993 - PPI Pedoman Surveilance

7/23/2019 993 - PPI Pedoman Surveilance

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Daa . Ra Wa, S

Da . H. Ma Saa,

D . H. Ma AM, M.

EAA DI

J

. MKKa K

PPI

MARSD

Paaa

KD

Uaa

EK AH AKI IA A AGG

: 993/E/IA/I/2014

EAG

EDA EIA

AH AKI IA A AGG

11 Jaa 2014

15 Jaa 2014

17 Jaa 2014


2/74

PERATURAN DIREKTUR RUMAH SAKIT ISLAM SULTAN AGUNGNOMOR : 993/PER/RSISA/I/2014

TENTANG

PEDOMAN SURVEILAN

RUMAH SAKIT ISLAM SULTAN AGUNG

DIREKTUR RUMAH SAKIT ISLAM SULTAN AGUNG

MENIMBANG : a. Baa aaaa a a aaa aa,

aa aa a a a

aaa aa aa a a aa

a;

b. Baa aa a aa a a

a aa aaa aa aa a aa

aa aa a aa aa

a, a, a aaaa a a

a;

.

Baa aa a a Paa a Paa

I (PPI) aaa aa a;

. baa baaa baa baaaa a

aa a,b, a , aa D a PaOaa Baa La Ra Sa Ia Sa A

Saa.

MENGINGAT : 1. UaUa Rb Ia N 44 a 2009

a Ra Sa

2.

UaUa Rb Ia N 36 a 2009

a Kaa

3.

UaUa Rb Ia N 29 a 2004

a Pa Ka

4. Paa M Kaa Rb Ia N

1045/M/P/XI/2006 a Pa Oaa

Ra Sa D La Da Kaa.

5.

Paa M Kaa Rb Ia N

1144/M/P/VIII/2010 a Oaa a Taa

Ka Da Kaa.

6.

Ka M Kaa Rb Ia N

1333/M/SK/XII/1999 a Saa Paaa Ra

Sa.


3/74

3

7.

Ka M Kaa Rb Ia N

1204/M/SK/II/2007 a Paaa Kaa

La Ra Sa.

8.

Ka M Kaa Rb Ia N

129/M/SK/XII/2008 a Saa Paaa MaRa Sa.

9. Sa Eaa D Ja Ba Paaa M N

H.K.03.01/III/3744/08 a Pba K a T

Paa a Paa I Ra Sa

10.Sa Ka M Kaa Rb Ia

N : HK.07.06/III/2371/2009 a I Paaa

Ra Sa Ia Sa A

11.

Sa Ka P Baa Yaaa Baa Waa

Sa A N 68/SK/YBWSA/V/2013 a

Paa S Oaa Ra Sa Ia Sa

A.

12.Sa Ka P Yaaa Baa Waa Sa

A N: 090/SK/YBWSA/XII/2009 a

Paaa D Ra Sa Ia Sa A Maa

Ba 20092013

M E M U T U S K A N :

MENETAPKAN :

KESATU : Pa Oaa Sa Ra Sa Ia Sa A

baaaa a aa Laa Ka .

KEDUA : Ka ba a aa aaa a aa

aa aa a aa.

KETIGA : Aaba a aa aaa aaa baa aa aa

aaa baa baaaa a

Daa : Saa

Taa : 15 Rab Aa 1435H

17 Jaa 2014M

RUMAH SAKIT ISLAM SULTAN AGUNG

SEMARANG

D. H. Ma AM, M. K

D Uaa


4/74

4

LAMPIRAN PERATURAN DIREKTUR RUMAH SAKIT ISLAM SULTAN AGUNG

NOMOR : 993/PER/RSISA/I/2014

TANGGAL : 17 JANUARI 2014

BAB I

EDAHA

A. AA BEAKAG

Paa a aa a a a aa aaa

aa aa a aa aa aa aa a

aa aa a, a, a aaaa a a

a. Saa a a Paa a Paa I (PPI) aaa

aa a, a aaa aa a a a aa,

aaaa a a baa aa aba a aa.

Kaa a aa aaa aa aa aa a

aa a a a aa a aa , a a a

a a aa aa baa a a PPI.

Da a aa aa aaa aa baa a a (

) aa baa a a a a (

) a ba a a a a. Kaa

a a ba aa a a aa . Maa aa a

a (Ha a ) a a a ba aH A I (HAI)a a a b a a

aa a a a a aa aa aa. Ja a baa

aa a aa, a a aa a aa a aa

aa aa aa aa aaa a. K a a

aa aa a a aa b I (I).

Kaa a aa aaa aa aa a

a a, aa a, a,

aa aa aa a a aa a a a a

aaa aa aa a ba. Ha aa a

aa aa baa aa aa,

a aaa aa a baa (KLB) a baa aa

a.

Kaa a IRS Ia b aaaa a a a aa

aa baba b aa aaaa. O aa


5/74

5

P Paaaa a I Ra Sa a ba aa

aa aaaa aa a a a.

Sa a a aa aaa a aa a a

aa aaaa a a ba a aa aa. Da aaa aa a aa a Paa a

Paa I a a (PPIRS) aaa aa a a

.

B. D H

1. UaUa Rb Ia N 29 a 2004 a Pa

Ka (Lbaa Naa RI Ta 2004 N 116, Tabaa Lbaa

Naa RI N 4431).

2. UaUa Rb Ia N 36 Ta 2009 a Kaa

(Lbaa Naa RI Ta 2009 N 144, Tabaa Lbaa Naa RI

N 5064)

3. UaUa Rb Ia N 44 Ta 2009 a Ra

Sa (Lbaa Naa RI Ta 2009 N 153, Tabaa Lbaa

Naa RI N 5072)

4.

Paa M Kaa Rb Ia N

1045/M/P/XI/2006 a Pa Oaa Ra Sa D

La Da Kaa.

5.

Paa M Kaa Rb Ia N

1144/M/P/VIII/2010 a Oaa a Taa Ka Da

Kaa.

6.

Ka M Kaa Rb Ia N

1333/M/SK/XII/1999 a Saa Paaa Ra Sa.

7.

Ka M Kaa Rb Ia N

1204/M/SK/II/2007a Paaa Kaa La Ra

Sa.

8.

Ka M Kaa Rb Ia N

129/M/SK/XII/2008 a Saa Paaa Ma Ra Sa.

9.

Sa Eaa D Ja Ba Paaa M N

H.K.03.01/III/3744/08 a Pba K a T Paa aPaa I Ra Sa.

C.

Da aaaa aa a aa aaaa a

a a a a, a a ba Ka

Kaa RI.


6/74

6

D.

T PPI a a Pa a Saa, Da Kaa a I

Pa.

E.

Da aaa Pa Sa I Ra Sa aaa

aa b a a a a a aa aa

b aa a a aa aa ba aaa a ba

aa.


7/74

7

BAB II

DEFIII DA JA EIA I

A.

DSa IRS aaa a a a, a,

aa a, a, aa a a a aa aa

a aa a a a aa aa baa

aa aa a a aa aa aaa,

aa a aa a aa a bba a aa.

.

,

. ( , .

I Ra Sa (IRS) aa Haa Aa I (HAI) aaa

a a aa a aa aaa RS aa aa aaa

aa a a a a a a aa aa ba aa a

a RS. IRS a a a aa RS a ba

a a a RS a a aba a aa aa aa.

Ra Pa Sa aaa a a

(IRS) a a aa a.

B.

Sa a a a a a a a a aa baa

aa a a, a ba a a bba.

Pbaabaa a a b :

1.

Aaa ba

2. Pbaa a a, aa aa aa

a a b

3.

Pbaa a a a4.

Pbaa a a aa ab

Pa a aaa aa a a aa a a a

a aa aa. O aa b aa a

aaaa a b a a a

a a a b a.


8/74

8

Aa a a a a aa aaa :

1.

Maaa aa aa I Ra Sa

2. Ma La I RS

3.

Ia Kaa La Baa (KLB) I Ra Sa

4.

Maa aa aa aa a aaa aaa aa aaa

5. M a a baa a a PPI RS

6.

M aa aaa a aaa

7.

Saa a aa RS

A. 1. I

Paa aaa aa a IRS aa a aa aa

( ) a RS. Da a aa a baa b

a aa a a a aa a a. Sbaa

ba (9095%) a IRS aaa a a a KLB a a a.

O aa aa a IRS a a a aa

b.

M aa a aa aa a a aa

, a a aa aa a aa a

a a a a aa aa a aa a

aa. Ba a aa aa a aa aa baa, baa

a aa a aa a aa a a.

A. 2.

Da a a a IRS a aa a

aa a a aa IRS. U aa a a a

baaa aa aa aa, b aa aa a aa a a.

A. 3. I K B (KB) I

Ba a aa aa a a, aa a aa a a ba a

a aa a aa aa b a a a

aa a aa aa a baa () a IRS.

Kaa La Baa (KLB) aaa ba aa aa aa aaa / aa aa a baa aa aa aa aa

a a aa aaa a aa aa

aba.

KB aaa ba aa aa aa RS a a

a aa aa a baa aa a .


9/74

9

D aa aaaa aa a a aa

a RS a aa aa aaa aa a

a (a) aa a aa RS.

U a aaa aa a aa a aa

aa aa b aa a KLB, aa aaa a aa a aa a ba aab

.

Pa aaa a aa aa a aaa/ aaa

baa aa a baa. Sa KLB aaa aaba aa a

a baa b:

a.

Tba a a a ba a aa aa a a aa

a aa

b. Paa aa aa aa 3 (a) a

aa a, a aa b aa

.

Paa aa aa a a aa b baa a

ba aa a a, a aa b

aa

.

Ja a ba aa a 1 (a) ba a

aa a a aa b baa a aa aaaa ba

aa a ba

.

Raaaa a aa aa ba aa 1 (a) a

a aa a a aa b baa a aaaa

a aa aa ba aa a ba

. Aa aa a a a ( ) aa 1 (a)

a a aa 50% (a ) aa b

baa a aa aa a a a

ba aa a a aa.

. Aa a ( ) a ba a a

aa a a aa a a aa b ba a

ba aa a a aa

Taa aaa aa b aa a aa a aa

a aa aa aa a a KLB aa a a aa.

A. 4.

Daa a a a a ba a aa aa aa

aa aa aa aa aa a aa

(PPI). Daa aa a aa a aa a

aa b , aa a aa. Ua ba a a


10/74

10

baaa aa aa aa aa

aa aa PPI RS.

A. 5. I

Sa aaaa aa a a aaa aa a a

aa aa a aa a aaa, aa a a

a aa baba a aa baa aaaa a

aa baba a aa. Da aaa a

aa a aa aa a aaa aa aa aa aa

a baa aa a aa a, baa , baa

aaa a a a a IRS aa a aa

a a aa a a baa a aa aaaa.

A. 6.

Paaaaaa a a ba a a aa a aa a a

aa a a aa aa aba aa

a aa IRS.

Sa a ba aa aa aa aa baa aa

a a aa aa aa aaa a a.

A. 7.

Sa IRS aa aa a aa RS a

Paa Paa I. Aa a, a aa a

aa a aa aaa a ba b aa a

a baa aa ba aaa aa a a aa aa a

aa. O aa a a baa aa a a

baa a a IRS.


11/74

11

BAB III

EDE EIA I

M a IRS aa a a bbaa .1. B

( ) aaa a a aa a

aa IRS (aa ILO, IADP, ISK, a). Sa a ba

abaa a b aa IRS. Sa a

a a aba b. Sa , a a

aa a a aa a aa (>100 aa

a aa ba) a/aa b ba IRS.

( )aaa a a aa

aaaa aaaa aa IRS. Paa IRS baa

aa a aaa a aa . Daa

aa aa a b aa a

ba IRS. Sa baa a a aa a ba,

aa aaa a a IRS. Sa aa aa

a a aa aba b. Sa , a

aa aa aa a aa aa (< 100 aa

a aa ba, aa aaa a) a aa a b

a ba IRS (aa ILO aa a).

2. B

( ) aaa a

a aa a aa aaa a a a

aa aa a a. Daa a a aaa ,

aaa aaa, aba a aa aa. M a

aa aa a aa CDC aa a 1970, a

a baa a, aa a baa.

( ) aaa a a

aa aa, a, aa aa a . Ca a a aaa (ICU),

a aa a a a a a, aa a a

a. Sa a aa ba a a b aa a

a b aa a b .


12/74

12

3. B

aaa a a aa aa a a

a , aa a ba aa a . Sa ba

aa aa baa, aa a a aa bbaa aa

a a a.

( ) aaa a a

a a IRS ba a aa a ba, aa a . Kaa

a a aa a ba, a a a aa b a

a . Sa a aa aa a

a MRa Sa A

(MRSA) aa VaRa E (VRE)

4. B J

aaa a a aa aa a

aa aa a aa. Sa aa aaa b a aa,

a aa a IRS a b aa a a a.

( ) aaa a a

aa a a a a a a. Sa aa aa aa

IRS a a a b, ILO a ba b 30 a

(aa a) aa 1 a a a (a a). Sa aa

aa a a a a a ba a aa

a a a aa aa a a a a,

aa aa a a a a a aa a.

U aa aa aa a aa, a a a aa

a a a aaa a aa .


13/74

13

BAB I

DEFIII KA

I Ra Sa (IRS) aa aa a a a b baa (), aa a bba a a

aaa a. Ja a a aa a aa aaa a

a a a aa aaa. Da a a aa aaa

aa IRS a aa a a. B a a baa

aa aaa a ba a aa aa aa IRS. Da

aaa , aa IRS aa a a aa aa aaa

aa a a a ba aa a aa ba a

a a a aa a aa aa a a aa.

IRS aa a a aa aaa. U a aaa a

a IRS aa ba, b a a ba baa

b a b aa a a a aa a ba aa a

aa.

Pa aa a a a a aa a, a

a a b baa aa ba. Paa 23 a a

aaa baa aa a a, aa aa ba a aa

ba bab a a ba a baa. I

a a a aa ba 23 a, a a ba

ba a bbaa a, , ba aa baa a (aa Tb,

HIV, aa La). U , a aaaa a, ba a aaa,

aa aa baa aba ba .

J IRS aa baa, a a aaa a aa a a

aa aa a (aa aaa, aa, , b

aa, aa a, a ). Daaa IRS aa 4 (a) a

a a a I Aa Daa P (IADP), I a bba

a aaa a aa (VAP), aba

aaa a aa I Saa K (ISK), a aba aabaa (SSI)

A. I A D (IAD)

I Aa Daa P aa a a aba aa

ba a aaa a a aa a b

aa. Daa a CDC b baa ()


14/74

14

A a aa aa aa ba a a, a a

a a aa aa a, ba aa aa aaa a

a, a aa b baa a a a (

).

Ca aaa aaa a a (CVC : Ca V Ca), a (), aa.

1. D K I A D (IAD)

.

D IAD

Aaa aa a a a aa aa/

aa a aa a a a a aa baa

a a a a/aa a aa aaa

a a .

Sa Pb aa baa IADP. IADP bba a Pb

( & ). Pbaa aaa IADP a Pb

aaa:

1) Pb, aa aaaa aaa aa aa a

a . Taaaa aaa b aaa a,

ba, aa baa a a ba a

2) IADP aaa aaa baa a aaa aa a

aa

.

K IAD

Aa bbaa a a IADP. Ka IADP 1 a 2 aa

aa a a a a a < 1 a,

a a a a b:

1)

Ka 1 IADP

Da a aa 1 aa a a

Mba a aa a bba a

baa a a b a (a aa 1 & 2)

2) Ka 2 IADP:

Pa a a a aa : a ( >

38C), aa a Taa a aa a aa aba

a a bba a baa a a b

a, a

Ha a baa a 2 aa aa a

aba a bba aaa ba aa

a , aa (Cba ). Ba ,

(ba B aa) Pba , Sa


15/74

15

aa a a S , S a,

A , M , (a aaa 3&4)

3)

Ka 3 IADP

Pa aa a 1 a a a a aa b : a ( a > 38C), ( a < 37

C), a aa baaa a

Taa a aa a a aa aba a

a bba a baa a a b a

a

Ha a baa a 2 aa aa a

aba a bba aaa ba aa

a , aa (Cba ), Ba ,

(ba B aa) Pba , Sa

aa a a S , S a,

A , M .

K :

1. Daa a 1, a aa a aaa a 1 b

a aa a ab ba a aa .

2.

Daa a 1 a a aaa ba a a a

aa ba aa a aaa (a a 2

& 3). C ba a a ba a a a

aaa S. A, E , E , Pa ,Kba , Caa , a aa

3. Daa a 2 a 3 a 2 aa ab a a a

bba aaa :

a.

Da CV aa a CV a

b. Saa 2 a aba aa a a

a a b a 2 a (aa aba aa aa a

S a Saa, aa S a Rab, aa a a aa

S Ka) aa aa a a baaa a a a

bba.

.

Ma 1 b a aa a ab a baa aa a aa. (a aaa 4

a aaa ba)

C :

a.

Pa aa ab aa a 8.00 a a ab a a

8.15 aa a a aa, aa aa a a aba

a aa 2 b a ba (a 4 b). Ba 1 b


16/74

16

a baa a a aba aa aaa Sa

aa a, a .

b. Na ab aa aa Saa a Sab.

Da ba a aa . Kaa a a

aba aa > 2 a, aa a a aa a. Paa aba aa a aaaa, aa baaa

aa, aa 1 b aa aa ab. Aa a

a a , aa aa aba a aa b

a a a a a a b a 2 aaa a

a ba a aa a aa.

4.

Bbaa a aa aa a aaa

ba :

a. Ba aa a 1 a aa a ,

a aaa aa a a aa baa aa

(aa aa aa a ) aa aa baa ba

ba b aaa . S ba a aa

baa a bab .

b.

Ba ba aa a a a aa

a a b aa aba, aa a

aa aba aa aa 1 a, aa aa

baa baba b aaa .

.

Ba aa a a aba a bba

2 ab, aa aa baa baa aaa

.

U a aa aba ( aa a aa

WHO) aa a a TIDAK DIPAKAI

baa aaa 2 ba aa

Tab 4.1 C Kaaa ba

K K aaa Daa

baa

S Sa a (CNS) Caa S.

E

Ba Ba B. C

S. Saa S a S. Saa


17/74

17

Tab 4.2. C Kaaa aba ba

Naa ba Ia A Ia B Daa

baa

S. a ba S a ba S ba a aaS. OX R OX S ba a bba

CEFAZ R CEFAZ S

Cba P G R P G S ba a bba

C S C R

S a Sa ba S a Oba S a ba a aa

E R

Kaa: S : S R :

Caaa :

a.

Iaa, aa a ab 24 a a bba (aa a a

aba a aa) a TIDAK DIAMBIL DARI SELANG INFUS. Daa

ab aa a aa aa a a a (aa aa

bbaa a)

b. Ba a aa a baa a aa aa

a aa b aa IADP a a a aaa

aa, a a aa a a a

aa a a aa a b ba.

2. CE (C EI) / EI K

CSEP aa aa aa aa IADP aa a a ba.

Ta aa a aa a aa.

K CE

a.

Pa b 1 a a a 1 aa aa aa

aaa bab a : a ( a > 38 C,

( a < 37 C), a aa baaa, a

b.

Ta aa aa aa aa a, a

.

Ta a a a, a

. K aa a baa a

3.

F IAD

R IADP a aaa a a a aa a a.

Saa a a aa a a :

a.

Laa aaa : baa a aaa aa

b.

J a aaa (a a, a , aa, a baaa)

a aa.

. La aaa : b aa, a, a a,


18/74

18

.

T aaa : aa a, a, a,

a baa aaa aa (, a, )

. Paaa : a aaa, aaa aaa, aa

.

K a : a, a a aa

.

T .

4. D IAD

Daaaa aa a a aa a IADPaaa aaaa

a bba a a aa (aa a

aa, a aaa a aa, aa aaa

a, a aaaa a aa aa a aa

aa), a aaaa a a aa (aa aaa

a a aa aba).

Paa a a IADP a aa baa a aaa

a a a aba aa a aa,

aa baa a aaa a a aa aa

aa.

5.

IAD

Pb a a a aa a

a, a ba a a aa a aa aa aa

aa baa b, ba baa IADP. Paa ba a a

aa baa IADP ba a a a a baa b.

R :

a.

CDC : Mb a Ma W R, Ra a

R A 9,2002/V. 51/ N. RR10

b. CDC.2006. O F HaaAa I Sa

B.

(E)

Pa aa aaa aa aa a aa. Daa

a a aa baaa 3 (a) a, a aa ,

a a aba,

Aa 2 (a) Pa a bba a IRS, a Pa

a aaa aba aaa a aa aa b baa

() a Pa a a aba

aaa a a aa baa

().


19/74

19

1.

D K HA A

. D HA

HAP aaa aa aa baa a a a a

a a aa a a > 48 a aa aa baa ba a a aa aa baa. HAP

aa abaa a ba aa (a/a aa, a,

a, Eaa Tb/ETT)

. D A

VAP aaa aa aa baa a a a a

a aaa a a > 48 a a ba a

a aaaa aa aa

2.

D D

Pa (PNEU) a baaa a , a, a

aba. (La Gaba 4.2. Daa A Pa a Gaba

4.3 Daa A Ka Pa aa Ba a Aa).

.

G K

B Pa aaa ba a a 1 (a)a aa

a aa b :

1)

Da (38C) aa bab aa

2)

La (,4.000 WBC/3) aa L (12.000

SDP/2)

3)

U a b 70 a, aaa baa a

a a a bab aa.

a a a 2 aa b :

1) Tba ba aa baa a

2)

Ma aa a aa ba a b aa

(a aa) aa aa (aa )

3) R baa aa aa aa ba

4)

Mba aa a, aa aa O2

(PaO2/FO2240), aa ba , aa aaa a

Kaa :

1)

S aaa a baa aa , b

aa aa a a 25 a 10

a/aaa aa a (100) aa LPK


20/74

20

2)

Pbaa a aa a a aa, , ba,

a a

3) Daa aa a aa baa a

a a aa a b a 24 a, b a a

a aaa baa aa a

4) Taa aaa aa aa/ (RR) a

aa a aa > 25, ba a aa a

a 37 > 75, ba a ( aa 40) > 60, aa < 2

ba > 50, aa b 2 12 ba > 30

.

B aaa Pa aa Ra aaa ba a 2

a aaa a 1 aa b:

1)

Ia ba aa a a

2)

Ka

3) Kaa

4) Pa aa ba b 1 a

Caaa :

Paa a a aa a aa aa a (a

, ba aa, a a,

aa b a a) a aa, 1 b

a a a aa a

. K

Aa 3 (a) a

1)

Pa (PNU 1)

2) Pa a abaa aba (PNU 2)

3)

Pa aa a (PNU 3)

Gaba 4.2 a 4.3 aa aa a a

a a aa aaaa baa a aa.

1)

K 1 : K

Daa a baa PNU 1 ba aaa aa a

a b :

)

K 1 : a

Taa a Gaa K Pa (B.3.a.)

Taa Ra Pa (B.3.b.)


21/74

21

) K 1 2: ba b 1 a

Ba aa a

a a a 3 a aa b :

S a a ab, a a a bab

aa L (< 4.000/) aa ( 15.000/3) a

abaa aa a a ( 10 %

b b baa)

Ma ba aa baa

aa aa aaa aa

aaa aa aa a aa

()

Aa, aa, aa aaa a

a aa

R baa aa a a

Ba

Baaa (< a 100 /) aa aaa (> 170

/)

) K 13: aa b b a > 1 a aa

b 12 a, a a 3 a aa b :

Da ( > 38,4 C) aa (


22/74

22

Ma 1 a aa aba b :

K a aa aa a aa baa

a b a

K a aa a

K aa a Saa NaaBaa (BAL aa aa b )

5 % a aa aa BAL a ba

a aa aa a

Paa a a 1 (a) a

b b :

Pba ab aa a a

ba PMN a baa aa b a

a

K aa a a aa

B aaa a a a aa a

aa a aa

K

SNB : Saa Naa Baa (=LRT : L a a)

Ia a aa a aa.

Baa aa a aa a a aa a

aa aa a a. Paa a

, aaa baa CNS

aa a a aa aa a a

a a Na aba aa aa a aa ab

4.3

Paa aa a, a

aaa a aa a, aa

a a BAL aa aa b . S

a a aa a aa aa aa

a a

BAL : B aa aa

)

K 22 :

, , C, ,

:

Daa a baa PNU22, ba a bb

b :

Taa a aa Pa (B.3.a)


23/74

23

Taa Ra Pa (B.3.b)

Ma 1 (a) a aa ab b:

K aa Caa a

aaa

D a aa ab a aaa

Daaa aa 4 aa b IG a

a a aa a (aa a

, Caa)

PCR Caa aa Maa

T IF Caa

K aa aa IF La

, a aaa a aa

Ta a La a

I a a aa RIA aa EIA

Paa aa IFA aaa aa

4 aa b ab a a a aa

La a I a 1 :

128

K :

D a a aa aa bbaa

a (EIA, RIA, FAMA, IF) PCR aa

PCR : Pa Ca Ra, aa

a a aa baa aa a

a aa

Pa a aaa aaa a a ab aa a

a aa a ba a. Paa a a

a ba () aa aaa

aa a aa a ba ba

4 baa a a aa a a.

Ba aa baba RSV,

a aa a , aa

a a aa a aa aa aa

aa a aa a a aa

a aa .

) K 3 :

Pa Paa Pa I


24/74

24

Daa a baa PNU 3 ba a bb

b :

Taa a aa a aba a

a aa a aa :

H N aa

Taa Ra Pa

Ma 1 a aa aba b :

K aaa a a aa a

aa Caa

B aaa a aa a a

aa a SBL (BAL aa

aa b ) a 1 aa b :

Paa a

K a

Aa a a aa a aba

PNU 2

Kaa :

Ya aa a aaa a

:

Pa a ( ab 40

aa aa ( 160 , a

32 , aa 6 , 200 ) / a

> 2

S a a ab aa a a

baa (48 a)

S aa aa aa

aa ab a ba aa, , aa aa

baa. Ba aa a, a a

aa.


25/74

25

4.3. A K K

J / Pa a

S b

Baa baa (BAL)

P BAL

P b

S N b (b)

BAL

P BAL

104/ aa

104/

104/

104/

104/

104/

C : ,

Pa a aa ab a

aba aa aa

Ba a a baba RSV, a

aa a , aa a a aa

a aa aa aa aa a aa

a a a aa a aa .


26/74

26

G 1. D A

a aaa a aa a 1

aa b a a a aa a

b :

Ia ba aa a a

Ka

Kaa

Pa aa a < 1 a

Pa a b :

Da > 380C aa bab a

La (< 4000L)aa (>

12000 L)

Pbaa a a aa bab a

a a >70 a

Saa 1 a b aa a

a :

Da > 380C aa bab a

Pbaa a aa bab

a aa a > 70

Daa a ba ,

aa baa a aa, aa

aa aa Tb ba aa ba ba,

aa a, aa aa a

R aa aa aa ba

Pba aa a ( 02

a PaO2/FIO


27/74

27

G 2. D A K

B A

) F

Pa aa baa a:

- a a aa aa, aa a,

aa aa aaa (a)

Pa a a a

aa a 2 aab a a a

aa a b :

Ia ba aa a

Ka

Kaa

Pa aa a < 1

a

Pa aa a a

aa a 2 aab a a a

aa a b :

Ia ba aa a

Ka

Kaa

Pa aa a < 1

a

Ba < 1 aPba aa a (

02 a PaO2/FIO 15000 L) a

a (>10%

b baa)

Daa a ba

, aa baa a

aa, aa aa

aa A, a, aa

a a

aa aa ()

W, a aa

Ba

Baa ( 170/)

Aa > 1 a < 12

Sa 3 b :

Da (38.40C)aa

(< 36.50C) aa bab a

a a

La (< 4000L)aa

(> 15000 L) a

Daa a ba

, aa baa a

aa, aa aa

aa

Ra aaa aa aa

ba

Pba aa a (

02 a PaO2/FIO


28/74

28

- Paaa a aa aa aaa a:

Eaa Tb (ETT), Naa Tb (NGT), S

a, B, Ra .

- Oa a: , aa, , a

a a a .

Fa R aa Pa aaa a:

- K a: (>70 a), Pa ,

Pbaa (Ta aa Ab), Pa Pa

Ob K (PPOK), Pa Ja K,

Caa Vaa Da (CVO), Ka, ba

- Taa baa aa aaa: a, a

, ba aa, a, aaa a

a a aa, ba aaa a, a

ab, ba aa a

Pa b aa a IRS baa

baaa aa.

- Pa b VAP aaa a a a aa

a a a aaa aa

aa aa aa a ICU, NICU/PICU, HCU.

Sa a aa baa a aa

a aaa a a VAP

(1 ba, 6 ba, 1 a), aa

aa aaa a a aaa aa

a a a .

- Pa b HAP aaa a a ba aa a

aa a a, a a aa baa

a aaa a a HAP

(1 ba, 6 ba, 1 a), aa aa

aaa a a aa a a ba

(1 ba, 6 ba, 1 a).

)

D Daaaa aa a a aa a

Pa aa, aaa aa b

a aa HAP aa VAP.Daa a

a aaa aa a bUba a a

a aaaa a a a a

a a , a a aba.Pa

aa a aaa


29/74

29

a a, a aa aa

aa aba.

) KK

- Ha A Pa (HAP) a aa aa

baa a a aa.

- M a aa ba a aa,

a a a a

aa.

- Pa a a (VAP, a a aa

a a aa aa ba a

aa aaa aa a

a aa ba aa aaaa a

48 a b a , a

aa) a aa aa a aa aa.

- Paa a aa a aa

a, a baa baa aaa

a baba aaa a a a,

b a, aa aa, aa, aaa,

PPOK, a ba a, aaa

b, . Paa a aa a

aa a ba, a baa aaa

a aa, aa aa aa (aa

ab) a aa aa a. P aa

baa a HAP aa a

a, ba a a aa aaa

aa aaaa aa aa a

a. Ka a a a, ba

a a a aa aa

HAP .

- HAP aa aa a a: aa aa aba.

Pa aa b aa 4 a aa

aaa a baba Maaaaa, H a, a S a. Pbab

a a ba a a a

aa S a, a a S a

(MRSA). V (aa a A a B aa RSV) aa

baba a a a a a,

aa aa, a, a, a P


30/74

30

a a aa a a

a.

- Pa a baba aa ba (aa aa

a ba a aa aa aa a)

aa HAP a a aa aa a aa aa a aa aa ba aa

aa a a a a.

- HAP ba aa a aa aa a a

ba a a a a a a aa.

Paa a aa aaa aa HAP

ba aa a a, a bb

baa aa a aa . Pabaa

aa baa a aa ba a . ba

a. Da ba aa a aa a

b a aa a a.

- Paaa Ga ba a KOH

a a a/aa a a a a

a a aa a ba aa

a aa a bab . Na

a aa aa a a

aa aa a a

a aa. Saa , aa a

aa aaa, aa a baba HAP.

C. I K (IK)

I Saa K (ISK) aa a CDC b baa

(UT/), aa a a aa aa

(a a aa a ) aa baa baa a

Ib aa a aa aa (a, , a

, a a aa a a aa a ).

U , aa a ISK, I a abaa b

1.

Saa K Sa

2.

Saa K Aa3. Saa K aa

1. IK

.

IK:

1) Da (> 38C )

2) U

3)

F

4)

Da, aa


31/74

31

5)

N Sa Pb

. IK :

1)

Da > 38 CC a

2)

H < 37 C a

3) Aa

4) Baaa

5)

Laa

6)

Maa

2. K IK

T a aa a ba aa aaa ISK.

1)

T a a aa aa aa a

aa a a a a aba

aa2)

T a aa aa aa b: ISK ,a

aaa a a baa aa aaa ISK.

3) T a aa ba: aa a

a a aa aaa , aa

a aaa a ISK aa aa , a

a a aa.

Ha baa aa a (a) >105 a

a a a a b a 2 (a) .

1) T a () a a/aa

.

2)

P (aa >10 aa aa>3 (7

LPB( a /1000) a aa aa

a).

3) Da a a aaa Ga a a a

a.

4) Pa 2 aa aaa a a

aa (ba a a aa S. a) a a

102 a a a a (a aa

aa ab).

5) K a 5105 /1 a a a (ba

a a aa S.a) aa a a aa

baa aba ISK.


32/74

32

6)

D a baa 1SK.

7)

D ba a a a ISK.

3. K IK :

.

IK :

1) Ka 1 ISK a.

a)

Da a a ISK (2.a.), a

b)

T a a (3.a)

2) Ka 2 ISK a.

a) Da a a ISK (2.a.), a

b)

Sa a (3.b)

3)

Ka 3 ISK a aa a a.

a) Da a a aa ISK (2.b.), a

b)

T a a (3.a)

4)

Ka 2 ISK a aa a ..7 1 a.

a) Da a a ISK aa a a SK

(2.b.),a

b)

Sa T a ': (3.b)

.

1K A

ISK aa a a A a b :

1)K 1 IK A:

a)

Pa a aa a aa a 7 a

b baa , a

b)T a a ISK , a

)

S ISK a.

2)

K 2 1K A:

a)Pa aa a a aa 7 a b baa

aa , a

b)

T a a a a a

aa 2 b, a

)

S ISK a.

Caaa:a.

K a a a aa aa

a ISK

b.

K a a ab a a

a aa aa a ISK.

. S a aaa a a

ba, aa a a aa

a, aa aa.


33/74

33

.

Paa ba, ab a a aa a

aa aa a b.

3)I K (G. , K K,

)Ha aaa a a a a

aa baa b :

a)

Ka I ISK La:

Da a a a aa (a )

aa aa .

b) Ka 2 ISK La:

Da ab aa aa a a a ba

aa aa a, aa baa aa a

aa a.

)

Ka 3 ISK a:

.1) Da a a a aa aa aa baa

b :

Da ( > 38 C )

N a

N a aa aa a a , a

.2) aa aa a a a b

Daa a a a a .

Ka a b aa aa a a

a a a a a Taa b aaa aa aa

a (USG, CT Sa, MRI, Raab Sa).

Da a aa.

D a aa ba baa

aba a a a.

.3) Ka 4.15K a a b 38C a

H


34/74

34

aa aa a a a b :

Daa a a a a .

Ka a b aa aa a a

a a a a a .

Taa b aaa aa aaa (USG, CT Sa, MR1, Raab Sa).

Da a aa.

D a aa ba baa

aba a a.

.

F IK

Fa aa ISK aaa a a aa

a, a aa a baa a:

1)

K a (a ): ba a (aa

DM), a Jaa aa b (aa a),

a (aa: , a , ).

2)

P aaa: aaa, a a.

3)

Paaa: Paaa a a, a a, a

a , aa (aba a ).

G 4.4.K

. D IK

Pa aa a ISK aaa a a aa

aa. Daaaa a aaa aaaa a bba

a a , aaaa a a aa aaa


35/74

35

a, a a aa aa a aa a a

.

D. I (I)

ILO aa a CDC bU baa (SSI).Aa bbaa a aa a, a aa aa aa ILO a

a baaa baa a a aa aa a a,

a aHa:

1.

ILO Sa: ba aa aa a aa baa

(ba)

2.

ILO Pa: ba a aa a a b aa (.a

a aa )

3.

ILO Oa/Ra b: ba aa aa a aa aa

a aa b.

U aa aa a aa Gaba 4.5.

1. K I

. K I ( /):

1)

I a a aa a 30 a a aaa a

2) Ma aa aa a aa baa (ba)

aa a a

3)

Pa aaa a/ aa a

aaa baa :

a) Daa baa a a.


36/74

36

b)

D'aa a a bab a baa aa aa

aa a ab aa a a a

a.

)

Saaa aa:

a aa aa aa baa b : aa ,baa a a, aa, aa aa

aa

abaa, a

a aa a ba ba a

a baa aa a aa baa. Ha baa

a a a a .

4)

Da ILO a ba aa a

aa a b.

Taa 2 (a) ILO a, a :

1)

Sa a a (SIP) :

I"a aa a aa a a a

aa aa a a a aa b (

aa a Ca aa aa aa aa a ba

a ).

2) Sa a a (SIS)

a aa a aa a a

aa aa a b a a ( aa

[baaa aa a] CBGB).

CBGB: Ca ba a

/ I :

1) Jaa aa " ab" (aa a a aaa

a aa [a] aa a a/a a aa

a aa) baa a

2)

Jaa aa a a a ("a ab

") baa ILO, baa aa baa

(SKIN) aa aa a (ST) a a

aaaa . Laa aa aa aa ba ba a baa CIRC. S a a

aa a aa NHSN Laa aa a

baa baa BURN.

3)

Ba aa a a aa a aa

aa a aa , aa baa ILO a ("

a SSI"). Aaba a baa ILO

a a ILO a aaa baa ILO a.


37/74

37

. K I (D I):

1)

a a aa a 30 a a aa

a aa aaa a aa aa a 1 a ba

a a aaa a a a aa

aaa a a a2) Ma aa a a b aa (aa a aa )

aa a a

3)

Pa aaa a / aa a

aaa baa :

a) Daa a aa a aa a ba a

a aa a aa aa a a'.

b)

Ta aa aa "" aa a

a aa ba ba a a baa

aa a aabaa a aaba a a

aaa a aa aa aa baa b:

b (> 38 C), aa a a. Ha baa a

a a a aa a .

) Ab aa aaa b a aa a a

aa a a baaa aa a,

aa a', aa baaa a aa

a (PA) aa a.

)

Da ILO a ba aa a

aa a b.

Ya a a a aaa a ba. baa aa,

aa a baa ba a aa ( a a

a, a b aa a ba baa a aa,

a baa (a), aa a a a) a

aa aa b a aa a aa a aa

a Ca a aa aa ba a

a a a a.

2 I , :1)

(DIP) :

a Eaa a aa a a a

aa aa a' a a aa 'bb (

aa a Ca aa aa aa aa a' ba

a ).

2) (DIS) :


38/74

38

a aa a aa a a

aa aa a b a a ( ' Paa

[baaa aa a] CBGB).

/ I :Aaba a baa ILO a a ILO

a aaa baa ILO a.

.

K I / (/

1) I a a aa a 30 a a aa

a aa aaa a aa aa a 1 a ba

a' a aaa a a a aa

aaa a a a

2) I a a baa a b, a , aa

a aa a aa ba aa aa aa

/ aa a

3) Pa aaa a/ aa a

aaa baa :

a)

Daa a a a a aa a "

" aa a/a b.

b) Daa a a baD a baa aa aa aa

a ab aa a a aa b.

)

Ab aa aaa b a aa a

aa/a b a a baaa

aaa, aa a, aa baaa a

aa a (PA) aa a.

)

Da ILO a/a b ba aa

a aa a b.

/ I / :

1)

Oa aa a b a baa/a b

aa a , aa aa aa , a aa ba

aa aa aa aa a. Ta aa aa

a b a a aa aa ILOa/a b aa a aa

.

2)

Saa a aa a aa aa

aa ILO aa b (Ia a a a

b). Sbaa , aa aa a a

a a ab baaa, aa aa baa ILO


39/74

39

a/a b a a a aa "a

aba" (ILOIAB).

3) Daa aa a a aa aa aaa /

aa ILO a/a b.

BONE

DISC

ENDO

IAB

LUNG

ORAL

VASC

SA

IC

EYE

BRST

EAR

VCUF

SINU

MED

OREP

JNT

GIT

EMET

CARD

MEN

OUTI

UR

4)

Baaa a/a b a (a) a a

. I b a a a a a

aa baa a a , a aaa b

a aaa baa a ILO a.

2. F I

Fa aa ILO aa baa a:

a.

a , aa a, ba, a ba,

ASAS, a MRSA, aa aa a a, a, DM,

a aaa.

b. P a: C ab b a, aa,

ab a, aaa a, aa b a 1 ,

ba a, a aa, a b a, a

, a.

.

J a: a b, a b aa, a

.

. Paaa aa : a aaa, aaaa

aaa (aa ba), aa aaa.

E.

I

1.

Pb aa aa HAI CDC, a aa CVSVASC

(Aa ).

K

I a aa a a a 1 a a b:

a.

Ha a a aa a a ab aa a.

Taa b a a aa a a a aa a

aa baaa b a.

b.

Pa a a 1 aa a aa b, aa

a bab aa:


40/74

40

- Da (>38C), a, a, aa aa aa a a

ba, a

- K aa a aa aa b >

15 ba, a

-K aa a aa aa a a.

. Aaa aa aa aa a a ba.

. U a 51a, a a aa a aa b,

aa a bab aa:

- Da (>38C a), (

15 ba, a

- K aa a aa aa a a.

a. a aaa aa, , aa a aa a

aa a baa CVSVASC aa aaa a a

aa.

b.

I aa a a aa , aa

baa IADP.

2. IFEKI DEKBI

Ka b:

b a a b:

a.

Pa a a a 2 (a) aa a aa b, a

a a bab aa: aa, a, aa

baa a b, a

b. Ma a 1 (a) a b b:

Ha a aa aa aa a ab aa

ba.

Ha aa .

a. Aaa aa aa, b baa b .

b.

K a aa b b baa b

.S a ba aa a ab a baa

aa a b a aa a aa. S

aa a aa b a .

C:

J IRS a, a aa IRS baaa CDC aa a aa aa 6.


41/74

41

BAB

AAJEE EIA

A. I K

Aaba a a IRS, aa aa a a a aa

1. Aaa a IRS aaa aa a aa a?

2.

Aaa a IRS aaa baaa a aa a aba?

3.

Aaa a IRS aaa aa aa ?

A. 1. K I

Paa a aa a, a a a aa K/T PPI

aa aa a aa ba a aa

aaa.Maa a a aa aa aaa ba a IRS aa aa.O aa aa a

aa aa aa Ib aa aaa a aaa

aaa a, aa a a aa aaa a a aa aa

a a aaa a aa, a a a

a a aa a .

Sa a aaa aa a aa aa a a

IRS aa a a a a a a a KT PPI

b a aa a bbaa b a a a

a aaa a IRS aa a.

A. 2. K I

Sa a aaa aa a a, aa a ,

aa aaa a a a a

aa a aa .Daa a a aaa

a a aaa a a aa aa a

aa.

Sa a baaa aa a aba, aaaa aaa

aa a aa aba aa aa .O aa a

a a a a BAL aa (baaa aa a

aa ) aa, aa aa, aa a baa

aa a aa aa aa aa baa IRS (aa

a' aa aa a a ba ).


42/74

42

A. 3. K I

Ya a a a aaa aaa a a

aa aa a a a a a aa a aa (a ba a aa a a a a a aa

aaa a).

Sa ! aa aaa aaa a a a

a aa aa IRS.

Ka a a aa aa a aaa

1.

Daa a a a .

2.

Aaa a K/T PPI a aaa.

3. Ma aa aa baaa a a aa ba

a ba.

Kaaa aaa a b aa a b ba

baa a .

S a IRS aa Naa a a a baaa

a a a a .

Sa a aa aa bab (Ia ab 4) aa

a a ba aa IRS a aa a

a ( ).

1.

D

T PPI ba aab aa a aa b aa, aa

a a a' aa aa a IRS a

a a aa.Saa aaa aa aaa 1PCN a

ba IPCLN.

Baa b aa a aa aaa a IRS a

a aaa a ba a a a. K/TPPI a a a a aa b aa a aaa

a aa a a ba:Ia / a a b, aa aa

aaaa a a ba aa aaaa a a

KLB.

Sa a b a ,aa, a a aa

a, a aa, aaa , aaa aa. aa


43/74

43

K/T PPI aa a ba a a a a

a aa aa a aaa.

2. D

.

DPa a aa aa aa ) a IPCN,

aaIPCLN a a a aa a a a a

aaaba , a a IPCN aa a IPCO (I

P C O) aa IPCD (I P C D)

a ba a a a aaa IRS baaa a

a aa a aaa IRS.

.

J D D

1) Daa a: aa, aa a, a, aaa

, aa a RS.

2)

I: aa , a , a aaa

aa; aa a.

3) Fa : aa, , a a a bba a IRS.

4)

Daa aba: ba, aba, , a.

5)

Daa Ra/a: Xa, CT a, MRI, b.

.

1)

Caaa a/a/a aa, aaa aba b.

2)

Maa baa a aa a b a

aa.

3)

Daaaa a (aaa a aa ) a

a:

.

Ha aba a a/a

.Caaa aa a a a

.Da aa a RS

.

Raa a a aa

.Caaa a a ba

. Caaa

.

Ia ba ab4)

U a SSI a, b aa a aaa a

ba, aaa , a .

.

B IC

1) Aa aaa a/a/a aa aa a a

a , aa a aa aaa

IRS.


44/74

44

2)

R aa aba a a a a

(aa b, a a) a

baaa a a aba a a

a a a a ,

a aa aa a a aa a a IRS.3) Saa aa a aa, aa ba

aa, aaa , ba ba ab, a Caaa M

Pa; baa a aa a ba

a aa a a .

4) Laa aa a a a a IRS;

aaa a a ba a aa, aa

aba, aaaa, aa a, b.; ba aa

aa, aa aa a , a

aa a a, aa, a !

aa.

5)

R a aa a b a aa Ia IRS.

3. D D

.

Pa a aa &a aa a IPCN, aa

1PCI_N a a a.Daa a aa , aaa aa

aa baa a bba a aa a a aa

aa.

. J

1)

Ja a a a b a IRS.

2)

U aa a a IRS a bba a aa:

aaa aa a a a a a a a aaa

aa (a, a , a a ) aa aa a aa

a. Jaa a aa aa a a

aa baa a.

3) U a SSI aa a : aa a

a a 1 a (a: ,

aa, a , b.)

.

1)

U a a a bba a aa: aa aa

aaa a aaa a aa a a

a a aa a a a a aa aa a

a bba a aa IRS (a: a ,

a, aa a a).


45/74

45

2)

U a SSI: aaa aa aa a a aa a

aa a.

. B IC

1)

U a a a bba a aa: aaaaa a a a aa a a a a aa

aa aa.

2)

U a SSI : aaa aa a aa a a aaaa

a a a.

4.

.

Aa aa a aa aa.

Taa a a a aa aa a a a IRS,

a: aa a, a a aa aba.

. D

Daa a aa.

Da a a aaa aba a aa aa

a a aa :

1) a a a a a aa a ,

2)

a a aaa a,

3)

a a a aaa a a a a

4)

a a aaa a a

. D

M a aa aa a IRS aaa a a

a a a aa a aaa (baa). Daa

a aaa a aa aa aaaa a

aa aa , ba a aaaa

a aa aa aa aba baa

aa a.Kaa a aaa aa , aa

K/T PPI aa aa aa a a a

a aa a a aa.

Baaa, a a ;a a aa a ba

a a a a (ba a a

IRS aa aaa ba) a aa a a

aaa IRS a ab aa a a

a I a. Saa aba

a aa baa b.Ha aa ba K/T


46/74

46

(/)

PPI a a aa a aa b a.D baa

aa ba a, aa aaa, a ,

a ba ab.U aaa aa a b aa

aa aa aaaa a , aa a a

a aaa. Ka baa a aba b aa aa K/T PPI aaa a

a a a aaa aa aba, aa

abaa aaa IRS a abaa aa aaa aa aa

a ba ba a a () a

aa a aa aa a aa Kaaaa

Saa aa a.

.

:

1)

Caaa / aaa aa.

2)

Caaa a aa a (aba a a).

3) Pa / aa a.

4) Faa

5)

Ra

5. :

a.

Pa aa a a a aa IPCN a

ba IPCLN.

b.

Daa a a a a, a a a,a

aaa aaaa aa (a a, a a,

a a a, a a ) a a a a.

.

Daa a aa ba aa a ba

aa (ISK), aa aa (IADP), a ba

a aa a a a a aa a

a, a a (ILO).

6. A D

Ma a a.

La aaa a baba a aa. Baa aaa aa abaa b :

= a, aaa a a aa aa a .

= a, aaa a a a aa a aa

aa b baa aa a a aa.


47/74

47

I = (A / I)

= aa ba a aa ba aa a aa a baa (100,

1000 aa 10.000).

aaa a a a

a a b a a.

Aa a aa a a aa aa Oa IRS aa a a

, a .

.

Aaa a a ba a a a a b aa a

a aa a a.

D aa a IRS aa aaa a a IRS ba aa

a ba a a a

aaa IRS a aa aa a a aa

.

Aaa a a a ba ba a aa a aa,

a.: a ( a) aa aa a a

( a).

P a a a aaa a a IRS a aa

ba a a a aa .

Ra aaa ba aaa a a aaa

baa b :

I = I a

P = Pa a

LA = Ma aaaa a aa aa a a

LN = Na aaaa a aa aa a a aa

aaa

Ib IRS.

INTN = Ia aaaa aaa a a a a a a

aa aa IRS aa aa a aa

a

aa Ib IRS b.

Daa aa a a aa a a a. ba

a aa aa aa a a a

a aa IRS baaa Ib a aa aa a a

IRS.

Ha aa Ib a a a aa Wa a baa

b:


48/74

48

Daa Pa aa a I a Laa I.

.

Aaa aaaa a aa a, a aa baa

a a baba .I aa aa a

a a aa a aa a.

C a a I D Ra (IDR) a aa

a a aaa a IRS 1000 a/a.

aa ba aa aa aaa baa b :

1)

Saa ba ba a a aa a a

aa a aa a aa a (aa a

aa a aa, a ba aa ).C a (IDR)

Ja a ISK / a a aaa a.

Lb ba aaa I Ra (IR) baa

Ja 1SK a a a aa a .

O aa 1DR aa aaa a aa

a a (aa a aaa a ) a

bba aa a .

2)

Ja a a a aa aaa Aa Ra (AR) a a

b a a. Baaa aaa a

(%) aa 100 a aa aa aaKLB IRS a aa aaaaa a a a aa a .

Sa aa aa a aa ba a a

a a a a a a IPCN a ba

a ( ). Daa a baa aa aa

ba, aa aa aa aa aa aa.

Baa aa a a a a a aa aaa

aa aaa a aa aa ,

a a ! a. La a a a aa

baaa a aaa aa a aa aa, a a a

aa aaa aa a.

Daa aa b aa bba.a a a a

baa, a :

1) M a aa aa, aa

aa .

= ( I) / A


49/74

49

K aa ba a b a, a aa a

Ib ba a aa a aa a aa

a a.Sa aa a a, a

Iaba a baaa, aa aa .Na

a a baa aa aaa aa baba a aaa.Ta a a aa

aaa a a aa a .Sa

a aa a aa IRS ba

aa aa aa a baa. M a Ib

a a Ib a aaa a a.

2) Ma a a a a a aa.

Pa a a aa aa a

baa a a a a a a aa

aaaa a a.

7. E, D

Ha a aa aa aa aaaa a

aa a aa a a (PPIRS) aa a a

.

B. I D K

Da a a a (a) a abaa a a . Daa

baa a aa a aa a a a, aa a

b a aa b a aa a a

ba ba aa aa . Kaa a

aa a aa , aa a

a aaa.

Fa aaa a ba ba a 2 a a a

a a .

1. F aaa a a a aa a a a

aa a aa. Ma a aa a

a a a a aa (a).2.

F aaa a b bba a aaaa

aa aaa (a a a a).

M a a a ba IRS, a a b

baa aaa aaa ; a b ,

aa a, aa a aa aaa aa a a. Baa

aaa a aa a aa a a a b ba


50/74

50

a a aaa. Aa b aa baa ba aa

a a a baa b a a aa baa b a a a

a. R aa a a (ILO), baa a

bbaa a. Daaaa, a aaa baaYaa a

aaaa, a aa a a a, aa a'a a a. O aa aa b a aa

a aa aa ILO aa aa aa b.

Da a aa a a a a, aaba aa baa

aa a a aa a a a aa aa

baaa a baa.

C.

I D

Ra a aa aa aa a IRS aa a

aa a aa IRS a baa aa a IRS a

a a a a aa a a a aa. Maa

baa a IRS a a ICU aa aa a aa a IRS

a aa a (ba a) a a aa a aa

baa aa a a a .

M aa a a aa aa a a

aaa a a a aaaa b a aa aa

aa aa a a a.Baa a aa baa aa a

a a a baa a aaa a a

aaa / aaa a aa aa aaa aa aa aa

aa a aa IRS.

M aa baa, a baa a a a aaa

baa aa b.

, a aa aa aa a a aaaa

a a aaa a aa aa a a a a

aaa a aa. Ha ba aa a a a aa aa.

K, a aa a aa bb aba a

aaa a b aa a aa aa

a a a aa a IRS a aa.


51/74

51

a aaa aa

DU =

a aa a

K, aa a aa aa a . Fa C

aa a aa aa aaa a IRS, a a b a

aaa a aa baa a a a a a a a a

a. Sbaa , a a a a a

aaa a a b baaaa a a a a aa a .

K, a a a (aa a a a / a,

a a aa, aa a a) a ba

aa a IRS a a a a b.

M a a a b aa, a

a aa a aa b aa aa a a

baa a b aa aa ba a.

K K

Ua aa (D Ua = DU) a baa b :

D ICU aa a aa aa a aaa aa a a a a

a aaa a, a a aaa a . DU a ICU

aa aa a aa a aa aa a a

ba a ba IRS. Maa DU aa aa baa aa

ba aa a a aa b, a a a aa

aa .DU a bba a a ( a)

a baa a aaa aa, a aaa.

Paa K/T PPI a aa a aa a a a.

Sba a aaa / aaa aa a aaa

a "aaa aaa a aa aa a a a

IRS a aa 7'. Paa aa DU ICU a a

Ib a.U a a aa aa a , aa

b a a a a aa baaa.aa,

ba aaaa a ba. Ma aaa

a a ba a aaa aaa a aa.


52/74

52

BAB I

EAA

Laa baa a, a a, a a. Daa aa aa

aa bbaa b, a a a aaa .a a.

Paa aa a a, aa, aa aa . Ba ba

aa b ab, a,a . Paa ba a aa a.

Laa ba aa , a ba, a, , aa

Ta ba aa baa b:

1.

Maa a IRS a baa a a ().

2.

Maa aa a a aa

Sa ba a aaaa aaba aaa baa aa a ba aaaa aa

a aa . O bab a a aa a

aaa aa , a a, aa aa

a aa baba, a aab aa ba aa

b aa.

O aa IRS a a a aa , aa aa a aa

aa a aa aaa a baba aa aaaaa.

Dbbaa aa aa ba aaa. Daa a aa

ba a a aa aa a baa aaa.

Ta a aa a a aa aaaa a b

aa a aa IRS. Laa aa aa

baa, a, aa. B aaa aa aa a aa

a, , aa b.

Sa aaa K/T PPI aa aa a aa b

aa a a a ba aa aa a (aa), ab,

a aa K/T PPI. Aa a aa a a aa

aaaa ba abaa a, a a

a a a a.


53/74

53

4.4H I

.

EIA

AI

A IK

EA

IFEKI

DAA

DEIA

AJ /

AI

Daa a

a

Sa

Sa

a a

a

a

aa

a

Sa

a

a

aa

aa

ba a

aa

Ja :

1.Pa a

aa a

a a

aa

a

2.

Paa

a

3.Oa

aa

La a 100

a a aa

a :

1.

Saa

a

2.S ba

a

3.

S a

aaa.

La 100

aa a

La 100

Oa Caa.

Raa Sa

a

a aa

a

a

aa 48

a a

a

Sa

a

a

aa

aa

ba a

aa

1.

a

2.

a a

3.

a

a

4.

a

5.

a aa

aa 1 ba

a aa

aa 1 ba

ba

6. a aa

a a

a a aa

aa 10 ba

a aa

aa 1 ba

ba.

1.

Aa

ICU a

100 a

aa 1000

a/a.

2.

Aa ISJ Ra

Sa a

1000 a

a.

3.

ANa

a

1000

aaa

a

4.ANa

a

Ra Sa

a

1000 a

a

ICU.

:

1.

U

2.

Ca L

3.Va

Ka


54/74

54

Ra aa

ba

Sa ba

a

aaa

a III.

Sa

a

aa 48.

Ja a

a

Sa

IRS a

aa

baa

.

Daa

a

4 aa

a ba

ba (BB) a

Ja ba

100 a a

1000 a aa.

Daa 4 a aa

a

BB a

1.Raaa a 100

a b

aa 1000 a

aa.

2.

a

baa

a

1000 a

a.

:

1.

Saa

2. U a

a ba

a

3. Ca

(ba)

4.

VaPa Oa Sa

a a

aa

aa

a

Sa

aa

aa

aa

a a

a

a

aa

ba a

aa.

Daa a

a a

a aa :

1.

Taa

a

2. J a

3.

N

a

4.

U5.

J a

6.

Laa a

7. J a

8.

A

9.

ASA

10.E

11.

Taa

SSI a b ;

1.

I

a

2.2. Ka a

Ra

a

aa aa a

a

a .


55/74

55

12.P

aa

13.

Paa

14.Taa

a

D

Sa

Saa

a

aa

Saa

a

aa

1. a aa

a

aaa

2. a a

a a

a aa

a a

aa3.

a aa

aa a

a

Aa aaaa

a 1000

a aa

1.

U

2. J aaa

3.

Ta

4.

Ta

aaaa

Aa aaaa

a

aa a

100 a a

aa a, aa

a 1000 a

aa.

S a

100 a

a aa a,aa 1000 a

aa.

DRG

a

100 a a

a a aa

DRG.

Pa a Saa

a

aa

Saa

a

aa

Naa aa

ba

SSI a

a,

a .

Oa aaa a a

aa

a

a .

Raaaa

a a

a a.


56/74

LAPORANBULAN

DEPARTEMEN

KARAKTERPENANGGU

NGJAWABPPI

EAEA

EAEFIE

K

IAD

%

%

I

AAEGGAAA

IBIIKA

/

ACAAB

AAAB

1ACA

2

Ma:

ADNURSE

I

AHAKI:

: :

AIABE

EE

EAI

IAHBA

IG

E

K

%

I

%

HA

%

I

ID

I

IKA

AGDIGAKAADAAIEBEIIKIFEKI

AHAKI

ACA

3ACA

JEIAIB

....,....

IPCNLRaa:

.

FIAAHAIEIA

FEKIAHAKI&EAKAIAAIBIIKA

..

EIA

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A

%

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/JAH

F.

03

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I


57/74

BAB II

E

I a a a aaa a a ba a a ba

aa aa a aa a aa. U a aaa a a a, a a aaa.

Paaaa a a aa a a a a IPCN.

U a aa IPCN a a a.


58/74

AIAAIA

1. : Ra Ma S (2009) (IADP)

Ea a a aaa, aaa a aaa a a

a aa IADP

A

1.

Paa aa aa aaa

2.

Laa ba aa

3. Ha aaa aa a a aa a aa

4.

Gaa aaa a

5.

Paaa APD aa aa aaa a a

6. Paaa a bba ba aa

aa a a > 2 ba

1.

Laa aa (b), aa a, a

b ba aa/a

2. Sa aa a a a a

3.

U a a aa aa () aa a aa, aa

a a aaa a aa aa a a a

bba a 57 a, aa ba , a aa

bab, aa aa ba a 2 a aa a .

4.

Jaa aa b , a aaa , a a, a

a aa a b a 96 a.

5.

Laa a aa aaa IADP

6.

Paaa a ab aa aa aaa a aa


59/74

1.: Paa K Paa IADP

Ja aa a IADP aa a aa aa aa PPI :

1.

Maa a ICU a a aa >2 ba a a a

2.

Paaa a aa aba a aaaa a a aa

a aa3. Paaa (ba aa) a a a

a aa a a aa> 2 ba

4.

Paaa aba / b aba aa a a aa

a a aa a aa

R :

Pa VD Ra, DG Ma a INICC 2008 :

Ka a HAI ba a aa / b aa :

19921998 6.0 1000 a aaa aa.

19952003 4.9 1000 a aaa aa.20072008 1000 a aaa aa.


60/74

2. C I A D (IAD)

T Pa

La I :

C a :

Daa Raa A Ra Sa X baa b :

Ja a aa ba Fba 2009 = 196 a

Ja a aa = 960 a

Ja a aa = 90 a a a a aaa =

212 a

Da aaaa IRS baaa a a aa a a baa 9 a.

La IADP = 9/212 1000 = 42.5%


61/74

3. C A HA

:

Caa aa aa aa aa a baa aa ba.

Ta a a a

Aa VAP aaa Ja VAP ba

a aa aaa aa a a

Aa VAP =

Aa HAP aaa Ja a HAP

ba a a a aa a a a aa b.

Aa HAP :

C a HAP :

Daa a ba Db 2008 a a aa RS X : a a

a a 77 a, a a aa 833 a, a a a ba baa:

16 a a

9 a a Ja a a a a 375, a

Da HAP 2 a : a MO Kba a

Baa aa HAP ?

Aa HAP aaa : 2/375 1000 = 5,33%

Daa a ba Jaa 2009 a ICU :

Ja a 5 a

Taa a a 3 a

Ja a aaa aa a 30 a

T VAP baa 1 a aa : a, aaa , a aa, , Xa a a (+)

Baa aa VAP ?

Aa VAP aaa : 1/30 1000 = 33,3%


62/74

4. C I K (IK)

B IK

Pa a b aa ISK RS a a a a aa aa

a a aa a 2 24 a.

D

- Daa aa aa a aa, aaa

a aa aa a a a a aa.

- Ia ISK :

* Laa

* Laa a aa : Oba aa aaaa

- Daa ISK RS a aa aa a ab aa a,

aa .

- Daa a aa a baba.

C :

Daa aaa aaa

Ra/U : ICU../RS X. Ba : J.. Ta : 2009..

T. N. Naa

Paaa aa

KAb

a

K.ET

T CVL IVL UC

010709 1 A 1 A

2 B 1 U

(+)

C E.

3 C 1

020709 1 D 1

2 F 1 U

(+)

A Pa

3 F 1 A

D

310709 1 M 1 C

2 N 1 C D ISK 3 O 1 G

4 R 1 M


63/74

C a baa :

F Baa

Daa aaa aa &

Ra/U :./ Ba :. Ta:

TJ

PETT CVL IVL UC VAP Baa Pb ISK

1 3 2 2 3 3 1

2 3 2 2 3 2 1

D. 2

31 4 1 1 1 1 1

Ja 196 212 5

- Na

Na aaa a a aba aa a

a a a aa a .

- Da

Da aaa a a aaa a aa a

a aa a a.

T a

Aa (Ra) ISK RS = 5/2 1000 = 23.5 a aaa a.


64/74

5.C (I)

K :

1.

J a :

La b a b aa : 0

La b aa a : 1

Kaa :

1) La b : aa, a a a , a ba aa

aaa a a.

2)

B aa : a a ba aa aaa a

a.

3) Kaa a ba : aa ba.

4)

K a : aa ba, aa. Fa.

2.

Laa Oa : a a ba aa a

Sa a bba aa a (a ab)

Laa a a aa a a a a a, ).

Ba b a a a a, : 1

3.

ASA S

ASA 12, : 0

ASA 35, : 1

X / Y 100%

X : a a a a aa a .

Ja a a aa a .


65/74

6..JJ I K CDC.

I

ASB Aa baa

SUTI Sa a a

OUTI O a a

I

SUO Sa a a SSI

SIS Sa a a SSI

DIP D a a SSI

DIS D a a SSI

Oa/a Oa/a SSI, Ia :

BONE

BRST

CARD

DISC

EAR

EMET

ENDO

EYE

GIT

IAB

IC

JNT

LUNG

MED

MEN

ORAL

OREP

OUTI

SA

SINU

UR

VASC

VCUP

BI B

LCBI Laba ba

CSEP Ca

E

PNU1 Ca a

PNU2 Pa aba

PNU3 Pa a

BJ B

B O

JNT J ba

DISC D a

C C

IC Iaaa

MEN M

SA Sa ab


66/74

C C

VASC Aa

ENDO Ea

CARD Ma a

MED Ma

EE E, , , ,

CONJ C

EYE E, a

EAR Ea, a

ORAL Oa a (, , )

SINU S

UR U a a, a, a,

GI G

GE Ga

GIT Gaa (GI) aHEP Ha

IAB Iaba,

I ,

BRON B, ab, a,

LUNG O a a

E

EMET E

EPIS EVCUF Vaa

OREP O a a a

a

SKIN S

ST S

DECU Db

BURN B

BRST Ba Ab a

UMB OaPUST P

CIRC Nb

I

DI Da


67/74

BULAN/TAHUN

:

RUANGAN

:

SURVEYOR

:

DIVISI/DEPARTEMEN

:

G

AA/

JK

KEEAGA

DMEDIS:DaaM

U

S

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I

7

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C

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E/EI

A

HA

IK

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IDAKA

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D.

EDI

:Ua

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AP

:H

aAPa

AP

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aAaPa

D

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AaDaa

IEIAHAIAIFEKIAH

AKI

AH

AKI:

..

IAH

BAIG

HAIK

AB

F

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68/74

BULAN/TAHUN

:

RUANGAN

:

SURVEYOR

:

DIVISI/DEPARTEMEN

:

G

AA/

JK

KEEAGA

DMEDIS:DaaM

U

S

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I

7

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C

I

C

E/EI

A

HA

IK

IAD

IDAKA

IFEKIAHAKI

D.

EDI

:Ua

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AP

:H

aAPa

AP

:V

aAaPa

D

:I

AaDaa

IEIAHAIAIFEKIAH

AKI

AHAKI:

..

IAH

BAIG

HAIK

AB

F.

01

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I


69/74

BULAN

:

TAHUN

:

RUANGAN

:

SURVEYOR

:

C

I

C

E

/

B

B

K

IDAKA

G

JK

D

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EDI

KETERANGAN

DMEDIS

:DaaM

U

U

:Ua

S

:S

JK

:JKa

UC

:UKa

HAP

:HaA

IVL

:Iaa

/

VAP

:Va

AHA

IK

EBII

IAD

I

ID

I

A

IFEKIAHAKI

IAH

BAIG

DEK

HAI

K

AB

CVL

:CaVaL

SSI/IDO

OB

:OaB

ILD

Pa

OBT

:OaBT

a

ILK

aP

OK

:OaaK

ILS

DEKU

:Db

PLEB

IEIABAAIFEKI

AHAKI

AHAKI:

..

B

1

2

3

>3

DAA

H

AB

IE

JEIKA

CA

AIBIIK

:SaSI/IDaaOa

:ILaDaa

:ILaK

:ILaSa

:Pb

F.

02

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I


70/74

LAPORANBULAN

DEPARTEMEN

DOKTERPENANGGUNGJAWABPPI

VENASENTRAL

VEN

APERIFER

KAT

IAD

%

N

P

LEBITIS

%

N

IS

LAPORANPENGGUNAANANTIBIOTIKAa

MACAMA

BYANGDIGUNAK

TANPAAB

1M

ACAM

2MACA

Ma:

ADNURSE

FIA

IFEKIAH

AHAKI:

:

.

:

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:

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VARIABEL

TER

OPERASI

TIRAHBARING

ETT/V

K

%

N

SSI

%

N

HA

P

%

N

ILS

ILD

ILO

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AN

NPADAPASIENBERISIKOINFEKSIRUMAHSAKIT

3MA

CAM

JENISANTIBIOTIK/JUMLAH

.,..

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AHAI

EIA

AKI&EAKAIAAIBIIKA

..

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T

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%

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71/74

F

BULAN/TAHUN

:

RUANGAN

:

SURVEYOR

:

DIVISI/DEPARTEMEN

:

G

AA

/

JK

D

.

EAI

JE

B

KETERANGAN

DOa

:Daa

Oa

S

:S

U

:Ua

JK

:JKa

P

:Pa

RMULIRSURVEILANSHARIANINFEKSIRUMAHSAKIT

RUM

AHSAKIT:..

IEAI

AACE

KAIFIKA

KA

EAI

AA

B

K

1

2

3

4

5

I

ID

I

RM

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OB

:OaB

OBT

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a

OK

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EAI

ID

AIBIIK

CI

EEKIF

FI

EAI

IDO

:I

DaaOa

ILD

:I

LaDaa

ILO

:I

LaOa

ILS

:INLaSa

F.04

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I


72/74

BULAN/TAHUN

:

RUANGAN

:

SURVEYOR

:

DIVISI/DEPARTEMEN

:

TGL

JML.OP

SUBDIVISI

JENISOPERASI

OB

OBT

OK

KETERANGAN

JML.OP

:Ja

Oa

JK

:JKa

OB

:Oa

B

OBT

:Oa

BTa

OK

:Oa

K

ASASCORE

KLASIFIKASILUKAOPERASI

OPERASI

2

3

4

5

ILS

ILD

ILO

CITO

ELEKTIF

RM

:RaM

IDO

:IDaaOa

ILD

:INLaDaa

ILO

:ILOa

ILS

:ILaS

a

FIEIAHAIAIFEKIAH

AHAKI:..

IDO

ANTIBIOTIK

H

KU

ILS

ILD

ILO

PROFIL

TERAPI

P:Pa

AKI

F.

05

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I


73/74

DAFA IGKAA DA IIAH

AR : Aa Ra, a b a a

BAL : Baa aa

CDC : C Da C

CFU : C F U

C

E

C

: Ha baa a ba a

A I : I a baa a a

EIA : E aa

FAMA : FAb Mb A

CBGB : Ca ba a

HAI : Ha A I. I a a

HAI : Haa Aa I. Pa a b a

a aa a a a a aa aaa

aa aa. Ja a baa aa a aa

a a aa a aa a aa aa aaaa aa aaa a.

IADP : I Aa Daa P (BSI / Ba )

IFA : I ab

ILO : I La Oa (SSI / Sa S I)

I : Ja a IRS ba aa a ba

a a a aaa IRS a aa

aa a a aa a.

I D : Raa aa a aa a, a aa

baa a a bba

I D

Ra ( IDR )

: Ja IRS 1000 a / a

Da : a a a aa a aa

aa b baa aa a a aa a

IP : Ia Pa (Kaaaa )

IRS : I a a. K a a aa

aa a a

ISK : I aa (UTI/ )

ISPA : I aa aaa aa

ISPB : I aa aaa baa

KPPI : K Paa a Paa I

LRT : L a a

MRSA : MRa Sa ANa : a a aa aa a

NNISS : Naa Na I Sa

PCR : Pa a a

PMN : Pa

PPI : Paa a aa

PPIRS : Paa a aa a a

Pa : Ja a a ba ba a aa a


74/74

a aa a a ( a)

aa aa a a ( a)

RIA : Raaa

Sa : Ja aa IRS a aa ba a a IRS

a baba a

SP : Saa Pa (Kaaaa Saa)

Sa : a a a aa a aa IRS ba

a a a a bb a aa IRS

TPPI : T Paa a aa

VAP : Va Aa Pa

VRE : Va Ra E

Documents

993 - PPI Pedoman Surveilance