BULAN/TAHUN :
RUANGAN :
SURVEYOR :
DEPARTEMEN :
KETERANGAN
Dx Medis : Diagnosa Medis ETT : Endotracheal Tube
U : Usia HAP : Hospital Associated Pneumonia
JK : Jenis Kelamin VAP : Ventilator Associated Pneumonia
UC : Urine Catheter IAD : Infeksi Aliran Darah
IVL : Intra Vena Line/Vena Perifer
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JANUARI 2022
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 9 1 9 0 0 9 0 0
2 9 1 9 0 0 9 0 0
3 8 1 8 0 0 8 0 0
4 12 1 12 0 0 12 0 0
5 24 5 24 0 0 24 1 0
6 18 1 18 0 0 18 1 0
7 10 2 10 0 0 10 1 0
8 6 0 6 0 0 6 0 0
9 5 1 5 0 0 5 1 0
10 12 0 12 0 0 12 0 0
11 24 9 24 0 0 24 1 0
12 12 3 12 0 0 12 1 0
13 11 1 11 0 0 11 2 0
14 10 2 10 0 0 10 1 0
15 6 2 6 0 0 6 0 0
16 6 0 6 0 0 6 2 0
17 14 1 14 0 0 14 1 0
18 16 6 16 0 0 16 0 0
19 9 3 9 0 0 9 2 0
20 15 1 15 0 0 15 1 0
21 10 1 10 0 0 10 1 0
22 5 1 5 0 0 5 1 0
23 9 2 9 0 0 9 0 0
24 7 2 7 0 0 7 0 0
25 12 2 12 0 0 12 0 0
26 13 2 13 0 0 13 2 0
27 14 1 14 0 0 14 0 0
28 15 3 15 0 0 15 1 0
29 14 2 14 0 0 14 0 0
30 12 2 12 0 0 12 0 0
31 12 2 12 0 0 12 0 0
JML 359 61 359 0 0 359 20 0
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : FEBRUARI 2022
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 5 1 5 0 0 5 1 0
2 8 0 8 0 0 8 0 0
3 9 2 9 0 0 9 0 0
4 9 0 9 0 0 9 0 0
5 7 0 7 0 0 7 0 0
6 10 0 10 0 0 10 0 0
7 18 2 18 0 0 18 0 0
8 13 3 13 0 0 13 1 0
9 15 4 15 0 0 15 1 0
10 16 3 16 0 0 16 0 0
11 10 3 10 0 0 10 0 0
12 11 3 11 0 0 11 0 0
13 11 0 11 0 0 11 0 0
14 15 0 15 0 0 15 0 0
15 26 0 26 0 0 26 0 0
16 14 0 14 0 0 14 0 0 An.Rianti ido meninggal
17 11 0 11 0 0 11 0 0
18 6 1 6 0 0 6 0 0
19 3 0 3 0 0 3 0 0
20 2 0 2 0 0 2 0 0
21 3 0 3 0 0 3 0 0
22 10 2 10 0 0 10 0 0
23 8 3 8 0 0 8 1 0
24 7 0 7 0 0 7 1 0
25 7 0 7 0 0 7 0 0
26 5 0 5 0 0 5 0 0
27 5 0 5 0 0 5 0 0
28 4 0 4 0 0 4 0 0
JML 268 27 268 0 0 268 5 0
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : MARET 2022
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 14 14 0 0 14 0 0
2 6 1 6 0 0 6 0 0
3 5 1 5 0 0 5 0 0
4 5 0 3 0 0 5 0 0
5 4 0 4 0 0 4 0 0
6 11 0 11 0 0 11 1 0
7 17 3 17 0 0 17 0 0
8 12 3 11 0 0 12 2 0
9 11 5 11 0 0 11 0 0
10 3 0 3 0 0 3 0 0
11 3 0 3 0 0 3 0 0
12 4 0 4 0 0 4 0 0
13 11 0 11 0 0 11 0 0
14 11 0 11 0 0 11 0 0
15 15 4 15 0 0 15 0 0
16 16 3 16 0 0 16 0 0
17 6 1 6 0 0 6 0 0
18 5 0 4 0 0 5 0 0
19 7 0 7 0 0 7 0 0
20 5 2 5 0 0 5 0 0
21 9 2 9 0 0 9 1 0
22 11 3 11 0 0 11 0 0
23 11 3 11 0 0 11 0 0
24 20 4 20 0 0 20 0 0
25 15 2 1 15 0 0 15 0 0
26 14 3 14 0 0 14 0 0
27 18 5 1 18 0 0 18 0 0
28 17 4 17 0 0 17 1 0
29 28 3 1 28 0 0 28 0 0
30 18 4 18 0 0 18 0 0
31 11 2 11 0 0 11 0 0
JML 343 58 339 0 0 343 5 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : APRIL 2022
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 6 0 6 0 0 6 0 0
2 10 0 10 0 0 10 0 0
3 13 3 13 0 0 13 0 0
4 16 5 16 0 0 16 0 0
5 20 7 20 0 0 20 0 0
6 14 8 14 0 0 14 0 0
7 14 8 14 0 0 14 0 0
8 11 3 11 0 0 11 0 0
9 10 1 10 0 0 10 0 0
10 6 1 6 0 0 6 1 0
11 10 0 10 0 0 10 2 0
12 18 3 18 0 0 18 2 0
13 10 2 10 0 0 10 0 0
14 6 0 6 0 0 6 1 0
15 6 0 6 0 0 6 0 0
16 6 0 6 0 0 6 0 0
17 4 0 4 0 0 4 0 0
18 6 0 6 0 0 6 0 0
19 6 0 6 0 0 6 0 0
20 2 0 2 0 0 2 0 0
21 4 0 4 0 0 4 0 0
22 4 0 4 0 0 4 0 0
23 8 0 8 0 0 8 0 0
24 6 0 6 0 0 6 0 0
25 8 0 8 0 0 8 0 0
26 6 4 6 0 0 6 0 0
27 7 2 7 0 0 7 1 0
28 4 1 4 0 0 4 0 0
29 4 0 4 0 0 4 0 0
30 1 0 1 0 0 1 0 0
JML 246 48 246 0 0 246 7 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : MEI 2022
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 1 0 1 0 0 0 0 0
2 2 0 2 0 0 0 0 0
3 3 0 3 0 0 0 0 0
4 3 0 3 0 0 0 0 0
5 3 0 3 0 0 0 0 1
6 6 0 6 0 0 0 0 1
7 5 0 5 0 0 0 0 1
8 4 0 4 0 0 0 0 1
9 6 0 6 0 0 0 0 1
10 9 0 9 0 0 0 0 1
11 11 0 11 0 0 0 0 0
12 7 0 7 0 0 0 0 0
13 9 0 9 0 0 0 0 0
14 8 0 8 0 0 0 0 0
15 6 0 6 0 0 0 0 0
16 8 0 8 0 0 0 0 0
17 9 0 9 0 0 0 1 0
18 13 1 13 0 0 0 0 1
19 15 0 15 0 0 0 0 1
20 15 0 15 0 0 0 0 1
21 15 0 15 0 0 0 0 1
22 9 2 9 0 0 5 0 0
23 12 0 12 0 0 6 0 0
24 15 0 15 0 0 7 0 1
25 14 5 14 0 0 0 0 0
26 4 3 4 0 0 8 0 0
27 5 2 5 0 0 5 0 0
28 11 2 11 0 0 11 0 1
29 11 2 11 0 0 8 1 1
30 21 3 21 0 0 6 0 0
31 27 6 27 0 0 13 0 0
JML 287 26 287 0 0 69 2 13
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JUNI 2022
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KET AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING
1 4 0 4 0 0 29 0 0
2 13 1 13 0 0 10 2 0
3 14 0 14 0 0 10 1 0
4 11 0 11 0 0 10 0 0
5 7 0 7 0 0 10 2 0
6 11 0 11 0 0 11 1 0
7 17 0 17 0 0 26 0 2 dirumah
8 19 4 19 0 0 32 1 1 dirumah
9 25 3 25 0 0 27 0 1 dirumah
10 11 0 11 0 0 22 0 1 dirumah
11 15 0 15 0 0 13 0 1 dirumah
12 12 0 12 0 0 11 0 0
13 28 3 28 0 0 9 0 0
14 29 3 29 0 0 14 0 0
15 19 3 19 0 0 14 0 0
16 14 1 14 0 0 16 0 0
17 11 0 11 0 0 9 0 0
18 12 0 12 0 0 8 0 0
19 11 0 11 0 0 8 0 0
20 9 0 9 0 0 14 2 0
21 10 0 10 0 0 21 0 0
22 13 1 13 0 0 29 0 0
23 13 1 13 0 0 14 0 0
24 14 3 14 0 0 13 0 0
25 7 0 7 0 0 8 1 0
26 5 1 5 0 0 8 0 0
27 11 1 11 0 0 6 0 0
28 21 6 21 0 0 15 0 0
29 18 1 18 0 0 14 1 0
30 11 3 11 0 0 11 0 0
JML 415 35 415 0 0 442 11 6
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JULI 2021
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 12 4 12 0 0 12 0 0
2 9 1 9 0 0 9 0 0
3 4 1 4 0 0 4 0 0
4 4 1 4 0 0 4 0 0
5 9 1 9 0 0 9 0 0
6 11 3 11 0 0 11 0 0
7 10 4 10 0 0 10 0 0
8 9 2 9 0 0 9 0 0
9 7 1 7 0 0 7 0 0
10 4 1 4 0 0 4 0 0
11 3 1 3 0 0 3 0 0
12 4 0 4 0 0 4 0 0
13 9 0 9 0 0 9 0 0
14 7 3 7 0 0 7 0 0
15 6 1 6 0 0 6 0 0
16 3 1 3 0 0 3 0 0
17 3 3 3 0 0 3 0 0
18 3 0 3 0 0 3 0 0
19 6 0 6 0 0 6 0 0
20 7 1 7 0 0 7 0 0
21 5 0 5 0 0 5 0 0
22 5 0 5 0 0 5 0 0
23 2 0 2 0 0 2 0 0
24 1 0 1 0 0 1 0 0
25 1 0 1 0 0 1 0 0
26 5 1 5 0 0 5 0 0
27 7 2 7 0 0 7 0 0
28 5 0 5 0 0 5 0 0
29 6 1 6 0 0 6 0 0
30 3 1 3 0 0 3 0 0
31 2 1 2 0 0 2 0 0
JML 172 35 172 0 0 172 0 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : AGUSTUS 2021
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 2 0 2 0 0 0 0 0
2 2 0 2 0 0 0 0 0
3 3 1 3 0 0 0 0 0
4 6 0 6 0 0 0 0 0
5 4 0 4 0 0 0 0 0
6 3 1 3 0 0 0 0 0
7 2 1 2 0 0 0 0 0
8 3 1 3 0 0 0 0 0
9 8 0 8 0 0 0 0 0
10 9 1 9 0 0 0 0 0
11 7 1 7 0 0 0 0 0
12 5 1 5 0 0 0 0 0
13 5 0 5 0 0 0 0 0
14 5 1 5 0 0 0 0 0
15 4 0 4 0 0 0 0 0
16 5 0 5 0 0 0 0 0
17 7 2 7 0 0 0 0 0
18 4 0 4 0 0 0 0 0
19 4 1 4 0 0 0 0 0
20 5 1 5 0 0 0 0 0
21 5 1 5 0 0 0 0 0
22 5 1 5 0 0 0 0 0
23 11 2 11 0 0 0 0 0
24 11 3 11 0 0 0 0 0
25 11 2 11 0 0 0 0 0
26 13 2 13 0 0 0 0 0
27 8 0 8 0 0 0 0 0
28 5 0 5 0 0 0 0 0
29 6 0 6 0 0 0 0 0
30 16 0 16 0 0 0 0 0
31 12 1 12 0 0 0 0 0
JML 196 24 196 0 0 0 0 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : SEPTEMBER 2021
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 11 0 11 0 0 11 1 0
2 9 0 9 0 0 9 0 0
3 7 0 7 0 0 7 1 0
4 3 1 3 0 0 3 0 0
5 2 2 2 0 0 2 0 0
6 7 2 7 0 0 7 1 0
7 17 2 17 0 0 17 0 1 pinru dr hcu
8 27 0 27 0 0 27 0 1 pinru dr hcu
9 14 1 14 0 0 14 0 1 pinru dr hcu meninggal
10 8 2 8 0 0 8 0 0
11 8 0 8 0 0 8 0 0
12 3 0 3 0 0 3 0 0
13 7 0 7 0 0 7 0 0
14 13 1 13 0 0 13 0 0
15 12 3 12 0 0 12 0 0
16 12 4 12 0 0 12 0 0
17 5 2 5 0 0 5 0 0
18 3 1 3 0 0 3 0 0
19 3 1 3 0 0 3 0 0
20 9 2 9 0 0 9 0 0
21 13 0 13 0 0 13 0 0
22 10 2 10 0 0 10 0 1 dirumah
23 11 2 11 0 0 11 0 1 dirumah
24 12 2 12 0 0 12 0 1 dirumah
25 8 2 8 0 0 8 0 1 dirumah
26 7 2 7 0 0 7 0 1 dirumah
27 12 1 12 0 0 12 0 1 dirumah
28 15 2 15 0 0 15 0 1 dirumah
29 16 4 16 0 0 16 0 0
30 12 0 12 0 0 12 0 0
JML 296 41 296 0 0 296 3 10
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT (HAIs)
RSUD MALINGPING PROVINSI BANTEN
BULAN : OKTOBER 2021
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 9 2 6 0 0 6 0 0
2 6 2 6 0 0 6 0 0
3 6 2 6 0 0 6 0 0
4 0 0 0 0 0 1 0 0
5 9 1 9 0 0 9 0 0
6 17 1 17 0 0 10 0 0
7 25 2 25 0 0 25 0 0
8 11 2 11 0 0 11 0 0
9 8 1 8 0 0 8 0 0
10 6 0 6 0 0 6 0 0
11 9 0 9 0 0 9 0 0
12 13 5 13 0 0 13 0 0
13 11 3 11 0 0 11 0 0
14 9 1 9 0 0 9 0 0
15 5 1 5 0 0 5 0 0
16 4 1 4 0 0 4 0 0
17 5 0 5 0 0 5 0 0
18 7 0 7 0 0 7 0 0
19 14 3 14 0 0 14 0 0
20 6 1 6 0 0 6 0 0
21 8 0 8 0 0 8 0 0
22 5 0 5 0 0 5 0 0
23 6 0 6 0 0 6 0 0
24 5 0 5 0 0 5 0 0
25 8 0 8 0 0 8 0 0
26 12 4 12 0 0 12 0 0
27 16 0 16 0 0 16 0 0
28 8 0 8 0 0 8 1 0
29 6 1 6 0 0 6 0 0
30 6 0 6 0 0 6 0 0
31 4 1 4 0 0 4 0 0
JML 264 34 261 0 0 255 1 0
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : NOVEMBER 2021
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 5 1 5 0 0 5 0 0
2 18 3 18 0 0 18 0 0
3 18 3 18 0 0 18 2 0
4 13 3 13 0 0 13 0 0
5 8 3 8 0 0 8 1 0
6 3 1 3 0 0 3 0 0
7 2 1 2 0 0 2 0 0
8 4 1 4 0 0 4 0 0
9 12 2 12 0 0 12 0 0
10 8 2 8 0 0 8 0 0
11 7 1 7 0 0 7 0 0
12 7 2 7 0 0 7 0 0
13 5 0 5 0 0 5 0 0
14 7 0 7 0 0 7 0 0
15 12 1 12 0 0 12 0 0
16 14 1 14 0 0 14 0 0
17 10 3 10 0 0 10 0 0
18 12 1 12 0 0 12 0 0
19 8 2 8 0 0 8 0 0
20 7 1 7 0 0 7 0 0
21 6 0 6 0 0 6 0 0
22 7 2 7 0 0 7 0 0
23 11 3 11 0 0 11 0 0
24 9 2 9 0 0 9 0 0
25 12 4 12 0 0 12 0 0
26 5 2 5 0 0 5 0 0
27 5 1 5 0 0 5 0 0
28 6 1 6 0 0 6 0 0
29 9 1 9 0 0 9 0 0
30 14 4 14 0 0 14 0 0
JML 264 52 264 0 0 264 3 0
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : DESEMBER 2021
RUANGAN : TULIP
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 9 2 9 0 0 9 0 0
2 15 3 15 0 0 15 0 0
3 7 2 7 0 0 7 0 0
4 6 2 6 0 0 6 0 0
5 6 2 6 0 0 6 0 0
6 11 2 11 0 0 11 0 0
7 14 1 14 0 0 14 0 0
8 12 3 12 0 0 12 0 0
9 9 1 9 0 0 9 0 0
10 7 0 7 0 0 7 0 0
11 10 1 10 0 0 10 0 0
12 9 1 9 0 0 9 0 0
13 13 0 13 0 0 13 0 0
14 24 0 24 0 0 24 0 0
15 13 3 13 0 0 13 0 0
16 10 3 10 0 0 10 0 0
17 13 0 13 0 0 13 0 0
18 12 2 12 0 0 12 0 0
19 9 2 9 0 0 9 0 0
20 12 1 12 0 0 12 0 0
21 9 2 9 0 0 9 0 0
22 9 2 9 0 0 9 0 0
23 10 1 10 0 0 10 0 0
24 12 1 12 0 0 12 0 0
25 14 0 14 0 0 14 0 0
26 12 0 12 0 0 12 0 0
27 12 0 12 0 0 12 0 0
28 12 2 12 0 0 12 0 0
29 16 10 16 0 0 16 0 0
30 9 5 9 0 0 9 0 0
31 10 4 10 10 0 0
JML 346 58 346 0 0 346 0 0
apr mei jun jul
0 4.69 9.049 0
0 0.4 0.9 0
9.049
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JANUARI 2022
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 26 1 26 0 0 26 2 1
2 29 0 29 0 0 29 0 0
3 26 0 26 0 0 26 0 0
4 22 0 22 0 0 22 0 0
5 24 1 24 0 0 24 1 0
6 31 3 31 0 0 31 1 0
7 36 0 36 0 0 36 0 0
8 30 0 30 0 0 30 0 0
9 34 4 34 0 0 34 1 0
10 33 2 33 0 0 33 0 0
11 35 0 35 0 0 35 0 0
12 35 1 35 0 0 35 0 0
13 39 1 39 0 0 39 0 0
14 28 4 28 0 0 28 0 0
15 31 2 31 0 0 31 0 0
16 33 1 33 0 0 33 0 0
17 30 1 30 0 0 30 0 0
18 21 2 21 0 0 21 0 0
19 25 1 25 0 0 25 2 0
20 24 1 24 0 0 24 0 0
21 24 1 24 0 0 24 0 0
22 26 0 26 0 0 26 0 0
23 25 1 25 0 0 25 0 0
24 24 2 24 0 0 24 0 0
25 24 2 24 0 0 24 1 0
26 28 3 28 0 0 28 0 0
27 24 2 24 0 0 24 0 0
28 24 4 24 0 0 24 0 0
29 26 4 26 0 0 26 0 0
30 25 1 25 0 0 25 0 0
31 24 3 24 0 0 24 0 0
JML 866 48 866 0 0 866 8 1
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : FEBRUARI 2022
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 20 1 20 0 0 3 0 0
2 17 2 17 0 0 0 0 0
3 16 2 16 0 0 0 1 0
4 21 2 21 0 0 0 0 0
5 19 1 19 0 0 0 0 0
6 15 2 15 0 0 0 0 0
7 17 1 17 0 0 0 0 0
8 19 0 19 0 0 0 0 0
9 23 3 23 0 0 0 0 0
10 20 3 20 0 0 0 0 0
11 25 4 25 0 0 0 0 0
12 27 4 27 0 0 0 0 0
13 21 3 21 0 0 0 0 0
14 21 3 21 0 0 0 1 0
15 20 4 20 0 0 0 0 0
16 23 3 23 0 0 0 0 0 deku dirumah
17 27 2 27 0 0 1 1 0
18 25 2 25 0 0 2 1 0
19 23 4 23 0 0 2 1 0
20 24 1 24 0 0 1 0 0
21 21 0 21 0 0 0 1 0
22 15 1 15 0 0 0 0 0
23 19 3 19 0 0 1 1 0
24 27 5 27 0 0 1 0 0
25 17 3 17 0 0 0 1 0
26 13 1 13 0 0 0 0 0
27 13 1 13 0 0 0 0 0
28 16 4 16 0 0 0 0 0
JML 564 65 564 0 0 11 8 0
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : MARET 2022
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 19 2 19 0 0 1 0 0
2 19 2 19 0 0 1 1 0
3 25 1 19 0 0 1 1 0
4 23 1 23 0 0 0 0 0
5 26 1 26 0 0 0 0 0
6 17 1 17 0 0 0 0 0
7 19 1 19 0 0 0 0 0
8 16 1 16 0 0 1 0 0
9 15 1 15 0 0 0 2 0
10 20 1 20 0 0 2 0 0
11 17 3 17 0 0 0 2 0
12 14 3 14 0 0 0 0 0
13 11 2 11 0 0 0 0 0
14 7 1 7 0 0 1 0 0
15 13 2 13 0 0 1 0 0
16 12 1 12 0 0 1 0 1 deku dirumah
17 15 2 15 0 0 3 0 1 deku dirumah
18 23 0 23 0 0 0 0 0
19 13 0 13 0 0 0 0 0
20 17 0 17 0 0 0 0 0
21 19 0 19 0 0 0 2 0
22 18 0 18 0 0 0 0 0
23 19 1 19 0 0 0 0 0
24 15 1 15 0 0 0 0 0
25 16 1 16 0 0 0 0 0
26 17 0 17 0 0 0 0 0
27 14 0 14 0 0 0 0 0
28 16 1 16 0 0 0 0 0
29 14 0 14 0 0 0 0 0
30 14 1 14 0 0 0 0 0
31 21 2 21 0 0 0 0 0
JML 524 33 518 0 0 12 8 2
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : APRIL 2022
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 20 2 20 0 0 20 0 0
2 19 3 19 0 0 19 0 0
3 19 2 19 0 0 19 0 0
4 14 2 14 0 0 14 0 0
5 14 2 14 0 0 14 0 0
6 20 1 20 0 0 20 0 0
7 18 3 18 0 0 18 1 0
8 15 1 15 0 0 15 0 0
9 16 1 16 0 0 16 0 0
10 18 1 18 0 0 18 0 0
11 18 1 18 0 0 18 2 0
12 17 1 17 0 0 17 2 0
13 24 1 24 0 0 24 2 0
14 24 1 24 0 0 24 0 0
15 26 1 26 0 0 26 0 0
16 27 1 27 0 0 27 0 0
17 27 1 27 0 0 27 0 0
18 26 2 26 0 0 26 0 0
19 20 1 20 0 0 20 0 0
20 18 2 18 0 0 18 0 0
21 14 3 14 0 0 14 2 0
22 14 3 14 0 0 14 0 0
23 14 2 14 0 0 14 0 0
24 17 1 17 0 0 17 0 0
25 22 2 22 0 0 22 0 0
26 18 1 18 0 0 18 0 0
27 13 0 13 0 0 13 0 0
28 13 2 13 0 0 13 0 0
29 14 1 14 0 0 14 0 0
30 13 2 13 0 0 13 0 0
JML 552 47 552 0 0 552 9 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : MEI 2022
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 9 2 9 0 0 1 0 0
2 4 1 4 0 0 1 1 0
3 8 2 8 0 0 1 0 0
4 13 1 13 0 0 0 1 0
5 20 0 20 0 0 0 3 0
6 25 2 25 0 0 0 0 0
7 22 1 22 0 0 0 0 0
8 18 2 18 0 0 0 3 0
9 19 3 19 0 0 0 0 0
10 19 4 19 0 0 0 1 0
11 17 1 17 0 0 0 0 0
12 25 2 25 0 0 0 0 0
13 27 3 27 0 0 0 1 0
14 24 3 24 0 0 0 0 0
15 21 2 21 0 0 0 1 0
16 22 0 22 0 0 0 0 0
17 25 4 25 0 0 0 0 0
18 20 0 20 0 0 0 0 0
19 20 0 20 0 0 0 0 0
20 23 0 23 0 0 0 0 0
21 8 0 8 0 0 0 0 0
22 29 1 29 0 0 0 0 0
23 34 1 34 0 0 0 0 0
24 28 0 28 0 0 0 0 0
25 20 0 20 0 0 0 0 0
26 24 8 24 0 0 0 1 0
27 28 8 28 0 0 0 4 0
28 26 2 26 0 0 0 0 0
29 26 1 26 0 0 0 0 0
30 28 0 28 0 0 0 0 0
31 19 0 19 0 0 0 0 0
JML 651 54 651 0 0 3 16 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JUNI 2022
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 21 0 21 0 0 0 0 0
2 25 2 25 0 0 0 0 0
3 27 1 27 0 0 0 0 0
4 24 1 24 0 0 0 0 0
5 23 1 23 0 0 0 0 0
6 30 3 30 0 0 0 0 0
7 25 2 25 0 0 0 0 0
8 29 2 29 0 0 1 1 0
9 25 0 25 0 0 0 5 0
10 29 1 29 0 0 0 0 0
11 29 1 29 0 0 0 0 0
12 33 1 33 0 0 0 0 0
13 33 0 33 0 0 0 1 0
14 24 4 24 0 0 0 0 0
15 24 3 24 0 0 2 2 0
16 23 1 23 0 0 0 0 0
17 25 3 25 0 0 3 1 0
18 23 2 23 0 0 1 0 0
19 25 2 25 0 0 0 0 0
20 26 4 26 0 0 0 0 0
21 30 3 30 0 0 1 2 0
22 31 2 31 0 0 2 1 0
23 32 0 32 0 0 0 0 0
24 28 5 28 0 0 1 0 0
25 27 5 27 0 0 0 3 0
26 26 2 26 0 0 0 5 0
27 24 0 24 0 0 1 5 0
28 24 2 24 0 0 0 2 1 dirumah
29 15 2 15 0 0 0 2 0
30 24 4 24 0 0 2 0 0
JML 784 59 784 0 0 14 30 1
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JULI 2021
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 12 0 12 0 0 12 0 0
2 12 1 12 0 0 12 1 0
3 11 1 11 0 0 11 0 0
4 9 2 9 0 0 9 0 0
5 13 1 13 0 0 13 1 0
6 15 1 15 0 0 15 1 0
7 14 1 14 0 0 14 1 0
8 11 1 11 0 0 11 0 0
9 10 1 10 0 0 10 0 0
10 9 1 9 0 0 9 0 0
11 10 1 10 0 0 10 0 0
12 10 2 10 0 0 10 0 0
13 8 2 8 0 0 8 1 0
14 5 2 5 0 0 5 0 0
15 6 2 6 0 0 6 0 0
16 10 3 10 0 0 10 0 0
17 6 1 6 0 0 6 0 0
18 9 2 9 0 0 9 0 0
19 6 2 6 0 0 6 0 0
20 5 0 5 0 0 5 1 0
21 5 0 5 0 0 5 0 0
22 6 0 6 0 0 6 0 0
23 5 1 5 0 0 5 0 0
24 8 1 8 0 0 8 0 0
25 7 4 7 0 0 7 0 0
26 6 4 6 0 0 6 1 0
27 8 4 8 0 0 8 0 0
28 5 0 5 0 0 5 0 0
29 6 2 6 0 0 6 0 0
30 5 2 5 0 0 5 0 0
31 7 2 7 0 0 7 0 0
JML 259 47 259 0 0 259 7 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : AGUSTUS 2021
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 6 1 6 0 0 6 0 0
2 6 1 6 0 0 6 0 0
3 6 0 6 0 0 6 0 0
4 4 0 4 0 0 4 1 0
5 4 0 4 0 0 4 0 0
6 6 0 6 0 0 6 0 0
7 7 0 7 0 0 7 0 0
8 8 0 8 0 0 8 0 0
9 10 0 10 0 0 10 0 0
10 7 1 7 0 0 7 0 0
11 6 1 6 0 0 6 0 0
12 6 0 6 0 0 6 0 0
13 8 0 8 0 0 8 0 0
14 8 1 8 0 0 8 0 0
15 8 1 8 0 0 8 0 0
16 9 0 9 0 0 9 0 0
17 14 1 14 0 0 14 1 0
18 13 1 13 0 0 13 1 0
19 15 1 15 0 0 15 0 0
20 17 1 17 0 0 17 0 0
21 15 1 15 0 0 15 0 0
22 14 2 14 0 0 14 0 0
23 15 2 15 0 0 15 0 0
24 18 2 18 0 0 18 0 0
25 20 1 20 0 0 20 0 0
26 19 0 19 0 0 19 0 0
27 19 3 19 0 0 19 0 0
28 18 2 18 0 0 18 0 0
29 12 1 12 0 0 12 0 0
30 12 2 12 0 0 12 0 0
31 11 2 11 0 0 11 0 0
JML 341 28 341 0 0 341 3 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : SEPTEMBER 2021
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 18 2 18 0 0 0 0 0
2 21 1 21 0 0 0 4 0
3 17 2 17 0 0 0 0 0
4 26 1 26 0 0 0 0 0
5 23 1 23 0 0 1 1 0
6 21 1 21 0 0 1 0 0
7 17 1 17 0 0 1 1 0
8 12 2 12 0 0 3 1 0
9 18 2 18 0 0 0 0 1 dirumah
10 12 4 12 0 0 0 0 0
11 19 4 19 0 0 0 0 0
12 17 4 17 0 0 0 0 0
13 20 3 20 0 0 0 0 0
14 14 1 14 0 0 0 1 0
15 17 2 17 0 0 1 3 0
16 18 0 18 0 0 0 0 0
17 15 1 15 0 0 0 0 0
18 19 0 19 0 0 0 0 0
19 17 0 17 0 0 0 0 0
20 20 0 20 0 0 1 3 0
21 23 2 23 0 0 0 0 0
22 22 2 22 0 0 0 1 0
23 22 1 22 0 0 0 1 0
24 13 1 13 0 0 0 0 0
25 19 2 19 0 0 0 0 0
26 20 2 20 0 0 0 1 0
27 19 1 19 0 0 0 0 0
28 21 3 21 0 0 0 0 0
29 19 2 19 0 0 0 0 0
30 23 1 23 0 0 0 0 0
JML 562 49 562 0 0 8 17 1
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT (HAIs)
RSUD MALINGPING PROVINSI BANTEN
BULAN : OKTOBER 2021
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 23 5 23 0 0 1 0 0
2 27 5 27 0 0 1 2 0
3 23 2 23 0 0 0 0 0
4 30 2 30 0 0 0 0 0
5 20 3 20 0 0 0 0 0
6 25 2 25 0 0 1 2 0
7 29 3 29 0 0 1 1 0
8 24 4 24 0 0 0 0 0
9 26 4 26 0 0 0 0 0
10 20 2 20 0 0 0 0 0
11 19 4 19 0 0 0 0 0
12 17 2 17 0 0 0 0 0
13 24 1 24 0 0 0 0 0
14 29 0 29 0 0 0 0 0
15 28 2 28 0 0 0 0 0
16 23 2 23 0 0 1 2 0
17 22 2 22 0 0 0 0 0
18 22 2 22 0 0 0 0 0
19 17 3 17 0 0 0 0 0
20 19 3 19 0 0 0 0 0
21 21 3 21 0 0 2 0 0
22 19 3 19 0 0 1 0 0
23 12 1 12 0 0 0 1 0
24 7 0 7 0 0 0 0 0
25 5 0 5 0 0 0 0 0
26 12 2 12 0 0 0 0 0
27 17 2 17 0 0 0 0 0
28 20 1 20 0 0 0 4 0
29 16 0 16 0 0 0 0 0
30 14 0 14 0 0 0 0 0
31 16 0 16 0 0 0 0 0
JML 626 65 626 0 0 8 12 0
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : NOVEMBER 2021
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 18 1 18 0 0 0 0 0
2 12 2 12 0 0 0 0 0
3 14 2 14 0 0 1 2 0
4 10 1 10 0 0 0 0 0
5 14 2 14 0 0 0 0 0
6 11 0 11 0 0 0 0 0
7 14 2 14 0 0 3 0 0
8 16 6 16 0 0 2 1 0
9 20 6 20 0 0 0 0 1 deku dirumah
10 20 4 20 0 0 1 1 0
11 19 3 19 0 0 0 0 0
12 22 4 22 0 0 0 0 0
13 18 4 18 0 0 0 0 0
14 18 2 18 0 0 0 0 0
15 19 3 19 0 0 0 0 0
16 12 0 12 0 0 0 0 0
17 19 2 19 0 0 0 0 0
18 17 1 17 0 0 0 0 0
19 14 1 14 0 0 0 0 0
20 20 0 20 0 0 0 0 0
21 14 0 14 0 0 0 0 0
22 25 4 25 0 0 0 0 0
23 26 5 26 0 0 0 0 0
24 27 2 27 0 0 0 0 0
25 33 5 33 0 0 0 0 0
26 31 7 31 0 0 0 4 0
27 28 5 28 0 0 0 0 0
28 38 5 38 0 0 0 0 0
29 30 6 30 0 0 0 0 0
30 25 3 25 0 0 0 0 0
JML 604 88 604 0 0 7 8 1
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : DESEMBER 2021
RUANGAN : BOUGENVILE
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS KETERANGAN
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 30 0 30 0 0 30 0 0
2 30 4 30 0 0 30 0 0
3 29 5 29 0 0 29 2 0
4 23 2 23 0 0 23 0 0
5 29 2 29 0 0 29 0 0
6 23 2 23 0 0 23 0 0
7 24 4 24 0 0 24 0 0
8 15 1 15 0 0 15 1 0
9 19 3 19 0 0 19 0 0
10 22 2 22 0 0 22 0 0
11 24 0 24 0 0 24 0 0
12 29 4 29 0 0 29 0 2 dirumah
13 28 3 28 0 0 28 0 2 dirumah
14 29 4 29 0 0 29 0 0
15 25 2 25 0 0 25 0 1 dirumah
16 21 3 21 0 0 21 0 1
17 25 0 25 0 0 25 0 0
18 20 1 20 0 0 20 0 0
19 24 4 24 0 0 24 0 0
20 26 3 26 0 0 26 0 0
21 26 3 26 0 0 26 0 0
22 34 3 34 0 0 34 4 1 dirumah
23 37 3 37 0 0 37 1 0
24 32 2 32 0 0 32 0 0
25 34 4 34 0 0 34 0 0
26 34 3 34 0 0 34 0 0
27 30 3 30 0 0 30 0 0
28 24 3 24 0 0 24 0 0
29 28 3 28 0 0 28 3 0
30 28 1 28 0 0 28 0 2 dirumah
31 24 2 24 0 0 24 0 1 dirumah
JML 826 79 826 0 0 826 11 7
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JANUARI 2022
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS ANTI BIOTIK
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 14 3 0 0 0 0 0 0
2 8 2 0 0 0 0 1 0
3 4 0 0 0 0 0 1 0
4 4 0 2 0 0 4 0 0
5 10 0 1 0 0 2 0 0
6 11 0 11 0 0 1 0 0
7 8 0 2 0 0 2 0 0
8 6 0 0 0 0 0 0 0
9 5 1 2 0 0 2 0 0
10 3 1 3 0 0 3 0 0
11 6 1 4 0 0 4 0 0
12 7 0 5 0 0 5 1 0
13 5 0 3 0 0 3 1 0
14 6 1 3 0 0 3 0 0
15 7 1 3 0 0 3 0 0
16 8 1 1 0 0 1 0 0
17 9 1 1 0 0 1 0 0
18 11 3 4 0 0 4 0 0
19 9 0 5 0 0 5 0 0
20 11 1 4 0 0 4 0 0
21 11 2 4 0 0 4 0 0
22 6 0 4 0 0 4 0 0
23 7 0 4 0 0 4 1 0
24 6 0 6 0 0 6 0 0
25 10 1 8 0 0 8 0 0
26 12 1 8 0 0 8 0 0
27 13 1 4 0 0 4 0 0
28 9 2 2 0 0 2 0 0
29 10 2 2 0 0 2 0 0
30 5 0 1 0 0 1 0 0
31 4 0 1 0 0 1 0 0
JML 245 25 98 0 0 91 5 0
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : FEBRUARI 2022
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS ANTI BIOTIK
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 3 0 3 0 0 0 0 0
2 3 0 3 0 0 0 0 0
3 5 0 5 0 0 0 1 0
4 6 1 6 0 0 0 1 0
5 4 0 4 0 0 0 0 0
6 3 0 3 0 0 0 0 0
7 3 0 3 0 0 0 0 0
8 2 0 2 0 0 0 0 0
9 3 0 3 0 0 0 0 0
10 3 1 3 0 0 0 0 0
11 3 0 3 0 0 0 0 0
12 1 0 1 0 0 0 0 0
13 3 0 3 0 0 0 0 0
14 3 1 3 0 0 0 0 0
15 4 2 4 0 0 0 0 0
16 3 0 3 0 0 0 1 0
17 1 0 1 0 0 0 0 0
18 3 2 3 0 0 0 0 0
19 3 0 3 0 0 0 0 0
20 1 0 1 0 0 0 0 0
21 0 0 0 0 0 0 0 0
22 0 0 0 0 0 0 0 0
23 1 2 1 0 0 0 0 0
24 0 2 0 0 0 0 0 0
25 1 2 1 0 0 0 0 0
26 1 0 1 0 0 0 0 0
27 1 2 1 0 0 0 0 0
28 2 3 2 0 0 0 0 0
JML 66 18 66 0 0 0 3 0
LAPORAN DISEMINASI PROGRAM SURVEILANS HAIs PPI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : MARET 2022
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 2 0 2 0 0 2 0 0
2 0 0 0 0 0 0 0 0
3 5 2 5 0 0 0 1 0
4 5 1 5 0 0 0 1 0
5 0 0 0 0 0 1 1 0
6 0 0 0 0 0 1 0 0
7 0 0 0 0 0 0 2 0
8 0 0 0 0 0 0 0 0
9 2 0 2 0 0 0 0 0
10 2 0 2 0 0 0 0 0
11 2 0 2 0 0 0 1 0
12 1 0 1 0 0 0 0 0
13 1 0 1 0 0 0 0 0
14 4 0 4 0 0 0 0 0
15 5 1 5 0 0 1 0 0
16 5 1 5 0 0 0 1 0
17 5 1 5 0 0 0 4 0
18 4 1 4 0 0 1 0 0
19 4 1 4 0 0 1 0 0
20 2 1 2 0 0 1 0 0
21 3 1 3 0 0 1 0 1
22 7 2 7 0 0 1 0 1
23 5 2 5 0 0 5 1 1
24 5 2 5 0 0 2 0 1
25 7 4 7 0 0 1 1 1
26 8 3 8 0 0 2 1 1
27 6 1 6 0 0 0 0 0
28 6 1 6 0 0 0 1 0
29 3 3 3 0 0 0 0 0
30 1 0 1 0 0 0 0 0
31 1 0 1 0 0 0 0 0
JML 101 28 101 0 0 20 15 6
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : APRIL 2022
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 7 2 7 0 0 7 0 0
2 6 1 6 0 0 6 0 0
3 5 1 5 0 0 5 0 0
4 6 1 6 0 0 6 0 0
5 5 2 5 0 0 5 0 0
6 3 2 3 0 0 3 0 0
7 3 0 3 0 0 3 0 0
8 5 1 5 0 0 5 1 0
9 6 1 6 0 0 6 0 0
10 5 1 5 0 0 5 0 0
11 2 1 2 0 0 2 0 0
12 2 2 2 0 0 2 1 0
13 4 1 4 0 0 4 1 0
14 6 2 6 0 0 6 0 0
15 2 3 2 0 0 2 0 0
16 2 0 2 0 0 2 0 0
17 2 0 2 0 0 2 0 0
18 4 0 4 0 0 4 1 0
19 4 1 4 0 0 4 0 0
20 7 3 7 0 0 7 0 0
21 6 0 6 0 0 6 0 0
22 7 0 7 0 0 7 0 0
23 5 0 5 0 0 5 0 0
24 6 1 6 0 0 6 0 0
25 6 1 6 0 0 6 0 0
26 3 1 3 0 0 3 0 0
27 3 0 3 0 0 3 0 0
28 2 0 2 0 0 2 0 0
29 3 1 3 0 0 3 0 0
30 2 1 2 0 0 2 0 0
JML 129 30 129 0 0 129 4 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : MEI 2022
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 1 1 1 0 0 0 2 0
2 1 1 1 0 0 0 1 0
3 2 0 2 0 0 0 0 0
4 2 0 2 0 0 0 1 0
5 2 1 2 0 0 0 1 0
6 1 1 1 0 0 0 0 0
7 1 0 1 0 0 0 0 0
8 2 0 2 0 0 0 1 0
9 3 1 3 0 0 0 0 0
10 5 2 5 0 0 0 0 0
11 4 2 4 0 0 0 0 0
12 4 1 4 0 0 0 0 0
13 2 2 2 0 0 0 0 0
14 3 0 3 0 0 0 0 0
15 3 0 3 0 0 0 0 0
16 5 0 5 0 0 0 0 0
17 5 0 5 0 0 0 1 0
18 8 1 8 0 0 0 0 0
19 8 1 8 0 0 0 1 0
20 5 0 5 0 0 0 0 0
21 6 0 6 0 0 0 0 0
22 5 0 5 0 0 0 0 0
23 5 0 5 0 0 0 1 0
24 4 0 4 0 0 0 0 0
25 6 0 6 0 0 0 0 0
26 6 0 6 0 0 0 2 0
27 6 0 6 0 0 0 1 0
28 6 1 6 0 0 0 0 0
29 5 1 5 0 0 0 0 0
30 4 1 4 0 0 0 1 0
31 5 2 5 0 0 0 1 0
JML 125 19 125 0 0 0 12 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JUNI 2022
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 12 1 12 0 0 0 0 0
2 7 1 7 0 0 0 1 0
3 8 3 8 0 0 0 1 0
4 7 3 7 0 0 0 0 0
5 4 0 4 0 0 0 0 0
6 4 0 4 0 0 0 1 0
7 7 0 7 0 0 0 0 0
8 7 0 7 0 0 0 0 0
9 7 1 7 0 0 0 0 0
10 5 0 5 0 0 0 0 0
11 3 1 3 0 0 0 0 0
12 5 0 5 0 0 0 0 0
13 7 2 7 0 0 0 0 0
14 7 2 7 0 0 0 0 0
15 8 2 8 0 0 0 0 0
16 8 1 8 0 0 0 0 0
17 7 0 7 0 0 0 1 0
18 18 0 18 0 0 0 0 0
19 3 0 3 0 0 0 0 0
20 5 0 5 0 0 0 0 0
21 6 0 6 0 0 0 0 0
22 4 0 4 0 0 1 0 1
23 1 1 1 0 0 1 0 1
24 1 1 1 0 0 1 0 1
25 1 0 1 0 0 0 1 0
26 2 1 2 0 0 1 1 0
27 5 1 5 0 0 0 0 0
28 7 1 7 0 0 0 0 0
29 10 1 10 0 0 0 0 0
30 6 0 6 0 0 0 2 0
JML 182 23 182 0 0 4 8 3
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : JULI 2021
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 3 0 3 0 0 3 1 0
2 4 0 4 0 0 4 0 0
3 4 0 4 0 0 4 1 0
4 2 0 2 0 0 2 0 0
5 5 1 5 0 0 5 0 0
6 3 1 3 0 0 3 0 0
7 4 0 4 0 0 4 0 0
8 1 0 1 0 0 1 0 0
9 1 0 1 0 0 1 0 0
10 2 1 2 0 0 2 1 0
11 1 1 1 0 0 1 0 0
12 4 1 4 0 0 4 0 0
13 3 1 3 0 0 3 0 0
14 3 2 3 0 0 3 1 0
15 2 2 2 0 0 2 1 0
16 1 1 1 0 0 1 1 0
17 0 0 0 0 0 0 0 0
18 3 0 3 0 0 3 0 0
19 3 0 3 0 0 3 0 0
20 3 0 3 0 0 3 0 0
21 2 0 2 0 0 2 0 0
22 2 0 2 0 0 2 0 0
23 2 1 2 0 0 2 0 0
24 4 2 4 0 0 4 0 0
25 2 1 2 0 0 2 0 0
26 2 0 2 0 0 2 0 0
27 2 0 2 0 0 2 0 0
28 5 0 5 0 0 5 0 0
29 3 1 3 0 0 3 0 0
30 3 1 3 0 0 3 0 0
31 1 0 1 0 0 1 0 0
JML 80 17 80 0 0 80 6 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : AGUSTUS 2021
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 1 1 1 0 0 0 0 0
2 1 1 1 0 0 0 0 0
3 1 1 1 0 0 0 0 0
4 1 1 1 0 0 0 0 0
5 1 0 1 0 0 0 0 0
6 1 0 1 0 0 0 0 0
7 2 0 2 0 0 0 0 0
8 2 0 2 0 0 0 0 0
9 3 0 3 0 0 0 0 0
10 0 0 0 0 0 0 0 0
11 2 0 2 0 0 0 0 0
12 2 0 2 0 0 0 0 0
13 0 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0 0
15 0 0 0 0 0 0 0 0
16 0 0 0 0 0 0 0 0
17 1 1 1 0 0 0 0 0
18 1 1 1 0 0 0 0 0
19 2 0 2 0 0 0 0 0
20 2 1 2 0 0 0 0 0
21 2 0 2 0 0 0 0 0
22 1 2 1 0 0 0 0 0
23 3 2 3 0 0 0 0 0
24 2 0 2 0 0 0 0 0
25 2 0 2 0 0 0 0 0
26 0 0 0 0 0 0 0 0
27 2 2 2 0 0 0 0 0
28 3 2 3 0 0 0 0 0
29 3 2 3 0 0 0 0 0
30 4 1 4 0 0 0 0 0
31 8 2 8 0 0 0 0 0
JML 53 20 53 0 0 0 0 0
FORMULIR SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : SEPTEMBER 2021
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 7 0 7 0 0 0 0 0
2 6 1 6 0 0 0 1 0
3 3 0 3 0 0 0 0 0
4 3 0 3 0 0 0 0 0
5 2 1 2 0 0 0 0 0
6 4 1 4 0 0 0 0 0
7 4 1 4 0 0 0 0 0
8 10 1 10 0 0 0 1 0
9 5 1 5 0 0 0 1 0
10 5 1 5 0 0 0 1 0
11 5 1 5 0 0 0 0 0
12 2 1 2 0 0 0 0 0
13 7 1 7 0 0 0 0 0
14 7 0 7 0 0 0 0 0
15 5 0 5 0 0 0 1 0
16 2 1 2 0 0 0 0 0
17 6 2 6 0 0 0 0 0
18 4 2 4 0 0 0 0 0
19 6 1 6 0 0 0 0 0
20 5 1 5 0 0 0 0 0
21 2 1 2 0 0 0 1 0
22 5 1 5 0 0 1 0 0
23 6 1 6 0 0 0 0 0
24 7 0 7 0 0 0 0 0
25 6 0 6 0 0 0 0 0
26 4 0 4 0 0 0 0 0
27 4 0 4 0 0 0 0 0
28 5 0 5 0 0 1 1 0
29 7 1 7 0 0 0 3 0
30 6 0 6 0 0 0 0 0
JML 150 21 150 0 0 2 10 0
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT (HAIs)
RSUD MALINGPING PROVINSI BANTEN
BULAN : OKTOBER 2021
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 5 1 5 0 0 0 0 0
2 4 1 4 0 0 0 0 0
3 1 0 1 0 0 0 0 0
4 3 2 3 0 0 0 0 0
5 7 3 7 0 0 0 0 0
6 8 1 8 0 0 0 2 0
7 5 0 5 0 0 0 0 0
8 5 1 5 0 0 1 1 0
9 3 0 3 0 0 0 0 0
10 2 0 2 0 0 0 0 0
11 3 0 3 0 0 0 0 0
12 6 2 6 0 0 0 1 0
13 5 2 5 0 0 0 0 0
14 4 0 4 0 0 0 2 0
15 1 0 1 0 0 0 0 0
16 1 0 1 0 0 0 0 0
17 1 0 1 0 0 0 0 0
18 1 0 1 0 0 0 0 0
19 2 0 2 0 0 0 0 0
20 6 1 6 0 0 0 2 0
21 6 1 6 0 0 0 0 0
22 9 3 9 0 0 0 2 0
23 6 2 6 0 0 0 0 0
24 3 1 3 0 0 0 0 0
25 3 1 3 0 0 0 0 0
26 7 1 7 0 0 0 1 0
27 8 0 8 0 0 0 0 0
28 5 0 5 0 0 0 2 0
29 5 1 5 0 0 0 0 0
30 5 1 5 0 0 0 0 0
31 3 0 3 0 0 0
JML 133 25 133 0 0 1 13 0
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : NOVEMBER 2021
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 3 0 3 0 0 3 0 0
2 6 0 6 0 0 6 0 0
3 6 0 6 0 0 6 1 0
4 5 0 5 0 0 5 0 0
5 5 0 5 0 0 5 0 0
6 6 0 6 0 0 6 2 0
7 5 0 5 0 0 5 1 0
8 6 0 6 0 0 6 0 0
9 6 0 6 0 0 6 1 0
10 6 2 6 0 0 6 0 0
11 6 0 6 0 0 6 2 0
12 5 0 5 0 0 5 0 0
13 7 0 7 0 0 7 1 0
14 6 0 6 0 0 6 1 0
15 6 0 6 0 0 6 0 0
16 2 0 2 0 0 2 0 0
17 3 0 3 0 0 3 1 0
18 4 0 4 0 0 4 0 0
19 4 0 4 0 0 4 0 0
20 4 1 4 0 0 4 0 0
21 1 0 1 0 0 1 1 0
22 3 1 3 0 0 3 0 0
23 5 1 5 0 0 5 0 0
24 5 0 5 0 0 5 0 0
25 6 0 6 0 0 6 0 0
26 8 0 8 0 0 8 0 0
27 5 2 5 0 0 5 0 0
28 5 0 5 0 0 5 0 0
29 6 1 6 0 0 6 0 0
30 6 0 6 0 0 6 0 0
JML 151 8 151 0 0 151 11 0
LAPORAN SURVEILANS BULANAN INFEKSI RUMAH SAKIT
RSUD MALINGPING PROVINSI BANTEN
BULAN : DESEMBER 2021
RUANGAN : WIJAYA KUSUMA
TINDAKAN INFEKSI RUMAH SAKIT TIRAH HASIL
TGL JUMLAH PASIEN PLEBITIS DEKUBITUS AB
UC CVL IVL ETT/V VAP HAP ISK IAD BARING KULTUR
1 10 0 10 0 0 10 0 0
2 8 0 8 0 0 8 0 0
3 11 0 11 0 0 11 0 0
4 11 0 11 0 0 11 1 0
5 0 0 0 0 0 0 0 0
6 4 1 4 0 0 4 0 0
7 11 2 11 0 0 11 0 0
8 13 2 13 0 0 13 0 0
9 13 2 13 0 0 13 0 0
10 10 1 10 0 0 10 0 0
11 5 0 5 0 0 5 0 0
12 5 0 5 0 0 5 0 0
13 3 0 3 0 0 3 0 0
14 8 1 8 0 0 8 0 0
15 14 2 14 0 0 14 0 0
16 11 0 11 0 0 11 0 0
17 8 0 8 0 0 8 1 0
18 7 0 7 0 0 7 0 0
19 3 0 3 0 0 3 0 0
20 9 3 9 0 0 9 0 0
21 8 2 8 0 0 8 0 0
22 9 2 9 0 0 9 0 0
23 5 0 5 0 0 5 0 0
24 5 2 5 0 0 5 0 0
25 6 1 6 0 0 6 0 0
26 6 1 6 0 0 6 0 0
27 5 1 5 0 0 5 0 0
28 11 1 11 0 0 11 0 0
29 9 2 9 0 0 9 1 0
30 8 2 8 0 0 8 2 0
31 13 3 13 0 0 13 0 0
JML 249 31 249 0 0 249 5 0