FORMULIR SURVEILANS ILO RUMAH SAKIT MOHAMMAD HOESIN PALEMBANG

IRNA EX. IBS LANTAI II KEBIDANAN JANUARI 2014

TANGGAL NAMA RM DX. MEDIS JENIS LUKA ROSK ASA RIKS LAMA RIKS HASIL ANTIBIOTIK

PASIEN B BT T K SCORE SCORE OPERASI SCORE KULTUR
(JAM)
2-1-2014 Suhartini 784622 Kolpotomi 0 I 0 40 menit 0 0 Ceftriaxone , Gentamicin

3-1-2014 Mastuti 656299 Salfingoooforektomi 0 I 0 1 jam 0 0 Ceftriaxone,

Metronidazole
3-1-2014 Kima 780401 Histerektomi 0 II 0 2 jam 0 0 Ceftriaxone

4-1-2014 Asmah 7789632 Histerektomi 0 II 0 1,5 jam 0 0 Ceftriaxone,

Ahmad Metronidazole,
Gentamicin

6-1-2014 Evi 787234 Histerektomi 0 II 0 2 jam 0 0 Ceftriaxone,

Baharudin Metronidazole
6-1-2014 Suis Puspita 782486 Histerektomi 0 II 0 2 jam 0 0 Ceftriaxone,
Metronidazole

8-1-2014 Mulyati 789997 Histerektomi 0 I 0 3,5 jam 0 0 Ceftriaxone,

Hadi Metronidazole

9-1-2014 Kartini 782535 Histerektomi 0 I 0 5 jam 0 0 Ceftriaxone,

Metronidazole

13-1-2014 Mirayanti 753443 Histerektomi 0 I 0 5 jam 0 0 Ceftriaxone,

Metronidazole

15-1-2014 Karsinem 785960 Laparatomi 0 II 0 3 jam 0 0 Ceftriaxone,

Metronidazole

1
16-1-2014 Hamida 771784 Laparatomi 0 II 0 1,5 jam 0 0 Ceftriaxone,
Ahmad Metronidazole
16-1-2014 Nurhayani 778625 Salfingoooforektomi 0 II 0 1 jam 0 0 Ceftriaxone

17-1-2014 Munsiawati 740315 Histerektomi 0 II 0 2 jam 0 0 Ceftriaxone

17-1-2014 Paniyem 781960 Laparatomi 0 II 0 1 jam 0 0 Ceftriaxone,
Metronidazole

23-1-2014 Cik Ro 703307 Salfingoooforektomi 0 I 0 1 jam 0 0 Ceftriaxone

23-1-2014 Usmarini 793311 Histerektomi 0 II 0 2,5 jam 0 0 Ceftriaxone
Usni

28-1-2014 Ririn 786901 Salfingoooforektomi 0 I 0 2,15 jam 0 0 Ceftriaxone

Amaya
28-1-2014 Dina Saputri 791926 Salfingoooforektomi 0 I 0 2 jam 0 0 Ceftriaxone

29-1-2014 Elva 788349 0 0 0 0

Yudiyanti
29-1-2014 Pinarsih 775264 Laparatomi 0 0 1 jam 0 0 Ceftriaxone,
Metronidazole