ABCDFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQARASATAUAVAWAXAYAZBABBBCBDBEBFBGBHBIBJBKBLBMBNBOBPBQBRBSBTBUBVBWBXBYBZCACBCCCDCECFCGCHCICJCKCLCMCNCOCPCQCRCSCTCUCVCW
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WORKSHEET PEMANTAUAN KEPATUHAN KEBIJAKAN PELAYANAN RAWAT INAP
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LANTAI : 1 GPS
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PERIODE : 26 Agustus - 25 September 2026
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NONAMA PASIENNo RMDPJPTANGGAL MASUK RUANGANTGL KELUARLOSKEPATUHAN TERHADAP PASIEN BARU
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DPJP sesuai SMRSPengkajian awal 1x24 JamBuat Care Plan TerukurMemberi Edukasi ke Pasien
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262728293031123456789101112131415161718192021222324
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06 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 12 212 - 14 2>14 206 - 1212 - 14>1406 - 12 212 - 14 2>14 206 - 12 312 - 14 3>14 306 - 12 412 - 14 4>14 406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 12 212 - 14 2>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14>1406 - 1212 - 14
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5NY. SITI NURSIAH2058249dr Raden Achmad Hussein Fachruddin Sp. B Subsp. BD (K)17/8/202626/8/202601000
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1GILANG RAMADHAN2035516dr. Yoshi Pratama Djaja Sp.OT6/8/202626/8/2026110011101101001
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3DINDA SALSABILA APRIYANI2150347dr Mohamad Almer Sahala Sp.OT15/8/202626/8/20260101000
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10Adhinda anindiya bella2148026 dr. Dimas Radithya Boedijono Sp.OT (K)23/08/202626/8/20261
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12MAYLIANNA336305dr. Ahmad Nugroho Sp.OT23/08/202626/8/20260
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13IMAM SUWARTO2151430dr Raden Achmad Hussein Fachruddin Sp. B Subsp. BD (K)24/8/202627/8/202600
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6ENDANG PUJIATIE2151203dr. Harsya Dwindaru Gunardi, Sp.B.(K)21/08/202627/8/202610
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9ACHMAD 2151277dr. Sara Ester Triatmoko Sp.BPRE(K)22/8/202628/8/20260001
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TN. INDRA IRMAWAN2139378Dr. dr Wahyu Widodo Sp.OT (K)26/8/202628/8/2026000
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Ny. SUPRIHATIN 2065825dr. Mursid Fadli, Sp.B(K)V26/8/202628/8/2026000
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4NY. IDA JAUHARIAH2150449dr. Yoshi Pratama Djaja Sp.OT17/8/202629/8/202610010100
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17E NURHAYATI2146323 dr. Dimas Radithya Boedijono Sp.OT (K)25/8/202629/8/2026100
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20JOE CHRISTIAN GINTING2151688 dr. Dina Aprilya, Sp.O.T, Subsp.T.L.B.M. (K)25/8/202629/8/20260000
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11NY. ARIYAH2150280dr. Arfan Mappalilu Sp.S26/8/202630/8/202600000
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7Debby Stevania 2067427dr. Phedy Sp.OT (K)25/8/202630/8/2026001000
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8Puspitayaningtiyas2080053dr. Didik Librianto Sp.OT, KSpine25/8/202631/08/2026000000
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9SUPENNY2051366dr. Amrizal Umran, Sp.U, Sub.Spec. Urologi Andrologi (K)25/8/202631/08/2026000000
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2M. MIRZA BAHTIAR1305610dr. Muhammad Wahyudi Sp.OT (K)21/08/20261/9/20260000011
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7NY. Djumirah2143707dr. Jamot Silitonga Sp.OT (K)26/8/20261/9/202600000
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10Paiyem2073674dr. Maelissa Pramaningasih Sp.B, Subsp.Onk (K)27/8/20261/9/202600000
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12MARSYA SYAFIRA KHOIRUNISSYA2152260dr. Mohammad Zul Hazmi Al Badruzzaman, Sp.B29/8/20261/9/2026011
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3TRI HARYANTO 2151370dr Mohamad Almer Sahala Sp.OT23/08/20262/9/202600000000
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6SURYATI2143331dr. Muhammad Wahyudi Sp.OT (K)27/8/20262/9/2026000110
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7A.W. SUMIRTA2124833dr. Anggaditya Putra Sp.OT27/8/20262/9/2026000000
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12NY. FITRIAH2148333 dr. Ahmad Nugroho Sp.OT30/8/20262/9/2026010
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15MARYANI1208572dr. Yulia Miftahul Janna Sp.M31/08/20262/9/202611
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18Angellinajane2044189dr. Didik Librianto Sp.OT, KSpine2/9/20263/8/20260
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HANAFI1422581dr Zulfahmi Sp B3/9/20263/8/20261
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13ROHETI2151453dr. Heru Angkoso Sp.B01/09/20263/8/202600
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16AI SUSANTI2130179dr. Muhammad Wahyudi Sp.OT (K)2/9/20263/8/20260
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NAMIN 2153048dr. Mohammad Zul Hazmi Al Badruzzaman, Sp.B4/9/2026
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7LEVANA RIZKY ABDULLAH2152277dr. Ahmad Nugroho Sp.OT29/8/20264/9/2026001000
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8An. BELIA PUTRI2137409dr. Enos Hagogoan Siburian Sp.B(K) Onk30/8/20264/9/2026001000
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17KEIYLA INDAH PRATASYA2097754 dr. Faisal Mi raj Sp.OT2/9/20264/9/202600
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9Heratina mahzar2142672dr. Yoshi Pratama Djaja Sp.OT31/08/20265/9/202601010
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13MUTRIAH BINTI SANIM2147327dr. Claudia Hartomuljono Sp.M3/9/20265/9/202600
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15SITI AMSRIYAH 2120003dr. Indah Jamtani Sp.B.Subsp.BD (K)3/9/20265/9/202600
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2IRMA NOVIANTI 2038634dr. Ramadhana Effendy Sp.B22/08/20266/9/2026000000010100
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10SUYATI 1796140dr. Arief Wibisono Sp.B (K) Onk01/09/20266/9/202600000
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11ASMAUL HUSNA2053698dr. Maelissa Pramaningasih Sp.B, Subsp.Onk (K)01/09/20266/9/202600100
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14Andriani Amboy2144443dr. Iman Widya Aminata Sp.OT(K)3/9/20266/9/2026000
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6ASHJA RADITHYA LESMANA2152312dr. Iman Widya Aminata Sp.OT(K)29/8/20267/9/20260000100001
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8ROHAETI2140447dr. Didik Librianto Sp.OT, KSpine31/08/20267/9/20260000001
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12SYAMSUDIN 2148491dr. Ratih Pahlesia Sp.P01/09/20267/9/20260101000
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16MUHAMAD ARIS MUKTI2005275dr. Faisal Mi raj Sp.OT4/9/20267/9/2026000
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17TUSMIARTO TUSLAN2148968dr. Mochammad Evodia Slamet Rahardjo Sp.B.S4/9/20267/9/2026000
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1GHULAM AQILAH DZAKWAN M2138266dr. Yoshi Pratama Djaja Sp.OT13/8/20260000001010000
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3SELAMET2151545 dr. Endi Suryo Utomo SpBS24/8/20260000011010001
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4Yulinda2150777 dr Erwin Sp OT 25/8/202600000100000000
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5ARIL NUARI SAPUTRA2152118dr. Yoshi Pratama Djaja Sp.OT28/8/20260001010010000
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7YULIWATI2152576dr. Yoshi Pratama Djaja Sp.OT31/08/20260010010000
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SUNANI2153494dr. Iman Widya Aminata Sp.OT(K)5/9/26010
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TRIPUJI HANDAYANI2153499dr. Iman Widya Aminata Sp.OT(K)5/9/26010
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MOHAMMED MAHYOUB ABDULWAHAB1932899 dr. Heru Angkoso Sp.B5/9/260110
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VIOLA ALMIRA AURELLIA1917612dr. Faisal Mi raj Sp.OT5/9/26000
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INTAN DWI ANDINI<==20540542051656dr. Mochammad Evodia Slamet Rahardjo Sp.B.S5/9/2026000
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DEDEH MASRIYAH2062252dr. Budiman Gumilang Koerniawan, Sp.T.H.T.B.K.L6/9/202610
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Fadillah Rizkyah2038677dr. Didik Librianto Sp.OT, KSpine7/9/20260
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PUTRI NOVRIYANTI2027774dr. Muhammad Wahyudi Sp.OT (K)7/9/20260
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MARIA IDA DJAIM2140312dr. Didik Librianto Sp.OT, KSpine7/9/20260
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CLARA YUANITA HARNO2123683dr. Didik Librianto Sp.OT, KSpine7/9/20260
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HENDRA WAHYULIADI2150937 dr. Arief Wibisono Sp.B (K) Onk7/9/20260
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TRI HARYANTO2151370 dr. Anggaditya Putra Sp.OT7/9/20260
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Rona 2144262dr. Budiman Gumilang Koerniawan, Sp.T.H.T.B.K.L7/9/20260
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ROCHMAD HARDYANTO2150592 dr Diah Asih Lestari Sp.B, Subsp.B.D. (K)
7/9/20260
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#REF!#REF!#REF!#REF!
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Keterangan Pengisian :
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1. Pencatatan dan pengumpulan data dilakukan setiap hari hanya untuk kepatuhan jam Visite
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2. Setiap Pasien Baru harus dipantau kepatuhan terhadap kesesuai DPJP. Pengkajian Awal, Pemberian Edukasi dan Pembuatan Rencana Pulang
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3. Cara Pengisian Kolom :
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a. untuk kolom no, no RM ,Nama Pasien , nama DPJP dan Tgl MRS sudah jelas
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b. untuk Kolom kepatuhan, diisi angka satu (1) bila sesuai dan angka nol (0) bila tidak sesuai dengan ketetapan
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c. untuk kolom Rerata Kepatuhan adalah Rata - rata nilai kepatuhan ( Average ) dikali persentase
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