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 patient’s 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
• Encourage implementation of PEP if needed
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 patient’s 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 patient’s 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