ABCDEFGHIJKLMNOPQRSTUVWXYZ
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FORMULIR SURVEILANS HARIAN INFEKSI
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RUMAH SAKIT UMUM DAERAH LAHAT
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Bulan/Tahun:Agustus 2023
Ruangan: Utama
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TanggalNamaUmurL/PDiagnosa MedisTanggalTINDAKANInfeksi Rumah SakitDecubAntibiotik (AB)
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MRSKRSIVLUCETTVAPISKPleb
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PasangLepasJumlah HariPasangLepasJumlah HariPasangLepasJumlah Hari
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1/8/23
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1Rizkia permata putri1999pVertigo31/7/2331/7/23-
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2Faiz Al fahri2020LGead rs dg penyulit1/8/20231/8/2023Ceftriaxon
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2/8/2023
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1Rizkia Permata putri1999pVertigo31/7/20232/8/2331/7/232/8/233 hari-
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2Faiz Al fahri2020LGead rs dg penyulit1/8/20231/8/2023Ceftriaxon
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3/8/2023
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1Faiz Al fahri2020LGead rs dg penyulit1/8/20233/8/231/8/20233/8/233 hariCeftriaxon
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4/8/2023
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/234/8/23Ceftriaxone
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5/3/2023
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/234/8/23Ceftriaxone
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6/8/2023
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/234/8/23Ceftriaxone
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2Adiba azahra nesa2022PBP+ TFA6/8/20236/8/23Ceftriaxone
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7/8/2023
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/237/8/237/8/233 hariCeftriaxone
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2Adiba azahra nesa2022PBP+ TFA6/8/20237/8/236/8/237/8/232 hariCeftriaxone
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3Muhamad khalid2020LAcute viral infection7/8/237/8/23Ceftriaxone
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8/8/2023
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/237/8/237/8/23Ceftri, azit
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2Muhamad khalid2020LAcute viral infection7/8/237/8/23Ceftriaxone
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3Ariadna hanifa2022Pgead rs8/8/238/8/23Ceftriaxone
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IVL : Intra vena Line
Decub : Decubitus
Lahat, Agustus 2023
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UC : Urin Chateter
Pleb : PlebitisIPCLN
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ETT : Endo Tracheal Tube
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VAP : Ventilation Associated Pneumonia
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ISK : Infeksi Saluran Kemih
(..............................)
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FORMULIR SURVEILANS HARIAN INFEKSI
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RUMAH SAKIT UMUM DAERAH LAHAT
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Bulan/Tahun:
Ruangan:
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TanggalNamaUmurL/PDiagnosa MedisTanggalTINDAKANInfeksi Rumah SakitDecubAntibiotik (AB)
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MRSKRSIVLUCETTVAPISKPleb
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PasangLepasJumlah HariPasangLepasJumlah HariPasangLepasJumlah Hari
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4Jesna Al thafunisa2021PAcute viral infection8/8/238/8/23Ceftriaxone
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5Riska Triana Dewi1996PG1p0A0 hlm 5 mgg dgn ab imminens8/8/238/8/23Ceftriaxone
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9/8/2023
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/237/8/237/8/23Ceftri, azit, Ampi
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2Muhamad khalid2020LAcute viral infection7/8/237/8/23Ceftri, Azit
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3Ariadna hanifa2022Pgead rs8/8/238/8/23Ceftriaxone
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4Jesna Al thafunisa2021PAcute viral infection8/8/238/8/23Ceftriaxone
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5Riska Triana Dewi1996PG1p0A0 hlm 5 mgg dgn ab imminens8/8/238/8/23Ceftriaxone
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10/8/2023
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/2310/8/2310/8/233 hariCeftri, azit, Ampi
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2Muhamad khalid2020LAcute viral infection7/8/2310/8/2310/8/233 hariCeftri, Azit
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3Ariadna hanifa2022Pgead rs8/8/2310/8/238/8/2310/8/233 hariCeftriaxone
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4Jesna Al thafunisa2021PAcute viral infection8/8/238/8/23Ceftriaxone
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5Riska Triana Dewi1996PG1p0A0 hlm 5 mgg dgn ab imminens8/8/2310/8/238/8/2310/8/233 hariCeftriaxone
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11/8/2023
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/2310/8/2310/8/23Ceftri, azit, Ampi
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2Muhamad khalid2020LAcute viral infection7/8/2310/8/2310/8/23Ceftri, Azit
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3Jesna2021PAcute viral infection + BP8/8/2311/8/238/8/2311/3/23ceftriaxone
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4Luci indriyani1978PGEAD Sedang11/8/2311/8/23-
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12/8/23
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1M.Sultan Alfatih2018LAcute viral infection + CP + epilepsi4/8/2312/3/2310/8/2312/8/233 hariCeftri, azit, Ampi
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2Muhamad khalid2020LAcute viral infection7/8/2312/8/2310/8/2312/8/233 hariCeftri, Azit
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3Luci indriyani1978PGEAD Sedang11/8/2312/8/2311/8/2312/8/232 hari-
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IVL : Intra vena Line
Decub : Decubitus
Lahat, Agustus 2023
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UC : Urin Chateter
Pleb : PlebitisIPCLN
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ISK : Infeksi Saluran Kemih
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ETT : Endo Tracheal Tube
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VAP : Ventilation Associated Pneumonia
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ISK : Infeksi Saluran Kemih
(..............................)
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FORMULIR SURVEILANS HARIAN INFEKSI
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RUMAH SAKIT UMUM DAERAH LAHAT
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Bulan/Tahun:
Ruangan:
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TanggalNamaUmurL/PDiagnosa MedisTanggalTINDAKANInfeksi Rumah SakitDecubAntibiotik (AB)
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MRSKRSIVLUCETTVAPISKPleb
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PasangLepasJumlah HariPasangLepasJumlah HariPasangLepasJumlah Hari
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13/8/2023
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1Azzam Putra2016LFebris ec susp TB kelenjar13/8/2313/8/23Ceftriaxone
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2Suraida M.sani1954PVertigo + Ht gr II13/8/2313/8/23ceftriaxone
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14/8/2023
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1Azzam Putra2016LFebris ec susp TB kelenjar13/8/2313/8/23Ceftriaxone
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2Suraida M.sani1954PVertigo + Ht gr II13/8/2313/8/23ceftriaxone
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15/8/2023
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1Azzam Putra2016LFebris ec susp TB kelenjar13/8/2313/8/23Ceftriaxone
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2Suraida M.sani1954PVertigo + Ht gr II13/8/2315/8/2313/8/2315/8/233 hariceftriaxone
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16/8/2023
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1Azzam Putra2016LFebris ec susp TB kelenjar13/8/2313/8/2316/8/233 hariCeftriaxone
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2Firliani1997PVertigo16/8/2316/8/23-
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17/8/2023