Formulir Bulanan Surveilan PPI RS

Data pemakaian alat & infeksi

Unit/ruang : ICU Bulan : SEPTEMBER Tahun: 2017

Jmlh Psn IVL UC ISK

1 4 4 2
2 5 5 2
3 4 4 2
4 3 3 2
5 3 3 2
6 3 3 2
7 1 1 0
8 0 0 0
9 1 1 1
10 3 3 2
11 2 2 0
12 0 0 0
13 1 1 1
14 1 1 1
15 0 0 0
16 0 0 0
17 2 2 2
18 4 4 2
19 4 4 4
20 3 3 3
21 3 3 3
22 3 3 2
23 1 1 1
24 1 1 1
25 3 3 2
26 4 4 4
27 1 1 1
28 1 1 1
29 2 2 2
30 4 4 0
31
67 67 45 0

IPCN PER MIL

0‰
29,85‰
...............EMERITA........................

Unit/ruang : ICU Bulan : OKTOBER Tahun: 2017

Tgl Jmlh Psn IVL UC ISK
1 2 2 2
2 2 2 2
3 4 4 3
4 4 4 3
5 4 4 3
6 3 3 3
 7 4 4 3
8 3 3 3
9 3 3 3
10 2 2 2
11 2 2 2
12 3 3 3
13 3 3 3
14 4 4 3
15 4 4 3
16 4 4 4
17 3 3 3
18 2 2 2
19 0 0 0
20 1 1 1
21 1 1 1
22 1 1 1
23 1 1 1
24 1 1 1
25 1 1 1
26 4 4 3
27 3 3 2
28 3 3 2
29 1 1 1
30 2 2 2
31 3 3 3
JUMLAH 78 78 69 0

IPCN PER MIL

0‰
38,46‰
...............EMERITA........................

Unit/ruang : POST 3 Bulan : SEPTEMBER Tahun:2017

Tgl Jmlh Psn IVL UC ISK
1 2 2 1
2 2 2 1
3 2 2 1
4 2 2 1
5 3 3 1
6 3 3 1
7 4 4 2
8 6 6 1
9 6 6 1
10 5 5 1
11 7 7 1
12 5 5 0
13 6 6 0
14 7 7 1
15 4 4 1
16 4 4 0
17 3 3 0
18 3 3 1
19 2 2 1
20 4 4 1
21 4 4 0
22 4 4 0
23 4 4 0
24 4 4 1
25 3 3 1
 26 2 2 0
27 2 2 0
28 2 2 1
29 4 4 1
30 4 4 1
31
JUMLAH 113 113 22 0

IPCN PER MIL

0‰
8,849‰
...............EMERITA........................

Unit/ruang : POST 3 Bulan : OKTOBER Tahun:2017

Tgl Jmlh Psn IVL UC ISK
1 2 2 0
2 3 3 0
3 7 7 2
4 4 4 2
5 2 2 1
6 4 4 1
7 5 5 1
8 4 4 1
9 2 2 1
10 4 4 1
11 4 4 1
12 5 5 1
13 5 5 1
14 6 6 1
15 3 3 1
16 4 4 1
17 3 3 1
18 4 4 2
19 5 5 0
20 3 3 0
21 4 4 0
22 3 3 0
23 5 5 1
24 3 3 1
25 6 6 1
26 3 3 1
27 5 5 1
28 5 5 1
29 7 7 0
30 3 3 0
31 4 4 0
JUMLAH 127 127 25 0

IPCN PER MIL

0‰
15,74‰
...............EMERITA........................

Unit/ruang : POST 2 Bulan : SEPTEMBER Tahun:2017

Tgl Jmlh Psn IVL UC ISK
1 8 8 3
 2 13 13 3
3 12 12 4
4 14 14 1
5 9 9 1
6 8 8 1
7 8 8 1
8 7 7 2
9 7 7 2
10 6 6 1
11 9 9 1
12 11 11 1
13 10 10 2
14 6 6 1
15 6 6 1
16 5 5 2
17 5 5 1
18 6 6 1
19 9 9 1
20 11 11 3
21 11 11 3
22 6 6 1
23 6 6 1
24 6 6 1
25 8 8 1
26 6 6 1
27 6 6 3
28 5 5 1
29 8 8 1
30 5 5 0
31
JUMLAH 237 237 46

IPCN PER MIL

0‰
12,65 ‰
...............EMERITA........................

Unit/ruang : POST 1 Bulan : OKTOBER Tahun:2017

Tgl Jmlh Psn IVL UC ISK
1 6 6 3
2 11 11 4
3 9 9 3
4 9 9 4
5 8 8 1
6 8 8 1
7 7 7 1
8 7 7 1
9 12 12 0
10 10 10 0
11 12 12 2
12 14 14 3
13 13 13 1
14 12 12 1
15 11 11 0
16 12 12 1
17 13 13 1
18 14 14 1
19 11 11 1
20 14 14 1
 21 12 12 1
22 15 15 1
23 12 12 0
24 11 11 0
25 15 15 3
26 14 14 3
27 12 12 2
28 12 12 2
29 13 13 1
30 14 14 1
31 16 16 0
JUMLAH 359 359 44

IPCN PER MIL

0‰
8,35‰
...............EMERITA........................

Unit/ruang : POST 2 Bulan : SEPTEMBER Tahun:2017

Tgl Jmlh Psn IVL UC ISK
1 16 16 4
2 18 18 3
3 19 19 4
4 21 21 5
5 20 20 2
6 21 21 2
7 14 14 4
8 11 11 2
9 14 14 2
10 18 18 1
11 17 17 4
12 17 17 2
13 18 18 2
14 14 14 2
15 14 14 4
16 17 17 3
17 12 12 3
18 12 12 2
19 17 17 1
20 15 15 2
21 21 21 4
22 13 13 2
23 11 11 2
24 10 10 2
25 13 13 3
26 13 13 3
27 15 15 2
28 14 14 4
29 14 14 2
30 14 14 4
31
JUMLAH 463 463 82

IPCN PER MIL

0‰
15,11‰
...............EMERITA........................
 Unit/ruang : POST 2 Bulan : OKTOBER Tahun:2017
Tgl Jmlh Psn IVL UC ISK
1 18 18 2
2 16 16 3
3 20 20 4
4 20 20 2
5 21 21 2
6 18 18 1
7 22 22 1
8 24 24 1
9 20 20 3
10 21 21 4
11 22 22 3
12 18 18 1
13 20 20 1
14 18 18 4
15 16 16 3
16 19 19 1
17 24 24 1
18 18 18 3
19 22 22 4
20 19 19 2
21 20 20 3
22 24 24 5
23 24 24 6
24 22 22 2
25 16 16 6
26 16 16 2
27 16 16 2
28 12 12 6
29 22 22 2
30 22 22 2
31 22 22 3
JUMLAH 612 612 85

IPCN PER MIL

0‰
8,16‰
...............EMERITA........................
n PPI RS
0
 Formulir Bulanan Surveilan PPI RS
Data pemakaian alat & infeksi

Unit/ruang : ICU Bulan : NOVEMBER Tahun: 2017

Tgl Jmlh Psn IVL UC ILI ISK
1 4 4 1
2 4 4 1
3 3 3 1
4 1 1 2
5 4 4 2 1
6 2 2 3
7 3 3 1
8 4 4 1
9 3 3 2
10 4 4 2
11 3 3 1
12 3 3 1
13 3 3 2
14 4 4 2
15 3 3 2
16 2 2 2
17 2 2 1
18 1 1 1
19 3 3 2
20 4 4 3
21 4 4 3
22 4 4 3
23 4 4 3
24 4 4 1
25 4 4 1
26 1 1 1
27 2 2 1
28 2 2 1 1
29 2 2 1
30 2 2 1
89 89 49 2 0
JUMLAH

IPCN JENIS INFEKSI

JENIS INFEKSI PERMIL
ISK ISK 0‰
ILI ILI 22,47‰
...............EMERITA........................
 Unit/ruang : POSTBulan : OKTOBER Tahun:2017
Tgl Jmlh Psn IVL UC ILI ISK
1 16 16
2 18 18 1
3 18 18
4 19 19
5 21 21
6 23 23
7 13 13
8 11 11
9 9 9
10 11 11
11 7 7
12 11 11
13 17 17 1
14 19 19
15 16 1
16 18 18 1
17 14 14
18 13 13
19 11 11
20 12 12
21 16 16
22 17 17 2
23 15 15
24 13 13
25 11 11
26 6 6
27 6 6
28 6 6
29 7 7
30 10 10

JUMLAH 404 404 4 1 0

IPCN JENIS INFEKSI

JENIS INFEKSI PERMIL
ISK ISK 0‰
ILI ILI 2,475 ‰
...............EMERITA........................

Unit/ruang : POSTBulan : NOVEMBER Tahun:2017

Tgl Jmlh Psn IVL UC ILI ISK
1 16 16 8
2 15 15 7
 3 17 17 8
4 16 16 8
5 20 20 7 1
6 13 13 6
7 13 13 6 1
8 12 12 6
9 12 12 1
10 15 15 2
11 12 12 2
12 15 15 5
13 15 15 4
14 13 13 3
15 11 11 4
16 15 15 4
17 11 11 7
18 17 17 6
19 10 10 6
20 14 14 5
21 15 15 7 1
22 20 20 4
23 23 23 3
24 12 12 4
25 15 15 5
26 11 11 2
27 11 11 4
28 18 18 2
29 18 18 1
30 20 20 2

JUMLAH 445 445 139 3 0

3
IPCN JENIS INFEKSI
JENIS INFEKSI PERMIL
ISK ISK 0‰
ILI ILI 6,741‰
...............EMERITA........................

Unit/ruang : POSTBulan : NOVEMBER Tahun:2017

Tgl Jmlh Psn IVL UC ILI ISK
1 5 5
2 3 3 1
3 3 3
4 0 0
5 6 6
6 1 1
 7 2 2
8 0 0
9 1 1 1
10 1 1
11 2 2
12 1 1
13 5 5
14 4 4 1
15 0 0
16 3 3
17 3 3 1
18 0 0
19 1 1
20 0 0
21 0 0
22 0 0
23 0 0
24 0 0
25 4 4
26 1 1 1
27 2 2
28 4 4
29 2 2
30 2 2

JUMLAH 56 56 4 1

IPCN JENIS INFEKSI

JENIS INFEKSI PERMIL
ISK ISK 0‰
ILI ILI 17,85‰
...............EMERITA........................
 Formulir Bulanan Surveilan PPI RS
Data pemakaian alat & infeksi

Unit/ruang : ICU Bulan : Desember Tahun: 2017

Jmlh Psn IVL UC ILI ISK
1 2 2 2
2 3 3 2
3 3 3 3
4 3 3 3
5 2 2 1
6 4 4 3
7 4 4 4
8 4 4 3
9 4 4 4
10 4 4 2
11 4 4 3
12 4 4 1
13 4 4 2
14 4 4 3 1
15 4 4 4
16 4 4 2
17 4 4 3
18 4 4 2
19 4 4 3
20 4 4 4
21 4 4 3
22 4 4 3
23 4 4 2
24 4 4 3
25 4 4 3
26 4 4 3 1
27 4 4 3
101 101 74 2 0

IPCN JENIS INFEKSI PER MIL

ISK 0‰
ILI 19,80‰
...............EMERITA........................

Unit/ruang : POST 1 Bulan : Desember Tahun:2017

Tgl Jmlh Psn IVL UC ILI ISK
1 6 6 1
2 5 5 2
 3 10 10 3
4 15 15 4 1
5 16 16 2
6 17 17 3
7 24 24 4
8 21 21 3
9 17 17 2
10 17 17 6 1
11 18 18 4
12 16 16 2
13 17 17 2
14 16 16 3
15 17 17 4
16 12 12 2
17 10 10 3
18 10 10 2
19 8 8 4
20 9 9 4
21 11 11 2
22 11 11 3
23 9 9 2
24 10 10 4
25 8 8 5 1
26 9 9 5
27 10 10 3
JUMLAH 349 349 84 3 0

IPCN JENIS INFEKSI PER MIL

ISK 0‰
PLEBITIS 8,595‰
...............EMERITA........................

Unit/ruang : POST 2 Bulan : Desember Tahun:2017

Tgl Jmlh Psn IVL UC ILI ISK
1 23 23 6
2 26 26 7
3 27 27 8
4 21 21 4
5 18 18 7
6 23 23 4 1
7 22 22 3
8 23 23 2 1
9 18 18 5
 10 17 17 4
11 15 15 7
12 19 19 6
13 26 26 8
14 23 23 5
15 24 24 4
16 15 15 9
17 18 18 7
18 22 22 6 1
19 22 22 4
20 22 22 3
21 21 21 5
22 24 24 2
23 17 17 6
24 17 17 7
25 18 18 5
26 22 22 3
27 23 23 2
JUMLAH 566 566 139 3 0

IPCN JENIS INFEKSI PER MIL

ISK 0‰
ILI 5,300‰
...............EMERITA........................

Unit/ruang : POST 3 Bulan : Desember Tahun:2017

Tgl Jmlh Psn IVL UC ILI ISK
1 0 0
2 2 2
3 0 0
4 0 0
5 0 0
6 1 1
7 1 1
8 2 2
9 1 1
10 1 1 1
11 3 3
12 0 0
13 5 5
14 3 3
15 0 0
16 1 1 1
 17 1 1
18 0 0
19 0 0
20 2 2
21 1 1
22 3 3 1
23 1 1
24 1 1
25 1 1
26 2 2
27 2 2
JUMLAH 34 34 2 1 0

IPCN JENIS INFEKSI PER MIL

ISK 0‰
ILI 29,41 ‰
...............EMERITA........................
 RUANG SEPTEMBER OKTOBER NOVEMBER DESEMBER
ICU 29.85 38.46 22.4 19.8
POST 1 12.65 11.14 2.475 8.595
POST 2 8.639 4.901 6.741 5.3
POST 3 17.69 15.74 17.85 29.41
TOTAL 12.5 11.05 7.042 8.571

SURVEY SEPTEMBER OKTOBER NOVEMBER DESEMBER

ILO 0 0 0 0
ISK 0 0 0 0
ILI 12.5 11.05 7.042 8.571

INSIDEN RATE INFEKSI

ILO ISK ILI
15 15 15
12.5
11.05
8.571
7.042

0 0 0 0 0 0 0 0

SEPTEMBER OKTOBER NOVEMBER DESEMBER TARGET

SURVEY SEPTEMBER OKTOBER NOVEMBER DESEMBER

DOKTER 83.5 88.3 91.3 92.6
PERAWAT 76.3 83.3 96.3 93.3
CS 66.3 67.6 76.6 92

TINGKAT KEPATUHAN APD

100
90
80
70
60
TARGET

50
40
30
20
10
0
 80
70
60

TARGET
50
40
30
20
10
0
SEPTEMBER OKTOBER NOVEMBER DESEMBER TARGET
TARGET
15
15
15
15
15

TARGET
15
15
15

TARGET
100
100
100