MANAGEMENT OF EMERGENCY NURSING CARE WITH EXCELLENT SERVICE FOR MS.H WITH SEVERE HEAD INJURY IN THE ICU OF H. ADAM MALIK HOSPITAL MEDAN CITY NORTH SUMATRA PROVINCE IN 2025

Abstract

Head injury is one of the most common emergency cases encountered in Emergency Departments (ED) and can lead to increased intracranial pressure and decreased consciousness. Prompt and appropriate nursing management, especially with a service-excellent approach, is essential to support patient recovery and prevent complications. Objective This scientific paper aims to describe the emergency nursing care management with a service excellence approach for Mrs. H, a patient with severe head injury treated in the Adult ICU of RSUP H. Adam Malik Medan. Method This is a descriptive case study involving one patient with severe head injury. Data collection was conducted through observation, interviews, and medical record reviews between April 25th and April 27th, 2025. The case focused on comprehensive nursing care processes including assessment, diagnosis, intervention, implementation, and evaluation. Results The main nursing diagnoses found were: ineffective spontaneous ventilation, risk of ineffective cerebral perfusion, and impaired physical mobility. Nursing interventions included respiratory monitoring, maintaining airway patency, positioning, collaboration for medical therapy, and continuous evaluation. Over three days of care, the patient's condition showed partial improvement but required ongoing intensive treatment. Conclusion The implementation of emergency nursing care with a service excellent approach in patients with severe head injury demands competent clinical skills, multidisciplinary collaboration, and continuous evaluation. Nurses play a vital role in managing clinical deterioration, ensuring airway support, monitoring neurological status, and supporting family education to optimize patient outcomes.