PPI TB IDI dr. GANDA

PENCEGAHAN DAN PENGENDALIAN INFE INFEK KSI / IN INFECT FECTIO ION N CONT CONTRO ROL L TB

Ganda R.P Sinaga  Direktorat Bina Pelayanan Medik Dasar Direktorat Jenderal Bina Pelayanan Medik  Kementerian Kesehatan RI

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LATAR BELAKANG  Juml Jumlah ah Pasi Pasien en TB TB di Indo Indone nesi sia a ada adala lah h kelim kelima a terbes terbesar ar di dunia dunia..  Tahun Tahun 2005, 2005, Inside Insiden n TB TB nasi nasiona onall 108 108 per  100.000 pddk.  Tahu Tahun n 2005 2005 Ang Angka ka Kem Kemat atia ian n akib akibat at TB TB nasional 41 per 100.000 pddk.

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LATAR LATAR BELAKANG... BELAKANG..... LANJUTAN LANJUTAN

 Preva Prevalen lensi si MDRMDR-TB TB diperk diperkira irakan kan 3 kali kali lebih lebih besar  sekitar 1 juta  WHO  Indonesia peringkat ke delapan dari 27 negara dengan jumlah kasus MDR-TB tertinggi.  Petug Petugas as keseh kesehata atan n (healt (health h care care worke workers) rs) kelompok resiko tinggi terinfeksi TB

p

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ILLENIU M  DEVELOP M ENT ENT  M ILLENIU

GOALS

GOAL GOAL 1 : MEMBERANTAS ME MBERANTAS KEMISKINAN DAN KELAPARAN KELAPARAN GOAL GOAL 2 : MENCAPAI PENDIDIKAN DASAR DASAR UNTUK SEMUA SEM UA GOAL GOAL 3 : MENDORONG KESETARAAN KESETARAAN GENDER DAN PEMBERDAYAAN PEMBERDAYAAN PEREMPUAN GOAL GOAL 4 : MENURUNKAN KEMATIAN ANAK GOAL GOAL 5 : MENINGKATKAN KESEHATAN KESEHATAN IBU IB U GOAL 6 : MENGENDALIKAN HIV DAN AIDS, MALARIA DAN PENYAKIT MENULAR LAINNYA (TB) GOAL GOAL 7 : MENJAMIN KELESTARIAN LINGKUNGAN HIDUP

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RANTAI PENULARAN PENYAKIT INFEKSI

 Agen Penyebab Infeksi Bakteri, Jamur, Virus, Riketsia, Parasit 

Pejamu Rentan:

Reservoir:

Immunocompromised; Pasca bedah; Luka bakar; Penyakitkronik;Umur Penyakitkronik;Umur muda; Lansia

Manusia; Air dan Larutan; Obat; Peralatan

Tempat Masuk: Masuk:

Tempat Keluar:

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PATOGENESA TB transmisi Jumlah kasus TB BTA+ Faktor lingkungan : Ventilasi Kepadatan Dalam ruangan Faktor Perilaku   

TERPAJAN

Risiko menjadi TB bila dengan HIV:  5-10% 5-10% setiap setiap tahun  >30% >30% lifeti lifetime me

HIV(+)

INFEKSI 10%

Konsentrasi Kuman Lama kontak

SEMBUH

TB 

MATI

Keterlambatan diagnosis dan pengobatan

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TUJUAN INFECTION CONTROL  Bagian dari kualitas pelayanan  Mencegah infeksi silang dalam

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

1.

Dua Hal penting di fasilitas pelayanan kesehatan

orang ( pasien,petugas,pengunjung )

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Beberapa cara mengurangi risiko transmisi penyakit  Diantara klien-petugas  ± Cuci tangan

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



Infe Infeksi ksi noso nosoko komi mial al diga digant ntii Infe Infeks ksii yang ang dida didapa patt atau atau terj terjad adii di RS/f RS/fas asy yanke ankes s sete setela lah h >48 >48 jam jam hari hari rawa rawatt

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KEWASPADAAN ISOLASI ( isolation isolation precautions ) 2007 kombinasi

1. Standard Precautions /Kewaspadaan Standar gabungan dari

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Etika Etik tik batuk batu batuk k

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Droplet: Percikan >5µm mel melayang di udara jatuh men mengenai muk mukosa mat mata, hidung atau mul mulut orang tanpa pelindung dan akan jatuh pada  ja  jarak rak < 1m Pen Penyakit kit men menular lar lew lewat drop roplet let  ba batu tuk, k,be bers rsin in da dan n berbicaradroplet besar sar dan droplet kecil

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`

 APD masker bedah/medik bedah/medik sarung tangan gaun

`

Batasi gerak pasien

`

Ruang terpisah,TT berjarak berjarak > 1m atau kohorting

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2.3

Transmisi melalui airborne

Drop Drople lett Nukle Nuklei: i: Sisa partikel kecil < 5µm mel melayang di udara atau partikel debu mengandung mikroba penyebab infeksi , terbawa aliran udara > 2 M dari sumber  



 Ada  Adany nya a Prob Probllem kual kualiitas tas udar udara a dal dalam lingkungan Pali Paling ng efe efekt ktif if untuk untuk me menc nceg egah ah HA HAIs Is adalah

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Tran Transmisi ransm smisi isi Droplet Drop Dr oplet let

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Transmisi Airborne

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KEBIJAKA KEBIJAKAN N PENGEN PENGENDA DALIA LIAN N INFEKS INFEKSII TB PADA PADA FASILITAS PELAYANAN KESEHATAN

 Pilar Man Mana ajerial (Komitmen, Tim survailance)

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Ruang terpisah 

Penataan ruangan disertai pengaturan udara dan ventilasi adalah penting untuk menurunkan risiko transmisi mikroba

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Pengendalian Penge Pengenda ndali lian an Lingkungan Lingk Lingkung ungan an Tujuan : 

Untuk Untu Untuk k menu me menur nuru nurunk runk unkan nkan an konsen kon konsentras sentrasi trasi d droplet roplet nuclei yg g mengandung meng mengan andu dung ng M. tuberculosis di

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3 tipe ventilasi lingkungan 1.

Ventil Ven Ventilasi tilasi asi mekanik mekan mek anik ik ,dg e ekshaus ksh ks haus fan fan mendorong udara udar udara a kelu keluar luar  ar ar gedung, gedu gedung ng, dapa dapat dapatt dikomb dik dikombin ombin inasi asi dg AC + sistem siste sistem m filter  filt filter  er 

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Pengendalian Lingkungan  Ventilasi  Ven  Venti tila lasi si (natural (natu (natura rall dan dan mekanik mekanik )  Filtrasi 

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Laju p pergantian ergantian u udara dara

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Apa Apa yang yang dibutuhkan dibu dibutu tuhk hka an untuk unt untuk

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 ACH pada ventilasi natural

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Perkiraan Perk Perkir ir risi risiko ik ko t

misi miisii T TB B

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