Manajemen Pasien Safety: Kepastian Tepat-lokasi, Tepat-prosedur, Tepat-pasien Operasi
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MANAJEMEN PASIEN SAFETY KEPASTIAN TEPAT-LOKASI, TEPAT-PROSEDUR, TEPATPASIEN OPERASI KELOMPOK 3 KELAS 3A DIV KEPERAWATAN
2019
PENANDAAN AREA OPERASI Merupakan suatu cara yang dilakukan oleh ahli bedah untuk melakukan penandaan area operasi terhadap pasien yang akan dilakukan tindakan pembedahan.
01
Meminimalkan risiko terjadinya kesalahan pada tempat dilakukannya operasi dan pasien.
02
Meminimalkan risiko terjaadinya kesalahan prosedur operasi.
03
Menginformasikan dan membimbing ahli bedah operasi dalam hal metode yang digunakan pada proses penandaan tempat operasi.
04
Memastikan bagian tubuh (anatomi) yang akan dilakukan tindakan operasi.
PROSES PENANDAAN AREA OPERASI
SURGICAL SAFETY CHECKLIST
SIGN IN Apakah tempat ditandai?
1
Apakah pasien memiliki kesulitan jalan nafas dan risiko aspirasi?
Apakah pulse oximetry pada pasien telah berfungsi?
3
5
7
Start
2019 2
Apakah pasien telah dikonfirmasi identitas tempat, prosedur dan persetujuan?
4
Apakah mesin anestesi dan obat-obat telah lengkap?
6
Apakah pasien memiliki alergi?
Apakah pasien memiliki risiko kehilangan darah > 500 ml (7 ml / kg) pada anak-anak?
TIME OUT 1
Konfirmasi semua anggota tim telah menyebutkan nama dan peran masingmasing.
2
Konfirmasikan nama pasien, prosedur dan area yang akan dilakukan tindakan pembedahan.
3
Apakah antibiotik profilaksis telah diberikan dalam 60 menit terakhir?
4
Peristiwa penting untuk dokter bedah, untuk tim anastesi, dan untuk tim keperawatan.
5
Apakah pencitraan telah di pasang dengan benar?
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Penyelesaian jumlah instrumen, spons danYour jarum. Text Here
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Ahli bedah, ahli anestesi dan perawat meninjau kembali mengenai rencana pemulihan dan pengelolaan bagi pasien.
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Masalah universal di kamar Get peralatan a modern bersifat PowerPoint Presentation operasi. yang tidak berfungsi thatperalatan is beautifully designed. Easy todengan baik dapat didaur ulang, supaya dapat change colors, photos and Text. digunakan kembali.
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PENGECUALIAN PENANDAAN AREA OPERASI Semua tindakan endoskopi, prosedur invasif yang direncanakan dianggap dibebaskan dari penandaan bedah, seperti katerisasi jantung.
Daerah lain / bagian anatomis secara teknis sulit untuk menandai daerah operasi meliputi bidangbidang seperti perineum, gembur kulit di sekitar penandaan dan neonatus atau bayi prematur.
1
4
Prosedur yang memiliki pendekatan garis tengah yang dimaksudkan untuk satu organ tertentu yaitu operasi caesar, histerektomi atau tyroidectomy.
Untuk luka atau lesi yang jelas, penandaan area operasi tidak berlaku jika luka atau lesi adalah tempat dilakukannya tindakan pembedahan.
2
5
Hal ini diakui bahwa tidak ada cara praktis atau dapat diandalkan untuk menandai gigi atau selaput lendir, terutama dalam kasus gigi yang direncanakan untuk ekstraksi.
Jika ada beberapa luka atau lesi dan hanya beberapa dari luka /lesi tersebut yang dirawat maka penandaan area operasi harus dilakukan sesegera mungkin setelah keputusan dibuat untuk tindakan operasi.
3
6
Untuk lokasi tubuh manapun yang tidak dilakukan penandaan, harus dilakukan peninjauan verifikasi pasien dan prosedur di 'Time Out' yang merupakan bagian dari WHO Keselamatan Checklist.
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KTD TINDAKAN PEMBEDAHAN Pelayanan pembedahan di kamar operasi merupakan pelayanan yang multi komplek, yang sering kali menimbulkan cedera medis atau Kejadian Tidak Diharapkan (KTD). Risiko- risiko atau kemungkinan-kemungkinan yang terjadi hampir semua berakibat fatal, diantaranya adalah:
01
Salah pasien yang dioperasi (wrong person surgery)
02
Salah pasien yang dioperasi (wrong person surgery)
03
Salah prosedur operasi (wrong procedure)
04
05
Infeksi pada daerah yang dioparasi (surgical site infection) Tertinggalnya instrumen operasi seperti gunting, kasa, jarum (retained instruments and sponges after surgery)
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SIAPA YANG MEMBERI TANDA AREA OPERASI? 1) Orang yang bertanggung jawab dalam memberikan tanda pada pasien yang akan dilakukan prosedur operasi adalah dokter yang akan melakukan tindakan/wakilnya.
2) Jika pada proses penandaan dilakukan oleh wakil/yang mewakili maka dokter yang melakukan tindakan operasi harus hadir selama prosedur penandaan area tersebut.
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SURGICAL SAFETY CHECKLIST
Merupakan suatu daftar periksa yang digunakan untuk memperkuat keselamtan pasien.
Tujuan checklist ini dimaksudkan sebagai alat yang digunakan oleh tim bedah (dokter bedah, dokter anestesi, perawat) dalam meningkatkan keselamatan pasien pada proses operasi dan mengurangi risiko infeksi yang tidak perlu/kematian.
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Secara khusus, dalam the 2008 National Patient Safety Goals, JCAHO menetapkan protokol universal dalam rangka untuk mencegah kesalahan identifikasi pasien dalam pelayanan bedah. Dalam protokol tersebut disebutkan tiga prosedur penting yang harus dilakukan, yaitu: 1. Proses verifikasi pre-operatif. Tujuan yang ingin dicapai pada tahap ini adalah untuk menjamin semua dokumen yang terkait dengan prosedur operasi tersedia, dan dikaji ulang dan telah diyakini semuanya telah konsisten sesuai dengan harapan pasien dan tim bedah.
2. Membuat penandaan tempat operasi. Tujuan pemberian tanda di tempat operasi adalah menjamin tidak terjadinya keraguan tempat insisi bedah.
3. Melakukan Time out sebelum tindakan operasi dimulai. Melakukan “time out“ sebelum operasi bertujuan untuk menjamin tidak terjadinya salah pasien, salah prosedur atau salah sisi operasi.
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MEMBUAT TANDA AREA OPERASI 1) Pada pasien yang akan dilakukan tindakan operasi harus dilakukan penandaan area terlebih dahulu. Ketika proses penandaan, pasien dilibatkan dalam keadaan terjaga/sadar dan sebaiknya proses penandaan dilakukan sebelum induksi anestesi.
2) Tanda yang digunakan berupa lingkaran (→O) pada tempat area operasi.
3) Tanda yang dibuat harus menggunakan spidol hitam permanen dan tidak terhapus/tetap terlihat setelah dilakukan disinfeksi dan drapping.
4) Tempat operasi yang diberi tanda lingkaran ((→O) berupa prosedur yang melibatkan sayatan (permukaan kulit, spesifik digit/lesi, lateral).
5) Semua tanda yang dibuat harus melihat catatan medis, identitas pasien dan hasil pencitraan pasien untuk memastikan tingkat kebenaran pada proses penandaan.
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1
SURGICAL SAFETY CHECKLIST
3
Hal ini setidaknya membutuhkan kehadiran personel anestesi dan perawat
2
Time Out (sebelum dilakukan incisi) Hal ini membutuhkan kehadiran semua personel tim bedah.
Sign out (Sebelum pasien meninggalkan ruang operasi) Tujuannya adalah untuk memfasilitasi transfer informasi penting kepada tim perawatan yang bertanggung jawab untuk pasien setelah tindakan operasi.
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2019
PENANDAAN AREA OPERASI Merupakan suatu cara yang dilakukan oleh ahli bedah untuk melakukan penandaan area operasi terhadap pasien yang akan dilakukan tindakan pembedahan.
01
Meminimalkan risiko terjadinya kesalahan pada tempat dilakukannya operasi dan pasien.
02
Meminimalkan risiko terjaadinya kesalahan prosedur operasi.
03
Menginformasikan dan membimbing ahli bedah operasi dalam hal metode yang digunakan pada proses penandaan tempat operasi.
04
Memastikan bagian tubuh (anatomi) yang akan dilakukan tindakan operasi.
PROSES PENANDAAN AREA OPERASI
SURGICAL SAFETY CHECKLIST
SIGN IN Apakah tempat ditandai?
1
Apakah pasien memiliki kesulitan jalan nafas dan risiko aspirasi?
Apakah pulse oximetry pada pasien telah berfungsi?
3
5
7
Start
2019 2
Apakah pasien telah dikonfirmasi identitas tempat, prosedur dan persetujuan?
4
Apakah mesin anestesi dan obat-obat telah lengkap?
6
Apakah pasien memiliki alergi?
Apakah pasien memiliki risiko kehilangan darah > 500 ml (7 ml / kg) pada anak-anak?
TIME OUT 1
Konfirmasi semua anggota tim telah menyebutkan nama dan peran masingmasing.
2
Konfirmasikan nama pasien, prosedur dan area yang akan dilakukan tindakan pembedahan.
3
Apakah antibiotik profilaksis telah diberikan dalam 60 menit terakhir?
4
Peristiwa penting untuk dokter bedah, untuk tim anastesi, dan untuk tim keperawatan.
5
Apakah pencitraan telah di pasang dengan benar?
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Apakah ada masalah peralatan Your Text Here yang harus ditangani.
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Ahli bedah, ahli anestesi dan perawat meninjau kembali mengenai rencana pemulihan dan pengelolaan bagi pasien.
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Masalah universal di kamar Get peralatan a modern bersifat PowerPoint Presentation operasi. yang tidak berfungsi thatperalatan is beautifully designed. Easy todengan baik dapat didaur ulang, supaya dapat change colors, photos and Text. digunakan kembali.
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PENGECUALIAN PENANDAAN AREA OPERASI Semua tindakan endoskopi, prosedur invasif yang direncanakan dianggap dibebaskan dari penandaan bedah, seperti katerisasi jantung.
Daerah lain / bagian anatomis secara teknis sulit untuk menandai daerah operasi meliputi bidangbidang seperti perineum, gembur kulit di sekitar penandaan dan neonatus atau bayi prematur.
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Prosedur yang memiliki pendekatan garis tengah yang dimaksudkan untuk satu organ tertentu yaitu operasi caesar, histerektomi atau tyroidectomy.
Untuk luka atau lesi yang jelas, penandaan area operasi tidak berlaku jika luka atau lesi adalah tempat dilakukannya tindakan pembedahan.
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Hal ini diakui bahwa tidak ada cara praktis atau dapat diandalkan untuk menandai gigi atau selaput lendir, terutama dalam kasus gigi yang direncanakan untuk ekstraksi.
Jika ada beberapa luka atau lesi dan hanya beberapa dari luka /lesi tersebut yang dirawat maka penandaan area operasi harus dilakukan sesegera mungkin setelah keputusan dibuat untuk tindakan operasi.
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Untuk lokasi tubuh manapun yang tidak dilakukan penandaan, harus dilakukan peninjauan verifikasi pasien dan prosedur di 'Time Out' yang merupakan bagian dari WHO Keselamatan Checklist.
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KTD TINDAKAN PEMBEDAHAN Pelayanan pembedahan di kamar operasi merupakan pelayanan yang multi komplek, yang sering kali menimbulkan cedera medis atau Kejadian Tidak Diharapkan (KTD). Risiko- risiko atau kemungkinan-kemungkinan yang terjadi hampir semua berakibat fatal, diantaranya adalah:
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Salah pasien yang dioperasi (wrong person surgery)
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Salah pasien yang dioperasi (wrong person surgery)
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Salah prosedur operasi (wrong procedure)
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Infeksi pada daerah yang dioparasi (surgical site infection) Tertinggalnya instrumen operasi seperti gunting, kasa, jarum (retained instruments and sponges after surgery)
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SIAPA YANG MEMBERI TANDA AREA OPERASI? 1) Orang yang bertanggung jawab dalam memberikan tanda pada pasien yang akan dilakukan prosedur operasi adalah dokter yang akan melakukan tindakan/wakilnya.
2) Jika pada proses penandaan dilakukan oleh wakil/yang mewakili maka dokter yang melakukan tindakan operasi harus hadir selama prosedur penandaan area tersebut.
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AWESOME SLIDE LOREM IPSUM DOLOR SIT AMET, LOREM IPSUM DOLOR SIT AMET, CU USU AGAM INTEGRE IMPEDIT.
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SURGICAL SAFETY CHECKLIST
Merupakan suatu daftar periksa yang digunakan untuk memperkuat keselamtan pasien.
Tujuan checklist ini dimaksudkan sebagai alat yang digunakan oleh tim bedah (dokter bedah, dokter anestesi, perawat) dalam meningkatkan keselamatan pasien pada proses operasi dan mengurangi risiko infeksi yang tidak perlu/kematian.
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STRENGTHS
WEAKNESS
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T THREATS
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Secara khusus, dalam the 2008 National Patient Safety Goals, JCAHO menetapkan protokol universal dalam rangka untuk mencegah kesalahan identifikasi pasien dalam pelayanan bedah. Dalam protokol tersebut disebutkan tiga prosedur penting yang harus dilakukan, yaitu: 1. Proses verifikasi pre-operatif. Tujuan yang ingin dicapai pada tahap ini adalah untuk menjamin semua dokumen yang terkait dengan prosedur operasi tersedia, dan dikaji ulang dan telah diyakini semuanya telah konsisten sesuai dengan harapan pasien dan tim bedah.
2. Membuat penandaan tempat operasi. Tujuan pemberian tanda di tempat operasi adalah menjamin tidak terjadinya keraguan tempat insisi bedah.
3. Melakukan Time out sebelum tindakan operasi dimulai. Melakukan “time out“ sebelum operasi bertujuan untuk menjamin tidak terjadinya salah pasien, salah prosedur atau salah sisi operasi.
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MEMBUAT TANDA AREA OPERASI 1) Pada pasien yang akan dilakukan tindakan operasi harus dilakukan penandaan area terlebih dahulu. Ketika proses penandaan, pasien dilibatkan dalam keadaan terjaga/sadar dan sebaiknya proses penandaan dilakukan sebelum induksi anestesi.
2) Tanda yang digunakan berupa lingkaran (→O) pada tempat area operasi.
3) Tanda yang dibuat harus menggunakan spidol hitam permanen dan tidak terhapus/tetap terlihat setelah dilakukan disinfeksi dan drapping.
4) Tempat operasi yang diberi tanda lingkaran ((→O) berupa prosedur yang melibatkan sayatan (permukaan kulit, spesifik digit/lesi, lateral).
5) Semua tanda yang dibuat harus melihat catatan medis, identitas pasien dan hasil pencitraan pasien untuk memastikan tingkat kebenaran pada proses penandaan.
Infographic Style Sign in ( sebelum induksi anestesi )
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SURGICAL SAFETY CHECKLIST
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Hal ini setidaknya membutuhkan kehadiran personel anestesi dan perawat
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Time Out (sebelum dilakukan incisi) Hal ini membutuhkan kehadiran semua personel tim bedah.
Sign out (Sebelum pasien meninggalkan ruang operasi) Tujuannya adalah untuk memfasilitasi transfer informasi penting kepada tim perawatan yang bertanggung jawab untuk pasien setelah tindakan operasi.
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