FORMULIR SURVEILANS HARIAN INFEKSI

RUMAH SAKIT : ………………………………………

BULAN/TAHUN :JULI 2019
RUANGAN :PERINATOLOGI
SURVEYOR :

TINDAKAN
NAMA U Dx Medis
UC CVL IVL
7/1/2019 BY SRI RAHMI N 2BLN BP+POST OP √
BY SRI WIDYA N 3HR FEBRIS+DEHIDRASI √
BY MIKHAYLA AMIRA 9HR HIPERBILLIRUBIN √
BY RADHIATUL 1HR RD +DEMAM √
BY VIOLINA IRMAN 1HR RD √
BY YULIA KARTIKA A 1HR RD √
BY YUDIA 4HR PERDARAHN VAGINA √
7 2

7/2/2019 BY SRI RAHMI N 2BLN BP+POST OP √

BY MIKHAYLA AMIRA 9HR HIPERBILLIRUBIN √
BY RADHIATUL 1HR RD +DEMAM √
BY VIOLINA IRMAN 1HR RD √
BY YULIA KARTIKA A 1HR RD √
BY YUDIA 4HR PERDARAHN VAGINA √
BY DIRGA MAHENDRA 10BLN BP √
BY SUCI HIDAYATI 13HR HIPERBILLIRUBIN √
BY WILLA SEPRIANI 1HR RD √
9 9

7/3/2019 BY SRI RAHMI N 2BLN BP+POST OP √

BY MIKHAYLA AMIRA 9HR HIPERBILLIRUBIN √
BY RADHIATUL 1HR RD +DEMAM √
BY VIOLINA IRMAN 1HR RD √
BY SUCI HIDAYATI 13HR HIPERBILLIRUBIN √
BY WILLA SEPRIANI 1HR RD √
BY ELVIRA MARYENI 7HR HIPERBILLIRUBIN
BY WATI 1HR RD+BBLR √
8 7

7/4/2019 BY SRI RAHMI 2BLN BP+POST OP √

BY MIKHAYLA AMIRA 9HR HIPERBILLIRUBIN √
BY RADHIATUL 1HR RD + DEMAM √
BY VIOLINA IRMAN 1HR RD √
 BY SUCI HIDAYATI 13HR HIPERBILLIRUBIN √
BY WILLA SEPRIANI 1HR RD √
BY ELVIRA MARYENI 7HR HIPERBILLIRUBIN
BY WATI 1HR RD +BBLR √
8 7

7/5/2019 BY SRI RAHMI 2BLN BP+POST OP √

BY MIKHAYLA AMIRA 9HR HIPERBILLIRUBIN √
BY RADHIATUL 1HR RD + DEMAM √
BY VIOLINA IRMAN 1HR RD √
BY SUCI HIDAYATI 13HR HIPERBILLIRUBIN √
BY WILLA SEPRIANI 1HR RD √
BY WATI 1HR RD +BBLR √
7 7

7/6/2019 BY SRI RAHMI 2BLN BP+POST OP √

BY RADHIATUL 1HR RD + DEMAM √
BY SUCI HIDAYATI 13HR HIPERBILLIRUBIN √
BY WILLA SEPRIANI 1HR RD √
BY WATI 1HR RD +BBLR √
BY NEDYA SHERYL 2BLN BP √
6 6

7/7/2019 BY SRI RAHMI 2BLN BP+POST OP √

BY SUCI HIDAYATI 13HR HIPERBILLIRUBIN √
BY WILLA SEPRIANI 1HR RD √
BY WATI 1HR RD +BBLR √
BY NEDYA SHERYL 2BLN BP √
BY MARIANTI 3HR SEPSIS + BRADIKARDI √
6 6

7/8/2019 BY SRI RAHMI 2BLN BP+POST OP √

BY SUCI HIDAYATI 13HR HIPERBILLIRUBIN √
BY NEDYA SHERYL 2BLN BP √
BY MARIANTI 3HR SEPSIS + BRADIKARDI √
BY FITRIANI 14HR RD + BBLSAR √
BY APRILIANA PUTRI 1HR RD √
BY JENNI F 14HR HIPERBILLIRUBIN √
7 1 6
 7/9/2019 BY SRI RAHMI 2BLN BP+POST OP √
BY SUCI HIDAYATI 13HR HIPERBILLIRUBIN √
BY MARIANTI 3HR SEPSIS + BRADIKARDI √
BY FITRIANI 14HR RD + BBLSAR √
BY APRILIANA PUTRI 1HR RD √
BY JENNI F 14HR HIPERBILLIRUBIN √
6 1 5

7/10/2019 BY SRI RAHMI 2BLN BP+POST OP √

BY MARIANTI 3HR SEPSIS + BRADIKARDI √
BY FITRIANI 14HR RD + BBLSAR √
BY APRILIANA PUTRI 1HR RD √
BY JENNI F 14HR HIPERBILLIRUBIN √
BY MEGA 10HR RD √
6 1 5

7/11/2019 BY FITRIANI 14HR RD + BBLSAR √

BY APRILIANA PUTRI 1HR RD √
BY JENNI F 14HR HIPERBILLIRUBIN √
BY MEGA 10HR RD √
4 1 3

7/12/2019 BY FITRIANI 14HR RD + BBLSAR √

BY APRILIANA PUTRI 1HR RD √
BY MEGA 10HR RD √
BY SARI AMRI Y 1 HR RD √
4 1 3

7/13/2019 BY FITRIANI 14HR RD + BBLSAR √

BY APRILIANA PUTRI 1HR RD √
BY SARI AMRI Y 1 HR RD √
3 1 2

7/14/2019 BY FITRIANI 14HR RD + BBLSAR √

BY APRILIANA PUTRI 1HR RD √
BY SARI AMRI Y 1 HR RD √
BY JANNE FIRME S 1HR RD √
4 1 3

7/15/2019 BY FITRIANI 14HR RD + BBLSAR √

BY SARI AMRI Y 1 HR RD √
BY JANNE FIRME S 1HR RD √
 5 1 2

7/16/2019 BY FITRIANI 14HR RD + BBLSAR √

BY JANNE FIRME S 1HR RD √
BY DIANA SRI 5HR DEHIDRASI+CHEPALO H √
3 3 1 2

7/17/2019 BY FITRIANI 14HR RD + BBLSAR √

BY JANNE FIRME S 1HR RD √
BY DIANA SRI 5HR DEHIDRASI+CHEPALO H √
BY MEGA 17HR ISK √
BY RITA PUTRI Y 1HR RD +BBLR √

5 1 4

7/18/2019 BY FITRIANI 14HR RD + BBLSAR √

BY JANNE FIRME S 1HR RD √
BY DIANA SRI 5HR DEHIDRASI+CHEPALO H √
BY MEGA 17HR ISK √
BY RITA PUTRI Y 1HR RD +BBLR √
5 1 4

7/19/2019 BY FITRIANI 14HR RD + BBLSAR √

BY JANNE FIRME S 1HR RD √
BY MEGA 17HR ISK √
BY RITA PUTRI Y 1HR RD +BBLR √
4 1 3

7/20/2019 BY FITRIANI 14HR RD + BBLSAR √

BY RITA PUTRI Y 1HR RD +BBLR √
BY MEGA 17HR ISK √
3 1 2

7/21/2019 BY FITRIANI 14HR RD + BBLSAR √

BY RITA PUTRI Y 1HR RD +BBLR √
BY DELVIA ANDELINA 3HR HIPERBILLIRUBIN √
3 1 3

7/22/2019 BY FITRIANI 14HR RD + BBLSAR √

BY RITA PUTRI Y 1HR RD +BBLR √
BY DELVIA ANDELINA 3HR HIPERBILLIRUBIN √
BY RANI ZULDAYANTI 1HR RD √
4 1 3

7/23/2019 BY FITRIANI 14HR RD + BBLSAR √

BY RITA PUTRI Y 1HR RD +BBLR √
 BY DELVIA ANDELINA 3HR HIPERBILLIRUBIN √
BY RANI ZULDAYANTI 1HR RD √
BY DONA SARI 2HR RD √
5 1 4

7/24/2019 BY FITRIANI 14HR RD + BBLSAR √

BY RITA PUTRI Y 1HR RD +BBLR √
BY DELVIA ANDELINA 3HR HIPERBILLIRUBIN √
BY RANI ZULDAYANTI 1HR RD √
BY DONA SARI 2HR RD √
5 1 4

7/25/2019 BY FITRIANI 14HR RD + BBLSAR

BY RANI ZULDAYANTI 1HR RD √
BY DONA SARI 2HR RD √
BY FITRI HANDAYANI 1HR RD √
BY JUMIATI 1HR RD √
BY RAHMI 8HR HIPERBILLIRUBIN
6 1 3

7/26/2019 BY FITRIANI 14HR RD + BBLSAR

BY RANI ZULDAYANTI 1HR RD √
BY DONA SARI 2HR RD √
BY FITRI HANDAYANI 1HR RD √
BY JUMIATI 1HR RD √
BY RAHMI 8HR HIPERBILLIRUBIN
AN INGGRID AULIA 14TH HIPOKALSEMIA √
BY MIRA YULIANA 1HR ASPIRASI PNEUMONIA √
BY M SYAFIQ 1BLN HIPERBILLIRUBIN
9 1 5

7/27/2019 BY FITRIANI 14HR RD + BBLSAR

BY DONA SARI 2HR RD √
BY FITRI HANDAYANI 1HR RD √
BY JUMIATI 1HR RD √
BY RAHMI 8HR HIPERBILLIRUBIN
AN INGGRID AULIA 14TH HIPOKALSEMIA √
BY M SYAFIQ 1BLN HIPERBILLIRUBIN
BY SRI RAHMI NOVA 1BLN BP+DEHIDRASI BERAT √
8 1 4

7/28/2019 BY FITRIANI 14HR RD + BBLSAR

 BY FITRI HANDAYANI 1HR RD √
BY JUMIATI 1HR RD √
BY M SYAFIQ 1BLN HIPERBILLIRUBIN
4 1 1

7/29/2019 BY FITRIANI 14HR RD + BBLSAR

BY JUMIATI 1HR RD √
BY AIRA HANEEN 4BLN BP √
3 1 1

7/30/2019 BY FITRIANI 14HR RD + BBLSAR

BY SUFRIANI 2HR RD+HIPOGLIKEMIA √
BY DELVIA ANDELINA 11HR HIPERBILLIRUBIN
3 1

7/31/2019 BY FITRIANI 14HR RD + BBLSAR

BY SUFRIANI 2HR RD+HIPOGLIKEMIA √
BY DELVIA ANDELINA 11HR HIPERBILLIRUBIN
3 1

JUMLAH PASIEN : 35 ORANG

PASANG INFUS PERIFER : 23 ORANG
PASANG INFUS UMBILICAL : 3 ORANG
ILO : TIDAK ADA
VAP : TIDAK ADA
PASANG ETT : 2 0RANG
PASANG KATETER : TIDAK ADA
PLEBITIS : TIDAK ADA
OPERASI : 1 ORANG
ISK : TIDAK ADA
EILANS HARIAN INFEKSI RUMAH SAKIT
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