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Critical Care Nursing

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Critical Care Nursing

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s=100&p[url]=https://documents.mx/documents/criticalstatus=Critical url=https://documents.mx/documents/criticalmedia=https://reader002.documents.mx/reader002/image/20171228/5695d1e91a28ab9b0298640e.png&url=https://documents.mx/documents/criticalmini=true&url=https://documents.mx/documents/criticalcare-

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CRITICAL CARE NURSINGCRITICAL CARE NURSING Ns. Reni Sulung Utami, S.Kep., M.Sc Adult Nursing Department PSIK-FK UNDIP nursingNursing nursing-nursing-nursingTujuan Pembelajaran Definisi pasien kritis Indikasi dan prioritas masuk ICU Tujuan pelayanan Karakteristik ICU Peran dan tanggung jawab perawat kritis Pengkajian Kebutuhan keluarga pasien kritis Isu Etik dan Legal di area keperawatan kritis 56c509228f265.html&p[title]=Critical 56c509228f265.html) 56c509228f265.html&is_video=false&description=Critical 56c509228f265.html&title=Critical DISKUSI PASIEN?? TUJUAN PELAYANAN? FASILITAS?? SUMBER DAYA MANUSIA?? DEFINISI (1) Critical care nursing is the delivery of specialized care to critically ill patients—that is, ones who have life-threatening illnesses Care Documents+https://documents.mx/documents/criticalCare Care or injuries. Such patients may be unstable, have complex needs, and require intensive and vigilant nursing care (Manaci et al, 2012) DEFINISI (2) ICU adalah suatu bagian dari rumah sakit yang mandiri (instalasi di bawah direktur pelayanan), dengan staf dan perlengkapan Nursing careNursing Nursing yang khusus yang ditujukan untuk observasi, perawatan dan terapi pasien-pasien yang menderita penyakit, cedera atau penyulit-penyulit yang mengancam nyawa atau potensial mengancam nyawa dengan prognosis dubia (tidak tentu/ragu-ragu). (KMK NO 1778 Th. 2010) nursingDEFINISI (3) Area praktik keperawatan yang kompleks dan menantang yang bertujuan merawat pasien kritis yang mengancam nyawa, yang memerlukan pemantauan dan perawatan intensif, dengan melibatkan tenaga terlatih serta didukung dengan peralatan khusus. Documents&p[summary]=CRITICAL 56c509228f265.html) Documents) Documents&source=https://documents.mx/documents/criticalGOALS Menyelamatkan kehidupan Mencegah terjadinya kondisi memburuk dan komplikasi Meningkatkan kualitas hidup dan mempertahankan kehidupan Mengoptimalkan kemampuan fungsi organ tubuh Mempercepat proses penyembuhan pasien Mengurangi CARE careangka kematian pasien kritis RUANG LINGKUP PELAYANAN 1. Diagnosis dan penatalaksanaan spesifik penyakit2 akut yang mengancam nyawa dan dapat NURSINGCRITICAL nursingmenimbulkan kematian dalam beberapa menit sampai beberapa hari 2. Memberi bantuan dan mengambil alih fungsi vital tubuh sekaligus melakukan pelaksanaan spesifik problema dasar 3. Pemantauan fungsi vital tubuh dan penatalaksanaan terhadap komplikasi yang CARE 56c509228f265.html) ditimbulkan oleh penyakit atau iatrogenik (penyakit yg diakibatkan oleh kesalahan diagnosis/kealpaan dokter) 4. Memberikan bantuan psikologis pada pasien yang kehidupannya sangat tergantung pada alat dan orang lain (KMK No. 1778 Tahun 2010) NURSING KARAKTERISTIK PASIEN 1. Pasien yang memerlukan intervensi medis segera oleh tim intensive care 2. Pasien yang memerlukan pengelolaan fungsi sistem organ tubuh secara terkoordinasi dan berkelanjutan sehingga dapat dilakukan pengawasan yang konstan dan metode terapi titrasi 3. Pasien sakit kritis yang memerlukan pemantauan kontinue dan tindakan segera untuk mencegah timbulnya Ns. dekompensasi fisiologis (KMK No. 1778 Tahun 2010) COMMENTS DEFINISI PASIEN KRITIS 1. Pasien-pasien yang secara fisiologis tidak stabil dan memerlukan dokter, perawat, profesi lain yang terkait Reni secara terkoordinasi dan berkelanjutan, serta memerlukan perhatian teliti, agar dapat dilakukan pengawasan yang ketat dan terus menerus 0 Comments Sort by Oldest serta terapi titrasi 2. Pasien-pasien yang dalam bahaya mengalami dekompensasi fisiologis sehingga memerlukan pemantauan ketat dan Sulung terus menerus serta dilakukan intervensi segera untuk mencegah timbulnya penyulit yang merugikan INDIKASI MASUK… Ancaman/ kegagalan sistem pernafasan (gagal nafas) Ancaman/kegagalan sistem hemodinamik (syok) Utami, Ancaman/kegagalan sistem neurologi Overdosis obat Intoksikasi Infeksi berat (sepsis) dll Add a comment... PRIORITAS MASUK (KMK no 1778 th 2010) PrioritasPrioritas 11 Pasien kritis, tidak stabil, perlu terapi intensif dan tertitrasi Do S.Kep., all/everything (terapi tidak memiliki batasan) Contoh: post bedah jantung, edema paru, septic shock, AMI, Disritmia PrioritasPrioritas 22 Perlu pelayanan pemantauan canggih di ICU Do everything : post bedah mayor, post bedah jantung, pasca henti jantung, penyakit dasar M.Sc jantung-paru PrioritasPrioritas 33 Kemungkinan sembuh/manfaat perawatan di ICU kecil Terapi diberikan untuk mengatasi kegawatan Facebook Comments Plugin akutnya Do something : Metastase, penyakit jantung dan paru terminal dengan komplikasi akut. PengecualianPengecualian Adult PertimbanganPertimbangan luarluar biasabiasa dandan persetujuanpersetujuan kepalakepala ICUICU SewaktuSewaktu22 pasienpasien harusharus dapatdapat dikeluarkandikeluarkan ContohContoh:: menolakmenolak terapiterapi agresifagresif,, vegetatifvegetatif Nursing permanenpermanen,, matimati batangbatang otakotak INDIKASI KELUAR Tidak memerlukan terapi intensif Terapi intensif gagal MBO Copyright © 2017 Powered By Documents.mx - All Rights Reserved About (/about.html) / Terms (/info/terms.html) / DMCA (/info/dmca.html) / Department FASILITAS DAN KETENAGAAN KMK No 1778 Tahun 2010 Tentang Pedoman Penyelenggaraan Pelayanan Intensive Care Unit Di Rumah Contact (/contacts.html) Sakit Keputusan Direktur Jenderal Bina Upaya Kesehatan no HK.02.04/I tahun 1966 tentang Petunjuk Teknis Penyelenggaraan Pelayanan ICU di Rumah Sakit PSIKWhat Nurse do? Critical care nurses fill many roles in the critical care setting, such as staff nurses, nurse-educators, nurse-managers, case managers, clinical nurse specialists, nurse practitioners, and nurse researchers. FK PERAN DAN TANGGUNG JAWAB NERS Advocate Menggunakan penilaian klinis (decision maker) Menunjukkan perilaku caring (care giver) Berkolaborasi dengan tim kesehatan lain Mendemonstrasikan pemahaman ttg keragaman budaya Memberikan pendidikan kepada UNDIP pasien dan keluarga (Educator) ADVOCATE Melindungi hak-hak pasien Membantu pasien dan keluarganya dalam proses pengambilan keputusan dengan menyediakan Tujuan pendidikan dan dukungan Bernegosiasi dengan anggota tim kesehatan lain atas nama pasien dan keluarganya Memberikan informasi kepada pasien dan keluarganya tentang rencana perawatan Advokasi untuk fleksibilitas kunjungan di ICU Menghormati dan mendukung Pembelajaran keputusan pasien dan keluarganya Melayani sebagai penghubung antara pasien dan keluarganya dgn anggota tim kesehatan lain Menghormati nilai-nilai dan budaya pasien Bertindak untuk kepentingan terbaik pasien CLINICAL JUDGEMENT A critical care nurse needs to exercise clinical judgment. To develop sound clinical judgment, you need critical thinking skills. Critical thinking is a complex mixture of knowledge, intuition, logic, common sense, and experience. Definisi WHY BE CRITICAL????? Mendorong pemahaman tentang masalah dan memungkinkan perawat untuk cepat menemukan jawaban atas pertanyaan-pertanyaan sulit Meningkatkan kemampuan perawat untuk mengidentifikasi kebutuhan pasien Memungkinkan perawat untuk pasien menggunakan kemampuan dlm pengambilan keputusan klinis dan untuk menentukan tindakan keperawatan terbaik guna memenuhi kebutuhan pasien Diperlukan ketika menerapkan proses keperawatan: pengkajian, perencanaan, intervensi kritis CARING PRACTICE Caring practice is the use of a therapeutic and compassionate environment to focus on the patient’s needs. Although care is based on standards and protocols, it must also be individualized to each patient. Caring practice also involves: maintaining a safe Indikasi… environment interacting with the patient and his family in a compassionate and respectful manner throughout the critical care stay supporting the patient and his family in end-of-life issues and decisions COLLABORATION Collaboration allows a health care team to use all available resources for the patient. The collaborative goal is to &p[images[0]=https://reader002.documents.mx/reader002/image/20171228/5695d1e91a28ab9b0298640e.png) optimize patient outcomes and to provide effective and comprehensive (holistic) care. Multidisciplinary Teams Team Member: Registered nurses Doctors Physician assistants Advanced practice nurses (such as clinical nurse specialists and nurse practitioners) Patient care technicians Respiratory therapists and others. BENEFITS MULTIDISCPLINARY CARE TEAMS (Barnato et al, 2010) Reduced mortality Improve communication Facilitate implementation of best clinical practices CULTURAL DIVERSITY A critical care nurse is expected to demonstrate awareness and sensitivity toward a patient’s religion, lifestyle, family makeup, socioeconomic status, age, gender, and values. Be sure to assess cultural factors and concerns and integrate them into the care plan EDUCATOR As an educator, a critical care nurse is the facilitator of patient, family, and staff education. Patient education involves teaching patients and their families about: The patient’s illness The importance of managing comorbid disorders (such as diabetes, arthritis, and hypertension) Diagnostic and laboratory testing Planned surgical procedures, including preoperative and postoperative expectations Instructions on specific patient care, such as wound care and range-of-motion exercises. ASSESSMENT The assessment can be individualized by adding more specific assessment requirements depending on the specific patient diagnosis Assessments should focus first on the patient, then on the technology. The patient needs to be the focal point of the critical care practitioner's attention, with technology augmenting the information obtained from the direct assessment. TYPE OF ASSESSMENT Pre-arrival Assessment Admission quick check ("just the basics“) Comprehensive admission Assessment Ongoing assessment PREARRIVAL ASSESSMENT WHEN?? About the upcoming admission of the patient. HOW?? The initial health care team contact paramedics in emergency department (ED), operating room (OR), or medical/surgical nursing unit. WHAT?? Paints the initial picture of the patient and allows the critical care nurse to begin anticipating the patient's physiologic and psychological needs. Allows the critical care nurse to determine the appropriate resources that are needed to care for the patient. PREARRIVAL ASSESSMENT Abbreviated report on patient (age, sex, chief complaint, diagnosis, pertinent history, physiologic status, invasive devices, equipment and status of laboratory/diagnostic tests) Room setup complete, including verification of proper equipment functioning ADMISSION QUICK CHECK Obtained immediately upon arrival and is based on assessing the parameters represented by the ABCDE acronym A quick overview of the adequacy of ventilation and perfusion to ensure early intervention for any life- threatening situations. Also focused on exploring the chief complaint and obtaining essential diagnostic tests to supplement physical assessment findings. A highlevel view of the patient, but is essential because it validates that basic cardiac and respiratory function is sufficient. ADMISSION QUICK ASSESSMENT General appearance (consciousness) Airway Patency; Position of artificial airway (if present)

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