FORMULIR SURVEILANS HARIAN INFEKSI RUMAH SAKIT

RUMAH SAKIT UMUM KARTINI

BULAN/TAHUN : AGUSTUS 2019

RUANGAN : PERAWATAN DEPAN
SURVEYOR :

TINDAKAN INFEKSI
TGL NAMA No RM U JK Dx Medis UC IVL PLEBITIS
HAP ISK
Fiksasi No Posisi No
1 TN. MAD SARI 32284 74 L BRONKITIS,TB MC 18
1 NY. SITI 13899 48 P VERTIGO MC 18
1 NY. AHIRIYAH 27877 24 P DYSPEPSIA MC 18
1 TN. SUWARYO 29829 77 L CHF MC 18
1 TN. DIRMAN 32276 56 L CHF MC 20
1 NY. WARTIMAH 32264 65 P OBS HEMATOMESIS MC 20
1 NY. MURTASIAH 32275 53 P CHF MC 20
2 TN. SODIKIN 31920 44 L KOLIK ABDOMEN MC 20
2 NY. SRIYATI 32307 50 P FEBRIS,HIPERTENSI MC 20
2 NY. KARSIH 32310 43 P FEBRIS, PPOK MC 20
2 NY. WAGIYANTI 16150 30 P KOLIK ABDOMEN MC 20
2 TN. DISMAN 32300 64 L OBS. VOMITUS MC 20
3 NY. SUTILAH 32317 53 P HIPERTENSI MC 20
3 TN. WARISO 18309 75 L OBS DISPNEU,CHF MC 20
1 SDR. MUSTOFA 32267 25 L SPASME OTOT MC 20
3 TN. JAIMAN 24054 94 L CHF, DHF MC 20
3 TN. MISMAN 32332 50 L KOLIK ABDOMEN MC 20
4 NY. KATIMAH 32338 63 P SNH MC 20
4 TN. SARJUNI 19170 66 L HIPERTENSI,VERTIGO MC 20
4 TN. ANDUN GUNAWAN 10694 42 L DYSPEPSIA MC 20
5 NY. KARNI HANDAYANI 19189 26 P FEBRIS MC 20
5 NY. SRI LIRYATI 32089 54 P ABDOMINAL PAINT MC 20
6 NN. EKA KURIANINGSIH 32395 22 P DYSPEPSIA MC 20
6 NY. MARSIYEM 32387 55 P ASMA BRONKIAL MC 18
6 NY. KHUSNUL 31735 21 P DYSPEPSIA MC 20
7 NY. MANISEM 24681 64 P ASMA BRONKIAL MC 20
7 NY. LILIS 32412 50 P ASMA BRONKIAL MC 20
7 TN. TUGIYO 32417 67 L SNH,LBP MC 20
7 NY. NURHAYATI 32410 28 P SUSP HEPATITIS MC 20
7 NY. SUKINAH 32409 66 P ANEMIA MC 18
7 TN. SUTRASNO 32400 50 L HIPERPIRESIA MC 18
7 TN. MUSONUDIN 32402 43 L VERTIGO,HIPERTENSI MC 20
7 TN. TARMIDI 32401 78 L HIPERTENSI,VERTIGO MC 20
7 TN. SUDARNO 3655 65 L CAD MC 20
8 NY. SUPIYEM 32442 57 P TB PARU, DYSPEPSIA MC 20
8 TN. HADI SUKAMTO 6413 68 L ASMA BRONKIAL MC 20
8 NN. NUNUNG 32418 20 P SUSP TB PARU MC 20
8 NY. TUMINEM 24307 70 P FEBRIS MC 20
8 NN. RISKA 15943 17 P VOMITUS MC 20
9 NY. SUYATUN 30867 47 P FEBRIS MC 20
9 TN. SUGIYANTO 29765 31 L TB TULANG.LBP MC 20
9 NY. NINING 31661 40 P FEBRIS MC 20
9 TN. SOBARI 21763 80 L FEBRIS MC 20
9 TN. BUDI SISWANTO 32446 40 L FEBRIS MC 20
9 NN. PUTRI PRASADA 30978 18 P VOMITUS MC 20
9 NN. MARCIANA 32263 25 P DYSPEPSIA MC 20
9 SDR. VALENTINUS 32453 22 L VERTIGO MC 20
9 SDR. RONI 32450 18 L DYSPEPSIA MC 20
10 TN. EFENDI 32472 29 L DYSPEPSIA MC 20
10 NY. SITI FATIMAH 13864 57 P OBS. VOMITUS MC 20
10 TN. SAMTO MIARJO 32473 82 L SUSP SNH MC 20
10 TN. DIRIN 16812 92 L PPOK MC 20
10 TN. JONEN 32470 36 L HIPERTENSI MC 20
10 TN. SAMSUMAR 32462 58 L SPASME OTOT MC 20
10 TN. SUPRAPTO 32478 36 L COMBUSTIO PEDIS D MC 20
9 NY. SRI SUMARTI 32449 42 P GEA, DHF MC 20
10 NY. RUSMINAH 32467 40 P FEBRIS, ISK MC 20
10 NY. ROHMANI 32475 65 P RETENSIO URINE MC 20
11 NY. INDI YULIANTI 13182 27 P FEBRIS MC 20
11 NY. SUMIRAH 32489 65 P COLIC RENAL, HT MC 20
12 TN. SARIYADI 32501 36 L THYPOID MC 20
12 TN. TONI 32494 38 L MIGRAIN MC 20
12 NN. ELIA DEWI 32500 17 P POSE SINKOP MC 20
12 TN. SUMARLI 12577 48 L ANEMIA MC 20
12 NN. SELLY 32504 18 P MALARIA MC 20
12 NY. SADIYEM 17831 66 P CHF MC 20
I3 TN. DALIMIN 16393 82 L FEBRIS MC 20
13 TN .MUROHMAN 32534 39 L LBP,HIPERTENSI MC 20
13 TN. BASIRIN 29670 44 L FEBRIS MC 20
13 NY. SUSILAH 32531 53 P ACUT ABDOMEN MC 20
13 SDR. SAHRUL 32507 19 L THYPOID MC 20
13 NN. DINAR 32503 19 P FEBRIS,OBS VOMITUS MC 20
13 NY. PONIEM 32535 49 P CEPALGIA MC 20
13 NY. SITI HALIMAH 32533 43 P GEA MC 20
13 NY. MUNTIYAH 32511 52 P SUSP TB PARU MC 20
13 NY. NURHIDAYAH 32522 32 P HIPERTENSI MC 20
14 TN. EDI AWALUDIN 32543 46 L COLIC RENAL MC 20
15 TN. ARMASYAH 32573 29 L COMBUSTIO MC 20
15 TN. MADI YASA 32574 70 L DYSPEPSIA MC 20
15 NY. KATIEM 32580 65 P CEPALGIA MC 20
15 NN. SEPTI NOVITA 27810 17 P ANEMIA MC 20
15 NY. SITI NAFSIAH 11279 51 P COLIC ABDOMEN MC 20
15 TN. SUPRAPTO 32478 36 L COMBUSTIO MC 20
15 NY. MARIA 19162 75 P CEPALGIA MC 20
16 TN. S SUDARNO 3655 66 L CHF MC 20
16 NY. SUKATMI 24502 48 P CKD MC 20
16 NY. EKA 32597 40 P FEBRIS MC 20
16 NY. AZZRONITA 32589 52 P FEBRIS MC 20
16 TN. WAKIJAN 11669 60 L PPOK MC 20
17 NY. KOMINAH 21734 51 P DYSPEPSIA MC 20
17 TN. MARJUKI 30083 65 L ASMA BRONKIAL MC 20
17 NY. NURHAYATI 32416 28 P LBP,OA MC 20
17 TN. BAHUDIN 30367 80 L DYSPEPSIA MC 20
17 NY. SITI AMINAH 32609 61 P DYSPEPSIA MC 20
17 NY. BAERAH 32612 62 P HIPERTENSI MC 20
17 TN. SUGENG 32599 45 L FEBRIS MC 20
17 NY. RUSTINA 32606 59 P DYSPEPSIA MC 20
17 TN. ABDULAH 24931 86 L HIPERTENSI MC 20
17 NN. NURUL 8340 22 P DYSPEPSIA MC 20
17 NY. ELA SOLIHAT 32618 28 P GERD MC 20
18 NY. MUSIAH 29414 64 P CHF MC 20
18 SDR. SRIYONO 32630 26 L CHEPALGIA, SUSP HIV MC 20
19 NY. MANISAH 27505 60 P CHF,PPOK MC 20
19 NY. KARTINI 32118 55 P CHF, HHD MC 20
19 NY. SARMIYAH 32636 60 P VOMITUS,HIPERTENSI MC 20
19 NY. SUMINI 32640 75 P HIPERTENSI MC 20
19 TN. WARISO 18309 75 L CHF MC 20
19 TN. SUMARLI 32638 80 L PPOK MC 20
19 TN. ABDUL JALAL 32632 70 L CEPALGIA MC 20
20 NY. EKA 19035 32 P DHF, THYPOID MC 20
18 NY. NORA 21458 50 P VERTIGO MC 20
18 NY. MUJIATI 32624 56 P FEBRIS MC 20
11 NY. SUYAT WATI 32487 60 P CHEPALGIA MC 20
21 TN. ARIFIN 28532 44 L VERTIGO MC 20
21 TN. HADI RAHAYU 32680 70 L PPOK MC 20
21 TN. LAMIN 31862 63 L FEBRIS MC 20
22 TN. MUJIRIN 32685 42 L FEBRIS MC 20
22 NY. LEGINAH 32702 41 P GEA MC 20
22 TN. SAMSUMAR 32462 58 L CKD MC 20
22 NN. DWI PUTRI 32704 18 P THYPOID MC 20
22 TN. PAINO 32703 65 L PPOK MC 20
22 TN. MAD SARI 32281 60 L PPOK MC 20
23 NY. PUJIATI 30825 42 P DM TIPE II, HIPERTENSI MC 20
23 NY. SUMINEM 32711 53 P SUSP TB, DM TIPE II MC 20
23 TN. BAHRUDIN 30367 80 L BP MC 20
23 NY. MURNIATI 16872 55 P ASMA BRONKIAL MC 20
23 NY. PUJI LETARI 11402 35 P ABDOMINAL PAINT MC 20
24 NY. MUAH 32722 71 P OBS. DISPNOE MC 20
24 NY. SITI NURHUSNAH 28648 54 P VOMITUS MC 20
24 NY. PARIEM 32535 58 P HIPERTENSI, VERTIGO MC 20
24 NY. JUWARIYAH 32719 63 P DISPEPSIA MC 20
25 NY. ISMAWATI 32732 37 P OBS FEBRIS MC 20
25 NY. RANTINAH 32727 75 P VERTIGO, ANEMIA MC 20
25 NY. NUR HALIMAH 32737 39 P VOMITUS MC 20
25 TN. SUTARMIN 8915 75 P FEBRIS, HIPERTENSI MC 20
25 NY. NGADINAH 32731 35 P DYSPEPSIA MC 20
25 TN. JUMADIONO 32726 52 L ASMA BRONKIAL MC 20
25 NY. YULIANA 32738 22 P SIND DYSPEPSIA MC 20
25 NN. KHUSNUL 32725 20 P DYSPEPSIA MC 20
25 TN. MAFIKIN 32734 44 L FATIGUE,SIND DYSPEP MC 20
25 NY. PUJINAH 31100 52 P CEPALGIA, HIPERTENSI MC 20
25 NY. SRI LESTARI 18921 29 P FEBRIS MC 20
26 TN. SAIMAN 32752 44 L FEBRIS,DYSPEPSIA MC 20
26 NY. NGATENI 24305 69 P FEBRIS MC 20
26 NY. NIRANI 29653 28 P GASTRITIS MC 20
26 TN. WAHYUKIN 32742 59 L KOLIK RENAL MC 20
27 SDR. ITHOSAPUTRA 31018 31 L DISPEPSIA,KONSTIPASI MC 20
27 NY. RASMI 22002 76 P PPOK MC 20
27 NY. KARTINI 32118 55 P VOMITUS, CHF MC 20
28 TN. KASNO 32780 78 L PPOK,DYSPEPSIA MC 20
28 NY. YULIANTI 20731 52 P GE AKUT MC 20
28 SDR. MUKLAS 32810 24 L FEBRIS MC 20
28 TN. MISKIN 32795 60 L KOLIK ABDOMEN MC 20
29 TN. JUREMI 32821 51 L ANEMIA, CKD MC 20
29 TN. SADARODIN 32820 48 L DYSPEPSIA MC 20
29 NY. SUMINI 32877 58 P STRUK HEMORAGIK MC 20
29 TN. SARPAN 32830 63 L FEBRIS MC 20
30 TN. MESTAM 32846 83 L PPOK MC 20
30 NY. MASNI 26322 68 P DYSPEPSIA, HT MC 20
30 NY. SUKARTI 32842 45 P DYSPEPSIA MC 20
30 NY. NARTI 32845 37 P FEBRIS, GEA MC 20
30 TN. TULOHADI 32823 75 L PPOK MC 20
30 TN. SUTIMAN 22212 63 L DM TIPE II, DYSPEPSIA MC 20
31 TN. TASDIH 30865 55 L BRONKITIS MC 20
31 NY. TUMIYEM 21468 55 P HIPERTENSI MC 20
KETERANGAN
Dx Medis : Diagnosa Medis HAP : Hospital Associated Pneumonia
U : Usia ISK : Infeksi Saluran Kemih
JK : Jenis Kelamin AB : Anti Biotik
UC : Urine Catheter
IVL : Intra Vena Line/Vena Parifer
FORMULIR SURVEILANS HARIAN INFEKSI RUMAH SAKIT
RUMAH SAKIT UMUM KARTINI

BULAN/TAHUN : AGUSTUS 2019

RUANGAN : PERAWATAN BALAKANG
SURVEYOR :
TINDAKAN INFEKSI
TGL No RM U JK Dx Medis UC IVL PLEBITIS
HAP ISK
Fiksasi No Posisi No
1 NY. MARSIDAH 32283 66 P TUMOR MAMAE MC 18
1 TN. PARLIYONO 32287 54 L ABSES PEDIS MC 18
1 TN.TUMIRIN 32297 42 L P OP BATU BULI YA 18 MC 18
1 TN. BUDIONO 15147 37 L P OP PEDIS MC 18
1 TN. DAUSOREJO 32298 80 L P OP HERNIA YA 18 LB 18
1 NN. MARCIANA 32263 23 P ABDOMINAL PAINT MC 18
1 NY. MUJI 26358 31 P P OP HEMOROID YA 18 MC 18
1 TN. SAKIRAN 32272 76 L HEMOROID MC 18
4 NY. TURWIYAH 20874 40 P KOLIK RENAL D MC 18
3 TN. SUPANIN 32330 46 L ABSES PEDIS MC 18
4 TN. SUDARMAN 32335 72 L ABDOMINAL PAINT MC 20
5 SDR. ANGGI ASREGA 32349 16 L CKR MC 20
6 TN. ABDUL 32381 42 L TUMOR PUNGGUNG MC 20
6 TN. EDI 32375 32 L ABSES PERIANTAL MC 20
6 NY. SRIYATUN 32372 44 P TUMOR MAMAE S MC 18
6 TN. RANTO 32389 34 L VULNUS SCLOPETORUM MC 20
6 NY. SURTINAH 31419 40 P TUMOR PUNGGUNG MC 20
6 NY. MURSIANTI 32377 43 P TUMOR MAMAE S MC 20
6 NY. JASEM 32369 55 P TUMOR OCIPITAL MC 20
6 NY. LISMAWATI 29530 30 P OPEN FRAKTUR FEMUR MC 20
6 TN. MUHAJIR 32269 53 L SNNT MC 18
6 NY. DARSINAH 32151 52 P KOLIK RENAL D MC 18
6 NY. ENDANG 19687 60 P OSTEOMYLITIS PEDIS MC 18
5 NY. SRI LIRYATI 32089 54 P ABDOMINAL PAINT MC 18
10 NY. MARIYANTI 32457 37 P ABDOMINAL PAINT MC 18
11 SDR. FERI 32490 17 L CKR MC 20
13 TN. SUGIYANTO 32515 45 L P OP VESIKOLITIASIS YA 18 MC 20
13 NY. TURSIYAH 32104 63 P SNNT DEXTRA MC 20
13 TN PURWANTO 32514 54 L P OP HIL YA 18 MC 18
13 TN. KAWIT 32521 66 L OSTEOMYLITIS PEDIS MC 18
15 TN. AHMAD IHSAN 32581 33 L P OP APP YA 18 MC 18
17 TN. SUPENO 16141 60 L KOLIK ABDOMEN MC 18
17 TN. WARSONO 32600 66 L P OP ABSES COLLI MC 18
18 NY. KASMINAH 12085 59 P TUMOR OMENTUM MC 18
18 TN. ISWANTO 32622 35 L CKR MC 20
18 TN. DARMAN 32623 50 L FRAKTUR DIGIT IV MC 20
19 TN. RUSMANTO 25312 45 L UROLITIASIS MC 20
19 TN. JONI ISKANDAR 32641 31 L ABDOMINAL PAINT MC 20
19 NY. KAMISAH 32621 50 P KOLIK ABDOMINAL MC 20
20 NY. SUCI MARLINA 16690 41 P ACUT ABDOMEN MC 20
20 NY. SANYEP 32353 91 P TUMOR FEMUR MC 20
20 TN. SUYANTO 32671 45 L P OP HIL YA 18 MC 18
20 TN. DALIMIN 16393 82 L OSTEOMILITIS MC 18
20 TN. SURATNO 32650 45 L TUMOR PUNGGUNG MC 18
20 NY. LILIS 32662 22 P TUMOR WIST JOINT MC 18
20 NY. MUGIYANTI 32667 35 P TUMOR PUNGGUNG MC 18
20 NY. LISNAWATI 32661 65 P CA NASOPARING MC 20
22 NY. TENTIANA 32613 46 P P OP ILEUS OBSTRUKT YA 18 MC 18
22 NY. MURTINI 24356 33 P CHEPALGIA. T OTAK MC 20
22 TN. JIMAN 32666 49 L P OP T COLLI D MC 18
 27 TN. WARSITO 32771 64 L P OP TUMOR PAROTIS MC 18
27 TN. SUKADAR 32764 44 L POST OP HIL S YA 18 MC 18
27 TN. TOHIRIN 32789 47 L OSTEOMILITIS CRONIS MC 18
29 NY. MARIYANTI 32457 37 P ULKUS DM PEDIS MC 18
29 TN. SUYUD 32822 45 L TUMOR ANTEBRACI MC 18
29 NY. SUPARNI 32826 78 P TUMOR MAMAE S MC 18

KETERANGAN
Dx Medis : Diagnosa Medis HAP : Hospital Associated Pneumonia
U : Usia ISK : Infeksi Saluran Kemih
JK : Jenis Kelamin AB : Anti Biotik
UC : Urine Catheter
IVL : Intra Vena Line/Vena Parifer
HASIL KULTUR AB

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ANBACIM

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ANBACIM
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