Perawatan hiv komprehensif(8 12-2010)
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Transcript of Perawatan hiv komprehensif(8 12-2010)
PERAWATAN HIV & AIDSKOMPREHENSIF
BERKESINAMBUNGAN
Oleh :Octo zulkarnain
PENGERTIAN
suatu konsep perawatan yang menyeluruh membentuk suatu
jejaring kerja diantara semua sumber daya yang ada
dalam rangka memberikan pelayanan dan perawatan holistic, menyeluruh dan dukungan yang luas bagi ODHA
dan keluarganya.
VCT
-Health posts-Dispensaries-Traditional
-Orphan care
-NGOs-Spiritual
-Youth group-Volunteer -Paliative
-Emotional & Spiritual support
- Self care
-Specialist &specialized care
facilities
-Distric hosp-Clinics-Hospice
Peersupport
PLHAThe entry
point
PELAYANA DAN DUKUINGAN ODHA
HIV(-)
TerpajanHIV(+)
AIDS Terminal
Pencegahan : Jangan menulari dan ditulari (IMS dan NAPZA suntik)
Konseling dan tes HIV sukarela Manfaat ?
Dukungan psiko-sosial-spiritual
Tx. peny.terkait HIV
Profilaksis & pengobatan IO
Anti retroviral teraphy
Perawatandi rmh
Perawatanpaliatif
Pengobatan komplementerPMTCT
PEP
Beberapa aspek perawatan HIV & AIDSkomprehensif dan berkesinambungan
Perawatandi rumah
Asuhan gizi
KDS
TatalaksanaIO
AsuhankeperawatanVCT
Menurunkanstigma
Dukungan sosial
DIKLATSistem
rujukan
Pengobatan dan perawatanVCT, PMTCT, profilaksis,
pengoatan IO, ART, tatalaksana IMS, gizi
Dukungan sosio-ekonomik Dukunngan material jaminan ekonomi dan jaminan hidup layak
Dukungan HAM dan Hukum
Menghapus stigma dan diskriminiasi,
perencanaan dan partisipasi ODHA,
kesetaraan kesempatan dan
Dukungan psikologis
Konseling, dukungan pada yatim piatu,
dukungan masyarakat,
dukungan spiritual
ODHAdan
keluarga
INTERAKSI ANTAR KOMPONEN
PRINSIPDASAR
Penghargaan
Ketersediaan
KesetaraanKoordinasi danintegrasi
Efisien danefektif
SEBELUM PROGRAM ART
•Prophilaxis
•Tatalaksana IO
•Pencegahan
•Perawatan paliatif
PROGRAM ART
•HIV Kronis
•Untuk mendapatkan program ART,ada beberapa syarat yang harus dipenuhi
•Patuh datang ke klinik
•Patuh program pengobatan
•Nutrisi adekwat
•Pola hidup sehat
•Dukungan psikososial
•Universal precaution
SELAMA PROGRAM ART
Dokter
ODHA
Ahli gizi
Perawat
Konselor
Relawan sosial
Perawatan paliatif
Farmasi
SEBAGAI TIM, PERAWAT HARUS:
•Partisipasi aktif
•Memberikan in-put untukmeningkatkan kualitas layanan
•Konsultasi dengan anggota tim lain
•Saling memberi dukunganpada sesama perawat
TUJUAN KEPERAWATANDALAM PERAWATAN KOMPREHENSIF
•Menurunkan morbidity dan mortality
•Meningkatkan QoL
•Memberikan asuhan keperawatan
•Prenvention
PERAN PERAWAT DALAM PERAWATAN KOMPREHENSIF
•Perawatan kronik•Perawatan akut
•Promosi dan pendidikan kesehatan•Pencegahan penyakit
•Perawatan paliatif•Dukungan mental
•Advokasi•Manajemen rujukan
TATALAKSANA HIV KRONIS
Testing and counseling
Health monitoring
Symptom management
Medication adherence monitoring
Health promotion/patient education
Empowering patients to make their own choices
PERAN PERAWAT DALAM PERAWATAN AKUT
*Melakukan pengkajian tentang tanda dan gejala/
staging
•Memberikan intervensi Non-pharmacologic
•Bijaksana dalam merespon pengobatan komplementer ODHA
•Monitoring program pengobatan
Nursing Roles in Health Promotion and Education
• Teach health promotion• Promote healthy practices that prolong the
asymptomatic stage, reduce HIV-related conditions, and avoid behaviors that can transmit HIV
• Assess and use patient’s and family members’ current knowledge as the basis for teaching
Nursing Roles in Prevention for Patients
• Assess• Identify risks for HIV infection
• Intervene• Counsel on the benefits of HIV testing • Educate on HIV transmission and risk reduction• Refer those testing HIV-positive to care and
support• Educate those testing HIV-negative about
prevention
Nursing Roles in Disease Prevention in the Clinical Setting
• Reduce transmission of infection• Practice standard precautions at work• Model optimum standard precautions and
advise colleagues on proper use• Know the postexposure prophylaxis (PEP)
protocol of the health facility• Encourage implementation of PEP if needed
Nursing Roles in Mental Health•Psychological or mood
disorders are common in patients with HIV
•Nurses can assess and intervene on a variety of mental health issues
Nursing Roles in Patient Support/Advocacy
• Identify needs (along with the patient and family) and refer to appropriate services within the clinical or community setting
• Advocate for patient when needed • Support patient’s achievement of needs, such as
informing patient of cost-sharing schemes
Nursing Roles in Referral Management
• A functional referral system with links to other facilities/services and feedback is critical to serve all the comprehensive care needs of patients
• Examples of services include community- and home-based services and PLHA support groups
• A referral system should include feedback to the referring clinician to determine if the patient’s needs were met
Nursing Roles in Palliative Care and End-of-Life Care
• Palliative care begins at the time of diagnosis and provides comfort and symptom management throughout life
• End-of-life care is focused on assisting the patient and family to have the highest quality of life possible
Nursing Roles in Documenting Care
• Complete and accurate documentation of the nursing care provided during each patient visit contributes to quality service delivery
• Recording assessment findings and interventions over time is required to manage HIV/AIDS as a chronic disease
Nursing Roles Realized:Four Steps for “Getting It Right”
• Make time for the patient• Use an open, supportive,
nonjudgmental approach• Maintain current knowledge• Believe in the importance of your
role
Importance of Nursing Roles in Care of PLHA
• Some nurses may feel their role is unimportant or they are “just nurses”
• Nurses’ roles in caring for PLHA and their families are vital for high-quality patient care and family wellbeing
• Nurses are the front line of trained health workers for PLHA