PANDUAN TATA LAKSANA PELAYANAN TIM CODE BLUE (RAPID RESPONSE SYSTEM FOR RESUCITATION )
RSUD SOLOK 2015
KATA PENGANTAR
Assalamu’alaium !"! !"! S#$a S#$ala la %u&i %u&i 'a$i 'a$i Alla lla ST ST* Tua+ a+ ,a+$ a+$ m#+m#+-i% i%.a .aa a+ + ma+u ma+usi sia a /a+ /a+ m#+am' m#+am'a a ilmu %#+$# %#+$#.a .aua+ ua+ 'a$i 'a$i m##a m##a ,a+$ ,a+$ '#usa '#usaa a m#+/a% m#+/a%a. a.a+ a++,a +,a"" Sala!a Sala!a.. /a+ salam salam s#+a+. s#+a+.ias iasa a .#-u .#-ua aa+ a+ #%a/ #%a/a a Rasulu Rasululla lla* * %#+$ %#+$ulu ulu /a+ maa$uu maa$uu 'a$i i.a s#mua"
Alam/u Alam/ulilla lilla Pa+/ua+ Pa+/ua+ Ta.ala Ta.alasa+a sa+a P#la,a+a+ P#la,a+a+ Tim Tim
C/# Blu# (Rapid (Rapid Response System For Resucitation) Resucitation ) E/isi 1 .au+ 2015 RSUD Sl .#la i.a milii" Pa+/ua+ i+i /iaa%a+ m#+&a/i a-ua+ /alam %#+i+$a.a+ mu.u %#la,a+a+ /aua. m#/is /i li+$u+$a+ RSUD Sl ,a+$ i.a -i+.ai i+i"
U-a U-a%a+ %a+
.#i .#ima ma asi asi
#%a #%a/a
Bi/a Bi/a+$ +$
P#la P#la, ,a+a a+a+
M#/i /i
,a+$ a+$
.#la .#la
m#+,#l#saia+ Pa+/ua+ Ta.alasa+a Ta.alasa+a P#la,a+a+ Tim C/# Blu# (Rapid Response System For Resucitation) Resucitation) E/isi 1 .au+ 2015 RSUD Sl i+i" Kami %#-a,a 'a!a .i/a a/a ,a+$ s#m%u+a #-uali Alla ST* saa+ /a+ masua+ /ai i.a sa+$a. /iaa%a+ u+.u #s#m%u+aa+ %a+/ua+ i+i u+.u masa ,a+$ aa+ /a.a+$" assalamu’alaium !" !" Sl* Di#.u U.ama*
2015
D$"E+ia+a* M"K#s NIP 1340111 136012 001
PANDUAN TATALAKSANA PELAYANAN TIM CODE BLUE (RAPID RESPONSE SYSTEM FOR RESUCITATION ) BAB I DEFINISI
A. Peng Penger erti tian an Code Bue a/ala Bue a/ala s.a'ilisasi +/isi /aua. m#/is ,a+$ .#&a/i /i /alam a#a uma sai." K+/isi K+/isi /aua. /aua. m#/is i+i m#m'u.ua m#m'u.ua+ + %#a.ia+ %#a.ia+ s#$#a" S#'ua code !ue aus aus s#$#a s#$#a /imulai /imulai s#.ia% s#.ia% ali s#s#a+$ s#s#a+$ /i.#mua+ /i.#mua+ /alam +/isi +/isi a.au respiratory arrest (.i/a #s%+si7* +a/i .i/a .#a'a* a.au '#+a7as) cardiac a.au misal+,a %asi#+ ,a+$ m#m'u.ua+ #susi.asi" Code !ue team a/ala team a/ala 8 .im ,a+$ .#/ii /ai /.# /a+ %aam#/is ,a+$ /i.u+&u /i.u+&u s#'a$ai s#'a$ai “ code - team “ ,a+$ s#-aa -#%a. # %asi#+ u+.u m#laua+ .i+/aa+ %#+,#lama.a+" Tim i+i m#+$$u+aa+ cras"#car * usi /a9 .a+/u* ala.:ala. %#+. %#+.i+ i+$ $ s#%# s#%#.i .i /#7i' /#7i'i ila la. .* su-. su-.i i+* +* si si$# $#+* +* am'u am'u'a 'a$* $* 'a. 'a.: :'a 'a.. #su #susi si.a .asi si (a/#+ali+* a.%i+* li$+-ai+#) /a+ I; s#. u+.u m#+s.a'ila+ %asi#+" Basic $i%e Support (BLS) (BLS) a.au 'a+.ua+ i/u% /asa m#u%aa+ a!al #s%+s .i+/aa+ $a!a. /aua." BLS /a%a. /ilaua+ l# .#+a$a m#/is* %aam#/is mau%u+ a+ a+$ $ a!am a!am ,a+$ ,a+$ m#li m#lia a.. %#. %#.am ama a ali ali ' 'a+ a+"" Sil Sills ls au ausl sla a /iu /iuas asai ai l# l# %aam# %aam#/is /is /a+ /a+ m#/is* m#/is* /a+ s#'ai s#'ai+, +,a a a+$ a+$ a!am a!am &u$a &u$a m#+$ua m#+$uasa sai+, i+,a* a* a#+a a#+a s#i+$ali 'a+ &us.u /i.#mua+ %#.amaali 'ua+ l# %#.u$as m#/is" BLS a/ala sua.u -aa m#m'#ia+ 'a+.ua+9%#.l+$a+ 'a+.ua+9%#.l+$a+ i/u% /asa ,a+$ m#li%u.i '#'as +,a &ala+ +a7as (air&ay ( air&ay 9A)* 9A)* %#+a7asa+ ,a+$ a/#ua. (!reat"in' ( !reat"in' 9B)* 9B)* siulasi ,a+$ a/#ua. (circuatio (circuatio+9C +9C )" Ad(ance Cardiac $i%e Support (ACLS) (ACLS) a/ala 'a+.ua+ i/u% la+&u. a.au %#.l+$a+ %#.ama %a/a %#+,ai. &a+.u+$"
B. Or Orga gani nia aii Ti! Ti! code blue
Tim code !ue m#u%aa+ !ue m#u%aa+ .im ,a+$ s#lalu sia% s#.ia% saa.9 s#%a+&a+$ !a.u* 1
(sa.u) .im code !ue respond primer '#a+$$.aa+ '#a+$$.aa+ u ,a+$ .#la m#milii s#.i7ia. /a+ m#+$ua m#+$uasai sai Basic $i%e Support (BLS (BLS)" )" Tim Tim code !ue !ue .#/ii /ai < sam%ai = a+$$.a ,ai.u 8 1" 1 (sa. (sa.u) u) K K/ /i+ i+a. a. .im .im 2" 1 (sa. (sa.u) u) P#. P#.u$ u$as as m#/ m#/is is
<" 1 (sa.u) (sa.u) Assis.#+ Assis.#+ %#.u$a %#.u$as s m#/is m#/is 8 1 a.au a.au 2 %#a!a. %#a!a. %#lasa+a %#lasa+a /a+ /a+ .im #susi.a #susi.asi si =" 1 (sa.u) (sa.u) #lm% #lm% %#+/u %#+/uu+$ u+$ (&ia /i%#lua /i%#lua+ + s#%#.i s#%#.i s#-ui.,9 s#-ui.,9 .im KD" 5" 1 (sa. (sa.u) u) .im .im ETD ETD (Emer'ency Trauma Disaster )
C. Urai Uraian an T" T"ga ga 1" K/ K/i+ i+a. a. .im .im Di&a'a. l# /.# KIC9ICU9NICU8 '#.u$as m#+$/i+i a+$$.a .im s#.a /a%a. '##&asama /#+$a+ /ila. m#m'ua. %#la.ia+ #$a!a./aua.a+ ,a+$ /i'u.ua+ l# a+$$.a .im 2" P#+a P#+a+$ +$$u $u+$ +$ &a!a &a!a' ' m#/is m#/is Di&a'a. l# / &a$a9 /.# ua+$a+8 '#.u$as m#+$i/#+.i7iasi a!al9 .#as# %asi#+*
s#.a
m#mim%i+
%#+a+$$ula+$a+
%asi#+
saa.
.#&a/i
a$a!a./a a$a!a./aua. ua.a+* a+* m#mim%i+ m#mim%i+ .im saa. %#lasa+a %#lasa+a R?P* R?P* /a%a. /a%a. m#+#+.ua m#+#+.ua+ + sia% s#la+&u.+,a" <" P#a P#a!a !a.. %#la %#las sa+ a+a a B#.u$as '#sama /.# %#+#+$$u+$ &a!a' m#/is m#laua+ .ia$# %a/a %asi#+* m#m'a+.u /.# %#+a+$$u+$&a!a' m#/is m#+a+$a+i %asi#+ $a!a. /aua. /iua+$ %#a!a.a+ " =" Tim Tim R#susi R#susi.as .asii (P#a! (P#a!a. a. .#la. .#la.i i /a+ /.# /.# ua+$a ua+$a+9 +9 /.# /.# &a$a .#la.i .#la.i)* )* '#.u$as m#m'#ia+ 'a+.ua+ i/u% /asa @ #susi.asi &a+.u+$ %au #%a/a %asi#+ $a!a. /aua. 5" Da7.a +ama Tim Code Bue m#u%aa+ m#u%aa+ .a+$$u+$ .a+$$u+$ &a!a' &a!a' K/i+a. K/i+a. .im s#.ia% 'ula+"
S#.ia% a+$$.a .im code !ue aa+ !ue aa+ m#milii .a+$$u+$ &a!a' s#%#.i %#mim%i+ .im* ma+a&# ai!a,* m%#si /a/a* I; Li+#* %#sia%a+ 'a. @ /#7i'ila.* s#.ia% a+$$.a .im ,a+$ /i.u+&u aus m#m'a!a ala. mu+iasi ( >T9>P)
D. Str"#t Str"#t"r "r Organi Organia ai i
KOORDINATOR TEAM
PENANGGUNG JAWAB MEDIS: DOKTER RUANGAN
TIM RESUSITASI DOKTER &PERAWAT TERLATIH(PERAWAT JAGA)
PERAWAT PELAKSANA/ PN: PERAWAT OK PERAWAT IW PERAWAT IP PERAWAT PARU PERAWAT PERINA PER INA PERAWAT PERAWAT ANAK PERAWAT NEURO PERAWAT THT PERAWAT ICU/CVCU ICU/CV CU PERAWAT PERAWAT IGD PERAWAT NIFAS PERAWAT JANTUNG JANTU NG PERAWAT PERAWAT PERAWAT BEDAH BED AH
E. Pen$i$i#an Pen$i$i#an%% Pe&ati'an Pe&ati'an $an a!inan a!inan K"a&ita K"a&ita Anggta Ti! C$e C$e B&"e. P#+/i/ia P#+/i/ia+ + /a+ %#la.ia+ %#la.ia+ BLS /i!a&i'a+ /i!a&i'a+ 'a$i a+$$.a a+$$.a .im code !ue /a+ aus aus m#milii m#milii s#.7i s#.7ia. a. ACLS9A ACLS9AT TLS '#la '#lau u < .au+* .au+* s#.#la s#.#la i.u /i.i+&au /i.i+&au
ula+$ ula+$
#m'ali #m'ali s#.i7ia. s#.i7ia. .s'* .#masu .#masu #'i&aa+ #'i&aa+ /a+ %s#/u* %s#/u* s#.a s#.a m#laua+ m#laua+ #i#! s.a+/a9 s.a+/a9 %#a.ua+* %#a.ua+* m#laua+ m#laua+ %#+$uu %#+$uua+ a+ s.a+/a s.a+/a %#la,a+a+ %#la,a+a+ (&am %#la,a+a+ %#la,a+a+)) s#.a au/i."
BAB II RUANG LINGKUP Sis.#m Sis.#m #s%+ #s%+ -#%a. -#%a. code !ue !ue /i'#+.u u+.u m#mas.ia+ 'a!a s#mua +/isi /aua. m#/is i.is .#.a+$a+i /#+$a+ #susi.asi /a+ s.a'ilisasi s#s#$#a mu+$i+" Sis.#m #s%+ .#'a$i /alam 2 .aa% 8 1" R#s%+ R#s%+ a!al (#s% (#s%+/# +/# %#.am %#.ama) a) '#asal '#asal /ai %#.u$as %#.u$as uma sai. sai. ,a+$ ,a+$ '#a/a /is#i.a+,a* /ima+a .#/a%a. la,a+a+ Basic $i%e Support (BLS) (BLS) 2" R#s%+ R#s%+ #/ua #/ua (#s% (#s%+/ +/# # #/ua) #/ua) m#u%a m#u%aa+ a+ .im usu usus s /a+ .#la.i .#la.i** ,a+$ ,a+$ '#asal /ai u+i. usus ,a+$ /i.u+&u l# %ia uma sai." Sis.#m #s%+ /ilaua+ /#+$a+ !a.u #s%+ .#.#+.u '#/asaa+ s.a+/a uali.as %#la,a+a+ ,a+$ .#la /i.#+.ua+ l# uma sai.* u+.u m#+u+&a+$ al .#s#'u. ,a+$ /ilaua+ a/ala 8 a" S#mua S#mua %#s+i %#s+ill /i uma sai. sai. aus aus /ila.i /ila.i /#+$a+ /#+$a+ #.#a #.#am%i m%ila+ la+ BLS u+.u m#+u+&a+$ #-#%a.a+ #s%+ u+.u BLS /ilasi #&a/ia+" '" P#a P#ala la.a .a+ + BLS BLS au aus s /i.# /i.#m% m%a. a.a a+ + /il /ila asi si ,a+$ a+$ s.a s.a.# .#$i $is s /ala /alam m a!asa+ uma sai.* misal +,a /i l'', uma sai.* ua+$ .u+$$u %li li+i* /a+ ua+$ a!a. i+a%* /ima+a %#ala.a+ /a%a. /i%i+/aa+ a.au /i'a!a u+.u u+.u #s%+ ,a+$ -#%a. /a+ .#%a."
Area *a#"+an Ti! C$e B&"e. N.
Ti! *$ *$e ,&" ,&"e +ri +ri!er
1"
(Kr$) ID
2" <" ="
Area Ca#"+an. A#a Pai* D#%a+ ID* I+s.alasi R? I*
;IP ICU
amasi* La' Pusa* I+s.alasi R? II* Muslala ICU9ICCU* Ra/il$i* OK* Ni7as* A+a*
I
?a+.u+$* B#/a* P#i+a I* IP* Pau* T>T* N#u* ii* Lu+/,* Kama Ma,a.
BAB III
TATA TATA LAKSANA LAKSAN A R#s% R#s%+ + .im code code !ue ue u+.u u+.u s#luu s#luu /a#a /i RSUD Sl .i/a /a%a. /i.a+$ /i.a+$a+i a+i l# l# .im /i'a!a /i'a!a I+s.al I+s.alasi asi a!a. a!a. Daua Daua.. (ID) (ID) sa&a* sa&a* a#+a a#+a #suli #suli.a+ .a+ &aa /a+ lasi ,a+$ .i/a .#&a+$au* %a/a al i/#al+,a !a.u a+.aa a.iasi code !ue sam%ai !ue sam%ai #/a.a+$a+ .im code !ue a/ala !ue a/ala 5 m#+i." S#i+$$a /iaa%a+ s#.ia% #$i #$i uma uma sai sai.. m#m% m#m%u+ u+, ,ai .im .im ,a+$ a+$ /a%a /a%a.. m#la m#lau ua a+ + BLS BLS a!al a!al sam' sam'il il m#+u m#+u+$ +$$u $u #/a #/a.a .a+$ +$a+ a+ .im .im code code !ue !ue uma uma sai sai.. ,a+$ ,a+$ .#la .#la /i.u /i.u+& +&u u u+.u u+.u m#+i+$a.a+ aa%a+ i/u% %asi#+" Tim /i'#+.u /#+$a+ #.#+.ua+ .ia% .im .#/ii /ai = sam%ai 5 a+$$.a ,a+$ .#la.i BLS" P#ala.a+ #susi.asi /aua. ,a+$ mu/a /i'a!a (sa.u i. #susi.asi /asa) /asa)** aus aus /i.#m% /i.#m%a. a.a+ a+ /i lasi lasi s.a.# s.a.#$is $is /i s#luu s#luu a!asa a!asa+ + uma uma sai.* sai.* .#u.ama /i /a#a %'a'ili.as .i+$$i .#&a/i +/isi /aua. m#/is* s#i+$$a .im /a%a. /#+$a+ -#%a. m#m'ilisasi /a+ m#ma+7aa.a+ %#ala.a+ i. #susi.asi /asa .s'* s#i+$$a s#i+$$a #7#.i7i.as #7#.i7i.as /a+ !a.u #s%+ /ai .im code !ue aa+ !ue aa+ l#'i 'ai /a+ aa%a+ i/u% %asi#+ aa+ m#+i+$a." >al i+i sama %#+.i+$+,a 'a!a s#mua %#s+il uma sai.* .#u.ama .#+a$a ++ ++ /. /.# # /a+ /a+ ++ ++ m#/i m#/is s /ila /ila.i .i #.# #.#a am% m%il ila+ a+ BLS* BLS* a$a a$a /a%a /a%a.. m#m' m#m'# #i ia+ a+ #susi.asi a!al #i/u%a+ (CPR) /i lasi #&a/ia+* sam'il m#+u+$$u #s%+ %im# a.au .im code !ue /a.a+$* !ue /a.a+$* s#la+&u.+,a %#lu /ilaua+ %#sia%a+ .#+.a+$ 8 -. Fae code blue a. Aler Alertt Syst System em.. >au >aus s a/a a/a sis. sis.#m #m ,a+$ ,a+$ 'ai 'ai /a+ /a+ .# .# / /i+ i+as asii /#+$ /#+$a+ a+ ua+ ua+$a $a+ + ,a+$ ,a+$ /i$u+aa+ u+.u m#+$a.i7a+ %#i+$a.a+ .#&a/i+,a #a/aa+ /aua. m#/is /alam li+$u% uma sai.* maa %#s+il uma sai. /ima+a sa&a '#a/a /a%a. m#+$a.i7a+ .a+/a9 code !ue !ue l#!a. .#l#%+# usus # N 1=6 lasi /i Sa.%am* i+7masi /is#'aa+ # .im code !ue a$a !ue a$a .im m#+$#.aui /ima+a lasi #&a/ia+ %asi#+ 'u.u 'a+.ua+ .im code !ue" !ue" S.a+/a la,a+a+ u+.u /uasi !a.u ,a+$ /i'u.ua+ a+.aa m#+#ima %#sa+ code !ue !ue (code !ue acti(ation) acti(ation) /a+ #/a.a+$ #/a.a+$a+ a+ .im code !ue !ue /i lasi #&a/ia+ a/ala 5 sam%ai 10 m#+i."
,.ocal ,.ocal Alert
a) T#$a+ $a+.u .u+$ +$ %a/a %a/a m#a m#a+i +ism sm# # ,a+$ a+$ /i'u /i'ua. a. l# l# uma uma sai sai.. ()one coordinator ) ,) P#+$umuma+ m#lalui -#+.al %#a. uma sai. m#lalui .#l#%+# N 1=6* ,a+$ .#la .#i+.#$asi #s#luu ua+$a+" -) M#+a M#+am% m%il ila+ a+ +ama:+ +ama:+am ama a .im .im code !ue primer /i lasi s.a.#$is ,a+$ .#la /i.u+&u l# /i+a. .im" /) S#.#la S#.#la a/a i+7masi i+7masi #&a/i #&a/ia+ a+ /ai /ai centra operator m#laui m#laui .#l#%+# N 1=6* .im code !ue %im# !ue %im# m#+i+$$ala+ %##&aa++,a %##&aa++,a /a+ m#+$am'il .as code !ue /i !ue /i ID* /a+ '#$#$as # lasi u+.u m#mulai B>D9CPR" *.!os"#tal *.!os"#tal Alert Nm .#l#%+# code !ue /#+$a+ N N 1=6* (aus .#s#/ia /a+ /a+ .#i+7masi # centra operator uma sai. ,a+$ .#i+.#$a .#i+.#$asi si # ua+$a+) s#'a$ai s#'a$ai %usa. %usa. %a+$$ila+ #$a!a./aua.a+ m#/is 8 a) Pririta - U+.u U+.u m#+$ m#+$a a.i .i7 7a+ a+ .im .im code code !ue !ue s#u+/ s#u+/# # /ai /ai .im #m#$#+-i .auma /isas.#" ') Pririta / U+.u U+.u m#m# m#m#i is sa a ( s#'a s#'a$a $aii &ai &ai+$ +$ %#+$ %#+$am ama+ a+ #/u #/ua) a) %#+$a.i7a+ .im code !ue %im#"
/. Tangg" angg"ng ng 0a1a, entra entra&2 &2 +eratr +eratr r"!a' r"!a' a#it a#it ter'a$ ter'a$a+ a+ code blue l#$e $i r"!a' a#it a" A+$$ A+$$a% a% s#.i s#.ia% a% %a+$ %a+$$i $ila la+ + /i code !ue ine ine a/ala a/ala code !ue !ue asus ,a+$ s#'#+a+,a (sam%ai 'isa /i'u.ia+) '" Pa+$$ +$$ila+ ila+ code !ue aus < F /#i+$ ) !ue aus /i&a!a' s#-#%a.+,a (
3. Inter4 Inter4en enii egera egera $i te!+a te!+att #e0a$ia #e0a$ian n
Tim Tim /i .#m%a. .#m%a. #&a/i #&a/ia+ a+ /aua /aua.. m#/is m#/is /i.#mu /i.#mua+ a+ %asi#+ %asi#+ .i/a .i/a sa/a sa/a a.au a.au /ala /alam m cardiac /a+ Respiratory arrest '#.a+$$u+$ '#.a+$$u+$ &a!a' u+.u m#mi+.a 'a+.ua+ l#'i la+&u.* m#mulai #susi.asi #susi.asi m#+$$u+aa+ m#+$$u+aa+ %#/ma+ Basic $i%e Support (BLS) /a+ #.#am%ila+ ALS s#.a %#ala.a+ -uu%* SDM .#la.i /a+ l#+$a%"
5. Pet"n0"# +e&a#anaan ti! code blue $i&a+angan blue $i&a+angan a. Peria+an e,e&"! #e$atangan a) Nm Nm a+/ a+/% %+ +# # .im .im code !ue uma !ue uma sai. /i.#m%a.a+ /i s#luu ua+$a+ /i uma sai. .#masu a+.* l'i li7.* i/* a+.i+* .ama+* .#m%a. %ai* /a+ lasi lai+ /i /alam uma sai." ') P#s+ P#s+ilil uma uma sai. sai. ,a+$ ,a+$ m#+#mu m#+#mua a+ + 'a+ 'a+ aus aus /a%a. /a%a. m#+$a. m#+$a.i7 i7a+ a+ %#m'#i.aua+ lal # .im code !ue primer a.au a.au s#s#a+$ # a+/%+# masi masi+$ +$ masi masi+$ +$ .im .im a.au a.au N 1=6* 1=6* /a+ /a+ /i .#u .#us sa+ a+ i+7 i+7m mas asii .#s .#s#' #'a a
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A&"r K!"ni#ai
Dokter ruangan/ jaga Perawat pelaksana / PN
Gawat Pasien Gawat Darurat
Dokter ruangan/ jaga Perawat terlatih(perawat jaga)
Aktivasi Blue Team
:. A&gr &grit it!a !a C$e C$e B&"e B&"e
Ditemukan korban/ pasien dengan cardiopulmonary arrest
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Sta# rumah sakit memanggil pertolongan &engakti#asi 'local alert( menuju tim code blue
"nggota bystander/ penemu pertama terlebih dahulu melakukan !S/ $P% bila memiliki skill yang cukup !anjutkan !S/ $P% sampai tim code blue datang Jika tidak memiliki skill !S, tunggu pertolongan datang, sementara menunggu,
Setelah mengakti#asi code blue tim primer yang bertugas disekitar tempat kejadian bergegas menuju tempat kejadian dengan resusitasi kit
Setelah tim code blue sekunder/ ETD atang, mereka akan mengambil alih resusitasi !S dilanjutkan dan dilakukan dila kukan "ED Dokumentasikan semua tindakan yang dilakukan oleh tim code blue
Pindahkan korban ke ETD secepat mungkin setelah stabil untuk mendapatkan perawatan lebih lanjut Jika resusitasi resusitasi berhasil atau korban meninggal di tempat, korban harus tetap dipindahkan ke ETD untuk mendapatkan perawatan lebih lanjut
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BAB I; DOKUMENTASI P#+/um#+.asia+ /ilaua+ s#suai /#+$a+ #'u.ua+ %asi#+ saa. /i.#mua+ /i lasi #&a/ia+ 8 1" M#+$is M#+$isii 7m 7ma. a. usu usus s .im code !ue /alam !ue /alam m#lasa+aa+ .u$as 2" Tim code !ue !ue '##&a s#suai /#+$a+ sua. #%u.usa+ /i#.u u.ama* /#+$ /#+$a+ a+ m#m% m#m%# #a a.i .ia a+ + as%# as%# patient sa%ety /a+ /a+ ma+a&# ma+a&#m#+ m#+ #si #si s#suai s.a+/a" <" ?a/! ?a/!al al .im .im .#i .#i+7 +7 ma masi si #'a #'a$i $ia+ a+ sa. sa.# # .# .#ai ai.. (Ba$ (Ba$ia ia+ + SDM* SDM* Bi/a Bi/a+$ +$ P#la, P#la,a+a a+a+ + M#/i* M#/i* Bi/a+$ Bi/a+$ P#la, P#la,a+a a+a+ + K#%#a K#%#a!a !a.a+ .a+** Ba$ia Ba$ia+ + Umum* Umum* I+s.alasi >umas* K/i+a. Sa.%am)
