PEMERINTAH KABUPATEN BULELENG

DINAS KESEHATAN
PUSKESMAS SUKASADA I
Jln. Jelantik Gingsir No.51 Singaraja
Email: puskesmas.1.sukasada.@mail.com
RENCANA USULAN KEGIATAN ( RUK ) TAHUN 2021
RUANG KIA / KB
PUSKESMAS SUKASADA I

UPAYA KEBUTUHAN SUMBER DAYA INDIKATOR SUMBER

NO KEGIATAN TUJUAN SASARAN TARGET PJ Mitra Kerja
KESEHATAN DANA ALAT TENAGA KEBERHASILAN BIAYA
1 Ruang KIA/KB 1 ATK 1 Amplop polos perekat 80gr 6 bh x 1 th x Rp40,300 = Rp241,800.00 Buku Bikor Terpenuhinya dan JKN
2 Ballpoint Biru Amprah terfasilitasi kebutuhan
4 bh x 1 th x Rp29,000 = Rp116,000.00
ATK
3 Ballpoint AE-7 12 bh x 1 th x Rp3,700 = Rp44,400.00 ATK Ruang KIA/KB

4 Box File Plastik 4 bh x 1 th x Rp24,200 = Rp96,800.00

5 Buku Ekspedisi isi 100 Kiky 1 bh x 1 th x Rp18,600 = Rp18,600.00
6 Buku Folio isi 100 Kiky 6 bh x th x Rp35,700 = Rp0.00
7 Buku Kwarto 100 4 bh x th x Rp17,600 = Rp0.00
8 Buku tulis 78 Sidu 6 bh x 1 th x Rp8,500 = Rp51,000.00
9 Clips Sea Gull 6 bh x 1 th x Rp24,600 = Rp147,600.00
10 Isi Staples Kangaroo No.3 6 bh x 1 th x Rp16,600 = Rp99,600.00
11 Isi Staples Kangaroo No.10 6 bh x 1 th x Rp9,300 = Rp55,800.00
12 Kertas HVS 70gr folio sidu 12 rim x 1 th x Rp79,600 = Rp955,200.00
13 Kertas HVS 70gr Kwarto 6 bh x th x Rp68,700 = Rp0.00
14 Klip Jepit Besar 50 bh x 1 th x Rp9,300 = Rp465,000.00
15 Klip Jepit Sedang 50 bh x 1 th x Rp5,700 = Rp285,000.00
16 Klip Jepit Kecil 50 bh x 1 th x Rp3,700 = Rp185,000.00
17 Lem Glukol B 6 bh x th x Rp13,500 = Rp0.00
18 Map Kertas Folio 24 bh x 1 th x Rp2,600 = Rp62,400.00
19 Map Order TK 10 bh x th x Rp35,700 = Rp0.00
20 Pelubang Kertas 330 1 bh x 1 th x Rp47,600 = Rp47,600.00
21 Spidol Permanent G12 4 bh x 1 th x Rp17,600 = Rp70,400.00
22 Spidol White Board 4 bh x 1 th x Rp18,600 = Rp74,400.00
23 Steples alat,besar 1 bh x 1 th x = Rp0.00
24 Steples alat,Kecil 1 bh x 1 th x Rp88,901 = Rp88,901.00
25 Tinta Printer Epson Standr
1.Black 10 bh x 1 th x Rp198,300 = Rp1,983,000.00
2.Magenta 3 bh x 1 th x Rp198,300 = Rp594,900.00
3.Yellow 3 bh x 1 th x Rp198,300 = Rp594,900.00
4.Cyan 3 bh x 1 th x Rp198,300 = Rp594,900.00
30 LAPTOP 1 bh x 1 th x = Rp0.00
31 Penggaris 2 bh x 1 th x = Rp0.00
 Jumlah Rp6,873,201.00

UPAYA KEBUTUHAN SUMBER DAYA INDIKATOR SUMBER

NO KEGIATAN TUJUAN SASARAN TARGET PJ Mitra Kerja
KESEHATAN DANA ALAT TENAGA KEBERHASILAN BIAYA
2 Alat listrik dan 1 BOX kabel(bulat10M+lampu) Petugas Aset 100% Luh Widiastuti Petugas Aset 1 bh x 1 th x Rp37,200 = Rp37,200.00 Buku Bikor Terpenuhinya dan JKN
elektronik 2 Lampu LED 4-5 Watt Amprah terfasilitasi kebutuhan
4 bh x 1 th x Rp85,300 = Rp341,200.00
ATK
ATK Ruang KIA/KB
3 Alat Kebersihan dan 1 Alat Pel Super Mop 1 bh x 1 th x Rp258,200 = Rp258,200.00
Bahan Pembersih 2 Bayclin 3 btl x 1 th x Rp27,200 = Rp81,600.00
3 Diterjen total harum 2 kg x 1 th x Rp21,200 = Rp42,400.00
4 Keset Wool kecil 1 bh x 1 th x Rp17,000 = Rp17,000.00
5 Lap Kuning Kecil 2 bh x 1 th x Rp8,800 = Rp17,600.00
6 Sabun Tangan 60 btl x 1 th x Rp59,100 = Rp3,546,000.00
7 Sapu bulu ayam super 1 bh x 1 th x Rp38,000 = Rp38,000.00
8 Sapu ijuk plastik kipas 1 bh x 1 th x Rp59,100 = Rp59,100.00
9 Serok sampah 1 bh x 1 th x Rp63,500 = Rp63,500.00
10 Super pel 12 bh x 1 th x Rp21,200 = Rp254,400.00
11 Tas Kresek Merah Besar 12 bks x 1 th x Rp21,200 = Rp254,400.00
12 Tissue Kotak Besar 60 bh x 1 th x Rp18,800 = Rp1,128,000.00
13 Mama Lemon 3 bh x 1 th x Rp33,600 = Rp100,800.00

4 Alat Laboratorium 1 Masker Medis 30 ktk x 1 th x Rp175,000 = Rp5,250,000.00

5 Barang pakai habis 1 Alkohol Swab isi 100pcs 12 ktk x 1 th x Rp400,000 = Rp4,800,000.00
kesehatan 2 Hand Sanitizer btl x 1 th x = Rp0.00
3 Hand Schoen 72 ktk x 1 th x = Rp0.00
4 Kapas 75gram 4 bh x 1 th x Rp16,500 = Rp66,000.00
5 Nurse Cup 15 ktk x 1 th x Rp132,000 = Rp1,980,000.00
6 Plester 7,5x4,5(ISOPLAST) 12 rol x 1 th x Rp35,700 = Rp428,400.00
7 HBSAG Strip 36 ktk x 1 th x Rp991,500 = Rp35,694,000.00
8 Reagen HIV 30 ktk x 1 th x Rp342,000 = Rp10,260,000.00
9 Reagen Syphilis 36 ktk x 1 th x Rp350,000 = Rp12,600,000.00
10 Sofratulle 10x10 cm 12 scht x 1 th x Rp40,000 = Rp480,000.00
11 Stik Glukosa isi 25 buah 36 ktk x th x = Rp0.00
12 Yodium Povidone 1L/Molexdine 4 bh x 1 th x Rp101,200 = Rp404,800.00

6 Barang Pakai Habis 1 Pembersih kaca cling 4 btl x 1 th x Rp34,600 = Rp138,400.00

Kebersihan 2 Pengharum mobil gantung 6 bh x 1 th x Rp26,900 = Rp161,400.00
3 Pengharum ruangan stela 6 bh x 1 th x Rp41,400 = Rp248,400.00
4 Kresek kuning besar 12 bks x 1 th x Rp52,900 = Rp634,800.00
5 Tisu gulung 50 glng x 1 th x Rp6,400 = Rp320,000.00

7 Bahan Obat-obatan 1 Alkohol 70% 1 liter 6 btl x 1 th x Rp76,000 = Rp456,000.00

2 Hifafix 5CM x 1M 12 ktk x 1 th x Rp26,500 = Rp318,000.00

8 Bahan Kimia 1 Reagen Golongan Darah 4 set x 1 th x Rp345,000 = Rp1,380,000.00

2 Stik pemeriksaan HB 36 ktk x 1 th x Rp172,500 = Rp6,210,000.00
 Rp88,069,600.00
Jumlah Rp94,942,801.00

UPAYA KEBUTUHAN SUMBER DAYA INDIKATOR SUMBER

NO KEGIATAN TUJUAN SASARAN TARGET PJ Mitra Kerja
KESEHATAN DANA ALAT TENAGA KEBERHASILAN BIAYA
9 Belanja Cetak 1 Blanko Persetujuan Pasien 2 rim x 1 th x Rp64,100 = Rp128,200.00
2 Form Permintaan Lab 12 rim x 1 th x Rp64,100 = Rp769,200.00
3 Kartu indeks pasien/ibu hamil 1,500 lmbr x 1 th x Rp300 = Rp450,000.00
x th x = Rp0.00
10 Pengadaan 1 Foto Copy folio 70g/m2 1,500 lmbr x 1 th x Rp200 = Rp300,000.00

11 Pemeliharaan alat 1 Puls Oxymeter 1 unit x 1 th x = Rp0.00

Kedokteran dan
Kesehatan
12 Meja dan kursi 1 Kursi Kerja Eselon 4 bh x 1 th x Rp5,580,000 = Rp22,320,000.00
Kerja / rapat Ukuran 50x50x45 cm x th x = Rp0.00
Pejabat x th x = Rp0.00
x th x = Rp0.00
13 Alat kesehatan 1 Gunting Benang 2 Pcs x 1 th x Rp1,369,000 = Rp2,738,000.00
kebidanan dan 2 Pinset Anatomis 2 Pcs x 1 th x Rp488,100 = Rp976,200.00
Penyakit Kandungan 3 Pinset Cirugis 2 Pcs x 1 th x Rp513,100 = Rp1,026,200.00

14 Alat Kesehatan 1 Head Lamp,GEA Bistos 2 unit x 1 th x Rp1,558,000 = Rp3,116,000.00

Umum lainnya 2 Heacting Set Bbraun aesculap 2 unit x 1 th x Rp6,530,000 = Rp13,060,000.00
3 Instrument Troley,Nuritek 1 unit x 1 th x Rp5,795,000 = Rp5,795,000.00
4 Kuvet Instrumen stein 512 Js 5 buah x 1 th x Rp314,000 = Rp1,570,000.00
5 Lampu Periksa 1 unit x 1 th x Rp104,844,000 = Rp104,844,000.00
6 Nalpuder,Stenlis Uk18cm 2 bh x 1 th x Rp95,000 = Rp190,000.00
7 Nierbeken 243x125mm 1 bh x 1 th x Rp830,000 = Rp830,000.00
8 Nierbeken 204x130mm 1 bh x 1 th x Rp714,000 = Rp714,000.00
9 Standar Infus 1 unit x 1 th x Rp3,018,000 = Rp3,018,000.00
10 Tempat tidur periksa 1 unit x 1 th x Rp10,525,000 = Rp10,525,000.00
11 Termometer,ABN Digital 2 unit x 1 th x Rp119,000 = Rp238,000.00
12 Korentang 1 bh x 1 th x Rp1,607,872 = Rp1,607,872.00
13 Palu Refleks/Refleks Hammer 1 bh x 1 th x Rp327,690 = Rp327,690.00
14 Tissu Forcep 2 bh x 1 th x Rp744,686 = Rp1,489,372.00
15 Stetoskop 1 bh x 1 th x = Rp0.00
16 Sulip lidah logam,Panjang:12cm 2 bh x 1 th x Rp400,000 = Rp800,000.00
17 Sulip lidah logam,P : 16,5cm 2 bh x 1 th x Rp500,000 = Rp1,000,000.00
18 Tensimeter Jarum(kompas) 1 bh x 1 th x = Rp0.00
19 Tensimeter Digital 1 bh x 1 th x Rp1,323,300 = Rp1,323,300.00
20 Spekulum Vagina kecil 2 bh x 1 th x Rp9,289,500 = Rp18,579,000.00
21 Spekulum Vagina standard 5 bh x 1 th x = Rp0.00
22 Spekulum Vagina Besar 2 bh x 1 th x Rp9,289,500 = Rp18,579,000.00
23 Spekulum (sims) 2 bh x 1 th x Rp600,000 = Rp1,200,000.00
24 Tampon Tang 2 bh x 1 th x Rp500,000 = Rp1,000,000.00
25 Torniquet karet 2 bh x 1 th x Rp600,000 = Rp1,200,000.00
26 Partus set 1 set x 1 th x Rp359,000,000 = Rp359,000,000.00
27 Tabung Oksigen 1 set x 1 th x Rp5,705,370 = Rp5,705,370.00
 28 Regulator 1 bh x 1 th x Rp1,430,000 = Rp1,430,000.00
29 Canul Oksigen 2 bh x 1 th x Rp560,000 = Rp1,120,000.00
30 Gunting Verband 1 bh x 1 th x Rp500,000 = Rp500,000.00
31 Resusitator Bayi/Amu Bag 1 bh x 1 th x = Rp0.00
Rp587,469,404.00
Jumlah Rp682,412,205.00

UPAYA KEBUTUHAN SUMBER DAYA INDIKATOR SUMBER

NO KEGIATAN TUJUAN SASARAN TARGET PJ Mitra Kerja
KESEHATAN DANA ALAT TENAGA KEBERHASILAN BIAYA
32 Tromol Kasa/Kain Steril 1 bh x 1 th x Rp556,600 = Rp556,600.00
33 Mangkok untuk larutan 2 bh x 1 th x Rp250,000 = Rp500,000.00
34 Air Timer 1 bh x 1 th x Rp167,100 = Rp167,100.00
35 Celemek Plastik / Apron 4 bh x 1 th x Rp6,988,351 = Rp27,953,404.00
36 Pispot 1 bh x 1 th x Rp1,500,000 = Rp1,500,000.00
37 Pompa Payudara untuk ASI 1 bh x 1 th x Rp700,000 = Rp700,000.00

38 Benang Chromik catgut 2 bh x 1 th x Rp57,400 = Rp114,800.00

39 Lubricant Gel 6 btl x 1 th x = Rp0.00
40 Stabimet/Cairan Desinfektan 12 bh x 1 th x = Rp0.00
bh x th x = Rp0.00
41 Baki lobam tempat alat steril 1 bh x 1 th x Rp1,500,000 = Rp1,500,000.00
42 Implant Kit 2 bh x 1 th x Rp617,700 = Rp1,235,400.00
43 IUD Kit 2 bh x 1 th x Rp3,762,300 = Rp7,524,600.00

44 Sprei Putih&sarung bantal 2 set x 1 th x = Rp0.00

45 Sikat membersihkan alat 2 bh x 1 th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
15 Kelengkapan 1 Partisi/Penyekat ruangan bh x th x = Rp0.00
Ruangan 2 Wallpaper ruangan/Aula bh x th x = Rp0.00
3 Pelindung tembok,1/2 dinding bh x th x = Rp0.00
4 Papan Data bh x th x = Rp0.00
5 Papan White Board 1 bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
 bh x th x = Rp0.00
bh x th x = Rp0.00
bh x th x = Rp0.00
Mengetahui Singaraja, 31 Desember 2020
Kepala Puskesmas Sukasada I Pemegang Program Ibu

`
drg.I Putu Novara Sona Luh Widiastuti
Nip. 19661121 200212 1 006 Nip. 19730226 200604 2 008

2 Masker : 4 orang/hari x 30hr x 12bl==> 4x30x12 = 1440 : 50 (isi 1ktk) = 28,8 (30)
3 Nurse Cup : 4 orang/hari x 30hr x 12bl==> 4x30x12 = 1440 : 100 (isi 1ktk) = 14,4 (15)
4 TRI E : sasaran ibu hamil 846(900)
HIV ==> 900 : 30(isi 1ktk) = 30kotak
Syphilis==> 900 : 25(isi 1ktk) = 36kotak
HBSAG ==> 900 :
5 Stik HB dan GDA 900:25:00