PENGANTAR KEPERAWATAN

MEDIKAL-BEDAH
by. Ns., Asep Solihat, S.Kep., M.Kep.
Tujuan Pembelajaran

• Memahami Konsep dan ruang lingkup

keperawatan medikal bedah,
• Memahami peran perawat medikal bedah,
• Memahami standar pelayanan keperawatan
medikal bedah
Contents:

• Perawat Medikal-Bedah
• Fokus Kep. Medikal-Bedah
• Apa yang Dibutuhan Perawat Medikal-Bedah
• Positioning Kep. Medikal-Bedah
• Lingkup Praktik Kep. Medikal-Bedah
• Peran Perawat Medikal-Bedah
Who is Nurse in Medical-surgical nursing?

Medical-surgical nurses are

nurses provide nursing care to
adults experience complex
variation in health.

(Canadian Association of Medical and Surgical Nurses, March 2012)

Who is Nurse in Medical-surgical nursing?

Registered nurses in this specialty practice

primarily on hospital units and care for adult
patients who are acutely ill with a wide variety of
medical problems and diseases or are recovering
from surgery.

https://www.amsn.org/practice-resources/what-medical-surgical-nursing
Who is Medical-Surgical Nurse Specialist?

The Medical-Surgical Clinical Nurse Specialist

(CNS) is the clinical expert in evidence-based
nursing practice in adult health care.

https://www.amsn.org/sites/default/files/documents/practice-resources/scope-and-standards/AMSN-
Scope-Standards-MS-CNS.pdf
 The Focus of MedSurg Nursing

The Focus of MedSurg Nursing is on the

adulth client with acute and chronic illness
in any health care setting or on the client
who is at risk for illness
(Ignatavicius & Workman, 2006, p 6)
What is Needed by a Nurse Specialist In Medical-
surgical Nursing?

..need a have broad knowledge of the biologic,

psychological, and social sciences....,
because their clients have a
range of needs, to achivement of an optimal
level of wellness & the prevention of illness.

(Ignatavicius & Workman, 2006, p 6)

POSITIONING

• MedSurg nursing adalah dasar dari semua praktik

keperawatan.
• Saat ini lebih banyak perawat memilih bekerja
dlm spesialisasi MedSurg nursing.
Practice Setting for MedSurg Nurses (Scope)—1

• Hospital setting:
• Critical care unit
• Intermediate or specialty care unit
• Long term care units
• Community-based (home care) setting
to provide care for primarily adult patients before and after surgical
procedures.

(http://allnurses.com/medical-surgical-nursing/; Ignatavicius & Workman, 2006)

Practice Setting for MedSurg Nurses (Scope)—2

• Unit Keperawatan Kritis:

• Area utk ps dg keadaan komplek & kritis.
• Shock, trauma, neurosurgical.
• Departemen emergensi.
• Perawat:
• punya sense thd situasi krisis
• mampu tetap efektif pada situasi stresfull
• rasio p:k = 1:2 atau 1:3

(Ignatavicius & Workman, 2006)

Practice Setting for MedSurg Nurses (Scope)—3

• Long-Term Care Unit:

• Pasien membutuhkan perawatan dlm waktu
lama: beberapa minggu-bulan
• Sinonim dg nursing home care
• Unit perawatan transisi
• Fasilitas perawatan kronik
• Pusat rehabilitasi

(Ignatavicius & Workman, 2006)

The Role of MedSurg Nurse

• Coordinator of care
• Caregiver
• Continuing care planner
• Educator
• Researcher

(Ignatavicius & Workman, 2006, pp. 6-7)

 Caregiver

Researcher Advocate

Peran
Perawat
MedSug

Manager Educator
Coordinator of care

• Tidaklah mudah memenuhi semua kebutuhan

pasien.
• Sebagai koordinator—perlu berkolaborasi dg tim
kes lain secara interdisiplin
• Melalui “ronde klinik interdisiplin” dan “metode
komunikasi lainnya” mempermudah proses
perencanaan dan implementasi

(Ignatavicius & Workman, 2006, p 6)

Caregiver

• Assess client
• Analyzies collected information to determine client’s
need
• Develop “nursing diagnosis” and “collaborative
problems” Nursing
process
• Develop “care plan” and “carry out the plan with the
health care team”
• Evaluate care given.

(Ignatavicius & Workman, 2006, p 6)

Caregiver

• Memenuhi kebutuhan fisik, psikososial dan spiritual.

• Aktivitasnya di kategorikan sbg:
• Independen
• Dilakukan perawat tanpa dipengaruhi tim kes lain.
• Misalnya: elevating the head of bed to facilitating breathing or
reducting intracranial pressure
• Kolaboratif (interdependen)
• Ditentukan bersama-sama perawat dan anggota tim kes
lain. Misalnya: pemberian diet khusus
• Diorder oleh tim kes lain tetapi membutuhkan judgment
perawat untuk melakukannya. Misalnya: pemberian
medikasi
(Ignatavicius & Workman, 2006, p 6)
Continuing care planner

• Saat ini pelayanan kes telah menekankan “pemulangan dini (early discharge)”
dari rumah sakit.
• Peran MedSurg Nurse sbg “perencana asuhan lanjutan” menjadi penting
• Proses:
• Mengkaji kebutuhan kesehatan ps
• Mengkaji kebutuhan pendidikan kes
• Mengkaji keadaan rumah: sumber2, support system, dan peralatan, jika
dibutuhkan
• Dilakukan oleh discharge planner atau case manager (umumnya perawat, dapat
juga social worker)

(Ignatavicius & Workman, 2006, p 6)

Educator

• Pendidikan pd klien merupakan komponen utama dalam

Kep. MedSurg.
• Bekerja dalam tim kes. utk meningkatkan kes klien melalui
proses belajar klien ttg promkes, penanganan keadaan
sakit, dan penanganan khusus.
• Peran ini semakin penting lagi, karena kebijakan rumah
sakit untuk melakukan pemulangan dini.

(Ignatavicius & Workman, 2006, p 6)

Researcher

• Terlibat aktif dlm penelitian

• Menggunakan hasil penelitian ke dalam praktik
 wassalam

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