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Anita Apriliawati
 Safe
care is a basic need of all clients
 Nurses
are responsible for providing the
client with a safe environment through the
delivery of professional, quality nursing care
that incorporates safety precautions,
infection control practices, and hygiene
assistance.
 Diasosiasikan
secara positif dengan promosi
kesehatan dan pencegahan
 Lingkungan
yang aman menurunkan angka
kecelakaan, gangguan kesehatan dan gaya
hidup serta biaya pelayanan kesehatan
 Age
 Lifestyle
 Sensory
and Perceptual Alteration
 Mobillty
 Emotional
State
In the health care setting:
 Client behavior accidents


Therapeutic procedure accidents occur during
the delivery of medical or nursing interventions


example, poisonings, burns, and self-inflicted cuts
For example, medication errors, client falls during
transfers, contamination of sterile instruments or
wounds
Equipment accidents result from the
malfunction or improper use of medical
equipment

for example, electrocution and fire.
 Nurses
and other health care providers are at
risk for injury in the workplace.
 Example






:
latex allergy
blood-borne pathogens
work-related musculoskeletal disorders (MSDs)
Chemotherapeutic agents
Environmental pollution
Violence (kekerasan)

Client safety in the health care environment requires
the reduction of microorganism transmission.

Infection control practices are directed at controlling
or eliminating sources of infection in the health care
agency or home.

Nurses are responsible for protecting clients and
themselves by using infection control practices.

Nurses and clients must be educated on the types of
infections, modes of transmission, risks for
susceptibility, and infection control practices
required to control or prevent further transmission.
Beberapa istilah dalam pengontrolan infeksi :
 Pathogenicity (kemampuan MO
menimbulkan penyakit)
 pathogen
 Virulence (derajat patogenitas)
 Infection
 infectious agents.
 Communicable agents.
 communicable diseases.
 Colonization
Host
Agent
Lingkungan
 Biological
agents: bacteria, viruses, fungi,
protozoa, and Rickettsia
 Chemical
agents: pesticides, food additives,
medications, and industrial chemicals
 Physical
agents: Factors in the
environment that are capable of causing
disease, such as heat, light, noise, radiation,
and machinery
 organism


that can be affected by an agent
Individu yang rentan (susceptible host)
Individu yang normal (compromised host)
 Environmental








factors
Water
food,
plants,
animals,
housing conditions,
noise,
Meteorological conditions,
environmental chemicals
 Contact
transmission
 Airborne transmission


Droplet
udara
 Vehicle
transmission (melalui objek)
 Vectorborne transmission (melalui binatang
spt lalat, nyamuk dll)
 Infectious



Agent
Cleaning
Desinfection
Sterilization
 Reservoir
or Source (tempat / sumber)
Hygiene
 Dressing changes
 Disposal of fluid container
 Change soiled linen (ganti alas tempat tidur
kotor)


Portal of Exit from Reservoir or Source (keluar
dari sumber infeksi)
Clean dressing over wounds (perawatan luka)
 Cover mouth and nose when coughing or sneezing


Mode of transmission (cara transmisi)




Handwashing
pembuangan objek yang terkontaminasi dengan benar
medical or surgical sepsis (tehnik sepsis dalam medikal
bedah)
Menggunakan sarung tangan, masker, gown & goggle
 Portal


of Entry to Host (masuk kedalam host)
Gunakan jarum disposible
Tehnik steril
 Susceptible




Host (host yang rentan)
Integritas kulit
Nutrisi yang simbang
Latihan gerak
Sistem imun yang baik
 Kulit
dan flora normal
 Membran mukosa
 Reflek bersin dan batuk, air mata
 Eliminasi dan keasaman
 Inflamasi (respon terhadapinfeksi)
 Merupakan
infeksi yang didapat dirumah
sakit atau layanan kesehatan lainnya
 Bisa juga timbul gejala saat pasien sudah
pulang
 Most nosocomial infections are transmitted
by health care personnel who fail to practice
proper hand washing procedures or change
gloves between client contacts.
Riwayat keperawatan
 Pemeriksaan fisik






Level of consciousness: Use the Glasgow Coma Scale
Range of motion or total immobilization of an extremity.
Localized infection: Redness, swelling, warmth, pain,
and loss of movement in a specific body part.
Systemic infection: Fever, with a corresponding increase
in pulse and respirations; weakness; anorexia, with
possible accompanying findings of nausea, vomiting, and
diarrhea; enlarged and/or tender lymph nodes
Secretions or exudate of the skin or mucous membranes
and detection of crackles, rhonchi, or wheezes in the
lungs on auscultation.

Pemeriksaan laboratorium
 An elevated leukocyte (white blood cell [WBC])
and WBC differential:
Neutrophils: Increased in acute, severe
inflammation
 Lymphocytes: Increased in chronic bacterial and
viral infections
 Monocytes: Increased in some protozoan and
rickettsial infections and tuberculosis
 Eosinophils and basophils: Unaltered in an
infectious process


An elevated erythrocyte sedimentation rate
(ESR): Increased in the presence of
inflammation
 Pemeriksaan



laboratorium
An elevated erythrocyte sedimentation rate
(ESR): Increased in the presence of inflammation
An elevated pH of involved body fluids (gastric,
urine, or vaginal secretions): Indicates the
presence of microorganisms
Positive cultures of involved body fluids
(blood, sputum, urine, or other drainage):
Indicates the growth of microorganisms
 Risiko
injury
 Defisit perawatan diri
 Gangguan keseimbangan nutrisi : kurang dari
kebutuhan tubuh
 Gangguan integritas kulit
 Isolasi sosial
 Koping individu tidak efektif
 Gangguan mobilitas fisik
 Kurang pengetahuan
 Cemas
 Nyeri
Ny. W, 50 tahun dirawat dengan ca.mamae stadium
III. Saat dilakukan pengkajian, Ny W tidak sadar
dengan posisi supine, terpasang oksigen dengan
nasal kanul, terpasang infus dilengan kanan,
terpasang NGT, untuk memfasilitasi fungsi
eliminasi Ny W terpasang pempers. Tanda vital :
TD 110/90 mmHg, suhu 38C, Nadi 100x/menit, RR
23x/menit. Menurut keluargannya yang menunggu,
Ny W sudah 2 hari ini hanya dimandikan sebagian,
sudah 1 mgg belum keramas. Rambut dan kulit
tampak kotor, berminyak dan bau. Di Payudara kiri
tampak luka kanker dengan kondisi luka bernanah,
bengkak, dan berbau. Klien telah menjalani 1 kali
kemoterapi