CONTOH LAPORAN PELATIHAN PPI (INTERNET).doc
July 28, 2019 | Author: Diahtuntian Iga | Category: N/A
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LAPORAN SEMI MI NAR
Pemb mbi naanPencegahan DanPengendal i anI nf eksidiRuma m ahSaki t RSKGM Bandung,19Okt ober2013
Peme mer i ntahKot aBandung
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Ruma mahSaki tKhususGi gidanMu Mul ut Jl .LLRE Mar t adi nat aNo.45Bandung Tahun2013 LAPORAN KE KEGI ATAN
A.TemaSemi nar Semi mi narPenceg ahanDanPenge ndal i anI nf eksidiRumahSaki t B.Juml ahPes er t a 48Or ang C.Wakt udanTempat Semi mi nardi l aksanakandiAnggr ekShoppi ngHo Hot elBandung,t angg al 19Okt ober2013pukul08. 00–13. 00WI B. D.Nar asumb mber 1.Dr .Dj at ni ka 2.D .Dr .Angg r aeni 3.W .WawanAri fSawananSKp. 4.L .Li aNugr ahaSkp. E. Pembahas an
KEBI JAKAN KE KEMK MKESDALAM PENCEGAHA HAN DAN PENGENDALI AN I NFEKS KSIDIRUMAH SAKI KI T
A.LATAR BELAKANG
Ter j adipeni ngkat an kasuskasuspenyaki ti nf eksi( ne w eme r gi ng, eme mer gi ng- dan r eeme mer gi ng di se ase s) ,Wabah/KLB dir umah saki t . Rumah Saki t se bagai f asi l i t as pel ay anan kes ehat an ber pot ensi
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l ai ny a har us mampu membe r i kan pe l ayanan yang be r mut u, akunt abel ,t r anspar an t er hadap masy ar akat , khususnya j ami mi nan ke s e l amat anpas i e n( pat i e nts af e t y ) .
Tuj uan pr ogr am PPI Rumah Saki t : Mengur angi /me mi ni mal i si r pot ensipenul aran penyaki ti nf eksikepadapet ugaskesehat an,pasi en danpengunj ungRS.
Kebi j akanKeme ment er i anKes ehat andal am PPIRSyai t u:
1.S .Se t i ap RS dan Fasi l i t as pel ay anan kese hat an l ai nnya har us mel aksanakanPPI :
- Membe nt ukKomi t edanTi m PPI RS
- MempunyaiI PCN pur nawakt u1:100–150TT
2. .P Pel aksanaanPPIyangdi maksuddengan:
- Pedoma man,manaj er i alPPIdiRS& Fasi l i t aspel ay anan kes ehat an l ai nny a
- Pedoma man PPIdiRS dan Fasi l i t aspel ay anan kes ehat an l ai nnya ( r e v i s i )
- Pedoma manSur v ei l ansPPI( Fi nal i sas i )
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KEWA WASPADAAN I SOLASI Upaya unt uk memu mut usr ant aipenul ar an i nf eksidar ipasi en ke pasi en l ai nnya,daripasi enkepet ugasat au sebal i knya. Adadual i ni: 1.K .Kewas padaans t andar 2.Kewaspadaanber dasar kant r ansmi si : Kewaspadaankont ak,dr opl et ,ai r borne à
KEWA WASPADAAN PENULARAN 1.
Kewaspadaanberbasi st r ansmi mi si: - Di t er apkan saatpasi en per t ama madat ang/pasi en bar u masukat au hadi r nyai nf eksibaru - Di t er apkan pada pasi en dengan ge j al a/di cur i gaiat au t er i nf eksi kumanpat og ensebagait am mb bahanKe was padaanSt andar d - Di put uskan dengan dasar kr i t er i a kl i ni s dan epi demi mi ol ogi s se bel um hasi ll abor at or i um dapatmeneg akkandi agnosi s 3 kewas padaan: - ke waspadaankont ak o pl e t - ke waspadaandr - ke waspadaanai r bo r ne Kuncikewa waspadaanber basi st r ansmi si: - Tam mb bahanKewas padaanSt andar d - APD Kont ak :sar ungt ang an& gaun Dr opl e t :pe l i ndungma mat a& mas ke rwaj ah :r espi r at orN95pengat ur anvent i l asiudara Ai r bor ne
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Kont ak:t er banyak,t angan pet ugas,per al at an pasi en,mai nan anak,al atdi ag no s t i k MRSA, VRE,r esi st en E col iI s us pe k Cl o s t r i di um SK,di arekarena di ffic i l e, nor ovi r us, Pseudomo monas aer ugi nosa, Her pes si mpl ex
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vi r us angsung: Kontakl pasi en–pet ugas,pasi en–pasi en, pasi enpengunj ung i dakl angsung: Kontakt Pasi en/pet ugas–per mukaant er kont am mi i nasi pe t ugas/pasi en
Kewas padaanTr ansmi siKont ak: Per mukaan l i ngkungan dapat t er kont ami mi nasimel al uikont ak dengan t angan pasi en at au pet ugas, gaun/al at /saput angan /t i ssueyangt el ah di pakaidan bendayangt er kont ami mi nasicai r an t ubuh. APD :sar ungt angan
gaun Lepas kangaunse bel um meni ngg al kanr uangan Mi ni mal i sasiger akpasi en Kont r ol l i ngkungan: cl eani ng & di si nf eksi per mukaan t er kont am mi i nasi
B.Tr ansmi sidr opl et Penyaki tmenul arl ewatdr opl età bat uk, ber si ndan ber bi caraà •
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dr o pl e tke c i ldandr o pl e tbe s ar Dr opl et : - Pe r ci kan>5µm mel ayangdiudar aj at uhme menge nai mukosa mat a,hi dungat au mul utor angt anpa pel i ndungdan akan j at uh padaj ar ak1m at au kohor t i ng Cucit angant i apsel esaimel epasAPD C.Tr ansmi siAi r bone Par t i ke lke ci l< 5m mm m mengandungmi kr oba mel ay ang/me menet ap di •
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udara beber apa j am, m, di t r ansf er sebagai aer osol me mel al ui al i r an udar adal am r uangan/j ar akl ebi hj auhdari2m. m. sp,t i ndakan Mycobact er i um TB,Campak,Cac arAi r , Asper gi l l us yang
meni mbul kan
aer osol
pada
suspek
TB,
SARS
( i nt ubas i , s uc t i o n,br o nko sko pi ) Kewaspadaant r ansmi s i i A r bor ne APD masker bedah ( pasi en) ,r espi r at or part i kul at ( mi s N95, •
pet ugas)sar ungt angan,gaunapr on( menghadapicai r anyg
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banyak) Cucit angan:‘ washi nwashout ’( WI WA)
2.K .Kewas padaanStandar padaan St andar: Har usse l al udi t amb mbahkan denganKewas Penanganan khusus udar a/v ent i l as i dan penggunaan dar i •
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r espi r at orpart i kul at /N95/set ar a Ruang t er pi sah dg pengat ur an v ent i l asi waspada t r ansmi mi si ai r bo r ne , at au c o ho r t i ng dengan penat aan v ent i l as i yang
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Bat asige r ak pasi en, pasi en pakaimaske r bedah bi l a akan
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kel uarr uangr awat r bor ne unt Ruang dengan ke was padaan t r ansmi mi siai uk se gal a
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t i ndakanyangdapatmeni mbul kan aer os ol Pengendal i an sumberi nf eksià penempat anpasi en Di l usi v ent i l asi s ec ar a umum à ada penge ndal i an ant ar a kual i t as dan kuant i t as udar a yang mas uk dan ke l uar , menge ncer kan par t i kel i nf eksi us kedal am v ol ume udar ay g
besarà Me Mengar ahkan al i r anudar a Menj agaper bedaant ekananudar aant arr uangygber dekat an I r adi asiUVsebagaiger mi ci da Re s pi r a t o rpar t i kul at Penemp mpat anpasi en: I deal nyadiR dengant ekanan negat i f Pert ukaranudar a>12x/j am, m, al i r anudaray angt er kont r ol Jangan gunakan AC sent r al ,bi l a mungki n AC + fil t er • • •
HEPA Ter pi sahbi l ame mungki nkanat aukohor t i ng
3t i pevent i l asil i ngkungan: 1. .V Vent i l as i mekani k , dengan ekshaus f an mendor ong udar a kel uargedung,dapatdi kombi nasidgAC +si st em fil t er 2.Vent i l asinat ur al,dor ongan al ami mial i r an udarakel uarà angi n, ’ Chi mneyeffec t ’per bedaan t ekanan udar a di l uardan di dal am
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DEKONTAMI NASI:PEMBERSI HAN,DI SI NFEKSI , STERI LI SASI Pasi en dan pet ugas ber i si ko t er kena i nf eksij i ka t i dak mener apkan penceg ahan dan pengendal i an i nf eksi( PPI )dengan bai k.Sal ah sat u car a unt uk mencegah pe nul ar an
à
pr os es dekont ami mi nasi : pember si han,
di s i nf e ks idans t e r i l i s as i . Dekont ami mi nasiyai t u Pr os esunt uk menghi l angkan dan memusnahkan mi kr oba / kot or an yg mel ekatdiper al at an medi sà sehi ngg a ama man à uan D pema makai an sel anj ut nya. Tuj De ekont am mi i nas i
à
Memut us r ant ai
penul arani nf eksi eani ng/Pemb A.Cl mber si han t upr osesunt ukmenghi l angkankot or anygt er l i hat /t i dakpada Sua
i ns t r umenme medi sà se bel um di l akukanpenangananl ebi hl anj ut Menggunakan ai rme mengal i r ,si kat ,det er gen à samp mpaikot or an /
bahanor gani khi l angdar iper mukaan anj ur kanmenggunakande t er gen+enz i m pr ot eol i t i k Di B.Di si nf eksi Suat u pr os es menghi l angkan / memusnahkan mi kr oba ( vi r us, bakt er i , par asi t , j amur dan sej uml ah spor a) pada per al at an
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Ant i sept i k, Lar ut an ki mi a unt uk membunuh mi kr oba
à
pd
per mukaan hi dup ( kul i t , mu mukosa) mi sal nya : c uci t angan, per si apan ope r as i . Di si nf ekt an,Lar ut an ki mi aunt uk membunuh mi kr obapadabe nda mat imi sal nya:i nst r umen,l ant ai ,per mukaanat au per al at anRS. Pengel ol aan al athabi spakai: r e c l e ani ng( per endama man) P /Pencuci an Cl eani ng s i nf e ks i( DTT) Di er i l i sasi St
ALAT PELI NDUNG DI RI( APD) TUJUAN PENGGUNAAN APD Mel i ndungikul i t dan anggo t at ubuh pe t ugas dar ir i si ko paj anan darah,semu mua j eni scai r an t ubuh,sekr et ,ekskr et a,kul i tyang t i dak ut uhdansel aputl endi rpasi en. JENI SAPD 1.S .Sar ungt angan: Tuj uanPenggunaan : Mel i ndungit angan dar ikont ak dengan dar ah, s emua j eni s •
cai r an t ubuh,sekr et ,ekskr et a,kul i tyangt i dak ut uh,sel aputl endi r pasi endanbendayangt er kont am mi i nasi
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sekr et ,ekskr et a,kul i tyang t i dak ut uh,sel aputl endi rpasi en,dan bendayangt er kont ami nasi . 2.P .Pel i ndungWaj ah i ndungisel aputl endi rhi dung,mul ut ,danMat a T uj uan:Mel eni sal atyangdi gunakan: ma masker ,kacamat a,vi sor J
3.P .PenutupKepal a nce gah j at uhnya mi kr oor gani sme yang ada di T uj uan : me r amb mbutdan kul i tkepal apet ugast er hadap al at al atdaer ah st er i ldan j uga sebal i knya unt uk mel i ndungi kepal a/r ambut pe t ugas dar i
4.
per ci kanbahanbahandaripasi en. Gaun/Baj uPel i ndung Tuj uan:me l i ndungipet ugasdar i
kemungki nan
genangan
at au per ci kan dar ah at au cai r an t ubuh l ai nnya yang dapat mencemar ibaj u Jeni s: Gaun pel i ndungt i dakkedap ai r ,Gaun pel i ndungkedap ai r ,Gauns t e r i l ,Gaunno ns t e r i l 5.S .Sepat u/Pel i ndungKa Kaki Tuj uan : me l i ndung kakipet ugas dar it umpahan/ per ci kan dar ah at au cai r an t ubuh l ai nnya dan mencegah dar ikemungki nan t usukanbendat aj am at aukej at uhanal atkes ehat an Jeni s:sepat u kar etat au pl ast i kyangme menut upise l ur uh uj ung
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Khusus unt uk t i ndakan yang menghasi l kan ae r os olmas ke r yang di gunakanr es pi r at orN95
HAND HYGI ENE Keg agal anmel akukankeber si hant angan(BoykedanPi t t e t2002) à mer upakanpenyebabut ama mai nf eks inos okomi mi al ,penyebar ankumanmul t i r esi st en,kont ri but ort er hadapt i mbul nyawabah. Ber dasar kan hasi l Penel i t i an Semm mmel wei s( 1861) dan penel i t i– pe ne l i t il ai nny aà
Penul ar an penyaki t menul ar dar ipasi en ke pasi en
t erj adimel al uit anganpet ugas. Menj agakeber si hant angan denganbai kdan benardapatmence gah penul ar anmi kr oor gani sme medanmenur unkanf r ekuensii nf eksinosokomi mi al ( Boy ce1999,Lar son1995) . Pengert i an Mencuci t angan
adal ah
suat u
pr osedur
t i ndakan
member si hkan t angan dengan mengg unakan sabun/ant i sept i k di bawa wah ai rber si h yangme mengal i rdan sabun yangdi gos okgos okan se l ama ma40samp mpai60de t i k. Tuj uan
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Ji ka ai r mengal i r /kr an t er kont ami nasi , gunakan ai r yang t el ah di di di hkan sel am ma a 10 meni t dan kal au per l u di sar i ng, at au
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mendi si nf eksiai rdengan l arut an sodi um hi pokl ori t0. 001% Al t er nat i fme ncucit angan dapatgunakan handrub ber basi s al kohol 70%
a.A .Ai rber si h Ai r yang secar a al amiat au ki mi awidi ber si hkan dan di sar i ng •
sehi ngg a ama man unt uk di mi num,ser t a unt uk pema makai an l ai nnya
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se per t imencucit angandanmemb mber si hkani ns t r umenme medi s Ai rber si h har us bebasdar imi kr oor gani sme ,t i dakber bau,t i dak
ber war na,j er ni h,t i dakber kabut b.Handsrub anti septi c Ant i sept i khandsrub y angber eaksice patunt uk menghi l angkan sement ar a at au mengur angi mi mi kr oor gani sme penghuni t e t ap dan mel i ndungikul i tt anpamenggunakanai r
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membant u mel epas kan kot or an/debr i s dan mi kr oor gani sme yang menempelpadat angan d.Agenant i septi kat auant i mi kr oba Bahan ki mi ayangdi apl i kasi kan di at askul i tat au j ari ngan hi dupl ai n unt uk menghambat at au membunuh mi kr oor gani sme t r ans i en maupunr es i den,se hi nggame mengur angij uml ahhi t ungbakt er it ot al Cont ohagenant i sept i k: Al kohol60–90% (e t i ldani sopr opi lat aume t i lal kohol ) Kl orheksi di ngl ukonat2–4% (Hi bi scrub,Hi bi t ane,Hi bi cl ens) Kl orheksi di ngl ukonatdancet ri mi de( savl on) Yodi um 3% Tr i kl osan I odof or7. 5–10% (Bet adi ne) e.E .Emol l i ent Cai r an organi k sepert igl i ser ol ,pr opi l en gl i kolat au sorbi t olyang •
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di t am mb bahkan padahandsr ub dan l ot i on t anganunt ukme mel unakkan kul i tdan mem mb bant u mence gah ker usakan kul i t(keker i ngan,i r i t asi , de r ma mat i t i s ,ke r e t akan)
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Sebel um dansesudahmel akukant i ndakanpadapasi en Sesudahkekama markeci l Ses udahkont akdengandar ahat aucai r ant ubuhl ai nnya Bi l at angankot or Sebel um meni ngg al kanr umahsaki t Sege r ase t el ahmel epaskansar ungt angan Sege r aset el ahmem mb ber si hkan se kr es ihi dung Sebe l um danse t el ahmenyi apkandanmengkonsums msimakanan
AUDI T HandHy Hygi ene PENDAHULUAN Masyar akat diRumah Saki t ber esi ko t er j adi nya HAI s( He al t hc ar e Assoc i at ed I nf ec t i ons) Heal t h .HAI sdapatdi cegah dengan ke pat uhan HCW (
am mel aks anakan pr og r am dan pr akt ek Pence gahan Car e Wor ker s)dal Pengendal i anI nf eksiRumahSaki t( PPI RS) . Kepat uhan t er hadapkebi j akan Pence gahan & Penge ndal i an I nf eksi à
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Unt uk mengukur apakah Pr ogr am PPI RS dan pr akt ek t i ndakan pence gahan penge ndal i an I nf eksi , sudah di l aksanakan dengan bai k
o o l s danbenardenganmengunakan t Unt uk meni ngkat kan ke pat uhan pe t ugas ke sehat an
dal am
mel aksanakanPr ogr am PPIRS Meni ngkat kankual i t asPr ogr am PPIRS Hasi laudi tdapatdigunakanmemb mbuatkebi j akanRS Meni l aikeber hasi l an pr ogram pel at i han
PERAN AUDI TOR Audi t orPPIRS adal ah Komi t e/Ti m PPI(I PCN /I PCLN )yangsudah t e r l at i h.Pe r anaudi t or: Menat apr ogr am audi t(r uangl i ngkup) Mem mb buatf or mul asit ool saudi t Mempe r si apkan/me mel at i h t enag a
mengi mpl eme ment asi kant ool sdal am pr ose saudi t Memb mbuatj adwalkegi at anaudi t Pr os esaudi tdan memb mbuatskor i ng Mel k hasi l di t
ke sehat an
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MANAJEME MEN KESEHA HATAN LI NGKUNGA GAN RUMA MAH SAKI KI T Mengacu pada
à
Keput us an MENTERI KESEHA HATAN RI . NO OM MOR
1204/ME MENKES/SK/X/2004
à
t ent ang PERSYARATAN
KESEHATAN
LI NG GK KU UN NG GA AN RUM UMAH SAKI T
LI MBAH MEDI S& BENDATAJAM A.Penger t i anLi mbahRumahSaki t Semu mua hasi lkegi at an dar il ay anan kes ehat an dir umah saki tyang t i dakl agiber gunaat au yangakandi buang. B.Tuj uan Pengel ol aanLi mbah Mence gah penul ar an penyaki ty ang di sebabkan ol eh Li mbah •
bai k unt uk pasi en ,pengunj ung dan t enaga kesehat an ser t a mel i ndungi masy ar akatse ki t ar nya dar ibahay a pence mar an l i mbahyangber asaldarir umahsaki t
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Kant or /Admi ni st r asi ,RawatI nap,RawatJal an,Dapur dst .Dal am penge l ol aannya t i dak ada bedanya dengan penge l ol aan dit emp mpat umum,hanyakal aupadal ay anankes ehat anhar usdi kel ol adengan bai kdenganSOPyangj el as. I I .Li mbahMe di s me l i put i: Li mbah yang ber asaldar ikeg i at an yang ber hubungan dengan pasi en bai k yang ber obat j al an ( Pol i kl i ni k, I GD) ma maupun yang se dangdi r awat . Li mbah i nf eksi us( kuni ng) ,Li mbah Farma masidan Ki mi a( cokl at ) , Li mbah Labor at or i um dan Pat hol ogi( kuni ng) , Li mbah Radi ol ogi
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