Perlindungan Kesehatan Karyawan Ppi Lanjut Persi 2015

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PERLINDUNGAN PERLINDUNGAN KESEHATAN KESEHATAN PETUGAS PETUGAS HARUS DILAKSANAKAN HARUS DILAKSANAKAN DI RS & FANYANKES DI RS & FANYANKES LAINNYA LAINNYA

PENDAHULUAN

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EPIDEMIOLOGI

• 56 kasus tertular HIV paa ke!elakaa" ker#a

– 50 terpajan melalui luka tusuk

– 5 terpajan percikan cairan tubuh yang tercemar melalui mukosa

– 1 terpajan melalui tusukan dan percikan

– 52 terpajan dengan darah

– 1 terpajan cairan tubuh tercampur darah – 3 terpajan langsung dengan virus di Lab

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EPIDEMIOLOGI

Risiko terinfeksi Persentase

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D$str$%us$ Resp"e" 'erasarka" T$"aka" Saat

Ter#a$ Pa#a"a" $ (( RS) *akarta

+,,-Jenis

Tindakan

Terpajan

(n= 282)

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TABEL 24: DATA PETUGAS SESUAI PROFESI TERKENA LUKA TUSUK JARUM PERIODE 2001-2010 DI RSJPDHK

Pr0es$3Ta4u" +,,( +,,+ +,, -+,,  +,, 5 +,, 6 +,, +,, 7 +,, 8 Dkter + ( , ( ( + ( +  Pera9at  + + , + ( -  6 Petu/as Ke%ers$4a" 5 - - ( ( (  + ( Petu/as lau"r: , , , , , ( , ( , Petu/as la%ratr$u. , , , , , ( + , , Pekar:a , , , , , , , , ( Petu/as Far.as$ , , , , , , , , (

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Luka tusuk

#aru.

21.5% se!"! #$se&'$ 21.5% se!"! #$se&'$ ()*&!+!* ()*&!+!* ,.5 % se(e! ()*&!+!* ,.5 % se(e! ()*&!+!* Re/!##)* Re/!##)* Mee#!s !$'"s/!#e Mee#!s !$'"s/!#e Pe*e"#!(!* !$'" Pe*e"#!(!* !$'" Res)+ ()*) (e$)*3e+s) )+! Res)+ ()*) (e$)*3e+s) )+! &)(!*&!) &)(!*&!) L'+! &!!" L'+! &!!" D!$! (e$)!( e!s D!$! (e$)!( e!s A+)!( '+! ('s'+ !$'" A+)!( '+! ('s'+ !$'"

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PENGERTIAN

• Pe$)&'!* Kese!(!*

K!$6!7!* "e$'#!+!*

s'!(' '#!6! '*('+

"e)&') #e('!s

+ese!(!* &!$) +e!&)!*

)3e+s) (e$+!)( &e!*

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T''!* P$$!" Pe$)&'!*

Kese!(!* K!$6!7!*

• Me*)*+!(+!* $!s! !"!* +!$6!7!*

• Me"#e$(!!*+!* +ese!(!*Me"#e$(!!*+!* +ese!(!* +!$6!7!*

+!$6!7!*

• Me*'$!*) )!6!Me*'$!*) )!6! #e$!7!(!*#e$!7!(!* • Me*/e! ()"'*6! 7!!Me*/e! ()"'*6! 7!! • Me*/e! ('*('(!* '+'"Me*/e! ('*('(!* '+'"

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PROGRAM PERLINDUNGAN

PETUGAS KESEHATAN MELIPUTI

8 Pe.er$ksaa" kese4ata" %erkala_{Pe.er$ksaa" kese4ata"} %erkala 8 _{Pe"!e/a4a" pe"ulara" $"0eks$}_{Pe"!e/a4a" pe"ulara"} _$"0eks$

ter4aap

ter4aap petu/as kese4ata"petu/as kese4ata"

8 _Pe":e$aa"_Pe"_{:e$aa" Sara"a Ke9aspaaa"}_{Sara"a Ke9aspaaa"}

sta"ar sta"ar

8 Pe.%er$a" $..u"$sas$ 3pr;laks$s_{Pe.%er$a" $..u"$sas$} 3pr;laks$s

a"t$ <$rus a" <aks$" =u a"t$ <$rus a" <aks$" =u

8 Pe"atalaksa"aa_{Pe"atalaksa"a}a"" pas!apas!a luka tusukluka tusuk

%e"a ta#a. %ekas paka$ %e"a ta#a. %ekas paka$

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PE2ERIKSAAN KESEHATAN

8

_{Dilakukan secara berkala}

8

_{Khusus untuk karyawan}

_{Khusus untuk}

_{karyawan terpajan :}

_{terpajan :}

 _{1uhu tubuh}₁_{uhu tubuh dipantau}_{dipantau 29:hari}_{29:hari untuk}_{untuk petugas yang mera;at}petugas yang mera;at pasien <lu

pasien <lu BBurungurung

 _{Bila timbul}_Bila _{timbul demam6 harus menjalani uji diagnostik}demam6 harus menjalani uji diagnostik

 _{=ika penyebab tidak dapat diidentifikasi6}_=ika _{penyebab tidak dapat diidentifikasi6 dianjurkan}_{dianjurkan petugas}petugas mendapat

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Pe/e!! #e'!$! )*3e+s)

(e$!&!# #e('!s +ese!(!*

• Me!+s!!+! +ee$s)!* (!!

ses'!) )*&)+!s)

• Me'!+!* A!( Pe)&' D)$)

ses'!) )*&)+!s)

• Me'!+!* !!( !$'" &!* e*&!

(!!" !)**6! ses'!) #$se&'$

• Me'!+!* !!( e&! (!!" 6!

!"!* '('+ #e('!s +ese!(!

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Pe6e&)!! S!$!! Ke7!s#!&!!

S(!*&!$

? 1arana kebersihan tangan6 *P,6

peralatan suntik6dekontaminasi

alkes6linen6tempat limbah6 harus tersedia

cukup dan memadai

? (ndikasi kebersihan tangan dan *P,6

proses dekontaminasi alkes6 harus

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PE2'ERIAN

I2UNISASI

8 _{II"'*)s!s) He#!()()s B}_{"'*)s!s) He#!()()s B}

8 Pe"e$)!* 8!+s)* F_{Pe"e$)!* 8!+s)*} F'' ""'s)"!* 6!*'s)"!* 6!*

&)!*'$+!* 9HO

&)!*'$+!* 9HO __ )+! +*(!+ &e*!* )+! +*(!+ &e*!* #!s)e* #e*6!+)( "e*'!$ "e!') '&!$! #!s)e* #e*6!+)( "e*'!$ "e!') '&!$!

airborneairborne_;;

8 K!&!$ !*()&) #$(e+()3 #e$'_{K!&!$ !*()&) #$(e+()3} #e$' &)&)#e$)+s!#e$)+s!

2

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Pe!(!!+s!!!* #!s+! '+! ('s'+

!$'" !(!' e*&! (!!" e+!s

#!+!)

8

Pe$)+s! s(!('s +ese!(!* #e('!s

(e$#!!*

8

Ke(!') s(!('s +ese!(!* s'"e$

#!!!

8

T)&!+! ses'!) e)s #!#!$!

8

Te$!#+!* #$<!+s)s #!s/! #!!!

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TINDAKAN PERTA2A PADA PA*ANAN TINDAKAN PERTA2A PADA PA*ANAN

'AHAN KI2IA ATAU

'AHAN KI2IA ATAU DARAH3DARAH3>AIRAN>AIRAN TU'UH

TU'UH

8 _M!(! __{see$! )!s &e*!* !)$ "e*!)$}

se!"! 15 "e*)(

8 _K')( __{see$! )!s &e*!* !)$ "e*!)$ 1}

"e*)(

8 M''( _ see$! +'"'$-+'"'$ se!"! 1 "e*)( 8 _{See$! ''*) D+(e$ 6!* e$7e*!*}

'*('+ "e!+'+!* #e$!7!(!* #!s/! #!!*!*

8 _{L!#$ +e K")(e  T)" PPI  #!*)()! K=RS !(!'}

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• >'/) &e*!* !)$ "e*!)$ "e*'*!+!* s!'*_{>'/) &e*!* !)$ "e*!)$ "e*'*!+!* s!'*} !(!'

!(!' /!)$!* !*()se#()+/!)$!* !*()se#()+ (!*#! "e!+'+!* (!*#! "e!+'+!* #e")!(!*

#e")!(!*

• Be$)+!* /!)$!* !*()se#()+ #!&! !$e! (e$('s'+ '+!_{Be$)+!* /!)$!* !*()se#()+ #!&! !$e! (e$('s'+ '+!}

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Tindak lanjut Tim PPI :

- Tentukan status HIV, HBV, dan HCV sumber pajanan

- Periksa status HIV, HBV, dan HCV petugas yang terpajan - Monitoring dengan pemeriksaan laboratorium

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? Bila status pasien bebas H(6HB6H% dan bukan

dalam masa inkubasi tidak perlu tindakan khusus untuk petugas terhadap H(6HB6H%6 tetapi bila petugas

kha;atir dapat dilakukan konseling

? Bila status pasien H(6HB&H% positif maka tentukan status H(&HB6H% petugas kesehatan tsb

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See'" &)!+'+!* #$e (es( &!* #s( (es( (e$!&!# #e('!s 6!* (e$#!#!$ !$'s &)!+'+!* +*se)*

&'' *!"'* s!!( )*) (!*#! +*se)* &!#!( &)!+'+!* #e"e$)+s!!*

P$e (es( '*('+ "e*e(!') !#!+! #e('!s s'&! (e$)*3e+s) see'"*6!

J)+! !s) #$e (es( #s)()3 e!s !7! #e('!s s'&! (e$)*3e+s) see'"*6!

J)+! !s) #$e (es( *e!()3 se"e*(!$! s'"e$ P!s)e* #s)()3 HB? "!+! &)e$)+!* )""'*)s!s) HB? )! #!s)e* #s)()3 HI? $''+ +e T)" AIDS

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- Berikan dukungan kepada petugas yang terpapar

- Bila hasil pre test HIV pasien negatif petugas tetap di konseling

-Pemeriksaan ulang dilakukan,  minggu, ! bulan dan  bulan

-"apat minum obat #$V untuk memperke%il risiko penularan, jika luka tusuk & ' jam

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• P$<!+s)s &)e$)+!* se!"! 2 !$)

• D)'('+!*

D)'('+!* &'+'! #s)+ss)!

&'+'! #s)+ss)!

• Pe"e$)+s!!* !$!($)'" '*('+

Pe"e$)+s!!* !$!($)'" '*('+

"e*e(!')

"e*e(!') #$ses

#$ses )3e+s) &!

)3e+s) &!

"e"*)($

"e"*)($ e3e+

e3e+ (+s)

(+s)+

+ !(

!( AR?

AR?

• Tes HI? &)'! se(e! @ ")' =

Tes HI? &)'! se(e! @ ")' =

'!* &!* @ '!*

21NIT1RING PPP?HIV

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8 T!!( "e*e$!#+!*_{T!!( "e}*e$!#+!* K K e7!s#!&!!*e7!s#!&!!* Is!s) :Is!s) :

S(!*&!$ &!* Be$&!s!$+!* T$!*s")s) S(!*&!$ &!* Be$&!s!$+!* T$!*s")s)

8 _{Me*!! +ese!(!}_{Me*!! +ese!(}_{!* s!'$!*}_{* s!'$!* *!#!s}_{*!#!s ()&!+}_()&!+

"e$++ "e$++;;

8 _{Me*!! +ese!(!* ('' se/!$! '"'"}_{Me*!! +ese!(!* ('' se/!$! '"'"} 8 _{Me*!! +ee$s)!*}_M_{e*!! +ee$s)!* &)$)}_&)$)

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 L!+'+!* +ee$s)!* (!*!* ")*)"! 5 s!!(  G'*!+!* !+) )! "e"e$)+!* e*&! (!!"  Pe*&)&)+!*  !()!* e$+es)*!"'*!*

 G'*!+!* APD ses'!) e*)s ()*&!+!*

 B!/! e()+e( !(/!)$!* see'" &)e$)+!* 8_{T)&!+ "e"!*)#'!s) !$'" e+!s #!+!)}_{T)&!+ "e"!*)#'!s) !$'" e+!s #!+!)}

 T)&!+ "e*6!$'*+!* +e"!) !$'" 6!*

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• BB'!* !$'" e+!s #!+!) #!&! +*(!)*e$'!* !$'" e+!s #!+!) #!&! +*(!)*e$ 6!* (e! &)se&)!+!*

6!* (e! &)se&)!+!*

• J!*!* #e$*! "e"e$)+!* !$'" e+!s J!*!* #e$*! "e"e$)+!* !$'" e+!s #!+!) +e#!&! $!* '*('+ &)'!*

#!+!) +e#!&! $!* '*('+ &)'!* • B'!* +*(!)*e$ !$'" )+! s'&!B'!* +*(!)*e$ !$'" )+! s'&! 2=2=

#e*' #e*'

• BB'!* s!"#! ses'!) (e"#!(*6!'!* s!"#! ses'!) (e"#!(*6! • J!! +ee$s)!* )*+'*!* J!! +ee$s)!* )*+'*!*

• J!! #e$"'+!!* !*(!) (e(!# +e$)* &!* J!! #e$"'+!!* !*(!) (e(!# +e$)* &!* ()&!+ )/)*

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• Le#!s+!* !$'" "e"!+!) !!( 6!* (e#!(Le#!s+!* !$'" "e"!+!) !!( 6!* (e#!( !(!' '!* !$'" e$s!"! s6$)*e

!(!' '!* !$'" e$s!"! s6$)*e

• B'!* !$'" #!&! +*(!)*e$ 6!* (!!*B'!* !$'" #!&! +*(!)*e$ 6!* (!!* ('s'+

('s'+!*!* &!* (!!* /$&!* (!!* /$

• G'*!+!* s)s(e" ?!/'(!)*e$G'*!+!* s)s(e" ?!/'(!)*e$

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8 _{Pe('!s "e*&e$)(!}_Pe('!s _{"e*&e$)(! C'}_{C' &)")*(!}_{&)")*(! ()&!+ "e$!7!(}_{()&!+ "e$!7!( !(!'}_!(!'

+*(!+ &e*!* #!s)e*

+*(!+ &e*!* #!s)e* ))"'*"'*)(!s $e*&!)(!s $e*&! )"'*+"#$"!)s;

)"'*+"#$"!)s;

8 Pe('!s 6!* &e"!"  "e*&e$)(!_{Pe('!s 6!* &e"!"} "e*&e$)(! !*'!*!*'!*

#e$*!3!s!* &!!" 10 !$) se(e! (e$#!!* #e$*!3!s!* &!!" 10 !$) se(e! (e$#!!*

#e*6!+)( "e*'!$ "e!') '&!$!

#e*6!+)( "e*'!$ "e!') '&!$! airborneairborne_{;; #e$'}_#e$' &)e!s-('!s+!* &!* !$'s &))s!s)

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KESIMPULA

1.

1. Pe"e$)+s!!* +ese!(!* $'()* (e$!&!#Pe"e$)+s!!* +ese!(!* $'()* (e$!&!#

#e('!s &) $'"! s!+)( "e$'#!+!* +e)!+!* #e('!s &) $'"! s!+)( "e$'#!+!* +e)!+!*

6!* "e*!&) #$)$)(!s &!$) "!*!e"e* 6!* "e*!&) #$)$)(!s &!$) "!*!e"e* 2.

2. S!$!*! &!* #$!s!$!*! !&!! ! 6!*S!$!*! &!* #$!s!$!*! !&!! ! 6!* "e*!&) #$)$)(!s '*('+ &)se&)!+!* e "e*!&) #$)$)(!s '*('+ &)se&)!+!* e

"!*!e"e* "!*!e"e* =.

=. Pe('!s e+e$! !$'s ses'!) &e*!*Pe('!s e+e$! !$'s ses'!) &e*!* s(!*&!$ 6!* (e! &) (e(!#+!*

s(!*&!$ 6!* (e! &) (e(!#+!* 4.

4. See$! !#$+!* +e!&)!* +e/e!+!!* +e$! &)See$! !#$+!* +e!&)!* +e/e!+!!* +e$! &) $'"! s!+)( se#e$() (e$('s'+ e*&! (!!"

$'"! s!+)( se#e$() (e$('s'+ e*&! (!!" !)s #!+!)

Perlindungan Kesehatan Karyawan Ppi Lanjut Persi 2015

PENDAHULUAN

PENDAHULUAN

EPIDEMIOLOGI

EPIDEMIOLOGI

Risiko terinfeksi Persentase

HB

!0"#5

$

H%

2&'

$

H(

0&#

$

+,,-Jenis

Tindakan

Terpajan

(n= 282)

%

Pe.asa"/a

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