Anda di halaman 1dari 36

Community Health Nursing Standards of Practice (CHN Standards)

Thomas Aquino Erjinyuare Amigo

Ns. TAENA, S.Kep

Standar Praktik Kep


Masyarakat mempunyai kebutuhan dan harapan untuk hidup lebih sehat dan umur panjang Menyarankan & mendukung pasien untuk menentukan pilihan yg positif tentang status kesehatan terutama dalam hal manajemen diri Memampukan masyarakat utk melakukan perawatan di dalam keluarga secara terpadu & manajemen diri terhadap penyakit jangka panjang

Ns. TAENA, S.Kep

Standar Perawatan

Cara lain yang digunakan oleh profesi keperawatan dalam memastikan bahwa praktisi keperawatan kompeten & aman utk berpraktik adalah melalui penetapan standar praktik (Blois, Hayes, Kozies, & Erb, 2006) Standar digunakan utk mevaluasi kualitas perawatan yg dibrikan oleh perawat
Ns. TAENA, S.Kep

Standards of Practice is a published set of behavioral and professional expectations of certificate holders (Mildon, Betker, & Underwood, 2011) Komitment profesi keperawatan dlm melindungi masyarakat terhadap praktek yg dilakukan oleh profesi (DPP.PPNI,1999)
Ns. TAENA, S.Kep

Standard Praktik Keperawatan Klinis


(ANA, 1998)

Mcerminkan nilai & prioritas profesi keperawatan Mbrikan arahan utk praktik keperawatan profesional Mbrikan kerangka kerja utk evaluasi praktik keperawatan Mdefinisikan tanggung gugat profesi thdp masyarakat & hasil akhir yg mjd tanggung jawab perawat (Blois, Hayes, Kozies, & Erb, 2006)
Ns. TAENA, S.Kep

Laverack (2004), identifies four characteristics of community


(Sines, Saunders, Forbes-Burford, 2009,p.50):

Dimensi spasial, yaitu tempat atau lokasi Kepentingan, masalah, identitas yang menghubungkan kelompok-kelompok lain yang heterogen Berbagi kebutuhan dan kekhawatiran yang dapat dicapai melalui kegiatan kelompok Interaksi sosial dan hubungan yang mengikat orang bersama-sama

Ns. TAENA, S.Kep

Skills Required For Community Development


(Sines, Saunders, Forbes-Burford, 2009,p.58)

Building relationships with key partners Appropriate organisational and leadership styles Communication with people at different levels Humility (rendah hati) Maintaining confidentiality Flexibility negotiating skills Awareness of equal opportunities Accountability Advocacy/lobbying Evaluation skills Research awareness Team working Interpersonal skills Health promoter
Ns. TAENA, S.Kep

Family roles include, but are not limited to, the following:
(DeLaune & Ladner, 2011,p. 299):

Nurturance (mengasuh) and support Allocation of resources Development of life skills Division of labor (pembagian kerja) Socialization of members (Antai-Otong, 2007)

Ns. TAENA, S.Kep

Beberapa Sifat Kesehatan Keluarga


(DeLaune & Ladner, 2011,p. 299)

Supporting members (mendukung anggota keluarga) Teaching respect for others (mengajarkan untuk mhormati org lain) Helping with problem solving (mbantu dlm pemecahan masalah) Communicating (berkomunikasi)
Ns. TAENA, S.Kep

Setting Praktik Perawatan kesehatan Masyarakat (Perkesmas):


(DeLaune & Ladner, 2011,p. 303)

Schools Workplaces (tempat kerja) Public health units Family

Ns. TAENA, S.Kep

Dalam rangka mempromosikan kesehatan masyarakat, perkesmas melakukan fungsi:


(DeLaune & Ladner, 2011,p. 304)

Prevention of epidemics and spread of disease (Pencegahan epidemi dan penyebaran penyakit) Protection against environmental hazards (Perlindungan terhadap bahaya lingkungan) Prevention of injuries (Pencegahan cedera) Promotion of health behaviors (Promosi perilaku kesehatan) Response to disasters (Respon terhadap bencana)
Ns. TAENA, S.Kep

Why are CHN Standards important?


Define scope & depth of CHN (community health nurse) practice / Menentukan lingkup & kedalaman praktek CHN (perawat kesehatan masyarakat) 2. Establish criteria and expectations for acceptable practice and safe ethical care / Menetapkan kriteria dan harapan untuk praktek dan perawatan yang dapat diterima dan aman 3. Provide criteria for measuring performance / Menyediakan kriteria untuk mengukur kinerja
1.
Ns. TAENA, S.Kep

Why are CHN Standards important?


Support the ongoing development of CHN (Mendukung pengembangan berkelanjutan terhadap CHN) 5. Promote CHN as a specialty (Promosikan CHN secara khusus) 6. Inspire excellence in & commitment to CHN practice (Mempunyai keunggulan & komitmen dlm praktek CHN) 7. Set a benchmark for new community health nurses (Menetapkan patokan bagi CHN baru)
4.
Ns. TAENA, S.Kep

COMMUNITY HEALTH NURSING


Includes: Nurses promoting health of individuals, groups & communities and an environment that supports health

Public Health (PHN) 1. Focus on health promotion, illness prevention & population health 2. Link individual & family health experiences into the population health framework and links population health to families and individuals 3. Practice in diverse settings ex. Community health centers, schools, streets, nursing stations 4. Educational preparation: gelar sarjana

Home Health (HHN) 1. Focus on prevention, health restoration, maintenance & palliation 2. Focus on clients & families 3. Practice in homes, schools or workplace and integrates health promotion, teaching & counseling with provision of care 4. Educational preparation: gelar sarjana

Ns. TAENA, S.Kep

Unique Characteristics of Community Health Nursing

CHNs promote, protect & preserve the health of individuals, families, groups, communities & populations View health as a resource & focus on capacities Marshal resources to support health by coordinating care & plan Nsg services, programs & policies Work at a high level of autonomy

wherever people live, work, learn, worship & play.

in a continuous versus episodic process Combine specialized nursing, social and public health science with experiential knowledge

Build Have a unique partnerships understanding of based on the influence of primary health the environmental care principles, context of health caring & empowerment Ns. TAENA, S.Kep

Components of Professional Practice Model


Individuals, families, groups, communities, populations, systems Code of Ethics Community Health Nurse Community Health Nursing Standards Delivery Structure and Process Determinants of Health Discipline specific competencies: Public Health, Home Health Government support Management practices Professional relationships and partnerships Professional Regulatory Standards Theoretical Foundation Values and principles

Ns. TAENA, S.Kep

The Community Health Nursing Process


(Anderson & McFarlane, 2004)

1. 2. 3. 4.

Assessment Diagnosis & Planning Intervention (action) Evaluation

Ns. TAENA, S.Kep

CCHN Standards of Practice


1. Promoting Health a. Health Promotion b. Prevention and Health Protection c. Health Maintenance, Restoration and Palliation 2. Professional Relationships 3. Capacity Building 4. Access and Equity (keadilan) 5. Professional Responsibility and Accountability
Ns. TAENA, S.Kep

Parts of each Standard: Description & Indicators

Description of Standard is provided in initial paragraph Indicators: begin with the heading The community health nurse... and define the specific activities that CHNs are expected to perform to achieve the Standard. The indicators begin with assessment type activities, move to planning, action and end with evaluation activities.

Ns. TAENA, S.Kep

Standard 1- Health Promotion


Melibatkan penduduk secara keseluruhan dalam konteks kehidupan sehari-hari mereka daripada berfokus hanya pada orang beresiko Apakah proses menangani ketidaksetaraan kesehatan dan memungkinkan orang untuk meningkatkan kontrol atas & untuk meningkatkan kesehatan mereka. Membawa bersama-sama orang yang menyadari bahwa sumber daya dasar & kondisi untuk kesehatan (misalnya faktor sosial dan lingkungan dari kesehatan) sangat penting. Bekerja terbaik ketika semua tingkat-individu, kelompok, komunitas, masyarakat (pemerintah, media) dan beberapa pendekatan yang digunakan
Ns. TAENA, S.Kep

EXAMPLES from practice - Health Promotion

PHNs work with a community to advocate for a smoke-free town or municipality PHNs promote physical activity and healthy eating through programs such as the In-Motion, Supermarket Safari and the Schools Awards Program. HHNs encourage families dealing with a chronic illness to participate in regular physical and social activities

Ns. TAENA, S.Kep

Standard 2- Prevention & Health Protection Para CHN menerapkan kegiatan untuk meminimalkan terjadinya penyakit atau cedera dan akibatnya. Strategi perlindungan kesehatan sesuai dengan program dan kebijakan

Ns. TAENA, S.Kep

EXAMPLES from practice Prevention & Health Protection

PHN track immunization schedules for each child so that when a child is overdue for vaccine they can be contacted. (CHNAC)

A CHN observes high rates of smoking within a particular client group. The concern is raised with the practice team and a plan is developed to find ways to address the issue. PHN work with a parents organization and the police to promote proper installation of car seats through the media and conduct several clinics to provide one-on-one assessment and teaching.
Ns. TAENA, S.Kep

Standard 3Health Maintenance, Restoration & Palliation

Utk masalah kesehatan yg akut, kronik, paliatif (HHNs) health teaching & counseling for health maintenance or dealing with acute, chronic or terminal illness (HHNs and PHNs). Links people to community resources & facilitates/coordinates care needs & supports (koordinasi dengan berbagai pihak)

Ns. TAENA, S.Kep

Examples from practiceHealth Maintenance, Restoration & Palliation


HHNs care for disabled students in the classroom: Communication is required with the childs guardian, teacher and/classroom assistant CHNs provides ongoing nursing care to families with seniors who are experiencing difficulties. The care may be provided directly or through unregulated workers. This may include telephone follow-up, home visits or community referrals.
Ns. TAENA, S.Kep

Group work
Introductions: Your name, where you live, where you work, focus of your practice (change for student groups) Each person in turn (no discussion) describes their experience Recorder takes down main points of each experience Discuss and determine which of the first three Standards is most relevant for each experience. Decide which example from your group could be used in the reporting session at the end.
Ns. TAENA, S.Kep

Standard 4. Professional Relationships


Built on the principles of connecting & caring Relationships may be with clients and/or with organizations/stakeholders Relationships built on mutual respect and on an understanding of the power inherent to the CHN position. Unique to CHN is building a network of relationships & partnerships occurs within a complex environment for both PHNs and HHNs.
Ns. TAENA, S.Kep

Examples from practice Professional Relationships


A HHN working in palliative care listens to the concerns of stressed and exhausted caregivers and supports them in making decisions about respite and hospice care.

A group of PHN working with families experiencing child care difficulties identify that post natal visits based on issues or tasks moves them around too much to be able to develop a continuing relationship with families. They bring their concern to the attention of management.
Ns. TAENA, S.Kep

Standard 5. Capacity Building


Peningkatan kapasitas kemampuan individu / masyarakat untuk mendefinisikan, menilai, menganalisis & bertindak pada masalah kesehatan. Aktif terlibat dalam mengatasi masalah yang kritis CHN bekerja sama dg orang-orang yang berpengaruh mengontrol sumber daya & dalam masalah kesehatan CHNs menilai tahap kesiapan untuk perubahan & prioritas tindakan. CHNs membangun kekuatan yang ada.
Ns. TAENA, S.Kep

Examples from practice Capacity Building

A HHN encourages a mother and teens to work out a schedule for ROM exercises for the grandmother. The family is happy that they were able to work out the problem together.

A PHN encourages a school to mobilize a school health committee that includes students, parents, teachers, administration, and community partners. Committee members identify the school communitys strengths and needs, and prioritize, plan, implement, evaluate and celebrate action for a healthier school. The school communitys capacity to take its own action for health is enhanced via a sustainable structure (the committee). The PHN is a partner in the process.
Ns. TAENA, S.Kep

Standard 6. Access & Equity


CHNs megidentifikasi fasilitas umum serta sumber dan pelayanan yang dapat dijangkau CHNs memfasilitasi semua tingkatan di dalam masyarakat untuk mendapatkan pelayanan yang tepat CHNs bekerjasama dg pelayanan dan sektor lain utk pelayanan yang komperehensif pada klien dan memperoleh hasil yang optimal

Ns. TAENA, S.Kep

Examples from practice Access & Equity


A PHN identifies that one ethnic group does not use health care services (including prenatal classes) outside their area. The PHN works with a champion from this group to organize local prenatal classes delivered by a PHN and translated by a woman from the community.

Ns. TAENA, S.Kep

Standard 7. Professional Responsibility & Accountability

CHNs bekerja dengan tingkat otonomi yang paling tinggi yang mempunyai tanggung jawab atas kompetensinya CHNs bekerja di lingkungan yang paling kompleks dengan bertanggungjawab terhadap berbagai otoritas CHNs menghadapi dilema etika yang unik
Ns. TAENA, S.Kep

Examples from practiceProfessional Responsibility and Accountability

HHN diminta oleh keluarga untuk melepaskan semua peralatan yang terpasang pada pasien yang telah koma 1 minggu. Jika dilepaskan maka pasien tersebut akan meninggal. Perawat harus mendiskusikan dg keluarga apa yang membuat keluarga membuat keputusan seperti itu PHN adalah ditugaskan untuk bekerja dalam program pertukaran jarum suntik didasarkan pada pengurangan bahaya. Dia memiliki kesulitan menerima prinsip-prinsip pengurangan dampak buruk dan menggunakan praktik reflektif pribadi dan dengan atasannya untuk memahami dan mengubah asumsi-asumsi.
Ns. TAENA, S.Kep

REFERENSI
Anderson, E. T., & McFarlane, J. (2004). Community As Partner. Philadelphia: Lippincott Williams & Wilkins. Blois, K. K., Hayes, J. S., Kozies, B., & Erb, G. (2006). Praktik Keperawatan Profesional: Konsep & Perspektif. Jakarta: EGC. DeLaune, S. C., & Ladner, P. K. (2011). Fundamentals of Nursing: Standards & Practice. New York: Delmar Cengage Learning. Mildon, B., Betker, C., & Underwood, J. (2011). Standards of Practice in Community Health Nursing: A Literature Review Undertaken to Inform Revisions to the Canadian Community Health Nursing Standards of Practice. Ottawa: Community Health Nurses of Canada. Sines, D., Saunder, M., & Forbes-Burford, J. (2009). Community Health Care Nursing. United Kingdom: Wiley-Blackwell.
Ns. TAENA, S.Kep

eacarolamigo01.blogspot.com
Ns. TAENA, S.Kep