MOBILISASI BERTAHAP PASCA-SECTIO CAESARIA: STUDI KASUS DI RSUD dr. HARYOTO LUMAJANG

Abstract

ABSTRAK

Pasca-sectio caesarea (SC), pasien diharapkan melakukan mobilisasi secara bertahap untuk mencegah bahaya fisiologis dan psikologis yang mungkin dapat terjadi. Namun, masih sedikit informasi yang melaporkan tentang pelaksanaan mobilisasi dini di lapangan. Tujuan penelitian: Menggambarkan asuhan keperawatan pada pasien pasca-SC, khususnya pada aspek hambatan mobilitas fisik. Keluhan utama: Pasien 1 (21 tahun) ditemani suami datang ke RS atas rujukan puskesmas. Mereka sudah memahami bahwa harus melahirkan secara SC karena panggul sempit. Selanjutnya, dilakukan operasi SC dengan anestesi lumbal, insisi melintang, luka ± 10 cm. Pasien 1 mengalami anemia sehingga dilakukan transfusi darah. Pasien 2 (32 tahun), datang ke RS ditemani suami, dirujuk karena panggul sempit dari puskesmas, kemudian dilakukan operasi SC dengan anestesi lumbal, insisi melintang, luka ± 10 cm.  Pengkajian melalui wawancara, obervasi, pemeriksaan fisik, dan studi dokumentasi.  Hasil:Intervensi untuk mobilisasi dilakukan setelah tindakan operasi selesai secara bertahap selama tiga hari perawatan. Hari pertama dilakukan pemberian informasi dan ambulasi awal di tempat tidur. Hari kedua pengaturan posisi semi-fowler, membantu perpindahan, latihan keseimbangan berdiri, berjalan. Hari ketiga pasien melakukan aktivitas mandiri tanpa bantuan, penyuluhan perawatan di rumah setelah operasi. Diskusi: Peran perawat pada pasien dengan melakukan mobilisasi secara bertahap serta berkolaborasi dengan tenaga kesehatan yang lain dapat mendukung percepatan pasien melakukan tindakan mobilisasi secara mandiri. Simpulan: Perawat perlu meningkatkan mobilisasi pasien secara bertahap dengan memerhatikan faktor ibu dan keluarga. Perawat disarankan meningkatkan pengetahuan, misalnya mengenai ERAC dan dalam proses asuhan keperawatan menggunakan rangkaian standar pelayanan untuk penyelenggaraan praktik keperawatan di Indonesia, yaitu SDKI, SIKI, SLKI, dan SPO.

Kata kunci: mobilisasi dini, sectio caesaria

Gradual Mobilization in Post Cesarean Section: A Case Study at Dr. Haryoto Hospital of Lumajang

ABSTRACT

After the caesarean section (CS), patients are expected to mobilize gradually to prevent physiological and psychological hazards. However, there is still little information reporting about the implementation of early mobilization. Objective: to describe nursing care in post-CS patients, especially regarding physical mobility barriers. Primary complaint: Patient 1 (21 years old), accompanied by her husband, came to the hospital based on the referral of the Public Health Center. They already understood that they had to give birth by cesarean section because the pelvis was narrow. Next, SC surgery was performed with lumbar anesthesia, transverse incision, and wound ± 10 cm. Patient 1 was anemic, so a blood transfusion was performed. Patient 2 (32 years) came to the hospital accompanied by her husband and was referred by the Public Health Center because of a narrow pelvis; then, an SC operation was performed with lumbar anesthesia, transverse incision, and wound ± 10 cm. Assessment through interviews, observations, physical examinations, and documentation studies.  Results: interventions for mobilization were performed after the surgery was completed in stages for 3 days of treatment. On the first day, information was given and early ambulation was performed in bed. On the second day, the activities included adjusting semi-Fowler's position, assisting the movement, exercising balanced standing, and walking. On the third day, the patient did independent activities without assistance and counseling on home care after surgery. Discussion: The nurses play a role by gradually mobilizing patients and collaborating with other health workers to support patients' acceleration to mobilize independently. Conclusion: Nurses need to increase patient mobilization gradually by paying attention to maternal and family factors. Nurses are advised to increase knowledge, for example, about ERAS and the nursing care process by using a series of service standards for implementing nursing practice in Indonesia, namely SDKI, SIKI, SLKI, dan SPO.

Keywords: early mobilization, cesarean section