SOP PENYIMPANAN RM
PENYIMPANAN BERKAS REKAM MEDIK PUSKESMAS DANGA No. Dokumen
No. Rev!
"#$#m#n
01/MEDIK/V/24/05/15/00
00
1 %#& 4
'#n((#$ 'e&)* 24 Me 2015
SPO REKAM MEDIK
D*n+#u Kem)#$ ,
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D*e*#-k#n D&ek*u&
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Pen(#&!-#n )e&k#! &ek#m me%k #%#$# !u#*u )en*uk -enm-#n#n/ -enu!un#n &ek#m &ek# m me%k ke %#$#m $em#& #&!-. 1. S*#n%#&!#! -enm-#n#n &ek#m me%k 2. Mem-e&m Mem-e&mu%# u%# %#n mem-e& mem-e&e-#* e-#* -enemu# -enemu#n n kem)#$ kem)#$ #&!#&!- &ek#m &ek#m me%k.
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1. S!*em -en(#&!-#n -en(#&!-#n &ek#m me%k #n( %(un#k#n #%#$# S!*em An(k# Ak& Ak& 3Terminal /'D #*u #*u !u#*u !u#*u !!*em !!*em -en(#&! -en(#&!-#n -#n erminal Digit Filing /'D %okumen %okumen &ek#m &ek#m me%k me%k %en(#n %en(#n men!e+#+ men!e+#+#&k# #&k#n n u&u*#n u&u*#n folder %okumen &ek#m me%k )e&%#!#&k#n u&u*#n nomo& &ek#m me%k -#%# 2 3%u# #n(k# ke$om-ok #k&. 2. Un*u Un*uk k men+ men+#$ #$#n #nk# k#n n !!* !!*em em n n *e&$ *e&$e) e) %#u %#u$u $u %! %!##-k# k#n n &#k &#k -enm-#n#n %en(#n mem)#(n# men+#% 100 3!e&#*u! nomo& #*#u 1 P&o!e%u&
3!#* 3!#*u u section !e!u# %en(#n 2 3%u# #n(k# ke$om-ok #k& *e&!e)u* mu$# %#& section 00601602 %#n !e*e&u!n# !#m-# section 77. 8. 9#&# menm-#n -#%# !e*#- section %! %en(#n folder %okumen %okumen &ek#m me%k %m#n# nomo& &ek#m me%k %en(#n 2 3%u# #n(k# ke$om-ok #k #k&& #n( #n( !#m !#m# %#n %#n(( ((##- !e)# !e)#(# (# digit -e&*#m -e&*#m## 3 Primary Primary Digit !e)#(# !e)#(# -#*ok#n. -#*ok#n. Se$#n+u Se$#n+u*n *n## !e#&# !e#&# )e&*u&u* )e&*u&u*,*u& ,*u&u* u* 3% )e$#k#n(n )e$#k#n(n# # %en(#n )e&-#*ok#n -#%# 2 3%u# #n(k# ke$om-ok *en(# !e)#(# digit ke%u# 3Secondary Digit %#n -#*ok#n
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Prosedur Pelayanan Instalasi Rekam Medis
a. TPPRJ
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'em-#* -ene&m##n -#!en &#:#* +#$#n #*#u *em-#* -en%#;*#&#n -#!en &#:#* +#$#n 3'PPR< %!e)u* +u(# $oke* -en%#;*#&#n -#!en &#:#* +#$#n. un(! #*#u -e&#nn# %#$#m -e$##n#n ke-#%# -#!en #%#$# !e)#(# -em)e& -e$##n#n #k#n %n$# %!n. Mu*u -e$##n#n me$-u* kee-#*#n ke*e-#*#n ke$en(k#-#n %#n ke+e$#!#n n;o&m#! ken#m#n#n &u#n( *un((u %#n $#n,$#n 3B#m)#n( So;#& 2004. De!k&-! -okok ke(#*#n -e$##n#n &ek#m me%! % 'PPR< 3B#m)#n( So;#& 2004 = Men#-k#n ;o&mu$& %#n #*#*#n !e&*# nomo& &ek#m me%! #n( %-e&$uk#n un*uk -e$##n#n. o&mu$& %#n #*#*#n #n( -e&$u %!#-k#n #*u = o&mu$&,;o&mu$& %okumen &ek#m me%! &#:#* +#$#n )#&u #n( *e$# %)e& nomo& &ek#m me%! #*u ;o&mu$& &ek#m me%! #n( )e$um )e&! #*#*#n -e$##n#n -#!en #n( $#$u. Buku &e(!*e& -en%#;*#&#n -#!en &#:#* +#$#n #*u )uku #n( )e&! #*#*#n %en**#! -#!en !e)#(# #*#*#n -en%#;*#&#n. Buku ek!-e%! #*u )uku #n( %(un#k#n un*uk !e&# *e&m# %okumen &ek#m me%! #(#& +e$#! !#-# #n( mene&m#n#. KIUP 3K#&*u In%ek! U*#m# P#!en #*u k#&*u n%ek! #n( %(un#k#n !e)#(# -e*un+uk -en#&#n kem)#$ %en**#! -#!en. KIB/K'PP 3K#&*u I%en**#! Be&o)#*/ K#&*u '#n%# Pen(en#$ P#!en #*u k#&*u %en**#! -#!en #n( %!e&#k#n ke-#%# o# un*uk %(un#k#n kem)#$ )$# %#*n( )e&o)#* $#(. '&#e& #*u k#&*u #n( %(un#k#n un*uk -e*un+uk %(un#knn# 3ke$u#&n# %okumen &ek#m me%! %#& &#k ;$n( !en((# %#-#* %(un#k#n un*uk -emn+#m#n %okumen &ek#m me%! ke ;$n(. Buku #*#*#n -en((un##n nomo& &ek#m me%! #*u )uku #n( )e&! #*#*#n -en((un##n nomo& &ek#m me%!. K#&! -en%#;*#&#n -#!en. Men#n#k#n ke-#%# -#!en #n( %#*n( #-#k# !u%# -e&n# )e&o)#*> B$# )e$um )e&#&* -#!en )#&u %#n )$# !u%# )e&#&* -#!en $#m# Pe$##n#n ke-#%# -#!en )#&u me$-u* = Men#n#k#n %en**#! -#!en !e#&# $en(k#- un*uk %#*#* -#%# ;o&mu$& &ek#m me%! -#!en &#:#* +#$#n KIB %#nKIUP. Mene&#k#n Mene&#k#n KIB ke-#%# -#!en %en(#n -e!#n un*uk mem)#:# kem)#$ )$# %#*n( )e&o)#* )e&ku*n#. Menm-#n KIUP !e!u# u&u*#n #)+#* 3#$;#)e*k. Men#n#k#n ke$u#n u*#m#n# (un# memu%#k#n m#n(#&#k#n -#!en ke -o$k$nk #n( !e!u#. Men#n#k#n #-#k# mem)#:# !u&#* &u+uk#n. B$# mem)#:# = 'em-e$k#n -#%# ;o&mu$& &ek#m me%! -#!en &#:#* +#$#n. B## !n# %*u+uk#n ke-#%# %ok*e& !#-# #*#u %#(no!!n# #-# (un# men(#&#k#n -#!en menu+u ke -o$k$nk #n( !e!u#. Mem-e&!$#k#n -#!en menun((u % &u#n( *un((u -o$k$nk #n( !e!u#. Men(&mk#n %okumen &ek#m me%! ke -o$ok$nk #n( !e!u# %en(#n men((un#k#n )uku ek!-e%!.
Pe$##n#n ke-#%# -#!en $#m# me$-u* = # Men#n#k#n *e&$e) %#u$u mem)#:# KIB #*#u *%#k. ) B$# mem)#:# KIB m#k# #*#*$# n#m# %#n nomo& &ek#m me%!n# -#%# *&#e& un*uk %mn*#k#n %okumen &ek#m me%! $#m# ke )#(#n ;$n(. B$# *%#k mem)#:# KIB m#k# *#n#k#n$# n#m# %#n #$#m#*n# un*uk %#& % KIUP. % Men#*#* n#m# %#n nomo& &ek#m me%! #n( %*emuk#n % KIUP -#%# *&#e& un*uk %mn*#k#n %okumen &ek#m me%! $#m# ke )#(#n ;$n(. e Mem-e&!$#k#n -#!en )#&u #*#u mem)##& % $oke* -em)##&#n. ; Pe$##n#n -#!en #!u&#n! ke!e#*#n %!e!u#k#n %en(#n -e&#*u&#n %#n -&o!e%u& #!u&#n! -en#n((un( )## -e$##n#n ke!e#*#n. 8 Se*e$# #k& -e$##n#n ke(#*#nn# #%#$# = # Men#*#* %en**#! -#%# )uku &e(!*e& -en%#;*#&#n -#!en &#:#* +#$#n. ) Menookk#n +um$# -#!en %en(#n +um$# -en%#;*#&#n -#!en &#:#* +#$#n %en(#n k#!& &#:#* +#$#n. Mem)u#* $#-o&#n #&#n *en*#n( = . Pen((un##n nomo& &ek#m me%! #(#& *%#k *e&+#% %u-$k#!. . Pen((un##n ;o&mu$& &ek#m me%! un*uk -en(en%#$#n -en((un##n ;o&mu$& &ek#m me%!. . Me&ek#-*$#! +um$# kun+un(#n -#!en )#&u %#n $#m# un*uk ke-e&$u#n !*#*!* &um# !#k*.
Rekam medis adalah sebuah berkas mengenai data sosial, data medis, maupun data yang berisi informasi mengenai segala tindakan dan segala keadaan pasien di masa lalu maupun di masa sekarang. Karena sebuah rekam medis berisi berkas keadaan pasien maka berkas tersebut harus dikelola dengan baik agar dapat terasakan manfaatnya. Jadi, pengertian rekam medis bukan hanya sebuah kegiatan pencatatan namun juga berbagai kegiatan mulai dari penerimaan pasien hingga pengambilan kembali maupun pemusnahan.
Rek#m me%! #%#$# !e(#$# )en*uk ke(#*#n %#& -ene&m##n -#!en n((# -#!en kem)#$ %#& *em-#* -e$##n#n ke!e#*#n )#k %#$#m ke#%##n !e#* m#u-un menn((#$. De;n! &ek#m me%! )e&%#!#&k#n K#mu! Be!#& B##!# In%one!# %-!#k#n -e&,k#*# #*u Rek#m 3KBBI 1775=?2? #n( )e&#&* 1 )e&k#! #*#u #n( %u#-k#n %#n %*u$! #*#u 2#!$ -e&ek#m#n #n( )e&u-# ke*e&#n(#n men(en# #!$ -en(o)#*#n *e&#%#- -#!en !e%#n(k#n Me%! 3KBBI 1775=@40 )e&#&* *e&m#!uk #*#u )e&u)un(#n %en(#n )%#n( ke%ok*e&#n. Menu&u* Huffman (1982:33 &ek#m me%! #%#$# n;o&m#! men(en# !#-# #-# men(#-# %m#n# )$#m#n# %#n )#(#m#n# -e$##n#n #n( %)e&k#n ke-#%# -#!en !e$#m# m#!# -e&#:#*#nn# #(#& $en(k#- m#k# &ek#m me%! #&u! )e&! n;o&m#! #n( uku- %#n !e#&# +e$#! mene&#n(k#n %en**#! -#!en men%ukun( %#(no!e mem)en#&k#n -en(o)#*#n #n( %*e&m#n# !e&*# men#*#* #!$,#!$ -eme&k!##n !e#&# *e-#*. Menu&u* !emala Hatta ("a#ar$una 2%%&:'3 &ek#m me%! #%#$# !#-# #-# men(#-# %m#n# #&#-#n %#n )#(#m#n# -e$##n#n #n( %-e&o$e -#!en !e$#m# %&#:#* %#n %o)#*. Se%#n(k#n -#%# Permenkes o. 2'9)Menkes)Per)III)2%%8 %+e$#!k#n )#:# &ek#m me%! #%#$# )e&k#! #n( )e&!k#n #*#*#n %#n %okumen *en*#n( %en**#! -#!en -eme&k!##n -en(o)#*#n *n%#k#n %#n -e$##n#n $#n #n( *e$# %)e&k#n ke-#%# -#!en. Se%#n(k#n menu&u* *ir+en ,anmed (2%%' %+e$#!k#n !e#&# $u#! )#:# &ek#m me%! *%#k #n# !eke%#& ke(#*#n -en#*#*#n #k#n *e*#- mem-un# -en(e&*#n !e)#(# !u#*u !!*em -ene$en((#&##n suatu
instalasi
atau
unit
kegiatan .
Se%#n(k#n
ke(#*#n
-en#*#*#nn# !en%& #n# me&u-#k#n !#$# !#*u )en*uk ke(#*#n #n( *e&#n*um % %#$#m u&##n *u(#! #n( %mu$# -#%# !##* %*e&m#n# -#!en % &um# !#k* %*e&u!k#n ke(#*#n -en#*#*#n %#*# me%k -#!en !e$#m# -#!en *u men%#-#*k#n -e$##n#n me%k % &um# !#k* %#n %$#n+u*k#n %en(#n -en#n(#n#n )e&k#! &ek#m me%! #n( me$-u* -ene$en((#&##n -enm-#n#n !e&*# -en(e$u#&#n )e&k#! %#& *em-#* -enm-#n#n un*uk me$##n -e&mn*##n #*#u -emn+#m#n #-#)$# %#& -#!en #*#u un*uk ke-e&$u#n $#nn#. Ke(#*#n Rek#m Me%! )e&%#!#&k#n SK D&+en Y#nme% No. YM.00.08.2.2.127@ *#un 1. 2. 8. 4. 5.
177@ #*u = Pene&m##n -#!en Pen#*#*#n Pen(e$o$##n D#*# Me%! Penm-#n#n Rek#m Me%! Pen(#m)$#n kem)#$ 3Re*&v#$ Se%#n(k#n )e&%#!#&k#n Pe%om#n Ak&e%e*#! RS *#un 2002 ke(#*#n &ek#m me%! #*u =
. 2. 8. 4. 5.
Pene&m##n -#!en 3-en#*#*#n %#*# !o!#$ -#!en Pen#*#*#n %#*#,%#*# -e$##n#n Pen(e$o$##n %#*# 3o%n( n%en( Pe$#-o&#n Penm-#n#n #*#u -en(#m)$#n kem)#$ D#& -en+e$#!#n %#*#! m#k# !e#&# (#&! )e!#& ke(#*#n &ek#m me%! *e&%& %#& 8
ke(#*#n #*u = 1. Pencatatan #*u -en#*#*#n %en**#! -#!en #n( %$#kuk#n % *em-#* -en%#;*#&#n #*#u *em-#* -ene&m##n -#!en 3'PP )#k % &#:#* +#$#n UGD m#u-un &#:#* n#- %#n %ke&+#k#n o$e -e*u(# &ek#m me%!. Pen#*#*#n #n#mne!# -eme&k!##n ;!k %#(no!! -eme&k!##n -enun+#n( *e&#- %#n *n%#k#n me%! %$#kuk#n % *em-#* -e$##n#n ke!e#*#n &#:#* +#$#n UGD %#n &#:#* n#- !e&*# &u#n( -eme&k!##n -enun+#n(. 2. Pengelolaan atau pengarsipan #*u u-## men(e$o$# &ek#m me%! #(#& !n# $en(k#- mu%# %!m-#n %#n mu%# %#m)$ kem)#$k# %)u*uk#n. Pen(e$o$##n )e&k#*#n %en(#n *em-#* -enm-#n#n &ek#m me%! !!*em -enomo&#n #$#*,#$#* #n( %(un#k#n #!!em)$n( %#n #n#$!# )#k !e#&# ku#$*#*; m#u-un ku#n**#*;. 8. Pengelolaan data #*u ke(#*#n men(um-u$k#n men(*un( %#n men(#n#$!# %#*#,%#*# %#& ke(#*#n m#u-un %#*#,%#*# me%! %#n non,me%! #n( #%# %&ek#m me%! !en((# men+#% $#-o&#n #*#u n;o&m#! #n( %)u*uk#n )#k o$e -#k n*e&n m#u-un ek!*e&n. -. Pen$elolaan dan Penyimanan Rekam Medis 1. "istem Penamaan Rekam Medis Penu$!#n N#m# -#%# )e&k#! &ek#m me%! menu&u* '#*# Pene$en((#&##n Rek#m Me%!
Rum# S#k* 31771=11 #%#$# = #. n#m# -#!en #&u! $en(k#- mnm#$ *e&%& %#& %u# !uku k#*#. Den(#n %emk#n #%# )e)e&#-# kemun(kn#n %#$#m -enu$!#n n#m# = 1 n#m# -#!en !en%& )$# *e$# *e&%& %#& %u# !uku k#*#. 2 n#m# -#!en !en%& %ku* %en(#n n#m# !u#m )$# %# me&u-#k#n -e&em-u#n )e&!u#m. 8 n#m# -#!en %$en(k#- %en(#n n#m# o&#n( *u# )#!#n# ##. 4 )#( -#!en #n( mem$k n#m# ke$u#&(#/m#&(# %%#u$uk#n %#n kemu%#n %ku* %en(#n n#m# -#!en !en%&. ). n#m# %*u$! %en(#n u&u; e*#k %#n men(ku* e+##n #n( %!em-u&n#k#n. . )#( -#!en -e&em-u#n %#k& %en(#n N. A*#u Nn. !e!u# %en(#n !*#*u!n#. %. -en#n*um#n **e$ %*u$! !e*e$# n#m# $en(k#- -#!en. e. *u#n !#u%#&# )#-#k *%#k %#n*umk#n. 2. "istem Penomoran Rekam Medis P#%# !e*#- $em)#(# -e$##n#n ke!e#*#n &ek#m me%! %!m-#n !e!u# nomo& #*u nomo&
-#!en m#!uk 3 admission number . Menu&u* )uku '#*# 9#&# Pene$en((#&##n Rek#m Me%! Rum# S#k* !!*em -enomo&#n -#!en m#!uk #%# *(# #*u =
#. -em)e&#n nomo& #&# !e& S!*em n %$#kuk#n %en(#n #&# mem)e&k#n nomo& &ek#m me%! #n( )e&)e%# !e*# -#!en )e&kun+un( ke &um# !#k* *e&!e)u*. Sen((# &ek#m me%!n# -un %!m-#n
%
)e&)#(# *em-#* !e!u# %en(#n nomo&n#. ). -em)e&#n nomo& #&# un* S!*em n %$#kuk#n %en(#n mem)e&k#n #n# nomo& &ek#m me%! )#k un*uk )e&o)#* &#:#* +#$#n m#u-un &#:#* n#-. Sen((# nomo& *e&!e)u* #k#n %(un#k#n o$e -#!en !e*#k#$ )e&o)#* ke &um# !#k* *e&!e)u* %#n )e&k#! &ek#m me%!n# -un #n# %!m-#n -#%# !#*u *em-#* %en(#n !#*u nomo& #n( !#m#. . -em)e&#n nomo& #&# !e& un* S!*em n me&u-#k#n (#)un(#n %#& ke%u# !!*em %#*#!. <#% -#!en #k#n %)e&k#n nomo& &ek#m me%! #n( )#&u !e*#- )e&kun+un( ke &um# !#k*. N#mun )e&k#! &ek#m me%!n# #k#n %!m-#n %)#:# &ek#m me%! !e)e$umn#. Se*#- &ek#m me%! #n( %#m)$ %#n %-n%#k#n #&u! %)e&k#n #*#*#n -#%# *em-#* !e)e$umn# %-n%#k#n kem#n# &ek#m me%! *e&!e)u*. D#& ke*(# !!*em *e&!e)u* !!*em !e& un* $# #n( %#n((#- -#$n( e;ek*; k#&en# #k#n memu%#k#n -e*u(#! &ek#m me%! %#$#m -en(e$o$##nn#. Se$#n *u +u(# #k#n e-#* un*uk men((#m)#&k#n &:##* -en#k* ! -#!en. Se%#n(k#n -#%# !!*em !e& ke$em##nn# *e&$e*#k -#%# $e*#k )e&k#! #n( )e&ee&#n %#n !!*em !e& un* ke$em##nn# -#%# ke(#*#n memn%#,mn%#k#n )e&k#! *e&!e)u*. 3. "istem Penyimanan Rekam Medis Ke(#*#n -enm-#n#n &ek#m me%! )e&*u+u#n un*uk me$n%un(n# %#& ke&u!#k#n ;!k %#n
!n# *u !en%&. Rek#m me%! #&u! %$n%un( %#n %&#:#* k#&en# me&u-#k#n )en%# #n( !#n(#* )e&#&(# )#( &um# !#k*.
A%# %u# #&# -enm-#n#n )e&k#! &ek#m me%! *u !en%& #*u = a. sentralisasi #*u -enm-#n#n &ek#m me%! %m#n# #n*#&# &ek#m me%! kun+un(#n -o$k$nk %#n &ek#m me%! ke*k# -#!en %&#:#* %)u#* men+#% !#*u ke!#*u#n %#n %!m-#n % )#(#n &ek#m me%!. Ta#el.1. Penyimanan "entralisasi
1
/00-IH /00MH %#-#* men(u&#n( *e&+#%n# %u-$k#!1 -e&$u :#k*u %#$#m -e$##n#n &ek#m me%!
)e&k#! &ek#m me%! 2 %#-#* mene&#(#mk#n *#*# ke&+# -e&#*u&#n2 -e&$u &u#n(#n #$#* %#n -e(#:# #n( $e) %#n #$#* #n( %(un#k#n )#n#k +k# *em-#* -enm-#n#n +#u 8 e;!en! ke&+# -e*u(#! %en(#n $ok#! -en((un##n &ek#m me%! 4 -e&mn*##n &ek#m me%! %#-#* %$##n !e*#- !##* #. desentralisasi #*u !!*em -enm-#n#n &ek#m me%! %m#n# *e&+#% -em!##n #n*#&# &ek#m me%! kun+un(#n -o$k$nk %#n &ek#m me%! !e$#m# -#!en %&#:#*. Rek#m me%! kun+un(#n -o$k$nk %!m-#n % -o$k$nk #n( )e&!#n(ku*#n !e%#n(k#n &ek#m me%! -e&#:#*#n %!m-#n % )#(#n &ek#m me%!. Ta#el.2. Penyimanan *esentralisasi 1
e;!en!
/00-IH :#k*u %m#n#
-#!en1
men%#-#*k#n -e$##n#n #n( $e) e-#*
/00MH *e&+#% %u-$k#! &ek#m me%! !en((#
&:##* -en#k* *e&-!#
2 ke&+# -e*u(#! &ek#m me%! $e) &n(#n 2 )## -en(#%##n &ek#m me%! $e) )#n#k 8 -en(#:#!#n *e&#%#- )e&k#! &ek#m me%!8 )en*uk %#n ! &ek#m me%! )e&)e%# 4 men(#m)#* -e$##n#n +k# &ek#m me%! $e) ke*#* k#&en# $n(ku-n# !em-* %)u*uk#n o$e un* $#n Se%#n(k#n !!*em -enm-#n#nn# )#!#n# %$#kuk#n %en(#n !!*em nume&k. A%# *(# !!*em nume&k %#$#m -enm-#n#n )e&k#! &ek#m me%! #*u = a. sistem nomor lan$sun$ (straight numerical filling system #*u -enm-#n#n )e&k#! &ek#m me%! -#%# !e#&# )e&u&u*#n !e!u# %en(#n nomo& u&u* &ek#m me%! *e&!e)u*. M!#$n# = 220710 220711 220712 %#n !e*e&u!n#. Kelebihan : 1 memu%#k#n %#$#m -en(#m)$#n !e+um$# &ek#m me%! %en(#n nomo& #n( )e&u&u*#n %#n un*uk &ek#m me%! #n( *%#k #k*; $#( 2 memu%#$#n %#$#m me$#* -e*u(#! -enm-#n#n &ek#m me%! Kelemahan : 1 ke!)uk#n *%#k me&#*# ke(#*#n *e&!e)uk *e&+#% -#%# &#k -enm-#n#n &ek#m me%! %en(#n nomo& *e&)#&u
2 -e&$u kon!en*&#! -e*u(#! un*uk men(n%#& ke!#$##n -enm-#n#n &ek#m me%! 3nomo& *e&*uk#& 8 -en(#:#!#n ke&#-#n !uk#& %$#kuk#n #. sistem nomor akir (terminal digit filling system #*u !!*em #n( men((un#k#n nomo& %en(#n @ #n(k# #n( %ke$om-okk#n men+#% *(#. An(k# -e&*#m# *e&%& %#& %u# ke$om-ok #n(k# #n( *e&$e*#k -#$n( k#n#n #n(k# ke%u# *e&%& %#& %u# ke$om-ok #n(k# #n( *e&$e*#k % *en(# %#n #n(k# ke*(# *e&%& %#& %u# #n(k# #n( *e&$e*#k -#$n( k&. M!#$n# = 22 %9 1% (an$ka keti$a (an$ka kedua (an$ka ertama tertiary digit secondary digit primary digit D#$#m -enm-#n#n %en(#n !!*em #n(k# #k& #%# 100 ke$om-ok #n(k# -e&*#m# #*u 00 !#m-# %en(#n 77. -#%# :#k*u menm-#n -e*u(#! #&u! me$#* #n(k# -e&*#m# %#n mem)#:# &ek#m me%! *e&!e)u* ke%#e&# &#k -enm-#n#n un*uk ke$om-ok #n(k# -e&*#m# #n( )e&!#n(ku*#n. P#%# ke$om-ok #n(k# -e&*#m# n &ek#m me%! %!e!u#k#n u&u*#n $e*#kn# menu&u* #n(k# ke%u# kemu%#n &ek#m me%! %m-#n %%#$#m u&u*#n !e!u# %en(#n ke$om-ok #n(k# ke*(# !en((# %#$#m !e*#- ke$om-ok -enm-#n#n nomo& -#%# ke$om-ok #n(k# ke*(#$# #n( !e$#$u )e&$#n#n. 9on*o = 22,07,10 28,07,10 24,07,10 25,07,11 2@,07,12 Kelebihan : 1 -e&*#m)##n &ek#m me%! me&#*# ke 100 ke$om-ok 3!e*on % %#$#m &#k -enm-#n#n 2 -eke&+##n -enm-#n#n %#n -en(#m)$#n &ek#m me%! %#-#* %)#( !e#&# me&#*# 8 keke$&u#n menm-#n %#-#* % e(# k#&en# -e*u(#! #n# mem-e&#*k#n 2 3%u# #n(k# #k& !#+# %#$#m mem#!ukk#n &ek#m me%! ke%#$#m &#k Se%#n(k#n kelemahann# #%#$# -e&$u :#k*u #n( uku- $#m# un*uk me$#* %#n mem)m)n( -e*u(#! -enm-#n#n. 4. sistem nomor ten$a (middle digit
D#$#m !!*em -enm-#n#n #n(k# *en(# &ek#m me%! %u&u*k#n %en(#n -#!#n(#n #n(k#, #n(k#. An(k# #n( *e&$e*#k %*en(# men+#% #n(k# -e&*#m# #n(k# #n( *e&$e*#k -#$n( k& men+#% #n(k# ke%u# %#n #n(k# -#$n( k#n#n men+#% #n(k# ke*(#. 9on*o = 22 (an$ka kedua
%9 1% (an$ka ertama (an$ka keti$a
Kelebihan : 1 memu%#k#n -en(#m)$#n 100 )u# &ek#m me%! #n( nomo&n# )e&u&u*#n 2 -en((#n*#n %#& !!*em nomo& $#n(!un( ke !!*em #n(k# *en(# $e) mu%# %#&-#%#
-en((#n*#n !!*em nomo& $#n(!un( ke !!*em #n(k# #k& 8 -ene)#&#n nomo&,nomo& $e) me&#*# +k# %)#n%n(k#n %en(#n !!*em nomo& $#n(!un( *e*#- m#! *%#k men#m# !!*em #n(k# #k& 4 -e*u(#! %#-#* %)#( -#%# !e*on -enm-#n#n *e&*en*u !en((# keke$&u#n menm-#n %#-#* % e(# Kelemahan : 1 meme&$uk#n $#*#n %#n )m)n(#n #n( $e) $#m# )#( -e*u(#! 2 *e&+#% &#k $o:on( -#%# )e)e&#-# !e*on )$# &ek#m me%! %#$k#n ke *em-#* -enm-#n#n n,#k*; 3De-ke! 1771 = 17
5. Pen$am#ilan /em#ali (Retri6al -erkas Rekam Medis Pen(#m)$#n &ek#m me%! +u(# mem$k *#*# #&# *e&*en*u. A%#-un *#*# #&# -en(#m)$#n
&ek#m me%! -#!en #n( %)u*uk#n %#& &u#n( -enm-#n#n &ek#m me%! #%#$# !e)#(# )e&ku*= 1. Pen$eluaran rekam medis Ke*en*u#n -okok #n( #&u! %*##* % *em-#* -enm-#n#n #%#$# = #. &ek#m me%! *%#k )o$e ke$u#& %#& &u#n(#n &ek#m me%! *#n-# *#n%# ke$u#&/k#&*u -e&mn*##n. ). #-#)$# &ek#m me%! %-n+#m :#+) %kem)#$k#n %#$#m ke#%##n )#k %#n *e-#* :#k*un#. Se#&u!n# !e*#- &ek# me%! kem)#$ $#( ke&#kn# -#%# !e*#- #k& ke&+# -#%# #& #n( )e&!#m##n. . &ek#m me%! *%#k % )en#&k#n %#m)$ %#& &um# !#k* keu#$ #*#! -e&n*# -en(#%$#n.
%. -e&mn*##n &u*n *e&#%#- &ek#m me%! #n( %#*#n( %#& -o$k$nk %#& %ok*e& #n( me$#kuk#n &!e* #&u! %#+uk#n ke)#(#n &ek#m me%! !e*#- #& -#%# +#m #n( *e$# %*en*uk#n. -e*u(#! #&u! menu$! %en(#n )en#& %#n +e$#! n#m# -#!en %#n nomo& &ek#m me%!n#.
2. Petun+uk keluar (outguide Pe*un+uk ke$u#& #%#$# !u#*u #$#* #n( -en*n( un*uk men(#:#! -en((un##n &ek#m me%!.
Pe*un+uk ke$u#& n %(un#k#n !e)#(# -en((#n* -#%# *em-#* &ek#m me%! #n( %#m)$ %#& &#k -enm-#n#n %#n *e*#- )e&#%# % &#k *e&!e)u* !#m-# &ek#m me%! #n( %#m)$ kem)#$. 3. /ode 7arna (sampul map Ko%e :#&n# #%#$# un*uk mem)e&k#n :#&n# *e&*en*u -#%# !#m-u$ un*uk mene(# ke$&u
!m-#n %#n memu%#k#n men#& m#- #n( !#$# !m-#n. G#&!,(#&! :#&n# %en(# -o!! #n( )e&)e%# -#%# -n((&#n ;o$%e& men-*#k#n )e&m##m,m##m -o!! :#&n# #n( )e&)e%#,)e%# un*uk *#- !e*on -enm-#n#n &ek#m me%!. 'e&-u*u!n# kom)n#! :#&n# %#$#m !#*u !ek! -enm-#n#n menun+ukk#n #%#n# keke$&u#n menm-#n. 9#&# #n( %(un#k#n #%#$# 10 m##m :#&n# un*uk 10 #n(k# -e&*#m# %#& 0 !#m-# 7. 3De-. Ke! 1771 = 2. *. Ruan$ Pen$elolaan dan Penyimanan Rekam Medis
Cok#! &u#n(#n &ek#m me%! #&u! %#-#* mem)e& -e$##n#n e-#* ke-#%# !e$u&u -#!en mu%# %+#n(k#u %#& !e(#$# -en+u&u %#n mu%# menun+#n( -e$##n#n #%mn!*&#!. A$#* -enm-#n#n #n( )#k -ene&#n(#n #n( )#k -en(#*u&#n !uu &u#n(#n -eme$#&##n &u#n(#n -e&#*#n *e&#%#- ;#k*o& ke!e$#m#*#n -e*u(#! )#( !u#*u &u#n(#n -enm-#n#n &ek#m me%! !#n(#* mem)#*u meme$#&# %#n men%o&on( ke(#&##n ke&+# %#n -&o%uk*v*#! -e(#:#. Pene&#n(#n #*#u $#m-u #n( )#k men(n%#& ke$e$##n -en($#*#n -e*u(#!. Pe&$u %-e&#*k#n -en(#*u&#n !uu &u#n(#n ke$em)#)#n -ene(##n %e)u %#n -ene(##n )### ke)#k#&#n. Ru#n(#n -enm-#n#n #&!- #&u! mem-e&#*k#n #$,#$ )e&ku* = 1. Ru#n(#n -enm-#n#n #&!- +#n(#n *e&$#$u $em)#) #&u! %+#(# !u-## *e*#- ke&n(. Su-## &u#n(#n *%#k *e&$#$u $em)#) -e&$u %#*u& )e&k!#& @50 !#m-# 50 %#n ke$em)#)#n u%#&# !ek*#& 50 !#m-# @5. Un*uk %%u-k#n !e$#m# 24 +#m *e&u! mene&u!. Pe&#*k#n A9 +u(# )!# men(u&#n( )#n#kn# %e)u. 2. Ru#n(#n #&u! *e&#n( %#n !e)#kn# men((un#k#n -ene&#n(#n #$#m #*u !n#& m#*##&. Sn#& m#*##& !e$#n mem)e&k#n -ene&#n(#n &u#n(#n +u(# %#-#* mem)#n*u mem)#!m mu!u ke&*#! #&!-.
8. Ru#n(#n en%#kn# *e&n%#& %#& !e&#n(#n #m# -e&u!#k #*#u -em#k#n ke&*#! #&!- #n*#&# $#n +#mu& &##- n(en(#*. Un*uk men(n%#&n# %#-#* %(un#k#n !o%um #&!en*e %en(#n me$e*#kk#nn# % e$#,e$# $#n*#. Se*#- en#m )u$#n !ek#$ &u#n(#n %!em-&o* %en(#n &#un !e&#n((# !e-e&* = DD' De$%&n P&*&um G##m# Benene "e#$o&%e %en(#n #&# menem-&o*k#n &#un -#%# %n%n( $#n*# %#n #$#*,#$#* #n( %)u#* %#& k#u. 4. Ru#n(#n -enm-#n#n #&!- !e)#kn# *e&-!# %#& &u#n(#n k#n*o& $#n un*uk men+#(# ke#m#n#n #&!-,#&!- *e&!e)u* men(n(#* )#:# #&!- *e&!e)u* !;#*n# &##!# men(u&#n( $#$u $n*#! -e(#:# $#nn# %#n men(n%#& -e(#:# $#n mem#!uk &u#n(#n !en((# -enu&#n #&!- %#-#* %n%#&. 3Fu&!#n*o 1771 = 221. A$#* -enm-#n#n &ek#m me%! #n( umum %-#k# #%#$# &#k *e&)uk# 3o-en !e$; ;$e un* $em#& $m# $# 3;ve,%&#:e& ;$e #)ne* %#n roll o’pack. A$#* n #n# m#m-u %m$k o$e &um# !#k* *e&*en*u k#&en# #&(#n# #n( !#n(#* m##$. R#k *e&)uk# %#n+u&k#n k#&en# #&(#n# $e) mu&# -e*u(#! %#-#* men(#m)$ %#n menm-#n &ek#m me%! $e) e-#* %#n men(em#* &u#n(#n %en(#n men#m-un( $e) )#n#k &ek#m me%! %#n *%#k *e&$#$u m#k#n *em-#*. "#&u! *e&!e%# &#k, &#k -enm-#n#n #n( %#-#* %#n(k#* %en(#n mu%# #*#u &#k,&#k )e&o%#. 5. <#&#k #n*#&# %u# )u# &#k un*uk $#$u $#$#n( %#n+u&k#n !e$e)#& 70 m. <k# men((un#k#n $em#& $m# $# %+e+e& !#*u )#&! &u#n(#n $o:on( %%e-#nn# #&u! 70 m +k# %$e*#kk#n !#$n( )e&#%#-#n #&u! %!e%#k#n &u#n( $o:on( -#$n( *%#k 150 m un*uk memun(knk#n mem)uk# $#,$# *e&!e)u*. Cem#& $m# $# mem#n( *#m-#k $e) &#- %#n &ek#m me%! *e&$n%un(%#& %e)u %#n ko*o&#n %#& $u#&. Peme$#&##n ke)e&!#n #n( )#k #k#n meme$#&# &ek#m me%! *e*#- &#- %#$#m #$ -en((un##n &#k,&#k *e&)uk#. #k*o&,;#k*o& ke!e$#m#*#n #&u! %u*#m#k#n -#%# )#(#n -enm-#n#n &ek#m me%!. 3De-.Ke! 1771 = 24. 0. Peren4anaan -erkas Rekam Medis yan$ Tidak ktif
Re*en! #*#u $#m#n# -enm-#n#n &ek#m me%! %#*u& )e&%#!#&k#n Su&#* Ke-u*u!#n Nomo& = YM.00.08.8.8@?8 *#n((#$ 1@ A(u!*u! 1771 *en*#n( +#%:#$ &e*en!/$#m# -enm-#n#n &ek#m me%!. Pemu!n##n &ek#m me%! men(#u ke-#%# Su&#* E%#&#n D&+en Y#n.Me% Nomo& "K.00.05.001.@0 *#un 1775 *en*#n( -e*un+uk *ekn! -en(#%##n ;o&mu$& &ek#m me%! %#n -emu!n##n )e&k#! &ek#m me%! % &um# !#k*. Be&ku* n #%#$# +#%:#$ &e*en!/$#m#n# -enm-#n#n &ek#m me%!. Ta#el.3. Jad7al Retensi atau amanya Penyimanan o. 1.
/"" Pen#k* %#$#m =
#. umum ). +#n*un(
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S#&#; Pen#k* ku$* =
#. umum ). ku!*# 4.
10 *#un
2 *#un
5 *#un 5 *#un
2 *#un 2 *#un
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15 *#un
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15 *#un 5 *#un 5 *#un 5 *#un 5 *#un 10 *#un 5 *#un
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10 *#un
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5 *#un D*en*uk#n
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<:# = #. umum ). Ke*e&(#n*un(#n o)#*
5. @. . ?. 7. 10. 11.
An#k Ke)%#n#n/k#n%un(#n Be%# Be%# !#&#; O&*o-e% '"' G( %#n mu$u* =
#. n;ek! &##n( 1 %e:#!# 2 #n#k ). *&#um# . ##* )#:##n 1 e$# ))& 2 e$# $#n(* %. ke$#n#n &##n( e. *umo& ;. eo%en*# (. o&*o%en* . e%o%en* . -e&o%en* 1 -&o*e* 2 -e%o%en*
12.
K#!u! $#nn#
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o$e
m#!n(, !e!u#
ke*en*u#nn# Sum)e& = Buku Pe%om#n Rek#m Me%! 3RSU Gunun( S*o$ 2005 = 85
P#%# umumn# &ek#m me%! %n#*#k#n *%#k #k*; #-#)$# !e$#m# 5 *#un *e&#k& &ek#m me%! *e&!e)u* *%#k %(un#k#n $#(. A-#)$# *%#k *e&!e%# *em-#* -enm-#n#n &ek#m me%! #k*; #&u! %$#k!#n#k#n ke(#*#n men!k#n &ek#m me%! #n( #k*; !e&#m# %en(#n -e&*#m)##n +um$# &ek#m me%! )#&u %#n -#%# !##* %#m)$n# &ek#m me%! *%#k #k*; % *em-#* !emu$# #&u! %$e*#kk#n *#n%# ke$u#& un*uk mene(# -en#&#n #n( )e&$#&u*,$#&u* -#%# !##* %-e&$uk#n. Rek#m me%! #n( *%#k #k*; %#-#* %!m-#n % &u#n(#n $#n #n( *e&-!# %#& )#(#n &ek#m me%! #*#u %)u#* microfilm. <k# %(un#k#n microfilm, &ek#m me%! #k*; %#n *%#k #k*; %#-#* %!m-#n )e&!#m##n k#&en# -enm-#n#n microfilm *%#k )#n#k mem#k#n *em-#*. 3De-.Ke! 1771 =80. Se)#(#n )e!#&
&ek#m me%! !e$#$u men(#%#-
m#!#$# ku&#n(n#
&u#n(
-enm-#n#n. S#*u &en#n# #n( -#!* *en*#n( -en(e$o$##n &ek#m me%! #n( *%#k #k*; 3in active records #&u! %*e*#-k#n !en((# !e$#$u *e&!e%# *em-#* -en-#n#n un*uk &ek#m
me%! #n( )#&u. P#*ok#n u*#m# un*uk menen*uk#n &ek#m me%! #k*; #*#u *%#k #k*; #%#$# )e!#&n# &u#n(#n #n( *e&!e%# un*uk menm-#n &ek#m me%! #n( )#&u. Su#*u &um# !#k* menen*uk#n 5 *#un #%#$# )#*#! umu& un*uk &ek#m me%! #k*; !e%#n(k#n % &um# !#k* $#n &ek#m me%! #n( )e&umu& 2 *#un !u%# %n#*#k#n *%#k #k*; k#&en# !#n(#* *e&)#*#!n# &u#n( -enm-#n#n.
. Pemusnaan -erkas Rekam Medis
Se!u# Pe&menke! No. 2@7/MENKES/PER/III/200? %+e$#!k#n )#:# un*uk Pe$##n#n Ke!e#*#n % Rum# S#k* %#$#m men(e$o$# %#n -emu!n##n &ek#m me%! m#k# #&u! memenu #*u&#n !e)#(# )e&ku*= 1. Rek#m me%! -#!en &#:#* n#- :#+) %!m-#n !eku&#n(,ku#n(n# 5 *#un !e+#k -#!en )e&o)#* *e&#k& #*#u -u$#n( %#& )e&o)#* % &um# !#k*. 2. Se*e$# 5 *#un &ek#m me%! %#-#* %mu!n#k#n keu#$ &n(#k#!#n -u$#n( %#n -e&!e*u+u#n *n%#k#n me%k. 8. Rn(#k#!#n -u$#n( %#n -e&!e*u+u#n *n%#k#n me%k :#+) %!m-#n %#$#m +#n(k# :#k*u 10 !e+#k &n(k#!#n %#n -e&!e*u+u#n me%k %)u#*. 4. Rek#m me%! %#n &n(k#!#n -u$#n( %!m-#n o$e -e*u(#! #n( %*un+uk o$e -m-n#n !#&#n# -e$##n#n ke!e#*#n. Un*uk Pe$##n#n Ke!e#*#n non &um# S#k* %#$#m men(e$o$# %#n -emu!n##n &ek#m me%! #&u! memenu #*u&#n !e)#(# )e&ku*= 1. Rek#m me%! -#!en :#+) %!m-#n !eku&#n(,ku#n(n# 2 *#un !e+#k -#!en )e&o)#* *e&#k& #*#u -u$#n( %#& )e&o)#*. Se*e$# 2 *#un m#k# &ek#m me%! %#-#* %mu!n#k#n.
Ke&##!##n ! &ek#m me%! #n( )e&u-# %en**#! %#(no!! &:##* -en#k* &:##* -eme&k!##n %#n &:##* -en(o)#*#n #&u! %+#(# ke&##!##nn# o$e %ok*e& %ok*e& (( -e*u(#! ke!e#*#n $#n -e*u(#! -en(e$o$# %#n -m-n#n !#&#n# -e$##n#n ke!e#*#n. Un*uk ke-e&$u#n *e&*en*u &ek#m me%! *e&!e)u* %#-#* %)uk# %en(#n ke*en*u#n= 1. Un*uk ke-en*n(#n ke!e#*#n -#!en. 2. A*#! -e&n*# -en(#%$#n un*uk -ene(#k#n ukum. 8. Pe&mn*##n %#n #*#u -e&!e*u+u#n -#!en !en%&. 4. Pe&mn*##n $em)#(# /n!**u! )e&%#!#&k#n un%#n(,un%#n(. 5. Un*uk ke-en*n(#n -ene$*#n #u%* -en%%k#n %en(#n !#&#* *%#k mene)u*k#n %en**#! -#!en. Pe&mn*##n &ek#m me%! *e&!e)u* #&u! %$#kuk#n *e&*u$! ke-#%# -m-n#n !#&#n# -e$##n#n ke!e#*#n. Se!u# Ke*en*u#n Pe&menke! No. 2@7/MENKES/PER/III/200? m#k# k*# %#-#* men+#$#nk#n -en(e$o$##n &ek#m me%! % &um# !#k* m#u-un non &um# !#k*. Dok*e& %ok*e& (( %#n -e*u(#! $#n -en(e$o$# %#n -m-n#n #&u! men+#(# ke&##!##n &ek#m me%! !e&*# %#-#* mem#n;##*k#n &ek#m me%! !e!u# ke*en*u#nn#
SOP Pen$##n Ke$en(k#-#n %#n Ke*e-#*#n I! Rek#m Me%! Pen(e&*#n =Rek#m me%! #%#$# #*#*#n kon%! ke!e#*#n -#!en -en(o)#*#n &en#n# *n%#k#n %#n *e&#- -#!en #n( #&u! *e&+#mn ke&##!##nn#. Rek#m me%! #&u! %n$# %#n %! %en(#n $en(k#- %#n +e$#! tujuan =Men$# %#n me$en(k#- ! &ek#m me%! mem)u#* )uk* -e$#k!#n##n #!$ %#n *n%#k $#n+u* -en$##nKe)+#k#n =Semu# &ek#m me%! #&u! %)u#* !e#&# *e&*u$! $en(k#%#n +e$#!Ree&en! = P&o!e%u& =)e&k#! &ek#m me%! %n$# 10 %#& +um$# kun+un(#n !e*#- #&n# )e & k # ! & e k # m m e % ! % n $ # ! e * # - # & H . P e n $ # # n % $ # k u k # n % e n ( # n e k $ ! * . % $ # k uk # n & e k # - # n # ! $ - e n $ # # n % $ # k u k # n * n % # k $ # n + u * !e *e $# -e n $# # n un* *e&k#* =
Pe*u(#! -en%#;*#&#n %ok*e& ten#(# ke!e#*#n $#nn#
UP'DKESE"A'ANPUSKESMASPEKKAEPENICAIAN DAN KECENGKAPAN REKAM MEDISS'ANDARPROSEDUROPERASIONAC N o . D o k u m e n = D * e * # k # n o $ e Ke-#$# UP'D Ke!e#*#nPu!ke!m#! Pekk#e ". '#!: S.#&mA-* NIP.1700418 177108 100@N o . R e ! = '#n#$ 'eJ*= # $ # m # n = 1 . P e n ( e & * # n R e k # m m e % ! # % # $ # # * # * # n k o n % ! k e ! e # * # n - # ! e n - e n ( o ) # * # n &en#n# *n%#k#n %#n *e&#- -#!en #n( #&u! % +#mn ke&##!##nn#. Rek#m me%! #&u! % n$# %#n %! %en(#n $en(k#- %#n +e$#!.2 . ' u + u # n M e n $ # % # n m e $ e n ( k # - ! & e k # m m e % ! m e m ) u # * ) u k * - e $ # k ! # n # # n # ! $ %#n *n%#k $#n+u* -en$##n.8 .K e)+#k# n emu# &ek#m me%! #&u! % )u#* ! e#&# *e&*u$! $en(k#%#n +e$#!. . R e e & e n ! P e & m e n k e ! n o . 2 J * # u n 2 L . H.P&o!e%u&3 # n ( k # $#n(k#1 . ! & e k # m m e % ! u n * u k - # ! e n & # # * + # $ # n m e m u # * # . % e n * * # ! - # ! e n ).*#n((#$ %#n #k*u . # ! $ # n # m n e ! ! k e $ u # n % # n &##* -en#k*,%.#!$ -eme&k!##n !k %#n - e n u n + # n ( e . % # ( n o ! ! . & e n # n # - e n # * # $ # k ! # n # # n ( . - e n ( o ) # * # n # * # u * n % # k # n .u n*u k -#! e n # n( k#!u! (( %$en(k#- %en(#n o%on*o(&#m k$nk.. -e &! e* u+ u# n * n% #k #n ) $# % - e & $ u k # n 2 . ! &e k# m m e% ! u n* uk - #! e n (# # * % #& u& #* me mu #* # . % e n * * # ! - # ! e n ).kon%! !##* -#!en *)# % -u!ke!m#! . * # n ( ( # $ % # n # k * u % . # ! $ # n # m n e ! ! k e $ u # n % # n & # # * - e n # k * , e . # ! $ - e m e & k ! # # n ! k % # n - en u n+ # n( m e % ! . . # ( n o ! ! ( . - e n ( o ) # * # n % # n * n % # k # n .n#m# %#n *#n%# *#n(#n %ok*e& #*#u %ok*e& (( #*#u n#m# *en#(# ke!e#*#n *e&*en*u #n( mem)e&k#n *en#(# ke!e#*#n. . ! # & # n # * & # n ! o & * # ! # n ( % ( u n# k # n )# ( -# ! e n # n ( # k# n % -n%#k#n ke!#&#n# ke!e#*#n #n( $#n.8.ke$en(k#-#n ! &ek#m me%! %$#kuk#n -en$##n#.)e&k#! &ek#m me%! %n$# 1 / %#& +um$# kun+u n(#n *#- #&n#. ).% n$# !e*#- #& . - e n $ # # n %$#kuk#n %en(#n ek $!*%.%$#kuk#n &ek#-#n #!$ - e n $ # # n e . % $ # k u # k # n * n % # k $ # n + u * ! e * e $ # - e n $ # # n . . 0 n * ' e & k # * K # & * u P o $ u m u m - o $ ( ( .
