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