This study describes the development of an enterostomal therapy nurse outpatient wound clinic in Indonesia. The clinic was established to improve wound care quality and outcomes. It was staffed by an ET nurse, general nurse and two associated nurses. Over nine months, the clinic treated 148 patients with various wound types. Results found the clinic reduced costs, treatment time, complications and improved healing rates compared to hospital care. However, 38.4% of patients dropped out of treatment due to financial barriers, lack of family support and cultural beliefs. The study concludes the ET nurse clinic provides high-quality primary healthcare for wound management in Indonesia.

1. 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-Japan
2Griya 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

2. 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-Japan
2Griya 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

3. Background (latar belakang)
INDONESIA
JEPANG
234.181,400
127.380,000
624.000
1.470.421
Rasio Perawat4
Per 10.000 penduduk
20
41
Jumlah ET
Nurse/WOCN5,6
67
1.598
Populasi 1
Jumlah Perawat2,3
1.
2.
3.
4.
5.
6.
7.
8.
http://www.worldatlas.com/aatlas/populations/ctypopls.htm
http://news.detik.com/read/2012/04/05/201034/1886357/10/dpr-targetkan-ruu-keperawatan-selesai-tahun-ini
http://www.nurse.or.jp/toukei/pdf/toukei01.pdf
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=75
Stott, C. (2010). Stomal therapy nursing in Indonesia. Journal of Stomal Therapy Australia, 30(3), 20–27.
www.nurse.or.jp
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.
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

4. Indonesian Health Care System
(Sistem kesehatan di Indonesia)
Hospital
•
•
•
•
•
RS. Pemerintah.
RS. Swasta.
RS. Pendidikan.
RS. Khusus.
RS. Militer.
• Puskesmas Utama.
• Puskesmas
Pembantu.
• Posyandu.
Curative &
Rehabilitative
Promotive &
Preventive
Outpatient
Clinic
Public Health
Centre
•
•
•
•
Praktek Dokter.
Praktek Bidan.
Praktek Perawat.
Dll.
Supportive

5. Development ET Clinic: Administration
Proses Administrasi Izin Praktek
Pemohon
Surat Permohonan
Harus Anggota PPNI
PPNI
Dinas Kesehetan
Pemohon
Surat Rekomendasi
Surat Izin Praktek Perawat
Diajukan Ke Dinas Kesehatan
Berlaku 5 tahun

6. Development ET Clinic: Preparation
Staffing
1 ET Nurse
1 General Nurse
2 Associated Nurse
Infrastructure
Bed, Sterilization
set, instrument
set, trolley, home care
set, digital
camera, office
desk, printer, PC
desktop, phone and
internet line.
Payment strategy
Supplier
• Total payment (pay dressing
and nursing care).
• Partial payment (pay just
dressing).
• No payment (free at all).

7. Clinic Layout
Branding
Lobby
Office
Clinic

8. Results

9. 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

10. 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

11. Wound Status
Dermatitis
Pressure Ulcers
Burn
Cancer
Surgical Site Infection
Diabetic Foot Ulcers

12. 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

13. 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

14. 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

15. 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.

16. Diskusi
Masalah baru

17. 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.

18. See full text at
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

19. Thank you very much