the infants fulfilled and also increasing the infants rsquo weight. Nurse could make the intervention as a standard procedure for premature infants who experienced breastfeeding difficulty."

"Pengontrolan suhu tubuh sangat penting pada bayi prematur karena fluktuasi suhu meningkatkan ketidakseimbangan tingkat metabolisme bayi baru lahir. Pengaturan suhu tubuh yang buruk menjadi sasaran faktor lingkungan yang dapat menyebabkan kehilangan panas yang cepat sehingga rentan terhadap peningkatan risiko morbiditas dan mortalitas akibat hipotermia. Tujuan dari penelitian ini untuk mengetahui penerapan teori Konservasi  Levine dalam mengatasi masalah risiko termoregulasi tidak efektif pada bayi baru prematur di ruang Perinatologi. Model Konservasi Levine berfokus pada peningkatan adaptasi dan mempertahankan integritas diri (wholeness) dengan menggunakan prinsip konservasi. Masalah risiko termoregulasi tidak efektif merupakan salah satu gambaran terganggunya konservasi energi mencakup ketersediaan dan pengeluaran energi bayi baru lahir dan menyebabkan terjadinya peningkatan konsumsi oksigen dengan mempertahankan fungsi normal termogenesis

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Body temperature control is very important in preterm infant because temperature fluctuations improve the balance. Poor body temperature regulation is the target of environmental factors that can cause rapid heat loss, making them susceptible to an increased risk of morbidity and mortality due to hypothermia. The purpose of this study was to determine the application of Levine's Conservation theory in overcoming the problem of ineffective thermoregulation risk in premature newborns in the Perinatology room. Levine's Conservation Model focuses on increasing adaptation and maintaining wholeness using conservation principles. The problem of the risk  ineffective thermoregulation is one of the features of the disruption energy conservation and energy expenditure of baby and causes an increase in oxygen consumption by maintaining normal thermogenesis function.

 

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"Bayi prematur mempunyai banyak risiko gangguan kesehatan yang dapat dialami akibat fungsi dan sistem tubuh yang belum sempurna. Mandi merupakan tindakan non invasif yang dilakukan setiap hari dan dapat mengakibatkan stres pada bayi. Respon stres yang ditunjukkan oleh bayi prematur selama prosedur memandikan dapat berupa menangis, tremor, kehilangan suhu tubuh, dan perubahan tanda-tanda vital. Tujuan penelitian ini adalah memberikan gambaran penerapan Model Konservasi Levine pada asuhan keperawatan bayi prematur dengan risiko gangguan termoregulasi melalui teknik memandikan swaddled bath. Penelitian ini menggunakan metode studi kasus terhadap lima bayi prematur yang berisiko mengalami gangguan termoregulasi melalui pendekatan proses keperawatan. Gangguan termoregulasi dapat menghambat proses adaptasi bayi prematur dalam mencapai keutuhannya, sehingga diperlakukan intervensi berbasis Model Konservasi Levine melalui empat prinsip konservasi. Hasil penelitian menunjukkan bahwa Model Konservasi Levine dapat digunakan dalam asuhan keperawatan bayi prematur dengan masalah termoregulasi melalui penggunaan teknik memandikan swaddled bath.

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Premature babies have many risks of health problems that can be experienced due to immature body functions and systems. Bathing is a non-invasive action that is performed every day and can cause stress to the baby. The stress respone shown by premature babies during the bathing procedure can be in the form of crying, tremors, loss of body temperature, and changes in vital signs. The purpose of this study was to provide an overview of the application of the Levine Conservation Model in nursing care of premature infants with a risk of thermoregulation disorders through the swaddled bath technique. This research used a case study method of five premature babies who were at risk of experiencing thermoregulation disorders through the nursing process approach. Disorders of thermoregulation can hinder the adaptation process of premature babies in achieving their wholeness, so interventions based on the Levine Conservation Model are treated through four principles of conservation. The results of this study indicate that the Levine Conservation Model can be used in nursing care of premature infants with thermoregulation problems through the use of the swaddled bath technique."

"ABSTRAKKetidakseimbangan termoregulasi berisiko terjadi pada Bayi Berat Lahir Rendah secarastruktur tubuh masih belum matang. Tujuan penulisan karya ilmiah akhir ini adalahmemberikan gambaran tentang bagaimana penerapan model konservasi Levine dalamproses asuhan keperawatan pada bayi berat lahir rendah untuk mencegahketidakseimbangan termoregulasi, juga memberikan gambaran langkah pencegahannyaselama transport BBLR intra hospital. Pada lima kasus kelolaan, masalah termoregulasiyang terjadi meliputi inefektif termoregulasi, risiko inefektif termoregulasi, hipotermiadan hipertermia. Pendekatan teori Konservasi Levine menggunakan prinsip konservasienergi, konservasi integritas struktural, konservasi integritas personal dan konservasiintegritas sosial dilakukan sebagai intervensi keperawatan dalam mengatasi masalahtermoregulasi. Evaluasi yang didapatkan, masalah ketidakseimbangan termoregulasidapat teratasi selama perawatan. Selanjutnya langkah pencegahan ketidakseimbangantermoregulasi pada BBLR yang baru lahir selama transportasi intra hospital dilakukandengan penyusunan Standar Prosedur Operasional Transportasi BBLR Intra hospitaldengan Kangaroo Care berdasarkan model konservasi Levine.

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Thermoregulatory imbalances are at risk for Low Birth Weight Infants, the bodystructure is still immature. The purpose of writing this final scientific paper is toprovide an overview of how the application of the Levine conservation model in thenursing care process in low birth weight infants to prevent thermoregulatoryimbalance, as well as provide an overview of its preventive measures during intrahospital LBW transport. In five cases of management, thermoregulation problemsthat occurred include ineffective thermoregulation, thermoregulatory ineffectiverisks, hypothermia and hyperthermia. The Levine Conservation theory approachuses the principles of energy conservation, conservation of structural integrity,conservation of personal integrity and conservation of social integrity carried out asnursing interventions in overcoming the problem of thermoregulation. Evaluationobtained, the problem of thermoregulation imbalance can be resolved duringtreatment. The next step is to prevent thermoregulation imbalance in newborn LBWduring intra-hospital transportation by preparing Standard Operating Proceduresfor LBW Intra-hospital Transportation with Kangaroo Care based on the Levineconservation model."

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Proses menyusui bayi di ruang perawatan khusus bayi baru lahir sering mengalami hambatan dikarenakan faktor lingkungan, dampak hospitalisasi dan ketidaknyamanan ibu selama menyusui. Tujuan penelitian untuk mengetahui adakah perbedaan penggunaan bantal menyusui pada kelompok intervensi dan pada kelompok kontrol. Penelitian dengan desain penelitian randomized control Trial (RCT), melibatkan 70 responden yang dibagi menjadi kelompok intervensi (n=35) dan kelompok kontrol (n=35) sesuai kriteria inklusi. Kelompok intervensi mengunakan bantal menyusui saat menyusui bayinya; sedangkan kelompok kontrol memberikan ASI sesuai yang disarankan di ruang perawatan. Pengukuran menggunakan lembar observasi berisi penilaian terhadap posisi, perlekatan, kemampuan menghisap dan durasi menyusu bayi terdiri dari 14 pernyataan, dan instrumen body part discomport scale (BPDS), dengan empat kali penilaian yaitu penilaian awal, penilaian hari I, penilaian hari II dan penilaian akhir. pada kelompok intervensi dan kelompok kontrol. Hasil analisis statistik menunjukkan ada perbedaan yang signifikan penggunaan bantal menyusui terhadap penurunan ketidaknyamanan ibu, perlekatan, perbaikan posisi, kemampuan menghisap dan durasi menyusu bayi (p<0,05). Dengan demikian implementasi manajemen perlekatan dan posisi dengan bantal menyusui dapat membantu mengatasi masalah pemenuhan nutrisi (menyusu) bayi prematur dan ketidaknyamanan ibu saat menyusui bayi.

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The process breastfeeding babies in special care rooms for newborns often experiences obstacles due to environmental factors, the impact of hospitalization and maternal discomfort during breastfeeding. The research objective was to determine whether there were differences in breastfeeding pillow use in the intervention group and in the control group. Research with randomized control Trial (RCT) research design, involving 70 respondents who were divided into intervention groups (n = 35) and the control group (n = 35) according to inclusion criteria. The intervention group uses a breastfeeding pillow when breastfeeding its baby; while the control group provided ASI as recommended in the treatment room. Measurements using an observation sheet containing an assessment of the position, attachment, sucking ability and duration of infant feeding consisted of 14 statements, and body part discomport scale (BPDS) instruments, with four assessments namely initial assessment, day I assessment, day II assessment and final assessment in the intervention group and the control group. The results of the statistical analysis showed that there was a significant difference in the use of breastfeeding pillow to decrease maternal discomfort, attachment, improvement in position, sucking ability and duration of breastfeeding (p <0.05). Thus the implementation of attachment management and positioning with the breastfeeding pillow can help overcome the problem of fulfilling the nutrition of premature babies and maternal discomfort when breastfeeding babies.

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"[ABSTRAK Pemenuhan nutrisi pada bayi prematur seringkali menimbulkan masalah yang diakibatkan oleh imaturitas fungsi pencernaannya. Asuhan keperawatan yang tepat dapat mendukung keberhasilan terhadap pemenuhan kebutuhan nutrisi pada bayi prematur. Asuhan keperawatan berbasis Model Konservasi Levine telah digunakan dalam menganalisis pemenuhan nutrisi pada bayi prematur melalui aplikasi praktik residensi pada lima kasus terpilih di Ruang Perinatologi Rumah Sakit Cipto Mangunkusumo pada bulan Maret-Mei tahun 2015. Analisis aplikasi Model Konservasi Levine melalui tahapan pengkajian, tropokognosis, hipotesis, intervensi, dan evaluasi. Tropikognosis utama terjadi pada konservasi energi yaitu masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Keberhasilan aplikasi Model Konservasi Levine terjadi pada empat kasus. Masalah nutrisi pada satu kasus lain belum teratasi. Hal ini mungkin ada kaitannya dengan faktor-faktor lain seperti hipomotilitas, tersangka sepsis, dan imaturitas fungsi pencernaan. Keberhasilan penerapan Model Konservasi Levine dicapai melalui kompetensi perawat sebagai pemberi asuhan, edukator, promotor kesehatan, konsultan, inovator, dan peneliti.ABSTRACT Fulfillment of nutritional needs on premature baby occasionally give rise to problems that lead into immaturity digestive system. Nursing care that execute correctly can support to solve this problems. Levine?s Conservation Model is being used to analyze nutrition achievement on preterm baby through nursing practice residency on selected five cases in Perinatology Unit on Cipto Mangunkusumo Hospital. The analysis of Levine?s Conservation Model through stages of assessment, trophicognosis, hypothesis, intervention, and evaluation. The main trophicognosis founded on conservation energy, the imbalance of body needs nutrition. Four of five cases have been succeded using Levine?s Conservation Model. The other one still has nutrition problem. This problem related to another factors, like intestine hypomotility, suspect of sepsis, and the immaturity of intestinal function. The objectives of nursing care can be achieved through nurse?s role as a good caregiver, educator, health supervisor, consultant, innovator, and researcher.;Fulfillment of nutritional needs on premature baby occasionally give rise to problems that lead into immaturity digestive system. Nursing care that execute correctly can support to solve this problems. Levine?s Conservation Model is being used to analyze nutrition achievement on preterm baby through nursing practice residency on selected five cases in Perinatology Unit on Cipto Mangunkusumo Hospital. The analysis of Levine?s Conservation Model through stages of assessment, trophicognosis, hypothesis, intervention, and evaluation. The main trophicognosis founded on conservation energy, the imbalance of body needs nutrition. Four of five cases have been succeded using Levine?s Conservation Model. The other one still has nutrition problem. This problem related to another factors, like intestine hypomotility, suspect of sepsis, and the immaturity of intestinal function. The objectives of nursing care can be achieved through nurse?s role as a good caregiver, educator, health supervisor, consultant, innovator, and researcher., Fulfillment of nutritional needs on premature baby occasionally give rise to problems that lead into immaturity digestive system. Nursing care that execute correctly can support to solve this problems. Levine’s Conservation Model is being used to analyze nutrition achievement on preterm baby through nursing practice residency on selected five cases in Perinatology Unit on Cipto Mangunkusumo Hospital. The analysis of Levine’s Conservation Model through stages of assessment, trophicognosis, hypothesis, intervention, and evaluation. The main trophicognosis founded on conservation energy, the imbalance of body needs nutrition. Four of five cases have been succeded using Levine’s Conservation Model. The other one still has nutrition problem. This problem related to another factors, like intestine hypomotility, suspect of sepsis, and the immaturity of intestinal function. The objectives of nursing care can be achieved through nurse’s role as a good caregiver, educator, health supervisor, consultant, innovator, and researcher.]"