Panduan Pelayanan Gizi Ruang Rawat Inap
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PANDUAN
PELAYANAN GIZI DI RUANG RAWAT INAP
(Edisi 1)
RSUP DR. M. DJAMI DJAMIL L PADANG 2015
KATA KAT A PENGAN PE NGANTAR TAR
Assalam!alai"m Assalam!al ai"m #.# #.# S$%ala &'i a%i Alla SWT* Ta+ ,a+% m$+-i&a"a+ ma+sia da+ m$+ama ilm &$+%$aa+ a%i m$/$"a ,a+% $/saa m$+da&a"a++,a. Sala#a da+ salam s$+a+iasa $/-/a" $/- /a"a+ a+ "$&ada Rasllla Rasllla** &$+%l &$+%l da+ maa%/ maa%/ a%i "ia s$ma. s$ma. Alamdl Alamdlilla illa Pa+da+ P$la,a+a+ Gii di Ra+% Ra#a I+a& Edisi 1 a+ 2015 RSUP D/. D/. M. D'amil $la "ia mili"i. Pa+da+ i+i dia/a&"a+ m$+'adi a-a+ dalam &$+i+%"aa+ m &$la,a+a+ %ii %ii di li+%"+%a+ RSUP D/. D/. M. D'amil ,a+% "ia -i+ai i+i. U-a&a Ua&a+ + $/ima $/ima"as "asi i "$&ada "$&ada I+s I+sal alasi asi Gii Gii ,a+% ,a+% $la $la m$+,$ m$+,$l$ l$sai sai"a+ "a+ Pa+da Pa+da+ + P$la,a+a P$la ,a+a+ + Gii di Ra+% Ra#a Ra#a I+a& Edisi 1 a+ 2015 2015 RSUP D/. D/. M. D'amil D'amil i+i. ami &$/-a,a a#a ida" ada ,a+% s$m&/+a "$-ali Alla SWT* sa/a+ da+ mas"a+ da/i "ia sa+%a dia/a&"a+ +" "$s$m&/+aa+ &a+da+ i+i +" masa ,a+% a"a+ daa+%. Wassalam!alai"m #. #. Pada+%* A%ss 2015 Di/$"/ Uama*
d/. I/a,a+i* S&.M* MARS NIP 13201241012001 1320124101 2001
PANDUAN PELA PELAY YANAN GIZI DI R RUANG UANG R RAW AWA AT IN INAP AP
BAB I DEFINISI
P$la,a+a P$la,a +a+ + %i %iii /a# /a#a a i+a i+a& & m$/ m$/& &a"a a"a+ + &$l &$la, a,a+a a+a+ + %i %iii ,a+ ,a+% % dim dimla laii da/i da/i &/6 &/6s$s s$s &$+%"a'ia &$+% "a'ia+ + %ii* dia%+ dia%+6sis 6sis %ii* i+$/7 i+$/7$+si $+si %ii m$li& m$li&i i &$/$+ &$/$+-a+a -a+aa+* a+* &$+, &$+,$diaa $diaa+ + ma"a+a+* &$+,la+8 $d"asi* da+ "6+s$li+% %ii* s$/a m6+i6/i+% da+ $7alasi %ii.
BAB II RUANG LINGKUP
Unit
Jenis Pelayanan
RRI A+a"
RRI :$da
RRI P$+,a"i Dalam
Kualifikasi Tenaa
Ju!la" Tenaa
- P$+$/a+%a+ da+ 6+slasi
D I9 Gii8 SI
Gii - A+am+$sa Gii Pasi$+ Pasi$+ - P$+%amaa+ Ma"a+a+ Pasi$+
Gii 8 DIII Gii
- P$+$/a+%a+ da+ 6+slasi
D I9 Gii8 SI Gii 8 DIII Gii
2 6/a+%
D I9 Gii8 SI Gii 8 DIII Gii
2 6/a+%
Pasi$+ - Dis/isi Ma"a+a+ Pasi$+
SMA8 SM :6%a
11 6/ 6/a+% a+%
- P$+$/a+%a+ da+ 6+slasi
D I9 Gii8 SI Gii 8 DIII Gii
1 6/a+%
SM8 SMA
< 6/a+%
S2 :i6m$d8 D I9 Gii8 SI Gii 8 DIII Gii
2 6/a+%
SM8SMA
4 6/a+%
D I9 Gii8 SI Gii 8 DIII Gii
1 6/a+%
SM8SMA
5 6/a+%
Gii - A+am+$sa Gii Pasi$+ Pasi$+ - P$+%amaa+ Ma"a+a+ Pasi$+
- P$+$/a+%a+ da+ 6+slasi Gii
1 6/a+%
Pasi$+ - A+am+$sa Gii Pasi$+ - P$+%amaa+ Ma"a+a+
RRI Pa/ da+ S,a/a;
RRI I=U* =9=U da+ Ja++%
Gii - A+am+$sa Gii Pasi$+ Pasi$+ - P$+%amaa+ Ma"a+a+ Pasi$+ - Dis/isi Ma"a+a+ Pasi$+
- P$+$/a+%a+ da+ 6+slasi -
RRI $ida+a+ -
Gii A+am+$sa Gii Pasi$+ Pasi$+ P$+%amaa+ Ma"a+a+ Pasi$+ Dis/isi Ma"a+a+ Pasi$+ P$+$/a+%a+ da+ 6+slasi Gii A+am+$sa Gii Pasi$+ Pasi$+ P$+%amaa+ Ma"a+a+ Pasi$+ Dis/isi Ma"a+a+ Pasi$+
BAB III TATA LAKSANA P$la,a P$l a,a+a +a+ + %i %iii /a# /a#a a i+a i+a& & m$/ m$/& &a"a a"a+ + &$l &$la, a,a+a a+a+ + %i %iii ,a+ ,a+% % dim dimla laii da/i da/i &/6 &/6s$s s$s &$+%"a'ia &$+% "a'ia+ + %ii* dia%+ dia%+6sis 6sis %ii* i+$/7 i+$/7$+si $+si %ii m$li& m$li&i i &$/$+ &$/$+-a+a -a+aa+* a+* &$+, &$+,$diaa $diaa+ + ma"a+a+* &$+,la+8 $d"asi* da+ "6+s$li+% %ii* s$/a m6+i6/i+% da+ $7alasi %ii.
A# Tu$uan M$/&a"a+ &$la,a+a+ %ii "$&ada &asi$+ /a#a i+a& a%a/ m$m&$/6l$ as&a+ ma"a+a+ ,a+% s$sai "6+disi "$s$aa++,a dalam &a,a m$m&$/-$&a &/6s$ &$+,$ma+** m$m&$/aa+"a+ da+ m$+i+%"a"a+ sas %ii. &$+,$ma+
B# Sasa%an 1. Pasi$+ 2. $la/%a
&# 'ekanis!e Keiatan
1. S"/i+i+% Gii Taa&a+ &$la,a+a+ %ii /a#a i+a& dia#ali d$+%a+ s"/i+i+%8&$+a&isa+ %ii 6l$ &$/a#a /a+%a+ da+ &$+$a&a+ 6/d$/ di$ a#al (&/$s"/i&si di$ a#al) 6l$ d6"$/. S"/i+i S"/ i+i+% +% %i %iii $/ $/' 'a+ a+ + +" " m$+ m$+%id %id$+ $+i;i" i;i"asi asi &as &asi$+ i$+8"l 8"li$+ i$+ ,a+ ,a+% % $/ $/isi isi"6* "6* ida ida" " $/isi $/ isi"6 "6 ma mal+ l+/is /isii aa aa "6+ "6+dis disii " "ss ss.. 6+ 6+dis disii " "ss ss ,a+ ,a+% % dim dima"s a"sd d ada adala la &asi$+ d$+%a+ "$adaa+ $/$+ da/i masi+% > masi+% //a+% /a#a i+a& (Misal RRI A+a" ? &asi$+ Dia$$s da+ EP EP** RRI :$da ? Pasi$+ :$da Di%$si; da+ Dia$$s* RRI N6+ :$da ? Pasi$+ Di$$s M$llis* dll) . Id$al+,a s"/i+i+% dila""a+ &ada &asi &a si$+ $+ a a/ / 1 @ 2 'am 'am s$ s$$ $la la &a &asi si$+ $+ ma mas s" " RS RS.. M$ M$6 6da da s"/i s"/i+i +i+% +% ad adal ala a Malnutrition Screening Tools (MST).
:ila asil s"/i+i+% %ii m$++'""a+ &asi$+ $/isi"6 mal+/isi* ma"a dila""a+ &$+%"a'ia+8ass$sm$+ %ii da+ dila+'"a+ d$+%a+ la+%"aBla+%"a &/6s$s asa+ %ii $/sa+da/ 6l$ Di$isi$+. Pasi$+ d$+%a+ sas %ii ai" aa ida" $/isi"6 mal+/isi* dila""a+ s"/i+i+% la+%8s"/i+i+% la+'. Ji"a asil s"/i+i+% la+%8s"/i+i+%
la+' $/isi"6 mal+/isi ma"a dila""a+ &/6s$s asa+ %ii $/sa+da/. Pasi$+ sa"i "/iis aa "ass sli ,a+% $/isi"6 %a+%%a+ %ii $/a a"a+ l$i ai" ila dia+%a+i s$-a/a im.
2. P/6s$s Asa+ Gii T T$/sa+d $/sa+da/ a/ (P (PAGT) AGT) P/6s$s Asa+ %ii T$/sa+da/ dila""a+ &ada &asi$+ ,a+% $/isi"6 "/a+% %ii* sda m$+%alami "/a+% %ii da+ aa "6+disi "ss d$+%a+ &$+,a"i $/$+* &/6s$s i+i m$/&a"a+ s$/a+%"aia+ "$%iaa+ ,a+% $/la+% (si"ls).
La+%"a PAGT $/di/i da/i?
a# Ass Asses! es!en( en(Pen Penka ka$ia $ian n i) i)ii Ass$sm$+ %ii di"$l6m&6""a+ dalam 5 "a$%6/i ,ai 1) A+am+$sis /i#a,a %iiC 2) Da Daa a :i6 :i6"im "imia* ia* $s m$ m$dis dis da+ &/6 &/6s$d s$d/ / ($ ($/ma /mas" s" da daa a la la6/a 6/a6/ 6/im im)C )C 4) P$+%"/a+ a+/6&6m$/iC ) P$m$/i"saa+ ;isi" "li+isC 5) Ri#a,a &$/s6+al. $$/a+%a+?
1) A+am+$sis /i#a,a % %ii ii A+am+$sis /i#a,a %ii adala daa m$li&i as&a+ ma"a+a+ $/mas" "6m& "6 m&6s 6sis isi* i* &6 &6la la ma ma"a "a+* +* di$ di$ sa saa a i+i i+i da da+ + da daa a la lai+ i+ ,a+% ,a+% $ $/" /"ai ai. . S$ S$la lai+ i+ i i di&$/l"a+ daa "$&$dlia+ &asi$+ $/ada& %ii da+ "$s$aa+* a"i7ias ;isi" da+ 6la/a%a da+ "$$/s$diaa+ ma"a+a+ di li+%"+%a+ "li$+. Gama/a+ as&a+ ma"a+a+ da&a ma"a+a+ da&a di%al di%alii m$la m$lali li a+am a+am+$sis +$sis "aliai; da+ "a+ "a+iai iai;. ;. A+am+$si A+am+$sis s /i#a,a %ii s$-a/a "aliai; dila""a+ +" m$m&$/6l$ %ama/a+ "$iasaa+ ma"a+8&6la ma"a+ s$a/i $/dasa/"a+ ;/$"$+si &$+%%+aa+ aa+ ma"a+a+. A+am+$sis s$-a/a "a+iai; dila""a+ +" m$+da&a"a+ %ama/a+ as&a+ a %ii s$a/i m$lali !!recall !! recall ! ma"a+a+ 2 'am d$+%a+ ala a+ ’food model !!.. $mdi $m dia+ a+ dil dila" a""a "a+ + a+a a+alisi lisis s a %i %iii ,a+ ,a+% % m$/ m$/' '" " "$ "$&ad &ada a da; da;a/ a/ ma" ma"a+ a+a+ a+ &$+ &$ +"a "a//* a aa a da da; ;a/ a/ "6 "6m& m&6s 6sis isii a a %ii %ii ma ma"a "a+a +a+. +. Ri Ri#a #a,a ,a %i %ii i " "a+ a+i ia ai i; ; di$/'$ma"a+ "$ dalam 'mla aa+ ma"a+a+ da+ "6m&6sisi a %ii.
2) :i6"imia Daa Da a i6 i6"im "imia ia m$l m$li& i&i i as asilil &$ &$m$/ m$/i"s i"saa+ aa+ la la6/a 6/a6/ 6/im im** &$m &$m$/i $/i"sa "saa+ a+ ,a+ ,a+% % $/"aia+ d$+%a+ sas %ii* sas m$a6li" da+ %ama/a+ ;+%si 6/%a+ ,a+% $/&$+%a/ $/&$ +%a/ $/a $/ada& da& im iml+,a l+,a masa masala la %ii. P$+% P$+%amil amila+ a+ "$sim "$sim&la+ &la+ da/i daa la6/a6/im $/"ai masala %ii a/s s$la/as d$+%a+ daa ass$sm$+ %ii lai lai++, ++,a a s$& s$&$/ $/ii /i# /i#a,a a,a %i %iii ,a+ ,a+% % l$+ l$+%"a %"a&* &* $/ $/mas mas" " &$+ &$+%% %%+aa +aa+ + s& s&l$m l$m$+* $+* &$m$/i"saa &$m$/ i"saa+ + ;isi" da+ s$a s$a%ai+, %ai+,a. a. Disa Disam&i+% m&i+% i &/6s$ &/6s$s s &$+, &$+,a"i* a"i* i+da i+da"a+* "a+* &$+ &$ +%6 6a aa a+* +* &/ &/6s 6s$d $d /
da+
sa a s s
hidrasi
(-ai/a+ (-a i/a+))
da da&a &a m$ m$m&$ m&$+%a +%a/ /ii
&$/aa+ "imia#i da/a da+ /i+* s$i+%%a al i+i &$/l m$+'adi &$/ima+%a+.
4) A+/6&6m$/i A+/6&6m$/i m$/&a"a+ &$+%"/a+ ;isi" &ada i+di7id. A+/6&6m$/i da&a dila""a+ dila" "a+ d$+%a+ $/a $/a%ai %ai -a/a* a+a/a lai+ &$+%"/ &$+%"/a+ a+ Ti+%%i :ada+ (T:)C :$/a :ada+ (::). Pada "6+disi i+%%i ada+ ida" da&a di"/ da&a di%+a"a+ Pa+'a+ Pa+' a+% % a ada da+* +* Ti+%% i+%%ii L L (TL) (TL).. P$ P$+i +ila laia ia+ + sa sas s %i %ii i di dila la" ""a "a+ + d$ d$+% +%a+ a+ m$ma+di+%"a+ $$/a&a "/a+ $/s$ diaas misal+,a I+d$"s Massa T (IMT) ,ai /ai6 :: $/ada& T:. Pa/am$$/ a+/6&6m$/i ,a+% &$+i+% +" m$la""a+ $7alasi sas %ii &ada a,i* a+a" da+ /$ma'a adala P$/ma+. P$/ma P$/m a+ + i+i da&a da&a di%a di%ama/" ma/"a+ a+ m$la m$lali li &$+%"/ &$+%"/a+ a+ a+/6& a+/6&6m$/ 6m$/ii s$&$ s$&$/i /i $/a $ /a a ada da+* +* &a &a+' +'a+ a+% % aa aa i i+% +%%i %i a ada da+* +* li li+% +%"a "a// "$ "$&a &ala la da da+ + $ $$ $/a /a&a &a &$+%" &$+ %"/a /a+ + lai lai++, ++,a. a. as asilil &$+ &$+%" %"/a /a+ + i+i "$m "$mdi dia+ a+ di dia+d a+di+% i+%"a+ "a+ d$ d$+%a +%a+ + sa+da/. P$m$/i"saa+ ;isi" ,a+% &ali+% s$d$/a+a +" m$lia sas %ii &ada &asi$+ &as i$+ /a# /a#a a i+a i+a& & ada adala la ::. :$/ :$/a a ad ada+ a+ a" a"/a /a s$ s$ai" ai"+, +,a a di dia+d a+di+% i+%"a+ "a+ d$+%a+ d$+% a+ :: id$a id$all &a &asi si$+ $+ aa aa :: &a &asi si$+ $+ s$ s$$ $l lm m sa sa"i "i. . P$ P$+% +%" "/ /a+ a+ :: s$ai" s$ ai"+,a +,a m$m m$m&$/ &$/im ima+ a+%"a %"a+ + al alBa Ball dia dia+a +a/a+ /a+,a ,a "6+ "6+dis disii "$% "$%$m $m"a+ "a+ da+ $d$ma. $d$m a. $%$ $%$m"a m"a+ + da&a da&a did$ did$$"si $"si d$+% d$+%a+ a+ &$/i &$/i+% +%a+ a+ IMT IMT.. Nam Nam+* +* &ada &$+%" &$+ %"/a /a+ + i+i $/ $/"ad "ada+% a+% $/ $/'ad 'adii "$s "$sala alaa+ a+ ,a+ ,a+% % dis dis$a $a"a "a+ + 6l$ 6l$ ada ada+,a +,a $d$ma. $d$ ma. :: &as &asi$+ i$+ s$ s$ai" ai"+,a +,a didi-aa aa &a &ada da saa saa &as &asi$+ i$+ mas mas" " di/ di/a#a a#a da+ dila""a+ &$+%"/a+ :: s$-a/a &$/i6di" s$lama &asi$+ di/a#a s$sai "6+disi &asi$+.
) P$m$/i"saa+ isi"8li+is P$m$/i"sa P$m$/i "saa+ a+ ;isi" ;isi" dil dila" a""a+ "a+ + +" " m$+ m$+d$ d$$"s $"sii ada ada+,a +,a "$ "$lai lai+a+ +a+ "li "li+is +is ,a+ ,a+% % $/" $ /"ai aia a+ + d$ d$+% +%a+ a+ %a %a+% +%% %a+ a+ %ii %ii aa aa da da&a &a m$ m$+i +im ml l"a "a+ + ma masa sala la %i %ii i..
P$m$/i"saa+ ;isi" $/"ai %ii m$/&a"a+ "6mi+asi da/i* a+daBa+da 7ial da+ a+/ a+ /6& 6&6m 6m$ $/i /i ,a ,a+% +% da da&a &a di" di"m& m&l l"a "a+ + da da/i /i -a -aa aa a+ + m$ m$di di" " &a &asi si$+ $+ s$ s$/ /a a #a#a+#a# a+-a/a a/a.. =6+ =6+6 6 $ $$/a $/a&a &a da daa a &$m &$m$/i $/i"sa "saa+ a+ ;is ;isi" i" $/ $/"ai "ai %i %iii a+ a+a/ a/a a lai lai+ + $d$ma* asi$s* "6+disi %i%i %$li%i* massa 66 ,a+% ila+%* l$ma" ,a+% m$+m&"* dll.
5) Ri#a,a P$/s6+al Daa /i#a,a &$/s6+al m$li&i a/$a ,ai /i#a,a 6aB6aa+ aa s&l$m$+ ,a+% s$/i+% di"6+smsiC s6sial da,aC /i#a,a &$+,a"iC daa mm &asi$+. a) Ri#a, Ri#a,a a 6aB6 6aB6aa aa+ + ,a+% di% di%+a"a +a"a+ + da+ s&l$ s&l$m$+ m$+ ,a+ ,a+% % di"6+s di"6+smsi. msi. ) S6 S6si sial al : :d da, a,a a S Sa as s s6 s6si sial al $" $"6+ 6+6m 6mi* i* da da,a ,a** "$ "$&$ &$//-a, a,aa aa+8 +8 a% a%am ama* a* si sias asii / /ma ma* * d"+%a+ &$la,a+a+ "$s$aa+ da+ s6sial s$/a+%a+ s6sial. -) Ri#a, Ri#a,a a P P$+,a $+,a"i "i d) $l $la+ a+ ama ,a ,a+% +% $/"ai d$ d$+%a+ +%a+ mas masala ala %i %ii* i* /i#a,a &$ &$+,a" +,a"i i dl da+ s$"a/a s$" a/a+%* +%* /i# /i#a,a a,a &$m &$m$d $daa aa+* +* &$+ &$+,a" ,a"i i "/6 "/6+i" +i" aa aa /$si"6 /$si"6 "6m "6m&li" &li"asi asi** /i#a,a &$+,a"i "$la/%a* sas "$s$aa+ m$+al8$m6si s$/a "$mam&a+ "6%+ii;s$&$/i &ada &asi$+ stroke stroke.. $) Daa m mm m &asi$+ a+ a+a/a a/a lai+ m m/ /** &$"$/'a &$"$/'aa+* a+* da+ i+% i+%"a "a &$+d &$+didi"a idi"a+ + *# Dia Dian+ n+si sis sG Gi) i)ii Pada Pad a la+ la+%"a %"a i+i didi-a/i a/i &6l &6la a da+ + +%a+ %a+ a+ a+a/ a/ da daa a ,a+ ,a+% % $/ $/"m "m&l &l da da+ + "$m+%"i+a+ &$+,$a+,a. $mdia+ m$mila masala %ii ,a+% s&$si;i" da+ m$+,aa"a+ masala %ii s$-a/a si+%"a da+ '$las m$+%%+a"a+ $/mi+6l6%i ,a+% ada. P$+lisa+ P$+ lisa+ dia%+6 dia%+6sa sa %ii $/s $/s/" /"// d$+% d$+%a+ a+ "6+s "6+s$& $& PES aa Problem Etiologi da+ Signs/ Symptoms. Symptoms.
Dia%+6sis %ii di"$l6m&6""a+ m$+'adi i%a d6mai+ ,ai? 1) D6mai+ As&a+ adala masala a"al ,a+% $/+%a+ d$+%a+ as&a+ $+$/%i* a %ii* -ai/a+* ssa+si i6a"i; da/i ma"a+a+ ai" ,a+% m$lali 6/al ma&+ &a/$+$/al da+ $+$/al. =6+6 ? As&a+ &/6$i+ ,a+% ,a+% "/a+% (P) $/"aia+ d$+% d$+%a+ a+ &$/aa+
i+d$/a &$/asa da+ +a;s ma"a+ (E) dia+dai d$+%a+ as&a+ &/6$i+ /aaB/aa s$a/i "/a+% da/i 0 F "$a+ (S ) 2) D6mai+ li+is adala masala %ii ,a+% $/"aia+ d$+%a+ "6+disi m$dis aa ;isi"8;+%si 6/%a+. =6+6 ? $slia+ m$,si (P) $/"aia+ d$+%a+ E) "/a+%+,a d"+%a+ "$la/%a dia+dai d$+%a+ &$+%%+aa+ ss ;6/mla a,i amaa+ (S) 4) D6mai+ P$/ila"8li+%"+%a+ adala masala %ii ,a+% $/"aia+ d$+%a+ &$+% &$ +%$ $a aa a+* +*
&$ &$/i /ila la" "8" 8"$& $&$/ $/-a -a,a ,aa+ a+**
li+%" li+%"+ +%a %a+ +
;i ;isi si" "
da da+ +
a" a"s$ s$s s
da da+ +
"$ama+a+ ma"a+a+. =6+6 ? /a+%+,a &$+%$aa+ $+a+% ma"a+a+ da+ %ii (P) $/"aia+ d$+%a+ m$+da&a i+;6/masi ,a+% sala da/i li+%"+%a++,a m$+%$+ai a+'/a+ di$ ,a+% di'ala+i+,a (E) dia+dai d$+%a+ m$mili aa+ ma"a+a+8ma"a+a+ ,a+% ida" dia+'/"a+ da+ a"i7ias ;isi" ,a+% ida" s$sai a+'/a+ (S)
,# Inte Inte%%-en ensi si G Gi) i)ii
T$/da&a da "6m&6+$+ i+$/7$+si %ii ,ai &$/$+-a+aa+ i+$/7$+si da+
im&l$m$+asi. 1) P$/$+-a+aa+ I+$/7$+si I+$/7$+si %ii dia m$/'" &ada dia%+6sis %ii ,a+% di$%a""a+. T$a&"a+ 'a+ da+ &/i6/ias i+$/7$+si $/dasa/"a+ ma masala sala %ii+,a (P/6l$m)* /a+-a+% s/a$%i I+$/7$+si I+$/7 $+si $/da $/dasa/"a sa/"a+ + &$+, &$+,$a $a masa masala+, la+,a a (Ei6l (Ei6l6%i) 6%i) aa ila &$+, &$+,$a $a ida" da&a da&a
dii+ dii+$/7$+ $/7$+si si ma"a s/a$% s/a$%ii i+$/7$+s i+$/7$+sii di'"a di'"a+ + +" m$+%/a m$+%/a+%i +%i
G$'ala8Ta+da (Sign (Sign & Symptom). Symptom). T$+"a+ &la 'ad#al da+ ;/$"$+si asa+. utput da/i i+$/7$+si i+i adala 'a+ ,a+% $/"/* &/$s"/i&si di$ da+ s/a$%i &$la"sa+aa+ (im&l$m$+asi).
P$/$+-a+aa+ i+$/7$+si m$li&i?
a) P$+$a&a+ 'a+ i+$/7$+si P$+$a&a+ 'a+ a/s da&a di"/* di-a&ai da+ di$+"a+ #a"+,a. ) P/$s"/i&si di$ P/ P/$s $s"/ "/i& i&si si di$ di$ s$ s$-a -a/a /a
si+% si+%"a "a
m$ m$+% +%%a %am ma/ a/"a "a+ +
/$ /$"6 "6m$ m$+d +das asii
m$ m$+% +%$+ $+ai ai
"$a+ $+$/%i da+ a %ii i+di7idal* '$+is di$* $+" ma"a+a+* "6m&6sisi a %ii* ;/$"$+si ma"a+. (1) P$/i+%a+ "$a+ %ii. P$+$+a P$+$ +a+ + "$ "$a+ a+ a %ii ,a+% di$ di$/i"a+ /i"a+ "$&ada &asi &asi$+8"l $+8"li$+ i$+ aas dasa/ dia%+6sis %ii* "6+disi &asi$+ da+ '$+is &$+,a"i+,a.
(2) J$+is Di$ Pada mm+,a &asi$+ mas" "$ /a+% /a#a sda dia &$/mi+aa+ ma"a+a+ ma"a +a+ $/d $/dasa/" asa/"a+ a+ &$sa &$sa+a+ +a+ / ord d6"$// 'a%a8 'a%a8DPJP DPJP.. rde er di$ a#al da/i d6"$ Di$isi$+ $/sama im aa s$-a/a ma+di/i a"a+ m$+$a&"a+ '$+is di$ $/dasa/"a+ dia%+6sis %ii. :ila '$+is di$ ,a+% di$+"a+ s$sai d$+%a+ di$ di$ 6/ 6/d$ d$// ma ma"a "a di$ di$ $ $/s /s$ $ di$ di$/ /s" s"a+ a+ d$ d$+% +%a+ a+ di dil$ l$+% +%"a "a&i &i d$ d$+% +%a+ a+ /a+-a+%a+ di$. :ila di$ ida" s$sai a"a+ dila""a+ sla+ &$/aa+ '$+is di$ d$+%a+ m$+dis"si"a++,a m$+dis"si"a++,a $/l$ $/l$i i dal $/sama (DPJP (DPJP). ).
(4) M6di;i"asi di$ M6di;i M6d i;i"as "asii di$ di$ m$/ m$/&a &a"a+ "a+ &$ &$+% +%a aa+ a+ da da/i /i ma" ma"a+ a+a+ a+ ia iasa sa (+6 (+6/ma /mal). l). P$+%aa+
da&a
$/&a
&$/aa+
dalam
"6+sis$+siC
m$+i+%"a"a+8m$+/+a+ +ilai $+$/%iC m$+ama8m$+%/a+%i '$+is aa+ ma"a+a+ aa a %ii ,a+% di"6+smsiC membatasi membatasi '$+is '$+is aa "a+d+%a+ ma"a+a+ $/$+C m$+,$sai"a+ "6m&6sisi a %ii (&/6$i+* l$ma"* * -ai/a+ -ai /a+ da+ a %i %iii lai lai+)C +)C m$+ m$+% %a a 'm 'mla la** ;/$ ;/$"$ "$+si +si ma" ma"a+ a+ da+ / /$ $ ma"a+a+. Ma"a+a+ di /ma sa"i mm+,a $/$+" ma"a+a+ iasa* l+a"* sa/i+% da+ -ai/.
() Jad#al P$m$/ia+ Di$ Jad#al Jad #al &$m &$m$/ $/ia+ ia+ di$ di$8m 8ma"a a"a+a +a+ + di dili lis"a s"a+ + s$s s$sai ai d$+ d$+%a+ %a+ ;/$ ;/$"$ "$+si +si &$m$/ia+.
(5) Jal/ ma"a+a+
Jal/ ma"a+a+ ,a+% di$/i"a+ da&a m$lali 6/al da+ $+$/al aa &a/$+$/al.
2). Im&l$m$+asi I+$/7$+si Im&l Im &l$m $m$+ $+a asi si
ad adal ala a
a a%i %ia+ a+
"$ "$%i %ia aa+ a+
i+ i+$ $/7 /7$+ $+si si
%i %ii i
di dima ma+a +a
di di$ $is isi$ i$+ +
m$la"sa+a m$la "sa+a"a+ "a+ da+ m$+% m$+%"6m+ "6m+i"asi i"asi"a+ "a+ /$+-a /$+-a+a +a as asa+ a+ "$&a "$&ada da &asi$ &asi$+ + da+ $+a%a "$s$aa+ aa $+a%a lai+ ,a+% $/"ai. Sa i+$/7$+si %ii a/s m$+%%ama/"a+ d$+%a+ '$las? a&a* dima+a dim a+a** "a& "a&a+* a+* da+ a% a%aim aima+a a+aHH i+ i+$/7 $/7$+s $+sii i dil dila" a""a "a+. +. $% $%ia iaa+ a+ i+i '% '%a a $/mas" &$+%m&la+ daa "$mali* dima+a daa $/s$ da&a m$++'""a+ /$s&6+s &asi$+ da+ &$/l aa ida"+,a m6di;i"asi i+$/7$+si %ii.
.# '+n '+nit+ it+%in %in .a .an n EE-alu aluasi asi G Gi)i i)i $%ia $% iaa+ a+ m6+ m6+i6 i6/i+ /i+% % da+ $7 $7al alasi asi %i %iii dil dila" a""a+ "a+ + +" " m$+ m$+%$ %$a aii /$s /$s&6+ &6+ &asi$+8"li$+ $/ada& i+$/7$+si da+ i+%"a "$$/asila++, "$$/asila++,a a Ti%a la+%"a "$%iaa+ m6+i6/i+% da+ $7alasi %ii* ,ai? 1) M6+ M6+i6 i6// &$ &$/"$ /"$ma ma+%a +%a+ + ,ai ,ai "$ "$%ia %iaa+ a+ m$+ m$+%am %amai ai &$/ &$/"$m "$ma+ a+%a+ %a+ "6+ "6+dis disii &asi &a si$+ $+8" 8"li li$+ $+ ,a ,a+% +% $ $/ /' 'a+ a+ + + " " m$ m$li lia a a asi sill ,a ,a+% +% $ $/' /'ad adii s$ s$s sai ai ,a ,a+% +% dia/a di a/a&"a &"a+ + 6l$ 6l$ "li$+ "li$+ ma ma& &+ + im im.. $% $%ia iaa+ a+ ,a ,a+% +% $/ $/"a "aia ia+ + d$+ d$+%a+ %a+ m6+ m6+i6 i6/ / &$/"$ma+%a+ a+a/a lai+ ? a) M$+%$-$" &$maama+ da+ "$aaa+ di$ &asi$+8"li$+ ) M$+%$-$" as&a+ ma"a+ &asi$+8"li$+ -) M$+$+"a+ a&a"a i+$/7$+si dila"sa+a"a+ s$sai d$+%a+ /$+-a+a8&/$s"/i&sii Di$. /$+-a+a8&/$s"/i&s d) M$+$+"a+ a&a"a sas %ii &asi$+8"li$+ $a& aa $/a $) M$+%id$+i;i"asi asil lai+ ai" ,a+% &6sii; ma&+ +$%ai; ;) M$+%m&l"a+ ii+;6/masi +;6/masi ,a+% m$+ m$++'""a+ +'""a+ alasa alasa+ + ida" ada+, ada+,a a &$/"$ma+%a+ da/i "6+disi &asi$+8"li$+ 2) M$+%"/ a asil. sil. $%iaa+ i+ i+ii adala m$+% m$+%"/ "/ &$/"$ma &$/"$ma+%a+8&$/aa+ +%a+8&$/aa+ ,a+% $/'adi s$a%ai /$s&6+ $/ada& i+$/7$+si %ii. Pa/am$$/ ,a+% a/s di"/ $/dasa/"a+ a+da da+ %$'ala da/i dia%+6sis %ii.
4) E7alasi asil :$/dasa/"a+ "$i%a aa&a+ "$%iaa+ di aas a"a+ dida&a"a+ '$+is asil * ,ai? a) Dam&a" &$/ila" da+ li+%"+%a li+%"+%a+ + $/"ai %ii ,ai i+%"a &$maama &$maama+* +* &$/ila"* a"s$s* da+ "$mam&a+ ,a+%m+%"i+ m$m&+,ai &$+%a/ &ada as&a+ ma"a+a+ da+ a %ii. ) Dam&a" as&a+ ma"a+a+ da+ a %ii m$/&a"a+ as&a+ ma"a+a+ da+ aa a %ii da/i $/a%ai sm$/* misal+,a ma"a+a+* mi+ma+* s&l$m$+* da+ m$lali /$ $+$/al ma&+ &a/$+$/al. -) Dam&a" $/ada& a+ a+da da da+ %$'ala ;isi" ,a+% $/" $/"ai ai %ii ,ai &$+%"/a+ ,a+% $/"ai d$+%a+ a+/6&6m$/i* i6"imia da+ &a/am$$/ &$m$/i"saa+ ;isi"8"li+is. d) Dam&a" $/ada& &asi$+8"li$+ $/ada& i+$/7$+si %ii ,a+% di$/i"a+ &ada "alias id&+,a.
) P$+-aaa+ P$la&6/a+ P$+-aaa+ da+ la&6/a+ "$%iaa+ asa+ %ii m$/&a"a+ $+" &$+%a#asa+ da+ &$+%$+ &$+ %$+da dalia lia+ + m m &$ &$la, la,a+a a+a+ + da+
"6m "6m+i +i"as "asii ,a+ ,a+% % di dia a d$+% d$+%a+ a+ ;6/ ;6/ma ma
!ssessment "iagnosis #nter$ensi Monitoring dan E$aluasi (ADIM (ADIME). E). 6/ma ADIME m$/&a"a+ m6d$l ,a+% s$sai d$+%a+ la+%"a P/6s$s Asa+ Gii T$/sa+da/ (PAGT) *. s$a%ai a%ia+ da/i d6"m$+asi "$%iaa+ PAGT* $/da&a $$/a&a -6+6 ;6/mli/ asa+ %i %iii a+a/a lai+ ;6/mli/ as asa+ a+ %ii d$#asa d da+ a+ a+a".
D# K++%.inasi Pelayanan
6m+i"asi a+a/ disi&li+ ilm sa+%a di&$/l"a+ +" m$m$/i"a+ asa+ ,a+% $/ai" a%i &asi$+. S$a%ai a%ia+ da/i im &$la,a+a+ "$s$aa+* di$isi$+ a/s $/"6la6/asi d$+%a+ d6"$/* &$/a#a* ;a/masi da+ $+a%a "$s$aa+ lai++,a ,a+% $/"ai dalam m$m$/i"a+ &$la,a+a+ asa+ %ii. l$ "a/$+a+,a &$/l m$+%$ai &$/a+a+ masi+% masi+% $+a%a "$s$aa+ $/s$ dalam m$m$/i"a+ &$la,a+a+. 1. D6"$/ P$+a+%%+% Ja#a P$la,a+a+ a. :$ :$/a /a+% +%% %+% +% 'a# 'a#a a da dala lam m as as&$ &$" " %ii %ii ,a ,a+% +% $ $/" /"ai ai d$ d$+% +%a+ a+ "$ "$ad adaa aa+ + "li+ "li+is is &asi$+.
. M$ M$+$ +$+ +" "a+ a+ & &/$ /$"s "s/i& /i&si si d di$ i$ a# a#al al ((order order di$ a#al) c. :$/sama di$isi$+ m$+$a&"a+ &/$s"/i&si di$ definiti$e. d. M$ M$m m$/ $/i" i"a+ a+ $d $d" "as asii "$ "$&a &ada da &a &asi si$+ $+ da da+ + "$ "$l la/ a/%a %a+, +,a a m$ m$+% +%$+ $+ai ai &$ &$/a /a+a +a+ + $/a&i %ii. $. M$/' M$/'" " "l "li$+8&a i$+8&asi$+ si$+ ,a+% m$m m$m"a "a+ + as asa+ a+ %i %iii aa " "6+s$ 6+s$li+% li+% % %ii. ii. ;. M$ M$la la" ""a "a+ + &$ &$ma ma+ +a aa+ a+ da+ $7 $7al ala asi si $ $/" /"ai ai ma masa sala la %i %ii i s$ s$-a -a/a /a $ $/" /"al ala a $/sama di$isi$+* &$/a#a da+ $+a%a "$s$aa+ lai+ s$lama "li$+8&asi$+ dalam masa &$/a#aa+.
2. P$/a#a a. M$la" M$la""a+ "a+ s"/i+ s"/i+i+% i+% %ii &asi$ &asi$+ +& &ada ada as$sm as$sm$+ $+ a a#al #al &$/a# &$/a#aa+. aa+. . M$ M$/ /' '" " &a &asi si$+ $+ ,a ,a+% +% $ $/is /isi" i"6 6 ma ma& &+ + s sda da $ $/' /'ad adii ma mal+ l+ /is /isii da da+ + a aa a -.
"6+disi "ss "$ d di$isi$+. i$isi$+. M$l M$la" a""a "a+ + &$+ &$+% %"/ "/a+ a+ a+/6 a+/6&6m &6m$/ $/ii ,ai ,ai &$+ima+ &$+ima+%a+ %a+ $/a $/a a ada+ da+** i+ i+%%i %%i
ada+8 &a+'a+% ada+ s$-a/a $/"ala. d. M$ M$la la" ""a "a+ + &$ &$ma ma+ +a aa+ a+** m$ m$++-a aa a as as& &a+ a+ ma ma"a "a+a +a+ + da da+ + /$ /$s& s&6+ 6+ "l "li+ i+is is "li$+8 "li$+8&as &asi$+ i$+ $/ $/ad ada& a& di$ di$ ,a+ ,a+% % di di$/i $/i"a+ "a+ da+ m$+ m$+,am ,am&ai &ai"a+ "a+ i+;6 i+;6/ma /masi si "$&ada di$isi$+ ila $/'adi &$/aa+ "6+disi &asi$+. $. M$ M$m m$/ $/i" i"a+ a+ m6 m6i i7a 7as si "$ "$&a &ada da &as asi$ i$+ + da da+ + "$l $l a/ a/%a %a $ $/" /"ai ai &$m $m$ $/i /ia a+ ma"a+a+ m$lali 6/al8$+$/al da+ &a/$+$/al.
4. Di$isi$+ a. M$+% M$+%"a'i "a'i asil asil s" s"/i+i+ /i+i+% % %ii & &$/a#a $/a#a da+ 6 6/d$/ /d$/ d di$ i$ a# a#al al da/i da/id6" d6"$/ $/.. . M$ M$la la" ""a "a+ + as as$s $sm$ m$+8 +8&$ &$+% +%"a "a'i 'ia+ a+ %ii %ii la la+' +' &a &ada da &a &asi si$+ $+ ,a ,a+% +% $ $/i /isi si"6 "6 mal+/isi* mal+/isi aa "6+disi "ss m$li&i &$+%m&la+* a+alisa da+ i+$/&/$asi daa /i#a,a %iiC /i#a,a &$/s6+alC &$+%"/a+ a+/6&6m$/iC asil -.
la6/a6/im $/"ai %ii da+ asil &$m$/i"saa+ ;isi" $/"ai %ii. M$ M$+% +%id id$+ $+i i;i" ;i"as asii ma masa sala la8 8di dia% a%+6 +6sa sa %ii %ii $ $/d /das asa/ a/"a "a+ + a asi sill as as$s $sm$ m$+ + da da+ +
m$+$a&"a+ &/i6/ias dia%+6sis %ii. d. M$/a+ M$/a+-a+% -a+% ii+$/7$ +$/7$+si +si %i %iii d$+% d$+%a+ a+ m$+ m$+$a&" $a&"a+ a+ ' 'a+ a+ da+ & &/$s"/ /$s"/i&si i&si di di$ $ ,a+% l$i $/&$/i+-i +" &$+$a&a+ di$ d$;i+ii7$ s$/a m$/$+-a+a"a+ $d"asi8 "6+s$li+%. $. M$la" M$la""a+ "a+ "66/ "66/di+as di+asii d$ d$+%a+ +%a+ d6" d6"$/ $/ $ $/"ai /"ai d$+% d$+%a+ a+ d di$ i$ definiti$e. definiti$e. ;. 66 66/d /di+ i+a asi d$+ $+% %a+ d6" 6"$ $//* &$/ $/a a#a #a* * ;a ;a/m /mas asi* i* da da+ + $ $+a +a%a %a la lai+ i+ dala lam m &$la"sa+aa+ i+$/7$+si %ii %. M$la" M$la""a+ "a+ m6+i m6+i6/i+% 6/i+% /$s&6 /$s&6+ + &a &asi$+ si$+ $/a $/ada& da& i+$/7 i+$/7$+si $+si %ii. . M$la" M$la""a+ "a+ $7al $7alasi asi &/6s &/6s$s $s m ma& a&+ +d dam&a am&a" "a asa sa+ + %i %ii. i. i. M$m M$m$/ $/i"a i"a+ + &$+, &$+,l la+ a+** m6i7 m6i7asi asi** da+ "6+ "6+s$ s$li+ li+% % %ii &a &ada da "li$ "li$+8& +8&as asi$+ i$+ da da+ + "$la/%a+,a.
'. ". l. m.
M$+-aa da+ m$la&6/" m$la&6/"a+ a+ asil asa+ %ii " "$&ada $&ada d6"$/ d6"$/.. M$ M$la la" ""a "a+ + as ass$ s$sm sm$+ $+ %ii %ii la la+% +% ((reassesment reassesment ) a&aila 'a+ $lm $/-a&ai. M$ M$+% +%i" i" ii /6+ /6+d$ d$ & &as asi$ i$+ + $ $/s /sam ama a im " "$s $s$ $a aa+ a+.. :$/ :$/&a/ &a/is isi&a i&asi si a" a"i; i; dal dalam am &$/ &$/$m $ma+ a+ aa dis dis"s "sii d$+ d$+%a+ %a+ d6"$ d6"$//* &$/ &$/a#a a#a* * a+%%6 a+% %6a a im as asa a+ + %i %iii lai lai+* +* "li "li$+8 $+8&as &asi$+ i$+ da+ "$l "$la/ a/%a %a+,a +,a dal dalam am /a+ /a+%"a %"a $7alasi "$$/asila+ &$la,a+a+ %ii.
. a/masi a. M$m& M$m&$/sia $/sia&"a+ &"a+ 6 6a a d da+ a+ a % %ii ii $/ $/"ai "ai s$ s$&$/i &$/i 7 7iami+ iami+** mi+$/a mi+$/al* l* $l$" $l$"/6li /6li d da+ a+ +/isi &a/$+$/al. . M$+$ M$+$+"a +"a+ + "6m "6m&ai &ailias lias a % %ii ii ,a ,a+% +% di di$/i" $/i"a+ a+ "$ "$&ada &ada &asi &asi$+. $+. -. M$ M$m ma+ a+ m$ m$+% +%a# a#as asii da da+ + m$ m$+% +%$7 $7al ala as si &$ &$+% +%% %+a +aa+ a+ 6 6a a da da+ + -a -ai/ i/a+ a+ &a/$+$/al 6l$ "li$+8&asi$+ $/sama &$/a#a. d. :$ :$/" /"6l 6la a6/ 6/as asii d$ d$+% +%a+ a+ di$ di$is isi$ i$+ + da dala lam m &$ &$ma ma+ +a aa+ a+ i+ i+$ $/a /a"s "sii 6 6a a da da+ + ma"a+a+. $. M$m M$m$/ $/i"a i"a+ + $d $d"as "asii "$& "$&ad ada a &a &asi$ si$+ + da+ "$l "$la/ a/%a %a m$+% m$+%$+a $+aii i+ i+$/a $/a"s "sii 6a 6a da+ ma"a+a+.
5. T$+a%a "$s$aa+ lai+ misal+,a adala $+a%a $/a&i 6"&asi da+ $/a&i #i-a/a $/"aia+ dalam &$/$+-a+aa+ da+ &$la"sa+aa+ i+$/7$+si &ada &asi$+ d$+%a+ %a+%%a+ m$+$la+ ,a+% $/a.
BAB I/ D0KU'ENTASI
6/mli/ Asa+ Gii
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