KESELAMATAN PASIEN DALAM PEMBEDAHAN.pptx

8/12/2019 KESELAMATAN PASIEN DALAM PEMBEDAHAN.pptx

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KESELAMATAN PASIEN DALAMPEMBEDAHAN


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INTRODUCTION

Patient safety is a global issue affecting

countries at all levels of development.

Although estimates of the size of the problemare scarce, particularly in developing and

transitional countries, it is likely that millions of

patients worldwide suffer disabilities, injuries or

death every year due to unsafe medical care.


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PATIENT SAFETY PROBLEM

Transfussion error

Adverse Drug Event

Wrong-site surgery Surgical injuries & Needle Stick Injuries

Hosp-acquired infection

Falls

Burns

Mistaken Identity


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ELEMEN PATIENT SAFETY

Adverse drug events(ADE)/ medication errors (ME)

Restraint use

Nosocomial infections

Surgical mishaps Pressure ulcers

Blood product safety/administration

Antimicrobial resistance

Immunization program

Falls Blood stream - vascular catheter care

Systematic review, follow-up, and reporting ofpatient/visitor incident reports


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Communication problems Inadequate information flow

Human problems

Patient-related issues

Organizational transfer of knowledge

Staffing patterns/work flow

Technical failures

Inadequate policies and procedures

(AHRQ Publication No. 04-RG005, December 2003)

Agency for Healthcare Research and Quality


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1. Communication

2. Patient Assessment

3. Procedural Compliance

4. Environmental Safety/Security

5. LeadershipSources: Michael S. Woods, M.D., How Communication Complicates the Patient Safety

Movement, Patient Safety & Quality Healthcare, May/June 2006; Joint Commission

on Accreditation of Healthcare Organizations, 2006; H&HNresearch, 2006


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Health care-associated infections, misdiagnosis,

delays in treatment, injury due to theinadequate use of medical devices, and, adverseevents due to medication errors, are commoncauses of preventable harm to patients.

Reducing the incidence of patient harm is amatter for everyone in health care and there is

much to be learned and shared betweendeveloped nations, developing countries andcountries in transition.


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JENIS INSIDEN PATIENT SAFETY

/ Kejadian Nyaris Cedera / Near miss Suatu kesalahan akibat melaksanakan suatu tindakan

(commission) atau tdk mengambil tindakan yg seharusnyadiambil (omission), yg dpt mencederai pasien, tetapi cederaserius tdk terjadi,

1. Dapat obat c.i., tidak timbul (chance),

2. Dosis lethal akan diberikan, diketahui, dibatalkan(prevention),

3. Dapat obat c.i./dosis lethal, diketahui, diberi antidote-nya (mitigation).

/ Kejadian Tidak cedera / No harm incident

Insiden terpapar kepada pasien tapi tidak menyebabkan cedera


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JENIS INSIDEN PATIENT SAFETY

/ Kejadian Tidak diharapkan / Harmful incident / Adverse eventSuatu kejadian yg mengakibatkan cedera yg tdk diharapkanpada pasien krn suatu tindakan (commission) atau krn tdkbertindak (omission), bukan krn underlying diseaseatau

kondisi pasien.

/ Kondisi Potensial Cedera / Reportable circumstance

Kondisi yang sangat potensial untuk menimbulkan cedera, tetapibelum terjadi insiden


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Salah identifikasi==>

pasien tidak sadar/ disorientasi,pindah kamar,pindah tt,pindah lokasi di rs

Identifikasi pasien penting :memberi obat,pemeriksaan lab,

tindakan,operasi,transfusi darah

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PERLU ADA KEBIJAKAN/ SPO :

MINIMAL 2 IDENTITAS PASIEN

NAMA ( 2 KARAKTER )

NO. REKAM MEDIS

UMUR ( tanggal lahir)

GELANG NAMA ( TANGAN/ KAKI)

WARNA : merah jambu, biru, merah

BARCODE / LABEL NAMA

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ALERGI : GELANG MERAH

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ELEMEN PENILAIAN :

PROSES TERINTEGRASI => PROSEDUR IDENTIFIKASIPASIEN SECARA AKURAT

ADA KEBIJAKAN/ PROSEDUR IDENTIFIKASI PASIEN

==> 2 IDENTIFIERS ( NO. KAMAR TDK BOLEH)

PASIEN DIIDENTIFIKASI SEBELUM ==> PEMBERIAN

OBAT, DARAH / PRODUK DARAH

PASIEN DIIDENTIFIKASI SEBELUM MENGAMBIL

DARAH/ SPECIMEN PASIEN DIIDENTIFIKASI SEBELUM DILAKUKAN

TINDAKAN/ PENGOBATAN

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STIMULUS

ENCODER

STIMULUS

DECODERUMPAN BALIK


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The Joint Commission for Accreditation for HealthOrganization has listed effective communication asgoal no.2 of the 2006 National Safety Goals.

Effective communication depends on clarity: thespeaker must convey his or her message in such a waythat the listener clearly understands that message.

But the truth is communication is influenced by a hostof factors: gender, ethnicity, culture, professionaldynamics. So a speakers intended message may notbe what the listener hears or understands, which cancompromise patient safety.


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Effective communication must meet certainstandard when delivering information from thesender to the receiver.

must be clear and easily understood. Effective communication must be complete. All

pertinent information must be said with less

unnecessary details. Too much use of the detailscan also confuse the receiver instead of helpingone to understand.


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Timeliness of giving the information isimportant especially when communicatingwith patient care related issues. Timeliness

also gives a true sense of urgency. Any delaysin patient-related communication will oftenlead to patient being compromised.

The information communicated must beacknowledged and verified by the receiver inorder for the exchange of information to beeffective.


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Improved communication is one of the Joint Commissions 2006 NationalPatient Safety Goals. JCAHO requires organizations to establish processesthat will help eliminate communication errors, such as:

Have individuals verify verbal and telephone orders and critical test resultsby reading back the complete order or test result.

Standardize a list of abbreviations, acronyms and symbols that are not tobe used throughout the organization.

Measure, assess and, if appropriate, take action to improve the timelinessof reporting, and the timeliness of receipt by the responsible licensedcaregiver, of critical test results and values.

Implement a standardized approach to hand off communications,including an opportunity to ask and respond to questions.

Source: Joint Commission on Accreditation of Healthcare Organizations, 2006; H&HNresearch, 2006


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1. Culture/Ethnicity

A patients culture may influence how he or she interacts withcaregivers. Language barriers can cause misunderstandings and

miscommunications.2. Socioeconomics

Levels of education, literacy, economics, beliefs and behaviorscan differ tremendously among patients, can affect the ability of

staff to communicate with one another (e.g., nurses and doctors)and can lead to miscommunication.

3. Literacy

How well does the patient understand medical terms? Can the

patient follow take-home instructions?


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4. Gender Gender influences relationships among staff and

between caregivers and patients.

5. Personality/Behavior

Individuals personalities color their daily communicationand influence how others perceive them.

6. Personality/Behavior

Urgency affects a speakers tone. For example, a hurrieddoctor or a stressed-out nurse may be perceived as curt bythe patient or other staff.

Sources: Michael S. Woods, M.D., How Communication Complicates the Patient Safety Movement, Patient Safety & QualityHealthcare, May/June 2006; H&HN research, 2006


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Lack of structure, policies, and procedures related tothe content, timing, or purpose of verbal reports.

No shared mental model or framework for verbal

healthcare communication. No rules for verbal transmission of information, either

face-to-face or over the telephone.

Differing opinions, even among nurses, as to what

information should be communicated during a verbalreport.

Frequent interruptions and distractions.

Frequency of communication.


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KOLABORASI

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AREA KELABU PADAT RISIKO/ ERROR

( PELIMPAHAN SECARA TERTULIS / STANDING ORDER dan

SESUAI KOMPETENSI)

PRAKTIK

KEPERAWATANPRAKTIK

KEDOKTERAN

PERAWAT DOKTER


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For verbal or telephone orders

For reporting critical results

Method:

The individual receiving the information Writes down the complete order or test result, or

Enters it into the computer

The individual receiving the information

Reads back what has been written

The individual who gave the order

Verifies the correctness


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Check-back is a good way to verifyinformation especially when transcribing adoctors order.

Medical orders must be reviewed forcompleteness and clarity.

The medical orders must be questioned if

penmanship is illegible or abbreviations areused that are not acceptable by theinstitution.


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Call-out is another technique when acritical information is called out during

an emergency situation. The critical information is said aloud so

that any team members present duringan emergency that are hearing andlistening to the information.


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Hand-off is another technique of verbally transferringinformation, responsibility, and accountability of patient care toanother staff.

This includes the review of written report on the pertinent

patient information, the latest significant changes in patientstatus, and the latest recommendation on the plan of care.

The receiving staff has to acknowledge the completeness,pertinence of information, and accepts the responsibilities in

providing patient care. Using the S-B-A-R method in hand-off will enhance

communication and promote a culture of patient safety.


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SBAR is a technique that provides aframework.

easy-to-remember allows for an easy and focused way to

set expectations


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Communication Tools :

SBAR Situation:What is going on with the patient?What is happening at the present time?

Background:What are the circumstances

leading up to this situation?What is the clinicalbackground?

Assessment:What is the problem? What is thecurrent situation?

Recommendation:What should be done tocorrect the problem?

------- Response/Repeat back: Repeat back theplan of care


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S : Situation

Kondisi terkini yg terjadi

pada pasien

B : Background

Informasi penting apa ygberhubungan dg kondisi

pasien terkini

A : Assessment

hasil pengkajian kondisi

pasien terkini

R : Recommendation

apa yg perlu dilakukan

Untuk mengatasi masalah

Dapat digunakan

saat serah terima

perawat antar

shift, perawat ke

doktersaat

melaporkankondisi pasien,dokter ke dokter.


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S SITUATION- nama. Umur, tgl masuk, hari

perawatan, dr yg merawat- diagnosa medis dan masalahkep yg belum dan sdh teratasi

B BACKGROUND- keluhan uatama, intervensi yg

telah dilakukan, respon psndiagnosa kep.

- riwayat alergi, rwyt pembedahan,pemasangan alat invasif dan obat/infuus

- pengetahuan pasien/ kelD/ medis


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AASSESSMENT

- jelaskanhasil pengkajian pasienterkinitanda vital, pain score, tkkesadaran, status restrain, risikojatuh, status nutrisi, eliminasi, halyg kritis, dll.

- hasil investigasi yg abnormal- informasi klnik lain yg mendukung

RRECOMMENDATION- rekomendasi intervensi keperawatan

yg perlu dilanjutkan ( refer ke nursingcare plan) termasukdischargeplanning

- edukasi pasien/ keluarga


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example

S = Dr. Smith, this is Mary at General Hospital

calling regarding Mr. Cook in 212. His temperature is up to 103.5.

B = He is POD #2 S/P right knee replacement.

A = The wound is red; pulse is up to 115 from baseline of 80; his pain

level has increased to 9/10 despite increasing his Vicodin dosing to ii tabsQ4.

Specific numerical values are given in the assessment

R = I would like you to come see him. When can I expect you?

Asking for a specific time frame

R = I will be there in 15 minutes, I am in the PACU.


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MENINGKATKAN KOMUNIKASI PADA SAAT

OPERAN / HAND- Off

GUNAKAN BAHASA YANG JELAS GUNAKAN TEHNIK KOMUNIKASI YG

EFEKTIF : kurangi interupsi, alokasikan waktu

yg cukup , terapkanread back

ataucheck

backtehnik,

Standarisasi laporanantar shift / antar unit

Saat transisi ==> pasien mau pulang/

pindah, berikan informasi yg jelas kpdpasien/ kel: obat, diagnosa pulang,hasil pemeriksaan, kapan dan dimanakonsultasi fo llow up

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Standardized abbreviations, acronyms,symbols, and dose designations

Do Not Use list

Do not use in medication orders

Do not use in medication-related documentation

Do not use on pre-printed forms

Do not use in handoff communications to otherproviders


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Limit Abbreviations The Joint Commission has a list of abbreviations that should not be used on

orders or on any medication-related documentation that is handwritten or onpreprinted forms. The list below provides the following substitutions:

JCAHO Do Not Use List

*Exception: Use a trailing zero where required to demonstrate the level of precision of the value being reported, such asfor laboratory results. It may not be used in medication orders or other medication-related documentation.

Source: Joint Commission on Accreditation of Healthcare Organizations, 2006; H&HNresearch, 2006


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Poor handwriting

Lotrison or Lotrimin ? Coumadin or Kemadrin ?

Doxorubicin or Daunorubicin ? Pentobarbital or Phenobarbital ?


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3. KESALAHAN PEMBERIAN OBATBENAR OBAT

BENAR DOSIS,BENAR CARA,

BENAR WAKTU,

BENAR ORANGCEK ALERGY OBAT

JELASKAN TUJUAN DAN

KEMUNGKINAN EFEK OBAT

CATAT / DOKUMENTASI

kerjakan SESUAI SAK/ SOP

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( lanjutan)

Cek untuk reaksi obat

Cek skin integrityuntuk injeksi Monitor pasien

2 orang staf mengecek pemberian

obat parenteral Update catatan obat

PISAHKAN :

NAMA OBAT YANG MIRIP KEMASAN OBAT YANG MIRIP

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ASSESSMEN DAN REASSESSMEN

OBAT YANG DIBERIKAN

MEDICATION DOSE ROUTE FREQUENCY TIME &

DATE LAST

TAKEN

1

2

3

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Memindahkan konsentrat elektrolit

(termasuk namun tidak terbatas

pada potasium klorida, potasiumfosfat, sodium klorida> o.9%) dari

ruang perawatan.

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DIDIK PASIEN/ KELUARGA

KENALILAH OBAT ANDA!!!

SUDAHKAH ANDA TAHU:

KEGUNAAN OBAT ANDA ? CARA PAKAI OBAT ANDA ?

WAKTU PENGGUNAAN OBAT ANDA

?

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4.MENCEGAH SALAH ORANG, SALAH TEMPAT,

SALAH PROSEDUR ==> TINDAKAN PEMBEDAHAN

MENGAPA TERJADI : KURANG EFEKTIF KOMUNIKASI DIANTARA

ANGGOTA TIM OPERASI PASIEN TIDAK DILIBATKAN DALAM

PEMBERIAN TANDA ==> LOKASI OPERASI (MARKING SITE)

PROSEDUR VERIFIKASI PRA OPERASIKURANG BAIK

KURANG ADEKUAT ASESMEN PASIEN

KURANG ADEKUAT REVIEW REKAM MEDIS BUDAYA YG KURANG MENDUKUNG

KOMUNIKASI TERBUKA DIANTARA ANGGOTATIM

PENGGUNAAN SINGKATAN TULISAN YANG KURANG TERBACA

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PROTOKOL PENCEGAHAN

( JCI): Salah Orang, Salah

Lokasi, Salah prosedur/Tindakan Operasi

1) PENANDAAN ( MARKING SITE)LOKASI OPERASI

2) PROSES VERIFIKASI PRE OPERASI

3) TIME OUT PRACTICE

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1). VERIFIKASI SEBELUM

OPERSASITUJUAN :

MEYAKINKAN BAHWA SEMUA DOKUMEN MEDISDAN HASIL PEMERIKSAAN TERSEDIA SBELUMPROSEDUR DILAKSANAKAN

MEYAKINKAN BAHWA SEMUA DOKUMEN DANHASIL PEMERIKSAAN SUDAH DI TELAAH ULANG (REVIEW)

MEYAKINKAN DATA DALAM DOKUMEN KONSISTENSATU DG LAINNYA

APABILA ADA DATA YNG HILANG/ TIDAK SESUAIHARUS SEGERA DICARI SEBELUM OPERASIDIMULAI

INFORMED CONSENT SUDAH DILAKSANAKAN DAN

ADA DOKUMEN 55


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VERIFIKASI DOKUMEN

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2). PENANDAAN (MARKING SITE)


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2). PENANDAAN (MARKING SITE)

LOKASI OPERASI

TUJUAN :

MENGIDENTIFIKASI TEMPAT INSISI ATAUINSERSI YANG BENAR

PROSES : DILAKUKAN UNTUK PROSEDUR YG HARUS

DIBEDAKAN:

SISINYA ( KIRI/ KANAN);

STRUKTUR YANG BERBEDA ( IBU JARI KAKI DANJARI LAINNYA )

LEVEL YANG BERBEDA ( LEVEL TULANG BELAKANG)

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LANJUTAN


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LANJUTAN

SISI YANG BENAR HARUS DIBERI TANDA (

MARKING) DAN TANDA TSB HARUS TETAPTERLIHAT SETELAH PASIEN DILAKUKAN

PREPARASI DAN DRAPING

BERI TANDAPADA DAERAH YANG

AKAN DIOPERASI ==> LIBATKAN

PASIEN/ KELUARGA==>YANG

MEMBERI TANDA ADALAH DOKTER

YANG AKAN MELAKUKANOPERASI

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IDENTIFIKASI PASIEN

DAN PENANDAAN LOKASI

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TIME OUT PRACTICE


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TIME OUT PRACTICE

DILAKUKAN SEGERA SEBELUM DILAKUKAN

PROSEDUR TUJUAN :

MELAKUKAN VERIFIKASI AKHIR BENAR PASIEN, BENARLOKASI, BENAR PROSEDUR/ TINDAKAN OPERASI

PROSES :

KOMUNIKASI AKTIF OLEH SEMUA ANGGOTA TIMPEMBEDAHAN/ YG AKAN MELAKUKAN PROSEDUR (PERAWAT, DOKTER BEDAH, DOKTER ANESTESI,PERAWAT ANESTESI )

PROSEDUR TIDAK BOLEH DIMULAI SEBELUM

SEMUA MASALAH/ PERTANYAAN DANKEKHAWATIRAN TERKAIT PASIEN DISELESAIKANDAN MENDAPAT PENJELASAN SECARAMENYELURUH

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TIME OUT ==> FINAL VERIFICATION PROCESS


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Verifikasi final

dilakukan pk :

Step 1Penandaan Prosedurverifikasi Final

Veri f ikasi di lakukan

oleh

( ) dr Anestesi ( ) Nurse ( ) dr Bedah( ) Lain-lain :

Step 2 Nama Pasien ( IDENTITAS PASIEN )

Dikonf i rmasi oleh :


Step 3 Prosedur Verifikasi

Jenis Prosedur :

( ) dr Anestesi ( ) Nurse ( ) dr Bedah( ) Lain-lain : 63

St 4 V ifik i b i /Si i


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Step 4 Verifikasi bagian/Sisi

Bagian/sisi prosedur

:

* Bila tidak dapat dilakukan, berikanalasan :

Bagian/Sisi dikon f i rmasi oleh

:

( ) dr Anestesi ( ) Nurse ( ) dr Bedah( ) Lain-lain ::Step 5 Verifikasi Implant

Implant :

* Bila tidak dilakukan, indikasikan : tidak ada

Prosedur telah dikonf i rm asi oleh :


Verifikasi selesai Pk.

Nama pasien ( sticker )64


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APA YANG HARUS DIHITUNG


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APA YANG HARUS DIHITUNG

PERLU SPO: APA SAJA YG HARUS DIHITUNG/ PROSEDUR

PERAWAT MENGHITUNG SEMUA ITEM YG MEMASUKI BIDANGSTERIL

YANG HARUS DIHITUNG :

KASA

FORCEPS, JARUM, RETRAKTOR

KANTUNG YG DIMASUKAN TUBUH DLL

KAPAN DIHITUNG :

SEBELUM PROSEDUR ( BASE LINE DATA)

SEBELUM PENUTUPAN RONGGA TUBUH

SEBELUM PENUTUPAN LUKA WAKTU PENUTUPAN KULIT SETELAH PROSEDUR

WAKTU TUGAS CIRCULATING NURSE ATAU SCRUB NURSESELESAI

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BAGAIMANA CARA MENGHITUNG


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BAGAIMANA CARA MENGHITUNG

PERLU SPO YANG JELAS DAN KONSISTEN

PENGHITUNGAN DIMULAI DI LAPANGANPEMBEDAHAN

KASA TAMBAHAN HARUS DIHITUNG DANDICATAT

CHEKLIST YANG SUDAH DICETAK

SIAPA YG MENGHITUNG : HARUS LEBIH 1 ORG PADA SAAT BERSAMAAN REKOMENDASI AORN : HARUS DIHITUNG DG

SUARA KERAS DAN JELAS ==> DISAKSIKAN 2

ORANG PADA WAKTU MENGHITUNG TIDAK ADA

GANGGUAN

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PERHATIKAN

PELATIHAN CARA MENGHITUNG ==> SPO

KOMUNIKASI EFEKTIF (SELURUH ANGGOTATIM)

X RAY UNTUK PASIEN RESIKO TINGGI

TEKNOLOGI BARU (ELECTRONIC TAGGING )

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FAKTOR YG MENYEBABKAN


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FAKTOR YG MENYEBABKAN

TERTINGGALNYA BENDA ASING ==>

TUBUH PASIEN

PROSEDUR DARURAT

JENIS PROSEDUR

PERUBAHAN RENCANA OPERASI SEMULA

BERAT BADAN PASIEN

KEGAGALAN PENGHITUNGAN SELAMAPEMBEDAHAN ATAU PENGHITUNGAN TIDAKAKURAT

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ELEMEN PENILAIAN


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ELEMEN PENILAIAN

PROSES TERINTEGRASI ==> MENGEMBANGKANKEBIJAKAN/ SOP==> KESERAGAMAN PROSES ==>MENJAMIN : BENAR LOKASI, BENAR PROSEDUR,BENAR PASIEN

RS MENGGUNAKAN PEMBERIAN IDENTIFIKASI TANDA

LOKASI OPERASI ( MARK SITE)YANG DIMENGERTI DANPROSESNYA MELIBATKAN PASIEN/ KEL.

RS MENGGUNAKAN PROSES VERIFIKASI==> SEMUADOKUMEN DAN PERALATANYG DIBUTUHKAN ==>TERSEDIA, BERFUNGSI BAIK, AKURAT/ BENAR

RS MENGGUNAKAN CHECK LISTDAN PROSEDURTIME- OUTSEBELUM ==> TINDAKAN OPERASI

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5 MENCEGAH PASIEN


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5. MENCEGAH PASIENJATUH

Melakukan pengkajian ulangsecara berkala mengenairesiko pasien jatuh,

termasuk resiko potensialyang berhubungan denganjadwal pemberian obat serta

mengambil tindakanuntukmengurangi semua resikoyang telah diidentifikasikantersebut.

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ASSESSMENT RISIKO JATUHMONITOR SEJAK ADMISSION

MONITORING KETAT PASIEN

RISIKO TINGGI( beri tanda pada TT :hijau, kuning, merah)

LIBATKAN PASIEN/ KEL DALAM

PENCEGAHAN PASIEN JATUH Laporan peristiwa pasien jatuh

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HAL YG PERLU DIPERHATIKAN==>

FALLS

1. OBAT YANG DIGUNAKAN PASIEN SIDEEFFECTS JATUH

2. PENGLIHATAN PASIEN

3. PERHATIKAN PERUBAHAN STATUS MENTAL /PERILAKU PASIEN

4. SEPATU/ SANDAL YG TIDAK COCOK

5. LANTAI LICIN

6. TERLALU BANYAK FURNITUR

7. KEKURANGAN CAIRAN

8. TANGGA

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ASSESSMEN DAN REASSESSMEN TERHADAP


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ASSESSMEN DAN REASSESSMEN TERHADAP

RISIKO JATUH

SCORE DIMENSION SCORE DIMENSION

15 POINT HISTORY OF FALLS 5 POINT UNSTEADY ON

FEET

15 POINT RECENT hx : LOSS

OF CONSCIOUSNESS

5 POINT POOR EYE SIGHT

15 POINT AGE 65 OR MORE 5 POINT POOR HEARING10 POINT CONFUSED/

DISORIENTED/

HALLUCINATING

5 POINT POSTURAL

HYPERTENSION

10 POINT USES ASSISTIVE

DEVICE FORMOBILITY (

WALKER,

WHEELCHAIR, ETC

5 POINT SEDATED

5 POINT DETOXING FROM

DRUGS/ ALCOHOL

5 POINT LANGUAGE

BARRIER77

Total points assessed: 0-10= no risk;Total point assessed :15 0r more patient is a fall risk

UPAYA MENURUNKAN RISIKO


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UPAYA MENURUNKAN RISIKO

JATUH IDENTIFIKASI : OBATYG BERHUBUNGAN DG

PENINGKATAN RISIKO JATUH : SEDATIF, ANALGESIK,ANTIHIPERTENSI, DIURETIK, LAZATIF, PSYCHOTROPIKA

GUNAKAN PROTOKOL==> PEMINDAHAN PASIEN SECARAAMAN : BRANKAR, KURSI RODA, TT

EVALUSI BERAPA LAMA RESPON STAFTERHADAPPANGGILAN PASIEN ( TOILET, MAKAN, DLL)

GUNAKAN INSTRUMENUTK MEMPREDIKSI RISIKO PASIENJATUH ==> KOMUNIKASIKAN DG PASIEN/ KEL; BERI TANDA/ WARNA

PERHATIKAN LINGKUNGAN: CAHAYA, KONTROL SUARA/KEBISINGAN,

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ELEMEN PENILAIAN

PROSES TERINTEGRASI ==>MENGEMBANGKAN KEBIJAKAN/ SOP ==>MENURUNKAN RISIKO PASIEN CIDERA ==>JATUH DI RS

RS ==> MELAKSANAKAN PROSES ASESMENDAN REASESMEN RISIKO PASIEN JATUH ==>INDIKASI : PERUBAHAN KONDISI, PEMBERIANOBAT BERISIKO JATUH, DLL

MENGUKUR PELAKSANAAN ==> PROGRAMMENURUNKAN RISIKO PASIEN JATUH

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6 PENCEGAHAN DAN


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6. PENCEGAHAN DANPENGENDALIAN INFEKSI

Reduce the risk of health care -aquiered infections

Requirement : Comply withcurrent CDC (Center for DiseaseControl) hand hygiene

guidelinesWHO : CLEAN CARE IS

SAFER CARE

GETTING YOUR HANDS ON ACULTURE OF SAFETY

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KENAPA PENTING ?


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Cara transmisi dari infeksi yang paling sering adalah melalui tangan.

Membersihkan tangan adalah faktor terpentingdidalam mencegah penyebaran patogen danresistensi antibiotika

Angka kepatuhan yang diharapkan adalah 90% ( CDCrecommmendations)

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KENAPA PENTING ?


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Acknowledgement : WHO World Alliance for Patient Safety 82

INDIKASI CUCI TANGAN


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INDIKASI CUCI TANGAN

Bila tangan tampak kotor ( cuci tangan rutin ) Sebelum dan sesudah kontak dengan pasien

Sebelum dan sesudah prosedur

Setelah kontak dengan peralatan yang ada dandigunakan oleh pasien

Sebelum makan, sesudah dari toilet

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HAND RUB

IS

PREFERRED

It only

takes 20

30 sec

to do it!

CDC (Center for Disease Control) HAND


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CDC (Center for Disease Control) HAND

HYGIENE

REKOMENDASI SPESIFIK

1. Indikasi untuk cuci tangan dan anti sepsis

2. Teknik :

* Air dan sabun ( 15 detik )* Tanpa air ( alcohol hand rub/gel )

3. Surgical handwashing

4. Seleksi produk5. Perawatan kulit

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Alcohol Hand Rub/Gel


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Alcohol Hand Rub/Gel

Dipakai bila tangan tidak tampak kotor

Sediakan diarea kerja

Efektif dan efisien

KESELAMATAN PASIEN DALAM PEMBEDAHAN.pptx

Documents

Transcript of KESELAMATAN PASIEN DALAM PEMBEDAHAN.pptx