RUMAH SAKIT UMUM YARSI PONTIANAK

KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN

TAHUN 2018

RUANGAN : Bersalin
BULAN : Januari 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
Tunggu + 0 0 0 0 0 0 0
Hasil - 0 0 0 0 0 0 0
Pelayana
3 Waktu JLH 0 0 0 0 0 0 0
Tunggu + 0 0 0 0 0 0 0
Hasil - 0 0 0 0 0 0 0
Pelayana
4 Angka JLH 0 0 0 0 0 0 0
kepatuan + 0 0 0 0 0 0 0
pengisia - 0 0 0 0 0 0 0
n Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
n Resep + 0 0 0 0 0 0 0
Obat - 0 0 0 0 0 0 0
tidak
6 Kesalaha JLH 0 0 0 0 0 0 0
n Penulis + 0 0 0 0 0 0 0
an Resep - 0 0 0 0 0 0 0
(Prescri
7 Evaluasi JLH 0 0 0 0 0 0 0
pelaksan + 0 0 0 0 0 0 0
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 1 0 0 0 0 0 0
ng Reak + 0 0 0 0 0 0 0
si - 1 0 0 0 0 0 0
tranfusi
9 Ketepata JLH 0 0 0 0 0 0 0
n + 0 0 0 0 0 0 0
pengemb - 0 0 0 0 0 0 0
alian
10 Angka JLH 0 0 0 0 0 0 0
kejadian + 0 0 0 0 0 0 0
plebitis - 0 0 0 0 0 0 0
grII/Lebi
11 Pasien JLH 0 0 0 0 0 0 0
stroke + 0 0 0 0 0 0 0
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
stroke
12

stroke - 0 0 0 0 0 0 0
iskemik
13 Aspirin JLH 0 0 0 0 0 0 0
diterima + 0 0 0 0 0 0 0
dalam - 0 0 0 0 0 0 0
waktu 24
14 Aspirin JLH 0 0 0 0 0 0 0
diresepk + 0 0 0 0 0 0 0
an untuk - 0 0 0 0 0 0 0
pasien
15 Persenta JLH 0 0 0 0 0 0 0
se + 0 0 0 0 0 0 0
tindakan - 0 0 0 0 0 0 0
Sectio
16 Jumlah JLH 0 0 0 0 0 0 0
kekoson + 0 0 0 0 0 0 0
gan stok - 0 0 0 0 0 0 0
obat
17 Insiden JLH 0 0 0 0 0 0 0
tertusuk + 0 0 0 0 0 0 0
jarum - 0 0 0 0 0 0 0
18 Penggun JLH 0 0 0 0 0 0 0
aan + 0 0 0 0 0 0 0
Ruang - 0 0 0 0 0 0 0
ICU
19 Demogra JLH 0 0 1 0 0 0 0
fi pasien Tj. Raya 0 0 0 0 0 0 0
yang Siantan 0 0 1 0 0 0 0
terdiagn
osa Pre- Tj. Hulu 0 0 0 0 0 0 0
20 Kecepata JLH 0 0 0 0 0 0 0
n waktu + 0 0 0 0 0 0 0
pemberia - 0 0 0 0 0 0 0
n
21 Baku JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
limbah - 0 0 0 0 0 0 0
cair
22 Kepatuh JLH 3 0 0 0 0 0 0
an + 3 1 4 4 1 0 0
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh JLH 3 1 4 4 1 0 0
an + 0 0 0 0 0 0 0
penerapa - 3 1 4 4 1 0 0
n
24 Kepatuh JLH 0 0 0 0 0 0 0
an + 0 0 0 0 0 0 0
pemberia - 0 0 0 0 0 0 0
n label
25 Kepatuh JLH 0 0 0 0 0 0 0
an + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
kepatuha apotik 0 0 0 0 0 0 0
n
petugas radiologi 0 0 0 0 0 0 0
27 Insiden JLH 0 0 0 0 0 0 0
pasien
27
pasien + 0 0 0 0 0 0 0
jatuh - 0 0 0 0 0 0 0
selama
28 Reaksi JLH 0 0 0 0 0 0 0
Obat + 0 0 0 0 0 0 0
Anastesi - 0 0 0 0 0 0 0
29 Kepuasa JLH
n pasien +
-
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3 2 0 1 1 0 3 3 2 2
0 0 0 0 0 0 0 0 0 0
2 2 0 1 1 0 3 3 2 2
0 0 0 0 0 0 0 0 0 0
2 2 0 1 1 0 3 3 2 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 1 0 0
1 0 0 0 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 2 5 2 1 1 1 2 3 2
0 0 0 0 0 0 0 0 0 0
1 2 5 2 1 1 1 2 3 2
0 0 0 0 0 0 0 0 0 0
1 2 5 2 1 1 1 2 3 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
59 59
0 0 0 0 0
0 0 0 59 59
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 5
0 0 0 0 0
0 0 0 0 5
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 1 0 4
0 0 1 0 4
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 2
0 0 0 0 0
0 0 0 0 2
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
3 2 2 2 59
0 0 0 0 0
3 2 2 2 58
0 0 0 0 0
3 2 2 2 58
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Februari 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH 4 2 0 2 3 3 2
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 0 1 0 0 0 0 1
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 0 1 0 0 0 0 1
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 0 0 0 0
dengan
si
sakit
se + 0 0 0 0 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 0 0 0 0 0 0
untuk
bayifi pasien Tj. Raya 0 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 0 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 4 2 0 2 3 3 2
rawat
an + 4 2 0 2 3 3 2
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 4 2 0 2 3 3 2
an + 4 2 0 2 3 3 2
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17
4 1 0 4 1 0 5 0 3 5
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 1 0 0
0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
4 1 0 4 1 0 5 0 3 5
4 1 0 4 1 0 5 0 3 5
0 0 0 0 0 0 0 0 0 0
4 1 0 4 1 0 5 0 3 5
4 1 0 4 1 0 5 0 3 5
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27
2 2 5 3 1 2 0 3 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 1 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 1 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 2 5 3 1 2 0 3 0 0
2 2 5 3 1 2 0 3 0 0
0 0 0 0 0 0 0 0 0 0
2 2 5 3 1 2 0 3 0 0
2 2 5 3 1 2 0 3 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
1 0 0 0 58
0 0 0 13 13
0 0 0 45 45
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 6
0 0 0 0 0
0 0 0 0 6
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
0 0 0 0 1
0 0 0 0 2
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 0 0 58
1 58
0 0 0 0 0
1 0 0 0 58
1 0 0 0 58
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Maret 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH 2 1 2 1 2 0 2
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 0 0 0 0 1 0 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 0 0 0 0 1 0 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 1 0 0 0
dengan
si
sakit
se + 0 0 0 1 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 0 0 0 0 0 0
untuk
bayifi pasien Tj. Raya 0 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 0 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 2 1 2 1 2 0 2
rawat
an + 2 1 2 1 2 0 2
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 1 1 2 1 2 0 2
an + 1 1 2 1 2 0 2
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17
2 3 1 2 5 3 1 3 2 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 1 0 1 0 0 0 0
1 0 0 1 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 0 1 0 0 0 0 0
1 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 3 1 2 5 3 1 3 2 1
2 3 1 2 5 3 1 3 2 1
0 0 0 0 0 0 0 0 0 0
3 3 1 2 5 3 1 5 2 1
3 3 1 2 5 3 1 5 2 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27
2 2 1 2 3 3 4 2 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 0 0 0
0 0 0 0 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 2 1 2 3 3 4 2 0 1
2 2 1 2 3 3 4 2 0 1
0 0 0 0 0 0 0 0 0 0
2 2 1 1 4 3 4 2 0 1
2 2 1 1 4 3 4 2 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
2 2 1 2 60
0 0 0 8 0
0 0 0 52 52
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
0 0 0 0 0
0 0 0 0 3
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 1 0 8
1 0 1 0 8
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
0 0 0 0 2
0 0 0 0 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2 2 1 2 60
2 2 1 2 60
0 0 0 0 0
2 2 1 2 62
2 2 1 2 62
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : April 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH 4 5 3 2 1 4 6
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 0 0 0 0 0 0 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 0 0 0 0 0 0 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 0 0 0 0
dengan
si
sakit
se + 0 0 0 0 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 2 0 0 0 0 0
untuk
bayifi pasien Tj. Raya 0 1 0 0 0 0 0
pasien
posisi yang Siantan 0 1 0 0 0 0 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 4 5 3 2 1 4 6
rawat
an + 4 5 3 2 1 4 6
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 0 0 0 0 0 0 0
an + 0 0 0 0 0 0 0
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17
1 2 1 1 1 4 4 0 2 3
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 2 1 1 1 4 4 0 2 3
1 2 1 1 1 4 4 0 2 3
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27
1 1 1 3 0 2 1 1 2 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 1 3 0 2 1 1 2 1
1 1 1 3 0 2 1 1 2 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
4 0 2 0 63
0 0 0 0 0
0 0 0 63 63
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 2
0 0 0 0 1
0 0 0 0 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 0 2 0 63
4 0 2 0 63
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Mei 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH 5 2 1 2 2 1 2
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 1 1 0 0 0 0 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 1 1 0 0 0 0 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 1 0 0 0
dengan
si
sakit
se + 0 0 0 1 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 1 0 0 0 0 1 0
untuk
bayifi pasien Tj. Raya 1 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 1 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 5 2 1 2 2 1 2
rawat
an + 5 2 1 2 2 1 2
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 5 2 1 2 2 1 2
an + 5 2 1 2 2 1 2
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17
2 2 0 2 4 1 3 2 3 5
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 0 0 0 2
0 0 0 0 0 0 0 0 0 1
0 0 0 1 0 0 0 0 0 1
0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 2 0 2 4 1 3 2 3 5
2 2 0 2 4 1 3 2 3 5
0 0 0 0 0 0 0 0 0 0
2 2 0 2 4 1 3 2 3 5
2 2 0 2 4 1 3 2 3 5
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27
0 2 1 2 3 4 1 2 5 3
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 0 0 1
0 1 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 2 1 2 3 4 1 2 5 3
0 2 1 2 3 4 1 2 5 3
0 0 0 0 0 0 0 0 0 0
0 2 1 2 3 4 1 2 5 3
0 2 1 2 3 4 1 2 5 3
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
5 2 3 1 73
0 0 0 73 73
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 0 0 5
0 0 0 0 0
1 1 0 0 5
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 2 0 0 7
1 2 0 0 7
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 8
0 0 0 0 4
0 0 0 0 3
0 0 0 0 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
5 2 3 1 73
5 2 3 1 73
0 0 0 0 0
5 2 3 1 73
5 2 3 1 73
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Juni 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH 4 0 1 0 3 0 2
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 1 0 0 0 0 1 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 1 0 0 0 0 1 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 2 0 0 0 0 0 0
dengan
si
sakit
se + 2 0 0 0 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 1 0 0 0 0 0 0
untuk
bayifi pasien Tj. Raya 1 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 0 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 4 0 1 0 3 0 2
rawat
an + 4 0 1 0 3 0 2
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 4 0 1 0 3 0 2
an + 4 0 1 0 3 0 2
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17
2 0 3 5 3 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 0 3 5 3 0 1 0 1 0
2 0 3 5 3 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0
2 0 3 5 3 0 0 0 2 0
2 0 3 5 3 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27
4 1 2 2 1 1 3 1 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
4 1 2 2 1 1 3 1 0 1
4 1 2 2 1 1 3 1 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
1 0 3 0 45
0 0 0 4 4
0 0 0 41 41
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 0 0 4
0 0 0 0 0
1 0 0 0 4
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 4
0 0 0 0 4
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 1 0 3
0 0 0 0 1
0 0 0 0 1
0 0 1 0 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 3 0 45
1 0 3 0 45
0 0 0 0 0
0 0 0 0 25
0 0 0 0 25
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Juli 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH 0 2 3 1 2 2 3
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 0 0 0 0 0 0 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 0 0 0 0 0 0 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 0 0 0 0
dengan
si
sakit
se + 0 0 0 0 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 0 0 0 0 1 0
untuk
bayifi pasien Tj. Raya 0 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 1 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 0 2 3 1 2 2 3
rawat
an + 0 2 3 1 2 2 3
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 0 2 3 1 2 2 3
an + 0 2 3 1 2 2 3
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17
2 4 1 3 3 4 2 3 6 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 2 0 1 1 0 1 0 1
0 0 0 0 0 0 0 0 0 0
0 0 2 0 1 1 0 1 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 0 1 0 1 1 0 0
1 0 0 0 1 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 0 0
0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 4 1 3 3 4 2 3 6 1
2 4 1 3 3 4 2 3 6 1
0 0 0 0 0 0 0 0 0 0
2 4 1 3 3 4 2 3 6 1
2 4 1 3 3 4 2 3 6 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27
4 2 0 1 2 1 0 1 2 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
4 2 0 1 2 1 0 1 2 1
4 2 0 1 2 1 0 1 2 1
0 0 0 0 0 0 0 0 0 0
4 2 0 1 2 1 0 1 2 1
4 2 0 1 2 1 0 1 2 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
2 1 2 2 63
0 0 0 63 63
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 1 0 7
0 0 0 0 0
0 0 1 0 7
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 5
0 0 0 0 5
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
0 0 0 0 1
0 0 0 0 2
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2 1 2 2 63
2 1 2 2 63
0 0 0 0 0
2 1 2 2 63
2 1 2 2 63
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Agustus 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH 2 2 3 1 3 0 0
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 0 0 1 0 0 0 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 0 0 1 0 0 0 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 0 0 0 0
dengan
si
sakit
se + 0 0 0 0 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 0 0 0 0 0 0
untuk
bayifi pasien Tj. Raya 0 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 0 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 2 2 3 1 3 0 0
rawat
an + 2 2 3 1 3 0 0
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 2 2 3 1 3 0 0
an + 2 2 3 1 3 0 0
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17
1 4 2 2 1 3 1 4 1 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 1 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 1 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 4 2 2 1 3 1 4 1 2
1 4 2 2 1 3 1 4 1 2
0 0 0 0 0 0 0 0 0 0
1 4 2 2 1 3 1 4 1 2
1 4 2 2 1 3 1 4 1 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27
1 0 0 1 3 1 0 2 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 1 3 1 0 2 0 0
1 0 0 1 3 1 0 2 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 1 3 1 0 2 0 0
1 0 0 1 3 1 0 2 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
0 0 1 3 44
0 0 0 44 44
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 5
0 0 0 0 0
0 0 0 0 5
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 1
0 0 0 0 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 1 3 44
0 0 1 3 44
0 0 0 0 0
0 0 1 3 44
0 0 1 3 44
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : September 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH 2 1 4 2 5 0 1
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 1 0 0 0 0 0 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 1 0 0 0 0 0 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 1 0 1 1
dengan
si
sakit
se + 0 0 0 1 0 1 1
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 0 0 0 0 0 0
untuk
bayifi pasien Tj. Raya 0 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 0 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 2 1 4 2 5 0 1
rawat
an + 2 1 4 2 5 0 1
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 2 1 4 2 5 0 1
an + 2 1 4 2 5 0 1
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17
2 0 3 4 1 3 3 0 3 6
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 0 3 4 1 3 3 0 3 6
2 0 3 4 1 3 3 0 3 6
0 0 0 0 0 0 0 0 0 0
2 0 3 4 1 3 3 0 3 6
2 0 3 4 1 3 3 0 3 6
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27
1 3 3 3 4 4 2 2 3 3
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 3 3 3 4 4 2 2 3 3
1 3 3 3 4 4 2 2 3 3
0 0 0 0 0 0 0 0 0 0
1 3 3 3 4 4 2 2 3 3
1 3 3 3 4 4 2 2 3 3
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
2 3 1 0 74
0 0 0 70 70
0 0 0 4 4
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 6
0 0 0 0 0
0 0 0 0 6
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 0 9
1 1 1 0 9
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 2
0 0 0 0 0
0 0 0 0 2
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2 3 1 0 74
2 3 1 0 74
0 0 0 0 0
2 3 1 0 74
2 3 1 0 74
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Oktober2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 0 0 1 0 0 0 1
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 0 0 1 0 0 0 1
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 0 0 0 1
dengan
si
sakit
se + 0 0 0 0 0 0 1
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 0 0 0 0 1 0
untuk
bayifi pasien Tj. Raya 0 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 1 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 3 0 0 0 0 0 0
rawat
an + 3 1 4 4 1 0 0
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 1 1 4 2 4 3 3
an + 1 1 4 2 4 3 3
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 1 2 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
1 0 0 1 2 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 1 0 0
0 0 0 0 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3 2 0 1 1 0 3 3 2 2
0 0 0 0 0 0 0 0 0 0
5 0 5 1 6 0 0 5 0 1
5 0 5 1 6 0 0 5 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 0 0 2 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 0 0 2 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 2 5 2 1 1 1 2 3 2
0 0 0 0 0 0 0 0 0 0
1 2 0 0 0 0 0 0 0 0
1 2 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
68 68
0 0 0 68 68
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 11
0 0 0 0 0
0 0 0 0 11
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
0 0 0 0 3
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 0 0 3
0 1 0 0 2
0 0 0 0 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
3 2 2 2 59
0 0 0 0 0
0 0 0 0 44
0 0 0 0 44
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Januari 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 0 0 0 0 0 0 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 0 0 0 0 0 0 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 0 0 0 0
dengan
si
sakit
se + 0 0 0 0 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 0 0 0 0 0 0
untuk
bayifi pasien Tj. Raya 0 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 0 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 3 0 0 0 0 0 0
rawat
an + 3 1 4 4 1 0 0
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 0 0 0 0 0 0 0
an + 0 0 0 0 0 0 0
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3 2 0 1 1 0 3 3 2 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 2 5 2 1 1 1 2 3 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
59 59
0 0 0 0 0
0 0 0 59 59
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
3 2 2 2 59
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 RUMAH SAKIT UMUM YARSI PONTIANAK
KOMITE PENINGKATAN MUTU DAN KESELAMATAN PASIEN
TAHUN 2018

RUANGAN : Bersalin
BULAN : Januari 2018

NO VARIABEL
1 2 3 4 5 6 7
1 Kelengk JLH
apan + 0 0 0 0 0 0 0
pelaksan - 0 0 0 0 0 0 0
aan
2 Waktu JLH 0 0 0 0 0 0 0
pengisia
Tunggu + 0 0 0 0 0 0 0
n
Hasil - 0 0 0 0 0 0 0
asesmen
Pelayana
3 awal
Waktu JLH 0 0 0 0 0 0 0
nmedis
Tunggu + 0 0 0 0 0 0 0
Laborato
dan
Hasil
rium - 0 0 0 0 0 0 0
keperaw
Pelayana
4 Patologi
Angka JLH 0 0 0 0 0 0 0
natan Thorax
Klinik
kepatuan
pasien + 0 0 0 0 0 0 0
Foto
pengisia
baru - 0 0 0 0 0 0 0
untuk
nPasien Daftar
5 Penulisa JLH 0 0 0 0 0 0 0
Tilik
nRawat Resep + 0 0 0 0 0 0 0
Operasi
inap
Obat
(check - 0 0 0 0 0 0 0
tidak
6 in, sign
Kesalaha JLH 0 0 0 0 0 0 0
sesuai Fo
in,
nrmulariutame
Penulis + 0 0 0 0 0 0 0
out,Resep
an sign
m oleh D - 0 0 0 0 0 0 0
out,(Prescri
7 okter
Evaluasi
check JLH 0 0 0 0 0 0 0
ption Err
pelaksan
out) + 0 0 0 0 0 0 0
ors)
aan - 0 0 0 0 0 0 0
Penatala
8 Monitori JLH 0 0 0 0 0 0 0
ksanaan
ng Reak + 0 0 0 0 0 0 0
Operasi
si - 0 0 0 0 0 0 0
Elektif
tranfusi
9 dengan
Ketepata JLH 0 0 0 0 0 0 0
24 jam
nAnestesi + 0 0 0 0 0 0 0
pasca
Umum
pengemb - 0 0 0 0 0 0 0
tranfusi
alian
10 Angka JLH 0 0 0 0 0 0 0
berkas
kejadian + 0 0 0 0 0 0 0
rekam
plebitis - 0 0 0 0 0 0 0
medis
grII/Lebi
11 lengkap
Pasien JLH 0 0 0 0 0 0 0
h≤ 2x24
akibat
stroke + 0 0 0 0 0 0 0
perawata
jam
ischemic
nsetelah
di rum
dan
ah sakit
pasien
hemorrar
keluar
ghic
perawata
yang
11 Pasien
stroke
ischemic - 0 0 0 0 0 0 0
dan
12 Pasien
hemorrar JLH 0 0 0 0 0 0 0
dengan + 0 0 0 0 0 0 0
ghic
stroke - 0 0 0 0 0 0 0
yang
iskemik
13 telah
Aspirin JLH 0 0 0 0 0 0 0
diresepk
dikaji
diterima + 0 0 0 0 0 0 0
an terapi
untuk
dalam
antitrom - 0 0 0 0 0 0 0
mendapa
waktu 24
14 botik
Aspirin JLH 0 0 0 0 0 0 0
tkan dari
jam
pada
diresepk
pelayana saat + 0 0 0 0 0 0 0
kedatang
pulang
an
nan untuk
ke - 0 0 0 0 0 0 0
pasien
rehabilita JLH
15 rumah
Persenta 0 0 0 0 0 0 0
dengan
si
sakit
se + 0 0 0 0 0 0 0
acut
pada
tindakan
myocardi - 0 0 0 0 0 0 0
pasien
Sectio
16 al
Jumlah
dengan JLH 0 0 0 0 0 0 0
Caesare
infarctio
kekoson + 0 0 0 0 0 0 0
ainfark (SC)
ngan
miokard (AMI)
stok
yang - 0 0 0 0 0 0 0
saat
obat
17 akut
dilakuka
Insiden
pulang
esensial / JLH 0 0 0 0 0 0 0
n(AMI)
tertusuk
keluar pada + 0 0 0 0 0 0 0
primigra
jarum
rumah - 0 0 0 0 0 0 0
vida usia
18 sakit
Penggun
kehamila JLH 0 0 0 0 0 0 0
aan
n 37-42 + 0 0 0 0 0 0 0
Ruang
minggu - 0 0 0 0 0 0 0
ICU
dengan
19 Demogra JLH 0 0 0 0 0 0 0
untuk
bayifi pasien Tj. Raya 0 0 0 0 0 0 0
pasien
posisi yang Siantan 0 0 0 0 0 0 0
yang
normal
terdiagn
memerlu
osa Pre- Tj. Hulu
tunggal
kan
0 0 0 0 0 0 0
20 Kecepata
Eklamsia JLH
hidup 0 0 0 0 0 0 0
perawata
ndi rawatwaktu + 0 0 0 0 0 0 0
npemberia
inap
Intensive - 0 0 0 0 0 0 0
n
21 Baku
informas JLH 0 0 0 0 0 0 0
mutu + 0 0 0 0 0 0 0
i tentang
limbah - 0 0 0 0 0 0 0
tagihan
cair
22 pasien
Kepatuh JLH 3 0 0 0 0 0 0
rawat
an + 3 1 4 4 1 0 0
inap
identifik - 0 0 0 0 0 0 0
asi
23 Kepatuh
pasien di JLH 0 0 0 0 0 0 0
an + 0 0 0 0 0 0 0
ruangan
penerapa - 0 0 0 0 0 0 0
rawat
ninap
24 Kepatuh JLH 0 0 0 0 0 0 0
komunik
an + 0 0 0 0 0 0 0
asi
pemberia - 0 0 0 0 0 0 0
dengan
nmetode label
25 Kepatuh
obat high JLH 0 0 0 0 0 0 0
READ
an + 0 0 0 0 0 0 0
alert
BACK
pelaksan
oleh
pada saat
aan
farmasi
menerim
prosedur
aSite
perintah
Marking
25 Kepatuh
an
pelaksan - 0 0 0 0 0 0 0
aan
26 Persenta
prosedur dokter 0 0 0 0 0 0 0
se lab 0 0 0 0 0 0 0
Site
kepatuha
Marking apotik 0 0 0 0 0 0 0
nsebelum
radiologi 0 0 0 0 0 0 0
petugas
27 tindakan
Insiden JLH 0 0 0 0 0 0 0
kesehata
operasi
pasien
n dalam + 0 0 0 0 0 0 0
jatuh
melakuk - 0 0 0 0 0 0 0
selama
an
28 Reaksi JLH 0 0 0 0 0 0 0
perawata
kebersih
Obat + 0 0 0 0 0 0 0
nan rawat
Anastesi - 0 0 0 0 0 0 0
inap di
tangan
29 rumah
Kepuasa
dengan JLH
sakit
nmetode
pasien +
enam -
langkah
dan lima
momen
 SENSUS HARIAN MUTU DAN KESELAMATAN PASIEN

JUMLAH/TANGGAL
8 9 10 11 12 13 14 15 16 17

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3 2 0 1 1 0 3 3 2 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
AMATAN PASIEN

NGGAL
18 19 20 21 22 23 24 25 26 27

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 2 5 2 1 1 1 2 3 2
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
28 29 30 31 TOTAL
59 59
0 0 0 0 0
0 0 0 59 59
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 3
3 2 2 2 59
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0