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This study aims to analyzei thei peirformancei and contributing factors to thei failurei of thei digital-baseid Civil Seirvant Manageimeint Information Sisteim (SIKILAT) adoption at thei Jambi Provincei Human Reisourceis Deiveilopmeimnt Ageincy (BPSDM) using a Teichnology, Organization, and EInvironmeint (TOEI) peirspeictivei. Thei study eimployeid a qualitativei, deiscriptivei approach. Thei reisults indicatei that SIKILAT impleimeintation is suboptimal and unsustainablei. From a teichnological peirspeictivei, obstacleis includei lack of minteinancei, limiteid systeim quality, and complicateid usability. From an organizational peirspeiktivei, thei lack of mandatory policieis and low useir compeiteincy and participation arei keiy obstacleis. Meianwhilei, from an einvironmeintal peirspeictivei thei lack of reigulations and eixteirnal preissureis havei leid to thei systeim’s deiclinei as a priority.

This study examines postpartum nursing care for mothers undergoing Sectio Caesarea (SC) with the primary nursing diagnosis of ineffective breastfeeding. The purpose is to evaluate the effectiveness of oxytocin massage intervention in improving breastfeeding outcomes in post-SC mothers. The study was conducted in Mawar Ward, RSUD dr. H. Soewondo Kendal, involving four patients experiencing delayed lactation, difficulty in baby latching, and psychological challenges such as anxiety and lack of confidence. The intervention was based on the Indonesian Nursing Intervention Standards (SIKI), focusing on observation, therapeutic actions, education, and collaboration with healthcare teams and family members. Oxytocin massage was performed 2–3 times daily, complemented by warm compresses, breastfeeding position training, and emotional support. The results indicated significant improvements: increased breast milk production, better baby latching, reduced maternal anxiety, and higher self-confidence in breastfeeding. This evidence-based approach highlights that comprehensive postpartum nursing care—integrating physical, psychological, and family support—plays a crucial role in ensuring breastfeeding success and overall maternal recovery after SC.

This study examines postpartum nursing care for mothers undergoing Sectio Caesarea (SC) with the primary nursing diagnosis of ineffective breastfeeding. The purpose is to evaluate the effectiveness of oxytocin massage intervention in improving breastfeeding outcomes in post-SC mothers. The study was conducted in Mawar Ward, RSUD dr. H. Soewondo Kendal, involving four patients experiencing delayed lactation, difficulty in baby latching, and psychological challenges such as anxiety and lack of confidence. The intervention was based on the Indonesian Nursing Intervention Standards (SIKI), focusing on observation, therapeutic actions, education, and collaboration with healthcare teams and family members. Oxytocin massage was performed 2–3 times daily, complemented by warm compresses, breastfeeding position training, and emotional support. The results indicated significant improvements: increased breast milk production, better baby latching, reduced maternal anxiety, and higher self-confidence in breastfeeding. This evidence-based approach highlights that comprehensive postpartum nursing care—integrating physical, psychological, and family support—plays a crucial role in ensuring breastfeeding success and overall maternal recovery after SC.

Hypertension is one of the most common non-communicable diseases, with a high incidence rate that has become a major global health concern. It is often referred to as a “silent killer” because many patients are unaware of their condition until serious complications arise. In Indonesia, the prevalence of hypertension is relatively high, yet many sufferers remain undiagnosed or do not receive proper medical treatment. Several risk factors contribute to hypertension, including age, heredity, high-salt diet, obesity, lack of physical activity, and unhealthy lifestyles such as smoking and alcohol consumption. Without proper management, hypertension may lead to severe complications such as stroke, heart failure, and chronic kidney disease. Management of hypertension generally involves pharmacological therapy, such as the administration of antihypertensive drugs, as well as non-pharmacological interventions through lifestyle modifications. Nurses play a crucial role in patient education, monitoring, and preventing complications through comprehensive nursing care. The purpose of this study is to describe the nursing care provided to Mr. R, who experienced a cardiovascular system disorder, namely hypertension, in the Dahlia Ward of RSUD dr. Soeselo, Tegal Regency. The research method used was descriptive with a case study approach, allowing for a systematic and clear presentation of the patient’s condition. The case findings showed that the patient’s main complaint was a headache radiating to the nape of the neck. Based on nursing assessment, two nursing diagnoses were identified: acute pain and lack of knowledge regarding the disease and its management. Interventions were determined using national standards such as SDKI, SLKI, and SIKI, which are expected to reduce symptoms and improve the patient’s understanding of hypertension.

Disorders of the musculoskeletal system encompass a wide range of conditions affecting the bones, joints, and muscles. Bone-related disorders include osteoporosis, fractures, spinal deformities, osteopenia, osteomalacia, Paget’s disease of bone, osteopetrosis, achondroplasia, osteogenesis imperfecta, and osteomyelitis. Joint-related disorders consist of arthritis, bursitis, tendinitis, tendon injuries, tennis elbow, and carpal tunnel syndrome, while muscle disorders include myalgia, fibromyalgia, muscle injuries, muscular dystrophy, muscle atrophy, cramps, and spasms (Astuti et al., 2024). Fractures may lead to complications in surrounding tissues, such as soft tissue edema, bleeding into muscles and joints, joint dislocation, nerve damage, vascular injury, and tendon rupture (Rumapea, 2024). A patellar tendon rupture occurs when the fibrous tissue connecting the patella to the quadriceps muscle tears, and complete ruptures typically require surgical repair. The objective of this study was to design and implement a nursing care plan for patient A, who underwent post-operative management of a patellar tendon rupture in Mawar Ward 2 at RSUD dr. Soeselo, Tegal Regency, in 2025. This study applied a descriptive case study method. The findings revealed that the main complaint reported by the patient was pain in the left knee. Three nursing diagnoses were identified: acute pain, impaired physical mobility, and risk of infection. Nursing interventions were structured based on standardized guidelines from SDKI, SLKI, and SIKI, enabling systematic implementation. The results highlight the importance of comprehensive and evidence-based nursing care to optimize recovery outcomes for patients with post-operative tendon rupture.

When problems such as antepartum hemorrhage, fetal distress, atypical fetal presentation, and gestational hypertension occur, a cesarean section can save the lives of both mother and baby. A cesarean section (CS) is a surgical technique in which the uterus and abdominal wall are opened to deliver the fetus. In many countries, cesarean sections are the most common surgical procedure, and over the past 30 years, their use has gradually increased. Intrauterine fetal death is the death of a fetus weighing 500 grams or more in the womb at 20 weeks of gestation or later. The partial or complete separation of a normally implanted placenta after 22 weeks before birth is known as placental abruption. he purpose of this paper is to provide nursing care to Mrs. P with a Caesarean section indicating intra uterine fetal death (IUFD) due to placental abruption in the Nusa Indah room of dr. Soeselo Regional General Hospital, Tegal Regency, according to nursing standards. The method used is descriptive with a case study approach. The data collection techniques in this scientific paper are in the form of interviews, observations, documentation studies and literature studies. From the case review, the main complaint was pain in the operated area, pain increased when moving, pain like being squeezed with a pain scale of 5, pain that comes and goes. The patient appeared to be grimacing in pain and restless, the patient always held the area that had been operated on, the results of the vital signs examination obtained: BP: 139/100 mmHg, pulse: 103 x / minute, S: 36.5oC, RR: 20 x / minute, there was a bandage on the lower abdomen along 15 cm with a horizontal line, the patient did not know and was confused about the birth control used after the CS. The nursing problems identified were acute pain, risk of infection, and knowledge deficit. Interventions were developed based on the theory in the SDKI, SLKI, and SIKI, as well as the client's condition, and were implementable

The digestive system plays a role in processing food into nutrients so that they can be absorbed and utilized by the body, but it is often found that the digestive system experiences disorders that can be caused by various factors such as infection, inflammation, motility disorders, or even neoplasms (Suryati et al., 2025).One of the diseases caused by digestive system disorders is ileus obstruction, which is a disorder of the digestive system that occurs due to a mechanical blockage in the intestine and is often found in patients with intestinal obstruction. One of the diseases resulting from digestive system disorders isileus obstruction, which is a disorder of the digestive system caused by a mechanical obstruction in the intestines and is commonly found in patients who visit the emergency room. It is estimated that approximately 2-8% and 15% of patients require treatment in the surgical unit (Andi Nailah et al., 2024). Obstructive ileus occurs in the small intestine and can be caused by incarcerated hernia, intussusception, intestinal adhesions or adhesions, ascariasis, volvulus, tumors, or gallstones entering the ileum (Su’un, Gani, & Purnama, 2024). The purpose of this writing is to understand and provide nursing intervention  for Mrs. T with a digestive system disorders: a case of ileus obstruction in Mawar 2 ward dr. Soeselo Regional General Hospital, Tegal Regency. The method used in this writing is a descriptive method. From the case review, it was found that the patient's main complaint was pain in the lower right abdomen. Three diagnoses emerged: acute pain, anxiety, and knowledge deficit. Interventions were developed based on SDKI, SLKI, and SIKI, which can be implemented.

The endocrine system is a ductless body control system that produces hormones to regulate various organs and physiological processes. Hormones act as important biological messengers in the human body. One of the most essential hormones is insulin, which plays a key role in blood sugar regulation. Insufficient insulin production or impaired insulin action can cause disruption of blood glucose control, leading to diabetes mellitus. Diabetes mellitus is a chronic metabolic disorder characterized by persistently high blood glucose levels caused by impaired insulin secretion, insulin action, or both. The purpose of this paper is to apply nursing care to Mr. N, a patient with endocrine system disorders: diabetes mellitus, treated in the Dahlia Ward of Dr. Soeselo Regional Hospital, Tegal Regency. This descriptive case study method was used to explain the nursing process in a structured manner. The main complaint presented by the client was pain in the wound on the left foot. Four nursing diagnoses were identified during the assessment, namely unstable blood glucose levels, acute pain, impaired skin/tissue integrity, and knowledge deficit. Nursing interventions were developed and implemented based on the Standar Diagnosis Keperawatan Indonesia (SDKI), Standar Luaran Keperawatan Indonesia (SLKI), and Standar Intervensi Keperawatan Indonesia (SIKI). The case highlights the importance of comprehensive nursing care in diabetes management, with a focus on blood glucose stabilization, pain management, wound care, and patient education. The results of this study are expected to provide additional references for clinical practice and strengthen the role of nurses in preventing complications of diabetes mellitus.

Post-operative care is a critical phase in the recovery process, beginning immediately after the completion of surgery until the patient is stabilized and transferred to the inpatient ward. Among various surgical procedures, lumpectomy is a common intervention performed to manage mammary tumors, aiming to preserve breast tissue while removing the tumor (Arif et al., 2021). This paper presents a case study of Mrs. D, a patient with an endocrine disorder who underwent a right breast lumpectomy at Mawar 2 Ward, Dr. Soeselo Regional General Hospital, Tegal Regency. The study employed a descriptive method to explore the patient’s condition and nursing interventions. Upon assessment, the main complaint reported by the patient was pain localized in the post-operative area. Based on the findings, two primary nursing diagnoses were established: acute pain related to surgical trauma and knowledge deficit related to post-operative care and self-management. Nursing interventions were designed and implemented according to the Indonesian Nursing Diagnosis Standard (SDKI), the Indonesian Nursing Outcomes Standard (SLKI), and the Indonesian Nursing Interventions Standard (SIKI). Interventions included pain management strategies, such as pharmacological support and non-pharmacological relaxation techniques, as well as health education to improve patient knowledge and self-care ability. The case highlights the importance of comprehensive nursing care that addresses both physical discomfort and the patient’s understanding of recovery, thereby promoting optimal health outcomes after breast surgery.

A tumor is a collection of abnormal cells that develop due to excessive and uncontrolled cell division (Angkotasan & Vioneery, 2022). Currently, tumors are considered one of the leading causes of morbidity and mortality worldwide (Maryati, 2023). The purpose of this study is to provide an in-depth understanding and description of nursing care for Mr. T, a patient with a medical diagnosis of post-operative soft tissue tumor (STT) in the right arm, who was treated in Room Mawar 2 at RSUD dr. Soeselo, Tegal Regency, in accordance with standardized nursing care guidelines. This study employed a descriptive case study method, with data obtained through interviews, observations, physical examinations, and documentation reviews. Based on the case analysis, the patient’s main complaint was severe pain following surgery. Three priority nursing diagnoses were identified: acute pain, knowledge deficit related to the disease and its management, and risk of infection due to post-surgical wound. Nursing interventions were planned and implemented according to SDKI (Standar Diagnosa Keperawatan Indonesia), SIKI (Standar Intervensi Keperawatan Indonesia), and SLKI (Standar Luaran Keperawatan Indonesia), adapted to the patient’s condition. The interventions included pain management techniques, health education, wound care, and infection prevention strategies. The results showed that after the nursing care was carried out, the patient reported a decrease in pain intensity, demonstrated increased knowledge regarding his condition, and exhibited no signs of infection. This study highlights the importance of systematic nursing care in post-operative soft tissue tumor patients to reduce complications, promote recovery, and improve quality of life. The findings are expected to contribute as a reference for nursing practice and further research on tumor management in clinical settings.

Effective nursing documentation and optimal nurse performance are essential pillars of high-quality healthcare services. Despite standardised guidelines being available, incomplete documentation and low compliance rates persist in various hospital settings. This study investigated the impact of implementing the 3S-based Nursing Care Guidelines, comprising standardised nursing diagnoses (SDKI), interventions (SIKI), and outcomes (SLKI), along with structured supervision by the hospital's nursing committee, on improving documentation quality and nurse performance. Employing a true experimental pre-posttest control group design, the research involved 49 nurses allocated into three groups: control, intervention with 3S, and intervention with 3S combined with the supervision nursing committee. Data were collected through observation sheets, document audits, and performance checklists. Statistical analyses using Wilcoxon, Mann-Whitney U, and Kruskal-Wallis tests revealed significant post-intervention improvements (p = 0.000) in both outcome areas. The results affirm that integrating structured care models and active supervision effectively enhances the quality of nursing care delivery.

The spirituality of shepherding (Satua Niha Keriso) plays a crucial role in shaping spiritual leadership within the congregation. This article examines the concept of shepherding from a New Testament perspective and its implications for church development. Using a qualitative approach based on biblical and theological studies, this research highlights Christ’s example as the Good Shepherd and its application in church ministry. The findings indicate that the spirituality of shepherding is not only related to teaching and faith nurturing but also reflects love, humility, and responsibility in building a spiritually healthy community. These findings emphasize that church leaders must embody the values of true shepherding in nurturing, guiding, and serving their congregation with integrity. Thus, the spirituality of shepherding contributes to strengthening faith and fostering church growth in the contemporary context.    

The program of efforts to improve the quality of educational facilities and infrastructure services at TKK St. Michael Baobolak, the development of economic literacy in the Maryke Village community aims to improve the quality of educational services at TK St. Michael Baobolak through the provision of facilities and infrastructure that are still inadequate, such as teaching aids, reading books, and play equipment. Thus, it is expected to create a more conducive and enjoyable learning environment for children, and support their optimal growth and development. This study uses a qualitative approach with a descriptive method. Data were collected through direct observation, interviews with related parties such as the principal, teachers, and staff, as well as documentation related to educational facilities and infrastructure at TKK St. Michael Baobolak. The results of the study showed that this program succeeded in improving the quality of educational facilities and infrastructure services at TKK St. Michael Baobolak. On the other hand, the results of this activity have also provided coloring tools and alphabet posters. Coloring tools, such as crayons, colored pencils, and markers, are very important media to stimulate children's creativity. Through coloring activities, children not only train their fine motor skills, but also develop their imagination and ability to express themselves. Meanwhile, alphabet posters serve as effective visual aids to help children recognize letters and build the foundations of reading skills, thus having a positive impact on their well-being.

Cholelithiasis or gallostones is a digestive tract disease caused by the accumulation of solid mass deposits in the vesica fellea ar gallbladder. The purpose of this paper is to find out and provide nursing care to Mr. S with cholelithiasis is the dahlia ward of dr. Soeselo hospital, Tegal Regency according to nursing standards. The methods used were interviews, medical history, physical examinations and laboratory examination results and diagnoses to create basic assessment data. From the case review, it was found that the patient’s main complaint was shortness of breath. The nursing problems found were hypervolemia and knowledge deficit. Interventions were arranged based on the theory in SDKI, SLKI and SIKI as well as on the client’s condition and could be implemented.

Indonesia still faces big challenges in developing public health. Changing people's lifestyles are one of the reasons for the shift in patterns from infectious diseases to non-communicable diseases (epidemiological transition). One of the non-communicable diseases that occupies the fourth position as the cause of death is diabetes mellitus, which was recorded as contributing 1.5 million cases in 2019 (Sarifah & Siyam, 2023). The signs and symptoms in diabetes mellitus patients are high blood sugar levels. The purpose of this writing is to find out and provide family nursing care to Mrs. S Family Mr. N With Endocrine System Disorders: Diabetes Mellitus in Bonjot Hamlet, Kalibuntu Village, RT 02 RW 04, Losari District, Brebes Regency, in accordance with nursing standards. The methods used are descriptive methods and data collection methods. From the case review, it was found that Mrs. S complains of frequent urination. There were two diagnoses found, namely knowledge deficit and instability of blood glucose levels. Interventions are prepared based on the theory of SDKI, SLKI and SIKI as well as on the client's condition and can be implemented.

Bronchopneumonia is an inflammatory condition of the lung parenchyma caused by microorganisms. Microorganisms enter the lungs through the respiratory tract into the bronchioles and alveoli and stimulate epithelial cells to produce mucus, causing accumulation of secretions in the alveoli (Utami et al., 2023). According to data from (WHO, 2022) In 2019, 740,180 people died from bronchopneumonia, which caused 14% of deaths in children under 5 years. The number of bronchopneumonia cases in children in developing countries is 82% higher compared to 0.5% cases in developed countries (Syahrinisya et al., 2024). The purpose of this writing is for the author to be able to create and apply nursing care to Patient. K with respiratory system disorders: bronchopneumonia at dr. Soeselo, Regional Hospital, Tegal Regency. The method used is that the nurse will collect basic data in the form of assessment from interviews, physical examination, observation, laboratory examination results and diagnosis. From the case review, it was found that the main complaint was that the client's mother stated that her child was coughing up phlegm. There were three diagnoses found, namely ineffective airway clearance, anxiety, knowledge deficit. Interventions are structured based on the theory of SDKI, SLKI and SIKI as well as on the client's condition and can be implemented.

A fracture or what is called a broken bone is an event that often occurs due to trauma or physical exertion which can cause disability and even complications (Appley & Solomon, 2021). The signs and symptoms in fracture patients include pain. The purpose of this writing is to find out and provide nursing care to An. E with musculoskeletal system disorders: post-operative open reduction internal fixation right clavicle fracture in the rose room 2 RSUD dr. Soeselo Tegal Regency in accordance with nursing standards. The methods used are descriptive methods and data collection methods. From the case review, it was found that An's main complaint was. E complains of pain. There were two diagnoses found, namely acute pain, impaired skin and tissue integrity. Interventions are prepared based on the theory of SDKI, SLKI and SIKI as well as on the client's condition and can be implemented.

Tumor is a disease that is currently one of the health problems that causes death, soft tissue tumor or soft tissue tumor is an abnormal lump that is formed due to the growth of new cells (Irsal et al., 2020). The signs and symptoms in soft tissue tumor patients include pain due to the surgical process. The purpose of this writing is to find out and provide nursing care to Mr. A with a medical diagnosis post-operative soft tissue tumor (STT) left flank in the rose room 2 RSUD dr. Soeselo Tegal Regency in accordance with nursing standards. The methods used are descriptive methods and data collection methods. From the case review, it was found that Mr. A complains of pain. Three diagnoses were found, namely acute pain, impaired physical mobility and knowledge deficit. Interventions are prepared based on the theory of SDKI, SLKI and SIKI as well as on the client's condition and can be implemented.    

Post partum is the period after giving birth or also known as the postpartum period, namely the period needed for the uterine organs to recover to their pre-pregnancy state, the postpartum period starts from the birth of the baby and lasts for 6 weeks or 42 days (Saudah & Certainlya, 2023). The purpose of this writing is to find out and provide nursing care to Mrs. A with spontaneous post partum in the Nusa Indah room at Dr. RSUD. Soeselo, Tegal Regency. The methods used are descriptive methods and data collection methods. From the case review, it was found that the client's main complaint was that there were no complaints of occasional pain. There were two nursing diagnoses found, namely risk of infection and knowledge deficit. Interventions are structured based on theory on the SDKI, SLKI, and SIKI as well as on the client's condition and can be implemented.

Caesarean section (CS) delivery is a surgical process to deliver a fetus through an incision in the abdominal wall and uterine wall. The purpose of this paper is to determine and provide nursing care for Mrs. Swith post-operative cesarean section indications of fetal distress in the Nusa Indah ward of dr. Soeselo hospital, Tegal Regency in accordance with nursing standards. The method used is descriptive with a case study approach. The data collection tchniques in this scientific paper are in the form of interviews, observations, documentation studies and literature studies. From the case review, it was found that the client’s main complaint was pain in the surgical stitches, P: pain when moving, Q: pain like being pressed, R: pain in the surgical stitches, S: scale 5, T: intermittent. The nursing problems found were acute pain, impaired skin/tissue integrity and knowledge deficit. Interventions were arranged based on the theory in DKI, SLKI and SIKI as well as on the client’s condition and could be implemented.