Panduan Menurunkan Resiko Infeksi Rumah Sakit

PERATURAN DIREKTUR RUMAH SAKIT NOMOR : 948/PER/RSI/I/2014  TENTANG  TENT ANG PANDUAN MENURUNKAN RESIKO INFEKSI RUMAH SAKIT

DIREKTUR RUMAH SAKIT MENIMBANG

:a.

*.

3.

&.

MENGINGAT

Bahwa r!ah "a#$% &$%'%% '%# &a(a% !)!*)r$#a' ()+a,a'a' ,a'- *)r!% ")"a$ &)'-a' "%a'&ar ,a'- "&ah &$%)'%#a' Bahwa !a",ara#a% ,a'- !)')r$!a ()+a,a'a' #)")ha%a' %)'a-a #)")ha%a' &a' ()'-''- &$ r!ah "a#$% &$ha&a(#a' (a&a r$"$# %)ra&$',a $')#"$ &$ r!ah "a#$% a%a $')#"$ '"#!$a+ '"#!$a+ Bahwa &a+a! (a,a !)!$'$!a+#a' !)!$'$!a+#a' r$"$# %)ra&$',a $')#"$ &$ R!ah Sa#$% ()r+ &$%)ra(#a' P)'3)-aha' &a' P)'-)'&a+$a' P)'-)'&a+$a' I')#"$ *ahwa *)r&a"ar#a' ()r%$!*a'-a' ")*a-a$!a'a &$!a#"& &a+a! a* 3 &a' & ()r+ &$%)r*$%#a' P)ra%ra' D$r)#%r %)'%a'- Pa'&a' M)'r'#a' R)"$# I')#"$ &$ R!ah Sa#$% I"+a!.

U'&a'- R)(*+$# R)(*+$# I'&')"$a N!r 44 :1. U'&a'%ah' 2009 %)'%a'- R!ah Sa#$% U'&a'- R)(*+$# R)(*+$# I'&')"$a N!r 56 2. U'&a'%ah' 2009 %)'%a'- K)")ha%a' P)ra%ra' M)'%)r$ K)")ha%a' R)(*+$# 5. I'&')"$a N!r 1555/M)'#)"/SK/7II/1999 1555/M)'#)"/SK/7II/1999 %)'%a'- S%a'&ar P)+a,a'a' R!ah Sa#

%$ P)ra%ra' M)'%)r$ K)")ha%a' R)(*+$# 4. I'&')"$a N!r 1691/MENKES/PER/III/2011 T)'%a'K)")+a!a%a' Pa"$)' R!ah Sa#$% P)r!)'#)" N!r 1204 Tah' 2004 2 004 T)'%a'T)'%a'. P)r",ara%a' K)")ha%a' $'-#'-a' R!ah Sa#$% 6.

2

MEMUTUSKAN: MENET MENETAPK APKAN AN : KESA ESATU : Pa'& a'&a' a' M)'r )'r '#a' '#a' R)"$# )"$#  I' I')#"$ )#"$ &$ R!ah !ah Sa#$ Sa#$%%   ")*a-a$!a'a %)r3a'%! &a+a! a!($ra' K)(%"a' $'$. KEDUA

: Sra% K)(%"a' K)(%"a' $'$ $'$ *)r+a# *)r+a# ")a# %a'--a+ &$%)r*$%#a' &a' a#a' &$+a##a' &$+a##a' );a+a"$ ")%$a( %ah'',a.

KETIGA

: A(a*$+a ha"$+ );a+a"$ !)'",ara%#a' a&a',a ()r*a$#a' !a#a a#a' &$a&a#a' ()r*a$#a' ")*a-a$!a'a !)"%$',a

D$%)%a(#a' &$  Ta'--a+  Ta'--a+

: S)!ara': 15 Ra*$+ Awa+ Awa+ 145H 1
D$r)#%r U%a!a

5

AMPIRAN PERATURAN DIREKTUR RUMAH SAKIT NOMOR

: 948/PER/RSI/I/2014

 TANGGA : 1
BAB I PENDAHULUAN

A.

Latar Belakang

R!ah "a#$% ")*a-a$ "a+ah "a% "ara'a #)")ha%a' ,a'- !)!*)r$#a' ()+a,a'a' #)")ha%a' #)(a&a !a",ara#a% !)!$+$#$ ()ra' ,a'- "a'-a% ()'%$'- &a+a! !)'$'-#a%#a' &)raa% #)")ha%a' !a",ara#a%. O+)h #ar)'a $% r!ah "a#$% &$%'%% '%# &a(a% !)!*)r$#a' ()+a,a'a' ,a'- *)r!% ")"a$ &)'-a' "%a'&ar ,a'- "&ah &$%)'%#a'. Ma",ara#a% ,a'- !)')r$!a ()+a,a'a' #)")ha%a' %)'a-a #)")ha%a' &a' ()'-''- &$ r!ah "a#$% &$ha&a(#a' (a&a r$"$# %)ra&$',a $')#"$ &$ r!ah "a#$% a%a $')#"$ '"#!$a+/HAI" =H)a+%h >ar) A""3$a%) I')3%$'? ,a$% $')#"$ ,a'&$()r+)h &$ r!ah "a#$% *a$# #ar)'a ()rawa%a' a%a &a%a'- *)r#''- #) r!ah "a#$%.

K)a&$a' $')#"$ '"#!$a+/HAI" $'$ a#$*a% $')#"$ ,a'- &$&a(a% a%a %$!*+ (a&a wa#% (a"$)' &$rawa% &$ r!ah "a#$%. Ba-$ (a"$)' &$ r!ah "a#$% ha+ $'$ !)r(a#a' ()r"a+a' ")r$" ,a'- &a(a% !)'a&$ ()',)*a* +a'-"'- a%a %$&a# +a'-"'-. B)*)ra(a #)a&$a' $')#"$ '"#!$a+/HAI" !'-#$' %$&a# !)',)*a*#a' #)!a%$a' (a"$)' a#a' %)%a($ !)'a&$ ()',)*a* (a"$)' &$rawa% +)*$h +a!a &$ r!ah "a#$%. I'$ *)rar%$ (a"$)' !)!*a,ar +)*$h !aha+ &a' &a+a! #'&$"$ %$&a# (r&#%$ &$"a!($'- ($ha# r!ah "a#$% -a a#a' !)'-)+ar#a' *$a,a +)*$h *)"ar.

P)',)*a*',a a&a+ah #!a' ,a'- *)ra&a &$ +$'-#'-a' r!ah "a#$% a%a #!a' ,a'- "&ah &$*awa +)h (a"$)' ")'&$r$ ,a$% #!a' )'&-)'. Dar$ *a%a"a' $'$ &a(a% &$"$!(+#a' *ahwa #)a&$a' $')#"$ '"#!$a+ =HAI"? a&a+ah $')#"$ ,a'")3ara (%)'"$a+ &a(a% &$3)-ah a%a ")*a+$#',a -a !)r(a#a' $')#"$ ,a'%$&a# &a(a% &$3)-ah. A'-#a $')#"$ '"#!$a+/ HAI" %)r" !)'$'-#a% =A+ ara& 2000? !)'3a(a$ ")#$%ar 9@ =;ar$a"$ 521@? a%a +)*$h &ar$ 14 %a (a"$)' rawa% $'a( &$ r!ah "a#$% ")+rh &'$a. D$ RS< Har#$%
4

*)r*a-a$ ()',a#$% $')#"$ *ar =new emerging, emerging diseases dan reemerging diseases)



BAB II RUANG LINGKUP

Pa'&a' $'$ !)!*)r$ ()%'# *a-$ ()%-a" #)")ha%a' =!)&$" &a' (ara!)&$"? &$ R!ah Sa#$% ()+a,a'a' #)")ha%a' +a$'',a &a+a! !)+a#"a'a#a' ()'3)-aha' &a' ()'-)'&a+$a' $')#"$ (a&a ()+a,a'a' %)rha&a( (a"$)' &)'-a' *a%a"a' *a%a"a': 1.

I')#"$ r!ah "a#$% a%a $')#"$ '"#!$a+/HAI" a&a+ah $')#"$ ,a'- %)ra&$ a%a &$&a(a% &$ r!ah "a#$%. Sa% $')#"$ ,a'- &$&a(a% &$ r!ah "a#$% a(a*$+a :

a. *.

Pa&a "aa% !a"# r!ah "a#$% %$&a# a&a %a'&a &a' -)a+a a%a %$&a# &a+a! !a"a $'#*a"$ $')#"$ %)r")*% I')#"$ %)ra&$ 2724 a! ")%)+ah (a"$)' &$rawa% &$ r!ah "a#

%$3.

I')#"$ (a&a +#a"$ ,a'- "a!a %)%a($ &$")*a*#a' +)h !$#rr-a'$"!) ,a'*)r*)&a &ar$ !$#rr-a'$"!) (a&a "aa% !a"# r!ah "a#$% a%a !$#rr-a'$"!) ()',)*a* "a!a %)%a($ +#a"$ $')#"$ *)r*)&a.

2.

P)'3)-aha' &a' ()'-)'&a+$a' $')#"$ r!ah "a#$% a&a+ah #)-$a%a' ,a'!)+$(%$ ()r)'3a'aa' ()+a#"a'a' &a' ()'-awa"a' ")r%a ()!*$'aa' &a+a! (a,a !)'r'#a' a'-#a #)a&$a' $')#"$ '"#!$a+/HAI" &$ r!ah "a#$%.

5.

Sr;)$+a'" a&a+ah #)-$a%a' ()'-a!a%a' "$"%)!a%$" a#%$ &a' %)r"!)')r" %)rha&a( %$!*+',a &a' ()',)*ara' $')#"$ '"#!$a+ (a&a "a% ()r$"%$wa.

4.

Sa% #)a&$a' &$ r!ah "a#$% &a(a% &$")*% K)a&$a' ar B$a"a =KB? *$+a proportional rate ()'&)r$%a *ar &ar$ "a% ()',a#$% !)'+ar &a+a! wa#% "a%*+a' &$*a'&$'-#a' &)'-a' (r(r%$'a+ ra%) ()'&)r$%a *ar &ar$ ()',a#$% !)'+ar ,a'- "a!a ")+a!a ()r$&) wa#% ,a'- "a!a &ar$ %ah' ,a'- +a+ !)''##a' #)'a$#a' &a #a+$ a%a +)*$h a%a %)r&a(a% "a% #)a&$a' (a&a #)a&aa' &$!a'a ")*)+!',a %$&a# ()r'ah a&a.

6

BAB III TATA LAKSANA

A. ".

 Jenis-Jenis Infeksi Nosokoial!HAIs Dan Kriteria Infeksi L#ka $%erasi &IL$'

U'%# !)!*aha" $')#"$ +#a ()ra"$ ()r+ &$#)%ah$ #+a"$#a"$ +#a ()ra"$ ,a$% ")*a-a$ *)r$#%: a.

K+a"$#a"$ ()ra"$/)'$" ()ra"$

1?

O()ra"$ B)r"$h

O()ra"$ &$+a##a' (a&a &a)rah/#+$% ,a'- (a&a #'&$"$ (ra *)&ah % $&a# %)r&a(a% ()ra&a'-a' &a' %$&a# !)!*#a %ra#%" r)"($ra%r$" %ra#%" -a"%r$'%)"%$'a+ rar$'- %ra#%" r$'ar$" a%a %ra#%" *$+$)r O()ra"$ *)r)'3a'a &)'-a' ()'%(a' #+$% (r$!)r &)'-a' a%a %a'(a ()!a#a$a' &ra$' %)r%%( 2?

O()ra"$ B)r"$h T)r3)!ar O()ra"$ !)!*#a %ra#%" &$-)"%$;" %ra#%" *$+$)r %ra#%" r$'ar$" %ra#%" r)"($ra%r$" "a!(a$ &)'-a' rar$'- a%a %ra#%" r)(r&#"$ #)3a+$ ;ar$! O()ra"$ %a'(a ()'3)!ara' ',a%a =-r"" "($++a-)? 3'%h',a ()ra"$ (a&a %ra#%" *$+$)r a(()'&$#" ;a-$'a a%a rar$'-

5?

O()ra"$ T)r3)!ar O()ra"$ ,a'- &$+a##a' (a&a #+$% %)r*#a %)%a($ !a"$h &a+a! wa#% )!a" =G+&)' P)r$&)?

4?

O()ra"$ K%r a%a &)'-a' I')#"$ P)rra"$ %ra#%" &$-)"%$;" %ra#%" r-)'$%a+$" a%a %ra#%" r)"($ra%r$" ,a'%)r$')#"$ M)+)wa%$ &a)rah (r+)' =I'Ca!a"$ Ba#%)r$a+? #a %)r*#a +)*$h &ar$ 6 a! ")%)+ah #)a&$a' %)r&a(a% ar$'-a' +a" a%a #%r D#%)r ,a'- !)+a##a' ()ra"$ !)',a%a#a' ")*a-a$ +#a ()ra"$ #%r/%)r$')#"$

*.

Kr$%)r$a I')#"$ #a O()ra"$

1?

Kr$%)r$a I')#"$ I'"$"$'a+ S()r"$a+ I')#"$ (a&a +#a $'"$"$ =#+$% &a' "*3%a'? %)ra&$ &a+a! 50 har$ (a"3a *)&ah. Kr$%)r$a ")*a-a$ *)r$#% K)+ar 3a$ra' (r+)' &ar$ +#a $'"$"$ K+%r ("$%$ &ar$ 3a$ra' ,a'- #)+ar a%a ar$'-a' ,a'- &$a!*$+ ")3ara a")(%$# 

D$%)!#a' (a+$'- %$&a# "a% %a'&a $')#"$ : ',)r$ *)'-#a# +#a+ #)!)raha' #)3a+$ *$+a ha"$+ #+%r ')-a%$  D#%)r ,a'- !)'a'-a'$ !)',a%a#a' $')#"$ 2?

Kr$%)r$a I')#"$ I'"$"$'a+ Da+a! I')#"$ (a&a +#a $'"$"$ %)ra&$ &a+a! 50 har$ (a"3a *)&ah a%a "a!(a$ 1 %ah' *$+a a&a $!(+a'%. T)r&a(a% (a+$'- %$&a# "a% #)a&aa' &$ *awah $'$: K)+ar 3a$ra' (r+)' &ar$ +#a $'"$"$ %a($ *#a' *)ra"a+ &ar$ r'--a/r-a' S)3ara "('%a' !)'-a+a!$ &)h$")'" a%a &)'-a' ")'-aa &$*#a +)h ah+$ *)&ah &a' (a+$'- ")&$#$% "a% &ar$ %a'&a *)r$#% &)!a! =58>? ',)r$ +#a+ #+%r =? D#%)r !)',a%a#a' +#a $')#"$

5?

Kr$%)r$a I')#"$ Or-a'/R'--a I')#"$ ,a'- %)ra&$ &a+a! 50 har$ (a"3a *)&ah a(a*$+a %$&a# a&a $!(+a'%. I')#"$ %)ra&$ &a+a! 1 %ah' (a"3a *)&ah a(a*$+a %)r&a(a% $!(+a'%. Pa+$'- ")&$#$% !)''##a' "a% -)a+a *)r$#% : Dra$'a") (r+)' &ar$ &ra$' ,a'- &$(a"a'- !)+a+$ +#a $'"$"$ #) &a+a! r-a'/r'--a D$%)!#a' r-a'$"!) !)+a+$ a")(%$# #+%r &ar$ r-a'/r'--a D#%)r !)',a%a#a' $')#"$ (a&a r-a' %)r")*%

(atatan )

a?

D$ &a+a! ()'--'aa' a'%$*$%$# ,a'- ra"$'a+ $#a &$%)!#a' %a'&a ()ra&a'-a' !a#a &$!a"##a' #) &a+a! #)!'-#$'a' $')#"$.

*? A*")" ah$%a' ,a'- ")!*h 5 har$ ")%)+ah ah$%a' &$a'-#a% *#a' $')#"$ +#a ()ra"$. 3.

Fa#%r r)"$# I')#"$ #a O()ra"$

1?

I'%r$'"$# : U"$a "%a%" -$$ D$a*)%)" M)+$%" ()r*aha' r)"(' $!' $')#"$ &$ %)!(a% +a$' +a!a rawa% $'a( (r)()ra%$ *)"$%a" !)r## #+'$"a"$ !$#rr-a'$"!) ()'--'aa' #r%$#"%)r$&

2?

E#"%r$'"$# : P)%-a"/%$! *)&ah %)#'$# ()!*)&aha' +$'-#'-a' ra'- ()ra"$ ()ra+a%a' $'"%r!)' &a' a+a% #)")ha%a'

&.

P)'3)-aha' I')#"$ #a O()ra"$

1?

Pra O()ra"$

Persiapan pasien sebelum operasi  S)!a ()!)r$#"aa' &a' ()'-*a%a' '%# ()r"$a(a' ()ra"$ h)'&a#',a &$+a##a' ")*)+! rawa% $'a( a-ar wa#% (ra*)&ah !)'a&$ ()'&)# =1 har$?

8

 <$#a &$%)!#a' a&a',a %a'&a%a'&a $')#"$ ")!*h#a' %)r+)*$h &ah+ $')#"$',a ")*)+! har$ ()ra"$ &a' $#a ()r+ %'&a har$ ()ra"$ "a!(a$ $')#"$ %)r")*% ")!*h P)r*a$#a' #)a&aa' ,a'- !)!()r*)"ar #)!'-#$'a' %)ra&$',a IO a'%ara +a$': D$a*)%)" M)+$%" !a+'%r$"$ *)"$%a" $')#"$ ()!a#a$a' #r%$#"%)r$& Ma'&$#a' (a"$)' &)'-a' a'%$")(%$# "r)/!a+a! har$ ")*)+! ()ra"$  3$ &a' *)r"$h#a' +#a"$ ()!*)&aha' &a' ")#$%ar',a '%# !)'-h$+a'-#a' #'%a!$'a"$ ")*)+! !)'-a&a#a' ()r"$a(a' #+$% &)'-a' a'%$")(%$# O+)"#a' a'%$")(%$# (a&a #+$% &)'-a' -)ra#a' !)+$'-#ar !+a$ &ar$ *a-$a' %)'-ah !)' #) arah +ar. Da)rah ,a'- &$()r"$a(#a' har"+ah 3#( +a" '%# !)!()r*)"ar $'"$"$ $#a &$()r+#a' !)!*a% $'"$"$ *ar '%# !)!a"a'&ra$' *$+a &$()r+#a' A'%$*$%$# (r+a#"$" &$*)r$#a' ")3ara "$"%)!$# har" !)!)'h$ ",ara% : %)(a% &"$" %)(a% $'&$#a"$ =ha',a '%# ()ra"$ *)r"$h %)r#'%a!$'a"$ ()!a#a$a' $!(+a'% &a' (r%)"$" a%a ()ra"$ &)'-a' r$"$# %$'--$ ")()r%$ *)&ah ;a"#+)r a%a *)&ah a'%' T)(a% 3ara ()!*)r$a' =har" &$*)r$#a' ")3ara $; &a a! ")*)+! $'"$"$ &$+a##a' &a' &$+a'%#a' %$&a# +)*$h &ar$ 48 a!?  T)(a% )'$" =")"a$ &)'-a' !$#rr-a'$"!) ,a'- ")r$'- !)'a&$ ()',)*a* IO?

2?

I'%ra O()ra"$

Persiapan Tim Pembedahan a? S)%$a( ra'- ,a'- !a"# #a!ar ()ra"$ har" : M)!a#a$ !a"#)r ,a'- !)'%($ h$&'- &a' !+% M)!a#a$ ()'%( #)(a+a ,a'- !)'%($ ")!a ra!*% M)!a#a$ "a'&a+ #h"" #a!ar ()ra"$ M)!a#a$ "ar'- %a'-a' "%)r$+ a(a*$+a "ar'- %a'-a' %)r")*% #%r/"*)# har" &$-a'%$ ,a'- *ar. P)%-a" OK har" !)'-)%ah$ %)#'$# !)!a#a$ &a' !)+)(a" "ar'- %a'-a' "%)r$+ M)!a#a$ -a'/*a "%)r$+ *?  
a##a' 33$ %a'-a' *)&ah ="r-$3a+ "3r*? &)'-a' a'%$")(%$# ,a'- ")"a$. >3$ %a'-a' &a' +)'-a' "a!(a$ #) "$# A'%$")(%$# ,a'- &$a'r#a' '%# 33$ %a'-a' a&a+ah ,a'- !)'-a'&'3h+rh)$&$') 4 @ S)%)+ah 33$ %a'-a' +)'-a' har" %)%a( !)'-arah #)a%a" &a' &$ah#a' &ar$ %*h "(a,a a$r !)'-a+$r &ar$ '- ar$ #) "$#. K)r$'-#a' %a'-a' &)'-a' ha'&# "%)r$+ &a' #)!&$a' (a#a$+ah -a' &a' "ar'- %a'-a' B)r"$h#a' ")+a")+a &$*awah ## ")%$a( har$ ")*)+! 33$ %a'-a' *)&ah ,a'()r%a!a  T)#'$# ()ra"$ har" &$+a##a' &)'-a' ")!(r'a '%# !)'-h$'&ar$ #)r"a#a'  ar$'-a' +'a# ,a'- *)r+)*$ha' !)'-ra'-$ ()r&araha' &a' !)'-h$'&ar#a' %)r%$'--a+',a *)'&a a"$'- ,a'- %$&a# &$()r+#a' a!a ()ra"$ har" ")"$'-#a%"$'-#a%',a &a+a! *a%a" ,a'- a!a' 5?

Pa"3a O()ra"$

a?

$'&'-$ +#a ,a'- "&ah &$ah$% &)'-a' ()r*a' "%)r$+ ")+a!a 24 "a!(a$ 48  a! (a"3a *)&ah

*? >3$ %a'-a' ")*)+! &a' ")"&ah !)'--a'%$ ()r*a'/*)r")'%ha' &)'-a' +#a ()ra"$ 3?

B$+a ()r*a' har" &$-a'%$ -'a#a' %)#'$# a")(%$#

&? B)r$#a' ()'&$&$#a' (a&a (a"$)' &a' #)+ar-a',a !)'-)'a$ ()rawa%a' +#a ()ra"$ ,a'- *)'ar -)a+a-)a+a IO &a' ()'%$'-',a !)+a(r#a' -)a+a %)r")*%

1?

B)*)ra(a &#%)r !)!*$ar#a' +#a $'"$"$ ()ra"$ ,a'- *)r"$h %)r*#a %a'(a #a"a %)r',a%a &ar$ "&% ()',)!*ha'',a ha"$+',a *a$#

2?

B)*)ra(a ()')+$%$a' %)+ah !)!*#%$#a' *ahwa +#a $'"$"$ ()ra"$ ,a'- *)r"$h &a(a% (+$h &)'-a' *a$# wa+a(' %a'(a #a"a

5?

B)+! a&a %)r*#%$ %)r%+$" ,a'- !)'-a%a#a' *)r%a!*ah',a #)!'-#$'a' %)ra&$',a $')#"$ *$+a +#a &$*$ar#a' %)r*#a %a'(a #a"a

4?

Na!' &)!$#$a' !a"$h *a',a# &#%)r %)%a( !)'%( +#a ()ra"$ &)'-a' #a"a "%)r$+ ")"a$ &)'-a' (r")&r ()!*)&aha' &)'-a' %a' : !)'%($ +#a %)rha&a( !$#rr-a'$"!) ,a'- &ar$ %a'-a' !)',)ra( 3a$ra' ,a'- !)+)+)h #)+ar a-ar +#a 3)(a% #)r$'- !)!*)r$#a' %)#a'a' (a&a +#a "(a,a &a(a% !)'aha' ()r&araha' "()r3$a+ !)+$'&'-$ '- +#a &ar$ %ra!a +a$'',a

%$'-#a%

10

4?

P)'-)'&a+$a' $'-#'-a'

a?

P)r%aha'#a' %)#a'a' +)*$h ("$%$ &a+a! #a!ar *)&ah &$*a'&$'-#a' &)'-a' #r$&r &a' ra'-a' &$")#$%ar',a

*?

)'%$+a"$ #a!ar ()ra"$ har" &$()rha%$#a' &a+a! ha+ : ")!a &ara har" &$"ar$'- *a$# &ara ")-ar !a(' &ara ha"$+ r)"$r#+a"$ ()r%aha'#a' !$'$!! 1 #a+$ ()r-a'%$a' &ara ()r a! &)'-a' !$'$!! 5 &$a'%ara',a a&a+ah &ara ")-ar "h a'%ara 1924 > #)+)!*a*a' &ara 4060@

3?

 
&?

P$'% #a!ar ()ra"$ har" ")+a+ %)r%%( #)3a+$ *$+a &$*%h#a' '%# +)awa%',a ()ra+a%a' ()%-a" &a' (a"$)'

)?

Ba%a"$ !+ah ra'- ,a'- !a"# &a+a! #a!ar ()ra"$

?

Ka!ar ()ra"$ har" &$*)r"$h#a'

-?

B$+a %a!(a# #%ra'/&arah/3a$ra' %*h +a$'',a (a&a ()r!#aa' *)'&a a%a ()ra+a%a' -'a#a' &)"$')#%a' '%# !)!*)r"$h#a'',a ")*)+! ()ra"$ &$!+a$

h?

A'%ara &a ()ra"$

$?

 T$a( !$'-- = "a% har$ %a'(a ()ra"$ '%# #)*)r"$ha' !)',)+rh?

 ? #?

 T$&a# ()r+ !)'-a&a#a' ()!*)r"$ha' #h"" /()'%(a' #a!ar ()ra"$ ")%)+ah ")+)"a$ ()ra"$ #%r P)+ &a' #)r$'-#a' +a'%a$ #a!ar ()ra"$ &a' &)"$')#"$ ")+rh ()r!#aa' +$'-#'-a'/()ra+a%a' &a+a! #a!ar ()ra"$ ")%)+ah ")+)"a$ ()ra"$ %)ra#h$r ")%$a( har$',a &)'-a' &)"$')#%a

+?

M)'--'a#a' $'"%r!)' "%)r$+ ")"a$ "%a'&ar

*.

Nosokoial Pne#onia!+AP & Ventilator Assosiated Pneumonia '

a.

Ba%a"a' P')!'$a P')!'$a a&a+ah "a% $')#"$ "a+ra' ()r'aa"a' *a-$a' *awah =ISPB?. AP &$&)'$"$#a' ")*a-a$ '"#!$a+ (')!'$a ,a'- %)ra&$ ")%)+ah 48 a! (a&a (a"$)' ,a'%)r(a"a';)'%$+a"$ !)#a'$# *a$# !)+a+$ ($(a )'&%ra3h)a/%ra3h)"%!$. S)ra'- (a"$)' &$#a%a#a' !)'&)r$%a (')!'$a *$+a &$%)!#a' "a% &$a'%ara #r$%)r$a *)r$#% :

Untuk dewasa dan anak > 12 bulan 1?

Pa&a ()!)r$#"aa' "$# %)r&a(a% r'3h$ *a"ah a%a ()#a# =dullnes? (a&a ()r#"$ &a' "a+ah "a% &$a'%ara',a #)a&aa' *)r$#% :



Bar %$!*+ "(%! (r+)'/%)ra&$',a ()r*aha' "$a% "(%!



I"+a"$ #!a' ("$%$ (a&a *$a#a' &arah



I"+a"$ #!a' (a%-)' ("$%$ &ar$ a"($ra"$ %ra#)a/*$("$ 11

2?

F% r'%-)' &a&a !)''##a' a&a',a $'+%ra% #'"+$&a"$ #a;$%a"$ )J"$ (+)ra *ar/(r-)"$ &a' "a+ah "a% &$a'%ar #)a&aa' *)r$#% :



Bar %$!*+',a "(%! (r+)'/%)ra&$',a ()r*aha' "$a% "(%!



I"+a"$ #!a' ("$%$ &a' *$a#a' &arah



I"+a"$ #!a' (a%-)' ("$%$ &ar$ a"($ra"$ %ra#)a *$("$



$r" &a(a% &$$"+a""$/%)r&a(a% a'%$-)' ;$r" &a+a! ")#r)"$ "a+ra' 'aa"



 T$%)r I-M/I-G "()"$# !)'$'-#a% (a&a ()!)r$#"aa' h$"%(a%+-$

Untuk pasien umur ≤ 12 bulan D$&a(a%#a' 2 &$a'%ara #)a&aa' *)r$#% : a(')a %a#$(')a *ra&$#ar&$ !)'-$ =wheezing ? r'3h$ *a"ah/*a%# &a' "a+ah "a% &$a'%ara',a ")*a-a$ *)r$#% :

1?

Pr&#"$ &a' ")#r)"$ "a+ra' 'aa" !)'$'-#a%

2?

Bar %$!*+ "(%! (r+)'/%)ra&$ ()r*aha' "$a% "(%!

5?

I"+a"$ #!a' ("$%$ (a&a *$a#a' &arah

4?

I"+a"$ #!a' (a%-)' ("$%$ &ar$ a"($ra"$ %ra#)a/*$("$

?

$r" &a(a% &$$"+a"$/%)r&a(a% a'%$-)' ;$r" &a+a! ")#r)"$ "a+ra' 'aa"

6?

 T$%)r I-M/I-G "()"$# !)'$'-#a% 4  +$(a% &a+a! &a ()!)r$#"aa'

?

 T)r&a(a% %a'&a%a'&a (')!'$a (a&a ()!)r$#"aa' h$"%(a%+-$

A%a -a!*ara' ra&$+-$ %hra# ")r$a+ (a&a ()'&)r$%a !r  12 *+a' !)''##a' $'+%ra% *ar/(r-r)"$ #'"+$&a"$ #a;$%a"$ a%a )J"$ (+)ra &a' "a+ah "a% &$a'%ar #)a&aa' *)r$#% : 1?

Pr&#"$ &a' ")#r)"$ "a+ra' 'aa" !)'$'-#a%

2?

Bar %$!*+ "(%! (r+)'/%)ra&$ ()r*aha' "$a% "(%!

5?

I"+a"$ #!a' ("$%$ (a&a *$a#a' &arah

4?

I"+a"$ #!a' (a%-)' ("$%$ &ar$ a"($ra"$ %ra#)a *$("$

?

$r" &a(a% &$$"+a"$/%)r&a(a% a'%$-)' &a+a! ;$r" ")#r)"$ "a+ra' 'aa"

6?

 T$%)r I-M/I-G "()"$# !)'$'-#a% 4 +$(a% &a+a! &a ()!)r$#"aa' ?

1? 2? 5?

 T)r&a(a% %a'&a%a'&a (')!'$a (a&a ()!)r$#"aa' h$"%(a%+-$ *.

Fa#%ra#%r R)"$# I')#"$ P')!'$a I'"%r!)'%a"$ "$%)! "a+ra' 'aa" !$"a+',aa (a&a ()!a"a'-a' ($(a )'&%ra3h)a+%*) ;)'%$+a"$ !)#a'$# %ra#h)"%!$  T$'&a#a' ()ra"$ %)r%a!a ()ra"$ %hra# &a' a*&!)' K'&$"$ ,a'- !&ah !)',)*a*#a' a"($ra"$ !$"a+',a ()!a"a'-a' ($(a +a!*'- ()'r'a' #)"a&ara' &a' &$"a-$a

4?

U"$a %a

?

O*)"$%a"

6?

P)',a#$% *"%r#"$ (ar !)'ah'

?

R$wa,a% !)r## 12

8?

 T)" '-"$ (ar a*'r!a+

9?

I'%*a"$ &a+a! wa#% +a!a

10?

Ga'--a' '-"$ $!!'+-$

3.

M)#a'$"!) T)ra&$',a P')!'$a N"#!$a+  T$'&a#a' (a&a "a+ra' 'aa" ")()r%$ $'%*a"$ )'&%ra3h)a+ "3%$' &a' ;)'%$+a"$ !)#a'$# !)!()r!&ah !)!$'&ah#a' !$#rr-a'$"!) &ar$ a+a% =h!$&$)r ')*+$)r ;)'%$+a%r ,a'- %)r#'%a!$'a"$? #)(a&a (a"$)' &a' !)!$'&ah#a' !$#rr-a'$"!) (a&a %a'-a' ()%-a" #)")ha%a' &ar$ (a"$)' #) (a"$)' ,a'- +a$'. P')!'$a '"#!$a+ (a+$'- ")r$'- %)ra&$ #ar)'a a"($ra"$ #+'$ *a#%)r$ &ar$ rar$'- a%a "a+ra' 3)r'a *a-$a' a%a" (a"$)'. I'%*a"$ &a' ;)'%$+a"$ !)#a'$# !)'$'-#a%#a' r$"$# %)r*)"ar %)ra&$',a $')#"$.

&.

P)%'# P)'-)!*a'-a' Sr;)$+a'" P')!'$a

1?

S)!a a#%r r$"$# har" &$3a%a% &)'-a' +)'-#a( (a&a 3a%a%a' (a"$)' +)h &#%)r ()rawa% a%a a'--%a %$! #)")ha%a' +a$' ,a'- !)'a'-a'$ (a"$)'.

2?

P)+a#"a'a "r;)$+a'" ha" !'-h$%'- ra%) !)'r% a#%r r)"$# "()"$# !$'$!a+ )'$" ()ra"$ %ra# &a' a*&!)' &a' ;)'%$+a%r ")r%a !)+a(r#a'',a #)(a&a #!$%) ()'-)'&a+$a' $')#"$ r!ah "a#$% !$'$!a+ 6 *+a' ")#a+$ &a' ")#a+$-" !)',)*ar+a"#a'',a !)+a+$ *+)%$' R!ah Sa#

%$5?

P)+a#"a'a "r;)$+a'" !)!*a% +a(ra' ra%) (')!'$a #a"ar (a&a *+)%$' R!ah Sa#$% !$'$!a+ ")%$a( 5 *+a' ")#a+$.

).

P)'3)-aha' P')!'$a P)'3)-aha' (')!'$a '"#!$a+ &$+a##a' &)'-a' 3ara *)r$#%:

Pencegahan Pneumonia Pasca Bedah 1? a?

P)'-)++aa' (ra &a' (a"3a *)&ah &$%#a' (a&a: Pa"$)' ,a'- a#a' !)'&a(a% ()!*$"a' &a' !)'a+a'$ ()!*)&aha' %ra# &a' a*&!)'

*?

D$"'-"$ (ar *)ra%

3?

K)+a$'a' (ar(ar P)'-)++aa' (ara &a' (a"3a *)&ah !)+$(%$ ()'-*a%a' &a' $'"%r#"$ !)&$" &a' ()rawa%a'

2? a?

P)'-)++aa' (ra *)&ah !)+$(%$: P)'-*a%a' &a' r)"+"$ $')#"$ (ar

*? M)!()r!&ah ()'-)+ara' ")#r)% "a+ra' 'aa" =*r'#&$+a%r &ra$'a") ("%ra+ ()r#"$? 15

3? 5? a?

B)rh)'%$ !)r## I'"%r#"$ (ra *)&ah !)+$(%$ : D$"#"$ &)'-a' (a"$)' !)'-)'a$ ()'%$'-',a ")r$'- *a%# 'aa" &a+a! &a' !*$+$%a"$ (a"3a *)&ah

*? Pa"$)' !)!()ra-a#a' 3ara *a%# &a' 'aa" &a+a! (ra &a' (a"3a *)&ah 4?

P)'-*a%a' &a' $'"%r#"$ (a"3a *)&ah &$%#a' '%# !)'&r'- (a"$)' ")r$'- *a%# 'aa" &a+a! &a' a!*+a"$ $#a a&a #'%ra $'&$#a"$ ")3ara !)&$"

?

B$+a 3ara #'")r;a%$ &$a%a" -a-a+ '%# !)'-)+ar#a' ")#r)% "a+ra' 'aa" &a(a% &$#)ra#a' &ra$'a") ("%ra+ &a' ()r#"$

6?

N,)r$ a#$*a% *a%# &a' 'aa" &a+a! &a(a% &$a%a"$ &)'-a' a'a+-)%$# &a' !)'(a'- +#a &$ &a)rah ()r% =!$"a+',a &)'-a' !)+)%a##a' *a'%a+ #)3$+ &a' r$'-a' &$a%a" ()r%? ")r%a !)!*)r$ *a% ()'-ha!*a% ",ara +#a+

?

A'%$*$%$# "$"%)!$# %$&a# &$a'r#a' '%# &$(a#a$ r%$'

Kebersihan Tangan K)*)r"$ha' %a'-a' &$+a##a' ")%$a( #a+$ #'%a# &)'-a' ")#r)% "a+ra' 'aa" *a$# &)'-a' a%a %a'(a "ar'- %a'-a'. K)*)r"$ha' %a'-a' -a &$+a##a' ")*)+! &a' ")"&ah #'%a# &)'-a' (a"$)' ,a'- !)'&a(a% $'%*a"$ &a' %ra#)"%!$

airan dan !bat  1?

N)*+a"$ &a' h!$&$#a"$ ha',a *+)h !)'--'a#a' 3a$ra' "%)r$+ ,a'&$*)r$#a' ")3ara a")(%$#. >a$ra' %)r")*% %$&a# *+)h &$-'a#a' (a&a a+a% ,a'%)r#'%a!$'a"$

2?

B$+a Ca#' !+%$&") &$-'a#a' '%# %)ra($ har" &$"$!(a' &a+a! +)!ar$ )" a%a "h #a!ar ")"a$ a%ra' (a#a$ &a' %$&a# !)+)wa%$ %a'--a+ #a&a+ar"a

Pemeliharaan Alat Terapi Perna"asan #ang $edang %ipakai  1?

P)'a!('- 3a$ra' har" &$$"$ ")-)ra ")*)+! &$(a#a$. B$+a 3a$ra' h)'&a# &$%a!*ah !a#a "$"a 3a$ra' har" &$*a'- %)r+)*$h &ah+. A$r ,a'- %)+ah !)'-)!*' &a+a! ($(a har" &$*a'- &a' %$&a# *+)h &$a+$r#a' *a+$# #) &a+a! ()'a!('-

2?

A+a% ')*+a"$ &$'&$'- &a' ()'a!('-a'',a har" &$-a'%$ ")3ara r%$' ")%$a( 24 a! &)'-a' ,a'- "%)r$+ a%a "&ah &$&)"$')#"$

5?

A+a% ()'a!('- ()+)!*a* &ara #"$-)' &$'&$'- ,a'- &a(a% &$(a#a$ +a'har" &$*)r"$h#a' &$33$ &a' &$#)r$'-#a' ")%$a( har$

14

4?

S)%$a( ($(a &a' !a"#)r ,a'- &$-'a#a' '%# %)ra($ #"$-)' har" &$-a'%$ (a&a ")%$a( (a"$)'

?

S$r#$% a+a% *a'% 'aa" =%)r!a"# ($(a &a' #a%* $'ha+a"$? har" ")3ara r%$' &$-a'%$ &)'-a' ,a'- "%)r$+/"&ah &$&)"$')#"$ ")%$a( 24 a!

6?

B$+a !)"$' r)"($ra%r &$-'a#a' '%# *)*)ra(a (a"$)' !a#a ")%$a( ()r-a'%$a' (a"$)' ")!a "$r#$% a+a% *a'% 'aa" har" &$-a'%$ &)'-a' ,a'"%)r$+/"&ah &$&)"$')#"$

Peralatan $ekali Pakai  A+a% %)ra($ ()r'aa"a' ,a'- &$ra'3a'- '%# ")#a+$ (a#a$ %$&a# *+)h &$(a#a$ +a'-.

Penanganan Peralatan #ang %ipakai Ulang 1?

S)%$a( ()ra+a%a' ,a'- a#a' &$"%)r$+#a'/&$&)"$')#"$ har" &$*)r"$h#a' &)'-a' ")#"a!a '%# !)'-h$+a'-#a' &arah ar$'-a' !a#a'a' a%a r)"$& +a$'',a. P)ra+a%a' har" &$&)#'%a!$'a"$ ")*)+!/")+a!a (r")" ()!*)r"$ha' *$+a a+a% %)r")*% &$%a'&a$ %)r#'%a!$'a"$ &a' *)ra"a+ &ar$ (a"$)' &)'-a' )'$" $"+a"$ %)r%)'%

2?

A+a% %)ra($ ()r'aa"a' ,a'- !)',)'%h ")+a(% +)'&$r har" &$"%)r$+#a' ")*)+! &$(a#a$ (a&a (a"$)' +a$' $#a ha+ $'$ %$&a# !)!'-#$'#a' a+a% %)r")*% &$&)"$')#"$ #a% =h$-h +);)+ &)"$')3%$'?

5?

S$r#$% a+a% *a'% 'aa" =%)r!a"# ($(a &a' #a%* )#"ha+a"$? &a' ")!a a+a% ,a'- *)rh*'-a' &)'-a' %)ra($ ()r'aa"a' har" &$"%)r$+#a' #a%

4?

Ra'- ()'&$'-$' (a&a a+a% ')*+a"$ +%ra"'$# "+$% &$&)"$')#"$ ")3ara a&)#a% #ar)'a $% har" &$"%)r$+#a' &)'-a' -a" =)%$+$' #"$&a? a%a &)"$')#"$ #a% (a+$'- ")&$#$% ")+a!a 50 !)'

%$?

Ba-$a' &a+a! !)"$' ;)'%$+a%r &a' !)"$' ()r'aa"a' %$&a# ()r+ &$"%)r$+#a'/&$&)"$')#"$ ")3ara r%$' '%# ")%$a( ()!a#a$a' #)3a+$ ")%$a( a+a% %)r")*% (%)'"$a+ %)r#'%a!$'a"$ &)'-a' !$#rr-a'$"!) *)r*aha,a

6?

R)"($r!)%)r &a' a+a% +a$' ,a'- &$-'a#a' '%# !)!a'%a *)*)ra(a (a"$)' ")3ara *)r-a'%$a' %$&a# *+)h +a'-"'- !)',)'%h *a-$a' "$r#$% a+a% *a'%'aa" #)&a a+a% %)r")*% ()r+ ()'-h*'- &a' a+a% ()'-h*'- $'$ har" &$-a'%$ (a&a ")%$a( ()!a#a$a' (a&a (a"$)' +a$'. <$#a %$&a# !)'--'a#a' ()'-h*'- &a' a+a% ()!a'%a +a'-"'- *)rh*'-a' &)'-a' a+a% ,a'%)r#'%a!$'a"$ !a#a a+a% ()!a'%a %)r")*% har" &$"%)r$+#a'/&$&)"$')#"$ #a% ")*)+! &$(a#a$ (a"$)' +a$'

?

Ka'%'- a+a% r)""$%a"$ !a'a+ har" &$"%)r$+#a' /&$&)"$')#"$ #a% ha*$" &$(a#a$

1

Pemantauan &ikroorganisme 1?  <$#a %$&a# a&a K)a&$a' ar B$a"a =KB? / ra%) )'&)!$# $')#"$ (ar '"#!$a+ %$&a# %$'--$ !a#a (r")" &)"$')#"$ a+a% %)ra($ ()r'aa"a' %$&a# ()r+ &$(a'%a &)'-a' *$a#a' "a!()+ &ar$ a+a% %)r")*%. D)'-a' #a%a +a$' "a!()+ r%$' %$&a# ()r+ &$+a##a' 2?

I'%)r(r)%a"$ ha"$+ ()!)r$#"aa' !$#r*$+-$ "+$% &$+a##a' #aar)'a $% "a!()+ !$#r*$+-$# r%$' a+a% *a'% 'aa" ,a'- ")&a'- &$(a#a$ (a"$)' %$&a# &$a'r#a'

Pasien %engan Trakeostomi  1?  T$'&a#a' %ra#)"%!$ har" &$+a##a' &$ #a!r ()ra"$ ")3ara a")(%$# #)3a+$ &a+a! #)a&aa' &arra% &a(a% &$+a##a' &$ ra'- ()rawa%a' 2?

K)3a+$ +#a %ra#)"%!$ "&ah !+a$ ")!*h/!)!*)'%# ar$'-a' -ra'+a"$ ")#$%ar ($(a !a#a %$&a# *+)h &$")'%h &)'-a' %a'-a' +a'-"'- a%a ")%$a( !a'$(+a"$ #)&a %a'-a' !)'--'a#a' "ar'- %a'-a' "%)r$+

5?

B$+a &$()r+#a' ()'--a'%$a' ($(a %ra#)"%!$ !a#a ($(a ()'--a'%$ har" "%)r$+ a%a &$ &)"$')#"$ #a%

4?

S)wa#% !)'--a'%$ ($(a har" &$-'a#a' %)#'$# a")(%$# %)r!a"# ()'--'aa' "ar'- %a'-a' &a' ()'%( =&#? "%)r$+

Pengisapan $ekret $aluran 'a"as 1?

P)'-$"a(a' ")#r)% "a+ra' ()r'aa"a' &$+a##a' ha',a *$+a &$()r+#a' #ar)'a ()'-$"a(a' ,a'- %)r"!)')r" a#a' !)'$'-#a%#a' r$"$# #'%a!$'a"$ "$+a'&a' %ra!a

2?

P)'-$"a(a' ")#r)% "a+ra' 'aa" %$&a# *+)h &$+a##a' &)'-a' %a'-a' +a'-"'- !)+a$'#a' !)'--'a#a' "ar'- %a'-a' "%)r$+

5?

S)%$a( #a+$ !)'-$"a( ")#r)% "a+ra' 'aa" -'a#a' #a%)%)r ,a'- "%)r$+ a%a #a+a ()!a#a$a' ha',a &a+a! wa#% "$'-#a% !a#a #a%)%)r &a(a% &$(a#a$ +a'")%)+ah &$*$+a" &a' &$*)r"$h#a'

4?

B$+a %)r&a(a% ")#r)% ,a'- #)'%a+ &a' #a%)%)r ()'-h$"a( !)!)r+#a' *$+a"a' !a#a '%# !)!*$+a" -'a#a' 3a$ra' "%)r$+ P)'--'aa' ($(a &a' %a*'- ()'-$"a( a&a+ah "** :

1?

P)!a#a$a' ($(a ()'-$"a( "a!(a$ *a%a" %a*'- har" &$-a'%$ '%# ")%$a( (a"$)'

2?  Ta*'- ()'-$"a( ,a'- &$-'a#a' '%# "a% (a"$)' %$&a# ()r+ &$-a'%$/&$#"'-#a' ")3ara r%$' 5?  Ta*'- ()'-$"a( har" &$-a'%$ ")%$a( (a"$)' #)3a+$ (a&a '$% ()rawa%a'  a'-#a ()'&)# =%$&a#  24 a!? 4?

Pa&a '$% ()rawa%a' a'-#a ()'&)# %a*'- ()r+ &$-a'%$ ")%$a( har$ %)%a($ %$&a# ()r+ &$-a'%$ '%# ")%$a( (a"$)' 16

? 6?

S)%$a( #a+$ %a*'- ()'-$"a( &$-a'%$ har" &$"%)r$+#a'/&$&)"$')#"$ #a% U'%# ()'-$"a( ")#r)% "a+ra' 'aa" (r%a*)+ ,a'- #)!'-#$'a' !)'-$"a( a)r"+ %)r#'%a!$'a"$ !a#a -'a#a' +%)r *a#%)r$ ,a'- *a$# a'%ara %a*'()'a!('- &a' ($(a ()'-$"a(

Perlindungan Pasien dari Pasien (ain dan Personil  1?

a##a' $"+a"$ (a&a (a"$)' ,a'- !'-#$' !)',)*ar#a' $')#"$ "a+ra' 'aa" $"+a"$ ")"a$ &)'-a' %)#'$# !%a#h$r

2?

P)r"'$+ ,a'- %)r#)'a $')#"$ "a+ra' 'aa" %$&a# *+)h !)!*)r$ a"ha' +a'-"'- (a&a (a"$)' &)'-a' r$"$# %$'--$ =!$"a+ ')'a%a+ *a,$ (a"$)' &)'-a' *"%r#"$ (ar #r'$" &a' (a"$)' &)'-a' &a,a %aha' %*h !)'r'

5?

B$+a &$()r#$ra#a' a&a KB $'C)'a +a##a' ()'3)-aha' '%# ")!a (a"$)' &a' ()%-a" ,a'- !)!*)r$ a"ha' +a'-"'- &)'-a' !)'--'a#a' %)#'$" $"+a"$ ()r'aa"a'

,. a.

Infeksi Sal#ran Kei &ISK' Ba%a"a' I')#"$ Sa+ra' K)!$h K+a"$#a"$ ISK !)+$(%$ :

1?

I')#"$ Sa+ra' K)!$h S$!(%!a%$"

2?

I')#"$ Sa+ra' K)!$h A"$!(%!a%$"

5?

I')#"$ Sa+ra' K)!$h +a$'',a

)$K $imptomatis har" !)!)'h$ (a+$'- ")&$#$% "a% #r$%)r$a "** : 1?

D)!a! =58>?

2?

N$#r$a =a',a'-a',a'-a'?

5?

P+a#$"r$a

4?

D$"r$

?

N,)r$ "(ra (*$#

6?

Ha"$+ *$a#a' r$' a+$ra' %)'-ah =!$&"%r)a!?  10⁵cfu kuman/ml dengan jumlah kuman tidak lebih dari 2 species

?

K!a' ("$%$ &ar$ r$' ('-"$ "(ra (*$# %a'(a !)+$ha% !+ah #!a'

Pa&a (a"$)' L 1 %h &$&a(a% (a+$'- ")&$#$% "a% -)a+a "** %a'(a a&a ()',)*a* +a$'',a : 1?

D)!a! =58>?

2?

H$(%)r!$ =5>?

5?

Bra&$#ar&$  100/!'%

4?

)%ar-$

?

!$%$'-

1

Da' &$%)!#a' "a+ah "a% &ar$ ha"$+ &$ *awah $'$ : 1?

Ha"$+ r$' #+%r 10⁵cfu kuman/ml dengan jumlah kuman tidak lebih dari 2 spesies

2?

K+%r r$' 2 *)r%r%%r% %)r&a(a% #!a' Cra 'r!a+ ,a'- "a!a !$". S. "a(r(h,%$3" S.)($&)r!$&$" &)'-a' !+ah #!a'  10⁵cfu kuman/ml

)$K Asimptomatis (a+$'- ")&$#$% 1 #r$%)r$a : 1?

R$wa,a% !)'--'a#a' r$' #a%)%)r   har$ ,a'- +a+

2?  T)r&a(a% !a#"$!a+ 2 "()3$)" )'$" #!a' &a+a! *$a#a' r$' 5?  T$&a# %)r&a(a% -)a+a-)a+a Da' "a+ah "a% &ar$ ha"$+ &$ *awah $'$ : 1? 2?

Ha"$+ r$' #+%r 10⁵cfu kuman/ml dengan jumlah kuman tidak lebih dari 2 species K+%r r$' 2 *)r%r%%r% %)r&a(a% #!a' Cra 'r!a+ ,a'- "a!a !$". S. "a(r(h,%$3" S.)($&)r!$&$" &)'-a' !+ah #!a'  10⁵cfu kuman/ml

)$K (ainn#a har" !)!)'h$ "a+ah "a% #r$%)r$a : 1?

D$%)!#a' #!a' ,a'- %!*h &ar$ 3a$ra'

2?

A&a a*")" a%a %a'&a $')#"$ +a$' ,a'- &a(a% &$+$ha% ()!)r$#"aa' +a'-"'")+a!a ()!*)&aha' a%a h$"%(a%+-$

5?

A&a 2 %a'&a *)r$#% : &)!a! =58 >? ',)r$ +#a+ ',)r$ %)#a' (a&a &a)rah ,a'- &$3r$-a$ $')#"$

*.

Fa#%r R)"$# I')#"$ Sa+ra' K)!$h

1?

K)%)%)r$"a"$ !)')%a( :

5?

>ara ()!a"a'-a' #a%)%)r

4?

a!a ()!a"a'-a'

?

Ka+$%a" ()rawa%a' #a%)%)r

6?

S%a%" $!!'+-$ (a"$)' : Pa"$)' %a D)*$+$%a" (a"3a ()r"a+$'a'

3.

P)'3)-aha' I')#"$ Sa+ra' K)!$h U'%# !)'3)-ah %)ra&$',a $')#"$ "a+ra' #)!$h '"#!$a+ ()r+ &$()rha%$#a' *)*)ra(a ha+ ,a'- *)r#a$%a' &)'-a' ()!a"a'-a' 3a%%)r r$'.

Tenaga Pelaksana 1?

P)!a"a'-a' #a%%)r ha',a &$+a##a' +)h %)'a-a ,a'- *)%+*)%+ !)!aha!$ &a' %)ra!($+ &a+a! %)#'$# ()!a"a'-a' #a%%)r ")3ara a")(%$# &a' ()rawa%a' #a%%)r ,a'- *)'ar

2?

 T)'a-a ,a'- !)!*)r$#a' a"ha' #)()rawa%a' (a&a (a"$)' &)'-a' 3a%%)r r$' "&ah !)'&a(a%#a' ()+a%$ha' ")3ara *)r#a+a &)'-a' %)#'$# 18

,a'- *)'ar !)'-)'a$ (r")&r ()!a"a'-a' 3a%%)r r$' &a' ()'-)%aha' %)'%a'- #!(+$#a"$ (%)'3$a+ ,a'- %$!*a+

Pemasangan Kat*ter  1?

P)!a"a'-a' #a%%)r r$' &$+a##a' ha',a *$+a ()r+ "aa &a' ")-)ra &$+)!a" *$+a %$&a# &$()r+#a' +a-$. A+a"a' ()!a"a'-a' 3a%%)r *#a' #ar)'a '%# !)!()r!&ah %)'a-a ()+a#"a'a &a+a! !)!*)r$#a' a"ha' (a&a (a"$)'

2?

>ara "a$'a") r$' ,a'- +a$' ")()r%$ 3a%%)r #'&! #a%%)r "(ra (*$" #a%)%)r$"a"$ ")+a'-")+$'- =$'%)r!$%%)'? &a(a% &$-'a#a' ")*a-a$ -a'%$ #a%)%)r$"a"$ !)')%a( *$+a !)!'-#$'#a'

5?

>3$ %a'-a' : ")*)+! &a' ")"&ah ()!a"a'-a' #a%%)r

Teknik Pemasangan at*ter  1?

P)!a"a'-a' #a%%)r har" !)'--'a#a' %)#'$# a")(%$# &a' ()ra+a%a' "%)r$+

2?

G'a#a' #a%)%)r ")#)3$+ !'-#$' &)'-a' +a &ra$'a") ,a'- #'"$"%)' '%# !)!$'$!a+#a' %ra!a r)%ra

5?

Ka%)%)r !)')%a( har" %)r(a"a'- &)'-a' *a$# &a' !)')!()+ (a&a *a&a' '%# ! )'3)-ah ()r-)ra#a' &a' %)-a'-a' (a&a r)%ra

%rainase $istem Tertutup dan $teril  1? 2?

S$"%)! &ra$'a") ,a'- %)r%%( &a' "%)r$+ har" &$()r%aha'#a' Ka%)%)r &a' ")+a'-/%*) &ra$'a") %$&a# *+)h &$+)(a" "a!*'-a'', #)3a+$ *$+a #a%)%)r a#a' &$+a##a' $r$-a"$

5?

4?

B$+a %)ra&$ #)"a+aha' (a&a %)#'$# a")(%$# "a!*'-a' %)r+)(a" a%a *3r !a#a "$"%)! ()'a!('-a' har" &$-a'%$ &)'-a' %)#'$# a")(%$# ,a'- *)'ar &a' ")*)+!',a #a%)%)r har" &$&)"$')#"$  T$&a# a&a #'%a# a'%ara r$' *a- &)'-a' +a'%a$

ara )rigasi Kateter  1?

Ir$-a"$ ha',a &$#)ra#a' a(a*$+a &$()r#$ra#a' a&a "!*a%a' a+$ra' !$"a+',a #ar)'a *)#a' &arah (a&a ()ra"$ (r"%a%/#a'&'- #)!$h. U'%# !)'3)-ah ha+ $'$ &$-'a#a' $r$-a"$ #'%$', ")3ara %)r%%( '%# !)'-h$+a'-#a' "!*a%a' a#$*a% *)#a' &arah

2?

Sa!*'-a' #a%)%)r har" &$&)"$')#"$ ")*)+! &$+)(a"

5?

G'a#a' ")!(r$% *)"ar "%)r$+ '%# $r$-a"$ &a' ")%)+ah $r$-a"$

4?

 <$#a #a%)%)r ")r$'- %)r"!*a% &a' har" ")r$'- &$$r$-a"$ !a#a #a%)%)r har" &$-a'%$

19

(a+u Aliran Urin 1?

a a+$ra' r$' ,a'- %$&a# %)rha!*a% har" &$()r%aha'#a'

2?

U'%# !)!()r+)h a+$ra' +a'3ar :

a? *?

 
3?

Ka%)%)r ,a'- #ra'- +a'3ar/%)r"!*a% har" &$$r$-a"$/#a+a ()r+ &$-a'%$

&?

Ka'%'- ()'a!('- &$+)%a##a' +)*$h r)'&ah &ar$ #a'%'- #)!$h/*+a&&)r

Pengambilan $pecimen Urin

1?

Baha' ()!)r$#"aa' r$' &a+a! !+ah #)3$+ &a(a% &$a!*$+ &ar$ *a-$a' &$"%a+ #a%)%)r a%a $#a +)*$h *a$# &ar$ %)!a(% ()'-a!*$+a' *aha' ,a'- %)r")&$a &a' ")*)+! r$' &$a"($ra"$ &)'-a' ar! &a' ")!(r$% ,a'- "%)r$+ %)!(a% ()'-a!*$+a' *aha' har" &$&)"$')#"$

2?

B$+a &$()r+#a' *aha' &a+a! !+ah *)"ar !a#a r$' har" &$a!*$+ &ar$ #a'%'- ()'a!('- ")3ara a")(%$#

Perawatan &eatus B)r"$h#a' &a #a+$ ")har$ &)'-a' a'%$")(%$# &a' ")%$a( har$ *)r"$h#a' &)'-a' "a*' &a' a$r.

Penggantian Kateter  Ka%)%)r r$' !)')%a( har" &$-a'%$ &a+a! #r' wa#%  har$ =1 !$'--? .

Infeksi Aliran Dara Prier &IADP'

a.

Ba%a"a' I')#"$ A+$ra' Darah Pr$!)r I')#"$ a+$ra' &arah (r$!)r a&a+h $')#"$ a+$ra' &arah ,a'- %$!*+ %a'(a a&a r-a' a%a ar$'-a' +a$' ,a'- &$3r$-a$ ")*a-a$ "!*)r $')#"$. Kr$%)r$a $')#"$ a+$ra' &arah (r$!)r &a(a% &$%)%a(#a' ")3ara #+$'$" &a' +a*ra%r$" &)'-a' -)a+a/%a'&a *)r$#%:

U'%# &)wa"a &a' a'a#  12 *+a' &$%)!#a' "a+ah "a% &$a'%ara -)a+a *)r$#% %a'(a ()',)*a* +a$' : 1?

D)!a! "h  58>

2?

H$(%)'"$

5?

 T$&a# a&a %a'&a%a'&a $')#"$ &$ %)!(a% +a$'

20

U'%# *a,$ !r  1 %ah' &$%)!#a' "a+ah "a% -)a+a/%a'&a *)r$#% %a'(a ()',)*a* +a$' :

1?

D)!a! "h  58>

2?

H$(%)r!$

5?

A(')a

4?

Bra&$#ar&$  100 /!'%

? *. 1?

 T$&a# a&a %a'&a%a'&a $')#"$ &$ %)!(a% +a$' Fa#%r R)"$# I')#"$ A+$ra' Darah Pr$!)r P)!a"a'-a' #a%)%)r $'%ra;)'a =$.;? ,a'- *)r#a$%a' &)'-a' :

a?  <)'$" #a'+a *?  T)#'$# ()!a"a'-a' 3? 2? 3.

a!a ()!a"a'-a' #a'+a K)r)'%a'a' (a"$)' %)rha&a( $')#"$ P)%'# P)'-)!*a'-a' Sr;)$+a'" I')#"$ A+$ra' Darah Pr$!)r

1?

S)!a a#%r r$"$# har" &$3a%a% &)'-a' +)'-#a( (a&a 3a%a%a' (a"$)' +)h &#%)r ()rawa% a%a a'--%a %$! #)")ha%a' +a$' ,a'- !)'a'-a'$ (a"$)'

2?

P)+a#"a'a "r;)$+a'" !)'-h$%'- ra%) !)'r% a#%r r$"$# "()"$# =#a%)%)r $'%ra;)'a? !$' ")%$a( 6 *+a' ")#a+$ &a' !)+a(r#a'',a (a&a %$! ()'3)-aha' &a' ()'-)'&a+$a' $')#"$ r!ah "a#$% &a' -a !)',)*ar+a"#a'',a !)+a+$ *+)%$' r!ah "a#

%$5?

P)+a#"a'a "r;)$+a'" !)!*a% +a(ra' ra%) $')#"$ a+$ra' &arah (r$!)r #a"ar (a&a *+)%$' r!ah "a#$% !$' ")%$a( 5 *+a' ")#a+$

&.

P)'3)-aha' I')#"$ A+$ra' Darah Pr$!)r P)'3)-aha' IADP %)r%a!a &$%#a' (a&a ()!a"a'-a' &a' ()rawa%a' I.

1?

P)'&$&$#a' &a' P)+a%$ha' P)%-a" M)&$" a#"a'a#a' ()'&$&$#a' &a' ()+a%$ha' *)r#)+a'%a' *a-$ ()%-a" !)&$" ,a'!a%)r$',a !)',a'-#% $'&$#a"$ ()!a#a$a' a+a% $'%ra;a"#+)r (r")&r ()!a"a'-a' #a%)%)r ()!)+$haraa' ()ra+a%a' $'%ra;a"#+)r &a' ()'3)-aha'

2?

Sr;)$+a'" A#%$ IADP

a#"a'a#a' "r;)$+a'" '%# !)'-)%ah$ a&a',a #)a&$a' $')#"$. 5? 4? 5?

I'&$#a"$ ()!a"a'-a' I. ha',a &$+a##a' '%# %$'&a#a' ()'-*a%a' &a' a%a #)()'%$'-a' &$a-'"%$# P)!$+$ha' #a'+a '%# $'" ()r$)r : P$+$h a+a% ,a'- r)"$# #!(+$#a"$',a r)+a%$ r)'&ah &a' har-a',a (a+$'- !rah &a' &a(a% &$-'a#a' '%# %)ra($ $'%ra;)'a &)'-a' )'$" &a'

21

 a'-#a wa#% ,a'- ")"a$ "aa% $'$ *aha' ;$a+' +)*$h *a$# &$*a'&$'-#a' %)C' 4?

)(a" ")!a )'$" ()ra+a%a' $'%ra;a"#+)r *$+a "&ah %$&a# a&a $'&$#a"$ #+$'$"

?

P)r$#"a ")3ara ;$"a+ +#a"$ ()!a"a'-a' #a%)%)r '%# !)'-)%ah$ a(a#ah a&a ()!*)'-#a#a' &)!a! %a'(a a&a',a ()',)*a* ,a'- )+a" a%a -)a+a $')#"$ +#a+/$')#"$ *a#%)r$!$a

6?

Pa&a (a"$)' ,a'- !)!a#a$ ()r*a' %)*a+ ")h$'--a ""ah &$ra*a/&$+$ha% +)(a" ()r*a' %)r+)*$h &ah+ ()r$#"a ")3ara ;$"a+ ")%$a( har$ &a' (a"a'- ()r*a' *ar

?

>a%a% %a'--a+ &a' wa#% ()!a"a'-a' #a%)%)r &$ +#a"$ ,a'- &a(a% &$+$ha% &)'-a' )+a"

).

K)*)r"$ha' Ta'-a'

1?

K)*)r"$ha' %a'-a' &$+a##a' ")*)+! &a' ")"&ah (a+(a"$ ()!a"a'-a' a+a% $'%ra;a"#+)r ()'--a'%$a' a+a% $'%ra;a"#+)r a%a !)!a"a'- ()r*a'

2?

U'%# ()!a"a'-a' ;)'a 3)'%ra+ !)+a+$ $'"$"$ (r$'"$( a")(%$#',a har" &$-'a#a'

.

I'%ra;)'a Ka%)%)r Peasangan Kateter : a'-a' !)',$'-#a% (r")&r ()!a"a'-a' #a%)%)r,a'"&ah &$%)'%#a' Pera/atan L#ka Kateter : *)r"$h#a' #+$% &$ +#a"$ &)'-a' a'%$")(%$# ,a'- ")"a$ ")*)+! ()!a"a'-a' #a%)%)r *$ar#a' a'%$")(%$# !)'-)r$'- (a&a

+#a"$ ")*)+! !)!a"a'- a'-a' !)+a##a' (a+(a"$ (a&a +#a"$ ")%)+ah #+$% &$*)r"$h#a' &)'-a' a'%$")(%$# =+#a"$ &$a'--a( &a)rah "%)r$+? -'a#a' #a"a "%)r$+ a%a ()r*a' %ra'"(ara' '%# !)'%( +#a"$ ()!a"a'-a' *$+a &$(a#a$ $&$') %$'3%r) '%# !)!*)r"$h#a' #+$% ")*)+! ()!a"a'-a' #a%)%)r !a#a har" &$*$+a" &)'-a' a+#h+ -a'%$ ()r*a' *$+a %a!(a# #%r &a' *a"ah h$'&ar$ ")'%ha' ,a'- !)'-#'%a!$'a"$ +#a"$ #a%)%)r "aa% !)'--a'%$ ()r*a'

-. 1?

2? 5?

P)'--a'%$ P)r+)'-#a(a' &a' >a$ra' I'%ra;)'a S)% P)r+)'-#a(a' S)3ara !! ")% ()r+)'-#a(a' $'%ra;a"#+)r %)r&$r$ a%a" ")+rh *a-$a' !+a$ &ar$ '- ")+a'- ,a'- !a"# #) #'%a$')r 3a$ra' $'" "a!(a$ #) h*'-a' a+a% Ga'%$ ")+a'- ()'-h*'- %)r")*% *$+a a+a% ;a"#+)r &$-a'%$ Ga'%$ ")+a'- I %)r!a"# ")+a'- ($--,*a- &a' "%(33# &)'-a' $'%)r;a+ ,a'%$&a# #ra'- &ar$ 2
4?

Ga'%$ ")+a'- ,a'- &$(a#a$ '%# !)!a"##a' &arah #!(')' &arah a%a )!+"$ +)!a# &a+a! 24 a! &ar$ &$awa+$',a $'"

?

 <$#a &ar$ %)!(a% %"#a' #)+ar (" *)'-#a# #)!)raha' (a&a %)!(a% I/ &$&-a *a#%)r$!$a ,a'- *)ra"a+ &ar$ #a'+a !a#a ")!a "$"%)! har" &$3a*%

25

BAB I+ PENUTUP

Pa'&a' P)'r'a' HAI" PPI RS !)r(a#a' ()%'#()%'# %)#'$" *a-$ ")!a ($ha# ,a'- *)r#)()'%$'-a' &a' (##(## ()!$#$ra' &a"ar *)r*a-a$ (a,a ()'3)-aha' &a' ()'-)'&a+$a' %)ra&$',a $')#"$ '"#!$a+ &$ r!ah "a#$% #h""',a RSI

Pa&a ha#)#a%',a (a,a ()'3)-aha' &a' ()'-)'&a+$a' $')#"$ &$ r!ah "a#$% *ar a#a' %)r")+)'--ara *$+a ")!a &$r)#"$ &a' "%a r!ah "a#$% ,a'- %)r#a

%$ !)!(',a$ !%$;a"$ &a' $%$#a& ()'-)!*a'-a' ")r%a ()'h #)"a&ara' &a' %a'--'- awa*.

B# Pa'&a' P)'r'a' HAI" PPI RS $'$ &$hara(#a' *)r!a'aa% &a' &a(a% &$-'a#a' '%# !)'$'-#a%#a' !% ()+a,a'a' ")3ara *)r&a,a-'a &a' *)rha"$+ -'a. 24

DA0TAR PUSTAKA

1.

P)&!a' P)'3)-aha' &a' P)'-)'&a+$a' I')#"$ &$ R!ah Sa#$% &a' Fa"$+$%a" P)+a,a'a' K)")ha%a' a$'',a K)"$a(a' !)'-ha&a($ E!)r-$'- I')3%$" D$")a") D)(#)" RI #)ra"a!a &)'-a' PERDAIN 2008

2.

P)&!a' Ma'a)r$a+ P)'3)-aha' &a' P)'-)'&a+$a' I')#"$ &$ R!ah Sa#$% &a' Fa"$+$%a" P)+a,a'a' K)")ha%a' +a$'',a D)( K)" RI *)#)ra"a!a &)'-a' PERDAIN 2008

5.

P)%'# Pra#%$" Sr;)$+a'" I')#"$ R!ah Sa#$% D)( K)" RI 2010