INTRODUCTION
Aspect Medikolegal Phlebotomi For Health Analyst
Phlebotomy associated with activities to get blood from a patient's specimen to be inspected in the laboratory. In Phlebotomy action, a blood phlebotomys need to know what's going to take, what equipment will be used, which took anatomy section, there iv-line is already installed, how to prevent infection, how to prevent or reduce pain, how to communicate well with patients including obtaining consent, how can the correct procedures for proper implementation of the vein and the factor of safety (safety).
Therefore, medikolegal problem that can be drawn are:
1. Matter who the implementing phlebotomy (competence and authority).
2. How standart procedure.
3. Should supervision.
4. Who is responsible for the risks that occur.
In practice, phlebotomy in the hospital or in the laboratory can be performed by nurses or laboratory analyst, or a person specially trained for it (phelebotomys).
Ability or competence of a person obtained from education or training, while the authority or the authority obtained from the authorities or authorities in the field through licensing.
The authority is only given to those who have the ability, but the capability does not mean by itself has the authority.
As doctors, nurses and midwives, competence in performing phlebotomy action has had, and authority to do it too has had, without explicitly mentioned in the certification of competency and or permit the practice of his profession. As for laboratory analysts and technicians phlebotomys their competence derived from secondary education or training, or courses, so that competence should be explicitly stated in the certificate of competency.
Certificates of competency shall be issued by an accredited educational institution, or by a particular certification agency. Education and phlebotomys laboratory analyst is not education nor vocational education profession.
The legislation in Indonesia is not regulated as a health worker called phlebotomys technician, technician phlebotomys therefore not valid as one health worker. There is a tendency that a worker in the field of health will be more easily recognized as a health worker if his education at least reach the D III. This needs to be done in order to secure the interests of consumer health and safety.
Mean while, health analysts had a health worker as stipulated in Regulation 32 of 1996 on health personnel, although there has been no further regulation of health minister that govern it, especially those associated with the authority to do phlebotomy. Thus, the authority conducted by qualified health analyst phlebotomys or not yet recognized as an independent authority, but should be regarded as an authority that requires the supervision of a professional who became "giver works" as the person replied. Work ethics and standards must be established, governed and enforced by the insurer replied.
According to Law No.20 of 2003 on National Education System, stated that:
Certificate of competency granted by the education and training institutions to students and community members in recognition of the competence to perform a specific job after graduation competency test conducted by an accredited educational unit or certification bodies (Article 61 paragraph 3).
Then in the explanation of article 15 states that professional education is the highest education after an undergraduate program that prepares with special education skill requirements are higher education vocational education that prepares students to have jobs with specific applied skills equivalent to the maximal degree program.
Professional Ethics and Professional Standards
Professional ethics are made by professional organizations, or rather the profession, to set the attitude members, mainly concerned with morality. Professional ethics in the health sector based provisions - provisions in it to the general ethics and nature - the specific nature of morality in general therapeutic professions, such as patient autonomy, beneficence, non maleficence, justice, truth telling, privacy, confidentiality, loyality, etc.. Professional ethics aims to maintain professional dignity and protect the people associated with the profession. Professional ethics are generally written in the form of codes of ethics and its implementation monitored by an Assembly or of the Honorary Board of Ethics. Professional Standards consists of 3 parts, namely:
a. Competency standards that have been discussed above as part of the requirements of the profession.
b. Standards of behavior that most regulated in the code of ethics.
c. Service standards.
Standards of service in the Health Act referred to as the professional standards, defined as the guideline to be used as a guide in conducting a good profession.
Law no. 18 year 2002 on Science and Technology Advisory Council explained that the Code of Conduct established by the Organization of the profession to uphold the ethical, professional activities and assess violations of the profession that can harm the public or professional life in their environment (Article 25). The provisions in this paragraph is intended to provide a foundation in the field of profession to ensure the protection of the public on professional execution irregularities.
BASIC
1. From the medicolegal aspect that the implementation of blood sampling (phlbotomy) has not been set explicitly via regulation of health minister or Health Act so that health analysts do not have the authority in an attempt phlebotomys and not part of the competence of health care analyst.
2. Doctors, nurses and midwives, a health worker has been given the authority and competence phlebotomy as part of the invasive action against the patient. Thus physicians, nurses, midwives have been given the authority to do phlebotomy.
3. Whereas in the provision of health care analyst SSKNI (Indonesian National Competency Standard Work) Analyst health by BNSP (National Agency for Professional Standards) and LSP Telapi (Manpower Professional Certification Institute Pathology Laboratory of Indonesia) as a health analyst certification standards bodies do not include phlebotomy as part of the competence of health analyst .
4. Health workers who make mistakes or omissions Dlm perform their duties subject to disciplinary action interchangeable. Health workers who perform duties not in accordance with relevant professional standards. Subject to disciplinary action (psl. 53 paragraph Kes Act. 23 th 1992)
5. PP 32 YEAR 1996, THE POWER OF HEALTH,
6. Law no. 20 of 2003 on National Education System Article 61 paragraph 3
7. Act No, 18 in 2002. about science and technology article 25.
TAKING INTO ACCOUNT
1. Standard job descriptions of work an analyst in the daily duties required to perform sample analysis in a professional and accountable (precision and high acurasi)
2. Hospital Accreditation guidance in 2010 recommended that health analyst job description that requires the analyst to work in accordance with their respective competence, and concentration of business analysis to avoid any mistakes.
3. Needs of health analyst in hospital accreditation standards are lacking (not enough)
4. The need for efficiency and alignment tasks in accordance Auth health analyst
Conclude
1. Phlebotomy action is not part of analyst competence of health so that the implementation of blood collection (phlebotomy) which is currently carried out by health analyst at RSKD health but not our task is an additional duty to help nurses and midwives space limitations. (In case the health analysts must have a certificate of phlebotomy and get authority of leadership)
2. The health analyst in accordance with tupoksinya analyzing clinical samples, has no obligation in performing the blood sampling to the rooms.
3. The need to provide a clear understanding to the doctor, nurse, midwife that taking blood into the patient (plebotomy) is part of tupoksinya. (Similar to other invasive measures of patient).
4. That the charges against 24-hour fully plebotomy by health analysts do not have any legal basis (legal aspects) so that the future should all blood sampling (plebotomy) returned to the doctor, nurse, midwife room each according tupoksinya.
Aberdeen, June 2010,
Adapted by;
Amat Rajasa S.Si.
Sources and / Literature:
http://www.freewebs.com/phlebotomy, Budi Sampurna
