PEMERINTAH KOTA MATARAM RUMAH SAKIT UMUM DAERAH KOTA MATARAM Jalan Bung Karno No. 3 Pagutan. Telp. (030! "#0# $ Matara%
KEPUTUSAN DIREKTUR RUMAH SAKIT UMUM DAERAH NOMOR TENTANG PANDUAN PELAY PEL AYANAN ANAN PONEK PONE K DI RUMAH SAKIT UMUM DAERAH KOTA MATARAM DIREKTUR RUMAH SAKIT UMUM DAERAH KOTA MATARAM
Meni Menimb mban ang g
: 1. Bahwa Bahwa pelak pelaksa sana naan an Pelay Pelayan anan an PONE PONEK K di Rumah Rumah Sakit Sakit Umum Umum ae!a ae!ah h K"ta Mata!am menga#u pada ped"man sebagai diatu! dalam SK i!ektu! n"m"! .............................. $. Bahwa aga! ped"man PONEK dapat dilaksanakan se#a!a "pe!asi"nal di lapan lapanga gan n pe!lu pe!lu disu disusu sun n pandu panduan an yang yang lebi lebih h be!s be!si% i%at at tekni teknis& s& yang yang pembe!lakuannya pe!lu ditetapkan melalui SK i!ektu!
Menging Mengingat at
: 1. 'ngga 'ngga!an !an asa asa!! dan 'ngga! 'ngga!an an Rumah Rumah (an (angga gga Ruma Rumah h Sakit Sakit Umum Umum ae!a ae!ah h K"ta Mata!am $. Undang)Undang N". *+ (ahun (ahun $,,- tentang Kesehatan. *. Undang)undang N". (ahun (ahun $,,- tentang Rumah Sakit. . SK Menekes Menekes R/ N"m"! N"m"! $0,Me $0,Menke nkesS sSK/ K/// //$,,0 $,,0 tentan tentang g Ped"m Ped"man an Mana2e!ial Pen#egahan dan Pengendalian /n%eksi di RS dan 3asilitas Pelayanan Kesehatan 4ainnya 5. SK SK Menkes Menkes R/ R/ N". *+1--* *+1--* tentang tentang 6Be!lakunya 6Be!lakunya Standa! Standa! Rumah Rumah Sakit Sakit dan Standa! Pelayanan Medis di /nd"nesia7. +. SK i!ektu! N". ......................... tentang tentang Ped"man Pelayanan PONEK di RSU K"ta Mata!am 0. SK i!ektu! N" ............................. tentang tentang Kebi2akan Pelayanan PONEK di RSU K"ta Mata!am
Menetapkan
Pe!tama . Kedua
MEMUTUSKAN : P'NU'N P'NU'N PE4'8'N' PE4'8'N'N N OBS(E(R/ NEON'(US NEON'(US EMER9EN8 KOMPRE;ENS/3 / RUM'; S'K/( UMUM 'ER'; KO(' M'('R'M
: Membe!lakukan panduan PONEK yang di disusun "leh (im M9
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Ketiga
Keemp Keempat at
: Keputusan ini be!laku untuk 2angka waktu * >tiga? tahun se2ak tanggal dite diteta tapka pkan n denga dengan n kete ketent ntua uan n akan akan dila dilaku kukan kan peny penyem empu! pu!na naan an dan dan atau atau e@aluasi seku!ang)ku!angnya sekali dalam masa be!lakunya. : Bila Bila dik dikem emudi udian an ha! ha!ii te!d te!dapa apatt keke kekeli li!u !uan an dal dalam am pen penet etap apan an ini ini&& akan akan dit ditin in2a 2au u kembali sesuai dengan Pe!undangan Kesehatan yang ada dan kemampuan Rumah Sakit Umum ae!ah K"ta Mata!am.
ite iteta tapka pkan n di : Mata Mata!am !am Pada Pada tangg anggal al : ... ..... ....
/REK(UR& RUM'; S'K/( UMUM KO(' KO (' M'('R' M'('R'M M
Dr. H. L. HERMAN HERMA N MAHAPUTRA, MAHAP UTRA, M.Kes . NIP. 196811102001121003
(embusan 1; (im PONEK 2; Ka Unit (e!kait
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DI RUMAH SAKIT UMUM DAERAH KOTA MATARAM
DISUSUN OLEH & TIM MDG's RSUD KOTA MATARAM TAHUN 201(
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DA!TAR ISI
;alaman Audul a%ta! isi I; II; III; IV; IV;
E3/N/S/ RU'N9 4/N9KUP ('(' 4'KS'N' OKUMEN('S/
'3('R PUS('K'
1 $ * 1,
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A.
DEFINISI
Ponek adalah pelayanan obstetri neonatal esensial / emergensi komperhensif. T!an tama mamp menyelamatkan ib dan anak bar lahir meleli program r!kan beren"ana dalam sat #ilayah kabpaten kotamadya ata pro$nsi. %.
&IN'()P PE&A*ANAN PE&A*ANAN +),A- SA(IT PNE( 2 0A,
)paya Pelayanan PNE( 1 . Stabilisasi di )'D dan persiapan ntk pengobatan de$nitif 2. Penanganan kass ga#at darrat oleh tim PNE( +S di rang tindakan 3. Penanganan operatif "epat dan tepat melipti laparotomi4 dan sektio saesaria . Pera#atan intensif ib dan bayi. 5. Pelayanan Ashan Ante Natal +isiko Tinggi
BAB II RUANG LINGKUP PONEK DI RSUD KOTA MATARAM
+ang lingkp pelayanan kesehatan maternal dan neonatal pada PNE( terbagi atas 2 kelas4 antara lain 1 a. PNE( +),A- SA(IT (E&AS 6 . Pelayanan (esehatan ,aternal dan Neonatal Fisiologis 7 Pelayanan (ehamilan 7 Pelayanan Persalinan 7 Pelayanan Nifas 7 Ashan %ayi %ar &ahir 8&e9el : 7 Immnisasi dan Stimlasi4 Deteksi4 Inter9ensi Dini Tmbh (embang 8SDIDT(:
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2. Pelayanan kesehatan ,aternal dan Neonatal dengan risiko tinggi ,asa antenatal ;
Perdarahan Perdarahan pada kehamilan kehamilan mda
;
Nyeri pert dalam kehamilan kehamilan mda dan lan!t
;
'erak !anin tidak dirasakan
;
Demam dalam kehamilan dan persalinan
;
(ehamilan ektopik 8(E: < (ehamilan Ektopik Ektopi k Tergangg 8(ET:
;
(ehamilan (ehamilan dengan Nyeri kepala4 ganggan penglihatan4 ke!ang
dan/koma4 tekanan darah tinggi ,asa intranatal ;
Persalinan Persalinan dengan part ters
;
Persalinan Persalinan dengan distensi ters
;
'a#at !anin dalam persalinan
;
Pelayanan Pelayanan terhadap syok
;
(etban pe"ah dini
;
Persalinan lama
;
Indksi dan akselerasi persalinan
;
Aspirasi 9akm manal
;
Ekstraksi 6nam
;
Seksio sesarea
;
Epiosotomi
;
(raniotomi dan kraniosentesis
;
,alpresentasi dan malposisi
;
Distosia bah
;
Prolapss tali psat
;
Plasenta manal
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;
Perbaikan Perbaikan robekan dinding ters
;
+eposisi Inersio )teri
;
-isterektomi
;
Skar bernapas
;
(ompresi bimanal dan aorta
;
Dilatasi dan kretase kretase
;
&igase arteri terina
;
%ayi bar lahir dengan as$ksia
;
%%&+
;
+essitasi +essitasi bayi bar lahir
;
Anestesia mm dan lokal ntk seksio sesaria
;
Anestesia spinal4 ketamin
;
%lok paraser9ikal
;
%lok pdendal 8bila memerlkan pemeriksaan spesialistik4 dir!k ke
+SIA/ +S): ,asa Post Natal ;
,asa nifas
;
Demam pas"a persalinan
;
Perdarahan Perdarahan pas"a persalinan
;
Nyeri pert pas"a persalinan
;
(elarga %eren"ana
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;
ke!ang4
;
sepsis neonatal
;
ganggan keseimbangan "airan dan elektrolit4
;
ganggan pernapasan4
;
kelainan !antng 8payah !antng4 payah !antng ba#aan4 PDA:4
;
ganggan pendarahan4
;
ren!atan 8sho"k:4
;
aspirasi mekonim4 mekonim4
;
koma4
;
Inisiasi dini ASI 8%reast Feeding:4 Feeding:4
;
(angaroo ,other 6are4
;
+essitasi +essitasi Neonats4
;
Penyakit ,embran -yalin4
;
Pemberian Pemberian minm pada bayi risiko tinggi4
. Pelayanan 'inekologis ;
(ehamilan (ehamilan ektopik
;
Perdarahan Perdarahan ters disfngsi
;
Perdarahan menoragia
;
(ista o9arim akt
;
+adang Pel9ik akt
;
Abses Pel9ik
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;
Pelayanan Pelayanan Persalinan Persalinan normal dan Persalinan Persalinan dengan tindakan operatif
;
Pelayanan Pelayanan Nifas
;
Ashan %ayi %ar &ahir 8&e9el 2:
;
Immnisasi Immnisa si dan Stimlasi4 Stimlas i4 Deteksi4 Inter9ensi Inter9ens i Dini Tmbh (embang
8SDIDT(: ;
Intensi9e 6are )nit 8I6):
;
NI6)
;
Endoskopi
2. Pelayanan kesehatan ,aternal dan Neonatal dengan risiko tinggi ,asa antenatal ;
Perdarahan Perdarahan pada kehamilan kehamilan mda / aborts.
;
Nyeri pert dalam kehamilan kehamilan mda dan lan!t / kehamilan ektopik.
;
(ehamilan ektopik 8(E: < (ehamilan Ektopik Ektopi k Tergangg 8(ET:.
;
-ipertensi4 Preeklampsi Preeklampsi / Eklampsi.
;
Perdarahan Perdarahan pada masa (ehamilan (ehamilan
;
(ehamilan (ehamilan ,etabolik
;
(elainan =asklar / 0antng 0antn g
,asa intranatal ;
Persalinan Persalinan dengan part ters
;
Persalinan Persalinan dengan distensi ters
;
'a#at !anin dalam persalinan
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;
Episiotomi
;
(raniotomi dan kraniosentesis
;
,alpresentasi dan malposisi
;
Distosia bah
;
Prolapss tali psat
;
Plasenta manal
;
Perbaikan robekan ser9iks
;
Perbaikan Perbaikan robekan 9agina dan perinem
;
Perbaikan Perbaikan robekan dinding ters
;
+eposisi Inersio )teri
;
-isterektomi
;
Skar bernapas
;
(ompresi bimanal dan aorta
;
Dilatasi dan kretase kretase
;
&igase arteri terina
;
Anestesia mm dan lokal ntk seksio sesaria
;
Anestesia spinal4 ketamin
;
%lok pdendal
,asa Post Natal ;
,asa nifas
;
Demam pas"a persalinan
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;
as$ksia4
;
trama kelahiran4
;
ke!ang4
;
sepsis neonatal
;
ganggan keseimbangan keseimbangan "airan dan elektrolit4 elektrolit4
;
ganggan pernapasan4
;
kelainan !antng 8payah !antng4 payah !antng ba#aan4 PDA:4
;
ganggan pendarahan4
;
ren!atan 8sho"k:4
;
aspirasi mekonim4 mekonim4
;
koma4
;
Inisiasi dini ASI 8%reast Feeding:4 Feeding:4
;
(angaroo ,other 6are4
;
+essitasi +essitasi Neonats4
;
Penyakit Penyakit ,embran -yalin4
;
Pemberian Pemberian minm pada bayi risiko tinggi4
;
Pemberian "airan Parenteral
;
(elainan (elainan ba#aan
. Pelayanan 'inekologis ;
(ehamilan (ehamilan ektopik
;
Perdarahan Perdarahan ters disfngsi
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5. Pera#atan Intensif Neonatal
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Mekanisme pelaksanaan pengumpulan data!ekapan kasus kasus : 1; Ketua Ketua timpen timpenang anggung gung2aw 2awab ab shi%t shi%tBid Bidan an melakuk melakukan an !ekapit !ekapitula ulasi si data data tiap tiap shi%t shi%t dengan %"!mat yang telah ditentukan. Ruangantim PONEK setiap ha!i me!ekap data yang telah 2; Kepala dilap"!kandituliskan "leh ketua timpenanggung2awab shi%tbidan. 3; Pada akhi! bulan Kepala Ruangantim PONEK melap"!kan hasil !ekapitulasi ke !ekam medik B; S-er D
sumbe! dapat dipe!"leh da!i : 1; Rekam medis 2; atatan kebidanan 3; atatan hasil penun2ang >lab"!at"!ium dan !adi"l"gi? 4; Pasienkelua!ga C; N-er4r
Aumlah kasus ke2adian setiap bulannya. D; De*4-5*4r
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Su!@eilans me!upakan kegiatan yang m 2; A*/5s5s * 5*erres5 3; Pe/4r*, re4-e*s5 * 5se-5*s5
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ite iteta tapk pkan an di : Mata Mata!a !am m Pada Pada tan tangg ggal al : .... ...... ..
/REK(UR& RUM'; S'K/( UMUM KO(' KO (' M'('R' M'('R'M M
Dr. H. L. HERMAN MAHAPUTRA, MAHAPU TRA, M.Kes M.Ke s. NIP. 196811102001121003