TINDAKAN
Can be managed by Clinical Manager / Lead Clinician Detailed review & urgent Immediate review &
procedure should assess the consequences treatment should be undertaken action required at Board
againts cost of treating the risk by senior management level. Director must be
informed
TABEL ASESMEN RISIKO
No. Insiden Jenis Dampak Probabilitas Skor Bands Rangking Tindakan Penanggung
Insiden (D) (P) Risiko Risiko Jawab
(D x P)
1 2 3 4 5 1 2 3 4 5 1-25 L M H E
1 KNC (Tn. Joko KNC 1 2 2 vv 4 Membatalkan Radiologi
Sur) Salah pasien v CT Scan
dengan
identifikasi
pasien,investi
gasi
sederhana
2 Sentinel (Tn. Ali) Sentinel 4 1 4 v 2 Bilas spinal, Sp. An
Salah obat pelaporan
RCA,
direktur
3 KTC (Tn. A) KTC 3 1 3 v 3 Endoskopi Sp. PD, Sp. An
Kalibrasi alat ulang,
investigasi
sederhana
4 Sentinel (Tn. B) Sentinel 5 2 10 v 1 RCA Perawat bangsal
Jatuh meninggal
( Diisi Oleh Unit )