Lab Clinic Equipment: March 2011 [PDF]

Mar 4, 2011 - Tindakan phlebotomy bukan bagian dari kompetensi analis kesehatan sehingga pelaksanaan pengambilan darah (

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Friday, March 4, 2011

Aspects of Medikolegal Phlebotomy for Analyst

INTRODUCTION Aspect Medikolegal Phlebotomi For Health Analyst Phlebotomy associated with activities to get blood from a patient's specimen to be inspected in the laboratory. In Phlebotomy action, a blood phlebotomys need to know what's going to take, what equipment will be used, which took anatomy section, there iv-line is already installed, how to prevent infection, how to prevent or reduce pain, how to communicate well with patients including obtaining consent, how can the correct procedures for proper implementation of the vein and the factor of safety (safety). Therefore, medikolegal problem that can be drawn are: 1. Matter who the implementing phlebotomy (competence and authority). 2. How standart procedure. 3. Should supervision. 4. Who is responsible for the risks that occur. In practice, phlebotomy in the hospital or in the laboratory can be performed by nurses or laboratory analyst, or a person specially trained for it (phelebotomys). Ability or competence of a person obtained from education or training, while the authority or the authority obtained from the authorities or authorities in the field through licensing. The authority is only given to those who have the ability, but the capability does not mean by itself has the authority. As doctors, nurses and midwives, competence in performing phlebotomy action has had, and authority to do it too has had, without explicitly mentioned in the certification of competency and or permit the practice of his profession. As for laboratory analysts and technicians phlebotomys their competence derived from secondary education or training, or courses, so that competence should be explicitly stated in the certificate of competency. Certificates of competency shall be issued by an accredited educational institution, or by a particular certification agency. Education and phlebotomys laboratory analyst is not education nor vocational education profession. The legislation in Indonesia is not regulated as a health worker called phlebotomys technician, technician phlebotomys therefore not valid as one health worker. There is a tendency that a worker in the field of health will be more easily recognized as a health worker if his education at least reach the D III. This needs to be done in order to secure the interests of consumer health and safety. Mean while, health analysts had a health worker as stipulated in Regulation 32 of 1996 on health personnel, although there has been no further regulation of health minister that govern it, especially those associated with the authority to do phlebotomy. Thus, the authority conducted by qualified health analyst phlebotomys or not yet recognized as an independent authority, but should be regarded as an authority that requires the supervision of a professional who became "giver works" as the person replied. Work ethics and standards must be established, governed and enforced by the insurer replied. According to Law No.20 of 2003 on National Education System, stated that: Certificate of competency granted by the education and training institutions to students and community members in recognition of the competence to perform a specific job after graduation competency test conducted by an accredited educational unit or certification bodies (Article 61 paragraph 3). Then in the explanation of article 15 states that professional education is the highest education after an undergraduate program that prepares with special education skill requirements are higher education vocational education that prepares students to have jobs with specific applied skills equivalent to the maximal degree program. Professional Ethics and Professional Standards Professional ethics are made by professional organizations, or rather the profession, to set the attitude members, mainly concerned with morality. Professional ethics in the health sector based provisions - provisions in it to the general ethics and nature - the specific nature of morality in general therapeutic professions, such as patient autonomy, beneficence, non maleficence, justice, truth telling, privacy, confidentiality, loyality, etc.. Professional ethics aims to maintain professional dignity and protect the people associated with the profession. Professional ethics are generally written in the form of codes of ethics and its implementation monitored by an Assembly or of the Honorary Board of Ethics. Professional Standards consists of 3 parts, namely: a. Competency standards that have been discussed above as part of the requirements of the profession. b. Standards of behavior that most regulated in the code of ethics. c. Service standards. Standards of service in the Health Act referred to as the professional standards, defined as the guideline to be used as a guide in conducting a good profession. Law no. 18 year 2002 on Science and Technology Advisory Council explained that the Code of Conduct established by the Organization of the profession to uphold the ethical, professional activities and assess violations of the profession that can harm the public or professional life in their environment (Article 25). The provisions in this paragraph is intended to provide a foundation in the field of profession to ensure the protection of the public on professional execution irregularities. BASIC 1. From the medicolegal aspect that the implementation of blood sampling (phlbotomy) has not been set explicitly via regulation of health minister or Health Act so that health analysts do not have the authority in an attempt phlebotomys and not part of the competence of health care analyst. 2. Doctors, nurses and midwives, a health worker has been given the authority and competence phlebotomy as part of the invasive action against the patient. Thus physicians, nurses, midwives have been given the authority to do phlebotomy. 3. Whereas in the provision of health care analyst SSKNI (Indonesian National Competency Standard Work) Analyst health by BNSP (National Agency for Professional Standards) and LSP Telapi (Manpower Professional Certification Institute Pathology Laboratory of Indonesia) as a health analyst certification standards bodies do not include phlebotomy as part of the competence of health analyst . 4. Health workers who make mistakes or omissions Dlm perform their duties subject to disciplinary action interchangeable. Health workers who perform duties not in accordance with relevant professional standards. Subject to disciplinary action (psl. 53 paragraph Kes Act. 23 th 1992) 5. PP 32 YEAR 1996, THE POWER OF HEALTH, 6. Law no. 20 of 2003 on National Education System Article 61 paragraph 3 7. Act No, 18 in 2002. about science and technology article 25.

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TAKING INTO ACCOUNT 1. Standard job descriptions of work an analyst in the daily duties required to perform sample analysis in a professional and accountable (precision and high acurasi) 2. Hospital Accreditation guidance in 2010 recommended that health analyst job description that requires the analyst to work in accordance with their respective competence, and concentration of business analysis to avoid any mistakes. 3. Needs of health analyst in hospital accreditation standards are lacking (not enough) 4. The need for efficiency and alignment tasks in accordance Auth health analyst

BELI

Conclude 1. Phlebotomy action is not part of analyst competence of health so that the implementation of blood collection (phlebotomy) which is currently carried out by health analyst at RSKD health but not our task is an additional duty to help nurses and midwives space limitations. (In case the health analysts must have a certificate of phlebotomy and get authority of leadership) 2. The health analyst in accordance with tupoksinya analyzing clinical samples, has no obligation in performing the blood sampling to the rooms. 3. The need to provide a clear understanding to the doctor, nurse, midwife that taking blood into the patient (plebotomy) is part of tupoksinya. (Similar to other invasive measures of patient). 4. That the charges against 24-hour fully plebotomy by health analysts do not have any legal basis (legal aspects) so that the future should all blood sampling (plebotomy) returned to the doctor, nurse, midwife room each according tupoksinya.

POSTING TIME 2013 (1) 2012 (2) t 2011 (8) October 2011 (1) May 2011 (1) April 2011 (1)

Aberdeen, June 2010, Adapted by;

t March 2011 (3) Aspects of Medikolegal Phlebotomy for Analyst

Amat Rajasa S.Si. www.labclinic-e-quipment.com Sources and / Literature: http://www.freewebs.com/phlebotomy, Budi Sampurna Link to Http://labclinic-e-quipment.com post by labclinic di 2:12 AM

phlebotomy ditinjau sebagai aspek legalitas bagi a...



phlebotomy ditinjau sebagai aspek legalitas bagi a...

Wednesday, March 2, 2011

phlebotomy ditinjau sebagai aspek legalitas bagi analis kesehatan PENDAHULUAN Aspek Medikolegal Phlebotomi Bagi Analis Kesehatan Phlebotomi berkaitan dengan kegiatan mendapatkan specimen darah dari pasien untuk diperiksa secara laboratorium. Didalam tindakan Phlebotomi, seorang phlebotomis perlu mengetahui darah apa yang akan diambil, perlatan apa yang akan dipakai, dibagian anatomi mana mengambilnya, adakah iv-line yang sudah terpasang, bagaimana mencegah infeksi, bagaimana mencegah atau mengurangi rasa sakit, bagaimana berkomunikasi yang baik dengan pasien termasuk memperoleh persetujuannya, bagaimana prosedur pelaksanaan yang benar agar tepat mengenai vena dan factor keselamatan (safety). Oleh sebab itu, masalah medikolegal yang dapat ditarik adalah : 1. Masalah siapa pelaksana phlebotomy (kompetesi dan wewenang). 2. Bagaimana prosedur standartnya. 3. Perlukah supervise. 4. Siapa yang bertanggung jawab atas resiko yang terjadi. Didalam praktek, phlebotomy diRumah Sakit atau di Laboratorium dapat dilakukan oleh perawat atau analis laboratorium, atau orang yang khusus dilatih untuk itu (phelebotomis). Kemampuan atau kompetensi diperoleh seseorang dari pendidikan atau pelatihannya, sedangkan wewenang atau authority diperoleh dari penguasa atau pemegang otoritas dibidang tersebut melalui pemberian izin. Kewenangan hanya diberikan kepada mereka yang memiliki kemampuan, namun adanya kemampuan tidak berarti dengan sendirinya memiliki kewenangan. Sebagai dokter, perawat dan bidan, kompetensi dalam melakukan tindakan phlebotomy telah dimilikinya, dan kewenangan melakukannya pun telah dimilikinya, tanpa disebutkan secara eksplisit didalam sertifikasi kompetensinya dan atau surat izin praktek profesinya. Sedangkan bagi analis laboratorium dan teknisi phlebotomis kompetensi mereka diperoleh dari pendidikan menengah atau pelatihan, atau kursus, sehingga kompetensinya harus dinyatakan secara tegas didalam sertifikat kompetensinya. Sertifikat kompetensi tersebut harus dikeluarkan oleh lembaga pendidikan yang terakreditasi, atau oleh lembaga sertifikasi tertentu. Pendidikan analis laboratorium dan phlebotomis bukanlah pendidikan profesi bukan pula pendidikan vokasi.

February 2011 (2)

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Dalam peraturan perundang-undangan di Indonesia belum diatur tenaga kesehatan yang disebut sebagai teknisi phlebotomis, oleh karena itu teknisi phlebotomis belum sah sebagai salah satu tenaga kesehatan. Ada kecenderungan bahwa suatu pekerja dibidang kesehatan akan lebih mudah diakui sebagai tenaga kesehatan apabila pendidikannya setidaknya mencapai D III. Hal ini perlu dilakukan agar konsumen kesehatan terjamin kepentingan dan keselamatannya. Sementara itu analis kesehatan telah merupakan tenaga kesehatan sebagaimana diatur dalam PP 32 Tahun 1996 tentang tenaga kesehatan, meskipun belum ada Permenkes yang mengaturnya lebih lanjut, terutama yang berkaitan dengan kewenangannya melakukan phlebotomy. Dengan demikian kewenangan yang dilakukan oleh teknisi phlebotomis ataupun analis kesehatan belum diakui sebagai suatu kewenangan yang mandiri, namun harus dianggap sebagai kewenangan yang memerlukan supervisi dari keprofesian yang menjadi “pemeberi kerjanya” sebagai penanggung jawabnya. Etika dan standart pekerjaannya pun harus ditetapkan, diatur dan ditegakkan oleh penanggung jawabnya. Menurut UU No.20 Tahun 2003 tentang Sistem Pendidikan Nasional, disebutkan bahwa : Sertifikat kompetensi diberikan oleh penyelenggara pendidikan dan lembaga pelatihan kepada peserta didik dan warga masyarakat sebagai pengakuan terhadap kompetensi untuk melakukan pekerjaan tertentu setelah lulus uji kompetensi yang diselenggarakan oleh satuan pendidikan yang terakreditasi atau lembaga sertifikasi (Pasal 61 ayat 3). Lalu dalam penjelasan pasal 15 disebutkan bahwa pendidikan profesi merupakan pendidikan tertinggi setelah program sarjana yang mempersiapkan dengan persyaratan keahlian khusus.Pendidikan vokasi merupakan pendidikan tinggi yang mempersiapkan pendidikan peserta didik untuk memiliki pekerjaan dengan keahlian terapan tertentu maximal setara dengan program sarjana. Etika Profesi dan Standar Profesi Etika profesi dibuat oleh organisasi profesi, atau tepatnya masyarakat profesi, untuk mengatur sikap dan tingkah lakupara anggotanya, terutama berkaitan dengan moralitas. Etika profesi di bidang kesehatan mendasarkan ketentuan – ketentuan di dalamnya kepada etika umum dan sifat – sifat khusus moralitas profesi pengobat pada umumnya, seperti patient autonomy, beneficence, non maleficence, justice, truth telling, privacy, confidentiality, loyality,dll. Etika profesi bertujuan untuk mempertahankan keluhuran profesi dan melindungi masyarakat yang berhubungan dengan profesi tersebut. Etika profesi umumnya dituliskan dalam bentuk Kode etik dan pelaksanaanya diawasi oelh sebuah Majelis atau Dewan Kehormatan Etik. Standar Profesi terdiri dari 3 bagian, yaitu : a. Standar kompetensi yang telah dibahas diatas sebagai bagian dari persyaratan profesi. b. Standar perilaku yang sebagian diatur dalam kode etik. c. Standar pelayanan. Standar pelayanan yang dalam UU Kesehatan disebut sebagai standar profesi, diartikan sebagai pedoman yang harus dipergunakan sebagai petunjuk dalam menjalankan profesi secara baik. UU No. 18 tahun 2002 tentang IPTEK menjelaskan bahwa Dewan Kehormatan Kode Etik dibentuk oleh Organisasi profesi untuk menegakkan etika, pelaksanaan kegiatan profesi serta menilai pelanggaran profesi yang dapat merugikan masyarakat atau kehidupan profesionalisme dilingkungannya (Pasal 25). Ketentuan dalam ayat ini dimaksudkan untuk memberikan landasan dibidang profesi untuk menjamin perlindungan masyarakat atas penyimpangan pelaksanaan profesi.

DASAR 1. Dari aspek medicolegal bahwa pelaksanaan pengambilan darah (phlbotomy ) belum diatur secara explisit melalui permenkes atau UU Kesehatan sehingga analis kesehatan tidak memiliki kewenangan dalam usaha phlebotomis dan bukan bagian dari kompetensi analis kesehatan. 2. Dokter, perawat dan bidan, merupakan tenaga kesehatan yang diberikan kewenangan dan telah memiliki kompetensi phlebotomy sebagai bagian dari tindakan invasive terhadap pasiennya. Dengan demikian dokter, perawat, bidan telah diberi kewenangan melakukan phlebotomy. 3. Bahwa analis kesehatan dalam ketentuan SSKNI( Standart Kerja Kompetensi Nasional Indonesia ) Analis kesehatan oleh BNSP ( Badan Nasional Standar Profesi ) dan LSP Telapi (Lembaga Sertifikasi Profesi Tenaga Laboratorium Patologi Indonesia) sebagai badan standar sertifikasi analis kesehatan tidak menyertakan phlebotomy sebagai bagian dari kompetensi analis kesehatan. 4. Nakes yang melakukan kesalahan atau kelalaian dlm melaksanakan tugasnya dpt dikenakan tindakan disiplin. Nakes yang melaksanakan tugas tidak sesuai dgn standar profesi ybs. Dikenakan tindakan disiplin (psl. 53 ayat UU Kes. No.23 th 1992) 5. PP 32 TAHUN 1996, TENTANG TENAGA KESEHATAN, 6. UU No. 20 Tahun 2003 tentang Sistim Pendidikan Nasional Pasal 61 ayat 3 7. UU No, 18 tahun 2002. tentang IPTEK pasal 25.

MEMPERHATIKAN 1. Uraian tugas standar pekerjaan seorang analis dalam tugasnya sehari hari dituntut untuk melakukan analisa sampel secara profesional dan akuntabel ( presisi dan acurasi yang tinggi ) 2. Bimbingan Akreditasi RS tahun 2010 merekomendasikan uraian pekerjaan analis kesehatan yang mengharuskan analis bekerja sesuai dengan kompetensi masingmasing, dan konsentrasi terhadap urusan analisa untuk menghindari adanya kesalahan . 3. Kebutuhan tenaga analis kesehatan yang secara standar akreditasi RS masih kurang (belum cukup) 4. Perlunya efesiensi dan penyelarasan tugas analis kesehatan sesuai Tupoksi

MENYIMPULKAN 1. Tindakan phlebotomy bukan bagian dari kompetensi analis kesehatan sehingga pelaksanaan pengambilan darah (phlebotomy) yang saat ini dilakukan oleh analis kesehatan di RSKD bukan tugas analis kesehatan tetapi merupakan tugas tambahan untuk membantu keterbatasan perawat dan bidan ruangan. (Dalam hal tersebut Analis kesehatan harus telah memiliki sertifikat phlebotomy dan mendapat kewenawangan dari pimpinan) 2. Bahwa analis kesehatan sesuai dengan tupoksinya menganalisa sampel klinik, tidak memiliki keharusan dalam melaksanakan pengambilan darah ke ruangan-ruangan . 3. Perlunya memberikan pemahaman yang jelas kepada Dokter, perawat, Bidan bahwa pengambilan darah ke pasien ( plebotomy) merupakan bagian dari tupoksinya. ( sama dengan tindakan invasif lainnya terhadap pasien). 4. Bahwa tuntutan terhadap plebotomy sepenuhnya 24 jam oleh analis kesehatan tidak memiliki dasar hukum ( aspek legalitas ) sehingga ke depan sebaiknya semua pengambilan sampel darah (plebotomy) dikembalikan kepada Dokter, perawat, bidan ruangan masing-masing sesuai tupoksinya.

Balikpapan, Juni 2010, Disadur oleh ; Amat Rajasa, S.Si. Sumber dan/Pustaka : http://www.freewebs.com/phlebotomy, Link to Http://labclinic-e-quipment.com post by labclinic di 11:53 PM



phlebotomy ditinjau sebagai aspek legalitas bagi analis kesehatan Link to Http://labclinic-e-quipment.com post by labclinic di 11:51 PM

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