View
34
Download
1
Category
Preview:
Citation preview
Manajemen Pelayanan & Manajemen Asuhan Keperawatan
Dr. Ns Rita Sekarsari SKp., Sp KV., MHSM
*) Disampaikan dalam Pelatihan & Bench Marking Manajemen Keperawatan Kontribusi Manajer Keperawatan Dalam Meningkatkan Pelayanan Keperawatan, Mesukseskan Akreditasi Rumah Sakit Versi 2012 & JCI
No Pendidikan
1 AKPER DEPKES RI 1985
2 S1 PSIK UI 1993
3 S2 Monas Uni Melbourne 2001
4 Pengakuan Ns Sp KV 2011
5 S3 FIK UI Doktor Keperawatan 2014
Rita Sekarsari
No Pekerjaan
1 Koordinator Program Diklat RSJPDHK
2012 -
2 Ketua Sub Komite Keperawatan
RSJPDHK 2007 - 2012
3 Ketua Komite Keperawatan & Manajer
Instalasi Rawat Inap GP II & Pav
Sukaman, RSJPDHK 2001- 2007
4 Ka Ru ICU RSJPDHK 1993 - 2001
5 Supervisor Keperawatan RSJPDHK
1993 - 2009
6 Koordinator DIKLAT POST BASIC
1993 - 2001
NO Organisasi saat ini
1 Ketua II PP PPNI 2010-2016
2 President INKAVIN 2012-2017
3 Ketua Kolegium Keperawatan Spesialis
Kardiovaskular 2010 - 2016
4 Pengurus MTKI 2011- 2016
5 Pengurus ARSPI 2011 - 2016
6 Pembimbing Akreditasi & Surveyor
Akreditasi Rumah Sakit V.2012 KARS
( 2013 sd> …..)
Kontak : ritaakbar@yahoo.com Ph: 08151626004
2
ICN Position Statement/ Sekarsari/2014
Sistem
Manajemen
Sistem Pelayanan
Klinis
Asuhan Pasien / Patient Care
Quality & Safety
PASIEN
Standar
Manajemen
PMKP, PPI,
TKP, MFK,
KPS, MKI
Sasaran KP
Sasaran
MDG’s
Std Yan
Fokus Pasien
APK, HPK,
AP, PP,
PAB, MPO
PPK
Regulasi :
• Kebijakan
• Pedoman,
• Panduan
• SPO
• Program
Indikator :
• Ind. Area
Klinis
• Ind Klinis
• Ind SKP
• Ind Upaya
Manajemen
Dokumen
Implementasi
Pengelolaan Rumah Sakit dlm Perspektif Standar Akreditasi v.2012
UU 44/2009 ttg
RS, Peraturan
Per UU an
lainnya
Tujuan utama pelayanan kesehatan Rumah Sakit adalah pelayanan pasien.
“Core Business RS = Patient Care” (Bab Pelayanan Pasien (PP/COP)
Asuhan Pasien
(Patient Care)
Cure Care
Pasien
PCC merupakan pendekatan yg lbh modern dan inovatif dlm pelayanan kes
sekarang, diterapkan dgn cepat di banyak RS di seluruh dunia.
Model ini telah menggeser semua PPA menjadi di SEKITAR PASIEN
fokus pada pasien Patient-centered Care
Sbg tambahan, mereka semua sama pentingnya pada kontribusi profesi nya
dalam asuhan pasien
“Interdisciplinary team model” kompetensi-kewenangan yang memadai
“Dokter = Team Leader”
Model Patient-centered Care
Kompetensi
yg memadai
“Interdisciplinary
Team
Model”
Dokter/
DPJP
Fisio
terapis
Perawat
Apoteker
Ahli
Gizi
Lainnya Analis
Radio
grafer
Asuhan
Integrasi
Staf Klinis
Pasien
“Dokter =
Team Leader”
Model Patient-centered Care
Kompetensi
yg memadai
“Interdisciplinary
Team Model”
Dokter/
DPJP
Fisio
terapis
Perawat
Apoteker
Ahli
Gizi
Lainnya Analis
Radio
grafer
Staf Klinis
Case
Manager
Asuhan
Integrasi
Case Manager
di Rumah Sakit
• Pengertian :
o CM adalah profesional dalam RS yang bekerja secara kolaboratif dgn PPA, memastikan bahwa pasien dirawat serta ditransisikan ke tingkat asuhan yang tepat, dalam perencanaan asuhan yang efektif dan menerima pengobatan yang ditentukan, serta didukung pelayanan dan perencanaan yang dibutuhkan selama maupun sesudah perawatan RS.
o American Case Management Association : CM adalah professional yang secara kolaboratif melakukan proses asesmen, perencanaan, fasilitasi, koordinasi asuhan, evaluasi, dan advokasi untuk opsi pelayanan dalam rangka memenuhi kebutuhan pasien & keluarga akan pelayanan kesehatan yang komprehensif, melalui komunikasi dan sumber daya yang ada untuk memperoleh hasil yang bermutu dan cost effective.
• Ciri : Manajemen, Komunikator,, Wawasan pelayanan klinis, Membantu pasien memenuhi kebutuhan pelayanan.
Nurses Play Key Role Improving Quality of Patient Care
Nurses today have many role. In addition to meeting the needs of patients and serving as part of the health care team, nurses also play a key and vital role in meeting the Joint Commission’s International Patient Safety Goals in such areas as medication safety, communication and patient safety. This role allows nurses to highly contribute to quality improvement by yielding desired patient outcomes and reducing the probability of undesired outcomes.
Joint Commission International/Sekarsari/2014
NURSES’ ROLE IN IMPLEMENTING JCI PATIENT-CENTERED STANDARD
The Role of Nurses in Implementing Access to Care & Continuity of Care
Carries out processes to ensure appropriate patient access & continuity of care services in the organization and coordinate among health care practitioners:
Admission to the organization Continuity of care Discharge, referral & follow up Transfer of patients Transportation
Joint Commission International/Sekarsari/2014
The Role of Nurses in Ensuring full Understanding of Patient & Family Rights
Identify patient’s values & believes & protect their rights
Inform patients of their rights Include the patient and his/ her family,
when appropriate , in decisions about the patient’s care
Obtain informed consent Inform patients about the organization
process of receiving and acting upon complaints
Joint Commission International/Sekarsari/2014
The Role of Nurses in Implementing Care of Patients
Planning & delivering nursing care to each patient
Monitoring patient progress and recording it to communicate the progress, evaluate the effectiveness of nursing measures taken and modifying the nursing care plan accordingly
Completing the care Planning the follow up
Joint Commission International/Sekarsari/2014
The Role of Nurses in Implementing Assessment of Patients
Collecting information & data on the patient’s physical, psychological, social status and health history ( initial upon admission, through out the patient stay, upon discharge)
Recording and analyzing the data and information to identify the patient’s health care needs
Developing a nursing care plan to meet the patient’s identified needs
Joint Commission International/Sekarsari/2014
The Role of Nurses in Implementing Medication Management and Use
Medications administered following the 7 rights. Report administration details as established in the organization process
Medication effects on patients are monitored & reported, including adverse effects
Adverse effects are reported in the time frame required by policy
Medication errors and near misses are reported in timely manner using en established process
Joint Commission International/Sekarsari/2014
The Role of Nurses in Implementing Patient and Family Education
Nurses assess and record patient’s educational needs & continuously educate patients from the moment of admission and till the discharge time
Encourage patient to speak up Educate patient also by involving in their
care Example:
Dressing change teaching Medication teaching Signs to report teaching
Joint Commission International/Sekarsari/2014
NURSES’ ROLE IN IMPLEMENTING JCI HCO MANAGEMENT STANDARDS
The Role of Nurses in Implementing Quality Improvement & Patient Safety
Nurses contribute a lot to this quality improvement trough this standards chapters by: Participating in data collection, analysis and
recommendations when evaluating nursing clinical & managerial processes
Designing new clinical & managerial processes well
Implementing & sustaining nursing care changes that result in improvement
Joint Commission International/Sekarsari/2014
The Role of Nurses in Implementing Management of Communication & Information
Nurses should actively participated in tecnology training to ensure that they are: Comfortable with and knowledgeable about
any new medication management technology such as electronic medical records, smart pumps, or bar-coding systems
They should incorporate technology into daily practice and make suggestions for way to use it to reduce errors
Joint Commission International/Sekarsari/2014
The Role of Nurses in Implementing Prevention and Control of Infections
Nurses should represent and engaged in the activities with the infection prevention and control professionals
Minimize the risk of infection by ensuring proper cleansing, disinfection, and sterilization processes & by wearing gloves and/or mask or eye protection as needed
Continuously apply hand washing and hand disinfection procedures
Educate patients and families and encourage them to participate in the implementation and use of infection prevention and control practices in the organization
Joint Commission International/Sekarsari/2014
The Role of Nurses in Implementing Governance, Leadership and Direction
Nursing leaders, among other organization leaders, have special responsibilities to parients and organization. They: Support good communication between nurses Jointly plan and develop policies together with
other leaders to guide the delivery of clinical services
Provide for the ethical practice of nursing profession
Oversee the quality of patient care Joint Commission International/Sekarsari/2014
The Role of Nurses in Implementing Facility Management and Safety
Hazardous waste is properly disposed Proper protective equipment and procedures
are used during use, spill, or exposure of contaminated or radioactive or any other harmful materials
Spills, exposures, and other incidents are reported
Nurses can describe and/or demonstrate actions to eliminate, to minimize, or to report safety, security and other risks
Oversee the quality of patient care Joint Commission International/Sekarsari/2014
Staff Qualification and Education
Staff Recruitment, Planning Orientation & Education Clinical Privilleges
Joint Commission International/Sekarsari/2014
Reporting and Investigating Event
Organizations depend on staff, including nurse to report adverse events - whether they are sentinel events or near misses- so that systems can be revised as necessary
Nurses should actively lead participation in root cause analysis teams. Because nurses have the most direct, 24/7 contact with patients, they provide a unique perspective on system issues that could lead to a near miss or sentinel event.
Joint Commission International/Sekarsari/2014
Para
Pem
beri
A
su
han
(PP
A)
I. Asesmen Pasien (Skrining, “Periksa Pasien”)
1) Pengumpulan Informasi : Anamnesa, pemeriksaan, pemeriksaan lain / penunjang, dsb
2) Analisis informasi : dihasilkan Diagnosis / Problem / Kondisi, identifikasi Kebutuhan Yan Pasien
3) Susun Rencana Pelayanan / Pengobatan : untuk memenuhi Kebutuhan Yan Pasien
II. Implementasi /
Pelaksanaan
Rencana
Asuhan Pasien
Patient Care A
sesm
en
Ula
ng
Catatan Perkembangan Pasien Terintegrasi (Integrated Note)
Nama pasien (Semua Pemberi Asuhan menulis ttg perkembangan pasien disini, dan “semua membaca semua”)
Tanggal Jam
(Tepi utk mulai
menulis)
Dokter
(Tepi utk mulai menulis)
Staf Klinis lainnya
10/5/13 7.30 8.15 9.10
S O A P
S aaaa bbbbb ccccc hhhhhh vvvvvvv nbnnnnnn bbbbbbbbbb nn…….. O ddd eeee ….. A ggggg hhhhh kkkkk ….. P nnnn pppppp qqqqq.
ttd, nama Perawat S O A P
Skrining
Asesmen awal
Rencana asuhan
Rencana pulang
Hak pasien
MKI PPI SKP
Registrasi
Transfer
Rujuk
Terminal
Asesmen ulang
Ringkasan pulang
Lab, Rad
Risiko tinggi
Restraint
Risiko malnutrisi
Asesmen nyeri
Risiko jatuh
Analisis data ->
Dx
Pengumpulan data klinis
Implementasi Rencana asuhan
Pelayanan fokus pasien: MULTI PROFESI - ASUHAN – EDUKASI
Implementasi Rencana asuhan
“Kepuasan Pasien”
Sistem
Manajemen
Sistem
Pelayanan Klinis
Asuhan Pasien / Patient
Care
Quality & Safety
PASIEN
Profesi
Pemberi
Asuhan
Manajemen
Pasien
Perawat
Apoteker
Fisio
terapis
Ahli
Gizi Radio
grafer
Pasien Dokter
Analis
“BPIS”
“Enthusiatic Patient”
Lainnya
30
Bukan kaki kita
yang menggerakkan kita
tetapi pikiran kita
Pepatah Cina Kuno
Recommended