Abstrak

Pasien kritis memiliki tingkat morbiditas dan mortalitas yang tinggi, hal ini diperparah dengan pemberian imobilisasi yang berkepanjangan. Perubahan hemodinamik yang tidak stabil, menjadikan alasan perawat di ICU untuk menghentikan kegiatan mobilisasi. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian mobilisasi progresif level I terhadap perubahan hemodinamik non invasif pada pasien kritis di ruang GICU RSUP Dr. Hasan Sadikin Bandung. Desain yang digunakan adalah quasi eksperiment. Jumlah sampel 30 responden yang diambil dengan cara consecutive sampling. Pemberian mobilisasi yang diberikan yaitu berupa pengaturan posisi head of bed 300, head of bed 450 disertai dengan passive range of motion, kemudian dilanjut dengan posisi lateral kanan dan kiri. Pengukuran hemodinamik dilakukan sebelum dan sesudah pemberian intervensi. Uji beda rerata perubahan hemodinamik non invasif menggunakan Anova Repeated Measurement. Hasil penelitian didapatkan setelah diberikan intervensi terlihat ada perubahan pada pameter sistolik, diastolik dan respiratory rate dibandingkan pada awal pengukuran. Pada parameter heart rate dan saturasi oksigen tidak mengalami perubahan. Analisi bivariat didapatkan pengaruh pemberian mobilisasi pada respiratory rate dengan p value = 0,023 sedang pada parameter lain didapatkan p value > 0,05. Simpulan, pemberian mobilisasi progresif berpengaruh terhadap perubahan respiratory rate. Implikasi dari hasil penelitian ini, diharapkan dapat dipertimbangkan dan dipergunakan sebagai bahan pertimbangan untuk memberikan mobilisasi pada pasien di ICU. Kata Kunci: Mobilisasi Progresif, Hemodinamik Non Invasif, ICU, pasien kritis

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Abstract

Patient with critical condition had high morbidity and mortality rate. This condition is worsened by long term immobilization. Instability hemodynamic parameters made nurses stationed in ICU delayedmobilization activities. The objective of this study was to identify progressive mobilization level I activities on non-invasive hemodynamic parameters among critical patients in General Intensive Care Unit (GICU) Dr. Hasan Sadikin Hospital, Bandung. The design of the study was quasi experiment design. Thirty respondents were included to the study using non probability sampling, which was consecutive sampling. Progressive mobilization given in the first level was head of bed 300, head of bed 450 with passive range of motion, continued with right and left lateral position. Measurement of hemodynamic parameters was done pre and post intervention. Anova repeated measurement was used to identify mean difference each of non-invasive hemodynamic parameters. The results of this study show changing more than 20% of systole, diastole and respiratory rate was seen post intervention compared to measurement before the intervention. However, there was no changing on heart rate and oxygen saturation. There was a significant difference of hemodynamic after intervention on respiratory rate (p value=0.023), while on the other parameters p value > 0.05. In conclusion, progressive mobilization has an effect on changing of respiratory rate. Thus, it is implicated from the results of this study to be used as a source of information in order to give early mobilization to critical patients in the ICU.

Keywords: progressive mobilization, non-invasive hemodynamic, ICU, critical patients