Development of an enterostomal therapy nurse outpatient wound clinic in Indonesia:

a retrospective descriptive study Saldy Yusuf1,2 Sukmawati2, Mayumi Okuwa1,

Junko Sugama1., Andi Afinda3

1,2Clinical Nursing Department, Kanazawa University-Japan2Griya Afiat, Wound Care and Home Care Clinic, Makassar-Indonesia

3ETN Centre Makassar-Indonesia

Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47

Asia Pacific Wound Care Congress, 6 – 8 Juni 2013, Manado - Indonesia

Development of an enterostomal therapy nurse outpatient wound clinic in Indonesia:

a retrospective descriptive study Saldy Yusuf1,2 Sukmawati2, Mayumi Okuwa1,

Junko Sugama1., Andi Afinda3

1,2Clinical Nursing Department, Kanazawa University-Japan2Griya Afiat, Wound Care and Home Care Clinic, Makassar-Indonesia

3ETN Centre Makassar-Indonesia

Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47

Asia Pacific Wound Care Congress, 6 – 8 Juni 2013, Manado - Indonesia

Background (latar belakang)

1. http://www.worldatlas.com/aatlas/populations/ctypopls.htm2. http://news.detik.com/read/2012/04/05/201034/1886357/10/dpr-targetkan-ruu-keperawatan-selesai-tahun-ini3. http://www.nurse.or.jp/toukei/pdf/toukei01.pdf4. http://www.globalhealthfacts.org/data/topic/map.aspx?ind=755. Stott, C. (2010). Stomal therapy nursing in Indonesia. Journal of Stomal Therapy Australia, 30(3), 20–27.6. www.nurse.or.jp7. Suriadi, Sanada H, Sugama J, Thigpen B, Subuh M. Development of a new risk assessment scale for predicting pressure ulcers in an intensive care unit. Nurs Crit Care 2008;13:34–43.8. Sanada H, Miyachi Y, Ohura T, Moriguchi T, Tokunaga K, Shido K, Nakagami G. The Japanese pressure ulcer surveillance study: a retrospective cohort study to determine prevalence of

pressure ulcers in Japanese hospitals. Wound 2008;2:176–82

INDONESIA JEPANG

Populasi 1 234.181,400 127.380,000

Jumlah Perawat2,3 624.000 1.470.421

Rasio Perawat4

Per 10.000 penduduk20 41

Jumlah ET Nurse/WOCN5,6

67 1.598

• RS. Pemerintah.• RS. Swasta.• RS. Pendidikan.• RS. Khusus.• RS. Militer.

Indonesian Health Care System(Sistem kesehatan di Indonesia)

Hospital Public Health Centre

Outpatient Clinic

• Puskesmas Utama.• Puskesmas

Pembantu.• Posyandu.

• Praktek Dokter.• Praktek Bidan.• Praktek Perawat.• Dll.

Curative & Rehabilitative

Promotive & Preventive Supportive

Development ET Clinic: AdministrationProses Administrasi Izin Praktek

Pemohon PPNI Dinas Kesehetan

Surat RekomendasiSurat Permohonan Surat Izin Praktek Perawat

Pemohon

Berlaku 5 tahunDiajukan Ke Dinas KesehatanHarus Anggota PPNI

Development ET Clinic: Preparation

Bed, Sterilization set, instrument set, trolley, home care set, digital

camera, office desk, printer, PC desktop, phone and

internet line.

Supplier

Staffing Infrastructure

Payment strategy

• Total payment (pay dressing and nursing care).• Partial payment (pay just

dressing).• No payment (free at all).

1 ET Nurse

1 General Nurse2 Associated Nurse

Lobby

ClinicOffice

Branding

Clinic Layout

Results

Tabel 1: Demographic Data

Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47

Tabel 2: Tipe dan Klasifikasi Luka

Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47

Wound Status

Dermatitis Burn Surgical Site Infection

Pressure Ulcers Cancer Diabetic Foot Ulcers

Tabel 3: Data Awal Ukuran Luka

Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47

Tabel 4: Durasi Perawatan dan Frekuensi Kunjungan

Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47

Tabel 4: Tipe dan Klasifikasi Luka berdasarkan proses penyembuhan

Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47

Diskusi

Masalah baru• Tingginya angka drop out pada pasien luka kronis

yakni 38.4 %.• Ada beberapa alasan, mengapa pasien drop out

dalam perawatan:– Faktor biaya.– Tidak ada dukungan keluarga.– Tidak ada waktu.– Budaya Mencoba mencari terapi alternatif.– Kurang pengetahuan Persepsi pasien dan keluarga

tentang luka dan proses penyembuhannya berbeda jauh.

Diskusi

Masalah baru

Conclusion (Kesimpulan)

ETN Clinic di Indonesia merupakan sistem pelayanan kesehatan primer yang bisa meningkatkan kualitas perawatan,

menurunkan biaya, menurunkan masa perawatan, menurunkan komplikasi dan meningkatkan proses penyembuhan

Outpatient ET Nurse clinic is a new healthcare in Indonesia which offers quality of care which reduce cost, reduce

dressing and nursing time, reduce complication and increase healing process.

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Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47

Thank you very much