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  example, poisonings, burns, and self-inflicted cuts  Therapeutic procedure accidents occur during the delivery of medical or nursing interventions  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

HostLingkunganAgent

 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