MONITORING PELAKSANAAN PERAWATAN M

RSUD SIMPANG LIMA GUMU

Bulan : Januari 2019
Tanggal
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0

KETERANGAN
Tanggal Keterangan
18 Januari Terdapat 1 pasien BBLR (2000gr) tidak dilakukan PMK karena kendala sarana RS yang belum siap

Kediri, .......
Kepala Ruanga

(......KUNTI WINARTI, A
WATAN METODE KANGURU DI UPTD
MA GUMUL KEDIRI

TOTAL
23 24 25 26 27 28 29 30 31
Capaian
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 1 100%

ang belum siap

Kediri, .......................
Kepala Ruangan ....................

NTI WINARTI, A.Md.Keb................................................................)

 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Pebruari 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 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 1 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0%

Tanpa PMK 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 1 100%

KETERANGAN
Tanggal Keterangan
17 Pebruari Terdapat 1 bayi BBLR dengan BB 2000gr, tidak dilakukan PMK karena kondisi belum memungkinkan, dg dx. Syok hipovolemia

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Maret 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : April 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Mei 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Juni 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Juli 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 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 1 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0%

Tanpa PMK 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 1 100%

KETERANGAN
Tanggal Keterangan
11 Juli Terdapat 1 pasien BBLR BB 1530gr, UK 33 minggu tidak dilakukan PMK karena kondisi tidak bagus pasien dipindah ke ruang ICU

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Agustus 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : September 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Oktober 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UPTD
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Nopember 2019
Tanggal
TOTAL
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Capaian
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)
 MONITORING PELAKSANAAN PERAWATAN METODE KANGURU DI UP
RSUD SIMPANG LIMA GUMUL KEDIRI
Bulan : Desember 2019
Tanggal
Denominator 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
BBLR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Tanpa PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

KETERANGAN
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................
(.....................................................................)
NGURU DI UPTD

TOTAL
Capaian
0 (%)

0
 MONITORING PELAKSANAAN PERAWATAN METODE
KANGURU DI UPTD RSUD SIMPANG LIMA GUMUL KEDIRI
Tahun 2019
Bulan
TOTAL
Denominator Jan Peb Mar Apr Mei Jun Jul Agu Sept Okt Nop Des
Capaian
BBLR 1 1 0 0 0 0 1 0 0 0 0 0 3 (%)

Numerator 
Dilakukan PMK 0 0 0 0 0 0 0 0 0 0 0 0 0 0%

Tanpa PMK 1 1 0 0 0 0 1 0 0 0 0 0 3 100%

KETERANGAN :
Tanggal Keterangan

Kediri, .......................
Kepala Ruangan ....................

(.....................................................................)