Form Monitoring PPI Lengkap
August 26, 2022 | Author: Anonymous | Category: N/A
Short Description
Download Form Monitoring PPI Lengkap...
Description
FORMULIR SURVEILANS HARIAN INFEKSI RUMAH SAKIT Bulan/ Tahun
: Juli 2018
Ruangan
:Perawatan Depan
Surveyor
:Franssisha
T-$.Mask T-$. Ke$ar
Nama/RM
S MASUK
Tindakan U
J.KEL
Infeksi rma! saki"
Dx Medis
A# ka"e"er
IV $ine
%&erasi
ISK
'HLE#
IDO
01/0/2018 $ 0,/0/2018
!
"# 18$!%&%
'ea
0
1
0
0
(e)ota*i+e
02/0/2018$ 0&/0/2018
,
"# 18$!%%2
-ea.ness
0
1
0
0
$
02/0/2018$ 05/0/2018
!
"# 18$2!18
"ppeni*
1
1
0
0
02/0/2018$ 0!/0/2018
1
"# 18$!%%
'ea
0
1
0
0
SynDispepsia
0
1
0
0
$
3s4e+ate+esis
0
1
0
0
(e)ota*i+e
Diare ".ut
0
1
0
0
(e)tria*one
1
0
(e)tria*one (e)tria*one
02/0/2018$ 0,/0/2018 0!/0/2018$ 0&/0/2018
2 !
"# 18$,0!!
0,/0/2018$ 0&/0/2018
2
"# 18$,0!5
0!/0/2018$ 05/0/2018
2
"# 18$!%2,
Dyspepsia
0
1
0
0
(e)ota*i+e
0,/0/2018$ 0/0/2018
!
"# 18$,05&
DBD
0
1
0
0
(e)ota*i+e
0,/0/2018$ 0/0/2018
!
"# 18$,0&&
3sFe3ris
0
1
0
0
(e)ota*i+e
05/0/2018$ 11/0/2018
&
"# 18$28,,
(o+3utio 'r66
0
1
0
1
(e)tria*one
0,/0/2018$ 0&/0/2018
2
"# 18$,0&,
3sFe3ris7D
0
1
0
0
$
05/0/2018$ 0%/0/2018
,
"# 18$,0%0
94S
0
1
0
0
$
0&/0/2018$ 10/0/2018
,
"# 1$&&0&
"s+a
0
1
0
0
(e)tria*one
0&/0/2018$ 08/0/2018
2
"# 18$,11
3sFe3ris
0
1
0
0
$
0/0/2018$ 10/0/2018
!
"# 1$!82
"3paint76S
0
1
0
0
$
0/0/2018$ 10/0/201%
!
"# 18$,1,0
D4F
0
1
0
0
$
!
"# 18$,1,,
';"7Dyspepsia
0
1
0
0
$
,
"# 18$,1,5
'2P1"07Susp6S
0
0
(e)tria*one
,
*
0/0/2018$ 10/0/2018 0/0/2018$ 11/0/2018
()
B S
0 *
: Diagnosa : Suhu
ena #ine
< J
1 *+
: am &ada Tem&a" K!ss An"i Tskan =a
Tidak
Isi ?ada! @:/< ?ada! =a
Tidak
#era" Lim0a! 0enda Ta>am
TTD
FORM MONITORIN2 'EM#UAN2AN LIM#AH #$an/Ta!n Uni" Sre;%r
: : :
Isi ?ada! @:/< ?ada!
'emisa!an Jenis Lim0a! N%
T-$ Sre;
9(Se&
N%n Medis
Medis
Infeksis
4airan T0!
TDK
TDK
TDK
=A
=a
Tidak
TIDAK
TTD
FORM MONITORIN2 'EN22UNAAN RUAN2 ISOLASI #$an/Ta!n Uni" Sre;%r
N%
T-$ Mask
3 3 3
Nama 'asien
Ka"e-%ri Transmisi Dia-n%sa K%n"ak
Dr%&$e"
Air0%rne
'en--naan ranis%$asi N%m%r kamar1
TTD
FORM MONITORIN2 LAUNDR= Bu Bula lan/ n/T Tah ahun un :
View more...
Comments