PROPOSAL PERMOHONAN PENGADAAN ALAT VENTILATOR NEONATAL
Disusun Oleh : 1. Fajar Ahmad Fauzi
20133010032
2. Muhammad Nasrullah
20133010033
3. Ika Nurcahyani
20133010044
4. Dyan Nova Lesiska N
20133010056
PRODI TEKNIK ELEKTROMEDIK PROGRAM VOKASI UNIVERSITAS MUHAMMADIYAH YOGYAKARTA
2016
I. Latar Belakang
Rumah sakit merupakan tempat atau rumah bagi para mereka yang sedang mengalami ketidakseimbangan atau kondisi tubuh yang sedang tidak stabil atau kondisi fisik yang tidak baik. Penyebab ini dikarenakan banyak banyak faktor di di antaranya kecelakaan yang yang tidak disengaja, disengaja, virus bahkan faktor genetik. Rumah sakit sebagai tempat untuk mengatasi dan mencari solusi permasalahan tersebut, dalam hal ini dituntut untuk mengedepankan fasilitas kesehatan di rumah sakit yang baik dan sesuai standar pela yanan yang memadai. Memberikan pelayanan fasilitas rumah sakit merupakan salah satu bentuk kepedulian rumah sakit di bidang medis. Fasilitas rumah sakit tersebut dibedakan menjadi 3 bagian yaitu; peralatan kesehatan (medis, non-medis, mebel air), sarana, dan prasarana. Salah satu aspek yang penting adalah ketersediannya peralatan kesehatan yang lengkap, berfungsi dengan baik dan sesuai standar badan kalibrasi. Pemerintah atau badan khusus penanganan peralatan kesehatan nasional telah membuat peraturan terkait dengan kelayakan dan standarisasi yang yang harus harus dipenuhi dipenuhi oleh public oleh public service dalam hal ini adalah rumah sakit. Peran pemerintah tersebut bertujuan untuk mendorong demi kemajuan dan perbaikan peralatan kesehatan. Ini merupakan kewajiban bagi pemerintah untuk untuk memenuhi tugasnya sebagai fungsi regulator, pelaksana dan pembiayaan. pembiayaan. Secara umum jika melihat peraturan pemerintah, alat kesehatan adalah alat yang merupakan barang, aparat, atau instrumen dengan tiap komponen array array bagiannya diproduksi dan dijual untuk pemeliharaan, perawatan, diagnosa, pencegahan, peringanan, dan penyembuhan untuk setiap gejala kelainan kesehatan yang terjadi pada tubuh manusia. Namun dalam pelaksanaan pela ksanaan di lapangan masih banyak terjadi kendala-kendala priciple kendala-kendala priciple di antaranya keterbatasan alat-alat yang memadai, maintenance dan maintenance dan service service yang yang tidak rutin, kerusakan alat yang tidak bisa di repair ulang, bahkan pemeliharaan dan penggunaan peralatan yang tidak sesuai prosedur sehingga s ehingga hal-hal hal -hal tersebut sangat mempengaruhi dan memperlambat pelayanan mutu kinerja rumah sakit. Dampak kurangnya penanganan peralatan kesehatan tersebut tentu akan memunculkan banyak permasalahan. Di antaranya terganggunya penanganan pasien pasie n yang membutuhkan peralatan cepat atau vital. Bahkan resiko yang paling merugikan merugikan adalah kematian. Rumah sakit sebagai pelayan kesehatan harus bersedia bertanggung jawab atas hal-hal tersebut jika demikian terjadi dan siap menerima segala sanksi serta tuntutan pihak berwenang terutama t erutama pengaduan dari pasien yang tidak bisa menerima secara prosedural. Karena alat-alat kesehatan semestinya harus dijadikan prioritas utama oleh rumah sakit
sebagai alat pembantu petugas medis untuk melayani pasien bahkan masyarakat umum yang memang penanganannya tidak hanya tergantung pada pemberian obat. Dengan menilai dan menimbang segala hal baik administrasi, teknik dan prosedur peraturan pemerintah tentang peralatan kesehatan yang standar. Maka selaku petugas lapangan dalam hal ini teknisi elektromedis rumah sakit, memiliki kewenangan untuk melaporkan dan memberi masukan serta gambaran kepada bagian kepala gudang bagian pengadaan barang alat kesehatan, untuk menerima proposal pengadaan alat kesehatan berupa alat ventilator. Untuk segala s egala perincian dan teknis alat serta perhitungan harga akan dijelaskan pada bagian berikutnya. Oleh karena itu, tim pimpinan staf elektromedik memutuskan untuk mengajukan proposal “PERMINTAAN “PERMINTAAN PENGADAAN ALAT VENTILATOR NEONATAL ”.
II. Rencana Teknis
Dalam pengajuan proposal ini, kami memiliki dua alternatif alat yang akan diajukan pengadaannya. Berikut beberapa pembanding yang kami jabarkan sebagai pertimbangan pemilihan keputusan. A. Spesifikasi (brochure (brochure)) dan Gambar Alat i.
Terlampir
B. Rencana Anggaran Biaya ii. Terlampir C. Analisis Perhitungan iii. Terlampir D. Rencana Jaringan Proyek iv. Terlampir E. Rencana Cash Flow v. Terlampir
III.Keputusan III. Keputusan
vi. Terlampir
IV. Daftar Referensi
1. (E-katalog lkpp 2016), Katalog alat-alat kesehatan, 2016 [online] tersedia :
. [8 januari 2016 14.47 WIB]. 2. (Scribd 2011) Proposal pengadaan alat kesehatan, 2011 [online] tersedia : . >. [6 januari 2016]. 3. (Hamilton medical 2016), The universal ventilator solution, hamilton-C2, hamilton-C2, 2016 [online] tersedia : . [6 Januari 2016]. HAMILTON-C2-tech-specs-en-689277.0 en-689277.08.pdf 8.pdf >.
4. (Imtmedical 2016), Bellavista® 1000, imtmedical, 2016 [online] tersedia : http://www.imtmedical.com/enus/products/bellavista/Documents/bellavista_Basis_Brochure_EN.pdf us/products/bellavista/Documents/ bellavista_Basis_Brochure_EN.pdf [8 januari 2016]. 5. (Detik News 2013), Berita terbaru, detik news, news, 2013 [online] tersedia : di-rscm> [14 desember 2015]. 6. (Lembaga Bank Indonesia 2016), Kurs transaksi bank ndonesia, bank indonesia, 2016 [online] tersedia : . >. [8 januari 2016 Pukul 15.20 WIB]. 7. (PT PLN (Persero), Distribusi Jakarta Raya dan Tangerang 2016) Penyesuaian 2016) Penyesuaian tarif tenaga listrik, PLN, 2015 PLN, 2015 [online] tersedia : > [7 januari [7 januari 2016]. 8. (Hamilton medical 2016), The universal ventilator solution, hamilton-C2, 2016[online] tersedia : C2.html> [4 januari 2016]. 9. (APBD DKI Jakarta 2015), Informasi 2015), Informasi Belanja Langsung, Informasi APBD, 2015 [online] tersedia : .[13 . [13 Januari 2016].
LAMPIRAN I
HAMILTON-C2 Spesifikasi Alternatif Alat 1
Technical specifications The HAMILTON-C2 mechanical ventilator is a uni-
•
Ventilation of adults, children, and neonates
versal ventilation solution for all patient groups.
•
Tidal volumes as low as 2 ml
The HAMILTON-C2’s compact design and indepen-
•
> 7 h of battery operating time
dence from external power and air supplies allow
•
Independent airsupply
for maximum mobility throughout the hospital. The
•
AdvancedventilationmodesincludingASV®
integrated high-performance turbine guarantees top
•
High-performance NIV ventilation
performance even with noninvasive ventilation.
For more information, visit our website: www.hamilton-medical.com/C2
Technical specifications Ventilation Cockpit Dynamic Lung
Real-time visualization of the lungs with representations of tidal volume, lung compliance, resistance, and patient activity
Vent Status
Visual representation of ventilator dependency, grouped into oxygenation, CO 2elimination, patient activity
ASV target graphics
Graphic display of target and actual parameters for tidal volume, frequency, pressure, patient activity, and minute ventilation
Monitoring
Display of 41 monitoring parameters
Real-time waveforms
1) Paw, Flow, Volume, Ptrachea, CO 2
Others 1)
1) Loops: P-V, V-Flow, P-Flow, V-FCO , V-PCO21), Trends: 1, 6, 12, 24, and 72 hours 2
Alarms Operator adjustable
Low/high minute volume, low/high pressure, low/high tidal volume, low/high rate, apnea time, low/high oxygen, low/high PetCO 21)
Special alarms
O2 cell, disconnection, exhalation obstructed, loss of PEEP, pressure not released, flow sensor, pressure limitation, performance limited, battery, power supply, gas supply, oxygen concentration, ASV
Loudness
Adjustable (1 – 10)
Ventilation Modes
Type
Mode
Closed-loop control
ASV
Description
Adaptive Support Ventilation. Guaranteed minute volume based on user
Adult/Ped.
Neonatal
ü
settings and application of lung-protective rules. Pressure
PCV+
Pressure-controlled ventilation. Biphasic breathing
ü
ü
PSIMV+
Pressure-controlled synchronized intermittent mandatory ventilation
ü
ü
Pressure support ventilation
ü
ü
ü
ü
SPONT APRV
Volume
Noninvasive
Airway pressure release ventilation
DuoPAP
Duo positive airway pressure
ü
ü
(S)CMV+/APVcmv
(Synchronized) controlled mandatory ventilation
ü
ü
SIMV+/APVsimv
Synchronized intermittent mandatory ventilation
ü
ü
NIV
Noninvasive ventilation
ü
ü
Spontaneous / timed noninvasive ventilation
ü
ü
NIV-ST 1)
nCPAP-PS
Nasal continuous positive airway pressure - pressure control
Maintenance Blower lifetime
1)
Optional - not available in all markets
Dynamic lifetime surveillance; typically 8 years. 5 year warranty.
ü
1)
Technical specifications Standards
IEC 60601-1, IEC 60601-1-2, ISO 80601-2-12, CAN/CSA-C22.2 No. 601.1, UL 60601-1
Configurations Options 1)
Neonatal ventilation, nasal CPAP, volumetric mainstream capnography, sidestream capnography
Electrical and gas supplies Input voltage
10 0 to 240 VAC, 50 / 60 Hz or 12 to 24 V DC
Power consumption
50 W typical, 150 W maximum
Backup battery time
7 h typical with 2 Li-Ion batteries / hot swappable
Oxygen supply
280 to 600 kPa (41 to 87 psi), V´max 120 l/min
Low pressure oxygen
≤15 l/min, max. 600 kPa for low pressure
Air supply Degree of protection
Integrated ultra-quiet turbine IP21
Environment Temperature
Operating: 5ºC to 40ºC (41ºF to 104ºF) Storage: -20ºC to 60ºC (-4ºF to 140ºF)
Humidity Altitude
10% to 95%, noncondensing (operating and storage) Up to approx. 4,000 m (13‘120 ft), 1,100 to 600 hPa
Interface connectors
USB, RS-232, nurse call, CO 2
Event log
Storage and display of up to 1,000 events with date and time
IntelliTrig Leak compensation
Automatic response to varying leaks and configurable trigger sensitivity in all modes Inspiratory leakage up to 85 l/min, expiratory leakage up to 30 l/min
IntelliSync
1)
Optional - not available in all markets
Guaranteed rate ventilation
Technical specifications Controls
Type
Adult / Pediatric
Neonatal
Special functions
Manual breath, O2enrichment, standby, sigh, screen
Manual breath, O 2enrichment, standby, screen lock,
lock, apnea backup ventilation, inspiratory hold, print
apnea backup ventilation, inspiratory hold, print
screen, suctioning tool, dimmable screen, configurable
screen, dimmable screen, configurable quick-start set-
quick-start settings, start up settings based on patient height and gender, integrated pneumatic nebulizer, ube resistance compensation TRC, reference loops
1)
ings, start up settings based on patient weight and gender, tube resistance compensation TRC, reference loops
Ventilation modes
See page 2, Ventilation modes
See page 2, Ventilation modes
Patient groups
adult / pediatric
neonatal
Patient height
30 to 250 cm
-
Patient gender
male / female
-
Patient weight
-
0.2 to 30 kg
(S)CMV+/APVcmv
4 to 80 b/min
15 to 150 b/min
SIMV+/APVsimv+
1 to 80 b/min
1 to 150 b/min
PCV+
4 to 80 b/min
15 to 150 b/min
NIV-ST
5 to 80 b/min
15 to 150 b/min
PSIMV+
5 to 80 b/min
15 to 150 b/min (without IntelliSync 5 to 150 b/min)
DuoPAP
1 to 80 b/min
1 to 150 b/min
1 to 80 b/min
1 to 150 b/min
-
15 to 150 b/min
Tidal volume
20 to 2,000 ml
2 to 300 ml
PEEP/CPAP
0 to 35 cmH 2O
0 to 25 cmH 2O
Oxygen
21% to 100%
21% to 100%
I:E ratio
1:9 to 4:1 (DuoPAP 1:599 to 149:1)
1:9 to 4:1 (DuoPAP 1:599 to 149:1)
%MinVol (ASV)
25% to 350%
-
Inspiratory time (TI)
0.1 to 12 s
0.1 to 12 s
Flow trigger
off, 1 to 20 l/min
off, 0.1 to 5 l/min
Pressure control
5 to 60 cmH 2O, added to PEEP/CPAP
3 to 60 cmH 2O, added to PEEP/CPAP
Pressure support
0 to 60 cmH 2O, added to PEEP/CPAP
0 to 60 cmH 2O, added to PEEP/CPAP
Pressure ramp
0 to 2,000 ms
0 to 600 ms
P high (APRV/DuoPAP)
0 to 60 cmH 2O
0 to 60 cmH 2O
P low (APRV)
0 to 35 cmH 2O
0 to 25 cmH 2O
T high (APRV/DuoPAP)
0.1 to 40 s
0.1 to 40 s
T low (APRV)
0.2 to 40 s
0.2 to 40 s
Expiratory trigger sensitivity (ETS)
5% to 80% of peak inspiratory flow
5% to 80% of peak inspiratory flow
Peak flow
up to 240 l/min
up to 240 l/min
Respiratory rate
APRV 1)
nCPAP-PS
1)
Optional - not available in all markets
Technical specifications Monitoring parameters
Type
Parameter
Unit
Description
Pressure
Paw
cmH2 O;mbar;hPa Real-time airway pressure
Ppeak
cmH2 O;mbar;hPa Peak airway pressure
ü
Pmean
cmH2 O;mbar;hPa Mean airway pressure
ü
Pinsp
cmH2 O;mbar;hPa Inspiratory pressure
PEEP/CPAP
cmH2 O;mbar;hPa Positive end expiratory pressure/
Numeric monitoring
aveforms
Vent Status
Dynamic Lung
ü
ü ü
ü
continuous positive airway pressure
Flow
Volume
Ptrachea
cmH2 O;mbar;hPa Real-time tracheal pressure
Pplateau
cmH2 O;mbar;hPa Plateau or end inspiratory pressure
Flo
l/min
Real-time inspiratory flow
Insp Flo
l/min
Peak inspiratory flow
ü
Exp Flow
l/min
Peak expiratory flo
ü
Volume
ml
Real-time tidal volume
VTE/VTE NIV
ml
Expiratory tidal volume
ü
VTI/VTI NIV
ml
Inspiratory tidal volume
ü
ExpMinVol/MinVol NIV
l/min
Expiratory minute volume
ü
Spontaneous expiratory minute volume
ü
MVSpont/MVSpont NIV l/min
ü ü
ü ü
ü
ü
ü
Leakage minute volume Leak/MV Leak Time
ü
Inspiratory-expiratory ratio
ü
ü
b/min
Total breathing frequency
ü
ü
fSpont
b/min
Spontaneous breathing frequency
ü
TI
s
Inspiratory time
ü
TE
s
Expiratory time
ü
%fSpont
%
Percentage of spontaneous breathing rate
ml/cmH2O
Static compliance
AutoPEEP
ü ü ü
ü
ü
cmH2 O;mbar;hPa AutoPEEP or intrinsic PEEP
ü
RCexp
s
Expiratory time constant
ü
Rinsp
cmH2 O*s/l
Inspiratory flow resistance
ü
RSB
1/l*min
Rapid shallow breathing index
PTP
cmH2 O*s;mbar*s
Pressure-time product
P0.1
cmH2 O;mbar;hPa Airway occlusion pressure
ü
O2
%
Airway oxygen concentration (FiO2 )
ü
mmHg%
Real-time CO2 measurement
FetO2
%
Fractional end-tidal CO2 concentration
ü
ü
PetCO2
mmHg;Torr;kPa
End-tidal CO2 partial pressure
ü
ü
SlopeCO2
%CO2/l
V/Q status of the lung
ü
VTalv
ml
Alveolar tidal ventilation
ü
VTaiv/min
ml
Alveolar minute ventilation
ü
V‘CO2 /min
ml/min
CO2 elimination
ü
VDa
ml
Airway dead space
ü
VDaw/VTE
%
Dead space fraction measured at the airway opening
ü
VeCO2
ml
Exhaled volume of CO2
ü
ViCO2
ml
Inspired volume of CO2
ü
Carbon dioxide1) CO2
1)
Leakage percentage at the airway
fTotal
Lung mechanics Cstat
Oxygen
%;l/min
I:E
Optional - not available in all markets
ü ü
ü
ü ü
ü
Technical specifications Accessories Trolley accessories
Cylinder holder, humidifier support, tubing support arm, infusion poole
Compact transport solution
Bed mount and wall mount available
Adapter plate
Quick-lock adapter plate for various applications s e
Physical dimensions Size
See illustrations below
eight
9.5 kg (21 lb) without trolley
Display
10.4 in, TFT color, backlit, touch screen
Main patient outlet
ISO 5356-1; 22M/15F
Oxygen inlet (high pressure)
DISS or NIST male
Oxygen inlet (low pressure)
CPC quick coupling, 3.2 min ID
e igr
140 cm
43 cm
(55.1 in)
(16.9 in)
e
25 cm 31 cm
(9.8 in)
(12.2 in) S
46 cm (18.1 in)
66 cm (26 in)
Hamilton Medical AG Via Crusch 8, 7402 B onaduz, Switzerland ( + 41 58 610 10 20 [email protected] www.hamilton-medical.com
Your contact:
8 6
Spesifikasi (brochure) Alternatif Alat 2
Design and performance
Good things can be improved. With this in mind, we have developed a revolutionary new generation of ventilators. bellavista ensures a step into the future for all of our clients. Not only the attractive, elegant outward appearance and outstanding technology, but also the new, groundbreaking operating system, developed closely with leading physicians, set bellavista apart from the competition. bellavista refreshingly redefines ventilation technology with an attractive yet conspicuously discreet design, which stands out from the typical clinical instrumentation and integrates functionality, Swiss quality and high performance with user-friendliness and innovative design.
Intelligent aesthetics
bellavista offers a new type of operating experience by allowing individual adaptation of the applications to suit the needs and habits of the user. W hether a patient, nurse, or doctor, the relevant information is immediately visible and available.
Revolutionary operation
Smart touch operation bellavista’s new touch screen simplifies the set-up process and adjustment of ventilator and monitoring values and curves. By using the direct menu, the user can see the actions available in the selected field, thereby guaranteeing intuitive operation of the device. Various respiratory parameter setting methods are additionally available to the user.
UserView ™ The screen displays only relevant information for the selected user. A status indicator simplifies the screen by hiding complicated graphs and figures that could otherwise confuse the patient. The physician, however, sees all values, curves and loops, which enables him/her to rapidly familiarise himself/ herself with the patient’s condition. The user interface can be individually customised directly on the screen according to the user’s wishes and requirements by positioning each operating component where expected.
Building user confidence bellavista supports daily use of the ventilator with multimedia capabilities. Wizards and instructional videos displayed directly on the device support the bellavista set-up and operating process. These instruments assist in reducing user anxiety while operating the device. Videos and pictures detailing health conditions and treatments can be loaded and displayed directly on the ventilator. These informational spots support the patient as well as physician with video and audio functions and ensure comfortable assistance for example during mask fitting. These capabilities enable ventilator acceptance by the patient and increase the chances of successful therapy.
VentilationAssist™ VentilationAssist supports the medical specialist in parameter adjustment when a patient is initially connected t bellavista ventilator. After entering the relevant patient information (inclu patient history, age, lung volume, etc) VentilationAssist suggests a suitable v lation configuration. This suggestion can then be evaluated and adjusted b medical specialist.
Innovative features
MaskFit™ Experts agree that initial ventilator contact is critical in determining future therapy success. If the patient accepts the ventilator and mask during this first phase, it is very likely that n on-invasive ventilation can be used throughout the therapy. If non-invasive therapy is not an option, the consequence is often intubation causing long-term therapy with increased complications. MaskFit assists the patient and medical specialist during initial contact with the device and mask. With assisted guidance and multimedia support, the patient easily adjusts to ventilation step by step.
WeanVent™ During ventilator weaning, bellavista supports the patient with WeanVent. During this phase, the patient is prepared with targeted measures and training programs that are individually customised by the medical specialist. The entire weaning process is supported by multimedia functions. Real-time patient information and measuring results are continuously available for review and diagnosis during therapy.
ChameleonLook™ The multitude of ventilators with varying user-interfaces presents significant challenges for medical specialists. The consequences encountered by this variety are increased costs for device familiarisation and training. bellavista’s ChameleonLook offers revolutionary support for anyone working with a broad range of ventilators. At the click of a button, the ChameleonLook adapts bellavista’s operating surface to an interface that the operator is more familiar with.
ModeAssist™ While the ventilation is running, a new mode or form of therapy can be selecte and pre-configured using ModeAssist. Selections of varying ventilation patter based upon empirical values are available. Changes are only applied when t configuration is complete and the user initiates the new settings.
1
Innovative features
FlexiView™ The bellavista user interface can be individually customised using FlexiView. This feature allows users to continuously adjust the user interface to their needs and wishes. While the device is in operation, monitoring values and curves can be adjusted and loops can easily be configured.
ActiveHelp™ ActiveHelp is easily accessible directly on bellavista’s user interface. In every phase of operation, assistance pertaining to the current topic is available by the push of a button. The bellavista ventilator details responses with informative text including pictures, instructional videos or relevant sections from the electronic user manual.
ConnectionAssist™ Correctly connecting and operating bellavista is detailed step-by-step with ConnectionAssist. All interfaces have a ConnectionAssist button next to them. When this button is pushed, information appears on the screen describing the function of the selected connection.
An adequate pneumological examination requires a subs tantial diagnosis. During this process, parameters from various machines must be correlatively analysed. bellavista is the world’s first ventilator where all the sensors necessary for a reliable pneumological diagnosis are either integrated in the device or attachable. All relevant parameters are displayed and recorded polygraphically and simultaneously. This allows the specialist to make a reliable diagnosis quickly and simply and evaluate critical changes in the patient’s condition. With a complete record of all patient parameters, a detailed post-analysis can be determined. The ArtefactFinder supports the physician in evaluating the data displayed and reliably highlights irregularities.
Cardio Pleth SpO2
CO2
FiO2
Lung mechanics
Flow & volume
Pressure
12
World premier in diagnostics and monitoring
Standard parameters The flow, volume and pressure parameters give insight into respiratory tract obstructions, compliance dysfunctions and leakages. Alarm parameters can be comfortably adjusted directly on the touch screen. Capnography The integrated capnograph enables simple monitoring of the tubus and indicates potential pulmonary embolism.
Lung mechanics The quantitative analysis of the respiratory system must be accompanied by an understanding of the complex reciprocal effect between patient and ventilator. This analysis delivers important clinical information about lung function and the course of a disease and allows the medical specialist to customise ventilator settings for the individual patient.
Blood gas monitoring Pulse oximetry, the transcutaneous measurement of SpO2, is crucial in recognizin the quality of ventilation. Blood gas monitoring simplifies long-term monitoring and avoids invasive arterial blood gas analysis.
Ventilators providing high-performance for every type of therapy are rare. For years the devices used at home were dramatically different from those used in hospitals. bellavista combines the advantages of the proven, classic proportional valve technology of ICU ventilators, with the high-performance blower technology primarily used in non-invasive ventilation. Thus, bellavista offers a ventilation platform for all applications; for noninvasive and invasive ventilation, for children and adults, at home and in the hospital.
14
Top ventilation performance
Ventilation and synchronisation The proportional valve technology patented for bellavista enables optimal synchronisation between the ventilator and patient and regulates an exact air dosage for each breathing phase. bellavista’s superior exhalation performance also increases patient comfort.
Various types of therapy Pressure and volume controlled ventilation modes give the user the greatest flexibility in selecting the appropriate therapy. For anxiety-free and assisted mask adjustment, bellavista offers the MaskFit mode which provides multimedia assistance to doctors and patients. The DayNight mode enables patients to switch independently between two different types of prescribed therapies. This accommodates the physiological differences of the lung functions and optimises the patient’s comfort. The DayNight mode also takes into account differing therapies at the relevant time of day and adjusts the ventilation appropriately.
Oxygen Depending on the clinical diagnosis and therapy, the air provided can be mixed with a precise dose of o xygen. bellavista supports all O2 supply systems available in the market. Medication therapy support An integrated medication nebuliser permits exact dosages of medication in accordance with the chosen therapy. The intelligent control system can adapt the dosage patterns. Customised modes such as pressure and volume controlled sighs or targeted administration of manual breath can further promote patient weaning off the ventilator.
The appropriate device for every application. The bellavista model 1000 is available in two separate basic versions in order to accommodate varying ventilator applications – bellavista 1000 and bellavista 1000e. Each version distinguishes itself through unique attributes and advantages. Several features are available separately or after an initial purchase.
1000 Area of application Intensive care unit (ICU) Subacute / Intermediate care unit (IMC) Emergency Room (ER) Intrahospital transfers Ventilation Non-invasive (High Performance NIV) Invasive Neonatal Pediatric Adult Single limb breathing circuit Dual limb breathing circuit Ventilation modes Pressure controlled CPAP, PCV, P-A/C, PC-SIMV, PSV, beLevel, APRV CPAP, S, S/T, T, P-A/C Volume controlled VCV, V-A/C, VC-SIMV PLV (Pressure Limited Ventilation) on all volume controlled modes Oxygen Basic Oxygen Therapy Advanced Oxygen Therapy Oxygen flush
included in delivery optionally available optionally available, included in the ClinicSuite
1000 e
TM package
1000 ExpertVentilation TM package Single & multiple sighs Manual breath Inspiratory hold Expiratory hold AutoPEEP NIF (Negative Inspiratory Force) Vtrapped (trapped volume) P0.1 (occlusion pressure) ATC (fully configurable)
bellavistaModes (beModes) SingleVent™ Backup Ventilation TargetVent™ DualVent™ DayNight™ MaskFit™ WeanVent™ Special features UserView™ FlexiView™ UserAssist™ VentilationAssist™ Various monitoring and trending views ConnectionAssist™ ActiveHelp™ ChameleonClassic™ ChameleonGreen™
1
16
Overview
1000 Monitoring Standard parameters Pressure Ppeak, Pplateau, Pmean, PEEP Volume Vti, MVi (MinVol), Vti/kg, MVi/kg, Vte, MVe (MinVol), Vte/kg, MVe/kg Timing Rate, Ti, Te, I:E, Ti/Tot Oxygen FiO2 Curves Pressure, Flow, Volume incl. Ptrach curve if ATC is enabled Up to three curves Up to eight curves & loops Curve freeze Curve cursor Leak Leak flow, Auto-Leak TM Pulse oximetry Pulse rate, SpO2 saturation, Cardio pleth curve Capnography inCO2, etCO2, CO2-curve SBE
% Spont
ExpertMonitoring TM Volume MVi spont MVe spont Timing Rate spont, Ti support, SBE %Spont 1h, %Spont 8h WOBimp Work of Breathing imposed PTP Pressure Time Product P0.1 breath-by-breath occlusion pressure Tobin Index RSBI (Rapid Shallow Breathing Index) Leak % Leak Curves Up to eight real time curves
1000 e
1000 Patient info Patient info sheet
Diagnostics Correlated diagnostic data Oxygen fraction FiO2 Diagnostic Package Pulse Oximetry Diagnostic Packages Capnography Diagnostic lung m echanics Curves Proximal flow & volume Loops P/V (pressure/volume) P/F (pressure/flow) F/V (flow/volume) Loop freeze Loop cursor (inflection points, ...) Reference loop Loop overlay Parameters Rinsp, Rexp, Cstat, Cdyn, C20/Cdyn, CDyn/kg, CStat/kg Trending Standard trending (all monitoring parameters) Real time trending (all curves) Alarms Alarm log Ventilation alarms System alarms Auto self-test
100
1000 Data transfer / Central Monitoring (PDMS) USB-stick Screenshot (on USB-stick) bellavista ConfigurationSuite™ Philips VueLink™ and IntelliBridge Operation and signals Giant screen (13,3") Touch screen operation 360° multicolor signals Stereo loudspeakers Ergonomics Compact design Innovative bellavista operating concept Ergonomic colour design Integrated carrying handle Integrated mounting possibilities Low noise design Technology Multiprocessor architecture Redundant safety components Low power design Proportional valve technology High performance turbine Oxygen External medication nebulizer
1000 e
1000
1000 e
Extension modules beBay™ Humidifier
Software upgrades Software upgrade via USB interface iVista software download
Maintenance Minimal maintenance Easy air filter exchange ServiceAssist™ Easy to clean surface Support Test and diagnostic tools Training Integrated multimedia applications Tutorial videos Integrated electronic user manual
18
Overvie
1000 Technical data Ventilation settings Pinsp (IPAP)
0 .. 60 mbar 0 .. 80 mbar Psupport 0 .. 60 mbar 0 .. 80 mbar PEEP (EPAP) 0 .. 40 mbar CPAP 4 .. 30 mbar Rise time 0 .. 2000 ms Ramp Off, 5 .. 45 min Tidal volume 40 .. 2500 mL 10 .. 2500 mL 2 .. 2500 mL Body Weight 6 .. 250 kg 1.5 .. 250 kg 0.4 .. 250 kg Peak flow 260 L/min Flow pattern Square, Dec., Dec. 50 % Breathing frequency 1 .. 100 bpm 1 .. 150bpm Inspiration time 0.1 .. 10 s I:E ratio 1:599 .. 49:1 Inspiration trigger (flow) 0.1 .. 20 L/min Inspiration trigger (pressure) 0.1 .. 15 mbar Expiration trigger 5 .. 90 % of insp. peak flow Auto-Synch TM Apnea backup off, 2 .. 100 s Oxygen 5 levels Advanced Oxygen Therapy 21 .. 100 % FiO2
1000 e
1000 Technical data Technical specifications Weight Dimensions (w x h x d) Ambient temperature Ambient humidity Ambient pressure Energy supply Wide range power input Low voltage input Battery operation Intelligent battery management Green power mode Oxygen connector Wide range oxygen inlet
9.1 kg 35 x 22 x 33 cm 5 .. 40 °C 10 ..90 % r.H. 600 .. 1100 hPa
100-240 VAC / 50-60 Hz / 80 W 24 VDC / 3.5 A (Typ.) 4-6 h (internal)
0 .. 7 bar/0 .. 100 psi
Interfaces Coded plug connections 100 MBit ethernet beBus™ USB 2.0 interfaces Serial ports Nurse call
included in delivery optionally available optionally available, included in the ClinicSuite
TM package
100
20 0 8 Good Design Award of The Chicago Athenaeum, USA Design Award of the F ederal Republic of Germany 2010
imtmedical ag Gewerbestrasse 8 9470 Buchs Switzerland T +41 81 750 66 99 www.bellavista-ventilator.com
MADE IN SWITZERLAND
LAMPIRAN II RENCANA ANGGARAN BIAYA
Tabel 1. Perkiraan biaya Ventilator Neonatus Hamilton C2
Harga alat
Per unit
CHF
39.085,83
Kurs beli CHF - IDR
17 Desember 2015
Rp
13.842,37
Harga alat dalam IDR
Per unit
Rp 541.040.520,62
Perkiraan tarif dokter NICU (dari ventilator)
Per tindakan
Rp
40.000,00
Perkiraan ganti Oxygen Cell
Per tahun
Rp
3.000.000,00
Perkiraan maintenance kit
Per tahun
Rp
14.000.000,00
Tarif Listrik
Rp/Kwh
Rp
1.509,38
Daya alat
Watt
100
Perkiraan kebutuhan
jam/hari
13
Perkiraan penggunaan listrik
kWH/hari
1,3
Perkiraan bayar listrik
Per hari
Rp
1.962,19
Asumsi 1 bulan=30 hari
Per bulan
Rp
58.865,82
Per tahun
Rp
706.389,84
Total biaya perawatan
Per tahun
Rp
17.000.000,00
Perkiraan tarif ventilator
Per tindakan
Rp
230.000,00
Tabel 2. Perkiraan biaya Ventilator Neonatus Bellavista 1000
Harga alat
Per unit
Rp 666.270.000,00
Ongkos kirim
Rp
2.730.650,00
Total biaya awal
Rp 669.000.650,00
Perkiraan tarif dokter NICU (dari ventilator)
Per tindakan
Rp
40.000,00
Perkiraan ganti Oxygen Cell
Per tahun
Rp
3.500.000,00
Perkiraan maintenance kit
Per tahun
Rp 15.000.000,00
Tarif listrik
Rp/kWH
Rp
Daya alat
Watt
80
Perkiraan kebutuhan
jam/hari
15
Perkiraan penggunaan listrik
kWH/hari
1,2
Perkiraan bayar listrik
Per hari
Rp
1.811,26
Asumsi 1 bulan=30 hari
Per bulan
Rp
54.337,68
Per tahun
Rp
652.052,16
Total biaya perawatan
Per tahun
Rp 18.500.000,00
Perkiraan tarif ventilator
Per tindakan
Rp
1.509,38
240.000,00
LAMPIRAN III ANALISIS PERHITUNGAN
Asumsi (untuk kedua alternatif):
1. Analisis periode 10 tahun. 2. Suku bunga 7,5% (17 Desember 2015) 3. Rata-rata inflasi tahun 2015 = 6,38%. 4. Kenaikan pasien mulai tahun ke 3 sebesar 0,1% per tahun. 5. Kenaikan tarif dokter dan tarif ventilator mulai tahun ke-3 sesuai besar rata-rata inflasi tahun 2015. 6. Kenaikan biaya perawatan mulai tahun ke-2 sesuai rata-rata inflasi tahun 2015.
Tabel 3. Perkiraan Jumlah Pasien Tahun
(1+0,1%)n
Jumlah Pasien Tahun 1 & 2
Jumlah Pasien
F/P
P
F=Px(F/P)
1
-
-
1800
2
-
-
1800
3
1,001
1800
1802
4
1,002001
1800
1804
5
1,003003001
1800
1805
6
1,004006004
1800
1807
7
1,00501001
1800
1809
8
1,00601502
1800
1811
9
1,007021035
1800
1813
10
1,008028056
1800
1814
PERKIRAAN ALTERNATIF 1 Tabel 4. Perkiraan Biaya Dokter n
Tahun
Jumlah Biaya
(1+6,38%)
Jumlah Biaya Dokter (P)
F/P
Tarif Dokter x jumlah pasien tahun ke n
Dokter F=Px(F/P)
1
-
- Rp 72.072.000,00
2
-
- Rp 72.072.000,00
3
1,0638 Rp 72.072.000,00
Rp 76.670.193,60
4
1,13167044 Rp 72.144.072,00
Rp 81.643.313,70
5
1,203871014 Rp 72.216.216,07
Rp 86.939.009,28
6
1,280677985 Rp 72.288.432,29
Rp 92.578.203,78
7
1,36238524 Rp 72.360.720,72
Rp 98.583.177,88
8
1,449305419 Rp 72.433.081,44
Rp 104.977.657,41
9
1,541771104 Rp 72.505.514,52
Rp 111.786.907,19
10
1,640136101 Rp 72.578.020,04
Rp 119.037.830,78
Tabel 5. Perkiraan Pendapatan dari Ventilator
Tahun
(1+6,38%)n F/P
Jumlah Pendapatan (P)
Jumlah
Tarif ventilator x jumlah pasien tahun ke
Pendapatan
n
F=Px(F/P)
1
-
- Rp 414.414.000,00
2
-
- Rp 414.414.000,00
3
1,0638 Rp 414.414.000,00
Rp 440.853.613,20
4
1,13167044 Rp 414.828.414,00
Rp 469.449.053,80
5
1,203871014 Rp 415.243.242,41
Rp 499.899.303,33
6
1,280677985 Rp 415.658.485,66
Rp 532.324.671,76
7
1,36238524 Rp 416.074.144,14
Rp 566.853.272,81
8
1,449305419 Rp 416.490.218,29
Rp 603.621.530,12
9
1,541771104 Rp 416.906.708,50
Rp 642.774.716,33
10
1,640136101 Rp 417.323.615,21
Rp 684.467.526,97
Tabel 6. Perkiraan Biaya Perawatan
Tahun
Jumlah
(1+6,38%)n
Jumlah Biaya Perawatan (P)
F/P
1
Pendapatan F=Px(F/P)
-
- Rp 17.000.000,00
2
1,0638 Rp 17.000.000,00
Rp 18.084.600,00
3
1,13167044 Rp 17.000.000,00
Rp 19.238.397,48
4
1,203871014 Rp 17.000.000,00
Rp 20.465.807,24
5
1,280677985 Rp 17.000.000,00
Rp 21.771.525,74
6
1,36238524 Rp 17.000.000,00
Rp 23.160.549,08
7
1,449305419 Rp 17.000.000,00
Rp 24.638.192,11
8
1,541771104 Rp 17.000.000,00
Rp 26.210.108,77
9
1,640136101 Rp 17.000.000,00
Rp 27.882.313,71
10
1,744776784 Rp 17.000.000,00
Rp 29.661.205,33
PERKIRAAN ALTERNATIF 2 Tabel 7. Perkiraan Biaya Dokter
Tahun
(1+6,38%)n
Jumlah Biaya Dokter (P)
F/P
Tarif Dokter x jumlah pasien tahun ke n
Jumlah Biaya Dokter F=Px(F/P)
1
-
- Rp 72.072.000,00
2
-
- Rp 72.072.000,00
3
1,0638 Rp 72.072.000,00
Rp 76.670.193,60
4
1,13167044 Rp 72.144.072,00
Rp 81.643.313,70
5
1,203871014 Rp 72.216.216,07
Rp 86.939.009,28
6
1,280677985 Rp 72.288.432,29
Rp 92.578.203,78
7
1,36238524 Rp 72.360.720,72
Rp 98.583.177,88
8
1,449305419 Rp 72.433.081,44
Rp 104.977.657,41
9
1,541771104 Rp 72.505.514,52
Rp 111.786.907,19
10
1,640136101 Rp 72.578.020,04
Rp 119.037.830,78
Tabel 8. Pendapatan Dari Ventilator
Tahun
Jumlah Pendapatan (P)
(1+6,38%)n
Tarif ventilator x jumlah pasien tahun ke
F/P
Jumlah Pendapatan F=Px(F/P)
n
1
-
- Rp 414.414.000,00
2
-
- Rp 414.414.000,00
3
1,0638 Rp 432.432.000,00
Rp 460.021.161,60
4
1,13167044 Rp 432.864.432,00
Rp 489.859.882,22
5
1,203871014 Rp 433.297.296,43
Rp 521.634.055,65
6
1,280677985 Rp 433.730.593,73
Rp 555.469.222,71
7
1,36238524 Rp 434.164.324,32
Rp 591.499.067,28
8
1,449305419 Rp 434.598.488,65
Rp 629.865.944,48
9
1,541771104 Rp 435.033.087,14
Rp 670.721.443,13
10
1,640136101 Rp 435.468.120,22
Rp 714.226.984,67
Tabel 9. Perkiraan Biaya Perawatan Tahun
1
(1+6,38%)n
Jumlah Biaya Perawatan (P)
F/P
-
Jumlah Pendapatan F=Px(F/P)
- Rp 17.706.389,84
2
1,0638 Rp 17.706.389,84
Rp 18.836.057,51
2
1,0638 Rp 18.500.000,00
Rp 19.680.300,00
3
1,13167044 Rp 18.500.000,00
Rp 20.935.903,14
4
1,203871014 Rp 18.500.000,00
Rp 22.271.613,76
5
1,280677985 Rp 18.500.000,00
Rp 23.692.542,72
6
1,36238524 Rp 18.500.000,00
Rp 25.204.126,94
7
1,449305419 Rp 18.500.000,00
Rp 26.812.150,24
8
1,541771104 Rp 18.500.000,00
Rp 28.522.765,43
9
1,640136101 Rp 18.500.000,00
Rp 30.342.517,86
10
1,744776784 Rp 18.500.000,00
Rp 32.278.370,50
Tabel 10. Pembiayaan Setiap Alternatif
Biaya Awal
Ventilator Neonates
Ventilator Neonatal
Hamilton C2
Bellavista 1000
Rp 541.040.520,62
Rp 669.000.650,00
1 Rp 89.706.389,84
Rp 91.152.052,16
2 Rp 90.790.989,84
Rp 92.332.352,16
3 Rp 96.614.980,92
Rp 98.258.148,90
4
Rp 102.815.510,78
Rp 104.566.979,62
Biaya Operasional
5
Rp 109.416.924,86
Rp 111.283.604,15
(C)
6
Rp 116.445.142,71
Rp 118.434.382,89
7
Rp 123.927.759,83
Rp 126.047.380,28
8
Rp 131.894.156,02
Rp 134.152.475,00
9
Rp 140.375.610,74
Rp 142.781.477,21
10
Rp 149.405.425,94
Rp 151.968.253,44
1
Rp 414.000.000,00
Rp 432.000.000,00
2
Rp 414.000.000,00
Rp 432.000.000,00
3
Rp 440.853.613,20
Rp 460.021.161,60
4
Rp 469.449.053,80
Rp 489.859.882,22
Pendapatan
5
Rp 499.899.303,33
Rp 521.634.055,65
(B)
6
Rp 532.324.671,76
Rp 555.469.222,71
7
Rp 566.853.272,81
Rp 591.499.067,28
8
Rp 603.621.530,12
Rp 629.865.944,48
9
Rp 642.774.716,33
Rp 670.721.443,13
10
Rp 684.467.526,97
Rp 714.226.984,67
10 tahun
10 tahun
Rp -
Rp
Useful life Salvage value (Asumsi: digudangkan)
-
Tabel 11. Analisis Perhitungan n
(1+i)n
Biaya
Pendapatan
F/P
PC x (F/P)
PB x (F/P)
P
1
1,075
Rp 83.447.804,50
Rp 385.116.279,07
2
1,155625
Rp 78.564.404,40
Rp 358.247.701,46
3
1,242296875
Rp 77.771.250,06
Rp 354.869.775,55
PW
4
1,335469141
Rp 76.988.308,94
Rp 351.523.700,19
(PWB – PWC)
Hamilton
5
1,435629326
Rp 76.215.303,53
Rp 348.209.175,04
Rp 2.186.539.039,25
C2
6
1,543301526
Rp 75.451.971,49
Rp 344.925.902,63
7
1,65904914
Rp 74.698.064,60
Rp 341.673.588,27
FW
8
1,783477826
Rp 73.953.347,85
Rp 338.451.940,06
(PW x (F/P)10)
9
1,917238662
Rp 73.217.598,56
Rp 335.260.668,85
Rp 4.506.525.971,79
10 2,061031562 Rp 72.490.605,52
Rp 332.099.488,21
PWC
Total
n
Rp 762.798.659,47
PWB Rp 3.490.378.219,34
(1+i)n
Biaya
Pendapatan
F/P
PC x (F/P)
PB x (F/P)
1
1,075
Rp 84.792.606,66
Rp 401.860.465,12
2
1,155625
Rp 79.898.195,49
Rp 373.823.688,48
3
1,242296875
Rp 79.093.935,50
Rp 370.298.896,23
4
1,335469141
Rp 78.299.809,74
Rp 366.807.339,32
Bellavista
5
1,435629326
Rp 77.515.555,11
Rp 363.348.704,39
1000
6
1,543301526
Rp 76.740.922,57
Rp 359.922.681,01
7
1,65904914
Rp 75.975.676,21
Rp 356.528.961,68
8
1,783477826
Rp 75.219.592,35
Rp 353.167.241,81
9
1,917238662
Rp 74.472.458,75
Rp 349.837.219,67
10 2,061031562 Rp 73.734.073,86
Rp 346.538.596,39
Total
Rp 3.642.133.794,09
Rp 775.742.826,25
Rp 541.040.520,62
PW dan FW alternatif 2 LEBIH MENGUNTUNGKAN.
P Rp 669.000.650,00
PW (PWB – PWC – P) Rp 2.197.390.317,85
FW (PW x (F/P)10) Rp 4.528.890.799,47
Tabel 12. Payback Period Nama Alat Hamilton C2
Formula
Tahun 1
– P + (Benefit – Cost) th 1
Tahun 2
Saldo balik modal 1 + (Benefit – Cost) th 2
Payback Period Bellavista 1000
Saldo balik modal
Rp (216.746.910,46) Rp 106.462.099,70
1 - (saldo balik modal 1/ (benefit-cost) tahun 2) = 1,67 tahun
Tahun 1
– P + (Benefit – Cost) th 1
Tahun 2
Saldo balik modal 1 + (Benefit – Cost) th 2
Payback Period
Rp (328.152.702,16) Rp 11.514.945,68
1 - (saldo balik modal 1/ (benefit-cost) tahun 2) = 1,97 tahun
Payback period alternatif 1 LEBIH CEPAT dari alternatif 2.
Tabel 13. Benefits Costs Ratio
PWB Hamilton C2
=
Rp 3.490.378.219,34
PWB Bellavista 1000
B
PWB Bellavista 1000
=
Rp 3.642.133.794,09
– PWB Hamilton C2
Rp 151.755.574,75
PWC Hamilton C2
=
Rp 762.798.659,47
PWC Bellavista 1000
C
PWC Bellavista 1000
=
Rp 775.742.826,25
– PWC Hamilton C2
Rp 12.944.166,77
BCR (B/C)
11,724
Karena BCR>1 maka pilih alternative dengan biaya awal paling besar yaitu Alternatif 2 (Ventilator Neonates B ellavista 1000)
DEPRESIASI
Formula 1. Straight Line (SL) d t
B
S
N
2. Sum of Years Digits
3. Unit of Production Depreciati on per unit
B
S
Total number of unit
Tabel 14. Depresiasi Alternatif 1
n
Hamilton C2
Straight Line
SOYD
BV
BV
UP Pasien
BV
0
Rp 541.040.520,62
Rp 541.040.520,62
Rp 541.040.520,62
1
Rp 486.936.468,56
Rp 442.669.516,87
1800 Rp 487.130.996,36
2
Rp 432.832.416,49
Rp 354.135.613,49
1800 Rp 433.221.472,11
3
Rp 378.728.364,43
Rp 275.438.810,50
1802 Rp 379.258.038,33
4
Rp 324.624.312,37
Rp 206.579.107,87
1804 Rp 325.240.641,12
5
Rp 270.520.260,31
Rp 147.556.505,62
1805 Rp 271.169.226,51
6
Rp 216.416.208,25
Rp 98.371.003,75
1807 Rp 217.043.740,48
7
Rp 162.312.156,19
Rp 59.022.602,25
1809 Rp 162.864.128,97
8
Rp 108.208.104,12
Rp 29.511.301,12
1811 Rp 108.630.337,85
9
Rp 54.104.052,06
Rp 9.837.100,37
1813 Rp 54.342.312,94
10
Rp
Rp (0,00)
1814 Rp (0,00)
-
Tabel 15. Depresiasi Alternatif 2
n
Bellavista 1000
Straight Line
SOYD
BV
BV
UP Pasien
BV
0
Rp 666.270.000,00
Rp 666.270.000,00
Rp 666.270.000,00
1
Rp 599.643.000,00
Rp 545.130.000,00
1800 Rp 599.882.553,30
2
Rp 533.016.000,00
Rp 436.104.000,00
1800 Rp 533.495.106,60
3
Rp 466.389.000,00
Rp 339.192.000,00
1802 Rp 467.041.272,45
4
Rp 399.762.000,00
Rp 254.394.000,00
1804 Rp 400.520.984,47
5
Rp 333.135.000,00
Rp 181.710.000,00
1805 Rp 333.934.176,20
6
Rp 266.508.000,00
Rp 121.140.000,00
1807 Rp 267.280.781,13
7
Rp 199.881.000,00
Rp 72.684.000,00
1809 Rp 200.560.732,65
8
Rp 133.254.000,00
Rp 36.342.000,00
1811 Rp 133.773.964,13
9
Rp 66.627.000,00
Rp 12.114.000,00
1813 Rp 66.920.408,84
10
Rp -
Rp
1814 Rp (0,00)
-
LAMPIRAN IV RENCANA JARINGAN PROYEK Tabel 16. Rencana Jaringan Proyek Alternatif 1 No.
1.
Kegiatan
Mengumpulkan data spesifikasi, fungsi, dan
Jalur
Waktu
-
1 minggu
2. Mencari penyedia barang
1
2 minggu
3. Membuat matrik pembanding (proposal)
2
3 hari
4. Mengajukan proposal
3
2 hari
5. Proposal disetujui
4
1 minggu
6. Kirim surat permintaan barang via email
5
1 hari
7. Tunggu balasan
6
1 minggu
8. Membuat surat kemitraan dan kerja sama
7
3 jam
9. Minta surat penawaran harga (negosiasi)
7
7 jam
10. Menjalin kerja sama di atas materai
9, 8
1 jam
11. Mencapai kesepakatan
9, 10
1 hari
12. Order pembelian (menunggu)
11
1 bulan
13. Barang diterima
12
1 hari
14. Disimpan di gudang
13
4 jam
15. Uji kelayakan
13, 14
1 bulan
16. Laporan barang telah diterima
13
1 hari
17. Membuat SOP dan jadwal pemeliharaan
15
4 hari
18. Terima faktur dari penyedia alat
16
3 hari
19. Alat dioperasikan
15, 17, 18
10 tahun
kegunaan alat
Gambar 1. Rencana Jaringan Proyek Alternatif 1
Gambar 2. Jalur Kritis Alternatif 1
Tabel 17. Rencana Jaringan Proyek Alternatif 2 No.
1.
Kegiatan
Mengumpulkan data spesifikasi, fungsi, dan
Jalur
Waktu
-
1 minggu
2. Mencari penyedia barang
1
2 minggu
3. Membuat matrik pembanding (proposal)
2
3 hari
4. Mengajukan proposal
3
2 hari
5. Proposal disetujui
4
1 minggu
6. Menghubungi penyedia barang dan membuat janji
5
2 hari
7. Menemui penyedia barang
6
1 hari
8. Minta surat penawaran harga (negosiasi)
7
2 jam
9. Mencapai kesepakatan
8
10 menit
10. Menjalin kerja sama di atas materai
9
20 menit
11. Order pembelian (menunggu)
10
1 bulan
12. Barang diterima
11
1 hari
13. Disimpan di gudang
12
4 jam
14. Uji kelayakan
12, 13
1 bulan
15. Laporan barang telah diterima
14
1 hari
16. Membuat SOP dan jadwal pemeliharaan
15
4 hari
17. Terima faktur dari penyedia alat
16
3 hari
18. Alat dioperasikan
14, 16, 17
10 tahun
kegunaan alat
Gambar 3. Rencana Jaringan Proyek Alternatif 2
Gambar 4. Jalur Alternatif 2
LAMPIRAN V RENCANA CASH F LOW
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9
10
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Gambar 5. Cash flow Alternatif 1
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8
9
10
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Gambar 6. Cash flow Alternatif 2
