Penerapan Pronasi dan Semi Fowler terhadap Peningkatan Saturasi Oksigen pada Pasien COVID-19
Abstract
This study aims to determine the effectiveness of prone and semi-fowler positions on oxygen saturation in COVID-19 pneumonia patients at the Jakarta Islamic Hospital Cempaka Putih. The quantitative method uses quasi-experimental data analysis techniques with a two-group preintervention-postintervention design. The results of the bivariate analysis with the T-test showed the value of Sig. P ≥ 0.05 found that the average before and after holding the prone position was 97%, and the pre-and post-intervention standards in the semi-Fowler class were 95% oxygen saturation. The value of this difference in oxygen saturation is influenced by age, sex, BMI, and HB, so the results affect the difference in pronation position, which is more effective than semi-fowler with the criterion of increasing oxygen saturation above the standard oximeter value, where pronation intervention in COVID-19 patients is more effective from semi fowler with the measure of an increase in oxygen saturation above 95%. In conclusion, there are different changes in oxygen saturation before and after the prone, and semi-fowler positions are carried out in COVID-19 pneumonia patients at the Jakarta Islamic Hospital Cempaka Putih.
Keywords: COVID-19, Pronation, Oxygen Saturation, Semi Fowler
References
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Caputo, N. D., Strayer, R. J., & Levitan, R. (2020). Early Self-Proning in Awake, Non-Intubated Patients in the Emergency Department: A Single ED’s Experience During the COVID-19 Pandemic. Academic Emergency Medicine, 27(5), 375-378. https://doi.org/10.1111/acem.13994
Chanif, C., & Prastika, D. (2019). Position of Fowler and Semi-fowler to Reduce of Shortness of Breath (Dyspnea) Level While Undergoing Nebulizer Therapy. South East Asia Nursing Research, 1(1), 14-19. https://doi.org/10.26714/seanr.1.1.2019.14-19
Chen, J., Qi, T., Liu, L., Ling, Y., Qian, Z., Li, T., Li, F., Xu, Q., Zhang, Y., Xu, S., Song, Z., Zeng, Y., Shen, Y., Shi, Y., & Zhu, T. (2020). Clinical Progression of Patients with COVID-19 in Shanghai, China. Journal Infections, 80(5), 1-6. https://doi.org/10.1016/j.jinf.2020.03.004
Dubosh, N. M., Wong, M. L., Grossestreuer, A. V., Loo, Y. K., Sanchez, L. D., Chiu, D., Leventhal, E. L., Ilg, A., & Donnino, M . W. (2021). Early, Awake Proning in Emergency Department Patients with COVID-19. American Journal of Emergency Medicine, 46, 640-645. https://dx.doi.org/10.1016/j.ajem.2020.11.074
Do-Prado, P. R., Bettencourt, A. R. de-C., Lopes, J. d-L (2019). Related Factors of the Nursing Diagnosis Ineffective Breathing Pattern in an Intensive Care Unit. Revista Latino-Americana de Enfermagem, 27. https://dx.doi.org/10.1590/1518-8345.2902.3153
Elharrar X., Trigui Y., Dols A-M., Touchon, F., Martinez, S., Prud’homme, E., & Papazian, L. (2020). Use of Prone Positioning in Nonintubated Patients with COVID-19 and Hypoxemic Acute Respiratory Failure. JAMA- Journal of the American Medical Association, 323(22) 2336-2338. https://doi.org/10.1001/jama.2020.8255
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Gonga, V. N. (2022). Relationship of Exclusive Breastfeeding with History of Acute Respiratory Infection (ARI) in Children Aged 0-24 Months in Siwalima Village in November 2021. Bioscientia Medicina: Journal of Biomedicine and Translational Research, 6(2) 1399-1404. https://dx.doi.org/10.37275/bsm.v6i2.450
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Handaya, J., & Benharash, P. (2020). Prone Positioning for Acute Respiratory Distress Syndrome (ARDS). JAMA- Journal of the American Medical Association, 324(13), 1361-1368. https://doi.org/10.1001/jama.2020.14901
Handayani, D., Hadi, D. .R., Isbaniah, F., Burhan, E., & Agustin, H. (2020). Corona Virus Disease 2019. Jurnal Respilogi Indonesia, 40(2), 119-129. https://doi.org/10.36497/jri.v40i2.101
Ismoyowati, T. W., Teku, I. S. D., Banik, J. C., & Sativa, R. A. O. (2021). Manajemen Nyeri untuk Congestive Heart Failure. Jurnal Penelitian Kesehatan Suara Forikes, 12(1), 108-112. http://dx.doi.org/10.33846/sf12126
Koriyama, N., Moriuchi, A., Higahsi, K, Kataoka, T., Arimizu, T., Tagaguchi, G., Matsuoka, H., & Otsuka, M. (2022). COVID-19 with Rapid Progression to Hypoxemia Likely due to Imbalance between Ventilation and Blood Flow: A Case Report. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary, 16, 1-7. https://dx.doi.org/10.1177/11795484211073273
Khoerunisa, N., & Noorikhsan, F. F. (2021). Comparison of COVID 19 Pandemic Handling Management in Indonesia and India. Journal of Political Issues, 2(2), 89-101. https://doi.org/10.33019/jpi.v2i2.36
Li, K., Wu, J., Wu, F., Guo, D., Chen,L., Fang, Z., & Li, C. (2020). The Clinical and Chest CT Features Associated with Severe and Critical COVID-19 Pneumonia. Investigative Radiology, 55(6), 327-331. https://doi.org/10.1097/RLI.0000000000000672
Mammen, S., Yosuf, B. & Shamsah, M. (2020). Transdermal Fentanyl Patch: An Approach to Enhance Tolerance of Conscious Proning in COVID-19 Patients. Journal of Opioid Management, 16(4), 237-238. https://doi.org/10.5055/jom.2020.0576
Nurkholis, N. (2020). Dampak Pandemi Novel-Corona Virus Disiase (COVID-19) terhadap Psikologi dan Pendidikan serta Kebijakan Pemerintah. Jurnal PGSD, 6(1), 39–49. https://doi.org/10.32534/jps.v6i1.1035
Ocal, S. (2020). Pulmonary Rehabilitation. Journal of Critical and Intensive Care, 11(1), https://dx.doi.org/10.37678/dcybd.2020.2367
Øfsti, R., Devik, S. A., Enmarker, I., & Olsen, R. M. (2020). “Looking for Deviationsâ€: Nurses’ Observations of Older Patients with COPD in Home Nursing Care. Global Qualitative Nursing Research, 7. https://dx.doi.org/10.1177/2333393620946331
Patel, P., & Shah, S. (2021). A Comparison of effevt of Semi Fowler’s and Side Lying Position on Pulmonary Functions and Oxygen Saturation in Bedridden Patients. International Journal of Health Sciences and Research, 11(5), 53-57. https://www.ijhsr.org/IJHSR_Vol.11_Issue.5_May2021/IJHSR07.pdf
Parashar, S., Karthik, A., Gupta, R., & Malviya, D. (2021). Awake Proning for Nonintubated Adult Hypoxic Patients with Covid-19: A Systematic Review of the Published Evidence. Indian Journal of Critical Care Medicine, 25(8), 906-916. https://dx.doi.org/10.5005/jp-journals-10071-23910
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Pérez-Vergara, M., Cañas-Lopera, E. M., Ortiz, J. A., Rojas, N. A., Laverde-Contreras, O. L., & Sánchez-Herrera, B. (2021). Nursing Care at the Service of Life: A Model Including Charity, Quality, and Leadership. Nursing Forum, 56(4), 844-848. https://doi.org/10.1111/nuf.12624
Pushpha, N., Viveka, S., & Vallabhaneni, V. (2021). Proning: Its Anatomical Basis and Effect on Oxygen Saturation in COVID Patients. National Journal of Clinical Anatomy, 10(3), 178-180. https://dx.doi.org/10.4103/NJCA.NJCA_82_21
Ridlo, I. A. (2020). Pandemi COVID-19 dan Tantangan Kebijakan Kesehatan Mental di Indonesia. INSAN Jurnal Psikologi dan Kesehatan Mental, 5(2), 162-171. https://doi.org/10.20473/jpkm.V5I22020.162-171
Roca O, Caralt B, Messika J, Samper, M., Sztymf, B., Hernandez, G., Garcia-de-Acilu, M., Frat, J. P., Masclans, J. R., & Ricard, J. D. (2019). An index Combining Respiratory Rate and Oxygenation to Predict Outcome of Nasal High-Flow Therapy. American Journal of Respiratory and Critical Care Medicine, 199(11), 1368-1376. https://dx.doi.org/10.1164/rccm.201803-0589OC
Sahrudi, S., & Satria, M. (2020). Posisi Semi Fowler Menurunkan Frekuensi Napas. Jurnal Antara Keperawatan. 3(2), 59-65. https://doi.org/10.37063/antaraperawat.v3i2.181
Suhendar, A., & Sahrudi, S. (2022). Efektivitas Pemberian Oksigen Posisi Semi Fowler dan Fowler terhadap Perubahan Saturasi pada Pasien Tuberculosis di IGD RSUD Cileungsi. Malahayati Nursing Journal, 4(3), 576-590. https://doi.org/10.33024/mnj.v4i3.6043
Suni, N.S.P. (2021). Tingginya Kasus Aktif dan Angka Kematian Akibat COVID-19 di Indonesia. Jurnal Pusat Penelitian Badan Keahlian DPR RI, 13(3), 13-18. https://scholar.google.co.id/citations?view_op=view_citation&hl=id&user=qgH-p4kAAAAJ&citation_for_view=qgH-p4kAAAAJ:_FxGoFyzp5QC
Sheikh, D., Tripathi, N., Chandler, T. R., Furmanek, S., Bordon, J., Ramirez, J. A., & Cavallazzi, R. (2022). Clinical Outcomes in Patients with COPD Hospitalized with SARS-CoV-2 Versus Non- SARS-CoV-2 Community-Acquired Pneumonia. Respiratory Medicine, 191, https://dx.doi.org/10.1016/j.rmed.2021.106714
Shoults, B., Barber, M., Millham, L., Mulla M., Nanji, N., Steele, G., Peck, T., Smithedajkul, P., Worsham, C., Currier, P., & Raphaely, R. A. (2021), Feasibility and Limitations of Proning Protocol for Nonintubated Patients with COVID-19. Journal of Patient Experience, 8, 1-5. https://dx.doi.org/10.1177/2374373520981486
Varghese, G. M., John, R., Manesh, A., Karthik, R., & Abraham, O. C. (2020), Clinical Management of COVID-19. Indian Journal of Medical Research, 151(5), 401-410. https://doi.org/10.4103/ijmr.IJMR_957_20
Vidale, S. (2021), Risk Factors, and Clinical and Etiological Characteristics of Ischemic Strokes in COVID-19-Infected Patients: A Systematic Review of Literature. Cerebrovascular Diseases, 50, 371-374. https://doi.org/10.1159/000514267
Waterer, G. (2021). What is Pneumonia?. Breath, 17(3), 1-6. https://breathe.ersjournals.com/content/17/3/210087.short
Wiggermann, N., Zhou, J., & Kumpar, D. (2020). Proning Patients with COVID-19: A Review of Equipment and Methods. Human Factors, 62(7), 1069-1076. https://dx.doi.org/10.1177/0018720820950532
Wijayati, S., Ningrum, D. H., & Putrono, P. (2019). Pengaruh Posisi Tidur Semi Fowler terhadap Kenaikan Nilai Saturasi Oksigen pada Pasien Gagal Jantung Kongestif di RSUD Loekmono Hadi Kudus. Medica Hospitalia: Journal of Clinical Medicine, 6(1), 13–19. https://doi.org/10.36408/mhjcm.v6i1.372
Yulia, A., Dahrizal, D., & Lestari, W. (2019). Pengaruh Nafas Dalam dan Posisi terhadap Saturasi Oksigen dan Frekuensi Nafas pada Pasien Asma. Jurnal Keperawatan Raflesia. 1(1), 67-75. https://doi.org/10.33088/jkr.v1i1.398
Zhu, H., Wei, L., & Niu, P. (2020). The Novel Coronavirus Outbreak in Wuhan, China. Global Health Research and Policy, 5(6), 1-3. https://doi.org/10.1186/s41256-020-00135-6
Armi, A., & Sartika, M. (2021). Posisi Pasien terhadap Tekanan Vena Sentral. Jurnal Keperawatan Silampari, 4(2), 519-525. https://dx.doi.org/10.31539/jks.v4i2.1983
Aysegul, C., Oznur, U. Y., & Asiye, A. (2020). Evidence-Based Practices for Preventing Ventilator-Associated Pneumonia in Intensive Care Nursing: Knowledge and Practice. International Journal of Caring Sciences, 13(3), 1794-1798. http://www.internationaljournalofcaringsciences.org/docs/30_celik_original_13_3.pdf
Çağlayan, S., & Gözen, D. (2021). Effect of Supine and Prone Flexion Position on Heart Rate, Oxygen Saturation and Pain Score of Preterm Infants. Erciyes Medical Journal, 43(1), 26-30. https://dx.doi.org/10.14744/etd.2020.82195
Caputo, N. D., Strayer, R. J., & Levitan, R. (2020). Early Self-Proning in Awake, Non-Intubated Patients in the Emergency Department: A Single ED’s Experience During the COVID-19 Pandemic. Academic Emergency Medicine, 27(5), 375-378. https://doi.org/10.1111/acem.13994
Chanif, C., & Prastika, D. (2019). Position of Fowler and Semi-fowler to Reduce of Shortness of Breath (Dyspnea) Level While Undergoing Nebulizer Therapy. South East Asia Nursing Research, 1(1), 14-19. https://doi.org/10.26714/seanr.1.1.2019.14-19
Chen, J., Qi, T., Liu, L., Ling, Y., Qian, Z., Li, T., Li, F., Xu, Q., Zhang, Y., Xu, S., Song, Z., Zeng, Y., Shen, Y., Shi, Y., & Zhu, T. (2020). Clinical Progression of Patients with COVID-19 in Shanghai, China. Journal Infections, 80(5), 1-6. https://doi.org/10.1016/j.jinf.2020.03.004
Dubosh, N. M., Wong, M. L., Grossestreuer, A. V., Loo, Y. K., Sanchez, L. D., Chiu, D., Leventhal, E. L., Ilg, A., & Donnino, M . W. (2021). Early, Awake Proning in Emergency Department Patients with COVID-19. American Journal of Emergency Medicine, 46, 640-645. https://dx.doi.org/10.1016/j.ajem.2020.11.074
Do-Prado, P. R., Bettencourt, A. R. de-C., Lopes, J. d-L (2019). Related Factors of the Nursing Diagnosis Ineffective Breathing Pattern in an Intensive Care Unit. Revista Latino-Americana de Enfermagem, 27. https://dx.doi.org/10.1590/1518-8345.2902.3153
Elharrar X., Trigui Y., Dols A-M., Touchon, F., Martinez, S., Prud’homme, E., & Papazian, L. (2020). Use of Prone Positioning in Nonintubated Patients with COVID-19 and Hypoxemic Acute Respiratory Failure. JAMA- Journal of the American Medical Association, 323(22) 2336-2338. https://doi.org/10.1001/jama.2020.8255
Fowler, C., Green, J., Elliott, D., Petty, J., & Whiting, L. (2019). The Forgotten Mothers of Extremely Preterm Babies: A Qualitative Study. Journal of Clinical Nursing, 28(12), 2124-2134. https://dx.doi.org/10.1111/jocn.14820
Gonga, V. N. (2022). Relationship of Exclusive Breastfeeding with History of Acute Respiratory Infection (ARI) in Children Aged 0-24 Months in Siwalima Village in November 2021. Bioscientia Medicina: Journal of Biomedicine and Translational Research, 6(2) 1399-1404. https://dx.doi.org/10.37275/bsm.v6i2.450
Guerin, C., & Mancebo, J. (2021). Lower VT and Prone Position: Quo vadis?. American Journal of Respiratory and Critial Care Medicine, 203(11), 1333-1338. https://doi.org/10.1164%2Frccm.202101-0156ED
Ghelichkhani, P., & Esmaeili, M. (2020). Prone Position in Management of COVID-19 Patients; A Commentary. Archives of Academic Emergency Medicine, 8(1), 1-3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158870/pdf/aaem-8-e48.pdf
Handaya, J., & Benharash, P. (2020). Prone Positioning for Acute Respiratory Distress Syndrome (ARDS). JAMA- Journal of the American Medical Association, 324(13), 1361-1368. https://doi.org/10.1001/jama.2020.14901
Handayani, D., Hadi, D. .R., Isbaniah, F., Burhan, E., & Agustin, H. (2020). Corona Virus Disease 2019. Jurnal Respilogi Indonesia, 40(2), 119-129. https://doi.org/10.36497/jri.v40i2.101
Ismoyowati, T. W., Teku, I. S. D., Banik, J. C., & Sativa, R. A. O. (2021). Manajemen Nyeri untuk Congestive Heart Failure. Jurnal Penelitian Kesehatan Suara Forikes, 12(1), 108-112. http://dx.doi.org/10.33846/sf12126
Koriyama, N., Moriuchi, A., Higahsi, K, Kataoka, T., Arimizu, T., Tagaguchi, G., Matsuoka, H., & Otsuka, M. (2022). COVID-19 with Rapid Progression to Hypoxemia Likely due to Imbalance between Ventilation and Blood Flow: A Case Report. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary, 16, 1-7. https://dx.doi.org/10.1177/11795484211073273
Khoerunisa, N., & Noorikhsan, F. F. (2021). Comparison of COVID 19 Pandemic Handling Management in Indonesia and India. Journal of Political Issues, 2(2), 89-101. https://doi.org/10.33019/jpi.v2i2.36
Li, K., Wu, J., Wu, F., Guo, D., Chen,L., Fang, Z., & Li, C. (2020). The Clinical and Chest CT Features Associated with Severe and Critical COVID-19 Pneumonia. Investigative Radiology, 55(6), 327-331. https://doi.org/10.1097/RLI.0000000000000672
Mammen, S., Yosuf, B. & Shamsah, M. (2020). Transdermal Fentanyl Patch: An Approach to Enhance Tolerance of Conscious Proning in COVID-19 Patients. Journal of Opioid Management, 16(4), 237-238. https://doi.org/10.5055/jom.2020.0576
Nurkholis, N. (2020). Dampak Pandemi Novel-Corona Virus Disiase (COVID-19) terhadap Psikologi dan Pendidikan serta Kebijakan Pemerintah. Jurnal PGSD, 6(1), 39–49. https://doi.org/10.32534/jps.v6i1.1035
Ocal, S. (2020). Pulmonary Rehabilitation. Journal of Critical and Intensive Care, 11(1), https://dx.doi.org/10.37678/dcybd.2020.2367
Øfsti, R., Devik, S. A., Enmarker, I., & Olsen, R. M. (2020). “Looking for Deviationsâ€: Nurses’ Observations of Older Patients with COPD in Home Nursing Care. Global Qualitative Nursing Research, 7. https://dx.doi.org/10.1177/2333393620946331
Patel, P., & Shah, S. (2021). A Comparison of effevt of Semi Fowler’s and Side Lying Position on Pulmonary Functions and Oxygen Saturation in Bedridden Patients. International Journal of Health Sciences and Research, 11(5), 53-57. https://www.ijhsr.org/IJHSR_Vol.11_Issue.5_May2021/IJHSR07.pdf
Parashar, S., Karthik, A., Gupta, R., & Malviya, D. (2021). Awake Proning for Nonintubated Adult Hypoxic Patients with Covid-19: A Systematic Review of the Published Evidence. Indian Journal of Critical Care Medicine, 25(8), 906-916. https://dx.doi.org/10.5005/jp-journals-10071-23910
Pascoal, L. M., Lopes, M. V. D, da-Silva, V. M., Diniz, C. M., Nunes, M. M., Beltrao, B. A., & Freire, V. E. C. d-S. F. (2021). A Content Analysis of Clinical Indicators of the Nursing Diagnosis Ineffective Breathing Pattern. International Journal of Nursing Knowledge, 32(1), 53-58. https://dx.doi.org/10.1111/2047-3095.12290
Pérez-Vergara, M., Cañas-Lopera, E. M., Ortiz, J. A., Rojas, N. A., Laverde-Contreras, O. L., & Sánchez-Herrera, B. (2021). Nursing Care at the Service of Life: A Model Including Charity, Quality, and Leadership. Nursing Forum, 56(4), 844-848. https://doi.org/10.1111/nuf.12624
Pushpha, N., Viveka, S., & Vallabhaneni, V. (2021). Proning: Its Anatomical Basis and Effect on Oxygen Saturation in COVID Patients. National Journal of Clinical Anatomy, 10(3), 178-180. https://dx.doi.org/10.4103/NJCA.NJCA_82_21
Ridlo, I. A. (2020). Pandemi COVID-19 dan Tantangan Kebijakan Kesehatan Mental di Indonesia. INSAN Jurnal Psikologi dan Kesehatan Mental, 5(2), 162-171. https://doi.org/10.20473/jpkm.V5I22020.162-171
Roca O, Caralt B, Messika J, Samper, M., Sztymf, B., Hernandez, G., Garcia-de-Acilu, M., Frat, J. P., Masclans, J. R., & Ricard, J. D. (2019). An index Combining Respiratory Rate and Oxygenation to Predict Outcome of Nasal High-Flow Therapy. American Journal of Respiratory and Critical Care Medicine, 199(11), 1368-1376. https://dx.doi.org/10.1164/rccm.201803-0589OC
Sahrudi, S., & Satria, M. (2020). Posisi Semi Fowler Menurunkan Frekuensi Napas. Jurnal Antara Keperawatan. 3(2), 59-65. https://doi.org/10.37063/antaraperawat.v3i2.181
Suhendar, A., & Sahrudi, S. (2022). Efektivitas Pemberian Oksigen Posisi Semi Fowler dan Fowler terhadap Perubahan Saturasi pada Pasien Tuberculosis di IGD RSUD Cileungsi. Malahayati Nursing Journal, 4(3), 576-590. https://doi.org/10.33024/mnj.v4i3.6043
Suni, N.S.P. (2021). Tingginya Kasus Aktif dan Angka Kematian Akibat COVID-19 di Indonesia. Jurnal Pusat Penelitian Badan Keahlian DPR RI, 13(3), 13-18. https://scholar.google.co.id/citations?view_op=view_citation&hl=id&user=qgH-p4kAAAAJ&citation_for_view=qgH-p4kAAAAJ:_FxGoFyzp5QC
Sheikh, D., Tripathi, N., Chandler, T. R., Furmanek, S., Bordon, J., Ramirez, J. A., & Cavallazzi, R. (2022). Clinical Outcomes in Patients with COPD Hospitalized with SARS-CoV-2 Versus Non- SARS-CoV-2 Community-Acquired Pneumonia. Respiratory Medicine, 191, https://dx.doi.org/10.1016/j.rmed.2021.106714
Shoults, B., Barber, M., Millham, L., Mulla M., Nanji, N., Steele, G., Peck, T., Smithedajkul, P., Worsham, C., Currier, P., & Raphaely, R. A. (2021), Feasibility and Limitations of Proning Protocol for Nonintubated Patients with COVID-19. Journal of Patient Experience, 8, 1-5. https://dx.doi.org/10.1177/2374373520981486
Varghese, G. M., John, R., Manesh, A., Karthik, R., & Abraham, O. C. (2020), Clinical Management of COVID-19. Indian Journal of Medical Research, 151(5), 401-410. https://doi.org/10.4103/ijmr.IJMR_957_20
Vidale, S. (2021), Risk Factors, and Clinical and Etiological Characteristics of Ischemic Strokes in COVID-19-Infected Patients: A Systematic Review of Literature. Cerebrovascular Diseases, 50, 371-374. https://doi.org/10.1159/000514267
Waterer, G. (2021). What is Pneumonia?. Breath, 17(3), 1-6. https://breathe.ersjournals.com/content/17/3/210087.short
Wiggermann, N., Zhou, J., & Kumpar, D. (2020). Proning Patients with COVID-19: A Review of Equipment and Methods. Human Factors, 62(7), 1069-1076. https://dx.doi.org/10.1177/0018720820950532
Wijayati, S., Ningrum, D. H., & Putrono, P. (2019). Pengaruh Posisi Tidur Semi Fowler terhadap Kenaikan Nilai Saturasi Oksigen pada Pasien Gagal Jantung Kongestif di RSUD Loekmono Hadi Kudus. Medica Hospitalia: Journal of Clinical Medicine, 6(1), 13–19. https://doi.org/10.36408/mhjcm.v6i1.372
Yulia, A., Dahrizal, D., & Lestari, W. (2019). Pengaruh Nafas Dalam dan Posisi terhadap Saturasi Oksigen dan Frekuensi Nafas pada Pasien Asma. Jurnal Keperawatan Raflesia. 1(1), 67-75. https://doi.org/10.33088/jkr.v1i1.398
Zhu, H., Wei, L., & Niu, P. (2020). The Novel Coronavirus Outbreak in Wuhan, China. Global Health Research and Policy, 5(6), 1-3. https://doi.org/10.1186/s41256-020-00135-6
Published
2023-01-31
Section
Articles
Copyright (c) 2023 Sri Mulati Nendah Agreta, Nyimas Heny Purwati, Fitrian Rayasari, Rohman Azzam
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
