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Pelayanan Anestesi dan Bedah

Pada standar akreditasi SNARS ED 01, disebutkan tindakan anestesi, sedasi, dan intervensi bedah merupakan proses yang kompleks dan sering dilaksanakan di rumah sakit. Hal tersebut memerlukan:

  1. asesmen pasien yang lengkap dan menyeluruh;
  2. perencanaan asuhan yang terintegrasi;
  3. pemantauan yang terus menerus;
  4.  transfer ke ruang perawatan berdasar atas kriteriatertentu;
  5. rehabilitasi;
  6.  transfer ke ruangan perawatan dan pemulangan.

Anestesi dan sedasi umumnya merupakan suatu rangkaian proses yang dimulai dari sedasi minimal hingga anastesi penuh. Oleh karena respons pasien dapat berubah-ubah sepanjang berlangsungnya rangkaian tersebut maka penggunaan anestesi dan sedasi diatur secara terpadu. Dalam bab ini dibahas anestesi serta sedasi sedang dan dalam yang keadaan ketiganya berpotensi membahayakan refleks protektif pasien terhadap fungsi pernapasan. Dalam bab ini tidak dibahas penggunaan sedasi minimal (anxiolysis) atau penggunaan sedasi untuk penggunaan ventilator.

Karena tindakan bedah juga merupakan tindakan yang berisiko tinggi maka harus direncanakan dan dilaksanakan secara hati-hati. Rencana prosedur operasi dan asuhan pascaoperasi dibuat berdasar atas asesmen dan didokumentasikan.

Standar pelayanan anestesi dan bedah berlaku di area manapun dalam rumah sakit yang menggunakan anestesi, sedasi sedang dan dalam, dan juga pada tempat dilaksanakannya prosedur pembedahan dan tindakan invasif lainnya yang membutuhkan persetujuan tertulis(informedconsent). Area ini meliputi ruang operasi rumah sakit, rawat sehari, klinik gigi, klinik rawat jalan, endoskopi, radiologi, gawat darurat, perawatan intensif, dan tempat lainnya.

Sedasi dan anestesi biasanya diartikan sebagai satu jalur layanan berkesinambungan dari sedasi minimal sampai anestesi dalam. Respons pasien bergerak mengikuti jalur ini dan selama menjalani perjalanan ini pasien menghadapi risiko pada refleksprotektif  jalan napas pasien. Sedasi dan anestesi adalah proses kompleks sehingga harus diintegrasikan ke dalam rencana asuhan. Sedasi dan anestesi membutuhkan asesmen lengkap dan komprehensif serta monitoring pasien terus-menerus. Rumah sakit mempunyai suatu system untuk pelayanan anestesi, serta sedasi moderat dan dalam untuk melayani kebutuhan pasien, kebutuhan pelayanan klinis yang ditawarkan, serta kebutuhan para PPA yang memenuhi peraturan perundang-undangan dan standar profesi. Pelayanan anestesi, serta sedasi moderat dan dalam (termasuk layanan yang diperlukan untuk kegawatdaruratan) tersedia 24 jam
Elemen Penilaian

  1. Rumah sakit menetapkan regulasi pelayanan anestesi, serta sedasi moderat dan dalam yang memenuhi standar profesi serta peraturan perundang-undangan.(R)
  2. Pelayanan anestesi, serta sedasi moderat dan dalam yang adekuat, regular, dan nyaman tersedia untuk memenuhi kebutuhan pasien,(O,W)
  3. Pelayanan anestesi, serta sedasi moderat dan dalam (termasuk layanan yang diperlukan untuk kegawatdaruratan) tersedia 24 jam.(O,W)

Pelayanan anestesi, serta sedasi moderat dan dalam berada di bawah penanggung jawab pelayanan anestesi   yang   memenuhi  peraturan   perundang-undangan.

Tanggung jawab pelayanan anestesi, serta sedasi moderat dan dalam meliputi:

  • mengembangkan, menerapkan, dan menjaga regulasi;
  • melakukan pengawasan administratif;
  • menjalankan program pengendalian mutu yang dibutuhkan.

Sumber : Pedoman Akreditasi Rumah Sakit KARS

 

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