Overview of

Critical Care
Nursing
Sri Wulandari N., M.Kep., Ns.Sp.Kep.An.
What Critical Care Nurse Do ?

What Nurse Do ?
1. Attend human
experience &
responce
2. Integrate objective
data
3. Apply scientific
knowledge
4. Establish a caring
relationship
Critical care Nurses Do ...

1. Critical care nurses deal with
human responses to life
threathening problems
2. The scope of practice
includes all ages and involves
a dynamic interaction
between critically ill patients,
the patients family, dritical
care nurse and the
environment
3. Framework of practice
Framework of Practice
Support & maintain physiologic stability of
patients
Assimilate & prioritize infomation focused
action
Respond with confidence & adapt to rapidly
changing patients conditions
Framework...contd
Respond to the unique needs of patient
and family
Manage appropriately interface between
the patients & technology
Monitor & allocate critical care services
The Environment of Critical Care
Complexity
requiring
vigilance
Organizational
model for
humane,
caring &
healing
environment
Patient safety

Complexity Vigilance
Critically ill patients require
complex assesment and
therapies, high-intensity
interventions, and continous
vigilance
1. Critical care nurse workes with interdiciplinary team. Five
elements of an organizational model for health and healing:
a. Common values of health as a function of mind-body-
spirit interrelationships
b. Patient & family-centered philosophy
c. Physical environment that support healing
d. Use of complementary and alternative therapies as well
as conventional therapies
e. Organizational culture that promotes personal growth
Organizational Model
Contd...
2. Critical care nurse is a constant in the environment & works to
develop an organizational culture that support the following:
a. Providers that acts as advocates on behalf of patients, family
& communities
b. The dominance of the patients & familys value
c. Practise based in research & driven by outcomes
d. Ethical decision making
e. Collaboration
f. The fostering of leadership at all levels & in all activities
g. Lifelong learning as fundamental to professional growth
h. Optimalization of existing talents & resources
i. The rewarding of innovation & creativity
j. Respect for diversyty
Patient Safety Goals (JCAHO, 2006)
Patient Identity
Communication
Safety
medications
Safety for
operative/inva
sive prosedure
Hand hygiene
Fall reduction
program
Model Sinergi
Rumusan Model Sinergi disusun oleh
American Association of Critical Care-Nurse
(AACN).
Menjelaskan praktik keperawatan menurut
kebutuhan dan karakteristik pasien bukan
pada penyakit dan modalitas pengobatannya.
Ketika karakteristik pasien dan kompetensi
perawat cocok & bersinergi, hasil pasien yang
optimal dapat tercapai
Description of Synergy Model
Patient/family
needs
Resilency
Vulnerability
Stability
Complexity
Predictability
Resource availability
Participation in care
Participation in decision
making
Nurse
Competencies
Clinical judgement
Clinical inquiry
Collaboration
System thinking
Advocacy / moral
agency
Caring practice
Response to diversity
Facilitator of learning
Patient
Outcome
(Synergy)
Comfort & healing
Satisfaction with care
Absence of complication
Perceived change in
function
Perceived improvement
in quality of live
Decreased recidivism
Efective cost resource
utilization balance
Karakteristik Pasien
Kemampuan mengembalikan fungsi restoratif
Menggunakan mekanisme koping
Resilensi
Mudah terserang stressor
Menghasilkan efek yang merugikan
Kerentanan
Keterlibatan yg kompleks dari dua atau lebih
sistem (mis: tubuh, klg, terapi)
Kompleksitas
Sumber: teknis, personal, sosial, psikologis
Ketersediaan
Sumber
Karakteristik Pasien (contd)
Seberapa jauh pasien &klg terlibat dalam
aspek perawatan
Partisipasi dlm
Perawatan
Seberapa jauh pasien &klg terlibat dalam
pengambilan keputusan
Partisipasi dlm
Pengambilan
Keputusan
Kemampuan pasien dalam memperkirakan
perjalanan penyakit
Kemampuan
Memperkirakan
Kompetensi Perawat
Kompetensi Deskripsi
Penilaian Klinis Pengambilan keputusan klinis, berpikir kritis,
pemahaman menyeluruh thd situasi, keterampilan
keperawatan (pengetahuan formal +
pengalaman).
Advokasi Berfungsi sbg agen moral dalam mengidentifikasi
dan membantu menyelesaikan masalah etis dan
klinis di tatanan klinis.
Praktik caring Aktivitas yg responsif thd keunikan pasien & klg,
menciptakan lingkungan yg menyayangi &
terapeutik, bertujuan meningktkan kenyamanan.
Kolaborasi Bekerjasama dg pasien, keluarga, & tim kesehatan
lain.
Kompetensi Perawat (Contd)
Kompetensi Deskripsi
Pemikiran Sistem Landasan pengetahuan & Instrumen yg
mendukung perawat u/ menghargai lingkungan
perawatan dari sudut pandang holistik .
Respon terhadap
keragaman
Kepekaan dalam mengenali , menghargai, dan
memadukan perbedaan dalam pemberian
perawatan.
Peneliti Klinis / inovator Proses berkelanjutan dalam praktik, membuat
inovasi melalui penelitian & pembelajaran
eksperiensal, terlibat dalam pengembangan
pengetahuan klinis.
Fasilitator pembelajaran Kemampuan memfasilitasi pembelajaran pasien,
staf keperawatan, tim kesehatan lain.