Manajemen Pelayanan & Manajemen Asuhan Keperawatan

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 : [email protected] 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


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


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


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


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


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


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


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


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


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


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.


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

Form Edukasi

FORM ASESMEN EDUKASI_2014.pdf

30

Bukan kaki kita

yang menggerakkan kita

tetapi pikiran kita

Pepatah Cina Kuno

Documents

Manajemen Pelayanan & Manajemen Asuhan Keperawatan