Global Nurses Assistance

Alhamdulillah, sekali lagi saya telah membuktikan bahwa saya bisa,
Bahwa perawat indonesia layak untuk bekerja profesional di Luar negeri. Ya saat ini saya telah tercatat sebagai seorang Clinical Instruktor di Colej Shahputra Kota Kwantan Malaysia.

Sebuah Perguruan tinggi swasta di negeri jiran yang telah menerapkan twining program bekerjasama dengan University of Cambridge .

About Kolej Shahputra



Kolej SHAHPUTRA, formerly known as Institute Fitra, was incorporated on 1st February 1998 and is wholly owned by Graduate Achievement Studies Centre Sdn Bhd (100% Bumiputera Equity). It officially changed its name on 28 August 1998 due to the changing needs and dynamic global aims. The main objective is to provide top quality education and
training.

Kolej SHAHPUTRA started its operations in April 1998 in Kuantan. Its first intake comprised of 17 students from Universiti Putra Malaysia (UPM) undertaking the Matriculation TESL program. Later, Kolej SHAHPUTRA moved its operations to the royal town of Pekan due to the increase in the student population.

Through effective marketing strategies and the high quality education provided by the college, as well as support from various quarters, the college enrolment increased to 4,000 students and 218 staff, as on 1st August 2003.

To accommodate the increase in the number of students, and as a prelude to the setting up of its new main campus, the college move its operations to Indera Mahkota, Kuantan.

Dibawah ministry of Health of Kuwait.

Kuwait adalah negara yang tidak saja kaya akan minyak tapi negara yang juga sangat memperhatikan tentang kesejahteraan penduduknya khususnya kesehatan.Pemerintah kuwait memiliki banyak rumah sakit dengan pelayanan kesehatan yang cukup bagus,oleh karena itulah pemerintah kuwait membutuhkan banyak tenaga medis terutama perawat profesiaonal.

Pemerintah kuwait setiap tahun mengagendakan untuk melakukan perekrutan tenaga medis-perawat seperti dari india,philiphine,Indonesia dan beberapa negara asia lainnya dalam jumlah yang cukup besar dengan melalui test seleksi yang di adakan oleh lembaga penyedia tenaga kerja luar negeri resmi di bawah pengawasan pemerintah.Bagi calon tenaga perawat yang telah lulus seleksi akan mendapatkan fasilitas seperti akomodasi,transportasi dan juga cuti tahunan selama 40 hari /tahun,selain itu juga gaji yang di tawarkan berkisar antara US $1000 – US $1300, tidak hanya itu perawat juga dapat bekerja di private hospital (rumah sakit swasta) yang menawarkan fasilitas dan gaji lebih baik seperti KOC, KNPC dll (Info lihat di webside).

Seleksi recruitment.

Seleksi recruitment akan terdiri dari;

-Seleksi adminisrasi.

-Test tulis kompetensi keperawatan dalam bahasa inggris standart NCLEX

-Test interview keperawatan dalam bahasa Inggris

Apa yang perlu di persiapkan perawat di tanah air?

-Mendaftar di lebaga perekrut/agency yang di tunjuk ( PJTKI ).

-Mengikuti training untuk meningkatkan kompetensi keperawatan dan English Skill.

"Global Nurses Assistance" adalah lembaga pelatihan kompetensi keperawatan yang bertujuan untuk meningkatkan kemampuan profesional perawat Indonesia sehingga mampu memenuhi standard profesionalisme global.

Visi : Menjadi lembaga pelatihan keperawatan yang berwawasan global dan terbaik di Indonesia.

Misi : Memberikan pelatihan kompetensi keperawatan professional yang sistematis dan terintegrasi dalam bahasa internasional untuk menyiapkan perawat indonesia dalam memenuhi standart global.

Kedudukan : Global Nurses Assistance berkedudukan di Malang.

E-Mail;gna_mlg@yahoo.com
www.gna-info.blogspot.com


Found and directed by Ns. Slamet Widodo Kanapi. Seorang Perawat Indonesia Yang telah membuktikan diri menembus pasar global dengan berkarir di Kuwait Police Health Services,Ministry of Health of Kuwait. Dan aktif dalam usaha peningkatan kualitas kompetensi keperawatan di tanah air.
Lahir di ujung timur pulau jawa Banyuwangi 15 januari 1978. Menamatkan Diploma of Nursing tahun 1999.
Tidak puas dengan kondisi keperawatan di daerah kemudian hengkang ke Jakarta dan bergabung dalam International Health care Training Program tahun 2001. Mendapat kesempatan memperdalam English Competence, dengan belajar di The British Council Jakarta dalam IELTS PreparationCourse tahun 2002. Menjadi Trainer dalam Program pelatihan perawat ke luar negeri di Binawan Institute Of Health Sciences Jakarta pada tahun yang sama. Berkarir di Kuwait Police Health Cervices, Ministry of Health of Kuwait sejak 2003 sampai 2008.
Saat ini talah kembali ketanah air dan aktif sebagai pengelola Lembaga Pendidikan dan Pelatihan Profesi "LPP.Duta Pertiwi Malang" dengan memegang posisi sebagai Marketing manager & International Relation.
LPP.Duta Pertiwi Malang adalah lembaga pelatihan pelatihan yang bertujuan mencetak tenaga profesional khususnya bidang kesehatan untuk bisa berkarir tanpa batas hingga ke luar negeri.
Dengan ruang lingkup program meliputi, Recruitment ,Training ,Consultancy ,dan Placement .Bekerja sama dengan Perusahaan Jasa Tenaga Kerja Profesional terbesar di Indonesia

The lack of basic maths skills can be a major problem when it comes to nurses administering drugs to patients. Calculations are still a significant source of drug error. Parenteral opiates are often relied on to manage acute pain in patients needing effective analgesia. But errors resulting in overdose of intravenous opiate can lead rapidly to respiratory depression. The opiate antagonist naloxone reverses opiate overdose and is usually needed quickly. However, this can cause confusion, because the product is prepared in micrograms. A small volume is involved, and the dose given needs to be titrated against response. Postoperatively, the epidural route is now common for infusions of opiate and local anaesthetic. If opiates or, indeed, most drugs, have been calculated incorrectly, the consequences for patients can be serious. If given in too high concentrations, local anaesthetic used in epidural infusions can cause extensive motor blockade, leading to immobility and pressure ulcers, which is distressing to the patient (Lee, 1991). Wheatley et al (2001) call for routine use of pre-filled epidural infusion bags to avoid the risk of calculation error when ward staff prepare infusions. Nursing competence in drug calculations has been a cause for concern (Duffin, 2000; Coombes, 2000). Hutton (1998a) suggests that a degree of 'de-skilling' has resulted from the increasingly user-friendliness of drug preparations and widespread use of electronic drip counters. Her research into students' competence in drug calculations demonstrated a marked improvement on initial test results after a structured revision programme. Written accounts obtained from students in the study revealed that many felt unable to perform calculations such as long division and fractions without using a calculator, as they had come to rely on these at school. There is some debate over calculator use. Hutton (1998b) argues that calculators are usually available in areas where calculations are complex, and that their use should be encouraged. The opinion of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) (now the Nursing and Midwifery Council) is that nurses should not rely too heavily on calculators. The latest guidelines for the administration of medicines (UKCC, 2000) state that the use of calculators 'should not act as a substitute for arithmetical knowledge and skill'. Developing calculation skills relies on understanding decimals to make conversion easier. And when using long division it is essential to get it the right way round. The use of simple, memorable formulae for regular reference can be a great help . Drug calculations Drug calculations appear to be impossibly difficult, unless you break them down into small steps. They are vitally important to get right, yet they are so easy to get wrong. This paper will now look at some commonly used drug calculations and the way that mistakes can happen. Type A calculations When the dose you want is not a whole ampoule. For example: - Prescription states 200mg (milligrams) - You have an ampoule of 500mg (milligrams) in 4ml (millilitres). What volume contains the dose you need? If you have an ampoule of 500mg in 4ml, and you need 200mg, it can appear to be a daunting calculation. The first step is to find out what volume contains 1mg (4/500) and then multiply it by how many mg you want (200). The easy way to remember this is the famous nursing equation: 'What you want, over what you've got, times what it's in' In this instance: 200mg x 4ml / 500mg = 1.6ml The common error here is to get it upside down, and divide what you've got by what you want. This fortunately gives you a stupid answer, which is obviously wrong, in this case 10ml. You already know that you need a fraction of an ampoule and not two and a bit ampoules, which highlights the error. To help make sure you get it the right way up, remember WIG: What you Want x what it's In / What you've Got Converting units All weights, volumes and times in any equation must be in the same units. With weights the unit changes every thousand. For example, you need 1000 micrograms (mcg) to make 1 milligram (mg) and 1000 milligrams to make one gram (g) . Type B calculations These are infusion rate calculations. For example: - Prescription states 30 mg/hour - You have a bag containing 250mg in 50ml Therefore, at what rate (ml/hr) do you set the pump? These are the same as type A calculations, only once you have worked out the volume that contains the amount of drug you need, you set the pump to give that amount per hour. In this instance, work out how many ml contain ONE mg of drug Using the WIG equation 30 x 50 / 250 = 6ml Therefore the calculation shows that, to give 30mg per hour, the infusion pump rate would need to be set at 6ml per hour. This calculation is straightforward when the rate you want (30mg/hour) and the amount of the drug in the bag (250mg) are both in the same units (mg). However, if the infusion required that 600 micrograms were to be infused each hour instead, this would first need to be converted into mg before the infusion rate was calculated, that is, 600 micrograms = 0.6mg. The equation for infusion rate calculation is dose stated in prescription (milligrams per hour) times volume in syringe (in millilitres) divided by the amount in the syringe (in milligrams) equals the infusion rate (millilitres per hour), or: Dose (mg/hr) x volume in syringe (ml) / Amount in syringe (mg) = Infusion rate

The earlier that effective treatment is provided, the more likely it is that a person suffering from cardiopulmonary arrest will survive (RCUK and ERC, 2000).

The interventions that contribute to a successful outcome after cardiopulmonary arrest can be conceptualised as a chain, which has been called the 'chain of survival' (Smith, 2000). The chain is only as strong as its weakest link. Each link must therefore be strong and comprise:

- Recognition of cardiorespiratory arrest

- Early activation of emergency services

- Early basic life support (BLS)

- Early defibrillation

- Early advanced life support (ALS).

Failure of the circulation for three to four minutes will lead to irreversible cerebral damage. BLS acts to slow down the deterioration of the brain and the heart until defibrillation and/or ALS can be provided (RCUK and ERC, 2000). Prompt recognition of cardiopulmonary arrest and prompt instigation of BLS can double the patient's chance of survival (BHF, 2001). Although national guidelines may continue to vary, the underlying scientific principles upon which resuscitation guidelines are based are now international (Winser, 2001).

Health-care professionals in the UK are legally liable for any act or omission on their part that harms such a patient (BMA, 2001; NMC, 2002). The national guidelines indicate health professionals must attend BLS training at least once every 12 months (NHSLA, 2000).

Wherever patients are treated, automated external defibrillation (AED) is a proven effective means for any health-care professional to deliver a defibrillator shock quickly in an emergency (Mancini and Kaye, 1999; Smith, 2000). Use of an AED removes the need for the operator to be able to interpret an electrocardiogram (ECG) trace.

Basic life support procedure
The guidelines (RCUK and ERC, 2000). indicate that a rescuer should:

1. Ensure own safety and that of the patient.

2. Check the patient's responsiveness by gently shaking them and shouting 'Can you hear me?'

3. If there is no response the rescuer should shout for help.

4. Check the patient's mouth and remove any debris and then open the patient's airway using the head-tilt, chin-lift manoeuvre. If cervical spine injury is suspected the jaw-thrust method should be employed.

5. Look, listen and feel for breathing in the patient for 10 seconds.

6. If patient is not breathing call emergency services or hospital cardiac arrest team.

7. Give the patient two rescue breaths with a pocket mask or bag-valve-mask (Jevon, 2002).

8. Check for signs of circulation for 10 seconds. The carotid pulse is located by placing the second and third finger on the patient's trachea - locating the Adam's apple or cricoid cartilage. Move fingers laterally approximately 4-5cm to the sternomastoid muscle mass. Pushing medially you should then be able to locate the carotid artery.

9. If there are no signs of circulation start chest compressions.

10. Continue rescue breathing and chest compressions at a ratio of 2:15 until the emergency services/cardiac team arrive and take over or the patient makes a sign of life.

AED procedure
When an AED is available the RCUK and ERC guidelines (2000) state:

1. Follow BLS steps 1-5

2. If the patient is not breathing call the emergency services or cardiac arrest team and bring the AED to the patient. If the AED is not immediately available start BLS as above.

3. Switch on the AED and attach the electrode pads following spoken or visual directions given by the AED.

4. Ensure that nobody touches the patient while the AED is analysing the rhythm.

5. If a shock is indicated, ensure that everybody is clear of the patient, push the shock button as directed by the AED.

6. Repeat analyse +/- shock, as directed by AED.

7. If there are no signs of circulation after three shocks perform one minute of BLS.

8. Continue to follow AED instructions until advanced life support is available.

If at any time signs of a circulation are present, check for breathing. If breathing is present place the patient in the recovery position and, where possible, give oxygen.

If breathing is absent give rescue breaths at a rate of 10 per minute and then reassess. This action should continue until the emergency services/cardiac arrest team arrive or the patient starts to breathe unaided.

ANATOMY
- The heart lies between the sternum and the spine. External compressions force the sternum down onto the left ventricle, squeezing it between the sternum and the spine and resulting in blood ejection from the heart (RCUK and ERC, 2000; Tortora and Grabowski, 2001)

- Carotid pulse checks are difficult to undertake in patients who have had a cardiorespiratory arrest. These checks are also something not normally performed in everyday practice due to the possibility of undiagnosed thickened carotid arteries - usually due to artherosclerosis. In such cases trying to locate a carotid pulse may result in a small clot breaking off the thickened layer of the artery, resulting in a stroke (RCUK and ERC, 2000; Tortora and Grabowski, 2001)

- The cardiovascular and the respiratory nervous centres are positioned in the medulla oblongata, which is a continuation of the upper portion of the spinal cord. This centre provides the neural control for increasing heart rate and breathing rate. You can expect abnormalities in these functions following a successful resuscitation if the medulla has received a reduced oxygen supply during resuscitation attempts (RCUK and ERC, 2000; Tortora and Grabowski, 2001).

RESUSCITATION
- Successful resuscitation is defined as a return of spontaneous circulation that lasts longer than 20 minutes

- For cardiac compressions, being taught to locate your hands in the centre of the chest (simple method) resulted in greater accuracy of hand placement when compared to the standard method of sliding up the rib cage to the xiphisternum. This resulted in less delay between ventilation and resuming chest compressions

- Effectiveness declines in cardiac compressions after one minute. A study has demonstrated that one minute of compressions followed by two minutes rest (a three-person compression team) was significantly better than a two-person team with only one minute's rest in between each cycle of BLS.

(RCUK, 2000c)