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Formulir surveilans Infeksi Daerah Operasi (IDO)

No

Nama Ps

Register

Tgl
msk

Tgl
klr

D/

Tind/
OP

Jenis operasi
B

1.

Ny.Nen

29/1

2.

Tn.Ari

28/1

3.

Tn.Arly

28/1

4.

Tn.Endi

10/1

5.

Tn.Erwin

19/1

Post
APP
Post
CABG
Post
App
Post
CABG
CABG

6.

Ny.R

25/1

SC

7.
8.

Tn.G
Ny.Ani

4/1

APP
SC

9.

Ny.Isan

10

Tn.Ac

cabg

App

sc

app

BK
0

Score

Ktr
0

ASA Klasifikasi
1
0

0
0

3
1

Score

Score

Total
score

Anti
biotk

Ket

T
time
< >
0

Merop

Vanco

Merop
Sharox

IDO
S.Epidermidis
IDO
MRSA
IDO
P.Aeroginosa
IDO
S.Epidermidis
IDO
S.Epidermidis
IDO
P.Aeroginosa

0
1
0

0
0

0
0

0
0

0
0

0
0

0
0

SC

APP

Sharox
IDO
P.Aeroginosa
IDO
Acinetobacter
Sp
IDO