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EWS ANAK.xls
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EWS ANAK.xls
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Hafni Goldati
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RUMAH S AKIT HELSA JATIRAHAYU
=:021;!42"23
FORMULIR EARLY EARLY WARNING WARNING SYSTEM S YSTEM (EWS) (E WS) ANAK Pemantauan Tanda Vital untuk pasien ANAK EWS
Tanggal Jam
Sadar/Bermain T6NGKAT K.SA9A'AN/ Prilaku
Tidur Gelisah Tidak Respon Nyeri Letragi
Score
≥ 140 130 120 110 9en&ut 7antun :den&ut/mnt;
100 0 !0 "0 #0 $0 ≤ 40
FRM 0!"!"#MR#0"$ Re%!0 Re%!0 N'+ 8 Nama 8
DAFTAR PEMBERIAN OBAT-OBATAN
No.Rekam Medik :…………………………………………….. Nama Pasien :……………………………………………… L / P Tanggal Lahir :……………………………………………… No
Oral
Dosis
Tgl/Jam
Umur :…………………………….. Dokter yang Merawat :………………………………
Tgl/Jam
Tgl/Jam
Alergi :………………
Tgl/Jam
Nama Perawat Nama Pasien/eluarga No
Injeksi & Supp
Nama Perawat Nama Pasien/eluarga
Dosis
Tgl/Jam
Tgl/Jam
Tgl/Jam
Tgl/Jam
!ontoh Para" NO Nama
Para"
……….
Ket
Ket
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