HOME CARE, PELAYANAN PROFESIONAL ATAU VOKASIONAL

Saldy Yusuf, S.Kep.Ns.ETN

Clinical Advisor GRIYA AFIAT -Makasssar Home Care Specialist.

PENGERTIAN

Istilah ’Home Care’ bagi sebagian orang sudah tidak asing lagi, istilah lain yang sering digunakan adalah ’Nursing Home’, dan ’Home Health Care’. Istilah Home Care atau Perawatan di Rumah merupakan salah satu bentuk pemberian Asuhan Keperawatan yang dilaksanakan di rumah oleh tenaga kesehatan profesional. Di Amerika bentuk pelayanan ini diberikan secara informal oleh perawat, caregiver atau voluntary. Biasanya istilah home care dicampur adukkan dengan isitlah non medical care atau custodial care yang merupakan perawatan yang diberikan bukan oleh perawat, dokter atau tenaga medis lainnya yang berwenang. Namun apapun istilahnya bentuknya sama yaitu pemberian pelayanan kesehatan di rumah klien sendiri.

Bagi kami di GRIYA AFIAT, kami mendefinisikan Home Care sebagai bentuk Asuhan Keperawatan Profesional yang diberikan secara profesional pada individu dan atau keluarga yang disebabkan oleh keterbatasannya dalam mempertahankan dan meningkatkan kesehatannya secara mandiri. 

Mengapa kami menyebut ’Pelayanan Profesional’ karena pelayanan ini di dasarkan pada ’evidence based’ bukan semata atas dasar pertimbangan situasional. Asuhan Keperawatan berdsarkan evidence based akan mengarahkan bentuk pelayanan keperawatan yang diberikan pada peningkatan derajat kesehatan.

Istilah Home Care atau Perawatan di Rumah merupakan salah satu bentuk pemberian Asuhan Keperawatan yang dilaksanakan di rumah oleh tenaga kesehatan profesional. Di Amerika bentuk pelayanan ini diberikan secara informal oleh perawat, caregiver atau voluntary. Biasanya istilah home care dicampur adukkan dengan isitlah non medical care atau custodial care yang merupakan perawatan yang diberikan bukan oleh perawat, dokter atau tenaga medis lainnya yang berwenang.

 

BENTUK PELAYANAN HOME CARE

Tujuan utama home care adalah memungkinkan klien mendapatkan pelayanan kesehatan di rumah sendiri. Sifat pelayanan yang diberikan dapat kombinasi antara pelayanan kesehatan professional dan pelayanan kesehatan non professional atau vokasional. Oleh karena itu secara jelas dapat dibedakan bentuk pelayanan profesional atau vokasional dalam konteks home care.

Contoh Pelayanan Kesehatan Professional:

·          Pemeriksaan kesehatan.

·          Pemeriksaan status psikologis.

·          Perawatan Luka.

·          Pendidikan kesehatan.

·          Terapi fisik.

·          Terapi wicara.

·          Terapi Okupasi.

·          Manajemen nyeri.

·          Pendidikan kesehatan.

·          Dll.

Adapun Contoh Pelayanan Vokasional antara lain:

·          Menyiapkan makanan.

·          Mengingatkan jadwal minum obat.

·          Mencuci pakaian.

·          Menjaga rumah.

·          Belanja ke  pasar.

·          Dll

KEMANA ARAH HOME CARE

Tahun 2005 diperkirakan 11.000 orang Indonesia berobat ke Singapura, mengapa? Kurang modernkah alat medis di Indonesia? Tidak. Kurangkah tenaga ahli di Indonesia/ Tidak. Masyarakat Indonesia yang berobat dan menjalani perawatan di Singapura rata-rata punya jawaban yang sama yaitu mendapatkan ‘pelayanan yang memuaskan’. Disinilah salah satu keuntungan konsep ‘Home Care’ karena pelayanan yang diberikan bersifat prima. Bilka kita hubungkan dengan Model Praktek Keperawatan Profesional (MPKP) maka pelayanan Home Care bersifat dilakukan oleh “Perawat Primer”.bersambung...

 

Wound Management: Using Levine’s Conservation Model to Guide Practice

author: 

Matthew J. Leach, BN(Hons), ND, PhD

Levine’s conservation model,¹ initially constructed as a teaching framework for medical-surgical nursing,² is based on the belief that nursing interventions should be aimed at conserving function.^3,4 Roberts and Taylor⁵ and Fawcett⁴ state that nurses currently use Levine’s model in practice by acting to preserve client energy and integrity — encouraging bed rest, maintaining pressure area care, and preserving privacy. To clarify the relationship between Levine’s conservation model and wound management, each of the four principles of Levine’s model will be examined. To enhance understanding of the context in which Levine’s conservation principles are presented, the underlying assumptions, definitions, and limitations of the model are discussed.

Definitions

Levine’s conservation model¹ consists of four major principles. The principles are defined as follows:

  • conservation of energy — balancing energy output and input to avoid excessive fatigue⁴

  • conservation of structural integrity — maintaining or restoring the body structure by preventing physical breakdown and promoting healing⁵

  • conservation of personal integrity — maintaining or restoring the patient’s sense of identity and self-worth⁵ and…acknowledging uniqueness⁴

  • conservation of social integrity — fostering awareness that the patient…is a social being who interacts with others⁵ in their social environment. read more...

An Overview of Tissue Types in Pressure Ulcers: A Consensus Panel Recommendation

author: 

Joyce Black, PhD, RN, CPSN, CWCN, FAPWCA; Mona Baharestani, MD, PhD, ANP, CWON, CWS; Steven Black, MD, FACS; Jamie Cavazos, RN, MSN, CWOCN; Teresa Conner-Kerr, PhD, PT, FACCWS, CWS, CLT; Laura Edsberg, PhD; Benjamin Peirce, RN, CWOCN, COS-C; Evelyn Rivera, RN, CWOCN; and Greg Schultz, PhD

 

Abstract: Pressure ulcer assessment is usually performed at the bedside by a clinician with minimal training in wound assessment. A multidisciplinary panel of United States’ wound experts was assembled to provide anatomically accurate and practical terms associated with pressure ulcer assessment, healing, and nonhealing in order to help clinicians identify and describe tissue types and pressure ulcer stages. Specifically, anatomical markers and/or structures within the wound are described to facilitate tissue type identification and pressure ulcer staging. The panel agreed that the provision of a common language facilitates quality care across settings. Although some research has been conducted, additional studies to determine the validity and reliability of wound assessment and healing terms and definitions, as well as pressure ulcer staging systems, are needed.

Accurate physical and psychosocial assessment is imperative to determine an appropriate plan of care for the patient with a pressure ulcer.¹ Chronic wounds occur in 2.8 million people in the US and cost billions of dollars to treat.² However, Patel and Granick³ examined 50 medical school curricula and found that medical students receive an average of only 4 hours of instruction on wound-related topics (including anatomy and physiology of wounds and wound healing) during their entire medical school training. Nurses receive similar minimal training. Vogelpohl and Dougherty⁴ reviewed 10 nursing textbooks and reported that on average only 200 lines of text and 10 tables were presented on wounds, some of which were inaccurate. Many nurses learn human anatomy using only textbook descriptions and pictures and lack a thorough knowledge of the appearance of human tissues in either a cadaver or surgical specimen. The lack of wound and pressure ulcer training also has an impact on practice. Subsequent inaccurate assessments of ulcer size, stage, and visible tissues may affect payment and processes of care needed to support healing can be developed in error. At times, these inaccuracies can lead to fines and litigation. read more...