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PERAWATAN HIV & AIDS

KOMPREHENSIF
BERKESINAMBUNGAN

Oleh :
Purwaningsih

PENGERTIAN

suatu konsep perawatan yang


menyeluruh membentuk suatu
jejaring kerja diantara
semua sumber daya yang ada
dalam rangka memberikan pelayanan
dan perawatan holistic, menyeluruh
dan dukungan yang luas bagi ODHA
dan keluarganya.

- NGOs
- Spiritual
- Youth group
- Volunteer
VCT

The entry
point

- Health posts
- Dispensaries
- Traditional
- Orphan care

- Distric hosp
- Clinics
- Hospice

PLHA
Peer
support

- Paliative
- Emotional &
Spiritual support
- Self care

- Specialist &
specialized care
facilities

PELAYANA DAN DUKUINGAN ODHA


PMTCT

Perawatan
paliatif
Perawatan
di rmh
Anti retroviral teraphy

Pengobatan komplementer

PEP
Tx. peny.
terkait HIV

Profilaksis &
pengobatan IO

Dukungan psiko-sosial-spiritual
Konseling dan tes HIV sukarela

Manfaat ?

Pencegahan : Jangan menulari dan ditulari (IMS dan NAPZA suntik)


HIV
(-)

Terpajan

HIV
(+)

AIDS

Terminal

Beberapa aspek perawatan HIV & AIDS


komprehensif dan berkesinambungan

VCT

Perawatan
di rumah

Tatalaksana
IO

Asuhan
gizi

Asuhan
keperawatan

KDS

Menurunkan
stigma

DIKLAT

Dukungan
sosial

Sistem
rujukan

INTERAKSI ANTAR KOMPONEN

Pengobatan dan perawatan


VCT, PMTCT,
profilaksis, pengoatan
IO, ART, tatalaksana
IMS, gizi

ODHA
dan
keluarga

Dukungan
psikologis
Konseling, dukungan pada
yatim piatu, dukungan
masyarakat, dukungan
spiritual

Dukungan sosio-ekonomik
Dukunngan material
jaminan ekonomi dan
jaminan hidup layak

Dukungan HAM
dan Hukum
Menghapus stigma dan
diskriminiasi, perencanaan
dan partisipasi ODHA,
kesetaraan kesempatan dan

Penghargaan

Efisien dan
efektif

Ketersediaan
PRINSIP
DASAR

Koordinasi dan
integrasi

Kesetaraan

SEBELUM
PROGRAM ART

Prophilaxis
Tatalaksana IO
Pencegahan
Perawatan paliatif

PROGRAM ART

HIV Kronis
Untuk mendapatkan program ART,
ada beberapa syarat yang harus dipenuhi

Patuh datang ke klinik


Patuh program pengobatan
Nutrisi adekwat
Pola hidup sehat
Dukungan psikososial
Universal precaution

SELAMA PROGRAM ART

Dokter
Ahli gizi

Farmasi

Konselor

ODHA

Perawat
Perawatan
paliatif

Relawan
sosial

SEBAGAI TIM,
PERAWAT HARUS:
Partisipasi aktif
Memberikan in-put untuk
meningkatkan kualitas layanan
Konsultasi dengan anggota tim lain
Saling memberi dukungan
pada sesama perawat

TUJUAN KEPERAWATAN
DALAM PERAWATAN KOMPREHENSIF

Menurunkan morbidity dan mortality


Meningkatkan QoL
Memberikan asuhan keperawatan
Prenvention

PERAN PERAWAT DALAM


PERAWATAN KOMPREHENSIF

Perawatan kronik
Perawatan akut
Promosi dan pendidikan kesehatan
Pencegahan penyakit
Perawatan paliatif
Dukungan mental
Advokasi
Manajemen rujukan

TATALAKSANA HIV KRONIS

Testing and counseling


Health monitoring
Symptom management
Medication adherence monitoring
Health promotion/patient education
Empowering patients to make their own choices

PERAN PERAWAT DALAM PERAWATAN AKUT

*Melakukan pengkajian tentang tanda dan gejala/


staging
Memberikan intervensi Non-pharmacologic
Bijaksana dalam merespon pengobatan
komplementer ODHA
Monitoring program pengobatan

Nursing Roles in Health Promotion


and Education
Teach health promotion
Promote healthy practices that prolong the
asymptomatic stage, reduce HIV-related
conditions, and avoid behaviors that can transmit
HIV
Assess and use patients and family members
current knowledge as the basis for teaching

Nursing Roles in Prevention for Patients


Assess
Identify risks for HIV infection
Intervene
Counsel on the benefits of HIV testing
Educate on HIV transmission and risk reduction
Refer those testing HIV-positive to care and
support
Educate those testing HIV-negative about
prevention

Nursing Roles in Disease Prevention in the


Clinical Setting

Reduce transmission of
infection
Practice standard precautions at
work
Model optimum standard
precautions and advise colleagues
on proper use
Know the postexposure prophylaxis
(PEP) protocol of the health facility

Nursing Roles in Mental


Health
Psychological or mood
disorders are common in
patients with HIV
Nurses can assess and
intervene on a variety of
mental health issues

Nursing Roles in Patient Support/Advocacy


Identify needs (along with the patient and family)
and refer to appropriate services within the
clinical or community setting
Advocate for patient when needed
Support patients achievement of needs, such as
informing patient of cost-sharing schemes

Nursing Roles in Referral Management


A functional referral system with links to other
facilities/services and feedback is critical to serve
all the comprehensive care needs of patients
Examples of services include community- and
home-based services and PLHA support groups
A referral system should include feedback to the
referring clinician to determine if the patients
needs were met

Nursing Roles in Palliative Care


and End-of-Life Care
Palliative care begins at the time of diagnosis and
provides comfort and symptom management
throughout life
End-of-life care is focused on assisting the patient
and family to have the highest quality of life
possible

Nursing Roles in Documenting Care


Complete and accurate documentation of the
nursing care provided during each patient visit
contributes to quality service delivery
Recording assessment findings and interventions
over time is required to manage HIV/AIDS as a
chronic disease

Nursing Roles Realized:


Four Steps for Getting It Right

Make time for the patient


Use an open, supportive,
nonjudgmental approach
Maintain current knowledge
Believe in the importance of
your role

Importance of Nursing Roles in Care of PLHA


Some nurses may feel their role is unimportant or
they are just nurses
Nurses roles in caring for PLHA and their families
are vital for high-quality patient care and family
wellbeing
Nurses are the front line of trained health workers
for PLHA