Sambutan Menteri Kesehatan

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\pard\sb0\sl-240{\bkmkstart Pg1}{\bkmkend
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\par\pard\ql \li5368\sb33\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs24 Kata Pengantar\par\pard\qj \li2460\sb0\sl-
275\slmult0 \par\pard\qj \li2461\ri1809\sb9\sl-275\slmult0\fi720 \up0 \expndtw-
8\charscalex77 \ul0\nosupersub\cf2\f3\fs20 Penyebaran HIV/AIDS merupakan salah
satu masalah kesehatan utama di \line \up0 \expndtw-8\charscalex74 Indonesia,
terutama karena adanya kecenderungan peningkatan prevalensi masalah tersebut
\line \up0 \expndtw-8\charscalex78 dari waktu ke waktu. Sejak tahun 2000 Indonesia
dikategorikan sebagai negara dengan \line \up0 \expndtw-8\charscalex74 tingkat
epidemi HIV/AIDS terkonsentrasi karena terdapat daerah-daerah dengan prevalensi
\line \up0 \expndtw-8\charscalex78 HIV/AIDS lebih dari 5% pada beberapa populasi
tertentu. Sekalipun penyebaran virus \line \up0 \expndtw-8\charscalex79 terjadi
melalui berbagai cara, namun kasus-kasus baru sejak lima tahun terakhir di \line
\up0 \expndtw-8\charscalex77 kota/propinsi tertentu lebih banyak disumbangkan oleh
populasi pengguna napza suntik \line \up0 \expndtw-9\charscalex76
(penasun).\par\pard\qj \li2461\ri1809\sb0\sl-275\slmult0\fi720 \up0 \expndtw-
9\charscalex85 Program pengurangan dampak buruk (harm reduction HR) khususnya yang
\up0 \expndtw-8\charscalex76 berkaitan dengan penggunaan napza suntik terutama
ditujukan bagi pengendalian epidemi \up0 \expndtw-8\charscalex74 HIV. Program ini
di Indonesia telah dilaksanakan sejak 1998. Selama hampir satu dekade, \up0
\expndtw-8\charscalex76 inisiatif tersebut telah berkembang, baik ragam kegiatan
maupun wilayah kerjanya. Di \up0 \expndtw-8\charscalex78 sejumlah wilayah,
pemerintah lokal berupaya keras untuk dapat mengendalikan epidemi \up0 \expndtw-
9\charscalex73 dengan melaksanakan kegiatan-kegiatan intervensi kepada
penasun.\par\pard\qj \li2460\ri1810\sb0\sl-275\slmult0\fi720 \up0 \expndtw-
8\charscalex81 Hingga saat ini layanan kesehatan bagi penasun, termasuk layanan-
layanan \line \up0 \expndtw-8\charscalex72 penyediaan jarum alat suntik steril,
terapi substitusi dengan rumatan oral metadon, serta \line \up0 \expndtw-
8\charscalex74 pengobatan dan perawatan HIV terus diintegrasikan ke dalam sistem
kesehatan masyarakat. \line \up0 \expndtw-8\charscalex80 Dengan dikeluarkannya
Permenko Kesra No. 02 tahun 2007 tentang Kebijakan Nasional \line \up0 \expndtw-
8\charscalex84 Penanggulangan HIV dan AIDS Melalui Pengurangan Dampak Buruk
Penggunaan Napza \line \up0 \expndtw-8\charscalex81 Suntik, integrasi ini
memberikan kesempatan kepada pemerintah bersama masyarakat \line \up0 \expndtw-
8\charscalex74 secara lebih meluas dalam melindungi dari dampak sosial dan
kesehatan penggunaan napza. \line \up0 \expndtw-8\charscalex75 Kebijakan pemerintah
pusat, integrasi layanan pengurangan dampak buruk ke dalam sistem \line \up0
\expndtw-8\charscalex77 kesehatan masyarakat, serta penguatan dukungan kepada
pengguna Napza merupakan bekal \line \up0 \expndtw-8\charscalex77 untuk mengatasi
hambatan serta meningkatkan cakupan layanan program demi terciptanya \line \up0
\expndtw-8\charscalex80 lingkungan yang kondusif bagi layanan pengurangan dampak
buruk di Indonesia. Bila \line \up0 \expndtw-8\charscalex82 menilik pada estimasi
jumlah penasun yang terinfeksi HIV berdasarkan Departemen \line \up0 \expndtw-
8\charscalex80 Kesehatan dan Komisi Penanggulangan AIDS Nasional (KPAN) pada tahun
2006 sebanyak \line \up0 \expndtw-8\charscalex78 90,030 orang, tampaknya penularan
infeksi HIV di kalangan penasun belum menunjukkan \line \up0 \expndtw-
8\charscalex82 penurunan yang signifikan. Oleh karena itu diperlukan perluasan
program layanan \line \up0 \expndtw-8\charscalex74 pengurangan dampak buruk bagi
penasun di Puskemas dan institusi layanan kesehatan dasar \line \up0
\expndtw0\charscalex64 lainnya.\par\pard\ql \li6109\sb0\sl-230\slmult0 \par\pard\ql
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276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 Sambutan
Menteri Kesehatan\par\pard\qj \li11814\sb0\sl-290\slmult0 \par\pard\qj
\li21\ri811\sb12\sl-290\slmult0\fi720 \up0 \expndtw-8\charscalex73
\ul0\nosupersub\cf2\f3\fs20 Dua dekade telah berlalu sejak pertama kali negara kita
melaporkan temuan kasus \up0 \expndtw-8\charscalex75 HIV/AIDS pertama kali di Bali.
Sejak itu berbagai upaya telah dicanangkan secara terus \up0 \expndtw-
8\charscalex82 menerus. Pada pertengahan tahun 1990 terlihat ada perubahan pola
penularan pada \up0 \expndtw-8\charscalex75 permasalaahan HIV/AIDS di Indonesia.
Pola penularan yang tadinya didominasi oleh jalur \up0 \expndtw-8\charscalex77
transmisi seksual, berubah dengan dominasi penularan melalui penggunaan jarum
suntik \up0 \expndtw-9\charscalex70 tidak steril pada kalangan pengguna Napza
suntik.\par\pard\qj \li21\ri811\sb1\sl-290\slmult0\fi720 \up0 \expndtw-
8\charscalex80 Sebagai leading sektor dalam penanggulangan HIV/AIDS Nasional,
Departemen \line \up0 \expndtw-8\charscalex78 Kesehatan terus menerus berupaya
memberikan arahan dan dukungan langsung baik dalam \line \up0 \expndtw-
8\charscalex84 pengembangan program dan layanan, ataupun penguatan terhadap upaya-
upaya yang \line \up0 \expndtw-8\charscalex86 tengah dilakukan dalam
penanggulangan HIV/AIDS, termasuk dalam upaya \line \up0 \expndtw-
8\charscalex81 penanggulangan HIV/AIDS pada pengguna Napza suntik yang dikenal juga
dengan Harm \line \up0 \expndtw-9\charscalex79 Reduction.\par\pard\qj
\li21\ri811\sb1\sl-290\slmult0\fi720 \up0 \expndtw-8\charscalex82 Sejak tahun 2002,
Departemen Kesehatan Republik Indonesia dalam Rencana \up0 \expndtw-8\charscalex77
Strategi Nasional Penanggulangan HIV/AIDS telah menyebutkan secara eksplisit
tentang \up0 \expndtw-8\charscalex78 penerapan Pengurangan Dampak Buruk Napza
suntik sebagai salah satu strategi penting \up0 \expndtw-8\charscalex83 untuk
penanggulangan HIV/AIDS Nasional. Untuk itu Departemen Kesehatan bekerja \up0
\expndtw-8\charscalex75 dengan berbagai lembaga swadaya masyarakat di tingkat
Nasional dan lokal, serta dengan \up0 \expndtw-8\charscalex81 dukungan lembaga
lembaga Internasional lainnya, berusaha memenuhi kebutuhan para \up0 \expndtw-
8\charscalex74 pelaksana di lapangan terhadap pedoman, panduan ataupun referensi
lainnya agar kualitas \up0 \expndtw-9\charscalex72 pelaksanaan program di lapangan
terus menerus dapat ditingkatkan.\par\pard\qj \li20\ri812\sb0\sl-
290\slmult0\fi720 \up0 \expndtw-9\charscalex77 Penerbitan \up0 \expndtw-
9\charscalex78 4 buku pedoman sekaligus rujukan dalam pengembangan dan \line
\up0 \expndtw-8\charscalex79 pengelolaan program HIV/AIDS khususnya pada pengguna
Napza suntik pada tahun 2005, \line \up0 \expndtw-8\charscalex81 dilanjutkan dengan
penegasan posisi Departemen Kesehatan melalui Surat Keputusan \line \up0 \expndtw-
8\charscalex81 Menteri Kesehatan yang dijadikan sebagai Buku Pedoman Pelaksanaan
Penanggulangan \line \up0 \expndtw-8\charscalex82 HIV/AIDS pada pengguna Napza
Suntik pada tahun 2006, telah memberikan arah yang \line \up0 \expndtw-
8\charscalex77 semakin jelas terkait dengan bagaimana seharusnya upaya besar
berjalan. Buku pedoman \line \up0 \expndtw-8\charscalex72 dan rujukan tersebut
telah menjadi acuan penting dalam pelaksanaan program selama ini.\par\pard\qj
\li20\ri812\sb6\sl-317\slmult0\fi720 \up0 \expndtw-8\charscalex75 Terima kasih dan
penghargaan bagi semua pihak yang telah aktif terlibat dalam \up0 \expndtw-
9\charscalex76 penyusunan buku ini.\par\pard\ql \li15410\sb0\sl-230\slmult0
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\ul0\nosupersub\cf3\f4\fs20 iii
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eeda38ccf3485171f7256917749f749bf9a3192b36af7b36bee6145145311fffd9}}}}}
lsr160\qj \li2461\sb0\sl-303\slmult0 \par\pard\qj \li2461\ri1810\sb269\sl-
303\slmult0\fi720 \up0 \expndtw-8\charscalex100 \ul0\nosupersub\cf4\f5\fs20 Seiring
dengan berkembangnya kapasitas dan upaya untuk peningkatan kualitas \line \up0
\expndtw-8\charscalex95 layanan terkait HIV/AIDS di Unit Pelayanan Teknis dalam
sistem kesehatan yang ada, maka \line \up0 \expndtw-8\charscalex95 dalam beberapa
tahun terakhir sebagian Pusat Kesehatan Masyarakat telah mulai dilibatkan \line
\up0 \expndtw-6\charscalex100 secara intensif dalam program penanggulangan
HIV/AIDS. Program ini diterapkan oleh \line \up0 \expndtw-7\charscalex100 banyak
Puskesmas terutama di wilayah-wilayah dengan konsentrasi masalah pengguna \line
\up0 \expndtw-6\charscalex100 Napza suntik yang tinggi. Dalam waktu ke depan akan
dikembangkan secara bertahap \line \up0 \expndtw-4\charscalex100 untuk wilayah-
wilayah lainnya yang memerlukan. Untuk itu, kami menyambut dengan \line \up0
\expndtw-8\charscalex95 baik uapay terbitnya buku Pedoman Prosedur Pelaksanaan
Program Pengurangan Dampak \line \up0 \expndtw-7\charscalex100 Buruk bagi pengguna
Napza suntik berbasis Puskesmas. Diharapkan buku Pedoman ini \line \up0 \expndtw-
8\charscalex93 akan dapat menjadi acuan bagi para pelaksana lapangan, khususnya
sumber daya manusia di \line \up0 \expndtw-8\charscalex92 tingkat Pusat Kesehatan
Masyarakat yang sudah dan akan mengembangkan layanan serupa.\par\pard\qj
\li6795\sb0\sl-258\slmult0 \par\pard\qj \li6795\sb0\sl-258\slmult0 \par\pard\qj
\li6795\sb0\sl-258\slmult0 \par\pard\qj \li6795\ri2846\sb130\sl-258\slmult0\fi0
\up0 \expndtw-9\charscalex93 Jakarta, Nopember 2008 \line \up0 \expndtw-
9\charscalex96 Menteri Kesehatan RI\par\pard\ql \li6795\sb0\sl-230\slmult0
\par\pard\ql \li6795\sb0\sl-230\slmult0 \par\pard\ql \li6795\sb0\sl-230\slmult0
\par\pard\ql \li6795\sb109\sl-230\slmult0 \up0 \expndtw-9\charscalex94 Dr. dr. Siti
Fadilah Supari, Sp.JP(K)\par\pard\ql \li6058\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf3\f4\fs20 iv\par\pard\column \qj \li11815\sb0\sl-258\slmult0
\par\pard\qj \li11815\sb0\sl-258\slmult0 \par\pard\qj \li20\ri811\sb93\sl-
258\slmult0\fi720 \up0 \expndtw0\charscalex107 \ul0\nosupersub\cf4\f5\fs20 Pada
tahun \up0 \expndtw0\charscalex115 2006 melalui Keputusan Menteri Kesehatan
No \line \up0 \expndtw-6\charscalex100 567/Menkes/SK/VIII/2006 telah ada Pedoman
Pelaksanaan Penanggulangan HIV/AIDS \line \up0 \expndtw-3\charscalex100 pada
Pengguna Napza Suntik yang menjadi acuan bagi institusi kesehatan, institusi
\line \up0 \expndtw-4\charscalex100 pemerintah maupun non pemerintah yang terkait
dengan penanggulangan HIV/AIDS, \line \up0 \expndtw-4\charscalex100 Lembaga Swadaya
Masyarakat (LSM) ataupun masyarakat yang akan melaksanakan \line \up0 \expndtw-
8\charscalex100 pencegahan penularan HIV pada kelompok Penasun. Sedangkan buku ini
adalah sebuah \line \up0 \expndtw-7\charscalex100 pedoman prosedur pelaksanaan
program pengurangan dampak buruk bagi penggunaan \line \up0 \expndtw-
1\charscalex100 Napza Suntik di Puskesmas, Di dalamnya tercakup berbagai pedoman
yang dapat \line \up0 \expndtw-5\charscalex100 diterapkan pada institusi layanan
kesehatan dasar, khususnya Puskesmas.. Pedoman \line \up0 \expndtw-7\charscalex100
pelaksanaan yang dimaksud mencakup Layanan Kesehatan Dasar, Layanan Pemulihan \line
\up0 \expndtw-5\charscalex100 Ketergantungan Napza, Layanan Jarum Suntik
Steril, Layanan Konseling Testing \line \up0 \expndtw-4\charscalex100 HIV/AIDS
dan Layanan Terapi Rumatan Metadon. Buku ini secara spesifik menyoroti \line
\up0 \expndtw-8\charscalex96 masalah penggunaan napza suntik, sehingga bersifat
melengkapi buku-buku pedoman lain \line \up0 \expndtw-8\charscalex98 yang telah
ada. Diharapkan buku ini dapat bermanfaat sebagai acuan dalam penanganan \line \up0
\expndtw-9\charscalex92 penasun di tingkat Puskesmas .\par\pard\qj \li11815\sb0\sl-
8\charscalex97 Kami ingin menyampaikan penghargaan yang setinggi-tingginya kepada
segenap \up0 \expndtw-8\charscalex96 pihak baik perorangan maupun lembaga yang
telah berperan serta dalam penyusunan dan \up0 \expndtw-8\charscalex100
penyempurnaan buku ini.\par\pard\qj \li12535\sb0\sl-258\slmult0 \par\pard\qj
\li20\ri811\sb1\sl-258\slmult0\fi720 \up0 \expndtw-8\charscalex98 Tentu saja masih
terbuka banyak ruang untuk perbaikan pada buku pedoman ini. \up0 \expndtw-
8\charscalex94 Karena itu kami harapkan berbagai pihak yang menggunakan atau
menelaah buku pedoman \up0 \expndtw-4\charscalex100 dapat memberikan masukan
agar buku ini dapat disempurnakan sesuai dengan \up0 \expndtw-5\charscalex100
keperluannya. Semoga kehadiran buku pedoman ini memperjelas bagaimana program
\up0 \expndtw-4\charscalex100 penanggulangan HIV/AIDS pada pengguna Napza suntik
berbasis Puskesmas dapat \up0 \expndtw-9\charscalex93 diterapkan dengan lebih baik
di masa mendatang\par\pard\ql \li16874\sb0\sl-258\slmult0 \par\pard\ql
\li16874\sb0\sl-258\slmult0 \par\pard\ql \li5079\ri950\sb1\sl-258\slmult0\fi0
\up0 \expndtw-9\charscalex93 Jakarta, Nopember 2008 \line \up0 \expndtw-
9\charscalex96 Direktur Jenderal PP & PL\par\pard\qj \li16874\sb0\sl-258\slmult0
\par\pard\qj \li16874\sb0\sl-258\slmult0 \par\pard\qj \li16874\sb0\sl-
4\charscalex100 Dr. T.Marwan Nusri, MPH \up0 \expndtw-9\charscalex94 NIP.
140\par\pard\ql \li15431\sb0\sl-230\slmult0 \par\pard\ql \li15431\sb0\sl-
230\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 ii
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\pard\sb0\sl-240{\bkmkstart Pg3}{\bkmkend Pg3}\par\pard\li2461\sb0\sl-
287\slmult0\par\pard\li2461\sb275\sl-287\slmult0\fi2266\tx11815\tx12417 \dn3
\expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs24 DAFTAR KONTRIBUTOR\tab \up0
\expndtw-9\charscalex93 \ul0\nosupersub\cf4\f5\fs20 10.\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Konselor \ul0\nosupersub\cf4\f5\fs20
adalah pemberi pelayanan konseling yang telah dilatih
keterampilan\par\pard\li2461\sb55\sl-230\slmult0\fi9974 \up0 \expndtw-
9\charscalex95 konseling dan dinyatakan
mampu.\par\pard\sect\sectd\sbknone\cols3\colno1\colw5926\colsr160\colno2\colw5579\c
olsr160\colno3\colw8205\colsr160\ql \li2461\sb98\sl-230\slmult0\tx2879 \up0
3\charscalex100 Dr. Sigit Priohutomo, MPH\par\pard\ql \li2461\sb0\sl-230\slmult0
\par\pard\ql \li2461\sb132\sl-230\slmult0\tx2879 \up0 \expndtw-2\charscalex100
2.\tab \up0 \expndtw-2\charscalex100 Drg.Dyah Erty Mustikawati, MPH\par\pard\ql
\li2461\sb0\sl-230\slmult0 \par\pard\ql \li2461\sb131\sl-230\slmult0\tx2879 \up0
\expndtw-2\charscalex100 3.\tab \up0 \expndtw-3\charscalex100 Sisworo Rini,
AKP,M.Kes\par\pard\ql \li2461\sb0\sl-230\slmult0 \par\pard\ql \li2461\sb131\sl-
230\slmult0\tx2879 \up0 \expndtw-2\charscalex100 4.\tab \up0 \expndtw-
3\charscalex100 Dr. Diah Setia Utami, S.pKJ\par\pard\ql \li2461\sb66\sl-
2\charscalex100 Riza Sarasvita, Msi\par\pard\ql \li2461\sb65\sl-
3\charscalex100 Nurjannah, SKM, M.Kes\par\pard\ql \li2461\sb0\sl-230\slmult0
7.\tab \up0 \expndtw-2\charscalex100 Adele Hutapea\par\pard\ql \li2461\sb0\sl-
230\slmult0 \par\pard\ql \li2461\sb132\sl-230\slmult0\tx2878 \up0 \expndtw-
2\charscalex100 8.\tab \up0 \expndtw-3\charscalex100 dr. Tita G
Salim\par\pard\ql \li2461\sb65\sl-230\slmult0\tx2878 \up0 \expndtw-2\charscalex100
9.\tab \up0 \expndtw-4\charscalex100 dr. Fadlina\par\pard\ql \li2461\sb66\sl-
3\charscalex100 dr. Sri Mulyanti\par\pard\ql \li2461\sb65\sl-230\slmult0\tx2878
\up0 \expndtw-9\charscalex100 11.\tab \up0 \expndtw-3\charscalex100 dr. Elizabeth
R\par\pard\ql \li2461\sb66\sl-230\slmult0\tx2878 \up0 \expndtw-4\charscalex100
12.\tab \up0 \expndtw-3\charscalex100 dr. Eka Dewi\par\pard\ql \li2461\sb66\sl-
2\charscalex100 Imanudin\par\pard\ql \li2461\sb65\sl-230\slmult0\tx2878 \up0
\expndtw-7\charscalex100 14.\tab \up0 \expndtw-2\charscalex100 Siti Rama S,
SKM\par\pard\ql \li2461\sb66\sl-230\slmult0\tx2878 \up0 \expndtw-4\charscalex100
15.\tab \up0 \expndtw-3\charscalex100 dr.Remsi M\par\pard\ql \li2461\sb65\sl-
2\charscalex100 Krisnatalina C\par\pard\ql \li2461\sb66\sl-230\slmult0\tx2878
\up0 \expndtw-9\charscalex93 17.\tab \up0 \expndtw-3\charscalex100 Verry
Kamil\par\pard\ql \li2461\sb66\sl-230\slmult0\tx2878 \up0 \expndtw-6\charscalex100
18.\tab \up0 \expndtw-2\charscalex100 Rizky Ika Syafitri\par\pard\ql
\li2461\sb65\sl-230\slmult0\tx2878 \up0 \expndtw-5\charscalex100 19.\tab \up0
\expndtw-3\charscalex100 Muhammad Nasrun\par\pard\ql \li2461\sb66\sl-
3\charscalex100 dr. Robert Kosasih\par\pard\ql \li2461\sb65\sl-
3\charscalex100 dr. Margaretha Sitanggang\par\pard\ql \li2461\sb66\sl-
3\charscalex100 Irawan Afrianto\par\pard\ql \li2461\sb66\sl-230\slmult0\tx2878 \up0
\expndtw-2\charscalex100 23.\tab \up0 \expndtw-3\charscalex100 Audila Fitri
Yani\par\pard\ql \li2461\sb65\sl-230\slmult0\tx2878 \up0 \expndtw-2\charscalex100
24.\tab \up0 \expndtw-2\charscalex100 Ajat\par\pard\ql \li2461\sb66\sl-
2\charscalex100 Risa Alexander\par\pard\ql \li2461\sb65\sl-230\slmult0\tx2878
\up0 \expndtw-2\charscalex100 26.\tab \up0 \expndtw-3\charscalex100 Awied
Wijayanti\par\pard\column \qj \li251\ri3257\sb45\sl-295\slmult0 \up0 \expndtw-
2\charscalex100 Kasubdit AIDS & PMS, \line \up0 \expndtw-2\charscalex100 Ditjen PP
& PL, Depkes\par\pard\qj \li251\ri2978\sb1\sl-295\slmult0 \up0 \expndtw-
2\charscalex100 Kasi Bimbingan & Evaluasi, \up0 \expndtw-2\charscalex100 Ditjen PP
& PL, Depkes\par\pard\qj \li251\ri1898\sb1\sl-295\slmult0 \up0 \expndtw-
3\charscalex100 Subdit Napza, Rokok & Alokohol, Ditjen \up0 \expndtw-
3\charscalex100 Keswa, Depkes\par\pard\qj \li251\ri4132\sb1\sl-295\slmult0\fi0 \up0
\expndtw-2\charscalex100 RSKO Jakarta \line \up0 \expndtw-2\charscalex100 RSKO
Jakarta\par\pard\ql \li251\ri3257\sb0\sl-295\slmult0 \up0 \expndtw-2\charscalex100
Subdit AIDS & PMS, \line \up0 \expndtw-2\charscalex100 Ditjen PP & PL,
Depkes\par\pard\qj \li251\ri1976\sb0\sl-295\slmult0 \up0 \expndtw-3\charscalex100
Subdit RS Pendidikan, Ditjen Yanmedik \up0 \expndtw-2\charscalex100 Spesialistik,
Depkes\par\pard\ql \li251\sb55\sl-230\slmult0 \up0 \expndtw-3\charscalex100
Puskesmas Cilandak\par\pard\qj \li251\ri2946\sb12\sl-295\slmult0\fi0 \up0 \expndtw-
3\charscalex100 Puskesmas Kecamatan Tebet \line \up0 \expndtw-2\charscalex100
Puskesmas Kecamatan Priok\par\pard\qj \li6317\sb0\sl-295\slmult0 \par\pard\qj
\li6317\sb0\sl-295\slmult0 \par\pard\qj \li6317\sb0\sl-295\slmult0 \par\pard\qj
\li251\ri2467\sb2\sl-295\slmult0\fi0 \up0 \expndtw-2\charscalex100 Puskesmas
Kecamatan Jatinegara \up0 \expndtw-3\charscalex100 Puskesmas Kecamatan Kemayoran
\up0 \expndtw-2\charscalex100 Puskesmas Kecamatan Gambir\par\pard\ql
\li251\sb55\sl-230\slmult0 \up0 \expndtw-2\charscalex100 FHI-ASA\par\pard\qj
\li251\ri4541\sb13\sl-295\slmult0\fi0 \up0 \expndtw-2\charscalex100 FHI-ASA
\line \up0 \expndtw-2\charscalex100 FHI-ASA \line \up0 \expndtw-2\charscalex100
HCPI\par\pard\ql \li251\sb54\sl-230\slmult0 \up0 \expndtw-2\charscalex100
HCPI\par\pard\qj \li251\ri4052\sb13\sl-295\slmult0\fi0 \up0 \expndtw-
3\charscalex100 Yayasan Stigma \line \up0 \expndtw-3\charscalex100 Yayasan
Stigma\par\pard\qj \li6317\sb0\sl-295\slmult0 \par\pard\qj \li251\ri3816\sb1\sl-
295\slmult0\fi0 \up0 \expndtw-3\charscalex100 Yayasan Kharisma \line \up0 \expndtw-
3\charscalex100 Yayasan Kharisma\par\pard\ql \li6086\sb0\sl-230\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 v\par\pard\column \ql
\li20\sb56\sl-230\slmult0\tx627 \up0 \expndtw-9\charscalex93
\ul0\nosupersub\cf4\f5\fs20 11.\tab \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Komunikasi, Informasi dan Edukasi
(KIE)\ul0\nosupersub\cf4\f5\fs20 adalah media informasi tentang
masalah\par\pard\qj \li640\ri811\sb11\sl-286\slmult0\fi0 \up0 \expndtw-
6\charscalex100 kesehatan yang dapat berupa media cetak, media elektronik ataupun
pemberian \up0 \expndtw-9\charscalex95 penerangan (seminar / penyuluhan) dan
pendidikan (pelatihan)\par\pard\ql \li20\sb47\sl-230\slmult0\tx627 \up0 \expndtw-
9\charscalex93 12.\tab \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf5\f6\fs20
Layanan Jarum Suntik Steril (LJSS) \ul0\nosupersub\cf4\f5\fs20 adalah layanan
distribusi jarum suntik steril dan\par\pard\qj \li640\ri811\sb11\sl-286\slmult0
\up0 \expndtw-5\charscalex100 pengumpulan jarum suntik bekas pada populasi penasun
yang disertai dengan \up0 \expndtw-8\charscalex100 pemberian
informasi\par\pard\ql \li20\sb47\sl-230\slmult0\tx627 \up0 \expndtw-9\charscalex93
13.\tab \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Penasun
\ul0\nosupersub\cf4\f5\fs20 adalah pengguna napza dengan cara suntikan (Inggris:
\ul0\nosupersub\cf6\f7\fs20 Injecting Drug User\par\pard\ql \li640\sb59\sl-
230\slmult0 \up0 \expndtw0\charscalex112 \ul0\nosupersub\cf4\f5\fs20
(IDU)\par\pard\ql \li20\sb57\sl-230\slmult0\tx627 \up0 \expndtw-9\charscalex93
14.\tab \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Pelayanan Medik
Dasar \ul0\nosupersub\cf4\f5\fs20 adalah pelayanan medik terhadap individu atau
keluarga\par\pard\qj \li640\ri811\sb10\sl-286\slmult0\fi0 \up0 \expndtw-
8\charscalex94 dalam masyarakat yang dilaksanakan oleh tenaga kesehatan maksimal
dokter umum \up0 \expndtw-9\charscalex94 atau dokter gigi.\par\pard\ql
\expndtw0\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Pelayanan Medik Spesialistik
\ul0\nosupersub\cf4\f5\fs20 adalah pelayanan medik terhadap individu
atau\par\pard\qj \li640\ri811\sb10\sl-286\slmult0\fi0 \up0 \expndtw-8\charscalex95
keluarga dalam masyarakat yang dilaksanakan oleh dokter spesialis atau dokter
gigi \up0 \expndtw-9\charscalex92 spesialis atau kelompok dokter
spesialis.\par\pard\ql \li20\sb47\sl-230\slmult0\tx627 \up0 \expndtw-9\charscalex93
16.\tab \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Orang yang hidup
dengan HIV/AIDS (ODHA) \ul0\nosupersub\cf4\f5\fs20 adalah orang yang tubuhnya
telah\par\pard\ql \li640\sb56\sl-230\slmult0 \up0 \expndtw-5\charscalex100
terinfeksi virus HIV/AIDS.\par\pard\ql \li20\sb57\sl-230\slmult0\tx627 \up0
\expndtw-9\charscalex93 17.\tab \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf7\f8\fs20 Poly drug use\ul0\nosupersub\cf5\f6\fs20 :
\ul0\nosupersub\cf4\f5\fs20 adalah penggunaan\ul0\nosupersub\cf5\f6\fs20
\ul0\nosupersub\cf4\f5\fs20 berbagai jenis napza dalam satu kurun waktu\par\pard\ql
\li640\sb61\sl-230\slmult0 \up0 \expndtw-5\charscalex100 tertentu.\par\pard\ql
\li20\sb56\sl-230\slmult0\tx627 \up0 \expndtw-9\charscalex93 18.\tab \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Program Terapi Rumatan Metadon
(PTRM): \ul0\nosupersub\cf4\f5\fs20
adalah program pemberian metadon\par\pard\qj \li640\ri811\sb10\sl-
286\slmult0\fi0 \up0 \expndtw-2\charscalex100 sebagai salah satu jenis zat opiat
kepada pecandu heroin sebagai pengganti \up0 \expndtw-8\charscalex97 penggunaan
heroin illegal. Pemberian zat diberikan setiap hari pada seting Rumah \up0
\expndtw-9\charscalex92 Sakit ataupun Puskesmas\par\pard\ql \li20\sb48\sl-
230\slmult0\tx626 \up0 \expndtw-9\charscalex93 19.\tab \up0 \expndtw-8\charscalex97
\ul0\nosupersub\cf5\f6\fs20 Pusat Kesehatan Masyarakat (Puskesmas)
\ul0\nosupersub\cf4\f5\fs20 adalah lembaga pemberi layanan kesehatan\par\pard\qj
\li639\ri812\sb10\sl-286\slmult0\fi0\tx2180 \up0 \expndtw-4\charscalex100 dasar
bagi masyarakat, yang berada dalam tanggung jawab Dinas Kesehatan \line \up0
\expndtw-8\charscalex100 Propinsi20. \tab \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf5\f6\fs20 Rumah Sakit Umum \ul0\nosupersub\cf4\f5\fs20 adalah
tempat pelayanan yang \line \up0 \expndtw-8\charscalex98 menyelenggarakan
pelayanan medik dasar dan spesialistik, pelayanan penunjang \line \up0 \expndtw-
8\charscalex97 medik, pelayanan instalasi dan pelayanan perawatan secara rawat
jalan dan rawat \line \up0 \expndtw-9\charscalex100 inap.\par\pard\ql
7\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Rumah Sakit Khusus
\ul0\nosupersub\cf4\f5\fs20 adalah tempat pelayanan yang menyelenggarakan
pelayanan\par\pard\qj \li639\ri812\sb16\sl-315\slmult0\fi0 \up0 \expndtw-
6\charscalex100 medik spesialistik tertentu, pelayanan penunjang medik, pelayanan
instalasi dan \up0 \expndtw-9\charscalex90 pelayanan perawatan secara rawat jalan
dan rawat inap.\par\pard\ql \li15391\sb0\sl-230\slmult0 \par\pard\ql
\li15391\sb0\sl-230\slmult0 \par\pard\ql \li15391\sb0\sl-230\slmult0
\ul0\nosupersub\cf3\f4\fs20 vii
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf4\f5\fs20 22.\tab \up0 \expndtw-8\charscalex94
\ul0\nosupersub\cf5\f6\fs20 Satelit\ul0\nosupersub\cf4\f5\fs20 adalah sarana
pelayanan kesehatan untuk Penasun dapat berupa puskesmas,\par\pard\ql
\li3087\sb66\sl-230\slmult0 \up0 \expndtw-8\charscalex96 klinik swasta atau
pemerintah, klinik dokter keluarga atau rumah sakit.\par\pard\ql \li2461\sb65\sl-
230\slmult0\tx3082 \up0 \expndtw-9\charscalex93 23.\tab \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Sistem Rujukan
\ul0\nosupersub\cf4\f5\fs20 adalah pengaturan dari institusi pemberi layanan
yang\par\pard\qj \li3086\ri1811\sb13\sl-295\slmult0\fi0 \up0 \expndtw-
3\charscalex100 memungkinkan petugasnya mengirimkan klien, sampel darah atau
informasi, \up0 \expndtw-4\charscalex100 memberi petunjuk kepada institusi lain
atas dasar kebutuhan klien untuk \up0 \expndtw-6\charscalex100 mendapatkan
layanan yang lebih memadai. Pengiriman ini senantiasa dilakukan \up0 \expndtw-
5\charscalex100 dengan surat pengantar, bergantung pada jenis layanan yang
dibutuhkan. \up0 \expndtw-5\charscalex100 Pengaturannya didasarkan atas peraturan
yang berlaku, atau persetujuan para \up0 \expndtw-8\charscalex93 pemberi layanan,
dan disertai umpan balik dari proses atau hasil layanan.\par\pard\ql
\expndtw-8\charscalex96 \ul0\nosupersub\cf5\f6\fs20 Sarana Kesehatan adalah
\ul0\nosupersub\cf4\f5\fs20 tempat yang menyediakan layanan kesehatan secara
medis\par\pard\ql \li3086\sb66\sl-230\slmult0 \up0 \expndtw-9\charscalex90 bagi
masyarakat.\par\pard\ql \li2461\sb65\sl-230\slmult0\tx3081 \up0 \expndtw-
9\charscalex93 25.\tab \up0 \expndtw-8\charscalex95 \ul0\nosupersub\cf5\f6\fs20
Take-home Dose (THD) \ul0\nosupersub\cf4\f5\fs20 adalah dosis metadon yang dapat
dibawa pulang oleh pasien.\par\pard\qj \li3086\ri1811\sb12\sl-295\slmult0\fi0
\up0 \expndtw-6\charscalex100 Dosis bawa pulang ini ditetapkan oleh tim staf klinik
PTRM yang mengacu pada \up0 \expndtw-5\charscalex100 Pedoman Nasional PTRM dan
mempertimbangkan kondisi mental, psikologis, \up0 \expndtw-9\charscalex91 sosial
dan fisik pasien\ul0\nosupersub\cf5\f6\fs20 .\par\pard\ql \li2460\sb55\sl-
230\slmult0\tx3081 \up0 \expndtw-9\charscalex93 \ul0\nosupersub\cf4\f5\fs20 26.\tab
\up0 \expndtw-8\charscalex96 \ul0\nosupersub\cf5\f6\fs20 Tuberkulosis (TB)
\ul0\nosupersub\cf4\f5\fs20 adalah penyakit infeksi yang disebabkan oleh bakteri
tuberkulosis\par\pard\ql \li6011\sb0\sl-230\slmult0 \par\pard\ql \li6011\sb0\sl-
\ul0\nosupersub\cf3\f4\fs20 viii\par\pard\column \ql \li11815\sb0\sl-276\slmult0
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs24 DAFTAR
ISTILAH\par\pard\ql \li11815\sb0\sl-230\slmult0 \par\pard\ql \li20\sb181\sl-
230\slmult0\tx627 \up0 \expndtw-9\charscalex93 \ul0\nosupersub\cf4\f5\fs20
1.\tab \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf7\f8\fs20 Acquired Immuno
Deficiency Syndrome\ul0\nosupersub\cf5\f6\fs20 (AIDS)\ul0\nosupersub\cf4\f5\fs20
adalah suatu gejala berkurangnya\par\pard\qj \li640\ri811\sb22\sl-
319\slmult0\fi0 \up0 \expndtw-7\charscalex100 kemampuan pertahanan diri yang
disebabkan oleh masuknya virus HIV ke dalam \up0 \expndtw-9\charscalex93 tubuh
seseorang.\par\pard\ql \li20\sb76\sl-230\slmult0\tx627 \up0 \expndtw-9\charscalex93
2.\tab \up0 \expndtw-7\charscalex100 \ul0\nosupersub\cf7\f8\fs20 Anti Retroviral
Therapy \ul0\nosupersub\cf5\f6\fs20 (ART)\ul0\nosupersub\cf7\f8\fs20
\ul0\nosupersub\cf4\f5\fs20 adalah sejenis\ul0\nosupersub\cf6\f7\fs20
\ul0\nosupersub\cf4\f5\fs20 obat untuk menghambat kecepatan\par\pard\qj
\li640\ri811\sb21\sl-319\slmult0\fi0 \up0 \expndtw-8\charscalex97 replikasi virus
dalam tubuh orang yang terinfeksi HIV/AIDS. Obat diberikan kepada \up0 \expndtw-
7\charscalex100 ODHA yang memerlukan berdasarkan beberapa kriteria klinis, juga
dalam rangka \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs20 Prevention
of Mother To Child Transmission \ul0\nosupersub\cf4\f5\fs20
(PMTCT).\par\pard\ql \li20\sb78\sl-230\slmult0\tx627 \up0 \expndtw-9\charscalex93
3.\tab \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf7\f8\fs20 Body Mass
Index\ul0\nosupersub\cf5\f6\fs20 (BMI) \ul0\nosupersub\cf4\f5\fs20 adalah suatu
penghitungan status gizi seseorang dengan\par\pard\ql \li640\sb95\sl-230\slmult0
\up0 \expndtw-9\charscalex94 menggunakan index massa tubuh\par\pard\ql
4\ul0\nosupersub\cf6\f7\fs20 .\tab \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf7\f8\fs20 Care Support and Treatment (\ul0\nosupersub\cf5\f6\fs20
CST\ul0\nosupersub\cf7\f8\fs20 )\ul0\nosupersub\cf5\f6\fs20
\ul0\nosupersub\cf4\f5\fs20 adalah suatu penanganan komprehensif
bagi\par\pard\ql \li640\sb94\sl-230\slmult0 \up0 \expndtw-9\charscalex96 ODHA yang
meliputi perawatan dukungan dan pengobatan.\par\pard\ql \li20\sb91\sl-
\ul0\nosupersub\cf7\f8\fs20 Diagnostic Statistical Manual of Mental Disorders
IV\ul0\nosupersub\cf4\f5\fs20 (\ul0\nosupersub\cf5\f6\fs20 DSM
IV\ul0\nosupersub\cf4\f5\fs20 ): buku pedoman\par\pard\qj \li640\ri810\sb21\sl-
319\slmult0\fi0 \up0 \expndtw-8\charscalex96 diagnostik gangguan mental / kejiwaan
yang dikeluarkan oleh American Psychiatrist \up0 \expndtw-8\charscalex97
Association (Asosiasi Psikiater Amerika). Buku pedoman ini digunakan secara luas
\up0 \expndtw-3\charscalex100 di seluruh dunia, termasuk untuk menegakkan
diagnosa terkait masalah \up0 \expndtw-9\charscalex91 penggunaan
napza\par\pard\ql \li20\sb75\sl-230\slmult0\tx627 \up0 \expndtw-9\charscalex96
6\ul0\nosupersub\cf6\f7\fs20 .\tab \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf7\f8\fs20 Harm Reduction (\ul0\nosupersub\cf5\f6\fs20
HR\ul0\nosupersub\cf7\f8\fs20 ) \ul0\nosupersub\cf5\f6\fs20 :
\ul0\nosupersub\cf4\f5\fs20 adalah program pengurangan dampak buruk yang
dalam\par\pard\ql \li640\sb94\sl-230\slmult0 \up0 \expndtw-9\charscalex94 buku ini
dikaitkan erat dengan perilaku penggunaan napza suntik\par\pard\ql \li20\sb91\sl-
8\charscalex98 \ul0\nosupersub\cf7\f8\fs20 Human Immuno-deficiency Virus
(\ul0\nosupersub\cf5\f6\fs20 HIV) \ul0\nosupersub\cf4\f5\fs20 adalah virus yang
menyebabkan AIDS.\par\pard\ql \li20\sb95\sl-230\slmult0\tx626 \up0 \expndtw-
9\charscalex96 8\ul0\nosupersub\cf6\f7\fs20 .\tab \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs20 Informed Consent\ul0\nosupersub\cf5\f6\fs20
(Persetujuan atas dilakukannya suatu Tindakan/ intervensi)\par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 adalah persetujuan yang diberikan oleh orang dewasa
yang secara kognisi dapat \up0 \expndtw-4\charscalex100 mengambil keputusan dengan
sadar untuk melaksanakan prosedur (tes HIV, \up0 \expndtw-8\charscalex97 operasi,
tindakan medik lainnya) bagi dirinya atau atas spesimen yang berasal dari \up0
\expndtw-5\charscalex100 dirinya. Juga\ul0\nosupersub\cf5\f6\fs20
\ul0\nosupersub\cf4\f5\fs20 termasuk persetujuan memberikan informasi tentang
dirinya untuk \up0 \expndtw-9\charscalex95 suatu keperluan
penelitian.\par\pard\ql \li20\sb76\sl-230\slmult0\tx626 \up0 \expndtw-
9\charscalex96 9\ul0\nosupersub\cf6\f7\fs20 .\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs20 Incinerator: \ul0\nosupersub\cf4\f5\fs20 alat pemusnah
sampah (khususnya sampah medik) yang bekerja\par\pard\ql \li640\sb94\sl-230\slmult0
\up0 \expndtw-8\charscalex96 dengan temperatur yang amat tinggi, untuk menjamin
hancurnya sampah tersebut\par\pard\ql \li15418\sb0\sl-230\slmult0 \par\pard\ql
230\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 vi
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf1\f2\fs24 DAFTAR ISI\par\pard\ql \li2459\sb0\sl-230\slmult0
\par\pard\ql \li3075\sb214\sl-230\slmult0\tldot\tx9153\tx9736 \up0 \expndtw-
9\charscalex91 \ul0\nosupersub\cf4\f5\fs20 Kata
Pengantar\expndtw0\charscalex100\tab \tab \up0 \expndtw-2\charscalex100
i\par\pard\ql \li3075\sb106\sl-230\slmult0\tldot\tx9469 \up0 \expndtw-
5\charscalex100 Sambutan-sambutan\expndtw0\charscalex100\tab \up0
\expndtw0\charscalex126 iii\par\pard\ql \li3075\sb106\sl-
230\slmult0\tldot\tx9185\tx9696 \up0 \expndtw-5\charscalex100 Daftar
Kontribusi\expndtw0\charscalex100\tab \tab \up0 \expndtw-2\charscalex100
v\par\pard\ql \li3075\sb107\sl-230\slmult0\tldot\tx9488 \up0
\expndtw0\charscalex103 Daftar Istilah\expndtw0\charscalex100\tab \up0
\expndtw0\charscalex103 vi\par\pard\ql \li3074\sb106\sl-230\slmult0\tldot\tx9488
\up0 \expndtw0\charscalex104 Daftar Isi\expndtw0\charscalex100\tab \up0
\expndtw0\charscalex102 xi\par\pard\ql \li2460\sb106\sl-
230\slmult0\tx3069\tx3433\tx9690 \up0 \expndtw-4\charscalex100 BAB\tab \up0
\expndtw-2\charscalex100 I\tab \up0 \expndtw0\charscalex105 PENDAHULUAN\tab \up0
\expndtw-9\charscalex93 1\par\pard\ql \li3074\sb106\sl-
230\slmult0\tx3433\tldot\tx9154\tx9655 \up0 \expndtw-9\charscalex93 1.\tab \up0
\expndtw-9\charscalex93 Latar Belakang\expndtw0\charscalex100\tab \tab \up0
\expndtw-9\charscalex91 Permasalahan\expndtw0\charscalex100\tab \tab \up0 \expndtw-
9\charscalex93 2\par\pard\ql \li3074\sb107\sl-
\expndtw-9\charscalex96 Tujuan Buku Pedoman\expndtw0\charscalex100\tab \tab \up0
\expndtw-9\charscalex86 Sasaran\expndtw0\charscalex100\tab \tab \up0 \expndtw-
\expndtw-8\charscalex100 Ruang Lingkup\expndtw0\charscalex100\tab \tab \up0
230\slmult0\tx3099\tx3433\tldot\tx9165\tx9467 \up0 \expndtw-4\charscalex100 BAB\tab
\up0 \expndtw0\charscalex122 II\tab \up0 \expndtw-9\charscalex92 Pengetahuan Dasar
Penggunaan Napza Suntik\expndtw0\charscalex100\tab \tab \up0 \expndtw-
\expndtw-9\charscalex95 Konsep Ketergantungan Napza\expndtw0\charscalex100\tab \tab
\up0 \expndtw-9\charscalex93 4\par\pard\ql \li3074\sb107\sl-
\expndtw-9\charscalex93 Bekerja Dengan Penasun\expndtw0\charscalex100\tab \tab \up0
\expndtw-8\charscalex100 Proses Pengkajian Pola Penggunaan Napza
Suntik\expndtw0\charscalex100\tab \tab \up0 \expndtw-9\charscalex93
6\par\pard\ql \li2460\sb106\sl-230\slmult0\tx3069\tx3433 \up0 \expndtw-
4\charscalex100 BAB\tab \up0 \expndtw0\charscalex122 III\tab \up0 \expndtw-
9\charscalex97 Prosedur Layanan Pengurangan Dampak Buruk Terkait Penggunaan
NAPZA\par\pard\ql \li3465\sb106\sl-230\slmult0\tldot\tx8556 \up0 \expndtw-
4\charscalex100 Suntik\expndtw0\charscalex100\tab \up0 \expndtw-9\charscalex93
9\par\pard\ql \li3074\sb106\sl-230\slmult0\tx3433\tldot\tx9378\tx9690 \up0
\expndtw-9\charscalex93 1.\tab \up0 \expndtw-9\charscalex96 Pelayanan Kesehatan
Dasar\expndtw0\charscalex100\tab \tab \up0 \expndtw-9\charscalex93 9\par\pard\ql
\li3074\sb107\sl-230\slmult0\tx3433\tldot\tx9447 \up0 \expndtw-9\charscalex93
2.\tab \up0 \expndtw-7\charscalex100 Pelayanan Pemulihan Ketergantungan
Napza\expndtw0\charscalex100\tab \up0 \expndtw-9\charscalex93 16\par\pard\ql
3.\tab \up0 \expndtw-5\charscalex100 Program Layanan Jarum Suntik
Steril\expndtw0\charscalex100\tab \up0 \expndtw-9\charscalex93 18\par\pard\ql
4.\tab \up0 \expndtw-7\charscalex100 Pelayanan Terapi Rumatan
metodan\expndtw0\charscalex100\tab \up0 \expndtw-9\charscalex93 27\par\pard\ql
\li2459\sb106\sl-230\slmult0\tx3069\tx3433\tldot\tx9445 \up0 \expndtw-
4\charscalex100 BAB\tab \up0 \expndtw0\charscalex102 IV\tab \up0 \expndtw-
2\charscalex100 Monitoring dan Evaluasi\expndtw0\charscalex100\tab \up0
\expndtw-9\charscalex93 40\par\pard\ql \li3437\sb107\sl-230\slmult0 \up0 \expndtw-
8\charscalex100 Penutup\par\pard\ql \li3437\sb118\sl-230\slmult0 \up0 \expndtw-
9\charscalex94 Daftar Pustaka\par\pard\ql \li3437\sb130\sl-230\slmult0 \up0
\expndtw-6\charscalex100 Lampiran\par\pard\ql \li6057\sb0\sl-230\slmult0
\ul0\nosupersub\cf3\f4\fs20 ix\par\pard\column \ql \li11815\sb0\sl-276\slmult0
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 BAB
I\par\pard\ql \li2766\sb2\sl-276\slmult0 \up0 \expndtw-5\charscalex100
PENDAHULUAN\par\pard\ql \li11815\sb0\sl-230\slmult0 \par\pard\ql \li11815\sb0\sl-
6\charscalex100 \ul0\nosupersub\cf5\f6\fs20 1.\tab \up0 \expndtw-3\charscalex100
Latar Belakang\par\pard\qj \li11815\sb0\sl-246\slmult0 \par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 Pada awal penyebaran HIV/AIDS, penularan telah
didominasi oleh hubungan seks \line \up0 \expndtw-8\charscalex95 heteroseksual
bukan homoseksual yang menjadi stigma selama ini. Ini membuktikan bahwa \line
\up0 \expndtw0\charscalex100 HIV/AIDS dapat mengenai siapa saja, bukan hanya orang-
orang 'tertentu'. Hal ini \line \up0 \expndtw-5\charscalex100 dibuktikan bahwa
kasus-kasus yang ditemukan banyak yang mempunyai perilaku \line \up0
\expndtw-8\charscalex96 hubungan seks heteroseksual serta ditemukan pada kelompok
perempuan 'baik-baik'. Pola \line \up0 \expndtw-7\charscalex100 ini terus berlanjut
sampai sekarang dengan data penularan melalui hubungan seks pada \line \up0
\expndtw-8\charscalex97 kelompok heteroseksual masih mendominasi pola penyebaran
HIV/AIDS di Indonesia.\par\pard\qj \li20\ri811\sb1\sl-246\slmult0\fi580 \up0
\expndtw-4\charscalex100 Berbicara mengenai kasus baru HIV/AIDS di Indonesia, sudah
beberapa tahun \line \up0 \expndtw-8\charscalex96 belakangan ini banyak
disumbangkan oleh kelompok penasun. Pada kurun waktu 10 tahun \line \up0 \expndtw-
7\charscalex100 mulai 1995 hingga Maret 2005 proporsi penularan melalui kelompok
penasun meningkat\par\pard\qj \li20\ri811\sb1\sl-246\slmult0\fi0 \up0 \expndtw-
8\charscalex98 50 kali lipat, yaitu dari 0,65% pada tahun 1995 menjadi 35,87% pada
tahun 2004. Bahkan \up0 \expndtw-9\charscalex95 selama Januari sampai dengan
September \up0 \expndtw-7\charscalex100 2008, penambahan kasus HIV/AIDS dengan \up0
\expndtw-8\charscalex96 faktor risiko pada kelompok penasun mencapai proporsi 52%,
yang merupakan faktor risiko \up0 \expndtw-4\charscalex100 terbesar. Sedangkan
untuk faktor risiko heteroseksual hanya mencapai 26,30%, yaitu \up0 \expndtw-
8\charscalex98 setengah dari kelompok penasun. Hal ini semakin membuktikan bahwa
penularan melalui \up0 \expndtw-9\charscalex94 perilaku berisiko pada populasi
penasun menjadi media penularan utama.\par\pard\qj \li20\ri810\sb1\sl-
246\slmult0\fi580 \up0 \expndtw-8\charscalex96 Masalah menjadi lebih serius karena
orang yang teridentifikasi HIV dan telah masuk \up0 \expndtw-7\charscalex100 dalam
tahap AIDS saat ini yang terbanyak justru pada kelompok penasun, yaitu 46,48%. \up0
\expndtw-4\charscalex100 Sedangkan yang ditularkan melalui hubungan heteroseksual
hanya 36,23%. Padahal, \up0 \expndtw-8\charscalex97 sebagaimana yang dialami pada
negara-negara lain yang juga memiliki masalah HIV/AIDS \up0 \expndtw-
7\charscalex100 pada penasun, tingginya prevalensi HIV/AIDS pada kelompok ini cepat
atau lambat akan \up0 \expndtw-7\charscalex100 menyebar pada populasi lainnya,
seperti misalnya pada kelompok ibu-ibu dan bayi yang \up0 \expndtw-8\charscalex94
dikandungnya. Hal ini mengingat penasun juga relatif aktif secara
seksual.\par\pard\qj \li20\ri811\sb4\sl-268\slmult0\fi580 \up0 \expndtw-
8\charscalex96 Persoalan penanganan masalah HIV/AIDS pada penasun tidak hanya
terbatas pada \up0 \expndtw-7\charscalex100 penyediaan layanan konseling, testing
serta penyediaan layanan terapi \ul0\nosupersub\cf6\f7\fs20
antiretroviral\ul0\nosupersub\cf4\f5\fs20 (ART), \up0 \expndtw-8\charscalex95 tapi
juga harus memperhatikan permasalahan medis psikologis yang terkait dengan perilaku
\up0 \expndtw-7\charscalex100 adiksi para penasun. Hal ini diperlukan karena
perhatian pada masalah medis psikologis \up0 \expndtw-8\charscalex96 penasun dapat
membantu meningkatkan perubahan perilak\ul0\nosupersub\cf8\f9\fs20 u
\ul0\nosupersub\cf4\f5\fs20 yang signifikan.\par\pard\ql \li15441\sb0\sl-
230\slmult0 \par\pard\ql \li15441\sb0\sl-230\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 1
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\pard\sb0\sl-240{\bkmkstart Pg6}{\bkmkend Pg6}\par\pard\qj \li2461\sb0\sl-
245\slmult0 \par\pard\qj\li2461\sb0\sl-245\slmult0
\par\pard\qj\li2461\ri10145\sb127\sl-245\slmult0\fi0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf4\f5\fs20 Menyadari bahwa Puskesmas atau
institusi layanan kesehatan dasar lainnya memiliki \up0 \expndtw-6\charscalex100
beberapa keterbatasan, baik sarana dan tenaga, maka perlu dikembangkan suatu
buku \up0 \expndtw-8\charscalex98 Pedoman Pelaksanaan Pengurangan Dampak Buruk
terkait Penggunaan Napza Suntik di \up0 \expndtw-8\charscalex94 tingkat Puskesmas.
Berbagai layanan yang ada pada buku ini merupakan hal-hal yang dapat \up0 \expndtw-
9\charscalex90 secara realistis dilaksanakan oleh Puskesmas.
\par\pard\li2461\sb0\sl-230\slmult0\par\pard\li2461\sb18\sl-
230\slmult0\fi0\tx3070 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf5\f6\fs20
2.\tab \up0 \expndtw-3\charscalex100 Permasalahan\par\pard\ql \li3070\sb230\sl-
230\slmult0 \up0 \expndtw-3\charscalex100 a) Permasalahan Pelayanan Kesehatan
bagi Penasun \par\pard\ql \li3436\ri5182\sb0\sl-
248\slmult0\fi0\tx3761\tx3761\tx3761 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf4\f5\fs20 * Kurang optimalnya sistem dan subsistem dalam
pelayanan kesehatan \line \tab \up0 \expndtw-9\charscalex91 Penasun di Puskesmas
atau Institusi Layanan Kesehatan Dasar \line \up0 \expndtw-9\charscalex94 * Masih
banyaknya Penasun yang sulit menjangkau fasilitas kesehatan \line \up0 \expndtw-
4\charscalex100 * Belum ada Standar Pelayanan Medis bagi Penasun di Puskesmas atau
\line \tab \up0 \expndtw-6\charscalex100 Institusi Layanan Kesehatan Dasar
dalam melaksanakan Pedoman \line \tab \up0 \expndtw-9\charscalex92 Perawatan,
Dukungan dan Pengobatan bagi Penasun \par\pard\ql \li3436\sb3\sl-230\slmult0
\up0 \expndtw-9\charscalex94 * Belum adanya jaminan kualitas pelayanan kesehatan
bagi Penasun \par\pard\ql \li3070\sb0\sl-230\slmult0 \par\pard\ql\li3070\sb20\sl-
230\slmult0 \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf5\f6\fs20 b)
Permasalahan Sarana \par\pard\ql \li3436\sb10\sl-230\slmult0 \up0 \expndtw-
8\charscalex95 \ul0\nosupersub\cf4\f5\fs20 * Sarana pelayanan bagi penasun di
Puskesmas kurang bersifat komprehensif. \par\pard\ql \li3070\sb1\sl-217\slmult0
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf5\f6\fs20 c) Permasalahan SDM
\par\pard\ql \li3436\ri10146\sb24\sl-240\slmult0\tx3761 \up0 \expndtw-
6\charscalex100 \ul0\nosupersub\cf4\f5\fs20 * Kurangnya pengetahuan dan
ketrampilan petugas dalam memahami dan \line\tab \up0 \expndtw-9\charscalex93
melayani permasalahan pengguna napza suntik \par\pard\li2460\sb0\sl-
230\slmult0\par\pard\li2460\sb17\sl-230\slmult0\fi0\tx3070 \up0 \expndtw-
Tujuan Buku Pedoman\par\pard\ql \li2460\sb0\sl-230\slmult0
\par\pard\ql\li2460\sb2\sl-230\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf4\f5\fs20 Tujuan Umum \par\pard\qj \li2460\ri10147\sb22\sl-
240\slmult0\fi0 \up0 \expndtw-4\charscalex100 Meningkatkan pengetahuan dan
kemampuan petugas dalam pelayanan pengurangan \up0 \expndtw-9\charscalex90 dampak
buruk bagi Penasun di sarana kesehatan dasar \par\pard\ql \li2460\sb0\sl-
230\slmult0 \par\pard\ql\li2460\sb39\sl-230\slmult0 \up0 \expndtw-9\charscalex96
Tujuan khusus \par\pard\ql \li3078\sb10\sl-230\slmult0\tx3441 \up0 \expndtw-
9\charscalex82 a. \tab \up0 \expndtw-9\charscalex93 Meningkatkan fungsi pelayanan
Kesehatan Dasar \par\pard\ql \li3078\sb10\sl-230\slmult0 \up0 \expndtw-
9\charscalex97 b. Meningkatkan fungsi pelayanan Pemulihan Napza \par\pard\ql
\li3078\sb30\sl-230\slmult0 \up0 \expndtw-9\charscalex95 c. Meningkatkan fungsi
pelayanan Layanan Jarum Suntik Steril (LJSS) \par\pard\ql \li3078\ri10151\sb6\sl-
260\slmult0\tx3441 \up0 \expndtw0\charscalex100 d. Meningkatkan fungsi
pelayanan \ul0\nosupersub\cf6\f7\fs20 Voluntary Counseling
Testing\ul0\nosupersub\cf4\f5\fs20 (VCT) dan \ul0\nosupersub\cf6\f7\fs20 Care
\line\tab \up0 \expndtw-5\charscalex100 Support and
Treatment\ul0\nosupersub\cf4\f5\fs20 (CST) \par\pard\ql \li3078\sb45\sl-
230\slmult0 \up0 \expndtw-8\charscalex100 e. Meningkatkan fungsi pelayanan
Program Terapi Rumatan Metadon (PTRM) \par\pard\ql \li3078\sb90\sl-
230\slmult0\tx3441 \up0 \expndtw-6\charscalex100 f. \tab \up0 \expndtw-
9\charscalex94 Meningkatkan fungsi pencatatan dan pelaporan \par\pard\ql
\li6082\sb0\sl-230\slmult0 \par\pard\ql\li6082\sb0\sl-230\slmult0
\par\pard\ql\li6082\sb0\sl-230\slmult0 \par\pard\ql\li6082\sb0\sl-230\slmult0
\par\pard\ql\li6082\sb0\sl-230\slmult0 \par\pard\ql\li6082\sb40\sl-230\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 2
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf5\f6\fs20 4.\tab \up0 \expndtw-4\charscalex100 Ruang
lingkup\par\pard\qj \li2461\ri1810\sb16\sl-314\slmult0\fi0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf4\f5\fs20 Adapun pembahasan ruang lingkup dalam
Pedoman Prosedur Pelaksanaan Program \up0 \expndtw-9\charscalex95 Pengurangan
Dampak Buruk di Puskesmas, meliputi :\par\pard\ql \li3069\sb71\sl-
Pelayanan Kesehatan Dasar\par\pard\ql \li3069\sb85\sl-230\slmult0\tx3421 \up0
\expndtw-9\charscalex93 2.\tab \up0 \expndtw-9\charscalex94 Pelayanan Pemulihan
Ketergantungan Napza\par\pard\ql \li3069\sb85\sl-230\slmult0\tx3421 \up0 \expndtw-
9\charscalex93 3.\tab \up0 \expndtw-9\charscalex95 Program Layanan Jarum Suntik
Steril\par\pard\ql \li3069\sb84\sl-230\slmult0\tx3421 \up0 \expndtw-9\charscalex93
4.\tab \up0 \expndtw-8\charscalex100 Program VCT dan CST\par\pard\ql
\expndtw-9\charscalex93 Pelayanan Terapi Rumatan Metadon\par\pard\ql
\expndtw-9\charscalex90 Proses pencatatan dan pelaporan\par\pard\ql \li2461\sb0\sl-
Sasaran\par\pard\qj \li2461\ri1810\sb16\sl-314\slmult0\fi0 \up0 \expndtw-
8\charscalex97 \ul0\nosupersub\cf4\f5\fs20 Pusat kesehatan masyarakat atau
institusi layanan kesehatan dasar lainnya yang menjadi \up0 \expndtw-9\charscalex93
layanan program pengurangan dampak buruk bagi Penasun\par\pard\ql \li6085\sb0\sl-
\ul0\nosupersub\cf3\f4\fs20 3\par\pard\column \qj \li11815\sb0\sl-275\slmult0
275\slmult0\fi0 \up0 \expndtw-8\charscalex94 \ul0\nosupersub\cf4\f5\fs20 bagaimana
situasi dan kondisi sosial mereka, serta alternatif apa saja yang dapat
ditawarkan \up0 \expndtw-9\charscalex91 dan secara realistis dapat
dilakukan.\par\pard\ql \li11815\sb0\sl-230\slmult0 \par\pard\ql \li20\sb84\sl-
\ul0\nosupersub\cf5\f6\fs20 Bekerja dengan Pengguna Napza Suntik\par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 Seperti halnya dengan layanan-layanan umum lain yang
ada di Puskesmas, prinsip \up0 \expndtw-8\charscalex98 layanan HIV dan AIDS bagi
penasun juga memiliki kesamaan baik dalam hal keterbukaan \up0 \expndtw-
7\charscalex100 layanan dan komunikasi, keramahan, kenyamanan, dan mengutamakan
kualitas. Tujuan \up0 \expndtw-6\charscalex100 layanan kesehatan bagi Penasun
adalah membawa penasun dalam proses perawatan, \up0 \expndtw-6\charscalex100
mempertahankan mereka agar tetap mengikuti program dan mengembalikan mereka ke \up0
\expndtw-5\charscalex100 dalam program apabila terjadi kekambuhan. Dibutuhkan cara
promosi yang tepat agar \up0 \expndtw-4\charscalex100 program diminati oleh
penasun. Promosi layanan kesehatan ini merupakan alat untuk \up0 \expndtw-
5\charscalex100 meningkatkan pengetahuan dan kesadaran Penasun untuk berkunjung ke
Puskesmas. \up0 \expndtw-8\charscalex93 Dalam hal promosi layanan kepada Penasun
pihak puskesmas melatih kader kesehatan yang \up0 \expndtw-8\charscalex92 sudah ada
atau melibatkan masyarakat setempat atau bekerjasama dengan LSM yang tersedia
\up0 \expndtw-9\charscalex93 di daerahnya, khususnya yang memiliki tenaga-tenaga
penjangkau.\par\pard\qj \li20\ri811\sb1\sl-275\slmult0\fi617 \up0 \expndtw-
8\charscalex97 Prinsip bekerja dengan penasun adalah bersikap tulus, tegas dan
pragmatis. Sikap \line \up0 \expndtw-5\charscalex100 tulus dibutuhkan karena
penasun adalah individu yang seringkali mengalami perlakuan \line \up0 \expndtw-
4\charscalex100 diskriminatif. Oleh karena itu tidak jarang mereka menjadi
individu yang sensitif: tidak \line \up0 \expndtw-6\charscalex100 mudah begitu saja
percaya pada keinginan orang lain untuk menolong. Bersikaplah apa \line \up0
\expndtw-8\charscalex93 adanya, tanpa merasa perlu harus berpura-pura. Bilamana
anda sedang dalam keadaan lelah, \line \up0 \expndtw-8\charscalex94 katakan hal ini
secara terus terang. Bilamana anda tidak begitu jelas akan apa yang diuraikan \line
\up0 \expndtw-6\charscalex100 mereka, nyatakan pula secara terbuka.
Keterbukaan dan sikap yang familiar akan \line \up0 \expndtw-8\charscalex93
memudahkan terbentuknya rasa percaya penasun kepada kita. Rasa percaya ini pulalah
yang \line \up0 \expndtw-5\charscalex100 memudahkan proses layanan diberikan,
termasuk kemungkinan terjadinya perubahan \line \up0 \expndtw-9\charscalex94
perilaku ke arah positif.\par\pard\qj \li20\ri811\sb6\sl-307\slmult0\fi615 \up0
\expndtw-6\charscalex100 Bersikap tegas artinya adalah kemampuan memberikan saran
yang terbaik bagi \up0 \expndtw-3\charscalex100 penasun tanpa harus terpengaruh
oleh sikap ambivalensi mereka. Puskesmas perlu \up0 \expndtw-7\charscalex100
menegaskan perilaku penasun yang dapat dan tidak dapat diterima. Misalkan,
terjadinya \up0 \expndtw-5\charscalex100 transaksi jual beli napza ataupun
peralatan menyuntik di wilayah institusi, penggunaan \up0 \expndtw-4\charscalex100
napza di wilayah institusi, mencuri, kekerasan atau pelecehan, baik terhadap
petugas \up0 \expndtw-4\charscalex100 maupun sesama penasun. Peraturan program
perlu dijelaskan sejak awal. Perlu pula \up0 \expndtw-8\charscalex93 disepakati apa
yang akan mereka terima bila terjadi pelanggaran peraturan.\par\pard\ql
230\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 5
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
lsr160\qj \li2460\sb0\sl-267\slmult0 \par\pard\qj \li2460\sb0\sl-267\slmult0
\par\pard\qj \li2461\ri1807\sb67\sl-267\slmult0\fi615 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf4\f5\fs20 Bersikap pragmatis artinya adalah menentukan tujuan
terapi atau tindakan yang \line \up0 \expndtw-8\charscalex96 bersifat realistis,
dapat diraih oleh penasun dan dapat difasilitasi oleh puskesmas. Idealnya, \line
\up0 \expndtw-8\charscalex98 tujuan terapi ditentukan bersama-sama, antara terapis
dengan penasun itu sendiri. Dalam \line \up0 \expndtw-1\charscalex100 hal ini
teknik wawancara motivasional menjadi salah satu ketrampilan yang dapat \line \up0
\expndtw-5\charscalex100 membantu petugas puskesmas menarik minat penasun terhadap
program. Penentuan \line \up0 \expndtw-7\charscalex100 tujuan tentu saja berkait
dengan kondisi masing-masing individu. Ketergantungan napza \line \up0 \expndtw-
7\charscalex100 adalah \ul0\nosupersub\cf6\f7\fs20 chronic relapsing disorder
\ul0\nosupersub\cf4\f5\fs20 (penyakit kronis kambuhan). Untuk itu proses pengkajian
pola \line \up0 \expndtw-8\charscalex96 penggunaan dan masalah hidup penasun
menjadi penting dalam menentukan tujuan terapi. \line \up0 \expndtw-5\charscalex100
Tujuan yang pragmatis tidak saja membantu penasun untuk meraih kembali keyakinan
\line \up0 \expndtw-8\charscalex94 dirinya, tetapi juga membantu petugas untuk
merasa nyaman bekerja serta bersikap optimis.\par\pard\qj \li2460\ri1810\sb0\sl-
267\slmult0\fi615 \up0 \expndtw-8\charscalex96 Dengan karakteristik tersebut di
atas, puskesmas perlu mempersiapkan petugasnya \line \up0 \expndtw-7\charscalex100
dalam hal pengetahuan dan ketrampilan terkait penggunaan napza. Pengetahuan
dasar \line \up0 \expndtw-2\charscalex100 adiksi napza dan beberapa teknik
ketrampilan dasar lainnya seperti misalnya teknik \line \up0 \expndtw-
8\charscalex95 konseling serta wawancara motivasional akan sangat membantu petugas
puskesmas dalam \line \up0 \expndtw-6\charscalex100 menjalankan tugasnya. Selain
itu pengetahuan dan ketrampilan yang cukup dapat \line \up0 \expndtw-
4\charscalex100 membantu petugas mengatasi situasi yang menantang dan sekaligus
menimimalisasi \line \up0 \expndtw-7\charscalex100 timbulnya perasaan
\ul0\nosupersub\cf6\f7\fs20 'burn-out'\ul0\nosupersub\cf4\f5\fs20 (lelah fisik dan
mental) yang mungkin terjadi karena bekerja \line \up0 \expndtw-7\charscalex100
dengan penasun. Institusi juga perlu menentukan deskripsi kerja yang jelas bagi
masing-\line \up0 \expndtw-8\charscalex93 masing petugas, harapan yang realistis
dan mengadakan supervisi yang berkesinambungan.\par\pard\ql \li2460\sb0\sl-
Proses Pengkajian Pola Penggunaan Napza Suntik\par\pard\qj \li2460\ri1810\sb4\sl-
267\slmult0\fi585 \up0 \expndtw-8\charscalex93 \ul0\nosupersub\cf4\f5\fs20 Proses
pengkajian (asesmen) terhadap penasun tidak boleh hanya terfokus pada jenis \up0
\expndtw-8\charscalex96 zat yang disuntikkannya. Pada kenyataannya, penasun sering
menggunakan berbagai jenis \up0 \expndtw-8\charscalex96 zat dalam satu kurun waktu
tertentu (\ul0\nosupersub\cf6\f7\fs20 poly drug use\ul0\nosupersub\cf4\f5\fs20 ).
Pengkajian perlu mencakup jenis-jenis zat \up0 \expndtw-9\charscalex94 yang mungkin
disalahgunakan mereka, seperti:\par\pard\ql \li3046\sb31\sl-230\slmult0\tx3445 \up0
\expndtw-9\charscalex82 a.\tab \up0 \expndtw-2\charscalex100 Alkohol\par\pard\ql
\li3046\sb37\sl-230\slmult0 \up0 \expndtw-6\charscalex100 b.
Benzodiazepines\par\pard\ql \li3046\sb37\sl-230\slmult0\tx3445 \up0 \expndtw-
9\charscalex91 c.\tab \up0 \expndtw-9\charscalex95 Ganja\par\pard\ql
\li3046\sb37\sl-230\slmult0 \up0 \expndtw-3\charscalex100 d. Opiat
lainnya\par\pard\ql \li3046\sb37\sl-230\slmult0\tx3445 \up0 \expndtw-9\charscalex87
e.\tab \up0 \expndtw-9\charscalex94 Amfetamin (termasuk shabu dan
ecstasy)\par\pard\ql \li3046\sb37\sl-230\slmult0\tx3445 \up0 \expndtw-
6\charscalex100 f.\tab \up0 \expndtw-7\charscalex100 Halusinogen\par\pard\ql
\li3046\sb37\sl-230\slmult0\tx3445 \up0 \expndtw-9\charscalex90 g.\tab \up0
\expndtw-9\charscalex96 Inhalansia\par\pard\ql \li3046\sb37\sl-230\slmult0 \up0
\expndtw0\charscalex102 h. Kokain\par\pard\ql \li3046\sb45\sl-
230\slmult0\tx3445 \up0 \expndtw-2\charscalex100 i.\tab \up0
\expndtw0\charscalex105 Nikotin\par\pard\ql \li6082\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf3\f4\fs20 6\par\pard\column \ql \li11814\sb0\sl-276\slmult0
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 BAB
II\par\pard\ql \li569\sb43\sl-276\slmult0 \up0 \expndtw-4\charscalex100 PENGETAHUAN
DASAR PENGGUNAAN NAPZA SUNTIK\par\pard\ql \li11814\sb0\sl-230\slmult0
\ul0\nosupersub\cf5\f6\fs20 1.\tab \up0 \expndtw-4\charscalex100 Penggunaan Napza
Suntik\par\pard\qj \li21\ri811\sb7\sl-283\slmult0\fi637 \up0 \expndtw-
8\charscalex96 \ul0\nosupersub\cf4\f5\fs20 Penggunaan napza suntik umumnya
dilakukan para penasun baik secara intravena \up0 \expndtw-7\charscalex100 maupun
intramuscular. Jenis Napza yang umumnya disalahgunakan dengan cara suntik \up0
\expndtw-8\charscalex98 adalah jenis opiat (khususnya heroin atau dikenal dengan
nama jalanan putaw / pt / etep). \up0 \expndtw-8\charscalex98 Sekalipun
intensitasnya tidak setinggi heroin, napza jenis benzodiazepine dan opiat
semi-\line \up0 \expndtw-7\charscalex100 agonist seperti buphrenorphine juga cukup
sering disuntikkan. Fokus pembahasan pada \up0 \expndtw-9\charscalex94 pedoman kali
ini adalah penggunaan heroin (putaw) dengan cara suntik.\par\pard\qj
\li21\ri811\sb0\sl-283\slmult0\fi638 \up0 \expndtw-8\charscalex97 Penggunaan napza
suntik melalui intravena umumnya digunakan karena berbagai \up0 \expndtw-
8\charscalex96 alasan. Pertama, diperolehnya efek euphoria yang sangat cepat
dibandingkan penggunaan \up0 \expndtw-8\charscalex95 dengan cara oral ataupun cara
lainnya (termasuk suntik intramuscular). Kedua, penggunaan \up0 \expndtw-
8\charscalex97 dengan cara suntik mengoptimalkan masuknya napza ke dalam tubuh.
Tidak ada zat yang \up0 \expndtw-4\charscalex100 terbuang dibandingkan dengan cara
dihisap (bahasa jalanan: didrag). Di balik alasan \up0 \expndtw-6\charscalex100
penggunaan, ada berbagai kerugian yang ditimbulkan oleh penyuntikan napza.
Dinding \up0 \expndtw-6\charscalex100 vena yang berada di area sekitar
penyuntikan seringkali kehilangan kekuatan dan \up0 \expndtw-3\charscalex100
elastisitasnya. Akibatnya, dinding vena dapat mengalami \ul0\nosupersub\cf6\f7\fs20
collapses\ul0\nosupersub\cf4\f5\fs20 dan darah tidak lagi \up0 \expndtw-
1\charscalex100 mengalir melalui saluran tersebut. Selain itu penyuntikkan
napza juga sering \up0 \expndtw-8\charscalex100 memungkinkan masuknya bakteri
yang ada pada kulit ke dalam tubuh, baik melalui jarum \up0 \expndtw-
8\charscalex100 suntik, ataupun melalui penggunaan jarum dan tabung yang
terkontaminasi. Bagi mereka \up0 \expndtw-3\charscalex100 yang berbagi jarum dan
tabung memiliki risiko sangat tinggi untuk tertular virus yang \up0 \expndtw-
9\charscalex95 menular melalui darah seperti HIV, Hepatitis B dan C.\par\pard\qj
\li20\ri812\sb0\sl-283\slmult0\fi637 \up0 \expndtw-8\charscalex97 Satu hal yang
harus dipahami dalam manajemen penggunaan napza suntik adalah \up0 \expndtw-
7\charscalex100 bahwa setiap penasun memiliki kebiasaan dan kebutuhan yang berbeda-
beda. Seorang \up0 \expndtw-7\charscalex100 penasun tidak berarti pasti
ketergantungan heroin. Ada banyak fakta di berbagai penjuru \up0 \expndtw-
5\charscalex100 dunia bahwa sebagian orang menggunakan opium atau heroin, tetapi
tidak kecanduan \up0 \expndtw-8\charscalex95 terhadap zat-zat tersebut. Penggunaan
yang teratur saja tidak dapat langsung dikategorikan \up0 \expndtw-6\charscalex100
sebagai ketergantungan, sebab perlu memenuhi kriteria ketergantungan sesuai
\ul0\nosupersub\cf6\f7\fs20 Diagnostic \up0 \expndtw-2\charscalex100 Statistical
Manual of Mental Disorders IV\ul0\nosupersub\cf4\f5\fs20 (DSM IV). Oleh karena
itu, pendekatan terapi pun \up0 \expndtw-8\charscalex97 hendaknya bervariasi pula.
Kita perlu mengetahui lebih banyak tentang siapa penasun itu, \up0 \expndtw-
9\charscalex91 bagaimana pola penggunaan napza mereka,\par\pard\ql \li15435\sb0\sl-
230\slmult0 \par\pard\ql \li3641\sb93\sl-230\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 4
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
lsr160\qj \li2454\sb0\sl-245\slmult0 \par\pard\qj \li2454\sb0\sl-245\slmult0
\par\pard\qj \li2455\ri1804\sb114\sl-245\slmult0\fi0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf4\f5\fs20 Data empiris menunjukkan bahwa banyak
pengguna heroin yang juga menggunakan \up0 \expndtw-5\charscalex100 alkohol dan
benzodiazepine, dimana hal ini dapat meningkatkan risiko overdosis. \up0
\expndtw-8\charscalex96 Pengetahuan atas berbagai kombinasi zat yang digunakan
dapat membantu petugas untuk \up0 \expndtw-8\charscalex94 menegakkan diagnosis dan
menerapkan terapi yang lebih akurat. Untuk setiap jenis zat yang \up0 \expndtw-
9\charscalex95 digunakan, pengkajian hendaknya diarahkan pada hal-hal berikut
ini:\par\pard\ql \li3040\sb13\sl-230\slmult0 \up0 \expndtw-5\charscalex100 \u8226?
Kapan zat mulai digunakan\par\pard\ql \li3040\sb15\sl-230\slmult0 \up0 \expndtw-
8\charscalex98 \u8226? Kapan zat menjadi lebih sering digunakan atau mulai
menjadi masalah\par\pard\ql \li3040\sb15\sl-230\slmult0 \up0 \expndtw-
8\charscalex97 \u8226? Pernahkah mengurangi atau menghentikan zat, sekalipun
hanya sementara\par\pard\ql \li3040\sb15\sl-230\slmult0 \up0 \expndtw-
4\charscalex100 \u8226? Mengidentifikasi hal-hal terkait penggunaan zat,
terutama bilamana ada\par\pard\ql \li3439\sb15\sl-230\slmult0 \up0 \expndtw-
9\charscalex93 kesedihan atau trauma pada diri klien\par\pard\qj
\li3040\ri1804\sb3\sl-245\slmult0\tx3439 \up0 \expndtw-8\charscalex97 \u8226? Apa
yang dialami mereka baik secara fisik maupun psikis bilamana zat dikurangi
\line\tab \up0 \expndtw-9\charscalex96 atau dihentikan\par\pard\ql \li2454\sb13\sl-
230\slmult0 \up0 \expndtw-9\charscalex95 Selain itu perlu pula dilakukan penilaian
atas perilaku berisiko:\par\pard\qj \li3040\ri1804\sb3\sl-245\slmult0\tx3439
\up0 \expndtw-1\charscalex100 \u8226? Berbagi peralatan suntik (termasuk jarum &
tabung suntik, sendok, kapas \line\tab \up0 \expndtw-9\charscalex96 beralkohol,
penyaring dan \ul0\nosupersub\cf6\f7\fs20 torniquet\ul0\nosupersub\cf4\f5\fs20 /
pengikat)\par\pard\ql \li3040\sb16\sl-230\slmult0 \up0 \expndtw-8\charscalex100
\u8226? Perilaku seks yang tidak aman\par\pard\ql \li3040\sb15\sl-230\slmult0
\up0 \expndtw-1\charscalex100 \u8226? Menyetir sambil mabuk\par\pard\ql
\li3040\sb15\sl-230\slmult0 \up0 \expndtw-2\charscalex100 \u8226? Riwayat
overdosis\par\pard\ql \li3069\sb15\sl-230\slmult0 \up0 \expndtw-7\charscalex100
\u8226? Riwayat kejang selama putus zat\par\pard\qj \li2454\ri1805\sb3\sl-
245\slmult0\fi614 \up0 \expndtw-8\charscalex96 Pada saat proses pengkajian
sebaiknya petugas tidak hanya berpikir mengenai efek \up0 \expndtw-7\charscalex100
negatif, melainkan juga tentang efek positif yang mungkin dialami penasun. Perlu
diingat \up0 \expndtw-6\charscalex100 bahwa dibalik berbagai konsekuensi
negatif, penggunaan napza juga memberikan \up0 \expndtw-7\charscalex100
pengalaman positif. Pengalaman positif inilah yang menjadi penguat bagi penasun
untuk \up0 \expndtw-8\charscalex95 mengulangi penggunaan napzanya. Itu sebabnya
mengapa pertanyaan perlu diarahkan pula \up0 \expndtw-9\charscalex91 pada efek
positif penggunaan napza.\par\pard\qj \li2454\ri1805\sb1\sl-245\slmult0\fi0 \up0
\expndtw-5\charscalex100 Sejalan dengan pengkajian pengalaman positif, penting pula
ditanyakan pada penasun \line \up0 \expndtw-5\charscalex100 tentang alternatif
kegiatan yang dapat mereka lakukan untuk memperoleh pengalaman \line \up0 \expndtw-
8\charscalex97 positif yang sama sebagaimana yang diperoleh dari penggunaan napza
mereka. Misalnya, \line \up0 \expndtw-8\charscalex96 penggunaan napza membuat jadi
rileks. Tanyakan lebih lanjut, cara lain apa yang biasanya \line \up0 \expndtw-
4\charscalex100 dapat mereka lakukan untuk bisa merasa rileks. Menggali hal negatif
dan positif dapat \line \up0 \expndtw-8\charscalex94 membantu penasun dan juga
terapis memperoleh gambaran utuh pola penggunaan napza.\par\pard\qj
\li2454\ri1805\sb0\sl-245\slmult0\fi615 \up0 \expndtw-8\charscalex100 Proses
pengkajian hendaknya juga peka atas kemungkinan adanya masalah \up0
\expndtw-6\charscalex100 kesehatan mental yang mungkin dialami penasun. Masalah ini
dapat merupakan hal-hal \up0 \expndtw-8\charscalex94 yang telah ada jauh sebelum
penyalahgunaan napza dilakukan, dapat pula merupakan akibat \up0 \expndtw-
8\charscalex94 dari penyalahgunaan napzanya. Beberapa kondisi mental yang banyak
dialami oleh penasun \up0 \expndtw-9\charscalex91 aktif adalah: depresi, kecemasan
serta hilangnya rasa percaya diri.\par\pard\ql \li6086\sb0\sl-230\slmult0
230\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs20
7\par\pard\column \ql \li11815\sb0\sl-276\slmult0 \par\pard\ql \li11815\sb0\sl-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 BAB III\par\pard\qj
\li445\ri1197\sb15\sl-357\slmult0\tx1385 \up0 \expndtw-4\charscalex100 PROSEDUR
LAYANAN PENGURANGAN DAMPAK BURUK \line\tab \up0 \expndtw-3\charscalex100 TERKAIT
PENGGUNAAN NAPZA SUNTIK\par\pard\qj \li11815\sb0\sl-317\slmult0 \par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 Berikut ini akan dijelaskan prosedur atas setiap
layanan pengurangan dampak buruk terkait \up0 \expndtw-8\charscalex96 penggunaan
napza suntik yang diharapkan dapat dilaksanakan di Puskesmas atau institusi \up0
\expndtw-9\charscalex90 layanan kesehatan dasar sejenis. Jenis layanan yang
dimaksud mencakup:\par\pard\ql \li647\sb73\sl-230\slmult0\tx1016 \up0 \expndtw-
9\charscalex93 1.\tab \up0 \expndtw-9\charscalex92 Program Layanan Kesehatan
Dasar\par\pard\ql \li647\sb87\sl-230\slmult0\tx1016 \up0 \expndtw-9\charscalex93
2.\tab \up0 \expndtw-9\charscalex94 Program Layanan Terapi pemulihan
Napza\par\pard\ql \li647\sb88\sl-230\slmult0\tx1016 \up0 \expndtw-9\charscalex93
3.\tab \up0 \expndtw-9\charscalex94 Program Terapi Layanan Jarum Suntik\par\pard\ql
\expndtw-4\charscalex100 Program Voluntary Counseling and Testing (VCT) dan Care
Support and\par\pard\ql \li1011\sb87\sl-230\slmult0 \up0 \expndtw-7\charscalex100
Treatment (CST)\par\pard\ql \li647\sb88\sl-230\slmult0\tx1016 \up0 \expndtw-
9\charscalex93 5.\tab \up0 \expndtw-9\charscalex96 Program Terapi Rumatan
Metadon\par\pard\ql \li11815\sb0\sl-230\slmult0 \par\pard\ql \li20\sb139\sl-
1.\tab \up0 \expndtw-4\charscalex100 Program Layanan Kesehatan Dasar\par\pard\qj
Pengertian:\ul0\nosupersub\cf4\f5\fs20 layanan kesehatan dasar adalah berbagai
tindakan / upaya yang disasarkan untuk \up0 \expndtw-5\charscalex100 mengatasi
keluhan-keluhan fisik yang terkait dengan penggunaan napza suntik seperti \up0
\expndtw-8\charscalex95 misalnya, perawatan abses, gangguan pencernaan, gangguan
neuropsikologis dan masalah \up0 \expndtw-8\charscalex94 gizi, Selain itu juga
mencakup upaya melakukan rujukan ke layanan-layanan yang tepat yang \up0 \expndtw-
9\charscalex92 sesuai dengan kondisi medis Penasun.\par\pard\ql \li11815\sb0\sl-
4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Ruang
lingkup\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li647\sb87\sl-
1.1\tab \up0 \expndtw-9\charscalex94 \ul0\nosupersub\cf4\f5\fs20 Pengkajian Keluhan
Medis dan Proses Rujukan Medis\par\pard\ql \li647\sb88\sl-230\slmult0\tx1342
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 1.2\tab \up0 \expndtw-
9\charscalex95 \ul0\nosupersub\cf4\f5\fs20 Keluhan gangguan pembuluh darah dan
jaringan kulit\par\pard\ql \li647\sb126\sl-230\slmult0\tx1342 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 1.3\tab \up0 \expndtw-9\charscalex93
\ul0\nosupersub\cf4\f5\fs20 Keluhan gangguan pencernaan\par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 1.4\tab \up0 \expndtw-9\charscalex92
\ul0\nosupersub\cf4\f5\fs20 Keluhan gangguan asupan makanan\par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 1.5\tab \up0 \expndtw-9\charscalex96
\ul0\nosupersub\cf4\f5\fs20 Keluhan gangguan neuropsikiatris\par\pard\ql
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
Pg10}\par\pard\sect\sectd\sbknone\cols2\colno1\colw11655\colsr160\colno2\colw8205\c
olsr160\ql \li2455\sb0\sl-230\slmult0 \par\pard\ql \li2455\sb0\sl-230\slmult0
\ul0\nosupersub\cf5\f6\fs20 Prosedur :\par\pard\ql \li3067\sb33\sl-230\slmult0 \up0
\expndtw-5\charscalex100 1.1. Prosedur Pengkajian Keluhan Medis\par\pard\ql
\li3403\sb47\sl-230\slmult0\tx3674 \up0 \expndtw-2\charscalex100 \u8226? \tab
\up0 \expndtw-3\charscalex100 Tujuan :\ul0\nosupersub\cf4\f5\fs20 melakukan
pengkajian keluhan medis melalui anamnesa dan\par\pard\ql \li3698\sb50\sl-
230\slmult0 \up0 \expndtw-8\charscalex96 pemeriksaan fisik atau penunjang lain agar
diperoleh diagnosis kerja pasien\par\pard\ql \li3698\sb50\sl-230\slmult0 \up0
\expndtw-9\charscalex92 penasun yang mengalami masalah medis\par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 \u8226? \tab \up0 \expndtw-8\charscalex95
Pengertian :\ul0\nosupersub\cf4\f5\fs20 keluhan medis adalah sesuatu perasaan atau
kondisi baik secara\par\pard\ql \li3698\sb50\sl-230\slmult0 \up0 \expndtw-
6\charscalex100 subyektif maupun obyektif yang disampaikan oleh pasien penasun
yang\par\pard\qj \li3698\ri1804\sb9\sl-280\slmult0\fi0 \up0 \expndtw-8\charscalex94
mengganggu aktivitas pasien. Keluhan tersebut bisa berasal dari dalam tubuh \up0
\expndtw-9\charscalex97 (sistemik) maupun dari bagian luar tubuh
(topikal)\par\pard\ql \li3403\sb29\sl-230\slmult0\tx3674 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf5\f6\fs20 \u8226? \tab \up0 \expndtw-
5\charscalex100 Prosedur :\par\pard\qj \li3679\ri1849\sb5\sl-280\slmult0\fi0
\up0 \expndtw-9\charscalex93 \ul0\nosupersub\cf4\f5\fs20 1. \up0 \expndtw-
9\charscalex94 Pasien mendaftar pada loket pendaftaran untuk konsultasi dengan
dokter \up0 \expndtw-9\charscalex93 2. \up0 \expndtw-9\charscalex94 Dokter
melakukan anamnesa tentang:\par\pard\ql \li3955\sb42\sl-230\slmult0 \up0 \expndtw-
9\charscalex92 a. Keluhan utama pasien datang ke puskesmas\par\pard\ql
\li3955\sb50\sl-230\slmult0 \up0 \expndtw-9\charscalex96 b. Riwayat kronologis
penyakit yang menjadi keluhan utama\par\pard\ql \li3955\sb50\sl-230\slmult0 \up0
\expndtw-8\charscalex100 c. Riwayat penyakit terdahulu, khususnya yang terkait
dengan keluhan\par\pard\ql \li4267\sb50\sl-230\slmult0 \up0 \expndtw-9\charscalex92
saat ini dan penyakit berat atau tindakan bedah yang pernah dialami\par\pard\ql
\li3955\sb51\sl-230\slmult0 \up0 \expndtw-5\charscalex100 d. Riwayat pengobatan
dari dokter yang sudah pernah diterima bila\par\pard\qj \li4267\ri1804\sb9\sl-
280\slmult0\fi0 \up0 \expndtw-7\charscalex100 perlu dengan jenis dan nama-nama obat
baik jumlah, lama minum \up0 \expndtw-9\charscalex92 obat dan alasan
dihentikan\par\pard\qj \li3955\ri1804\sb0\sl-280\slmult0\tx4267 \up0 \expndtw-
9\charscalex95 e. Riwayat penggunaan Napza: jenis zat, mulai menggunakan,
frekuensi \line\tab \up0 \expndtw-9\charscalex92 penggunaan, jumlah dan cara
penggunaan\par\pard\ql \li3679\sb43\sl-230\slmult0\tx3950 \up0 \expndtw-
9\charscalex93 3.\tab \up0 \expndtw-5\charscalex100 Dokter melakukan pemeriksaan
fisik termasuk tanda-tanda vital dan\par\pard\ql \li3967\sb50\sl-230\slmult0
\up0 \expndtw-1\charscalex100 gejala-gejala infeksi oportunistik yang banyak
terjadi pada ODHA\par\pard\qj \li3967\ri1805\sb9\sl-280\slmult0\fi0 \up0 \expndtw-
5\charscalex100 seperti: Tuberkulosis, Kandidiasis, Pneumositis, Herpes Zoster atau
\up0 \expndtw-9\charscalex100 Gangguan kulit lain\par\pard\ql \li3679\sb42\sl-
7\charscalex100 Bila ada indikasi, dapat dilakukan pemeriksaan penunjang lain
seperti\par\pard\ql \li3967\sb51\sl-230\slmult0 \up0 \expndtw-9\charscalex96
pemeriksaan laboratorium, rontgen, EKG dsb.\par\pard\ql \li3679\sb50\sl-
5\charscalex100 Dokter membuat analisa dan menyimpulkan hasil pemeriksaan
dari\par\pard\ql \li3679\ri1804\sb0\sl-302\slmult0\fi288 \up0 \expndtw-
9\charscalex94 anamnesa, pemeriksaan fisik maupun pemeriksaan penunjang lain
\line \up0 \expndtw-9\charscalex93 6. \up0 \expndtw-8\charscalex100 Dokter membuat
Diagnosa Kerja yang dapat dijadikan pedoman untuk\par\pard\ql \li3967\sb65\sl-
230\slmult0 \up0 \expndtw-9\charscalex94 memberikan atau merencanakan
terapi\par\pard\ql \li6036\sb0\sl-230\slmult0 \par\pard\ql \li6036\sb0\sl-
10\par\pard\column \qj \li11815\sb0\sl-274\slmult0 \par\pard\qj \li11815\sb0\sl-
6\charscalex100 \ul0\nosupersub\cf4\f5\fs20 Penanganan kondisi kesehatan mental
pada beberapa orang penasun seringkali \line \up0 \expndtw-8\charscalex97
membutuhkan kerjasama dengan para ahli kesehatan jiwa, khususnya bilamana
ditengarai \line \up0 \expndtw-6\charscalex100 adanya kecenderungan untuk bunuh
diri, bersikap agitatif ataupun timbul paranoia yang \line \up0 \expndtw-
2\charscalex100 serius. Kerjasama yang baik dengan pihak keluarga akan sangat
membantu proses \line \up0 \expndtw-8\charscalex97 penanganan penasun, tidak saja
untuk keluhan fisik yang dialami tetapi juga untuk kondisi \line \up0 \expndtw-
9\charscalex100 psikiatrik mereka.\par\pard\qj \li20\ri811\sb0\sl-274\slmult0\fi615
\up0 \expndtw-8\charscalex97 Ketergantungan opioid ditandai oleh adanya toleransi
atas zat dan gejala putus zat \line \up0 \expndtw-5\charscalex100 bilamana zat
tersebut dihentikan penggunaannya (DSM IV). Pengertian toleransi disini \line
\up0 \expndtw-8\charscalex96 adalah adanya peningkatan jumlah zat (dosis) yang
digunakan sebagai reaksi penyesuaian \line \up0 \expndtw-8\charscalex97 tubuh untuk
memperoleh efek yang sama dari waktu ke waktu. Pengertian gejala putus zat \line
\up0 \expndtw-3\charscalex100 adalah adanya berbagai gejala fisik dan psikologis
yang timbul akibat dihentikannya \line \up0 \expndtw-6\charscalex100 penggunaan zat
secara tiba-tiba. Untuk ketergantungan opioid (heroin), gejala putus zat \line \up0
\expndtw-2\charscalex100 meliputi:\par\pard\ql \li635\sb43\sl-276\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24
\u8226?\ul0\nosupersub\cf4\f5\fs20 Gelisah, merinding, cemas\par\pard\ql
\ul0\nosupersub\cf9\f10\fs24 \u8226?\ul0\nosupersub\cf4\f5\fs20 Berkeringat,
menguap, bersin-bersin\par\pard\ql \li635\sb53\sl-276\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24
\u8226?\ul0\nosupersub\cf4\f5\fs20 Lakrimasi, midriasis\par\pard\ql
\ul0\nosupersub\cf9\f10\fs24 \u8226?\ul0\nosupersub\cf4\f5\fs20 Takikardia,
hipertensi\par\pard\ql \li635\sb54\sl-276\slmult0 \up0 \expndtw0\charscalex107
\ul0\nosupersub\cf9\f10\fs24 \u8226?\ul0\nosupersub\cf4\f5\fs20 Dilatasi
pupil\par\pard\ql \li635\sb53\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u8226?\ul0\nosupersub\cf4\f5\fs20 Nyeri otot dan
atau syaraf, tremor\par\pard\ql \li635\sb53\sl-276\slmult0 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf9\f10\fs24
\u8226?\ul0\nosupersub\cf4\f5\fs20 Diare, muntah\par\pard\ql \li635\sb53\sl-
276\slmult0 \up0 \expndtw0\charscalex111 \ul0\nosupersub\cf9\f10\fs24
\u8226?\ul0\nosupersub\cf4\f5\fs20 Insomnia\par\pard\qj \li20\ri811\sb12\sl-
274\slmult0\fi600 \up0 \expndtw-8\charscalex97 Sekalipun tidak mengancam jiwa
seseorang, penderita gejala putus zat opioid akan \up0 \expndtw-8\charscalex97
merasa sangat tidak nyaman. Oleh karenanya farmakoterapi yang sesuai dapat membantu
\up0 \expndtw-9\charscalex93 meringankan rasa tak nyaman tersebut.\par\pard\qj
\li20\ri811\sb1\sl-274\slmult0\fi600 \up0 \expndtw-5\charscalex100 Untuk ketepatan
penanganan, pengkajian derajat keparahan putus opioid perlu \up0 \expndtw-
9\charscalex94 dilakukan. Prediktor utama tingkat keparahan adalah:\par\pard\ql
\ul0\nosupersub\cf9\f10\fs24 \u8226?\ul0\nosupersub\cf4\f5\fs20 Dosis reguler
yang relatif tinggi (misal: 0.5 1 gram per hari)\par\pard\ql \li621\sb53\sl-
\u8226?\ul0\nosupersub\cf4\f5\fs20 Frekuensi penggunaan yang tinggi: menandakan
cepatnya tubuh merasakan\par\pard\ql \li1001\sb48\sl-230\slmult0 \up0 \expndtw-
9\charscalex93 putus dari zat\par\pard\qj \li20\ri811\sb8\sl-274\slmult0\fi600 \up0
\expndtw-8\charscalex98 Pertimbangkan juga pengalaman yang terjadi sebelum
timbulnya putus zat, situasi \up0 \expndtw-5\charscalex100 yang dialami saat
terjadi putus zat, kondisi fisik (perawatan diri dan nutrisi yang buruk), \up0
\expndtw-8\charscalex97 kemungkinan adanya kesedihan yang mendalam, konstipasi,
impotensi (bagi laki-laki) dan \up0 \expndtw-9\charscalex94 menstruasi yang tidak
reguler (bagi perempuan).\par\pard\ql \li15437\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf3\f4\fs20 8
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf4\f5\fs20 7.\tab \up0 \expndtw-6\charscalex100 Bila hasil analisa
menunjukkan diagnosa yang cukup serius dan tidak dapat\par\pard\qj
\li3497\ri1817\sb3\sl-241\slmult0\fi0 \up0 \expndtw-5\charscalex100 ditangani di
tingkat puskesmas, dokter dapat memberi rujukan ke layanan \up0 \expndtw-
9\charscalex95 kesehatan lain yang lebih lengkap atau rumah sakit rujukan
ODHA\par\pard\ql \li2461\sb0\sl-230\slmult0 \par\pard\ql \li3083\sb10\sl-
230\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf5\f6\fs20 \u8226?
Dokumen Terkait :\par\pard\ql \li3460\sb8\sl-230\slmult0\tx3896 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf4\f5\fs20 -\tab \up0 \expndtw-9\charscalex96
Kartu berobat\par\pard\ql \li3460\sb11\sl-230\slmult0\tx3896 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-9\charscalex95 Catatan Medik pasien\par\pard\ql
\li3460\sb12\sl-230\slmult0\tx3896 \up0 \expndtw-2\charscalex100 -\tab \up0
\expndtw-7\charscalex100 Formulir pengkajian (lihat lampiran)\par\pard\ql
\expndtw-9\charscalex95 Blanko pemeriksaan penunjang\par\pard\ql \li3459\sb11\sl-
230\slmult0\tx3896 \up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex89
Resep\par\pard\ql \li3459\sb12\sl-230\slmult0\tx3896 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-8\charscalex100 Surat rujukan\par\pard\ql \li2461\sb226\sl-
1.2\tab \up0 \expndtw-5\charscalex100 Penatalaksanaan Keluhan Gangguan Pembuluh
Darah dan Jaringan Kulit\par\pard\qj \li3083\ri1816\sb226\sl-241\slmult0 \up0
\expndtw-4\charscalex100 Tujuan\ul0\nosupersub\cf4\f5\fs20 : memberikan perawatan
gangguan yang terjadi pada pembuluh darah \up0 \expndtw-9\charscalex95 maupun
jaringan kulit lainnya akibat penggunaan napza suntik\par\pard\qj \li3082\sb0\sl-
241\slmult0 \par\pard\qj \li3082\ri1817\sb1\sl-241\slmult0 \up0 \expndtw-
8\charscalex98 \ul0\nosupersub\cf5\f6\fs20 Pengertian\ul0\nosupersub\cf4\f5\fs20 :
gangguan pembuluh darah dan jaringan adalah kerusakan yang terjadi \up0 \expndtw-
8\charscalex93 pada pembuluh darah dan jaringan sekitarnya akibat penggunaan napza
dengan cara \up0 \expndtw-8\charscalex96 suntik yang tidak memenuhi standar
kesehatan sehingga menimbulkan infeksi atau \up0 \expndtw-9\charscalex93 kerusakan
pada pembuluh darah dan jaringan lunak sekitarnya\par\pard\ql \li3082\sb0\sl-
5\charscalex100 \ul0\nosupersub\cf5\f6\fs20
Prosedur\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li3082\sb11\sl-
Pasien melakukan pendaftaran sesuai dengan alur yang telah
ditentukan\par\pard\ql \li3082\sb12\sl-230\slmult0\tx3454 \up0 \expndtw-
9\charscalex93 2.\tab \up0 \expndtw-6\charscalex100 Perawat melakukan rujukan
kepada dokter yang bertugas untuk konsultasi\par\pard\ql \li3461\sb11\sl-
230\slmult0 \up0 \expndtw-9\charscalex93 kepada dokter\par\pard\ql \li3082\sb11\sl-
6\charscalex100 Dokter melakukan asesmen melalui wawancara, pemeriksaan fisik
dan\par\pard\qj \li3459\ri1817\sb3\sl-241\slmult0\fi1 \up0 \expndtw-6\charscalex100
psikiatris secara sederhana seperti: sulit tidur, halusinasi, perasaan depresi,
\line \up0 \expndtw-4\charscalex100 cemas, sulit konsentrasi dan gangguan perasaan
serta pikiran lain. Untuk \line \up0 \expndtw0\charscalex112 petugas yang sudah
dilatih dapat menggunakan form Mini \line \up0 \expndtw-1\charscalex100 ICD
X.\par\pard\qj \li3082\ri1776\sb0\sl-289\slmult0\tx3460 \up0 \expndtw-
10\charscalex100 \ul0\nosupersub\cf9\f10\fs24 4. Dokter menentukan layanan yang
dibutuhkan oleh pasien sesuai \line\tab \up0 \expndtw-11\charscalex94 dengan
diagnosis yang ditentukan:\par\pard\qj \li3459\ri1777\sb6\sl-328\slmult0\tx3760
\up0 \expndtw-10\charscalex100 a.\ul0\nosupersub\cf1\f2\fs24 Untuk perawatan
abses:\ul0\nosupersub\cf9\f10\fs24 dilakukan pembersihan disekitar abses \line\tab
\up0 \expndtw-8\charscalex100 dengan larutan disinfektan, dilakukan pembalutan
bila area\par\pard\ql \li3760\sb43\sl-276\slmult0 \up0 \expndtw-11\charscalex88
abses cukup besar,\par\pard\ql \li6044\sb0\sl-230\slmult0 \par\pard\ql
\li6044\sb0\sl-230\slmult0 \par\pard\ql \li6044\sb16\sl-230\slmult0 \up0 \expndtw-
8\charscalex100 \ul0\nosupersub\cf3\f4\fs20 11\par\pard\column \ql \li11821\sb0\sl-
4.\tab \up0 \expndtw-4\charscalex100 Dokter menentukan layanan yang dibutuhkan oleh
pasien sesuai dengan\par\pard\ql \li1004\sb30\sl-230\slmult0 \up0 \expndtw-
9\charscalex95 diagnosis yang ditentukan:\par\pard\ql \li993\sb31\sl-
230\slmult0\tx1345 \up0 \expndtw-9\charscalex82 a.\tab \up0 \expndtw-
6\charscalex100 Untuk pasien yang mengalami Dispepsia akibat asupan makanan
tidak teratur dibantu dengan memberikan ajuvantibus berupa enzim dan \up0 \expndtw-
3\charscalex100 vitamin\par\pard\ql \li993\sb26\sl-230\slmult0\tx1345 \up0
\expndtw-9\charscalex97 b.\tab \up0 \expndtw-8\charscalex97 Pasien yang mengalami
iritasi lambung akibat penggunaan \ul0\nosupersub\cf6\f7\fs20
Polydrug\ul0\nosupersub\cf4\f5\fs20 (Heroin\par\pard\ql \li1340\sb32\sl-
230\slmult0 \up0 \expndtw-9\charscalex95 dengan Alkohol atau Metamfetamin) perlu
diberikan antasida dan penekan\par\pard\ql \li1340\sb31\sl-230\slmult0 \up0
\expndtw-9\charscalex97 H2 reseptor (misalnya omiprazole)\par\pard\ql
\li993\sb30\sl-230\slmult0\tx1345 \up0 \expndtw-9\charscalex91 c.\tab \up0
\expndtw-8\charscalex95 Pasien yang mengalami kesulitan buang air besar dapat
diberikan Laxantia\par\pard\qj \li1340\ri818\sb6\sl-260\slmult0\fi0 \up0 \expndtw-
4\charscalex100 maupun pencahar lain (Dulcolax) disertai dengan banyak minum dan
\up0 \expndtw-9\charscalex94 makanan berserat tinggi\par\pard\ql \li993\sb25\sl-
230\slmult0\tx1345 \up0 \expndtw-8\charscalex100 d.\tab \up0 \expndtw-
8\charscalex96 Pasien yang mengalami diare dapat diberikan antidiare yang ringan
seperti\par\pard\ql \li1340\sb30\sl-230\slmult0 \up0 \expndtw-7\charscalex100 New
Diatab atau Imodium. Bila kondisi diare berat (lebih dari 5-
10x/hari)\par\pard\qj \li1340\ri818\sb7\sl-260\slmult0\fi0 \up0 \expndtw-
3\charscalex100 dan bila disertai gejala dehidrasi sebaiknya diberikan cairan
elektrolit \up0 \expndtw-6\charscalex100 melalui infus\par\pard\ql \li993\sb25\sl-
230\slmult0\tx1345 \up0 \expndtw-9\charscalex87 e.\tab \up0 \expndtw-
4\charscalex100 Apabila pasien mengalami masalah yang lebih serius seperti
adanya\par\pard\qj \li1340\ri818\sb7\sl-260\slmult0\fi0 \up0 \expndtw-
7\charscalex100 perdarahan akibat tukak lambung (Hematemesis) atau gangguan
fungsi \up0 \expndtw-5\charscalex100 hati perlu dilakukan pemeriksaan kimia darah
khususnya darah perifer \up0 \expndtw-9\charscalex92 lengkap dan Tes Fungsi
Hati\par\pard\ql \li993\sb26\sl-230\slmult0\tx1345 \up0 \expndtw-6\charscalex100
f.\tab \up0 \expndtw-7\charscalex100 Bila kondisi pasien memburuk perlu dirujuk ke
ahli penyakit dalam rumah\par\pard\ql \li1340\sb30\sl-230\slmult0 \up0 \expndtw-
9\charscalex94 sakit terdekat\par\pard\ql \li11821\sb0\sl-230\slmult0
\ul0\nosupersub\cf5\f6\fs20 Dokumen terkait\ul0\nosupersub\cf4\f5\fs20
:\par\pard\ql \li650\sb30\sl-230\slmult0 \up0 \expndtw-6\charscalex100 - Catatan
Medik Pasien\par\pard\ql \li650\sb30\sl-230\slmult0 \up0 \expndtw0\charscalex100 -
Resep\par\pard\ql \li650\sb31\sl-230\slmult0 \up0 \expndtw-2\charscalex100 -
Surat Rujukan\par\pard\ql \li650\sb30\sl-230\slmult0 \up0 \expndtw-6\charscalex100
- Kertas Resep\par\pard\ql \li650\sb30\sl-230\slmult0 \up0 \expndtw-
6\charscalex100 - Buku Pedoman Program HR Nasional\par\pard\ql \li650\sb31\sl-
230\slmult0 \up0 \expndtw-5\charscalex100 - Buku Pedoman CST Nasional\par\pard\ql
\expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 1.4.\tab \up0 \expndtw-
4\charscalex100 Penatalaksanaan Gangguan Asupan Makanan\par\pard\qj
\li650\ri819\sb295\sl-303\slmult0 \up0 \expndtw-3\charscalex100
Tujuan\ul0\nosupersub\cf4\f5\fs20 : memberikan pendidikan dan tindakan pada pasien
yang mengalami \up0 \expndtw-7\charscalex100 gangguan asupan makanan/gizi sebagai
akibat langsung maupun tidak langsung \up0 \expndtw-9\charscalex95 penggunaan Napza
suntik\par\pard\ql \li15392\sb0\sl-230\slmult0 \par\pard\ql \li15392\sb0\sl-
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
olsr160\qj \li2454\sb0\sl-235\slmult0 \par\pard\qj \li2454\sb0\sl-235\slmult0
\par\pard\qj \li3075\ri1798\sb176\sl-235\slmult0 \up0 \expndtw-8\charscalex96
\ul0\nosupersub\cf5\f6\fs20 Pengertian\ul0\nosupersub\cf4\f5\fs20 : gangguan asupan
makanan adalah adanya perubahan pola makan yang \up0 \expndtw-6\charscalex100
mempengaruhi kesehatan pasien baik yang disebabkan langsung maupun tidak \up0
\expndtw-9\charscalex93 langsung penggunaan napza suntik\par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 Prosedur\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql
\expndtw-9\charscalex90 Pasien mendaftar pada layanan rawat jalan di
puskesmas\par\pard\ql \li3075\sb6\sl-230\slmult0\tx3424 \up0 \expndtw-
9\charscalex93 2.\tab \up0 \expndtw-8\charscalex94 Perawat akan lakukan pemeriksaan
awal dan melakukan rujukan kepada dokter\par\pard\ql \li3075\sb6\sl-
Dokter melakukan anamnesa maupun pemeriksaan fisik sesuai keluhan
pasien\par\pard\ql \li3075\sb6\sl-230\slmult0\tx3424 \up0 \expndtw-9\charscalex93
4.\tab \up0 \expndtw-6\charscalex100 Dilakukan perhitungan status gizi
menggunakan \ul0\nosupersub\cf6\f7\fs20 Body Mass Index\ul0\nosupersub\cf4\f5\fs20
(BMI) dengan\par\pard\ql \li7304\sb8\sl-115\slmult0 \up0 \expndtw-4\charscalex93
\ul0\nosupersub\cf11\f12\fs10 2\par\pard\qj \li3349\ri4193\sb0\sl-
180\slmult0\tx3429 \up0 \expndtw-9\charscalex96 \ul0\nosupersub\cf4\f5\fs20 rumus :
Berat Badan (Kg)/Tinggi Badan (Meter) \up0 \expndtw-2\charscalex100 : \line\tab
\up0 \expndtw-2\charscalex100 - Nilai < 17 = Kurang sekali\par\pard\ql
\expndtw-9\charscalex95 17 18,5 = Kurang\par\pard\ql \li3429\sb6\sl-
230\slmult0\tx3735 \up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-
6\charscalex100 18,5 -25 = Normal\par\pard\ql \li3429\sb6\sl-230\slmult0\tx3735
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-8\charscalex100 >25-27 = Berat
Badan Lebih\par\pard\ql \li3429\sb6\sl-230\slmult0\tx3735 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-7\charscalex100 > 27 = Obesitas\par\pard\ql
\expndtw-4\charscalex100 Dokter akan meminta pemeriksaan laboratorium khususnya
darah perifer\par\pard\qj \li3449\ri1799\sb2\sl-235\slmult0\fi0 \up0 \expndtw-
7\charscalex100 lengkap: untuk hasil laboratorium dengan hasil dibawah batas normal
ringan, \up0 \expndtw-3\charscalex100 dokter akan memberikan pendidikan Gizi
tentang asupan makanan yang \up0 \expndtw-2\charscalex100 diperlukan untuk
menunjang kondisi kesehatan pasien yang memenuhi \up0 \expndtw-9\charscalex93
standar gizi seimbang\par\pard\ql \li3074\sb6\sl-230\slmult0\tx3424 \up0 \expndtw-
9\charscalex93 6.\tab \up0 \expndtw-5\charscalex100 Pasien ditimbang berat badannya
secara periodik untuk melihat kemajuan\par\pard\ql \li3449\sb6\sl-230\slmult0
\up0 \expndtw-9\charscalex94 pengobatan yang diberikan\par\pard\ql \li3074\sb6\sl-
4\charscalex100 Hasil laboratorium yang jauh dibawah normal seperti untuk pasien
ODHA\par\pard\qj \li3449\ri1799\sb2\sl-235\slmult0\fi0 \up0 \expndtw-
8\charscalex100 dengan stadium lanjut yang mengalami gangguan pola makan di rujuk
ke ahli \up0 \expndtw-4\charscalex100 gizi, penyakit dalam atau ahli paru untuk
mendapatkan pengobatan yang \up0 \expndtw-6\charscalex100
komprehensif\par\pard\ql \li2454\sb0\sl-230\slmult0 \par\pard\ql \li3074\sb11\sl-
230\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Dokumen
terkait\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li3074\sb6\sl-230\slmult0\tx3424
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex94 Catatan Medik
Pasien\par\pard\ql \li3074\sb6\sl-230\slmult0\tx3424 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-9\charscalex97 Surat Rujukan\par\pard\ql \li3074\sb6\sl-
-\tab \up0 \expndtw-9\charscalex97 Buku Pedoman Program HR Nasional\par\pard\ql
\expndtw-9\charscalex100 Buku Pedoman CST Nasional\par\pard\ql \li2454\sb0\sl-
4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 1.5.\tab \up0 \expndtw-4\charscalex100
Penatalaksanaan gangguan neuropsikiatris\par\pard\qj \li3074\ri1799\sb241\sl-
254\slmult0 \up0 \expndtw-3\charscalex100 Tujuan:\ul0\nosupersub\cf4\f5\fs20 acuan
melakukan tindakan kepada pasien penasun yang mengalami \up0 \expndtw-
8\charscalex97 gangguan medis secara neurologis maupun psikiatris agar dapat
dilakukan deteksi \up0 \expndtw-8\charscalex100 dan intervensi dini untuk tindak
lanjutnya\par\pard\ql \li6038\sb0\sl-230\slmult0 \par\pard\ql \li6038\sb0\sl-
14\par\pard\column \qj \li11809\sb0\sl-240\slmult0 \par\pard\qj \li11809\sb0\sl-
240\slmult0 \par\pard\qj \li1333\ri805\sb162\sl-240\slmult0 \up0 \expndtw-
7\charscalex100 \ul0\nosupersub\cf4\f5\fs20 pemberian antibiotic Broad Spectrum
sesuai dosis yang dibutuhkan. Bila \line \up0 \expndtw-3\charscalex100 memerlukan
tindakan bedah yang lebih serius dapat dirujuk ke RSU \line \up0 \expndtw-
9\charscalex93 setempat\par\pard\qj \li981\ri805\sb240\sl-240\slmult0\tx1359
\up0 \expndtw0\charscalex101 b.\ul0\nosupersub\cf5\f6\fs20 Untuk Perawatan
Pembuluh Darah:\ul0\nosupersub\cf4\f5\fs20 memberikan pendidikan tentang \line\tab
\up0 \expndtw-8\charscalex100 fungsi pembuluh darah dan akibat yang dapat timbul
bila terus menyuntik\par\pard\qj \li1349\ri805\sb0\sl-240\slmult0\fi0 \up0
\expndtw-4\charscalex100 pada tempat yang sama. Memberikan pencegahan berupa
salep \up0 \expndtw-9\charscalex95 (Thrombophob) pada pembuluh darah yang sudah
pecah\par\pard\qj \li981\ri805\sb240\sl-240\slmult0\tx1359 \up0 \expndtw-
5\charscalex100 c.\ul0\nosupersub\cf5\f6\fs20 Kondisi Oportunistik Infeksi:
\ul0\nosupersub\cf4\f5\fs20 mengacu pada pedoman buku CST dan bila \line\tab
\up0 \expndtw-8\charscalex100 ada indikasi klinis dapat dirujuk ke layanan
kesehatan yang lebih lengkap\par\pard\ql \li1349\sb9\sl-230\slmult0 \up0 \expndtw-
6\charscalex100 (Rumah Sakit Rujukan ODHA)\par\pard\ql \li11809\sb0\sl-230\slmult0
:\par\pard\ql \li981\sb10\sl-230\slmult0\tx1338 \up0 \expndtw-2\charscalex100 -\tab
\up0 \expndtw-9\charscalex94 Catatan Medik Pasien\par\pard\ql \li981\sb10\sl-
-\tab \up0 \expndtw-9\charscalex97 Surat Rujukan\par\pard\ql \li981\sb10\sl-
8\charscalex100 Buku Pedoman HR Nasional\par\pard\ql \li981\sb10\sl-
8\charscalex100 Buku Pedoman CST\par\pard\ql \li20\sb224\sl-230\slmult0\tx633
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 1.3.\tab \up0 \expndtw-
4\charscalex100 Penatalaksanaan Keluhan Gangguan Pencernaan\par\pard\qj
Tujuan\ul0\nosupersub\cf4\f5\fs20 : memberi tindakan atas kondisi gangguan
pencernaan yang ditimbulkan \up0 \expndtw-8\charscalex95 secara langsung akibat
penggunaan napza suntik, khususnya pada kondisi putus zat \up0 \expndtw-
8\charscalex93 dan akibat pola makan yang tidak teratur seperti pada penggunaan
\ul0\nosupersub\cf6\f7\fs20 poly drug\par\pard\qj \li628\ri806\sb228\sl-240\slmult0
\up0 \expndtw-8\charscalex100 \ul0\nosupersub\cf5\f6\fs20
Pengertian\ul0\nosupersub\cf4\f5\fs20 : gangguan pencernaan adalah suatu kondisi
dimana pasien mengalami \up0 \expndtw-8\charscalex96 gangguan dalam proses
pencernaan seperti mual, muntah, diare dan sulit buang air \up0 \expndtw-
6\charscalex100 besar atau gangguan metabolisme berupa perasaan tidak nyaman dalam
sistem \up0 \expndtw-8\charscalex95 pencernaan seperti kembung, nyeri atau tidak
nafsu makan yang diakibatkan karena \up0 \expndtw-9\charscalex93 penggunaan napza
suntik\par\pard\ql \li12417\sb0\sl-230\slmult0 \par\pard\ql \li628\sb5\sl-
Prosedur\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li628\sb10\sl-230\slmult0
\up0 \expndtw-8\charscalex95 1. Pasien melakukan pendaftaran sesuai dengan alur
yang telah ditentukan\par\pard\ql \li628\sb37\sl-230\slmult0 \up0 \expndtw-
3\charscalex100 2. Perawat melakukan rujukan kepada dokter yang bertugas untuk
konsultasi\par\pard\ql \li1000\sb37\sl-230\slmult0 \up0 \expndtw-9\charscalex93
kepada dokter\par\pard\qj \li628\ri806\sb7\sl-267\slmult0\tx1010 \up0 \expndtw-
5\charscalex100 3. Dokter melakukan asesmen melalui wawancara, pemeriksaan fisik
dan (bila \line\tab \up0 \expndtw-8\charscalex100 diperlukan) pemeriksaan
laboratorium\par\pard\ql \li15390\sb0\sl-230\slmult0 \par\pard\ql \li15390\sb0\sl-
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\par\pard\qj \li3114\ri2463\sb23\sl-271\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Pengertian\ul0\nosupersub\cf4\f5\fs20 : gangguan
neuropsikiatris adalah suatu kondisi medis yang berupa \line \up0 \expndtw-
8\charscalex94 gangguan neurologis maupun psikiatris sebagai akibat langsung
penggunaan napza \line \up0 \expndtw-7\charscalex100 suntik. Keluhan terbanyak
biasanya adalah baal/kesemutan, nyeri pada otot dan \line \up0 \expndtw-
8\charscalex92 tulang belakang, nyeri kepala sebagai bagian dari gejala putus zat
maupun akibat cara \line \up0 \expndtw-8\charscalex95 menyuntik dan zat disuntikan
yang menimbulkan gangguan pada fungsi saraf tepi\par\pard\ql \li3113\sb0\sl-
Prosedur\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li3114\sb42\sl-
Pasien mendaftar pada layanan rawat jalan di puskesmas\par\pard\qj
\li3114\ri2463\sb9\sl-271\slmult0\fi0 \up0 \expndtw-9\charscalex93 2. \up0
\expndtw-8\charscalex94 Perawat akan lakukan pemeriksaan awal dan melakukan rujukan
kepada dokter \line \up0 \expndtw-9\charscalex93 3. \up0 \expndtw-8\charscalex96
Dokter melakukan anamnesa maupun pemeriksaan fisik dan neurologis
sesuai\par\pard\ql \li3463\sb34\sl-230\slmult0 \up0 \expndtw-9\charscalex94 keluhan
4.\tab \up0 \expndtw-4\charscalex100 Dokter membuat diagnosis untuk memastikan
penyebab keluhan pasien:\par\pard\ql \li3114\ri2463\sb9\sl-271\slmult0\fi349
\up0 \expndtw-8\charscalex93 sebagai akibat langsung atau tidak langsung karena
penggunaan Napza suntik \up0 \expndtw-9\charscalex93 5. \up0 \expndtw-
7\charscalex100 Bilamana ditemukan keluhan sebagai akibat langsung maka akan
diberikan\par\pard\ql \li3114\ri2463\sb1\sl-271\slmult0\fi349 \up0 \expndtw-
9\charscalex93 pengobatan sesuai dengan kondisi klinis putus zat atau
intoksikasi \up0 \expndtw-9\charscalex93 6. \up0 \expndtw-7\charscalex100 Bilamana
akibat dari cara penggunaan dan jenis napza yang disuntik, dokter\par\pard\ql
\li3463\sb35\sl-230\slmult0 \up0 \expndtw-9\charscalex94 akan memberikan pengobatan
simtomatis untuk 3 hari seperti :\par\pard\ql \li3442\sb42\sl-230\slmult0 \up0
\expndtw-7\charscalex100 - Analgesik ; Asam Mefenamat, Tramadol,
Metampiron\par\pard\ql \li3113\ri2466\sb9\sl-271\slmult0\fi328 \up0 \expndtw-
5\charscalex100 - Minor Tranqulizer ; Diazepam, Chlordiazepoxide \line \up0
\expndtw-9\charscalex93 7. \up0 \expndtw-9\charscalex94 Pasien diminta datang
kembali untuk kontrol setelah obat habis \line \up0 \expndtw-9\charscalex93 8. \up0
\expndtw-8\charscalex97 Perlu dipertimbangkan keluhan subyektif pasien dengan
melakukan beberapa\par\pard\ql \li3113\ri2464\sb1\sl-271\slmult0\fi349 \up0
\expndtw-8\charscalex94 tes sederhana seperti refleks fisiologis maupun patologis,
kaku kuduk dsb. \up0 \expndtw-9\charscalex93 9. \up0 \expndtw-8\charscalex96 Bila
saat kontrol keluhan neurologis maupun psikiatris masih ada atau
semakin\par\pard\qj \li3463\ri2463\sb1\sl-271\slmult0\fi0 \up0 \expndtw-
1\charscalex100 berat dokter akan merujuk ke RS rujukan khusus maupun umum yang
\up0 \expndtw-9\charscalex96 memiliki fasilitas yang lebih lengkap\par\pard\ql
5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Dokumen
terkait\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li3113\sb42\sl-230\slmult0
\up0 \expndtw-4\charscalex100 - Catatan Medik Pasien\par\pard\ql \li3113\sb76\sl-
230\slmult0 \up0 \expndtw0\charscalex106 - Resep\par\pard\ql \li3113\sb77\sl-
230\slmult0 \up0 \expndtw0\charscalex101 - Surat Rujukan\par\pard\ql
\li3113\sb76\sl-230\slmult0 \up0 \expndtw-4\charscalex100 - Buku Pedoman CST
Nasional\par\pard\ql \li6036\sb0\sl-230\slmult0 \par\pard\ql \li6036\sb0\sl-
\up0 \expndtw-6\charscalex100 - Catatan medik pasien\par\pard\ql \li449\sb23\sl-
230\slmult0 \up0 \expndtw-4\charscalex100 - Buku pedoman HR Nasional\par\pard\ql
4\charscalex100 Penatalaksanaan overdosis\par\pard\qj \li446\ri818\sb2\sl-
252\slmult0\fi2 \up0 \expndtw-2\charscalex100 Tujuan:\ul0\nosupersub\cf4\f5\fs20
memberikan tindakan medis gawat darurat di ruang unit gawat \up0 \expndtw-
9\charscalex92 darurat kepada pengguna napza suntik yang mengalami overdosis
opiat\par\pard\qj \li446\ri818\sb0\sl-252\slmult0\fi2 \up0 \expndtw-8\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Pengertian\ul0\nosupersub\cf4\f5\fs20 : overdosis
adalah suatu keadaan dimana tubuh pengguna napza \up0 \expndtw-8\charscalex95
suntik tidak dapat mentoleransi opiat yang masuk kedalam tubuhnya sehingga \up0
\expndtw-9\charscalex96 menimbulkan gangguan fungsi vital kehidupan\par\pard\ql
\li448\sb7\sl-230\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20
Prosedur :\par\pard\ql \li448\sb20\sl-230\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf4\f5\fs20 1. Dokter di unit gawat darurat \up0 \expndtw-
4\charscalex100 (UGD) melakukan penilaian kondisi\par\pard\ql \li694\sb23\sl-
230\slmult0 \up0 \expndtw-8\charscalex94 kegawatdaruratan pasien dengan pemeriksaan
tanda-tanda vital dan derajat\par\pard\ql \li694\sb22\sl-230\slmult0 \up0 \expndtw-
9\charscalex92 kesadaran Glasgow Coma Scale (GCS)\par\pard\qj \li448\ri818\sb5\sl-
252\slmult0\tx704 \up0 \expndtw-5\charscalex100 2. Pemberian intervensi Bantuan
Hidup Dasar yang meliputi A (Airway), B \line\tab \up0 \expndtw-6\charscalex100
(Breathing) dan C (Circulation) dan CPR (Cor Pulmonary Resusitation)\par\pard\ql
\li694\sb20\sl-230\slmult0 \up0 \expndtw-9\charscalex94 bila ada henti
jantung\par\pard\qj \li448\ri818\sb4\sl-252\slmult0\tx704 \up0 \expndtw-
2\charscalex100 3. Untuk kondisi overdosis heroin berat \ul0\nosupersub\cf5\f6\fs20
setelah dilakukan Bantuan Hidup \line\tab \up0 \expndtw-4\charscalex100
Dasar\ul0\nosupersub\cf4\f5\fs20 \ul0\nosupersub\cf5\f6\fs20 langsung
dirujuk\ul0\nosupersub\cf4\f5\fs20 ke rumah sakit yang memiliki fasilitas
Intensive\par\pard\ql \li694\sb20\sl-230\slmult0 \up0 \expndtw-1\charscalex100 Care
Unit (ICU)\par\pard\ql \li12461\sb0\sl-230\slmult0 \par\pard\ql \li448\sb45\sl-
\up0 \expndtw-6\charscalex100 - Catatan medik pasien\par\pard\ql \li448\sb23\sl-
230\slmult0 \up0 \expndtw-1\charscalex100 - Surat rujukan\par\pard\ql
4\charscalex100 Pemberian konseling adiksi\par\pard\qj \li446\ri818\sb2\sl-
252\slmult0\fi2 \up0 \expndtw-6\charscalex100 Tujuan:\ul0\nosupersub\cf4\f5\fs20
memberikan konseling adiksi kepada pengguna jarum suntik agar \up0 \expndtw-
7\charscalex100 terjadi pemahaman tentang masalah yang sedang dihadapi terkait
dengan \up0 \expndtw-9\charscalex96 perilaku penggunaan jarum suntik\par\pard\qj
\ul0\nosupersub\cf5\f6\fs20 Pengertian\ul0\nosupersub\cf4\f5\fs20 : konseling
adiksi adalah suatu bentuk intevensi psikososial yang \up0 \expndtw-5\charscalex100
diberikan oleh seorang konselor terlatih di bidang adiksi pada pasien yang \up0
\expndtw-6\charscalex100 memiliki kesadaran penuh. Konseling adiksi
merupakan bagian yang \up0 \expndtw-3\charscalex100 terintegrasi dari program
intervensi pada penasun. Konseling adiksi \up0 \expndtw-9\charscalex96 membantu
pengguna jarum suntik merubah perilaku dan pola hidupnya yang \up0 \expndtw-
8\charscalex94 dapat diberikan oleh petugas puskesmas terlatih maupun bekerja sama
dengan \up0 \expndtw-9\charscalex94 LSM yang bekerja di bidang
Napzan\par\pard\ql \li15400\sb0\sl-230\slmult0 \par\pard\ql \li15400\sb0\sl-
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\li3414\sb2\sl-230\slmult0 \up0 \expndtw-9\charscalex96 1. Pasien mendaftar ke
poliklinik rawat jalan untuk konsultasi\par\pard\ql \li3414\sb1\sl-230\slmult0 \up0
\expndtw-9\charscalex94 2. Perawat merujuk ke dokter untuk anamnesa dan
pemeriksaan fisik\par\pard\ql \li3414\sb2\sl-230\slmult0 \up0 \expndtw-
2\charscalex100 3. Dokter menilai kondisi pasien untuk memastikan dalam kondisi
sadar\par\pard\qj \li3690\ri1798\sb1\sl-231\slmult0\fi0 \up0
\expndtw0\charscalex100 penuh dan tidak dibawah pengaruh zat (kondisi intoksikasi
maupun \up0 \expndtw-9\charscalex95 putuszat berat)\par\pard\qj
\li3414\ri1799\sb0\sl-231\slmult0\tx3690 \up0 \expndtw-3\charscalex100 4. Dokter
menilai perubahan perilaku atau pemahaman pasien terhadap \line\tab \up0 \expndtw-
9\charscalex92 masalah pengguna napza suntik\par\pard\qj \li3414\ri1799\sb1\sl-
231\slmult0\tx3690 \up0 \expndtw-7\charscalex100 5. Dokter memberikan informasi
kepada pasien tentang konseling yang akan \line\tab \up0 \expndtw-6\charscalex100
diberikan\par\pard\qj \li3414\ri1799\sb1\sl-231\slmult0\tx3690 \up0 \expndtw-
5\charscalex100 6. Dokter/perawat terlatih konseling (konselor) melakukan
konseling adiksi \line\tab \up0 \expndtw-8\charscalex92 pada pasien sesuai dengan
tahapan dan etika konseling yang harus dijalankan\par\pard\ql \li3414\sb2\sl-
230\slmult0 \up0 \expndtw-9\charscalex93 7. Konselor membuat catatan yang
diperlukan pada status pasien\par\pard\ql \li3414\sb1\sl-230\slmult0 \up0 \expndtw-
6\charscalex100 8. Konselor membuat rangkuman hasil pertemuan dan membuat
perjanjian\par\pard\ql \li3690\sb2\sl-230\slmult0 \up0 \expndtw-9\charscalex96
untuk pertemuan selanjutnya dengan memberikan kartu perjanjian\par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 Dokumen terkait:\par\pard\ql \li3069\sb1\sl-228\slmult0
\up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf4\f5\fs20 - Catatan medik
-\tab \up0 \expndtw-8\charscalex100 Kartu perjanjian\par\pard\ql \li2455\sb207\sl-
230\slmult0\tx3064 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf5\f6\fs20 3.\tab
\up0 \expndtw-5\charscalex100 Program Layanan Jarum Suntik Steril\par\pard\qj
Pengertian: \ul0\nosupersub\cf4\f5\fs20 Layanan jarum suntik steril (LJSS) adalah
upaya penyediaan layanan \up0 \expndtw-2\charscalex100 yang meliputi penyediaan
jarum suntik steril (baru), pendidikan dan informasi \up0 \expndtw-8\charscalex96
tentang penularan HIV, rujukan terhadap akses medis, dan layanan sosial. Layanan
\up0 \expndtw-4\charscalex100 ini menyediakan dan memberikan peralatan suntik
steril, beserta materi-materi \up0 \expndtw-3\charscalex100 pengurangan risiko
lainnya kepada penasun, untuk memastikan bahwa setiap \up0 \expndtw-8\charscalex97
penyuntikan dilakukan dengan benar dan dengan menggunakan jarum suntik steril. \up0
\expndtw-7\charscalex100 Pada pelaksanaannya, layanan ini dapat dilaksanakan oleh
Puskesmas dan atau \up0 \expndtw-7\charscalex100 komponen masyarakat (LSM) yang
telah mendapat persetujuan pelaksanaan dari \up0 \expndtw-9\charscalex91
Puskesmas / Dinas Kesehatan setempat.\par\pard\ql \li3069\sb219\sl-230\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Seting layanan dapat
bersifat\ul0\nosupersub\cf4\f5\fs20 :\par\pard\qj \li3068\ri1799\sb1\sl-
231\slmult0\tx3407 \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf5\f6\fs20 a.
Menetap\ul0\nosupersub\cf4\f5\fs20 : Program menyediakan tempat khusus untuk
layanan distribusi jarum \line\tab \up0 \expndtw-9\charscalex95 suntik steril,
seperti; \ul0\nosupersub\cf6\f7\fs20 drop in center\ul0\nosupersub\cf4\f5\fs20
(DIC) atau Puskesmas\par\pard\qj \li3068\ri1799\sb7\sl-253\slmult0\tx3407 \up0
\expndtw-8\charscalex97 \ul0\nosupersub\cf5\f6\fs20 b.
Satelit\ul0\nosupersub\cf4\f5\fs20 : Program menyediakan tempat di lokasi komunitas
sebagai perpanjangan \line\tab \up0 \expndtw-8\charscalex97 dari lokasi menetap
(puskesmas). Petugas lapangan LJSS bertanggung jawab\par\pard\ql \li3407\sb20\sl-
230\slmult0 \up0 \expndtw-8\charscalex95 untuk datang dan bekerja di tempat yang
ditentukan dan waktu yang ditentukan\par\pard\ql \li6038\sb0\sl-230\slmult0
Program Layanan Terapi Pemulihan Napza\par\pard\qj \li603\ri806\sb219\sl-
234\slmult0\fi0 \up0 \expndtw-5\charscalex100 Pengertian:
\ul0\nosupersub\cf4\f5\fs20 adalah penatalaksanaan pasien ketergantungan opiat
(heroin/putau) \up0 \expndtw-2\charscalex100 dengan cara suntik yang ditujukan
untuk pemulihan keadaan umum, bantuan \up0 \expndtw-9\charscalex91 layanan hidup
dasar dan pemeliharaan gaya hidup sehat.\par\pard\ql \li603\sb213\sl-230\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Ruang
lingkup:\par\pard\ql \li976\sb2\sl-230\slmult0 \up0 \expndtw-9\charscalex94
2.1.\ul0\nosupersub\cf4\f5\fs20 Penatalaksanaan detoksifikasi / putus zat
opiat\par\pard\ql \li976\sb4\sl-230\slmult0 \up0 \expndtw-9\charscalex95
\ul0\nosupersub\cf5\f6\fs20 2.2.\ul0\nosupersub\cf4\f5\fs20 Penatalaksanaan
overdosis\par\pard\ql \li976\sb5\sl-230\slmult0 \up0 \expndtw-7\charscalex100
\ul0\nosupersub\cf5\f6\fs20 2.3.\ul0\nosupersub\cf4\f5\fs20 Pemberian konseling
adiksi\par\pard\ql \li603\sb227\sl-230\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf5\f6\fs20 2.1. Penatalaksanaan detoksifikasi / putus zat
opiat\par\pard\qj \li976\ri805\sb0\sl-234\slmult0 \up0 \expndtw-7\charscalex100
Tujuan\ul0\nosupersub\cf4\f5\fs20 : memberikan tindakan medis untuk mengurangi atau
menghilangkan \up0 \expndtw-9\charscalex92 gejala klinis putus zat pada pengguna
napza suntik\par\pard\qj \li976\ri805\sb0\sl-234\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Pengertian:\ul0\nosupersub\cf4\f5\fs20
detoksifikasi merupakan langkah awal penatalaksanaan pasien \up0 \expndtw-
8\charscalex93 ketergantungan opiat agar pasien merasa lebih nyaman dalam
menghadapi gejala \up0 \expndtw-9\charscalex93 putus zat opiat yang
dialaminya\par\pard\ql \li976\sb1\sl-219\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Prosedur :\par\pard\ql \li976\ri805\sb1\sl-
234\slmult0\fi0 \up0 \expndtw-9\charscalex93 \ul0\nosupersub\cf4\f5\fs20 1.
\up0 \expndtw-9\charscalex93 Pasien melakukan pendaftaran sesuai alur yang telah
ditentukan \line \up0 \expndtw-9\charscalex93 2. \up0 \expndtw-9\charscalex94
Perawat/petugas puskesmas merujuk kepada dokter untuk konsultasi \line \up0
\expndtw-9\charscalex93 3. \up0 \expndtw-9\charscalex95 Dokter melakukan asesmen
melalui wawancara, pemeriksaan fisik maupun\par\pard\ql \li1312\sb5\sl-
230\slmult0 \up0 \expndtw-7\charscalex100 psikiatris\par\pard\qj
\li976\ri805\sb1\sl-234\slmult0\fi0 \up0 \expndtw-9\charscalex93 4. \up0 \expndtw-
8\charscalex96 Dokter menentukan kondisi berat/ringannya gejala putus zat heroin
pasien \line \up0 \expndtw-9\charscalex93 5. \up0 \expndtw-7\charscalex100 Kondisi
ringan akan mendapatkan pengobatan simtomatik dengan obat-\par\pard\ql
\li1312\sb4\sl-230\slmult0 \up0 \expndtw-9\charscalex93 obat yang mengurangi
keluhan pasien\par\pard\ql \li976\sb5\sl-230\slmult0\tx1306 \up0 \expndtw-
9\charscalex93 6.\tab \up0 \expndtw-7\charscalex100 Kondisi putus zat yang lebih
berat dapat diberikan terapi subtitusi dengan\par\pard\ql \li1312\sb4\sl-
230\slmult0 \up0 \expndtw-8\charscalex92 codein dengan dosis antara 60-80 mg 4 kali
sehari selama 1 minggu dan dosis\par\pard\qj \li1312\ri806\sb2\sl-
234\slmult0\fi0 \up0 \expndtw-8\charscalex97 diturunkan setiap hari 10% ( kira-kira
5 mg/hari) dapat dikombinasi dengan \up0 \expndtw-8\charscalex100 simtomatis
seperti anti muntah, anti diare atau papaverin dengan dosis 3x \up0 \expndtw-
9\charscalex95 20-40 mg.\par\pard\ql \li976\sb4\sl-230\slmult0\tx1306 \up0
\expndtw-9\charscalex93 7.\tab \up0 \expndtw-6\charscalex100 Bilamana dokter
puskesmas sudah ada yang mendapat pelatihan terapi\par\pard\ql \li1312\sb5\sl-
230\slmult0 \up0 \expndtw-6\charscalex100 subtitusi Buphrenorphine dapat memberikan
terapi detoksifikasi dengan\par\pard\qj \li1312\ri806\sb1\sl-234\slmult0\fi0
\up0 \expndtw-4\charscalex100 Buphrenorphine sesuai buku pedoman subtitusi
Buphrenorphine yang \up0 \expndtw-9\charscalex93 tersedia\par\pard\ql
\expndtw-9\charscalex96 Dokter mencatat semua hasil pemeriksaan dan pengobatan yang
diberikan\par\pard\ql \li1312\sb30\sl-230\slmult0 \up0 \expndtw-9\charscalex89
kepada pasien\par\pard\ql \li976\sb31\sl-230\slmult0\tx1306 \up0 \expndtw-
9\charscalex93 9.\tab \up0 \expndtw-5\charscalex100 Perawat akan menjelaskan ulang
tentang pengobatan dan tindak lanjut\par\pard\ql \li1312\sb30\sl-230\slmult0
\up0 \expndtw-9\charscalex94 pengobatan sesuai instruksi dokter\par\pard\ql
\li976\sb49\sl-230\slmult0 \up0 \expndtw-9\charscalex95 10. Perawat menyimpan
seluruh dokumentasi pasien\par\pard\ql \li15393\sb0\sl-230\slmult0 \par\pard\ql
\up0 \expndtw-8\charscalex100 \ul0\nosupersub\cf3\f4\fs20 16
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\par\pard\qj \li3082\ri1824\sb57\sl-259\slmult0\tx3420 \up0 \expndtw-8\charscalex96
\ul0\nosupersub\cf5\f6\fs20 c. Bergerak\ul0\nosupersub\cf4\f5\fs20 : Program LJSS
memberikan tanggung jawab kepada petugas lapangan \line\tab \up0 \expndtw-
5\charscalex100 LJSS membawa tas yang berisi jarum suntik steril dan media
informasi dan\par\pard\ql \li3420\sb24\sl-230\slmult0 \up0 \expndtw-9\charscalex95
mendatangi tempat-tempat yang sering dikunjungi oleh Penasun\par\pard\qj
\ul0\nosupersub\cf5\f6\fs20 Waktu layanan\ul0\nosupersub\cf4\f5\fs20 : pada seting
layanan \ul0\nosupersub\cf5\f6\fs20 Satelit / Bergerak\ul0\nosupersub\cf4\f5\fs20 ,
hendaknya disesuaikan dengan 'jam \up0 \expndtw-8\charscalex97 kebutuhan' penasun
di lapangan dalam memperoleh jarum suntik steril. Selain itu petugas \up0 \expndtw-
8\charscalex96 LJSS hendaknya dapat secara rutin dan teratur datang ke tempat dan
dalam waktu dimana \up0 \expndtw-5\charscalex100 hubungan yang maksimal dengan
penasun dapat dibangun. Program hendaknya juga \up0 \expndtw0\charscalex100
memiliki identitas yang jelas, dapat berupa logo atau simbol. Logo atau simbol
ini \up0 \expndtw-8\charscalex100 dicantumkan dalam kartu petugas, kantor atau
ruang LJSS yang mudah terlihat baik oleh \up0 \expndtw-9\charscalex93 penasun
maupun oleh masyarakat.\par\pard\ql \li2467\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 Sasaran:\par\pard\ql \li3090\sb26\sl-230\slmult0
\up0 \expndtw-3\charscalex100 \u8226?\ul0\nosupersub\cf4\f5\fs20
Penasun\par\pard\ql \li3090\sb30\sl-230\slmult0 \up0 \expndtw-9\charscalex94
\ul0\nosupersub\cf5\f6\fs20 \u8226?\ul0\nosupersub\cf4\f5\fs20 Diutamakan bagi
penasun dengan usia di atas 18 tahun.\par\pard\ql \li3090\sb29\sl-230\slmult0
\u8226?\ul0\nosupersub\cf4\f5\fs20 Pengkajian yang komprehensif harus
diberlakukan bagi klien di bawah usia 18\par\pard\ql \li2467\sb0\sl-230\slmult0
\ul0\nosupersub\cf5\f6\fs20 Ruang Lingkup:\par\pard\ql \li3087\sb27\sl-
230\slmult0 \up0 \expndtw-9\charscalex93 3.1.\ul0\nosupersub\cf4\f5\fs20
Pembentukan Tim Pelaksana LJSS\par\pard\ql \li3087\sb29\sl-230\slmult0 \up0
\expndtw-9\charscalex93 \ul0\nosupersub\cf5\f6\fs20 3.2.\ul0\nosupersub\cf4\f5\fs20
Proses pendaftaran klien program LJSS\par\pard\ql \li3087\sb29\sl-230\slmult0
3.3.\ul0\nosupersub\cf4\f5\fs20 Penyediaan dan distribusi jarum suntik steril
kepada Penasun\par\pard\ql \li3087\sb29\sl-230\slmult0 \up0 \expndtw-9\charscalex93
\ul0\nosupersub\cf5\f6\fs20 3.4.\ul0\nosupersub\cf4\f5\fs20 Pengelolaan dan
pemusnahan jarum suntik bekas\par\pard\ql \li3087\sb30\sl-230\slmult0 \up0
\expndtw-9\charscalex95 \ul0\nosupersub\cf5\f6\fs20 3.5.\ul0\nosupersub\cf4\f5\fs20
Pelaporan Insiden\par\pard\ql \li2467\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 Prosedur:\par\pard\ql \li2467\sb14\sl-
230\slmult0\tx3082 \up0 \expndtw-7\charscalex100 3.1.\tab \up0 \expndtw-
5\charscalex100 Pembentukan Tim Pelaksana LJSS\par\pard\qj \li3087\ri1824\sb3\sl-
259\slmult0 \up0 \expndtw-8\charscalex100 Tujuan:\ul0\nosupersub\cf4\f5\fs20
Terbentuknya tim pelaksana LJSS yang memahami dengan benar proses \up0 \expndtw-
9\charscalex89 pelaksanaan LJSS bagi penasun\par\pard\ql \li3087\sb24\sl-
Sasaran\ul0\nosupersub\cf4\f5\fs20 : Petugas puskesmas, Petugas LSM dan institusi
lainnya\par\pard\ql \li3087\sb0\sl-230\slmult0 \par\pard\ql \li3087\sb88\sl-
230\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Personil &
Ruang Lingkup Tugas\ul0\nosupersub\cf4\f5\fs20 :\par\pard\qj
\li3087\ri1824\sb14\sl-304\slmult0\tx3437 \up0 \expndtw-8\charscalex100 1.
Koordinator Program, bertanggungjawab terhadap pelaksanaan program pada
\line\tab \up0 \expndtw-5\charscalex100 berbagai macam bentuk. Koordinator bertugas
memonitor dan melakukan\par\pard\qj \li3437\ri1826\sb1\sl-304\slmult0\fi0 \up0
\expndtw-5\charscalex100 supervisi kepada petugas lapangan dan melakukan
koordinasi dengan \up0 \expndtw-8\charscalex100 koordinator program
lainnnya\par\pard\ql \li6037\sb0\sl-230\slmult0 \par\pard\ql \li6037\sb0\sl-
2\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Dokumen:\par\pard\qj
\u8226?\ul0\nosupersub\cf4\f5\fs20 SK Pembentukan Tim Pelaksana LJSS \up0
\u8226?\ul0\nosupersub\cf4\f5\fs20 Prosedur Standar LJSS\par\pard\qj
\li651\ri818\sb1\sl-274\slmult0\tx1044 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf5\f6\fs20 \u8226?\ul0\nosupersub\cf4\f5\fs20 Kartu Identitas
Petugas: dikeluarkan oleh lembaga yang idealnya \line\tab \up0 \expndtw-
7\charscalex100 sepengetahuan pihak pemerintah terkait, seyogyanya institusi
kesehatan\par\pard\ql \li1034\sb38\sl-230\slmult0 \up0 \expndtw-9\charscalex93
(Dinas Kesehatan) setempat\par\pard\ql \li11822\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 3.2.\tab \up0 \expndtw-4\charscalex100 Proses
pendaftaran klien program LJSS\par\pard\ql \li650\sb41\sl-230\slmult0 \up0
\expndtw-9\charscalex92 Tujuan:\ul0\nosupersub\cf4\f5\fs20 Terdatanya klien
program LJSS secara sistematis\par\pard\qj \li650\ri819\sb9\sl-274\slmult0\fi0 \up0
\expndtw-8\charscalex97 \ul0\nosupersub\cf5\f6\fs20 Pengertian:
\ul0\nosupersub\cf4\f5\fs20 merupakan proses penerimaan awal penasun ke dalam
program LJSS, \up0 \expndtw-8\charscalex93 terutama yang bersifat menetap (dalam
institusi layanan kesehatan / Puskesmas)\par\pard\ql \li650\sb24\sl-230\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Personil:\par\pard\ql
\ul0\nosupersub\cf4\f5\fs20 -\tab \up0 \expndtw-9\charscalex86 Petugas
LJSS\par\pard\ql \li650\sb45\sl-230\slmult0\tx1026 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-9\charscalex89 Petugas Lapangan\par\pard\ql \li650\sb31\sl-
Prosedur:\par\pard\ql \li650\sb41\sl-230\slmult0\tx1026 \up0 \expndtw-
Memperkenalkan program LJSS kepada penasun.\par\pard\ql \li650\sb44\sl-
Pengisian formulir pendaftaran program LJSS.\par\pard\ql \li650\sb45\sl-
3\charscalex100 Pengisian formulir pengkajian klien: mencakup nama, tanggal lahir,
jenis\par\pard\qj \li1022\ri818\sb8\sl-274\slmult0\fi0 \up0 \expndtw-8\charscalex93
kelamin, pekerjaan, alamat ( dapat inisial atau nama wilayah saja ) kedalam form
\up0 \expndtw-4\charscalex100 sementara (bila tersedia kemudian dapat dipindahkan
kedalam komputer \up0 \expndtw-9\charscalex93 secara online).\par\pard\ql
\expndtw-1\charscalex100 Skrining atas kriteria inklusi klien: untuk
memastikan apakah yang\par\pard\qj \li1022\ri818\sb8\sl-274\slmult0\fi0 \up0
\expndtw-6\charscalex100 bersangkutan adalah penasun atau tidak. Apabila
terdapat tanda-tanda \up0 \expndtw-8\charscalex100 penyuntikan yang jelas pada
tubuh pasien, maka petugas Puskesmas dapat \up0 \expndtw-5\charscalex100 langsung
menerima yang bersangkutan. Apabila tanda-tanda penyuntikan \up0 \expndtw-
8\charscalex100 tidak jelas, maka hendaknya petugas Puskesmas bekerjasama dengan
LSM \up0 \expndtw-7\charscalex100 setempat khususnya dalam menetapkan apakah yang
bersangkutan adalah \up0 \expndtw-9\charscalex92 penasun atau tidak.\par\pard\ql
\expndtw-3\charscalex100 Bagi mereka yang memenuhi kriteri inklusi disiapkan kartu
identitas klien\par\pard\qj \li1022\ri818\sb16\sl-313\slmult0\fi0 \up0 \expndtw-
5\charscalex100 program LJSS. Pemberian kode pada kartu identitas disesuaikan
dengan \up0 \expndtw-9\charscalex96 program masing-masing.\par\pard\ql
\expndtw-8\charscalex95 Pemberian jarum suntik steril dan (bila ada) meminta jarum
suntik bekas pakai.\par\pard\ql \li15399\sb0\sl-230\slmult0 \par\pard\ql
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf5\f6\fs20 Dokumen:\par\pard\qj \li3053\ri2425\sb8\sl-
292\slmult0\tx3377 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf4\f5\fs20 -
Kartu Identitas Klien: berisi informasi singkat tentang program, lembaga
\line\tab \up0 \expndtw-7\charscalex100 pelaksana dan kode klien \up0 \expndtw-
6\charscalex100 (bukan nama dan alamat lengkap). Idealnya\par\pard\qj
\li3377\ri2425\sb1\sl-292\slmult0\fi0 \up0 \expndtw-6\charscalex100 dikeluarkan
oleh lembaga pelaksana program dengan sepengetahuan pihak \up0 \expndtw-
9\charscalex94 pemerintah terkait, khususnya institusi kesehatan (Dinas
Kesehatan)\par\pard\ql \li3053\sb53\sl-230\slmult0 \up0 \expndtw-5\charscalex100 -
Formulir Pengkajian (Asesmen) Klien\par\pard\ql \li3053\sb62\sl-230\slmult0 \up0
\expndtw-5\charscalex100 - Formulir Data Keluar/Masuk Jarum Suntik\par\pard\ql
5\charscalex100 Penyediaan dan distribusi jarum suntik steril\par\pard\qj
Tujuan:\ul0\nosupersub\cf4\f5\fs20 sebagai acuan dalam melakukan layanan jarum
suntik steril bagi penasun \line \up0 \expndtw-8\charscalex100 dalam hal melakukan
program pertukaran jarum suntik. Program ini tidak dipungut \line \up0 \expndtw-
9\charscalex91 biaya\par\pard\qj \li3053\ri2425\sb1\sl-292\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Pengertian: \ul0\nosupersub\cf4\f5\fs20
adalah pemberian paket jarum suntik yang berupa jarum dan tabung \up0 \expndtw-
5\charscalex100 steril, kapas beralkohol, kondom dan materi Komunikasi, Informasi
dan Edukasi \up0 \expndtw-9\charscalex92 (KIE). Kegiatan ini mengacu pada kegiatan
pada seluruh seting LJSS\par\pard\ql \li3053\sb38\sl-230\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Personil:\par\pard\ql \li3053\sb59\sl-
230\slmult0 \up0 \expndtw-7\charscalex100 \ul0\nosupersub\cf4\f5\fs20 - Petugas
LJSS\par\pard\ql \li3053\sb62\sl-230\slmult0 \up0 \expndtw-7\charscalex100 -
Petugas Lapangan\par\pard\ql \li3053\sb48\sl-230\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Prosedur:\par\pard\qj
\li3053\ri2425\sb9\sl-292\slmult0\tx3376 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf4\f5\fs20 1. Paket jarum suntik diberikan kepada penasun yang
terdaftar atau yang biasa \line\tab \up0 \expndtw-9\charscalex95 dijumpai di
lapangan. Paket diberikan maksimum 3 paket / kunjungan\par\pard\ql \li3053\sb53\sl-
230\slmult0 \up0 \expndtw-6\charscalex100 2. Paket jarum suntik idealnya terdiri
dari: 3 jarum + 3 alkohol swab + 6 kondom.\par\pard\qj \li3376\ri2426\sb11\sl-
292\slmult0\fi0 \up0 \expndtw-7\charscalex100 Jumlah perangkat ini dapat
disesuaikan dengan ketersediaan perangkat pada \up0 \expndtw-9\charscalex92 program
3.\tab \up0 \expndtw-8\charscalex94 (Bila ada) sekaligus mengembalikan jarum suntik
bekas yang ada. Sesuai dengan\par\pard\ql \li3376\sb63\sl-230\slmult0 \up0
\expndtw-8\charscalex97 standar kewaspadaan universal, jarum suntik bekas hendaknya
dimasukkan ke\par\pard\qj \li3376\ri2426\sb10\sl-293\slmult0\fi0 \up0 \expndtw-
9\charscalex95 dalam wadah penyimpanan yang memenuhi standar keamanan. Setelah
wadah \up0 \expndtw-6\charscalex100 terisi penuh atau bilamana terdapat jadwal
pemusnahan jarum suntik bekas, \up0 \expndtw-7\charscalex100 maka wadah tersebut di
bawa ke rumah sakit / institusi yang memiliki \ul0\nosupersub\cf6\f7\fs20
incinerator \up0 \expndtw-9\charscalex94 \ul0\nosupersub\cf4\f5\fs20 untuk
dimusnahkan bersama-sama dengan sampah medik lainnya.\par\pard\ql \li3053\sb85\sl-
230\slmult0 \up0 \expndtw-3\charscalex100 4. Petugas mencatat jumlah jarum, kapas
beralkohol dan kondom yang telah\par\pard\ql \li3376\sb96\sl-230\slmult0 \up0
\expndtw-9\charscalex100 terdistribusi kedalam form bulanan.\par\pard\ql
2.\tab \up0 \expndtw-8\charscalex100 Petugas LJSS bertugas melaksanakan layanan
LJSS dari mulai pendaftaran\par\pard\qj \li408\ri805\sb10\sl-284\slmult0\fi0
\up0 \expndtw-8\charscalex94 sampai dengan Penasun keluar dari tempat pelayanan.
Petugas pelaksana akan \up0 \expndtw-8\charscalex93 merekam dan menyimpan data yang
didapat selama layanan LJSS dilaksanakan \up0 \expndtw-6\charscalex100 menggunakan
formulir baku yang tersedia. Petugas bertanggung jawab \up0 \expndtw-
6\charscalex100 terhadap penyediaan dan penyimpanan jarum suntik steril dan
pengelolaan \up0 \expndtw-9\charscalex93 jarum suntik bekas pakai\par\pard\ql
5\charscalex100 Petugas Lapangan bertugas mempromosikan program LJSS kepada
para\par\pard\qj \li408\ri805\sb11\sl-284\slmult0\fi0 \up0 \expndtw-9\charscalex95
Penasun di lapangan, memberikan layanan LJSS kepada Penasun yang masih \up0
\expndtw-8\charscalex98 belum ingin berkunjung ke layanan secara mandiri dan
membantu perubahan \up0 \expndtw-9\charscalex93 perilaku kepada Penasun yang
didampingi.\par\pard\ql \li12436\sb0\sl-230\slmult0 \par\pard\ql \li20\sb68\sl-
Kepala Puskesmas mengadakan rapat dengan jajaran staf Puskesmas dan LSM\par\pard\qj
\li408\ri805\sb10\sl-284\slmult0\fi0 \up0 \expndtw-5\charscalex100 HR untuk
merumuskan seting LJSS yang paling realistis dan sesuai untuk \up0 \expndtw-
8\charscalex100 dijalankan\par\pard\ql \li20\sb45\sl-230\slmult0\tx394 \up0
\expndtw-9\charscalex93 2.\tab \up0 \expndtw-7\charscalex100 Kerjasama antara
Puskesmas dengan LSM HR diwujudkan dengan piagam\par\pard\qj \li408\ri805\sb10\sl-
284\slmult0\fi0 \up0 \expndtw-8\charscalex97 kerjasama (memorandum of
understanding) yang memuat deskripsi kerja dan \up0 \expndtw-9\charscalex93
tanggungjawab kedua belah pihak\par\pard\ql \li20\sb45\sl-230\slmult0\tx394 \up0
\expndtw-9\charscalex93 3.\tab \up0 \expndtw-8\charscalex95 Kepala Puskesmas
membuat Surat Keputusan (SK) untuk staf Puskesmas yang\par\pard\qj
\li407\ri806\sb11\sl-284\slmult0\fi0 \up0 \expndtw-8\charscalex95 terlibat dalam
kegiatan LJSS. Koordinator program berasal dari staf Puskesmas \up0 \expndtw-
3\charscalex100 yang dianggap memiliki kemampuan dan pengalaman cukup
dalam \up0 \expndtw-9\charscalex96 menghadapi penasun. Petugas LJSS sebaiknya
merupakan gabungan antara \up0 \expndtw-5\charscalex100 professional kesehatan
Puskesmas dengan kader muda yang berasal dari \up0 \expndtw-6\charscalex100
kelompok pemuda wilayah setempat. Penunjukkan kader muda hendaknya \up0 \expndtw-
6\charscalex100 memenuhi kriteria:\par\pard\ql \li389\ri2708\sb0\sl-284\slmult0\fi0
\u8226?\ul0\nosupersub\cf4\f5\fs20 Memahami karakteristik penasun setempat
\line \up0 \expndtw-9\charscalex96 \ul0\nosupersub\cf5\f6\fs20
\u8226?\ul0\nosupersub\cf4\f5\fs20 Memiliki pengalaman bekerjasama dengan
penasun\par\pard\qj \li389\ri806\sb1\sl-284\slmult0\tx710 \up0 \expndtw-
8\charscalex98 \ul0\nosupersub\cf5\f6\fs20 \u8226?\ul0\nosupersub\cf4\f5\fs20
Bila berasal dari kalangan penasun itu sendiri, hendaknya yang telah stabil
\line\tab \up0 \expndtw-9\charscalex94 masa pemulihannya\par\pard\ql \li20\sb45\sl-
SK atas petugas lapangan tidak berasal dari Puskesmas, melainkan
merupakan\par\pard\qj \li347\ri806\sb10\sl-284\slmult0\fi0 \up0 \expndtw-
8\charscalex100 staf LSM HR setempat. Petugas lapangan bersifat menjangkau penasun
yang \up0 \expndtw-7\charscalex100 masih belum ingin datang ke institusi layanan
kesehatan. Kerjasama dengan \up0 \expndtw-8\charscalex95 Puskesmas terutama adalah
untuk proses rujukan layanan kesehatan dasar dan \up0 \expndtw-9\charscalex94
layanan lanjutan lainnya\par\pard\ql \li15386\sb0\sl-230\slmult0 \par\pard\ql
\li15386\sb0\sl-230\slmult0 \par\pard\ql \li2970\sb224\sl-230\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 20
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf5\f6\fs20 Peralatan:\par\pard\ql \li3069\sb35\sl-
1.\tab \up0 \expndtw-8\charscalex97 Jarum suntik steril berdasarkan model yang
biasanya dipakai oleh Penasun di\par\pard\ql \li3463\sb38\sl-230\slmult0 \up0
\expndtw-9\charscalex93 daerah tersebut.\par\pard\ql \li3069\sb37\sl-
5\charscalex100 Kapas beralkohol, digunakan untuk membersihkan kulit tempat yang
akan\par\pard\qj \li3462\ri1825\sb8\sl-267\slmult0\fi0 \up0 \expndtw-
6\charscalex100 disuntik dan untuk membersihkan peralatan lain serta tangan. Paling
sedikit \up0 \expndtw-4\charscalex100 disediakan 2 kapas beralkohol untuk setiap
jarum suntik dan tabung yang \up0 \expndtw-7\charscalex100
diberikan.\par\pard\ql \li3069\sb32\sl-230\slmult0\tx3445 \up0 \expndtw-
9\charscalex93 3.\tab \up0 \expndtw-9\charscalex96 Kondom dan pelicin, untuk
mendorong perilaku seks aman.\par\pard\ql \li3069\sb38\sl-230\slmult0\tx3445
\up0 \expndtw-9\charscalex93 4.\tab \up0 \expndtw-6\charscalex100 Media informasi
terkait dengan HIV/AIDS dan Napza, berupa brosur, buklet,\par\pard\ql
\li3462\sb37\sl-230\slmult0 \up0 \expndtw-9\charscalex93 stiker atau media
lainnya\par\pard\ql \li2467\sb0\sl-230\slmult0 \par\pard\ql \li3069\sb63\sl-
Dokumen:\par\pard\ql \li3069\sb34\sl-230\slmult0\tx3444 \up0 \expndtw-
Kartu identitas petugas\par\pard\ql \li3069\sb38\sl-230\slmult0\tx3444 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-6\charscalex100 Kartu
klien\par\pard\ql \li2467\sb0\sl-230\slmult0 \par\pard\ql \li2467\sb63\sl-
3.4.\tab \up0 \expndtw-5\charscalex100 Pengelolaan dan Pemusnahan Jarum
Bekas\par\pard\qj \li3069\ri1824\sb4\sl-267\slmult0\tx3450 \up0 \expndtw-
8\charscalex97 Tujuan:\ul0\nosupersub\cf4\f5\fs20 Mempromosikan pengembalian jarum
suntik bekas pakai dan pemusnahan \line\tab \up0 \expndtw-9\charscalex92 dengan
aman\par\pard\ql \li3069\sb19\sl-230\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Personil:\par\pard\ql \li3069\sb34\sl-
-\tab \up0 \expndtw-9\charscalex86 Petugas LJSS\par\pard\ql \li3069\sb38\sl-
Petugas Lapangan\par\pard\ql \li3069\sb25\sl-230\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Peralatan:\par\pard\ql \li3069\sb34\sl-
1.\tab \up0 \expndtw-8\charscalex97 Wadah plastik sekali pakai/wadah plastik yang
tahan tusukan, botol kaca atau\par\pard\ql \li3069\ri1824\sb8\sl-
267\slmult0\fi381\tx3439 \up0 \expndtw-8\charscalex94 plastik atau kaca dengan
penutup yang aman (misalnya: galon air mineral). \line \up0 \expndtw-9\charscalex93
2. \tab \up0 \expndtw-3\charscalex100 Jika memungkinkan, sebaiknya wadah ini
berwarna kuning dan ditandai\par\pard\qj \li3069\ri3560\sb1\sl-
267\slmult0\fi381\tx3439 \up0 \expndtw-9\charscalex93 misalnya \u8220?
berbahaya\u8221?, atau \u8220?barang tajam yang tercemar\u8221?. \line \up0
\expndtw-9\charscalex93 3. \tab \up0 \expndtw-7\charscalex100 Penjempit
jarum\par\pard\ql \li3069\sb31\sl-230\slmult0\tx3444 \up0 \expndtw-9\charscalex93
4.\tab \up0 \expndtw-9\charscalex92 Sarung tangan\par\pard\ql \li3069\sb62\sl-
Penyediaan tempat/kotak pemusnahan jarum suntik bekas pakai dan
pemberian\par\pard\ql \li3069\ri1824\sb0\sl-334\slmult0\fi369\tx3439 \up0 \expndtw-
9\charscalex93 informasi tentang pemusnahan jarum suntik bekas pakai yang aman.
\line \up0 \expndtw-9\charscalex93 2. \tab \up0 \expndtw-8\charscalex97 Penyediaan
tempat untuk menyerahkan jarum suntik dan tabung suntik bekas\par\pard\ql
\li3438\sb102\sl-230\slmult0 \up0 \expndtw-9\charscalex93 pakai.\par\pard\ql
Dokumen:\par\pard\ql \li656\sb75\sl-230\slmult0\tx1024 \up0 \expndtw-
Kartu identitas petugas\par\pard\ql \li11822\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 3.5.\tab \up0 \expndtw-4\charscalex100 Pelaporan
Insiden\par\pard\qj \li655\ri818\sb11\sl-309\slmult0\fi0 \up0 \expndtw-
4\charscalex100 Tujuan:\ul0\nosupersub\cf4\f5\fs20 Meningkatkan daya tanggap
terjadinya kejadian yang tidak diinginkan \up0 \expndtw-5\charscalex100
(insiden)\par\pard\ql \li656\sb51\sl-230\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Personil:\par\pard\ql \li656\sb75\sl-230\slmult0\tx1024
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs20 -\tab \up0 \expndtw-
9\charscalex86 Petugas LJSS\par\pard\ql \li656\sb79\sl-230\slmult0\tx1024 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex89 Petugas
Lapangan\par\pard\ql \li656\sb64\sl-230\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Prosedur:\par\pard\ql \li656\sb76\sl-230\slmult0\tx1024
\up0 \expndtw-9\charscalex93 \ul0\nosupersub\cf4\f5\fs20 1.\tab \up0 \expndtw-
8\charscalex96 Apabila terjadi insiden di lokasi LJSS, petugas harus membuat
laporan dengan\par\pard\ql \li1032\sb79\sl-230\slmult0 \up0 \expndtw-9\charscalex96
menggunakan Formulir Pelaporan Insiden\par\pard\ql \li656\sb79\sl-
6\charscalex100 Insiden di sini meliputi penggunaan obat atau over dosis oleh
peserta pada\par\pard\qj \li1032\ri818\sb14\sl-309\slmult0\fi0 \up0 \expndtw-
7\charscalex100 waktu mereka berada di lokasi LJSS, luka tertusuk jarum atau luka
lain yang \up0 \expndtw-7\charscalex100 dialami peserta atau petugas di lokasi
kerja, atau apabila ada kejadian yang \up0 \expndtw-9\charscalex92 timbul karena
keberadaan polisi di dekat lokasi LJSS\par\pard\ql \li656\sb66\sl-
8\charscalex100 Untuk luka tertusuk jarum atau luka lain yang dialami peserta atau
petugas di\par\pard\qj \li1032\ri818\sb14\sl-309\slmult0\fi0 \up0 \expndtw-
8\charscalex96 lokasi kerja, tindakan yang perlu dilakukan merujuk pada prosedur
standar dari \up0 \expndtw-9\charscalex94 Kewaspadaan Universal\par\pard\ql
2\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Dokumen:\par\pard\ql \li656\sb75\sl-
-\tab \up0 \expndtw-8\charscalex100 Formulir Pelaporan Insiden\par\pard\ql
1\charscalex100 Pelaksanaan Program Voluntary Counseling and Testing (VCT) dan Care
Support\par\pard\ql \li655\sb60\sl-230\slmult0 \up0 \expndtw-5\charscalex100 and
Treatment (CST)\par\pard\qj \li655\ri820\sb11\sl-309\slmult0\fi0 \up0 \expndtw-
8\charscalex96 Tujuan\ul0\nosupersub\cf4\f5\fs20 : sebagai acuan untuk
mengidentifikasi penasun yang datang ke puskesmas \up0 \expndtw-9\charscalex95 yang
perlu mendapatkan layanan VCT maupun CST.\par\pard\qj \li655\ri818\sb8\sl-
351\slmult0\fi0 \up0 \expndtw-7\charscalex100 \ul0\nosupersub\cf5\f6\fs20
Pengertian\ul0\nosupersub\cf4\f5\fs20 : layanan VCT merupakan pintu masuk pagi
penasun yang mempunyai \up0 \expndtw-6\charscalex100 risiko tinggi untuk tertular
HIV untuk mendapatkan informasi, konseling serta tes \up0 \expndtw-8\charscalex96
HIV. Sementara CST adalah layanan lanjutan bagi mereka yang telah
teridentifikasi \up0 \expndtw-1\charscalex100 tertular HIV (ODHA).\par\pard\ql
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf5\f6\fs20 Prosedur \ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql
\expndtw-7\charscalex100 Petugas puskesmas terlatih VCT menilai tentang factor
risiko penularaan HIV\par\pard\qj \li3431\ri2425\sb5\sl-256\slmult0\fi0 \up0
\expndtw-8\charscalex96 pada penasun khususnya pertukaran jarum suntik dan perilaku
seksual berisiko \up0 \expndtw-9\charscalex93 melalui wawancara dan form penilaian
risiko yang ada di puskesmas\par\pard\ql \li3055\sb22\sl-230\slmult0\tx3403 \up0
\expndtw-9\charscalex93 2.\tab \up0 \expndtw-8\charscalex94 Apabila penasun dibawa
oleh petugas penjangkau dan sudah dikonseling pre tes\par\pard\qj
\li3431\ri2425\sb6\sl-256\slmult0\fi0 \up0 \expndtw-8\charscalex96 oleh petugas
penjangkau langsung dapat dibuatkan informed concent untuk tes \up0 \expndtw-
7\charscalex100 HIV dan dirujuk ke laboratorium\par\pard\ql \li3055\sb22\sl-
6\charscalex100 Bila pasien datang sendiri dan setelah diwawancara mempunyai risiko
untuk\par\pard\qj \li3431\ri2426\sb6\sl-256\slmult0\fi0 \up0 \expndtw-
7\charscalex100 tertular HIV diberikan motivasi untuk mendapatkan pre tes konseling
tentang \up0 \expndtw-7\charscalex100 tes HIV\par\pard\ql \li3055\sb23\sl-
Bila pasien setuju akan dibuatkan informed concent untuk pemeriksaan tes
HIV\par\pard\ql \li3431\sb26\sl-230\slmult0 \up0 \expndtw-8\charscalex100 dan
dirujuk ke laboratorium\par\pard\ql \li3055\sb27\sl-230\slmult0\tx3402 \up0
\expndtw-9\charscalex93 5.\tab \up0 \expndtw-8\charscalex94 Pasien yang belum
bersedia di tes HIV tetap dimotivasi dan dalam catatan medik\par\pard\ql
\li3431\sb26\sl-230\slmult0 \up0 \expndtw-9\charscalex91 dicatat alas an belum siap
tes HIV\par\pard\ql \li3054\sb27\sl-230\slmult0\tx3402 \up0 \expndtw-9\charscalex93
6.\tab \up0 \expndtw-7\charscalex100 Hasil tes yang telah selesai akan diberikan
kepada konselor yang dinyatakan\par\pard\ql \li3054\ri2426\sb5\sl-
256\slmult0\fi376\tx3397 \up0 \expndtw-9\charscalex96 mampu membaca diagnosis/hasil
lab (merujuk buku pedoman VCT) \line \up0 \expndtw-9\charscalex93 7. \tab \up0
\expndtw-8\charscalex95 Apabila kondisi pasien setelah hasil tes terjadi perubahan
alam perasaan (mood)\par\pard\qj \li3431\ri2426\sb0\sl-256\slmult0\fi0 \up0
\expndtw-8\charscalex98 harus dilakukan konseling lanjutan maksimal dalam 3 hari
setelah pembacaan \line \up0 \expndtw-9\charscalex88 tes\par\pard\ql
\expndtw-6\charscalex100 Kondisi pasien yang telah stabil secara psikologis dan
memerlukan tindakan\par\pard\qj \li3431\ri2426\sb6\sl-256\slmult0\fi0 \up0
\expndtw-7\charscalex100 lanjutan untukterapi dapat dirujuk ke program CST pada
rumah sakit rujukan \up0 \expndtw0\charscalex106 ODHA\par\pard\ql \li3054\sb23\sl-
2\charscalex100 Bilamana pasien belum siap ke rumah sakit rujukan dan sudah
memiliki\par\pard\qj \li3431\ri2426\sb5\sl-256\slmult0\fi0 \up0 \expndtw-
8\charscalex97 keluhan misalnya meriang, diare atau keluhan lain dapat diberikan
pengobatan \up0 \expndtw-9\charscalex100 simtomatis terlebih dahulu (merujuk pada
buku pedoman CST)\par\pard\ql \li3054\sb22\sl-230\slmult0\tx3402 \up0 \expndtw-
9\charscalex93 10.\tab \up0 \expndtw-4\charscalex100 Setiap hasil pemeriksaan harus
terjaga kerahasiannya dan digunakan atas\par\pard\ql \li3431\sb27\sl-230\slmult0
\up0 \expndtw-9\charscalex93 sepengetahuan pasien untuk kepentingan medis
11.\tab \up0 \expndtw-7\charscalex100 Bagi puskesmas yang belum memiliki klinik VCT
dapat merujuk ke klinik VCT\par\pard\ql \li3431\sb27\sl-230\slmult0 \up0 \expndtw-
9\charscalex91 yang ada di wilayah kerjanya\par\pard\ql \li3054\sb0\sl-
5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Dokumen terkait :\par\pard\ql
\ul0\nosupersub\cf4\f5\fs20 - Form penilaian risiko HIV\par\pard\ql
\expndtw-6\charscalex100 Informed Consent\par\pard\ql \li3054\sb47\sl-
Form pemeriksaan laboratorium\par\pard\ql \li3054\sb51\sl-230\slmult0\tx3402
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex93 Catatan medik
pasien\par\pard\ql \li6032\sb0\sl-230\slmult0 \par\pard\ql \li6032\sb0\sl-
Memonitoring setiap kegiatan dalam pengembalian jarum suntik bekas
pakai\par\pard\ql \li354\sb72\sl-230\slmult0 \up0 \expndtw-9\charscalex93 dan
pemusnahannya.\par\pard\ql \li21\sb73\sl-230\slmult0\tx339 \up0 \expndtw-
9\charscalex93 4.\tab \up0 \expndtw-7\charscalex100 Informasi mengenai pemusnahan
dengan aman sedapat mungkin dipadukan\par\pard\ql \li354\sb73\sl-230\slmult0
\up0 \expndtw-9\charscalex91 dalam setiap terjadinya pertukaran peralatan setiap
saat.\par\pard\ql \li21\sb72\sl-230\slmult0\tx339 \up0 \expndtw-9\charscalex93
5.\tab \up0 \expndtw-7\charscalex100 Petugas lapangan LJSS perlu selalu mengingat
untuk mendorong kebiasaan\par\pard\ql \li354\sb73\sl-230\slmult0 \up0 \expndtw-
8\charscalex95 pemusnahan secara aman oleh penasun, karena jarum suntik bekas pakai
dibuang secara sembarangan akan membuat masalah dengan lingkungan sekitar \up0
\expndtw-9\charscalex92 dan akan menjadi alasan kuat ditutupnya program
6.\tab \up0 \expndtw-2\charscalex100 Dalam pengumpulan jarum suntik bekas pakai,
beberapa hal yang perlu\par\pard\ql \li354\sb73\sl-230\slmult0 \up0 \expndtw-
9\charscalex95 diperhatikan antara lain:\par\pard\ql \li334\sb73\sl-
Tanpa alat bantu, petugas tidak boleh memegang jarum suntik bekas
pakai.\par\pard\ql \li334\sb73\sl-230\slmult0\tx653 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-9\charscalex94 Penasun langsung memasukkan jarum suntik bekas
pakai ke wadah khusus.\par\pard\ql \li648\sb72\sl-230\slmult0 \up0 \expndtw-
9\charscalex94 Dijelaskan dimana letak wadah khusus tersebut.\par\pard\ql
\li334\sb73\sl-230\slmult0\tx653 \up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-
9\charscalex94 Wadah penampungan jarum suntik bekas tidak boleh terlalu
penuh.\par\pard\ql \li334\sb73\sl-230\slmult0\tx653 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-5\charscalex100 Wadah tersebut harus langsung dibuang ke tempat
pembakaran tanpa\par\pard\ql \li648\sb73\sl-230\slmult0 \up0 \expndtw-
9\charscalex95 mengeluarkan jarum suntik bekasnya.\par\pard\ql \li334\sb72\sl-
Pembakaran jarum suntik bekas pakai menggunakan \ul0\nosupersub\cf6\f7\fs20
incinerator\ul0\nosupersub\cf4\f5\fs20 .\par\pard\ql \li334\sb76\sl-
Apabila ada jarum suntik yang dikembalikan dan menurut laporan
bersih\par\pard\qj \li648\ri806\sb14\sl-302\slmult0\fi0 \up0 \expndtw-
9\charscalex94 dan tidak dipakai, maka harus tetap dibuang ke dalam wadah
penampungan \up0 \expndtw-9\charscalex96 tersebut.\par\pard\ql \li334\sb61\sl-
Wadah pemusnahan yang telah penuh segera diletakkan di dalam kantong\par\pard\qj
\li648\ri805\sb14\sl-302\slmult0\fi0 \up0 \expndtw-4\charscalex100 plastik yang
telah diberi label yang sesuai yang terletak di dalam kotak \up0 \expndtw-
3\charscalex100 berlabel. Jika kotak tersebut telah penuh, tas plastik yang
didalamnya \up0 \expndtw-9\charscalex93 terdapat wadah pemusnahan ditutup, dan
kotak disegel.\par\pard\ql \li334\sb61\sl-230\slmult0\tx653 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-8\charscalex94 Kotak yang telah disegel
kemudian dibawa ke tempat pembakaran. Jika kotak\par\pard\qj \li648\ri805\sb14\sl-
302\slmult0\fi0 \up0 \expndtw-4\charscalex100 tersebut telah dimusnahkan, maka
laporan tentang pemusnahan akan \up0 \expndtw-9\charscalex97
diarsipkan.\par\pard\ql \li20\sb99\sl-230\slmult0\tx339 \up0 \expndtw-
9\charscalex93 7.\tab \up0 \expndtw-8\charscalex94 LJSS menjalin kerjasama dengan
rumah sakit atau institusi sejenis yang memiliki\par\pard\ql \li354\sb112\sl-
incinerator\ul0\nosupersub\cf4\f5\fs20 guna mendukung pembakaran jarum suntik
bekas pakai dengan\par\pard\ql \li354\sb114\sl-230\slmult0 \up0 \expndtw-
8\charscalex100 menggunakan \ul0\nosupersub\cf6\f7\fs20 incinerator\par\pard\ql
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf4\f5\fs20 -\tab \up0 \expndtw-9\charscalex89 Resep\par\pard\ql
\expndtw-9\charscalex97 Surat Rujukan\par\pard\ql \li3105\sb55\sl-
8\charscalex100 Form hasil laboratorium\par\pard\ql \li3105\sb55\sl-
8\charscalex100 Buku Pedoman Nasional VCT\par\pard\ql \li3105\sb55\sl-
9\charscalex100 Buku Pedoman Nasional CST\par\pard\ql \li2468\sb0\sl-230\slmult0
\ul0\nosupersub\cf5\f6\fs20 4.\tab \up0 \expndtw-5\charscalex100 Program Terapi
Rumatan Metadon\par\pard\ql \li3105\sb0\sl-230\slmult0 \par\pard\ql
\li3105\sb74\sl-230\slmult0 \up0 \expndtw-5\charscalex100 Pengertian
:\par\pard\qj \li3105\ri1824\sb8\sl-284\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf4\f5\fs20 Program Terapi Rumatan Metadon (PTRM) adalah
program layanan yang \up0 \expndtw-7\charscalex100 memberikan zat bernama Metadon
sebagai pengganti (substitusi) dari zat Heroin \up0 \expndtw-7\charscalex100
illegal yang dikonsumsi pasien. Pemberian zat yang bersifat substitusi ini bersifat
\up0 \expndtw-8\charscalex95 jangka panjang, oleh karena itu disebut sebagai
program rumatan. Metadon adalah \up0 \expndtw-8\charscalex95 zat sintetik golongan
opioid yang bersifat agonis. Dasar rasional PTRM adalah fakta \up0 \expndtw-
5\charscalex100 tingginya angka kekambuhan pada pecandu heroin yang
mengindikasikan \up0 \expndtw-6\charscalex100 kebutuhan tubuh atas zat jenis opiat
untuk membuat keseimbangan tubuh agar \up0 \expndtw-8\charscalex96 dapat
beraktivitas secara normal. Metadon bekerja pada tubuh selama rata-rata 24 \up0
\expndtw-8\charscalex100 jam, sehingga hanya perlu minum satu kali sehari. Program
rumatan ini diberikan \up0 \expndtw-8\charscalex97 minimal 6 bulan dan dapat
diteruskan sampai 2 tahun sesuai dengan kriteria yang \up0 \expndtw-9\charscalex96
telah ditentukan pada Pedoman Nasional PTRM.\par\pard\ql \li3105\sb0\sl-230\slmult0
\ul0\nosupersub\cf5\f6\fs20 Sasaran:\par\pard\ql \li3105\sb51\sl-230\slmult0
\up0 \expndtw-2\charscalex100 \u8226?\ul0\nosupersub\cf4\f5\fs20
\ul0\nosupersub\cf5\f6\fs20 \u8226?\ul0\nosupersub\cf4\f5\fs20 Keluarga
\ul0\nosupersub\cf5\f6\fs20 \u8226?\ul0\nosupersub\cf4\f5\fs20 LSM yang bekerja
untuk mendukung penasun\par\pard\ql \li3105\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 Ruang Lingkup :\par\pard\ql \li3105\sb51\sl-230\slmult0
\up0 \expndtw-9\charscalex95 4.1. \ul0\nosupersub\cf4\f5\fs20 Prosedur
Penerimaan Pasien PTRM\par\pard\ql \li3105\sb83\sl-230\slmult0 \up0 \expndtw-
8\charscalex100 \ul0\nosupersub\cf5\f6\fs20 4.2. \ul0\nosupersub\cf4\f5\fs20
Prosedur Konsultasi Dokter\par\pard\ql \li3105\sb82\sl-230\slmult0 \up0 \expndtw-
9\charscalex95 \ul0\nosupersub\cf5\f6\fs20 4.3. \ul0\nosupersub\cf4\f5\fs20
Prosedur dosis bawa pulang Metadon\par\pard\ql \li3105\sb105\sl-230\slmult0 \up0
\expndtw-6\charscalex100 \ul0\nosupersub\cf5\f6\fs20 4.4.
\ul0\nosupersub\cf4\f5\fs20 Prosedur Minum Metadon\par\pard\ql \li3105\sb105\sl-
4.5\ul0\nosupersub\cf4\f5\fs20 . Penggantian Dosis Muntah\par\pard\ql
6\charscalex100 \ul0\nosupersub\cf3\f4\fs20 27\par\pard\column \qj \li12434\sb0\sl-
263\slmult0 \par\pard\qj \li12434\sb0\sl-263\slmult0 \par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 9. Perawat / Petugas mempersilahkan pasien untuk ke
ruang pengambilan dosis \line\tab \up0 \expndtw-9\charscalex94 metadon yang
didampingi oleh orangtua / keluarga/penanggung jawab.\par\pard\ql \li12434\sb0\sl-
4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Dokumen Terkait\par\pard\ql
\ul0\nosupersub\cf4\f5\fs20 - Status pasien\par\pard\ql \li632\sb34\sl-
230\slmult0 \up0 \expndtw-1\charscalex100 - Kartu metadon\par\pard\ql
\li632\sb34\sl-230\slmult0 \up0 \expndtw-4\charscalex100 - Formulir pemeriksaan
urin/laborat\par\pard\ql \li632\sb34\sl-230\slmult0 \up0 \expndtw0\charscalex101 -
Resep\par\pard\ql \li11822\sb0\sl-230\slmult0 \par\pard\ql \li20\sb38\sl-
4.2.\tab \up0 \expndtw-4\charscalex100 Prosedur Konsultasi Dokter\par\pard\qj
Tujuan:\ul0\nosupersub\cf4\f5\fs20 sebagai acuan dalam prosedur konsultasi dokter
bagi pasien peserta PTRM \up0 \expndtw-9\charscalex91 di Puskesmas\par\pard\qj
\ul0\nosupersub\cf5\f6\fs20 Pengertian:\ul0\nosupersub\cf4\f5\fs20 konsultasi
dokter adalah menghadapkan pasien peserta PTRM kepada \up0 \expndtw-3\charscalex100
dokter yang bertugas untuk dilakukan evaluasi melalui pemeriksaan baik fisik
\up0 \expndtw-4\charscalex100 maupun penunjang lainnya sesuai dengan keluhan yang
dialami pasien terkait \up0 \expndtw-3\charscalex100 mengikuti PTRM\par\pard\ql
Prosedur\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li632\sb33\sl-230\slmult0
\up0 \expndtw-4\charscalex100 1. Pasien \up0 \expndtw-6\charscalex100 / keluarga
menyebutkan nomor peserta metadon pada petugas\par\pard\ql \li982\sb34\sl-
230\slmult0 \up0 \expndtw-9\charscalex94 pendaftaran/keamanan\par\pard\qj
\li632\ri818\sb7\sl-263\slmult0\tx992 \up0 \expndtw-7\charscalex100 2. Petugas
pendaftaran/keamanan memberitahu petugas dispensing ( perawat ) \line\tab \up0
\expndtw-2\charscalex100 dengan menyebutkan nomor peserta metadon pasien yang akan
konsul\par\pard\ql \li982\sb29\sl-230\slmult0\tx1465 \up0 \expndtw-9\charscalex93
3.\tab \up0 \expndtw-9\charscalex90 Perawat / Petugas menyerahkan status pasien
kepada dokter\par\pard\ql \li632\sb34\sl-230\slmult0 \up0 \expndtw-8\charscalex94
4. Perawat / Petugas mempersilahkan pasien / keluarga masuk ke ruang
konsultasi\par\pard\ql \li632\sb34\sl-230\slmult0 \up0 \expndtw-9\charscalex96 5.
Dokter mendokumentasikan hasil konsultasi ke dalam catatan dokter\par\pard\ql
\li632\sb33\sl-230\slmult0 \up0 \expndtw-9\charscalex100 6. Dokter memberikan
resep bila pasien memerlukan obat\par\pard\ql \li632\sb34\sl-230\slmult0 \up0
\expndtw-9\charscalex96 7. Dokter memberitahukan hasil konsultasi kepada perawat /
petugas\par\pard\ql \li632\sb34\sl-230\slmult0 \up0 \expndtw-9\charscalex94 8.
Perawat / Petugas mendokumentasikan kedalam catatan harian\par\pard\ql
\li632\sb34\sl-230\slmult0 \up0 \expndtw-9\charscalex93 9. Perawat / petugas
mengembalikan status pasien ke tempatnya\par\pard\ql \li12434\sb0\sl-230\slmult0
medik pasien\par\pard\ql \li632\sb74\sl-230\slmult0 \up0 \expndtw0\charscalex101 -
Resep\par\pard\ql \li632\sb74\sl-230\slmult0 \up0 \expndtw-3\charscalex100 -
Kartu peserta PTRM\par\pard\ql \li15387\sb0\sl-230\slmult0 \par\pard\ql
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf5\f6\fs20 4.3.\tab \up0 \expndtw-5\charscalex100 Prosedur dosis
bawa pulang Metadon\par\pard\qj \li3037\ri1799\sb8\sl-292\slmult0\fi0 \up0
\expndtw-8\charscalex93 Tujuan \ul0\nosupersub\cf4\f5\fs20 : sebagai acuan dalam
memberikan dosis bawa pulang pasien peserta PTRM \up0 \expndtw-8\charscalex98
\ul0\nosupersub\cf5\f6\fs20 Pengertian\ul0\nosupersub\cf4\f5\fs20 : dosis bawa
pulang adalah dosis yang boleh dibawa pulang oleh pasien \up0 \expndtw-
6\charscalex100 karena adanya alasan yang sangat kuat dan telah memenuhi kriteria
serta sudah \up0 \expndtw-6\charscalex100 dilakukan skrining oleh tim
PTRM\par\pard\ql \li3037\sb39\sl-230\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Prosedur :\par\pard\ql \li3037\sb59\sl-
1.\tab \up0 \expndtw-8\charscalex97 Pasien / keluarga/penanggung jawab
mendiskusikan jadwal dosis bawa pulang\par\pard\ql \li3419\sb63\sl-230\slmult0 \up0
\expndtw-9\charscalex92 dengan dokter yang bertugas\par\pard\ql \li3037\sb62\sl-
4\charscalex100 Dokter memberikan informasi secara rinci tentang segala persyaratan
dan\par\pard\ql \li3419\sb63\sl-230\slmult0 \up0 \expndtw-9\charscalex92
konsekuensi dosis bawa pulang\par\pard\ql \li3037\sb63\sl-230\slmult0\tx3413
\up0 \expndtw-9\charscalex93 3.\tab \up0 \expndtw-8\charscalex100 Dokter membuat
formulir pemeriksaan urin tes\par\pard\ql \li3037\sb62\sl-230\slmult0\tx3413
\up0 \expndtw-9\charscalex93 4.\tab \up0 \expndtw-9\charscalex92 Pasien
menyerahkahkan hasil tes urin kepada petugas/perawat\par\pard\ql \li3037\sb63\sl-
6\charscalex100 Pasien / keluarga \up0 \expndtw-4\charscalex100 / penangung jawab
mengisi dan menandatangani surat\par\pard\ql \li3037\ri1799\sb12\sl-
292\slmult0\fi381\tx3408 \up0 \expndtw-9\charscalex91 peryataan diatas materai
apabila segala persyaratan telah terpenuhi. \line \up0 \expndtw-9\charscalex93
6. \tab \up0 \expndtw-6\charscalex100 Dokter mendokumentasikan dosis metadon yang
boleh dibawa pulang oleh\par\pard\ql \li3419\sb53\sl-230\slmult0 \up0 \expndtw-
9\charscalex92 pasien / keluarga/penanggung jawab\par\pard\ql \li3037\sb63\sl-
Dokter menyerahkan Catatan Medikpasien pada perawat / petugas\par\pard\ql
\expndtw-7\charscalex100 Perawat / Petugas mendokumentasikan jadwal dosis metadon
bawa pulang\par\pard\ql \li3419\sb63\sl-230\slmult0 \up0 \expndtw-9\charscalex91
kedalam catatan harian pasien\par\pard\ql \li3037\sb63\sl-230\slmult0\tx3413
\up0 \expndtw-9\charscalex93 9.\tab \up0 \expndtw-8\charscalex95 Perawat / petugas
menginformasikan jadwal dosis bawa pulang kepada petugas\par\pard\ql
\li3419\sb63\sl-230\slmult0 \up0 \expndtw-9\charscalex96 farmasi\par\pard\ql
\expndtw-8\charscalex96 Petugas farmasi menyerahkan metadon untuk dosis bawa pulang
sesuai jadwal\par\pard\ql \li3419\sb63\sl-230\slmult0 \up0 \expndtw-9\charscalex96
yang diberikan dokter\par\pard\ql \li3037\sb63\sl-230\slmult0\tx3413 \up0 \expndtw-
9\charscalex93 11.\tab \up0 \expndtw-9\charscalex93 Perawat / Petugas menyimpan
Catatan Medikpasien ketempatnya\par\pard\ql \li3037\sb0\sl-230\slmult0 \par\pard\ql
:\par\pard\ql \li3037\sb63\sl-230\slmult0\tx3413 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-9\charscalex94 Catatan Medik Pasien\par\pard\ql
\expndtw-9\charscalex95 Hasil Psikotes dan urinalis\par\pard\ql \li3037\sb109\sl-
Surat Peryataan dosis bawa pulang (THD)\par\pard\ql \li3037\sb108\sl-
Surat Keterangan bekerja\par\pard\ql \li3037\sb129\sl-230\slmult0\tx3413 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex95 Jadwal
Kuliah\par\pard\ql \li5993\sb0\sl-230\slmult0 \par\pard\ql \li5993\sb0\sl-
4.6\ul0\nosupersub\cf4\f5\fs20 .\tab \up0 \expndtw-9\charscalex94 Prosedur
Pemberian Dosis Terlewat\par\pard\ql \li671\sb71\sl-230\slmult0\tx1365 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 4.7\ul0\nosupersub\cf4\f5\fs20
.\tab \up0 \expndtw-8\charscalex100 Prosedur Naik Dosis Metadon\par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 4.8.\tab \up0 \expndtw-9\charscalex96
\ul0\nosupersub\cf4\f5\fs20 Prosedur menurunkan dosis metadon\par\pard\ql
\ul0\nosupersub\cf4\f5\fs20 Prosedur Merujuk Pasien Ke Klinik/Satelit PTRM
lain\par\pard\ql \li671\sb72\sl-230\slmult0\tx1365 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf4\f5\fs20 Prosedur Penerimaan Rujukan Pindah Peserta
PTRM\par\pard\ql \li671\sb71\sl-230\slmult0\tx1395 \up0 \expndtw-8\charscalex100
\ul0\nosupersub\cf4\f5\fs20 Prosedur Penatalaksanaan Tindakan Kekerasan\par\pard\ql
\ul0\nosupersub\cf4\f5\fs20 Prosedur Mengeluarkan Pasien secara
Paksa\par\pard\ql \li671\sb71\sl-230\slmult0\tx1395 \up0 \expndtw-
7\charscalex100 \ul0\nosupersub\cf5\f6\fs20 4.13\ul0\nosupersub\cf4\f5\fs20
.\tab \up0 \expndtw-9\charscalex97 Prosedur \ul0\nosupersub\cf6\f7\fs20 Spot
Check\ul0\nosupersub\cf4\f5\fs20 peserta PTRM\par\pard\ql \li671\sb74\sl-
4.14\tab \up0 \expndtw-9\charscalex92 \ul0\nosupersub\cf4\f5\fs20 Prosedur
Penatalaksanaan Gangguan Diagnosis Ganda pada Peserta PTRM\par\pard\ql
3\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Prosedur:\par\pard\ql \li20\sb52\sl-
230\slmult0\tx676 \up0 \expndtw-7\charscalex100 4.1.\tab \up0 \expndtw-
4\charscalex100 Prosedur Penerimaan pasien PTRM\par\pard\qj \li671\ri805\sb10\sl-
301\slmult0 \up0 \expndtw-7\charscalex100 Tujuan\ul0\nosupersub\cf4\f5\fs20 : acuan
untuk prosedur penerimaan pasien baru maupun pindahan PTRM \up0 \expndtw-
9\charscalex91 di Puskesmas\par\pard\qj \li671\ri805\sb0\sl-301\slmult0 \up0
Pengertian:\ul0\nosupersub\cf4\f5\fs20 adalah penerimaan pasien PTRM yaitu proses
penerimaan pasien baru \up0 \expndtw-9\charscalex94 / ulangan atau pindahan yang
akan mengikuti PTRM di Puskesmas.\par\pard\ql \li671\sb45\sl-230\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Prosedur :\par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 1. Perawat / petugas PTRM menerima pasien, keluarga
dan catatan medik pasien \line\tab \up0 \expndtw-9\charscalex95 dari petugas
pendaftaran klinik metadon\par\pard\ql \li671\sb59\sl-230\slmult0 \up0 \expndtw-
6\charscalex100 2. Perawat \up0 \expndtw-3\charscalex100 / petugas PTRM
memberikan peraturan kepada pasien dan\par\pard\ql \li1016\sb72\sl-
230\slmult0 \up0 \expndtw-9\charscalex93 keluarga/penanggung jawab untuk di baca
dan ditandatangani\par\pard\qj \li670\ri806\sb13\sl-301\slmult0\tx1026 \up0
\expndtw-6\charscalex100 3. Perawat / petugas PTRM memberikan penjelasan pada
pasien dan keluarga \line\tab \up0 \expndtw-9\charscalex94 tentang peraturan yang
berlaku.\par\pard\qj \li670\ri806\sb0\sl-301\slmult0\tx1026 \up0 \expndtw-
7\charscalex100 4. Perawat / petugas memberikan informed consent PTRM untuk
ditandatangani \line\tab \up0 \expndtw-9\charscalex92 oleh pasien dan
keluarga/penanggung jawab\par\pard\qj \li670\ri806\sb0\sl-301\slmult0\tx1026
\up0 \expndtw-8\charscalex96 5. Perawat / petugas menandatangani informed consent
yang telah ditandatangani \line\tab \up0 \expndtw-9\charscalex92 pasien dan
keluarga/penanggung jawab\par\pard\ql \li670\sb73\sl-230\slmult0 \up0 \expndtw-
9\charscalex93 6. Perawat / petugas membuat status dan kartu metadon
pasien\par\pard\ql \li670\sb86\sl-230\slmult0 \up0 \expndtw-9\charscalex95 7.
Perawat/petugas membuat surat permintaan pemeriksaan urin\par\pard\ql
\li670\sb100\sl-230\slmult0 \up0 \expndtw-8\charscalex98 8. Perawat / petugas
mendokumentasikan instruksi dokter dan hasil pemeriksaan\par\pard\ql
\li1016\sb101\sl-230\slmult0 \up0 \expndtw-9\charscalex94 dalam rekam medik
pasien\par\pard\ql \li15348\sb0\sl-230\slmult0 \par\pard\ql \li15348\sb0\sl-
2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 28
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf5\f6\fs20 4.4.\tab \up0 \expndtw-4\charscalex100 Prosedur Minum
Metadon\par\pard\ql \li3113\ri1835\sb3\sl-260\slmult0\fi0 \up0 \expndtw-
9\charscalex94 Tujuan\ul0\nosupersub\cf4\f5\fs20 : sebagai acuan dalam memberikan
dosis minum peserta PTRM \line \up0 \expndtw-8\charscalex96
\ul0\nosupersub\cf5\f6\fs20 Pengertian:\ul0\nosupersub\cf4\f5\fs20 minum metadon
adalah suatu kegiatan dimana pasien akan mengambil \up0 \expndtw0\charscalex100
dosis metadon yang telah ditentukan oleh dokter yang diminum langsung \up0
\expndtw-9\charscalex91 dihadapan petugas\par\pard\ql \li3113\sb13\sl-
230\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Prosedur
:\par\pard\ql \li3113\sb27\sl-230\slmult0 \up0 \expndtw-7\charscalex100
\ul0\nosupersub\cf4\f5\fs20 1. Pasien menunggu giliran untuk minum
metadon\par\pard\ql \li3113\sb31\sl-230\slmult0 \up0 \expndtw-9\charscalex96 2.
Pasien menyebutkan nomer peserta PTRM pada petugas PTRM\par\pard\ql
\li3113\sb30\sl-230\slmult0 \up0 \expndtw-4\charscalex100 3. Perawat / Petugas
mengambil Catatan Medikpasien sesuai dengan nomer\par\pard\ql \li3460\sb31\sl-
230\slmult0 \up0 \expndtw-9\charscalex89 peserta pasien\par\pard\qj
\li3113\ri1835\sb6\sl-260\slmult0\tx3460 \up0 \expndtw-8\charscalex95 4. Perawat /
Petugas konfirmasi pada petugas farmasi tentang dosis metadon yang \line\tab
\up0 \expndtw-6\charscalex100 ditentukan.\par\pard\qj \li3113\ri1835\sb0\sl-
260\slmult0\tx3460 \up0 \expndtw-8\charscalex97 5. Perawat / Petugas
mendokumentasikan dosis metadon yang dinminum pasien \line\tab \up0 \expndtw-
9\charscalex90 ke dalam catatan harian pasien.\par\pard\qj \li3113\ri1835\sb0\sl-
260\slmult0\tx3460 \up0 \expndtw-4\charscalex100 6. Petugas farmasi
mendokumentasikan dosis metadon pasien kedalam form \line\tab \up0 \expndtw-
9\charscalex93 kehadiran pasien\par\pard\qj \li3113\ri1835\sb0\sl-
260\slmult0\tx3460 \up0 \expndtw-2\charscalex100 7. Petugas farmasi meminta pasien
untuk menandatangani form kehadiran \line\tab \up0 \expndtw-9\charscalex92
pasien.\par\pard\qj \li3113\ri1835\sb1\sl-260\slmult0\tx3460 \up0 \expndtw-
6\charscalex100 8. Petugas farmasi memberikan dosis metadon pada pasien sesuai
dosis yang \line\tab \up0 \expndtw-6\charscalex100 ditentukan.\par\pard\qj
\li3113\ri1835\sb1\sl-260\slmult0\tx3460 \up0 \expndtw-8\charscalex96 9. Perawat /
Petugas dan farmasi mengawasi bahwa dosis metadon telah diminum \line\tab \up0
\expndtw-9\charscalex91 habis oleh pasien.\par\pard\ql \li3113\sb26\sl-
230\slmult0 \up0 \expndtw-8\charscalex94 10. Perawat / Petugas dan farmasi
mengembalikan Catatan Medik ke tempatnya\par\pard\ql \li2472\sb0\sl-230\slmult0
:\par\pard\ql \li3113\sb30\sl-230\slmult0 \up0 \expndtw0\charscalex102 - Catatan
Medik\par\pard\ql \li3113\sb31\sl-230\slmult0 \up0 \expndtw-4\charscalex100 -
Standar operasional PTRM\par\pard\ql \li3113\sb56\sl-230\slmult0 \up0 \expndtw-
5\charscalex100 - Form Kehadiran Pasien\par\pard\ql \li2472\sb0\sl-230\slmult0
\ul0\nosupersub\cf5\f6\fs20 4.5.\tab \up0 \expndtw-4\charscalex100 Penggantian
Dosis Muntah\par\pard\qj \li3113\ri1835\sb11\sl-286\slmult0 \up0 \expndtw-
4\charscalex100 Tujuan:\ul0\nosupersub\cf4\f5\fs20 sebagai acuan dalam memberikan
dosis pengganti pada pasien yang \up0 \expndtw-5\charscalex100
muntah\par\pard\qj \li3113\ri1835\sb7\sl-316\slmult0 \up0 \expndtw-
8\charscalex94 \ul0\nosupersub\cf5\f6\fs20 Pengertian:\ul0\nosupersub\cf4\f5\fs20
penggantian dosis muntah adalah adalah pemberian dosis ulang kepada \up0 \expndtw-
8\charscalex94 pasien yang muntah setelah minum metadon sesuai dengan lamanya
pasien muntah \up0 \expndtw-9\charscalex94 setelah minum dosis
sebelumnya\par\pard\ql \li6045\sb0\sl-230\slmult0 \par\pard\ql \li6045\sb0\sl-
4.\tab \up0 \expndtw-8\charscalex94 Dokter menentukan dan meresepkan dosis sebanyak
50% dari dosis terakhir\par\pard\ql \li652\sb65\sl-230\slmult0\tx1018 \up0
\expndtw-9\charscalex93 5.\tab \up0 \expndtw-9\charscalex91 Pasien menerima dosis
sesuai yang tertulis dalam resep\par\pard\ql \li652\sb65\sl-230\slmult0\tx1018 \up0
\expndtw-9\charscalex93 6.\tab \up0 \expndtw-4\charscalex100 Pasien di observasi
minimal 30 menit setelah minum dosis terlewat untuk\par\pard\ql \li1051\sb64\sl-
230\slmult0 \up0 \expndtw-9\charscalex96 memastikan perlu tidaknya tindakan lebih
lanjut\par\pard\ql \li652\sb65\sl-230\slmult0\tx1018 \up0 \expndtw-9\charscalex93
7.\tab \up0 \expndtw-8\charscalex94 Petugas dispensing dan farmasi
mendokumentasikan dosis pada catatan harian\par\pard\ql \li1051\sb65\sl-230\slmult0
\up0 \expndtw-9\charscalex91 pasien\par\pard\ql \li652\sb65\sl-
8\charscalex100 Petugas mengembalikan Catatan Medik pasien pada box file sesuai
dengan\par\pard\ql \li1051\sb65\sl-230\slmult0 \up0 \expndtw-9\charscalex93 nomor
peserta pasien\par\pard\ql \li12459\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 Dokumen terkait \ul0\nosupersub\cf4\f5\fs20
\up0 \expndtw-9\charscalex95 Catatan Medik pasien\par\pard\ql \li652\sb65\sl-
Resep\par\pard\ql \li11827\sb0\sl-230\slmult0 \par\pard\ql \li20\sb97\sl-
4.7.\tab \up0 \expndtw-5\charscalex100 Prosedur Naik Dosis Metadon\par\pard\qj
Tujuan\ul0\nosupersub\cf4\f5\fs20 : sebagai acuan dalam menaikkan dosis metadon
peserta PTRM sesuai \up0 \expndtw-9\charscalex96 dengan indikasi klinis\par\pard\qj
\ul0\nosupersub\cf5\f6\fs20 Pengertian:\ul0\nosupersub\cf4\f5\fs20 adalah proses
menaikan dosis metadon pada pasien PTRM yang dosis \up0 \expndtw-9\charscalex95
metadonnya belum mencukupi setelah melalui pemeriksaan dokter\par\pard\ql
\expndtw-9\charscalex94 Pasien harus konsultasi kepada dokter terlebih
dahulu\par\pard\ql \li652\sb65\sl-230\slmult0\tx1018 \up0 \expndtw-9\charscalex93
2.\tab \up0 \expndtw-9\charscalex93 Dokter akan menilai keluhan yang disampaikan
pasien / keluarga\par\pard\ql \li652\sb65\sl-230\slmult0\tx1018 \up0 \expndtw-
9\charscalex93 3.\tab \up0 \expndtw-8\charscalex94 Dokter menilai dan mengobservasi
gejala klinis sesuai dengan keluhan pasien\par\pard\ql \li652\sb65\sl-
6\charscalex100 Dokter mendokumentasikan perubahan dosis pasien di catatan dokter
dan\par\pard\ql \li1051\sb64\sl-230\slmult0 \up0 \expndtw-9\charscalex94 membuat
resep\par\pard\ql \li651\sb65\sl-230\slmult0\tx1017 \up0 \expndtw-9\charscalex93
5.\tab \up0 \expndtw-9\charscalex93 Dokter menyerahkan Catatan Medikpasien kepada
perawat / petugas\par\pard\ql \li651\sb65\sl-230\slmult0\tx1017 \up0 \expndtw-
9\charscalex93 6.\tab \up0 \expndtw-8\charscalex96 Perawat / Petugas
mendokumentasikan kenaikan dosis metadon pada catatan\par\pard\ql \li1051\sb65\sl-
230\slmult0 \up0 \expndtw-9\charscalex92 harian pasien\par\pard\ql \li651\sb65\sl-
Perawat / Petugas menginformasikan kenaikan dosis metadon pasien kepada\par\pard\ql
\li1051\sb65\sl-230\slmult0 \up0 \expndtw-9\charscalex92 petugas
farmasi\par\pard\ql \li651\sb65\sl-230\slmult0\tx1017 \up0 \expndtw-9\charscalex93
8.\tab \up0 \expndtw-2\charscalex100 Petugas farmasi mendokumentasikan kenaikan
dosis metadon dan\par\pard\ql \li1051\sb64\sl-230\slmult0 \up0 \expndtw-
9\charscalex93 memberikan dosis metadon kepada pasien sesuai dengan intruksi
dokter\par\pard\ql \li15389\sb0\sl-230\slmult0 \par\pard\ql \li15389\sb0\sl-
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
Medik pasien\par\pard\ql \li3071\sb66\sl-230\slmult0 \up0 \expndtw-4\charscalex100
- Buku PTRM Pedoman Nasional\par\pard\ql \li3071\sb67\sl-230\slmult0 \up0
\expndtw0\charscalex100 - Resep\par\pard\ql \li2455\sb0\sl-230\slmult0
\ul0\nosupersub\cf5\f6\fs20 4.8.\tab \up0 \expndtw-4\charscalex100 Prosedur
menurunkan dosis metadon\par\pard\ql \li3071\ri1827\sb9\sl-296\slmult0\fi0 \up0
\expndtw-9\charscalex93 Tujuan \ul0\nosupersub\cf4\f5\fs20 : sebagai acuan
menurunkan dosis metadon pada pasien PTRM \up0 \expndtw-8\charscalex96
\ul0\nosupersub\cf5\f6\fs20 Pengertian:\ul0\nosupersub\cf4\f5\fs20 adalah proses
menurunkankan dosis metadon pada pasien PTRM yang \up0 \expndtw-8\charscalex97
sesuai dengan kondisi klinis dan telah memenuhi kriteria untuk turun
dosis\par\pard\ql \li3071\sb41\sl-230\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf5\f6\fs20 Prosedur:\par\pard\ql \li3071\sb63\sl-
1.\tab \up0 \expndtw-9\charscalex94 Pasien harus konsultasi kepada dokter terlebih
dahulu\par\pard\ql \li3071\sb66\sl-230\slmult0\tx3526 \up0 \expndtw-9\charscalex93
2.\tab \up0 \expndtw-3\charscalex100 Dokter akan menilai alasan yang disampaikan
pasien \up0 \expndtw0\charscalex100 / keluarga untuk\par\pard\ql \li3434\sb67\sl-
230\slmult0 \up0 \expndtw-9\charscalex100 menurunkan dosis\par\pard\ql
\expndtw-3\charscalex100 Dokter menilai kriteria secara fisik, psikologis dan
sosial untuk dapat\par\pard\ql \li3434\sb67\sl-230\slmult0 \up0 \expndtw-
9\charscalex100 menurunkan dosis\par\pard\ql \li3071\sb67\sl-230\slmult0\tx3409
\up0 \expndtw-9\charscalex93 4.\tab \up0 \expndtw-8\charscalex100 Dokter
mendiskusikan dengan tim metadon lain untuk mendapatkan informasi\par\pard\ql
\li3434\sb66\sl-230\slmult0 \up0 \expndtw-9\charscalex95 tambahan\par\pard\ql
\expndtw-4\charscalex100 Dokter mendokumensikan perubahan dosis pasien di catatan
dokter dan\par\pard\ql \li3434\sb66\sl-230\slmult0 \up0 \expndtw-9\charscalex92
membuat resep sesuai pedoman nasional\par\pard\ql \li3071\ri1827\sb13\sl-
296\slmult0\fi0\tx3439 \up0 \expndtw-9\charscalex93 6.\tab \up0 \expndtw-
9\charscalex93 Dokter menyerahkan Catatan Medik pasien kepada perawat / petugas
\line \up0 \expndtw-9\charscalex93 7. \up0 \expndtw-8\charscalex95 Perawat /
Petugas mendokumentasikan penurunan dosis metadon pada catatan\par\pard\ql
\li3434\sb56\sl-230\slmult0 \up0 \expndtw-9\charscalex92 harian
8.\tab \up0 \expndtw-8\charscalex96 Perawat / Petugas menginformasikan penurunan
dosis metadon pasien kepada\par\pard\ql \li3434\sb67\sl-230\slmult0 \up0 \expndtw-
9\charscalex92 petugas farmasi\par\pard\ql \li3071\sb66\sl-230\slmult0\tx3409
\up0 \expndtw-9\charscalex93 9.\tab \up0 \expndtw-3\charscalex100 Petugas farmasi
mendokumentasikan penurunan dosis metadon dan\par\pard\ql \li3433\sb67\sl-
230\slmult0 \up0 \expndtw-9\charscalex93 memberikan dosis metadon kepada pasien
sesuai dengan intruksi dokter\par\pard\ql \li3075\sb0\sl-230\slmult0
:\par\pard\ql \li3075\sb111\sl-230\slmult0 \up0 \expndtw-5\charscalex100 -
Catatan Medik pasien\par\pard\ql \li3075\sb111\sl-230\slmult0 \up0 \expndtw-
4\charscalex100 - Buku Pedoman PTRM Nasional\par\pard\ql \li3075\sb145\sl-
3\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Prosedur:\par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 1. Penggantian dosis muntah hanya diberikan kepada
pasien yang muntah dan \line\tab \up0 \expndtw-9\charscalex92 disaksikan oleh
salah satu petugas PTRM\par\pard\ql \li605\sb33\sl-230\slmult0 \up0 \expndtw-
9\charscalex96 2. Penggantian dosis muntah diberikan apabila:\par\pard\qj
\li945\ri805\sb11\sl-289\slmult0\tx1282 \up0 \expndtw-7\charscalex100 - Muntah
kurang dari 10 menit setelah minum metadon diganti penuh sesuai \line\tab \up0
\expndtw-9\charscalex90 dengan dosis pasien\par\pard\ql \li945\sb50\sl-230\slmult0
\up0 \expndtw-8\charscalex97 - Muntah 10 30 menit setelah minum metadon diganti
setengah dosis pasien\par\pard\ql \li945\sb59\sl-230\slmult0 \up0 \expndtw-
9\charscalex97 - Muntah 30 45 menit setelah minum metadon di ganti � dosis
pasien.\par\pard\ql \li945\sb59\sl-230\slmult0 \up0 \expndtw-6\charscalex100 -
Muntah > 45 menit dosis metadon tidak diganti\par\pard\qj \li605\ri805\sb11\sl-
289\slmult0\tx981 \up0 \expndtw-6\charscalex100 3. Dosis pengganti muntah harus di
minum di klinik PTRM yang disaksikan oleh \line\tab \up0 \expndtw-9\charscalex91
petugas.\par\pard\qj \li605\ri805\sb0\sl-289\slmult0\tx981 \up0 \expndtw-
7\charscalex100 4. Pasien di observasi minimal 30 menit setelah minum dosis
pengganti metadon \line\tab \up0 \expndtw-9\charscalex97 untuk memastikan perlu
tidaknya tindakan lebih lanjut\par\pard\qj \li605\ri805\sb1\sl-289\slmult0\tx981
\up0 \expndtw-7\charscalex100 5. Petugas dispensing dan farmasi mendokumentasikan
penggantian dosis pada \line\tab \up0 \expndtw-9\charscalex91 catatan harian
pasien\par\pard\qj \li605\ri805\sb0\sl-289\slmult0\tx981 \up0 \expndtw-
5\charscalex100 6. Petugas mengembalikan Catatan Medik pasien pada box file sesuai
dengan \line\tab \up0 \expndtw-9\charscalex92 nomer peserta pasien\par\pard\ql
terkait\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li605\sb59\sl-230\slmult0 \up0
\expndtw-6\charscalex100 - Catatan medik pasien\par\pard\ql \li605\sb60\sl-
230\slmult0 \up0 \expndtw-6\charscalex100 - Form kehadiran pasien\par\pard\ql
5\charscalex100 Prosedur Pemberian Dosis Terlewat\par\pard\qj \li605\ri805\sb12\sl-
289\slmult0 \up0 \expndtw-5\charscalex100 Tujuan\ul0\nosupersub\cf4\f5\fs20 :
sebagai acuan untuk memberikan dosis metadon yang terlewati karena \up0 \expndtw-
9\charscalex95 ketidakhadiran pasien\par\pard\qj \li605\ri805\sb0\sl-289\slmult0
Pengertian:\ul0\nosupersub\cf4\f5\fs20 adalah proses pemberian dosis metadon yang
diberikan kepada pasien \up0 \expndtw-9\charscalex93 PTRM yang melewati/membolos
dosis selama 1 sampai 3 hari.\par\pard\ql \li605\sb49\sl-230\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Prosedur
\ul0\nosupersub\cf4\f5\fs20 :\par\pard\qj \li605\ri805\sb11\sl-289\slmult0\tx981
\up0 \expndtw-5\charscalex100 1. Perawat/petugas menanyakan ketidakhadiran pasien
ke kilinik PTRM dalam \line\tab \up0 \expndtw-8\charscalex100 kurun waktu 1-3
hari\par\pard\ql \li605\sb50\sl-230\slmult0 \up0 \expndtw-9\charscalex96 2.
Perawat/petugas merujuk pasien untuk konsultasi dengan dokter\par\pard\ql
\li605\sb59\sl-230\slmult0 \up0 \expndtw-5\charscalex100 3. Dokter melakukan
pemeriksaan fisik dan psikologis untuk menentukan dosis\par\pard\ql \li971\sb59\sl-
230\slmult0 \up0 \expndtw-8\charscalex100 metadon\par\pard\ql \li15387\sb0\sl-
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf5\f6\fs20 4.9.\tab \up0 \expndtw-5\charscalex100 Prosedur Merujuk
Pasien Ke Klinik/Satelit PTRM lain\par\pard\qj \li3094\ri1834\sb13\sl-
322\slmult0\fi17 \up0 \expndtw-7\charscalex100 Tujuan\ul0\nosupersub\cf4\f5\fs20 :
sebagai acuan dalam proses merujuk pasien PTRM ke klinik atau satelit \up0
\expndtw-6\charscalex100 PTRM lainnya\par\pard\qj \li3094\ri1834\sb1\sl-
322\slmult0\fi17 \up0 \expndtw-7\charscalex100 \ul0\nosupersub\cf5\f6\fs20
Pengertian\ul0\nosupersub\cf4\f5\fs20 : adalah proses memindahkan / merujuk peserta
PTRM Puskesmas ke \up0 \expndtw-5\charscalex100 klinik PTRM/Satelit
lain\par\pard\ql \li3112\sb77\sl-230\slmult0 \up0 \expndtw-5\charscalex100
\expndtw-4\charscalex100 Pasien memberitahukan kepada perawat \up0 \expndtw-
4\charscalex100 / petugas tentang rencana\par\pard\ql \li3470\sb93\sl-
230\slmult0 \up0 \expndtw-9\charscalex96 kepindahannya ke PTRM yang dituju
-\tab \up0 \expndtw-9\charscalex93 3 hari sebelum pindah ( pindah
sementara )\par\pard\ql \li3459\sb93\sl-230\slmult0\tx3677 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-9\charscalex94 1 minggu sebelum pindah ( pindah
permanen / seterusnya)\par\pard\ql \li3111\sb92\sl-230\slmult0\tx3454 \up0
\expndtw-9\charscalex93 2.\tab \up0 \expndtw-7\charscalex100 Perawat / petugas
menyerahkan Catatan Medikpasien kepada dokter yang\par\pard\ql \li3470\sb93\sl-
230\slmult0 \up0 \expndtw-9\charscalex93 bertugas\par\pard\ql \li3111\sb93\sl-
5\charscalex100 Perawat / petugas mempersilahkan pasien dan orangtua / keluarga
untuk\par\pard\ql \li3470\sb92\sl-230\slmult0 \up0 \expndtw-7\charscalex100 menemui
dokter\par\pard\ql \li3111\sb93\sl-230\slmult0\tx3454 \up0 \expndtw-9\charscalex93
4.\tab \up0 \expndtw-8\charscalex96 Pasien dan orangtua / keluarga menyampaikan
alasan kepindahannya kepada\par\pard\ql \li3469\sb92\sl-230\slmult0 \up0 \expndtw-
9\charscalex94 dokter yang bertugas dan membuat surat permohonan pindah\par\pard\ql
\expndtw-8\charscalex98 Dokter membuat surat pengantar pindah / rujukan ke
klinik/satelit PTRM yang\par\pard\ql \li3111\ri1835\sb16\sl-322\slmult0\fi358
\up0 \expndtw-9\charscalex96 dituju dan mendokumentasikan kedalam Catatan Medik
pasien. \line \up0 \expndtw-9\charscalex93 6. \up0 \expndtw-9\charscalex95 Dokter
menyerahkan surat pengantar rujukan kepada petugas PTRM \line \up0 \expndtw-
9\charscalex93 7. \up0 \expndtw-2\charscalex100 Perawat / petugas PTRM menggandakan
surat rujukan untuk disimpan\par\pard\ql \li3111\ri1835\sb1\sl-322\slmult0\fi358
\up0 \expndtw-9\charscalex92 kedalam Catatan Medik pasien dan menyerahkan kepada
pasien / orangtua. \up0 \expndtw-9\charscalex93 8. \up0 \expndtw-6\charscalex100
Perawat / petugas mendokumentasikan kedalam Catatan Medikpasien dan\par\pard\ql
\li3469\sb77\sl-230\slmult0 \up0 \expndtw-9\charscalex95 mengembalikan Catatan
Medik pasien ketempatnya.\par\pard\ql \li2472\sb0\sl-230\slmult0 \par\pard\ql
Medik Pasien\par\pard\ql \li3111\sb92\sl-230\slmult0 \up0 \expndtw0\charscalex100 -
Surat rujukan\par\pard\ql \li3111\sb93\sl-230\slmult0 \up0 \expndtw-6\charscalex100
- Surat Permohonan Pindah\par\pard\ql \li3111\sb105\sl-230\slmult0 \up0 \expndtw-
4\charscalex100 - Buku Pedoman PTRM Nasional\par\pard\ql \li2472\sb0\sl-
Prosedur Penerimaan Rujukan Pindah Peserta PTRM\par\pard\ql \li6034\sb0\sl-
Petugas keamanan beserta tim PTRM melakukan pertemuan dengan pelaku\par\pard\ql
\li1014\sb33\sl-230\slmult0 \up0 \expndtw-9\charscalex94 kekerasan maupun
korban\par\pard\ql \li647\sb34\sl-230\slmult0\tx1019 \up0 \expndtw-9\charscalex93
5.\tab \up0 \expndtw-7\charscalex100 Dibuat kesepakatan tentang sanksi yang
akan diberikan kepada pelaku\par\pard\ql \li1014\sb33\sl-230\slmult0 \up0
\expndtw-9\charscalex91 kekerasan\par\pard\ql \li647\sb34\sl-230\slmult0\tx1019
\up0 \expndtw-9\charscalex93 6.\tab \up0 \expndtw-7\charscalex100 Apabila tindak
kekerasan dinilai cukup serius petugas keamanan dapat\par\pard\ql
\li1014\sb34\sl-230\slmult0 \up0 \expndtw-9\charscalex94 melaporkan kepada petugas
hukum\par\pard\ql \li647\sb33\sl-230\slmult0\tx1019 \up0 \expndtw-9\charscalex93
7.\tab \up0 \expndtw-9\charscalex97 Petugas keamanan mendokumentasi seluruh
pencatatan kejadian kekerasan\par\pard\ql \li1014\sb34\sl-230\slmult0 \up0
\expndtw-9\charscalex90 dalam berita acara\par\pard\ql \li11827\sb0\sl-
terkait\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li647\sb33\sl-230\slmult0\tx1019
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex94 Catatan Medik
Pasien\par\pard\ql \li647\sb34\sl-230\slmult0\tx1019 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-9\charscalex90 Berita acara\par\pard\ql \li647\sb33\sl-
8\charscalex100 Buku Pedoman PTRM Nasional\par\pard\ql \li11827\sb0\sl-
Prosedur Mengeluarkan Pasien secara Paksa\par\pard\qj \li647\ri824\sb3\sl-
263\slmult0\fi0 \up0 \expndtw-8\charscalex92 Tujuan\ul0\nosupersub\cf4\f5\fs20 :
sebagai acuan proses mengeluarkan pasien secara paksa dari peserta PTRM \up0
Pengertian\ul0\nosupersub\cf4\f5\fs20 : adalah proses penatalaksanaan mengeluarkan
secara paksa pasien yang \up0 \expndtw-7\charscalex100 melanggar tata-tertib di
klinik PTRM\par\pard\ql \li647\sb29\sl-230\slmult0 \up0 \expndtw-3\charscalex100
\expndtw-4\charscalex100 Tim PTRM nenilai tentang pelanggaran tata-tertib yang
dilakukan pasien\par\pard\ql \li1014\sb33\sl-230\slmult0 \up0 \expndtw-
9\charscalex94 sesuai dengan pedoman PTRM nasional\par\pard\ql \li647\sb34\sl-
Dokter mengundang orang tua/wali/penangung jawab pasien\par\pard\ql \li647\sb33\sl-
6\charscalex100 Dokter beserta tim menyampaikan hasil penilaian tentang pelanggaran
tata\par\pard\ql \li1014\sb34\sl-230\slmult0 \up0 \expndtw-9\charscalex92 tertib
yang dilakukan pasien dihadapkan pasien dan orang tua\par\pard\ql \li647\sb33\sl-
7\charscalex100 Orang tua/wali/penanggung jawab menandatangani kesepakatan
tentang\par\pard\ql \li1014\sb34\sl-230\slmult0 \up0 \expndtw-9\charscalex91 sanksi
untuk mengeluarkan pasien secara paksa\par\pard\ql \li647\sb33\sl-
Dokter memberikan saran atau pengobatan lain selain PTRM kepada orang
tua\par\pard\ql \li1014\sb34\sl-230\slmult0 \up0 \expndtw-9\charscalex90 dan
6.\tab \up0 \expndtw-5\charscalex100 Petugas mendokumentasikan seluruh laporan
kejadian pada status medik\par\pard\ql \li1014\sb34\sl-230\slmult0 \up0 \expndtw-
9\charscalex91 pasien\par\pard\ql \li12454\sb0\sl-230\slmult0 \par\pard\ql
\up0 \expndtw-9\charscalex94 Catatan Medik Pasien\par\pard\ql \li647\sb70\sl-
Laporan pelanggaran tata-tertib\par\pard\ql \li647\sb82\sl-230\slmult0\tx1019
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-8\charscalex100 Buku Pedoman PTRM
Nasional\par\pard\ql \li15395\sb0\sl-230\slmult0 \par\pard\ql \li15395\sb0\sl-
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf5\f6\fs20 4.13\ul0\nosupersub\cf4\f5\fs20 .\tab \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Prosedur Spot Check peserta
PTRM\par\pard\qj \li3060\ri1799\sb12\sl-289\slmult0 \up0 \expndtw-8\charscalex96
Tujuan\ul0\nosupersub\cf4\f5\fs20 : sebagai acuan dalam prosedur pengambilan spot
check urin pasien peserta \up0 \expndtw0\charscalex101 PTRM\par\pard\qj
\ul0\nosupersub\cf5\f6\fs20 Pengertian\ul0\nosupersub\cf4\f5\fs20 : adalah proses
pengambilan sampel urin peserta PTRM sebagai salah \up0 \expndtw-9\charscalex91
satu cara evaluasi efektifitas program tanpa sepengetahuan pasien\par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 Prosedur \ul0\nosupersub\cf4\f5\fs20 :\par\pard\qj
\li3060\ri1799\sb12\sl-289\slmult0\tx3393 \up0 \expndtw-6\charscalex100 1.
Dibentuk tim untuk pelaksanaan spot check yang terdiri dari perawat, petugas
\line\tab \up0 \expndtw-9\charscalex94 laboratorium dan petugas
keamanan\par\pard\ql \li3060\sb50\sl-230\slmult0 \up0 \expndtw-8\charscalex96 2.
Tentukan jenis urin tes yang akan dilakukan pada form pengiriman sampel\par\pard\ql
\li3060\sb59\sl-230\slmult0 \up0 \expndtw-7\charscalex100 3. Setiap pasien yang
akan di tes urin diberikan botol urin yangsudah diberi label\par\pard\ql
\li3392\sb60\sl-230\slmult0 \up0 \expndtw-9\charscalex89 sesuai dengan nama
pasien\par\pard\qj \li3060\ri1799\sb11\sl-289\slmult0\tx3392 \up0 \expndtw-
5\charscalex100 4. Pasien diantar petugas keamanan ke kamar kecil untuk kencing
dan air seni \line\tab \up0 \expndtw-9\charscalex92 dimasukkan ke dalam botol yang
telah dibawa pasien\par\pard\qj \li3060\ri1799\sb0\sl-289\slmult0\tx3392 \up0
\expndtw-8\charscalex97 5. Petugas laborat menerima sampel urin dan mencatat nama
di setiap botol pada \line\tab \up0 \expndtw-9\charscalex95 buku penerimaan
sampel\par\pard\qj \li3060\ri1798\sb0\sl-289\slmult0\tx3392 \up0 \expndtw-
1\charscalex100 6. Pasien menanda tangani form penerimaan urin yang telah
disiapkan dan \line\tab \up0 \expndtw-9\charscalex92 mengecek nama yang tertulis
benar namanya\par\pard\qj \li3060\ri1799\sb0\sl-289\slmult0\tx3392 \up0 \expndtw-
3\charscalex100 7. Urin yang sudah diberi label bersama dengan form pemeriksaan
urin yang \line\tab \up0 \expndtw-6\charscalex100 diminta dikirim ke
laboratorium\par\pard\ql \li3060\sb0\sl-230\slmult0 \par\pard\ql \li3060\sb109\sl-
\up0 \expndtw-7\charscalex100 - Form permintaaan pemeriksaan
laborat\par\pard\ql \li3060\sb60\sl-230\slmult0 \up0 \expndtw-7\charscalex100 -
Buku registrasi penerimaan sampel\par\pard\ql \li3060\sb59\sl-230\slmult0 \up0
\expndtw-5\charscalex100 - Form hasil pemeriksaan laboratorium\par\pard\ql
4\charscalex100 Prosedur Penatalaksanaan Gangguan Diagnosis Ganda pada Peserta
PTRM\par\pard\qj \li3060\ri1798\sb13\sl-302\slmult0\fi0 \up0 \expndtw-
5\charscalex100 Tujuan\ul0\nosupersub\cf4\f5\fs20 : sebagai acuan dalam
penatalaksanaan gangguan ganda pengguna zat \up0 \expndtw-6\charscalex100
psikoaktif\par\pard\qj \li3060\ri1799\sb7\sl-336\slmult0\fi0 \up0 \expndtw-
8\charscalex92 \ul0\nosupersub\cf5\f6\fs20 Pengertian\ul0\nosupersub\cf4\f5\fs20 :
adalah proses penatalaksanaan gangguan diagnosis ganda pada pengguna \up0 \expndtw-
9\charscalex96 zat psikoaktif\par\pard\ql \li3060\sb120\sl-230\slmult0 \up0
Prosedur\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li3060\sb154\sl-230\slmult0 \up0
\expndtw-8\charscalex95 1. Pasien melakukan pendaftaran sesuai dengan alur yang
telah ditentukan\par\pard\ql \li6033\sb0\sl-230\slmult0 \par\pard\ql
\ul0\nosupersub\cf3\f4\fs20 38\par\pard\column \qj \li12406\sb0\sl-284\slmult0
284\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Pengertian
\ul0\nosupersub\cf4\f5\fs20 : adalah proses penerimaan rujukan peserta PTRM dari
klinik/satelit \up0 \expndtw-3\charscalex100 PTRM lain\par\pard\ql \li617\sb45\sl-
230\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Prosedur
\ul0\nosupersub\cf4\f5\fs20 :\par\pard\qj \li617\ri805\sb10\sl-
284\slmult0\tx1007 \up0 \expndtw-7\charscalex100 1. Perawat / petugas menerima
surat rujukan dan menelaah alasan pasien untuk \line\tab \up0 \expndtw-
7\charscalex100 pindah\par\pard\ql \li617\sb45\sl-230\slmult0 \up0 \expndtw-
9\charscalex95 2. Perawat/petugas menghadapkan pasien kepada dokter untuk
konsultasi\par\pard\ql \li617\sb54\sl-230\slmult0 \up0 \expndtw-6\charscalex100 3.
Dokter membuatkan resep untuk pemberian dosis metadon sesuasi informasi\par\pard\ql
\li997\sb54\sl-230\slmult0 \up0 \expndtw-9\charscalex94 pada surat
rujukan\par\pard\qj \li617\ri805\sb11\sl-283\slmult0\tx1007 \up0 \expndtw-
6\charscalex100 4. Perawat/petugas membuatkan status tetap/sementara pasien sesuai
dengan \line\tab \up0 \expndtw-9\charscalex100 tujuan kepindahan\par\pard\ql
\li617\sb45\sl-230\slmult0 \up0 \expndtw-9\charscalex96 5. Petugas farmasi
mendokumentasikan kedalam form kehadiran pasien\par\pard\ql \li617\sb54\sl-
230\slmult0 \up0 \expndtw-5\charscalex100 6. Petugas farmasi meminta pasien untuk
menandatangani form kehadiran dan\par\pard\ql \li997\sb54\sl-230\slmult0 \up0
\expndtw-9\charscalex96 memberikan dosis metadon\par\pard\ql \li617\sb54\sl-
230\slmult0 \up0 \expndtw-9\charscalex94 7. Perawat / petugas mendokumentasikan
kedalam catatan harian perawat\par\pard\ql \li617\sb54\sl-230\slmult0 \up0
\expndtw-9\charscalex95 8. Perawat / petugas menyimpan Catatan Medik pasien
ketempatnya\par\pard\ql \li12406\sb0\sl-230\slmult0 \par\pard\ql \li617\sb108\sl-
terkait\ul0\nosupersub\cf4\f5\fs20 :\par\pard\ql \li617\sb54\sl-
Catatan Medik Pasien\par\pard\ql \li617\sb54\sl-230\slmult0\tx975 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-8\charscalex100 Surat rujukan\par\pard\ql
8\charscalex100 Buku Pedoman PTRM Nasional\par\pard\ql \li11809\sb0\sl-
Prosedur Penatalaksanaan Tindakan Kekerasan\par\pard\qj \li617\ri805\sb8\sl-
283\slmult0 \up0 \expndtw-6\charscalex100 Tujuan\ul0\nosupersub\cf4\f5\fs20 :
sebagai acuan dalam tata laksana tindak kekerasan yang dilakukan oleh \up0
\expndtw-8\charscalex100 pasien PTRM\par\pard\qj \li617\ri805\sb1\sl-283\slmult0
Pengertian\ul0\nosupersub\cf4\f5\fs20 : adalah proses penatalaksanaan tindak
kekerasan pasien baik secara verbal \up0 \expndtw-9\charscalex91 maupun fisik
kepada petugas dan atau sesama pasien PTRM\par\pard\ql \li617\sb45\sl-
Prosedur\ul0\nosupersub\cf4\f5\fs20 :\par\pard\qj \li617\ri805\sb10\sl-
284\slmult0\tx989 \up0 \expndtw-5\charscalex100 1. Perawat/pasien yang mendapatkan
perlakuan tindak kekerasan melaporkan \line\tab \up0 \expndtw-9\charscalex90 kepada
petugas keamanan\par\pard\qj \li617\ri805\sb8\sl-328\slmult0\tx989 \up0 \expndtw-
8\charscalex96 2. Petugas keamanan melakukan interograsi kepada pasien yang
malakukan tindak \line\tab \up0 \expndtw-9\charscalex92 kekerasan dan melakukan cek
ulang kepada korban\par\pard\qj \li617\ri805\sb1\sl-328\slmult0\tx989 \up0
\expndtw-8\charscalex100 3. Petugas keamanan membuat berita acara tentang tindakan
kekerasan sebagai \line\tab \up0 \expndtw-9\charscalex94 laporan kepada kepala
PTRM\par\pard\ql \li15386\sb0\sl-230\slmult0 \par\pard\ql \li15386\sb0\sl-
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
183\slmult0\tx3469 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf4\f5\fs20 2.
Perawat melakukan rujukan kepada dokter yang bertugas untuk konsultasi \line\tab
\up0 \expndtw-9\charscalex93 kepada dokter\par\pard\qj \li3132\ri1835\sb19\sl-
289\slmult0\tx3469 \up0 \expndtw-5\charscalex100 3. Dokter melakukan asesmen
melalui wawancara, pemeriksaan fisik dan \line\tab \up0 \expndtw-
7\charscalex100 psikiatris\par\pard\qj \li3132\ri1835\sb0\sl-289\slmult0\tx3469
\up0 \expndtw-7\charscalex100 4. Dokter menentukan tingkat keparahan diagnosis
ganda yang ditemukan pada \line\tab \up0 \expndtw-9\charscalex91 pasien\par\pard\qj
\li3132\ri1834\sb0\sl-289\slmult0\tx3469 \up0 \expndtw-3\charscalex100 5. Dokter
dapat memberikan pengobatan dengan antipsikotik ringan seperti \line\tab \up0
\expndtw-8\charscalex100 Halaoperidol 1,5-5 mg, Trifluoperazine 5-15 mg dengan
dosis terbagi disertai\par\pard\qj \li3469\ri1835\sb0\sl-289\slmult0\fi0 \up0
\expndtw-6\charscalex100 dengan Chlorpromazine 50-100 mg. Triheksilfenidil 3x2 mg
atau kombinasi \up0 \expndtw-9\charscalex91 dengan antiansietas dosis
rendah\par\pard\qj \li3132\ri1835\sb1\sl-289\slmult0\tx3469 \up0 \expndtw-
6\charscalex100 6. Dokter akan merujuk pasien ke rumah sakit yang lebih lengkap
untuk pasien \line\tab \up0 \expndtw-4\charscalex100 yang mengalami gangguan ganda
yang berat disertai perilaku yang tidak\par\pard\ql \li3469\sb50\sl-230\slmult0
\up0 \expndtw-7\charscalex100 terkendali (akut)\par\pard\qj \li3132\ri1836\sb11\sl-
289\slmult0\tx3469 \up0 \expndtw-4\charscalex100 7. Perawat menjelaskan ulang
tentang terapi dokter kepada pasien dan \line\tab \up0 \expndtw-9\charscalex96
menyerahkan surat rujukan untuk pasien yang dirujuk\par\pard\ql \li3132\sb49\sl-
230\slmult0 \up0 \expndtw-9\charscalex96 8. Perawat menyimpan seluruh catatan dan
dokumentasi\par\pard\ql \li3132\sb0\sl-230\slmult0 \par\pard\ql \li3132\sb119\sl-
\up0 \expndtw-5\charscalex100 - Catatan MedikPasien\par\pard\ql \li3132\sb60\sl-
230\slmult0 \up0 \expndtw-1\charscalex100 - Resep\par\pard\ql \li3132\sb59\sl-
230\slmult0 \up0 \expndtw-1\charscalex100 - Surat rujukan\par\pard\qj
\li3132\ri1836\sb12\sl-289\slmult0\tx3469 \up0 \expndtw-8\charscalex100 - Buku
Pedoman Petunjuk Pelaksanaan Program pengurangan Dampak Buruk \line\tab \up0
\expndtw-8\charscalex100 Napza Suntik\par\pard\ql \li6032\sb0\sl-230\slmult0
39\par\pard\column \qj \li11827\sb0\sl-295\slmult0 \par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 Hasil penilaian disampaikan segera setelah penilaian
selesai kepada tim administrasi \line \up0 \expndtw-3\charscalex100 bulanan dan
manajemen. Monitoring dan evaluasi pelayanan program pengurangan \line \up0
\expndtw-3\charscalex100 dampak buruk dapat dikembangkan dalam riset spesifik di
tingkat nasional. Dengan \line \up0 \expndtw-8\charscalex96 demikian hasil
monitoring dan evaluasi tersebut dapat diperbandingkan satu sama lain dan \line
\up0 \expndtw-8\charscalex94 dapat menjadi bahan masukan strategis bagi para
penentu kebijakan di bidang pengurangan \line \up0 \expndtw-9\charscalex100 dampak
buruk.\par\pard\qj \li20\ri823\sb41\sl-295\slmult0\fi637 \up0 \expndtw-
4\charscalex100 Selain untuk menilai proses dan dampak pelaksanaan program,
kegiatan \up0 \expndtw-4\charscalex100 monitoring dan evaluasi dapat pula diarahkan
pada suatu riset khusus yang berkaitan \up0 \expndtw-6\charscalex100 dengan
berbagai pertanyaan yang muncul terkait layanan pengurangan dampak buruk. \up0
\expndtw-7\charscalex100 Misalnya, riset tentang protokol pemeriksaan sampel
dengan testing cepat, penerimaan \up0 \expndtw-8\charscalex91 klien akan
ketersediaan akses pada terapi Tuberkulosis, analisis biaya dan
sebagainya.\par\pard\ql \li657\sb76\sl-230\slmult0 \up0 \expndtw-9\charscalex95
Aspek yang perlu dimonitor dan dievaluasi:\par\pard\ql \li657\sb126\sl-
Kebijakan, tujuan, dan sasaran mutu,\par\pard\ql \li657\sb126\sl-230\slmult0\tx1014
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex92 Sumber daya
manusia\par\pard\ql \li657\sb126\sl-230\slmult0\tx1014 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-9\charscalex88 Sarana, prasana, dan
peralatan\par\pard\ql \li657\sb126\sl-230\slmult0\tx1014 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-9\charscalex95 Standar minimal pelayanan
pengurangan dampak buruk\par\pard\ql \li657\sb127\sl-230\slmult0\tx1014 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex93 Prosedur Pelayanan
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex94 Hambatan pelayanan
\expndtw-2\charscalex100 -\tab \up0 \expndtw-5\charscalex100 Uraian Rincian
Layanan\ul0\nosupersub\cf5\f6\fs20 \ul0\nosupersub\cf4\f5\fs20 dengan menilai
ketersediaan petugas diberbagai\par\pard\qj \li1027\ri824\sb16\sl-
320\slmult0\fi0 \up0 \expndtw-8\charscalex96 tingkat layanan, kepatuhan terhadap
protokol, ketersediaan materi pengajaran \up0 \expndtw-5\charscalex100 mengenai
kesehatan dan kondom, ketersediaan dan penggunaan catatan \up0 \expndtw-
5\charscalex100 terformat\par\pard\ql \li657\sb111\sl-230\slmult0\tx1014 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex93 Pengelolaan yang
profesional dan efektif\par\pard\ql \li657\sb126\sl-230\slmult0\tx1014 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex97 Akuntabilitas dan
\ul0\nosupersub\cf6\f7\fs20 \ul0\nosupersub\cf4\f5\fs20 keajegan
(\ul0\nosupersub\cf6\f7\fs20 sustainability).\par\pard\ql \li657\sb130\sl-
-\tab \up0 \expndtw-9\charscalex91 Kepuasan dan evaluasi klien secara langsung atau
melalui kotak saran.\par\pard\ql \li15399\sb0\sl-230\slmult0 \par\pard\ql
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\pard\sb0\sl-240{\bkmkstart Pg26}{\bkmkend Pg26}\par\pard\ql \li15083\sb0\sl-
276\slmult0 \par\pard\ql\li15083\sb0\sl-276\slmult0 \par\pard\ql\li15083\sb59\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 BAB IV
\par\pard\ql \li14278\sb1\sl-256\slmult0 \up0 \expndtw-3\charscalex100 Monitoring
dan Evaluasi \par\pard\qj \li11809\sb0\sl-340\slmult0
\par\pard\qj\li11809\ri685\sb15\sl-340\slmult0\fi615 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf4\f5\fs20 Monitoring dan evaluasi adalah bagian
integral dari pengembangan program, \line \up0 \expndtw-8\charscalex96 pemberian
layanan, penggunaan optimal sediaan layanan, dan jaminan kualitas. Karena itu \line
\up0 \expndtw-4\charscalex100 untuk kepentingan layanan program pengurangan dampak
buruk napza suntik, maka \line \up0 \expndtw-6\charscalex100 monitoring dan
evaluasi hendaknya dilakukan dengan cara sistematis dan berkala pada \line \up0
\expndtw-8\charscalex95 program pelayanan di sarana kesehatan. Monitoring adalah
kegiatan kontrol yang diarahkan \line \up0 \expndtw-7\charscalex100 atas
pelaksanaan program, atau disebut juga dengan istilah evaluasi proses. Sementara
\line \up0 \expndtw-8\charscalex96 Evaluasi adalah kegiatan yang mengkaji
sejauhmana program berjalan secara efektif dalam \line \up0 \expndtw-8\charscalex96
mengubah perilaku peserta program, atau disebut juga dengan istilah evaluasi hasil.
\par\pard\ql \li12424\sb91\sl-230\slmult0 \up0 \expndtw-1\charscalex100 Monitoring
dan Evaluasi dapat dilakukan secara internal maupun eksternal.
\par\pard\li4451\sb1\sl-324\slmult0\fi0\tx11809 \up0 \expndtw0\charscalex97
\ul0\nosupersub\cf12\f13\fs30 LAMPIRAN - LAMPIRAN\tab \dn3 \expndtw-6\charscalex100
\ul0\nosupersub\cf4\f5\fs20 Dilakukan secara internal artinya adalah pihak
Puskesmas secara rutin melakukan\par\pard\ql \li11809\ri685\sb30\sl-
346\slmult0\fi0 \up0 \expndtw-8\charscalex100 pencatatan dan pelaporan atas
pelaksanaan program. Dilakukan secara eksternal artinya \up0 \expndtw-
4\charscalex100 adalah pihak luar Puskesmas yang bersifat independen melakukan
analisis dokumen\up0 \expndtw-8\charscalex93 dokumen yang ada serta melakukan
kajian terarah tentang hasil dari pelaksanaan program. \up0 \expndtw-9\charscalex93
Tujuan monitoring dan evaluasi adalah: \par\pard\ql \li11809\sb90\sl-230\slmult0
\up0 \expndtw-6\charscalex100 - Untuk menyusun perencanaan dan tindaklanjut
\par\pard\ql \li11809\sb150\sl-230\slmult0 \up0 \expndtw-7\charscalex100 - Untuk
perbaiki pelaksanaan pelayanan program \par\pard\ql \li11809\ri685\sb60\sl-
340\slmult0\tx12141 \up0 \expndtw-7\charscalex100 - Untuk mengetahui kemajuan dan
hambatan pelayanan program pengurangan dampak \line\tab \up0 \expndtw-
8\charscalex100 buruk \par\pard\qj \li11808\ri686\sb40\sl-340\slmult0\fi615 \up0
\expndtw-7\charscalex100 Pelayanan program pengurangan dampak membutuhkan sumber
daya manusia \up0 \expndtw-5\charscalex100 yang terlatih dan bermotivasi tinggi.
Monitoring secara teratur sangat dibutuhkan untuk \up0 \expndtw-8\charscalex97
memastikan kualitas yang baik dan konsisten, dan akan membantu staf agar terhindar
dari \up0 \expndtw-8\charscalex94 kejenuhan. Penilaian dapat dilakukan setiap 6
bulan atau satu tahun oleh Kepala Puskesmas \up0 \expndtw-1\charscalex100 atau
penanggung jawab program pengurangan dampak buruk atau konsultan \up0
\expndtw-9\charscalex94 berpengalaman dari luar institusi layanan.
\par\pard\li6032\sb0\sl-230\slmult0\par\pard\li6032\sb0\sl-
230\slmult0\par\pard\li6032\sb0\sl-230\slmult0\par\pard\li6032\sb0\sl-
230\slmult0\par\pard\li6032\sb220\sl-230\slmult0\fi0\tx15386 \dn2 \expndtw-
2\charscalex100 \ul0\nosupersub\cf3\f4\fs20 42\tab \up0 \expndtw-2\charscalex100
40\par\pard\sect\sectd\fs24\landscape\paperw20160\paperh12240{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
0fec4ff006b4ff92f9ff04c1ffb3e5f1fff00ebb53fe0a1b451fb5a7fc97cff008260ff00d9f2f8ff00
ff005da9ff00050da292de5ebfa21bda3e9fab3eb7f12f80bc21e30d67e1ff00887c4ba15a6afad7c2b
f175ef8f7e1f6a172d70b3785fc5fa8f80bc6ff000c2f75db010cd146f7771e02f88fe37f0cbadda5c5
b8b1f115ebac2b7496d71014514c47ffd9}}}}}
\ul0\nosupersub\cf5\f6\fs20 Lampiran 1\par\pard\ql \li2455\sb0\sl-230\slmult0
\par\pard\ql \li4257\sb196\sl-230\slmult0 \up0 \expndtw-3\charscalex100 Formulir
Pengkajian Klinis Untuk Puskesmas\par\pard\ql \li2455\sb209\sl-
230\slmult0\tx4586 \up0 \expndtw-9\charscalex93 \ul0\nosupersub\cf4\f5\fs20 Tanggal
pemeriksaan\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql \li2455\sb1\sl-
227\slmult0\tx4586 \up0 \expndtw-6\charscalex100 Nama\tab \up0 \expndtw-
2\charscalex100 :\par\pard\ql \li2455\sb1\sl-227\slmult0\tx4586 \up0 \expndtw-
9\charscalex95 Tanggal lahir\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
\li2455\sb1\sl-227\slmult0\tx4586 \up0 \expndtw-9\charscalex93 Alamat
sekarang\tab \up0 \expndtw-2\charscalex100 :\par\pard\qj \li2455\ri6955\sb1\sl-
227\slmult0\tx4586 \up0 \expndtw-9\charscalex96 Jenis kelamin\tab \up0 \expndtw-
2\charscalex100 : \up0 \expndtw-9\charscalex97 Pekerjaan :\par\pard\ql
\li2455\sb1\sl-227\slmult0\tx4586 \up0 \expndtw-6\charscalex100 Tingkat
pendidikan\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql \li2455\sb1\sl-
227\slmult0\tx4586 \up0 \expndtw-4\charscalex100 Faktor risiko HIV\tab \up0
\expndtw-2\charscalex100 :\par\pard\ql \li2455\sb227\sl-230\slmult0\tx4586 \up0
\expndtw-8\charscalex100 Keluhan utama\tab \up0 \expndtw-2\charscalex100
:\par\pard\ql \li2455\sb0\sl-230\slmult0 \par\pard\ql \li2455\sb224\sl-
230\slmult0\tx4586 \up0 \expndtw-9\charscalex97 Keluhan tambahan\tab \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-8\charscalex100 Demam?\par\pard\ql
\expndtw-9\charscalex97 Berat badan menurun?\par\pard\ql \li2995\sb32\sl-
Sakit kepala?\par\pard\ql \li2995\sb32\sl-230\slmult0\tx3328 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-9\charscalex94 Pusing?\par\pard\ql
\expndtw-9\charscalex92 Kejang?\par\pard\ql \li2995\sb32\sl-230\slmult0\tx3328 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex92 Sakit mata?\par\pard\ql
\expndtw-9\charscalex97 Sakit hidung, telinga dan tenggorokan?\par\pard\ql
\expndtw-9\charscalex100 Luka pada mulut?\par\pard\ql \li2995\sb33\sl-
7\charscalex100 Keputihan di lidah?\par\pard\ql \li2995\sb32\sl-
8\charscalex100 Mual atau muntah?\par\pard\ql \li2995\sb32\sl-230\slmult0\tx3328
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-7\charscalex100 Nafsu makan
menurun?\par\pard\ql \li2995\sb32\sl-230\slmult0\tx3328 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-9\charscalex96 Diare?\par\pard\ql
\expndtw-9\charscalex96 Batuk?\par\pard\ql \li2995\sb32\sl-230\slmult0\tx3328
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex86 Sesak
nafas?\par\pard\ql \li2995\sb57\sl-230\slmult0\tx3328 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-9\charscalex97 Nyeri dada?\par\pard\ql \li2995\sb56\sl-
Kaki/tungkai terasa sakit, baal?\par\pard\ql \li2995\sb57\sl-230\slmult0\tx3328
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex95 Nyeri pada tempat
lain? Jika ya, dimana?\par\pard\ql \li2995\sb85\sl-230\slmult0\tx3328 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-8\charscalex100 Adakah kelainan kulit?
Gatal? Nyeri?\par\pard\ql \li2995\sb85\sl-230\slmult0\tx3328 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-9\charscalex97 Tanda-tanda IMS? (gunakan
pertanyaan yang dapat dipahami ODHA)\par\pard\ql \li6035\sb0\sl-230\slmult0
\up0 \expndtw-9\charscalex95 \ul0\nosupersub\cf4\f5\fs20 Pemeriksaan
Fisik:\par\pard\ql \li12429\sb0\sl-230\slmult0 \par\pard\ql \li640\sb171\sl-
230\slmult0\tx1025\tx2905\tldot\tx3557 \up0 \expndtw-2\charscalex100 -\tab \up0
\expndtw-9\charscalex94 Berat Badan\tab \up0 \expndtw-2\charscalex100
:\expndtw0\charscalex100\tab\up0 \expndtw-9\charscalex96 kg\par\pard\ql
\expndtw-9\charscalex95 Tanda vital:\par\pard\ql \li1020\sb85\sl-
230\slmult0\tx2905\tldot\tx3656 \up0 \expndtw-8\charscalex100 Temperatur\tab
\up0 \expndtw-2\charscalex100 :\expndtw0\charscalex100\tab\up0 \expndtw-
5\charscalex100 �C\par\pard\ql \li1020\sb86\sl-230\slmult0\tx2905\tldot\tx3656 \up0
\expndtw-9\charscalex94 Laju nafas\tab \up0 \expndtw-2\charscalex100
:\expndtw0\charscalex100\tab\up0 \expndtw-4\charscalex100 x/menit\par\pard\ql
\li1020\sb85\sl-230\slmult0\tx2905\tldot\tx3656 \up0 \expndtw-7\charscalex100 Laju
nadi\tab \up0 \expndtw-2\charscalex100 :\expndtw0\charscalex100\tab\up0 \expndtw-
4\charscalex100 x/menit\par\pard\ql \li1020\sb85\sl-230\slmult0\tx2905\tldot\tx3656
\up0 \expndtw-9\charscalex93 Tekanan darah\tab \up0 \expndtw-2\charscalex100
:\expndtw0\charscalex100\tab\up0 \expndtw0\charscalex100 mmHg\par\pard\ql
\li12429\sb0\sl-230\slmult0 \par\pard\ql \li640\sb170\sl-
230\slmult0\tx1025\tx4002 \up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-
9\charscalex97 Keadaan umum\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
\li640\sb85\sl-230\slmult0\tx1025\tx4002 \up0 \expndtw-2\charscalex100 -\tab
\up0 \expndtw-7\charscalex100 Mata\tab \up0 \expndtw-2\charscalex100
Konjungtiva\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql \li1020\sb85\sl-
230\slmult0\tx4002 \up0 \expndtw-9\charscalex94 Sklera\tab \up0 \expndtw-
2\charscalex100 :\par\pard\ql \li640\sb85\sl-230\slmult0\tx1025\tx4002 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw0\charscalex100 Hidung\tab \up0
\expndtw-2\charscalex100 :\par\pard\ql \li640\sb86\sl-230\slmult0\tx1025\tx4002
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw0\charscalex106 Mulut\tab \up0
\expndtw-2\charscalex100 :\par\pard\ql \li1020\sb85\sl-230\slmult0 \up0 \expndtw-
7\charscalex100 Bercak putih di lidah?\par\pard\ql \li1020\sb85\sl-230\slmult0 \up0
\expndtw-5\charscalex100 Ulkus?\par\pard\ql \li640\sb86\sl-
9\charscalex95 Tenggorokan\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
\expndtw-9\charscalex96 Kelenjar getah bening \up0 \expndtw-2\charscalex100
:\par\pard\ql \li640\sb85\sl-230\slmult0\tx1025\tx4002 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-8\charscalex100 Paru-paru\tab \up0 \expndtw-
2\charscalex100 :\par\pard\ql \li640\sb86\sl-230\slmult0\tx1025\tx4002 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex94 Jantung\tab \up0
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-6\charscalex100 Abdomen\tab
\up0 \expndtw-2\charscalex100 :\par\pard\ql \li1020\sb86\sl-230\slmult0 \up0
\expndtw-7\charscalex100 Nyeri tekan?\par\pard\ql \li1020\sb85\sl-230\slmult0
\up0 \expndtw-9\charscalex94 Bising usus?\par\pard\ql \li640\sb85\sl-
7\charscalex100 Area Genital (bila diperlukan)\tab \up0 \expndtw-
2\charscalex100 :\par\pard\ql \li1020\sb137\sl-230\slmult0 \up0 \expndtw-
5\charscalex100 Laboratorium\par\pard\ql \li640\sb137\sl-
9\charscalex94 Pemeriksaan darah lengkap\tab \up0 \expndtw-2\charscalex100
:\par\pard\ql \li1020\sb136\sl-230\slmult0\tx4003 \up0 \expndtw0\charscalex104 o
Tanggal\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql \li1020\sb137\sl-
230\slmult0\tx4003 \up0 \expndtw0\charscalex118 o Hasil\tab \up0 \expndtw-
2\charscalex100 :\par\pard\ql \li15388\sb0\sl-230\slmult0 \par\pard\ql
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
\ul0\nosupersub\cf4\f5\fs20 -\tab \up0 \expndtw-9\charscalex97 Pemeriksaan fungsi
liver\par\pard\ql \li3473\sb0\sl-228\slmult0\tx6445 \up0 \expndtw-5\charscalex100 o
2\charscalex100 -\tab \up0 \expndtw-9\charscalex96 Pemeriksaan BTA\par\pard\ql
\li3472\sb0\sl-228\slmult0\tx6445 \up0 \expndtw-5\charscalex100 o Tanggal\tab \up0
\expndtw-2\charscalex100 :\par\pard\ql \li3472\sb0\sl-228\slmult0\tx6445 \up0
\expndtw0\charscalex106 o Hasil\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
\up0 \expndtw-9\charscalex96 Pemeriksaan Foto Thoraks\tab \up0 \expndtw-
5\charscalex100 o Tanggal\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
\li3472\sb0\sl-228\slmult0\tx6445 \up0 \expndtw0\charscalex106 o Hasil\tab \up0
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-8\charscalex100 Pemeriksaan
HIV\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql \li3472\sb17\sl-
230\slmult0\tx6445 \up0 \expndtw-6\charscalex100 o Tangga\tab \up0 \expndtw-
2\charscalex100 :\par\pard\ql \li3472\sb16\sl-230\slmult0\tx6445 \up0
\expndtw0\charscalex106 o Hasil\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
\up0 \expndtw-9\charscalex97 Pemeriksaan CD4\tab \up0 \expndtw-2\charscalex100
:\par\pard\ql \li3472\sb29\sl-230\slmult0\tx6445 \up0 \expndtw-5\charscalex100 o
2\charscalex100 -\tab \up0 \expndtw-8\charscalex100 Pemeriksaan lain (fungsi
ginjal, viral load, dll..):\par\pard\ql \li3472\sb55\sl-230\slmult0\tx6445 \up0
\expndtw-5\charscalex100 o Tanggal\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
\li3472\sb55\sl-230\slmult0\tx6445 \up0 \expndtw0\charscalex106 o Hasil\tab
\up0 \expndtw-2\charscalex100 :\par\pard\ql \li2473\sb0\sl-230\slmult0 \par\pard\ql
\li2473\sb109\sl-230\slmult0 \up0 \expndtw-1\charscalex100 ANALISA\par\pard\ql
\li2473\sb56\sl-230\slmult0\tx6445 \up0 \expndtw-9\charscalex95 Diagnosa\tab
\up0 \expndtw-2\charscalex100 :\par\pard\ql \li2473\sb55\sl-230\slmult0\tx6445 \up0
\expndtw-9\charscalex95 Diagnosa banding\tab \up0 \expndtw-2\charscalex100
Stadium HIV (WHO)\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql \li2473\sb55\sl-
230\slmult0\tx6445 \up0 \expndtw-9\charscalex95 Status fungsional\tab \up0
\expndtw-2\charscalex100 :\par\pard\qj \li2473\sb0\sl-285\slmult0 \par\pard\qj
\li2473\ri5113\sb11\sl-285\slmult0\fi0\tx6445 \up0 \expndtw-1\charscalex100
PENATALAKSANAAN\tab \up0 \expndtw-2\charscalex100 : \up0 \expndtw-9\charscalex92
Pengobatan\par\pard\ql \li2473\sb0\sl-230\slmult0 \par\pard\ql \li2473\sb101\sl-
230\slmult0\tx6445 \up0 \expndtw-9\charscalex96 Kausatik\tab \up0 \expndtw-
2\charscalex100 :\par\pard\ql \li2473\sb0\sl-230\slmult0 \par\pard\ql
Simptomatis\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql \li2473\sb0\sl-
8\charscalex100 Profilaksis\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
\expndtw-6\charscalex100 ARV\tab \up0 \expndtw-2\charscalex100 :\par\pard\ql
Wanita:\par\pard\ql \li20\sb6\sl-230\slmult0\tx397 \up0 \expndtw-9\charscalex93
1.\tab \up0 \expndtw-9\charscalex95 Duh vagina yang tidak normal? Bau? Warna?
Gatal?\par\pard\ql \li20\sb5\sl-230\slmult0\tx397 \up0 \expndtw-9\charscalex93
2.\tab \up0 \expndtw-7\charscalex100 Benjolan/tumbuhan?\par\pard\ql \li20\sb6\sl-
Nyeri saat berkemih?\par\pard\ql \li20\sb5\sl-230\slmult0\tx397 \up0 \expndtw-
9\charscalex93 4.\tab \up0 \expndtw-8\charscalex100 Nyeri di perut bagian
bawah?\par\pard\ql \li20\sb14\sl-230\slmult0\tx397 \up0 \expndtw-9\charscalex93
5.\tab \up0 \expndtw-9\charscalex95 Luka (ulkus) pada daerah
genital?\par\pard\ql \li20\sb20\sl-230\slmult0\tx397 \up0 \expndtw-9\charscalex93
6.\tab \up0 \expndtw-9\charscalex95 Nyeri di daerah selangkang?\par\pard\qj
\li20\ri4508\sb5\sl-254\slmult0\tx397 \up0 \expndtw-9\charscalex93 7.\tab \up0
\expndtw-9\charscalex93 Ada perdarahan saat berhubungan seks? \up0 \expndtw-
9\charscalex94 Jangan lupa tanya tentang haid:\par\pard\ql \li20\sb20\sl-
Haid terakhir? Kemungkinan hamil?\par\pard\ql \li20\sb24\sl-230\slmult0\tx397
\up0 \expndtw-9\charscalex93 2.\tab \up0 \expndtw-9\charscalex95 Kram
haid?\par\pard\ql \li20\sb24\sl-230\slmult0\tx397 \up0 \expndtw-9\charscalex93
3.\tab \up0 \expndtw-8\charscalex97 Haid tidak teratur? Lebih pendek atau lebih
panjang? Lebih banyak atau lebih sedikit?\par\pard\qj \li20\ri5817\sb0\sl-
240\slmult0\fi351 \up0 \expndtw-9\charscalex92 Berapa pembalut sehari? \line
\up0 \expndtw-9\charscalex97 Pria:\par\pard\ql \li20\sb20\sl-230\slmult0\tx397 \up0
\expndtw-9\charscalex93 1.\tab \up0 \expndtw-9\charscalex96 Duh yang tidak
normal?\par\pard\ql \li20\sb24\sl-230\slmult0\tx397 \up0 \expndtw-9\charscalex93
2.\tab \up0 \expndtw-7\charscalex100 Benjolan/tumbuhan?\par\pard\ql \li20\sb24\sl-
Nyeri saat berkemih?\par\pard\ql \li20\sb24\sl-230\slmult0\tx397 \up0 \expndtw-
9\charscalex93 4.\tab \up0 \expndtw-9\charscalex94 Nyeri di perut bagian
bawah?\par\pard\ql \li20\sb24\sl-230\slmult0\tx397 \up0 \expndtw-9\charscalex93
5.\tab \up0 \expndtw-9\charscalex92 Luka (ulkus) pada daerah
genital?\par\pard\ql \li20\sb24\sl-230\slmult0\tx397 \up0 \expndtw-9\charscalex93
6.\tab \up0 \expndtw-9\charscalex93 Nyeri di daerah selangkangan?\par\pard\ql
9\charscalex93 Apakah memakai kondom setiap kali melakukan hubungan
seks?\par\pard\ql \li357\sb24\sl-230\slmult0\tx797 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-4\charscalex100 Apakah menjalankan program KB (Keluarga
Berencana)? Metoda KB yang\par\pard\ql \li827\sb0\sl-220\slmult0 \up0 \expndtw-
9\charscalex93 dipakai?\par\pard\ql \li357\sb26\sl-230\slmult0\tx797 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-3\charscalex100 Gejala psikiatri? Ansietas
dan depresi?(lihat bagan pengkajian dengan\par\pard\ql \li827\sb0\sl-
220\slmult0 \up0 \expndtw-9\charscalex96 menggunakan K10)\par\pard\ql
9\charscalex94 Adakah ketergantungan napza? (lihat bagan ICD-10)\par\pard\ql
6\charscalex100 Jika ada, riwayat penggunaan napza? (lihat bagan pengkajian
ketergantungan\par\pard\ql \li827\sb1\sl-217\slmult0 \up0 \expndtw-9\charscalex92
napza)\par\pard\ql \li356\sb27\sl-230\slmult0\tx797 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-2\charscalex100 Apakah anda pernah masuk rumah sakit? Jika ya,
lihat catatan medis atau\par\pard\ql \li827\sb0\sl-220\slmult0 \up0 \expndtw-
9\charscalex93 diagnosisnya.\par\pard\ql \li356\sb26\sl-230\slmult0\tx797 \up0
\expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex94 Obat apa yang sering
diminum?\par\pard\ql \li356\sb24\sl-230\slmult0\tx797 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-9\charscalex91 Apakah ada masalah setelah minum
obat?\par\pard\ql \li356\sb56\sl-230\slmult0\tx797 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-5\charscalex100 Apakah anda menggunakan obat-obatan lain (jamu,
nafza, obat resep dokter\par\pard\ql \li827\sb18\sl-230\slmult0 \up0 \expndtw-
9\charscalex92 dokter, TB, ARV, dan lain-lain)? Jika ya, sebutkan nama
obatnya.\par\pard\ql \li356\sb56\sl-230\slmult0\tx797 \up0 \expndtw-2\charscalex100
-\tab \up0 \expndtw-4\charscalex100 Bagaimana penerimaan orang di sekitar anda?
(Keluarga, pacar, suami/istri,\par\pard\ql \li826\sb19\sl-230\slmult0 \up0
\expndtw-9\charscalex93 masyarakat)\par\pard\ql \li356\sb74\sl-230\slmult0\tx797
\up0 \expndtw-2\charscalex100 -\tab \up0 \expndtw-9\charscalex91 Bagaimana kegiatan
anda sehari-hari?\par\pard\ql \li356\sb35\sl-230\slmult0\tx797 \up0 \expndtw-
2\charscalex100 -\tab \up0 \expndtw-9\charscalex92 Apakah ada hal lain yang ingin
dibicarakan?\par\pard\ql \li15385\sb0\sl-230\slmult0 \par\pard\ql \li15385\sb0\sl-
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108000800
a403012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
0fefe28a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a
0028a28a00ffd9}}}}}
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108000800
7803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
0fefe28a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a00ffd9}}}}}
\ul0\nosupersub\cf5\f6\fs20 Lampiran 2\par\pard\ql \li4502\sb178\sl-230\slmult0
\up0 \expndtw-3\charscalex100 PROGRAM JARUM SUNTIK STERIL\par\pard\qj
\li2679\ri2024\sb0\sl-202\slmult0\tx5659 \up0 \expndtw-4\charscalex100 PROGRAM
PENCEGAHAN DAN PERAWATAN HIV/AIDS PADA KELOMPOK \line\tab \up0 \expndtw-
2\charscalex100 PENASUN\par\pard\ql \li2455\sb0\sl-230\slmult0 \par\pard\ql
4\charscalex100 \ul0\nosupersub\cf24\f25\fs20\ul FORMULIR
PARTISIPASI\par\pard\ql \li2455\sb1\sl-211\slmult0 \up0 \expndtw-9\charscalex96
\ul0\nosupersub\cf4\f5\fs20 Program Jarum Suntik Steril\par\pard\ql \li2455\sb0\sl-
Tanggal : \u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\par\pard\qj
\li2455\ri5759\sb23\sl-434\slmult0\fi0 \up0 \expndtw-7\charscalex100 Kode
Partisipan : \u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?
\up0 \expndtw-8\charscalex100 Nama Petugas :
\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?..\par\pard\ql
4\charscalex100 1. Umur :
\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?.\par\pard\ql
\li2455\sb205\sl-230\slmult0\tx5359\tx6799 \up0 \expndtw-9\charscalex94 2. Jenis
Kelamin : Laki-laki\tab \up0 \expndtw-9\charscalex95 Perempuan\tab \up0 \expndtw-
9\charscalex93 Transgender\par\pard\ql \li2455\sb205\sl-230\slmult0 \up0 \expndtw-
8\charscalex96 3. Lokasi :
\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?..(lihat kode
lokasi, jika di luar area isi dengan 98)\par\pard\qj \li2455\ri6684\sb216\sl-
217\slmult0\tx3204 \up0 \expndtw-9\charscalex95 4. Mengetahui Proyek ini dari :
\line\tab \up0 \expndtw-9\charscalex94 Teman\par\pard\qj \li3204\ri6961\sb1\sl-
217\slmult0\fi0 \up0 \expndtw-9\charscalex89 Petugas Lapangan \up0 \expndtw-
9\charscalex93 Lembaga lain\par\pard\ql \li3204\sb0\sl-217\slmult0\tldot\tx6250
\up0 \expndtw-9\charscalex96 Lain :\expndtw0\charscalex100\tab\par\pard\ql
\ul0\nosupersub\cf5\f6\fs20 BACAKAN UNTUK PARTISIPAN :\par\pard\ql \li2455\sb1\sl-
211\slmult0 \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf4\f5\fs20 Dengan
mengisi ini Anda akan memperoleh Kartu Pengenal Peserta Proyek yang
akan\par\pard\ql \li2455\sb3\sl-217\slmult0 \up0 \expndtw-6\charscalex100
melindungi anda dari tuduhan atau penangkapan karena membawa jarum suntik
secara\par\pard\ql \li2454\sb0\sl-217\slmult0 \up0 \expndtw-5\charscalex100 tidak
sah. Jika anda kehilangan kartu ini, segeralah menghubungi kami dan kami
akan\par\pard\ql \li2454\sb0\sl-217\slmult0 \up0 \expndtw-8\charscalex92
menggantinya dengan yang baru. Tentu saja Anda harus mengingat kode yang ada pada
kartu\par\pard\ql \li2454\sb1\sl-217\slmult0 \up0 \expndtw-9\charscalex96 pengenal
terdahulu.\par\pard\ql \li2454\sb0\sl-230\slmult0 \par\pard\ql \li2454\sb5\sl-
230\slmult0 \up0 \expndtw-3\charscalex100
\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?.\par\pard\ql
2\charscalex100 \u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\par\pard\ql
\li2454\sb31\sl-230\slmult0 \up0 \expndtw-9\charscalex91 Paraf\par\pard\ql
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Lampiran 4\par\pard\ql
3\charscalex100 PROGRAM JARUM SUNTIK STERIL\par\pard\qj \li244\ri1031\sb0\sl-
223\slmult0\tx3234 \up0 \expndtw-4\charscalex100 PROGRAM PENCEGAHAN DAN PERAWATAN
HIV/AIDS PADA KELOMPOK \line\tab \up0 \expndtw-2\charscalex100
PENASUN\par\pard\ql \li11809\sb0\sl-230\slmult0 \par\pard\ql \li20\sb4\sl-
230\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf24\f25\fs20\ul
Kuesioner Program Jarum Suntik Steril\par\pard\ql \li11809\sb0\sl-230\slmult0
\up0 \expndtw-9\charscalex94 \ul0\nosupersub\cf4\f5\fs20 Hari/tanggal
____________________Kode Peserta _______________________\par\pard\ql
9\charscalex93 Lokasi :\par\pard\ql \li740\sb8\sl-230\slmult0 \up0 \expndtw-
9\charscalex91 Tetap _____\par\pard\qj \li740\ri4186\sb2\sl-238\slmult0\fi0 \up0
\expndtw-9\charscalex93 Semi Tetap __________ (tulis no lokasi) \line \up0
\expndtw-9\charscalex94 Tidak Tetap __________ (tulis kode PO)\par\pard\ql
\li11809\sb0\sl-230\slmult0 \par\pard\ql \li20\sb15\sl-230\slmult0\tx2905\tx4345
\up0 \expndtw-9\charscalex93 1. Jenis Kelamin \up0 \expndtw-9\charscalex92 : 0
Perempuan\tab \up0 \expndtw-7\charscalex100 1 Laki-laki\tab \up0 \expndtw-
9\charscalex92 2 Transgender\par\pard\ql \li11809\sb0\sl-230\slmult0
\par\pard\ql \li20\sb17\sl-230\slmult0 \up0 \expndtw-8\charscalex94 2. Berapa umur
Anda ketika anda mulai menggunakan narkoba suntik ? ________\par\pard\ql
9\charscalex91 3. Berapa umur Anda sekarang ? ____________\par\pard\qj
\li11809\sb0\sl-238\slmult0 \par\pard\qj \li20\ri2423\sb3\sl-
238\slmult0\tx750\tx3620 \up0 \expndtw-9\charscalex92 4. Narkoba jenis apa yang
anda gunakan ketika pertama kali menyuntik ? \line\tab \up0 \expndtw-9\charscalex93
1. ____ putaw \tab \up0 \expndtw-9\charscalex97 3. _______ morfin\par\pard\ql
\li740\sb7\sl-230\slmult0\tx3625 \up0 \expndtw-9\charscalex92 2. ____ shabu-
shabu\tab \up0 \expndtw-9\charscalex93 4. ____ lainnya
__________________\par\pard\qj \li11809\sb0\sl-238\slmult0 \par\pard\qj
\li20\ri805\sb3\sl-238\slmult0\tx375 \up0 \expndtw-8\charscalex97 5a. Sebelum anda
menyuntik, apakah anda menggunakan putaw dengan cara menghirup \line\tab \up0
\expndtw-8\charscalex100 (nge-drag)\par\pard\ql \li740\sb7\sl-230\slmult0 \up0
\expndtw-9\charscalex92 0 ___ tidak\par\pard\ql \li740\sb9\sl-230\slmult0 \up0
\expndtw-9\charscalex86 1 ___ ya\par\pard\qj \li11809\sb0\sl-238\slmult0
\par\pard\qj \li20\ri2712\sb2\sl-238\slmult0\tx750\tx2900 \up0 \expndtw-
9\charscalex92 5b. Berapa lama anda menggunakan putaw dengan cara menghirup ?
\line\tab \up0 \expndtw-9\charscalex92 1 ___ hari \tab \up0 \expndtw-9\charscalex92
3 ___ bulan\par\pard\ql \li740\sb8\sl-230\slmult0\tx2905 \up0 \expndtw-
9\charscalex95 2 ___ minggu\tab \up0 \expndtw-9\charscalex93 4 ___
tahun\par\pard\qj \li11809\sb0\sl-285\slmult0 \par\pard\qj \li20\ri804\sb12\sl-
285\slmult0\tx374 \up0 \expndtw-8\charscalex95 6a. Pada 30 hari terakhir ini, jenis
narkoba apa saja yang anda gunakan dengan cara suntik? \line\tab \up0 \expndtw-
9\charscalex93 (cek semua yang disebutkan)\par\pard\ql \li740\sb47\sl-
230\slmult0\tx3625 \up0 \expndtw-9\charscalex93 1. ____ putaw\tab \up0 \expndtw-
9\charscalex97 3. _______ morfin\par\pard\ql \li740\sb56\sl-230\slmult0\tx3625 \up0
\expndtw-9\charscalex92 2. ____ shabu-shabu\tab \up0 \expndtw-9\charscalex93 4.
____ lainnya __________________\par\pard\ql \li15387\sb0\sl-230\slmult0
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
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10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108000700
e703012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
0fefe28a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a
0028a28a0028a28a0028a28a0028a28a0028a28a00ffd9}}}}}
\par\pard\qj \li2473\ri1834\sb54\sl-270\slmult0\tx2796 \up0 \expndtw-8\charscalex98
\ul0\nosupersub\cf4\f5\fs20 6b. Dari berbagai jenis narkoba yang disuntikkan, mana
yang paling sering anda gunakan \line\tab \up0 \expndtw-9\charscalex95 dalam 30
hari terakhir ini?\par\pard\ql \li3193\sb35\sl-230\slmult0\tx6068 \up0 \expndtw-
9\charscalex93 1. ____ putaw\tab \up0 \expndtw-9\charscalex97 3. _______
morfin\par\pard\ql \li3193\sb40\sl-230\slmult0\tx6068 \up0 \expndtw-9\charscalex92
2. ____ shabu-shabu\tab \up0 \expndtw-9\charscalex93 4. ____ lainnya
__________________\par\pard\ql \li2473\sb0\sl-230\slmult0 \par\pard\ql
\li2473\sb142\sl-230\slmult0 \up0 \expndtw-8\charscalex94 7a. Dalam 30 hari
terakhir ini, berapa hari anda menyuntik narkoba? ____ hari\par\pard\qj
\li2473\sb0\sl-301\slmult0 \par\pard\qj \li2473\ri1834\sb13\sl-
301\slmult0\tx2778 \up0 \expndtw-8\charscalex96 7b. Pada hari anda menyuntik
tersebut, berapa kali anda menyuntik dalam satu hari? ____ \line\tab \up0 \expndtw-
5\charscalex100 kali\par\pard\qj \li2473\ri1834\sb301\sl-301\slmult0\tx2785 \up0
\expndtw-4\charscalex100 7. Dalam 30 hari terakhir ini, berapa kali anda
menggunakan jarum suntik yang telah \line\tab \up0 \expndtw-9\charscalex93
digunakan oleh orang lain sebelumn ya? _____ kali\par\pard\qj
\li2473\ri1834\sb0\sl-301\slmult0\tx2785 \up0 \expndtw-8\charscalex95 8. Berapa
banyak orang yang berbeda yang menggunakan jarum suntik yang sama dengan
\line\tab \up0 \expndtw-9\charscalex94 anda dalam 30 hari terakhir
ini\par\pard\ql \li6031\sb0\sl-230\slmult0 \par\pard\ql \li6031\sb0\sl-
4\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Lampiran 3\par\pard\ql
\li2049\sb186\sl-230\slmult0 \up0 \expndtw-3\charscalex100 PROGRAM JARUM SUNTIK
STERIL\par\pard\qj \li226\ri1031\sb0\sl-207\slmult0\tx3216 \up0 \expndtw-
4\charscalex100 PROGRAM PENCEGAHAN DAN PERAWATAN HIV/AIDS PADA KELOMPOK
\line\tab \up0 \expndtw-2\charscalex100 PENASUN\par\pard\ql \li11827\sb0\sl-
5\charscalex100 \ul0\nosupersub\cf24\f25\fs20\ul Ketentuan dan Hak Peserta Program
Jarum Suntik Steril\par\pard\qj \li11827\sb0\sl-221\slmult0 \par\pard\qj
\ul0\nosupersub\cf4\f5\fs20 Seseorang yang berhak untuk menjadi peserta program
jarum suntik steril jika yang \up0 \expndtw-9\charscalex95 bersangkutan memenuhi
ketentuan-ketentuan sebagai berikut :\par\pard\ql \li374\sb216\sl-230\slmult0\tx745
\up0 \expndtw-9\charscalex93 1.\tab \up0 \expndtw-9\charscalex96 Harus berumur 18
tahun atau lebih\par\pard\ql \li380\sb1\sl-219\slmult0\tx745 \up0 \expndtw-
9\charscalex93 2.\tab \up0 \expndtw-9\charscalex95 Harus mampu menunjukkan dirinya
bahwa dia adalah penasun\par\pard\ql \li380\sb2\sl-221\slmult0\tx745 \up0 \expndtw-
9\charscalex93 3.\tab \up0 \expndtw-8\charscalex96 Harus memiliki jarum suntik
bekas untuk bisa ditukarkan dengan yang baru\par\pard\ql \li380\sb1\sl-
Harus menandatangani surat persetujuan untuk terlibat di dalam program
ini\par\pard\ql \li740\sb1\sl-221\slmult0 \up0 \expndtw-9\charscalex88 secara
sukarela.\par\pard\qj \li11827\sb0\sl-221\slmult0 \par\pard\qj \li20\ri823\sb1\sl-
221\slmult0\fi0 \up0 \expndtw-8\charscalex97 Seseorang yang telah memenuhi syarat
untuk pernjadi peserta program akan memiliki hak \up0 \expndtw-9\charscalex92
sebagai berikut :\par\pard\ql \li374\sb215\sl-230\slmult0\tx745 \up0 \expndtw-
9\charscalex93 1.\tab \up0 \expndtw-3\charscalex100 Untuk tetap anonim, meski ini
akan berkonsekuensi tidak dapat mengakses\par\pard\ql \li728\sb0\sl-221\slmult0
\up0 \expndtw-9\charscalex93 seluruh layanan yang disediakan.\par\pard\ql
9\charscalex97 Untuk mengundurkan diri dari kepesertaan di dalam program
ini.\par\pard\ql \li380\sb0\sl-221\slmult0\tx745 \up0 \expndtw-9\charscalex93
3.\tab \up0 \expndtw-9\charscalex93 Untuk bebas dari pelecehan fisik dan mental
dari petugas pelayanan\par\pard\ql \li380\sb1\sl-221\slmult0\tx745 \up0 \expndtw-
9\charscalex93 4.\tab \up0 \expndtw-9\charscalex94 Untuk mengetahui cara mengajukan
keluhan kepada penyedia layanan.\par\pard\ql \li380\sb1\sl-221\slmult0\tx745
\up0 \expndtw-9\charscalex93 5.\tab \up0 \expndtw-8\charscalex100 Untuk dihormati
hak-haknya sebagai individu\par\pard\ql \li380\sb1\sl-221\slmult0\tx745 \up0
\expndtw-9\charscalex93 6.\tab \up0 \expndtw-6\charscalex100 Untuk memperoleh
layanan-layanan lain yang disediakan oleh organisasi atau\par\pard\ql
\li740\sb0\sl-221\slmult0 \up0 \expndtw-9\charscalex93 lembaga lain.\par\pard\qj
\li11827\sb0\sl-221\slmult0 \par\pard\qj \li11827\sb0\sl-221\slmult0
\par\pard\qj \li20\ri823\sb2\sl-221\slmult0\fi0 \up0 \expndtw-7\charscalex100
Setelah membaca dan penjelasan tentang ketentuan menjadi peserta dan hak-hak
yang \up0 \expndtw-8\charscalex95 dimiliki oleh seseorang setelah menjadi program
ini, maka saya sangat mengerti tentang hal \up0 \expndtw-9\charscalex91 tersebut di
atas.\par\pard\ql \li380\sb1\sl-221\slmult0\tx4345 \up0 \expndtw-9\charscalex94
______________________________\tab \up0 \expndtw-9\charscalex94
___________________\par\pard\ql \li380\sb20\sl-230\slmult0\tx4345 \up0 \expndtw-
9\charscalex90 Kode Peserta\tab \up0 \expndtw-9\charscalex91 Tanggal\par\pard\ql
230\slmult0\tx4345 \up0 \expndtw-9\charscalex94
______________________________\tab \up0 \expndtw-9\charscalex94
___________________\par\pard\ql \li380\sb38\sl-230\slmult0\tx5065 \up0 \expndtw-
9\charscalex88 Petugas\tab \up0 \expndtw-9\charscalex91 Tanggal\par\pard\ql
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001500
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc0001108001300
0803012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
{\shp
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101010
10101010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101ffdb0043010101010101010101010101010101010101010101010101010101010101010
1010101010101010101010101010101010101010101010101010101010101010101ffc000110801f901
0c03012200021101031101ffc4001f00000105010101010101000000000000000001020304050607080
90a0bffc400b5100002010303020403050504040000017d010203000411051221314106135161072271
14328191a1082342b1c11552d1f02433627282090a161718191a25262728292a3435363738393a43444
5464748494a535455565758595a636465666768696a737475767778797a838485868788898a92939495
0102030405060708090a0bffc400b511000201020404030407050404000102770001020311040521310
61241510761711322328108144291a1b1c109233352f0156272d10a162434e125f11718191a26272829
2a35363738393a434445464748494a535455565758595a636465666768696a737475767778797a82838
0feca7f6d4fdac7c43fb28e81f0325f05fc0ef107ed09e3cf8fff00b417877f67bf047c3cf0e78dfc1f
f0f6f24d7f5df877f13fe24c9ac5c7897c773d9f86adecec345f85bac44f6f7d7d626e2e2eed963ba56
1b24f20ff0086b3fdbf3fe9143f123ff12eff00649ffe6f2a8ffc146bfe4a6ffc12a7fed279e05ffd64
5fdb26bf4f2a756dead59f4b764faa6568945f2a6ddef7bf47e4d1f9a3ff000d67fb7e7fd2287e247fe
25dfec93ffcde5790e89ff0521fdaff00c45f1bfe207ecfda4ffc12cfe265c7c45f861e01f879f11fc6
7a59fdab7f65d822d2bc37f14f55f1b68fe08b94d42e3c59168f7edabddfc3af17ab5be9ba9de5ee9df
d921b55b3b18eff004c92f7f632bf313e0dff00ca5c3f6ecffb336fd813ff00560feda7434f4f7a5bf6
8f67fddf2fc5f959a6ad27cab457de5de2bf9bcdfccbbff0d67fb7e7fd2287e247fe25dfec93ff00cde
51ff0d67fb7e7fd2287e247fe25dfec93ff00cde57e9751459ff34bff0025ff00e47fabbf2b2bafe58f
fe4dff00c97f577e56fc6bfd9fff00e0a55fb5d7ed2ff0a7c3df19fe15ff00c12d3e26eb5e01f155e78
9acb41d5a6fdaaff65fd2a4bd97c21e29d6bc15af16d3b5df15e93ab5a8b4f13787759d397ed76108b9
5b35bdb569acae6da797d9bfe1acff006fcffa450fc48ffc4bbfd927ff009bcae63fe089bff28d0fd9f
7fec61fda2bff005a87e34d7eaad28ddc62dc9ea93da3d52feeff0057f4b3934a524a2ac9b5bcba3ff1
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{\shp
3\charscalex100\ul0\nosupersub\cf1\f2\fs24 PROGRAM JARUM SUNTIK STERIL{\par}}}}
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4\charscalex100\ul0\nosupersub\cf1\f2\fs24 PROGRAM PENCEGAHAN DAN PERAWATAN
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4\charscalex100\ul0\nosupersub\cf1\f2\fs24 PADA KELOMPOK PENASUN{\par}}}}
{\shp
6\charscalex100\ul0\nosupersub\cf22\f23\fs20 LAPORAN HARIAN PERJASUN{\par}}}}
{\shp
6\charscalex100\ul0\nosupersub\cf23\f24\fs20 LOKASI : A ; B : (kode lokasi satelit)
C : (kode lokasi outreach){\par}}}}
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3\charscalex100\ul0\nosupersub\cf23\f24\fs20 Tanggal : ______________{\par}}}}
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4\charscalex100\ul0\nosupersub\cf22\f23\fs20 No{\par}}}}
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5\charscalex100\ul0\nosupersub\cf22\f23\fs20 No ID Peserta{\par}}}}
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5\charscalex100\ul0\nosupersub\cf22\f23\fs20 Jarum{\par}}}}
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5\charscalex100\ul0\nosupersub\cf22\f23\fs20 Bleach{\par}}}}
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6\charscalex100\ul0\nosupersub\cf22\f23\fs20 # Air{\par}}}}
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6\charscalex100\ul0\nosupersub\cf22\f23\fs20 # Alkohol {\par}}}}
{\shp
5\charscalex100\ul0\nosupersub\cf22\f23\fs20 Swab{\par}}}}
{\shp
2\charscalex100\ul0\nosupersub\cf22\f23\fs20 # {\par}}}}
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5\charscalex100\ul0\nosupersub\cf22\f23\fs20 Kondom{\par}}}}
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{\*\shpinst\shpleft14509\shptop947\shpright14915\shpbottom2556\shpfhdr0\shpbxpage\s
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5\charscalex100\ul0\nosupersub\cf22\f23\fs20 # Media{\par}}}}
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2\charscalex100\ul0\nosupersub\cf23\f24\fs20 1{\par}}}}
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\par\pard\sect\sectd\fs24}

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