Implementasi modifikasi emergency severity index (ESI) terhadap outcome tatalaksana pasien dengan hipertensi emergensi - Ardiansyah, Diki; Badrujamaludin, Asep; Fadhilah, Najwa Hilmia; Ardianto, M. Dwi (JOURNAL OF Qualitative Health Research & Case Studies Reports, 2025)
Background: Hypertensive crises account for 27.5% of all emergency cases, with 1-2 cases per 100,000 patients considered a hypertensive emergency. Blood pressure >180/120 mmHg requires a gradual reduction of >10-15% within the first hour, reaching 160/100 mmHg within 2-6 hours to prevent breathless hyperfusion in target organs. Therefore, a rapid response time is required to prevent target organ damage. Implementing the modified Emergency Severity Index (ESI) accelerates the response time through assessment and categorization of emergency room patients. Purpose: To understand the impact of the implementation of the modified Emergency Severity Index (ESI) on the outcomes of nursing care for hypertensive emergency patients. Method: This case report study included patients with blood pressure >180/120 mmHg and evidence of target organ damage. The ESI Emergency Department triage assessment form from Cibabat Regional Hospital was used as a research instrument to assess the implementation of ESI on the outcomes of hypertensive emergency patient management. Nursing care began upon patient arrival in the Emergency Department and lasted for 6 hours. Results: Conclusion: Accurate response time supports the success of nursing care for hypertensive emergency patients. Understanding the ESI triage process, and teamwork are essential to achieving the stated objectives.   Keywords: Nursing Care; Emergency Severity Index (ESI); Hypertensive Emergency; Implementation; Response Time.   Pendahuluan: Krisis hipertensi mengambil 27.5% keseluruhan kasus emergensi 1-2 kasus per 100.000 pasien. Kondisi tekanan darah >180/120 mmHg memerlukan penurunan tekanan darah bertahap >10-15% dalam 1 jam pertama dan 160/100 mmHg dalam 2-6 jam untuk mencegah breakthrough hyperfusion pada organ target. Sehingga diperlukan response time yang cepat untuk mencegah kerusakan organ. Target implementasi modifikasi Emergency Severity Index (ESI) memberikan percepatan response time melalui pengkajian kondisi dan pengkategorian pasien IGD. Tujuan: Untuk memahami gambaran implementasi modifikasi Emergency Severity Index (ESI) terhadap outcome tatalaksana asuhan keperawatan pasien hipertensi emergensi. Metode: Penelitian case report atau studi kasus dengan kriteria inklusi pasien tekanan >180/120 mmHg disertai dengan adanya bukti kerusakan organ target. Form asesmen triase UGD ESI RSUD Cibabat digunakan sebagai instrumen penelitian. Hasil: Asuhan keperawatan yang diberikan memperoleh hasil bahwa kesadaran meningkat delirium GCS 10 (E3 V2 M5), tekanan darah membaik 152/107 mmHg, pola nafas regular, RR 24x/menit, penggunaan otot bantu nafas menurun, dan kedalaman nafas membaik. Masalah ketidakseimbangan kadar glukosa darah tidak teratasi dikarenakan pasien tidak melakukan implementasi dan dirujuk ke rumah sakit lain untuk menerima perawatan intensif. Simpulan: Adanya ketepatan respon time yang menunjang keberhasilan asuhan keperawatan pasien hipertensi emergensi dalam proses pemahaman proses triase ESI dan kerjasama tim.   Kata Kunci: Asuhan Keperawatan; Emergency Severity Index (ESI); Hipertensi Emergensi; Implementasi; Response Time.