Penanggulangan Bencana

di Rumah Sakit.

Ns Chandra W SKp,Mkep,SpMat
Bencana di Rumah Sakit:
• Situasi di RS dalam keadaan bencana:
▫ Kemampuan terlampaui ---- chaos ---- pelayanan sub standard
• Rencana Penanggulangan Bencana di Rumah Sakit:
▫ Hospital Disaster Plan
• Mengatur penanganan pasien yang jumlahnya banyak, saat
bencana:
▫ Organization of Mass-Admission of Patients in the Hospital (
OMP )
• Tujuan / target:
▫ Keadaan chaos sesingkat mungkin
▫ Mortalitas dan morbiditas serendah mungkin
▫ Distribusi pasien ke RS-RS merata
▫ Tidak meninggalkan pelayanan individu
Pelaksanaan:
• Bekerja semaksimal mungkin dengan
meningkatkan daya kemampuan
• Tidak meninggalkan prinsip penanganan
individual
• Melanjutkan penanganan pasien yg sudah ada di
RS sebelemnya
• Mengatasi problem non medis akibat bencana
• Mendukung pelayanan di area bencana.
Prinsip PB-RS
• Bukan sekedar eskalasi / peringatan dini
• Based on existing organizational structures
( supaya pelayanan rutin tdk terganggu )
• As simple as possible, as comprehensive as
necessary
• OMP fro preparedness, Check-list during
emergency
Prinsip organisasi
• Bukan sekedar eskalasi / peringatan dini
• Ramping
• Pelimpahan wewenang yang cepat
• Markas yg sudah disiapkan berserta
pendukungnya
• Siapkan fasilitas – protap – personil sesuai
rencana
• Collapsable Concept
 Organisasi PB-RS:
Coordination Team

Medical
Coordinator

Senior
Senior Senior
Emergency
Manager Nurse
Physician
 Organisasi PB RS Tipe D / Puskesmas Ranap

Ketua Tim
Medis

Seksi Seksi Seksi

Administrasi Keperawatan Medis

Operator Dokter Gadar /

Ranap UGD Laboratorium
telpon Spesialis

Pekarya
 Senior Manager

Operation Management Facilities

Suport

Senior Press
Telephonist Officer

Senior Senior Senior Senior Senior Volunteer Religious Senior

Porter Transport Enquiries Security Admissions Coordinator Officer Social
Manger Officer Manager Officer Worker

Creche Medical Senior Senior TSSU CSSU Senior Linen

Manager Photographer Engineer Catering Manager Manager Supplies Service
Manager Manager Manager

The Management Hierarchy

 Medical
Coordinator

Medical Support Senior

Services Emergency
Physician

Consultan Consultan Senior Consultan Consultant Consultan House Sub-Spciality Senior Senior Senior
Haemato- Biochemist MLSO Pathologist Psychiatrist Radiologist Officers Consultants Phamacist Surgeon
logist SpRs Physician

Surgical
Senior Radiologist Area Senior Senior
Radiographer On-call Intensivist Paediatrician
MLSO MLSO MLSO
Biochemistry Haematology Transfusion

Duty Senior Senior

Radiographer Surgeon Anaes
Theatres thetis

Senior Senior Specialist Operating Trans-

Surgeon Surgeon Operating Teams fer
Pre-Op Post-Op Teams Teams

P1 & P2 P3

Paediatric Treatment Surgeon Treatment Physician

Assessment Teams Minors Teams Minors
Teams

The Clinical Hierarchy

 Senior Nurse

Senior Nurse Senior Nurse Senior Nurse Senior Nurse Senior Nurse
ED Discharge Area ITU Theatres Wards

Triage Senior Senior Senior Team ITU Senior ODP/ Theatre Senior Senior Senior Senior
Nurse Nurse Nurse Nurse Coordinator Nurses Anaesthetic Nurse Nurse Nurse Nurse Nurse
P3 Admissions Paediatrics Pre-Op Post-Op
P1 Resus P2 Nurse Wards

Treatment Treatment Treatment Anaesthetic

Team Team Team Nurses/
Nurses Nurses Nurses
P1 P2 P3
ODPs

The Nursing Hierarchy

Harus ada Pengembangan Pengembangan

1 2
 Organisasi PB-RS

DIREKTUR
RS

Pelaksana / eksekutor
Laiason
Officer
Bertanggung jawab ke Direktur
Ketua Tim

Menejemen Koordinator Koordinator

RS Paramedis Medis

Profesional / mandiri / self generating

Bertanggung jawab ke ketua tim
 Organisasi PB-RS

Ka UGD
( Dokter Jaga
Bedah

KaBid YanMed
KaBid Pelayanan KaBid Perawatan
( Dokter Jaga
( Case Manager ) ( KaRu UGD )
UGD )

Logistik Tehnik Perawat ICU Perawat OK Bedah Anestesib

 Organisasi PB-RS

Ka UGD
( Dokter Jaga
Bedah

KaBid KaBid KaBid

Tim Penunjang
Pelayanan Perawatan YanMed
Lapangan Medis
( Case Manager ) ( KaRu UGD ) ( Dr Jaga UGD )

Logistik Tehnik Relawan Komunikasi Perawat ICU Perawat OK Bedah Anestesi Lab. Radiologi

OK

UGD
 Prosedur tetap
Rapid Health Assessement
Peringatan dini
Aktivasi
Pelaporan
Koordinator Standar SDM
Hazard maping
Networking
Koordinasi relawan
Bidang Bidang Bidang
Menejemen Keperawatan Medis

Pengaturan Media Rekruitmen tim Rekruitmen tim

Menejemen relawan Persiapan OK Triase
Logistik medis Persiapan Triase Area cadangan
Komunikasi Rujukan
Cadangan listrik
Logistik team
Transportasi
 Standar Pelatihan

Disaster Management
Incident Commander
HOPE
Koordinator

Bidang Bidang Bidang

Menejemen Keperawatan Medis

HOPE PPGD ATLS

Komunikasi medik Perawat ICU ACLC
Menejemen logistik Perawat OK First reponder
Struktur gedung Komunikasi medik
Ekstrikasi
The Ten Commandments

1. Scope and Run

2. Patient flooding
3. Write plant
4. Surge capacity
5. Triage at Hospital
6. Care Priorities
7. Mental Health
8. Family care
9. Decontamination
10. Drill