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sr160\colno3\colw1404\colsr160\ql \li1408\sb0\sl-322\slmult0 \par\pard\ql
\li1408\sb0\sl-322\slmult0 \par\pard\ql \li1408\sb0\sl-322\slmult0 \par\pard\ql
\li1408\sb0\sl-322\slmult0 \par\pard\ql \li1408\sb0\sl-322\slmult0 \par\pard\ql
\li1408\sb0\sl-322\slmult0 \par\pard\ql \li1408\sb0\sl-322\slmult0 \par\pard\ql
\li1408\sb0\sl-322\slmult0 \par\pard\ql \li1408\sb0\sl-322\slmult0 \par\pard\ql
\li1408\sb136\sl-322\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf2\f3\fs28 Efektif 1 Januari 2018\par\pard\column \ql
\li5006\sb0\sl-648\slmult0 \par\pard\ql \li5006\sb0\sl-648\slmult0 \par\pard\ql
\li5006\sb0\sl-648\slmult0 \par\pard\ql \li5006\sb0\sl-648\slmult0 \par\pard\ql
\li20\sb312\sl-648\slmult0 \up0 \expndtw0\charscalex97 \ul0\nosupersub\cf3\f4\fs72
STANDAR\par\pard\ql \li20\sb85\sl-828\slmult0 \up0 \expndtw0\charscalex97
NASIONAL\par\pard\ql \li20\ri17\sb10\sl-883\slmult0 \up0 \expndtw0\charscalex97
AKREDITASI \line \up0 \expndtw0\charscalex97 RUMAH SAKIT\par\pard\ql
\li20\sb166\sl-828\slmult0 \up0 \expndtw0\charscalex97 \ul0\nosupersub\cf4\f5\fs72
Edisi 1,\par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
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299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li5006\sb0\sl-299\slmult0 \par\pard\ql \li5006\sb0\sl-
299\slmult0 \par\pard\ql \li20\sb147\sl-299\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf5\f6\fs26 KOMISI AKREDITASI RUMAH
SAKIT\par\pard\ql \li20\sb20\sl-299\slmult0 \up0 \expndtw-3\charscalex100 AGUSTUS
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253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
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253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
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253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
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253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
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253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
253\slmult0 \par\pard\ql \li10356\sb0\sl-253\slmult0 \par\pard\ql \li10356\sb0\sl-
253\slmult0 \par\pard\ql \li20\sb131\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 1
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg2}
{\bkmkend Pg2}\par\pard\ql \li5433\sb0\sl-276\slmult0 \par\pard\ql\li5433\sb0\sl-
276\slmult0 \par\pard\ql\li5433\sb0\sl-276\slmult0 \par\pard\ql\li5433\sb0\sl-
276\slmult0 \par\pard\ql\li5433\sb0\sl-276\slmult0 \par\pard\ql\li5433\sb0\sl-
276\slmult0 \par\pard\ql\li5433\sb156\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 SAMBUTAN \par\pard\ql \li2726\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 KETUA EKSEKUTIF KOMISI AKREDITASI RUMAH
SAKIT \par\pard\ql \li4763\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Dr.
dr. Sutoto, M.Kes \par\pard\ql \li10355\sb0\sl-253\slmult0
\par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0
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\par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0
\par\pard\ql\li10355\sb206\sl-253\slmult0 \up0 \expndtw-3\charscalex100
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\li1900\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. dr. Pranawa,
Sp.PD,KGH \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4.
Prof. Dr. dr. Bambang Supriyatno, Sp.A(K) \par\pard\ql \li1900\sb24\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 5. dr. Kuntjoro Adi Purjanto, M.Kes
\par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 6.
Suarhatini Hadad \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 7. Prof. Dr. drg. Tri Erri Astoeti,M.Kes \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 TIM PELAKSANA \par\pard\ql
\li1900\sb0\sl-276\slmult0 \par\pard\ql\li1900\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Dr. dr. Sutoto, M.Kes
\par\pard\ql \li1900\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. dr.
Djoti Atmodjo, Sp.A, MARS \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3. Dra. M. Amatyah S, M.Kes \par\pard\ql \li1900\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 4. dr. Nico A. Lumenta, K.Nefro, MM,
MH.Kes \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 5.
dr. Luwiharsih, M.Sc \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 6. dr. Djoni Darmadjaja, Sp.B, MARS \par\pard\ql \li1900\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 7. Dr. dr. Hanny Ronosulistyo, Sp.OG, MM
\par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 8. dr.
Achmad Hardiman, Sp.KJ, MARS \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 9. dr. Nina Sekartina, MHA \par\pard\ql \li1900\sb24\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 10.Dr. dr. Meliana Zailani, MARS
\par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 11.dr. Henry
Boyke Sitompul, Sp.B, FICS \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 12.Dra. Pipih Karniasih, S.Kp, M.Kep \par\pard\ql \li1900\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 13.dr. Nurul Ainy Sidik, MARS
\par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 14.Dr. dr.
Ina Rosalina, Sp.AK, M.Kes, MH.Kes \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 15.Saida Simanjuntak, S.Kp, MARS \par\pard\ql
\li1900\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 16.dr. Sri Rachmani,
M.Kes, MH.Kes \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 17.dr. Wasista Budiwaluyo, MHA \par\pard\ql \li1900\sb24\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 18.dr. Dahsriati, Sp.KJ \par\pard\ql
\li1900\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 19.dr. Yawestri Pudjiati
G, MARS \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
20.dr. Tedjo W. Putranto, MM \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 21.Poniwati Yacub, SKM \par\pard\ql \li1900\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 22.Didin Syaefudin, S.Kp, MARS
\par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 23.Dr.
Widaningsih SKp, M.Kep \par\pard\ql \li1900\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 24.dr. Mary S. Maryam, MHA, PhD \par\pard\ql \li1900\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 25.Susihar, SKM, MKep \par\pard\ql
\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0
\par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0
\par\pard\ql\li10355\sb151\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 3
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg4}
{\bkmkend Pg4}\par\pard\ql \li4766\sb0\sl-276\slmult0 \par\pard\ql\li4766\sb0\sl-
276\slmult0 \par\pard\ql\li4766\sb0\sl-276\slmult0 \par\pard\ql\li4766\sb0\sl-
276\slmult0 \par\pard\ql\li4766\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 DAFTAR ISI \par\pard\li1548\sb0\sl-
276\slmult0\par\pard\li1548\sb86\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 PENDAHULUAN\tab \up0 \expndtw-
3\charscalex100 6\par\pard\li1548\sb139\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-
3\charscalex100 KEBIJAKAN UMUM AKREDITASI RUMAH SAKIT\tab \up0 \expndtw-
3\charscalex100 13\par\pard\li1548\sb137\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-
3\charscalex100 KEBIJAKAN PRA SURVEI AKREDITASI\tab \up0 \expndtw-3\charscalex100
19\par\pard\li1548\sb139\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
KEBIJAKAN SURVEI AKREDITASI RUMAH SAKIT\tab \up0 \expndtw-3\charscalex100
22\par\pard\li1548\sb137\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
KEBIJAKAN PEMBERIAN SKOR\tab \up0 \expndtw-3\charscalex100
30\par\pard\li1548\sb139\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
KEBIJAKAN PENENTUAN KELULUSAN\tab \up0 \expndtw-3\charscalex100
36\par\pard\li1548\sb137\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
KEBIJAKAN PENUNDAAN PENETAPAN STATUS AKREDITASI\tab \up0 \expndtw-3\charscalex100
38\par\pard\li1548\sb139\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
KEBIJAKAN PASCA SURVEI\tab \up0 \expndtw-3\charscalex100
39\par\pard\li1548\sb137\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
PERPANJANGAN STATUS AKREDITASI\tab \up0 \expndtw-3\charscalex100
42\par\pard\li1548\sb139\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
KEBIJAKAN REMEDIAL\tab \up0 \expndtw-3\charscalex100 42\par\pard\li1548\sb137\sl-
276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100 KEBIJAKAN SURVEI
VERIFIKASI\tab \up0 \expndtw-3\charscalex100 43\par\pard\li1548\sb139\sl-
276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100 KEBIJAKAN SURVEI TERFOKUS\tab
\up0 \expndtw-3\charscalex100 43\par\pard\li1548\sb134\sl-
276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100 KEBIJAKAN
BANDING\ul0\nosupersub\cf8\f9\fs24 (APPEAL)\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 43\par\pard\li1548\sb142\sl-276\slmult0\fi0\tx10569
\up0 \expndtw-3\charscalex100 PENGUNGKAPAN KEPADA PUBLIK DAN KERAHASIAAN\tab
\up0 \expndtw-3\charscalex100 44\par\pard\li1548\sb137\sl-
276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100 KEBIJAKAN PROMOSI
AKREDITASI\tab \up0 \expndtw-3\charscalex100 44\par\pard\li1548\sb139\sl-
276\slmult0\fi107\tx2147\tx10569 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 I.\tab \up0 \expndtw-3\charscalex100 SASARAN
KESELAMATAN PASIEN\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24
45\par\pard\li1548\sb137\sl-276\slmult0\fi628\tx10569 \up0 \expndtw-3\charscalex100
SASARAN 1 : MENGIDENTIFIKASI PASIEN DENGAN BENAR\tab \up0 \expndtw-3\charscalex100
45\par\pard\li1548\sb139\sl-276\slmult0\fi628\tx10569 \up0 \expndtw-3\charscalex100
SASARAN 2 : MENINGKATKAN KOMUNIKASI YANG EFEKTIF\tab \up0 \expndtw-3\charscalex100
46\par\pard\li1548\sb137\sl-276\slmult0\fi628\tx10569 \up0 \expndtw-3\charscalex100
SASARAN 3 : MENINGKATKAN KEAMANAN OBAT-OBAT YANG HARUS\tab \up0 \expndtw-
3\charscalex100 49\par\pard\ql \li3710\sb134\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 DIWASPADAI\ul0\nosupersub\cf8\f9\fs24 (HIGH ALERT MEDICATIONS)
\par\pard\li2176\sb142\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 SASARAN 4 : MEMASTIKAN LOKASI PEMBEDAHAN YANG
BENAR,\tab \up0 \expndtw-3\charscalex100 51\par\pard\qj \li3710\ri1517\sb8\sl-
420\slmult0 \up0 \expndtw-3\charscalex100 PROSEDUR YANG BENAR, PEMBEDAHAN PADA
PASIEN \up0 \expndtw-3\charscalex100 YANG BENAR \par\pard\ql \li2176\sb119\sl-
276\slmult0\tx10569 \up0 \expndtw-3\charscalex100 SASARAN 5 : MENGURANGI RISIKO
INFEKSI TERKAIT PELAYANAN \tab \up0 \expndtw-3\charscalex100 53 \par\pard\ql
\li3710\sb124\sl-276\slmult0 \up0 \expndtw-3\charscalex100 KESEHATAN
\par\pard\li2176\sb153\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-3\charscalex100
SASARAN 6 : MENGURANGI RISIKO CEDERA PASIEN AKIBAT\tab \up0 \expndtw-
3\charscalex100 54\par\pard\li1588\sb137\sl-276\slmult0\fi2121 \up0 \expndtw-
3\charscalex100 TERJATUH\par\pard\li1588\sb139\sl-276\slmult0\fi0\tx2147\tx10569
\up0 \expndtw-3\charscalex100 II.\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 STANDAR PELAYANAN BERFOKUS PASIEN\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 57\par\pard\li1588\sb137\sl-
276\slmult0\fi561\tx10569 \up0 \expndtw-3\charscalex100 BAB 1. AKSES KE RUMAH SAKIT
DAN KONTINUITAS PELAYANAN (ARK)\tab \up0 \expndtw-3\charscalex100
57\par\pard\li1588\sb139\sl-276\slmult0\fi561\tx10569 \up0 \expndtw-3\charscalex100
BAB 2. HAK PASIEN DAN KELUARGA (HPK)\tab \up0 \expndtw-3\charscalex100
78\par\pard\li1588\sb137\sl-276\slmult0\fi561\tx10569 \up0 \expndtw-3\charscalex100
BAB 3. ASESMEN PASIEN (AP)\tab \up0 \expndtw-3\charscalex100
99\par\pard\li1588\sb139\sl-276\slmult0\fi561\tx10569 \up0 \expndtw-3\charscalex100
BAB 4. PELAYANAN DAN ASUHAN PASIEN (PAP)\tab \up0 \expndtw-3\charscalex100
135\par\pard\ql \li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb137\sl-
253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 4
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg5}
{\bkmkend Pg5}\par\pard\li1495\sb0\sl-276\slmult0\par\pard\li1495\sb0\sl-
276\slmult0\par\pard\li1495\sb0\sl-276\slmult0\par\pard\li1495\sb0\sl-
276\slmult0\par\pard\li1495\sb92\sl-276\slmult0\fi655\tx10569 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 BAB 5. PELAYANAN ANESTESI DAN BEDAH
(PAB)\tab \up0 \expndtw-3\charscalex100 153\par\pard\li1495\sb137\sl-
276\slmult0\fi655\tx10569 \up0 \expndtw-3\charscalex100 BAB 6. PELAYANAN
KEFARMASIAN DAN PENGGUNAAN OBAT (PKPO)\tab \up0 \expndtw-3\charscalex100
171\par\pard\li1495\sb139\sl-276\slmult0\fi655\tx10569 \up0 \expndtw-
3\charscalex100 BAB 7. MANAJEMEN KOMUNIKASI DAN EDUKASI (MKE)\tab \up0 \expndtw-
3\charscalex100 187\par\pard\li1495\sb137\sl-276\slmult0\fi26\tx2147\tx10569
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 III.\tab \up0 \expndtw-
3\charscalex100 STANDAR MANAJEMEN RUMAH SAKIT\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 198\par\pard\li1495\sb139\sl-
276\slmult0\fi655\tx10569 \up0 \expndtw-3\charscalex100 BAB 1. PENINGKATAN MUTU DAN
KESELAMATAN PASIEN (PMKP)\tab \up0 \expndtw-3\charscalex100
198\par\pard\li1495\sb137\sl-276\slmult0\fi655\tx10569 \up0 \expndtw-
3\charscalex100 BAB 2. PENCEGAHAN DAN PENGENDALIAN INFEKSI (PPI)\tab \up0 \expndtw-
3\charscalex100 226\par\pard\li1495\sb139\sl-276\slmult0\fi655\tx10569 \up0
\expndtw-3\charscalex100 BAB 3. TATA KELOLA RUMAH SAKIT (TKRS)\tab \up0 \expndtw-
3\charscalex100 249\par\pard\li1495\sb137\sl-276\slmult0\fi655\tx10569 \up0
\expndtw-3\charscalex100 BAB 4. MANAJEMEN FASILITAS DAN KESELAMATAN (MFK)\tab
\up0 \expndtw-3\charscalex100 293\par\pard\li1495\sb139\sl-
276\slmult0\fi655\tx10569 \up0 \expndtw-3\charscalex100 BAB 5. KOMPETENSI DAN
KEWENANGAN STAF (KKS)\tab \up0 \expndtw-3\charscalex100
326\par\pard\li1495\sb137\sl-276\slmult0\fi655\tx10569 \up0 \expndtw-
3\charscalex100 BAB 6. MANAJEMEN INFORMASI DAN REKAM MEDIS (MIRM)\tab \up0
\expndtw-3\charscalex100 353\par\pard\li1495\sb139\sl-276\slmult0\fi0\tx2147
\up0 \expndtw-3\charscalex100 IV.\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 PROGRAM NASIONAL\par\pard\li1495\sb137\sl-
276\slmult0\fi655\tx10569 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24
SASARAN I PENURUNAN ANGKA KEMATIAN IBU DAN BAYI DAN\tab \up0 \expndtw-
3\charscalex100 369\par\pard\li1548\sb139\sl-276\slmult0\fi2135 \up0 \expndtw-
4\charscalex100 PENINGKATAN KESEHATAN IBU DAN BAYI\par\pard\li1548\sb137\sl-
276\slmult0\fi602\tx10569 \up0 \expndtw-4\charscalex100 SASARAN II PENURUNAN
ANGKA KESAKITAN HIV/AIDS\tab \up0 \expndtw-4\charscalex100
372\par\pard\li1548\sb139\sl-276\slmult0\fi602\tx10569 \up0 \expndtw-
4\charscalex100 SASARAN III PENURUNAN ANGKA KESAKITAN TUBERKULOSIS\tab \up0
\expndtw-4\charscalex100 373\par\pard\li1548\sb137\sl-276\slmult0\fi602\tx10569
\up0 \expndtw-4\charscalex100 SASARAN IV PENGENDALIAN RESISTENSI
ANTIMIKROBA\tab \up0 \expndtw-4\charscalex100 376\par\pard\li1548\sb139\sl-
276\slmult0\fi602\tx10569 \up0 \expndtw-4\charscalex100 SASARAN V PELAYANAN
GERIATRI\tab \up0 \expndtw-4\charscalex100 379\par\pard\li1548\sb137\sl-
276\slmult0\fi14\tx2147\tx10569 \up0 \expndtw-4\charscalex100 V.\tab \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 INTEGRASI PENDIDIKAN KESEHATAN DALAM
PELAYANAN RUMAH\tab \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24
381\par\pard\li1548\sb139\sl-276\slmult0\fi599 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 SAKIT (IPKP)\par\pard\li1548\sb137\sl-
276\slmult0\fi0\tx10569 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24
DAFTAR SINGKATAN DAN ISTILAH (GLOSSARY)\tab \up0 \expndtw-4\charscalex100
389\par\pard\li1548\sb139\sl-276\slmult0\fi0\tx10569 \up0 \expndtw-4\charscalex100
DAFTAR PUSTAKA\tab \up0 \expndtw-4\charscalex100 405\par\pard\ql \li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-
253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb13\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 5
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg6}
{\bkmkend Pg6}\par\pard\ql \li5025\sb0\sl-276\slmult0 \par\pard\ql\li5025\sb0\sl-
276\slmult0 \par\pard\ql\li5025\sb0\sl-276\slmult0 \par\pard\ql\li5025\sb0\sl-
276\slmult0 \par\pard\ql\li5025\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 PENDAHULUAN \par\pard\qj
\li1440\ri1183\sb311\sl-317\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Akreditasi Rumah Sakit di Indonesia dilaksanakan untuk
menilai kepatuhan rumah \line \up0 \expndtw0\charscalex103 sakit terhadap standa
akreditasi. Akreditasi rumah sakit yang sudah mulai \line \up0 \expndtw-
1\charscalex100 dilaksanakan sejak tahun 1995 di Indonesia, selama ini
menggunakan standar \line \up0 \expndtw0\charscalex103 akreditasi berdasarkan
tahun berapa standar tersebut mulai dipergunakan untuk \line \up0 \expndtw-
3\charscalex100 penilaian, sehingga selama ini belum pernah ada Standar Nasional
Akreditasi Rumah \line \up0 \expndtw-2\charscalex100 Sakit di Indonesia, sedangkan
status akreditasi saat ini ada status akreditasi nasional \line \up0
\expndtw0\charscalex100 dan status akreditasi internasional, maka di Indonesia
perlu ada Standar\ul0\nosupersub\cf6\f7\fs24 Nasional \line \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Akreditasi Rumah Sakit.
Berdasarkan hal tersebut maka standar akreditasi untuk \line \up0
\expndtw0\charscalex104 rumah sakit yang mulai diberlakukan pada Januari 2018 ini
diberi nama Standar \line \up0 \expndtw-2\charscalex100 Nasional Akreditasi Rumah
Sakit Edisi 1 dan disingkat menjadi SNARS Edisi 1. \par\pard\qj \li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\ri1233\sb1\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Standar Nasional Akreditasi Rumah Sakit Edisi 1, merupakan standar
akreditasi baru \up0 \expndtw-1\charscalex100 yang bersifat nasional dan
diberlakukan secara nasional di Indonesia. Disebut \up0
\expndtw0\charscalex102 dengan edisi 1, karena di Indonesia baru pertama kali
ditetapkan standar nasional \up0 \expndtw-3\charscalex100 untuk akreditasi rumah
sakit. \par\pard\qj \li1440\ri1243\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
Standar Nasional Akreditasi Rumah Sakit edisi 1 berisi 16 bab. Dalam
Standar \up0 \expndtw0\charscalex102 Nasional Akreditasi Rumah Sakit Edisi 1 yang
selanjutnya disebut SNARS Edisi 1 \up0 \expndtw0\charscalex100 ini juga dijelaskan
bagaimana proses penyusunan, penambahan bab penting pada \up0 \expndtw-
2\charscalex100 SNARS Edisi 1 ini, referensi dari setiap bab dan juga glosarium
istilah-istilah penting, \up0 \expndtw-3\charscalex100 termasuk juga kebijakan
pelaksanaan akreditasi rumah sakit. \par\pard\ql \li1996\sb0\sl-276\slmult0
\par\pard\ql\li1996\sb0\sl-276\slmult0 \par\pard\ql\li1996\sb105\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Proses Penyusunan Standar
Nasional Akreditasi Rumah Sakit Edisi 1 \par\pard\qj \li1440\ri1243\sb308\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pada tahap
awal Komisi Akreditasi Rumah Sakit (KARS) membentuk Tim penyusun \line \up0
\expndtw0\charscalex104 yang terdiri dari 25 orang, Tim tersebut dibagi menjadi
sub tim-sub tim, masing-\line \up0 \expndtw0\charscalex100 masing sub tim mereview
3 - 4 bab dari standar akreditasi versi 2012. Mengingat di \line \up0 \expndtw-
2\charscalex100 tingkat internasional ada panduan prinsip-prinsip standar
akreditasi yang dikeluarkan \line \up0 \expndtw0\charscalex100 oleh ISQua (The
International Society for Quality in Health Care) yaitu badan \line \up0
\expndtw0\charscalex103 akreditasi yang melakukan akreditasi standar akreditasi
yang dipergunakan oleh \line \up0 \expndtw-3\charscalex100 badan akreditasi.
\par\pard\ql \li1440\ri1235\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex104 Langkah
awal yang dilakukan KARS adalah mengundang pakar akreditasi untuk \up0
\expndtw0\charscalex103 menjelaskan bagaimana prinsip-prinsip standar akreditasi
dari ISQua yang harus \up0 \expndtw-3\charscalex100 diperhatikan oleh KARS dalam
menyusun standar akreditasi di Indonesia. \line \up0 \expndtw-1\charscalex100
Berdasarkan hal tersebut maka Standar Nasional Akreditasi Rumah Sakit Edisi 1
ini, \up0 \expndtw-2\charscalex100 disusun dengan menggunakan acuan acuan sebagai
berikut: \par\pard\ql \li1646\sb17\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Prinsip-prinsip
standar akreditasi dari ISQua \par\pard\ql \li1646\ri1186\sb28\sl-
320\slmult0\tx2006\tx2006 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Peraturan dan
perundangan-undangan termasuk pedoman dan panduan di \line\tab \up0 \expndtw-
2\charscalex100 tingkat Nasional baik dari pemerintah maupun profesi yang wajib
dipatuhi dan \line \tab \up0 \expndtw-4\charscalex100 dilaksanakan oleh rumah
sakit di Indonesia \par\pard\ql \li1646\sb57\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Standar akreditasi JCI edisi 4 dan edisi 5
\par\pard\ql \li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb230\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 6

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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9079,314);(9079,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
13952251}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg7}
{\bkmkend Pg7}\par\pard\ql \li1646\sb0\sl-276\slmult0 \par\pard\ql\li1646\sb0\sl-
276\slmult0 \par\pard\ql\li1646\sb0\sl-276\slmult0 \par\pard\ql\li1646\sb0\sl-
276\slmult0 \par\pard\ql\li1646\sb88\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Standar akreditasi rumah sakit KARS versi 2012 \par\pard\qj \li1646\ri1204\sb28\sl-
320\slmult0\tx2006 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Hasil kajian hasil survei dari standar dan
elemen yang sulit dipenuhi oleh rumah \line\tab \up0 \expndtw-3\charscalex100 sakit
di Indonesia \par\pard\qj \li1440\sb0\sl-317\slmult0
\par\pard\qj\li1440\ri1184\sb6\sl-317\slmult0 \up0 \expndtw0\charscalex100 Setelah
draft standar nasional akreditasi rumah sakit selesai disusun oleh masing-\line
\up0 \expndtw-4\charscalex100 masing sub tim, KARS mengadakan pertemuan tim
penyusun untuk membahas setiap \line \up0 \expndtw0\charscalex102 bab yang ada di
dalam standar akreditasi tersebut. Masukan dari anggota sub tim \line \up0
\expndtw-1\charscalex100 lainnya, dipergunakan oleh sub tim untuk memperbaiki
standar, selanjutnya masing-\line \up0 \expndtw0\charscalex102 masing sub tim
membahas dengan pemangku kepentingan\ul0\nosupersub\cf8\f9\fs24
(stakeholder)\ul0\nosupersub\cf7\f8\fs24 terkait. \line \up0
\expndtw0\charscalex100 Sebagai contoh untuk bab Pencegahan dan Pengendalian
Infeksi, dibahas dengan \line \up0 \expndtw-2\charscalex100 mengundang Kementerian
Kesehatan, Perhimpunan Rumah Sakit Seluruh Indonesia \line \up0 \expndtw-
3\charscalex100 (PERSI), Persatuan Perawat Nasional Indonesia \up0 \expndtw-
3\charscalex100 (PPNI), Himpunan Perawat \par\pard\qj \li1440\ri1245\sb7\sl-
313\slmult0 \up0 \expndtw-1\charscalex100 Pencegahan dan Pengendalian Infeksi
(HIPPI), Persatuan Pengendalian Infeksi \up0 \expndtw0\charscalex104 (Perdalin)
dan lain-lain. Pembahasan dilakukan untuk setiap bab yang dilakukan \up0 \expndtw-
2\charscalex100 secara intens, sehingga terjadi diskusi dua arah dan masukan-
masukan yang sangat \up0 \expndtw-3\charscalex100 bermanfaat. \par\pard\qj
\li1440\ri1243\sb2\sl-320\slmult0 \up0 \expndtw0\charscalex100 Berdasarkan masukan
dari pemangku kepentingan\ul0\nosupersub\cf8\f9\fs24
(stakeholder)\ul0\nosupersub\cf7\f8\fs24 tersebut, sub tim \line \up0
\expndtw0\charscalex100 melakukan perbaikan draft standar tersebut. Setelah
perbaikan selesai dilakukan di \line \up0 \expndtw-2\charscalex100 masing-masing
sub tim, Komisi Akreditasi Rumah Sakit (KARS) mengundang semua \line \up0 \expndtw-
3\charscalex100 pemangku kepentingan \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf8\f9\fs24 (stakeholder)\ul0\nosupersub\cf7\f8\fs24 dan
beberapa rumah sakit yang akan \par\pard\qj \li1440\ri1184\sb4\sl-
316\slmult0 \up0 \expndtw0\charscalex103 dipergunakan uji coba untuk membahas
standar tersebut secara pleno. Masukan \line \up0 \expndtw0\charscalex103 pada
rapat pleno tersebut oleh masing-masing sub tim dipergunakan untuk \line
\up0 \expndtw-1\charscalex100 memperbaiki draft standar tersebut. Hasil
perbaikan draft standar tersebut diuji \line \up0 \expndtw-1\charscalex100
cobakan ke rumah sakit berdasarkan kelas dan jenis rumah sakit. Rumah sakit yang
\line \up0 \expndtw-4\charscalex100 dipilih sebagai tempat uji coba, dikirimi
terlebih dahulu draft standar akreditasi tersebut \line \up0 \expndtw-
4\charscalex100 dan diminta secara aktif untuk membahas standar akreditasi tersebut
di internal rumah \line \up0 \expndtw0\charscalex103 sakit, baik dari segi tata
bahasa maupun bisa tidaknya standar tersebut di \line \up0 \expndtw-
3\charscalex100 implementasikan. Setelah itu KARS menugaskan tim penyusun melakukan
kunjungan \line \up0 \expndtw0\charscalex106 ke rumah sakit untuk melakukan diskusi
dengan tim akreditasi rumah sakit dan \line \up0 \expndtw0\charscalex104 pimpinan
di rumah sakit. Rumah sakit diminta membuat masukan tertulis terkait \line \up0
\expndtw-2\charscalex100 dengan standar dan elemen yang perlu diperbaiki,
dihilangkan atau ditambah. \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1248\sb1\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Tim
penyusun memperbaiki draft standar kembali dengan memperhatikan masukan \up0
\expndtw0\charscalex100 dari rumah sakit dan selanjutnya dibahas secara
internal di Rapat KARS dan \up0 \expndtw0\charscalex103 kemudian diunggah
di\ul0\nosupersub\cf8\f9\fs24 website\ul0\nosupersub\cf7\f8\fs24 www.kars.or.id,
dengan harapan dapat mendapat \up0 \expndtw-3\charscalex100 masukan dari rumah
sakit lainnya dan masyarakat. \par\pard\qj \li1440\ri1184\sb300\sl-320\slmult0 \up0
\expndtw0\charscalex100 Setelah tim melakukan perbaikan berdasarkan masukan
dari rumah sakit dan \up0 \expndtw-4\charscalex100 unggahan
di\ul0\nosupersub\cf8\f9\fs24 website\ul0\nosupersub\cf7\f8\fs24 maka Komisi
Akreditasi Rumah Sakit mempresentasikan standar \up0 \expndtw-2\charscalex100
tersebut dihadapan para pejabat Kementerian Kesehatan dan Badan Pembina KARS
\up0 \expndtw-1\charscalex100 serta mengajukan penetapan Standar Nasional
Akreditasi Rumah Sakit Edisi 1 yang \up0 \expndtw-2\charscalex100 efektif akan
diberlakukan di bulan Januari 2018. \par\pard\ql \li10355\sb0\sl-253\slmult0
\par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0
\par\pard\ql\li10355\sb57\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 7
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg8}
{\bkmkend Pg8}\par\pard\ql \li2215\sb0\sl-276\slmult0 \par\pard\ql\li2215\sb0\sl-
276\slmult0 \par\pard\ql\li2215\sb0\sl-276\slmult0 \par\pard\ql\li2215\sb0\sl-
276\slmult0 \par\pard\ql\li2215\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Pengelompokan Standar Nasional
Akreditasi Rumah Sakit Edisi 1 \par\pard\qj \li1440\ri1241\sb308\sl-320\slmult0
\up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Standar dikelompokkan
menurut fungsi-fungsi penting yang umum dalam organisasi \up0
\expndtw0\charscalex103 perumahsakitan. Pengelompokan berdasarkan fungsi, saat
ini paling banyak \up0 \expndtw-3\charscalex100 digunakan di seluruh dunia.
\par\pard\qj \li1440\ri1191\sb3\sl-317\slmult0 \up0 \expndtw0\charscalex100 Standar
dikelompokkan menurut fungsi-fungsi yang terkait dengan penyediaan \line \up0
\expndtw-2\charscalex100 pelayanan bagi pasien; juga dengan upaya menciptakan
organisasi rumah sakit yang \line \up0 \expndtw-1\charscalex100 aman, efektif, dan
terkelola dengan baik. Fungsi-fungsi tersebut tidak hanya berlaku \line \up0
\expndtw0\charscalex102 untuk rumah sakit secara keseluruhan tetapi juga untuk
setiap unit, departemen, \line \up0 \expndtw0\charscalex100 atau layanan yang ada
dalam organisasi rumah sakit tersebut. Lewat proses survei \line \up0 \expndtw-
2\charscalex100 dikumpulkan informasi sejauh mana seluruh organisasi mentaati
pedoman yang \line \up0 \expndtw-3\charscalex100 ditentukan oleh standar.
Keputusan pemberian akreditasinya didasarkan pada tingkat \line \up0 \expndtw-
2\charscalex100 kepatuhan terhadap standar di seluruh organisasi rumah sakit yang
bersangkutan. \line \up0 \expndtw-2\charscalex100 Pengelompokan Standar Nasional
Akreditasi Rumah Sakit Edisi 1 (SNARS Edisi \up0 \expndtw-3\charscalex100 1)
\par\pard\ql \li1440\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 sebagai
berikut: \par\pard\ql \li1655\sb0\sl-276\slmult0 \par\pard\ql\li1655\sb88\sl-
276\slmult0\tx2147 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 I.
\tab \up0 \expndtw-3\charscalex100 SASARAN KESELAMATAN PASIEN \par\pard\qj
\li2147\ri3575\sb44\sl-640\slmult0 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf7\f8\fs24 SASARAN 1 : Mengidentifikasi pasien dengan
benar \line \up0 \expndtw-6\charscalex100 SASARAN 2 : Meningkatkan
komunikasi yang efektif \par\pard\ql \li2147\sb0\sl-276\slmult0
\par\pard\ql\li2147\sb25\sl-276\slmult0 \up0 \expndtw-5\charscalex100 SASARAN 3
: Meningkatkan keamanan obat-obatan yang harus \par\pard\ql \li4017\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 diwaspadai (High Alert Medications)
\par\pard\ql \li2147\sb0\sl-276\slmult0 \par\pard\ql\li2147\sb68\sl-276\slmult0
\up0 \expndtw-6\charscalex100 SASARAN 4 : Memastikan lokasi pembedahan yang
benar, \par\pard\qj \li4017\ri2567\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
prosedur yang benar, pembedahan pada pasien \up0 \expndtw-3\charscalex100 yang
benar. \par\pard\ql \li2147\sb0\sl-276\slmult0 \par\pard\ql\li2147\sb81\sl-
276\slmult0 \up0 \expndtw-7\charscalex100 SASARAN 5 : Mengurangi risiko
infeksi terkait \par\pard\ql \li4017\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 pelayanan kesehatan \par\pard\ql \li2147\sb0\sl-276\slmult0
\par\pard\ql\li2147\sb88\sl-276\slmult0 \up0 \expndtw-6\charscalex100 SASARAN 6
: Mengurangi risiko cedera pasien akibat terjatuh \par\pard\ql \li1588\sb0\sl-
276\slmult0 \par\pard\ql\li1588\sb68\sl-276\slmult0\tx2147 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 II. \tab \up0 \expndtw-3\charscalex100
STANDAR PELAYANAN BERFOKUS PASIEN \par\pard\ql \li2147\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Akses ke Rumah Sakit dan
Kontinuitas Pelayanan (ARK) \par\pard\ql \li2147\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 2. Hak Pasien dan Keluarga (HPK) \par\pard\ql \li2147\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 3. Asesmen Pasien (AP) \par\pard\ql
\li2147\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4. Pelayanan dan Asuhan
Pasien (PAP) \par\pard\ql \li2147\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
5. Pelayanan Anestesi dan Bedah (PAB) \par\pard\ql \li2147\sb44\sl-276\slmult0
\up0 \expndtw-3\charscalex100 6. Pelayanan Kefarmasian dan Penggunaan Obat
(PKPO) \par\pard\ql \li2147\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100 7.
Manajemen Komunikasi dan Edukasi (MKE) \par\pard\ql \li1521\sb0\sl-276\slmult0
\par\pard\ql\li1521\sb88\sl-276\slmult0\tx2147 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 III. \tab \up0 \expndtw-3\charscalex100 STANDAR
MANAJEMEN RUMAH SAKIT \par\pard\ql \li10355\sb223\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 8

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg9}
{\bkmkend Pg9}\par\pard\ql \li2147\sb0\sl-276\slmult0 \par\pard\ql\li2147\sb0\sl-
276\slmult0 \par\pard\ql\li2147\sb0\sl-276\slmult0 \par\pard\ql\li2147\sb0\sl-
276\slmult0 \par\pard\ql\li2147\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Peningkatan Mutu dan Keselamatan
Pasien (PMKP) \par\pard\ql \li2147\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 2. Pencegahan dan Pengendalian Infeksi (PPI) \par\pard\ql
\li2147\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. Tata Kelola Rumah
Sakit (TKRS) \par\pard\ql \li2147\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
4. Manajemen Fasilitas dan Keselamatan (MFK) \par\pard\ql \li2147\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 5. Kompetensi dan Kewenangan Staf
(KKS) \par\pard\ql \li2147\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 6.
Manajemen Informasi dan Rekam Medis (MIRM) \par\pard\li1495\sb0\sl-
276\slmult0\par\pard\li1495\sb95\sl-276\slmult0\fi0\tx2147 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 IV.\tab \up0 \expndtw-3\charscalex100
PROGRAM NASIONAL\par\pard\ql \li2147\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Menurunkan Angka Kematian Ibu dan
Bayi. \par\pard\ql \li2147\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2.
Menurukan Angka Kesakitan HIV/AIDS. \par\pard\ql \li2147\sb24\sl-276\slmult0
\up0 \expndtw-2\charscalex100 3. Menurukan Angka Kesakitan TB \par\pard\ql
\li2147\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4. Pengendalian
Resistensi Antimikroba (PPRA) \par\pard\ql \li2147\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 5. Pelayanan Geriatri \par\pard\qj \li1562\sb0\sl-
320\slmult0 \par\pard\qj\li1562\ri1244\sb8\sl-320\slmult0\tx2147 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf6\f7\fs24 V. INTEGRASI PENDIDIKAN
KESEHATAN DALAM PELAYANAN DI RUMAH \line\tab \up0 \expndtw-3\charscalex100 SAKIT
\par\pard\ql \li1636\sb0\sl-276\slmult0 \par\pard\ql\li1636\sb0\sl-276\slmult0
\par\pard\ql\li1636\sb105\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Yang Perlu
Diketahui Pada Standar Nasional Akreditasi Rumah Sakit edisi 1 \par\pard\qj
\li1440\ri1238\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Standar Nasional Akreditasi Rumah Sakit Edisi 1
merupakan standar pelayanan \up0 \expndtw0\charscalex102 berfokus pada pasien untuk
meningkatkan mutu dan keselamatan pasien dengan \up0 \expndtw-3\charscalex100
pendekatan manajemen risiko di Rumah Sakit. \par\pard\ql \li1440\sb37\sl-
276\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Setiap elemen
penilaian dilengkapi dengan (R) atau (D), atau (W) atau (O) atau \par\pard\ql
\li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 (S), atau kombinasinya
yang berarti sebagai berikut : \par\pard\ql \li1540\ri1223\sb14\sl-
313\slmult0\tx2147\tx2147\tx2147 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 (R) =Regulasi, yang dimaksud dengan regulasi adalah
dokumen pengaturan yang \line\tab \up0 \expndtw-2\charscalex100 disusun oleh
rumah sakit yang dapat berupa kebijakan, prosedur (SPO), \line \tab \up0
\expndtw-2\charscalex100 pedoman, panduan, peraturan Direktur rumah sakit,
keputusan Direktur rumah \line \tab \up0 \expndtw-3\charscalex100 sakit dan atau
program. \par\pard\ql \li1540\ri1209\sb2\sl-320\slmult0\tx2147\tx2147\tx2147
\up0 \expndtw-2\charscalex100 (D) = Dokumen, yang dimaksud dengan dokumen adalah
bukti proses kegiatan atau \line\tab \up0 \expndtw-1\charscalex100 pelayanan yang
dapat berbentuk berkas rekam medis, laporan dan atau \line \tab \up0
\expndtw0\charscalex100 notulen rapat dan atau hasil audit dan atau ijazah
dan bukti dokumen \line \tab \up0 \expndtw-3\charscalex100 pelaksanaan kegiatan
lainnya. \par\pard\ql \li1540\ri1246\sb9\sl-310\slmult0\tx2147\tx2147 \up0
\expndtw-1\charscalex100 (O) =Observasi, yang dimaksud dengan observasi
adalah bukti kegiatan yang \line\tab \up0 \expndtw0\charscalex100 didapatkan
berdasarkan hasil penglihatan/observasi yang dilakukan oleh \line \tab \up0
\expndtw-3\charscalex100 surveior. \par\pard\qj \li1540\ri1243\sb2\sl-
320\slmult0\tx2147 \up0 \expndtw0\charscalex102 (S) =Simulasi, yang dimaksud dengan
simulasi adalah peragaaan kegiatan yang \line\tab \up0 \expndtw-3\charscalex100
dilakukan oleh staf rumah sakit yang diminta oleh surveior. \par\pard\ql
\li1540\ri1244\sb5\sl-315\slmult0\tx2147\tx2147\tx2147\tx2147 \up0 \expndtw-
1\charscalex100 (W) =Wawancara, yang dimaksud dengan wawancara adalah kegiatan
tanya jawab \line\tab \up0 \expndtw0\charscalex100 yang dilakukan oleh surveior
yang ditujukan kepada pemilik/representasi \line \tab \up0
\expndtw0\charscalex100 pemilik, direktur rumah sakit, pimpinan rumah sakit,
profesional pemberi \line \tab \up0 \expndtw-2\charscalex100 asuhan (PPA), staf
klinis, staf non klinis, pasien, keluarga, tenaga kontrak dan \line \tab \up0
\expndtw-3\charscalex100 lain-lain. \par\pard\ql \li10355\sb0\sl-253\slmult0
\par\pard\ql\li10355\sb0\sl-253\slmult0 \par\pard\ql\li10355\sb0\sl-253\slmult0
\par\pard\ql\li10355\sb98\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 9

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg10}{\bkmkend Pg10}\par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb132\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Ada beberapa perubahan nama bab yaitu: \par\pard\qj
\li1507\ri1196\sb8\sl-320\slmult0\tx1867 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Akses Pelayanan
dan Kontinuitas (APK) berubah nama menjadi Akses ke Rumah \line\tab \up0 \expndtw-
4\charscalex100 Sakit dan Kontinuitas Pelayanan (ARK) \par\pard\qj
\li1507\ri1251\sb20\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Pelayanan Pasien
(PP) berubah nama menjadi Pelayanan Asuhan Pasien (PAP) \line \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Manajemen Penggunaan Obat \up0 \expndtw-5\charscalex100 (MPO) berubah nama
menjadi Pelayanan \par\pard\ql \li1867\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Kefarmasian dan Penggunaan Obat (PKPO) \par\pard\ql
\li1507\ri1244\sb28\sl-320\slmult0\tx1867\tx1867 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Pendidikan
Pasien dan Keluarga (PPK) berubah nama menjadi Manajemen \line\tab \up0
\expndtw-4\charscalex100 Komunikasi dan Edukasi (MKE), dimana beberapa
standar dari Manajemen \line \tab \up0 \expndtw-5\charscalex100 Komunikasi dan
Informasi \up0 \expndtw-5\charscalex100 (MKI) standar versi \up0 \expndtw-
5\charscalex100 2012 yang terkait dengan \par\pard\ql \li1867\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 komunikasi, dijadikan satu di Manajemen
Komunikasi dan Edukasi ini. \par\pard\qj \li1507\ri1247\sb8\sl-
320\slmult0\tx1867 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Tata Kelola, Kepemimpinan dan Pengarahan (TKP)
berubah nama menjadi Tata \line\tab \up0 \expndtw-4\charscalex100 Kelola Rumah
Sakit (TKRS) \par\pard\qj \li1507\ri1248\sb20\sl-320\slmult0\tx1867 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Kualifikasi dan Pendidikan Staf (KPS) berubah
nama menjadi Kompetensi dan \line\tab \up0 \expndtw-5\charscalex100 Kewenangan Staf
(KKS) \par\pard\qj \li1507\ri1250\sb0\sl-320\slmult0\tx1867 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Manajemen Komunikasi dan Informasi (MKI) berubah nama menjadi Manajemen
\line\tab \up0 \expndtw-4\charscalex100 Informasi dan Rekam Medis (MIRM)
\par\pard\qj \li1507\ri1191\sb20\sl-320\slmult0\tx1867 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Sasaran Milenium Development Goals (SMDGs) berubah nama menjadi Program
\line\tab \up0 \expndtw-5\charscalex100 Nasional dimana terdiri dari:
\par\pard\qj \li1955\ri1252\sb0\sl-320\slmult0\tx2315 \up0 \expndtw0\charscalex100
1. menurunkan angka kematian ibu dan bayi serta meningkatkan angka
\line\tab \up0 \expndtw-3\charscalex100 kesehatan ibu dan bayi \par\pard\ql
\li1955\sb17\sl-276\slmult0 \up0 \expndtw-4\charscalex100 2. menurunkan angka
kesakitan HIV/AIDS \par\pard\ql \li1955\sb44\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 3. menurunkan angka kesakitan tuberkulosis \par\pard\ql
\li1955\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 4. pengendalian
resistensi antimikroba \par\pard\ql \li1955\sb44\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 5. pelayanan geriatri \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1241\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Ada penambahan standar pada Standar Nasional Akreditasi
Rumah Sakit Edisi \up0 \expndtw-4\charscalex100 1 ini yaitu: \par\pard\ql
\li1507\sb37\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf6\f7\fs24 Pengendalian
Reistensi Antimikroba (PRA) \par\pard\qj \li1867\ri1183\sb8\sl-320\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pengendalian Resistensi
Antimikroba (PRA) merupakan upaya pengendalian \line \up0 \expndtw-
1\charscalex100 resistensi antimikroba secara terpadu dan paripurna di
fasilitas pelayanan \line \up0 \expndtw-3\charscalex100 kesehatan termasuk rumah
sakit dan merupakan standar baru di dalam Standar \line \up0 \expndtw-
3\charscalex100 Nasional Akreditasi Rumah Sakit Edisi 1 ini. Standar ini dianggap
perlu mengingat \line \up0 \expndtw-4\charscalex100 Resistensi mikroba terhadap
antimikroba \up0 \expndtw-4\charscalex100 (disingkat: resistensi antimikroba,
\par\pard\qj \li1867\ri1189\sb0\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf8\f9\fs24 antimicrobial resistance,\ul0\nosupersub\cf7\f8\fs24
AMR) telah menjadi masalah kesehatan yang mendunia, \line \up0
\expndtw0\charscalex103 dengan berbagai dampak merugikan yang dapat
menurunkan mutu dan \line \up0 \expndtw0\charscalex103 meningkatkan risiko
pelayanan kesehatan khususnya biaya dan keselamatan \line \up0 \expndtw-
3\charscalex100 pasien. \par\pard\ql \li1507\sb237\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf6\f7\fs24
Integrasi Pendidikan Kesehatan dalam Pelayanan Rumah Sakit (IPKP) \par\pard\qj
\li1867\ri1242\sb16\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Standar Integrasi Pelayanan dalam Pendidikan Klinis di
Rumah Sakit (IPKP) \line \up0 \expndtw0\charscalex100 merupakan standar baru di
Standar Nasional Akreditasi Rumah Sakit Edisi 1. \line \up0 \expndtw-
4\charscalex100 Standar IPKP ini hanya diberlakukan untuk rumah sakit yang
menyelenggarakan \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb245\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 10
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg11}
{\bkmkend Pg11}\par\pard\qj \li1867\sb0\sl-317\slmult0 \par\pard\qj\li1867\sb0\sl-
317\slmult0 \par\pard\qj\li1867\sb0\sl-317\slmult0
\par\pard\qj\li1867\ri1207\sb208\sl-317\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 proses pendidikan tenaga kesehatan sesuai
peraturan perundang-undangan. \line \up0 \expndtw-2\charscalex100 Standar ini juga
menunjukkan suatu kerangka untuk mencakup pendidikan medis \line \up0
\expndtw0\charscalex100 dan pendidikan staf klinis lainnya dengan memperhatikan
mutu pelayanan dan \line \up0 \expndtw0\charscalex100 keselamatan pasien di rumah
sakit tersebut. Kegiatan pendidikan harus masuk \line \up0 \expndtw-1\charscalex100
dalam kerangka peningkatan mutu dan keselamatan pasien rumah sakit, karena \line
\up0 \expndtw-1\charscalex100 itu rumah sakit wajib mempunyai sistem
pengawasan mutu pelayanan dan \line \up0 \expndtw-2\charscalex100 keselamatan
pasien terhadap aktivitas pendidikan yang dilaksanakan di rumah \line \up0
\expndtw-3\charscalex100 sakit. \par\pard\ql \li1507\sb37\sl-276\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf6\f7\fs24 Penyelenggaraan Pelayanan Geriatri
\par\pard\qj \li1867\ri1185\sb11\sl-317\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien geriatri adalah pasien lanjut usia dengan multi
penyakit/gangguan akibat \line \up0 \expndtw0\charscalex100 penurunan fungsi
organ, psikologi, sosial, ekonomi dan lingkungan yang \line \up0
\expndtw0\charscalex100 membutuhkan pelayanan kesehatan secara tepadu dengan
pendekatan multi \line \up0 \expndtw0\charscalex100 disiplin yang bekerja sama
secara interdisiplin. Dengan meningkatnya sosial \line \up0 \expndtw-
3\charscalex100 ekonomi dan pelayanan kesehatan maka usia harapan hidup semakin
meningkat, \line \up0 \expndtw-3\charscalex100 sehingga secara demografi terjadi
peningkatan populasi lanjut usia. Oleh karena \line \up0 \expndtw-3\charscalex100
itu rumah sakit perlu menyelenggarakan pelayanan geriatri sesuai dengan tingkat
\line \up0 \expndtw-4\charscalex100 jenis pelayanan geriatri. \par\pard\ql
\li3717\sb0\sl-276\slmult0 \par\pard\ql\li3717\sb0\sl-276\slmult0
\par\pard\ql\li3717\sb85\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Seberapa sering standar diperbaharui? \par\pard\qj
\li1440\ri1240\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Secara terus-menerus akan dikumpulkan berbagai
informasi dan pengalaman yang \up0 \expndtw-2\charscalex100 terkait dengan
standar. Bila standar tidak lagi mencerminkan praktik pelayanan \up0
\expndtw0\charscalex100 kesehatan mutakhir, teknologi yang umum ada, praktik
manajemen mutu, dan \up0 \expndtw0\charscalex100 sebagainya, maka standar akan
direvisi atau dihapus. Setiap 3 (tiga) tahun standar \up0 \expndtw-3\charscalex100
akan direview. \par\pard\ql \li2488\sb0\sl-276\slmult0 \par\pard\ql\li2488\sb61\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Arti
tanggal \u8216?berlaku\u8217? pada sampul Standar Nasional Edisi 1 \par\pard\ql
\li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Tanggal \u8216?berlaku\u8217? yang tercetak pada sampul
berarti: \par\pard\qj \li1440\ri1238\sb212\sl-315\slmult0 \up0 \expndtw-
1\charscalex100 Bagi rumah sakit yang telah terakreditasi menurut standar versi
2012, bila akreditasi \up0 \expndtw0\charscalex100 ulang dilaksanakan tahun 2018
akan menggunakan Standar Nasional Akreditasi \up0 \expndtw0\charscalex100 Rumah
Sakit edisi 1 ini. Standar ini dipublikasikan 5 (lima) bulan sebelum tanggal \up0
\expndtw-1\charscalex100 berlaku, sehingga memberikan
waktu bagi rumah sakit untuk mempelajari dan \up0 \expndtw-3\charscalex100
mempersiapkan pelaksanaan SNARS Edisi 1. \par\pard\qj \li1440\ri1185\sb201\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 Bagi rumah sakit yang baru pertama kali
akreditasi di tahun 2018, akan menggunakan \up0 \expndtw0\charscalex102 SNARS Edisi
1. Standar akreditasi versi 2012 akan berlaku sampai dengan 31 \up0 \expndtw-
3\charscalex100 Desember 2017. \par\pard\ql \li3844\sb0\sl-276\slmult0
\par\pard\ql\li3844\sb0\sl-276\slmult0 \par\pard\ql\li3844\sb5\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Cara menggunakan buku
standar ini. \par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Buku standar ini dapat digunakan sebagai:
\par\pard\ql \li1507\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Pedoman untuk
mengelola organisasi rumah sakit agar efisien dan efektif; \par\pard\qj
\li1507\ri1183\sb28\sl-320\slmult0\tx1867 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Pedoman bagi
pengelolaan dan pemberian pelayanan dan asuhan pasien; \line\tab \up0 \expndtw-
3\charscalex100 juga pedoman bagi upaya memperbaiki kualitas dan efisiensi
pelayanan tersebut; \par\pard\ql \li10243\sb236\sl-253\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 11

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\par\pard\ql\li1507\sb0\sl-330\slmult0 \par\pard\ql\li1507\sb0\sl-330\slmult0
\par\pard\ql\li1507\ri1183\sb158\sl-330\slmult0\tx1867 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Sarana untuk menilai fungsi-fungsi penting dalam suatu organisasi rumah sakit; \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Sarana untuk memahami apa saja standar
yang harus dipenuhi seluruh \line\tab \up0 \expndtw-5\charscalex100 organisasi
rumah sakit dalam proses akreditasi oleh KARS; \par\pard\qj \li1507\ri1243\sb19\sl-
320\slmult0\tx1867 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Sarana untuk menilai seberapa jauh suatu
organisasi belum atau telah \line\tab \up0 \expndtw-4\charscalex100 memenuhi
standar; \par\pard\qj \li1507\ri1244\sb0\sl-320\slmult0\tx1867 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Sarana untuk mengetahui kebijakan-kebijakan akreditasi, bagaimana prosedur
\line\tab \up0 \expndtw-4\charscalex100 serta prosesnya; dan \par\pard\ql
\li1507\sb57\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Mengenal
terminologi yang digunakan dalam buku standar. \par\pard\ql \li3974\sb0\sl-
276\slmult0 \par\pard\ql\li3974\sb88\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Kategori-kategori Ketentuan KARS
\par\pard\ql \li1440\ri4424\sb0\sl-340\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ketentuan KARS dijelaskan dalam kategori berikut
ini : \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Ketentuan Mengikuti Akreditasi Rumah Sakit
\line \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Standar \par\pard\ql \li1507\sb5\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Maksud dan Tujuan \par\pard\ql \li1507\sb64\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Elemen Penilaian (EP) \par\pard\ql
\li3381\sb0\sl-276\slmult0 \par\pard\ql\li3381\sb88\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Ketentuan Mengikuti Akreditasi Rumah
Sakit \par\pard\qj \li1440\ri1182\sb11\sl-317\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Bagian Ketentuan Mengikuti
Akreditasi Rumah Sakit, merupakan regulasi baru di \line \up0 \expndtw-
2\charscalex100 KARS, Ketentuan ini meliputi Ketentuan spesifik untuk mengikuti
proses akreditasi \line \up0 \expndtw0\charscalex100 dan untuk mempertahankan
status akreditasi. Rumah sakit harus mematuhi \line \up0
\expndtw0\charscalex100 Ketentuan dalam bagian ini sepanjang waktu dalam proses
akreditasi. Walaupun \line \up0 \expndtw-2\charscalex100 demikian, Ketentuan ini
tidak diberi nilai seperti standar lain dalam survei di tempat. \line \up0
\expndtw-2\charscalex100 Rumah sakit akan dinilai antara memenuhi atau tidak
memenuhi Ketentuan ini. Jika \line \up0 \expndtw-3\charscalex100 rumah sakit tidak
memenuhi Ketentuan tertentu, maka rumah sakit akan diminta untuk \line \up0
\expndtw-4\charscalex100 segera memenuhinya atau terancam tidak mendapatkan
akreditasi. \par\pard\ql \li5503\sb0\sl-276\slmult0 \par\pard\ql\li5503\sb81\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar
\par\pard\qj \li1440\ri1183\sb0\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Standar KARS mencakup harapan kinerja, struktur, atau
fungsi yang harus diterapkan \up0 \expndtw-2\charscalex100 agar suatu rumah sakit
dapat terakreditasi oleh KARS. Sasaran Keselamatan \up0
\expndtw0\charscalex102 Pasien dianggap sebagai standar dan dimonitoring sama
seperti standar lainnya \up0 \expndtw-3\charscalex100 dalam survei di tempat.
\par\pard\ql \li4833\sb0\sl-276\slmult0 \par\pard\ql\li4833\sb69\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
\par\pard\qj \li1440\ri1179\sb11\sl-316\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Maksud dan tujuan dari suatu standar akan
membantu menjelaskan makna \line \up0 \expndtw0\charscalex102 sepenuhnya dari
standar tersebut. Maksud dan tujuan akan mendeskripsikan \line \up0 \expndtw-
1\charscalex100 tujuan dan rasionalisasi dari standar, memberikan penjelasan
bagaimana standar \line \up0 \expndtw-1\charscalex100 tersebut selaras dengan
program secara keseluruhan, menentukan parameter untuk \line \up0 \expndtw-
3\charscalex100 Ketentuan-Ketentuannya, atau memberikan \u8220?gambaran tentang
Ketentuan dan tujuan-\line \up0 \expndtw-4\charscalex100 tujuannya. \par\pard\ql
\li4696\sb0\sl-276\slmult0 \par\pard\ql\li4696\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian (EP) \par\pard\qj
\li1440\ri1243\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Elemen Penilaian (EP) dari suatu standar akan menuntun
rumah sakit dan surveior \line \up0 \expndtw-1\charscalex100 terhadap apa yang akan
ditinjau dan dinilai selama proses survei. EP untuk setiap \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb123\sl-253\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 12

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\par\pard\qj\li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\ri1182\sb215\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 standar menunjukkan ketentuan untuk kepatuhan
terhadap standar tersebut. EP \up0 \expndtw-4\charscalex100 ditujukan untuk
memberikan kejelasan pada standar dan membantu rumah sakit untuk \up0
\expndtw0\charscalex104 memenuhi sepenuhnya ketentuan yang ada, untuk
membantu mengedukasi \up0 \expndtw-1\charscalex100 pimpinan dan tenaga kesehatan
mengenai standar yang ada serta untuk memandu \up0 \expndtw-2\charscalex100 rumah
sakit dalam persiapan proses akreditasi. \par\pard\ql \li3203\sb0\sl-276\slmult0
\par\pard\ql\li3203\sb82\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN UMUM AKREDITASI RUMAH SAKIT \par\pard\ql
\li2951\sb0\sl-276\slmult0 \par\pard\ql\li2951\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 PERSYARATAN AKREDITASI RUMAH SAKIT (PARS) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Gambaran Umum \par\pard\qj \li1440\ri1246\sb11\sl-316\slmult0
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Bagian ini merupakan
hal baru dalam pelaksanaan akreditasi rumah sakit di \line \up0
\expndtw0\charscalex104 Indonesia, di akreditasi sebelumnya tidak ada persyaratan
yang ditetapkan oleh \line \up0 \expndtw0\charscalex103 KARS untuk mengikuti
akreditasi rumah sakit. Persyaratan ini bukan berarti \line \up0
\expndtw0\charscalex100 menghambat rumah sakit untuk mengikuti akreditasi, tetapi
mendorong rumah sakit \line \up0 \expndtw0\charscalex100 untuk mengikuti
peraturan dan perundang-undangan, sehingga akreditasi yang \line \up0
\expndtw0\charscalex100 dilaksanakan dalam rangka peningkatan mutu dan
keselamatan pasien dapat \line \up0 \expndtw-1\charscalex100 dicapai.
\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1236\sb1\sl-
320\slmult0 \up0 \expndtw0\charscalex104 Untuk rumah sakit yang akan melakukan
akreditasi pertama kalinya, kesesuaian \line \up0 \expndtw-1\charscalex100 dengan
seluruh persyaratan akreditasi rumah sakit dinilai selama survei awal. Untuk
\line \up0 \expndtw-2\charscalex100 rumah sakit yang sudah terakreditasi,
kesesuaian dengan persyaratan akreditasi \line \up0 \expndtw-2\charscalex100
rumah sakit dinilai sepanjang siklus akreditasi, melalui survei lokasi langsung.
\par\pard\ql \li3156\sb0\sl-276\slmult0 \par\pard\ql\li3156\sb0\sl-276\slmult0
\par\pard\ql\li3156\sb5\sl-276\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf6\f7\fs24 Persyaratan, Maksud dan Tujuan, Monitoring,
\par\pard\ql \li4432\sb24\sl-276\slmult0 \up0 \expndtw0\charscalex106 Dampak
ketidakpatuhan \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb132\sl-276\slmult0 \up0 \expndtw-4\charscalex100
Persyaratan Pertama : PARS.1 \par\pard\qj \li1440\ri1244\sb8\sl-320\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit memenuhi semua
persyaratan informasi dan data kepada Komisi \up0 \expndtw-3\charscalex100
Akreditasi Rumah Sakit (KARS). \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan tujuan untuk PARS.1 \par\pard\qj
\li1440\ri1245\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex106
\ul0\nosupersub\cf7\f8\fs24 Pada waktu mengajukan permohonan survei
akreditasi, rumah sakit perlu \line \up0 \expndtw0\charscalex100 memberikan
data dan dan informasi yang dibutuhkan untuk proses akreditasi. \line
\up0 \expndtw0\charscalex103 Misalnya : mengisi aplikasi survei secara lengkap,
data direktur rumah sakit, data \line \up0 \expndtw0\charscalex100 kelengkapan
surat tanda registrasi dan surat izin praktik para staf medis serta data \line \up0
\expndtw0\charscalex100 perizinan-perizinan lainnya, termasuk bila ada
perubahan direktur rumah sakit, \line \up0 \expndtw0\charscalex100 kepemilikan,
peningkatan kelas, pembangunan/renovasi yang cukup luas, dan lain \line \up0
\expndtw0\charscalex100 sebagainya serta bila ingin mengajukan banding keputusan
akreditasi. \par\pard\qj \li1440\ri1265\sb288\sl-320\slmult0 \up0
\expndtw0\charscalex104 Rumah sakit wajib memberikan data dan informasi kepada
KARS, data tersebut \line \up0 \expndtw0\charscalex100 dimulai pada waktu
pengajuan survei dan selama siklus survei akreditasi tiga \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb83\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 13

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,315);(9079,315);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
14996726}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
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{\shp
{\*\shpinst\shpleft1411\shptop11777\shpright10490\shpbottom12092\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz6940\shplid7
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 315}}
{\sp{\sn pVerticies}{\sv 8;4;(0,315);(9079,315);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
16181725}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg14}{\bkmkend Pg14}\par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1266\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 tahunan. Penyampaian data sesuai yang diminta KARS,
harus disampaikan oleh \up0 \expndtw-1\charscalex100 rumah sakit ke KARS.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.1
\par\pard\qj \li1440\ri1236\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Monitoring dilaksanakan terus-menerus selama siklus
akreditasi terkait dengan \up0 \expndtw-3\charscalex100 pengajuan yang
diperlukan. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Dampak
Ketidakpatuhan terhadap PARS.1 \par\pard\qj \li1440\ri1183\sb11\sl-317\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Jika rumah sakit gagal
memenuhi persyaratan informasi dan data hingga waktu yang \line \up0
\expndtw0\charscalex100 ditentukan kepada KARS, rumah sakit akan dianggap berisiko
gagal akreditasi atau \line \up0 \expndtw0\charscalex102 penetapak akreditasi
tertunda sampai semua persyaratan akreditasi dipenuhi dan \line \up0 \expndtw-
1\charscalex100 dilakukan survei terfokus. Sebagai contoh, jika informasi pada
aplikasi survei rumah \line \up0 \expndtw0\charscalex102 sakit tidak tepat /tidak
sesuai selama pelaksanaan survei maka dibutuhkan survei \line \up0
\expndtw0\charscalex100 terfokus dan rumah sakit diminta menanggung biaya
dari pelaksanaan survei \line \up0 \expndtw-3\charscalex100 terfokus. Sebagai
tambahan, jika terdapat bukti bahwa rumah sakit telah memalsukan \line \up0
\expndtw0\charscalex102 atau menahan informasi atau bermaksud menghilangkan
informasi yang diajukan \line \up0 \expndtw-3\charscalex100 kepada KARS,
persyaratan dan konsekuensi pada PARS.2 akan berlaku. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb105\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Persyaratan
Kedua: PARS.2 \par\pard\qj \li1440\ri1243\sb8\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyediakan informasi yang
lengkap dan akurat kepada KARS selama \up0 \expndtw-2\charscalex100 keseluruhan
fase dari proses akreditasi. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan tujuan untuk PARS.2 \par\pard\qj
\li1440\ri1243\sb14\sl-313\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 KARS menginginkan setiap rumah sakit yang mengajukan
akreditasi atau sudah \up0 \expndtw0\charscalex102 terakreditasi untuk melaksanakan
proses akreditasi secara jujur, berintegritas dan \up0 \expndtw0\charscalex100
transparan. Hal ini dibuktikan dengan menyediakan informasi yang lengkap
dan \up0 \expndtw0\charscalex100 akurat selama proses akreditasi dan pasca
akreditasi . \par\pard\qj \li1440\ri3957\sb0\sl-340\slmult0 \up0 \expndtw-
3\charscalex100 KARS mendapatkan informasi tentang rumah sakit melalui: \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 informasi dari rumah sakit dan karyawan
\par\pard\ql \li1507\sb18\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 informasi dari
masyarakat \par\pard\ql \li1507\sb64\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
informasi dari pemerintah \par\pard\qj \li1507\ri5041\sb28\sl-320\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 informasi dari media massa dan media sosial \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 komunikasi secara lisan \par\pard\qj
\li1507\ri1238\sb20\sl-320\slmult0\tx1867 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Observasi
langsung dengan atau melalui wawancara atau komunikasi lainnya \line\tab \up0
\expndtw-3\charscalex100 kepada pegawai KARS \par\pard\qj \li1507\ri1234\sb0\sl-
340\slmult0\tx1867 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Dokumen elektronik
atau\ul0\nosupersub\cf8\f9\fs24 hard-copy\ul0\nosupersub\cf7\f8\fs24 melalui
pihak ketiga, seperti media massa \line\tab \up0 \expndtw-2\charscalex100 atau
laporan pemerintahan \par\pard\qj \li1440\ri1183\sb281\sl-320\slmult0 \up0
\expndtw0\charscalex100 Untuk Persyaratan ini, pemalsuan informasi
didefinisikan sebagai pemalsuan \line \up0 \expndtw0\charscalex102 (fabrikasi),
secara keseluruhan atau sebagian dari informasi yang diberikan oleh \line \up0
\expndtw-3\charscalex100 pihak yang mengajukan atau rumah sakit yang diakreditasi
kepada KARS. Pemalsuan \line \up0 \expndtw-3\charscalex100 bisa meliputi perubahan
draft, perubahan format, atau menghilangkan isi dokumen \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb163\sl-253\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 14

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{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9079,314);(9079,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
16181725}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

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}}

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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 317}}
{\sp{\sn pVerticies}{\sv 8;4;(0,317);(9079,317);(9079,0);(0,0)}}
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg15}{\bkmkend Pg15}\par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 atau mengirimkan informasi,
laporan, data dan materi palsu lainnya. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb112\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.2
\par\pard\qj \li1440\ri1223\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Monitoring dari PARS ini dimulai sejak proses
pendaftaran dan terus berlanjut hingga \up0 \expndtw-2\charscalex100 rumah sakit
tersebut terakreditasi oleh atau mencari akreditasi dari KARS \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Dampak Ketidakpatuhan terhadap
PARS.2 \par\pard\qj \li1440\ri1183\sb12\sl-315\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Jika KARS meyakini bahwa rumah sakit memasukkan
informasi yang tidak akurat \up0 \expndtw-3\charscalex100 atau palsu atau
mempresentasikan informasi yang tidak akurat atau palsu ke surveior, \up0
\expndtw0\charscalex100 maka rumah sakit akan dianggap Berisiko Gagal Akreditasi
dan kemungkinan perlu \up0 \expndtw-3\charscalex100 menjalani survei terfokus.
Kegagalan mengatasi masalah ini tepat waktu atau pada \up0 \expndtw-
4\charscalex100 saat survei terfokus dapat berakibat Kegagalan Akreditasi.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Persyaratan Ketiga:
PARS.3 \par\pard\qj \li1440\ri1223\sb16\sl-310\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaporkan bila ada
perubahan dari profil rumah sakit (data elektronik) \up0 \expndtw-1\charscalex100
atau informasi yang diberikan kepada KARS saat mengajukan aplikasi survei dalam
\up0 \expndtw-3\charscalex100 jangka waktu maksimal 10 hari sebelum waktu
survei. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb83\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
tujuan untuk PARS.3 \par\pard\qj \li1440\ri1229\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Untuk memahami kepemilikan,
perizinan, cakupan dan volume pelayanan pasien, \up0 \expndtw0\charscalex100 dan
jenis fasilitas pelayanan pasien, serta faktor lainnya, KARS memerlukan profil
\up0 \expndtw-1\charscalex100 rumah sakit melalui aplikasi survei. KARS memerlukan
data profil rumah sakit terkini \up0 \expndtw0\charscalex100 untuk mempertimbangkan
proses pelaksanaan survei. Data-data tersebut termasuk \up0 \expndtw-
3\charscalex100 tapi tidak hanya terbatas pada informasi di bawah ini: \par\pard\ql
\li1507\sb37\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Perubahan nama
rumah sakit \par\pard\ql \li1507\sb64\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Perubahan kepemilikan rumah sakit \par\pard\qj \li1507\ri5025\sb28\sl-
320\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Perubahan bentuk badan hukum rumah sakit
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Perubahan kategori rumah sakit \par\pard\ql
\li1507\sb57\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Perubahan kelas
rumah sakit \par\pard\ql \li1507\ri1243\sb34\sl-313\slmult0\tx1867\tx1867\tx1867
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Pencabutan atau pembatasan izin operasional,
keterbatasan atau penutupan \line\tab \up0 \expndtw-3\charscalex100 layanan
pasien, sanksi staf klinis atau staf lainnya, atau tuntutan terkait masalah
\line \tab \up0 \expndtw-2\charscalex100 peraturan dan hukum oleh pihak
Kementerian Kesehatan dan atau Dinas \line \tab \up0 \expndtw-3\charscalex100
Kesehatan \par\pard\qj \li1507\ri1226\sb22\sl-320\slmult0\tx1867 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Penambahan atau penghapusan, satu atau lebih
jenis pelayanan kesehatan, \line\tab \up0 \expndtw-3\charscalex100 misalnya
penambahan unit dialisis atau penutupan perawatan trauma. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.3 \par\pard\qj
\li1440\ri1236\sb0\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Monitoring dari PARS.3 ini dilaksanakan saat
pengajuan aplikasi survei secara \up0 \expndtw-2\charscalex100 elektronik atau
saat berlangsungnya proses survei. Apabila ditemukan adanya \up0 \expndtw-
1\charscalex100 perubahan profil rumah sakit yang tidak dilaporkan
dapat mengakibatkan \up0 \expndtw-3\charscalex100 dilaksanakannya survei terfokus
dalam waktu yang berbeda. \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb218\sl-
253\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 15

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9079,314);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
16181725}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,315);(9079,315);(9079,0);(0,0)}}
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\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Dampak Ketidakpatuhan terhadap
PARS.3 \par\pard\qj \li1440\ri1238\sb14\sl-313\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Apabila rumah sakit pada saat pengajuan
aplikasi survei secara elektronik atau saat \up0 \expndtw0\charscalex103
berlangsungnya proses survei tidak menyampaikan perubahan profil rumah sakit
\up0 \expndtw0\charscalex106 dapat berakibat tidak dilaksanakan survei
akreditasi, gagal akreditasi atau \up0 \expndtw-3\charscalex100 dilaksanakan
survei terfokus dalam waktu yang berbeda. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Persyaratan Keempat: PARS. 4
\par\pard\qj \li1440\ri1231\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengizinkan memberikan akses kepada
KARS untuk melakukan \up0 \expndtw0\charscalex104 monitoring terhadap
kepatuhan standar, melakukan verifikasi mutu dan \up0 \expndtw-
3\charscalex100 keselamatan atau terhadap laporan dari pihak yang berwenang.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan tujuan untuk
PARS.4 \par\pard\qj \li1440\ri1242\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Atas hasil akreditasi yang
dicapai rumah sakit memiliki arti rumah sakit memiliki \line \up0
\expndtw0\charscalex102 komitmen terhadap pemangku kepentingan seperti,
masyarakat, Kementerian \line \up0 \expndtw-1\charscalex100 Kesehatan, badan
pemerintahan pusat/propinsi/kabupaten/kota, sumber pendanaan \line \up0 \expndtw-
2\charscalex100 (asuransi kesehatan), dan pihak lainnya bahwa rumah sakit
akan menjaga untuk \line \up0 \expndtw-3\charscalex100 memenuhi standarnasional
akreditasi rumah sakit edisi 1 \up0 \expndtw-3\charscalex100 termasuk
kebijakan \par\pard\qj \li1440\ri1182\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex100 akreditasi oleh KARS. Dengan demikian, perlu dipahami
bahwa KARS memiliki \up0 \expndtw-4\charscalex100 kewenangan untuk melakukan
telusur dan investigasi terhadap pelaksanaan mutu dan \up0 \expndtw0\charscalex100
keselamatan pasien ke seluruh atau sebagian rumah sakit, dengan pemberitahuan
\up0 \expndtw-2\charscalex100 atau tanpa pemberitahuan, untuk memastikan rumah
sakit tetap memenuhi dan \up0 \expndtw-2\charscalex100 mematuhi standar.
Surveior selalu menggunakan tanda pengenal resmi sebagai \up0
\expndtw0\charscalex100 identitas dan surat tugas dari KARS ketika
melakukan kunjungan tanpa \up0 \expndtw-3\charscalex100 pemberitahuan kepada
rumah sakit sebelumnya. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb41\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.4 \par\pard\qj \li1440\ri1246\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Monitoring
dari persyaratan ini dilaksanakan selama fase siklus akreditasi tiga
\up0 \expndtw-3\charscalex100 tahunan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Dampak Ketidakpatuhan terhadap PARS.4 \par\pard\qj
\li1440\ri1240\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 KARS akan menarik status akreditasi dari rumah
sakit yang menolak atau \up0 \expndtw0\charscalex100 membatasi akses terhadap
surveior KARS yang ditugaskan untuk melaksanakan \up0 \expndtw-3\charscalex100
telusur dan investigasi langsung. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Persyaratan Kelima : PARS.5 \par\pard\qj
\li1440\ri1238\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit bersedia menyerahkan data hasil
monitoring dari Kementerian \up0 \expndtw0\charscalex100 Kesehatan/Dinas
Kesehatan Propinsi/Kabupaten/Kota berupa berkas asli atau \up0 \expndtw-
3\charscalex100 fotokopi legalisir kepada KARS. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan tujuan untuk PARS.5
\par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Dalam pelaksanaan survei akreditasi yang
menyeluruh, surveior KARS dapat \par\pard\li1440\sb41\sl-
276\slmult0\fi0\tx4209\tx5102 \up0 \expndtw0\charscalex103 meminta informasi\tab
\up0 \expndtw0\charscalex103 dari\tab \up0 \expndtw0\charscalex103 Kementerian
Kesehatan/Dinas Kesehatan\par\pard\qj \li1440\ri1245\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex103 Provinsi/Kabupaten/Kota berbagai aspek operasional rumah
sakit dan lembaga \line \up0 \expndtw0\charscalex100 lainnya yang juga melakukan
penilaian terhadap area yang berhubungan dengan \par\pard\ql \li10243\sb207\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 16

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Pg17}{\bkmkend Pg17}\par\pard\qj \li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\sb0\sl-313\slmult0 \par\pard\qj\li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1219\sb223\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 mutu dan keselamatan, sebagai contoh pemeriksaan
keselamatan kebakaran, \line \up0 \expndtw0\charscalex104 pemeriksaan sanitasi
rumah sakit dan lain sebagainya. Dalam hal ini termasuk \line \up0 \expndtw-
1\charscalex100 kepatuhan terhadap peraturan perundang-undangan dan monitoring
dari mutu dan \line \up0 \expndtw-2\charscalex100 keselamatan berupa
insiden/kejadian yang dilaporkan ke pihak berwenang. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.5 \par\pard\qj
\li1440\ri1239\sb11\sl-316\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Apabila diperlukan, rumah sakit bersedia memberikan
semua catatan resmi, laporan \line \up0 \expndtw0\charscalex100 dan rekomendasi
dari lembaga lain seperti lembaga yang membidangi perizinan, \line \up0
\expndtw0\charscalex102 pemeriksaan, peninjauan ulang, pemerintahan dan
perencanaan. KARS juga bisa \line \up0 \expndtw-1\charscalex100 meminta laporan
secara langsung dari lembaga lain tersebut. Laporan tersebut bisa \line \up0
\expndtw-2\charscalex100 diminta selama berlangsungnya fase siklus akreditasi tiga
tahunan, termasuk selama \line \up0 \expndtw-1\charscalex100 survei akreditasi atau
sebagai bagian dari monitoring yang menyangkut insiden atau \line \up0 \expndtw-
4\charscalex100 mutu. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Dampak Ketidakpatuhan terhadap PARS.5 \par\pard\qj
\li1440\ri1196\sb16\sl-310\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Apabila rumah sakit tidak bersedia menyediakan
laporan resmi ketika diminta \up0 \expndtw0\charscalex100 pada saat survei
berlangsung, dapat berakibat dilaksanakannya survei terfokus \up0 \expndtw-
4\charscalex100 untuk mengkaji kembali laporan dan standar yang berhubungan.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb83\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Persyaratan Keenam :
PARS.6 \par\pard\qj \li1440\ri1219\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengizinkan
pejabat KARS atau surveior senior yang ditugaskan \up0 \expndtw0\charscalex102
oleh KARS untuk mengamati proses survei secara langsung. Pejabat KARS atau \up0
\expndtw0\charscalex100 surveior senior yang ditugaskan wajib menggunakan tanda
pengenal resmi sebagai \up0 \expndtw0\charscalex102 identitas dan surat tugas dari
KARS, termasuk ketika melakukan kunjungan tanpa \up0 \expndtw-3\charscalex100
pemberitahuan kepada rumah sakit sebelumnya. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb105\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
tujuan untuk PARS.6 \par\pard\qj \li1440\ri1236\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex108 \ul0\nosupersub\cf7\f8\fs24 Pejabat KARS atau surveior
senior dapat ditugaskan oleh Ketua Eksekutif \line \up0
\expndtw0\charscalex104 KARS untuk mengawasi surveior baru, melakukan evaluasi
standar baru dan \line \up0 \expndtw-2\charscalex100 melaksanakan evaluasi terhadap
adanya perubahan tersebut selain aktivitas lainnya. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.6 \par\pard\qj
\li1440\ri1239\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Evaluasi bisa dilaksanakan pada semua fase proses
akreditasi, termasuk saat \up0 \expndtw-3\charscalex100 pelaksanaan survei
verifikasi dan survei terfokus. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Dampak Ketidakpatuhan terhadap PARS.6 \par\pard\qj
\li1440\ri1240\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Apabila rumah sakit tidak bersedia dilaksanakan
evaluasi pada semua fase proses \up0 \expndtw0\charscalex103 akreditasi, termasuk
saat pelaksanaan survei verifikasi dan survei terfokus dapat \up0 \expndtw-
3\charscalex100 berakibat kegagalan akreditasi. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Persyaratan Ketujuh : PARS.7
\par\pard\qj \li1440\ri1245\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit bersedia bergabung dalam sistem
penilaian perkembangan mutu \line \up0 \expndtw0\charscalex102 dengan memberikan
hasil pengukuran indikator mutu. Dengan demikian direktur \par\pard\ql
\li10243\sb216\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 17

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{\shp
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Pg18}{\bkmkend Pg18}\par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1248\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 rumah sakit dapat membandingkan capaian indikator area
klinis, area manajemen \line \up0 \expndtw0\charscalex100 dan sasaran keselamatan
pasien dengan rumah sakit lain melalui Sismadak KARS. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan tujuan untuk PARS.7
\par\pard\qj \li1440\ri1183\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kumpulan indikator KARS memberikan keseragaman,
ketepatan spesifikasi dan \up0 \expndtw-3\charscalex100 standarisasi data yang
dikumpulkan sehingga dapat dilakukan perbandingan di dalam \up0 \expndtw-
4\charscalex100 rumah sakit dan antar rumah sakit. \par\pard\qj
\li1440\ri1191\sb5\sl-315\slmult0 \up0 \expndtw0\charscalex100 Pengumpulan,
analisis dan penggunaan data merupakan inti dari proses akreditasi \line \up0
\expndtw-1\charscalex100 KARS. Data dapat menunjang perbaikan yang berkesinambungan
bagi rumah sakit. \line \up0 \expndtw-3\charscalex100 Data juga bisa
menyediakan arus informasi yang berkesinambungan bagi KARS \line \up0 \expndtw-
1\charscalex100 dalam mendukung kelangsungan perbaikan mutu dan keselamatan
pasien rumah \line \up0 \expndtw-2\charscalex100 sakit. \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1182\sb1\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Pemilihan dan penggunaan kumpulan indikator
diintegrasikan ke dalam prioritas \up0 \expndtw-3\charscalex100 parameter rumah
sakit, seperti yang dijabarkan dalam standar TKRS.5, TKRS.11, dan \up0 \expndtw-
4\charscalex100 TKRS.11.1. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.7 \par\pard\qj \li1440\ri1182\sb8\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Indikator
wajib dan indikator yang dipilih dievaluasi secara menyeluruh selama proses \up0
\expndtw-3\charscalex100 akreditasi berlangsung. Pengisian kedua indikator tersebut
dilakukan sebelum proses \up0 \expndtw0\charscalex103 survei. Evaluasi dilaksanakan
pada semua fase proses akreditasi, termasuk saat \up0 \expndtw-3\charscalex100
pelaksanaan survei verifikasi dan survei terfokus. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Dampak Ketidakpatuhan terhadap
PARS.7 \par\pard\qj \li1440\ri1208\sb308\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Apabila rumah sakit tidak bersedia
bergabung dalam sistem penilaian perkembangan \up0 \expndtw0\charscalex102 mutu
dengan memberikan hasil pengukuran indikator mutu dan dapat berakibat \up0
\expndtw-3\charscalex100 pada hasil akreditasi. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Persyaratan Kedelapan: PARS.8
\par\pard\qj \li1440\ri1242\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit wajib menampilkan status akreditasi
dengan tepat, program dan \up0 \expndtw0\charscalex103 pelayanan sesuai dengan
tingkatan status akreditasi yang diberikan oleh KARS \up0 \expndtw-3\charscalex100
melalui website atau promosi lainnya. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan tujuan untuk PARS.8 \par\pard\qj
\li1440\ri1231\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Situs, iklan dan promosi rumah sakit serta
informasi lain yang dibuat oleh \up0 \expndtw0\charscalex104 rumah sakit kepada
masyarakat harus secara tepat menggambarkan capaian \up0 \expndtw-
1\charscalex100 tingkatan status akreditasi yang diberikan oleh KARS, program dan
pelayanan yang \up0 \expndtw-3\charscalex100 diakreditasi oleh KARS.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.8
\par\pard\qj \li1440\ri1187\sb0\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Evaluasi terhadap persyaratan ini dilaksanakan pada
seluruh fase akreditasi, termasuk \up0 \expndtw-5\charscalex100 siklus akreditasi
tiga tahunan. \par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb18\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 18

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg19}{\bkmkend Pg19}\par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Dampak Ketidakpatuhan terhadap
PARS.8 \par\pard\qj \li1440\ri1222\sb308\sl-320\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Apabila informasi tentang
capaian tingkatan status akreditasi yang diberikan oleh \up0 \expndtw-
3\charscalex100 KARS tidak sesuai, dapat berakibat pada hasil akreditasi.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb125\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Persyaratan kesembilan: PARS.9 \par\pard\qj
\li1440\ri1236\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyelenggarakan pelayanan pasien dalam
lingkungan yang tidak \up0 \expndtw-1\charscalex100 memiliki risiko atau
mengancam keselamatan pasien, kesehatan masyarakat atau \up0 \expndtw-
3\charscalex100 keselamatan staf. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan tujuan untuk PARS.9 \par\pard\qj
\li1440\ri1237\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit yang dipercaya pasien, staf dan
masyarakat, dinyatakan berisiko \up0 \expndtw0\charscalex100 rendah dan
merupakan tempat yang aman. Oleh karena itu, rumah sakit menjaga \up0
\expndtw0\charscalex100 kepercayaan dengan melakukan peninjauan dan pengawasan
terhadap praktik \up0 \expndtw-3\charscalex100 keselamatan. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Monitoring PARS.9 \par\pard\qj
\li1440\ri1243\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Evaluasi dilaksanakan terutama selama proses
survei berlangsung termasuk \line \up0 \expndtw0\charscalex103 melalui laporan
atau pengaduan dari masyarakat atau sanksi dari pihak yang \line \up0
\expndtw-2\charscalex100 berwenang pada seluruh fase akreditasi, termasuk siklus
akreditasi tiga tahunan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Dampak Ketidakpatuhan terhadap PARS.9 \par\pard\qj
\li1440\ri1184\sb16\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Risiko keamanan yang membahayakan pasien, pengunjung
dan staf yang ditemukan \up0 \expndtw-3\charscalex100 pada saat survei dapat
berakibat pada hasil akreditasi sampai masalah tersebut dapat \up0 \expndtw-
4\charscalex100 diatasi dengan baik. \par\pard\ql \li3717\sb0\sl-276\slmult0
\par\pard\ql\li3717\sb0\sl-276\slmult0 \par\pard\ql\li3717\sb127\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN PRA SURVEI
AKREDITASI \par\pard\ql \li4262\sb0\sl-276\slmult0 \par\pard\ql\li4262\sb8\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Persyaratan kelayakan umum
\par\pard\qj \li1440\ri1223\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap rumah sakit dapat mengajukan survei
akreditasi kepada Komisi Akreditasi \up0 \expndtw-3\charscalex100 Rumah Sakit
(KARS) bila memenuhi semua kriteria sebagai berikut: \par\pard\ql \li1800\sb37\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 1. Rumah sakit berlokasi di wilayah
Indonesia \par\pard\qj \li1800\ri1247\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex102 2. Rumah sakit umum maupun rumah sakit khusus untuk semua
kelas rumah \line\tab \up0 \expndtw-3\charscalex100 sakit \par\pard\ql
\li1800\sb25\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. Izin operasional
rumah sakit masih berlaku \par\pard\ql \li1800\ri1192\sb11\sl-
316\slmult0\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex100
4. Bila izin rumah sakit sudah habis masa berlakunya, pengajuan permohonan
\line\tab \up0 \expndtw-2\charscalex100 survei bisa dilakukan, bila Dinas Kesehatan
meminta syarat perpanjangan izin \line \tab \up0 \expndtw0\charscalex104
operasional harus sudah terakreditasi. Untuk itu rumah sakit mengirimkan \line \tab
\up0 \expndtw0\charscalex100 surat/ persyaratan dari Dinas Kesehatan tersebut ke
KARS dan survei dapat \line \tab \up0 \expndtw-1\charscalex100 dilaksanakan. Hasil
survei yang diberikan berupa surat keterangan hasil \line \tab \up0 \expndtw-
3\charscalex100 akreditasi yang dapat dipergunakan untuk mengurus izin
operasional. Bila izin \line \tab \up0 \expndtw-3\charscalex100 operasional sudah
terbit, rumah sakit mengirimkan dokumen izin tersebut ke \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb44\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 19

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg20}{\bkmkend Pg20}\par\pard\qj \li2160\sb0\sl-320\slmult0
\par\pard\qj\li2160\sb0\sl-320\slmult0 \par\pard\qj\li2160\sb0\sl-320\slmult0
\par\pard\qj\li2160\ri1190\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf10\f11\fs24 survei@kars.or.id\ul0\nosupersub\cf7\f8\fs24 dan
Komisi Akreditasi Rumah Sakit akan memberikan \up0 \expndtw-4\charscalex100
sertifikat akreditasi kepada rumah sakit tersebut. \par\pard\ql \li1800\sb17\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 5. Direktur/Kepala rumah Sakit adalah
tenaga medis (dokter atau dokter gigi) \par\pard\ql \li1800\ri1184\sb8\sl-
320\slmult0\tx2160\tx2160 \up0 \expndtw-3\charscalex100 6. Rumah sakit beroperasi
penuh\ul0\nosupersub\cf8\f9\fs24 (full operation)\ul0\nosupersub\cf7\f8\fs24
dengan menyediakan pelayanan \line\tab \up0 \expndtw0\charscalex102 rawat inap,
rawat jalan, dan gawat darurat secara paripurna selama 24 jam \line \tab \up0
\expndtw-3\charscalex100 sehari dan 7 hari seminggu. \par\pard\qj
\li1800\ri1248\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 7. Rumah
sakit mempunyai izin Instalasi Pengelolaaan Limbah Cair (IPLC) yang \line\tab
\up0 \expndtw-2\charscalex100 masih berlaku. \par\pard\ql \li1800\ri1219\sb6\sl-
313\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex100 8. Rumah sakit
mempunyai izin pengelolaan limbah bahan berbahaya dan \line\tab \up0
\expndtw0\charscalex100 beracun yang masih berlaku atau kerjasama dengan
pihak ketiga yang \line \tab \up0 \expndtw-2\charscalex100 mempunyai izin sebagai
pengolah limbah bahan beracun dan berbahaya yang \line \tab \up0 \expndtw-
3\charscalex100 masih berlaku dan atau izin sebagai transporter yang masih berlaku.
\par\pard\qj \li1800\ri1248\sb2\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100
9. Semua tenaga medis pemberi asuhan di rumah sakit telah mempunyai Surat
\line\tab \up0 \expndtw-3\charscalex100 Tanda Registrasi (STR) dan Surat Izin
Praktik (SIP) \par\pard\qj \li1800\ri1244\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex102 10.Rumah sakit melaksanakan atau bersedia melaksanakan
kewajiban dalam \line\tab \up0 \expndtw-2\charscalex100 meningkatkan mutu asuhan
dan keselamatan pasien. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Catatan\ul0\nosupersub\cf7\f8\fs24 : \par\pard\qj
\li1440\ri1223\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100 Bila dalam kajian
persyaratan yang disampaikan tidak memenuhi kriteria 1. sampai \up0 \expndtw-
2\charscalex100 dengan 10. maka KARS dapat memutuskan bahwa tidak dilaksanakan
survei sampai \up0 \expndtw-3\charscalex100 dengan persyaratan dipenuhi.
\par\pard\ql \li2087\sb0\sl-276\slmult0 \par\pard\ql\li2087\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Tata cara pengajuan
survei akreditasi pertama kali dan survei ulang \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0\tx2006 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. \tab \up0 \expndtw0\charscalex102
Rumah sakit mengajukan permohonan survei akreditasi yang dikirim melalui
\par\pard\qj \li2006\ri1249\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100 email
ke\ul0\nosupersub\cf10\f11\fs24 survei@kars.or.id\ul0\nosupersub\cf7\f8\fs24 atau
secara online melalui website :\ul0\nosupersub\cf10\f11\fs24 www.kars.or.id
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 paling lambat 1 (satu)
bulan sebelum tanggal pelaksanaan yang diajukan oleh \up0 \expndtw-3\charscalex100
rumah sakit. \par\pard\li1440\sb36\sl-276\slmult0\fi0\tx2006 \up0 \expndtw-
1\charscalex100 2.\tab \up0 \expndtw0\charscalex100 Surat permohonan survei
dilampiri dengan kelengkapan sebagai berikut :\par\pard\li1440\sb41\sl-
276\slmult0\fi633 \up0 \expndtw0\charscalex100 a. Aplikasi survei yang sudah diisi
dan ditandatangani oleh Direktur/Kepala\par\pard\li1440\sb41\sl-
276\slmult0\fi993 \up0 \expndtw-1\charscalex100 rumah sakit.\par\pard\ql
\li2073\sb39\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b. Hasil self asessment
terakhir, dengan skor minimal 80 % \par\pard\ql \li2073\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 c. Izin operasional yang masih berlaku \par\pard\ql
\li2073\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d. Ijazah dokter atau
dokter gigi dari Direktur/Kepala rumah sakit. \par\pard\ql \li2073\sb44\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 e. Surat pernyataan Direktur/Kepala
rumah sakit yang berisi: \par\pard\ql \li2431\sb64\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Tidak keberatan memberikan akses rekam medis kepada surveior \par\pard\qj
\li2431\ri1593\sb0\sl-340\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Tidak
meninggalkan rumah sakit selama kegiatan survei berlangsung \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Semua tenaga medis sudah mempunyai STR dan SIP. \par\pard\qj \li2073\ri1251\sb0\sl-
320\slmult0\tx2433 \up0 \expndtw-3\charscalex100 f. Daftar tenaga medis yang
dilengkapi dengan nomer Surat Tanda Registrasi \line\tab \up0 \expndtw-
4\charscalex100 (STR) dan Surat Izin Praktik (SIP) dan masa berlakunya \par\pard\ql
\li2073\sb26\sl-276\slmult0 \up0 \expndtw-5\charscalex100 g. Surat izin
pengelolaan air limbah (IPLC) yang masih berlaku \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb111\sl-
253\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 20

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Pg21}{\bkmkend Pg21}\par\pard\ql \li2073\sb0\sl-310\slmult0
\par\pard\ql\li2073\sb0\sl-310\slmult0 \par\pard\ql\li2073\sb0\sl-310\slmult0
\par\pard\ql\li2073\ri1184\sb234\sl-310\slmult0\tx2433\tx2433 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 h. Surat izin pengelolaan limbah
B-3 yang masih berlaku atau perjanjian \line\tab \up0 \expndtw-4\charscalex100
kerjasama dengan pihak ke 3 yang mempunyai izin pengolah limbah B-3 dan \line
\tab \up0 \expndtw-5\charscalex100 tranporter yang masih berlaku. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb83\sl-276\slmult0\tx2006 \up0
\expndtw-3\charscalex100 3. \tab \up0 \expndtw-3\charscalex100 Berdasarkan
pengajuan permohonan survei akreditasi pada poin 2. maka KARS \par\pard\ql
\li2006\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 akan melakukan evaluasi
permohonan dan menetapkan: \par\pard\qj \li2073\ri1251\sb28\sl-
320\slmult0\tx2433 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Bila rumah sakit telah memenuhi
persayaratan maka KARS akan \line\tab \up0 \expndtw-5\charscalex100 melanjutkan
proses akreditasi \par\pard\ql \li2073\ri1241\sb0\sl-
320\slmult0\tx2433\tx2433\tx2433 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Bila rumah
sakit belum memenuhi persyaratan maka KARS akan \line\tab \up0
\expndtw0\charscalex100 memberitahukan ke Rumah Sakit agar melengkapi
persyaratan dan \line \tab \up0 \expndtw-1\charscalex100 pelaksanaan akreditasi
ditunda sampai dengan kekurangan persyaratan \line \tab \up0 \expndtw-
3\charscalex100 dipenuhi oleh rumah sakit. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0\tx2006 \up0 \expndtw-
5\charscalex100 4. \tab \up0 \expndtw-5\charscalex100 Permohonan survei akreditasi
diterima, maka: \par\pard\qj \li2073\ri1248\sb0\sl-330\slmult0\tx2433 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 KARS menjadwalkan survei akreditasi dan
memberi tahu jadwal survei \line\tab \up0 \expndtw-5\charscalex100 kepada rumah
sakit dengan tembusan kepada Dinas Kesehatan Provinsi \line \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Rumah sakit melakukan kontrak komitmen dengan Komisi Akreditasi
\par\pard\ql \li2433\sb35\sl-276\slmult0 \up0 \expndtw-4\charscalex100 Rumah Sakit
yang antara lain berisi tentang: \par\pard\ql \li2433\ri1184\sb8\sl-
320\slmult0\tx2858\tx2858\tx2858\tx2858\tx2858\tx2858\tx2858\tx2858 \up0
\expndtw0\charscalex80 \ul0\nosupersub\cf9\f10\fs24 \u-3913? \tab \up0
\expndtw0\charscalex101 \ul0\nosupersub\cf7\f8\fs24 Kesediaan rumah sakit dilakukan
evaluasi terus menerus mulai dari \line\tab \up0 \expndtw0\charscalex100 permohonan
survei yang diajukan, pada waktu survei akreditasi \line \tab \up0 \expndtw-
2\charscalex100 dilaksanakan dan selama siklus akreditasi 3 tahunan. Evaluasi pasca
\line \tab \up0 \expndtw0\charscalex105 akreditasi ini dapat dilakukan setiap
saat dengan atau tanpa \line \tab \up0 \expndtw-3\charscalex100 pemberitahuan
terlebih dahulu, yang dilaksanakan oleh pejabat KARS \line \tab \up0 \expndtw-
4\charscalex100 atau surveior senior yang ditugaskan dengan menggunakan
tanda \line \tab \up0 \expndtw-4\charscalex100 pengenal dari KARS. Bila rumah sakit
menolak dilakukan evaluasi dapat \line \tab \up0 \expndtw-4\charscalex100 berisiko
sertifikat akreditasi ditarik kembali oleh KARS \par\pard\ql \li2433\ri1187\sb0\sl-
320\slmult0\tx2858\tx2858\tx2858\tx2858\tx2858 \up0 \expndtw0\charscalex80
\ul0\nosupersub\cf9\f10\fs24 \u-3913? \tab \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf7\f8\fs24 Kesediaan Rumah Sakit dilakukan survei verifikasi tepat
waktu atau \line\tab \up0 \expndtw-3\charscalex100 sesuai dengan jadwal sebanyak
dua kali yaitu satu tahun setelah survei \line \tab \up0 \expndtw0\charscalex102
dan dua tahun setelah survei. Bila Rumah Sakit menolak dilakukan \line \tab \up0
\expndtw-1\charscalex100 survei verifikasi maka berisiko sertifikat akreditasi
ditarik kembali oleh \line \tab \up0 \expndtw-5\charscalex100 KARS. \par\pard\ql
\li2433\ri1185\sb0\sl-320\slmult0\tx2858\tx2858\tx2858\tx2858\tx2858 \up0
\expndtw0\charscalex80 \ul0\nosupersub\cf9\f10\fs24 \u-3913? \tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Kesediaan rumah sakit memberikan
data dan informasi yang akurat \line\tab \up0 \expndtw-3\charscalex100 dan tidak
palsu kepada KARS dan surveior. Bila terbukti data dan \line \tab \up0
\expndtw-3\charscalex100 informasi tidak akurat atau dipalsukan maka rumah sakit
siap menerima \line \tab \up0 \expndtw-4\charscalex100 risiko gagal akreditasi dan
rumah sakit mengajukan ulang permohonan \line \tab \up0 \expndtw-4\charscalex100
untuk dilakukan survei oleh KARS. \par\pard\ql \li2433\ri1183\sb0\sl-
320\slmult0\tx2858\tx2858\tx2858\tx2858 \up0 \expndtw0\charscalex80
\ul0\nosupersub\cf9\f10\fs24 \u-3913? \tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kesediaan Rumah Sakit melaporkan perubahan data di
aplikasi survei \line\tab \up0 \expndtw0\charscalex102 (kepemilikan, Direktur
Rumah Sakit, perizinan, pelayanan, \line \tab \up0 \expndtw-
4\charscalex100 gedung/bangunan dan fasilitas dll) selambat-lambatnya 10 hari
sebelum \line \tab \up0 \expndtw-4\charscalex100 survei dilakukan \par\pard\ql
\li2433\ri1185\sb20\sl-320\slmult0\tx2858\tx2858\tx2858 \up0 \expndtw0\charscalex80
\ul0\nosupersub\cf9\f10\fs24 \u-3913? \tab \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf7\f8\fs24 Kesediaan Rumah Sakit melaporkan bila ada
kejadian sentinel, \line\tab \up0 \expndtw-4\charscalex100 perubahan kelas rumah
sakit, perubahan jenis atau kategori rumah sakit, \line \tab \up0 \expndtw-
5\charscalex100 penambahan pelayanan baik spesialistik atau sub
spesialistik, \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb123\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 21
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg22}
{\bkmkend Pg22}\par\pard\qj \li2858\sb0\sl-310\slmult0 \par\pard\qj\li2858\sb0\sl-
310\slmult0 \par\pard\qj\li2858\sb0\sl-310\slmult0
\par\pard\qj\li2858\ri1189\sb234\sl-310\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 perubahan bangunan yang lebih dari 25 % dari bangunan
saat sekarang \up0 \expndtw-2\charscalex100 selama siklus akreditasi 3 tahun dan
bersedia dilakukan survei terfokus \up0 \expndtw-3\charscalex100 sesuai
kebutuhan. \par\pard\qj \li2433\ri1252\sb22\sl-320\slmult0\tx2858 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Kesediaan Rumah Sakit melengkapi perizinan yang terkait dengan \line\tab
\up0 \expndtw-5\charscalex100 tenaga dan sarana-prasarana (fasilitas)
\par\pard\ql \li2433\ri1186\sb25\sl-315\slmult0\tx2858\tx2858\tx2858\tx2858 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Kesediaan Rumah Sakit mengizinkan pejabat KARS
atau surveior senior \line\tab \up0 \expndtw-5\charscalex100 yang ditugaskan
dengan menggunakan tanda pengenal dari KARS \line \tab \up0 \expndtw-
2\charscalex100 untuk melakukan evaluasi pada saat berlangsungnya survei.
Evaluasi \line \tab \up0 \expndtw0\charscalex100 bisa dilaksanakan pada seluruh
fase akreditasi, termasuk siklus \line \tab \up0 \expndtw-3\charscalex100
akreditasi tiga tahunan. \par\pard\ql \li2433\ri1247\sb21\sl-
320\slmult0\tx2858\tx2858 \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf9\f10\fs24
\u-3913?\ul0\nosupersub\cf7\f8\fs24 Kesediaan Rumah Sakit menyediakan fasilitas
dan lingkungan yang \line\tab \up0 \expndtw0\charscalex102 aman bagi pasien,
keluarga dan staf sesuai dengan peraturan \line \tab \up0 \expndtw-
5\charscalex100 perundang-undangan. \par\pard\qj \li2433\ri1249\sb0\sl-
320\slmult0\tx2858 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Kesediaan Rumah Sakit melakukan pembayaran
survei paling lambat 7 \line\tab \up0 \expndtw-5\charscalex100 hari sebelum
pelaksanaan survei \par\pard\ql \li2073\ri1243\sb20\sl-320\slmult0\tx2433\tx2433
\up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 KARS mengirimkan nama-nama surveior dan rumah
sakit dapat menolak \line\tab \up0 \expndtw-2\charscalex100 nama tersebut bila ada
conflict of interest antara surveior dan rumah sakit, \line \tab \up0 \expndtw-
5\charscalex100 antara lain sebagai berikut : \par\pard\qj \li2433\ri1252\sb0\sl-
320\slmult0\tx2858 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Surveior pernah bekerja dan atau pernah sebagai
pejabat di Rumah \line\tab \up0 \expndtw-3\charscalex100 Sakit tersebut.
\par\pard\qj \li2433\ri1185\sb12\sl-330\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Surveior
mempunyai hubungan saudara dengan Direksi Rumah Sakit \line \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Surveior bekerja di Rumah Sakit pesaing dari Rumah Sakit yang disurvei \line
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Surveior bekerja di Rumah Sakit yang
sedang ada konflik dengan \par\pard\ql \li2858\sb35\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Rumah Sakit yang disurvei \par\pard\ql
\li1440\ri1186\sb28\sl-320\slmult0\fi993\tx2433\tx2006\tx2006\tx2006\tx2006 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Surveior pernah melakukan survei akreditasi
pada
siklus sebelumnya. \line\tab \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Pernah terjadi
konflik antara surveior dengan Rumah Sakit. \line \up0 \expndtw-5\charscalex100 5.
\up0 \expndtw-1\charscalex100 KARS memberitahu jadwal kedatangan surveior dan
jadwal acara survei \line\tab \up0 \expndtw-3\charscalex100 akreditasi dan
dokumen-dokumen yang harus disampaikan kepada surveior. \line \up0 \expndtw-
5\charscalex100 6. \up0 \expndtw-3\charscalex100 Selama proses pengajuan survei
sampai dilaksanakan survei akreditasi, Rumah \line\tab \up0 \expndtw-
4\charscalex100 Sakit dapat melakukan komunikasi dengan sekretariat KARS, melalui
no telpun \line \tab \up0 \expndtw-1\charscalex100 (021) 29941553 atau (021)
29941552 atau melalui email ke survei@kars.or.id \line \tab \up0 \expndtw-
2\charscalex100 atau info@kars.or.id \par\pard\ql \li3131\sb0\sl-276\slmult0
\par\pard\ql\li3131\sb0\sl-276\slmult0 \par\pard\ql\li3131\sb105\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN SURVEI
AKREDITASI RUMAH SAKIT \par\pard\ql \li4627\sb0\sl-264\slmult0
\par\pard\ql\li4627\sb110\sl-264\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf11\f12\fs23 Dasar Proses Akreditasi \par\pard\qj
\li1440\ri1228\sb16\sl-313\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Proses akreditasi didasarkan pada hasil evaluasi
kepatuhan Rumah Sakit terhadap \up0 \expndtw-4\charscalex100 Standar Nasional
Akreditasi Rumah Sakit edisi 1 . Setelah terakreditasi, rumah sakit \up0 \expndtw-
2\charscalex100 diharapkan untuk menunjukkan kepatuhan terus menerus terhadap
standar di setiap \up0 \expndtw-3\charscalex100 siklus akreditasi. Standar
akreditasi diperbarui setiap tiga tahun. \par\pard\ql \li5191\sb0\sl-264\slmult0
\par\pard\ql\li5191\sb104\sl-264\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf11\f12\fs23 Tujuan Survei \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb113\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 22

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13431551}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

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13952251}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg23}{\bkmkend Pg23}\par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1202\sb196\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Survei akreditasi dilaksanakan dengan menilai
kesesuaian rumah sakit terhadap \up0 \expndtw-3\charscalex100 standar nasional
akreditasi rumah sakit edisi 1 melalui proses: \par\pard\li1440\sb49\sl-
276\slmult0\fi0\tx2006 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\tab \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 wawancara dengan staf dan pasien serta informasi lisan
lainnya;\par\pard\li1440\sb60\sl-276\slmult0\fi0\tx2006 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\tab \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 pengamatan proses penanganan pasien
secara langsung;\par\pard\li1440\sb67\sl-276\slmult0\fi0\tx2006 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 tinjauan terhadap kebijakan,
prosedur, panduan praktik klinis, rekam medis\par\pard\li1440\sb44\sl-
276\slmult0\fi566 \up0 \expndtw-3\charscalex100 pasien, catatan personel,
kepatuhan terhadap peraturan perundang-undangan,\par\pard\li1440\sb41\sl-
276\slmult0\fi566 \up0 \expndtw-4\charscalex100 dan dokumen lain yang diminta dari
rumah sakit;\par\pard\li1440\sb55\sl-276\slmult0\fi0\tx2006 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 tinjauan data peningkatan mutu dan
keselamatan pasien, penilaian kinerja dan\par\pard\li1440\sb43\sl-276\slmult0\fi566
\up0 \expndtw-4\charscalex100 hasil;\par\pard\ql \li1440\sb46\sl-
276\slmult0\tx2006\tx8260 \up0 \expndtw0\charscalex80
\ul0\nosupersub\cf9\f10\fs24 \u-3913? \tab \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 pelaksanaan aktivitas telusur pasien secara
individual \tab \up0 \expndtw-5\charscalex100 (yaitu mengevaluasi \par\pard\ql
\li1440\ri1183\sb8\sl-320\slmult0\fi566\tx2006\tx2006\tx2006 \up0 \expndtw-
2\charscalex100 pengalaman perawatan pasien melalui proses perawatan di rumah
sakit); dan \up0 \expndtw0\charscalex80 \ul0\nosupersub\cf9\f10\fs24 \u-3913?
\up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 pelaksanaan aktivitas
telusur terfokus terhadap sistem atau proses di seluruh \line\tab \up0
\expndtw0\charscalex100 organisasi (misalnya, manajemen obat, pengendalian
infeksi, limbah dan \line \tab \up0 \expndtw-1\charscalex100 bahan berbahaya,
atau sistem dan proses rawan masalah, berisiko tinggi, \line \tab \up0 \expndtw-
3\charscalex100 bervolume tinggi/rendah lainnya.) \par\pard\ql \li5186\sb0\sl-
264\slmult0 \par\pard\ql\li5186\sb103\sl-264\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf11\f12\fs23 Proses Survei \par\pard\qj
\li1440\ri1183\sb13\sl-317\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Metode aktivitas telusur merupakan proses survei
oleh surveior KARS langsung di \up0 \expndtw-3\charscalex100 lokasi. Dalam
metode aktivitas telusur, surveior memilih pasien dari populasi pasien \up0
\expndtw-3\charscalex100 di rumah sakit dan melakukan telusur terhadap asuhan yang
diberikan kepada pasien \up0 \expndtw0\charscalex100 oleh rumah sakit dan juga
akanmelakukan aktivitas telusur terhadap sistem dan \up0 \expndtw0\charscalex100
proses penting dalam pelayanan klinis dan manajerial. Dalam aktivitas ini
surveior \up0 \expndtw-2\charscalex100 dapat menemukan bukti masalah ketidakpatuhan
terhadap standar dalam satu atau \up0 \expndtw0\charscalex100 beberapa langkah
proses pelayanan dan asuhan pasien serta proses manajemen \up0 \expndtw-
3\charscalex100 atau pada saat acara pertemuan diantara proses-proses tersebut.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0
\up0 \expndtw-4\charscalex100 Dalam proses survei, surveior dapat melakukan:
\par\pard\qj \li1507\ri2837\sb0\sl-340\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 wawancara
kepada staf secara individual atau di dalam kelompok \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
mengamati perawatan pasien \par\pard\qj \li1507\ri4865\sb9\sl-320\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 wawancara kepada pasien dan keluarganya
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 meninjau rekam medis pasien \par\pard\ql
\li1507\sb57\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 meninjau
catatan personel/file pegawai \par\pard\ql \li1507\sb64\sl-276\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 meninjau kebijakan dan prosedur dan dokumen
lainnya. \par\pard\qj \li1440\ri1242\sb308\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Setelah rumah sakit menandatangani kontrak survei, rumah sakit
harus mempelajari \line \up0 \expndtw-2\charscalex100 Panduan Proses Survei
Rumah Sakit \up0 \expndtw-2\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 Hospital
Survey Process Guide\ul0\nosupersub\cf7\f8\fs24 ) yang \par\pard\qj
\li1440\ri1208\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100 ditetapkan oleh
KARS untuk mengetahui penjelasan rinci tentang proses yang terjadi \up0 \expndtw-
1\charscalex100 selama survei awal atau survei ulang, termasuk penjelasan rinci
mengenai seluruh \up0 \expndtw-2\charscalex100 aktivitas survei, dokumentasi yang
dibutuhkan, dan sumber daya lainnya. \par\pard\qj \li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1196\sb19\sl-310\slmult0 \up0 \expndtw-3\charscalex100 Sejak
hari kedua survei, pada pagi hari surveior melakukan klarifikasi kepada direktur
\line \up0 \expndtw-1\charscalex100 rumah sakit dan pimpinan lainnya pada pertemuan
kepemimpinan. Pada pertemuan \line \up0 \expndtw-1\charscalex100 ini, surveior
memberikan informasi mengenai temuan mereka. Penting untuk dicatat \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb85\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 23

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{\sp{\sn pVerticies}{\sv 8;4;(0,317);(9079,317);(9079,0);(0,0)}}
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
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\par\pard\qj\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1242\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 bahwa informasi awal apapun bukanlah merupakan
keputusan akhir sampai \up0 \expndtw-3\charscalex100 pemeriksaan laporan survei
di KARS selesai. \par\pard\qj \li1440\ri1237\sb300\sl-320\slmult0 \up0
\expndtw0\charscalex100 Jika selama proses survei surveior menemukan kondisi
yang dapat berakibat \line \up0 \expndtw-2\charscalex100 ancaman serius bagi
keselamatan publik atau pasien, mereka akan melaporkan \line \up0
\expndtw0\charscalex100 kepada KARS. Dalam situasi demikian, KARS dapat
memutuskan untuk \line \up0 \expndtw-1\charscalex100 menghentikan survei dan
mempertimbangkan untuk melaporkan kepada institusi \line \up0 \expndtw-
3\charscalex100 terkait. \par\pard\qj \li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1182\sb13\sl-313\slmult0 \up0 \expndtw-3\charscalex100 KARS
menetapkan tanggal berlakunya standar nasional akreditasi rumah sakit edisi 1 \line
\up0 \expndtw0\charscalex103 pada tanggal 1 Januari 2018. Dengan demikian setelah
tanggal tersebut, KARS \line \up0 \expndtw0\charscalex102 melakukan semua
kegiatan survei akreditasi dengan menggunakan standar \line \up0 \expndtw-
3\charscalex100 tersebut. \par\pard\ql \li4223\sb0\sl-276\slmult0
\par\pard\ql\li4223\sb82\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Survei Akreditasi Rumah Sakit \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf11\f12\fs23 Jenis-
jenis\ul0\nosupersub\cf6\f7\fs24 Survei \par\pard\qj \li1440\ri1244\sb0\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Survei
dilaksanakan sesuai dengan menilai semua standar nasional akreditasi
\line \up0 \expndtw-1\charscalex100 rumah sakit edisi 1 di seluruh rumah sakit.
Bentuk survei meliputi survei awal, survei \line \up0 \expndtw0\charscalex104
ulang, survei verifikasi dan survei terfokus. Definisi setiap survei adalah sebagai
\line \up0 \expndtw-3\charscalex100 berikut: \par\pard\ql \li1507\sb0\sl-
276\slmult0 \par\pard\ql\li1507\sb69\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
Survei Awal\u8212?Survei langsung penuh pertama pada rumah sakit \par\pard\qj
\li1440\ri1221\sb16\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Survei Remedial\u8212?Evaluasi langsung yang
dijadwalkan paling lambat 6 bulan setelah \line \up0 \expndtw-1\charscalex100
survei awal untuk mengevaluasi elemen penilaian (EP) yang mendapatkan nilai
\line \up0 \expndtw-2\charscalex100 \u8220?tidak terpenuhi\u8221? \up0 \expndtw-
2\charscalex100 (\u8220?\ul0\nosupersub\cf8\f9\fs24 not
met\ul0\nosupersub\cf7\f8\fs24 \u8221?) atau \up0 \expndtw-2\charscalex100 \u8220?
terpenuhi sebagian\u8221? \up0 \expndtw-2\charscalex100
(\u8220?\ul0\nosupersub\cf8\f9\fs24 partially met\ul0\nosupersub\cf7\f8\fs24
\u8221?) yang \par\pard\ql \li1440\sb39\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 mengakibatkan rumah sakit gagal untuk memenuhi persyaratan
kelulusan akreditasi. \par\pard\ql \li1507\sb0\sl-276\slmult0
\par\pard\ql\li1507\sb88\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 Survei
Ulang\u8212?Survei rumah sakit setelah siklus akreditasi tiga tahun \par\pard\qj
\li1440\ri1190\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Survei Remedial\u8212?Evaluasi langsung yang
dijadwalkan paling lambat 6 bulan setelah \up0 \expndtw-3\charscalex100 survei awal
untuk mengevaluasi elemen penilaian (EP) yang mendapatkan nilai \u8220?tidak
\up0 \expndtw-2\charscalex100 terpenuhi\u8221? (\u8220?not met\u8221?) atau \u8220?
terpenuhi sebagian\u8221? (\u8220?partially met\u8221?) yang mengakibatkan \up0
\expndtw-3\charscalex100 rumah sakit gagal untuk memenuhi persyaratan kelulusan
akreditasi. \par\pard\ql \li1507\sb0\sl-276\slmult0 \par\pard\ql\li1507\sb61\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 Survei Verifikasi \par\pard\qj
\li1440\ri1187\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Survei verifikasi dilaksanakan satu tahun dan dua tahun
setelah survei akreditasi awal \up0 \expndtw0\charscalex100 atau survei ulang
untuk melakukan verifikasi terhadap perencanaan perbaikan \up0 \expndtw-
3\charscalex100 strategis (PPS). \par\pard\ql \li1507\sb0\sl-276\slmult0
\par\pard\ql\li1507\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 Survei Terfokus
\par\pard\qj \li1440\ri1183\sb14\sl-313\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Survei terfokus adalah survei langsung yang terbatas
dalam lingkup, konten, dan \up0 \expndtw-1\charscalex100 lamanya, dan dirancang
untuk mengumpulkan informasi tentang suatu masalah, \up0 \expndtw-
3\charscalex100 standar, atau elemen penilaian secara spesifik. KARS melakukan
jenis survei terfokus \up0 \expndtw-4\charscalex100 sebagai berikut:
\par\pard\ql \li10243\sb217\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 24

{\shp
{\*\shpinst\shpleft1411\shptop5863\shpright10490\shpbottom6180\shpfhdr0\shpbxpage\s
hpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3743\shplid0
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 317}}
{\sp{\sn pVerticies}{\sv 8;4;(0,317);(9079,317);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
13952251}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1411\shptop6499\shpright10490\shpbottom6814\shpfhdr0\shpbxpage\s
hpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3800\shplid1
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 315}}
{\sp{\sn pVerticies}{\sv 8;4;(0,315);(9079,315);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
14217186}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1478\shptop8403\shpright10490\shpbottom8717\shpfhdr0\shpbxpage\s
hpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz5276\shplid2
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9012}}{\sp{\sn geoBottom}{\sv 314}}
{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9012,314);(9012,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
16181725}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1478\shptop10308\shpright10490\shpbottom10623\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz8150\shplid3
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9012}}{\sp{\sn geoBottom}{\sv 315}}
{\sp{\sn pVerticies}{\sv 8;4;(0,315);(9012,315);(9012,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
16181725}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1478\shptop12212\shpright10490\shpbottom12526\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz8390\shplid4
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9012}}{\sp{\sn geoBottom}{\sv 314}}
{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9012,314);(9012,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
16181725}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1478\shptop13798\shpright10490\shpbottom14115\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz8726\shplid5
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9012}}{\sp{\sn geoBottom}{\sv 317}}
{\sp{\sn pVerticies}{\sv 8;4;(0,317);(9012,317);(9012,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
16181725}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg25}{\bkmkend Pg25}\par\pard\ql \li1581\sb0\sl-320\slmult0
\par\pard\ql\li1581\sb0\sl-320\slmult0 \par\pard\ql\li1581\sb0\sl-320\slmult0
\par\pard\ql\li1581\ri1215\sb196\sl-
320\slmult0\tx2006\tx2006\tx2006\tx2006\tx2006 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928? \tab \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Bila KARS menemukan adanya ketidakpatuhan yang serius
terhadap standar, \line\tab \up0 \expndtw0\charscalex100 masalah perawatan atau
keselamatan pasien yang serius, masalah regulasi \line \tab \up0 \expndtw-
2\charscalex100 atau sanksi, atau masalah serius lainnya dalam suatu rumah
sakit yang \line \tab \up0 \expndtw0\charscalex100 terakreditasi atau program
bersertifikat, yang mungkin menempatkan rumah \line \tab \up0 \expndtw-
3\charscalex100 sakit pada status Berisiko Untuk Penolakan Akreditasi. \par\pard\ql
\li1581\ri1195\sb20\sl-320\slmult0\tx2006\tx2006\tx2073 \up0 \expndtw-
6\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928? \tab \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Bila rumah sakit memberitahu kepada
KARS adanya perubahan dalam waktu \line\tab \up0 \expndtw-5\charscalex100 15 hari,
termasuk namun tidak terbatas pada sebagai berikut: \line \tab \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Perubahan kepemilikan dan/atau nama rumah sakit \par\pard\ql \li2073\ri1254\sb0\sl-
320\slmult0\tx2433\tx2433\tx2433 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Pencabutan atau
pembatasan izin operasional, setiap pembatasan atau \line\tab \up0 \expndtw-
4\charscalex100 penutupan layanan perawatan pasien, sanksi profesi atau sanksi
untuk staf \line \tab \up0 \expndtw-2\charscalex100 lain, atau tindakan lain
menurut hukum dan peraturan yang diberikan oleh \line \tab \up0 \expndtw-
3\charscalex100 otoritas kesehatan terkait \par\pard\ql \li2073\ri1190\sb24\sl-
316\slmult0\tx2433\tx2433\tx2433\tx2433\tx2433\tx2433 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Peralihan atau
perubahan penggunaan bangunan perawatan pasien, \line\tab \up0 \expndtw-
4\charscalex100 pembangunan baru atau perluasan bangunan perawatan pasien,
atau \line \tab \up0 \expndtw-3\charscalex100 kepemilikan bangunan di lokasi baru
di masyarakat, memperluas jenis dan \line \tab \up0 \expndtw-4\charscalex100 volume
pelayanan perawatan pasien 25 persen atau lebih dari yang telah \line \tab
\up0 \expndtw-4\charscalex100 dilaporkan di dalam profil rumah sakit,
atau tidak dilaporkan sebagai \line \tab \up0 \expndtw0\charscalex100 lokasi
perawatan pasien, atau tidak termasuk dalam ruang lingkup survei \line \tab \up0
\expndtw-4\charscalex100 akreditasi sebelumnya \par\pard\ql \li2073\ri1188\sb1\sl-
320\slmult0\tx2433\tx2433\tx2433 \up0 \expndtw-7\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Perluasan
kapasitas rumah sakit yang memang dimaksudkan untuk \line\tab
\up0 \expndtw-2\charscalex100 memberikan pelayanan tanpa adanya fasilitas baru,
telah direnovasi, atau \line \tab \up0 \expndtw0\charscalex100 telah diperluas
sebesar 25 persen atau lebih, yang dinilai melalui volume \line \tab \up0 \expndtw-
3\charscalex100 pasien, cakupan layanan, atau penilaian lain yang relevan
\par\pard\qj \li2073\ri1195\sb20\sl-320\slmult0\tx2433 \up0 \expndtw-
7\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Penambahan satu atau lebih jenis layanan kesehatan,
seperti \line\tab \up0 \expndtw-8\charscalex100 penambahan unit dialisis atau
penghentian layanan pasien trauma \par\pard\ql \li4147\sb0\sl-276\slmult0
\par\pard\ql\li4147\sb0\sl-276\slmult0 \par\pard\ql\li4147\sb0\sl-276\slmult0
\par\pard\ql\li4147\sb149\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar Akreditasi Rumah Sakit \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1190\sb8\sl-320\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Standar akreditasi yang
dipergunakan mulai 1 Januari 2018 adalah\ul0\nosupersub\cf6\f7\fs24
STANDAR \line \up0 \expndtw-3\charscalex100 NASIONAL AKREDITASI RUMAH SAKIT EDISI
1\ul0\nosupersub\cf7\f8\fs24 yang terdiri dari 16 bab yaitu : \par\pard\ql
\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb81\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 1. Sasaran Keselamatan Pasien (SKP) \par\pard\ql \li1800\sb24\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 2. Akses ke Rumah Sakit dan Kontinuitas
(ARK) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 3.
Hak Pasien dan Keluarga (HPK) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0
\expndtw-4\charscalex100 4. Asesmen Pasien (AP) \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 5. Pelayanan Asuhan Pasien (PAP)
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 6.
Pelayanan Anestesi dan Bedah (PAB) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0
\expndtw-5\charscalex100 7. Pelayanan Kefarmasian dan Penggunaan Obat (PKPO)
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-5\charscalex100 8.
Manajemen Komunikasi dan Edukasi (MKE) \par\pard\ql \li1800\sb44\sl-276\slmult0
\up0 \expndtw-5\charscalex100 9. Peningkatan Mutu dan Keselamatan Pasien (PMKP)
\par\pard\ql \li1800\sb24\sl-276\slmult0 \up0 \expndtw-5\charscalex100
10.Pencegahan dan Pengendalian Infeksi (PPI) \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb190\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 25

{\shp
{\*\shpinst\shpleft1411\shptop10412\shpright10490\shpbottom10726\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz5276\shplid0
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 314}}
{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9079,314);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
13952251}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg26}{\bkmkend Pg26}\par\pard\ql \li1800\sb0\sl-276\slmult0
\par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0
\par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 11.Tata Kelola Rumah Sakit
(TKRS) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
12.Manajemen Fasilitas dan Keselamatan (MFK) \par\pard\ql \li1800\sb24\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 13.Kompetensi & Kewenangan Staf
(KKS) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
14.Manajemen Informasi dan Rekam Medis (MIRM) \par\pard\ql \li1800\sb44\sl-
276\slmult0\tx4442 \up0 \expndtw0\charscalex102 15.Program Nasional \tab \up0
\expndtw0\charscalex106 (menurunkan angka kematian ibu dan bayi serta
\par\pard\qj \li2160\ri1244\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex101
meningkatkan angka kesehatan ibu dan bayi, menurunkan angka kesakitan \up0
\expndtw-2\charscalex100 HIV/AIDS, menurunkan angka kesakitan tuberkulosis,
pengendalian resistensi \up0 \expndtw-3\charscalex100 antimikroba dan pelayanan
geriatri) \par\pard\ql \li1800\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100
16.Integrasi Pendidikan Kesehatan dalam Pelayanan Rumah Sakit (IPKP)
\par\pard\qj \li1440\ri1245\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex103
Ketentuan penggunaan Standar Nasional Akreditasi Rumah Sakit Edisi I sebagai
\up0 \expndtw-3\charscalex100 berikut: \par\pard\li1440\sb64\sl-
276\slmult0\fi0\tx5025 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Rumah Sakit
Pendidikan\tab \up0 \expndtw-2\charscalex100 : 16 bab\par\pard\ql \li1440\sb57\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Rumah Sakit non Pendidikan : 15 bab
\par\pard\ql \li3748\sb0\sl-276\slmult0 \par\pard\ql\li3748\sb268\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Jenis Surveior Akreditasi
Rumah Sakit \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Surveior
akreditasi terdiri dari : \par\pard\qj \li1516\ri2675\sb28\sl-320\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Surveior Manajemen yaitu tenaga medis yang ahli
perumah sakitan \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Surveior Medis yaitu para dokter spesialis
\par\pard\ql \li1516\sb57\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Surveior
Keperawatan yaitu para perawat. \par\pard\ql \li1516\sb64\sl-276\slmult0\tx3849
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Surveior lainnya \tab \up0 \expndtw-
2\charscalex100 : ahli rekam medis, apoteker, dan lain sebagainya akan
\par\pard\ql \li1876\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 ditugaskan
bila ada survei terfokus yang memerlukan keahliannya. \par\pard\ql \li3151\sb0\sl-
276\slmult0 \par\pard\ql\li3151\sb0\sl-276\slmult0 \par\pard\ql\li3151\sb0\sl-
276\slmult0 \par\pard\ql\li3151\sb36\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Pembagian tugas surveior akreditasi
rumah sakit \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1195\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pembagian tugas surveior pada pelaksanaan survei
akreditasi dengan menggunakan \up0 \expndtw-5\charscalex100 Standar Nasional
Akreditasi Rumah Sakit Edisi 1 sebagai berikut : \par\pard\ql \li5812\sb0\sl-
276\slmult0 \par\pard\ql\li5812\sb0\sl-276\slmult0 \par\pard\ql\li5812\sb125\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24
SURVEIOR\par\pard\sect\sectd\sbknone\cols2\colno1\colw5172\colsr160\colno2\colw6428
\colsr160\ql \li2781\sb260\sl-276\slmult0 \up0 \expndtw-3\charscalex100
MANAJEMEN\par\pard\ql \li2212\sb252\sl-276\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Pelayanan\par\pard\ql \li2572\sb41\sl-
276\slmult0\tx4435 \up0 \expndtw-3\charscalex100 Kefarmasian\tab \up0 \expndtw-
3\charscalex100 dan\par\pard\ql \li2572\sb43\sl-276\slmult0 \up0 \expndtw-
6\charscalex100 Penggunaan Obat\par\pard\ql \li2212\ri243\sb18\sl-
317\slmult0\tx2572\tx2572 \up0 \expndtw0\charscalex103 2. Peningkatan Mutu
\line\tab \up0 \expndtw0\charscalex103 dan Keselamatan \line \tab \up0
\expndtw-3\charscalex100 Pasien\par\pard\column \ql \li870\sb260\sl-
276\slmult0\tx3532 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24
MEDIS\tab \up0 \expndtw-3\charscalex100 PERAWAT\par\pard\ql \li20\sb252\sl-
276\slmult0\tx2862 \up0 \expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 1.
Akses ke RS dan\tab \up0 \expndtw0\charscalex106 1. Hak pasien
dan\par\pard\ql \li380\sb41\sl-276\slmult0\tx3222 \up0 \expndtw-3\charscalex100
Kontinuitas\tab \up0 \expndtw-3\charscalex100 Keluarga\par\pard\ql \li5332\sb0\sl-
276\slmult0 \par\pard\ql \li20\sb94\sl-276\slmult0\tx2862 \up0 \expndtw-
2\charscalex100 2. Asesmen Pasien\tab \up0 \expndtw-1\charscalex100 2.
Manajemen\par\pard\ql \li3217\sb40\sl-276\slmult0\tx5076 \up0 \expndtw-
3\charscalex100 komunikasi\tab \up0 \expndtw-3\charscalex100 dan\par\pard\ql
\li3217\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Edukasi
\par\pard\sect\sectd\sbknone \ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb101\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 26

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{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
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{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
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{\sp{\sn pVerticies}{\sv 8;4;(0,951);(20,951);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
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{\shp
{\*\shpinst\shpleft10891\shptop14736\shpright10898\shpbottom14743\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg27}{\bkmkend Pg27}\par\pard\li2212\sb0\sl-276\slmult0\par\pard\li2212\sb0\sl-
276\slmult0\par\pard\li2212\sb0\sl-276\slmult0\par\pard\li2212\sb0\sl-
276\slmult0\par\pard\li2212\sb102\sl-276\slmult0\fi0\tx5332\tx8169\tx10382 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Tata Kelola Rumah\tab
\up0 \expndtw-2\charscalex100 3. Pelayanan Asuhan\tab \up0 \expndtw-
2\charscalex100 3. Pencegahan\tab \up0 \expndtw-2\charscalex100
dan\par\pard\li2212\sb41\sl-276\slmult0\fi360\tx5692\tx8529 \up0 \expndtw-
2\charscalex100 Sakit\tab \up0 \expndtw-2\charscalex100 Pasien.\tab \up0 \expndtw-
2\charscalex100 Pengendalian infeksi\par\pard\li2212\sb52\sl-
276\slmult0\fi0\tx5332\tx8169 \up0 \expndtw-2\charscalex100 4. Manajemen
Fasilitas\tab \up0 \expndtw-2\charscalex100 4. Pelayanan Anestesi\tab \up0
\expndtw-2\charscalex100 4. Sasaran\par\pard\li2212\sb41\sl-
276\slmult0\fi360\tx5692\tx8529 \up0 \expndtw-2\charscalex100 dan
Keselamatan\tab \up0 \expndtw-2\charscalex100 dan Bedah\tab \up0 \expndtw-
2\charscalex100 Keselamatan Pasien\par\pard\li2212\sb51\sl-
276\slmult0\fi0\tx4440\tx5332\tx8169 \up0 \expndtw-2\charscalex100 5.
Kompetensi\tab \up0 \expndtw-2\charscalex100 dan\tab \up0 \expndtw-2\charscalex100
5. Menurunkan Angka\tab \up0 \expndtw-2\charscalex100 5.
Manajemen\par\pard\li2212\sb43\sl-276\slmult0\fi360\tx5692\tx8529 \up0 \expndtw-
2\charscalex100 Kewenangan Staf.\tab \up0 \expndtw-2\charscalex100 Kematian Ibu
dan\tab \up0 \expndtw-2\charscalex100 Informasi dan Rekam\par\pard\li5692\sb41\sl-
276\slmult0\fi0\tx6675\tx8529 \up0 \expndtw-3\charscalex100 Bayi,\tab \up0
\expndtw-3\charscalex100 Menurunan\tab \up0 \expndtw-3\charscalex100
Medis\par\pard\qj \li5692\ri3819\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex103
Angka Kesakitan \up0 \expndtw-3\charscalex100 HIV/AIDS, \par\pard\ql
\li5692\sb26\sl-276\slmult0 \up0 \expndtw0\charscalex102 Menurunan Angka
\par\pard\li5692\sb52\sl-276\slmult0\fi0\tx7515 \up0 \expndtw-3\charscalex100
Kesakitan\tab \up0 \expndtw-3\charscalex100 TB,\par\pard\qj \li5692\ri4548\sb0\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 Pengendalian \line \up0 \expndtw-
3\charscalex100 Resistensi \par\pard\li5692\sb38\sl-276\slmult0\fi0\tx7490 \up0
\expndtw-3\charscalex100 Antimikroba\tab \up0 \expndtw-3\charscalex100
dan\par\pard\ql \li5692\sb23\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Pelayanan
Geriatri \par\pard\ql \li5332\ri3818\sb34\sl-313\slmult0\tx5692\tx5692\tx5692
\up0 \expndtw-1\charscalex100 6. Integrasi Pendidikan \line\tab \up0
\expndtw0\charscalex103 Kesehatan dalam \line \tab \up0 \expndtw0\charscalex101
Pelayanan Rumah \line \tab \up0 \expndtw-3\charscalex100 Sakit (IPKP)
\par\pard\qj \li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\ri1187\sb121\sl-
315\slmult0 \up0 \expndtw0\charscalex103 Yang perlu diperhatikan adalah setiap
surveior harus memahami dan menguasai \up0 \expndtw-3\charscalex100 semua standar
dan elemen penilaian (EP) di setiap standar akreditasi yang terdiri dari \up0
\expndtw0\charscalex102 16 bab tersebut. Pembagian tugas lebih diperuntukkan untuk
penanggung jawab \up0 \expndtw0\charscalex100 penetapan skor dan nilai. Surveior
dapat saling memberikan masukan hasil temuan \up0 \expndtw-3\charscalex100 kepada
masing-masing penanggung jawab bab. \par\pard\qj \li1440\ri1244\sb1\sl-
320\slmult0 \up0 \expndtw0\charscalex102 Jenis surveior lainnya, akan ditugaskan
bila ada survei terfokus yang memerlukan \up0 \expndtw-3\charscalex100 keahliannya.
\par\pard\ql \li3098\sb0\sl-276\slmult0 \par\pard\ql\li3098\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Ketentuan Jumlah surveior
dan jumlah hari survei \par\pard\qj \li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1244\sb21\sl-313\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Mengingat rumah sakit di Indonesia sangat bervariasi,
maka jumlah surveior dan \up0 \expndtw-1\charscalex100 jumlah hari survei
tergantung besar kecil dan kompleksitas rumah sakit serta rumah \up0
\expndtw0\charscalex100 sakit pendidikan atau rumah sakit non pendidikan.
Ketentuan jumlah surveior dan \up0 \expndtw-3\charscalex100 jumlah hari survei
sebagai berikut : \par\pard\li2111\sb0\sl-276\slmult0\par\pard\li2111\sb0\sl-
276\slmult0\par\pard\li2111\sb144\sl-276\slmult0\fi381\tx4099\tx5632\tx8040 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 JUMLAH\tab \up0 \expndtw-
2\charscalex100 RSNP/\tab \up0 \expndtw-2\charscalex100 JUMLAH\tab \up0 \expndtw-
2\charscalex100 JENIS SURVEIOR\par\pard\li2111\sb41\sl-
276\slmult0\fi391\tx4099\tx5258\tx6268\tx8215\tx8812\tx9969 \up0 \expndtw-
2\charscalex100 TEMPAT\tab \up0 \expndtw-2\charscalex100 RSP*\tab \dn2 \expndtw-
2\charscalex100 HARI\tab \dn2 \expndtw-2\charscalex100 SURVEI\tab \dn2 \expndtw-
2\charscalex100 M\tab \dn2 \expndtw-2\charscalex100 MD*\tab \dn2 \expndtw-
2\charscalex100 PW*\par\pard\li2111\sb40\sl-
276\slmult0\fi515\tx5104\tx6535\tx7766 \up0 \expndtw-2\charscalex100 TIDUR\tab \dn2
\expndtw-2\charscalex100 SURVEI\tab \dn2 \expndtw-2\charscalex100 OR\tab \dn2
\expndtw-2\charscalex100 J*\par\pard\li2111\sb63\sl-
276\slmult0\fi0\tx4099\tx5078\tx6280\tx7814\tx8978\tx10142 \up0 \expndtw-
2\charscalex100 Kurang dari\tab \up0 \expndtw-2\charscalex100 RSNP\tab \up0
\expndtw-2\charscalex100 4 hari\tab \up0 \expndtw-2\charscalex100 3 orang\tab
\up0 \expndtw-2\charscalex100 1\tab \up0 \expndtw-2\charscalex100 1\tab \up0
\expndtw-2\charscalex100 1\par\pard\ql \li2111\sb34\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 100 \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb110\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 27

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}}

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{\shp
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{\shp
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\*\shpinst\shpleft1984\shptop1421\shpright1992\shpbottom1428\shpfhdr0\shpbxpage\sh
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hari\tab \up0 \expndtw-6\charscalex100 9\tab \up0 \expndtw-2\charscalex100
orang\tab \up0 \expndtw-2\charscalex100 3\tab \up0 \expndtw-2\charscalex100
3\tab \up0 \expndtw-2\charscalex100 3\par\pard\li1800\sb50\sl-
276\slmult0\fi311\tx4099\tx5078\tx5280\tx6280\tx6482\tx7814\tx8978\tx10142 \up0
\expndtw-2\charscalex100 Lebih dari 1000\tab \up0 \expndtw-2\charscalex100
RSK\tab \up0 \expndtw-6\charscalex100 5\tab \up0 \expndtw-2\charscalex100
hari\tab \up0 \expndtw-6\charscalex100 7\tab \up0 \expndtw-2\charscalex100
orang\tab \up0 \expndtw-2\charscalex100 2\tab \up0 \expndtw-2\charscalex100
3\tab \up0 \expndtw-2\charscalex100 2\par\pard\li1800\sb0\sl-
276\slmult0\par\pard\li1800\sb103\sl-
276\slmult0\fi311\tx4099\tx5078\tx5280\tx6280\tx6482\tx7814\tx8978\tx10142 \up0
\expndtw-2\charscalex100 Kelas A\tab \up0 \expndtw-2\charscalex100 RSP\tab \up0
\expndtw-6\charscalex100 4\tab \up0 \expndtw-2\charscalex100 hari\tab \up0
\expndtw-6\charscalex100 6\tab \up0 \expndtw-2\charscalex100 orang\tab \up0
\expndtw-2\charscalex100 2\tab \up0 \expndtw-2\charscalex100 2\tab \up0 \expndtw-
2\charscalex100 2\par\pard\li1800\sb41\sl-276\slmult0\fi311 \up0 \expndtw-
2\charscalex100 Khusus\par\pard\li1800\sb0\sl-276\slmult0\par\pard\li1800\sb94\sl-
276\slmult0\fi242 \up0 \expndtw-2\charscalex100
Penjelasan*)\par\pard\li1800\sb40\sl-276\slmult0\fi0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. RSNP = Rumah Sakit Non
Pendidikan\par\pard\li1800\sb41\sl-276\slmult0\fi0\tx2854 \up0 \expndtw-
2\charscalex100 2. RSP\tab \up0 \expndtw-2\charscalex100 = Rumah Sakit
Pendidikan (utama, afiliasi dan satelit)\par\pard\li1800\sb43\sl-
276\slmult0\fi0\tx2854 \up0 \expndtw-2\charscalex100 3. RSK\tab \up0 \expndtw-
2\charscalex100 = Rumah Sakit Khusus.\par\pard\li1800\sb41\sl-
276\slmult0\fi0\tx2814 \up0 \expndtw-2\charscalex100 4. MJ\tab \up0 \expndtw-
2\charscalex100 = Surveior Manajemen\par\pard\li1800\sb41\sl-
276\slmult0\fi0\tx2799 \up0 \expndtw-2\charscalex100 5. MD\tab \up0 \expndtw-
2\charscalex100 = Surveior Medis\par\pard\li1800\sb41\sl-
276\slmult0\fi0\tx2814 \up0 \expndtw-2\charscalex100 6. PW\tab \up0 \expndtw-
2\charscalex100 = Surveior Perawat\par\pard\ql \li4871\sb0\sl-264\slmult0
\par\pard\ql\li4871\sb96\sl-264\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf11\f12\fs23 Penjadwalan Survei \par\pard\qj \li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\ri1260\sb10\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Penetapan waktu pelaksanaan survei
didasarkan pada kesepakan KARS dan rumah \up0 \expndtw-3\charscalex100 sakit.
\par\pard\ql \li4732\sb0\sl-264\slmult0 \par\pard\ql\li4732\sb83\sl-264\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf11\f12\fs23 Ruang Lingkup Survei
\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1233\sb10\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Ruang
lingkup survei KARS ditentukan berdasarkan informasi di dalam aplikasi
\line \up0 \expndtw-2\charscalex100 survei dari rumah sakit. Setiap bangunan
serta area pelayanan dan asuhan pasien \line \up0 \expndtw-2\charscalex100 yang
tercantum dalam aplikasi survei akan tercakup dalam pelaksanaan survei.
\par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb203\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 28

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\par\pard\ql\li3890\sb0\sl-276\slmult0 \par\pard\ql\li3890\sb0\sl-276\slmult0
\par\pard\ql\li3890\sb0\sl-276\slmult0 \par\pard\ql\li3890\sb88\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Laporan kejadian pada waktu
survei \par\pard\ql \li1440\ri1242\sb303\sl-326\slmult0\tx1800\tx2160 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Surveior wajib memberikan
laporan khusus kepada Ketua Eksekutif KARS melalui \up0 \expndtw-4\charscalex100
telpon atau email bila pada waktu survei ditemukan hal-hal sebagai berikut:
\line \tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Direktur/Kepala Rumah Sakit tidak
hadir/meninggalkan rumah sakit sejak hari \line \tab \up0 \expndtw-4\charscalex100
pertama survei \par\pard\ql \li1800\sb36\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Izin operasional habis masa berlakunya \par\pard\qj \li1800\ri1255\sb28\sl-
320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Ada staf medis yang tidak mempunyai/habis masa
berlakunya STR dan atau \line\tab \up0 \expndtw-5\charscalex100 SIP \par\pard\qj
\li1800\ri1244\sb20\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Izin Pengolahan
limbah cair dan B-3 tidak ada/habis masa berlakunya/masih \line\tab \up0 \expndtw-
3\charscalex100 dalam proses perpanjangan \par\pard\ql \li1800\ri1251\sb0\sl-
320\slmult0\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Rumah sakit
memberikan informasi atau data palsu, misalnya Direktur Rumah \line\tab \up0
\expndtw0\charscalex103 Sakit ternyata bukan tenaga medis, ada staf dari rumah
sakit lain (bukan \line \tab \up0 \expndtw-2\charscalex100 pegawai/staf rumah
sakit) yang terlibat/membantu wawancara/presentasi \line \tab \up0
\expndtw0\charscalex100 pada waktu pelaksanaan survei), peminjaman peralatan medis
dari rumah \line \tab \up0 \expndtw-3\charscalex100 sakit lain, dan pemalsuan data
atau informasi lainnya. \par\pard\ql \li4843\sb0\sl-276\slmult0
\par\pard\ql\li4843\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Penghentian survei \par\pard\qj
\li1440\ri1247\sb308\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kegiatan survei
diberhentikan\ul0\nosupersub\cf8\f9\fs24 (show-stop)\ul0\nosupersub\cf7\f8\fs24
bila Direktur/Kepala Rumah Sakit tidak \up0 \expndtw0\charscalex102
hadir/meninggalkan rumah sakit sejak hari pertama survei atas keputusan Ketua
\up0 \expndtw-3\charscalex100 Eksekutif KARS. \par\pard\ql \li5063\sb0\sl-
264\slmult0 \par\pard\ql\li5063\sb103\sl-264\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf11\f12\fs23 Pembatalan Survei \par\pard\ql
\li1800\ri1206\sb10\sl-
320\slmult0\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160 \
up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 KARS atau rumah sakit dapat membatalkan survei
tanpa denda atau ganti rugi \line\tab \up0 \expndtw0\charscalex102 jika terdapat
peristiwa seperti bencana alam, perang, terorisme, atau \line \tab \up0
\expndtw-2\charscalex100 kedaruratan serupa lainnya, atau keadaan lain yang
menyebabkan survei \line \tab \up0 \expndtw-3\charscalex100 menjadi tidak mungkin
dilaksanakan. Pembatalan karena salah satu alasan \line \tab \up0
\expndtw0\charscalex100 yang disebutkan di atas harus dikomunikasikan secepatnya
secara tertulis. \line \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Jika rumah
sakit membatalkan survei dalam waktu 30 hari atau kurang \line\tab \up0
\expndtw-1\charscalex100 sebelum tanggal dimulainya survei karena alasan lain
selain dari yang \line \tab \up0 \expndtw-1\charscalex100 disebutkan di atas,
rumah sakit wajib membayar 50 persen dari biaya survei \line \tab \up0
\expndtw0\charscalex100 sebagai pengganti biaya administrasi KARS dan pembatalan
tiket pesawat. \line \tab \up0 \expndtw-2\charscalex100 Apabila pihak KARS yang
membatalkan survei untuk alasan apapun atau \line \tab \up0 \expndtw-
2\charscalex100 alasan selain dari yang disebutkan di atas, KARS tidak membebankan
biaya \line \tab \up0 \expndtw-3\charscalex100 apapun kepada rumah sakit.
\par\pard\ql \li4903\sb0\sl-276\slmult0 \par\pard\ql\li4903\sb81\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Penundaan Survei
\par\pard\qj \li1440\ri1182\sb308\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit dapat menunda survei yang sudah terjadwal
tanpa denda atau ganti rugi \up0 \expndtw-4\charscalex100 bila terjadi satu atau
lebih dari keadaan berikut: \par\pard\qj \li1800\ri1244\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 Bencana alam atau peristiwa besar lain
yang tidak terduga, yang \line\tab \up0 \expndtw-3\charscalex100 sepenuhnya
atau secara bermakna mengganggu operasional \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb163\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 29

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Pg30}{\bkmkend Pg30}\par\pard\ql \li1800\sb0\sl-310\slmult0
\par\pard\ql\li1800\sb0\sl-310\slmult0 \par\pard\ql\li1800\sb0\sl-310\slmult0
\par\pard\ql\li1800\ri1208\sb234\sl-310\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 Mogok kerja masal/besar yang menyebabkan rumah
sakit harus berhenti \line\tab \up0 \expndtw-2\charscalex100 menerima pasien,
membatalkan operasi dan/atau prosedur elektif lainnya, dan \line \tab \up0
\expndtw-3\charscalex100 memindahkan pasien ke rumah sakit lain \par\pard\qj
\li1800\ri1234\sb2\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 Pasien harus
pindah ke bangunan lain pada saat waktu survei yang \line\tab \up0
\expndtw-3\charscalex100 dijadwalkan misalnya akibat bencana \par\pard\ql
\li1800\ri1236\sb0\sl-320\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 KARS berhak
untuk melakukan survei langsung jika rumah sakit tetap \line\tab \up0
\expndtw0\charscalex100 melakukan pelayanan perawatan pasien pada keadaan di
atas. Proyek \line \tab \up0 \expndtw0\charscalex100 renovasi rumah sakit
tidak menghalangi KARS untuk melakukan survei \line \tab \up0 \expndtw-
3\charscalex100 langsung di lokasi. \par\pard\ql \li1800\sb37\sl-276\slmult0
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 Keadaan lain yang disetujui oleh KARS
\par\pard\ql \li5232\sb0\sl-276\slmult0 \par\pard\ql\li5232\sb0\sl-276\slmult0
\par\pard\ql\li5232\sb112\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Biaya Survei \par\pard\ql \li4943\sb0\sl-264\slmult0
\par\pard\ql\li4943\sb110\sl-264\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf11\f12\fs23 Perhitungan Biaya \par\pard\qj
\li1440\ri1245\sb19\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 KARS mencantumkan biaya untuk survei akreditasi rumah
sakit reguler di website \up0 \expndtw0\charscalex102 www.kars.or.id, baik untuk
survei awal, survei ulang, survei verifikasi dan survei \up0 \expndtw-
3\charscalex100 terfokus. \par\pard\qj \li1440\ri1182\sb5\sl-317\slmult0 \up0
\expndtw-2\charscalex100 KARS mendasarkan biaya survei akreditasi pada
beberapa faktor, yaitu jumlah \line \up0 \expndtw-1\charscalex100 tempat tidur,
jumlah surveior, kelas rumah sakit, jumlah hari survei dan kompleksitas \line
\up0 \expndtw0\charscalex100 layanan yang disediakan oleh rumah sakit. Waktu
untuk surveior melakukan \line \up0 \expndtw-1\charscalex100 pertemuan dengan
pimpinan rumah sakit sehari sebelum survei dilakukan dan \line \up0
\expndtw0\charscalex100 menyiapkan laporan sudah termasuk dalam hari survei
terhitung. KARS akan \line \up0 \expndtw-1\charscalex100 membebankan biaya
kepada rumah sakit untuk survei remedial, survei verifikasi \line \up0
\expndtw-4\charscalex100 dan survei terfokus, dan untuk beberapa penundaan atau
pembatalan survei dari pihak \line \up0 \expndtw-5\charscalex100 rumah sakit.
\par\pard\ql \li1440\sb0\sl-264\slmult0 \par\pard\ql\li1440\sb103\sl-264\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24
Biaya\ul0\nosupersub\cf11\f12\fs23 Perjalanan \par\pard\qj \li1440\ri1244\sb10\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Selain biaya
survei, rumah sakit menanggung seluruh biaya perjalanan surveior dari \up0
\expndtw0\charscalex100 tempat tinggal surveior sampai ke lokasi rumah sakit
berada, berangkat dan \up0 \expndtw-3\charscalex100 pulangnya. \par\pard\qj
\li1440\ri1231\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Biaya tersebut
termasuk biaya transportasi (tiket pesawat, kereta api, dan mobil) dan \up0
\expndtw-3\charscalex100 akomodasi hotel serta makanan yang wajar. \par\pard\ql
\li1440\sb0\sl-264\slmult0 \par\pard\ql\li1440\sb83\sl-264\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf11\f12\fs23 Jadwal
Pembayaran\ul0\nosupersub\cf6\f7\fs24 Biaya\ul0\nosupersub\cf11\f12\fs23 Survei
\par\pard\qj \li1440\ri1257\sb10\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pembayaran dilaksanakan sebelum 7 hari pelaksanaan
survei akreditasi ke rekening \up0 \expndtw-3\charscalex100 resmi KARS.
\par\pard\ql \li4118\sb0\sl-276\slmult0 \par\pard\ql\li4118\sb0\sl-276\slmult0
\par\pard\ql\li4118\sb125\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN PEMBERIAN SKOR \par\pard\ql \li4871\sb0\sl-
276\slmult0 \par\pard\ql\li4871\sb268\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Pemberian skoring \par\pard\ql \li1440\sb64\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Setiap Elemen Penilaian diberi skor 0 atau 5 atau 10, sesuai ketentuan yang ada
\par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb70\sl-
253\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 30

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\par\pard\ql\li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb0\sl-276\slmult0
\par\pard\ql\li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb88\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 di poin 2)
\par\pard\li1440\sb59\sl-276\slmult0\fi0\tx1867 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\tab \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Nilai setiap standar yang ada di bab merupakan
penjumlahan dari nilai elemen\par\pard\li1440\sb44\sl-276\slmult0\fi427 \up0
\expndtw-2\charscalex100 penilaian\par\pard\li1440\sb55\sl-
276\slmult0\fi0\tx1867 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\tab \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Nilai dari standar dijumlahkan menjadi nilai untuk
bab\par\pard\li1440\sb57\sl-276\slmult0\fi0\tx1867 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\tab \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Elemen penilaian yang tidak dapat diterapkan (TDD)
tidak diberikan skor dan\par\pard\li1440\sb44\sl-276\slmult0\fi427 \up0 \expndtw-
2\charscalex100 mengurangi jumlah EP\par\pard\li1440\sb0\sl-
276\slmult0\par\pard\li1440\sb84\sl-276\slmult0\fi0\tx1867 \up0 \expndtw-
2\charscalex100 1.\tab \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf6\f7\fs24
Selama survei di lapangan, setiap elemen penilaian (EP) pada standar
dinilai\par\pard\li1440\sb40\sl-276\slmult0\fi427 \up0 \expndtw-2\charscalex100
sebagai berikut\ul0\nosupersub\cf7\f8\fs24 :\par\pard\qj \li2006\ri1191\sb17\sl-
320\slmult0\tx2433 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Skor 10 (terpenuhi lengkap), yaitu bila rumah
sakit dapat memenuhi elemen \line\tab \up0 \expndtw-4\charscalex100 penilaian
tersebut minimal 80 % \par\pard\qj \li2006\ri1249\sb0\sl-320\slmult0\tx2433 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Skor 5 (terpenuhi sebagian) yaitu bila rumah
sakit dapat memenuhi elemen \line\tab \up0 \expndtw-4\charscalex100 penilaian
tersebut antara 20 - 79 % \par\pard\qj \li2006\ri1181\sb20\sl-320\slmult0\tx2433
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Skor 0 (tidak terpenuhi) yaitu bila rumah sakit
hanya dapat memenuhi elemen \line\tab \up0 \expndtw-5\charscalex100 penilaian
tersebut kurang dari 20 % \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0\tx1867 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 2. \tab \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf11\f12\fs23 Menentukan\ul0\nosupersub\cf6\f7\fs24 Skor
yang\ul0\nosupersub\cf11\f12\fs23 Tepat \par\pard\ql \li1934\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Skor \u8220?
Terpenuhi Lengkap\u8221? \par\pard\qj \li1867\ri1233\sb8\sl-320\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Suatu EP dikatakan \u8220?
terpenuhi lengkap bila jawabannya adalah \u8220?ya\u8221? atau \u8220?selalu\u8221?
\up0 \expndtw0\charscalex100 untuk setiap persyaratan khusus dari EP
tersebut. Hal yang juga menjadi \up0 \expndtw-3\charscalex100 pertimbangan
adalah sebagai berikut: \par\pard\qj \li2073\ri1224\sb0\sl-320\slmult0\tx2433
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Pengamatan negatif tunggal tidak selalu
menghalangi perolehan skor \line\tab \up0 \expndtw-4\charscalex100 \u8220?
terpenuhi lengkap\u8221?. \par\pard\li2073\sb69\sl-276\slmult0\fi0\tx4024 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Bila capaian\tab \up0 \expndtw-1\charscalex100
80% atau lebih dari semua observasi atau pencatatan\par\pard\li2073\sb43\sl-
276\slmult0\fi360 \up0 \expndtw-1\charscalex100 (contohnya, 8 dari 10)
terpenuhi\par\pard\qj \li2073\ri1242\sb17\sl-320\slmult0\tx2433 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Rentang implementasi yang berhubungan dengan skor \u8220?terpenuhi
lengkap\u8221? \line\tab \up0 \expndtw-3\charscalex100 adalah sebagai berikut :
\par\pard\ql \li2520\sb17\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 Kepatuhan sejak 12
bulan sebelumnya pada survei ulang \par\pard\ql \li2520\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24
Kepatuhan sejak 3 bulan sebelumnya pada survei awal \par\pard\qj
\li2520\ri1234\sb8\sl-320\slmult0\tx2880 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 Tidak ada rentang
implementasi untuk survei terfokus. Kesinambungan \line\tab \up0 \expndtw-
3\charscalex100 dalam usaha peningkatan mutu digunakan untuk menilai kepatuhan.
\par\pard\ql \li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Skor \u8220?Terpenuhi
Sebagian\u8221? \par\pard\qj \li1867\ri1193\sb16\sl-310\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Suatu EP dinilai \u8220?terpenuhi
sebagian\u8221? apabila jawabannya adalah \u8220?biasanya\u8221? atau \up0
\expndtw-2\charscalex100 \u8220?kadang-kadang\u8221? pada persyaratan khusus dari
EP tersebut. Hal yang juga yang \up0 \expndtw-3\charscalex100 menjadi pertimbangan
adalah sebagai berikut: \par\pard\qj \li1867\ri1236\sb22\sl-320\slmult0\tx2291 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Bila capaian 21% sampai 79%
(\ul0\nosupersub\cf6\f7\fs24 contohnya\ul0\nosupersub\cf7\f8\fs24 , 3 sampai 7 dari
10) pencatatan \line\tab \up0 \expndtw-3\charscalex100 atau observasi menunjukkan
kepatuhan. \par\pard\ql \li1867\ri1232\sb0\sl-320\slmult0\tx2291\tx2291 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Temuan EP sebelumnya dinilai \u8220?tidak
terpenuhi\u8221? pada survei awal atau survei \line\tab \up0
\expndtw0\charscalex100 ulang ataupun survei terfokus, dan temuan dari pengamatan
terkini adalah \line \tab \up0 \expndtw-3\charscalex100 capaian 21 % sampai 79%.
\par\pard\qj \li1867\ri1243\sb20\sl-320\slmult0\tx2291 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Bukti kepatuhan tidak dapat ditemukan secara konsisten pada semua \line\tab
\up0 \expndtw-3\charscalex100 bagian/departemen/unit dimana persyaratan-
persyaratan tersebut berlaku \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb83\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 31

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 315}}
{\sp{\sn pVerticies}{\sv 8;4;(0,315);(9079,315);(9079,0);(0,0)}}
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,317);(8652,317);(8652,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
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{\shp
{\*\shpinst\shpleft1838\shptop11722\shpright10490\shpbottom12039\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz9018\shplid4
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 8652}}{\sp{\sn geoBottom}{\sv 317}}
{\sp{\sn pVerticies}{\sv 8;4;(0,317);(8652,317);(8652,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
14996726}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg32}{\bkmkend Pg32}\par\pard\qj \li2291\sb0\sl-313\slmult0
\par\pard\qj\li2291\sb0\sl-313\slmult0 \par\pard\qj\li2291\sb0\sl-313\slmult0
\par\pard\qj\li2291\ri1183\sb223\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 (seperti misalnya ditemukan kepatuhan di unit di rawat
inap, namun tidak di \up0 \expndtw0\charscalex102 unit rawat jalan, patuh pada
ruang operasi namun tidak patuh di unit rawat \up0 \expndtw-4\charscalex100 sehari
(\ul0\nosupersub\cf8\f9\fs24 day surgery\ul0\nosupersub\cf7\f8\fs24 ), patuh pada
area-area yang menggunakan sedasi namun \up0 \expndtw-5\charscalex100 tidak patuh
di klinik gigi). \par\pard\qj \li1867\ri1243\sb42\sl-320\slmult0\tx2291 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Bila pada suatu EP terdapat berbagai macam
persyaratan, dan paling sedikit \line\tab \up0 \expndtw-5\charscalex100 21% - 79 %
persyaratan tersebut sudah terpenuhi. \par\pard\ql \li1867\ri1232\sb29\sl-
310\slmult0\tx2291\tx2291 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf9\f10\fs24
\u-3913?\ul0\nosupersub\cf7\f8\fs24 Suatu kebijakan/proses telah dibuat,
diterapkan, dan dilaksanakan secara \line\tab \up0 \expndtw0\charscalex102
berkesinambungan namun belum mempunyai rentang implementasi yang \line \tab \up0
\expndtw-3\charscalex100 memenuhi syarat untuk dinilai sebagai \u8220?terpenuhi
lengkap\u8221?. \par\pard\qj \li1867\ri1240\sb22\sl-320\slmult0\tx2291 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Suatu kebijakan/proses telah dibuat dan
diterapkan, namun belum \line\tab \up0 \expndtw-2\charscalex100 dilaksanakan
secara berkesinambungan \par\pard\ql \li1867\sb0\sl-276\slmult0
\par\pard\ql\li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb5\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Skor \u8220?Tidak
Terpenuhi\u8221? \par\pard\qj \li1867\ri1244\sb0\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Suatu EP dinilai \u8220?tidak
terpenuhi\u8221? apabila jawabannya adalah \u8220?jarang\u8221? atau \u8220?
tidak \up0 \expndtw0\charscalex100 pernah\u8221? untuk suatu persyaratan spesifik
pada EP. Hal yang juga yang menjadi \up0 \expndtw-3\charscalex100 pertimbangan
adalah sebagai berikut: \par\pard\qj \li1864\ri1233\sb8\sl-320\slmult0\tx2291
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Bila capaian kurang dari 21 % (contohnya,
kurang dari 2 dari 10) pencatatan \line\tab \up0 \expndtw-4\charscalex100 atau
observasi yang menunjukkan kepatuhan. \par\pard\ql \li1864\ri1184\sb0\sl-
320\slmult0\tx2291\tx2291 \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf9\f10\fs24
\u-3913?\ul0\nosupersub\cf7\f8\fs24 Terdapat temuan \u8220?tidak
terpenuhi\u8221? untuk EP selama survei lengkap atau \line\tab \up0 \expndtw-
3\charscalex100 survei terfokus, ataupun survei lanjutan lainnya, dan temuan dari
pengamatan \line \tab \up0 \expndtw-4\charscalex100 terkini adalah kepatuhan kurang
dari 21 %. \par\pard\qj \li1864\ri1246\sb20\sl-320\slmult0\tx2291 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Apabila terdapat sejumlah persyaratan dalam satu EP, dan kurang dari 21%
\line\tab \up0 \expndtw-4\charscalex100 menunjukkan kepatuhan. \par\pard\ql
\li1864\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Suatu kebijakan
atau proses telah dibuat namun belum diterapkan. \par\pard\ql \li1864\sb64\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Rentang implementasi untuk skor \u8220?tidak
terpenuhi\u8221? adalah sebagai berikut: \par\pard\ql \li2356\ri1232\sb8\sl-
320\slmult0\tx2716\tx2716 \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 Persyaratan untuk EP
adalah \u8220?terpenuhi sepenuhnya\u8221?; namun ternyata \line\tab \up0
\expndtw0\charscalex101 hanya terdapat kepatuhan kurang dari 5 bulan pada survei
ulang dan \line \tab \up0 \expndtw-3\charscalex100 kepatuhan kurang dari 1 bulan
pada survei awal \par\pard\ql \li2356\ri1184\sb4\sl-
316\slmult0\tx2716\tx2716\tx2716\tx2716\tx2716 \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 Tidak ada rentang
implementasi untuk survei terfokus. Kesinambungan \line\tab \up0 \expndtw-
3\charscalex100 dalam usaha perbaikan digunakan sebagai penilaian kepatuhan.
\line \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf13\f14\fs24
o\ul0\nosupersub\cf7\f8\fs24 Bila suatu EP dalam satu standar mendapat skor
\u8220?tidak terpenuhi\u8221? dan \line\tab \up0 \expndtw0\charscalex100 beberapa
atau EP lain bergantung pada EP yang mendapat skor \u8220?tidak \line \tab \up0
\expndtw-3\charscalex100 terpenuhi\u8221? ini, maka keseluruhan EP yang
berhubungan dengan EP \line \tab \up0 \expndtw-3\charscalex100 pertama tersebut
mendapat skor \u8220?tidak terpenuhi\u8221?. Lihat gambar di bawah \line \tab
\up0 \expndtw-4\charscalex100 ini untuk MIRM 13.4 sebagai contoh. \par\pard\ql
\li2714\sb0\sl-276\slmult0 \par\pard\ql\li2714\sb0\sl-276\slmult0
\par\pard\ql\li2714\sb6\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MIRM 13.4 \par\pard\qj \li2714\ri1250\sb188\sl-
320\slmult0 \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf7\f8\fs24 Dalam upaya
perbaikan kinerja, rumah sakit secara teratur melakukan \up0 \expndtw-
3\charscalex100 evaluasi atau review rekam medis. \par\pard\ql \li2714\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian MIRM 13.4 \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb37\sl-253\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 32

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg33}{\bkmkend Pg33}\par\pard\li3184\sb0\sl-276\slmult0\par\pard\li3184\sb0\sl-
276\slmult0\par\pard\li3184\sb0\sl-276\slmult0\par\pard\li3184\sb0\sl-
276\slmult0\par\pard\li3184\sb123\sl-276\slmult0\fi0\tx8956 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rekam medis pasien direview
secara berkala\tab \up0 \expndtw-5\charscalex100
(D,W)\ul0\nosupersub\cf14\f15\fs24 \u-3872?\par\pard\li3184\sb41\sl-
276\slmult0\fi360 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf15\f16\fs24 SKOR
= 0 (tidak ada review)\par\pard\ql \li3184\ri1671\sb216\sl-320\slmult0\tx3544
\up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Review menggunakan
sampel yang mewakili (D,W)\ul0\nosupersub\cf14\f15\fs24 \u-
3872?\ul0\nosupersub\cf15\f16\fs24 SKOR \line\tab \up0 \expndtw-6\charscalex100 =
0 \par\pard\ql \li3184\ri1677\sb249\sl-310\slmult0\tx3544\tx3544 \up0
\expndtw0\charscalex101 \ul0\nosupersub\cf7\f8\fs24 3. Review melibatkan dokter,
perawat dan PPA lainnya yang \line\tab \up0 \expndtw0\charscalex101 mempunyai
kewenangan pengisian rekam medDs atau \line \tab \up0 \expndtw-7\charscalex100
pengelola rekam medis (D,W)\ul0\nosupersub\cf14\f15\fs24 \u-
3872?\ul0\nosupersub\cf15\f16\fs24 SKOR = 0 \par\pard\ql \li3184\ri1675\sb262\sl-
320\slmult0\tx3544 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 4.
Fokus review adalah pada ketepatan waktu, keterbacaan dan \line\tab \up0 \expndtw-
6\charscalex100 kelengkapan rekam medis (D,W)\ul0\nosupersub\cf14\f15\fs24 \u-
3872?\ul0\nosupersub\cf15\f16\fs24 SKOR = 0 \par\pard\ql \li3184\ri1671\sb60\sl-
320\slmult0\tx3544\tx3544 \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf7\f8\fs24
5. Proses review termasuk isi rekam medis harus sesuai \line\tab \up0
\expndtw-6\charscalex100 dengan peraturan dan perundang-undangan
(D,W)\ul0\nosupersub\cf14\f15\fs24 \u-3872?\ul0\nosupersub\cf15\f16\fs24 SKOR
\line \tab \up0 \expndtw-6\charscalex100 = 0 \par\pard\ql \li3184\ri1681\sb40\sl-
320\slmult0\tx3544 \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf7\f8\fs24 6.
Proses review termasuk rekam medis pasien yang masih \line\tab \up0 \expndtw-
6\charscalex100 dirawat dan pasien yang sudah pulang
(D,W)\ul0\nosupersub\cf14\f15\fs24 \u-3872?\ul0\nosupersub\cf15\f16\fs24 SKOR = 0
\par\pard\ql \li3184\ri1676\sb40\sl-320\slmult0\tx3544 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 7. Hasil review dilaporkan secara berkala kepada
Direktur \line\tab \up0 \expndtw-8\charscalex100 rumah sakit (D,
W)\ul0\nosupersub\cf14\f15\fs24 \u-3872?\ul0\nosupersub\cf15\f16\fs24 SKOR = 0
\par\pard\ql \li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb0\sl-276\slmult0
\par\pard\ql\li1867\sb225\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penjelasan: \par\pard\qj \li1867\ri1184\sb14\sl-
313\slmult0 \up0 \expndtw0\charscalex102 Karena EP 1 adalah pembuktian bahwa ada
review rekam medis, begitu EP 1 \up0 \expndtw-3\charscalex100 Skor = 0 (tidak ada
review), maka EP 2 emapi dengan EP 7 yang juga membahas \up0 \expndtw-
4\charscalex100 review secara otomatis tidak mungkin dilaksanakan jadi SKOR untuk
EP 2 sampai \up0 \expndtw-5\charscalex100 dengan 7 mendapat SKOR = 0
\par\pard\ql \li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb82\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Tingkat Kepatuhan
\par\pard\qj \li1867\ri1181\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kepatuhan terhadap persyaratan dalam EP dicatat sebagai
angka (persentase) \line \up0 \expndtw0\charscalex100 kepatuhan yang diperlihatkan
oleh rumah sakit. Kepatuhan ditulis dalam bentuk \line \up0 \expndtw-
3\charscalex100 \u8220?positif\u8221? (\ul0\nosupersub\cf6\f7\fs24
contohnya\ul0\nosupersub\cf7\f8\fs24 , kepatuhan terhadap 20% persyaratan). Panduan
penentuan \line \up0 \expndtw0\charscalex100 skor ditulis dalam kalimat positif,
yang merupakan persentase kepatuhan yang \line \up0 \expndtw0\charscalex100
dibutuhkan untuk memperoleh skor \up0 \expndtw-2\charscalex100 \u8220?terpenuhi
lengkap\u8221? \up0 \expndtw0\charscalex100 (80% atau lebih), \par\pard\qj
\li1867\ri1246\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100 \u8220?terpenuhi
sebagian (21 - 79 %), atau tidak terpenuhi (kurang dari 21 %). Apabila \line
\up0 \expndtw-3\charscalex100 memungkinkan, kepatuhan yang diperlihatkan
dilaporkan sebagai \up0 \expndtw-3\charscalex100 \u8220?tingkat \par\pard\qj
\li1867\ri1221\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100 kepatuhan\u8221?
(%), yang menunjukkan persentase kepatuhan yang ditampilkan. \line \up0
\expndtw-2\charscalex100 Contohnya, 10 dari 15 (angka kepatuhan 67%) asesmen
keperawatan awal \line \up0 \expndtw0\charscalex102 dilengkapi dalam 24 jam
setelah pasien masuk di unit rawat inap medis/bedah \line \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 (3W, 2E, 4S, dan
4N),\ul0\nosupersub\cf7\f8\fs24 seperti yang disyaratkan oleh kebijakan rumah
sakit. Skor \line \up0 \expndtw-3\charscalex100 untuk penilaian ini adalah
\up0 \expndtw-3\charscalex100 \u8220?terpenuhi sebagian,\u8221? karena
persentase angka \par\pard\ql \li1867\sb17\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 kepatuhan dari temuan ini berkisar antara 21 - 79 %.
\par\pard\ql \li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb68\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Skor \u8220?Tidak Dapat
Diterapkan\u8221? (TDD) \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb230\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 33

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
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\par\pard\qj\li1867\sb0\sl-310\slmult0 \par\pard\qj\li1867\sb0\sl-310\slmult0
\par\pard\qj\li1867\ri1183\sb234\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Suatu EP mendapat skor \u8220?tidak dapat
dinilai\u8221? apabila persyaratan dalam EP tidak \up0 \expndtw-3\charscalex100
dapat dinilai karena tidak tercakup dalam pelayanan rumah sakit, populasi
pasien, \up0 \expndtw-4\charscalex100 dan sebagainya (\ul0\nosupersub\cf6\f7\fs24
contohnya\ul0\nosupersub\cf7\f8\fs24 , rumah sakit tidak melakukan penelitian).
\par\pard\ql \li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb83\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Periode Lihat ke Belakang
(\ul0\nosupersub\cf16\f17\fs24 Look-Back\ul0\nosupersub\cf6\f7\fs24 ) untuk Standar
Baru \par\pard\qj \li1867\ri1183\sb10\sl-318\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 KARS menetapkan tanggal
berlakunya standar nasional akreditasi rumah sakit \line \up0 \expndtw-
1\charscalex100 edisi 1 pada tanggal 1 Januari 2018. Dengan demikian setelah
tanggal tersebut, \line \up0 \expndtw0\charscalex102 KARS melakukan semua
kegiatan survei akreditasi dengan menggunakan \line \up0 \expndtw0\charscalex105
standar nasional tersebut. Rumah sakit diharapkan dapat menunjukkan \line
\up0 \expndtw0\charscalex102 kepatuhan terhadap standar pada tanggal efektif yang
dipublikasikan. Periode \line \up0 \expndtw-2\charscalex100 lihat ke belakang untuk
menilai standar nasional tersebut hanya dapat mundur ke \line \up0 \expndtw-
4\charscalex100 belakang sampai pada tanggal efektif saat standar nasional tersebut
diberlakukan. \line \up0 \expndtw0\charscalex104 Jadi, untuk standar nasional
akreditasi rumah sakit edisi 1 , periode lihat ke \line \up0 \expndtw-
3\charscalex100 belakang pada survei ulang tanggal 1 Juli 2018 adalah 3 bulan ke
belakang, yaitu \line \up0 \expndtw-3\charscalex100 tanggal efektif 1 April 2018,
bukan 12 bulan ke belakang. Hal serupa berlaku juga \line \up0
\expndtw0\charscalex102 untuk survei awal tanggal 1 Juli, periode lihat ke belakang
adalah 3 bulan dan \line \up0 \expndtw-3\charscalex100 bukan 4 bulan.
\par\pard\qj \li1867\ri1182\sb303\sl-317\slmult0 \up0 \expndtw-1\charscalex100 Bila
rumah sakit tidak memenuhi periode lihat ke belakang dalam waktu singkat \line \up0
\expndtw-4\charscalex100 untuk penerapan standar yang baru, maka skor untuk EP akan
diberlakukan sama \line \up0 \expndtw-3\charscalex100 seperti periode lihat ke
belakang yang sebelumnya, yaitu 12 bulan lengkap (survei \line \up0 \expndtw-
2\charscalex100 ulang 3 tahun) atau 3 bulan (survei pertama
kali).\ul0\nosupersub\cf6\f7\fs24 Contohnya\ul0\nosupersub\cf7\f8\fs24 , pada
survei ulang \line \up0 \expndtw-1\charscalex100 3 tahun , bila periode lihat ke
belakang yang memungkinkan untuk standar yang \line \up0 \expndtw-2\charscalex100
baru adalah 6 bulan, dan rumah sakit menunjukkan kepatuhan penuh (\u8220?
terpenuhi \line \up0 \expndtw0\charscalex106 sepenuhnya\u8221?) terhadap EP
tersebut, namun rumah sakit hanya dapat \line \up0 \expndtw-1\charscalex100
menunjukkan kepatuhan selama \up0 \expndtw0\charscalex102 3 bulan terakhir,
elemen penilaian akan \par\pard\qj \li1867\ri1182\sb1\sl-320\slmult0 \up0
\expndtw-3\charscalex100 mendapatkan skor sebagai \u8220?terpenuhi sebagian\u8221?,
karena 67% dari periode lihat ke \up0 \expndtw-1\charscalex100 belakang selama 6
bulan telah terpenuhi. EP tersebut akan dinilai sebagai \u8220?tidak \up0 \expndtw-
2\charscalex100 terpenuhi\u8221? apabila kepatuhan hanya dapat ditunjukkan selama 2
bulan, atau 33% \up0 \expndtw-3\charscalex100 dari kemungkinan periode lihat ke
belakang. \par\pard\ql \li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb81\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Periode Lihat
ke Belakang pada Survei Remedial dan Survei Terfokus \par\pard\qj
\li1867\ri1182\sb11\sl-317\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Bila setelah survei awal atau ulang dilaksanakan survei
remedial maksimal dalam \line \up0 \expndtw0\charscalex102 waktu 6 bulan setelah
survei awal atau ulang, periode lihat ke belakang untuk \line \up0 \expndtw-
3\charscalex100 survei remedial dimulai sejak tanggal survei remedial sampai dengan
hari terakhir \line \up0 \expndtw-4\charscalex100 survei awal atau ulang. Selama
periode lihat ke belakang ini, surveior akan menilai \line \up0 \expndtw-
2\charscalex100 tindakan yang diambil rumah sakit untuk membahas dan atau
memperbaiki \line \up0 \expndtw0\charscalex107 masalah yang ditemukan pada
survei awal atau ulang. Untuk menilai \line \up0 \expndtw-3\charscalex100
implementasi, pengkajian terhadap kepatuhan mempertimbangkan hal-hal berikut
\line \up0 \expndtw-4\charscalex100 ini: \par\pard\ql \li2006\sb37\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 dampak temuan hasil survei; \par\pard\qj
\li2006\ri1185\sb28\sl-320\slmult0\tx2291 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 adanya bukti
yang memadai untuk menunjukkan kepatuhan terhadap elemen \line\tab \up0 \expndtw-
4\charscalex100 penilaian atau standar yang diidentifikasi; \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb243\sl-253\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 34

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg35}{\bkmkend Pg35}\par\pard\ql \li1867\sb0\sl-330\slmult0
\par\pard\ql\li1867\sb0\sl-330\slmult0 \par\pard\ql\li1867\sb0\sl-330\slmult0
\par\pard\ql\li1867\ri3914\sb158\sl-330\slmult0\fi139 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 adanya
kesinambungan tindakan yang diambil; dan \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 implementasi
terhadap rekomendasi surveior \line \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Contoh \par\pard\qj \li1867\ri1242\sb0\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pada saat
survei awal atau ulang, rumah sakit tidak memenuhi standar \line \up0
\expndtw-1\charscalex100 penggunaan darah dan produk darah, standar PAP \up0
\expndtw-2\charscalex100 3.3, karena panduan dan \par\pard\qj
\li1867\ri1181\sb2\sl-317\slmult0 \up0 \expndtw-2\charscalex100 prosedur klinis
belum ada dan belum dilaksanakan dan tidak mencakup butir a) \line \up0 \expndtw-
1\charscalex100 sampai e) dalam maksud dan tujuan. Ketika surveior kembali untuk
melakukan \line \up0 \expndtw0\charscalex100 survei remedial, rumah sakit tersebut
menunjukkan bukti bahwa panduan dan \line \up0 \expndtw-3\charscalex100 prosedur
klinis telah dibuat dan berdasarkan bukti dari literatur, organisasi profesi, \line
\up0 \expndtw-3\charscalex100 dan sumber terpercaya lainnya, yang mencakup proses
untuk butir a) sampai e) \line \up0 \expndtw0\charscalex100 di maksud dan tujuan.
Selain itu, staf telah diedukasi tentang panduan ini dan \line \up0 \expndtw-
2\charscalex100 wawancara dengan staf menunjukkan bahwa mereka telah mengetahui
tentang \line \up0 \expndtw-3\charscalex100 proses ini. Dokumentasi pada rekam
medis menunjukkan bahwa proses ini telah \line \up0 \expndtw-4\charscalex100
dilakukan. \par\pard\qj \li1867\ri1228\sb301\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Berdasarkan tindak lanjut oleh rumah sakit dan bukti yang dilihat
oleh surveior, \up0 \expndtw-3\charscalex100 maka rumah sakit akan dianggap patuh
sepenuhnya. \par\pard\ql \li4665\sb0\sl-276\slmult0 \par\pard\ql\li4665\sb0\sl-
276\slmult0 \par\pard\ql\li4665\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 LAPORAN SURVEI \par\pard\qj \li1440\ri1239\sb208\sl-
320\slmult0\tx1867 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Pasca survei, surveior wajib membuat laporan hasil survei berbasis web kepada
\line\tab \up0 \expndtw-4\charscalex100 Ketua Eksekutif KARS paling lambat 7 hari
setelah pelaksanaan survei. \par\pard\qj \li1440\ri1246\sb17\sl-
300\slmult0\tx1867 \up0 \expndtw-2\charscalex100 2. Laporan survei akan
diperiksa/ditelaah keakuratan dan kebenaran oleh konsilor \line\tab \up0 \expndtw-
3\charscalex100 yang ditunjuk KARS \par\pard\qj \li1440\ri1181\sb4\sl-
320\slmult0\tx1867 \up0 \expndtw-3\charscalex100 3. Bila ada diskrepansi nilai
antara surveior dan konsilor yang sangat signifikan yang \line\tab \up0 \expndtw-
3\charscalex100 berdampak kepada status akreditasi rumah sakit akan dikaji di Dewan
Penilai \par\pard\ql \li1440\ri1210\sb0\sl-320\slmult0\tx1867\tx1867 \up0 \expndtw-
3\charscalex100 4. Pasca survei, rumah sakit wajib membuat Perencanaan
Perbaikan Strategis \line\tab \up0 \expndtw-2\charscalex100 (PPS) berdasarkan
rekomendasi dari surveior dan dikirim ke KARS paling lambat \line \tab \up0
\expndtw-3\charscalex100 satu bulan setelah rekomendasi surveior diterima.
\par\pard\ql \li3794\sb0\sl-264\slmult0 \par\pard\ql\li3794\sb0\sl-264\slmult0
\par\pard\ql\li3794\sb39\sl-264\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf11\f12\fs23 Perencanaan Perbaikan Strategis (PPS) \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1517\sb190\sl-320\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Perencanaan Perbaikan
Strategis (PPS) adalah rencana kerja tertulis yang harus \up0 \expndtw-
2\charscalex100 dibuat oleh rumah sakit sebagai tindak lanjut hasil penilaian
yang \u8220?tidak terpenuhi\u8221? \up0 \expndtw-2\charscalex100
(\u8220?\ul0\nosupersub\cf8\f9\fs24 not met\ul0\nosupersub\cf7\f8\fs24 \u8221?)
atau \u8220?terpenuhi sebagian\u8221? dari hasil survei oleh KARS. Perencanaan \up0
\expndtw-3\charscalex100 Perbaikan Strategis (PPS) yang tertulis diharapkan
dapat: \par\pard\ql \li1440\ri1183\sb209\sl-310\slmult0\tx1867\tx1867 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24
menegakkan strategi/pendekatan yang akan diterapkan oleh rumah sakit akan \line\tab
\up0 \expndtw-3\charscalex100 untuk menangani setiap temuan yang \u8220?tidak
terpenuhi\u8221? (\u8220?\ul0\nosupersub\cf8\f9\fs24 not
met\ul0\nosupersub\cf7\f8\fs24 \u8221?) atau \u8220?terpenuhi \line \tab \up0
\expndtw-4\charscalex100 sebagian\u8221? \par\pard\li1440\sb55\sl-
276\slmult0\fi0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf13\f14\fs24
o\ul0\nosupersub\cf7\f8\fs24 menjelaskan tindakan spesifik akan digunakan oleh
rumah sakit untuk mencapai\par\pard\li1440\sb39\sl-
276\slmult0\fi427\tx6367\tx8392 \up0 \expndtw-1\charscalex100 kepatuhan pada
standar yang dinilai\tab \up0 \expndtw-1\charscalex100 \u8220?tidak
terpenuhi\u8221?\tab \up0 \expndtw-1\charscalex100
(\u8220?\ul0\nosupersub\cf8\f9\fs24 not met\ul0\nosupersub\cf7\f8\fs24
\u8221?)/elemen\par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb199\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 35

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{\shp
{\*\shpinst\shpleft1411\shptop11256\shpright10490\shpbottom11573\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz9523\shplid1
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,317);(9079,317);(9079,0);(0,0)}}
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg36}{\bkmkend Pg36}\par\pard\ql \li1867\sb0\sl-276\slmult0
\par\pard\ql\li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb0\sl-276\slmult0
\par\pard\ql\li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb88\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 penilaiannya telah dikutip;
\par\pard\li1440\sb45\sl-276\slmult0\fi0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 menjelaskan langkah-
langkah spesifik yang akan digunakan rumah sakit untuk\par\pard\li1440\sb41\sl-
276\slmult0\fi427 \up0 \expndtw0\charscalex100 berkomunikasi dan mengedukasi
karyawan, dokter, dan staf lainnya dalam\par\pard\li1440\sb43\sl-
276\slmult0\fi427 \up0 \expndtw0\charscalex100 melaksanakan tindakan-tindakan untuk
mencapai kepatuhan pada standar atau\par\pard\li1440\sb38\sl-
276\slmult0\fi427\tx5414\tx7401\tx9388 \up0 \expndtw-1\charscalex100 elemen
penilaian yang dinilai\tab \up0 \expndtw-1\charscalex100 \u8220?tidak
terpenuhi\u8221?\tab \up0 \expndtw-1\charscalex100
(\u8220?\ul0\nosupersub\cf8\f9\fs24 not met\ul0\nosupersub\cf7\f8\fs24 \u8221?)
atau\tab \up0 \expndtw-1\charscalex100 \u8220?terpenuhi\par\pard\li1440\sb44\sl-
276\slmult0\fi427 \up0 \expndtw-1\charscalex100 sebagian\u8221?\par\pard\qj
\li1440\ri1232\sb0\sl-320\slmult0\tx1867 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 menjelaskan
metodologi untuk mencegah terjadinya kembali suatu tindakan \line\tab \up0
\expndtw-2\charscalex100 ketidakpatuhan dan untuk mempertahankan perbaikan dari
waktu ke waktu; dan \line \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 mengidentifikasi
langkah-langkah penilaian yang akan digunakan untuk \par\pard\ql
\li1867\sb34\sl-276\slmult0 \up0 \expndtw-3\charscalex100 mengevaluasi efektivitas
rencana perbaikan. \par\pard\qj \li1440\ri1241\sb308\sl-320\slmult0 \up0
\expndtw0\charscalex102 Perencanaan Perbaikan Strategis (PPS) harus menunjukkan
bahwa tindakan \up0 \expndtw0\charscalex100 yang dilakukan rumah sakit untuk
dapat mencapai \u8220?terpenuhi lengkap\u8221? terhadap \up0
\expndtw0\charscalex104 standar dan elemen penilaian. Perencanaan Perbaikan
Strategis (PPS) harus \up0 \expndtw0\charscalex104 sudah dikirim ke KARS dalam
waktu 1 (satu) bulan setelah s ertifikat akreditasi \up0 \expndtw-3\charscalex100
diterima oleh rumah sakit. \par\pard\ql \li3698\sb0\sl-276\slmult0
\par\pard\ql\li3698\sb0\sl-276\slmult0 \par\pard\ql\li3698\sb0\sl-276\slmult0
\par\pard\ql\li3698\sb149\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN PENENTUAN KELULUSAN \par\pard\ql
\li4718\sb0\sl-276\slmult0 \par\pard\ql\li4718\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Keputusan Akreditasi \par\pard\qj \li1440\ri1231\sb11\sl-
316\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Keputusan
akreditasi KARS berdasarkan capaian rumah sakit terhadap Standar \up0
\expndtw-2\charscalex100 Nasional Akreditasi Rumah Sakit Edisi 1. Ketua Eksekutif
KARS mempertimbangkan \up0 \expndtw0\charscalex103 semua hasil dan informasi saat
survei awal atau survei ulang untuk pengambilan \up0 \expndtw-1\charscalex100
keputusan hasil akreditasi. Hasilnya dapat berupa rumah sakit memenuhi
kriteria \up0 \expndtw0\charscalex100 untuk akreditasi keseluruhan atau sebagian,
atau tidak memenuhi kriteria dan tidak \up0 \expndtw-3\charscalex100 dapat
memperoleh akreditasi. \par\pard\qj \li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\ri1242\sb10\sl-315\slmult0 \up0 \expndtw-1\charscalex100
Keputusan akreditasi final didasarkan pada kepatuhan rumah sakit terhadap
standar \line \up0 \expndtw0\charscalex104 akreditasi. Rumah sakit tidak menerima
nilai/skor sebagai bagian dari keputusan \line \up0 \expndtw0\charscalex100
akreditasi final. Ketika suatu rumah sakit berhasil memenuhi persyaratan
akreditasi \line \up0 \expndtw-2\charscalex100 KARS, rumah sakit tersebut akan
menerima penghargaan Status Akreditasi Sebagai \line \up0 \expndtw-3\charscalex100
berikut: \par\pard\ql \li1507\sb0\sl-320\slmult0 \par\pard\ql\li1507\ri3450\sb1\sl-
320\slmult0\tx1800 \up0 \expndtw-3\charscalex100 A. Rumah Sakit Non Pendidikan
\line\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 Tidak lulus akreditasi \par\pard\qj
\li2520\ri1184\sb20\sl-320\slmult0\tx2880 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Rumah sakit
tidak lulus akreditasi bila dari 15 bab yang disurvei, semua \line\tab \up0
\expndtw-4\charscalex100 mendapat nilai kurang dari 60 % \par\pard\qj
\li2520\ri1191\sb0\sl-320\slmult0\tx2880 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Bila rumah
sakit tidak lulus akreditasi dapat mengajukan akreditasi ulang \line\tab \up0
\expndtw-5\charscalex100 setelah rekomendasi dari surveior dilaksanakan.
\par\pard\ql \li1800\sb37\sl-276\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 Akreditasi
tingkat dasar \par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb64\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 36

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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
13431551}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
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}}

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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,317);(9012,317);(9012,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
14996726}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg37}{\bkmkend Pg37}\par\pard\ql \li1800\sb0\sl-320\slmult0
\par\pard\ql\li1800\sb0\sl-320\slmult0 \par\pard\ql\li1800\sb0\sl-320\slmult0
\par\pard\ql\li1800\ri1184\sb196\sl-320\slmult0\fi720\tx2880\tx2880 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Rumah sakit mendapat sertifikat akreditasi tingkat dasar bila dari 15 bab \line\tab
\up0 \expndtw-4\charscalex100 yang di survei hanya 4 bab yang mendapat nilai
minimal 80 % dan 12 \line \tab \up0 \expndtw-3\charscalex100 bab lainnya tidak
ada yang mendapat nilai dibawah 20 % \line \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 Akreditasi
tingkat madya \par\pard\ql \li1800\ri1222\sb26\sl-
313\slmult0\fi720\tx2880\tx2880 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Rumah sakit
mendapat sertifikat akreditasi tingkat madya bila dari 15 \line\tab \up0 \expndtw-
3\charscalex100 bab yang di survei ada 8 bab yang mendapat nilai minimal 80 % dan
7 \line \tab \up0 \expndtw-3\charscalex100 bab lainnya tidak ada yang mendapat
nilai dibawah 20 % \line \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 Akreditasi
tingkat utama \par\pard\ql \li2520\ri1184\sb22\sl-320\slmult0\tx2880\tx2880 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mendapat sertifikat akreditasi
tingkat utama bila dari 15 bab \line\tab \up0 \expndtw-4\charscalex100 yang di
survei ada 12 bab yang mendapat nilai minimal 80 % dan 3 bab \line \tab \up0
\expndtw-4\charscalex100 lainnya tidak ada yang mendapat nilai dibawah 20 %
\par\pard\ql \li1800\sb37\sl-276\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 Akreditasi
tingkat paripurna \par\pard\qj \li2520\ri1186\sb8\sl-320\slmult0\tx2880 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mendapat sertifikat akreditasi
tingkat paripurna bila dari 15 \line\tab \up0 \expndtw-5\charscalex100 bab yang di
survei semua bab mendapat nilai minimal 80 % \par\pard\li1440\sb0\sl-
276\slmult0\par\pard\li1440\sb92\sl-276\slmult0\fi0\tx1867 \up0 \expndtw-
1\charscalex100 B.\tab \up0 \expndtw-1\charscalex100 Rumah Sakit
Pendidikan\par\pard\li1440\sb40\sl-276\slmult0\fi360\tx2160 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf13\f14\fs24 o\tab \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Tidak lulus
akreditasi\par\pard\li1440\sb56\sl-276\slmult0\fi1080\tx7911\tx8395 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Rumah sakit tidak lulus akreditasi bila dari\tab \up0 \expndtw-1\charscalex100
16\tab \up0 \expndtw-1\charscalex100 bab yang di survei\par\pard\ql
\li2880\sb25\sl-276\slmult0 \up0 \expndtw-5\charscalex100 mendapat nilai kurang
dari 60 % \par\pard\qj \li2520\ri1184\sb28\sl-320\slmult0\tx2880 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Bila rumah sakit tidak lulus akreditasi dapat mengajukan akreditasi ulang \line\tab
\up0 \expndtw-5\charscalex100 setelah rekomendasi dari surveior dilaksanakan.
\par\pard\ql \li1800\sb37\sl-276\slmult0\tx2160 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o \tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Akreditasi tingkat dasar \par\pard\ql
\li1800\ri1184\sb8\sl-320\slmult0\fi720\tx2880\tx2880\tx2880 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Rumah sakit mendapat sertifikat akreditasi tingkat dasar bila dari 16 bab \line\tab
\up0 \expndtw-4\charscalex100 yang di survei hanya 4 bab, dimana salah satu babnya
adalah Institusi \line \tab \up0 \expndtw-3\charscalex100 pendidikan pelayanan
kesehatan, mendapat nilai minimal 80 % dan \line \tab \up0 \expndtw-
3\charscalex100 12 bab lainnya tidak ada yang mendapat nilai dibawah 20 % \line
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf13\f14\fs24 o \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Akreditasi tingkat madya
\par\pard\ql \li1800\ri1187\sb25\sl-315\slmult0\fi720\tx2880\tx2880\tx2880 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mendapat sertifikat akreditasi
tingkat madya bila dari 16 \line\tab \up0 \expndtw-3\charscalex100 bab yang di
survei ada 8 bab, dimana salah satu babnya adalah Institusi \line \tab \up0
\expndtw-4\charscalex100 pendidikan pelayanan kesehatan, mendapat nilai
minimal 80 % dan \line \tab \up0 \expndtw-3\charscalex100 8 bab lainnya tidak ada
yang mendapat nilai dibawah 20 % \line \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Akreditasi tingkat utama \par\pard\ql
\li1800\ri1184\sb26\sl-315\slmult0\fi720\tx2880\tx2880\tx2880 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Rumah sakit mendapat sertifikat akreditasi tingkat utama bila dari 16 bab \line\tab
\up0 \expndtw-4\charscalex100 yang di survei ada 12 bab, dimana salah satu babnya
adalah Institusi \line \tab \up0 \expndtw-1\charscalex100 pendidikan pelayanan
kesehatan mendapat nilai minimal 80 % dan 4 \line \tab \up0 \expndtw-
3\charscalex100 bab lainnya tidak ada yang mendapat nilai dibawah 20 % \line
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf13\f14\fs24 o \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Akreditasi tingkat paripurna
\par\pard\qj \li2520\ri1186\sb21\sl-320\slmult0\tx2880 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Rumah sakit mendapat sertifikat akreditasi tingkat paripurna bila dari 16
\line\tab \up0 \expndtw-5\charscalex100 bab yang di survei semua bab mendapat
nilai minimal 80 % \par\pard\qj \li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1251\sb19\sl-310\slmult0 \up0 \expndtw-1\charscalex100 Bila
Rumah Sakit tidak mendapat status akreditasi paripurna dan ada bab nilainya \up0
\expndtw0\charscalex100 dibawah 80 % tetapi diatas 60 %, maka Rumah Sakit dapat
mengajukan survei \up0 \expndtw-3\charscalex100 remedial untuk bab tersebut.
\par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb125\sl-
253\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 37

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
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\par\pard\ql\li3146\sb0\sl-264\slmult0 \par\pard\ql\li3146\sb0\sl-264\slmult0
\par\pard\ql\li3146\sb0\sl-264\slmult0 \par\pard\ql\li3146\sb0\sl-264\slmult0
\par\pard\ql\li3146\sb0\sl-264\slmult0 \par\pard\ql\li3146\sb138\sl-264\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf11\f12\fs23
Tampilan\ul0\nosupersub\cf6\f7\fs24 dan\ul0\nosupersub\cf11\f12\fs23 Penggunaan
Penghargaan Akreditasi \par\pard\qj \li1440\ri1183\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pihak KARS memberikan
sertifikat akreditasi kepada setiap rumah sakit pada saat \up0 \expndtw-
2\charscalex100 akreditasi awal dan pada saat setiap survei ulang. Sertifikat dan
semua salinan tetap \up0 \expndtw-3\charscalex100 menjadi milik KARS. Sertifikat
harus dikembalikan jika rumah sakit tersebut menerima \up0 \expndtw-1\charscalex100
sertifikat baru yang mencerminkan perubahan nama atau jika akreditasi rumah
sakit \up0 \expndtw-3\charscalex100 ditarik atau dibatalkan dengan alasan
apapun. \par\pard\qj \li1440\sb0\sl-313\slmult0 \par\pard\qj\li1440\ri1238\sb3\sl-
313\slmult0 \up0 \expndtw-1\charscalex100 Rumah sakit yang telah terakreditasi oleh
KARS harus akurat dalam mengumumlan \up0 \expndtw0\charscalex102 kepada publik.
Rumah sakit harus jelas menyampaikan capaian status akreditasi. \up0
\expndtw0\charscalex100 KARS mengatur tata cara publikasi untuk mengumumkan
akreditasi yang diperoleh \up0 \expndtw-3\charscalex100 rumah sakit.
\par\pard\ql \li4247\sb0\sl-264\slmult0 \par\pard\ql\li4247\sb104\sl-264\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24
Masa\ul0\nosupersub\cf11\f12\fs23 Berlaku Status Akreditasi \par\pard\qj
\li1440\ri1243\sb16\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Status akreditasi berlaku selama tiga tahun
kecuali ditarik oleh KARS. Status \up0 \expndtw-1\charscalex100 akreditasi
berlaku surut sejak hari pertama pelaksanaan survei rumah sakit atau \up0
\expndtw0\charscalex100 saat survei ulang. Pada akhir tiga tahun siklus
akreditasi rumah sakit, rumah sakit \up0 \expndtw-2\charscalex100 harus
melaksanakan survei ulang untuk perpanjangan status akreditasi. \par\pard\ql
\li2397\sb0\sl-276\slmult0 \par\pard\ql\li2397\sb0\sl-276\slmult0
\par\pard\ql\li2397\sb0\sl-276\slmult0 \par\pard\ql\li2397\sb50\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN PENUNDAAN PENETAPAN
STATUS AKREDITASI \par\pard\qj \li1440\ri1235\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Kondisi yang menyebabkan
rumah sakit berisiko ditolak atau ditunda status \up0 \expndtw-
3\charscalex100 akreditasinya adalah sebagai berikut: \par\pard\ql
\li1800\ri1184\sb206\sl-313\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3880?\ul0\nosupersub\cf7\f8\fs24
Adanya ancaman terhadap keselamatan dan keamanan pasien atau keamanan \line\tab
\up0 \expndtw-2\charscalex100 dan keselamatan staf di dalam rumah sakit. KARS
menerima data ini bisa dari \line \tab \up0 \expndtw0\charscalex102 laporan Tim
Survei, atau dari sumber lain yang akurat. Tindakan yang akan \line \tab \up0
\expndtw-2\charscalex100 dilakukan KARS adalah melakukan survei terfokus.
\par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\ri1248\sb2\sl-
320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3880?\ul0\nosupersub\cf7\f8\fs24 Ada staf medis yang tidak mempunyai STR dan atau
SIP yang masih berlaku, \line\tab \up0 \expndtw-2\charscalex100 yang memberikan
pelayanan medis. \par\pard\qj \li2160\ri1251\sb4\sl-316\slmult0 \up0
\expndtw0\charscalex105 Bila ada laporan dari Tim Survei, masih ada staf medis yang
belum/habis \line \up0 \expndtw0\charscalex101 masa berlakunya/dalam proses
perpanjangan STR dan SIP nya maka \line \up0 \expndtw-1\charscalex100
penetapan status akreditasi ditunda dan KARS memberikan surat keterangan \line \up0
\expndtw-1\charscalex100 bahwa rumah sakit telah dilakukan survei akreditasi. Bila
STR dan SIP sudah \line \up0 \expndtw0\charscalex104 ada atau diperbarui, rumah
sakit agar melaporkan kepada KARS dengan \line \up0 \expndtw-1\charscalex100
melampirkan copy STR dan SIP melalui email\ul0\nosupersub\cf10\f11\fs24
survei@kars.or.id \par\pard\qj \li1800\sb0\sl-320\slmult0
\par\pard\qj\li1800\ri1250\sb1\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf12\f13\fs24 \u-
3880?\ul0\nosupersub\cf7\f8\fs24 Bila rumah sakit memberikan informasi atau data
palsu, misalnya Direktur \line\tab \up0 \expndtw0\charscalex104 rumah sakit
ternyata bukan tenaga medis, ada staf dari rumah sakit lain
\par\pard\li2160\sb38\sl-276\slmult0\fi0\tx3388\tx5243\tx6418\tx7487\tx8499 \up0
\expndtw-1\charscalex100 (bukan\tab \up0 \expndtw-1\charscalex100
pegawai/staf\tab \up0 \expndtw-1\charscalex100 rumah\tab \up0 \expndtw-
1\charscalex100 sakit)\tab \up0 \expndtw-1\charscalex100 yang\tab \up0 \expndtw-
1\charscalex100 terlibat/membantu\par\pard\qj \li2160\ri1259\sb24\sl-300\slmult0
\up0 \expndtw0\charscalex102 wawancara/presentasi pada waktu pelaksanaan
survei), peminjaman \line \up0 \expndtw0\charscalex102 peralatan medis dari rumah
sakit lain, dan pemalsuan data atau informasi \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb6\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 38

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(1901,20);(1901,0);(0,0)}}
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{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg39}{\bkmkend Pg39}\par\pard\ql \li2160\sb0\sl-276\slmult0
\par\pard\ql\li2160\sb0\sl-276\slmult0 \par\pard\ql\li2160\sb0\sl-276\slmult0
\par\pard\ql\li2160\sb0\sl-276\slmult0 \par\pard\ql\li2160\sb88\sl-276\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 lainnya, maka KARS akan
melakukan survei terfokus. \par\pard\ql \li1800\sb0\sl-276\slmult0
\par\pard\ql\li1800\sb68\sl-276\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3880?\ul0\nosupersub\cf7\f8\fs24 Izin
operasional rumah sakit habis masa berlakunya \par\pard\qj \li2160\ri1246\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex104 Bila ada laporan dari Tim Survei, izin
operasional rumah sakit habis masa \up0 \expndtw-1\charscalex100 berlakunya/masih
dalam proses perpanjangan maka Status kelulusan rumah \up0 \expndtw0\charscalex102
sakit ditunda dan KARS memberikan surat keterangan bahwa rumah sakit \up0
\expndtw0\charscalex103 telah dilakukan akreditasi oleh KARS. Dan bila izin
operasional sudah ada, \up0 \expndtw-1\charscalex100 rumah sakit agar melaporkan ke
KARS dengan melampirkan izin operasional \up0 \expndtw-2\charscalex100 melalui
email\ul0\nosupersub\cf10\f11\fs24 survei@kars.or.id \par\pard\ql \li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb61\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3880?\ul0\nosupersub\cf7\f8\fs24
Izin pengolahan limbah cair dan B-3 habis masa berlakunya. \par\pard\qj
\li2160\ri1245\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100 Bila ada laporan
dari Tim Survei, bahwa izin pengolahan limbah cair dan B-3 \line \up0
\expndtw0\charscalex101 habis masa berlakunya/dalam proses perpanjangan maka status
kelulusan \line \up0 \expndtw0\charscalex100 rumah sakit ditunda dan KARS
memberikan surat keterangan bahwa rumah \line \up0 \expndtw0\charscalex100 sakit
telah dilakukan akreditasi oleh KARS. Dan bila Izin pengolahan limbah \line \up0
\expndtw0\charscalex102 cair dan B-3 P sudah ada, rumah sakit agar melaporkan ke
KARS dengan \line \up0 \expndtw0\charscalex103 melampirkan Izin pengolahan
limbah cair dan B-3 melalui email \par\pard\ql \li2160\sb17\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf10\f11\fs24
survei@kars.or.id \par\pard\ql \li1800\sb0\sl-320\slmult0
\par\pard\ql\li1800\sb0\sl-320\slmult0 \par\pard\ql\li1800\ri1244\sb8\sl-
320\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf12\f13\fs24 \u-3880?\ul0\nosupersub\cf7\f8\fs24 Rumah Sakit
tidak menyampaikan Perencanaan Perbaikan Strategis (PPS) \line\tab \up0
\expndtw0\charscalex100 yang layak dalam waktu 1 (satu bulan) setelah mendapatkan
pemberitahuan \line \tab \up0 \expndtw-1\charscalex100 hasil survei akreditasi.
\par\pard\qj \li1440\sb0\sl-317\slmult0 \par\pard\qj\li1440\ri1241\sb6\sl-
317\slmult0 \up0 \expndtw0\charscalex100 Sekretaris Eksekutif KARS dan
surveior dapat mengidentifikasi kondisi-kondisi \line \up0
\expndtw0\charscalex100 tersebut selama survei langsung di rumah sakit, selama
peninjauan laporan survei \line \up0 \expndtw0\charscalex102 atau kegiatan tindak
lanjut setelah survei, atau dari pengaduan yang disampaikan \line \up0
\expndtw0\charscalex100 terhadap rumah sakit atau setelah penghapusan atau
pembatasan lisensi/izin \line \up0 \expndtw-1\charscalex100 beroperasi oleh
badan pengawas nasional atau lainnya atau pihak yang \line \up0
\expndtw0\charscalex103 berwenang. Ketika surveior menemukan bahwa kondisi ini
dibenarkan dan tidak \line \up0 \expndtw-1\charscalex100 diselesaikan, Penolakan
Akreditasi akan direkomendasikan kepada Ketua Eksekutif \line \up0 \expndtw-
3\charscalex100 KARS. \par\pard\ql \li4317\sb0\sl-276\slmult0
\par\pard\ql\li4317\sb261\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN PASCA SURVEI \par\pard\qj \li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\ri1194\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Pihak KARS membutuhkan
komunikasi berkesinambungan sepanjang siklus \up0 \expndtw0\charscalex105
akreditasi tiga tahunan antara rumah sakit yang telah terakreditasi,
untuk \up0 \expndtw-1\charscalex100 memastikan bahwa rumah sakit terus memenuhi
persyaratan akreditasi setelah \up0 \expndtw-5\charscalex100 dinyatakan
terakreditasi. \par\pard\qj \li1440\ri1240\sb300\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Survei ulang dilaksanakan sebelum habis masa berlakunya
sertifikat akreditasi. \up0 \expndtw-1\charscalex100 Pengajuan permohonan survei
ulang dilakukan paling lambat 3 bulan sebelum habis \up0 \expndtw-2\charscalex100
masa berlakunya sertifikat akreditasi rumah sakit. \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb83\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 39

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg40}{\bkmkend Pg40}\par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1244\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit wajib membuat laporan kepada Komisi
Akreditasi Rumah Sakit bila \up0 \expndtw-3\charscalex100 terjadi hal-hal sebagai
berikut: \par\pard\ql \li1440\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100 A.
Kejadian sentinel di rumah sakit. \par\pard\ql \li1723\ri1201\sb8\sl-320\slmult0
\up0 \expndtw-2\charscalex100 Laporan diterima paling lambat 5 x 24 jam, dan
disertai RCA paling lambat 45 hari. \up0 \expndtw0\charscalex103 Laporan dikirim
melalui email ke\ul0\nosupersub\cf10\f11\fs24
info@kars.or.id\ul0\nosupersub\cf7\f8\fs24 . Bila diperlukan, KARS akan \up0
\expndtw-3\charscalex100 melakukan evaluasi ke rumah sakit, untuk melakukan
verifikasi. \line \up0 \expndtw-3\charscalex100 Kejadian sentinel yang harus
dilaporkan antara lain : \par\pard\ql \li1788\ri1238\sb6\sl-
313\slmult0\tx2147\tx2147\tx2147 \up0 \expndtw0\charscalex104 1. kematian yang
tak terduga,\ul0\nosupersub\cf6\f7\fs24 sebagai
contoh\ul0\nosupersub\cf7\f8\fs24 , kematian yang tidak \line\tab \up0
\expndtw0\charscalex100 berhubungan dengan proses alami penyakit pasien atau
penyakit yang \line \tab \up0 \expndtw-3\charscalex100 mendasari \up0
\expndtw0\charscalex100 (\ul0\nosupersub\cf6\f7\fs24
misalnya\ul0\nosupersub\cf7\f8\fs24 kematian akibat infeksi pascaoperasi atau
emboli \line \tab \up0 \expndtw-3\charscalex100 paru); \par\pard\ql
\li1788\sb38\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. kematian bayi cukup
bulan; \par\pard\ql \li1788\sb64\sl-276\slmult0 \up0 \expndtw-1\charscalex100 3.
bunuh diri; \par\pard\qj \li1788\ri1246\sb0\sl-320\slmult0\tx2147 \up0
\expndtw0\charscalex100 4. kehilangan fungsi tubuh utama yang permanen yang
tidak berhubungan \line\tab \up0 \expndtw-3\charscalex100 dengan proses alami
penyakit pasien atau penyakit yang mendasari; \par\pard\ql \li1788\sb25\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 5. operasi yang salah lokasi, salah
prosedur, salah pasien \par\pard\qj \li1788\ri1243\sb8\sl-320\slmult0\tx2147
\up0 \expndtw0\charscalex100 6. transmisi penyakit kronis atau fatal akibat
transfusi darah atau produk darah \line\tab \up0 \expndtw-3\charscalex100 atau
transplantasi organ atau jaringan yang terkontaminasi; \par\pard\ql
\li1788\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 7. penculikan bayi atau
bayi dipulangkan dengan orang tua yang salah; dan \par\pard\ql
\li1788\ri1243\sb16\sl-310\slmult0\tx2147\tx2147 \up0 \expndtw0\charscalex105 8.
pemerkosaan, kekerasan di tempat kerja seperti penyerangan
\line\tab \up0 \expndtw-1\charscalex100 (menyebabkan kematian atau kehilangan
fungsi tubuh secara permanen), \line \tab \up0 \expndtw-2\charscalex100 atau
pembunuhan \up0 \expndtw-2\charscalex100 (sengaja membunuh) seorang pasien,
anggota staf, \par\pard\ql \li2147\sb39\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 tenaga medis, pengunjung, atau vendor ketika di lokasi di rumah
sakit \par\pard\qj \li1723\sb0\sl-320\slmult0 \par\pard\qj\li1723\ri1215\sb8\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Kejadian tersebut diatas disebut sentinel
dan perlu segera dilaporkan kepada Tim \line \up0 \expndtw-1\charscalex100
Keselamatan Pasien untuk dilakukan analisis akar masalah (RCA) segera karena
\line \up0 \expndtw-1\charscalex100 perlunya penyelidikan dan respons yang
segera. Istilah kejadian sentinel tidak \line \up0 \expndtw-2\charscalex100 identik
dengan kesalahan medis; tidak semua kejadian sentinel terjadi karena \line
\up0 \expndtw-3\charscalex100 kesalahan, dan tidak semua kesalahan menyebabkan
kejadian sentinel. \par\pard\qj \li1723\ri1246\sb300\sl-320\slmult0 \up0
\expndtw0\charscalex100 Respons rumah sakit yang tepat terhadap kejadian sentinel
termasuk melakukan \line \up0 \expndtw-1\charscalex100 analisis akar masalah \up0
\expndtw-1\charscalex100 (RCA) yang tepat waktu, teliti, dan dapat
dipercaya; \par\pard\qj \li1723\ri1221\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex100 mengembangkan rencana kerja yang dirancang untuk
melaksanakan perbaikan \up0 \expndtw-1\charscalex100 untuk mengurangi risiko;
melaksanakan perbaikan; dan memantau efektivitas \up0 \expndtw0\charscalex100
perbaikan tersebut. KARS akan meninjau hasil analisis akar masalah (RCA) dan
\up0 \expndtw0\charscalex103 rencana kerja bersama rumah sakit untuk memastikan
adanya perbaikan yang \up0 \expndtw-3\charscalex100 akan mengurangi risiko
terjadinya kejadian serupa di masa depan. \par\pard\qj \li1723\ri1238\sb300\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Selama survei berlangsung, surveior
menilai kepatuhan rumah sakit terhadap \line \up0 \expndtw0\charscalex102
standar terkait kejadian sentinel. Jika pada saat tim survei menemukan adanya \line
\up0 \expndtw0\charscalex100 kejadian sentinel yang tidak dilaporkan, maka
Direktur rumah sakit diberitahu \line \up0 \expndtw0\charscalex100 bahwa
kejadian tersebut dilaporkan kepada Ketua Eksekutif KARS untuk ditinjau \line
\up0 \expndtw-3\charscalex100 lebih lanjut. \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb10\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 40

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\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0\tx7779 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 B.
Bila terjadi peningkatan kelas, selambat-lambatnya \tab \up0 \expndtw-
1\charscalex100 2 minggu setelah surat \par\pard\qj \li1867\ri1244\sb25\sl-
300\slmult0 \up0 \expndtw0\charscalex103 keputusan peningkatan kelas diterima rumah
sakit harus melaporkan kepada \up0 \expndtw-3\charscalex100 kars.. Laporan dikirim
melalui email ke info@kars.or.id\ul0\nosupersub\cf10\f11\fs24 . \par\pard\ql
\li1440\ri1197\sb4\sl-320\slmult0\tx1867\tx1867 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 C. Bila terjadi perubahan nama rumah sakit, rumah
sakit mengirimkan laporan paling \line\tab \up0 \expndtw0\charscalex100 lama 1
bulan setelah perubahan nama rumah sakit ditetapkan. Laporan dikirim \line \tab
\up0 \expndtw-3\charscalex100 melalui email ke info@kars.or.id. \par\pard\ql
\li1440\ri1247\sb0\sl-320\slmult0\tx1867\tx1867 \up0 \expndtw0\charscalex100 D.
Bila terjadi perubahan kategori/jenis rumah sakit, rumah sakit
mengirimkan \line\tab \up0 \expndtw-1\charscalex100 laporan paling lama 1 bulan
setelah perubahan kategori rumah sakit ditetapkan. \line \tab \up0 \expndtw-
3\charscalex100 Laporan dikirim melalui email ke info@kars.or.id. \par\pard\ql
\li1440\ri1245\sb9\sl-310\slmult0\tx1867\tx1867 \up0 \expndtw0\charscalex100 E.
Bila terjadi penambahan pelayanan spesialistik/sub spesialistik, rumah sakit
\line\tab \up0 \expndtw-1\charscalex100 mengirimkan laporan paling lama 1
bulan setelah penambahan pelayanan. \line \tab \up0 \expndtw-3\charscalex100
Laporan dikirim melalui email ke info@kars.or.id \par\pard\qj
\li1440\ri1243\sb2\sl-320\slmult0\tx1867 \up0 \expndtw0\charscalex103 F. Bila
terjadi penambahan bangunan rumah sakit lebih dari 25 % dari bangunan \line\tab
\up0 \expndtw-1\charscalex100 sekarang, rumah sakit mengirimkan laporan
paling lama \up0 \expndtw-1\charscalex100 1 bulan setelah \par\pard\ql
\li1867\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 penambahan pelayanan.
Laporan dikirim melalui email ke info@kars.or.id \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Sertifikat akreditasi masih berlaku:
\par\pard\ql \li1440\ri1241\sb0\sl-320\slmult0\tx1867\tx1867 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 Bila ada kejadian sentinel, rumah sakit
telah melaporkan dan berdasarkan \line\tab \up0 \expndtw0\charscalex100 evaluasi
KARS, rumah sakit telah melakukan perbaikan dan tidak ada kejadian \line \tab
\up0 \expndtw-3\charscalex100 sentinel yang sama dalam kurun waktu 3 bulan
\par\pard\ql \li1440\ri1229\sb0\sl-
317\slmult0\tx1867\tx1867\tx1867\tx1867\tx1867 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 Bila ada
peningkatan kelas rumah sakit dan sudah dilaporkan dan berdasarkan \line\tab
\up0 \expndtw-3\charscalex100 survei terfokus dari KARS tidak ada penambahan
pelayanan yang berarti. \line \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 Bila ada
perubahan nama rumah sakit sesuai dengan izin operasional rumah sakit \line\tab
\up0 \expndtw0\charscalex100 dan sudah dilaporkan ke KARS maka KARS akan mengganti
sertifikat dengan \line \tab \up0 \expndtw-3\charscalex100 nama rumah sakit yang
baru sepanjang tidak ada penambahan pelayanan. \line \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 Bila ada
penambahan pelayanan spesialistik/sub spesialistik serta bangunan lebih
\line\tab \up0 \expndtw0\charscalex101 25% dan berdasarkan survei terfokus dari
KARS penambahan pelayanan dan \line \tab \up0 \expndtw-2\charscalex100 bangunan
sudah sesuai dengan standar nasional akreditasi rumah sakit edisi 1.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb116\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Sertifikat akreditasi dinyatakan tidak berlaku atau
dapat ditarik: \par\pard\ql \li2160\sb0\sl-276\slmult0 \par\pard\ql\li2160\sb88\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 a. Bila
habis masa berlakunya \par\pard\qj \li2160\ri1253\sb0\sl-320\slmult0\tx2520 \up0
\expndtw-1\charscalex100 b. Bila ada kejadian sentinel berulang yang sama di rumah
sakit dalam kurun \line\tab \up0 \expndtw-2\charscalex100 waktu 3 bulan.
\par\pard\qj \li2160\ri1250\sb0\sl-320\slmult0\tx2520 \up0 \expndtw0\charscalex100
c. Bila jenis pelayanan rumah sakit berubah kategori yaitu dari rumah sakit
\line\tab \up0 \expndtw-3\charscalex100 khusus menjadi rumah sakit umum.
\par\pard\ql \li2160\sb25\sl-276\slmult0 \up0 \expndtw-2\charscalex100 d. Bila
lokasi rumah sakit berpindah \par\pard\ql \li2160\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 e. Bila hal yang harus dilaporkan tetapi tidak dilaporkan
kepada KARS \par\pard\ql \li3681\sb0\sl-264\slmult0 \par\pard\ql\li3681\sb0\sl-
264\slmult0 \par\pard\ql\li3681\sb146\sl-264\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf11\f12\fs23 Mengelola
Pengaduan\ul0\nosupersub\cf6\f7\fs24 atau\ul0\nosupersub\cf11\f12\fs23 Masalah
Mutu \par\pard\qj \li1440\ri1242\sb10\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Sekretariat KARS mencatat
pengaduan, keluhan dan pertanyaan yang berkaitan \line \up0
\expndtw0\charscalex100 dengan rumah sakit yang telah terakreditasi.
Komunikasi ini dapat diterima dari \par\pard\ql \li10243\sb216\sl-253\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 41

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\par\pard\qj\li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\ri1190\sb215\sl-315\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 berbagai sumber, antara lain langsung dari pasien,
keluarga, atau tenaga medis, dari \up0 \expndtw-3\charscalex100 lembaga pemerintah
dalam bentuk laporan, atau melalui pemberitaan di media. Pada \up0 \expndtw-
2\charscalex100 rumah sakit yang tidak memiliki proses yang efisien dan efektif
untuk mengelola dan \up0 \expndtw0\charscalex100 menyelesaikan keluhan, staf
dan pasien dapat membawa masalah mereka \up0 \expndtw-2\charscalex100 yang
belum terselesaikan kepada KARS. \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1235\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex103 Setelah
pemeriksaan atas masalah mutu yang dilaporkan, KARS dapat \up0
\expndtw-3\charscalex100 mengambil sejumlah tindakan, termasuk: \par\pard\qj
\li1800\ri1225\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 merekam
informasi untuk tujuan mengetahui kecenderungan yang sering \line\tab \up0
\expndtw-4\charscalex100 terjadi dan kemungkinan tindakan di masa depan;
\par\pard\qj \li1800\ri1330\sb4\sl-340\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 meminta
perhatian rumah sakit yang terlibat terhadap masalah tersebut; atau \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
melakukan survei terfokus. \par\pard\ql \li3664\sb0\sl-276\slmult0
\par\pard\ql\li3664\sb77\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 PERPANJANGAN STATUS AKREDITASI \par\pard\qj
\li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\ri1196\sb15\sl-316\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 KARS mengingatkan rumah sakit
untuk mengajukan survei ulang sebelum tanggal \up0 \expndtw-3\charscalex100 jatuh
tempo akreditasi tiga tahunan. Dan rumah sakit harus mengajukan permintaan \up0
\expndtw-3\charscalex100 survei ulang kepada KARS. KARS akan menjadwalkan survei
ulang tersebut, dengan \up0 \expndtw0\charscalex100 berusaha menyesuaikan waktu
survei dengan akhir siklus akreditasi tiga tahunan. \up0 \expndtw0\charscalex100
Status akreditasi rumah sakit secara otomatis akan gugur bila pelaksanaan survei
\up0 \expndtw-5\charscalex100 ulang melampaui batas berlakunya status
akreditasi. \par\pard\ql \li4591\sb0\sl-276\slmult0 \par\pard\ql\li4591\sb82\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN
REMEDIAL \par\pard\ql \li1507\sb0\sl-276\slmult0 \par\pard\ql\li1507\sb68\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Remedial
dapat dilaksanakan pada rumah sakit yang belum mencapai paripurna \par\pard\ql
\li1507\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 2. Remedial dapat
dilakukan pada bab yang kurang dari 80% namun di atas 60 %. \par\pard\ql
\li1507\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 3. Pelaksanaan remedial
berdasarkan permohonan pengajuan oleh rumah sakit. \par\pard\qj
\li1507\ri1242\sb8\sl-320\slmult0\tx1867 \up0 \expndtw-3\charscalex100 4. Rumah
sakit dapat mengajukan remedial, bila minimal ada 4 bab yang lebih dari
\line\tab \up0 \expndtw-4\charscalex100 80%. \par\pard\qj \li1507\ri1243\sb0\sl-
320\slmult0\tx1867 \up0 \expndtw0\charscalex100 5. Pengajuan remedial paling
lambat 1 (satu) bulan setelah pemberitahuan hasil \line\tab \up0 \expndtw-
3\charscalex100 akreditasi diterima. \par\pard\qj \li1507\ri1245\sb17\sl-
300\slmult0\tx1867 \up0 \expndtw-2\charscalex100 6. Remedial dilakukan paling
lambat 6 (enam) bulan sejak tanggal pemberitahuan \line\tab \up0 \expndtw-
5\charscalex100 oleh KARS. \par\pard\qj \li1507\ri1243\sb4\sl-320\slmult0\tx1867
\up0 \expndtw-1\charscalex100 7. Jumlah surveior dan hari survei ditetapkan
berdasarkan jumlah bab yang \line\tab \up0 \expndtw-5\charscalex100 dilakukan
remedial. \par\pard\qj \li1507\ri1245\sb0\sl-320\slmult0\tx1867 \up0
\expndtw0\charscalex100 8. Rumah sakit berhak untuk tidak mengajukan remedial,
walaupun mempunyai \line\tab \up0 \expndtw-3\charscalex100 peluang untuk
remedial. \par\pard\qj \li1507\ri1188\sb0\sl-320\slmult0\tx1867 \up0 \expndtw-
3\charscalex100 9. Remedial wajib dilakukan bila hasil survei akreditasi sama
atau lebih rendah dua \line\tab \up0 \expndtw-4\charscalex100 kali berturut-
turut \up0 \expndtw-4\charscalex100 (kecuali paripurna). Bila tidak mengajukan
remedial maka \par\pard\ql \li1867\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 dinyatakan tidak lulus akreditasi. \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb158\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 42

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{\shp
{\*\shpinst\shpleft1411\shptop8463\shpright10490\shpbottom8777\shpfhdr0\shpbxpage\s
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 314}}
{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9079,314);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
13431551}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg43}{\bkmkend Pg43}\par\pard\ql \li4065\sb0\sl-276\slmult0
\par\pard\ql\li4065\sb0\sl-276\slmult0 \par\pard\ql\li4065\sb0\sl-276\slmult0
\par\pard\ql\li4065\sb0\sl-276\slmult0 \par\pard\ql\li4065\sb88\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN SURVEI VERIFIKASI
\par\pard\ql \li1507\ri1246\sb308\sl-320\slmult0\tx1867\tx1867 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Survei verifikasi 1
dilaksanakan satu tahun setelah tanggal survei yang sudah \line\tab \up0
\expndtw0\charscalex100 dilaksanakan. Surveior mempunyai tugas melakukan
verifikasi Perencanaan \line \tab \up0 \expndtw0\charscalex100 Perbaikan Strategis
\up0 \expndtw0\charscalex100 (PPS) yang sudah dilaksanakan dan yang belum
\par\pard\ql \li1867\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 dilaksanakan
\par\pard\ql \li1507\ri1245\sb8\sl-320\slmult0\tx1867\tx1867\tx1867 \up0
\expndtw0\charscalex100 2. Survei verifikasi 2 dilaksanakan dua tahun setelah
tanggal survei yang sudah \line\tab \up0 \expndtw-1\charscalex100 dilaksanakan.
Surveior mempunyai tugas melakukan verifikasi PPS yang sudah \line \tab \up0
\expndtw0\charscalex100 dilaksanakan dan yang belum dilaksanakan serta
persiapan akreditasi \line \tab \up0 \expndtw-3\charscalex100 selanjutnya.
\par\pard\qj \li1507\ri1244\sb0\sl-320\slmult0\tx1867 \up0 \expndtw0\charscalex100
3. Tanggal penetapan tanggal survei verifikasi dapat dirubah, bila tanggal
tersebut \line\tab \up0 \expndtw-3\charscalex100 adalah hari minggu atau hari libur
nasional. \par\pard\qj \li1507\ri1241\sb0\sl-320\slmult0\tx1867 \up0 \expndtw-
1\charscalex100 4. Bila rumah sakit menunda atau tidak melaksanakan survei
verifikasi, maka \line\tab \up0 \expndtw-3\charscalex100 sertifikat akreditasi
ditarik kembali. \par\pard\ql \li4043\sb0\sl-276\slmult0
\par\pard\ql\li4043\sb261\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN SURVEI TERFOKUS \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Survei terfokus dilaksanakan bila:
\par\pard\qj \li1507\ri1511\sb28\sl-320\slmult0\tx1867 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Berdasarkan laporan dari rumah sakit atau dari informasi lain yang akurat, ada
\line\tab \up0 \expndtw-5\charscalex100 kejadian sentinel di rumah sakit.
\par\pard\ql \li1507\sb57\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Berdasarkan
laporan dari rumah sakit atau informasi dari Kementerian \par\pard\qj
\li1867\ri1513\sb25\sl-300\slmult0 \up0 \expndtw-4\charscalex100 Kesehatan, ada
peningkatan kelas dan atau penambahan pelayanan dan atau \up0 \expndtw-
5\charscalex100 penambahan bangunan lebih dari 25%. \par\pard\ql \li1507\sb60\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Berdasarkan banding (appeal) yang perlu
ditindaklanjuti. \par\pard\ql \li1507\sb64\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Adanya pengaduan terkait dengn mutu pelayanan rumah sakit. \par\pard\ql
\li4058\sb0\sl-276\slmult0 \par\pard\ql\li4058\sb0\sl-276\slmult0
\par\pard\ql\li4058\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN BANDING\ul0\nosupersub\cf16\f17\fs24
(APPEAL) \par\pard\ql \li1440\sb0\sl-264\slmult0 \par\pard\ql\li1440\sb110\sl-
264\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf11\f12\fs23 Pengajuan
Banding Terhadap Keputusan Hasil Akreditasi \par\pard\qj \li1440\ri1342\sb10\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
dapat mengajukan banding\ul0\nosupersub\cf8\f9\fs24
(appeal)\ul0\nosupersub\cf7\f8\fs24 dengan ketentuan sebagai berikut \line \up0
\expndtw-3\charscalex100 : \par\pard\qj \li1507\ri1551\sb184\sl-340\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Banding hanya boleh diajukan satu kali untuk
setiap kegiatan survei akreditasi \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Membayar biaya
banding sebesar biaya survei akreditasi \par\pard\ql \li1507\ri1211\sb0\sl-
320\slmult0\tx1867\tx1867\tx1867\tx1867\tx1867\tx1867\tx1867 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Rumah sakit memiliki hak untuk mengajukan banding atas keputusan akreditasi
\line\tab \up0 \expndtw0\charscalex100 yang dianggap merugikan. Jika berdasarkan
survei atau survei terfokus, atau \line \tab \up0 \expndtw0\charscalex100 terjadi
situasi yang mengancam nyawa dan keselamatan, terdapat keputusan \line \tab \up0
\expndtw-2\charscalex100 untuk menolak atau menarik akreditasi, maka rumah sakit
memiliki waktu 10 hari \line \tab \up0 \expndtw0\charscalex103 sejak diterimanya
rekomendasi surveior secara resmi dari KARS atau \line \tab \up0 \expndtw-
3\charscalex100 pemberitahuan penarikan akreditasi, untuk memberi tahu KARS secara
tertulis \line \tab \up0 \expndtw0\charscalex103 atau
melalui\ul0\nosupersub\cf8\f9\fs24 email\ul0\nosupersub\cf7\f8\fs24 , mengenai
niatnya untuk mengajukan banding atas \line \tab \up0 \expndtw-3\charscalex100
keputusan tersebut. \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb180\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 43

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9079,314);(9079,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg44}{\bkmkend Pg44}\par\pard\ql \li1507\sb0\sl-320\slmult0
\par\pard\ql\li1507\sb0\sl-320\slmult0 \par\pard\ql\li1507\sb0\sl-320\slmult0
\par\pard\ql\li1507\ri1222\sb196\sl-320\slmult0\tx1867\tx1867 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Rumah sakit kemudian memiliki waktu tambahan 30 hari untuk mengajukan
\line\tab \up0 \expndtw-2\charscalex100 data dan informasi yang dapat diterima
untuk mendukung pengajuan bandingnya \line \tab \up0 \expndtw-5\charscalex100 ke
pihak KARS, secara tertulis atau melalui\ul0\nosupersub\cf8\f9\fs24
email\ul0\nosupersub\cf7\f8\fs24 . \par\pard\ql \li1507\ri1243\sb25\sl-
315\slmult0\tx1867\tx1867\tx1867\tx1867 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24 Ketua Eksekutif
KARS menugaskan Dewan Penilai untuk meninjau dan \line\tab \up0 \expndtw-
4\charscalex100 mengevaluasi materi yang diserahkan dalam waktu 30 hari dari
penerimaan, dan \line \tab \up0 \expndtw-3\charscalex100 Dewan Penilai dapat
meminta dokumen dan bahan tambahan. Dewan Penilai \line \tab \up0 \expndtw-
1\charscalex100 meninjau dokumen banding yang terkait, menyiapkan analisis, dan
menyajikan \line \tab \up0 \expndtw-4\charscalex100 rekomendasinya pada Ketua
Eksekutif KARS \par\pard\ql \li1507\ri2163\sb13\sl-330\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
KARS akan melakukan survei terfokus untuk bab yang diajukan banding \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Rumah Sakit menanggung biaya akomodasi dan transport surveior \line \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3928?\ul0\nosupersub\cf7\f8\fs24
Surveior memberikan laporan hasil survei terfokus. \par\pard\ql
\li1507\ri1245\sb19\sl-320\slmult0\tx1867\tx1867\tx1867 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Bila hasil survei terfokus sama dengan
atau berkurang dari hasil survei \line\tab \up0 \expndtw-1\charscalex100
sebelumnya, maka banding tidak diterima dan status akreditasi seperti semula
\line \tab \up0 \expndtw-1\charscalex100 yang ditetapkan, dan biaya biaya banding
sebesar biaya survei akreditasi tidak \line \tab \up0 \expndtw-2\charscalex100
dikembalikan. \par\pard\ql \li1507\ri1237\sb0\sl-320\slmult0\tx1867\tx1867 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3928?\ul0\nosupersub\cf7\f8\fs24 Bila hasil survei terfokus lebih baik dan dapat
mencapai nilai 80%, maka banding \line\tab \up0 \expndtw0\charscalex100 diterima
dan status akreditasi dapat berubah sesuai hasil survei terfokus. Atas \line
\tab \up0 \expndtw-2\charscalex100 kondisi ini KARS akan mengembalikan biaya
banding tersebut ke rumah sakit. \par\pard\ql \li2685\sb0\sl-276\slmult0
\par\pard\ql\li2685\sb0\sl-276\slmult0 \par\pard\ql\li2685\sb5\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 PENGUNGKAPAN KEPADA
PUBLIK DAN KERAHASIAAN \par\pard\qj \li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1214\sb26\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pihak KARS merahasiakan segala hal yang berkaitan
dengan proses akreditasi \up0 \expndtw-1\charscalex100 kecuali status hasil
akreditasi rumah sakit yaitu bila rumah sakit telah terakreditasi, \up0 \expndtw-
3\charscalex100 tidak terakreditasi, atau jika akreditasi ditarik oleh KARS.
\par\pard\qj \li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\ri1182\sb10\sl-
316\slmult0 \up0 \expndtw0\charscalex100 Status akreditasi rumah sakit ditampilkan
pada situs KARS sebagai Terakreditasi. \up0 \expndtw0\charscalex100 Bila masa
berlaku sertifikat akreditasi telah habis atau status akreditasinya maka \up0
\expndtw0\charscalex108 status akreditasi rumah sakit tersebut dihilangkan pada
situs KARS. Rumah \up0 \expndtw-2\charscalex100 sakit dapat memberikan informasi
atau mengumumkan capaian hasil akrediatsinya \up0 \expndtw-2\charscalex100 sesuai
keinginan rumah sakit. Namun, bila rumah sakit menyampaikan informasi \up0
\expndtw0\charscalex103 yang tidak tepat mengenai status akreditasinya maka
KARS berhak untuk \up0 \expndtw-5\charscalex100 mengklarifikasi informasi
tersebut. \par\pard\ql \li3885\sb0\sl-276\slmult0 \par\pard\ql\li3885\sb0\sl-
276\slmult0 \par\pard\ql\li3885\sb126\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 KEBIJAKAN PROMOSI AKREDITASI
\par\pard\qj \li1440\sb0\sl-300\slmult0 \par\pard\qj\li1440\ri1224\sb45\sl-
300\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Setelah rumah
sakit menerima pemberitahuan resmi tentang hasil akreditasi, rumah \up0 \expndtw-
4\charscalex100 sakit dapat mempublikasikan capaian status akreditasinya.
\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1197\sb4\sl-
320\slmult0 \up0 \expndtw-4\charscalex100 Informasi mengenai status akreditasi
rumah sakit akan dicantumkan dalam situs web \up0 \expndtw0\charscalex100 KARS
(\ul0\nosupersub\cf10\f11\fs24 www.kars.or.id)\ul0\nosupersub\cf7\f8\fs24 . Situs
web tersebut dapat diakses oleh setiap orang untuk \up0 \expndtw-4\charscalex100
mengetahui rumah sakit yang telah terakreditasi oleh KARS. \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb30\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 44

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{\*\shpinst\shpleft1411\shptop7764\shpright10490\shpbottom8079\shpfhdr0\shpbxpage\s
hpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz4714\shplid0
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 315}}
{\sp{\sn pVerticies}{\sv 8;4;(0,315);(9079,315);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
13431551}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1411\shptop12526\shpright10490\shpbottom12840\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz8950\shplid1
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 9079}}{\sp{\sn geoBottom}{\sv 314}}
{\sp{\sn pVerticies}{\sv 8;4;(0,314);(9079,314);(9079,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
13431551}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
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{\shp
{\*\shpinst\shpleft2289\shptop14679\shpright3945\shpbottom14699\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz11847\shplid2
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 1656}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(1656,20);(1656,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
12673541}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg45}{\bkmkend Pg45}\par\pard\ql \li10399\sb0\sl-276\slmult0
\par\pard\ql\li10399\sb0\sl-276\slmult0 \par\pard\ql\li10399\sb0\sl-276\slmult0
\par\pard\ql\li10399\sb0\sl-276\slmult0 \par\pard\ql\li10399\sb0\sl-276\slmult0
\par\pard\ql\li10399\sb132\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 I \par\pard\ql \li9278\sb24\sl-276\slmult0 \up0
\expndtw-3\charscalex100 SASARAN \par\pard\ql \li8627\ri1241\sb8\sl-
320\slmult0\tx9573 \up0 \expndtw-3\charscalex100 KESELAMATAN \line\tab \up0
\expndtw-3\charscalex100 PASIEN \par\pard\ql \li3566\sb0\sl-276\slmult0
\par\pard\ql\li3566\sb0\sl-276\slmult0 \par\pard\ql\li3566\sb125\sl-276\slmult0
\up0 \expndtw-3\charscalex100 SASARAN KESELAMATAN PASIEN (SKP) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb112\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Gambaran
Umum \par\pard\qj \li1440\ri1238\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Bab ini membahas Sasaran Keselamatan Pasien yang wajib
diterapkan di semua \up0 \expndtw-2\charscalex100 rumah sakit yang diakreditasi
oleh Komisi Akreditasi Rumah Sakit. Penyusunan \up0 \expndtw0\charscalex103
sasaran ini mengacu kepada\ul0\nosupersub\cf8\f9\fs24 Nine Life-Saving Patient
Safety Solutions\ul0\nosupersub\cf7\f8\fs24 dari WHO \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf8\f9\fs24 Patient Safety\ul0\nosupersub\cf7\f8\fs24 (2007) yang
digunakan juga oleh Pemerintah. \par\pard\qj \li1440\sb0\sl-316\slmult0
\par\pard\qj\li1440\ri1182\sb8\sl-316\slmult0 \up0 \expndtw0\charscalex100 Maksud
dan tujuan Sasaran Keselamatan Pasien adalah untuk mendorong rumah \up0
\expndtw0\charscalex104 sakit agar melakukan perbaikan spesifik dalam keselamatan
pasien. Sasaran ini \up0 \expndtw0\charscalex100 menyoroti bagian-bagian yang
bermasalah dalam pelayanan rumah sakit dan \up0 \expndtw-3\charscalex100
menjelaskan bukti serta solusi dari konsensus para ahli atas permasalahan ini.
Sistem \up0 \expndtw0\charscalex103 yang baik akan berdampak pada peningkatan mutu
pelayanan rumah sakit dan \up0 \expndtw-3\charscalex100 keselamatan pasien.
\par\pard\ql \li1612\sb0\sl-276\slmult0 \par\pard\ql\li1612\sb0\sl-276\slmult0
\par\pard\ql\li1612\sb126\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 SASARAN, STANDAR, MAKSUD DAN TUJUAN, SERTA ELEMEN
PENILAIAN \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb112\sl-276\slmult0 \up0 \expndtw-3\charscalex100
SASARAN 1: MENGIDENTIFIKASI PASIEN DENGAN BENAR \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar SKP.1 \par\pard\qj \li1440\ri1248\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi
untuk menjamin ketepatan (akurasi) identifikasi \up0 \expndtw-3\charscalex100
pasien. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan SKP.1 \par\pard\qj \li1440\ri1240\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Kesalahan identifikasi pasien
dapat terjadi di semua aspek diagnosis dan tindakan. \up0 \expndtw0\charscalex105
Keadaan yang dapat membuat identifikasi tidak benar adalah jika pasien dalam
\up0 \expndtw-1\charscalex100 keadaan terbius, mengalami disorientasi, tidak
sepenuhnya sadar, dalam keadaan \up0 \expndtw-2\charscalex100 koma, saat pasien
berpindah tempat tidur, berpindah kamar tidur, berpindah lokasi di \up0
\expndtw0\charscalex104 dalam lingkungan rumah sakit, terjadi disfungsi sensoris,
lupa identitas diri, atau \up0 \expndtw-3\charscalex100 mengalami situasi
lainnya. \par\pard\qj \li1440\ri1184\sb300\sl-320\slmult0 \up0
\expndtw0\charscalex100 Ada 2 (dua) maksud dan tujuan standar ini: pertama,
memastikan ketepatan pasien \up0 \expndtw-4\charscalex100 yang akan menerima
layanan atau tindakan dan kedua, untuk menyelaraskan layanan \up0 \expndtw-
5\charscalex100 atau tindakan yang dibutuhkan oleh pasien. \par\pard\ql
\li10243\sb216\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 45
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg46}
{\bkmkend Pg46}\par\pard\qj \li1440\sb0\sl-313\slmult0 \par\pard\qj\li1440\sb0\sl-
313\slmult0 \par\pard\qj\li1440\sb0\sl-313\slmult0 \par\pard\qj\li1440\sb0\sl-
313\slmult0 \par\pard\qj\li1440\ri1180\sb230\sl-313\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Proses identifikasi yang
digunakan di rumah sakit mengharuskan terdapat paling \line \up0 \expndtw-
3\charscalex100 sedikit 2 (dua) dari 3 (tiga) bentuk identifikasi, yaitu nama
pasien, tanggal lahir, nomor \line \up0 \expndtw-1\charscalex100 rekam medik,
atau bentuk lainnya (misalnya, nomor induk kependudukan atau \line \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf8\f9\fs24
barcode\ul0\nosupersub\cf7\f8\fs24 ). Nomor kamar pasien tidak dapat digunakan
untuk identifikasi pasien. Dua \par\pard\qj \li1440\ri1248\sb2\sl-320\slmult0
\up0 \expndtw0\charscalex103 (2) bentuk identifikasi ini digunakan di semua area
layanan rumah sakit seperti di \up0 \expndtw0\charscalex104 rawat jalan, rawat
inap, unit darurat, kamar operasi, unit layanan diagnostik, dan \up0 \expndtw-
3\charscalex100 lainnya. \par\pard\qj \li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\ri1245\sb10\sl-315\slmult0 \up0 \expndtw0\charscalex100 Dua (2)
bentuk identifikasi harus dilakukan dalam setiap keadaan terkait intervensi \up0
\expndtw0\charscalex103 kepada pasien. Misalnya, identifikasi pasien dilakukan
sebelum memberikan \up0 \expndtw0\charscalex100 radioterapi, menerima cairan
intravena, hemodialisis, pengambilan darah atau \up0 \expndtw0\charscalex102
pengambilan spesimen lain untuk pemeriksaan klinis, katerisasi jantung, prosedur
\up0 \expndtw-3\charscalex100 radiologi diagnostik, dan identifikasi terhadap
pasien koma. \par\pard\ql \li1507\sb0\sl-276\slmult0 \par\pard\ql\li1507\sb82\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian SKP 1 \par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mengatur
pelaksanaan identifikasi pasien. (R) \par\pard\ql \li1440\ri1241\sb0\sl-
320\slmult0\tx1797\tx1797 \up0 \expndtw-1\charscalex100 2. Identifikasi pasien
dilakukan dengan menggunakan minimal 2 (dua) identitas dan \line\tab \up0 \expndtw-
1\charscalex100 tidak boleh menggunakan nomor kamar pasien atau lokasi pasien
dirawat sesuai \line \tab \up0 \expndtw-2\charscalex100 dengan regulasi rumah
sakit. (D,O,W) \par\pard\qj \li1440\ri1188\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-
3\charscalex100 3. Identifikasi pasien dilakukan sebelum dilakukan tindakan,
prosedur diagnostik, dan \line\tab \up0 \expndtw-4\charscalex100 terapeutik.
(W,O,S) \par\pard\qj \li1440\ri1191\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-
1\charscalex100 4. Pasien diidentifikasi sebelum pemberian obat, darah, produk
darah, pengambilan \line\tab \up0 \expndtw-4\charscalex100 spesimen, dan pemberian
diet. (lihat juga PAP 4; AP 5.7) (W,O,S) \par\pard\ql \li1440\ri1246\sb0\sl-
313\slmult0\tx1797\tx1797\tx1797 \up0 \expndtw0\charscalex100 5. Pasien
diidentifikasi sebelum pemberian radioterapi, menerima cairan intravena,
\line\tab \up0 \expndtw0\charscalex104 hemodialisis, pengambilan darah atau
pengambilan spesimen lain untuk \line \tab \up0 \expndtw0\charscalex104
pemeriksaan klinis, katerisasi jantung, prosedur radiologi diagnostik,
dan \line \tab \up0 \expndtw-3\charscalex100 identifikasi terhadap pasien koma.
(W,O,S) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb120\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 SASARAN 2 : MENINGKATKAN KOMUNIKASI
YANG EFEKTIF \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar SKP.2 \par\pard\qj
\li1440\ri1248\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk melaksanakan
proses meningkatkan \up0 \expndtw-2\charscalex100 efektivitas komunikasi verbal
dan atau komunikasi melalui telpon antar-PPA. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar SKP.2.1 \par\pard\qj
\li1440\ri1243\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk proses
pelaporan hasil pemeriksaaan \up0 \expndtw-3\charscalex100 diagnostik kritis.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar SKP.2.2
\par\pard\qj \li1440\ri1181\sb0\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan dan melakanakan proses
komunikasi \u8220?Serah Terima\u8221? (\ul0\nosupersub\cf8\f9\fs24 hand \line
\up0 \expndtw-4\charscalex100
over\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 . \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb18\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 46
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg47}
{\bkmkend Pg47}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan SKP.2 sampai SKP.2.2
\par\pard\qj \li1440\ri1242\sb16\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Komunikasi dianggap efektif bila tepat waktu,
akurat, lengkap, tidak mendua \up0 \expndtw-1\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 ambiguous\ul0\nosupersub\cf7\f8\fs24 ), dan diterima
oleh penerima informasi yang bertujuan mengurangi \up0 \expndtw-
2\charscalex100 kesalahan-kesalahan dan meningkatkan keselamatan pasien.
\par\pard\qj \li1440\sb0\sl-317\slmult0 \par\pard\qj\li1440\ri1212\sb8\sl-
317\slmult0 \up0 \expndtw0\charscalex100 Komunikasi dapat berbentuk verbal,
elektronik, atau tertulis. Komunikasi yang jelek \up0 \expndtw-2\charscalex100
dapat membahayakan pasien. Komunikasi yang rentan terjadi kesalahan adalah saat
\up0 \expndtw-1\charscalex100 perintah lisan atau perintah melalui telepon,
komunikasi verbal, saat menyampaikan \up0 \expndtw0\charscalex102 hasil
pemeriksaan kritis yang harus disampaikan lewat telpon. Hal ini dapat \up0
\expndtw0\charscalex100 disebabkan oleh perbedaan aksen dan dialek. Pengucapan juga
dapat menyulitkan \up0 \expndtw-1\charscalex100 penerima perintah untuk memahami
perintah yang diberikan. Misalnya, nama-nama \up0 \expndtw0\charscalex100 obat yang
rupa dan ucapannya mirip (\ul0\nosupersub\cf8\f9\fs24 look
alike\ul0\nosupersub\cf7\f8\fs24 ,\ul0\nosupersub\cf8\f9\fs24 sound
alike\ul0\nosupersub\cf7\f8\fs24 ), seperti\ul0\nosupersub\cf8\f9\fs24
phenobarbital \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24
dan\ul0\nosupersub\cf8\f9\fs24 phentobarbital\ul0\nosupersub\cf7\f8\fs24 , serta
lainnya. \par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1241\sb1\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Pelaporan hasil pemeriksaaan diagnostik
kritis juga merupakan salah satu isu \line \up0 \expndtw0\charscalex100
keselamatan pasien. Pemeriksaan diagnostik kritis termasuk, tetapi tidak terbatas
\line \up0 \expndtw-3\charscalex100 pada \par\pard\ql \li1800\sb17\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 1. pemeriksaaan laboratorium;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2.
pemeriksaan radiologi; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3. pemeriksaan kedokteran nuklir; \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 4. prosedur ultrasonografi; \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
5.\ul0\nosupersub\cf8\f9\fs24 magnetic resonance imaging; \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 6. diagnostik jantung; \par\pard\ql
\li1800\ri1241\sb16\sl-310\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex100 7.
pemeriksaaan diagnostik yang dilakukan di tempat tidur pasien, seperti hasil
\line\tab \up0 \expndtw0\charscalex106 tanda-tanda
vital,\ul0\nosupersub\cf8\f9\fs24 portable
radiographs\ul0\nosupersub\cf7\f8\fs24 ,\ul0\nosupersub\cf8\f9\fs24 bedside
ultrasound\ul0\nosupersub\cf7\f8\fs24 , atau \line \tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 transesophageal
echocardiograms\ul0\nosupersub\cf7\f8\fs24 . \par\pard\qj \li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\ri1217\sb2\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Hasil yang diperoleh dan berada di luar rentang angka normal secara
mencolok akan \up0 \expndtw-1\charscalex100 menunjukkan keadaan yang berisiko
tinggi atau mengancam jiwa. Sistem pelaporan \up0 \expndtw0\charscalex106 formal
yang dapat menunjukkan dengan jelas bagaimana nilai kritis hasil \up0
\expndtw-1\charscalex100 pemeriksaaan diagnostik dikomunikasikan kepada staf medis
dan informasi tersebut \up0 \expndtw-1\charscalex100 terdokumentasi untuk
mengurangi risiko bagi pasien. Tiap-tiap unit menetapkan nilai \up0 \expndtw-
2\charscalex100 kritis hasil pemeriksaan diagnostiknya. \par\pard\qj
\li1440\ri1249\sb300\sl-320\slmult0 \up0 \expndtw0\charscalex100 Untuk melakukan
komunikasi secara verbal atau melalui telpon dengan aman \up0 \expndtw-
3\charscalex100 dilakukan hal-hal sebagai berikut: \par\pard\ql \li1800\sb37\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 1) pemesanaan obat atau permintaan obat
secara verbal sebaiknya dihindari; \par\pard\ql \li1800\ri1181\sb12\sl-
315\slmult0\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex103 2) dalam
keadaan darurat karena komunikasi secara tertulis atau komunikasi \line\tab \up0
\expndtw-3\charscalex100 elektronik tidak mungkin dilakukan maka harus ditetapkan
panduannya meliputi \line \tab \up0 \expndtw-2\charscalex100 permintaan
pemeriksaan, penerimaan hasil pemeriksaaan dalam keadaan \line \tab \up0
\expndtw0\charscalex100 darurat, identifikasi dan penetapan nilai kritis, hasil
pemeriksaaan diagnostik, \line \tab \up0 \expndtw-2\charscalex100 serta kepada
siapa dan oleh siapa hasil pemeriksaaan kritis dilaporkan; \par\pard\qj
\li1800\ri1242\sb1\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 3) prosedur
menerima perintah lisan atau lewat telpon meliputi penulisan secara \line\tab
\up0 \expndtw-1\charscalex100 lengkap permintaan atau hasil pemeriksaaan oleh
penerima informasi, \par\pard\ql \li10243\sb216\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 47
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg48}
{\bkmkend Pg48}\par\pard\qj \li2160\sb0\sl-320\slmult0 \par\pard\qj\li2160\sb0\sl-
320\slmult0 \par\pard\qj\li2160\sb0\sl-320\slmult0
\par\pard\qj\li2160\ri1242\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 penerima membaca kembali permintaan atau hasil
pemeriksaaan, dan \up0 \expndtw-3\charscalex100 pengirim memberi konfirmasi atas
apa yang telah ditulis secara akurat. \par\pard\qj \li1440\ri1187\sb300\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Penggunaan singkatan-singkatan yang tidak
ditetapkan oleh rumah sakit sering kali \up0 \expndtw-3\charscalex100 menimbulkan
kesalahan komunikasi dan dapat berakibat fatal. Oleh karena itu, rumah \up0
\expndtw0\charscalex100 sakit diminta memiliki daftar singkatan yang diperkenankan
dan dilarang. (lihat juga \up0 \expndtw-7\charscalex100 MIRM12 EP 5) \par\pard\ql
\li1440\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Serah terima asuhan
pasien (\ul0\nosupersub\cf8\f9\fs24 hand over\ul0\nosupersub\cf7\f8\fs24 ) di dalam
rumah sakit terjadi \par\pard\ql \li1891\ri1186\sb16\sl-
310\slmult0\tx2251\tx2251 \up0 \expndtw-3\charscalex100 a) antar-PPA seperti
antara staf medis dan staf medis, antara staf medis dan staf \line\tab \up0
\expndtw-4\charscalex100 keperawatan atau dengan staf klinis lainnya, atau antara
PPA dan PPA lainnya \line \tab \up0 \expndtw-5\charscalex100 pada saat
pertukaran\ul0\nosupersub\cf8\f9\fs24 shift\ul0\nosupersub\cf7\f8\fs24 ;
\par\pard\ql \li1891\ri1250\sb2\sl-320\slmult0\tx2251\tx2251 \up0
\expndtw0\charscalex102 b) antarberbagai tingkat layanan di dalam rumah sakit yang
sama seperti jika \line\tab \up0 \expndtw0\charscalex100 pasien dipindah dari unit
intensif ke unit perawatan atau dari unit darurat ke \line \tab \up0 \expndtw-
3\charscalex100 kamar operasi; dan \par\pard\qj \li1891\ri1244\sb0\sl-
320\slmult0\tx2251 \up0 \expndtw0\charscalex106 c) dari unit rawat inap ke unit
layanan diagnostik atau unit tindakan seperti \line\tab \up0 \expndtw-
3\charscalex100 radiologi atau unit terapi fisik. \par\pard\qj
\li1440\ri1243\sb300\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Gangguan
komunikasi dapat terjadi saat dilakukan serah terima asuhan pasien yang \line
\up0 \expndtw-3\charscalex100 dapat berakibatl kejadian yang tidak
diharapkan \up0 \expndtw-3\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 adverse
event\ul0\nosupersub\cf7\f8\fs24 ) atau kejadian \par\pard\qj
\li1440\ri1235\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100 sentinel.
Komunikasi yang baik dan terstandar baik dengan pasien, keluarga pasien, \line \up0
\expndtw-1\charscalex100 dan pemberi layanan dapat memperbaiki secara signifikan
proses asuhan pasien. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian SKP.2 \par\pard\qj
\li1440\ri1249\sb8\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang komunikasi efektif
antarprofesional pemberi asuhan. (lihat \line\tab \up0 \expndtw-3\charscalex100
juga TKRS 3.2). (R) \par\pard\ql \li1440\sb17\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 2. Ada bukti pelatihan komunikasi efektif antarprofesional pemberi
asuhan. (D,W) \par\pard\ql \li1440\ri1190\sb8\sl-320\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex100 3. Pesan secara verbal atau verbal lewat telpon ditulis
lengkap, dibaca ulang oleh \line\tab \up0 \expndtw0\charscalex102 penerima pesan,
dan dikonfirmasi oleh pemberi pesan. (lihat juga AP 5.3.1 di \line \tab \up0
\expndtw-5\charscalex100 maksud dan tujuan). (D,W,S) \par\pard\qj
\li1797\ri1186\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Penyampaian hasil
pemeriksaaan diagnostik secara verbal ditulis lengkap, dibaca \up0 \expndtw-
3\charscalex100 ulang, dan dikonfirmasi oleh pemberi pesan secara lengkap.
(D,W,S) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian SKP.2.1 \par\pard\qj \li1440\ri1248\sb0\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
besaran nilai kritis hasil pemeriksaan diagnostik dan \line\tab \up0 \expndtw-
3\charscalex100 hasil diagnostik kritis. (lihat juga AP 5.3.2). (R) \par\pard\ql
\li1440\ri1187\sb0\sl-320\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex102 2.
Rumah sakit menetapkan siapa yang harus melaporkan dan siapa yang harus
\line\tab \up0 \expndtw-3\charscalex100 menerima nilai kritis hasil pemeriksaan
diagnostik dan dicatat di rekam medis (lihat \line \tab \up0 \expndtw-
4\charscalex100 juga AP 5.3.2 EP 2). (W,S) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian SKP.2.2
\par\pard\ql \li1440\ri1181\sb16\sl-310\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada bukti catatan tentang
hal-hal kritikal dikomunikasikan di antara profesional \line\tab \up0 \expndtw-
3\charscalex100 pemberi asuhan pada waktu dilakukan serah terima pasien
(\ul0\nosupersub\cf8\f9\fs24 hand
over\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
.\ul0\nosupersub\cf7\f8\fs24 (lihat juga \line \tab \up0 \expndtw-4\charscalex100
MKE 5)\ul0\nosupersub\cf8\f9\fs24 .\ul0\nosupersub\cf7\f8\fs24 (D,W)
\par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb32\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 48
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg49}
{\bkmkend Pg49}\par\pard\qj \li1440\sb0\sl-300\slmult0 \par\pard\qj\li1440\sb0\sl-
300\slmult0 \par\pard\qj\li1440\sb0\sl-300\slmult0
\par\pard\qj\li1440\ri1250\sb273\sl-300\slmult0\tx1797 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 2. Formulir, alat, dan metode ditetapkan untuk
mendukung proses serah terima \line\tab \up0 \expndtw-3\charscalex100 pasien
(h\ul0\nosupersub\cf8\f9\fs24 and over)\ul0\nosupersub\cf7\f8\fs24 bila mungkin
melibatkan pasien. (D,W) \par\pard\qj \li1440\ri1246\sb4\sl-320\slmult0\tx1797 \up0
\expndtw-2\charscalex100 3. Ada bukti dilakukan evaluasi tentang catatan
komunikasi yang terjadi waktu serah \line\tab \up0 \expndtw-3\charscalex100 terima
pasien (\ul0\nosupersub\cf8\f9\fs24 hand over\ul0\nosupersub\cf7\f8\fs24 ) untuk
memperbaiki proses. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb125\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 SASARAN 3 : MENINGKATKAN
KEAMANAN OBAT-OBAT YANG HARUS \par\pard\ql \li3043\sb144\sl-276\slmult0 \up0
\expndtw-3\charscalex100 DIWASPADAI\ul0\nosupersub\cf16\f17\fs24 (HIGH ALERT
MEDICATIONS) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb68\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar SKP.3
\par\pard\qj \li1440\ri1247\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk melaksanakan
proses meningkatkan \up0 \expndtw-3\charscalex100 keamanan terhadap obat-obat yang
perlu diwaspadai. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar SKP.3.1 \par\pard\qj \li1440\ri1241\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi untuk melaksanakan proses mengelola \up0 \expndtw-
3\charscalex100 penggunaan elektrolit konsentrat. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan SKP.3 dan SKP.3.1
\par\pard\qj \li1440\ri1234\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap obat jika salah penggunaannya dapat
membahayakan pasien, bahkan \up0 \expndtw0\charscalex103 bahayanya dapat
menyebabkan kematian atau kecacatan pasien, terutama obat\up0
\expndtw0\charscalex103 obat yang perlu diwaspadai. Obat yang perlu
diwaspadai adalah obat yang \up0 \expndtw0\charscalex102 mengandung risiko
yang meningkat bila kita salah menggunakan dan dapat \up0 \expndtw-
3\charscalex100 menimbulkan kerugian besar pada pasien. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Obat yang perlu diwaspadai terdiri atas \par\pard\ql
\li1800\sb64\sl-276\slmult0\tx9026 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 obat risiko
tinggi, yaitu obat yang bila terjadi kesalahan \tab \up0 \expndtw-
2\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 error\ul0\nosupersub\cf7\f8\fs24 )
dapat \par\pard\qj \li2160\ri1243\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex103
menimbulkan kematian atau kecacatan seperti, insulin, heparin, atau \up0
\expndtw-5\charscalex100 kemoterapeutik; \par\pard\ql \li1800\ri1244\sb0\sl-
320\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 obat yang nama,
kemasan, label, penggunaan klinik tampak/kelihatan sama \line\tab \up0 \expndtw-
1\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 look
alike\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 bunyi ucapan sama (\ul0\nosupersub\cf8\f9\fs24 sound
alike\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 seperti Xanax dan Zantac atau \line \tab \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf8\f9\fs24
hydralazine\ul0\nosupersub\cf7\f8\fs24 dan\ul0\nosupersub\cf8\f9\fs24
hydroxyzine\ul0\nosupersub\cf7\f8\fs24 atau disebut juga nama obat rupa ucapan
mirip \line \tab \up0 \expndtw-3\charscalex100 (NORUM); \par\pard\ql
\li1800\ri1180\sb26\sl-313\slmult0\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 elektrolit konsentrat
seperti\ul0\nosupersub\cf8\f9\fs24 potasium\ul0\nosupersub\cf7\f8\fs24 klorida
dengan konsentrasi sama atau \line\tab \up0 \expndtw-3\charscalex100 lebih dari 2
mEq/ml,\ul0\nosupersub\cf8\f9\fs24 potasium\ul0\nosupersub\cf7\f8\fs24 fosfat
dengan konsentrasi sama atau lebih besar \line \tab \up0 \expndtw-3\charscalex100
dari \up0 \expndtw-1\charscalex100 3 mmol/ml, natrium klorida dengan
konsentrasi lebih dari 0,9% dan \line \tab \up0 \expndtw-2\charscalex100
magnesium sulfat dengan konsentrasi 20%, 40%, atau lebih. \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1182\sb2\sl-320\slmult0 \up0
\expndtw0\charscalex100 Ada banyak obat yang termasuk dalam kelompok NORUM.
Nama-nama yang \up0 \expndtw-4\charscalex100 membingungkan ini umumnya menjadi
sebab terjadi\ul0\nosupersub\cf8\f9\fs24 medication
error\ul0\nosupersub\cf7\f8\fs24 di seluruh dunia. \up0 \expndtw-5\charscalex100
Penyebab hal ini adalah \par\pard\ql \li1800\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 1) pengetahuan tentang nama obat yang tidak memadai;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2) ada
produk baru; \par\pard\ql \li1800\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100
3) kemasan dan label sama; \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb150\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 49
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg50}
{\bkmkend Pg50}\par\pard\ql \li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 4) indikasi klinik sama;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5) bentuk,
dosis, dan aturan pakai sama; \par\pard\ql \li1800\sb24\sl-276\slmult0 \up0
\expndtw-3\charscalex100 6) terjadi salah pengertian waktu memberikan perintah.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0\tx5536 \up0 \expndtw-2\charscalex100 Daftar obat yang perlu
diwaspadai \tab \up0 \expndtw-2\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 high
alert medication\ul0\nosupersub\cf7\f8\fs24 ) tersedia di berbagai \par\pard\qj
\li1440\ri1180\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100 organisasi kesehatan
seperti\ul0\nosupersub\cf8\f9\fs24 the World Health
Organization\ul0\nosupersub\cf7\f8\fs24 (WHO) dan\ul0\nosupersub\cf8\f9\fs24
Institute for \up0 \expndtw-3\charscalex100 Safe Heatlh Medication
Practices\ul0\nosupersub\cf7\f8\fs24 (ISMP), di berbagai kepustakaan, serta
pengalaman \up0 \expndtw-4\charscalex100 rumah sakit dalam hal KTD atau kejadian
sentinel. \par\pard\qj \li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\ri1233\sb10\sl-315\slmult0 \up0 \expndtw0\charscalex100 Isu
tentang penggunaan obat adalah pemberian yang salah atau ketidaksengajaan \up0
\expndtw-2\charscalex100 menggunakan elektrolit konsentrat.
Contohnya,\ul0\nosupersub\cf8\f9\fs24 potasium\ul0\nosupersub\cf7\f8\fs24 klorida
dengan konsentrasi \up0 \expndtw-1\charscalex100 sama atau lebih dari 2
mEq/ml,\ul0\nosupersub\cf8\f9\fs24 potasium\ul0\nosupersub\cf7\f8\fs24 fosfat
dengan konsentrasi sama atau lebih \up0 \expndtw-2\charscalex100 besar dari 3
mmol/ml, natrium klorida dengan konsentrasi lebih dari 0,9%, dan \up0
\expndtw-3\charscalex100 magnesium sulfat dengan konsentrasi 20%, 40%, atau
lebih. \par\pard\qj \li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\ri1240\sb9\sl-
316\slmult0 \up0 \expndtw0\charscalex100 Kesalahan dapat terjadi jika petugas tidak
memperoleh orientasi cukup baik di unit \up0 \expndtw0\charscalex100 perawatan
pasien dan apabila perawat tidak memperoleh orientasi cukup atau saat \up0
\expndtw-2\charscalex100 keadaan darurat. Cara paling efektif untuk mengurangi atau
menghilangkan kejadian \up0 \expndtw0\charscalex100 ini adalah dengan menetapkan
proses untuk mengelola obat yang perlu diwaspadai \up0 \expndtw0\charscalex104
(\ul0\nosupersub\cf8\f9\fs24 high alert medication\ul0\nosupersub\cf7\f8\fs24 ) dan
memindahkan elektrolit konsentrat dari area layanan \up0 \expndtw-3\charscalex100
perawatan pasien ke unit farmasi. (lihat juga PKPO 3 EP 4). \par\pard\qj
\li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\ri1225\sb10\sl-315\slmult0
\up0 \expndtw-1\charscalex100 Rumah sakit membuat daftar semua
obat\ul0\nosupersub\cf8\f9\fs24 high alert\ul0\nosupersub\cf7\f8\fs24 dengan
menggunakan informasi \line \up0 \expndtw-2\charscalex100 atau data yang terkait
penggunaan obat di dalam rumah sakit, data tentang \u8220?kejadian \line \up0
\expndtw0\charscalex100 yang tidak diharapkan\u8221? (\ul0\nosupersub\cf8\f9\fs24
adverse event\ul0\nosupersub\cf7\f8\fs24 ) atau \u8220?kejadian nyaris
cedera\u8221? (\ul0\nosupersub\cf8\f9\fs24 near
miss\ul0\nosupersub\cf7\f8\fs24 ) \line \up0 \expndtw-2\charscalex100 termasuk
risiko terjadi salah pengertian tentang NORUM. Informasi dari kepustakaan \line
\up0 \expndtw-3\charscalex100 seperti dari\ul0\nosupersub\cf8\f9\fs24 Institute
for Safe Health Medication Practices \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 (ISMP), Kementerian \par\pard\qj
\li1440\ri1233\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex100 Kesehatan, dan
lainnya. Obat-obat ini dikelola sedemikian rupa untuk menghindari \up0 \expndtw-
2\charscalex100 kekuranghati-hatian dalam menyimpan, menata, dan
menggunakannya termasuk \up0 \expndtw0\charscalex105 administrasinya, contoh
dengan memberi label atau petunjuk tentang cara \up0 \expndtw-3\charscalex100
menggunakan obat dengan benar pada obat-obat\ul0\nosupersub\cf8\f9\fs24 high
alert\ul0\nosupersub\cf7\f8\fs24 . \par\pard\qj \li1440\sb0\sl-316\slmult0
\par\pard\qj\li1440\ri1239\sb8\sl-316\slmult0 \up0 \expndtw-1\charscalex100 Untuk
meningkatkan keamanan obat yang perlu diwaspadai, rumah sakit perlu \up0
\expndtw-2\charscalex100 menetapkan risiko spesifik dari setiap obat dengan
tetap memperhatikan aspek \up0 \expndtw-2\charscalex100 peresepan, menyimpan,
menyiapkan, mencatat, menggunakan, serta monitoringnya. \up0
\expndtw0\charscalex100 Obat\ul0\nosupersub\cf8\f9\fs24 high
alert\ul0\nosupersub\cf7\f8\fs24 harus disimpan di instalasi farmasi/unit/depo.
Bila rumah sakit ingin \up0 \expndtw-2\charscalex100 menyimpan di luar lokasi
tersebut, disarankan disimpan di depo farmasi yang berada \up0 \expndtw-
3\charscalex100 di bawah tanggung jawab apoteker. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb150\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian SKP.3 \par\pard\qj
\li1440\ri1247\sb8\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang penyediaan, penyimpanan,
penataan, penyiapan, dan \line\tab \up0 \expndtw-3\charscalex100 penggunaan obat
yang perlu diwaspadai. (R) \par\pard\ql \li10243\sb216\sl-253\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 50
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg51}
{\bkmkend Pg51}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Rumah sakit mengimplementasikan
regulasi yang telah dibuat. (D,W) \par\pard\qj \li1440\ri1243\sb25\sl-
300\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Di rumah sakit tersedia daftar
semua obat yang perlu diwaspadai yang disusun \line\tab \up0 \expndtw-
3\charscalex100 berdasar atas data spesifik sesuai dengan regulasi. (D,O,W)
\par\pard\qj \li1440\ri1240\sb4\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex100
4. Tempat penyimpanan, pelabelan, dan penyimpanan obat yang perlu diwaspadai
\line\tab \up0 \expndtw-3\charscalex100 termasuk obat NORUM diatur di tempat aman.
(D,O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian SKP.3.1 \par\pard\qj \li1440\ri1244\sb8\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
regulasi untuk melaksanakan proses mencegah \line\tab \up0 \expndtw-
3\charscalex100 kekurang hati-hatian dalam mengelola elektrolit konsentrat. (R)
\par\pard\qj \li1440\ri1246\sb17\sl-300\slmult0\tx1797 \up0 \expndtw-
1\charscalex100 2. Elektrolit konsentrat hanya tersedia di unit
kerja/instalasi farmasi atau depo \line\tab \up0 \expndtw-3\charscalex100
farmasi. (D,O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb128\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 SASARAN 4 : MEMASTIKAN
LOKASI PEMBEDAHAN YANG BENAR, \par\pard\qj \li2976\ri2132\sb42\sl-400\slmult0
\up0 \expndtw-3\charscalex100 PROSEDUR YANG BENAR, PEMBEDAHAN PADA PASIEN \up0
\expndtw-3\charscalex100 YANG BENAR \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb67\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar SKP.4
\par\pard\qj \li1440\ri1239\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memastikan Tepat-Lokasi, Tepat-Prosedur,
dan Tepat-Pasien sebelum \up0 \expndtw-2\charscalex100 menjalani tindakan dan atau
prosedur. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar
SKP.4.1 \par\pard\qj \li1440\ri1238\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memastikan dilaksanakannya
proses\ul0\nosupersub\cf8\f9\fs24 Time-out\ul0\nosupersub\cf7\f8\fs24 di kamar
operasi atau \up0 \expndtw-3\charscalex100 ruang tindakan sebelum operasi
dimulai. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb69\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan SKP.4 dan SKP.4.1 \par\pard\qj \li1440\ri1231\sb8\sl-320\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Salah-Lokasi, Salah-Prosedur,
dan Salah-Pasien yang menjalani tindakan serta \up0 \expndtw-2\charscalex100
prosedur merupakan kejadian sangat mengkhawatirkan dan dapat terjadi. Kesalahan
\up0 \expndtw-3\charscalex100 ini terjadi antara lain akibat \par\pard\ql
\li1800\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 1) komunikasi yang tidak
efektif dan tidak adekuat antaranggota tim; \par\pard\qj \li1800\ri1248\sb25\sl-
300\slmult0\tx2160 \up0 \expndtw-1\charscalex100 2) tidak ada keterlibatan pasien
untuk memastikan ketepatan lokasi operasi dan \line\tab \up0 \expndtw-
3\charscalex100 tidak ada prosedur untuk verifikasi; \par\pard\ql \li1800\sb40\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 3) asesmen pasien tidak lengkap;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4) catatan
rekam medik tidak lengkap; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 5) budaya yang tidak mendukung komunikasi terbuka antaranggota
tim; \par\pard\qj \li1800\ri1248\sb8\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 6) masalah yang terkait dengan tulisan yang tidak terbaca,
tidak jelas, dan tidak \line\tab \up0 \expndtw-3\charscalex100 lengkap;
\par\pard\ql \li1800\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100 7)
penggunaan singkatan yang tidak terstandardisasi dan dilarang. \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1182\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 Tindakan bedah dan prosedur invasif memuat semua prosedur
investigasi dan atau \up0 \expndtw-3\charscalex100 memeriksa penyakit serta
kelainan dari tubuh manusia melalui mengiris, mengangkat, \up0
\expndtw0\charscalex100 memindahkan, mengubah atau memasukkan alat laparaskopi/
endoskopi ke dalam \up0 \expndtw-3\charscalex100 tubuh untuk keperluan diagnostik
dan terapeutik. \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb83\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 51
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg52}
{\bkmkend Pg52}\par\pard\qj \li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-
315\slmult0 \par\pard\qj\li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-
315\slmult0 \par\pard\qj\li1440\ri1182\sb220\sl-315\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit harus menentukan
area-area di dalam rumah sakit yang melakukan \up0 \expndtw-1\charscalex100
tindakan bedah dan prosedur invasif. Sebagai contoh, kateterisasi jantung,
radiologi \up0 \expndtw-3\charscalex100 intervensi, laparaskopi, endoskopi,
pemeriksaan laboratorium, dan lainnya. Ketentuan \up0 \expndtw-2\charscalex100
rumah sakit tentang Tepat-Lokasi, Tepat-Prosedur, dan Tepat-Pasien berlaku
di \up0 \expndtw-3\charscalex100 semua area rumah sakit di lokasi tindakan bedah
dan invasif dilakukan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Rumah sakit
diminta untuk menetapkan prosedur yang seragam sebagai berikut: \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1. beri tanda di tempat
operasi; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2.
dilakukan verifikasi praoperasi; \par\pard\ql \li1800\sb24\sl-276\slmult0 \up0
\expndtw-3\charscalex100 3. melakukan\ul0\nosupersub\cf8\f9\fs24 Time
Out\ul0\nosupersub\cf7\f8\fs24 sebelum insisi kulit dimulai. \par\pard\qj
\li1440\sb0\sl-317\slmult0 \par\pard\qj\li1440\ri1211\sb14\sl-317\slmult0 \up0
\expndtw-2\charscalex100 Pemberian tanda di empat dilakukan operasi atau prosedur
invasif melibatkan pasien \line \up0 \expndtw0\charscalex103 dan dilakukan dengan
tanda yang tepat serta dapat dikenali. Tanda yang dipakai \line \up0
\expndtw0\charscalex103 harus konsisten digunakan di semua tempat di rumah sakit,
harus dilakukan oleh \line \up0 \expndtw-2\charscalex100 individu yang melakukan
prosedur operasi, saat melakukan pasien sadar dan terjaga
\line \up0 \expndtw0\charscalex104 jika mungkin, serta harus masih terlihat jelas
setelah pasien sadar. Pada semua \line \up0 \expndtw-2\charscalex100 kasus, lokasi
tempat operasi harus diberi tanda, termasuk pada sisi lateral
(\ul0\nosupersub\cf8\f9\fs24
laterality\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 , \line \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 daerah struktur multipel
(\ul0\nosupersub\cf8\f9\fs24 multiple structure\ul0\nosupersub\cf7\f8\fs24 ), jari
tangan, jari kaki, lesi, atau tulang \line \up0 \expndtw-3\charscalex100
belakang. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 Tujuan proses verifikasi praoperasi
adalah \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 1)
memastikan ketepatan tempat, prosedur, dan pasien; \par\pard\qj
\li1800\ri1236\sb8\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103 2)
memastikan bahwa semua dokumen yang terkait, foto (imajing), dan hasil
\line\tab \up0 \expndtw-3\charscalex100 pemeriksaan yang relevan diberi label
dengan benar dan tersaji; \par\pard\qj \li1800\ri1246\sb0\sl-320\slmult0\tx2160
\up0 \expndtw0\charscalex105 3) memastikan tersedia peralatan medik khusus
dan atau implan yang \line\tab \up0 \expndtw-3\charscalex100 dibutuhkan.
\par\pard\qj \li1440\ri1188\sb300\sl-320\slmult0 \up0 \expndtw-3\charscalex100
Beberapa elemen proses verifikasi praoperasi dapat dilakukan sebelum pasien tiba di
\line \up0 \expndtw0\charscalex100 tempat praoperasi, seperti memastikan
dokumen, imajing, hasil pemeriksaaan, \line \up0 \expndtw-2\charscalex100
dokumen lain diberi label yang benar, dan memberi tanda di tempat (lokasi) operasi.
\par\pard\qj \li1440\ri1240\sb300\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf8\f9\fs24 Time-Out\ul0\nosupersub\cf7\f8\fs24 yang dilakukan
sebelum dimulainya insisi kulit dengan semua anggota tim \up0
\expndtw0\charscalex100 hadir dan memberi kesempatan untuk menyelesaikan
pertanyaan yang belum \up0 \expndtw-1\charscalex100 terjawab atau ada hal yang
meragukan yang perlu diselesaikan.\ul0\nosupersub\cf8\f9\fs24 Time-
Out\ul0\nosupersub\cf7\f8\fs24 dilakukan \up0 \expndtw-1\charscalex100 di lokasi
tempat dilakukan operasi sesaat sebelum prosedur dimulai dan melibatkan \up0
\expndtw0\charscalex103 semua anggota tim bedah. Rumah sakit harus menetapkan
prosedur bagaimana \up0 \expndtw-3\charscalex100 proses\ul0\nosupersub\cf8\f9\fs24
Time-Out\ul0\nosupersub\cf7\f8\fs24 berlangsung. \par\pard\qj \li1440\sb0\sl-
315\slmult0 \par\pard\qj\li1440\ri1242\sb10\sl-315\slmult0 \up0
\expndtw0\charscalex102 Salah-lokasi, salah-prosedur, dan salah-pasien operasi
adalah kejadian yang \line \up0 \expndtw0\charscalex103 mengkhawatirkan dan
dapat terjadi di rumah sakit. Kesalahan ini adalah akibat \line \up0 \expndtw-
1\charscalex100 komunikasi yang tidak efektif atau tidak adekuat antara anggota
tim bedah, kurang/ \line \up0 \expndtw0\charscalex103 tidak melibatkan pasien di
dalam penandaan lokasi (\ul0\nosupersub\cf8\f9\fs24 site
marking\ul0\nosupersub\cf7\f8\fs24 ), dan tidak ada \line \up0
\expndtw0\charscalex100 prosedur untuk memverifikasi lokasi operasi. Di samping
itu, juga asesmen pasien \par\pard\ql \li10243\sb217\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 52
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg53}
{\bkmkend Pg53}\par\pard\qj \li1440\sb0\sl-313\slmult0 \par\pard\qj\li1440\sb0\sl-
313\slmult0 \par\pard\qj\li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1182\sb223\sl-313\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 yang tidak adekuat, penelaahan ulang catatan medis
tidak adekuat, budaya yang tidak \up0 \expndtw0\charscalex102 mendukung komunikasi
terbuka antaranggota tim bedah, permasalahan yang \up0 \expndtw-
3\charscalex100 berhubungan dengan resep yang tidak terbaca
(\ul0\nosupersub\cf8\f9\fs24 illegible
handwriting\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 dan pemakaian \up0 \expndtw-3\charscalex100 singkatan
adalah merupakan faktor-faktor kontribusi yang sering terjadi. \par\pard\qj
\li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\ri1242\sb9\sl-316\slmult0 \up0
\expndtw0\charscalex100 Rumah sakit perlu untuk secara kolaboratif
mengembangkan suatu kebijakan \line \up0 \expndtw-2\charscalex100 dan/atau
prosedur yang efektif di dalam meminimalkan risiko ini. Kebijakan termasuk \line
\up0 \expndtw0\charscalex106 definisi operasi yang memasukkan sekurang-
kurangnya prosedur yang \line \up0 \expndtw0\charscalex100 menginvestigasi dan
atau mengobati penyakit serta kelainan/\ul0\nosupersub\cf8\f9\fs24
disorder\ul0\nosupersub\cf7\f8\fs24 pada tubuh \line \up0 \expndtw-1\charscalex100
manusia. Kebijakan berlaku atas setiap lokasi di rumah sakit bila
prosedur ini \line \up0 \expndtw-3\charscalex100 dijalankan. \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1242\sb1\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Praktik berbasis bukti ini diuraikan
dalam\ul0\nosupersub\cf8\f9\fs24 Surgical Safety
Checklist\ul0\nosupersub\cf7\f8\fs24 dari WHO\ul0\nosupersub\cf8\f9\fs24
Patient \up0 \expndtw-3\charscalex100 Safety\ul0\nosupersub\cf7\f8\fs24
terkini. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian SKP.4 \par\pard\qj \li1440\ri1247\sb25\sl-300\slmult0\tx1797 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi untuk
melaksanakan penandaan lokasi operasi atau tindakan invasif \line\tab \up0
\expndtw-3\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 site
marking\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
.\ul0\nosupersub\cf7\f8\fs24 (R) \par\pard\ql \li1440\ri1183\sb4\sl-
320\slmult0\tx1797\tx1797 \up0 \expndtw-3\charscalex100 2. Ada bukti rumah sakit
menggunakan satu tanda di empat sayatan operasi pertama \line\tab \up0
\expndtw0\charscalex103 atau tindakan invasif yang segera dapat dikenali dengan
cepat sesuai dengan \line \tab \up0 \expndtw-3\charscalex100 kebijakan dan prosedur
yang ditetapkan rumah sakit. (D,O) \par\pard\ql \li1440\ri1241\sb0\sl-
320\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex102 3. Ada bukti bahwa
penandaan lokasi operasi atau tindakan invasif (\ul0\nosupersub\cf8\f9\fs24 site
marking\ul0\nosupersub\cf7\f8\fs24 ) \line\tab \up0 \expndtw0\charscalex100
dilakukan oleh staf medis yang melakukan operasi atau tindakan invasif dengan \line
\tab \up0 \expndtw-3\charscalex100 melibatkan pasien. (D,O,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian SKP.4.1
\par\pard\qj \li1440\ri1241\sb8\sl-320\slmult0\tx1797 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi untuk prosedur bedah aman dengan
menggunakan\ul0\nosupersub\cf8\f9\fs24 \u8220?surgical check \line\tab \up0
\expndtw-3\charscalex100 list \u8221?\ul0\nosupersub\cf7\f8\fs24
(\ul0\nosupersub\cf8\f9\fs24 Surgical Safety Checklist\ul0\nosupersub\cf7\f8\fs24
dari WHO\ul0\nosupersub\cf8\f9\fs24 Patient Safety 2009\ul0\nosupersub\cf7\f8\fs24
). (R) \par\pard\ql \li1440\ri1180\sb0\sl-
320\slmult0\tx1797\tx1797\tx1797\tx1797 \up0 \expndtw-3\charscalex100 2. Sebelum
operasi atau tindakan invasif dilakukan, rumah sakit menyediakan
\u8220?\ul0\nosupersub\cf8\f9\fs24 check \line\tab \up0 \expndtw0\charscalex100
list\ul0\nosupersub\cf7\f8\fs24 \u8221? atau proses lain untuk mencatat,
apakah\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24
sudah benar dan \line \tab \up0 \expndtw0\charscalex104 lengkap, apakah Tepat-
Lokasi, Tepat-Prosedur, dan Tepat-Pasien sudah \line \tab \up0 \expndtw-
3\charscalex100 teridentifikasi, apakah semua dokumen dan peralatan yang dibutuhkan
sudah siap \line \tab \up0 \expndtw-4\charscalex100 tersedia dengan lengkap dan
berfungsi dengan baik. (D,O) \par\pard\ql \li1440\ri1237\sb0\sl-
320\slmult0\tx1797\tx1797\tx1797 \up0 \expndtw0\charscalex102 3. Rumah sakit
menggunakan Komponen\ul0\nosupersub\cf8\f9\fs24 Time-
Out\ul0\nosupersub\cf7\f8\fs24 terdiri atas identifikasi Tepat-\line\tab \up0
\expndtw0\charscalex100 Pasien, Tepat-Prosedur, dan Tepat-Lokasi, persetujuan
atas operasi dan \line \tab \up0 \expndtw-1\charscalex100 konfirmasi bahwa
proses verifikasi sudah lengkap dilakukan sebelum melakukan \line \tab \up0
\expndtw-3\charscalex100 irisan. (D,O,W,S). \par\pard\ql \li1440\ri1182\sb0\sl-
320\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex100 4. Rumah sakit menggunakan
ketentuan yang sama tentang Tepat-Lokasi, Tepat-\line\tab \up0 \expndtw-
3\charscalex100 Prosedur, dan Tepat-Pasien jika operasi dilakukan di luar kamar
operasi termasuk \line \tab \up0 \expndtw-4\charscalex100 prosedur tindakan medis
dan gigi. (D,O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb41\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 SASARAN 5 : MENGURANGI RISIKO INFEKSI TERKAIT PELAYANAN
\par\pard\ql \li3043\sb144\sl-276\slmult0 \up0 \expndtw-4\charscalex100
KESEHATAN \par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb190\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 53
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg54}
{\bkmkend Pg54}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb132\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar SKP.5
\par\pard\qj \li1440\ri1209\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk menggunakan dan
melaksanakan\ul0\nosupersub\cf8\f9\fs24 evidence\up0 \expndtw0\charscalex103 based
hand hygiene guidelines\ul0\nosupersub\cf7\f8\fs24 untuk menurunkan risiko infeksi
terkait pelayanan \up0 \expndtw-3\charscalex100 kesehatan. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan SKP.5 \par\pard\qj
\li1440\ri1239\sb11\sl-316\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pencegahan dan pengendalian infeksi merupakan sebuah
tantangan di lingkungan \up0 \expndtw0\charscalex103 fasilitas kesehatan. Kenaikan
angka infeksi terkait pelayanan kesehatan menjadi \up0 \expndtw-1\charscalex100
keprihatinan bagi pasien dan petugas kesehatan. Secara umum, infeksi
terkait \up0 \expndtw-2\charscalex100 pelayanan kesehatan terjadi di semua unit
layanan kesehatan, termasuk infeksi \up0 \expndtw0\charscalex100 saluran
kencing disebabkan oleh kateter, infeksi pembuluh/aliran darah terkait
\up0 \expndtw0\charscalex102 pemasangan infus baik perifer maupun sentral,
dan infeksi paru-paru terkait \up0 \expndtw-3\charscalex100 penggunaan
ventilator. \par\pard\qj \li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1176\sb19\sl-310\slmult0 \up0 \expndtw-2\charscalex100 Upaya
terpenting menghilangkan masalah infeksi ini dan infeksi lainnya adalah
\line \up0 \expndtw-3\charscalex100 dengan menjaga kebersihan tangan melalui cuci
tangan. Pedoman kebersihan tangan \line \up0 \expndtw-4\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 hand hygiene\ul0\nosupersub\cf7\f8\fs24 ) tersedia
dari\ul0\nosupersub\cf8\f9\fs24 World Health Organization \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (WHO). Rumah sakit \par\pard\ql
\li1440\sb39\sl-276\slmult0\tx6307 \up0 \expndtw-1\charscalex100 mengadopsi
pedoman kebersihan tangan \tab \up0 \expndtw0\charscalex101
(\ul0\nosupersub\cf8\f9\fs24 hand hygiene\ul0\nosupersub\cf7\f8\fs24 ) dari WHO
ini untuk \par\pard\qj \li1440\ri1188\sb8\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 dipublikasikan di seluruh rumah sakit. Staf diberi pelatihan
bagaimana melakukan cuci \line \up0 \expndtw-2\charscalex100 tangan dengan benar
dan prosedur menggunakan sabun, disinfektan, serta handuk \line \up0 \expndtw-
2\charscalex100 sekali pakai (\ul0\nosupersub\cf8\f9\fs24
towel\ul0\nosupersub\cf7\f8\fs24 ), tersedia di lokasi sesuai dengan pedoman.
(lihat juga PPI 9) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian SKP.5 \par\pard\qj
\li1440\ri1242\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang pedoman kebersihan tangan
(\ul0\nosupersub\cf8\f9\fs24 hand hygiene\ul0\nosupersub\cf7\f8\fs24 ) yang mengacu
\line\tab \up0 \expndtw-2\charscalex100 pada standar WHO terkini. (lihat juga PPI
9. EP 2, EP 6). (R) \par\pard\qj \li1440\ri1210\sb0\sl-320\slmult0\tx1797 \up0
\expndtw-2\charscalex100 2. Rumah sakit melaksanakan program kebersihan tangan
(\ul0\nosupersub\cf8\f9\fs24 hand hygiene\ul0\nosupersub\cf7\f8\fs24 ) di
seluruh \line\tab \up0 \expndtw-3\charscalex100 rumah sakit sesuai dengan regulasi.
(D,W) \par\pard\qj \li1440\ri1196\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-
3\charscalex100 3. Staf rumah sakit dapat melakukan cuci tangan sesuai dengan
prosedur. (lihat juga \line\tab \up0 \expndtw-4\charscalex100 PPI 9 EP 6).
(W,O,S) \par\pard\ql \li1440\sb25\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4.
Ada bukti staf melaksanakan lima saat cuci tangan. (W,O,S) ??? lima apa ??
\par\pard\qj \li1440\ri1243\sb8\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex102
5. Prosedur disinfeksi di rumah sakit dilakukan sesuai dengan regulasi. (lihat
juga \line\tab \up0 \expndtw-3\charscalex100 PPI 9 EP 2, EP 5, dan EP 6) (W,O,S)
\par\pard\qj \li1440\ri1189\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-3\charscalex100
6. Ada bukti rumah sakit melaksanakan evaluasi terhadap upaya menurunkan angka
\line\tab \up0 \expndtw-4\charscalex100 infeksi terkait pelayanan kesehatan. (D,W)
(lihat juga PPI 9 EP 6) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 SASARAN 6 : MENGURANGI RISIKO CEDERA PASIEN AKIBAT
TERJATUH \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb188\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar SKP.6 \par\pard\ql
\li1440\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan upaya mengurangi risiko cedera
akibat pasien jatuh. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan SKP.6 \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb4\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 54
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg55}
{\bkmkend Pg55}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1240\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Banyak cedera yang terjadi di unit rawat inap dan rawat
jalan akibat pasien jatuh. \up0 \expndtw-3\charscalex100 Berbagai faktor yang
meningkatkan riisiko pasien jatuh antara lain: \par\pard\ql \li1800\sb17\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 1. kondisi pasien; \par\pard\qj
\li1800\ri1246\sb8\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 2. gangguan
fungsional pasien (contoh gangguan keseimbangan, gangguan \line\tab \up0
\expndtw-3\charscalex100 penglihatan, atau perubahan status kognitif); \par\pard\ql
\li1800\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. lokasi atau situasi
lingkungan rumah sakit; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 4. riwayat jatuh pasien; \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 5. konsumsi obat tertentu;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 6. konsumsi
alkohol. \par\pard\qj \li1440\ri1184\sb308\sl-320\slmult0 \up0
\expndtw0\charscalex103 Pasien yang pada asesmen awal dinyatakan berisiko rendah
untuk jatuh dapat \line \up0 \expndtw-2\charscalex100 mendadak berubah menjadi
berisiko tinggi. Hal iIni disebabkan oleh operasi dan/atau \line \up0 \expndtw-
1\charscalex100 anestesi, perubahan mendadak kondisi pasien, serta
penyesuaian pengobatan. \line \up0 \expndtw0\charscalex102 Banyak pasien
memerlukan asesmen selama dirawat inap di rumah sakit. Rumah \line \up0 \expndtw-
3\charscalex100 sakit harus menetapkan kriteria untuk identifikasi pasien yang
dianggap berisiko tinggi \line \up0 \expndtw-4\charscalex100 jatuh. \par\pard\qj
\li1440\ri1234\sb300\sl-320\slmult0 \up0 \expndtw0\charscalex100 Contoh situasional
risiko adalah jika pasien yang datang ke unit rawat jalan dengan \up0
\expndtw0\charscalex103 ambulans dari fasilitas rawat inap lainnya untuk
pemeriksaan radiologi. Pasien ini \up0 \expndtw0\charscalex105 berisiko jatuh waktu
dipindah dari brankar ke meja periksa radiologi, atau waktu \up0 \expndtw-
3\charscalex100 berubah posisi sewaktu berada di meja sempit tempat periksa
radiologi. \par\pard\qj \li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1180\sb13\sl-313\slmult0 \up0 \expndtw0\charscalex104 Lokasi
spesifik dapat menyebabkan risiko jatuh bertambah karena layanan yang \up0
\expndtw-3\charscalex100 diberikan. Misalnya, terapi fisik (rawat jalan dan rawat
inap) memiliki banyak peralatan \up0 \expndtw0\charscalex100 spesifik digunakan
pasien yang dapat menambah risiko pasien jatuh seperti\ul0\nosupersub\cf8\f9\fs24
parallel \up0 \expndtw-3\charscalex100 bars\ul0\nosupersub\cf7\f8\fs24
,\ul0\nosupersub\cf8\f9\fs24 freestanding staircases\ul0\nosupersub\cf7\f8\fs24 ,
dan peralatan lain untuk latihan. \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1180\sb2\sl-320\slmult0 \up0 \expndtw0\charscalex100 Rumah
sakit melakukan evaluasi tentang pasien jatuh dan melakukan upaya \line
\up0 \expndtw0\charscalex100 mengurangi risiko pasien jatuh. Rumah sakit membuat
program untuk mengurangi \line \up0 \expndtw0\charscalex100 pasien jatuh yang
meliputi manajemen risiko dan asesmen ulang secara berkala di \line \up0 \expndtw-
3\charscalex100 populasi pasien dan atau lingkungan tempat pelayanan dan asuhan
itu diberikan. \par\pard\qj \li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1241\sb13\sl-313\slmult0 \up0 \expndtw0\charscalex103 Rumah
sakit harus bertanggung jawab untuk identifikasi lokasi (seperti unit terapi
\up0 \expndtw0\charscalex100 fisik), situasi (pasien datang dengan ambulans,
transfer pasien dari kursi roda atau \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf8\f9\fs24 cart\ul0\nosupersub\cf7\f8\fs24 ), tipe pasien, serta
gangguan fungsional pasien yang mungkin berisiko tinggi \up0 \expndtw-
3\charscalex100 untuk jatuh. \par\pard\qj \li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1239\sb15\sl-313\slmult0 \up0 \expndtw0\charscalex102 Rumah
sakit menjalankan program pengurangan risiko jatuh dengan menetapkan \line \up0
\expndtw0\charscalex102 kebijakan dan prosedur yang sesuai dengan lingkungan dan
fasilitas rumah sakit. \line \up0 \expndtw0\charscalex105 Program ini mencakup
monitoring terhadap kesengajaan dan atau ketidak-\line \up0
\expndtw0\charscalex101 kesengajaan dari kejadian jatuh. Misalnya, pembatasan
gerak \up0 \expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
restrain\ul0\nosupersub\cf7\f8\fs24 ) atau \par\pard\ql \li1440\sb38\sl-
276\slmult0
\up0 \expndtw-3\charscalex100 pembatasan\ul0\nosupersub\cf8\f9\fs24
intake\ul0\nosupersub\cf7\f8\fs24 cairan. \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb104\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 55
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg56}
{\bkmkend Pg56}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb132\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian SKP.6 \par\pard\qj \li1440\ri1248\sb0\sl-320\slmult0\tx1797 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mengatur
tentang mencegah pasien cedera karena jatuh. (lihat \line\tab \up0 \expndtw-
3\charscalex100 juga AP 1.2.1 EP 2). (R) \par\pard\ql \li1440\ri1241\sb0\sl-
320\slmult0\tx1797\tx1797 \up0 \expndtw-2\charscalex100 2. Rumah sakit
melaksanakan suatu proses asesmen terhadap semua pasien rawat \line\tab \up0
\expndtw0\charscalex103 inap dan rawat jalan dengan kondisi, diagnosis, dan lokasi
terindikasi berisiko \line \tab \up0 \expndtw-3\charscalex100 tinggi jatuh sesuai
dengan regulasi. (D,O,W) \par\pard\ql \li1440\ri1190\sb0\sl-
320\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex100 3. Rumah sakit melaksanakan
proses asesmen awal, asesmen lanjutan, asesmen \line\tab \up0 \expndtw-
4\charscalex100 ulang dari pasien pasien rawat inap yang berdasar atas catatan
teridentifikasi risiko \line \tab \up0 \expndtw-5\charscalex100 jatuh. (lihat juga
AP 2 EP 1). (D,O,W) \par\pard\qj \li1440\ri1248\sb0\sl-320\slmult0\tx1797 \up0
\expndtw-1\charscalex100 4. Langkah-langkah diadakan untuk mengurangi risiko jatuh
bagi pasien dari situasi \line\tab \up0 \expndtw-2\charscalex100 dan lokasi yang
menyebabkan pasien jatuh. (lihat juga AP 1.2.1 EP 3). (D,O,W) \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb224\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 56
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg57}
{\bkmkend Pg57}\par\pard\ql \li10334\sb0\sl-276\slmult0
\par\pard\ql\li10334\sb0\sl-276\slmult0 \par\pard\ql\li10334\sb0\sl-276\slmult0
\par\pard\ql\li10334\sb0\sl-276\slmult0 \par\pard\ql\li10334\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf17\f18\fs24 II \par\pard\qj
\li8980\ri1234\sb25\sl-300\slmult0\fi319 \up0 \expndtw-4\charscalex100 STANDAR
\line \up0 \expndtw-4\charscalex100 PELAYANAN \par\pard\ql \li8174\sb40\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 BERFOKUS PASIEN \par\pard\ql
\li5846\sb0\sl-276\slmult0 \par\pard\ql\li5846\sb0\sl-276\slmult0
\par\pard\ql\li5846\sb132\sl-276\slmult0 \up0 \expndtw-4\charscalex100 BAB 1
\par\pard\ql \li2812\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 AKSES KE
RUMAH SAKIT DAN KONTINUITAS PELAYANAN \par\pard\ql \li5867\sb4\sl-276\slmult0
\up0 \expndtw-4\charscalex100 (ARK) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb268\sl-276\slmult0 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf6\f7\fs24 GAMBARAN UMUM \par\pard\qj \li1440\sb0\sl-273\slmult0
\par\pard\qj\li1440\ri1248\sb14\sl-273\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf18\f19\fs24 Rumah sakit seyogianya mempertimbangkan bahwa
asuhan di rumah sakit \up0 \expndtw-1\charscalex100 merupakan bagian dari
suatu sistem pelayanan yang terintegrasi dengan para \up0
\expndtw0\charscalex103 profesional pemberi asuhan dan tingkat pelayanan yang akan
membangun suatu \up0 \expndtw-3\charscalex100 kontinuitas pelayanan.
\par\pard\qj \li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\ri1247\sb22\sl-
280\slmult0 \up0 \expndtw0\charscalex100 Maksud dan tujuan adalah menyelaraskan
kebutuhan asuhan pasien dengan \up0 \expndtw0\charscalex100 pelayanan yang
sudah tersedia di rumah sakit, mengoordinasikan pelayanan, \up0 \expndtw-
3\charscalex100 kemudian merencanakan pemulangan dan tindakan selanjutnya.
\par\pard\qj \li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\ri1242\sb1\sl-
280\slmult0 \up0 \expndtw0\charscalex106 Sebagai hasilnya adalah meningkatkan
mutu asuhan pasien dan efisiensi \up0 \expndtw-3\charscalex100 penggunaan
sumber daya yang tersedia di rumah sakit. \par\pard\ql \li1440\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Perlu informasi penting untuk membuat
keputusan yang benar tentang: \par\pard\ql \li1800\sb4\sl-276\slmult0 \up0
\expndtw-3\charscalex100 1. kebutuhan pasien yang dapat dilayani oleh rumah sakit;
\par\pard\ql \li1800\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. pemberian
pelayanan yang efisien kepada pasien; \par\pard\ql \li1800\sb24\sl-276\slmult0 \up0
\expndtw-3\charscalex100 3. rujukan ke pelayanan lain baik di dalam maupun keluar
rumah sakit; \par\pard\ql \li1800\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100
4. pemulangan pasien yang tepat dan aman ke rumah. \par\pard\qj \li1440\sb0\sl-
280\slmult0 \par\pard\qj\li1440\ri4481\sb261\sl-280\slmult0\tx1800 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 PROSES PENERIMAAN PASIEN KE RUMAH SAKIT
\line\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3880?\ul0\nosupersub\cf6\f7\fs24 SKRINING \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar
ARK.1 \par\pard\qj \li1440\ri1188\sb261\sl-280\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi tentang penerimaan
pasien dirawat inap atau \line \up0 \expndtw0\charscalex100 pemeriksaan pasien
dirawat jalan sesuai dengan kebutuhan pelayanan kesehatan \line \up0 \expndtw-
3\charscalex100 yang telah diidentifikasi sesuai dengan misi serta sumber daya
rumah sakit yang ada. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.1 \par\pard\qj
\li1440\ri1180\sb261\sl-280\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Menyesuaikan kebutuhan pasien dengan misi dan
sumber daya rumah sakit \up0 \expndtw0\charscalex100 bergantung pada informasi
yang didapat tentang kebutuhan pasien dan kondisinya \up0 \expndtw-5\charscalex100
lewat skrining pada kontak pertama. \par\pard\qj \li1440\ri1219\sb261\sl-
280\slmult0 \up0 \expndtw0\charscalex100 Skrining dilaksanakan melalui kriteria
triase, evaluasi visual atau pengamatan, atau \up0 \expndtw0\charscalex100 hasil
pemeriksaan fisis, psikologis, laboratorium klinis, atau diagnostik
imajing \up0 \expndtw-4\charscalex100 sebelumnya. \par\pard\ql \li10243\sb223\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 57
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg58}
{\bkmkend Pg58}\par\pard\qj \li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\sb0\sl-
280\slmult0 \par\pard\qj\li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\sb0\sl-
280\slmult0 \par\pard\qj\li1440\sb0\sl-280\slmult0
\par\pard\qj\li1440\ri1178\sb49\sl-280\slmult0 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Skrining dapat terjadi di tempat pasien, ambulans, atau
waktu pasien tiba di rumah sakit. \line \up0 \expndtw-4\charscalex100 Keputusan
untuk mengobati, mengirim, atau merujuk dibuat setelah ada evaluasi hasil \line
\up0 \expndtw-3\charscalex100 skrining. Bila rumah sakit mempunyai kemampuan
menyediakan pelayanan yang \line \up0 \expndtw0\charscalex100 dibutuhkan serta
konsisten dengan misi dan kemampuan pelayanannya maka \line \up0 \expndtw-
4\charscalex100 dipertimbangkan untuk menerima pasien rawat inap atau pasien rawat
jalan. \par\pard\qj \li1440\ri1177\sb264\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 Rumah sakit dapat menentukan tes atau bentuk penyaringan tertentu
untuk populasi \up0 \expndtw-3\charscalex100 pasien tertentu sebelum ditetapkan
pasien dapat dilayani. Misalnya, pasien diare aktif \up0 \expndtw-2\charscalex100
harus diperiksa\ul0\nosupersub\cf8\f9\fs24 Clostridium
difficile\ul0\nosupersub\cf7\f8\fs24 atau pasien tertentu
diperiksa\ul0\nosupersub\cf8\f9\fs24 Staphylococcus \up0 \expndtw-2\charscalex100
aureus\ul0\nosupersub\cf7\f8\fs24 yang resisten
terhadap\ul0\nosupersub\cf8\f9\fs24 methicillin.\ul0\nosupersub\cf7\f8\fs24 Tes
spesifik tertentu atau evaluasi tertentu \up0 \expndtw-3\charscalex100 dilakukan
jika rumah sakit mengharuskannya, sebelum diputuskan dapat dilayani \up0
\expndtw-4\charscalex100 dirawat inap atau terdaftar di unit rawat jalan. (lihat
juga AP 1) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb12\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.1 \par\pard\ql
\li1440\ri1245\sb261\sl-280\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi untuk proses skrining baik di dalam
maupun di luar rumah sakit \line\tab \up0 \expndtw0\charscalex102 termasuk
pemeriksaan penunjang yang diperlukan/ spesifik untuk menetapkan \line \tab \up0
\expndtw-3\charscalex100 apakah pasien diterima atau dirujuk. (R) \par\pard\ql
\li1440\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Ada pelaksanaan proses
skrining baik di dalam maupun di luar rumah sakit. (D,W) \par\pard\qj
\li1440\ri1251\sb0\sl-280\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Ada
proses pemeriksaan penunjang yang diperlukan/spesifik untuk menetapkan \line\tab
\up0 \expndtw-3\charscalex100 apakah pasien diterima atau dirujuk. (D,W)
\par\pard\qj \li1440\ri1251\sb0\sl-280\slmult0\tx1797 \up0 \expndtw-1\charscalex100
4. Berdasar atas hasil skrining ditentukan apakah kebutuhan pasien sesuai
dengan \line\tab \up0 \expndtw-3\charscalex100 kemampuan rumah sakit (lihat juga
TKRS 3.1 EP 1). (D,W) \par\pard\qj \li1440\ri1251\sb0\sl-260\slmult0\tx1797 \up0
\expndtw-1\charscalex100 5. Pasien diterima bila rumah sakit dapat memberi
pelayanan rawat jalan dan rawat \line\tab \up0 \expndtw-2\charscalex100 inap yang
dibutuhkan pasien. (D,O,W) \par\pard\qj \li1440\ri1248\sb3\sl-280\slmult0\tx1797
\up0 \expndtw-2\charscalex100 6. Pasien tidak dirawat, tidak dipindahkan, atau
tidak dirujuk sebelum diperoleh hasil \line\tab \up0 \expndtw-3\charscalex100 tes
yang dibutuhkan tersedia. (D,O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb268\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar ARK.1.1 \par\pard\qj \li1440\sb0\sl-280\slmult0
\par\pard\qj\li1440\ri1243\sb1\sl-280\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien dengan kebutuhan darurat, sangat mendesak,
atau yang membutuhkan \up0 \expndtw-2\charscalex100 pertolongan segera diberikan
prioritas untuk asesmen dan tindakan. \par\pard\ql \li1440\sb264\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK
1.1 \par\pard\qj \li1440\sb0\sl-275\slmult0 \par\pard\qj\li1440\ri1182\sb10\sl-
275\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien
darurat, sangat mendesak, atau pasien yang membutuhkan pertolongan \line
\up0 \expndtw0\charscalex107 segera diidentifikasi menggunakan proses
triase berbasis bukti untuk \line \up0 \expndtw-1\charscalex100
memprioritaskan kebutuhan pasien yang mendesak dengan mendahulukan dari
\line \up0 \expndtw0\charscalex100 pasien yang lain. Pada kondisi bencana
dapat menggunakan triase bencana. \line \up0 \expndtw-1\charscalex100 Sesudah
dinyatakan pasien darurat, mendesak, dan membutuhkan pertolongan \line
\up0 \expndtw-3\charscalex100 segera maka dilakukan asesmen dan menerima pelayanan
secepat-cepatnya. Kriteria \line \up0 \expndtw0\charscalex103 psikologis dibutuhkan
dalam proses triase. Pelatihan bagi staf diadakan agar staf \line \up0 \expndtw-
1\charscalex100 mampu memutuskan pasien yang membutuhkan pertolongan segera dan
pelayanan \line \up0 \expndtw-2\charscalex100 yang dibutuhkan. \par\pard\qj
\li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\ri1250\sb1\sl-280\slmult0 \up0
\expndtw-1\charscalex100 Jika rumah sakit tidak mampu memenuhi kebutuhan pasien
dengan kondisi darurat, \line \up0 \expndtw-1\charscalex100 pasien dirujuk ke rumah
sakit lain yang fasilitas pelayanannya dapat memenuhi \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb90\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 58
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg59}
{\bkmkend Pg59}\par\pard\qj \li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\sb0\sl-
260\slmult0 \par\pard\qj\li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\sb0\sl-
260\slmult0 \par\pard\qj\li1440\ri1184\sb166\sl-260\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 kebutuhan pasien. Sebelum ditransfer
atau dirujuk pasien harus dalam keadaan stabil \up0 \expndtw-4\charscalex100 dan
dilengkapi dengan dokumen pencatatan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb11\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen penilaian ARK 1.1 \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang proses triase berbasis bukti.
(R) \par\pard\qj \li1440\ri1241\sb0\sl-280\slmult0\tx1797 \up0
\expndtw0\charscalex102 2. Ada pelaksanaan penggunaan proses triase berbasis bukti
yang dipergunakan \line\tab \up0 \expndtw-3\charscalex100 untuk memprioritaskan
pasien yang sesuai dengan kegawatannya. (D,W) \par\pard\ql \li1440\sb1\sl-
257\slmult0 \up0 \expndtw-3\charscalex100 3. Staf sudah terlatih menggunakan
kriteria. (D,W,S) \par\pard\ql \li1440\sb8\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 4. Pasien dengan kebutuhan mendesak diberikan prioritas.
(D,W,S) \par\pard\qj \li1440\ri1196\sb18\sl-260\slmult0\tx1797 \up0 \expndtw-
3\charscalex100 5. Kondisi pasien distabilisasi sebelum ditransfer atau dirujuk
dan didokumentasikan. \line\tab \up0 \expndtw-4\charscalex100 (D,W,S)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb15\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar ARK.1.2 \par\pard\qj \li1440\ri1246\sb261\sl-
280\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Pada proses
admisi pasien rawat inap dilakukan skrining kebutuhan pasien untuk \up0 \expndtw-
1\charscalex100 menetapkan pelayanan preventif, paliatif, kuratif, dan
rehabilitatif yang diprioritaskan \up0 \expndtw-2\charscalex100 berdasar atas
kondisi pasien. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb8\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan ARK.1.2 \par\pard\qj \li1440\ri1181\sb264\sl-276\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pada waktu skrining dan
pasien diputuskan diterima untuk rawat inap, proses \line \up0
\expndtw0\charscalex102 asesmen membantu staf mengetahui prioritas kebutuhan pasien
untuk pelayanan \line \up0 \expndtw-1\charscalex100 preventif, kuratif,
rehabilitatif, paliatif, dan dapat menentukan pelayanan yang sesuai \line \up0
\expndtw-3\charscalex100 dengan prioritas kebutuhan pasien. Pelayanan preventif
(dalam proses admisi) adalah \line \up0 \expndtw-3\charscalex100 untuk mencegah
perburukan/ komplikasi, misalnya antara lain kasus luka tusuk dalam \line \up0
\expndtw-3\charscalex100 diberikan ATS dan kasus luka bakar derajat berat
dimasukkan ke unit luka bakar. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.1.2 \par\pard\qj
\li1440\ri1245\sb261\sl-280\slmult0\tx1797 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang skrining pasien masuk
rawat inap untuk menetapkan \line\tab \up0 \expndtw-2\charscalex100 kebutuhan
pelayanan preventif, paliatif, kuratif, dan rehabilitatif. (R) \par\pard\qj
\li1440\ri1236\sb1\sl-280\slmult0\tx1797 \up0 \expndtw-2\charscalex100 2. Ada
pelaksanaan skrining pasien masuk rawat inap untuk menetapkan kebutuhan
\line\tab \up0 \expndtw-3\charscalex100 pelayanan preventif, paliatif, kuratif, dan
rehabilitatif. (D,W) \par\pard\qj \li1440\ri1251\sb17\sl-260\slmult0\tx1797 \up0
\expndtw0\charscalex100 3. Temuan diproses skrining menentukan pelayanan atau
tindakan kepada pasien. \line\tab \up0 \expndtw-3\charscalex100 (D,O,W)
\par\pard\qj \li1440\ri1241\sb4\sl-280\slmult0\tx1797 \up0 \expndtw0\charscalex105
4. Prioritas diberikan pada pelayanan terkait preventif, paliatif, kuratif,
dan \line\tab \up0 \expndtw-3\charscalex100 rehabilitatif. (D) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.1.3 \par\pard\qj
\li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\ri1233\sb1\sl-280\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempertimbangkan
kebutuhan klinis pasien dan memberi tahu pasien \up0 \expndtw-3\charscalex100
jika \up0 \expndtw0\charscalex106 terjadi penundaan dan kelambatan dan
penundaan pelaksanaan \up0 \expndtw-3\charscalex100 tindakan/pengobatan dan atau
pemeriksaan penunjang diagnostik. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb28\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.1.3. \par\pard\qj
\li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\ri1243\sb38\sl-260\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien diberitahu jika ada
penundaan dan kelambatan pelayanan antara lain akibat \line \up0
\expndtw0\charscalex100 kondisi pasien atau jika pasien harus masuk dalam daftar
tunggu. Pasien diberi \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb53\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 59
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg60}{\bkmkend Pg60}\par\pard\qj \li1440\sb0\sl-273\slmult0
\par\pard\qj\li1440\sb0\sl-273\slmult0 \par\pard\qj\li1440\sb0\sl-273\slmult0
\par\pard\qj\li1440\sb0\sl-273\slmult0 \par\pard\qj\li1440\ri1180\sb103\sl-
273\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 informasi
alasan dan sebab mengapa terjadi penundaan/kelambatan atau harus \line
\up0 \expndtw-3\charscalex100 menunggu serta diberi tahu tentang alternatif yang
tersedia, ketentuan ini berlaku bagi \line \up0 \expndtw-1\charscalex100 pasien
rawat inap dan rawat jalan. Untuk beberapa pelayanan, seperti onkologi atau
\line \up0 \expndtw-3\charscalex100 transplan tidak berlaku ketentuan tentang
penundaan/kelambatan pelayanan atau tes. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb29\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.1.3. \par\pard\qj
\li1800\sb0\sl-280\slmult0 \par\pard\qj\li1800\ri1340\sb1\sl-280\slmult0\tx2160
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
penundaan dan kelambatan pelayanan di rawat jalan \line\tab \up0 \expndtw-
3\charscalex100 maupun rawat inap yang harus disampaikan kepada pasien. (R)
\par\pard\ql \li1800\ri1342\sb29\sl-270\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 2. Pasien diberi tahu alasan penundaan dan kelambatan
pelayanan dan diberi \line\tab \up0 \expndtw-1\charscalex100 informasi tentang
alternatif yang tersedia sesuai kebutuhan klinik pasien dan \line \tab \up0
\expndtw-2\charscalex100 dicatat di rekam medis. (D,W) \par\pard\ql \li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb18\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PENDAFTARAN \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb8\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar ARK.2 \par\pard\qj
\li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\ri1243\sb38\sl-260\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan
regulasi yang mengatur proses pasien masuk rumah sakit \up0 \expndtw-
3\charscalex100 untuk rawat inap dan proses pendaftaran rawat jalan.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb15\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.2 \par\pard\qj
\li1440\ri1246\sb261\sl-280\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Ditetapkan regulasi untuk proses penerimaan pasien
rawat inap dan pendaftaran \line \up0 \expndtw0\charscalex100 pasien rawat jalan.
Staf memahami dan mampu melaksanakan proses penerimaan \line \up0 \expndtw-
3\charscalex100 pasien. \par\pard\ql \li1440\sb4\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Proses tersebut meliputi \par\pard\ql \li1980\sb4\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 pendaftaran pasien rawat jalan dan rawat
inap; \par\pard\qj \li1980\ri3267\sb5\sl-300\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
penerimaan langsung dari unit darurat ke unit rawat inap; \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
menahan pasien untuk observasi. \par\pard\qj \li1440\ri1189\sb0\sl-280\slmult0 \up0
\expndtw-3\charscalex100 Dalam rangka keterbukaan kepada publik tersedia sistem
pendaftaran rawat inap dan \up0 \expndtw-4\charscalex100 rawat jalan secara
online \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb265\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian ARK.2 \par\pard\ql \li1440\ri1180\sb261\sl-
280\slmult0\tx1797\tx1797\tx1797 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang proses pendaftaran pasien
rawat jalan, pasien rawat inap, \line\tab \up0 \expndtw-3\charscalex100 pasien
gawat darurat, proses penerimaan pasien gawat darurat ke unit rawat inap, \line
\tab \up0 \expndtw-2\charscalex100 menahan pasien untuk observasi dan mengelola
pasien bila tidak tersedia tempat \line \tab \up0 \expndtw-5\charscalex100 tidur
pada unit yang dituju maupun di seluruh rumah sakit. (R) \par\pard\qj
\li1440\ri1243\sb0\sl-280\slmult0\tx1797 \up0 \expndtw-1\charscalex100 2. Ada
pelaksanaan proses penerimaan pasien rawat inap dan pendaftaran rawat \line\tab
\up0 \expndtw-5\charscalex100 jalan. (D,W) \par\pard\qj \li1440\ri1252\sb0\sl-
280\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Ada pelaksanaan proses
penerimaan pasien gawat darurat ke unit rawat inap. \line\tab \up0 \expndtw-
4\charscalex100 (D,W) \par\pard\ql \li1440\sb1\sl-258\slmult0 \up0 \expndtw-
5\charscalex100 4. Ada pelaksanaan proses menahan pasien untuk observasi. (D,W)
\par\pard\qj \li1440\ri1241\sb0\sl-280\slmult0\tx1797 \up0 \expndtw-1\charscalex100
5. Ada pelaksanaan proses mengelola pasien bila tidak tersedia tempat tidur
pada \line\tab \up0 \expndtw-5\charscalex100 unit yang dituju maupun di seluruh
rumah sakit. (D,W) \par\pard\ql \li1440\sb1\sl-260\slmult0 \up0 \expndtw-
4\charscalex100 6. Staf memahami dan melaksanakan semua proses sesuai dengan
regulasi. (D,W) \par\pard\ql \li10243\sb226\sl-253\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 60
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg61}
{\bkmkend Pg61}\par\pard\qj \li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\sb0\sl-
260\slmult0 \par\pard\qj\li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\sb0\sl-
260\slmult0 \par\pard\qj\li1440\ri1252\sb166\sl-260\slmult0\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 7. Ada pelaksanaan sistem
pendaftaran rawat jalan dan rawat inap secara online. \line\tab \up0 \expndtw-
3\charscalex100 (D,W) (lihat juga MIRM 1) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb11\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.2.1 \par\pard\qj
\li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\ri1234\sb38\sl-260\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Saat admisi, pasien dan
keluarga pasien dijelaskan tentang rencana asuhan, hasil \up0 \expndtw-
3\charscalex100 yang diharapkan dari asuhan, dan perkiraan biayanya.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb11\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
ARK.2.1 \par\pard\qj \li1440\sb0\sl-273\slmult0 \par\pard\qj\li1440\ri1237\sb14\sl-
273\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Saat
diputuskan rawat inap, dokter yang memutuskan rawat inap memberi informasi \up0
\expndtw0\charscalex102 tentang rencana asuhan yang diberikan, hasil asuhan yang
diharapkan, termasuk \up0 \expndtw-2\charscalex100 penjelasan oleh petugas
pendaftaran tentang perkiraan biaya yang harus dibayarkan \up0 \expndtw-
3\charscalex100 oleh pasien/keluarga. Pemberian informasi didokumentasikan.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb9\sl-276\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.2.1
\par\pard\ql \li1440\sb264\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Penjelasan termasuk rencana asuhan
didokumentasikan. (D,W) \par\pard\ql \li1440\sb4\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 2. Penjelasan termasuk hasil asuhan yang diharapkan dan
didokumentasikan. (D,W) \par\pard\qj \li1440\ri1249\sb1\sl-280\slmult0\tx1797
\up0 \expndtw-1\charscalex100 3. Penjelasan termasuk perkiraan biaya yang
ditanggung pasien atau keluarga. \line\tab \up0 \expndtw-2\charscalex100
(D,W) \par\pard\qj \li1440\ri1246\sb0\sl-280\slmult0\tx1797 \up0
\expndtw0\charscalex102 4. Penjelasan yang diberikan dipahami oleh pasien dan
keluarga untuk membuat \line\tab \up0 \expndtw-2\charscalex100 keputusan. (W)
\par\pard\ql \li1440\sb265\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar ARK.2.2 \par\pard\qj \li1440\ri1251\sb261\sl-
280\slmult0 \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan proses untuk mengelola alur pasien di seluruh bagian \up0 \expndtw-
3\charscalex100 rumah sakit. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.2.2 \par\pard\qj
\li1440\ri1195\sb264\sl-277\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Unit darurat yang penuh sesak dan tingkat hunian rumah
sakit yang tinggi dapat \line \up0 \expndtw-3\charscalex100 menyebabkan pasien
menumpuk di daerah unit darurat dan menciptakannya sebagai \line \up0
\expndtw0\charscalex103 tempat menunggu sementara pasien rawat inap. Mengelola alur
berbagai pasien \line \up0 \expndtw0\charscalex105 selama menjalani asuhannya
masing-masing menjadi sangat penting untuk \line \up0 \expndtw0\charscalex100
mencegah penumpukan yang selanjutnya mengganggu waktu pelayanan dan \line
\up0 \expndtw0\charscalex100 akhirnya juga berpengaruh terhadap keselamatan pasien.
Pengelolaan yang efektif \line \up0 \expndtw0\charscalex100 terhadap alur pasien
(seperti penerimaan, asesmen dan tindakan, transfer pasien, \line \up0 \expndtw-
3\charscalex100 serta pemulangan) dapat mengurangi penundaan asuhan kepada
pasien. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb8\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Komponen dari pengelolaan alur pasien
termasuk \par\pard\ql \li1800\sb1\sl-256\slmult0 \up0 \expndtw-3\charscalex100 a)
ketersediaan tempat tidur rawat inap; \par\pard\qj \li1800\ri1247\sb5\sl-
280\slmult0\tx2160 \up0 \expndtw0\charscalex100 b) perencanaan fasilitas alokasi
tempat, peralatan, utilitas,
teknologi medis, dan \line\tab \up0 \expndtw-3\charscalex100 kebutuhan lain untuk
mendukung penempatan sementara pasien; \par\pard\qj \li1800\ri1244\sb1\sl-
280\slmult0\tx2160 \up0 \expndtw-1\charscalex100 c) perencanaan tenaga untuk
menghadapi penumpukan pasien di beberapa \line\tab \up0 \expndtw-
2\charscalex100 lokasi sementara dan atau pasien yang tertahan di unit darurat;
\par\pard\ql \li1800\ri1184\sb0\sl-280\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex104 d) alur pasien di daerah pasien menerima asuhan,
tindakan, dan pelayanan \line\tab \up0 \expndtw-3\charscalex100 (seperti unit rawat
inap, laboratorium, kamar operasi, radiologi, dan unit pasca-\line \tab \up0
\expndtw-4\charscalex100 anestesi); \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb98\sl-253\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 61
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg62}
{\bkmkend Pg62}\par\pard\qj \li1800\sb0\sl-260\slmult0 \par\pard\qj\li1800\sb0\sl-
260\slmult0 \par\pard\qj\li1800\sb0\sl-260\slmult0 \par\pard\qj\li1800\sb0\sl-
260\slmult0 \par\pard\qj\li1800\ri1249\sb166\sl-260\slmult0\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 e) efisiensi pelayanan
nonklinis penunjang asuhan dan tindakan kepada pasien \line\tab \up0 \expndtw-
3\charscalex100 (seperti kerumahtanggaan dan transportasi); \par\pard\ql
\li1800\sb7\sl-276\slmult0 \up0 \expndtw-2\charscalex100 f) pemberian pelayanan ke
rawat inap sesuai dengan kebutuhan pasien; \par\pard\qj \li1800\ri1210\sb1\sl-
280\slmult0\tx2160 \up0 \expndtw-2\charscalex100 g) akses pelayanan yang bersifat
mendukung (seperti pekerja sosial, keagamaan \line\tab \up0 \expndtw-
3\charscalex100 atau bantuan spiritual, dan sebagainya). \par\pard\qj
\li1440\ri1182\sb265\sl-275\slmult0 \up0 \expndtw0\charscalex100 Monitoring dan
perbaikan proses ini merupakan strategi yang tepat dan bermanfaat \line \up0
\expndtw0\charscalex100 untuk mengatasi masalah. Semua staf rumah sakit, mulai dari
unit rawat inap, unit \line \up0 \expndtw0\charscalex102 darurat, staf medis,
keperawatan, administrasi, lingkungan, dan manajemen risiko \line \up0 \expndtw-
4\charscalex100 dapat ikut berperan serta menyelesaikan masalah arus pasien ini.
Koordinasi ini dapat \line \up0 \expndtw-5\charscalex100 dilakukan oleh seorang
Manajer Pelayanan Pasien (MPP)/\ul0\nosupersub\cf8\f9\fs24 Case
Manager\ul0\nosupersub\cf7\f8\fs24 . \par\pard\qj \li1440\sb0\sl-276\slmult0
\par\pard\qj\li1440\ri1228\sb9\sl-276\slmult0 \up0 \expndtw0\charscalex100 Alur
pasien menuju dan penempatannya di unit gawat darurat berpotensi membuat \line \up0
\expndtw0\charscalex100 pasien bertumpuk. Ada penempatan pasien di unit gawat
darurat yang merupakan \line \up0 \expndtw-2\charscalex100 jalan keluar sementara
mengatasi penumpukan pasien rawat inap rumah sakit. \line \up0 \expndtw-
2\charscalex100 Dengan demikian, rumah sakit harus menetapkan standar waktu berapa
lama pasien \line \up0 \expndtw0\charscalex100 di unit daruratdan di
unit\ul0\nosupersub\cf8\f9\fs24 intermediate\ul0\nosupersub\cf7\f8\fs24 , kemudian
harus ditransfer ke unit rawat inap \line \up0 \expndtw-2\charscalex100 rumah
sakit. Diharapkan rumah sakit dapat mengatur dan menyediakan tempat yang \line \up0
\expndtw-3\charscalex100 aman bagi pasien. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.2.2 \par\pard\qj
\li1440\ri1250\sb261\sl-280\slmult0\tx1797 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mengatur tentang proses untuk
mengatur alur pasien di rumah \line\tab \up0 \expndtw-2\charscalex100 sakit
termasuk elemen a) sampai dengan g) di Maksud dan Tujuan. (R) \par\pard\ql
\li1440\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Ada pelaksanaan
pengaturan alur pasien untuk menghindari penumpukan. (D,W) \par\pard\qj
\li1440\ri1250\sb18\sl-260\slmult0\tx1797 \up0 \expndtw0\charscalex104 3.
Dilakukan evaluasi terhadap pengaturan alur pasien secara berkala dan
\line\tab \up0 \expndtw-3\charscalex100 melaksanakan upaya perbaikannya. (D,O,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb11\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.2.3
\par\pard\qj \li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\ri1188\sb38\sl-
260\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi tentang kriteria yang ditetapkan untuk masuk rawat \up0
\expndtw-5\charscalex100 di pelayanan spesialistik atau pelayanan intensif.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb11\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.2.3
\par\pard\qj \li1440\sb0\sl-275\slmult0 \par\pard\qj\li1440\ri1182\sb10\sl-
275\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Unit yang
memberikan layanan intensif (misalnya ICU, ICCU, pascaoperasi) atau unit \up0
\expndtw0\charscalex100 layanan spesialistik (misalnya unit luka bakar atau
transplantasi organ) merupakan \up0 \expndtw-3\charscalex100 unit yang mahal dan
biasanya menempati ruangan dengan staf yang terbatas. Setiap \up0 \expndtw-
3\charscalex100 rumah sakit harus menetapkan kriteria untuk menentukan pasien yang
membutuhkan \up0 \expndtw-4\charscalex100 tingkat pelayanan yang tersedia di unit-
unit tersebut. \par\pard\qj \li1440\ri1179\sb265\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 Dengan mempertimbangkan bahwa pelayanan di unit spesialistik
menghabiskan \line \up0 \expndtw-2\charscalex100 banyak sumber daya, rumah sakit
mungkin membatasi hanya pasien dengan kondisi \line \up0 \expndtw0\charscalex100
medis yang reversibel yang dapat diterima masuk dan pasien kondisi khusus
\line \up0 \expndtw0\charscalex102 termasuk menjelang akhir kehidupan yang sesuai
dengan peraturan perundang-\line \up0 \expndtw-3\charscalex100 undangan. Agar
dapat konsisten maka kriteria menggunakan prioritas atau parameter \line \up0
\expndtw-3\charscalex100 diagnostik dan atau parameter objektif termasuk kriteria
berbasis fisiologis. \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb171\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 62
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg63}
{\bkmkend Pg63}\par\pard\qj \li1440\sb0\sl-270\slmult0 \par\pard\qj\li1440\sb0\sl-
270\slmult0 \par\pard\qj\li1440\sb0\sl-270\slmult0 \par\pard\qj\li1440\sb0\sl-
270\slmult0 \par\pard\qj\li1440\ri1242\sb117\sl-270\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Mereka yang berasal dari unit-
unit gawat darurat, intensif, atau layanan spesialistik \up0
\expndtw0\charscalex100 berpartisipasi menentukan kriteria. Kriteria
dipergunakan untuk menentukan \up0 \expndtw-3\charscalex100 penerimaan langsung
di unit, misalnya masuk dari unit darurat. \par\pard\qj \li1440\sb0\sl-
275\slmult0 \par\pard\qj\li1440\ri1180\sb11\sl-275\slmult0 \up0 \expndtw-
3\charscalex100 Kriteria juga digunakan untuk masuk dari unit-unit di dalam atau
dari luar rumah sakit, \up0 \expndtw0\charscalex100 seperti halnya pasien dipindah
dari rumah sakit lain. Pasien yang diterima masuk di \up0 \expndtw0\charscalex100
unit khusus memerlukan asesmen dan evaluasi ulang untuk menentukan apakah \up0
\expndtw-1\charscalex100 kondisi pasien berubah sehingga tidak memerlukan
lagi pelayanan spesialistik. \up0 \expndtw-1\charscalex100 Misalnya, jika status
fisiologis sudah stabil dan monitoring intensif baik, tindakan lain \up0
\expndtw0\charscalex103 tidak diperlukan lagi. Ataupun jika kondisi pasien menjadi
buruk sampai pada titik \up0 \expndtw-3\charscalex100 pelayanan intensif atau
tindakan khusus tidak diperlukan lagi, pasien kemudian dapat \up0 \expndtw-
3\charscalex100 dipindah ke unit layanan yang lebih rendah (seperti unit pelayanan
medis atau bedah, \up0 \expndtw-4\charscalex100 rumah penampungan, atau unit
pelayanan paliatif). \par\pard\qj \li1440\sb0\sl-275\slmult0
\par\pard\qj\li1440\ri1204\sb11\sl-275\slmult0 \up0 \expndtw0\charscalex100
Kriteria untuk memindahkan pasien dari unit khusus ke unit pelayanan lebih
rendah \line \up0 \expndtw0\charscalex100 harus sama dengan kriteria yang
dipakai untuk memindahkan pasien ke unit \line \up0 \expndtw0\charscalex100
pelayanan berikutnya. Misalnya, jika keadaan pasien menjadi buruk
sehingga \line \up0 \expndtw-2\charscalex100 pelayanan intensif dianggap tidak
dapat menolong lagi maka pasien masuk ke rumah \line \up0 \expndtw-3\charscalex100
penampungan \up0 \expndtw-3\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
hospices\ul0\nosupersub\cf7\f8\fs24 ) atau ke masuk ke unit pelayanan
paliatif dengan \par\pard\ql \li1440\sb5\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 menggunakan kriteria. \par\pard\qj \li1440\ri1187\sb264\sl-
276\slmult0 \up0 \expndtw0\charscalex100 Apabila rumah sakit melakukan riset atau
menyediakan pelayanan spesialistik atau \up0 \expndtw-3\charscalex100 melaksanakan
program, penerimaan pasien di program tersebut harus melalui kriteria \up0
\expndtw0\charscalex100 tertentu atau ketentuan protokol. Mereka yang terlibat
dalam riset atau program lain \up0 \expndtw-4\charscalex100 harus terlibat dalam
menentukan kriteria atau protokol. Penerimaan ke dalam program \up0
\expndtw0\charscalex103 tercatat di rekam medis pasien termasuk kriteria atau
protokol yang diberlakukan \up0 \expndtw-3\charscalex100 terhadap pasien yang
diterima masuk. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.2.3 \par\pard\ql
\li1440\ri1179\sb261\sl-280\slmult0\tx1797\tx1797\tx1797 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
kriteria masuk dan keluar ICU, unit spesialistik lain, ruang \line\tab \up0
\expndtw-2\charscalex100 perawatan paliatif termasuk bila digunakan untuk riset
atau program-program lain \line \tab \up0 \expndtw0\charscalex103 untuk memenuhi
kebutuhan pasien berdasar atas kriteria prioritas, diagnostik, \line \tab \up0
\expndtw-4\charscalex100 parameter objektif, serta kriteria berbasis fisiologi dan
kualitas hidup (\ul0\nosupersub\cf8\f9\fs24 quality of life). \par\pard\ql
\li1797\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 (R) \par\pard\qj \li1440\ri1244\sb0\sl-
280\slmult0\tx1797 \up0 \expndtw-1\charscalex100 2. Staf yang kompeten dan
berwenang dari unit intensif atau unit spesialistik terlibat \line\tab \up0
\expndtw-2\charscalex100 dalam menentukan kriteria. (D,W) \par\pard\ql
\li1440\sb1\sl-257\slmult0 \up0 \expndtw-2\charscalex100 3. Staf terlatih untuk
melaksanakan kriteria. (D,W) \par\pard\ql \li1440\ri1182\sb13\sl-
270\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex100 4. Catatan medis pasien
yang diterima masuk di atau keluar dari unit intensif atau \line\tab \up0 \expndtw-
3\charscalex100 unit spesialistik memuat bukti bahwa pasien memenuhi kriteria masuk
atau keluar. \line \tab \up0 \expndtw-4\charscalex100 (D,W) \par\pard\ql
\li1440\sb6\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5. \par\pard\ql
\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb8\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
KESINAMBUNGAN PELAYANAN \par\pard\ql \li1440\sb264\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Standar ARK.3 \par\pard\ql \li1440\sb4\sl-276\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Asesmen awal termasuk
menetapkan kebutuhan perencanaan pemulangan pasien. \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb144\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 63
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg64}
{\bkmkend Pg64}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan APK.3 \par\pard\qj
\li1440\ri1222\sb0\sl-300\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Kesinambungan asuhan pasien setelah dirawat inap
memerlukan persiapan dan \line \up0 \expndtw-2\charscalex100 pertimbangan khusus
bagi sebagian pasien seperti perencanaan pemulangan pasien \par\pard\qj
\li1440\ri1180\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
(P3)/\ul0\nosupersub\cf8\f9\fs24 discharge planning.\ul0\nosupersub\cf7\f8\fs24
Penyusunan P3 diawali saat proses asesmen awal rawat \line \up0 \expndtw-
3\charscalex100 inap dan membutuhkan waktu agak panjang, termasuk
pemutakhiran/\ul0\nosupersub\cf8\f9\fs24 updating\ul0\nosupersub\cf7\f8\fs24 .
Untuk \line \up0 \expndtw-3\charscalex100 identifikasi pasien yang membutuhkan P3
maka rumah sakit menetapkan mekanisme \line \up0 \expndtw0\charscalex100 dan
kriteria, misalnya antara lain usia, tidak ada mobilitas, perlu bantuan medis
dan \line \up0 \expndtw-2\charscalex100 keperawatan terus menerus, serta bantuan
melakukan kegiatan sehari hari. \par\pard\qj \li1440\ri1242\sb289\sl-320\slmult0
\up0 \expndtw0\charscalex102 Rencana pulang termasuk pendidikan/pelatihan khusus
yang mungkin dibutuhkan \line \up0 \expndtw-1\charscalex100 pasien dan keluarga
untuk kontinuitas (kesinambungan) asuhan di luar rumah sakit. \line \up0
\expndtw0\charscalex100 Sebagai contoh, adalah pasien yang baru didiagnosis tipe 1
diabetes melitus akan \line \up0 \expndtw0\charscalex100 membutuhkan pendidikan
yang terkait diet dan nutrisi, termasuk cara memberikan \line \up0
\expndtw0\charscalex100 suntikan insulin. Pasien yang dirawat inap karena infark
miokardium membutuhkan \line \up0 \expndtw-2\charscalex100 rehabilitasi sesudah
keluar rumah sakit pulang, termasuk mengatur makanan. \par\pard\qj \li1440\sb0\sl-
300\slmult0 \par\pard\qj\li1440\ri1181\sb37\sl-300\slmult0 \up0 \expndtw-
3\charscalex100 Kesinambungan asuhan pascarawat inap akan berhasil bila penyusunan
P3 dilakukan \line \up0 \expndtw-4\charscalex100 secara terintegrasi
antarprofesional pemberi asuhan \up0 \expndtw-4\charscalex100 (PPA)
terkait/relevan dan \par\pard\qj \li1440\ri1241\sb4\sl-320\slmult0 \up0
\expndtw0\charscalex100 difasilitasi manajer pelayanan pasien (MPP) (manajer
pelayanan pasien) (lihat juga \up0 \expndtw-3\charscalex100 ARK 4). \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb41\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.3
\par\pard\ql \li1440\sb4\sl-276\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan proses penyusunan
perencanaan pemulangan pasien \par\pard\ql \li1797\sb1\sl-256\slmult0 \up0
\expndtw-3\charscalex100 (P3), dimulai pada asesmen awal rawat inap. (R)
\par\pard\ql \li1440\sb8\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Rumah
sakit menetapkan kriteria pasien yang membutuhkan P3 (R,D,O W) \par\pard\qj
\li1440\ri1249\sb1\sl-280\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Proses P3
dan pelaksanaannya dicatat di rekam medis sesuai dengan regulasi \line\tab \up0
\expndtw-3\charscalex100 rumah sakit (lihat AP 1,7; ARK 4). (D) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb268\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.3.1 \par\pard\qj
\li1440\ri1189\sb9\sl-270\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk melaksanakan
proses kesinambungan \up0 \expndtw-3\charscalex100 pelayanan di rumah sakit dan
koordinasi diantara profesional pemberi asuhan (PPA) \up0 \expndtw-4\charscalex100
dibantu oleh manajer pelayanan pasien (MPP)/\ul0\nosupersub\cf8\f9\fs24 Case
Manager. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb14\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.3.1
\par\pard\qj \li1440\ri1196\sb7\sl-273\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Perjalanan pasien di rumah sakit mulai dari
admisi, keluar pulang, atau pindah \up0 \expndtw-2\charscalex100 melibatkan
berbagai profesional pemberi asuhan (PPA), unit kerja, dan MPP. Selama \up0
\expndtw-2\charscalex100 dalam berbagai tahap pelayanan, kebutuhan pasien dipenuhi
dari sumber daya yang \up0 \expndtw0\charscalex106 tersedia di rumah sakit dan
kalau perlu sumber daya dari luar. Kesinambungan \up0 \expndtw0\charscalex100
pelayanan berjalan baik jika semua pemberi pelayanan mempunyai informasi yang
\up0 \expndtw0\charscalex104 dibutuhkan tentang kondisi kesehatan pasien terkini
dan sebelumnya agar dapat \up0 \expndtw-3\charscalex100 dibuat keputusan yang
tepat. \par\pard\qj \li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\ri1240\sb2\sl-
280\slmult0 \up0 \expndtw0\charscalex102 Asuhan pasien di rumah sakit diberikan dan
dilaksanakan dengan pola pelayanan \line \up0 \expndtw0\charscalex100 berfokus pada
pasien (\ul0\nosupersub\cf8\f9\fs24 Patient/Person Centered
Care-\ul0\nosupersub\cf7\f8\fs24 PCC). Pola ini dipayungi oleh \line \up0 \expndtw-
1\charscalex100 konsep WHO:\ul0\nosupersub\cf8\f9\fs24 Conceptual framework
integrated people-centred health services\ul0\nosupersub\cf7\f8\fs24 .
\par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb130\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 64
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg65}
{\bkmkend Pg65}\par\pard\qj \li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\sb0\sl-
280\slmult0 \par\pard\qj\li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\sb0\sl-
280\slmult0 \par\pard\qj\li1440\ri1241\sb49\sl-280\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (\ul0\nosupersub\cf8\f9\fs24
WHO global strategy on integrated people-centred health services 2016-2026, July
\up0 \expndtw-3\charscalex100
2015\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 . \par\pard\qj
\li1440\sb0\sl-276\slmult0 \par\pard\qj\li1440\ri1180\sb8\sl-276\slmult0 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 Pelayanan berfokus pada
pasien diterapkan dalam bentuk Asuhan Pasien \up0 \expndtw0\charscalex100
Terintegrasi yang bersifat integrasi horizontal dan vertikal. Pada integrasi
horizontal \up0 \expndtw-3\charscalex100 kontribusi profesi tiap-tiap profesional
pemberi asuhan (PPA) adalah sama pentingnya \up0 \expndtw0\charscalex100 atau
sederajat. Pada integrasi vertikal pelayanan berjenjang oleh/melalui berbagai
\up0 \expndtw-3\charscalex100 unit pelayanan ke tingkat pelayanan yang berbeda maka
peranan manajer pelayanan \up0 \expndtw0\charscalex102 pasien (MPP) penting untuk
integrasi tersebut dengan komunikasi yang memadai \up0 \expndtw-3\charscalex100
terhadap profesional pemberi asuhan (PPA). \par\pard\qj \li1440\ri1190\sb261\sl-
280\slmult0 \up0 \expndtw-3\charscalex100 Pelaksanaan asuhan pasien terintegrasi
berpusat pada pasien dan mencakup elemen \up0 \expndtw-4\charscalex100 sebagai
berikut: \par\pard\qj \li1800\ri1245\sb21\sl-280\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
keterlibatan dan pemberdayaan pasien dan keluarga. (lihat AP 4, PAP 2, dan
\line\tab \up0 \expndtw-4\charscalex100 PAP 5); \par\pard\ql
\li1800\ri1183\sb1\sl-280\slmult0\tx2160\tx2160 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 dokter
penanggung jawab pelayanan (DPJP) sebagai Ketua tim asuhan pasien \line\tab \up0
\expndtw-3\charscalex100 oleh profesional pemberi asuhan (PPA)
(\ul0\nosupersub\cf8\f9\fs24 Clinical
Leader\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
.\ul0\nosupersub\cf7\f8\fs24 (lihat juga PAP 2.1, \line \tab \up0 \expndtw-
5\charscalex100 EP 4); \par\pard\ql \li1800\ri1212\sb0\sl-
283\slmult0\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 profesional
pemberi asuhan (PPA) bekerja sebagai tim interdisiplin dengan \line\tab \up0
\expndtw0\charscalex102 kolaborasi interprofesional dibantu antara lain oleh
Panduan Praktik Klinis \line \tab \up0 \expndtw0\charscalex100 (PPK), Panduan
Asuhan Profesional Pemberi Asuhan (PPA) lainnya, Alur \line \tab \up0
\expndtw0\charscalex100 Klinis/\ul0\nosupersub\cf8\f9\fs24 Clinical
Pathway\ul0\nosupersub\cf7\f8\fs24 terintegrasi, Algoritme, Protokol,
Prosedur,\ul0\nosupersub\cf8\f9\fs24 Standing \line \tab \up0 \expndtw-
3\charscalex100 Order\ul0\nosupersub\cf7\f8\fs24 dan CPPT (Catatan Perkembangan
Pasien Terintegrasi); \line \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 perencanaan
pemulangan pasien (P3)/\ul0\nosupersub\cf8\f9\fs24 Discharge
Planning\ul0\nosupersub\cf7\f8\fs24 terintegrasi; \line \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
asuhan gizi terintegrasi (lihat PAP 5); \par\pard\ql \li1800\sb1\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 manajer pelayanan
pasien/c\ul0\nosupersub\cf8\f9\fs24 ase manager. \par\pard\qj \li1440\sb0\sl-
280\slmult0 \par\pard\qj\li1440\ri1241\sb1\sl-280\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Manajer Pelayanan Pasien (MPP)
bukan merupakan profesional pemberi asuhan \up0 \expndtw-4\charscalex100 (PPA)
aktif dan dalam menjalankan manajemen pelayanan pasien mempunyai peran \up0
\expndtw-5\charscalex100 minimal adalah sebagai berikut: \par\pard\ql
\li1800\sb1\sl-255\slmult0 \up0 \expndtw-5\charscalex100 a) memfasilitasi
pemenuhan kebutuhan asuhan pasien; \par\pard\ql \li1800\sb8\sl-276\slmult0 \up0
\expndtw-5\charscalex100 b) mengoptimalkan terlaksananya pelayanan berfokus pada
pasien; \par\pard\ql \li1800\sb4\sl-276\slmult0 \up0 \expndtw-4\charscalex100 c)
mengoptimalkan proses reimbursemen; \par\pard\ql \li1440\sb4\sl-276\slmult0 \up0
\expndtw-5\charscalex100 dan dengan fungsi sebagai berikut: \par\pard\ql
\li1800\sb4\sl-276\slmult0 \up0 \expndtw-5\charscalex100 d) asesmen untuk
manajemen pelayanan pasien; \par\pard\ql \li1800\sb1\sl-256\slmult0 \up0 \expndtw-
5\charscalex100 e) perencanaan untuk manajemen pelayanan pasien; \par\pard\ql
\li1800\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100 f) komunikasi dan
koordinasi; \par\pard\ql \li1800\sb4\sl-276\slmult0 \up0 \expndtw-5\charscalex100
g) edukasi dan advokasi; \par\pard\ql \li1800\sb4\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 h) kendali mutu dan biaya pelayanan pasien; \par\pard\qj
\li1440\ri1248\sb261\sl-280\slmult0 \up0 \expndtw0\charscalex100 Keluaran yang
diharapkan dari kegiatan manajemen pelayanan pasien antara lain \up0 \expndtw-
5\charscalex100 adalah: \par\pard\qj \li1800\ri3557\sb21\sl-280\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 pasien mendapat asuhan sesuai dengan
kebutuhannya; \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 terpelihara kesinambungan pelayanan;
\par\pard\qj \li1800\ri1530\sb4\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pasien
memahami/mematuhi asuhan dan peningkatan kemandirian pasien; \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
kemampuan pasien mengambil keputusan; \par\pard\qj \li1800\ri3718\sb0\sl-
300\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 keterlibatan serta pemberdayaan pasien dan
keluarga; \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 optimalisasi sistem pendukung pasien;
\par\pard\ql \li1800\sb1\sl-252\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pemulangan yang
aman; \par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb175\sl-
253\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 65
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg66}
{\bkmkend Pg66}\par\pard\ql \li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
kualitas hidup dan kepuasan pasien. \par\pard\qj \li1440\sb0\sl-276\slmult0
\par\pard\qj\li1440\ri1238\sb8\sl-276\slmult0 \up0 \expndtw-4\charscalex100 Rekam
medis pasien merupakan sumber informasi utama tentang proses pelayanan \up0
\expndtw-3\charscalex100 dan kemajuannya sehingga merupakan alat komunikasi
penting. Rekam medis \up0 \expndtw-3\charscalex100 selama rawat inap dan
rawat jalan dengan catatan terkini tersedia agar dapat \up0 \expndtw-
2\charscalex100 mendukung serta bermanfaat untuk kesinambungan pelayanan pasien.
Profesional \up0 \expndtw-4\charscalex100 pemberi asuhan (PPA) melakukan asesmen
pasien berbasis IAR sehingga informasi \up0 \expndtw-5\charscalex100 MPP juga
dibutuhkan. \par\pard\qj \li1440\sb0\sl-273\slmult0
\par\pard\qj\li1440\ri1179\sb14\sl-273\slmult0 \up0 \expndtw0\charscalex100 Oleh
karenanya, dalam pelaksanaan manajemen pelayanan pasien, manajer \line
\up0 \expndtw0\charscalex100 pelayanan pasien (MPP) mencatat pada lembar form A
yang merupakan evaluasi \line \up0 \expndtw-4\charscalex100 awal manajemen
pelayanan pasien dan form B yang merupakan catatan implementasi \line \up0
\expndtw-4\charscalex100 manajemen pelayanan pasien. Kedua form tersebut merupakan
bagian rekam medis. \par\pard\qj \li1440\sb0\sl-275\slmult0
\par\pard\qj\li1440\ri1242\sb11\sl-275\slmult0 \up0 \expndtw0\charscalex100 Pada
form A dicatat antara lain identifikasi/skrining pasien untuk kebutuhan
\up0 \expndtw-3\charscalex100 pengelolaan manajer pelayanan pasien (MPP) dan
asesmen untuk manajemen \up0 \expndtw-2\charscalex100 pelayanan pasien termasuk
rencana, identifikasi masalah-risiko -kesempatan, serta \up0 \expndtw-
1\charscalex100 perencanaan manajemen pelayanan pasien, termasuk
memfasiltasi proses \up0 \expndtw-5\charscalex100 perencanaan pemulangan pasien
(\ul0\nosupersub\cf8\f9\fs24 discharge planning\ul0\nosupersub\cf7\f8\fs24 ).
\par\pard\qj \li1440\ri1242\sb261\sl-280\slmult0 \up0 \expndtw-4\charscalex100 Pada
form B dicatat antara lain pelaksanaan rencana manajemen pelayanan pasien, \up0
\expndtw0\charscalex102 monitoring, fasilitasi, koordinasi, komunikasi dan
kolaborasi, advokasi, hasil \up0 \expndtw-3\charscalex100 pelayanan, serta
terminasi manajemen pelayanan pasien. \par\pard\qj \li1440\sb0\sl-273\slmult0
\par\pard\qj\li1440\ri1236\sb13\sl-273\slmult0 \up0 \expndtw-2\charscalex100 Agar
kesinambungan asuhan pasien tidak terputus, rumah sakit harus menciptakan \up0
\expndtw0\charscalex100 proses untuk melaksanakan kesinambungan dan koordinasi
pelayanan di antara \up0 \expndtw-4\charscalex100 profesional pemberi asuhan (PPA),
manajer pelayanan pasien (MPP), pimpinan unit, \up0 \expndtw-5\charscalex100 dan
staf lain sesuai dengan regulasi rumah sakit di beberapa tempat. \par\pard\ql
\li1800\sb5\sl-276\slmult0 \up0 \expndtw-5\charscalex100 i) Pelayanan darurat dan
penerimaan rawat inap; \par\pard\ql \li1800\sb4\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 j) Pelayanan diagnostik dan tindakan; \par\pard\ql
\li1800\sb1\sl-256\slmult0 \up0 \expndtw-4\charscalex100 k) Pelayanan bedah dan
nonbedah; \par\pard\ql \li1800\sb8\sl-276\slmult0 \up0 \expndtw-4\charscalex100 l)
Pelayanan rawat jalan; \par\pard\ql \li1800\sb4\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 m) Organisasi lain atau bentuk pelayanan lainnya. \par\pard\qj
\li1440\sb0\sl-270\slmult0 \par\pard\qj\li1440\ri1185\sb19\sl-270\slmult0 \up0
\expndtw-3\charscalex100 Proses koordinasi dan kesinambungan pelayanan dibantu oleh
penunjang lain seperti \up0 \expndtw-3\charscalex100 panduan praktik klinis, alur
klinis/\ul0\nosupersub\cf8\f9\fs24 clinical pathways\ul0\nosupersub\cf7\f8\fs24 ,
rencana asuhan, format rujukan, \up0 \expndtw-4\charscalex100 daftar
tilik/\ul0\nosupersub\cf8\f9\fs24 check list\ul0\nosupersub\cf7\f8\fs24 lain, dan
sebagainya. \par\pard\qj \li1440\ri1237\sb2\sl-280\slmult0 \up0 \expndtw-
2\charscalex100 Diperlukan regulasi untuk proses koordinasi tersebut. (lihat
juga,\ul0\nosupersub\cf15\f16\fs24 SKP 2.2\ul0\nosupersub\cf7\f8\fs24 ; ARK
2.3; \up0 \expndtw-3\charscalex100 ARK 2.3.1; AP 4.1; AP 4.4; PAB 7.2) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb268\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.3.1 \par\pard\ql
\li1800\ri1213\sb1\sl-280\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang proses dan
pelaksanaan untuk mendukung \line\tab \up0 \expndtw-2\charscalex100
kesinambungan dan koordinasi asuhan, termasuk paling sedikit h. s/d l. yang
\line \tab \up0 \expndtw-3\charscalex100 dimuat di Maksud dan Tujuan ARK.3, sesuai
regulasi rumah
sakit \up0 \expndtw-7\charscalex100 (lihat juga \par\pard\ql \li2160\sb1\sl-
255\slmult0 \up0 \expndtw-5\charscalex100 TKP.10) (R) \par\pard\ql
\li1800\ri1181\sb5\sl-280\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw-
1\charscalex100 2. Ada penunjukkan MPP dengan uraian tugas antara lain
dalam konteks \line\tab \up0 \expndtw-2\charscalex100 menjaga kesinambungan dan
koordinasi pelayanan bagi individu pasien \line \tab \up0 \expndtw-
3\charscalex100 melalui komunikasi dan kerjasama dengan PPA dan pimpinan
unit serta \line \tab \up0 \expndtw-4\charscalex100 mencakup butir a) sampai
dengan h) di maksud dan tujuan. (D,W) \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb70\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 66
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg67}
{\bkmkend Pg67}\par\pard\qj \li1800\sb0\sl-260\slmult0 \par\pard\qj\li1800\sb0\sl-
260\slmult0 \par\pard\qj\li1800\sb0\sl-260\slmult0 \par\pard\qj\li1800\sb0\sl-
260\slmult0 \par\pard\qj\li1800\ri1250\sb166\sl-260\slmult0\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Pasien diskrining untuk
kebutuhan pelayanan manajemen pelayanan pasien \line\tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\qj \li1800\ri1189\sb4\sl-280\slmult0\tx2160 \up0
\expndtw-2\charscalex100 4. Pasien yang mendapat pelayanan MPP, pencatatannya
dilakukan dalam Form \line\tab \up0 \expndtw-5\charscalex100 MPP selalu
diperbaharui untuk menjamin komunikasi dengan PPA.(R,D) \par\pard\ql
\li1800\ri1241\sb9\sl-270\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex104 5.
Kesinambungan dan koordinasi proses pelayanan didukung dengan \line\tab
\up0 \expndtw0\charscalex101 menggunakan perangkat pendukung, seperti rencana
asuhan PPA, catatan \line \tab \up0 \expndtw-3\charscalex100 MPP, panduan, atau
perangkat lainnya. (D,O,W) \par\pard\qj \li1800\ri1209\sb2\sl-280\slmult0\tx2160
\up0 \expndtw-2\charscalex100 6. Kesinambungan dan koordinasi dapat dibuktikan di
semua tingkat/fase asuhan \line\tab \up0 \expndtw-3\charscalex100 pasien.
(D,O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb8\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar
ARK.3.2 \par\pard\qj \li1440\ri1237\sb0\sl-280\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi bahwa setiap pasien
harus dikelola oleh dokter \line \up0 \expndtw-2\charscalex100 penanggung jawab
pelayanan (DPJP) untuk memberikan asuhan kepada pasien. \par\pard\ql
\li1440\sb265\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.3.2 \par\pard\qj
\li1440\ri1243\sb261\sl-280\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asuhan pasien diberikan oleh profesional pemberi
asuhan (PPA) yang bekerja \up0 \expndtw0\charscalex100 sebagai tim interdisiplin
dengan kolaborasi interprofesional dan dokter penanggung \up0 \expndtw-
2\charscalex100 jawab pelayanan (DPJP) berperan sebagai ketua tim asuhan pasien
oleh profesional \up0 \expndtw-3\charscalex100 pemberi asuhan (PPA)
(c\ul0\nosupersub\cf8\f9\fs24 linical
leader\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 . \par\pard\qj
\li1440\ri1181\sb263\sl-277\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Untuk mengatur kesinambungan asuhan selama pasien
berada di rumah sakit, harus \line \up0 \expndtw-2\charscalex100 ada dokter
penanggung jawab pelayanan (DPJP) sebagai individu yang bertanggung \line \up0
\expndtw-1\charscalex100 jawab mengelola pasien sesuai dengan kewenangan
klinisnya, serta melakukan \line \up0 \expndtw-3\charscalex100 koordinasi dan
kesinambungan asuhan. Dokter penanggung jawab pelayanan (DPJP) \line \up0 \expndtw-
2\charscalex100 yang ditunjuk ini tercatat namanya di rekam medis pasien. Dokter
penanggung jawab \line \up0 \expndtw-3\charscalex100 pelayanan \up0 \expndtw-
1\charscalex100 (DPJP)/para DPJP memberikan keseluruhan asuhan selama
pasien \line \up0 \expndtw-2\charscalex100 berada di RS dapat meningkatkan antara
lain kesinambungan, koordinasi, kepuasan \line \up0 \expndtw0\charscalex100 pasien,
mutu, keselamatan, dan termasuk hasil asuhan. Individu ini membutuhkan \line
\up0 \expndtw-2\charscalex100 kolaborasi dan komunikasi dengan profesional pemberi
asuhan (PPA) lainnya. \par\pard\qj \li1440\ri1243\sb261\sl-280\slmult0 \up0
\expndtw0\charscalex103 Bila seorang pasien dikelola oleh lebih satu dokter
penanggung jawab pelayanan \up0 \expndtw0\charscalex100 (DPJP) maka harus
ditetapkan DPJP utama. Sebagai tambahan, rumah sakit \up0
\expndtw0\charscalex104 menetapkan kebijakan dan proses perpindahan tanggung jawab
dari satu dokter \up0 \expndtw-3\charscalex100 penanggung jawab pelayanan (DPJP) ke
DPJP lain. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb268\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian ARK.3.2 \par\pard\ql \li1440\sb4\sl-276\slmult0\tx8970 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
dokter penanggung jawab pelayanan \tab \up0 \expndtw0\charscalex101 (DPJP) yang
\par\pard\qj \li1797\ri1187\sb1\sl-280\slmult0 \up0 \expndtw0\charscalex102
bertanggung jawab melakukan koordinasi asuhan dan bertugas dalam seluruh \line \up0
\expndtw-3\charscalex100 fase asuhan rawat inap pasien serta teridentifikasi dalam
rekam medis pasien. (R) \par\pard\ql \li1440\ri1244\sb0\sl-
280\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex100 2. Regulasi juga
menetapkan proses pengaturan perpindahan tanggung jawab \line\tab \up0
\expndtw-1\charscalex100 koordinasi asuhan pasien dari satu dokter penanggung jawab
pelayanan (DPJP) \line \tab \up0 \expndtw-3\charscalex100 ke DPJP lain, termasuk
bila terjadi perubahan DPJP utama. (R) \par\pard\qj \li1440\ri1251\sb0\sl-
280\slmult0\tx1797 \up0 \expndtw-1\charscalex100 3. DPJP yang ditetapkan telah
memenuhi proses kredensial yang sesuai dengan \line\tab \up0 \expndtw-
3\charscalex100 peraturan perundangan. (D,W) \par\pard\qj \li1440\ri1249\sb0\sl-
280\slmult0\tx1797 \up0 \expndtw0\charscalex103 4. Bila dilaksanakan rawat bersama
ditetapkan DPJP utama sebagai koordinator \line\tab \up0 \expndtw-3\charscalex100
asuhan pasien. (D,W) \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb107\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 67
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg68}
{\bkmkend Pg68}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.3.3 \par\pard\ql
\li1440\sb264\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan informasi tentang pasien
disertakan pada proses transfer. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.3.3 \par\pard\qj
\li1440\ri1181\sb261\sl-280\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Selama dirawat inap di rumah sakit, pasien mungkin
dipindah dari satu pelayanan \line \up0 \expndtw-3\charscalex100 atau dari satu
unit rawat inap ke berbagai unit pelayanan lain atau unit rawat inap lain. \line
\up0 \expndtw-4\charscalex100 Jika profesional pemberi asuhan \up0 \expndtw-
4\charscalex100 (PPA) berubah akibat perpindahan ini maka \par\pard\qj
\li1440\ri1185\sb4\sl-276\slmult0 \up0 \expndtw0\charscalex100 informasi penting
terkait asuhan harus mengikuti pasien. Pemberian obat dan \line \up0
\expndtw-1\charscalex100 tindakan lain dapat berlangsung tanpa halangan dan kondisi
pasien dapat dimonitor. \line \up0 \expndtw0\charscalex104 Untuk memastikan setiap
tim asuhan menerima informasi yang diperlukan maka \line \up0
\expndtw0\charscalex100 rekam medis pasien ikut pindah atau ringkasan informasi
yang ada di rekam medis \line \up0 \expndtw-4\charscalex100 disertakan waktu pasien
pindah dan menyerahkan kepada tim asuhan yang menerima \line \up0 \expndtw-
2\charscalex100 pasien. Ringkasan memuat sebab pasien masuk dirawat, temuan
penting, diagnosis, \line \up0 \expndtw-2\charscalex100 prosedur atau tindakan,
obat yang diberikan, dan keadaan pasien waktu pindah. \par\pard\ql
\li1440\sb264\sl-276\slmult0\tx8946 \up0 \expndtw0\charscalex101 Bila pasien
dalam pengelolaan manajer pelayanan pasien \tab \up0
\expndtw0\charscalex101 (MPP) maka \par\pard\qj \li1440\ri1254\sb1\sl-280\slmult0
\up0 \expndtw-1\charscalex100 kesinambungan proses tersebut di atas dipantau,
diikuti, dan transfernya disupervisi \up0 \expndtw-2\charscalex100 oleh manajer
pelayanan pasien (MPP). \par\pard\ql \li1440\sb264\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen penilaian ARK.3.3
\par\pard\qj \li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\ri1245\sb1\sl-
280\slmult0\tx1711 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada
regulasi tentang transfer pasien antar unit pelayanan di dalam rumah sakit
\line\tab \up0 \expndtw-3\charscalex100 dilengkapi dengan form transfer pasien. (R)
\par\pard\ql \li1440\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Form
tersebut memuat indikasi pasien masuk dirawat. (D) \par\pard\qj
\li1440\ri1247\sb0\sl-280\slmult0\tx1711 \up0 \expndtw0\charscalex102 3. Form
tersebut memuat riwayat kesehatan, pemeriksaan fisis, dan pemeriksaan \line\tab
\up0 \expndtw-3\charscalex100 diagnostik. (D) \par\pard\ql \li1440\sb1\sl-
257\slmult0 \up0 \expndtw-3\charscalex100 4. Form tersebut memuat setiap
diagnosis yang dibuat. (D) \par\pard\ql \li1440\sb8\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 5. Form tersebut memuat setiap prosedur yang dilakukan. (D)
\par\pard\ql \li1440\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100 6. Form
tersebut memuat obat yang diberikan dan tindakan lain yang dilakukan. (D)
\par\pard\ql \li1440\sb1\sl-256\slmult0 \up0 \expndtw-2\charscalex100 7. Form
tersebut memuat keadaan pasien pada waktu dipindah (transfer). (D) \par\pard\ql
\li1440\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100 8. Ketentuan tersebut
dilaksanakan. (D,O,W) \par\pard\ql \li1800\sb0\sl-276\slmult0
\par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb12\sl-276\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PEMULANGAN DARI RUMAH SAKIT (DISCHARGE) DAN
TINDAK LANJUT \par\pard\ql \li1440\sb264\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Standar ARK.4 \par\pard\qj \li1440\ri1239\sb1\sl-280\slmult0
\up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan
regulasi melaksanakan proses pemulangan pasien \up0 \expndtw-1\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 discharge\ul0\nosupersub\cf7\f8\fs24 ) dari rumah
sakit berdasar atas kondisi kesehatan pasien dan kebutuhan \up0 \expndtw-
3\charscalex100 kesinambungan asuhan atau tindakan. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb268\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.4
\par\pard\qj \li1440\sb0\sl-275\slmult0 \par\pard\qj\li1440\ri1187\sb10\sl-
275\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Merujuk atau
mengirim pasien ke praktisi kesehatan di luar rumah sakit, unit \line \up0
\expndtw-1\charscalex100 pelayanan lain, rumah, atau keluarga didasarkan atas
kondisi kesehatan pasien dan \line \up0 \expndtw-3\charscalex100 kebutuhannya untuk
memperoleh kesinambungan asuhan. Dokter penanggung jawab \line \up0 \expndtw-
2\charscalex100 pelayanan (DPJP) dan profesional pemberi asuhan (PPA) lainnya yang
bertanggung \line \up0 \expndtw-2\charscalex100 jawab atas asuhan pasien menentukan
kesiapan pasien keluar rumah sakit berdasar \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb91\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 68
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg69}
{\bkmkend Pg69}\par\pard\qj \li1440\sb0\sl-276\slmult0 \par\pard\qj\li1440\sb0\sl-
276\slmult0 \par\pard\qj\li1440\sb0\sl-276\slmult0 \par\pard\qj\li1440\sb0\sl-
276\slmult0 \par\pard\qj\li1440\ri1179\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 atas kebijakan, kriteria, dan indikasi
rujukan yang ditetapkan rumah sakit. Kebutuhan \up0 \expndtw0\charscalex103
kesinambungan asuhan berarti rujukan ke dokter spesialis, rehabilitasi fisik,
atau \up0 \expndtw0\charscalex104 bahkan kebutuhan upaya preventif di rumah yang
dikoordinasikan oleh keluarga \up0 \expndtw0\charscalex100 pasien. Diperlukan
proses yang terorganisir dengan baik untuk memastikan bahwa \up0 \expndtw-
2\charscalex100 kesinambungan asuhan dikelola oleh praktisi kesehatan atau oleh
sebuah organisasi \up0 \expndtw-2\charscalex100 di luar rumah sakit. Pasien
yang memerlukan perencanaan pemulangan pasien \up0 \expndtw0\charscalex104
(\ul0\nosupersub\cf8\f9\fs24 discharge planning\ul0\nosupersub\cf7\f8\fs24 ) maka
rumah sakit mulai merencanakan hal tersebut sedini\up0 \expndtw0\charscalex103
dininya yang sebaiknya untuk menjaga kesinambungan asuhan dilakukan secara \up0
\expndtw-3\charscalex100 terintegrasi melibatkan semua profesional pemberi asuhan
(PPA) terkait/relevan serta \up0 \expndtw0\charscalex100 difasilitasi oleh manajer
pelayanan pasien (MPP). Keluarga dilibatkan dalam proses \up0 \expndtw-
3\charscalex100 ini sesuai dengan kebutuhan (lihat juga AP 1.8). \par\pard\qj
\li1440\ri1186\sb261\sl-280\slmult0 \up0 \expndtw-3\charscalex100 Rumah sakit dapat
menetapkan regulasi tentang kemungkinan pasien diizinkan keluar \up0 \expndtw-
4\charscalex100 rumah sakit dalam jangka waktu tertentu untuk keperluan penting.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb8\sl-276\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.4
\par\pard\qj \li1440\ri1240\sb261\sl-280\slmult0\tx1797 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang pemulangan
pasien disertai kriteria pemulangan pasien dan \line\tab \up0 \expndtw-
2\charscalex100 pasien yang rencana pemulangannya kompleks \up0 \expndtw-
2\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 discharge
planning\ul0\nosupersub\cf7\f8\fs24 ) untuk \par\pard\qj \li1797\ri1250\sb1\sl-
280\slmult0 \up0 \expndtw0\charscalex103 kesinambungan asuhan sesuai dengan
kondisi kesehatan dan kebutuhan \up0 \expndtw-3\charscalex100 pelayanan pasien.
(R) \par\pard\ql \li1440\sb1\sl-255\slmult0 \up0 \expndtw-2\charscalex100 2. Ada
bukti pemulangan pasien sesuai dengan kriteria pemulangan pasien. (D,W)
\par\pard\qj \li1440\ri1236\sb5\sl-280\slmult0\tx1797 \up0 \expndtw-2\charscalex100
3. Ada regulasi yang menetapkan kriteria tentang pasien yang diizinkan untuk
keluar \line\tab \up0 \expndtw-3\charscalex100 meninggalkan rumah sakit selama
periode waktu tertentu. (R) \par\pard\qj \li1440\ri1244\sb1\sl-
280\slmult0\tx1797 \up0 \expndtw-1\charscalex100 4. Ada bukti pelaksanaan tentang
pasien yang diizinkan untuk keluar meninggalkan \line\tab \up0 \expndtw-
2\charscalex100 rumah sakit selama periode waktu tertentu. (D,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb268\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.4.1 \par\pard\qj
\li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\ri1247\sb38\sl-260\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit bekerja sama dengan
praktisi kesehatan di luar rumah sakit tentang \up0 \expndtw-3\charscalex100 tindak
lanjut pemulangan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb15\sl-276\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.4.1
\par\pard\qj \li1440\ri1180\sb264\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Dibutuhkan perencanaan untuk mengatur tindak lanjut
pemulangan pasien ke praktisi \up0 \expndtw0\charscalex102 kesehatan atau
organisasi lain yang dapat memenuhi kebutuhan kesinambungan \up0 \expndtw-
4\charscalex100 asuhan pasien. Rumah sakit yang berada di komunitas tempat praktisi
kesehatan juga \up0 \expndtw-4\charscalex100 berada di dalamnya membuat kerja sama
formal dan informal. Jika pasien berasal dari \up0 \expndtw-1\charscalex100
komunitas/daerah lain maka rumah sakit akan merujuk pasien ke praktisi kesehatan
\up0 \expndtw-3\charscalex100 yang berasal dari komuitas tempat pasien tinggal.
\par\pard\qj \li1440\sb0\sl-276\slmult0 \par\pard\qj\li1440\ri1180\sb8\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 Mungkin juga, pasien membutuhkan
pelayanan dukungan dan pelayanan kesehatan \line \up0 \expndtw0\charscalex102 pada
waktu pasien keluar dari rumah sakit (\ul0\nosupersub\cf8\f9\fs24
discharge\ul0\nosupersub\cf7\f8\fs24 ). Misalnya, pasien mungkin \line \up0
\expndtw0\charscalex100 membutuhkan bantuan sosial, nutrisi, keuangan, psikologi,
atau bantuan lain pada \line \up0 \expndtw-3\charscalex100 waktu pasien keluar
rumah sakit. Proses perencanaan pemulangan pasien (\ul0\nosupersub\cf8\f9\fs24
discharge \line \up0 \expndtw-3\charscalex100 planning\ul0\nosupersub\cf7\f8\fs24 )
dilakukan secara terintegrasi melibatkan semua profesional pemberi asuhan \line
\up0 \expndtw-1\charscalex100 (PPA) terkait serta difasilitasi oleh manajer
pelayanan pasien (MPP) memuat bentuk \line \up0 \expndtw-2\charscalex100 bantuan
pelayanan yang dibutuhkan dan ketersediaan bantuan yang dimaksud. \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb90\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 69
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg70}
{\bkmkend Pg70}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb76\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.4.1
\par\pard\ql \li1800\sb0\sl-273\slmult0 \par\pard\ql\li1800\ri1243\sb14\sl-
273\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Ada bukti pemulangan pasien yang rencana
pemulangannya kompleks \line\tab \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf8\f9\fs24 (discharge planning)\ul0\nosupersub\cf7\f8\fs24
dimulai sejak awal pasien masuk rawat inap melibatkan \line \tab \up0 \expndtw-
2\charscalex100 semua PPA terkait serta difasilitasi oleh MPP, untuk kesinambungan
asuhan \line \tab \up0 \expndtw-3\charscalex100 sesuai dengan kondisi kesehatan dan
kebutuhan pelayanan pasien. (D,W) \par\pard\ql \li1800\ri1182\sb2\sl-
280\slmult0\tx2160\tx2160 \up0 \expndtw-1\charscalex100 2. Pada tindak lanjut
pemulangan pasien bila diperlukan dapat ditujukan kepada \line\tab \up0 \expndtw-
3\charscalex100 fasilitas kesehatan baik perorangan ataupun institusi yang berada
di komunitas \line \tab \up0 \expndtw-4\charscalex100 dimana pasien berada yang
bertujuan untuk memberikan \up0 \expndtw-4\charscalex100 bantuan \par\pard\ql
\li2160\sb1\sl-255\slmult0 \up0 \expndtw-3\charscalex100 pelayanan.(D) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb16\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar ARK.4.2 \par\pard\qj
\li1440\ri1185\sb30\sl-560\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ringkasan pasien pulang (\ul0\nosupersub\cf8\f9\fs24
discharge summary\ul0\nosupersub\cf7\f8\fs24 ) dibuat untuk semua pasien rawat
inap. \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
ARK.4.2 \par\pard\qj \li1440\ri1241\sb240\sl-270\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Ringkasan pasien pulang
memberikan gambaran tentang pasien yang tinggal di \up0 \expndtw-2\charscalex100
rumah sakit. Ringkasan dapat digunakan oleh praktisi yang bertanggung
jawab \up0 \expndtw-3\charscalex100 memberikan tindak lanjut asuhan. Ringkasan
memuat hal \par\pard\qj \li1800\ri2718\sb22\sl-280\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
indikasi pasien masuk dirawat, diagnosis, dan komorbiditas lain; \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
temuan fisik penting dan temuan-temuan lain; \par\pard\ql \li1800\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 tindakan diagnostik dan prosedur terapi yang
telah dikerjakan; \par\pard\qj \li1800\ri1209\sb21\sl-280\slmult0\tx2160 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 obat yang diberikan selama dirawat inap dengan
potensi akibat efek residual \line\tab \up0 \expndtw-2\charscalex100 setelah obat
tidak diteruskan dan semua obat yang harus digunakan di rumah; \line \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
kondisi pasien (\ul0\nosupersub\cf8\f9\fs24 status
present\ul0\nosupersub\cf7\f8\fs24 ); \par\pard\ql \li1800\sb24\sl-276\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 ringkasan memuat instruksi tindak lanjut agar
dihindari istilah anjuran. \par\pard\qj \li1440\ri1248\sb261\sl-280\slmult0 \up0
\expndtw-2\charscalex100 Ringkasan pasien pulang dijelaskan dan ditandatangani oleh
pasien/keluarga karena \up0 \expndtw-5\charscalex100 memuat instruksi. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb268\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.4.2
\par\pard\qj \li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\ri1245\sb1\sl-
280\slmult0\tx1800 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Ringkasan pulang memuat riwayat kesehatan, pemeriksaan fisis, dan
\line\tab \up0 \expndtw-5\charscalex100 pemeriksaan diagnostik. (D) \par\pard\qj
\li1440\ri1245\sb17\sl-260\slmult0\tx1800 \up0 \expndtw0\charscalex103 2.
Ringkasan pulang memuat indikasi pasien dirawat inap, diagnosis, dan
\line\tab \up0 \expndtw-5\charscalex100 komorbiditas lain. (D) \par\pard\ql
\li1440\sb7\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3. Ringkasan pulang
memuat prosedur terapi dan tindakan yang telah dikerjakan. (D) \par\pard\qj
\li1440\ri1250\sb1\sl-280\slmult0\tx1800 \up0 \expndtw0\charscalex100 4. Ringkasan
pulang memuat obat yang diberikan termasuk obat setelah pasien \line\tab \up0
\expndtw-5\charscalex100 keluar rumah sakit. (D) \par\pard\qj
\li1440\ri1239\sb0\sl-280\slmult0\tx1800 \up0 \expndtw-1\charscalex100 5.
Ringkasan pulang memuat kondisi kesehatan pasien (\ul0\nosupersub\cf8\f9\fs24
status present\ul0\nosupersub\cf7\f8\fs24 ) saat akan \line\tab \up0 \expndtw-
2\charscalex100 pulang dari rumah sakit. (D) (EP 5 untuk IGD dan transfer)
\par\pard\qj \li1440\ri1244\sb0\sl-280\slmult0\tx1800 \up0 \expndtw0\charscalex100
6. Ringkasan pulang memuat instruksi tindak lanjut dan dijelaskan kepada pasien
\line\tab \up0 \expndtw-5\charscalex100 dan keluarga. (D) \par\pard\ql
\li1440\sb266\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar ARK.4.2.1 \par\pard\ql \li10243\sb243\sl-
253\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs22 70
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg71}
{\bkmkend Pg71}\par\pard\qj \li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\sb0\sl-
280\slmult0 \par\pard\qj\li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\sb0\sl-
280\slmult0 \par\pard\qj\li1440\sb0\sl-280\slmult0
\par\pard\qj\li1440\ri1241\sb49\sl-280\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan pemberian ringkasan pasien
pulang kepada pihak yang \up0 \expndtw-3\charscalex100 berkepentingan. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb92\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.4.2.1 \par\pard\qj
\li1440\ri1249\sb58\sl-260\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ringkasan pasien pulang dibuat sebelum pasien keluar
dari rumah sakit oleh dokter \up0 \expndtw-3\charscalex100 penanggung jawab
pelayanan (DPJP). \par\pard\qj \li1440\sb0\sl-275\slmult0
\par\pard\qj\li1440\ri1237\sb13\sl-275\slmult0 \up0 \expndtw0\charscalex105 Satu
salinan/\ul0\nosupersub\cf8\f9\fs24 copy\ul0\nosupersub\cf7\f8\fs24 dari
ringkasan diberikan kepada tenaga kesehatan yang \up0 \expndtw0\charscalex100
bertanggung jawab memberikan tindak lanjut asuhan kepada pasien. Satu salinan
\up0 \expndtw0\charscalex102 diberikan kepada pasien sesuai dengan regulasi rumah
sakit yang mengacu pada \up0 \expndtw-1\charscalex100 peraturan perundangan yang
berlaku. Satu salinan diberikan kepada penjamin. \up0 \expndtw-3\charscalex100
Salinan ringkasan berada di rekam medis pasien. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb49\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.4.2.1 \par\pard\ql
\li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ringkasan pulang dibuat oleh DPJP sebelum pasien
pulang. (D,W) \par\pard\ql \li1440\ri1248\sb9\sl-270\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex100 2. Satu salinan ringkasan diberikan kepada pasien
dan bila diperlukan dapat \line\tab \up0 \expndtw-1\charscalex100 diserahkan
kepada tenaga kesehatan yang bertanggung jawab memberikan \line \tab \up0
\expndtw-3\charscalex100 kelanjutan asuhan. (D,W) \par\pard\ql \li1440\sb6\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 3. Satu salinan ringkasan yang lengkap
ditempatkan di rekam medis pasien. (D) \par\pard\qj \li1440\ri1244\sb1\sl-
280\slmult0\tx1797 \up0 \expndtw0\charscalex100 4. Satu salinan ringkasan
diberikan kepada pihak penjamin pasien sesuai dengan \line\tab \up0 \expndtw-
3\charscalex100 regulasi rumah sakit. (D) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb28\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.4.3 \par\pard\qj
\li1440\ri1247\sb41\sl-280\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Untuk pasien rawat jalan yang membutuhkan asuhan yang
kompleks atau diagnosis \up0 \expndtw-1\charscalex100 yang kompleks dibuat catatan
tersendiri Profil Ringkas Medis Rawat Jalan (PRMRJ) \up0 \expndtw-3\charscalex100
dan tersedia untuk PPA. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb28\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.4.3 \par\pard\qj
\li1440\ri1181\sb44\sl-277\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Jika rumah sakit memberikan asuhan dan tindakan
berlanjut kepada pasien dengan \up0 \expndtw-3\charscalex100 diagnosis kompleks dan
atau yang membutuhkan asuhan kompleks (misalnya, pasien \up0 \expndtw-
1\charscalex100 yang datang beberapa kali dengan masalah kompleks, menjalani
tindakan beberapa \up0 \expndtw-2\charscalex100 kali, datang di beberapa unit
klinis, dan sebagainya) maka kemungkinan dapat \up0 \expndtw0\charscalex102
bertambahnya diagnosis dan obat, perkembangan riwayat penyakit, serta temuan
\up0 \expndtw0\charscalex100 pada pemeriksaan fisis. Oleh karena itu, untuk
kasus seperti ini harus dibuat \up0 \expndtw0\charscalex102 ringkasannya.
Sangat penting bagi setiap PPA yang berada di berbagai unit yang \up0
\expndtw0\charscalex100 memberikan asuhan kepada pasien ini mendapat akses ke
informasi Profil Ringkas \up0 \expndtw-3\charscalex100 Medis Rawat Jalan (PRMRJ)
tersebut. \par\pard\ql \li1440\sb264\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Profil Ringkas Medis Rawat Jalan (PRMRJ) memuat informasi, termasuk:
\par\pard\ql \li1800\ri1185\sb21\sl-280\slmult0\tx2160\tx2160\tx2160\tx2160 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 identifikasi pasien yang menerima asuhan
kompleks atau dengan diagnosis \line\tab \up0 \expndtw-3\charscalex100 kompleks
(seperti pasien di klinis jantung dengan berbagai komorbiditas antara \line \tab
\up0 \expndtw0\charscalex100 lain DM tipe \up0 \expndtw0\charscalex100
2,\ul0\nosupersub\cf8\f9\fs24 total knee replacement\ul0\nosupersub\cf7\f8\fs24
, gagal ginjal tahap akhir, dan \line \tab \up0 \expndtw-2\charscalex100
sebagainya. Atau pasien di klinis neurologik dengan berbagai komorbiditas).
\line \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Identifikasi informasi yang dibutuhkan oleh
para dokter penanggung jawab \line\tab \up0 \expndtw-3\charscalex100 pelayanan
(DPJP) yang menangani pasien tersebut \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb4\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 71
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg72}
{\bkmkend Pg72}\par\pard\ql \li1800\sb0\sl-280\slmult0 \par\pard\ql\li1800\sb0\sl-
280\slmult0
\par\pard\ql\li1800\sb0\sl-280\slmult0 \par\pard\ql\li1800\sb0\sl-280\slmult0
\par\pard\ql\li1800\ri1185\sb69\sl-280\slmult0\tx2160\tx2160\tx2160\tx2160 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Menentukan proses yang digunakan untuk
memastikan bahwa informasi medis \line\tab \up0 \expndtw-3\charscalex100 yang
dibutuhkan dokter penanggung jawab pelayanan (DPJP) tersedia dalam \line \tab
\up0 \expndtw-5\charscalex100 format mudah ditelusur (\ul0\nosupersub\cf8\f9\fs24
easy-to-retrieve\ul0\nosupersub\cf7\f8\fs24 ) dan mudah
di-\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 . \line \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Evaluasi hasil implementasi proses untuk
mengkaji bahwa informasi dan \line\tab \up0 \expndtw-4\charscalex100 proses
memenuhi kebutuhan dokter penanggung jawab pelayanan (DPJP) dan \line \tab \up0
\expndtw-4\charscalex100 meningkatkan mutu serta keselamatan pasien.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb48\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian
ARK.4.3 \par\pard\ql \li1440\ri1241\sb49\sl-270\slmult0\tx1797\tx1797 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ditetapkan kriteria pasien
rawat jalan dengan asuhan yang kompleks atau yang \line\tab \up0 \expndtw-
1\charscalex100 diagnosisnya kompleks diperlukan Profil Ringkas Medis Rawat Jalan
(PRMRJ) \line \tab \up0 \expndtw-5\charscalex100 yang sesuai dengan regulasi rumah
sakit. (R) \par\pard\qj \li1440\ri1241\sb2\sl-280\slmult0\tx1797 \up0 \expndtw-
1\charscalex100 2. Ada regulasi yang menetapkan bahwa proses PRMRJ mudah ditelusur
(\ul0\nosupersub\cf8\f9\fs24 easy to \line\tab \up0 \expndtw-5\charscalex100
retrieve\ul0\nosupersub\cf7\f8\fs24 ) dan mudah di-\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 . (R) \par\pard\qj \li1440\ri1242\sb1\sl-
280\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Informasi penting yang
dimasukkan ke dalam PRMRJ diidentifikasi oleh DPJP. \line\tab \up0 \expndtw-
3\charscalex100 (R,D) \par\pard\qj \li1440\ri1242\sb0\sl-280\slmult0\tx1797 \up0
\expndtw0\charscalex103 4. Proses tersebut dievaluasi untuk memenuhi
kebutuhan para DPJP dan \line\tab \up0 \expndtw-5\charscalex100 meningkatkan
mutu serta keselamatan pasien. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb73\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.4.4
\par\pard\qj \li1440\ri1189\sb49\sl-270\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses untuk mengelola dan
melakukan tindak lanjut pasien \up0 \expndtw0\charscalex100 dan memberitahu staf
rumah sakit bahwa mereka berniat keluar rumah sakit serta \up0 \expndtw-
5\charscalex100 menolak rencana asuhan medis. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb50\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.4.4.1 \par\pard\qj
\li1440\ri1247\sb58\sl-260\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses untuk mengelola pasien
yang menolak rencana \up0 \expndtw-3\charscalex100 asuhan medis yang melarikan
diri. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb51\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan ARK.4.4 dan ARK.4.4.1 \par\pard\qj \li1440\ri1181\sb44\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Jika seorang pasien rawat
inap atau rawat jalan telah selesai menjalani pemeriksaan \line \up0 \expndtw-
3\charscalex100 lengkap dan sudah ada rekomendasi tindakan yang perlu dilakukan,
kemudian pasien \line \up0 \expndtw-2\charscalex100 ini memutuskan meninggalkan
rumah sakit maka pasien ini dianggap sebagai pasien \line \up0 \expndtw-
4\charscalex100 keluar menolak rencana asuhan medis. Pasien rawat inap dan rawat
jalan (termasuk \line \up0 \expndtw0\charscalex100 pasien dari unit darurat) berhak
menolak tindakan medis dan keluar rumah sakit. \line \up0 \expndtw-3\charscalex100
Pasien ini menghadapi risiko karena menerima pelayanan atau tindakan tidak
lengkap \line \up0 \expndtw-3\charscalex100 yang berakibat terjadi kerusakan
permanen atau kematian. Jika seorang pasien rawat \line \up0 \expndtw-
1\charscalex100 inap atau rawat jalan minta untuk keluar dari rumah sakit tanpa
persetujuan dokter \line \up0 \expndtw-4\charscalex100 maka pasien harus diberitahu
tentang risiko medis oleh dokter yang membuat rencana \line \up0 \expndtw-
1\charscalex100 asuhan atau tindakan dan proses keluarnya pasien sesuai dengan
regulasi rumah \line \up0 \expndtw-2\charscalex100 sakit. Jika pasien mempunyai
dokter keluarga maka dokter keluarga tersebut harus \line \up0
\expndtw0\charscalex100 diberitahu tentang keputusan pasien. Bila tidak ada dokter
keluarga maka pasien \line \up0 \expndtw-3\charscalex100 dimotivasi untuk
mendapat/mencari pelayanan kesehatan lebih lanjut. \par\pard\qj
\li1440\ri1222\sb261\sl-280\slmult0 \up0 \expndtw-2\charscalex100 Harus diupayakan
agar mengetahui alasan mengapa pasien keluar menolak rencana \up0
\expndtw0\charscalex100 asuhan medis. Rumah sakit perlu mengetahui alasan ini
agar dapat melakukan \up0 \expndtw-2\charscalex100 komunikasi lebih baik dengan
pasien dan atau keluarga pasien dalam rangka \up0 \expndtw-3\charscalex100
memperbaiki proses. \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb4\sl-253\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs22 72
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg73}
{\bkmkend Pg73}\par\pard\qj \li1440\sb0\sl-275\slmult0 \par\pard\qj\li1440\sb0\sl-
275\slmult0 \par\pard\qj\li1440\sb0\sl-275\slmult0 \par\pard\qj\li1440\sb0\sl-
275\slmult0 \par\pard\qj\li1440\ri1180\sb93\sl-275\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Jika pasien menolak rencana
asuhan medis tanpa memberi tahu siapapun di dalam \up0 \expndtw0\charscalex100
rumah sakit atau ada pasien rawat jalan yang menerima pelayanan kompleks atau
\up0 \expndtw0\charscalex100 pelayanan untuk menyelamatkan jiwa, seperti kemoterapi
atau terapi radiasi, tidak \up0 \expndtw-3\charscalex100 kembali ke rumah sakit
maka rumah sakit harus berupaya menghubungi pasien untuk \up0 \expndtw-
4\charscalex100 memberi tahu tentang potensi risiko bahaya yang ada.
\par\pard\qj \li1440\ri1234\sb261\sl-280\slmult0 \up0 \expndtw0\charscalex102 Rumah
sakit menetapkan regulasi untuk proses ini sesuai dengan peraturan \up0
\expndtw0\charscalex100 perundangan yang berlaku, termasuk rumah sakit
membuat laporan ke dinas \up0 \expndtw-2\charscalex100 kesehatan atau
kementerian kesehatan tentang kasus infeksi dan memberi informasi \up0 \expndtw-
3\charscalex100 tentang pasien yang mungkin mencelakakan dirinya atau orang
lain. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb48\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian ARK.4.4 \par\pard\ql \li1440\ri1236\sb21\sl-280\slmult0\tx1797\tx1797
\up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi untuk
mengelola pasien rawat jalan dan rawat inap yang menolak \line\tab \up0
\expndtw0\charscalex100 rencana asuhan medis termasuk keluar rumah sakit atas
permintaan sendiri dan \line \tab \up0 \expndtw-3\charscalex100 pasien yang
menghendaki penghentian pengobatan. (R) \par\pard\qj \li1440\ri1251\sb17\sl-
260\slmult0\tx1797 \up0 \expndtw0\charscalex100 2. Ada bukti pemberian edukasi
kepada pasien tentang risiko medis akibat asuhan \line\tab \up0 \expndtw-
3\charscalex100 medis yang belum lengkap. (D,O,W) \par\pard\qj
\li1440\ri1240\sb4\sl-280\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Pasien
keluar rumah sakit atas permintaan sendiri, tetapi tetap mengikuti proses \line\tab
\up0 \expndtw-3\charscalex100 pemulangan pasien. (D) \par\pard\qj
\li1440\ri1244\sb1\sl-280\slmult0\tx1797 \up0 \expndtw0\charscalex104 4. Dokter
keluarga (bila ada) atau dokter yang memberi asuhan berikutnya dari \line\tab \up0
\expndtw-3\charscalex100 pasien diberitahu tentang kondisi tersebut. (D)
\par\pard\ql \li1440\ri1185\sb0\sl-280\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex102 5. Ada dokumentasi rumah sakit melakukan pengkajian untuk
mengetahui alasan \line\tab \up0 \expndtw-4\charscalex100 pasien keluar rumah sakit
atas apakah permintaan sendiri, menolak asuhan medis, \line \tab \up0 \expndtw-
5\charscalex100 atau tidak melanjutkan program pengobatan. (D) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb29\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.4.4.1 \par\pard\qj
\li1440\ri1182\sb58\sl-260\slmult0\tx1797 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mengatur pasien rawat inap dan
rawat jalan yang meninggalkan \line\tab \up0 \expndtw-4\charscalex100 rumah sakit
tanpa pemberitahuan (melarikan diri). (R) \par\pard\qj \li1440\ri1247\sb4\sl-
280\slmult0\tx1797 \up0 \expndtw0\charscalex104 2. Rumah sakit melakukan
identifikasi pasien menderita penyakit yang \line\tab \up0 \expndtw-
3\charscalex100 membahayakan dirinya sendiri atau lingkungan. (D,W) \par\pard\qj
\li1440\ri1249\sb1\sl-280\slmult0\tx1797 \up0 \expndtw-2\charscalex100 3. Rumah
sakit melaporkan ke pada pihak yang berwenang bila ada indikasi kondisi
\line\tab \up0 \expndtw-3\charscalex100 pasien yang membahayakan dirinya sendiri
atau lingkungan. (D,W) \par\pard\ql \li1800\sb0\sl-276\slmult0
\par\pard\ql\li1800\sb28\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
RUJUKAN PASIEN \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar ARK.5
\par\pard\qj \li1440\ri1249\sb41\sl-280\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Pasien dirujuk ke fasilitas pelayanan kesehatan lain
berdasar atas kondisi pasien \line \up0 \expndtw0\charscalex104 untuk memenuhi
kebutuhan asuhan berkesinambungan dan sesuai dengan \line \up0 \expndtw-
2\charscalex100 kemampuan fasilitas kesehatan penerima untuk memenuhi kebutuhan
pasien. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb28\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan ARK.5 \par\pard\qj \li1440\ri1183\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien dirujuk ke fasilitas
kesehatan lain didasarkan atas kondisi pasien dan \line \up0 \expndtw-
3\charscalex100 kebutuhan untuk memperoleh asuhan berkesinambungan. Rujukan pasien
antara lain \line \up0 \expndtw0\charscalex100 untuk memenuhi kebutuhan pasien atau
konsultasi spesialistik dan tindakan, serta \line \up0 \expndtw0\charscalex102
penunjang diagnostik. Jika pasien dirujuk ke rumah sakit lain, yang merujuk
harus \line \up0 \expndtw-1\charscalex100 memastikan fasilitas kesehatan
penerima menyediakan pelayanan yang dapat \line \up0 \expndtw-3\charscalex100
memenuhi kebutuhan pasien dan mempunyai kapasitas menerima pasien. \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb4\sl-253\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 73
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg74}
{\bkmkend Pg74}\par\pard\qj \li1440\sb0\sl-275\slmult0 \par\pard\qj\li1440\sb0\sl-
275\slmult0 \par\pard\qj\li1440\sb0\sl-275\slmult0 \par\pard\qj\li1440\sb0\sl-
275\slmult0 \par\pard\qj\li1440\ri1193\sb93\sl-275\slmult0 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 Diperoleh kepastian terlebih
dahulu dan kesediaan menerima pasien serta \up0 \expndtw-3\charscalex100
persyaratan rujukan diuraikan dalam kerja sama formal atau dalam bentuk perjanjian.
\up0 \expndtw0\charscalex100 Ketentuan seperti ini dapat memastikan
kesinambungan asuhan tercapai dan \up0 \expndtw0\charscalex100 kebutuhan pasien
terpenuhi. Rujukan terjadi juga ke fasilitas kesehatan lain dengan \up0 \expndtw-
3\charscalex100 atau tanpa ada perjanjian formal. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb49\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.5 \par\pard\ql
\li1440\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang rujukan sesuai dengan
peraturan perundang-undangan. (R) \par\pard\qj \li1440\ri1246\sb1\sl-
280\slmult0\tx1800 \up0 \expndtw-1\charscalex100 2. Rujukan pasien dilakukan
sesuai dengan kebutuhan kesinambungan asuhan \line\tab \up0 \expndtw-
2\charscalex100 pasien. (D) \par\pard\qj \li1440\ri1197\sb17\sl-
260\slmult0\tx1800 \up0 \expndtw-3\charscalex100 3. Rumah sakit yang merujuk
memastikan bahwa fasilitas kesehatan yang menerima \line\tab \up0 \expndtw-
4\charscalex100 dapat memenuhi kebutuhan pasien yang dirujuk. (D,W) \par\pard\qj
\li1440\ri1250\sb4\sl-280\slmult0\tx1800 \up0 \expndtw0\charscalex102 4. Ada
kerjasama rumah sakit yang merujuk dengan rumah sakit yang menerima \line\tab
\up0 \expndtw-3\charscalex100 rujukan yang sering dirujuk. (R) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb48\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar ARK.5.1 \par\pard\qj
\li1440\ri1250\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses rujukan untuk memastikan
pasien pindah dengan \up0 \expndtw-3\charscalex100 aman. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK 5.1
\par\pard\qj \li1440\ri1246\sb41\sl-280\slmult0 \up0 \expndtw0\charscalex106
\ul0\nosupersub\cf7\f8\fs24 Rujukan pasien sesuai dengan kondisi pasien
menentukan kualifikasi staf \up0 \expndtw-3\charscalex100 pendamping yang
memonitor dan menentukan jenis peralatan medis khusus. \par\pard\qj \li1440\sb0\sl-
270\slmult0 \par\pard\qj\li1440\ri1189\sb19\sl-270\slmult0 \up0
\expndtw0\charscalex102 Selain itu, harus dipastikan fasilitas pelayanan kesehatan
penerima menyediakan \up0 \expndtw-3\charscalex100 pelayanan yang dapat memenuhi
kebutuhan pasien dan mempunyai kapasitas pasien \up0 \expndtw-4\charscalex100 dan
jenis teknologi medis. \par\pard\qj \li1440\sb0\sl-280\slmult0
\par\pard\qj\li1440\ri1248\sb2\sl-280\slmult0 \up0 \expndtw0\charscalex100
Diperlukan proses konsisten melakukan rujukan pasien untuk memastikan
\up0 \expndtw-3\charscalex100 keselamatan pasien. \par\pard\ql \li1440\sb264\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Proses ini menangani \par\pard\ql
\li1800\ri1239\sb1\sl-280\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex100 1.
ada staf yang bertanggung jawab dalam pengelolaan rujukan termasuk untuk
\line\tab \up0 \expndtw0\charscalex103 memastikan pasien diterima di rumah sakit
rujukan yang dapat memenuhi \line \tab \up0 \expndtw-3\charscalex100 kebutuhan
pasien; \par\pard\qj \li1800\ri1234\sb0\sl-280\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 2. selama dalam proses rujukan ada staf yang kompeten sesuai
dengan kondisi \line\tab \up0 \expndtw-3\charscalex100 pasien yang selalu memonitor
dan mencatatnya dalam rekam medis; \par\pard\qj \li1800\ri1186\sb0\sl-
280\slmult0\tx2160 \up0 \expndtw-3\charscalex100 3. dilakukan identifikasi
kebutuhan obat, bahan medis habis pakai, alat kesehatan \line\tab \up0 \expndtw-
4\charscalex100 dan peralatan medis yang dibutuhkan selama proses rujukan;
\par\pard\qj \li1800\ri1187\sb0\sl-260\slmult0\tx2160 \up0 \expndtw-3\charscalex100
4. dalam proses pelaksanaan rujukan, ada proses serah terima pasien antara staf
\line\tab \up0 \expndtw-4\charscalex100 pengantar dan yang menerima.
\par\pard\qj \li1440\ri1188\sb3\sl-280\slmult0 \up0 \expndtw-3\charscalex100 Rumah
sakit melakukan evaluasi terhadap mutu dan keamanan proses rujukan untuk \up0
\expndtw-3\charscalex100 memastikan pasien telah ditransfer dengan staf yang
kompeten dan dengan peralatan \up0 \expndtw-4\charscalex100 medis yang tepat.
\par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb172\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 74
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg75}
{\bkmkend Pg75}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian ARK.5.1
\par\pard\ql \li1440\sb0\sl-280\slmult0 \par\pard\ql\li1440\ri1249\sb61\sl-
280\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24
1. Ada staf yang bertanggung jawab dalam pengelolaan rujukan termasuk untuk
\line\tab \up0 \expndtw0\charscalex100 memastikan pasien diterima di rumah
sakit rujukan yang dapat memenuhi \line \tab \up0 \expndtw-3\charscalex100
kebutuhan pasien. (D,W) \par\pard\qj \li1440\ri1240\sb17\sl-260\slmult0\tx1797 \up0
\expndtw0\charscalex103 2. Selama proses rujukan ada staf yang kompeten sesuai
dengan kondisi pasien \line\tab \up0 \expndtw-3\charscalex100 yang selalu memonitor
dan mencatatnya dalam rekam medis. (D,W) \par\pard\qj \li1440\ri1247\sb4\sl-
280\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Selama proses rujukan tersedia
obat, bahan medis habis pakai, alat kesehatan, \line\tab \up0 \expndtw-
3\charscalex100 dan peralatan medis sesuai dengan kebutuhan kondisi pasien. (D,O,W)
\par\pard\qj \li1440\ri1246\sb1\sl-280\slmult0\tx1797 \up0 \expndtw-2\charscalex100
4. Ada proses serah terima pasien antara staf pengantar dan yang
menerima. \line\tab \up0 \expndtw-3\charscalex100 (D,O,W) \par\pard\qj
\li1440\ri1251\sb0\sl-280\slmult0\tx1797 \up0 \expndtw-1\charscalex100 5. Pasien
dan keluarga dijelaskan apabila rujukan yang dibutuhkan tidak dapat
\line\tab \up0 \expndtw-2\charscalex100 dilaksanakan. (D) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb73\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar ARK.5.2 \par\pard\qj \li1440\sb0\sl-260\slmult0
\par\pard\qj\li1440\ri1250\sb118\sl-260\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk mengatur proses
rujukan dan dicatat di \up0 \expndtw-3\charscalex100 rekam medis pasien.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb95\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.5.2 \par\pard\qj
\li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\ri1238\sb118\sl-260\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Informasi tentang pasien
dirujuk disertakan bersama dengan pasien untuk menjamin \up0 \expndtw-
2\charscalex100 kesinambungan asuhan. Dokumen rujukan berisi \par\pard\ql
\li1800\sb7\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1. identitas pasien;
\par\pard\qj \li1800\ri1237\sb1\sl-280\slmult0\tx2160 \up0 \expndtw-2\charscalex100
2. hasil pemeriksaan (anamesis, pemeriksaan fisis, dan pemeriksaan penunjang)
\line\tab \up0 \expndtw-3\charscalex100 yang telah dilakukan; \par\pard\ql
\li1800\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. diagnosis kerja.
\par\pard\ql \li1800\sb1\sl-256\slmult0 \up0 \expndtw-3\charscalex100 4. terapi
dan/atau tindakan yang telah diberikan; \par\pard\ql \li1800\sb8\sl-276\slmult0
\up0 \expndtw-2\charscalex100 5. tujuan rujukan; \par\pard\qj
\li1800\ri1250\sb1\sl-280\slmult0\tx2160 \up0 \expndtw0\charscalex100 6. nama dan
tanda tangan tenaga kesehatan yang memberikan pelayanan \line\tab \up0
\expndtw-3\charscalex100 rujukan. \par\pard\qj \li1440\ri1185\sb261\sl-
280\slmult0 \up0 \expndtw0\charscalex100 Dokumentasi juga memuat nama fasilitas
pelayanan kesehatan dan nama orang di \up0 \expndtw0\charscalex103 fasilitas
pelayanan kesehatan yang menyetujui menerima pasien, kondisi khusus \up0 \expndtw-
3\charscalex100 untuk rujukan (seperti kalau ruangan tersedia di penerima rujukan
atau tentang status \up0 \expndtw-4\charscalex100 pasien). Juga dicatat jika
kondisi pasien atau kondisi pasien berubah selama ditransfer \up0 \expndtw-
5\charscalex100 (misalnya, pasien meninggal atau membutuhkan resusitasi).
\par\pard\qj \li1440\ri1182\sb261\sl-280\slmult0 \up0 \expndtw0\charscalex100
Dokumen lain yang diminta sesuai dengan kebijakan rumah sakit (misalnya, tanda \up0
\expndtw-3\charscalex100 tangan perawat atau dokter yang menerima serta nama orang
yang memonitor pasien \up0 \expndtw-4\charscalex100 dalam perjalanan rujukan) masuk
dalam catatan. \par\pard\qj \li1440\ri1209\sb261\sl-280\slmult0 \up0 \expndtw-
2\charscalex100 Dokumen rujukan diberikan kepada fasilitas pelayanan kesehatan
penerima bersama \up0 \expndtw-3\charscalex100 dengan pasien. \par\pard\qj
\li1440\sb0\sl-280\slmult0 \par\pard\qj\li1440\ri1252\sb1\sl-280\slmult0 \up0
\expndtw-2\charscalex100 Catatan setiap pasien yang dirujuk ke fasilitas pelayanan
kesehatan lainnya memuat \up0 \expndtw-3\charscalex100 juga dokumentasi selama
proses rujukan. \par\pard\ql \li10243\sb203\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 75
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg76}
{\bkmkend Pg76}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb132\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian APK.5.2 \par\pard\qj \li1440\ri1188\sb0\sl-320\slmult0\fi67 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Dokumen rujukan berisi nama
dari fasilitas pelayanan kesehatan yang menerima dan \up0 \expndtw-4\charscalex100
nama orang yang menyetujui menerima pasien. (D) \par\pard\qj
\li1440\ri1238\sb22\sl-280\slmult0\tx1797 \up0 \expndtw-1\charscalex100 1. Dokumen
rujukan berisi alasan pasien dirujuk, memuat kondisi pasien, dan
\line\tab \up0 \expndtw-3\charscalex100 kebutuhan pelayanan lebih lanjut. (D)
\par\pard\ql \li1440\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Dokumen
rujukan juga memuat prosedur dan intervensi yang sudah dilakukan. (D)
\par\pard\qj \li1440\ri1240\sb0\sl-280\slmult0\tx1797 \up0 \expndtw-2\charscalex100
3. Proses rujukan dievaluasi dalam aspek mutu dan keselamatan pasien.
(lihat \line\tab \up0 \expndtw-3\charscalex100 PMKP) (D,O.W) \par\pard\ql
\li1440\sb0\sl-620\slmult0 \par\pard\ql\li1440\ri3925\sb1\sl-620\slmult0\fi360 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 TRANSPORTASI \line \up0 \expndtw-3\charscalex100
Standar ARK.6 \par\pard\qj \li1440\sb0\sl-280\slmult0
\par\pard\qj\li1440\ri1204\sb21\sl-280\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi tentang
transportasi dalam proses merujuk, \up0 \expndtw-2\charscalex100 memindahkan
atau pemulangan, serta pasien rawat inap dan rawat jalan untuk \up0
\expndtw-3\charscalex100 memenuhi kebutuhan pasien. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb48\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan ARK.6 \par\pard\qj
\li1440\sb0\sl-276\slmult0 \par\pard\qj\li1440\ri1184\sb68\sl-276\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Proses merujuk,
memindahkan, dan memulangkan pasien membutuhkan \line \up0 \expndtw-
3\charscalex100 pemahaman tentang kebutuhan transpor pasien. Misalnya, pasien dari
unit pelayanan \line \up0 \expndtw-3\charscalex100 kronik atau pusat rehabilitasi
yang membutuhkan pelayanan rawat jalan atau evaluasi \line \up0
\expndtw0\charscalex104 asuhan di unit darurat mungkin tiba dengan ambulans atau
transportasi lainnya. \line \up0 \expndtw-2\charscalex100 Setelah selesai, pasien
mungkin minta bantuan transpor untuk kembali ke rumahnya \line \up0 \expndtw-
4\charscalex100 atau fasilitas lain. Pada situasi lain, misalnya pasien mengemudi
kendaraannya sendiri \line \up0 \expndtw-2\charscalex100 menuju ke rumah sakit
untuk mendapatkan tindakan yang kemudian karena tindakan \line \up0 \expndtw-
1\charscalex100 tadi mengganggu kemampuannya mengemudi sendiri untuk pulang
(seperti, operasi \line \up0 \expndtw0\charscalex103 mata, prosedur yang memerlukan
sedasi dan sebagainya). Merupakan tanggung \line \up0 \expndtw-1\charscalex100
jawab rumah sakit melakukan asesmen kebutuhan transpor pasien dan memastikan
\line \up0 \expndtw0\charscalex102 pasien mendapat transportasi aman. Bergantung
pada kebijakan rumah sakit dan \line \up0 \expndtw0\charscalex102 peraturan
perundang-undangan apakah ongkos transpor dapat atau tidak menjadi \line \up0
\expndtw-3\charscalex100 tanggung jawab rumah sakit. \par\pard\qj
\li1440\ri1245\sb261\sl-280\slmult0 \up0 \expndtw0\charscalex100 Jenis kendaraan
untuk transportasi berbagai macam, mungkin ambulans atau \line \up0 \expndtw-
1\charscalex100 kendaraan lain milik rumah sakit atau berasal dari sumber yang
diatur oleh keluarga \line \up0 \expndtw0\charscalex100 atau teman. Jenis kendaraan
yang diperlukan bergantung pada kondisi dan status \line \up0 \expndtw-
3\charscalex100 pasien. \par\pard\qj \li1440\ri1183\sb264\sl-276\slmult0 \up0
\expndtw-2\charscalex100 Kendaraan transportasi milik rumah sakit harus tunduk pada
peraturan perundangan \line \up0 \expndtw-2\charscalex100 yang mengatur tentang
kegiatan operasionalnya, kondisi, dan perawatan kendaraan. \line \up0 \expndtw-
2\charscalex100 Rumah sakit mengidentifikasi kegiatan transportasi yang berisiko
terkena infeksi dan \line \up0 \expndtw0\charscalex100 menentukan strategi
mengurangi risiko infeksi (lihat juga PPI 7; PPI 7.1; PPI 7.1.1; \line \up0
\expndtw0\charscalex100 PPI 7.2; PPI 7.3; PPI 8; PPI 9). Persediaan obat dan
perbekalan medis yang harus \line \up0 \expndtw-4\charscalex100 tersedia dalam
kendaraan bergantung pada pasien yang dibawa. Misalnya, membawa \line \up0
\expndtw-4\charscalex100 pasien geriatri dari unit rawat jalan pulang ke rumahnya
sangat berbeda dengan jika \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb110\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 76
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg77}
{\bkmkend Pg77}\par\pard\qj \li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\sb0\sl-
260\slmult0 \par\pard\qj\li1440\sb0\sl-260\slmult0 \par\pard\qj\li1440\sb0\sl-
260\slmult0 \par\pard\qj\li1440\ri1241\sb166\sl-260\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 harus transfer pasien dengan
penyakit menular atau transpor pasien luka bakar ke \up0 \expndtw-3\charscalex100
rumah sakit lain. \par\pard\qj \li1440\sb0\sl-276\slmult0
\par\pard\qj\li1440\ri1183\sb11\sl-276\slmult0 \up0 \expndtw-4\charscalex100 Jika
rumah sakit membuat kontrak layanan transportasi maka rumah sakit harus dapat \line
\up0 \expndtw0\charscalex100 menjamin bahwa kontraktor harus memenuhi standar untuk
mutu dan keselamatan \line \up0 \expndtw-2\charscalex100 pasien dan kendaraan. Jika
layanan transpor diberikan oleh Kementerian Kesehatan \line \up0 \expndtw-
1\charscalex100 atau Dinas Kesehatan, perusahaan asuransi, atau organisasi lain
yang tidak berada \line \up0 \expndtw-3\charscalex100 dalam pengawasan rumah sakit
maka masukan dari rumah sakit tentang keselamatan \line \up0 \expndtw-
3\charscalex100 dan mutu transpor dapat memperbaiki kinerja penyedia pelayanan
transpor. \par\pard\qj \li1440\sb0\sl-270\slmult0
\par\pard\qj\li1440\ri1248\sb19\sl-270\slmult0 \up0 \expndtw-1\charscalex100 Dalam
semua hal, rumah sakit melakukan evaluasi terhadap mutu dan keselamatan \up0
\expndtw0\charscalex104 pelayanan transportasi. Hal ini termasuk penerimaan,
evaluasi, dan tindak lanjut \up0 \expndtw-3\charscalex100 keluhan terkait pelayanan
transportasi. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb50\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian ARK.6 \par\pard\ql \li1440\ri1246\sb49\sl-270\slmult0\tx1797\tx1797
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi untuk
proses transportasi pasien sesuai dengan kebutuhannya yang \line\tab \up0
\expndtw0\charscalex100 meliputi asesmen kebutuhan transportasi, obat, bahan medis
habis pakai, serta \line \tab \up0 \expndtw-3\charscalex100 alat kesehatan dan
peralatan medis sesuai dengan kebutuhan pasien. (R) \par\pard\ql
\li1440\ri1242\sb2\sl-280\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex104 2.
Berdasar atas hasil asesmen, alat transportasi yang digunakan untuk rujukan
\line\tab \up0 \expndtw0\charscalex103 harus sesuai dengan kondisi dan kebutuhan
pasien dan memenuhi ketentuan \line \tab \up0 \expndtw-3\charscalex100 keselamatan
transportasi termasuk memenuhi persyaratan PPI. (D,O,W) \par\pard\ql
\li1440\ri1181\sb0\sl-280\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex103
3. Bila alat transportasi yang digunakan terkontaminasi cairan tubuh pasien
atau \line\tab \up0 \expndtw-3\charscalex100 pasien dengan penyakit menular harus
dilakukan proses dekontaminasi. (lihat juga \line \tab \up0 \expndtw-
4\charscalex100 PPI 7.1) (D,O,W) \par\pard\qj \li1440\ri1240\sb0\sl-
280\slmult0\tx1797 \up0 \expndtw0\charscalex103 4. Ada mekanisme untuk menangani
keluhan proses transportasi dalam rujukan. \line\tab \up0 \expndtw-2\charscalex100
(D,W) \par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb34\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 77
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg78}
{\bkmkend Pg78}\par\pard\ql \li5532\sb0\sl-276\slmult0 \par\pard\ql\li5532\sb0\sl-
276\slmult0 \par\pard\ql\li5532\sb0\sl-276\slmult0 \par\pard\ql\li5532\sb0\sl-
276\slmult0 \par\pard\ql\li5532\sb88\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAB 2 \par\pard\ql \li3811\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 HAK PASIEN DAN KELUARGA (HPK)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb156\sl-276\slmult0
\up0 \expndtw-3\charscalex100 GAMBARAN UMUM \par\pard\qj \li1440\ri1375\sb8\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien dan
keluarganya adalah pribadi yang unik dengan sifat, sikap, perilaku yang \up0
\expndtw-2\charscalex100 berbeda-beda, kebutuhan pribadi, agama, keyakinan, dan
nilai-nilai pribadi. \par\pard\qj \li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1317\sb19\sl-310\slmult0 \up0 \expndtw0\charscalex103 Rumah
sakit membangun kepercayaan dan komunikasi terbuka dengan pasien \line \up0
\expndtw-3\charscalex100 untuk memahami dan melindungi nilai budaya, psikososial,
serta nilai spiritual setiap \line \up0 \expndtw-4\charscalex100 pasien.
\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1370\sb2\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Hasil pelayanan pada pasien akan meningkat
bila pasien dan keluarga yang tepat \line \up0 \expndtw-1\charscalex100 atau mereka
yang berhak mengambil keputusan diikutsertakan dalam pengambilan \line \up0
\expndtw-1\charscalex100 keputusan pelayanan dan proses yang sesuai dengan harapan,
nilai, serta budaya. \par\pard\qj \li1440\ri1308\sb300\sl-320\slmult0 \up0
\expndtw-3\charscalex100 Untuk mengoptimalkan hak pasien dalam pemberian pelayanan
yang berfokus pada \up0 \expndtw0\charscalex103 pasien dimulai dengan menetapkan
hak tersebut, kemudian melakukan edukasi \up0 \expndtw0\charscalex105 pada pasien
serta staf tentang hak dan kewajiban tersebut. Para pasien diberi \up0 \expndtw-
1\charscalex100 informasi tentang hak dan kewajiban mereka dan bagaimana harus
bersikap. Para \up0 \expndtw0\charscalex102 staf dididik untuk mengerti dan
menghormati kepercayaan, nilai-nilai pasien, dan \up0 \expndtw0\charscalex100
memberikan pelayanan dengan penuh perhatian serta hormat guna menjaga
\up0 \expndtw-3\charscalex100 martabat dan nilai diri pasien. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Pada bab ini dikemukakan proses-proses untuk \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 1. melakukan identifikasi, melindungi, dan mengoptimalkan hak
pasien; \par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2.
memberitahu pasien tentang hak mereka; \par\pard\qj \li1440\ri1361\sb8\sl-
320\slmult0\tx1797 \up0 \expndtw-1\charscalex100 3. melibatkan keluarga pasien
bila kondisi memungkinkan dalam pengambilan \line\tab \up0 \expndtw-
2\charscalex100 keputusan tentang pelayanan pasien; \par\pard\ql \li1440\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 4. mendapatkan persetujuan tindakan
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 );
\par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5. mendidik
staf tentang hak dan kewajiban pasien. \par\pard\qj \li1440\ri1373\sb308\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Bagaimana proses asuhan dilaksanakan di
rumah sakit sesuai dengan peraturan \up0 \expndtw0\charscalex100 dan perundang-
undangan, konvensi international, dan perjanjian atau persetujuan \up0 \expndtw-
3\charscalex100 tentang hak asasi manusia yang disahkan oleh pemerintah.
\par\pard\qj \li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\ri1361\sb8\sl-
316\slmult0 \up0 \expndtw0\charscalex100 Proses ini berkaitan dengan bagaimana
rumah sakit menyediakan pelayanan \line \up0 \expndtw-1\charscalex100 kesehatan
dengan cara yang wajar yang sesuai dengan kerangka pelayanan \line \up0
\expndtw-2\charscalex100 kesehatan dan mekanisme pembiayaan pelayanan kesehatan
yang berlaku. Bab ini \line \up0 \expndtw0\charscalex103 juga berisi hak dan
kewajiban pasien dan keluarganya serta berkaitan dengan \line \up0
\expndtw0\charscalex103 penelitian klinis (\ul0\nosupersub\cf8\f9\fs24 clinical
trial\ul0\nosupersub\cf7\f8\fs24 ) dan donasi, juga transplantasi organ serta
jaringan \line \up0 \expndtw-3\charscalex100 tubuh. \par\pard\ql \li10243\sb217\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 78
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg79}
{\bkmkend Pg79}\par\pard\ql \li2272\sb0\sl-276\slmult0 \par\pard\ql\li2272\sb0\sl-
276\slmult0 \par\pard\ql\li2272\sb0\sl-276\slmult0 \par\pard\ql\li2272\sb0\sl-
276\slmult0 \par\pard\ql\li2272\sb0\sl-276\slmult0 \par\pard\ql\li2272\sb132\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 STANDAR,
MAKSUD DAN TUJUAN, SERTA ELEMEN PENILAIAN \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb68\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar HPK.1 \par\pard\qj \li1440\ri1314\sb8\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Ada regulasi bahwa rumah sakit
bertanggung jawab dan mendukung hak pasien dan \up0 \expndtw-4\charscalex100
keluarga selama dalam asuhan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK.1 \par\pard\ql \li1440\sb44\sl-
276\slmult0\tx3324 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24
Kepemimpinan \tab \up0 \expndtw0\charscalex103 (\ul0\nosupersub\cf8\f9\fs24
leadership\ul0\nosupersub\cf7\f8\fs24 ) rumah sakit bertanggung jawab
bagaimana \par\pard\qj \li1440\ri1374\sb16\sl-310\slmult0 \up0
\expndtw0\charscalex100 memperlakukan pasiennya dan pimpinan perlu mengetahui serta
memahami hak \up0 \expndtw0\charscalex100 pasien dan keluarga juga tanggung
jawabnya seperti ditentukan dalam peraturan \up0 \expndtw-3\charscalex100
perundang-undangan. \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1312\sb2\sl-320\slmult0 \up0 \expndtw-1\charscalex100
Pimpinan rumah sakit memberikan arahan kepada kelompok staf medis (KSM) dan \up0
\expndtw-3\charscalex100 staf klinis lainnya di unit pelayanan untuk memastikan
semua staf di rumah sakit ikut \up0 \expndtw-4\charscalex100 bertanggung jawab
melindungi hak-hak ini. \par\pard\qj \li1440\ri1356\sb300\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Rumah sakit menghormati hak dan kewajiban pasien,
serta dalam banyak hal \line \up0 \expndtw0\charscalex100 menghormati keluarga
pasien, terutama hak untuk menentukan informasi apa saja \line \up0
\expndtw0\charscalex103 yang dapat disampaikan kepada keluarga atau pihak lain
terkait asuhan pasien. \line \up0 \expndtw-2\charscalex100 Sebagai contoh, pasien
tidak ingin diagnosis dirinya disampaikan kepada keluarga. \par\pard\qj
\li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\ri1362\sb10\sl-315\slmult0 \up0
\expndtw0\charscalex104 Hak serta kewajiban pasien dan keluarga merupakan elemen
dasar dari semua \up0 \expndtw0\charscalex103 interaksi di rumah sakit, staf rumah
sakit, pasien, dan keluarga. Oleh karena itu, \up0 \expndtw0\charscalex100 harus
ada regulasi yang memastikan semua staf sadar dan tanggap terhadap isu \up0
\expndtw-2\charscalex100 hak serta kewajiban pasien dan keluarga pada waktu
berinteraksi saat memberikan \up0 \expndtw-3\charscalex100 asuhan kepada pasien.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK.1
\par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang hak dan kewajiban pasien dan
keluarga (lihat juga TKRS \par\pard\ql \li1797\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 12.1 EP 1; dan TKRS 12.2 EP 2). (R) \par\pard\qj
\li1440\ri1374\sb8\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex100 2. Pimpinan
rumah
sakit memahami hak serta kewajiban pasien dan keluarga \line\tab \up0
\expndtw-3\charscalex100 sebagaimana ditetapkan dalam peraturan perundang-undangan.
(W) \par\pard\ql \li1440\ri1304\sb0\sl-320\slmult0\tx1797\tx1797 \up0 \expndtw-
3\charscalex100 3. Rumah sakit menghormati hak serta kewajiban pasien dan dalam
kondisi tertentu \line\tab \up0 \expndtw0\charscalex102 terhadap keluarga pasien
bahwa pasien memiliki hak untuk menentukan \line \tab \up0 \expndtw-
2\charscalex100 informasi apa saja yang dapat disampaikan pada keluarga dan pihak
lain. (D,W). \par\pard\ql \li1440\ri1307\sb0\sl-320\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex100 4. Semua staf memperoleh edukasi dan memahami tentang hak
serta kewajiban \line\tab \up0 \expndtw-3\charscalex100 pasien dan keluarga, juga
dapat menjelaskan tanggung jawabnya melindungi hak \line \tab \up0 \expndtw-
4\charscalex100 pasien. (D,W). \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb5\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 79
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg80}
{\bkmkend Pg80}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK.1.1 \par\pard\qj
\li1440\ri1364\sb16\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memberikan asuhan dengan menghargai agama,
keyakinan dan nilai\up0 \expndtw-2\charscalex100 nilai pribadi pasien, serta
merespons permintaan yang berkaitan dengan bimbingan \up0 \expndtw-3\charscalex100
kerohanian. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb83\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan HPK.1.1 \par\pard\qj \li1440\ri1304\sb11\sl-316\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Pasien dengan populasi yang
beragam dalam memeluk agama, keyakinan, dan \line \up0 \expndtw0\charscalex104
memiliki nilai-nilai pribadi maka beragam pula dalam menerima proses asuhan.
\line \up0 \expndtw-4\charscalex100 Beberapa agama, keyakinan, dan nilai-nilai
pribadi berlaku umum bagi semua pasien \line \up0 \expndtw-1\charscalex100 serta
biasanya berasal dari budaya dan agama. Ada keyakinan yang bersifat
\line \up0 \expndtw0\charscalex104 individual. Rumah sakit melakukan identifikasi
agama, keyakinan, dan nilai-nilai \line \up0 \expndtw-1\charscalex100 pribadi
pasien agar dalam memberikan asuhan selaras dengan agama, keyakinan, \line \up0
\expndtw-3\charscalex100 dan nilai-nilai pribadi. \par\pard\qj \li1440\sb0\sl-
315\slmult0 \par\pard\qj\li1440\ri1307\sb10\sl-315\slmult0 \up0
\expndtw0\charscalex104 Asuhan pasien yang menghargai agama, keyakinan, dan nilai-
nilai pribadi akan \up0 \expndtw0\charscalex102 membantu kelancaran proses asuhan
serta memberikan hasil asuhan yang lebih \up0 \expndtw-2\charscalex100 baik. Setiap
profesional pemberi asuhan (PPA) harus melakukan identifikasi agama \up0 \expndtw-
2\charscalex100 dan memahami agama, keyakinan, nilai-nilai pribadi pasien,
serta menerapkan \up0 \expndtw-5\charscalex100 dalam asuhan pasien yang
diberikan. \par\pard\qj \li1440\sb0\sl-316\slmult0
\par\pard\qj\li1440\ri1339\sb9\sl-316\slmult0 \up0 \expndtw-2\charscalex100 Jika
pasien atau keluarga ingin berbicara dengan seseorang terkait kebutuhan
\line \up0 \expndtw0\charscalex103 agama dan spiritualnya maka rumah sakit
menetapkan proses untuk menjawab \line \up0 \expndtw0\charscalex105 permintaan ini.
Proses ini dilaksanakan melalui staf kerohanian di rumah sakit. \line \up0
\expndtw0\charscalex100 Proses ini menjadi kompleks bila rumah sakit atau negara
tidak mengakui secara \line \up0 \expndtw-2\charscalex100 resmi atau mempunyai
sumber terkait sebuah agama, tetapi bila ada permintaan ini \line \up0 \expndtw-
2\charscalex100 maka rumah sakit dapat mengambil sumber di luar rumah sakit atau
dari keluarga. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb82\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian HPK.1.1 \par\pard\qj \li1440\ri1370\sb8\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Agama, keyakinan, dan
nilai-nilai pribadi pasien teridentifikasi (lihat juga MKE 8 \line\tab \up0
\expndtw-3\charscalex100 EP 1). (D,W) \par\pard\qj \li1440\ri1301\sb0\sl-
320\slmult0\tx1797 \up0 \expndtw-3\charscalex100 2. Staf memberikan asuhan dengan
cara menghormati agama, keyakinan, dan nilai-\line\tab \up0 \expndtw-
4\charscalex100 nilai pribadi pasien (lihat juga MKE 8 EP 2). (D,W) \par\pard\qj
\li1440\ri1314\sb17\sl-300\slmult0\tx1797 \up0 \expndtw-1\charscalex100 3. Rumah
sakit menanggapi permintaan rutin, termasuk permintaan kompleks \line\tab
\up0 \expndtw-4\charscalex100 terkait dukungan agama atau bimbingan kerokhanian.
(D,W,S). \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb84\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar
HPK.1.2 \par\pard\qj \li1440\ri1366\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 lnformasi tentang pasien adalah rahasia dan rumah
sakit diminta menjaga \up0 \expndtw-3\charscalex100 kerahasiaan informasi pasien
serta menghormati kebutuhan privasinya. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK.1.2 \par\pard\qj
\li1440\ri1361\sb14\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Staf wajib menjaga dan menghargai informasi
tentang pasien sebagai suatu \line \up0 \expndtw-2\charscalex100 kerahasiaan,
di samping itu juga menghormati kebutuhan privasi pasien. Pada \line \up0
\expndtw-2\charscalex100 implementasinya rumah sakit diminta tidak mencantumkan
informasi rahasia pasien \line \up0 \expndtw-2\charscalex100 pada pintu
pasien,\ul0\nosupersub\cf8\f9\fs24 lobby\ul0\nosupersub\cf7\f8\fs24 atau ruang
perawat (\ul0\nosupersub\cf8\f9\fs24 nurse station\ul0\nosupersub\cf7\f8\fs24 ),
dan tidak mengadakan \par\pard\ql \li10243\sb217\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 80
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg81}
{\bkmkend Pg81}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 diskusi yang terkait dengan pasien di
ruang publik. \par\pard\qj \li1440\ri1367\sb252\sl-315\slmult0 \up0
\expndtw0\charscalex103 Staf menyadari peraturan perundang-undangan yang
mengatur kerahasiaan \up0 \expndtw0\charscalex102 informasi serta memberitahukan
pasien bagaimana rumah sakit menghargai \up0 \expndtw0\charscalex102
kerahasiaan informasi dan privasi mereka. Dokter penanggung jawab pelayanan \up0
\expndtw-2\charscalex100 (DPJP) memberitahu pada pasien atau keluarga tentang
informasi kondisi pasien di \up0 \expndtw-3\charscalex100 setiap terjadi perubahan.
\par\pard\qj \li1440\ri1369\sb241\sl-320\slmult0 \up0 \expndtw0\charscalex100 Rumah
sakit memiliki kebijakan yang menunjukkan apakah pasien memiliki akses \up0
\expndtw0\charscalex102 terhadap informasi kesehatan mereka dan proses untuk
mendapatkan akses jika \up0 \expndtw-3\charscalex100 diizinkan. \par\pard\qj
\li1440\ri1369\sb243\sl-317\slmult0 \up0 \expndtw-2\charscalex100 Rumah sakit
diminta menghormati hak privasi pasien terutama ketika diwawancara, \up0 \expndtw-
1\charscalex100 diperiksa, dirawat, dan dipindahkan. Pasien mungkin
menginginkan privasinya \up0 \expndtw0\charscalex100 terlindung dari para
karyawan, pasien lain, masyarakat, dan bahkan dari anggota \up0 \expndtw-
1\charscalex100 keluarga. Di samping itu, pasien mungkin tidak ingin diambil
fotonya, direkam, atau \up0 \expndtw0\charscalex100 diikutsertakan dalam survei
wawancara tentang penelitian dan lainnya. Meskipun \up0 \expndtw-1\charscalex100
ada beberapa cara pendekatan umum untuk memberikan privasi bagi seluruh
\up0 \expndtw-2\charscalex100 pasien, setiap pasien memiliki harapan privasi yang
berbeda atau tambahan privasi \up0 \expndtw-3\charscalex100 sesuai dengan kebutuhan
privasi pasien. \par\pard\qj \li1440\ri1356\sb221\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Harapan akan kebutuhan ini mungkin saja berubah seiring
dengan waktu dan \line \up0 \expndtw0\charscalex104 kondisi. Oleh karena itu,
rumah sakit mengidentifikasi kebutuhan privasi pasien \line \up0
\expndtw0\charscalex100 terkait dengan asuhan pasien. Informasi medis dan
kesehatan lainnya ketika \line \up0 \expndtw0\charscalex100 didokumentasikan dan
dikumpulkan bersifat penting guna memahami pasien dan \line \up0
\expndtw0\charscalex100 kebutuhannya serta memberikan perawatan dan pelayanan
seiring dengan waktu. \line \up0 \expndtw-2\charscalex100 Informasi ini dapat
berupa kertas atau elektronik atau kombinasi dari keduanya. \par\pard\qj
\li1440\ri1364\sb246\sl-313\slmult0 \up0 \expndtw-1\charscalex100 Rumah sakit
menghargai informasi tersebut sebagai rahasia dan menerapkan \up0
\expndtw0\charscalex100 regulasi yang melindungi informasi tersebut dari kehilangan
atau penyalahgunaan. \up0 \expndtw0\charscalex100 Regulasi yang ada mencakup
informasi yang dapat diberikan sesuai dengan \up0 \expndtw-3\charscalex100
kebutuhan peraturan perundang-undangan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb2\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK.1.2 \par\pard\qj
\li1440\ri1372\sb8\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang kewajiban simpan rahasia
pasien dan menghormati \line\tab \up0 \expndtw-3\charscalex100 kebutuhan privasi
pasien. (R) \par\pard\ql \li1440\ri1374\sb0\sl-320\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex100 2. Ada bukti pasien diberitahu bahwa segala informasi
tentang kesehatan pasien \line\tab \up0 \expndtw0\charscalex100 adalah rahasia
dan kerahasiaan itu akan dijaga sesuai dengan peraturan \line \tab \up0
\expndtw-3\charscalex100 perundang-undangan. (D,W) \par\pard\qj
\li1440\ri1375\sb0\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Pasien
diminta persetujuannya untuk pelepasan informasi yang tidak tercakup \line\tab \up0
\expndtw-3\charscalex100 dalam peraturan perundang-undangan. (D,W). \par\pard\ql
\li1440\sb17\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4. Rumah sakit
menghormati kerahasiaan informasi kesehatan pasien. (D,W). \par\pard\qj
\li1440\ri1376\sb8\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex104 5. Staf
mengidentifikasi harapan dan kebutuhan privasi selama pelayanan dan \line\tab
\up0 \expndtw-3\charscalex100 pengobatan. (D,O,W) \par\pard\ql \li1440\sb37\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 6. Keinginan akan kebutuhan pasien untuk
privasi dihormati saat wawancara klinis, \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb110\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 81
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg82}
{\bkmkend Pg82}\par\pard\ql \li1797\sb0\sl-276\slmult0 \par\pard\ql\li1797\sb0\sl-
276\slmult0 \par\pard\ql\li1797\sb0\sl-276\slmult0 \par\pard\ql\li1797\sb0\sl-
276\slmult0 \par\pard\ql\li1797\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 pemeriksaan, prosedur, pengobatan, dan
transfer pasien. (O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb68\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK.1.3 \par\pard\qj \li1440\ri1375\sb8\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan ketentuan untuk melindungi harta benda milik pasien dari \up0 \expndtw-
3\charscalex100 kehilangan atau pencurian. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 1.3
\par\pard\qj \li1440\ri1303\sb11\sl-317\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memberitahu pasien tentang tanggung jawab
rumah sakit terhadap \up0 \expndtw-2\charscalex100 barang milik pasien dan
batasan-batasannya. Rumah sakit bertanggung jawab \up0 \expndtw0\charscalex102
terhadap barang milik pasien yang dibawa masuk ke rumah sakit sesuai dengan \up0
\expndtw-3\charscalex100 batasan. Rumah sakit memiliki proses untuk
mengidentifikasi dan melindungi barang \up0 \expndtw-1\charscalex100 milik pasien
yang dititipkan atau pasien tidak dapat menjaganya untuk memastikan \up0 \expndtw-
4\charscalex100 barang tidak hilang atau dicuri. Proses ini berlaku untuk pasien di
unit darurat, pasien \up0 \expndtw-1\charscalex100 pelayanan satu hari
(\ul0\nosupersub\cf8\f9\fs24 one day care\ul0\nosupersub\cf7\f8\fs24 ), rawat inap,
pasien yang tidak mampu menjaga \up0 \expndtw-3\charscalex100 barang miliknya, dan
mereka yang tidak mampu membuat keputusan tentang barang \up0 \expndtw-
4\charscalex100 miliknya. (lihat juga MFK 4.1) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 1.3
\par\pard\ql \li1440\ri1306\sb8\sl-320\slmult0\tx1797\tx1797\tx1797 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang penyimpanan
barang milik pasien yang dititipkan dan \line\tab \up0 \expndtw-
4\charscalex100 barang milik pasien karena pasiennya tidak dapat menjaga harta
miliknya. Rumah \line \tab \up0 \expndtw-1\charscalex100 sakit memastikan barang
tersebut aman dan menetapkan tingkat tanggung \line \tab \up0 \expndtw-
2\charscalex100 jawabnya atas barang milik pasien tersebut. (R) \par\pard\qj
\li1440\ri1306\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-2\charscalex100 2. Pasien
menerima informasi tentang tanggung jawab rumah sakit dalam menjaga \line\tab
\up0 \expndtw-5\charscalex100 barang milik pasien. (D,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 1.4 \par\pard\qj
\li1440\ri1371\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien yang rentan terhadap kekerasan fisik serta
kelompok pasien yang berisiko \up0 \expndtw-3\charscalex100 diidentifikasi dan
dilindungi. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan HPK 1.4 \par\pard\qj \li1440\ri1328\sb11\sl-316\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengidentifikasi kelompok
pasien berisiko yang tidak dapat melindungi \line \up0 \expndtw0\charscalex100
dirinya sendiri, misalnya bayi, anak-anak, pasien cacat, manula,
pascabedah, \line \up0 \expndtw0\charscalex100 gangguan jiwa, gangguan kesadaran,
dll. serta menetapkan tingkat perlindungan \line \up0 \expndtw0\charscalex100
terhadap pasien tersebut. Perlindungan ini mencakup tidak hanya kekerasan fisik,
\line \up0 \expndtw0\charscalex100 tetapi juga mencakup hal-hal terkait keamanan,
seperti kelalaian (\ul0\nosupersub\cf8\f9\fs24 negligent\ul0\nosupersub\cf7\f8\fs24
) dalam \line \up0 \expndtw0\charscalex103 asuhan, tidak memberi layanan, atau
tidak memberi bantuan waktu terjadi \line \up0 \expndtw-2\charscalex100
kebakaran. Semua anggota staf memahami tanggung jawabnya dalam proses ini.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Rumah sakit menjaga keamanan dalam tiga area,
yaitu \par\pard\qj \li1800\ri1372\sb8\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex102 1) area publik yang terbuka untuk umum seperti area
parkir, rawat jalan, dan \line\tab \up0 \expndtw-3\charscalex100 penunjang
pelayanan; \par\pard\qj \li1800\ri1368\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 2) area tertutup yang hanya dapat dimasuki orang tertentu
dengan izin khusus \line\tab \up0 \expndtw-3\charscalex100 dan pakaian tertentu,
misalnya kamar operasi; \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb10\sl-253\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 82
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg83}
{\bkmkend Pg83}\par\pard\ql \li1800\sb0\sl-315\slmult0 \par\pard\ql\li1800\sb0\sl-
315\slmult0 \par\pard\ql\li1800\sb0\sl-315\slmult0
\par\pard\ql\li1800\ri1361\sb215\sl-315\slmult0\tx2160\tx2160\tx2160\tx2160 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3) area semiterbuka, yaitu
area yang terbuka pada saat-saat tertentu dan \line\tab \up0
\expndtw0\charscalex100 tertutup pada saat yang lain, misalnya rawat inap pada saat
jam berkunjung \line \tab \up0 \expndtw0\charscalex104 menjadi area terbuka, tetapi
di luar jam berkunjung menjadi area tertutup \line \tab \up0
\expndtw0\charscalex100 untuk itu pengunjung di luar jam berkunjung harus diatur,
diidentifikasi, dan \line \tab \up0 \expndtw-3\charscalex100 menggunakan identitas
pengunjung. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb82\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian HPK 1.4 \par\pard\ql \li1440\ri1364\sb8\sl-320\slmult0\tx1797\tx1797 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
regulasi untuk melakukan identifikasi populasi pasien \line\tab \up0
\expndtw0\charscalex100 yang rentan terhadap risiko kekerasan dan melindungi
semua pasien dari \line \tab \up0 \expndtw-3\charscalex100 kekerasan (lihat juga
PP 3.1 s.d. 3.9). (R) \par\pard\qj \li1440\ri1364\sb0\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex103 2. Daerah terpencil, daerah terisolasi, dan rawan
terjadinya tindak kekerasan di \line\tab \up0 \expndtw-3\charscalex100 rumah sakit
dimonitor (lihat juga MFK 4). (O,W) \par\pard\qj \li1440\ri1369\sb0\sl-
320\slmult0\tx1797 \up0 \expndtw0\charscalex103 3. Staf rumah sakit memahami peran
mereka dalam tanggung jawabnya dalam \line\tab \up0 \expndtw-3\charscalex100
melaksanakan proses perlindungan. (D,O,W) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 2 \par\pard\qj
\li1440\ri1370\sb25\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi dan proses untuk
mendukung partisipasi pasien \up0 \expndtw-3\charscalex100 dan keluarga di dalam
proses asuhan. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb84\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan HPK 2 \par\pard\qj \li1440\ri1304\sb11\sl-317\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Partisipasi pasien dan
keluarga dalam proses asuhan melalui pengambilan \up0 \expndtw-1\charscalex100
keputusan tentang asuhan, bertanya soal asuhan, minta pendapat orang
lain \up0 \expndtw-3\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 second
opinion\ul0\nosupersub\cf7\f8\fs24
), dan menolak prosedur diagnostik atau tindakan. Saat pasien minta \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf8\f9\fs24 second
opinion\ul0\nosupersub\cf7\f8\fs24 , diharapkan rumah sakit tidak
menolak, mencegah atau \up0 \expndtw-1\charscalex100 menghalanginya, sebaliknya
rumah sakit diminta memfasilitasi permintaan tersebut \up0 \expndtw0\charscalex100
dengan jalan pasien diberi informasi tentang kondisinya, hasil tes,
diagnosis, \up0 \expndtw-1\charscalex100 rekomendasi tindakan, dan sebagainya.
Rumah sakit tidak boleh menyembunyikan \up0 \expndtw-2\charscalex100 informasi ini
jika pasien meminta\ul0\nosupersub\cf8\f9\fs24 second
opinion\ul0\nosupersub\cf7\f8\fs24 . Rumah sakit menetapkan regulasi \up0
\expndtw0\charscalex104 untuk mengatur hak pasien untuk
mencari\ul0\nosupersub\cf8\f9\fs24 second opinion\ul0\nosupersub\cf7\f8\fs24
tanpa rasa khawatir \up0 \expndtw-3\charscalex100 memengaruhi proses asuhannya.
\par\pard\qj \li1440\sb0\sl-313\slmult0 \par\pard\qj\li1440\ri1366\sb14\sl-
313\slmult0 \up0 \expndtw0\charscalex103 Rumah sakit mendorong pasien dan
keluarga terlibat dalam seluruh aspek \up0 \expndtw0\charscalex100 pelayanan.
Seluruh staf sudah dilatih melaksanakan regulasi dan perannya dalam \up0 \expndtw-
2\charscalex100 mendukung hak pasien serta keluarganya untuk berpatisipasi
di dalam proses \up0 \expndtw-3\charscalex100 asuhannya. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 2 \par\pard\ql
\li1440\ri1309\sb16\sl-310\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang rumah sakit mendorong
partisipasi pasien dan keluarga \line\tab \up0 \expndtw0\charscalex101 dalam proses
asuhan dan memberi kesempatan pasien untuk melaksanakan \line \tab \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf8\f9\fs24 second
opinion\ul0\nosupersub\cf7\f8\fs24 tanpa rasa khawatir akan memengaruhi proses
asuhannya. \up0 \expndtw-3\charscalex100 (lihat \par\pard\ql \li1797\sb59\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 juga PAP 7.1 EP 6; AP 1 EP 4; ARK 2.1 EP
4; dan MKE 9 EP 5). (R) \par\pard\ql \li1440\ri1329\sb0\sl-
320\slmult0\tx1797\tx1797 \up0 \expndtw-2\charscalex100 2. Staf dilatih dan
terlatih melaksanakan regulasi serta perannya dalam mendukung \line\tab \up0
\expndtw-1\charscalex100 hak pasien dan keluarga untuk berpartisipasi dalam
proses pelayanannya. \line \tab \up0 \expndtw-3\charscalex100 (D,W,S) \par\pard\ql
\li10243\sb204\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 83
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg84}
{\bkmkend Pg84}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb156\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 2.1 \par\pard\ql
\li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien diberitahu tentang semua aspek asuhan medis dan
tindakan. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan HPK 2.1 \par\pard\qj \li1440\ri1327\sb11\sl-316\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Agar pasien dan keluarganya dapat
berpartisipasi dalam membuat keputusan, \up0 \expndtw0\charscalex103 mereka
mendapat informasi tentang kondisi medis, setelah dilakukan asesmen, \up0
\expndtw0\charscalex100 termasuk diagnosis pasti dan rencana asuhan. Pasien serta
keluarga mengerti hal \up0 \expndtw-2\charscalex100 yang harus diputuskan tentang
asuhan dan bagaimana mereka berpartisipasi dalam \up0 \expndtw0\charscalex104
membuat keputusan. Sebagai tambahan, pasien serta keluarga harus mengerti \up0
\expndtw-1\charscalex100 tentang proses asuhan, tes pemeriksaan, prosedur,
dan tindakan yang harus \up0 \expndtw-3\charscalex100 mendapat persetujuan
(\ul0\nosupersub\cf8\f9\fs24 consent\ul0\nosupersub\cf7\f8\fs24 ) dari mereka.
\par\pard\qj \li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\ri1361\sb10\sl-
315\slmult0 \up0 \expndtw0\charscalex104 Selama dalam proses asuhan, pasien juga
berhak untuk mendapat penjelasan \up0 \expndtw-2\charscalex100 tentang hasil
pengobatan/tindakan termasuk kemungkinan hasil yang tidak terduga. \up0
\expndtw0\charscalex100 Pasien serta keluarga paham bahwa mereka berhak atas
informasi ini dan berhak \up0 \expndtw0\charscalex103 mengetahui siapa dokter yang
bertanggungjawab untuk melayaninya yang akan \up0 \expndtw-3\charscalex100
memberitahu hasil asesmen dan pengobatan/tindakan. \par\pard\qj \li1440\sb0\sl-
316\slmult0 \par\pard\qj\li1440\ri1305\sb9\sl-316\slmult0 \up0
\expndtw0\charscalex103 Terkadang beberapa pasien tidak ingin mengetahui diagnosis
penyakitnya atau \up0 \expndtw0\charscalex102 berpartisipasi dalam membuat
keputusan terkait asuhannya, tetapi mereka diberi \up0 \expndtw-3\charscalex100
kesempatan dan dapat memilih berpartisipasi melalui anggota keluarga, teman,
atau \up0 \expndtw-1\charscalex100 pengganti keluarga. Bagi pasien harus jelas
siapa DPJP yang akan memberi \up0 \expndtw-3\charscalex100 informasi tentang
kondisi medik, asuhan, tindakan, dan hasil termasuk kejadian yang \up0 \expndtw-
4\charscalex100 tidak terduga dan lain sebagainya. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 2.1
\par\pard\ql \li1440\ri1369\sb8\sl-320\slmult0\tx1797\tx1797\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang hak
pasien untuk mendapatkan informasi tentang kondisi, \line\tab \up0
\expndtw0\charscalex100 diagnosis pasti, rencana asuhan, dan dapat berpartisipasi
dalam pengambilan \line \tab \up0 \expndtw0\charscalex102 keputusan serta
diberitahu tentang hasil asuhan termasuk kemungkinan hasil \line \tab \up0
\expndtw-3\charscalex100 yang tidak terduga. (R) \par\pard\qj
\li1440\ri1366\sb17\sl-300\slmult0\tx1797 \up0 \expndtw-1\charscalex100 2. Pasien
diberi informasi tentang kondisi medis mereka dan diagnosis pasti. (lihat \line\tab
\up0 \expndtw-3\charscalex100 juga MKE 9 EP 1). (D,W) \par\pard\ql
\li1440\ri1367\sb4\sl-320\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex100 3.
Pasien diberi informasi tentang rencana asuhan dan tindakan yang akan
\line\tab \up0 \expndtw-1\charscalex100 dilakukan dan berpartisipasi dalam
pengambilan keputusan. (lihat juga AP 1 EP \line \tab \up0 \expndtw-2\charscalex100
4 dan MKE 9 EP 1). (D,W) \par\pard\ql \li1440\sb37\sl-276\slmult0\tx5431\tx8193
\up0 \expndtw0\charscalex105 4. Pasien diberi tahu bilamana \tab \up0
\expndtw0\charscalex100 \u8220?persetujuan tindakan\u8221? \tab \up0
\expndtw0\charscalex101 (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) \par\pard\qj \li1797\ri1356\sb8\sl-320\slmult0
\up0 \expndtw-2\charscalex100 diperlukan dan bagaimana proses memberikan
persetujuan. (lihat juga HPK 5.1; \line \up0 \expndtw-2\charscalex100 AP 6; AP 5.11
EP 2; PAP 3.3; PAB 3; PAB 4; PAB 7; dan MKE 9 EP 4). (D,W) \par\pard\qj
\li1440\ri1368\sb17\sl-300\slmult0\tx1797 \up0 \expndtw0\charscalex102 5. Pasien
dijelaskan dan memahami tentang hasil yang diharapkan dari proses \line\tab
\up0 \expndtw-3\charscalex100 asuhan dan pengobatan. (lihat juga ARK 2.1 EP 2 dan
PAP 2.4). (D,W) \par\pard\qj \li1440\ri1367\sb4\sl-320\slmult0\tx1797 \up0
\expndtw-1\charscalex100 6. Pasien dijelaskan dan memahami bila terjadi
kemungkinan hasil yang tidak \line\tab \up0 \expndtw-2\charscalex100 terduga.
(lihat juga PAP 2.4 EP 2). (D,W) \par\pard\ql \li10243\sb216\sl-253\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 84
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg85}
{\bkmkend Pg85}\par\pard\ql \li1440\sb0\sl-310\slmult0 \par\pard\ql\li1440\sb0\sl-
310\slmult0 \par\pard\ql\li1440\sb0\sl-310\slmult0
\par\pard\ql\li1440\ri1332\sb234\sl-310\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 7. Pasien serta keluarga
dijelaskan dan memahami tentang haknya dalam \line\tab \up0 \expndtw-
2\charscalex100 berpartisipasi membuat keputusan terkait asuhan jika diinginkan.
(lihat juga AP 1 \line \tab \up0 \expndtw-3\charscalex100 EP 4; ARK 2.1 EP 4; dan
MKE 9 EP 5). (W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 2.2 \par\pard\qj \li1440\ri1369\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien dan
keluarga menerima informasi tentang penyakit, rencana tindakan, dan \line \up0
\expndtw-2\charscalex100 DPJP serta para PPA lainnya agar mereka dapat memutuskan
tentang asuhannya. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 2.2 \par\pard\qj
\li1440\ri1373\sb25\sl-300\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Anggota staf menjelaskan setiap tindakan atau prosedur
yang diusulkan kepada \up0 \expndtw-3\charscalex100 pasien dan keluarga.
\par\pard\ql \li1440\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Informasi
yang diberikan memuat elemen \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 a) diagnosis (diagnosis kerja dan diagnosis banding) dan
dasar diagnosis; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 b) kondisi pasien; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 c) tindakan yang diusulkan; \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) tata cara dan tujuan
tindakan; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e)
manfaat dan risiko tindakan \par\pard\ql \li1800\sb24\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 f) nama orang mengerjakan tindakan; \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 g) kemungkinan alternatif dari tindakan;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 h)
prognosis dari tindakan; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 i) kemungkinan hasil yang tidak terduga; \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 j) kemungkinan hasil
bila tidak dilakukan tindakan. (lihat juga HPK 5.2) \par\pard\qj \li1440\sb0\sl-
316\slmult0 \par\pard\qj\li1440\ri1306\sb15\sl-316\slmult0 \up0 \expndtw-
3\charscalex100 Staf klinis juga memberi tahu pasien, nama dokter, atau profesional
pemberi asuhan \up0 \expndtw-3\charscalex100 (PPA) lainnya sebagai penanggung jawab
asuhan pasien yang diberi izin melakukan \up0 \expndtw-3\charscalex100 tindakan dan
prosedur. Sering, pasien bertanya tentang kompetensi, pengalaman, \up0
\expndtw0\charscalex103 jangka waktu bekerja di rumah sakit, dan sebagainya dari
para DPJP serta PPA \up0 \expndtw0\charscalex100 lainnya. Rumah sakit harus
menetapkan proses untuk menjawab jika pasien minta \up0 \expndtw-1\charscalex100
tambahan informasi tentang DPJP dan perawat penanggung jawab asuhan (PPJA) \up0
\expndtw-2\charscalex100 mereka. (lihat juga MKE 9) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 2.2
\par\pard\ql \li1440\ri1367\sb16\sl-310\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mengatur
pelaksanaan proses untuk menjawab pertanyaan \line\tab \up0 \expndtw-
1\charscalex100 informasi kompetensi dan kewenangan dari PPA. (R) (lihat juga KKS
9; KKS 13 \line \tab \up0 \expndtw-3\charscalex100 dan KKS 16) \par\pard\ql
\li1440\ri1306\sb2\sl-320\slmult0\tx1797\tx1797 \up0 \expndtw-3\charscalex100 2.
Pasien diberi informasi tentang elemen a) sampai dengan j) yang relevan dengan
\line\tab \up0 \expndtw0\charscalex102 kondisi dan rencana tindakan (D,W). (lihat
juga HPK 5.1; AP 6; AP 5.11 EP 2; \line \tab \up0 \expndtw-3\charscalex100 PAP 3.3;
PAB 3; PAB 4; PAB 7; dan MKE 9 EP 4) \par\pard\qj \li1440\ri1376\sb0\sl-
320\slmult0\tx1797 \up0 \expndtw0\charscalex103 3. DPJP, PPJA, dan PPA lainnya
harus memperkenalkan diri saat pertama kali \line\tab \up0 \expndtw-3\charscalex100
bertemu pasien. (W,S) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 2.3 \par\pard\qj \li1440\ri1313\sb8\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
memberitahu pasien dan keluarganya tentang hak dan tanggung jawab \line \up0
\expndtw-3\charscalex100 mereka yang berhubungan dengan penolakan atau tidak
melanjutkan pengobatan. \par\pard\ql \li10243\sb216\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 85
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg86}
{\bkmkend Pg86}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb132\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan HPK 2.3 \par\pard\qj \li1440\ri1308\sb0\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien atau mereka yang membuat
keputusan atas nama pasien dapat memutuskan \up0 \expndtw-1\charscalex100 untuk
tidak melanjutkan pelayanan atau pengobatan yang direncanakan atau tidak \up0
\expndtw0\charscalex103 meneruskan pelayanan atau pengobatan setelah kegiatan
dimulai. Rumah sakit \up0 \expndtw-1\charscalex100 memberitahukan pasien dan
keluarganya tentang hak mereka untuk membuat \up0 \expndtw-2\charscalex100
keputusan, potensi hasil dari keputusan tersebut, dan tanggung jawab
mereka \up0 \expndtw-3\charscalex100 berkenaan dengan keputusan tersebut. Pasien
serta keluarganya diberitahu tentang \up0 \expndtw-4\charscalex100 alternatif
pelayanan dan pengobatan. (lihat juga ARK 4.4, EP 1) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb49\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 2.3
\par\pard\ql \li1440\ri1364\sb8\sl-320\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit memberitahukan
pasien serta keluarganya tentang hak mereka \line\tab \up0 \expndtw0\charscalex100
untuk menolak atau tidak melanjutkan pengobatan. (lihat juga ARK 4.4, EP 1).
\line \tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\qj \li1440\ri1374\sb0\sl-
320\slmult0\tx1797 \up0 \expndtw-2\charscalex100 2. Rumah sakit memberitahukan
pasien dan keluarganya tentang konsekuensi dari \line\tab \up0 \expndtw-
3\charscalex100 keputusan mereka. (lihat juga ARK 4.4, EP 2). (D,W) \par\pard\qj
\li1440\ri1369\sb17\sl-300\slmult0\tx1797 \up0 \expndtw-2\charscalex100 3. Rumah
sakit memberitahukan pasien serta keluarganya tentang tanggung jawab \line\tab \up0
\expndtw-3\charscalex100 mereka berkaitan dengan keputusan tersebut. (D,W)
\par\pard\qj \li1440\ri1374\sb4\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex100
4. Rumah sakit memberitahukan pasien serta keluarganya tentang tersedianya
\line\tab \up0 \expndtw-3\charscalex100 alternatif pelayanan dan pengobatan.
(D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb125\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 2.4 \par\pard\qj
\li1440\ri1372\sb25\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menghormati keinginan dan pilihan pasien
untuk menolak pelayanan \line \up0 \expndtw-2\charscalex100 resusitasi, menunda,
atau melepas bantuan hidup dasar (\ul0\nosupersub\cf8\f9\fs24 do not
resucitate\ul0\nosupersub\cf7\f8\fs24 /DNR). \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 2.4 \par\pard\qj
\li1440\ri1308\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 Keputusan menolak pelayanan resusitasi serta
melanjutkan atau menolak \up0 \expndtw0\charscalex100 pengobatan bantuan hidup
dasar merupakan keputusan paling sulit yang dihadapi \up0 \expndtw0\charscalex104
pasien, keluarga, PPA, dan rumah sakit. Tidak ada satupun proses yang dapat \up0
\expndtw-3\charscalex100 mengantisipasi semua situas keputusan perlu dibuat. Karena
itu, penting bagi rumah \up0 \expndtw-2\charscalex100 sakit untuk mengembangkan
pedoman dalam pembuatan keputusan yang sulit \up0 \expndtw-3\charscalex100
tersebut. Rumah sakit diminta membuat pedoman yang berisi \par\pard\ql
\li1788\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1) rumah sakit harus
mematuhi peraturan perundang-undangan yang terkait; \par\pard\ql \li1788\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 2) rumah sakit harus memastikan sesuai
dengan norma agama dan budaya; \par\pard\qj \li1788\ri1370\sb8\sl-
320\slmult0\tx2147 \up0 \expndtw0\charscalex102 3) mencakup situasi keputusan
tersebut berubah sewaktu pelayanan sedang \line\tab \up0 \expndtw-3\charscalex100
berjalan; \par\pard\qj \li1788\ri1373\sb0\sl-320\slmult0\tx2147 \up0 \expndtw-
1\charscalex100 4) memandu PPA melalui isu hukum dan etika dalam melaksanakan
menunda \line\tab \up0 \expndtw-3\charscalex100 atau melepas bantuan hidup
dasar; \par\pard\qj \li1788\ri1369\sb0\sl-320\slmult0\tx2147 \up0
\expndtw0\charscalex100 5) rumah sakit mengembangkan kebijakan dan prosedur
melalui suatu proses \line\tab \up0 \expndtw-3\charscalex100 yang melibatkan banyak
profesi dari berbagai sudut pandang; \par\pard\qj \li1788\ri1364\sb17\sl-
300\slmult0\tx2147 \up0 \expndtw0\charscalex103 6) regulasi tentang identifikasi
tanggungjawab masing-masing pihak dan \line\tab \up0 \expndtw-3\charscalex100
pendokumentasiannya dalam rekam medis pasien. \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb113\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 86
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg87}
{\bkmkend Pg87}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 2.4
\par\pard\ql \li1440\ri1369\sb16\sl-310\slmult0\tx1797\tx1797 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rumah sakit pada
saat pasien menolak pelayanan resusitasi, \line\tab \up0
\expndtw0\charscalex104 menunda atau melepas bantuan hidup dasar sesuai
dengan peraturan \line \tab \up0 \expndtw-3\charscalex100 perundang-undangan,
norma agama, dan budaya masyarakat. (R) \par\pard\ql \li1440\sb39\sl-276\slmult0
\up0 \expndtw-3\charscalex100 2. Pelaksanaan sesuai dengan regulasi tersebut.
(D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb52\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 2.5 \par\pard\qj
\li1440\ri1369\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mendukung hak
pasien terhadap asesmen dan manajemen nyeri yang \up0 \expndtw-3\charscalex100
tepat. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan HPK 2.5 \par\pard\qj \li1440\ri1328\sb11\sl-316\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Nyeri merupakan hal yang banyak
dialami pasien dan nyeri yang tidak berkurang \line \up0 \expndtw0\charscalex102
menimbulkan dampak yang tidak diharapkan kepada pasien secara fisik maupun \line
\up0 \expndtw-1\charscalex100 psikologis. Respons pasien terhadap nyeri sering kali
berada dalam konteks norma \line \up0 \expndtw-1\charscalex100 sosial, budaya, dan
spiritual. Pasien didorong dan didukung melaporkan rasa nyeri. \line \up0 \expndtw-
2\charscalex100 Rumah sakit diminta untuk mengakui hak pasien terhadap nyeri dan
tersedia proses \line \up0 \expndtw0\charscalex100 melakukan asesmen serta
manajemen nyeri yang sesuai. (lihat juga PAP 7.1 dan \line \up0 \expndtw-
3\charscalex100 MKE 10 EP 4) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 2.5 \par\pard\ql \li1440\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada
regulasi tentang asesmen dan manajemen nyeri. (R) \par\pard\qj
\li1440\ri1366\sb8\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex100 2. Rumah
sakit menghormati serta mendukung hak pasien dengan melakukan \line\tab \up0
\expndtw-2\charscalex100 asesmen dan manajemen nyeri yang sesuai. (lihat juga PAP
7.1 EP 1). (D,W) \par\pard\ql \li1440\ri1305\sb9\sl-310\slmult0\tx1797\tx1797 \up0
\expndtw-2\charscalex100 3. Staf rumah sakit memahami pengaruh pribadi,
budaya, sosial, dan spiritual \line\tab \up0 \expndtw-3\charscalex100 tentang
hak pasien untuk melaporkan rasa nyeri, asesmen, dan manajemen nyeri \line \tab
\up0 \expndtw-4\charscalex100 secara akurat. (D,W) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb83\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 2.6 \par\pard\qj
\li1440\ri1365\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mendukung hak pasien untuk mendapatkan
pelayanan yang penuh \up0 \expndtw-3\charscalex100 hormat dan penuh kasih sayang
pada akhir kehidupannya. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 2.6 \par\pard\qj
\li1440\ri1306\sb11\sl-317\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien yang sedang menghadapi kematian mempunyai
kebutuhan yang unik dalam \up0 \expndtw-1\charscalex100 pelayanan yang penuh hormat
dan kasih-sayang. Perhatian terhadap kenyamanan \up0 \expndtw-1\charscalex100 dan
martabat pasien mengarahkan semua aspek pelayanan pada tahap akhir \up0
\expndtw0\charscalex103 kehidupan. Agar dapat terlaksana, semua staf harus
menyadari kebutuhan unik \up0 \expndtw-3\charscalex100 pasien pada akhir
kehidupannya. Kebutuhan ini meliputi pengobatan terhadap gejala \up0 \expndtw-
3\charscalex100 primer dan sekunder, manajemen nyeri, respons terhadap aspek
psikologis, sosial, \up0 \expndtw0\charscalex102 emosional, agama, budaya pasien
dan keluarganya, serta keterlibatannya dalam \up0 \expndtw-3\charscalex100
keputusan pelayanan. (lihat juga PAP 7.1 dan HPK 1.1) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 2.6
\par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang pelayanan pasien pada akhir
kehidupan. (R) \par\pard\ql \li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb50\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 87
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg88}
{\bkmkend Pg88}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1369\sb196\sl-320\slmult0\tx1797 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Rumah sakit mengakui dan
mengidentifikasi pasien yang menghadapi kematian \line\tab \up0 \expndtw-
2\charscalex100 dengan kebutuhan yang unik. (D,W) \par\pard\ql
\li1440\ri1365\sb0\sl-320\slmult0\tx1797\tx1797 \up0 \expndtw0\charscalex100 3.
Staf rumah sakit menghormati hak pasien yang sedang menghadapi kematian,
\line\tab \up0 \expndtw0\charscalex103 memiliki kebutuhan yang unik dalam proses
asuhan, dan didokumentasikan. \line \tab \up0 \expndtw-3\charscalex100 (D,W) (lihat
juga MIRM 13 EP 2) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb105\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 3
\par\pard\qj \li1440\ri1302\sb12\sl-315\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memberikan penjelasan kepada pasien
dan keluarganya tentang \up0 \expndtw0\charscalex103 proses untuk menerima,
menanggapi, dan menindaklanjuti bila ada pasien \up0 \expndtw-1\charscalex100
menyampaikan keluhan, konflik, serta perbedaan pendapat tentang pelayanan
\up0 \expndtw-3\charscalex100 pasien. Rumah sakit juga menginformasikan tentang hak
pasien untuk berpartisipasi \up0 \expndtw-4\charscalex100 dalam proses ini.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb82\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK
3 \par\pard\qj \li1440\ri1362\sb11\sl-316\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien mempunyai hak untuk menyampaikan keluhan
tentang pelayanan yang \line \up0 \expndtw0\charscalex102 mereka terima. Keluhan
tersebut dicatat, ditelaah, ditindaklanjuti, dan dicari \line \up0 \expndtw-
1\charscalex100 penyelesaiannya bila memungkinkan. Demikian pula, bila
keputusan mengenai \line \up0 \expndtw-1\charscalex100 pelayanan menimbulkan
pertanyaan, konflik, atau dilema lain bagi rumah sakit dan \line \up0 \expndtw-
2\charscalex100 pasien, keluarga atau pembuat keputusan, dan lainnya. Dilema ini
dapat timbul dari \line \up0 \expndtw-2\charscalex100 masalah akses, etis,
pengobatan atau pemulangan pasien, dsb. (lihat juga TKRS \par\pard\ql
\li1440\sb38\sl-276\slmult0 \up0 \expndtw-3\charscalex100 12.2) \par\pard\qj
\li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\ri1368\sb26\sl-310\slmult0 \up0
\expndtw0\charscalex104 Rumah sakit menetapkan cara-cara dalam mencari solusi
terhadap dilema dan \line \up0 \expndtw0\charscalex102 keluhan tersebut. Rumah
sakit mengidentifikasi dalam regulasi, siapa yang perlu \line \up0 \expndtw-
2\charscalex100 dilibatkan dalam proses, serta bagaimana pasien dan keluarganya
berpartisipasi. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 3 \par\pard\qj
\li1800\ri1360\sb8\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mendukung konsistensi pelayanan
dalam menghadapi \line\tab \up0 \expndtw-3\charscalex100 keluhan, konflik, atau
beda pendapat. (R) \par\pard\qj \li1800\ri1373\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 2. Pasien diberitahu tentang proses menyampaikan
keluhan, konflik, atau \line\tab \up0 \expndtw-3\charscalex100 perbedaan
pendapat. (D,W) \par\pard\qj \li1800\ri1364\sb17\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex100 3. Keluhan, konflik, dan perbedaan pendapat ditelaah serta
ditindaklanjuti oleh \line\tab \up0 \expndtw-3\charscalex100 rumah sakit serta
didokumentasikan. (D,W) \par\pard\ql \li1800\sb40\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 4. Pasien dan atau keluarga pasien ikut serta dalam proses
penyelesaian. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 4 \par\pard\qj \li1440\ri1364\sb8\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Semua pasien
diberi tahu tentang hak serta kewajiban dengan metode dan bahasa \up0 \expndtw-
2\charscalex100 yang mudah dimengerti. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 4 \par\pard\qj
\li1440\ri1365\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Proses penerimaan pasien rawat inap dan pendaftaran
pasien rawat jalan rumah \line \up0 \expndtw-2\charscalex100 sakit dapat
membingungkan atau menakutkan bagi pasien. Keadaan ini menjadikan \line \up0
\expndtw-2\charscalex100 pasien atau keluarga sulit bersikap sesuai dengan hak dan
kewajibannya. Rumah \par\pard\ql \li10243\sb204\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 88
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg89}
{\bkmkend Pg89}\par\pard\qj \li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-
315\slmult0 \par\pard\qj\li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\ri1351\sb215\sl-315\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 sakit menyiapkan keterangan tertulis tentang hak
dan kewajiban pasien yang \up0 \expndtw0\charscalex104 diberikan pada saat
mereka diterima sebagai pasien rawat inap atau mendaftar \up0
\expndtw0\charscalex100 sebagai pasien rawat jalan. Keterangan tersebut tersedia di
setiap kunjungan atau \up0 \expndtw-2\charscalex100 tersedia selama tinggal di
rumah sakit. Pernyataan dipasang atau disimpan di \up0 \expndtw-
3\charscalex100 fasilitas yang mudah
dilihat oleh publik. \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1369\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex104
Keterangan tertulis diberikan disesuaikan dengan usia dan bahasa pasien. Jika
\up0 \expndtw0\charscalex103 komunikasi tertulis dengan pasien tidak efektif atau
tidak tepat maka pasien dan \up0 \expndtw0\charscalex102 keluarga diberi tahu
tentang hak serta kewajibannya dengan bahasa yang dapat \up0 \expndtw-
3\charscalex100 dimengerti oleh mereka. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 4 \par\pard\qj
\li1440\ri1329\sb8\sl-320\slmult0\tx1797 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi bahwa setiap pasien serta keluarga
mendapatkan informasi tentang \line\tab \up0 \expndtw-3\charscalex100 hak dan
kewajiban pasien. (R) \par\pard\qj \li1440\ri1373\sb0\sl-320\slmult0\tx1797 \up0
\expndtw-1\charscalex100 2. Ada bukti bahwa informasi tentang hak serta kewajiban
pasien diberikan tertulis \line\tab \up0 \expndtw-3\charscalex100 kepada pasien,
terpampang, atau tersedia sepanjang waktu. (D,O,W) \par\pard\qj
\li1440\ri1357\sb17\sl-300\slmult0\tx1797 \up0 \expndtw-2\charscalex100 3. Rumah
sakit menetapkan proses pemberian informasi hak dan kewajiban pasien \line\tab \up0
\expndtw-3\charscalex100 jika komunikasi tidak efektif atau tidak tepat. (W,S)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb216\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 PERSETUJUAN UMUM (\ul0\nosupersub\cf16\f17\fs24 GENERAL
CONSENT\ul0\nosupersub\cf6\f7\fs24 ) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar HPK 5
\par\pard\qj \li1440\ri1305\sb0\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pada saat pasien diterima waktu mendaftar rawat jalan
dan setiap rawat inap, diminta \up0 \expndtw-2\charscalex100 menandatangani
persetujuan umum (\ul0\nosupersub\cf8\f9\fs24 general
consent\ul0\nosupersub\cf7\f8\fs24 ). Persetujuan umum (\ul0\nosupersub\cf8\f9\fs24
general \up0 \expndtw-3\charscalex100 consent\ul0\nosupersub\cf7\f8\fs24 ) harus
menjelaskan cakupan dan batasannya. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 5 \par\pard\qj
\li1440\ri1359\sb12\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit wajib meminta persetujuan umum
(\ul0\nosupersub\cf8\f9\fs24 general consent\ul0\nosupersub\cf7\f8\fs24 ) kepada
pasien \up0 \expndtw0\charscalex100 atau keluarganya berisi persetujuan
terhadap tindakan yang berisiko rendah, \up0 \expndtw-1\charscalex100 prosedur
diagnostik, pengobatan medis lainnya, batas-batas yang telah ditetapkan, \up0
\expndtw-1\charscalex100 dan persetujuan lainnya. Persetujuan umum diminta
pada saat pasien datang \up0 \expndtw-2\charscalex100 pertama kali untuk rawat
jalan dan setiap rawat inap. \par\pard\qj \li1440\ri1364\sb241\sl-320\slmult0
\up0 \expndtw0\charscalex104 Rumah sakit diminta untuk memberitahu pasien tentang
terdapat peserta didik/ \up0 \expndtw0\charscalex100 pelatihan yang ikut
berpartisipasi dalam asuhan pasien sebagai bagian dari \up0 \expndtw-
3\charscalex100 pendidikan/pelatihan mereka. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb1\sl-276\slmult0 \up0 \expndtw-2\charscalex100
Rumah sakit memiliki dokumentasi dalam rekam medik tentang persetujuan umum.
\par\pard\qj \li1440\ri1364\sb265\sl-300\slmult0 \up0 \expndtw-2\charscalex100
Pasien juga diberi informasi tentang tindakan dan prosedur, serta pengobatan
yang \line \up0 \expndtw-2\charscalex100 berisiko tinggi yang memerlukan
persetujuan khusus (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) secara \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb206\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 89
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg90}
{\bkmkend Pg90}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 terpisah. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 5 \par\pard\ql
\li1440\ri1306\sb0\sl-320\slmult0\tx1797\tx1797 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang persetujuan umum dan
pendokumentasiannya dalam rekam \line\tab \up0 \expndtw-2\charscalex100 medis
pasien di luar tindakan yang membutuhkan persetujuan khusus
(\ul0\nosupersub\cf8\f9\fs24 informed \line \tab \up0 \expndtw-3\charscalex100
consent\ul0\nosupersub\cf7\f8\fs24 ) tersendiri. (R) \par\pard\qj
\li1440\ri1369\sb0\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex102 2.
Persetujuan umum (\ul0\nosupersub\cf8\f9\fs24 general
consent\ul0\nosupersub\cf7\f8\fs24 ) diminta saat pertama kali pasien masuk
\line\tab \up0 \expndtw-3\charscalex100 rawat jalan atau setiap masuk rawat inap.
(D,W) \par\pard\qj \li1440\ri1368\sb0\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex102 3. Pasien dan atau keluarga diminta untuk membaca,
lalu menandatangani \line\tab \up0 \expndtw-3\charscalex100 persetujuan umum
(\ul0\nosupersub\cf8\f9\fs24 general consent\ul0\nosupersub\cf7\f8\fs24 ). (D,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb93\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 PERSETUJUAN KHUSUS (\ul0\nosupersub\cf16\f17\fs24
INFORMED CONSENT\ul0\nosupersub\cf6\f7\fs24 ) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar HPK 5.1 \par\pard\qj \li1440\ri1366\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan
regulasi pelaksanaan persetujuan khusus (i\ul0\nosupersub\cf8\f9\fs24
nformed \up0 \expndtw0\charscalex100 consent\ul0\nosupersub\cf7\f8\fs24 ) oleh DPJP
dan dapat dibantu oleh staf yang terlatih dengan bahasa yang \up0 \expndtw-
3\charscalex100 dapat dimengerti sesuai dengan peraturan perundang-undangan.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 5.1
\par\pard\qj \li1440\ri1316\sb11\sl-317\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Satu dari banyak upaya membuat pasien terlibat dalam
pengambilan keputusan \line \up0 \expndtw-1\charscalex100 dalam proses asuhan/
tindakan adalah dengan jalan memberikan persetujuan \line \up0
\expndtw0\charscalex103 (\ul0\nosupersub\cf8\f9\fs24
consent\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
.\ul0\nosupersub\cf7\f8\fs24 Untuk dapat memberikan persetujuan, seorang
pasien menerima \line \up0 \expndtw-2\charscalex100 penjelasan tentang faktor-
faktor terkait dengan rencana asuhan yang pelaksaannya \line \up0
\expndtw0\charscalex100 harus ada persetujuan khusus (\ul0\nosupersub\cf8\f9\fs24
informed consent\ul0\nosupersub\cf7\f8\fs24 ). Persetujuan khusus
(i\ul0\nosupersub\cf8\f9\fs24 nformed \line \up0 \expndtw-1\charscalex100
consent\ul0\nosupersub\cf7\f8\fs24 ) harus diperoleh sebelum dilakukan prosedur
atau tindakan tertentu yang \line \up0 \expndtw-3\charscalex100 berisiko tinggi.
Proses pemberian persetujuan khusus (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) diatur oleh \line \up0 \expndtw0\charscalex100
rumah sakit melalui regulasi yang jelas sesuai dengan peraturan
perundang-\line \up0 \expndtw-3\charscalex100 undangan terkait. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 5.1
\par\pard\qj \li1440\ri1374\sb25\sl-300\slmult0\tx1797 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang dijabarkan dengan jelas
mengenai persetujuan khusus \line\tab \up0 \expndtw-3\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 ). (R)
\par\pard\qj \li1440\ri1375\sb41\sl-300\slmult0\tx1797 \up0 \expndtw0\charscalex102
2. DPJP menjelaskan informasi tindakan yang akan diambil dan bila perlu dapat
\line\tab \up0 \expndtw-3\charscalex100 dibantu staf terlatih. (D,W)
\par\pard\ql \li1440\ri1305\sb4\sl-320\slmult0\tx1797\tx1797\tx1797\tx1797 \up0
\expndtw0\charscalex102 3. Pasien memahami informasi tindakan yang memerlukan
persetujuan khusus \line\tab \up0 \expndtw-3\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 ) melalui
cara dan bahasa yang dimengerti oleh pasien. Pasien \line \tab \up0
\expndtw0\charscalex100 dapat memberikan/menolak persetujuan khusus
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 )
tersebut. \line \tab \up0 \expndtw0\charscalex100 (D,W) (lihat juga HPK 2.1; AP 6;
AP 5.11 EP 2; PAP 3.3; PAB 3.3; PAB 4; PAB \line \tab \up0 \expndtw-3\charscalex100
7; dan MKE 9 EP 4) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 5.2 \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb164\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 90
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg91}{\bkmkend Pg91}\par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0\tx3849 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24
Persetujuan khusus \tab \up0 \expndtw0\charscalex101 (\ul0\nosupersub\cf8\f9\fs24
informed consent\ul0\nosupersub\cf7\f8\fs24 ) diberikan sebelum operasi,
anestesi \par\pard\qj \li1440\ri1312\sb25\sl-300\slmult0 \up0 \expndtw-
4\charscalex100 (termasuk sedasi), pemakaian darah dan produk darah, tindakan dan
prosedur, serta \up0 \expndtw-4\charscalex100 pengobatan lain dengan risiko tinggi
yang ditetapkan oleh regulasi rumah sakit. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb84\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 5.2
\par\pard\qj \li1440\ri1361\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Jika rencana asuhan termasuk prosedur bedah atau
invasif, anestesi (termasuk \line \up0 \expndtw-2\charscalex100 sedasi), pemakaian
darah dan produk darah, atau tindakan serta prosedur lain, dan \line \up0 \expndtw-
3\charscalex100 pengobatan dengan risiko tinggi maka persetujuan khusus
\up0 \expndtw-3\charscalex100 (i\ul0\nosupersub\cf8\f9\fs24 nformed
consent\ul0\nosupersub\cf7\f8\fs24 ) \par\pard\qj \li1440\ri1304\sb9\sl-310\slmult0
\up0 \expndtw-4\charscalex100 diminta secara terpisah (lihat juga PAB 3.3 EP 1 dan
PAB 7.1). Tidak semua tindakan \up0 \expndtw0\charscalex100 dan prosedur memerlukan
persetujuan khusus (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) dan umah sakit \up0 \expndtw-3\charscalex100
membuat daftar tindakan sebagaimana yang disebut di atas. \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1304\sb2\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Rumah sakit melatih staf untuk memastikan proses untuk
memberikan persetujuan \line \up0 \expndtw-3\charscalex100 khusus
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 )
dilakukan dengan benar. Daftar disusun oleh dokter serta \line \up0 \expndtw-
1\charscalex100 PPA lainnya yang melakukan tindakan dan prosedur secara
kolaboratif. Daftar juga \line \up0 \expndtw-1\charscalex100 memuat prosedur serta
tindakan yang dilakukan di unit rawat jalan dan rawat inap. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 5.2
\par\pard\ql \li1440\sb44\sl-276\slmult0\tx6755 \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang persetujuan khusus \tab
\up0 \expndtw0\charscalex101 (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) yang harus \par\pard\qj
\li1797\ri1365\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102 diperoleh sebelum
operasi atau prosedur invasif, sebelum anestesi (termasuk \up0 \expndtw-
1\charscalex100 sedasi), pemakaian darah dan produk darah, serta pengobatan
risiko tinggi \up0 \expndtw-3\charscalex100 lainnya. (R) \par\pard\ql
\li1440\ri1363\sb6\sl-313\slmult0\tx1797\tx1797\tx1797 \up0 \expndtw0\charscalex103
2. Ada bukti pelaksanaan tentang persetujuan khusus (\ul0\nosupersub\cf8\f9\fs24
informed consent\ul0\nosupersub\cf7\f8\fs24 ) yang \line\tab \up0
\expndtw0\charscalex100 harus diperoleh sebelum operasi atau prosedur
invasif, sebelum anestesi \line \tab \up0 \expndtw-1\charscalex100 (termasuk
sedasi), pemakaian darah dan produk darah, serta pengobatan risiko \line \tab
\up0 \expndtw-2\charscalex100 tinggi lainnya. (D, W) \par\pard\qj
\li1440\ri1366\sb2\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex103 3. umah
sakit menyusun daftar semua pengobatan/tindakan/prosedur yang \line\tab
\up0 \expndtw-3\charscalex100 memerlukan persetujuan khusus
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 ).
(D,W) \par\pard\qj \li1440\ri1357\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-
2\charscalex100 4. Identitas DPJP dan orang yang membantu memberikan informasi
kepada pasien \line\tab \up0 \expndtw-3\charscalex100 serta keluarga dicatat di
rekam medik pasien. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb125\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 5.3
\par\pard\qj \li1440\ri1362\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses dalam konteks peraturan
perundang-undangan \up0 \expndtw0\charscalex103 siapa pengganti pasien yang dapat
memberikan persetujuan dalam persetujuan \up0 \expndtw-3\charscalex100 khusus
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 ) bila
pasien tidak kompeten. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 5.3 \par\pard\qj
\li1440\ri1339\sb11\sl-316\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Persetujuan khusus (\ul0\nosupersub\cf8\f9\fs24
informed consent\ul0\nosupersub\cf7\f8\fs24 ) kadang-kadang membutuhkan orang (atau
\line \up0 \expndtw0\charscalex103 tambahan) selain pasien yang terlibat dalam
keputusan tentang asuhan pasien. \line \up0 \expndtw-2\charscalex100 Dalam hal ini
adalah pasien belum dewasa/anak-anak, mengidap gangguan mental, \line \up0
\expndtw0\charscalex100 retardasi mental, gangguan komunikasi karena
mereka tidak mempunyai \line \up0 \expndtw0\charscalex102 kemampuan untuk
mengambil keputusan, dan lainnya. Jika pasien tidak mampu \line \up0 \expndtw-
2\charscalex100 membuat keputusan tentang asuhannya maka pengganti ditetapkan untuk
memberi \par\pard\ql \li10243\sb217\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 91
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg92}
{\bkmkend Pg92}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1362\sb234\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 persetujuan. Jika orang lain sebagai pengganti yang
memberi persetujuan maka \up0 \expndtw0\charscalex104 harus sesuai dengan peraturan
perundang-undangan, nama orang ini dicatat di \up0 \expndtw-3\charscalex100 rekam
medik pasien. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb83\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian HPK 5.3 \par\pard\ql \li1440\ri1363\sb8\sl-320\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi sesuai dengan
peraturan perundang-undangan yang menetapkan \line\tab \up0 \expndtw-
1\charscalex100 proses dan siapa yang menandatangani persetujuan khusus
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 ) \line
\tab \up0 \expndtw-2\charscalex100 bila pasien tidak kompeten. (R) \par\pard\qj
\li1440\ri1374\sb17\sl-300\slmult0\tx1797 \up0 \expndtw0\charscalex103 2. Rumah
sakit menetapkan dan melaksanakan proses apabila orang lain yang \line\tab \up0
\expndtw-3\charscalex100 memberi persetujuan khusus (\ul0\nosupersub\cf8\f9\fs24
informed consent\ul0\nosupersub\cf7\f8\fs24 ). (D,W) \par\pard\ql
\li1440\ri1328\sb4\sl-320\slmult0\tx1797\tx1797 \up0 \expndtw-2\charscalex100 3.
Nama orang yang menggantikan pemberi persetujuan dalam persetujuan khusus \line\tab
\up0 \expndtw0\charscalex102 (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) sesuai dengan peraturan perundang-undangan
tercatat di \line \tab \up0 \expndtw-3\charscalex100 rekam medik. (D,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb125\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 PENELITIAN, DONASI, DAN TRANSPLANTASI ORGAN
\par\pard\ql \li1440\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar HPK
6 \par\pard\qj \li1440\ri1316\sb0\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pimpinan rumah sakit bertanggung jawab untuk melindungi
manusia/pasien sebagai \up0 \expndtw-4\charscalex100 subjek penelitian.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb69\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 6.1
\par\pard\qj \li1440\ri1311\sb8\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mematuhi semua peraturan dan persyaratan
penelitian/kode etik profesi \up0 \expndtw-1\charscalex100 serta kode etik
penelitian dan menyediakan sumber daya yang layak agar program \up0 \expndtw-
3\charscalex100 penelitian dapat berjalan dengan efektif. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 6 dan HPK 6.1
\par\pard\qj \li1440\ri1359\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penelitian dengan subjek manusia/pasien merupakan suatu
upaya yang kompleks \up0 \expndtw-1\charscalex100 dan bermakna penting bagi sebuah
rumah sakit. Pimpinan rumah sakit mengetahui \up0 \expndtw-1\charscalex100 tingkat
komitmen yang dibutuhkan dan keterlibatan personal yang diperlukan untuk \up0
\expndtw-2\charscalex100 menjawab pertanyaan ilmiah dan melindungi
manusia/pasien karena komitmen \up0 \expndtw-3\charscalex100 terhadap pasien
tersebut adalah mendiagnosis dan mengobatinya. \par\pard\qj \li1440\sb0\sl-
317\slmult0 \par\pard\qj\li1440\ri1342\sb6\sl-317\slmult0 \up0
\expndtw0\charscalex105 Komitmen para kepala unit pelayanan terhadap
penelitian dengan subjek \line \up0 \expndtw-1\charscalex100 manusia/pasien tidak
dapat dipisahkan
dari komitmen mereka terhadap pelayanan \line \up0 \expndtw0\charscalex104 pasien
dan komitmen ini terintegrasi pada semua tingkat. Oleh sebab itu, \line
\up0 \expndtw-2\charscalex100 pertimbangan etika, komunikasi yang baik, ketaatan
terhadap peraturan perundang-\line \up0 \expndtw0\charscalex100 undangan, serta
ketersediaan sumber daya finansial dan nonfinansial merupakan \line \up0 \expndtw-
1\charscalex100 komponen dari komitmen ini. Salah satu sumber daya adalah
penjaminan asuransi \line \up0 \expndtw0\charscalex104 yang baik untuk pasien yang
mengalami kejadian yang tidak diharapkan akibat \line \up0 \expndtw-3\charscalex100
protokol penelitian. \par\pard\qj \li1440\ri1363\sb301\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Pimpinan rumah sakit memahami kewajibannya untuk
melindungi manusia/pasien. \line \up0 \expndtw-2\charscalex100 Pimpinan rumah sakit
mengetahu mengenai, serta mentaati sumber peraturan dan \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb83\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 92
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg93}
{\bkmkend Pg93}\par\pard\qj \li1440\sb0\sl-300\slmult0 \par\pard\qj\li1440\sb0\sl-
300\slmult0 \par\pard\qj\li1440\sb0\sl-300\slmult0
\par\pard\qj\li1440\ri1363\sb273\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 standar profesi yang spesifik untuk penelitian/uji
klinis (\ul0\nosupersub\cf8\f9\fs24 clinical
trial\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 seperti standar \line \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf8\f9\fs24 International Conference on
Harmonisation \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24
(ICH)/\ul0\nosupersub\cf8\f9\fs24 World Health Organization \par\pard\ql
\li1440\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 WHO)/\ul0\nosupersub\cf8\f9\fs24 Good Clinical
Practice\ul0\nosupersub\cf7\f8\fs24 (GCP), dll. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 6 \par\pard\ql
\li1440\ri1358\sb11\sl-316\slmult0\tx1797\tx1797\tx1797\tx1797\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang
menetapkan pimpinan rumah sakit bertanggung jawab atas \line\tab \up0
\expndtw0\charscalex106 perlindungan terhadap pasien yang menjadi subjek
peserta penelitian, \line \tab \up0 \expndtw-2\charscalex100 mempromosikan kode
etik dan perilaku profesional, serta mendorong kepatuhan \line \tab \up0
\expndtw0\charscalex102 terhadap kode etik profesi dan perilaku profesional
termasuk dalam penelitian \line \tab \up0 \expndtw0\charscalex102 serta menyediakan
sumber daya yang layak agar program penelitian berjalan \line \tab \up0 \expndtw-
3\charscalex100 dengan efektif. (R) \par\pard\ql \li1440\ri1311\sb1\sl-
320\slmult0\tx1797\tx1797\tx1797 \up0 \expndtw-3\charscalex100 2. Pimpinan rumah
sakit secara lisan dan tertulis mengomunikasikan ke seluruh staf \line\tab \up0
\expndtw-1\charscalex100 rumah sakit mengenai komitmen mereka untuk
melindungi manusia/pasien \line \tab \up0 \expndtw-1\charscalex100 sebagai subjek
peserta penelitian dan mendukung perilaku yang sesuai dengan \line \tab \up0
\expndtw-2\charscalex100 kode etik profesi/penelitian. (lihat juga TKRS 12).
(D,O,W) \par\pard\ql \li1440\ri1373\sb6\sl-313\slmult0\tx1797\tx1797\tx1797 \up0
\expndtw0\charscalex102 3. Pimpinan rumah sakit menentukan komite yang
bertanggung jawab atas \line\tab \up0 \expndtw0\charscalex100 kesinambungan
perkembangan dan kepatuhan terhadap semua peraturan \line \tab \up0
\expndtw0\charscalex103 perundang-undangan serta regulasi rumah sakit tentang
penelitian yang \line \tab \up0 \expndtw-3\charscalex100 menggunakan manusia
sebagai subjek. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb82\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 6.1 \par\pard\ql
\li1440\ri1351\sb8\sl-320\slmult0\tx1797\tx1797 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi bahwa pimpinan rumah sakit
bersama komite memahami dan \line\tab \up0 \expndtw0\charscalex100 menyusun
mekanisme untuk memastikan ketaatan terhadap semua peraturan \line \tab \up0
\expndtw-2\charscalex100 perundang-undangan dan persyaratan profesi yang berkaitan
dengan penelitian. \par\pard\ql \li1797\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 (R) \par\pard\ql \li1440\ri1311\sb0\sl-320\slmult0\tx1797\tx1797
\up0 \expndtw0\charscalex100 2. Pimpinan rumah sakit dan komite memiliki proses
penyusunan anggaran untuk \line\tab \up0 \expndtw-4\charscalex100 menyediakan
sumber daya yang adekuat agar program penelitian berjalan efektif. \line \tab
\up0 \expndtw-5\charscalex100 (D,W) \par\pard\ql \li1440\ri1314\sb0\sl-
320\slmult0\tx1797\tx1797 \up0 \expndtw-2\charscalex100 3. Pimpinan rumah sakit
menyediakan atau memastikan terdapat jaminan asuransi \line\tab \up0 \expndtw-
3\charscalex100 yang adekuat untuk menanggung pasien yang berpartisipasi dalam uji
klinis yang \line \tab \up0 \expndtw-4\charscalex100 mengalami kejadian yang tidak
diharapkan (\ul0\nosupersub\cf8\f9\fs24 adverse
event\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
.\ul0\nosupersub\cf7\f8\fs24 (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 6.2 \par\pard\qj \li1440\ri1363\sb0\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
memberikan penjelasan kepada pasien dan keluarganya tentang \up0
\expndtw0\charscalex102 bagaimana cara mendapatkan akses untuk penelitian/uji
klinis (\ul0\nosupersub\cf8\f9\fs24 clinical trial\ul0\nosupersub\cf7\f8\fs24 )
yang \up0 \expndtw-3\charscalex100 melibatkan manusia sebagai subjek.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb69\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud danTujuan HPK
6.2 \par\pard\qj \li1440\ri1370\sb11\sl-316\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit yang melakukan penelitian/uji klinis
(\ul0\nosupersub\cf8\f9\fs24 clinical trial\ul0\nosupersub\cf7\f8\fs24 ) yang
melibatkan \up0 \expndtw-1\charscalex100 manusia sebagai subjek menyediakan
keterangan kepada pasien dan keluarganya \up0 \expndtw-1\charscalex100 tentang
bagaimana cara mendapatkan akses aktivitas tersebut bila relevan dengan \up0
\expndtw0\charscalex102 kebutuhan pengobatannya. Bila pasien diminta untuk
berpartisipasi, mereka \up0 \expndtw0\charscalex102 memerlukan penjelasan yang
dapat dijadikan dasar untuk mengambil keputusan \up0 \expndtw-1\charscalex100
mereka. Informasi tersebut meliputi \par\pard\ql \li10243\sb217\sl-253\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 93
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg94}
{\bkmkend Pg94}\par\pard\ql \li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. manfaat yang diharapkan;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 2.
kemungkinan/potensi ketidaknyamanan dan risiko; \par\pard\ql \li1800\sb24\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 3. alternatif yang dapat menolong
mereka; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 4.
prosedur yang harus diikuti. \par\pard\ql \li1440\sb0\sl-320\slmult0
\par\pard\ql\li1440\ri1373\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex103 Pasien
diberikan penjelasan bahwa mereka dapat menolak untuk berpartisipasi \up0
\expndtw0\charscalex100 atau mengundurkan diri sewaktu-waktu dan penolakan
atau pengunduran diri \up0 \expndtw0\charscalex100 tersebut tidak akan menutup
akses mereka terhadap pelayanan rumah sakit. \line \up0 \expndtw0\charscalex100
Rumah sakit mempunyai kebijakan dan prosedur untuk memberikan informasi
\up0 \expndtw-1\charscalex100 tentang hal ini kepada pasien dan keluargannya.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK
6.2 \par\pard\ql \li1440\ri1301\sb8\sl-320\slmult0\tx1797\tx1797\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang
mengarahkan informasi dan proses pengambilan keputusan \line\tab \up0 \expndtw-
1\charscalex100 untuk penelitian/uji klinis (\ul0\nosupersub\cf8\f9\fs24 clinical
trial\ul0\nosupersub\cf7\f8\fs24 ), serta pasien dan keluarganya yang tepat
\line \tab \up0 \expndtw-3\charscalex100 diidentifikasi dan diberi informasi
tentang bagaimana cara mendapatkan akses ke \line \tab \up0 \expndtw-
4\charscalex100 penelitian/uji klinis \up0 \expndtw-4\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 clinical trial\ul0\nosupersub\cf7\f8\fs24 ) yang
relevan dengan kebutuhan pengobatan \par\pard\ql \li1797\sb37\sl-276\slmult0 \up0
\expndtw-5\charscalex100 mereka. (R) \par\pard\qj \li1440\ri1325\sb0\sl-
320\slmult0\tx1797 \up0 \expndtw0\charscalex100 2. Pasien yang diminta untuk
berpartisipasi diberikan penjelasan tentang manfaat \line\tab \up0 \expndtw-
5\charscalex100 yang diharapkan. (D,W) \par\pard\qj \li1440\ri1304\sb0\sl-
320\slmult0\tx1797 \up0 \expndtw0\charscalex100 3. Pasien yang diminta untuk
berpartisipasi diberikan penjelasan tentang potensi \line\tab \up0 \expndtw-
5\charscalex100 ketidaknyamanan dan risiko. (D,W) \par\pard\qj
\li1440\ri1317\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-2\charscalex100 4. Pasien
yang diminta untuk berpartisipasi diberi penjelasan
tentang altenatif yang \line\tab \up0 \expndtw-4\charscalex100 dapat menolong
mereka. (D,W) \par\pard\qj \li1440\ri1301\sb0\sl-320\slmult0\tx1797 \up0 \expndtw-
4\charscalex100 5. Pasien yang diminta untuk berpartisipasi, kepadanya diberikan
penjelasan tentang \line\tab \up0 \expndtw-5\charscalex100 prosedur yang harus
diikuti. (D,W) \par\pard\ql \li1440\ri1302\sb0\sl-320\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex100 6. Pasien diyakinkan bahwa penolakan untuk berpartisipasi
atau pengunduran diri \line\tab \up0 \expndtw-5\charscalex100 dari partisipasi
tidak memengaruhi akses mereka terhadap pelayanan rumah sakit. \line \tab \up0
\expndtw-6\charscalex100 (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb49\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 6.3 \par\pard\qj \li1440\ri1366\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
harus memberi penjelasan kepada pasien dan keluarganya tentang \line \up0
\expndtw0\charscalex102 bagaimana pasien ikut berpartisipasi dalam
penelitian/uji klinis \up0 \expndtw0\charscalex102 (\ul0\nosupersub\cf8\f9\fs24
clinical trial\ul0\nosupersub\cf7\f8\fs24 ) \par\pard\ql \li1440\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 mendapatkan perlindungan. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb68\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 6.3
\par\pard\qj \li1440\ri1305\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit yang melaksanakan penelitian/uji klinis
(\ul0\nosupersub\cf8\f9\fs24 clinical trial\ul0\nosupersub\cf7\f8\fs24 ) yang
melibatkan \up0 \expndtw-3\charscalex100 manusia sebagai subjek penelitian memahami
bahwa tanggung jawab utama adalah \up0 \expndtw-4\charscalex100 kesehatan dan
keselamatan pasien. \par\pard\qj \li1440\ri1372\sb0\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Rumah sakit memberikan penjelasan kepada pasien dan keluarganya
sebelumnya \up0 \expndtw-3\charscalex100 mengenai proses yang baku untuk
\par\pard\ql \li1800\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 1) menelaah
protokol penelitian; \par\pard\ql \li1800\sb24\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 2) menimbang risiko dan manfaat yang relatif bagi para peserta;
\par\pard\qj \li1800\ri1374\sb8\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex105
3) mendapatkan surat persetujuan dari manusia/pasien sebagai subjek
\line\tab \up0 \expndtw-3\charscalex100 penelitian; \par\pard\ql \li10243\sb216\sl-
253\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 94
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg95}
{\bkmkend Pg95}\par\pard\ql \li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 4) mengundurkan diri dari
keikutsertaan sewaktu-waktu; \par\pard\ql \li1800\ri1365\sb16\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex102 5) informasi ini
dikomunikasikan kepada manusia/pasien dan keluarga untuk \line\tab \up0
\expndtw0\charscalex100 membantu pengambilan keputusan terkait partisipasi
mereka dalam \line \tab \up0 \expndtw-3\charscalex100 penelitian. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb83\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 6.3
\par\pard\qj \li1440\ri1328\sb8\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Pasien serta keluarganya
diberikan penjelasan tentang prosedur rumah sakit \line\tab \up0 \expndtw-
4\charscalex100 untuk menelaah protokol penelitian. (D,W) \par\pard\qj
\li1440\ri1319\sb0\sl-320\slmult0\tx1797 \up0 \expndtw0\charscalex103 2. Pasien
serta keluarganya diberikan penjelasan tentang prosedur rumah sakit \line\tab
\up0 \expndtw-4\charscalex100 untuk menimbang manfaat dan risiko bagi peserta.
(D,W) \par\pard\qj \li1440\ri1339\sb0\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex103 3. Pasien serta keluarganya diberikan penjelasan tentang
prosedur rumah sakit \line\tab \up0 \expndtw-4\charscalex100 untuk mendapatkan
persetujuan. (D,W) \par\pard\qj \li1440\ri1311\sb0\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex103 4. Pasien serta keluarganya diberikan penjelasan tentang
prosedur rumah sakit \line\tab \up0 \expndtw-4\charscalex100 untuk mengundurkan
diri dari keikutsertaan dalam penelitian. (D,W) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb105\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK
6.4 \par\pard\ql \li1440\sb24\sl-276\slmult0\tx3848 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Persetujuan khusus \tab \up0
\expndtw0\charscalex101 (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) penelitian diperoleh sebelum pasien
\par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
berpartisipasi dalam penelitian/uji klinis (\ul0\nosupersub\cf8\f9\fs24 clinical
trial\ul0\nosupersub\cf7\f8\fs24 ). \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 6.4 \par\pard\qj
\li1440\ri1357\sb12\sl-315\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien atau keluarganya harus memberikan persetujuan
khusus (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) \line \up0 \expndtw0\charscalex100 penelitian
bila memutuskan untuk berpartisipasi dalam penelitian/uji klinis
(\ul0\nosupersub\cf8\f9\fs24 clinical \line \up0 \expndtw0\charscalex103
trial\ul0\nosupersub\cf7\f8\fs24 ). Informasi yang diberikan pada saat
mengambil keputusan untuk ikut \line \up0 \expndtw-1\charscalex100
berpartisipasi mendasari persetujuan atau penolakan keterlibatan dalam
penelitian. \line \up0 \expndtw-2\charscalex100 (lihat juga HPK \up0 \expndtw-
2\charscalex100 5.1 dalam maksud dan tujuan). Petugas yang memberikan
\par\pard\ql \li1440\sb38\sl-276\slmult0 \up0 \expndtw-2\charscalex100 penjelasan
dan mendapatkan persetujuan dicatat dalam rekam medis pasien. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 6.4
\par\pard\qj \li1440\ri1303\sb8\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
persetujuan yang didokumentasikan dalam rekam medis \line\tab \up0 \expndtw-
5\charscalex100 pasien disertai tanda tangan persetujuan. (R) \par\pard\ql
\li1440\sb37\sl-276\slmult0\tx4238 \up0 \expndtw0\charscalex100 2. Persetujuan
khusus \tab \up0 \expndtw0\charscalex103 (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ) penelitian diperoleh saat pasien
\par\pard\ql \li1797\sb24\sl-276\slmult0 \up0 \expndtw-4\charscalex100 memutuskan
ikut serta dalam penelitian/uji klinis (\ul0\nosupersub\cf8\f9\fs24 clinical
trial)\ul0\nosupersub\cf7\f8\fs24 . (D,W) \par\pard\qj \li1440\ri1303\sb8\sl-
320\slmult0\tx1797 \up0 \expndtw-1\charscalex100 3. Keputusan persetujuan khusus
(\ul0\nosupersub\cf8\f9\fs24 informed consent\ul0\nosupersub\cf7\f8\fs24 )
penelitian didokumentasikan \line\tab \up0 \expndtw-5\charscalex100 sesuai dengan
peraturan perundang-undangan. (D,W) \par\pard\qj \li1440\ri1304\sb0\sl-
320\slmult0\tx1797 \up0 \expndtw-1\charscalex100 4. Identitas petugas yang
memberikan penjelasan untuk mendapatkan persetujuan \line\tab \up0 \expndtw-
5\charscalex100 dicatat dalam rekam medis pasien. (D,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb125\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 7 \par\pard\qj \li1440\ri1305\sb16\sl-
310\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
mempunyai sebuah komite etik penelitian untuk melakukan pengawasan \up0
\expndtw0\charscalex104 atas semua penelitian di rumah sakit tersebut yang
melibatkan manusia/pasien \up0 \expndtw-5\charscalex100 sebagai subjeknya.
\par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb32\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 95
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg96}
{\bkmkend Pg96}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 7 \par\pard\ql
\li1440\sb24\sl-276\slmult0\tx6939 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Bila rumah sakit melakukan penelitian/uji
klinis \tab \up0 \expndtw-1\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 clinical
trial\ul0\nosupersub\cf7\f8\fs24 ) yang melibatkan \par\pard\qj
\li1440\ri1309\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100 manusia/pasien
sebagai subjeknya, perlu ditetapkan sebuah komite yang melakukan \up0
\expndtw0\charscalex103 pengawasan atas seluruh kegiatan tersebut. Rumah sakit
membuat pernyataan \up0 \expndtw-3\charscalex100 tentang maksud pengawasan kegiatan
tersebut. Pengawasan atas kegiatan tersebut \up0 \expndtw0\charscalex104 termasuk
penelaahan prosedur seluruh protokol penelitian, prosedur untuk \up0
\expndtw-1\charscalex100 menimbang risiko dan manfaat yang relatif bagi subjek,
serta prosedur yang terkait \up0 \expndtw-2\charscalex100 dengan kerahasiaan dan
keamanan atas informasi penelitian dan pengawasan \up0 \expndtw-
3\charscalex100
terhadap pelaksanaan penelitian. \par\pard\ql \li1440\sb217\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 7
\par\pard\ql \li1440\ri1369\sb8\sl-320\slmult0\tx1797\tx1797\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada komite atau
mekanisme lain yang ditetapkan oleh rumah sakit yang \line\tab \up0
\expndtw-2\charscalex100 melibatkan perwakilan masyarakat untuk mengawasi seluruh
kegiatan penelitian \line \tab \up0 \expndtw0\charscalex103 di rumah sakit,
termasuk pernyataan yang jelas mengenai maksud dari \line \tab \up0 \expndtw-
3\charscalex100 pengawasan kegiatan. (R) \par\pard\ql \li1440\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 2. Kegiatan pengawasan tersebut mencakup
penelaahan prosedur. (D,W) \par\pard\qj \li1440\ri1369\sb8\sl-320\slmult0\tx1797
\up0 \expndtw-2\charscalex100 3. Kegiatan pengawasan tersebut mencakup prosedur
untuk menimbang risiko dan \line\tab \up0 \expndtw-3\charscalex100 manfaat yang
relatif bagi subjek. (D,W) \par\pard\qj \li1440\ri1375\sb0\sl-320\slmult0\tx1797
\up0 \expndtw0\charscalex100 4. Kegiatan pengawasan tersebut mencakup prosedur
menjaga kerahasiaan dan \line\tab \up0 \expndtw-3\charscalex100 keamanan informasi
penelitian. (D,W) \par\pard\ql \li1440\sb17\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 5. Kegiatan meliputi pengawasan saat pelaksanaan penelitian. (D,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 DONASI ORGAN \par\pard\qj \li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1303\sb26\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Catatan: sandar-standar berikut dimaksudkan untuk
digunakan bila transplantasi \up0 \expndtw-3\charscalex100 organ atau jaringan
tidak dilakukan, namun saat pasien meminta informasi mengenai \up0 \expndtw-
4\charscalex100 donasi organ atau jaringan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 8 \par\pard\qj \li1440\ri1369\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
memberi informasi pada pasien serta keluarga tentang bagaimana \up0 \expndtw-
3\charscalex100 memilih untuk mendonorkan organ dan jaringan lainnya.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar HPK 8.1
\par\pard\qj \li1440\ri1366\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan kebijakan dan prosedur untuk
melakukan pengawasan \up0 \expndtw-3\charscalex100 terhadap proses kemungkinan
terjadi jual beli organ dan jaringan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan HPK 8 dan HPK 8.1 \par\pard\qj
\li1440\ri1304\sb11\sl-316\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kelangkaan organ tubuh yang tersedia untuk
transplantasi mendorong banyak \line \up0 \expndtw0\charscalex104 negara
menetapkan sistem dan prosedur untuk meningkatkan persediaan. \line \up0
\expndtw-2\charscalex100 Persetujuan secara tegas diperlukan untuk donasi organ.
Rumah sakit bertanggung \line \up0 \expndtw-4\charscalex100 jawab untuk menentukan
proses mendapatkan dan mencatat persetujuan donasi sel, \line \up0 \expndtw-
2\charscalex100 jaringan, organ terkait standar etika internasional dan cara
pengelolaan penyediaan \line \up0 \expndtw-3\charscalex100 organ. \par\pard\ql
\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb204\sl-253\slmult0 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 96
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg97}
{\bkmkend Pg97}\par\pard\qj \li1440\sb0\sl-300\slmult0 \par\pard\qj\li1440\sb0\sl-
300\slmult0 \par\pard\qj\li1440\sb0\sl-300\slmult0 \par\pard\qj\li1440\sb0\sl-
300\slmult0 \par\pard\qj\li1440\ri1371\sb293\sl-300\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit bertanggung jawab
untuk memastikan tersedia pengawasan untuk \up0 \expndtw-3\charscalex100 mencegah
pasien merasa dipaksa memberikan donasi. \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1310\sb4\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Rumah
sakit mendukung pilihan pasien serta keluarga melakukan donasi organ dan \up0
\expndtw0\charscalex100 jaringan lain untuk riset dan atau transplantasi. Informasi
diberikan kepada pasien \up0 \expndtw-3\charscalex100 serta keluarga tentang proses
donasi dan ketentuan pengadaan organ yang dikelola \up0 \expndtw-4\charscalex100
untuk memenuhi kebutuhan masyarakat, daerah, atau negara. \par\pard\qj
\li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\ri1356\sb8\sl-316\slmult0 \up0
\expndtw-2\charscalex100 Kelangkaan organ untuk transplantasi menghasilkan praktik-
praktik penyediaan dan \line \up0 \expndtw0\charscalex100 transplantasi organ
yang dipertanyakan. Praktik membujuk orang-orang atau \line \up0 \expndtw-
1\charscalex100 kelompok rentan (seperti buta huruf, miskin, imigran gelap,
narapidana, serta \line \up0 \expndtw0\charscalex103 pelarian politik atau
ekonomi) untuk menjadi donor hidup,\ul0\nosupersub\cf8\f9\fs24 organ
trafficking \line \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24
(pembelian dan penjualan organ di perdagangan gelap), pengambilan organ tanpa \line
\up0 \expndtw0\charscalex105 persetujuan (\ul0\nosupersub\cf8\f9\fs24
consent\ul0\nosupersub\cf7\f8\fs24 ) dari orang mati atau orang yang dieksekusi
mati adalah \line \up0 \expndtw-3\charscalex100 bertentangan dengan upaya menjamin
keamanan donor dan resipien organ. \par\pard\qj \li1440\ri1302\sb304\sl-317\slmult0
\up0 \expndtw-3\charscalex100 Pengawasan terhadap proses pengadaan organ atau
jaringan termasuk menentukan \line \up0 \expndtw0\charscalex102 proses donasi
sesuai dengan ketentuan peraturan perundang-undangan, \line \up0
\expndtw0\charscalex100 menghormati agama dan budaya masyarakat, memastikan ada
praktik etika, dan \line \up0 \expndtw0\charscalex100 persetujuan
(\ul0\nosupersub\cf8\f9\fs24 consent\ul0\nosupersub\cf7\f8\fs24 ). Staf rumah sakit
dilatih tentang proses memperoleh donasi \line \up0 \expndtw0\charscalex100 untuk
membantu pasien dan keluarga membuat pilihan. Staf juga dilatih mengenai \line \up0
\expndtw-3\charscalex100 kekhawatiran dan isu terkait donasi organ. Rumah sakit
bekerja sama dengan rumah \line \up0 \expndtw-1\charscalex100 sakit lain dan
perkumpulan perkumpulan yang bertanggungjawab sepenuhnya atau \line \up0 \expndtw-
1\charscalex100 sebagian mengenai penyediaan,\ul0\nosupersub\cf8\f9\fs24
banking\ul0\nosupersub\cf7\f8\fs24 , pengangkutan, atau proses tranplantasi.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK 8
\par\pard\qj \li1440\ri1366\sb8\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mendukung
pasien serta keluarga untuk memberikan donasi \line\tab \up0 \expndtw-
2\charscalex100 organ atau jaringan lain sesuai dengan peraturan perundang-
undangan. (R) \par\pard\qj \li1440\ri1370\sb0\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex103 2. Rumah sakit memberi informasi kepada pasien dan
keluarga tentang proses \line\tab \up0 \expndtw-3\charscalex100 donasi sesuai
dengan regulasi. (D,W) \par\pard\qj \li1440\ri1373\sb0\sl-320\slmult0\tx1797
\up0 \expndtw-1\charscalex100 3. Rumah sakit memberi informasi kepada pasien dan
keluarga tentang organisasi \line\tab \up0 \expndtw-2\charscalex100 penyediaan
organ sesuai rdengan egulasi. (D,W) \par\pard\qj \li1440\ri1366\sb0\sl-
320\slmult0\tx1797 \up0 \expndtw-1\charscalex100 4. Rumah sakit memastikan
terselenggaranya pengawasan yang cukup untuk \line\tab \up0 \expndtw-
2\charscalex100 mencegah pasien merasa dipaksa untuk donasi sesuai dengan regulasi.
(D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian HPK 8.1 \par\pard\ql \li1440\ri1365\sb8\sl-320\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang
menetapkan proses donasi organ dan jaringan serta \line\tab \up0
\expndtw0\charscalex100 memastikan bahwa proses sesuai dengan peraturan
perundang-undangan, \line \tab \up0 \expndtw-3\charscalex100 agama, dan nilai-nilai
budaya setempat. (R) \par\pard\qj \li1440\ri1314\sb17\sl-300\slmult0\tx1797 \up0
\expndtw-3\charscalex100 2. Rumah sakit menetapkan proses untuk mendapatkan
persetujuan sesuai dengan \line\tab \up0 \expndtw-4\charscalex100 regulasi.
(D,W) \par\pard\qj \li1440\ri1377\sb4\sl-320\slmult0\tx1797 \up0
\expndtw0\charscalex104 3. Staf dilatih tentang isu dan masalah terkini terkait
dengan donasi organ dan \line\tab \up0 \expndtw-3\charscalex100 tersedianya
tranplantasi. (D,W) \par\pard\ql \li10243\sb216\sl-253\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 97
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg98}
{\bkmkend Pg98}\par\pard\ql \li1440\sb0\sl-310\slmult0 \par\pard\ql\li1440\sb0\sl-
310\slmult0 \par\pard\ql\li1440\sb0\sl-310\slmult0
\par\pard\ql\li1440\ri1311\sb234\sl-310\slmult0\tx1797\tx1797 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 4. Rumah sakit bekerja sama
dengan rumah sakit lain dan perkumpulan di \line\tab \up0 \expndtw-
3\charscalex100 masyarakat untuk menghargai serta melaksanakan pilihannya melakukan
donasi. \line \tab \up0 \expndtw-4\charscalex100 (D,W) \par\pard\ql \li1440\sb0\sl-
276\slmult0
\par\pard\ql\li1440\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar HPK 8.2 \par\pard\qj \li1440\ri1372\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menyediakan pengawasan terhadap pengambilan serta ransplantasi \up0 \expndtw-
3\charscalex100 organ dan jaringan\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Maksud dan Tujuan HPK 8.2 \par\pard\qj \li1440\ri1307\sb11\sl-
316\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Kebijakan
tersebut konsisten dengan peraturan perundang-undangan dan \line \up0
\expndtw-3\charscalex100 menghormati agama, keyakinan, dan nilai-nilai budaya yang
dianut masyarakat. Staf \line \up0 \expndtw0\charscalex100 rumah sakit dilatih
dalam pelaksanaan kebijakan dan prosedur untuk mendukung \line \up0 \expndtw-
1\charscalex100 pilihan pasien serta keluarganya. Staf rumah sakit juga dilatih
dalam persoalan dan \line \up0 \expndtw0\charscalex106 isu kontemporer yang
berkaitan dengan donasi organ serta ketersediaan \line \up0
\expndtw0\charscalex100 transplantasi seperti informasi tentang kurang tersedianya
organ dan jaringan, jual \line \up0 \expndtw0\charscalex100 beli organ manusia di
pasar gelap, pengambilan jaringan tubuh tanpa persetujuan \line \up0 \expndtw-
1\charscalex100 dari narapidana yang dihukum mati, atau dari pasien yang meninggal.
Rumah sakit \line \up0 \expndtw0\charscalex102 bertanggung jawab untuk memastikan
bahwa persetujuan yang sah diterima dari \line \up0 \expndtw-2\charscalex100 donor
hidup dan ada pengendalian yang memadai dalam mencegah pasien merasa \line \up0
\expndtw-3\charscalex100 tertekan untuk menjadi donor. \par\pard\qj \li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\ri1364\sb1\sl-320\slmult0 \up0
\expndtw0\charscalex100 Rumah sakit bekerjasama dengan rumah sakit lain dan
badan-badan dalam \line \up0 \expndtw0\charscalex100 masyarakat yang bertanggung
jawab terhadap seluruh atau sebagian dan proses \line \up0 \expndtw-2\charscalex100
mendapatkan organ, bank organ, serta transportasi atau proses transplantasi.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian HPK
8.2 \par\pard\qj \li1440\ri1313\sb8\sl-320\slmult0\tx1797 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang menjadi acuan
untuk pengawasan proses dalam mendapatkan \line\tab \up0 \expndtw-4\charscalex100
dan mendonasi organ atau jaringan serta proses transplantasi. (R) \par\pard\ql
\li1440\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Staf dilatih untuk
regulasi tersebut. (D,W) \par\pard\qj \li1440\ri1373\sb8\sl-320\slmult0\tx1797 \up0
\expndtw-1\charscalex100 3. Staf dilatih mengenai isu dan persoalan tentang donasi
organ dan ketersediaan \line\tab \up0 \expndtw-3\charscalex100 transplan. (D,W)
\par\pard\ql \li1440\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4. Rumah
sakit mendapat persetujuan dari donor hidup. (D,W) \par\pard\ql \li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-
253\slmult0 \par\pard\ql\li10243\sb228\sl-253\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs22 98
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg99}
{\bkmkend Pg99}\par\pard\ql \li5592\sb0\sl-276\slmult0 \par\pard\ql\li5592\sb0\sl-
276\slmult0 \par\pard\ql\li5592\sb0\sl-276\slmult0 \par\pard\ql\li5592\sb0\sl-
276\slmult0 \par\pard\ql\li5592\sb0\sl-276\slmult0 \par\pard\ql\li5592\sb0\sl-
276\slmult0 \par\pard\ql\li5592\sb156\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAB 3 \par\pard\ql \li4634\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 ASESMEN PASIEN (AP) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb212\sl-276\slmult0 \up0 \expndtw-3\charscalex100 GAMBARAN
UMUM \par\pard\qj \li1440\ri1187\sb211\sl-316\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Tujuan asesmen pasien yang
efektif akan menghasilkan keputusan tentang \line \up0 \expndtw-3\charscalex100
kebutuhan asuhan, pengobatan pasien yang harus segera dilakukan dan pengobatan
\line \up0 \expndtw-2\charscalex100 berkelanjutan untuk emergensi, elektif atau
pelayanan terencana, bahkan ketika \line \up0 \expndtw-1\charscalex100 kondisi
pasien berubah. Proses asesmen pasien adalah proses yang terus menerus \line
\up0 \expndtw0\charscalex102 dan dinamis yang digunakan pada sebagian besar unit
kerja rawat inap dan rawat \line \up0 \expndtw-3\charscalex100 jalan.
\par\pard\qj \li1440\ri1190\sb201\sl-320\slmult0 \up0 \expndtw-1\charscalex100
Asuhan pasien di rumah sakit diberikan dan dilaksanakan berdasarkan konsep
\up0 \expndtw-4\charscalex100 Pelayanan berfokus pada pasien (Patient/Person
Centered Care). \par\pard\qj \li1440\ri1179\sb200\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Pola ini dipayungi oleh konsep
WHO:\ul0\nosupersub\cf8\f9\fs24 Conceptual framework integrated people\up0
\expndtw-4\charscalex100 centred health services\ul0\nosupersub\cf7\f8\fs24
.\ul0\nosupersub\cf8\f9\fs24 (WHO global strategy on integrated people-
centred health \up0 \expndtw-5\charscalex100 services 2016-2026, July 2015).
\par\pard\qj \li1440\ri1240\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penerapan konsep pelayanan berfokus pada pasien adalah
dalam bentuk Asuhan \line \up0 \expndtw-2\charscalex100 Pasien Terintegrasi yang
bersifat integrasi horizontal dan vertikal dengan elemen: \par\pard\qj
\li1800\ri1248\sb200\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 \u8226?
Dokter penanggung jawab pelayanan (DPJP) sebagai ketua tim asuhan
\line\tab \up0 \expndtw-3\charscalex100 /\ul0\nosupersub\cf8\f9\fs24 Clinical
Leader \par\pard\ql \li1800\ri1182\sb165\sl-315\slmult0\tx2160\tx2160\tx2160\tx2160
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 \u8226? Profesional
Pemberi Asuhan bekerja sebagai tim intra- dan inter-disiplin \line\tab
\up0 \expndtw0\charscalex100 dengan kolaborasi interprofesional, dibantu antara
lain dengan Panduan \line \tab \up0 \expndtw0\charscalex100 Praktik Klinis
\up0 \expndtw0\charscalex101 (PPK), Panduan Asuhan PPA lainnya, Alur
Klinis/\ul0\nosupersub\cf8\f9\fs24 Clinical \line \tab \up0 \expndtw-
3\charscalex100 Pathway\ul0\nosupersub\cf7\f8\fs24 terintegrasi, Algoritme,
Protokol, Prosedur,\ul0\nosupersub\cf8\f9\fs24 Standing
Order\ul0\nosupersub\cf7\f8\fs24 dan CPPT \line \tab \up0 \expndtw-4\charscalex100
(Catatan Perkembangan Pasien Terintegrasi) \par\pard\ql \li1800\sb198\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? Manajer Pelayanan Pasien/ Case
Manager \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\u8226? Keterlibatan dan pemberdayaan pasien dan keluarga . \par\pard\ql
\li1440\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Asesmen pasien terdiri
atas 3 proses utama dengan metode IAR: \par\pard\qj \li1800\ri1249\sb208\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex104 1. Mengumpulkan informasi dari
data keadaan fisik, psikologis, sosial, kultur, \line\tab \up0 \expndtw-
3\charscalex100 spiritual dan riwayat kesehatan pasien (I - informasi dikumpulkan).
\par\pard\ql \li1800\ri1244\sb169\sl-310\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex103 2. Analisis informasi dan data, termasuk hasil
laboratorium dan radiologi \line\tab \up0 \expndtw-2\charscalex100 diagnostik
imajing untuk mengidentifikasi kebutuhan pelayanan kesehatan \line \tab
\up0 \expndtw-3\charscalex100 pasien. (A - analisis data dan informasi)
\par\pard\ql \li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb0\sl-253\slmult0
\par\pard\ql\li10243\sb0\sl-253\slmult0 \par\pard\ql\li10243\sb39\sl-253\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs22 99
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg100}
{\bkmkend Pg100}\par\pard\qj \li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\sb0\sl-
300\slmult0 \par\pard\qj\li1800\sb0\sl-300\slmult0
\par\pard\qj\li1800\ri1186\sb273\sl-300\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Membuat rencana pelayanan untuk
memenuhi semua kebutuhan pasien yang \line\tab \up0 \expndtw-4\charscalex100 telah
diidentifikasi. (R - rencana disusun) . \par\pard\qj \li1440\ri1241\sb164\sl-
320\slmult0 \up0 \expndtw0\charscalex103 Asesmen harus memperhatikan kondisi
pasien, umur, kebutuhan kesehatan, dan \up0 \expndtw0\charscalex100 permintaan atau
preferensinya. Kegiatan asesmen pasien dapat bervariasi sesuai \up0 \expndtw-
3\charscalex100 dengan tempat pelayanan. \par\pard\qj \li1440\ri1197\sb200\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Asesmen ulang harus dilakukan selama
asuhan, pengobatan dan pelayanan untuk \up0 \expndtw-2\charscalex100
mengidentifikasi kebutuhan pasien. Asesmen ulang adalah penting untuk memahami \up0
\expndtw-2\charscalex100 respons pasien terhadap pemberian asuhan, pengobatan dan
pelayanan, serta juga \up0 \expndtw-3\charscalex100 penting untuk menetapkan apakah
keputusan asuhan memadai dan efektif. \par\pard\qj \li1440\ri1250\sb180\sl-
320\slmult0 \up0 \expndtw0\charscalex100
Proses-proses ini paling efektif dilaksanakan bila berbagai profesional
kesehatan \up0 \expndtw-2\charscalex100 yang bertanggung jawab atas pasien bekerja
sama. \par\pard\ql \li2272\sb0\sl-276\slmult0 \par\pard\ql\li2272\sb0\sl-
276\slmult0 \par\pard\ql\li2272\sb205\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 STANDAR, MAKSUD DAN TUJUAN, SERTA
ELEMEN PENILAIAN \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb12\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Standar AP.1 \par\pard\qj \li1440\ri1233\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menentukan isi, jumlah dan jenis asesmen awal pada disiplin medis \line \up0
\expndtw0\charscalex103 dan keperawatan yang meliputi pemeriksaan fisik, riwayat
kesehatan, pengkajian \line \up0 \expndtw-2\charscalex100 pasien dari aspek
biologis, psikologis, sosial, ekonomi, kultural dan spiritual pasien.
\par\pard\ql \li1440\sb217\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.1.1 \par\pard\qj \li1440\ri1182\sb208\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Asesmen awal
masing-masing pasien rawat inap meliputi pemeriksaan fisik, riwayat \up0
\expndtw-3\charscalex100 kesehatan, pengkajian pasien dari aspek biologis,
psikologis, sosial, ekonomi, kultural \up0 \expndtw-4\charscalex100 dan spiritual
pasien. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.1.2 \par\pard\qj \li1440\ri1187\sb216\sl-
310\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Asesmen awal
masing-masing pasien rawat jalan meliputi pemeriksaan fisik, riwayat \up0
\expndtw-3\charscalex100 kesehatan, pengkajian pasien dari aspek biologis,
psikologis, sosial, ekonomi, kultural \up0 \expndtw-4\charscalex100 dan spiritual
pasien. \par\pard\ql \li1440\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.1.3 \par\pard\qj \li1440\ri1187\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Asesmen awal
masing-masing pasien gawat darurat meliputi pemeriksaan fisik, \up0 \expndtw-
3\charscalex100 riwayat kesehatan, pengkajian pasien dari aspek biologis,
psikologis, sosial, ekonomi, \up0 \expndtw-4\charscalex100 kultural dan spiritual
pasien. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.1, AP 1.1, AP 1.2 dan AP 1.3
\par\pard\qj \li1440\ri1248\sb216\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Asesmen yang efektif menghasilkan keputusan
tentang tindakan segera dan \line \up0 \expndtw0\charscalex103 berkelanjutan
yang dibutuhkan pasien untuk tindakan darurat, asuhan terencana, \line \up0
\expndtw0\charscalex100 bahkan jika kondisi pasien berubah. Asesmen
pasien merupakan proses \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb185\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 100
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg101}
{\bkmkend Pg101}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1248\sb234\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 berkelanjutan, dinamis dan dikerjakan di instalasi /
unit gawat darurat, rawat jalan, \up0 \expndtw0\charscalex100 rawat inap, dan unit
pelayanan lainnya. Asesmen pasien terdiri dari 3 proses utama \up0 \expndtw-
3\charscalex100 dengan metode IAR: \par\pard\qj \li1800\ri1240\sb202\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 a. Mengumpulkan data dan informasi
(huruf I) tentang hal-hal sesuai d sd n, \line\tab \up0 \expndtw-2\charscalex100
tersebut dibawah.\ul0\nosupersub\cf6\f7\fs24 Pada SOAP adalah S-Subyektif dan O-
Obyektif. \par\pard\ql \li1800\ri1247\sb160\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 b. Analisis data dan informasi
(huruf A) , yaitu melakukan analisis terhadap \line\tab \up0
\expndtw0\charscalex105 informasi yang menghasilkan diagnosis, masalah, dan
kondisi, untuk \line \tab \up0 \expndtw-3\charscalex100 mengidentifikasi kebutuhan
pasien.\ul0\nosupersub\cf6\f7\fs24 Pada SOAP adalah A-Asesmen. \par\pard\ql
\li1800\sb197\sl-276\slmult0\tx10394 \up0 \expndtw0\charscalex100
c.\ul0\nosupersub\cf7\f8\fs24 Membuat Rencana (huruf R), yaitu menyusun
solusi untuk mengatasi \tab \up0 \expndtw-3\charscalex100 / \par\pard\qj
\li2160\ri1237\sb16\sl-310\slmult0 \up0 \expndtw-2\charscalex100 memperbaiki
kelainan kesehatan sesuai butir b . Pelaksanaan R adalah untuk \line \up0 \expndtw-
2\charscalex100 memenuhi kebutuhan pasien yang telah
teridentifikasi.\ul0\nosupersub\cf6\f7\fs24 Pada SOAP adalah P-\line \up0
\expndtw-3\charscalex100 Plan. \par\pard\ql \li1800\sb199\sl-276\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Isi minimal asesmen awal
antara lain : \par\pard\ql \li1800\sb244\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 d. status fisik, \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 e. psiko-sosio-spiritual, \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw0\charscalex105 f. ekonomi \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 g. riwayat kesehatan pasien.
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 h. riwayat
alergi, \par\pard\li1800\sb41\sl-276\slmult0\fi0\tx2160 \up0 \expndtw-
3\charscalex100 i.\tab \up0 \expndtw-3\charscalex100 asesmen
nyeri,\par\pard\li1800\sb41\sl-276\slmult0\fi0\tx2160 \up0 \expndtw-3\charscalex100
j.\tab \up0 \expndtw-3\charscalex100 risiko jatuh,\par\pard\ql \li1800\sb30\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 k. asesmen fungsional,
\par\pard\li1800\sb54\sl-276\slmult0\fi0\tx2160 \up0 \expndtw-3\charscalex100
l.\tab \up0 \expndtw-3\charscalex100 risiko nutrisional,\par\pard\ql
\li1800\sb34\sl-276\slmult0 \up0 \expndtw-2\charscalex100 m. kebutuhan edukasi ,
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 n.
Perencanaan Pemulangan Pasien\ul0\nosupersub\cf8\f9\fs24 (Discharge Planning)
\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1183\sb188\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Jika pasien
sudah terdaftar atau diterima di rumah sakit untuk asuhan rawat inap dan \line \up0
\expndtw0\charscalex104 atau rawat jalan, sebuah asesmen lengkap perlu dilakukan
terkait alasan pasien \line \up0 \expndtw-4\charscalex100 datang di rumah sakit
mengacu kepada butir-butir isi minimal asesmen awal. Informasi \line \up0 \expndtw-
1\charscalex100 spesifik yang dibutuhkan rumah sakit pada tahap ini,
prosedur yang dilakukan \line \up0 \expndtw0\charscalex103 padanya, tergantung
kebutuhan pasien dan dimana asuhan diberikan (misalnya, \line \up0 \expndtw-
2\charscalex100 asuhan rawat inap atau rawat jalan). Rumah sakit menetapkan
regulasi proses \line \up0 \expndtw-3\charscalex100 asesmen dan
pendokumentasiannya di rekam medis (lihat juga, ARK.1). \par\pard\qj
\li1440\ri1189\sb204\sl-316\slmult0 \up0 \expndtw-1\charscalex100 Untuk melakukan
asesmen pasien secara efektif, rumah sakit menentukan regulasi, \up0
\expndtw0\charscalex103 isi minimal asesmen yang harus dilakukan oleh dokter,
perawat dan professional \up0 \expndtw0\charscalex102 pemberi asuhan lainnya.
Asesmen dilakukan oleh disiplin klinis sesuai kebutuhan. \up0 \expndtw-
2\charscalex100 Asesmen hanya dilakukan oleh orang yang kompeten dan diberi
kewenangan sesuai \up0 \expndtw-1\charscalex100 peraturan perundang-undangan.
Seluruh hasil asesmen itu harus ada sebelum \up0 \expndtw-6\charscalex100
dilakukan pengobatan. \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb78\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 101
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg102}
{\bkmkend Pg102}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1181\sb234\sl-310\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asesmen awal seorang pasien, rawat jalan, rawat inap,
dan gawat darurat merupakan \up0 \expndtw-2\charscalex100 proses yang penting
untuk identifikasi kebutuhan pasien untuk memulai proses \up0 \expndtw-
3\charscalex100 asuhan pasien. Proses asesmen awal memberikan informasi perihal:
\par\pard\ql \li1800\sb239\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
Pemahaman asuhan yang diinginkan oleh pasien \par\pard\ql \li1800\sb204\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? Pemilihan asuhan paling baik
untuk pasien \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw0\charscalex100
\u8226? Diagnosis awal, dan \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw-2\charscalex100 \u8226? Pemahaman respons pasien terhadap asuhan
sebelumnya \par\pard\qj \li1440\ri1237\sb174\sl-313\slmult0 \up0 \expndtw-
1\charscalex100 Untuk mendapatkan informasi ini, asesmen awal melakukan evaluasi
kondisi pasien \up0 \expndtw0\charscalex100 melalui pemeriksaan fisik dan
riwayat kesehatannya. Asesmen psikologis \up0 \expndtw0\charscalex102
menentukan status emosional pasien (misalnya, jika pasien depresi, takut jiwanya
\up0 \expndtw-3\charscalex100 terancam, suka berkelahi, membahayakan diri sendiri
atau orang lain). \par\pard\qj \li1440\ri1239\sb202\sl-320\slmult0 \up0
\expndtw0\charscalex100 Mengumpulkan informasi tentang pasien tidak bermaksud
\u8220?menggolongkan\u8221? pasien \up0 \expndtw-1\charscalex100
kedalam \u8220?satu golongan tertentu\u8221?. Tetapi status sosial, kultur,
spiritual, ekonomi, dari \up0 \expndtw-1\charscalex100 pasien merupakan faktor
penting yang dapat berpengaruh terhadap respons pasien \up0 \expndtw-
3\charscalex100 terhadap penyakit dan tindakan pengobatan. \par\pard\qj
\li1440\ri1184\sb203\sl-317\slmult0 \up0 \expndtw-1\charscalex100 Keluarga akan
membantu dalam proses asesmen dan untuk memahami keinginan \up0
\expndtw0\charscalex102 pasien dan pilihannya dari proses asesmen. Faktor ekonomi
dikaji sebagai bagian \up0 \expndtw0\charscalex100 asesmen sosial, atau asesmen
ekonomi terpisah jika pasien dan keluarganya \up0 \expndtw-3\charscalex100
bertanggung jawab terhadap semua atau sebagian biaya asuhan selama dirawat atau
\up0 \expndtw-1\charscalex100 sesudah keluar rumah sakit. Banyak profesional
pemberi asuhan (PPA) yangg \up0 \expndtw-3\charscalex100 kompeten dan diberi
kewenangan yang berbeda-beda terlibat dalam asesmen pasien. \up0 \expndtw-
2\charscalex100 Faktor terpenting adalah asesmen dilakukan lengkap dan tersedia
bagi mereka yang \up0 \expndtw-3\charscalex100 bekerja untuk memberikan asuhan
(lihat juga, ARK.3). \par\pard\qj \li1440\ri1184\sb207\sl-313\slmult0 \up0
\expndtw-1\charscalex100 Asesmen sangat bermanfaat jika mempertimbangkan
kondisi, umur, kebutuhan \up0 \expndtw-3\charscalex100 kesehatan, termasuk
permintaan keinginan pasien. Proses akan dilaksanakan sangat \up0
\expndtw0\charscalex103 efektif jika berbagai profesional pemberi asuhan (PPA)
yang bertanggung jawab \up0 \expndtw-4\charscalex100 terhadap asuhan pasien
berkerja sama (lihat juga, ARK 3.) \par\pard\qj \li1440\ri1246\sb202\sl-
320\slmult0 \up0 \expndtw0\charscalex106 Untuk asesmen keperawatan rawat jalan,
rumah sakit dapat mempolakan \up0 \expndtw0\charscalex100 pelaksanaan asesmen
tersebut secara sentral, yang terbagi sesuai kebutuhan \up0
\expndtw0\charscalex103 (keperawatan dewasa, keperawatan anak, keperawatan
bedah, keperawatan \up0 \expndtw-3\charscalex100 maternitas dsb). \par\pard\qj
\li1440\ri1183\sb206\sl-313\slmult0 \up0 \expndtw0\charscalex100 Pada rawat
jalan, asesmen awal dilakukan pada pasien baru, pasien dengan \up0
\expndtw0\charscalex102 diagnosis baru, pasien dengan diagnosis yang sama pada
kunjungan kedua yang \up0 \expndtw-3\charscalex100 jarak waktunya lama, sesuai
regulasi rumah sakit lebih dari satu bulan pada diagnosis \up0 \expndtw-
4\charscalex100 akut, atau misalnya tiga bulan pada penyakit yang kronis.
\par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb225\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 102
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg103}
{\bkmkend Pg103}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb56\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.1 \par\pard\qj
\li1800\ri1186\sb188\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menentukan isi, jumlah, dan jenis
asesmen awal pada disiplin \line\tab \up0 \expndtw-3\charscalex100 medis dan
keperawatan sesuai d) sampai dengan n) di maksud dan tujuan. (R) \par\pard\qj
\li1800\ri1197\sb160\sl-320\slmult0\tx2160 \up0 \expndtw-3\charscalex100 2. Ada
bukti pelaksanaan isi, jumlah dan jenis asesmen awal disiplin medis. (D,W \line\tab
\up0 \expndtw-4\charscalex100 ) \par\pard\qj \li1800\ri1249\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex107 3. Ada bukti pelaksanaan isi,
jumlah dan jenis asesmen awal disiplin \line\tab \up0 \expndtw-3\charscalex100
keperawatan. (D,W) \par\pard\qj \li1800\ri1252\sb177\sl-300\slmult0\tx2160 \up0
\expndtw-1\charscalex100 4. Ada bukti keterlibatan keluarga dalam melengkapi
asesmen awal (lihat HPK 2 \line\tab \up0 \expndtw-2\charscalex100 EP1). ( D,W )
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb168\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.1.1 \par\pard\qj
\li1800\ri1189\sb208\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada bukti pelaksanaan asesmen awal pasien
rawat inap meliputi riwayat \line\tab \up0 \expndtw-4\charscalex100 kesehatan
pasien dan pemeriksaan fisik (D,W) \par\pard\qj \li1800\ri1239\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex102 2. Ada bukti pelaksanaan asesmen
awal pasien rawat inap meliputi faktor bio-\line\tab \up0 \expndtw-3\charscalex100
psiko-sosio-kultural-spiritual. (D,W) \par\pard\qj \li1800\ri1182\sb177\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex100 3. Ada bukti pelaksanaan
asesmen awal pasien rawat inap menghasilkan \line\tab \up0 \expndtw-
3\charscalex100 diagnosis awal dan masalah kesehatan pasien (lihat juga ARK 3).
(D,W) \par\pard\qj \li1800\ri1247\sb164\sl-320\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 4. Ada bukti pelaksanaan asesmen awal pasien rawat inap harus
selesai dalam \line\tab \up0 \expndtw-2\charscalex100 waktu 24 jam atau lebih cepat
sesuai dengan kondisi pasien. (D,W) \par\pard\qj \li1800\ri1244\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 5. Ada bukti pelaksanaan
asesmen awal pasien rawat inap menghasilkan \line\tab \up0 \expndtw-
3\charscalex100 rencana asuhan (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb165\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian
AP.1.2 \par\pard\qj \li1800\ri1248\sb225\sl-300\slmult0\tx2160 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan kerangka
waktu penyelesaian asesmen awal pasien \line\tab \up0 \expndtw-3\charscalex100
rawat jalan. (R) \par\pard\qj \li1800\ri1192\sb164\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex102 2. Ada bukti pelaksanaan asesmen awal pasien rawat
jalan meliputi riwayat \line\tab \up0 \expndtw-4\charscalex100 kesehatan pasien dan
pemeriksaan fisik. (D,W) \par\pard\qj \li1800\ri1237\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 3. Ada bukti pelaksanaan asesmen
awal pasien rawat jalan meliputi faktor bio-\line\tab \up0 \expndtw-3\charscalex100
psiko-sosio-kultural-spiritual. (D,W) \par\pard\qj \li1800\ri1190\sb177\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex100 4. Ada bukti pelaksanaan
asesmen awal pasien rawat jalan menghasilkan \line\tab \up0 \expndtw-
3\charscalex100 diagnosis awal dan masalah kesehatan pasien (lihat juga ARK 3).
(D,W) \par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb160\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 103
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg104}
{\bkmkend Pg104}\par\pard\qj \li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\sb0\sl-
300\slmult0 \par\pard\qj\li1800\sb0\sl-300\slmult0
\par\pard\qj\li1800\ri1249\sb273\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 5. Ada bukti pelaksanaan asesmen awal pasien
rawat jalan menghasilkan \line\tab \up0 \expndtw-3\charscalex100 rencana asuhan.
(D,W) \par\pard\qj \li1800\ri1245\sb164\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 6. Ada bukti pelaksanaan pasien rawat jalan dengan
penyakit akut /non kronis, \line\tab \up0 \expndtw-3\charscalex100 asesmen awal
diperbaharui setelah 1 (satu) bulan. (D,W) \par\pard\qj \li1800\ri1244\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 7. Ada bukti pelaksanaan pasien
rawat jalan dengan penyakit kronis, asesmen \line\tab \up0 \expndtw-3\charscalex100
awal diperbaharui setelah 3 (tiga) bulan. (D,W) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb165\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian AP.1.3 \par\pard\qj \li1800\ri1247\sb225\sl-300\slmult0\tx2160 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
kerangka waktu penyelesaian asesmen awal pasien \line\tab \up0 \expndtw-
3\charscalex100 gawat darurat. (R) \par\pard\qj \li1800\ri1248\sb164\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 2. Ada bukti pelaksanaan asesmen
awal pasien gawat darurat meliputi riwayat \line\tab \up0 \expndtw-3\charscalex100
kesehatan pasien dan pemeriksaan fisik. (D,W) \par\pard\qj \li1800\ri1210\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 3. Ada bukti pelaksanaan asesmen
awal pasien gawat darurat meliputi faktor bio-\line\tab \up0 \expndtw-
3\charscalex100 psiko-sosio-kultural-spiritual berfokus pada kondisi pasien.
(D,W) \par\pard\qj \li1800\ri1244\sb160\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex103 4. Ada bukti pelaksanaan asesmen awal pasien gawat darurat
menghasilkan \line\tab \up0 \expndtw-3\charscalex100 diagnosis awal dan masalah
kesehatan pasien (lihat juga ARK 3). (D,W) \par\pard\qj \li1800\ri1250\sb177\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex103 5. Ada bukti pelaksanaan asesmen
awal pasien gawat darurat menghasilkan \line\tab \up0 \expndtw-3\charscalex100
rencana asuhan (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb168\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.1.4
\par\pard\qj \li1440\ri1246\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asesmen awal
pasien mencakup juga skrining status nutrisi, kebutuhan fungsional, \up0 \expndtw-
1\charscalex100 dan kebutuhan khusus lainnya, kemudian dirujuk untuk asesmen dan
tindakan lebih \up0 \expndtw-3\charscalex100 lanjut jika perlu. \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.1.4.1 \par\pard\qj \li1440\ri1243\sb225\sl-
300\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Asesmen awal
pasien mencakup juga kebutuhan fungsional, termasuk risiko jatuh, \up0 \expndtw-
3\charscalex100 kemudian dirujuk untuk asesmen dan tindakan lebih lanjut jika
perlu. \par\pard\ql \li1440\sb240\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.1.4 dan AP.1.4.1 \par\pard\qj
\li1440\ri1181\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Informasi yang diperoleh pada asesmen awal medis
dan atau asesmen awal \up0 \expndtw0\charscalex102 keperawatan, dapat
menunjukkan kebutuhan asesmen lebih lanjut atau lebih \up0 \expndtw-
3\charscalex100 mendalam tentang status nutrisional (antara lain metode MST-
Malnutrition Screening \up0 \expndtw-2\charscalex100 Tools), fungsional (antara
lain: dengan metode Barthel Index) termasuk risiko pasien \up0 \expndtw-
3\charscalex100 jatuh (lihat juga, SKP.6). \par\pard\qj \li1440\ri1241\sb217\sl-
300\slmult0 \up0 \expndtw0\charscalex103 Asesmen lebih mendalam dibutuhkan untuk
identifikasi pasien yang memerlukan \line \up0 \expndtw0\charscalex103 intervensi
nutrisi, layanan rehabilitasi atau layanan lain terkait kemampuan untuk
\par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb66\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 104
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg105}
{\bkmkend Pg105}\par\pard\qj \li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\sb0\sl-
316\slmult0 \par\pard\qj\li1440\sb0\sl-316\slmult0
\par\pard\qj\li1440\ri1184\sb211\sl-316\slmult0 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 berfungsi mandiri. Secara umum seleksi dilakukan
melalui evaluasi sangat \line \up0 \expndtw0\charscalex100 sederhana, mendalam
terhadap pasien untuk menentukan apakah pasien \line \up0 \expndtw-
3\charscalex100 menunjukkan gejala sebagai sebuah risiko yang kemudian dibutuhkan
asesmen lebih \line \up0 \expndtw-3\charscalex100 lanjut secara mendalam. Misalnya,
asesmen awal keperawatan memuat kriteria dasar \line \up0 \expndtw-4\charscalex100
untuk menyaring status nutirisional, seperti ada lima atau enam pertanyaan
sederhana \line \up0 \expndtw-1\charscalex100 yang menghasilkan skor angka terkait
dengan\ul0\nosupersub\cf8\f9\fs24 intake\ul0\nosupersub\cf7\f8\fs24 makanan yang
menurun, berat \line \up0 \expndtw-3\charscalex100 badan menurun selama 3 bulan
yang lalu, mobilitas dan lain sebagainya. \par\pard\qj \li1440\ri1245\sb201\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Jumlah angka (skor) akan menunjukkan
risiko nutrisional pasien yang membutuhkan \up0 \expndtw-3\charscalex100 asesmen
nutrisional lebih lanjut secara. \par\pard\qj \li1440\ri1243\sb204\sl-
316\slmult0 \up0 \expndtw0\charscalex102 Pada setiap kasus, kriteria pemeriksaan
digunakan oleh staf yang kompeten dan \up0 \expndtw0\charscalex102 diberi
kewenangan yang mampu melakukan asesmen lebih lanjut, jika perlu, \up0
\expndtw0\charscalex100 memberikan pelayanan yang diperlukan. Misalnya,
kriteria pemeriksaan risiko \up0 \expndtw0\charscalex100 nutrisional dibuat oleh
perawat yang menggunakan kriteria, dietisen yang memberi \up0
\expndtw0\charscalex100 saran intervensi diet, dan nutrisionis yang akan
mengintegrasikan kebutuhan nutrisi \up0 \expndtw-3\charscalex100 dengan kebutuhan
lain pasien. \par\pard\qj \li1440\ri1221\sb209\sl-310\slmult0 \up0 \expndtw-
2\charscalex100 Informasi yang dikumpulkan dalam asesmen awal medis dan keperawatan
termasuk \line \up0 \expndtw-2\charscalex100 asesmen lain yang dibutuhkan antara
lain untuk: gigi, pendengaran, penglihatan, dan \line \up0 \expndtw-2\charscalex100
sebagainya. Setelah pemulangan di rumah sakit dilanjutkan asuhan di komunitas.
\par\pard\ql \li1440\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian 1.4. \par\pard\qj
\li1800\ri1246\sb208\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan kriteria risiko
nutrisional yang dikembangkan \line\tab \up0 \expndtw-3\charscalex100 bersama
staf yang kompeten dan berwenang. (R) \par\pard\qj \li1800\ri1251\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex102 2. Pasien diskrining untuk risiko
nutrisional sebagai bagian dari asesmen awal \line\tab \up0 \expndtw-
3\charscalex100 (lihat SKP 1 EP 4). (D,W) \par\pard\ql \li1800\sb37\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 3. Pasien dengan risiko nutrisional
dilanjutkan dengan asesmen gizi. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb268\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.1.4.1 \par\pard\qj
\li1800\ri1242\sb208\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. RS menetapkan kriteria asesmen kebutuhan fungsional
dan risiko jatuh, yang \line\tab \up0 \expndtw-3\charscalex100 dikembangkan bersama
staf yang kompeten dan berwenang. (R) \par\pard\qj \li1800\ri1252\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 2. Pasien diskrining untuk
kebutuhan fungsional termasuk risiko jatuh (lihat juga \line\tab \up0 \expndtw-
3\charscalex100 SKP 6). (D,W) \par\pard\qj \li1800\ri1250\sb0\sl-320\slmult0\tx2160
\up0 \expndtw0\charscalex103 3. Pasien dengan kebutuhan fungsional lanjutan
termasuk risiko jatuh, \line\tab \up0 \expndtw-3\charscalex100 memperoleh asuhan
yang sesuai ketentuan RS. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb261\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.1.5 \par\pard\qj \li1440\ri1236\sb208\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Semua pasien
rawat inap dan rawat jalan diskrining terhadap nyeri dan jika ada nyeri \up0
\expndtw-3\charscalex100 dilakukan asesmen. \par\pard\ql \li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb197\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 105
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg106}
{\bkmkend Pg106}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.1.5
\par\pard\qj \li1440\ri1236\sb225\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pada asesmen awal dan selama asesmen ulang prosedur
skrining digunakan untuk \up0 \expndtw-3\charscalex100 mengidentifikasi pasien yang
merasakan nyeri. \par\pard\ql \li1440\sb240\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Contoh pertanyaan yang dapat dipakai pada skrining sebagai berikut:
\par\pard\ql \li1800\sb244\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \u8226?
Apakah anda merasa sakit sekarang? \par\pard\ql \li1800\sb204\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \u8226? Apakah rasa sakit anda menghalangi tidur
malam anda? \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\u8226? Apakah rasa sakit anda menghalangi anda beraktivitas? \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? Apakah anda
merasakan sakit setiap hari? \par\pard\qj \li1440\ri1191\sb176\sl-310\slmult0
\up0 \expndtw-4\charscalex100 Jawaban positif dari pertanyaan pertanyaan ini
menandakan ada kebutuhan dilakukan \up0 \expndtw-1\charscalex100 asesmen mendalam
terhadap nyeri pasien. Cakupan tindakan berdasar asuhan dan \up0 \expndtw-
3\charscalex100 pelayanan yang tersedia \par\pard\qj \li1440\ri1234\sb205\sl-
317\slmult0 \up0 \expndtw0\charscalex102 Untuk pasien rawat inap, jika diketahui
ada nyeri segera dilakukan asesmen lebih \up0 \expndtw0\charscalex100 dalam.
Asesmen ini disesuaikan dengan umur pasien dan mengukur intensitas dan \up0
\expndtw0\charscalex103 kualitas rasa nyeri, seperti karakteristik rasa nyeri,
frekuensi, lokasi dan lamanya. \up0 \expndtw0\charscalex107 Informasi tambahan
dapat diberikan seperti riwayat rasa nyeri, apa yang \up0
\expndtw0\charscalex103 menyebabkan rasa nyeri berkurang atau bertambah, apa
keinginan pasien untuk \up0 \expndtw-2\charscalex100 menghilangkan rasa nyeri, dan
lain sebagainya (misalnya PQRST). Asesmen dicatat \up0 \expndtw0\charscalex104
demikian rupa untuk memudahkan asesmen ulang rutin dan tindak lanjut sesuai \up0
\expndtw-3\charscalex100 kriteria yang ditetapkan rumah sakit dan kebutuhan pasien.
\par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.1.5 \par\pard\qj
\li1800\ri1210\sb208\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi pasien diskrining
untuk rasa nyeri (lihat juga \line\tab \up0 \expndtw-3\charscalex100 PAP.6, EP 1).
(R) \par\pard\ql \li1800\ri1240\sb0\sl-320\slmult0\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex102 2. Apabila diidentifikasi ada rasa nyeri pada asesmen
awal, lakukan asesmen \line\tab \up0 \expndtw-1\charscalex100 lebih mendalam,
sesuai dengan umur pasien, dan pengukuran intensitas dan \line \tab \up0 \expndtw-
1\charscalex100 kualitas nyeri seperti karakter, kekerapan/frekuensi, lokasi dan
lamanya (lihat \line \tab \up0 \expndtw-3\charscalex100 juga PAP 6 EP 1). (D,W)
\par\pard\ql
\li1800\ri1249\sb0\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex100 3.
Asesmen dicatat sedemikian sehingga memfasilitasi asesmen ulangan yang \line\tab
\up0 \expndtw0\charscalex100 teratur dan tindak lanjut sesuai kriteria yang
dikembangkan oleh rumah sakit \line \tab \up0 \expndtw-3\charscalex100 dan
kebutuhan pasien. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb261\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.1.6 \par\pard\qj \li1440\ri1209\sb208\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi tentang asesmen tambahan untuk populasi pasien \up0 \expndtw-
3\charscalex100 tertentu. \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb191\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 106
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg107}
{\bkmkend Pg107}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.1.6
\par\pard\qj \li1440\ri1181\sb212\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asesmen tambahan untuk pasien tertentu atau untuk
populasi pasien khusus \up0 \expndtw0\charscalex103 mengharuskan proses asesmen
perlu diubah. Tambahan ini disesuaikan dengan \up0 \expndtw0\charscalex102 keunikan
dan kebutuhan setiap populasi pasien tertentu. Setiap rumah sakit \up0
\expndtw-3\charscalex100 menentukan kelompok pasien khusus dan populasi pasien dan
menyesuaikan proses \up0 \expndtw-4\charscalex100 asesmen untuk memenuhi kebutuhan
khusus mereka. \par\pard\ql \li1440\sb238\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Asesmen tambahan antara lain untuk: \par\pard\ql \li1800\sb244\sl-
276\slmult0 \up0 \expndtw0\charscalex103 \u8226? Neonatus \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw0\charscalex106 \u8226? Anak
\par\pard\ql \li1800\sb184\sl-276\slmult0 \up0 \expndtw0\charscalex104 \u8226?
Remaja \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw0\charscalex100
\u8226? Obsteri/maternitas \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw0\charscalex104 \u8226? Geriatri \par\pard\ql \li1800\sb204\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? Pasien dengan kebutuhan untuk
P3(Perencanaan Pemulangan Pasien) \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw-1\charscalex100 \u8226? Sakit terminal/menghadapi kematian
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
Pasien dengan rasa sakit kronik atau nyeri (intense) \par\pard\ql \li1800\sb204\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? Pasien dengan gangguan
emosional atau pasien psikiatris \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw-2\charscalex100 \u8226? Pasien kecanduan obat terlarang atau alkohol
\par\pard\ql \li1800\sb184\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \u8226?
Korban kekerasan atau kesewenangan \par\pard\ql \li1800\sb204\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \u8226? Pasien dengan penyakit menular atau
infeksius \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \u8226? Pasien yang menerima kemoterapi atau terapi radiasi
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
Pasien dengan sistem imunologi terganggu \par\pard\qj \li1440\ri1241\sb168\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Tambahan asesmen terhadap pasien ini
memperhatikan kebutuhan dan kondisi \up0 \expndtw0\charscalex100 mereka dalam
kerangka kultural pasien. Proses asesmen disesuaikan dengan \up0 \expndtw-
3\charscalex100 peraturan perundangan dan standar profesional \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.1.6 \par\pard\qj
\li1800\ri1248\sb188\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi tentang asesmen
tambahan untuk populasi \line\tab \up0 \expndtw-3\charscalex100 pasien tertentu (R)
\par\pard\qj \li1800\ri1241\sb160\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 2. Terhadap populasi pasien tersebut dilaksanakan asesmen
tambahan sesuai \line\tab \up0 \expndtw-3\charscalex100 regulasi rumah sakit. (D,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb165\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.2 \par\pard\ql \li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb77\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 107
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg108}
{\bkmkend Pg108}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1245\sb234\sl-310\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk melakukan asesmen
ulang bagi semua \line \up0 \expndtw0\charscalex100 pasien dengan interval waktu
berdasarkan kondisi, tindakan, untuk melihat respons \line \up0 \expndtw-
2\charscalex100 pasien, dan kemudian dibuat rencana kelanjutan asuhan dan atau
rencana pulang. \par\pard\ql \li1440\sb239\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.2.1 \par\pard\ql
\li1440\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi hasil asesmen ulang
dicatat di rekam medis \par\pard\qj \li1440\ri1251\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 dan didokumentasikan dengan baik dan dapat dengan cepat dan
mudah ditemukan \up0 \expndtw-3\charscalex100 kembali dalam rekam medis.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.2
dan AP.2.1 \par\pard\qj \li1440\ri1181\sb211\sl-316\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Asesmen ulang oleh semua
profesional pemberi asuhan (PPA) merupakan faktor \up0 \expndtw0\charscalex103
penting untuk evaluasi terhadap keputusan tentang asuhannya sudah benar dan \up0
\expndtw0\charscalex100 efektif. Dilakukan asesmen ulang dengan interval
waktu yang didasarkan atas \up0 \expndtw-3\charscalex100 kebutuhan dan rencana
asuhan\ul0\nosupersub\cf6\f7\fs24 ,\ul0\nosupersub\cf7\f8\fs24 dan digunakan
sebagai dasar rencana pulang pasien \up0 \expndtw0\charscalex103 sesuai dengan
regulasi rumah sakit. Hasil asesmen ulang dicatat di rekam medik \up0
\expndtw0\charscalex100 pasien/CPPT sebagai informasi untuk di gunakan oleh semua
profesional pemberi \up0 \expndtw-3\charscalex100 asuhan (PPA) (lihat juga, ARK.3).
\par\pard\ql \li1440\sb238\sl-276\slmult0\tx9688 \up0 \expndtw0\charscalex103
Asesmen ulang oleh dokter penanggung jawab pemberi pelayanan \tab \up0
\expndtw-3\charscalex100 (DPJP) \par\pard\qj \li1440\ri1181\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex102 memperhitungkan asuhan pasien selanjutnya. Seorang dokter
penanggung jawab \up0 \expndtw0\charscalex102 pemberi pelayanan (DPJP) melakukan
asesmen terhadap pasien akut sekurang\up0 \expndtw-4\charscalex100 kurangnya setiap
hari, termasuk di akhir minggu /libur, dan jika ada perubahan penting \up0
\expndtw-5\charscalex100 kondisi pasien. \par\pard\qj \li1440\ri1248\sb188\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Asesmen ulang dilakukan dan dicatat di
CPPT berbasis IAR dengan metode SOAP, \up0 \expndtw-3\charscalex100 gizi dapat
dengan metode ADIME, dengan memperhatikan: \par\pard\ql \li1800\ri1248\sb209\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex102 \u8226? Interval sepanjang
asuhan pasien (contoh, perawat mencatat secara tetap, \line\tab \up0 \expndtw-
1\charscalex100 tanda-tanda vital (TTV), asesmen nyeri, detak jantung dan suara
paru, sesuai \line \tab \up0 \expndtw-2\charscalex100 kondisi pasien)
\par\pard\li1800\sb215\sl-276\slmult0\fi0\tx9687 \up0 \expndtw0\charscalex101
\u8226? Setiap hari oleh dokter penanggung jawab pemberi pelayanan\tab
\up0 \expndtw0\charscalex101 (DPJP)\par\pard\li1800\sb39\sl-276\slmult0\fi360
\up0 \expndtw0\charscalex101 terhadap pasien\par\pard\ql \li1800\sb193\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? Sebagai respons terhadap
perubahan penting kondisi pasien\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 \u8226? Jika diagnosis pasien berubah dan dibutuhkan
perubahan rencana asuhan \par\pard\qj \li1800\ri1250\sb168\sl-320\slmult0\tx2160
\up0 \expndtw0\charscalex100 \u8226? Menentukan apakah pengobatan dan tindakan
lain berhasil dan pasien dapat \line\tab \up0 \expndtw-3\charscalex100 dipindah
atau pulang \par\pard\qj \li1440\ri1186\sb166\sl-313\slmult0 \up0 \expndtw-
2\charscalex100 Temuan pada asesmen digunakan sepanjang proses pelayanan untuk
mengevaluasi \line \up0 \expndtw-4\charscalex100 kemajuan pasien dan untuk memahami
kebutuhan untuk asesmen ulang. Oleh karena \line \up0 \expndtw-2\charscalex100 itu
sangat perlu bahwa asesmen medis, keperawatan dan asesmen profesional \line
\up0 \expndtw-2\charscalex100 pemberi asuhan (PPA) lain yang berarti, dicatat dan
didokumentasikan dengan baik \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb251\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22
108 \par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg109}{\bkmkend Pg109}\par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1183\sb196\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 dan dapat dengan cepat dan mudah ditemukan kembali
dalam rekam medis atau dari \line \up0 \expndtw-3\charscalex100 lokasi lain yang
ditentukan standar dan digunakan oleh staf yang melayani pasien. \par\pard\ql
\li1440\sb217\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.2 \par\pard\ql
\li1800\ri1209\sb208\sl-320\slmult0\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
asesmen ulang oleh dokter penanggung jawab pemberi \line\tab \up0
\expndtw0\charscalex100 pelayanan (DPJP), perawat dan profesional pemberi asuhan
(PPA) lainnya \line \tab \up0 \expndtw-2\charscalex100 untuk evaluasi respons
pasien terhadap asuhan yang diberikan sebagai tindak \line \tab \up0 \expndtw-
3\charscalex100 lanjut. (lihat juga, ARK 3, PAP.5; PAB.6.1; MPO.7) (R) \par\pard\qj
\li1800\ri1249\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 2. Ada bukti
pelaksanaan asesmen ulang medis dilaksanakan minimal satu kali \line\tab \up0
\expndtw-3\charscalex100 sehari, termasuk akhir minggu / libur untuk pasien akut
(D,W) \par\pard\qj \li1800\ri1249\sb17\sl-300\slmult0\tx2160 \up0 \expndtw-
2\charscalex100 3. Ada bukti pelaksanaan asesmen ulang oleh perawat minimal satu
kali per shift \line\tab \up0 \expndtw-3\charscalex100 atau sesuai dengan perubahan
kondisi pasien. (D,W) \par\pard\qj \li1800\ri1253\sb4\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex104 4. Ada bukti asesmen ulang oleh profesional pemberi asuhan
(PPA) lainnya \line\tab \up0 \expndtw-3\charscalex100 dilaksanakan dengan interval
sesuai regulasi rumah sakit. (D,W) \par\pard\qj \li1800\ri1249\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 5. Asesmen ulang dicatat di
dokumen Catatan Perkembangan Pasien \line\tab \up0 \expndtw-3\charscalex100
Terintegrasi (CPPT). (D) \par\pard\ql \li1440\sb197\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.2.1 \par\pard\ql
\li1800\ri1182\sb214\sl-313\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan pengaturan
urutan penyimpanan lembar-lembar RM \line\tab \up0 \expndtw-3\charscalex100 agar
mudah dicari kembali diakses dan terstandar, profesional pemberi asuhan \line
\tab \up0 \expndtw-2\charscalex100 (PPA) dapat menemukan dan mencari kembali hasil
asesmen di rekam medis. \line \tab \up0 \expndtw-3\charscalex100 (Masukkan ke
MIRM). (R) \par\pard\qj \li1800\ri1189\sb162\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 2. Asesmen ulang dicatat di dokumen Catatan
Perkembangan Pasien \line\tab \up0 \expndtw-5\charscalex100 Terintegrasi (CPPT).
(D) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb165\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.3 \par\pard\qj
\li1440\ri1244\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi tentang PPA yang
kompeten dan diberi \up0 \expndtw-3\charscalex100 kewenangan melakukan asesmen
awal dan asesmen ulang. \par\pard\ql \li1440\sb217\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.3 \par\pard\qj
\li1440\ri1187\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asesmen awal dan asesmen ulang pasien adalah proses
penting/kritikal, memerlukan \line \up0 \expndtw0\charscalex100 pendidikan khusus,
pelatihan, pengetahuan dan keahlian bagi profesional pemberi \line \up0
\expndtw0\charscalex103 asuhan (PPA) dan telah mendapatkan SPK dan RKK termasuk
asesmen gawat \line \up0 \expndtw0\charscalex102 darurat. Identifikasi bagi mereka
yang memenuhi syarat melakukan asesmen dan \line \up0 \expndtw-3\charscalex100
tanggung jawabnya ditentukan secara tertulis. Asesmen dilakukan oleh setiap
disiplin/ \line \up0 \expndtw-4\charscalex100 profesional pemberi asuhan \up0
\expndtw-4\charscalex100 (PPA) dalam lingkup prakteknya, izin, peraturan
\par\pard\ql \li1440\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100 perundangan,
dan sertifikasi. \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb5\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 109
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg110}
{\bkmkend Pg110}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.3 \par\pard\ql
\li1800\sb244\sl-276\slmult0\tx9148 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang menetapkan profesional
pemberi asuhan \tab \up0 \expndtw-2\charscalex100 (PPA) yang \par\pard\qj
\li2160\ri1247\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex103 kompeten dan
berwenang melakukan asesmen awal, asesmen ulang dan \up0 \expndtw-3\charscalex100
asesmen gawat darurat. (R) \par\pard\qj \li1800\ri1248\sb0\sl-320\slmult0\tx2160
\up0 \expndtw0\charscalex107 2. Asesmen awal, asesmen ulang dan asesmen
gawat darurat hanya \line\tab \up0 \expndtw-3\charscalex100 dilaksanakan oleh
medis yang kompeten dan berwenang (D,W) \par\pard\qj \li1800\ri1245\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex107 3. Asesmen awal, asesmen ulang
dan asesmen gawat darurat hanya \line\tab \up0 \expndtw-3\charscalex100
dilaksanakan oleh perawat yang kompeten dan berwenang. (D,W) \par\pard\ql
\li1800\ri1243\sb0\sl-310\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex107 4.
Asesmen awal, asesmen ulang dan asesmen gawat darurat hanya \line\tab
\up0 \expndtw-1\charscalex100 dilaksanakan oleh profesional pemberi asuhan (PPA)
lainnya yang kompeten \line \tab \up0 \expndtw-3\charscalex100 dan berwenang. (D,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb164\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.4 \par\pard\qj \li1440\ri1244\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Profesional
Pemberi Asuhan (PPA) bekerja secara tim memberikan asuhan pasien \line \up0
\expndtw0\charscalex100 terintegrasi, masing-masing melakukan asesmen berbasis
pengumpulan Informasi, \line \up0 \expndtw-1\charscalex100 melakukan analisis
untuk membuat rencana asuhan \up0 \expndtw-3\charscalex100 (IAR), \up0 \expndtw-
1\charscalex100 dengan dokter \par\pard\qj \li1440\ri1187\sb9\sl-310\slmult0
\up0 \expndtw-1\charscalex100 penanggung jawab pemberi pelayanan (DPJP)
sebagai ketua tim asuhan yang \up0 \expndtw-3\charscalex100 mengintegrasikan
asuhan, termasuk menentukan prioritas kebutuhan mendesak bagi \up0 \expndtw-
4\charscalex100 pasien rawat inap. \par\pard\ql \li1440\sb239\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.4
\par\pard\qj \li1440\ri1236\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Hasil asesmen pasien diintegrasikan sesuai konsep
pelayanan berfokus pada pasien \up0 \expndtw0\charscalex100 (PCC). Hasil asesmen
yang terintegrasi menjadi dasar Asuhan Pasien Terintegrasi, \up0 \expndtw-
2\charscalex100 baik yang bersifat integrasi horisontal maupun vertikal, dengan
elemen: \par\pard\qj \li1800\ri1244\sb217\sl-300\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 a) dokter penanggung jawab pemberi pelayanan (DPJP) sebagai
ketua tim \line\tab \up0 \expndtw-3\charscalex100 asuhan pasien
(\ul0\nosupersub\cf8\f9\fs24 Clinical Leader) \par\pard\ql \li1800\ri1239\sb164\sl-
320\slmult0\tx2160\tx2160 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24
b) profesional pemberi asuhan (PPA) bekerja dalam tim interdisiplin dengan
\line\tab \up0 \expndtw0\charscalex100 kolaborasi interprofesional, berdasarkan
Standar Pelayanan Profesi masing-\line \tab \up0 \expndtw-3\charscalex100
masing. \par\pard\li1800\sb206\sl-276\slmult0\fi0\tx5478 \up0
\expndtw0\charscalex103 c) manajer pelayanan pasien\tab \up0
\expndtw0\charscalex103 /\ul0\nosupersub\cf8\f9\fs24 case
manager\ul0\nosupersub\cf7\f8\fs24 menjaga
kesinambungan\par\pard\li1800\sb41\sl-276\slmult0\fi360 \up0
\expndtw0\charscalex103 pelayanan\par\pard\qj \li1800\ri1183\sb162\sl-
320\slmult0\tx2160 \up0 \expndtw-3\charscalex100 d) proses asuhan melibatkan dan
memberdayakan pasien dan keluarga. (lihat AP \line\tab \up0 \expndtw-
4\charscalex100 4, PAP 2, PAP 5) \par\pard\ql \li1800\sb177\sl-276\slmult0 \up0
\expndtw-3\charscalex100 e) perencanaan pemulangan pasien
/\ul0\nosupersub\cf8\f9\fs24 discharge planning\ul0\nosupersub\cf7\f8\fs24
terintegrasi \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 f) asuhan gizi terintegrasi (lihat PAP 5) \par\pard\ql
\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb231\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 110
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg111}
{\bkmkend Pg111}\par\pard\qj \li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-
315\slmult0
\par\pard\qj\li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\ri1244\sb215\sl-
315\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Banyak pasien
mungkin menjalani berbagai bentuk asesmen diluar atau didalam \line \up0 \expndtw-
1\charscalex100 rumah sakit oleh berbagai unit kerja. Hasilnya adalah,
tersedia banyak bentuk \line \up0 \expndtw0\charscalex100 informasi, hasil tes,
data yang ada di rekam medis pasien. Akan bermanfaat bagi \line \up0
\expndtw0\charscalex102 pasien jika profesional pemberi asuhan (PPA) yang
bertanggung jawab terhadap \line \up0 \expndtw-1\charscalex100 pasien bekerja
sama melakukan analisis \up0 \expndtw0\charscalex100 (metode IAR) temuan
asesmen dan \par\pard\qj \li1440\ri1242\sb1\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 menggabungkan informasi menjadi sebuah gambaran komprehensif
kondisi pasien. \up0 \expndtw0\charscalex100 Dari kolaborasi ini, kebutuhan pasien
teridentifikasi, ditentukan urutan prioritas, dan \up0 \expndtw0\charscalex100
keputusan tentang asuhan dibuat. Integrasi temuan akan memudahkan kooordinasi
\up0 \expndtw-3\charscalex100 asuhan pasien (lihat juga AP.2) \par\pard\qj
\li1440\ri1203\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex104 Proses bekerjasama
adalah sederhana dan informal jika kebutuhan pasien tidak \line \up0
\expndtw0\charscalex102 kompleks. Pertemuan resmi tim, rapat tentang pasien,
ronde klinik, mungkin \line \up0 \expndtw-2\charscalex100 dibutuhkan dengan
kebutuhan pasien yang kompleks atau dengan pasien yang \line \up0 \expndtw-
1\charscalex100 kebutuhannya tidak jelas. Pasien, keluarga pasien dan
lainnya, yang membuat \line \up0 \expndtw-2\charscalex100 keputusan atas nama
pasien dilibatkan dalam proses membuat keputusan, jika perlu. \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.4 \par\pard\qj
\li1800\ri1241\sb208\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada bukti hasil asesmen awal dan asesmen
ulang oleh masing-masing \line\tab \up0 \expndtw-3\charscalex100 profesional
pemberi asuhan (PPA) diintegrasikan. (D,W) \par\pard\ql \li1800\sb177\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 2. Ada bukti hasil asesmen dianalisis
untuk membuat rencana asuhan. (D,W) \par\pard\qj \li1800\ri1243\sb168\sl-
320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 3. Berdasarkan hasil asesmen dan
rencana asuhan profesional pemberi asuhan \line\tab \up0 \expndtw-2\charscalex100
(PPA) lainnya, dokter penanggung jawab pemberi pelayanan \up0 \expndtw-
3\charscalex100 (DPJP) \par\pard\ql \li2160\sb37\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 mengintegrasikan rencana asuhan dan tindak lanjutnya (lihat PAP 2.1
dan PAP \par\pard\ql \li2160\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5).
(D,W) \par\pard\ql \li1507\sb0\sl-276\slmult0 \par\pard\ql\li1507\sb0\sl-
276\slmult0 \par\pard\ql\li1507\sb172\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PELAYANAN LABORATORIUM \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb152\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar AP.5 \par\pard\qj \li1440\ri1240\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Pelayanan
laboratorium tersedia untuk memenuhi kebutuhan pasien, dan semua \up0 \expndtw-
3\charscalex100 pelayanan sesuai peraturan perundangan. \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5 \par\pard\qj
\li1440\ri1188\sb212\sl-315\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai sistem untuk menyediakan
pelayanan laboratorium, meliputi \up0 \expndtw0\charscalex100 pelayanan patologi
klinik, dapat juga tersedia patologi anatomi dan pelayanan \up0 \expndtw-
3\charscalex100 laboratorium lainnya, yang dibutuhkan populasi pasiennya, dan
kebutuhan profesional \up0 \expndtw-2\charscalex100 pemberi asuhan (PPA).
Organisasi pelayanan laboratorium yang di bentuk dan \up0 \expndtw-
3\charscalex100 diselenggarakan sesuai peraturan perundangan \par\pard\qj
\li1440\ri1241\sb201\sl-320\slmult0 \up0 \expndtw0\charscalex104 Di rumah sakit
dapat terbentuk pelayanan laboratorium utama (induk), dan juga \line \up0
\expndtw0\charscalex100 pelayanan laboratorium lain, misalnya laboratorium Patologi
Anatomi , laboratorium \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb63\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 111
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg112}
{\bkmkend Pg112}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1211\sb196\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 mikrobiologi, termasuk pelayanan Tes di Ruang Rawat
(TRR /\ul0\nosupersub\cf8\f9\fs24 Point of Care Testing\ul0\nosupersub\cf7\f8\fs24
) \line \up0 \expndtw-2\charscalex100 dsb, maka harus diatur secara organisatoris
pelayanan laboratorium terintegrasi. \par\pard\qj \li1440\ri1247\sb180\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Pelayanan laboratorium, tersedia 24 jam
termasuk pelayanan darurat, diberikan di \up0 \expndtw-1\charscalex100 dalam rumah
sakit dan rujukan sesuai dengan peraturan perundangan. Rumah sakit \up0
\expndtw0\charscalex100 dapat juga menunjuk dan menghubungi para spesialis di
bidang diagnostik khusus, \up0 \expndtw-3\charscalex100 seperti parasitologi,
virologi, atau toksikologi, jika perlu. \par\pard\qj \li1440\ri1224\sb200\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Rumah sakit memilih sumber dari luar
ini berdasar rekomendasi dari pimpinan \up0 \expndtw-2\charscalex100
laboratorium di rumah sakit. Sumber dari luar tersebut dipilih oleh rumah sakit
karena \up0 \expndtw0\charscalex100 memenuhi peraturan perundangan dan mempunyai
sertifikat mutu. Bila melakukan \up0 \expndtw-3\charscalex100 pemeriksaan rujukan
keluar, harus melalui laboratorium RS. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb185\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5
\par\pard\qj \li1800\ri1245\sb208\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
pengorganisasian dan pengaturan pelayanan \line\tab \up0 \expndtw-
3\charscalex100 laboratorium secara terintegrasi. (R) \par\pard\ql
\li1800\sb197\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada pelaksanaan
pelayanan laboratorium tersedia 24 jam. (O,W) \par\pard\qj \li1800\ri1209\sb168\sl-
320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 3. Ada daftar spesialis dalam
bidang diagnostik khusus yang dapat dihubungi jika \line\tab \up0 \expndtw-
3\charscalex100 dibutuhkan (W) \par\pard\ql \li1800\ri1243\sb169\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex103 4. Ada bukti pemilihan
laboratorium di luar rumah sakit (pihak ketiga) untuk \line\tab \up0
\expndtw0\charscalex100 kerjasama berdasarkan pada sertifikat mutu dan diikuti
perjanjian kerjasama \line \tab \up0 \expndtw-3\charscalex100 sesuai peraturan
perundang-undangan. (D,W) \par\pard\qj \li1800\ri1248\sb162\sl-
320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 5. Ada bukti pelaksanaan rujukan
laboratorium keluar rumah sakit (pihak ketiga) \line\tab \up0 \expndtw-
3\charscalex100 harus melalui laboratorium rumah sakit. (D,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb165\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.5.1 \par\pard\qj \li1440\ri1236\sb225\sl-
300\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi bahwa seorang (atau lebih) yang kompeten dan \up0 \expndtw-
3\charscalex100 berwenang, bertanggung jawab mengelola pelayanan laboratorium.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb208\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.1 \par\pard\qj
\li1440\ri1180\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelayanan laboratorium berada dibawah pimpinan seorang
atau lebih yang kompeten \line \up0 \expndtw0\charscalex102 dan memenuhi
persyaratan peraturan perundangan. Orang ini bertanggung jawab \line \up0
\expndtw0\charscalex102 mengelola fasilitas dan pelayanan laboratorium,
termasuk pemeriksaan yang \line \up0 \expndtw-2\charscalex100 dilakukan di
tempat tidur pasien \up0 \expndtw-2\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
POCT - point-of-care testing\ul0\nosupersub\cf7\f8\fs24 ), juga tanggung
\par\pard\qj \li1440\ri1245\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
jawabnya dalam melaksanakan regulasi rumah sakit secara konsisten,
seperti \up0 \expndtw-3\charscalex100 pelatihan, manajemen logistik, dan lain
sebagainya. \par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb70\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 112
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg113}
{\bkmkend Pg113}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1189\sb234\sl-310\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Sedangkan supervisi sehari hari tetap dijalankan oleh
pimpinan unit. Spesialisasi atau \up0 \expndtw-2\charscalex100 sub spesialisasi
pelayanan laboratorium harus berada dibawah pengarahan seorang
\up0 \expndtw-3\charscalex100 profesional sesuai bidangnya. \par\pard\ql
\li1507\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Tanggung jawab
penanggung jawab / koordinator pelayanan laboratorium, \par\pard\ql
\li1800\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a) Menyusun dan
evaluasi regulasi \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 b) Terlaksananya pelayanan laboratorium sesuai regulasi
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c)
Pengawasan pelaksanaan administrasi. \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw-3\charscalex100 d) Melaksanakan program kendali mutu. (PMI dan PME)
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e) Monitor
dan evaluasi semua jenis pelayanan laboratorium. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb152\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian AP.5.1 \par\pard\ql \li1800\ri1247\sb128\sl-320\slmult0\tx2160\tx2160
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit
menetapkan seorang (atau lebih) tenaga profesional untuk \line\tab \up0
\expndtw-2\charscalex100 memimpin pelayanan laboratorium terintegrasi disertai
uraian tugas, tanggung \line \tab \up0 \expndtw-3\charscalex100 jawab dan wewenang
sesuai butir a) s/d e) dalam Maksud dan Tujuan. (R) \par\pard\ql \li1800\sb157\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada bukti pelaksanaan penyusunan dan
evaluasi regulasi. (D,W) \par\pard\ql \li1800\sb164\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3. Ada bukti pelaksanaan pelayanan laboratorium sesuai regulasi.
(D,W) \par\pard\ql \li1800\sb164\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4.
Ada bukti pengawasan pelaksanaan administrasi. (D,W) \par\pard\ql \li1800\sb144\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 5. Ada bukti pelaksanaan program kendali
mutu. (D,W) \par\pard\qj \li1800\ri1248\sb128\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 6. Ada bukti pelaksanaan monitoring dan evaluasi
semua jenis pelayanan \line\tab \up0 \expndtw-3\charscalex100 laboratorium. (D,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb45\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.5.2 \par\pard\qj \li1440\ri1243\sb128\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Semua staf
laboratorium mempunyai pendidikan, pelatihan, kualifikasi dan \up0
\expndtw-3\charscalex100 pengalaman yang dipersyaratkan untuk mengerjakan
pemeriksaan. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb25\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.2
\par\pard\qj \li1440\ri1205\sb128\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Syarat pendidikan, pelatihan, kualifikasi dan
pengalaman ditetapkan rumah sakit bagi \up0 \expndtw0\charscalex104 mereka yang
memiliki kompetensi dan kewenangan diberi ijin mengerjakan \up0 \expndtw-
1\charscalex100 pemeriksaan laboratorium, termasuk yang mengerjakan pemeriksaan di
tempat tidur \up0 \expndtw0\charscalex100 pasien\ul0\nosupersub\cf8\f9\fs24
(point-of-care testing\ul0\nosupersub\cf7\f8\fs24 ). Interpretasi hasil pemeriksaan
dilakukan oleh dokter \up0 \expndtw-3\charscalex100 yang kompeten dan berwenang.
\par\pard\ql \li1440\sb157\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Pengawasan
terhadap staf yang mengerjakan pemeriksaan diatur oleh rumah sakit. \par\pard\qj
\li1440\ri1179\sb145\sl-300\slmult0 \up0 \expndtw-4\charscalex100 Staf pengawas dan
staf pelaksana diberi orientasi tugas mereka. Staf pelaksana diberi \line \up0
\expndtw-4\charscalex100 tugas sesuai latar belakang pendidikan dan pengalaman.
Unit kerja laboratorium \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb66\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 113
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg114}
{\bkmkend Pg114}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1223\sb234\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 menyusun dan melaksanakan program pelatihan (program
staf) yang memungkinkan \line \up0 \expndtw-1\charscalex100 staf mampu melakukan
tugas pekerjaan dengan cepat (cito) dan juga dengan tujuan \line \up0 \expndtw-
1\charscalex100 untuk memastikan selalu tersedia cukup tenaga memberikan pelayanan
24 jam. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb47\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.2 \par\pard\qj
\li1800\ri1250\sb128\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit melakukan analisis pola ketenagaan
staf laboratorium yang \line\tab \up0 \expndtw-2\charscalex100 adekuat untuk
memenuhi kebutuhan pasien (D,W) \par\pard\qj \li1800\ri1242\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 2. Staf laboratorium yang
membuat interpretasi, memenuhi persyaratan \line\tab \up0 \expndtw-
3\charscalex100 kredensial. (lihat juga KPS.4, EP 1). (D,W) \par\pard\ql
\li1800\ri1181\sb140\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex102 3.
Staf laboratorium dan staf lain yang melaksanakan tes termasuk yang
\line\tab \up0 \expndtw0\charscalex104 mengerjakan Tes di Ruang Rawat (TRR
/\ul0\nosupersub\cf8\f9\fs24 Point of Care Testing\ul0\nosupersub\cf7\f8\fs24 )
pasien, \line \tab \up0 \expndtw-4\charscalex100 memenuhi persyaratan kredensial
(lihat juga KPS.4, EP 1). (D,W) \par\pard\ql \li1800\sb197\sl-276\slmult0 \up0
\expndtw-2\charscalex100 4. Ada pelaksanaan supervisi pelayanan laboratorium di
rumah sakit. (R, D) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb172\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.3
\par\pard\qj \li1440\ri1244\sb216\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyusun program manajemen risiko di
laboratorium, dilaksanakan, \line \up0 \expndtw0\charscalex102 dilakukan evaluasi,
di dokumentasikan dan program sejalan dengan program \line \up0 \expndtw-
2\charscalex100 manajemen risiko fasilitas dan program pencegahan dan pengendalian
infeksi. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb207\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.3
\par\pard\qj \li1440\ri1187\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan program terkait risiko dan
bahaya di laboratorium. Program \up0 \expndtw0\charscalex100 menangani kebiasaan
dan praktek kerja secara aman, tindakan pencegahan serta \up0 \expndtw-
3\charscalex100 dikoordinasikan dengan program manajemen risiko fasilitas dan
program pencegahan \up0 \expndtw-4\charscalex100 dan pengendalian infeksi (PPI)
rumah sakit. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Program manajemen risiko meliputi, \par\pard\ql \li1800\sb224\sl-
276\slmult0 \up0 \expndtw0\charscalex101 \u8226? Identifikasi risiko \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw0\charscalex101 \u8226? Analisis risiko
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \u8226?
Upaya pengelolaan risiko \par\pard\qj \li1800\ri1243\sb168\sl-320\slmult0\tx2160
\up0 \expndtw0\charscalex100 \u8226? Kegiatan sejalan dengan manajemen risiko
fasilitas rumah sakit dan program \line\tab \up0 \expndtw-3\charscalex100
pencegahan dan pengendalian infeksi \par\pard\ql \li1800\sb197\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \u8226? Kegiatan sejalan dengan peraturan
perundang-undangan \par\pard\ql \li1800\ri1250\sb176\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex103 \u8226? Tersedianya
peralatan keamanan yang cocok dengan cara dan lingkungan \line\tab \up0
\expndtw0\charscalex102 kerja di laboratorium serta bahaya yang mungkin timbul
karenanya (contoh \line \tab \up0 \expndtw-3\charscalex100 antara lain
:\ul0\nosupersub\cf8\f9\fs24 eye wash station, spill kits) \par\pard\ql
\li10132\sb198\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 114
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg115}
{\bkmkend Pg115}\par\pard\ql \li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 \u8226? Orientasi bagi staf tentang
prosedur keamanan dan pelaksanaanya. \par\pard\qj \li1800\ri1247\sb185\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex100 \u8226? Pelatihan tentang adanya
prosedur baru terkait penerimaan dan penggunaan \line\tab \up0 \expndtw-
3\charscalex100 bahan berbahaya baru (lihat, PPI.5; MFK.4; MFK.4.1; MFK.5)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb168\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.3 \par\pard\qj
\li1800\ri1190\sb208\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada program manajemen risiko menangani potensi
risiko di laboratorium \line\tab \up0 \expndtw-5\charscalex100 sesuai regulasi
rumah sakit. (R) \par\pard\ql \li1800\ri1249\sb169\sl-310\slmult0\tx2160\tx2160
\up0 \expndtw0\charscalex102 2. Ada
bukti pelaksanaan program manajemen risiko sebagai bagian dari
\line\tab \up0 \expndtw0\charscalex101 manajemen risiko rumah sakit dan program
pencegahan dan pengendalian \line \tab \up0 \expndtw-3\charscalex100 infeksi. (D,W)
\par\pard\qj \li1800\ri1188\sb162\sl-320\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 3. Ada bukti laporan kepada pimpinan rumah sakit paling sedikit
satu tahun sekali \line\tab \up0 \expndtw-4\charscalex100 dan bila ada kejadian.
(D,W) \par\pard\ql \li1800\ri1243\sb160\sl-320\slmult0\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex102 4. Ada pelaksanaan orientasi dan pelatihan
berkelanjutan\ul0\nosupersub\cf8\f9\fs24 (ongoing)\ul0\nosupersub\cf7\f8\fs24
bagi staf \line\tab \up0 \expndtw-2\charscalex100 laboratorium tentang prosedur
keselamatan dan keamanan untuk mengurangi \line \tab \up0 \expndtw0\charscalex100
risiko serta pelatihan tentang prosedur baru yang menggunakan bahan
\line \tab \up0 \expndtw-3\charscalex100 berbahaya. (lihat , MFK.11; TKRS.9; KKS.8)
(,D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb145\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.3.1 \par\pard\qj
\li1440\ri1244\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi bahwa unit laboratorium
melaksanakan proses \up0 \expndtw0\charscalex104 untuk mengurangi risiko infeksi
akibat paparan bahan-bahan dan limbah biologis \up0 \expndtw-3\charscalex100
berbahaya. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.3.1 \par\pard\qj
\li1440\ri1188\sb214\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Terdapat regulasi dan praktek yang dilaksanakan untuk
mengurangi bahaya akibat \up0 \expndtw0\charscalex100 terpapar bahan-bahan dan
limbah biologis berbahaya. Infeksi yang didapat di \up0 \expndtw-
3\charscalex100 laboratorium di catat dan dilaporkan secara internal sesuai
regulasi PPI, dilaporkan ke \up0 \expndtw-4\charscalex100 dinas kesehatan setempat
sesuai peraturan perundang-undangan. \par\pard\qj \li1440\ri1186\sb202\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 Dibawah ini diberikan daftar hal-hal yang
harus ditangani dan persyaratan yang harus \up0 \expndtw-4\charscalex100 dilakukan:
\par\pard\ql \li1800\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a)
Pengendalian paparan aerosol \par\pard\qj \li1800\ri1243\sb168\sl-
320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 b) Jas laboratorium, jubah atau
baju dinas harus dipakai untuk perlindungan dan \line\tab \up0 \expndtw-
1\charscalex100 mencegah kontaminasi, termasuk fasilitas \u8220?eye washer\u8220?
dan dekontaminasi. \par\pard\ql \li1800\sb177\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 c) Almari bio-safety dipakai, jika perlu \par\pard\qj
\li1800\ri1187\sb168\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 d)
Terdapat regulasi tentang pembuangan bahan infeksius, luka tusuk, terpapar
\line\tab \up0 \expndtw-4\charscalex100 dengan bahan infeksius. Dalam ketentuan
juga diatur, prosedur dekontaminasi, \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb103\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 115
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg116}
{\bkmkend Pg116}\par\pard\qj \li2160\sb0\sl-310\slmult0 \par\pard\qj\li2160\sb0\sl-
310\slmult0 \par\pard\qj\li2160\sb0\sl-310\slmult0
\par\pard\qj\li2160\ri1184\sb234\sl-310\slmult0 \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf7\f8\fs24 siapa yang harus dihubungi untuk mendapat tindakan
darurat, penempatan \line \up0 \expndtw-1\charscalex100 dan penggunaan peralatan
keamanan. Untuk pengelolaan bahan berbahaya \line \up0 \expndtw-4\charscalex100
disertakan MSDS (Material Safety Data Sheet) / LDP (Lembar Data Pengaman)
\par\pard\ql \li1800\ri1243\sb162\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-
1\charscalex100 e) Terdapat prosedur pengumpulan, transpor, penanganan
spesimen secara \line\tab \up0 \expndtw-1\charscalex100 aman. Juga diatur larangan
untuk makan, minum, pemakaian kosmetik, lensa \line \tab \up0 \expndtw-
2\charscalex100 kontak, pipet dimulut di tempat staf bekerja melakukan
kegiatannya \par\pard\qj \li1800\ri1246\sb160\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 f) Staf diberi pelatihan tentang tindakan, cara
penularan dan pencegahan \line\tab \up0 \expndtw-3\charscalex100 penyakit yang
ditularkan melalui darah dan komponen darah \par\pard\qj \li1800\ri1247\sb177\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex105 g) Terdapat prosedur untuk
mencegah terpapar penyakit infeksi seperti \line\tab \up0 \expndtw-
3\charscalex100 tuberculosis, MERS dll. \par\pard\qj \li1440\ri1246\sb164\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Bila teridentifikasi masalah praktek
laboratorium atau terjadi kecelakaan, maka ada \up0 \expndtw0\charscalex100
tindakan korektif, dicatat (dokumentasi), dilakukan evaluasi dan dilaporkan
kepada \up0 \expndtw-3\charscalex100 Penanggung jawab / koordinator K3 RS.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.3.1 \par\pard\qj
\li1800\ri1187\sb225\sl-300\slmult0\tx2160 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada bukti unit laboratorium melaksanakan manajemen
risiko fasilitas dan risiko \line\tab \up0 \expndtw-5\charscalex100 infeksi
sesuai regulasi di rumah sakit \up0 \expndtw-4\charscalex100 (D,W) \par\pard\ql
\li1800\ri1242\sb164\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex100 2.
Ada bukti pelaporan dan penanganan staf yang terpapar di unit laboratorium
\line\tab \up0 \expndtw0\charscalex100 dicatat sesuai dengan regulasi PPI rumah
sakit dan peraturan perundangan \line \tab \up0 \expndtw-2\charscalex100 (D,W)
\par\pard\qj \li1800\ri1250\sb160\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex104 3. Ada bukti unit laboratorium menjalankan ketentuan
sesuai dengan butir a) \line\tab \up0 \expndtw-3\charscalex100 sampai dengan g) di
maksud dan tujuan. (D, W) \par\pard\ql \li1800\ri1182\sb169\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw-3\charscalex100 4. Ada bukti dilakukan
tindakan koreksi, dicatat, dievaluasi dan dilaporkan kepada \line\tab \up0
\expndtw0\charscalex103 Penanggung jawab / koordinator K3 RS Jika muncul masalah
dan terjadi \line \tab \up0 \expndtw-3\charscalex100 kecelakaan. ( D,W )
\par\pard\ql \li1440\sb199\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.5.3.2. \par\pard\ql \li1440\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Ada prosedur
melaporkan hasil laboratorium yang kritis. \par\pard\ql \li1440\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan AP.5.3.2. \par\pard\qj \li1440\ri1232\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelaporan dari hasil
laboratorium yang kritis adalah bagian dari risiko terkait \line \up0
\expndtw-2\charscalex100 keselamatan pasien. Hasil laboratorium yang secara
signifikan diluar batas nilai \line \up0 \expndtw-2\charscalex100 normal dapat
memberi indikasi risiko tinggi atau kondisi yang mengancam kehidupan \line \up0
\expndtw-3\charscalex100 pasien. \par\pard\qj \li1440\ri1243\sb180\sl-
320\slmult0 \up0 \expndtw0\charscalex103 Sangat penting bagi rumah sakit untuk
mengembangkan suatu sistem pelaporan \line \up0 \expndtw0\charscalex100 formal yang
jelas menggambarkan bagaimana profesional pemberi asuhan (PPA) \par\pard\ql
\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb210\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 116
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg117}
{\bkmkend Pg117}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1248\sb196\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 mewaspadai hasil laboratorium yang kritis dan bagaimana
staf mendokumentasikan \up0 \expndtw-3\charscalex100 komunikasi ini (lihat juga SKP
2, EP 3 dan 4). \par\pard\qj \li1440\ri1188\sb180\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 Proses ini dikembangkan rumah sakit untuk pengelolaan hasil
laboratorium yang kritis \up0 \expndtw-1\charscalex100 sebagai pedoman bagi
profesional pemberi asuhan (PPA) ketika meminta dan \up0 \expndtw-
3\charscalex100 menerima hasil laboratorium pada keadaan gawat darurat.
\par\pard\qj \li1440\ri1202\sb204\sl-316\slmult0 \up0 \expndtw-1\charscalex100
Prosedur ini meliputi juga: penetapan hasil laboratorium yang kritis dan ambang
nilai \line \up0 \expndtw-1\charscalex100 kritis bagi setiap tipe tes, untuk setiap
pelayanan laboratorium yang ada (antara lain, \line \up0 \expndtw-1\charscalex100
laboratorium Klinik, laboratorium Patologi Anatomi, laboratorium Mikrobiologi
seperti \line \up0 \expndtw-2\charscalex100 misalnya MRSA, MRSE, CRE, ESBL,
Keganasan dsb), oleh siapa dan kepada siapa \line \up0 \expndtw0\charscalex100
hasil laboratorium yang kritis harus dilaporkan, termasuk waktu penyampaian
hasil \line \up0 \expndtw-2\charscalex100 tersebut, pencatatan dan menetapkan
metode monitoring yang memenuhi ketentuan. \par\pard\ql \li1440\sb238\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian AP.5.3.2. \par\pard\qj \li1800\ri1249\sb208\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang disusun
secara kolaboratif tentang hasil laboratorium yang \line\tab \up0 \expndtw-
2\charscalex100
kritis, pelaporan oleh siapa dan kepada siapa serta tindak lanjutnya. (R)
\par\pard\qj \li1800\ri1247\sb160\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 2. Hasil laboratorium yang kritis dicatat didalam rekam
medis pasien (lihat juga \line\tab \up0 \expndtw-3\charscalex100 SKP 2 .1 EP 2 )
(D,W) \par\pard\qj \li1800\ri1251\sb177\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex104 3. Ada bukti tindak lanjut dari pelaporan hasil
laboratorium yang kritis secara \line\tab \up0 \expndtw-3\charscalex100
kolaboratif. (D,W) \par\pard\qj \li1800\ri1187\sb164\sl-320\slmult0\tx2160 \up0
\expndtw-3\charscalex100 4. Ada bukti pelaksanaan evaluasi dan tindak lanjut
terhadap seluruh proses agar \line\tab \up0 \expndtw-5\charscalex100 memenuhi
ketentuan serta dimodifikasi sesuai kebutuhan. (D,W) \par\pard\ql
\li1440\sb197\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.5.4 \par\pard\ql \li1440\sb244\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan kerangka waktu penyelesaian pemeriksaan laboratorium. \par\pard\ql
\li1440\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.4 \par\pard\qj
\li1440\ri1241\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan kerangka waktu penyelesaian
pemeriksaan laboratorium. \up0 \expndtw-2\charscalex100 Penyelesaian pemeriksaan
laboratorium dilaporkan sesuai kebutuhan pasien. \par\pard\qj
\li1440\ri1193\sb180\sl-320\slmult0 \up0 \expndtw-3\charscalex100 Hasil pemeriksaan
cito, antara lain dari unit darurat, kamar operasi, unit intensif diberi \up0
\expndtw-2\charscalex100 perhatian khusus terkait kecepatan asuhan. Jika
pemeriksaan dilakukan melalui \up0 \expndtw0\charscalex100 kontrak (pihak ketiga)
atau laboratorium rujukan, kerangka waktu melaporkan hasil \up0
\expndtw0\charscalex100 pemeriksaan juga mengikuti ketentuan rumah sakit dan MOU
dengan laboratorium \up0 \expndtw-3\charscalex100 rujukan (lihat juga, SKP 2.).
\par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.4 \par\pard\qj
\li1800\ri1248\sb225\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan kerangka waktu
penyelesaian pemeriksaan \line\tab \up0 \expndtw-3\charscalex100 laboratorium. (R)
\par\pard\qj \li1800\ri1249\sb164\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex105 2. Ada bukti pencatatan dan evaluasi waktu
penyelesaian pemeriksaan \line\tab \up0 \expndtw-3\charscalex100 laboratorium.
(D,W) \par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb23\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 117
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg118}
{\bkmkend Pg118}\par\pard\qj \li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\sb0\sl-
300\slmult0 \par\pard\qj\li1800\sb0\sl-300\slmult0
\par\pard\qj\li1800\ri1250\sb273\sl-300\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Ada bukti pencatatan dan
evaluasi waktu penyelesaian pemeriksaan cito. \line\tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb168\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.5
\par\pard\qj \li1440\ri1246\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi yang mengatur
tentang uji fungsi, inspeksi, \line \up0 \expndtw-1\charscalex100 pemeliharaan,
kalibrasi secara tetap \up0 \expndtw-1\charscalex100 (regular) terhadap semua
peralatan yang \par\pard\qj \li1440\ri1249\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex107 digunakan untuk pemeriksaan di laboratorium dan
hasil pemeriksaan \up0 \expndtw-3\charscalex100 didokumentasikan. \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.5 \par\pard\qj
\li1440\ri1236\sb214\sl-313\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Staf laboratorium harus memastikan semua peralatan
laboratorium berfungsi dengan \up0 \expndtw0\charscalex102 baik dan aman bagi
penggunanya. Laboratorium menetapkan dan melaksanakan \up0 \expndtw0\charscalex102
program pengelolaan peralatan laboratorium termasuk peralatan yang merupakan
\up0 \expndtw-3\charscalex100 kerjasama dengan pihak ketiga yang meliputi,
\par\pard\ql \li1800\sb238\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a) Uji
fungsi \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b)
Inspeksi berkala \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 c) Pemeliharaan berkala \par\pard\ql \li1800\sb184\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 d) Kaliberasi berkala \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e) Identifikasi dan
inventarisasi peralatan laboratorium \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw-2\charscalex100 f) Monitoring dan tindakan terhadap kegagalan fungsi alat
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 g) Proses
penarikan\ul0\nosupersub\cf8\f9\fs24 (recall) \par\pard\ql \li1800\sb204\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 h)
Pendokumentasian \par\pard\ql \li1440\sb204\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.5 \par\pard\qj
\li1800\ri1246\sb208\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi dan program untuk pengelolaan
peralatan laboratorium yang \line\tab \up0 \expndtw-3\charscalex100 meliputi butir
a) sampai dengan h) dalam Maksud dan Tujuan. (R) \par\pard\qj
\li1800\ri1249\sb177\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex102 2. Ada
bukti staf yang terlatih melaksanakan uji fungsi dan didokumentasikan. \line\tab
\up0 \expndtw-2\charscalex100 (D,W) \par\pard\qj \li1800\ri1246\sb164\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex105 3. Ada bukti staf yang
terlatih melaksanakan inspeksi berkala dan \line\tab \up0 \expndtw-
3\charscalex100 didokumentasikan. (D,W) \par\pard\qj \li1800\ri1250\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex104 4. Ada bukti staf yang
terlatih melaksanakan pemeliharaan berkala dan \line\tab \up0 \expndtw-
3\charscalex100 didokumentasikan. (D,W) \par\pard\qj \li1800\ri1249\sb160\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 5. Ada bukti staf yang
terlatih melaksanakan kaliberasi berkala dan \line\tab \up0 \expndtw-
3\charscalex100 didokumentasikan. (D,W) \par\pard\ql \li1800\sb177\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 6. Ada daftar inventaris peralatan
laboratorium. (D) \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb30\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 118
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg119}
{\bkmkend Pg119}\par\pard\qj \li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\sb0\sl-
300\slmult0 \par\pard\qj\li1800\sb0\sl-300\slmult0
\par\pard\qj\li1800\ri1189\sb273\sl-300\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 7. Ada bukti pelaksanaan monitoring
dan tindakan terhadap kegagalan fungsi alat \line\tab \up0 \expndtw-4\charscalex100
dan didokumentasikan. (D,W) \par\pard\li1800\sb216\sl-276\slmult0\fi0\tx9076
\up0 \expndtw0\charscalex101 8. Ada bukti pelaksanaan bila terjadi
proses penarikan\tab \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf8\f9\fs24
(recall)\ul0\nosupersub\cf7\f8\fs24 dan\par\pard\li1800\sb41\sl-
276\slmult0\fi360 \up0 \expndtw0\charscalex101 didokumentasikan.
(D,W)\par\pard\qj \li1800\ri1241\sb155\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex105 9. Terhadap kegiatan a) sampai dengan h) di maksud dan
tujuan dilakukan \line\tab \up0 \expndtw-3\charscalex100 evaluasi berkala dan
tindak lanjut \par\pard\ql \li1440\sb197\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.6 \par\pard\qj
\li1440\ri1246\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Reagensia essensial dan bahan lainnya tersedia
secara teratur dan di evaluasi \up0 \expndtw-3\charscalex100 akurasi dan presisi
hasilnya. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb185\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.6.
\par\pard\qj \li1440\ri1241\sb211\sl-317\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan reagensia dan bahan-bahan lain
yang selalu harus ada \line \up0 \expndtw0\charscalex103 untuk pelayanan
laboratorium bagi pasien. Suatu proses yang efektif untuk \line \up0
\expndtw0\charscalex102 pemesanan atau menjamin ketersediaan reagensia esensial dan
bahan lain yang \line \up0 \expndtw0\charscalex103 diperlukan. Semua reagensia
disimpan dan didistribusikan sesuai prosedur yang \line \up0
\expndtw0\charscalex100 ditetapkan. Dilakukan audit secara periodik untuk semua
reagensia esensial untuk \line \up0 \expndtw0\charscalex103 memastikan akurasi
dan presisi hasil pemeriksaan, antara lain untuk aspek \line \up0
\expndtw0\charscalex100 penyimpanan, label, kadaluarsa dan fisik. Pedoman tertulis
memastikan pemberian \line \up0 \expndtw-1\charscalex100 label yang lengkap dan
akurat untuk reagensia dan larutan dan akurasi serta presisi \line \up0 \expndtw-
3\charscalex100 dari hasil. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24
Elemen Penilaian AP.5.6. \par\pard\ql \li1800\ri1183\sb216\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24
1. Rumah sakit menetapkan pengelolaan logistik laboratorium, reagensia
\line\tab \up0 \expndtw-3\charscalex100 esensial , bahan lain yang diperlukan,
termasuk kondisi bila terjadi kekosongan \line \tab \up0 \expndtw-4\charscalex100
sesuai peraturan perundangan. (lihat juga MFK.5, EP 1). (R) \par\pard\ql
\li1800\ri1249\sb162\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex100 2.
Ada bukti pelaksanaan semua reagensia esensial disimpan dan diberi label, \line\tab
\up0 \expndtw0\charscalex100 serta didistribusi sesuai pedoman dari pembuatnya
atau instruksi pada \line \tab \up0 \expndtw-3\charscalex100 kemasannya (lihat
juga MFK.5, EP 2). (D,O,W) \par\pard\ql \li1800\sb197\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 3. Ada bukti pelaksanaan evaluasi/audit semua reagen. (D,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb172\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.5.7 \par\pard\qj \li1440\ri1242\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Ada regulasi
tentang pengambilan, pengumpulan, identifikasi, pengerjaan, \up0 \expndtw-
3\charscalex100 pengiriman, penyimpanan, pembuangan spesimen dan dilaksanakan.
\par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb177\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 119
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg120}
{\bkmkend Pg120}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.7
\par\pard\ql \li1440\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Regulasi dan implementasi meliputi, \par\pard\ql
\li1800\sb224\sl-276\slmult0 \up0 \expndtw0\charscalex100 \u8226? Permintaan
pemeriksaan \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\u8226? Pengambilan, pengumpulan dan identifikasi spesimen \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? Pengiriman,
pembuangan, penyimpanan dan pengawetan spesimen \par\pard\ql \li1800\sb204\sl-
276\slmult0\tx7432 \up0 \expndtw0\charscalex100 \u8226? Penerimaan, penyimpanan,
telusur spesimen \tab \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf8\f9\fs24
(tracking)\ul0\nosupersub\cf7\f8\fs24 . Tracking adalah \par\pard\qj
\li2160\ri1187\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100 telusur spesimen
bila ada keluhan tidak ada hasil dari suatu spesimen yang \up0
\expndtw0\charscalex100 telah dikirim atau bila ada permintaan mengulang
pemeriksaan. Telusur \up0 \expndtw-4\charscalex100 biasanya untuk spesimen yang
diambil dalam waktu 24 jam. \par\pard\qj \li1440\ri1208\sb140\sl-320\slmult0
\up0 \expndtw0\charscalex102 Regulasi ini berlaku untuk spesimen yang dikirim ke
laboratorium rujukan layanan \up0 \expndtw-2\charscalex100 laboratorium untuk
dilakukan pemeriksaan. Pada jaringan / cairan tubuh yang diambil \up0
\expndtw0\charscalex102 dengan tindakan invasif, sebagai standar
penetapan diagnosis dilakukan \up0 \expndtw-3\charscalex100 pemeriksaan
patologi anatomi (laboratorium internal atau rujukan) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian AP.5.7 \par\pard\qj \li1800\ri1249\sb225\sl-300\slmult0\tx2160 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
pengambilan, pengumpulan, identifikasi, pengerjaan, \line\tab \up0 \expndtw-
3\charscalex100 pengiriman, pembuangan spesimen (R) \par\pard\qj
\li1800\ri1243\sb164\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 2. Ada
bukti pelaksanaan permintaan pemeriksaan oleh profesional pemberi
\line\tab \up0 \expndtw-3\charscalex100 asuhan (PPA) yang kompeten dan berwenang
(D,W) \par\pard\qj \li1800\ri1236\sb160\sl-320\slmult0\tx2160 \up0 \expndtw-
2\charscalex100 3. Ada bukti pelaksanaan pengambilan, pengumpulan dan
identifikasi specimen \line\tab \up0 \expndtw-3\charscalex100 sesuai dengan
regulasi (D,W) \par\pard\qj \li1800\ri1250\sb160\sl-320\slmult0\tx2160 \up0
\expndtw-1\charscalex100 4. Ada bukti pelaksanaan pengiriman, pembuangan,
penyimpanan, pengawetan \line\tab \up0 \expndtw-3\charscalex100 specimen sesuai
dengan regulasi (D,W) \par\pard\qj \li1800\ri1223\sb160\sl-320\slmult0\tx2160
\up0 \expndtw-2\charscalex100 5. Ada bukti pelaksanaan penerimaan, penyimpanan,
telusur spesimen\ul0\nosupersub\cf8\f9\fs24 (tracking) \line\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 sesuai dengan regulasi. (D,W)
\par\pard\qj \li1800\ri1245\sb140\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 6. Ada bukti pengelolaan pemeriksaan jaringan / cairan
sesuai dengan regulasi. \line\tab \up0 \expndtw-2\charscalex100 (D,W)
\par\pard\ql \li1800\sb197\sl-276\slmult0 \up0 \expndtw-4\charscalex100 7.
Ditetapkan prosedur bila menggunakan laboratorium rujukan. (D) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb172\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.5.8 \par\pard\qj \li1440\ri1245\sb208\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan nilai normal dan rentang nilai untuk interpretasi dan \up0
\expndtw-3\charscalex100 pelaporan hasil laboratorium
klinis\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb97\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 120
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg121}
{\bkmkend Pg121}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.8 \par\pard\qj
\li1440\ri1239\sb212\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan rentang nilai normal/rujukan
setiap jenis pemeriksaan. \line \up0 \expndtw0\charscalex104 Rentang nilai
dilampirkan di dalam laporan klinik, baik sebagai bagian dari \line \up0
\expndtw-2\charscalex100 pemeriksaan atau melampirkan daftar terkini, nilai
ini yang ditetapkan pimpinan \line \up0 \expndtw0\charscalex100 laboratorium.
Jika pemeriksaan dilakukan oleh lab rujukan, rentang nilai diberikan. \line \up0
\expndtw-2\charscalex100 Selalu harus dievaluasi dan direvisi apabila metode
pemeriksaan berubah. \par\pard\ql \li1440\sb238\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.8 \par\pard\qj
\li1800\ri1246\sb208\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang penetapan dan evaluasi
rentang nilai normal untuk \line\tab \up0 \expndtw-2\charscalex100 interpretasi,
pelaporan hasil lab klinis. (R) \par\pard\qj \li1800\ri1246\sb177\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex100 2. Pemeriksaan laboratorium harus
dilengkapi dengan permintaan pemeriksaan \line\tab \up0 \expndtw-3\charscalex100
tertulis disertai dengan ringkasan klinis. (D,W) \par\pard\ql \li1800\sb200\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 3. Setiap hasil pemeriksaan laboratorium
dilengkapi dengan rentang nilai normal. \par\pard\ql \li2160\sb44\sl-276\slmult0
\up0 \expndtw-3\charscalex100 (D) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb172\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.9
\par\pard\qj \li1440\ri1243\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk melaksanakan
prosedur kendali mutu \up0 \expndtw-3\charscalex100 pelayanan laboratorium, di
evaluasi dan dicatat sebagai dokumen. \par\pard\ql \li1440\sb217\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
AP.5.9 \par\pard\qj \li1440\ri1243\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Kendali mutu yang baik
sangat esensial bagi pelayanan laboratorium agar \up0 \expndtw-3\charscalex100
laboratorium dapat memberikan layanan prima. \par\pard\qj \li1440\ri1232\sb200\sl-
320\slmult0 \up0 \expndtw0\charscalex103 Program kendali mutu (pemantapan mutu
internal - PMI) mencakup tahapan Pra\up0 \expndtw-3\charscalex100 analitik,
Analitik dan Pasca analitik yang memuat antara lain \par\pard\ql \li1800\sb237\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 a) Validasi tes yang digunakan untuk tes
akurasi, presisi, hasil rentang nilai \par\pard\ql \li1800\sb204\sl-276\slmult0
\up0 \expndtw-3\charscalex100 b) Dilakukan surveilans hasil pemeriksaan oleh staf
yang kompeten \par\pard\ql \li1800\sb184\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 c) Reagensia di tes (lihat juga, AP.5.6) \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) Koreksi cepat jika
ditemukan kekurangan \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 e) Dokumentasi hasil dan tindakan koreksi \par\pard\ql
\li1440\sb204\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.9
\par\pard\qj \li1800\ri1245\sb208\sl-320\slmult0\tx2160 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan program mutu
laboratorium klinik meliputi a) sampai \line\tab \up0 \expndtw-3\charscalex100
dengan e) di maksud dan tujuan. (R) \par\pard\ql \li1800\sb197\sl-276\slmult0
\up0 \expndtw-3\charscalex100 2. Ada bukti pelaksanaan validasi metoda tes.
(D,W) \par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb144\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 121
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg122}
{\bkmkend Pg122}\par\pard\qj \li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\sb0\sl-
300\slmult0 \par\pard\qj\li1800\sb0\sl-300\slmult0
\par\pard\qj\li1800\ri1250\sb273\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 3. Ada bukti pelaksanaan surveilans harian dan
pencatatan hasil pemeriksaan. \line\tab \up0 \expndtw-2\charscalex100 (D,W)
\par\pard\ql \li1800\sb200\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4. Ada
bukti pelaksanaan tes reagen. (D,W) \par\pard\qj \li1800\ri1250\sb168\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 5. Ada bukti pelaksanaan tindakan
koreksi cepat dan dokumentasinya terhadap \line\tab \up0 \expndtw-3\charscalex100
masalah yang timbul. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb165\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.9.1.
\par\pard\ql \li1440\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ada proses untuk pemantapan mutu eksternal sebagai tes
pembanding mutu. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb192\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
AP.5.9.1 \par\pard\qj \li1440\ri1248\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Pemantapan Mutu Eksternal
(PME) sebagai tes pembanding mutu adalah proses \up0 \expndtw0\charscalex100
membandingkan seberapa baik kinerja (hasil) sebuah laboratorium dibandingkan \up0
\expndtw0\charscalex102 dengan hasil sebuah laboratorium lain. Tes ini dapat
menemukan masalah kinerja \up0 \expndtw-1\charscalex100 yang tidak dapat diketahui
melalui mekanisme internal. RS dapat mengikuti program \up0 \expndtw0\charscalex100
PME nasional dan atau internasional. Untuk kepentingan ini, unit laboratorium
ikut \up0 \expndtw-2\charscalex100 program PME. Laboratorium harus mengumpulkan
sertifikat tentang partisipasinya di \up0 \expndtw-3\charscalex100 dalam program
(lihat juga, AP.5.10 dan TKRS.11). \par\pard\ql \li1440\sb217\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.9.1
\par\pard\ql \li1800\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada bukti pelaksanaan PME. (D) \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada bukti tindak
lanjut dari hasil PME. (D) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb172\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.10
\par\pard\qj \li1440\ri1250\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Laboratorium rujukan yang bekerja sama dengan
rumah sakit mempunyai ijin, \up0 \expndtw-3\charscalex100 terakreditasi, ada
sertifikasi dari pihak yang berwenang. \par\pard\ql \li1440\sb237\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.10
\par\pard\ql \li1440\sb224\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Jika rumah sakit menggunakan pelayanan lab rujukan,
informasi berikut diperlukan: \par\pard\ql \li1800\sb244\sl-276\slmult0 \up0
\expndtw-3\charscalex100 a) copy surat ijin dari pihak berwenang yang menerbitkan
ijin \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b)
copy sertifikat akreditasi dari program akreditasi laboratorium yang diakui
\par\pard\qj \li1800\ri1250\sb168\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex102 c) bukti dokumen bahwa laboratorium rujukan ikut serta
program kendali mutu \line\tab \up0 \expndtw-3\charscalex100 (lihat juga, AP.5.9.1)
\par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb124\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 122
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg123}
{\bkmkend Pg123}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1190\sb234\sl-310\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Untuk pelayanan laboratorium rujukan, maka RS secara
teratur menerima laporan dan \up0 \expndtw0\charscalex100 mereview kontrol mutu
dari pelayanan laboratorium rujukan tersebut. Individu yang \up0 \expndtw-
3\charscalex100 kompeten mereview hasil kontrol mutu. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb207\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian AP.5.10 \par\pard\ql \li1800\sb244\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada bukti ijin dan atau sertifikasi
laboratorium rujukan. (D,W) \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw-3\charscalex100 2. Ada bukti pelaksanaan PME laboratorium rujukan.
(D,W) \par\pard\qj \li1800\ri1248\sb168\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex102 3. Ada staf yang bertanggungjawab atas hasil pemeriksaan
laboratorium yang \line\tab \up0 \expndtw-3\charscalex100 diberikan. (D,W)
\par\pard\qj \li1800\ri1249\sb177\sl-300\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 4. Laporan tahunan PME laboratorium rujukan diserahkan
kepada pimpinan \line\tab \up0 \expndtw-2\charscalex100 rumah sakit untuk evaluasi
kontrak klinis tahunan. (D,W) \par\pard\ql \li1507\sb0\sl-276\slmult0
\par\pard\ql\li1507\sb0\sl-276\slmult0 \par\pard\ql\li1507\sb168\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN DARAH \par\pard\ql \li1440\sb204\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar AP.5.11 \par\pard\qj
\li1440\ri1242\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi tentang penyelenggaraan
pelayanan darah dan \up0 \expndtw-2\charscalex100 menjamin pelayanan yang
diberikan sesuai peraturan perundang-undangan dan \up0 \expndtw-3\charscalex100
standar pelayanan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb185\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.11.1
\par\pard\qj \li1440\ri1240\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi bahwa seorang
profesional yang kompeten dan \up0 \expndtw0\charscalex100 berwenang, bertanggung
jawab untuk penyelenggaraan pelayanan darah dan \up0 \expndtw-1\charscalex100
menjamin pelayanan yang diberikan sesuai peraturan perundangan dan standar
\up0 \expndtw-3\charscalex100 pelayanan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.5.11.2
\par\pard\qj \li1440\ri1243\sb188\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan program dan pelaksanaan kendali
mutu. Pelayanan darah \up0 \expndtw-2\charscalex100 sesuai peraturan perundang-
undangan. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.5.11, AP.5.11.1
dan AP.5.11.2 \par\pard\qj \li1440\ri1233\sb212\sl-315\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelayanan darah, yang
diselenggarakan di rumah sakit, harus berada dibawah \up0 \expndtw-
2\charscalex100 tanggung jawab seorang profesional dengan pendidikan, keahlian,
pengalaman yang \up0 \expndtw-2\charscalex100 memenuhi syarat dan berdasar
peraturan perundangan d.h.i. kerjasama dengan PMI \up0 \expndtw0\charscalex100
(Palang Merah Indonesia). Staf tersebut bertanggung jawab terhadap semua aspek \up0
\expndtw-3\charscalex100 pelayanan darah di rumah sakit. \par\pard\ql
\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb64\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 123
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg124}
{\bkmkend Pg124}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Lingkup pelayanan meliputi penetapan,
pelaksanaan, dokumentasi dan proses untuk, \par\pard\ql \li1800\sb244\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 a) Permintaan darah \par\pard\ql
\li1800\sb184\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b) Penyimpanan darah
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c) Tes
kecocokan \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100
d) Distribusi darah \par\pard\qj \li1440\ri1246\sb168\sl-320\slmult0 \up0
\expndtw0\charscalex100 Proses kendali
mutu dari semua jenis pelayanan dilaksanakan dan terdokumentasi \up0 \expndtw-
2\charscalex100 untuk memastikan terselenggaranya pelayanan darah dan atau
transfusi yang aman. \up0 \expndtw0\charscalex100 Donor darah dan pelayanan
transfusi dilaksanakan sesuai peraturan perundangan \up0 \expndtw-3\charscalex100
dan standar praktek yang diakui. \par\pard\qj \li1440\ri1191\sb180\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Sebelum dilakukan pemberian darah
harus ada penjelasan dari DPJPnya dan \up0 \expndtw-5\charscalex100
persetujuan dari pasien atau keluarga. \par\pard\qj \li1440\ri1250\sb200\sl-
320\slmult0 \up0 \expndtw0\charscalex103 Selama pemberian transfusi darah harus
dilakukan monitoring dan evaluasi, dan \up0 \expndtw-3\charscalex100 dilaporkan
bila ada reaksi transfusi. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian
AP.5.11 \par\pard\ql \li1800\ri1241\sb216\sl-310\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
penyediaan dan pelayanan darah meliputi a) sampai \line\tab \up0
\expndtw0\charscalex100 dengan d) di maksud dan tujuan sesuai dengan
peraturan perundang-\line \tab \up0 \expndtw-3\charscalex100 undangan. (R)
\par\pard\ql \li1800\ri1234\sb162\sl-320\slmult0\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex100 2. Pemberian darah harus mendapatkan persetujuan dari
pasien atau keluarga, \line\tab \up0 \expndtw0\charscalex100 yang sebelumnya telah
mendapatkan penjelasan tentang tujuan, manfaat, \line \tab \up0 \expndtw-
1\charscalex100 risiko dan komplikasi pemberian transfusi darah dan produk darah
(Lihat juga \line \tab \up0 \expndtw-3\charscalex100 HPK.2.1 EP 4, SKP 1 EP 4).
(D,W \par\pard\qj \li1800\ri1181\sb160\sl-320\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 3. Ada bukti dilaksanakan monitoring dan evaluasi pemberian
transfusi darah dan \line\tab \up0 \expndtw-4\charscalex100 produk darah dan
dilaporkan bila terjadi reaksi transfuse \up0 \expndtw-4\charscalex100 (Lihat juga
PAP.3.3 \par\pard\ql \li2160\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 dan
PMKP.11). (D,W) \par\pard\ql \li1440\sb184\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.11.1
\par\pard\qj \li1800\ri1243\sb208\sl-320\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Seorang profesional yang kompeten
dan berwenang, ditetapkan bertanggung \line\tab \up0 \expndtw-2\charscalex100 jawab
untuk pelayanan darah dan tranfusi (lihat juga, PAP.3.3; TKRS.9) (R)
\par\pard\ql \li1800\sb197\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada
supervisi meliputi a) sampai dengan d) di maksud dan tujuan. (D,W)
\par\pard\ql \li1440\sb204\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.5.11.2 \par\pard\ql
\li1800\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ditetapkan program kendali mutu. (R)
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada
bukti pelaksanaan program kendali mutu. (D,W) \par\pard\ql \li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb64\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 124
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg125}
{\bkmkend Pg125}\par\pard\qj \li1507\sb0\sl-300\slmult0 \par\pard\qj\li1507\sb0\sl-
300\slmult0 \par\pard\qj\li1507\sb0\sl-300\slmult0
\par\pard\qj\li1507\ri1246\sb273\sl-300\slmult0\tx1867 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN
RADIODIAGNOSTIK, IMAJING DAN RADIOLOGI \line\tab \up0 \expndtw-
3\charscalex100 INTERVENSIONAL (RIR) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb168\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar AP.6 \par\pard\qj \li1440\ri1239\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelayanan
radiodiagnostik, imajing dan radiologi intervensional tersedia untuk \up0
\expndtw-2\charscalex100 memenuhi kebutuhan pasien, semua pelayanan ini memenuhi
peraturan perundang\up0 \expndtw-3\charscalex100 undangan. \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.6 \par\pard\ql \li1440\sb244\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelayanan
radiodiagnostik, imajing dan radiologi intervensional (RIR) meliputi:
\par\pard\ql \li1800\sb224\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a)
pelayanan radiodiagnostik \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 b) pelayanan diagnostik Imajing \par\pard\ql \li1800\sb204\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 c) pelayanan radiologi intervensional
\par\pard\qj \li1440\ri1215\sb168\sl-320\slmult0 \up0 \expndtw0\charscalex103 Rumah
sakit menetapkan sistem untuk menyelenggarakan pelayanan \line
\up0 \expndtw-2\charscalex100 radiodiagnostik, imajing dan radiologi intervensional
yang dibutuhkan pasien, asuhan \line \up0 \expndtw-2\charscalex100 klinik dan
profesional pemberi asuhan (PPA). Pelayanan radiodiagnostik, imajing dan \line \up0
\expndtw0\charscalex100 radiologi intervensional yang diselenggarakan memenuhi
peraturan perundang-\line \up0 \expndtw-3\charscalex100 undangan. \par\pard\qj
\li1440\ri1188\sb209\sl-310\slmult0 \up0 \expndtw-1\charscalex100 Pelayanan
radiodiagnostik, imajing dan radiologi intervensional termasuk kebutuhan \up0
\expndtw-3\charscalex100 darurat, dapat diberikan di dalam rumah sakit, dan
pelayanan rujukan radiodiagnostik, \up0 \expndtw-4\charscalex100 imajing dan
radiologi intervensional tersedia 24 jam. \par\pard\qj \li1440\ri1245\sb202\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Sebagai tambahan, rumah sakit dapat
mempunyai daftar konsultan yang dapat \up0 \expndtw-3\charscalex100 dihubungi,
seperti radiasi fisik, radionuklir. \par\pard\qj \li1440\ri1240\sb205\sl-
315\slmult0 \up0 \expndtw0\charscalex103 Rumah sakit memilih pelayanan rujukan
berdasarkan rekomendasi dari pimpinan \up0 \expndtw0\charscalex100 radiodiagnostik,
imajing dan radiologi intervensional di rumah sakit. Pelayanan \up0
\expndtw0\charscalex100 rujukan tersebut dipilih oleh rumah sakit karena memenuhi
peraturan perundangan, \up0 \expndtw0\charscalex100 mempunyai sertifikat mutu,
mempunyai ketepatan waktu dan akurasi layanan yang \up0 \expndtw-3\charscalex100
dapat dipertanggungjawabkan. \par\pard\qj \li1440\ri1182\sb201\sl-320\slmult0
\up0 \expndtw-3\charscalex100 Pelayanan rujukan mudah dijangkau oleh masyarakat,
dan laporan hasil pemeriksaan \up0 \expndtw-1\charscalex100 disampaikan pada waktu
yang tepat untuk mendukung kesinambungan asuhan. Bila \up0 \expndtw0\charscalex100
melakukan pemeriksaan rujukan keluar, harus melalui radiodiagnostik, imajing dan
\up0 \expndtw-3\charscalex100 radiologi intervensional rumah sakit. \par\pard\qj
\li1440\ri1196\sb209\sl-310\slmult0 \up0 \expndtw-3\charscalex100 Rumah sakit dapat
mempunyai daftar konsultan yang dapat dihubungi, seperti radiasi \line \up0
\expndtw-1\charscalex100 fisik, radionuklir harus terintegrasi untuk aspek
pengelolaan pelayanan dengan \line \up0 \expndtw-1\charscalex100 memperhatikan
aspek kepala pelayanan radiodiagnostik, imajing dan radiologi \par\pard\ql
\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb252\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 125
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg126}
{\bkmkend Pg126}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1240\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 intervensional, staf pelaksana, pengelolaan
peralatan, keamanan/\ul0\nosupersub\cf8\f9\fs24 safety\ul0\nosupersub\cf7\f8\fs24
dan \up0 \expndtw-3\charscalex100 sebagainya. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb185\sl-
276\slmult0 \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian AP.6 \par\pard\qj \li1800\ri1238\sb208\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
pengorganisasian dan pengaturan pelayanan \line\tab \up0 \expndtw-
2\charscalex100 radiodiagnostik, imajing dan radiologi intervensional secara
terintegrasi (R) \par\pard\qj \li1800\ri1183\sb160\sl-320\slmult0\tx2160 \up0
\expndtw-3\charscalex100 2. Ada pelayanan radiodiagnostik, imajing dan radiologi
intervensional tersedia 24 \line\tab \up0 \expndtw-4\charscalex100 jam ( O, W)
\par\pard\qj \li1800\ri1252\sb177\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex105 3. Ada daftar spesialis dalam bidang diagnostik khusus
dapat dihubungi jika \line\tab \up0 \expndtw-3\charscalex100 dibutuhkan ( D,W )
\par\pard\ql \li1800\ri1243\sb164\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 4. Pemilihan radiodiagnostik, imajing dan radiologi
intervensional di luar rumah \line\tab \up0 \expndtw0\charscalex103 sakit (pihak
ketiga) untuk kerjasama berdasarkan pada sertifikat mutu dan \line \tab \up0
\expndtw-2\charscalex100 diikuti perjanjian kerjasama sesuai peraturan perundang-
undangan. (D,W) \par\pard\ql \li1800\ri1247\sb160\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex105 5. Ada bukti pelaksanaan rujukan radiodiagnostik,
imajing dan radiologi \line\tab \up0 \expndtw-1\charscalex100 intervensional
keluar
rumah sakit (pihak ketiga) harus melalui radiodiagnostik, \line \tab \up0
\expndtw-2\charscalex100 imajing dan radiologi intervensional rumah sakit. (D,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb165\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.6.1 \par\pard\qj \li1440\ri1246\sb188\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah Sakit
menetapkan regulasi bahwa seorang (atau lebih) yang kompeten dan \up0
\expndtw0\charscalex100 berwenang, bertanggung jawab mengelola pelayanan
radiodiagnostik, imajing dan \up0 \expndtw-3\charscalex100 radiologi
intervensional. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.6.1
\par\pard\qj \li1440\ri1234\sb211\sl-316\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelayanan radiodiagnostik, imajing dan radiologi
intervensional berada dibawah \up0 \expndtw-1\charscalex100 pimpinan seorang atau
lebih yang kompeten dan berwenang memenuhi persyaratan \up0 \expndtw0\charscalex100
peraturan perundangan. Orang ini bertanggung jawab mengelola fasilitas
dan \up0 \expndtw0\charscalex103 pelayanan radiodiagnostik, imajing dan
radiologi intervensional, termasuk \up0 \expndtw-1\charscalex100 pemeriksaan
yang dilakukan di tempat tidur pasien (point-of-care testing), juga \up0
\expndtw0\charscalex103 tanggung jawabnya dalam melaksanakan regulasi rumah sakit
secara konsisten, \up0 \expndtw-3\charscalex100 seperti pelatihan, manajemen
logistik, dan lain sebagainya. \par\pard\qj \li1440\ri1234\sb201\sl-320\slmult0
\up0 \expndtw0\charscalex106 Sedangkan supervisi sehari hari tetap dijalankan
oleh pimpinan unit yang \up0 \expndtw0\charscalex100 mengerjakan pemeriksaan.
Spesialisasi atau sub spesialisasi pelayanan radiologi \up0 \expndtw-
3\charscalex100 harus berada dibawah pengarahan seorang profesional sesuai
bidangnya. \par\pard\qj \li1440\ri1241\sb217\sl-300\slmult0 \up0
\expndtw0\charscalex105 Tanggung jawab pimpinan pelayanan radiodiagnostik,
imajing dan radiologi \up0 \expndtw-3\charscalex100 intervensional.
\par\pard\ql \li1800\sb240\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a)
menyusun dan evaluasi regulasi \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb30\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 126
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg127}
{\bkmkend Pg127}\par\pard\qj \li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\sb0\sl-
300\slmult0 \par\pard\qj\li1800\sb0\sl-300\slmult0
\par\pard\qj\li1800\ri1248\sb273\sl-300\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 b) terlaksananya pelayanan
radiodiagnostik, imajing dan radiologi intervensional \line\tab \up0 \expndtw-
2\charscalex100 sesuai regulasi \par\pard\ql \li1800\sb200\sl-276\slmult0 \up0
\expndtw-2\charscalex100 c) pengawasan pelaksanaan administrasi. \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) melaksanakan program
kendali mutu. \par\pard\qj \li1800\ri1244\sb168\sl-320\slmult0\tx2160 \up0
\expndtw-2\charscalex100 e) monitor dan evaluasi semua jenis pelayanan
radiodiagnostik, imajing dan \line\tab \up0 \expndtw-3\charscalex100 radiologi
intervensional \par\pard\ql \li1440\sb197\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.6.1 \par\pard\ql
\li1800\ri1243\sb208\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan seorang (atau lebih)
tenaga profesional untuk \line\tab \up0 \expndtw-1\charscalex100 memimpin
pelayanan radiodiagnostik, imajing dan radiologi intervensional \line \tab
\up0 \expndtw-1\charscalex100 terintegrasi disertai uraian tugas, tanggung jawab
dan wewenang sesuai butir \par\pard\ql \li2160\sb17\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 a) sampai dengan e) dalam Maksud dan Tujuan. (R) \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada bukti
pelaksanaan penyusunan dan evaluasi regulasi. (D,W) \par\pard\qj
\li1800\ri1249\sb168\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 3. Ada
bukti pelaksanaan pelayanan radiodiagnostik, imajing dan radiologi
\line\tab \up0 \expndtw-3\charscalex100 intervensionalsesuai regulasi. (D,W)
\par\pard\ql \li1800\sb197\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4. Ada
bukti pengawasan pelaksanaan administrasi. (D,W) \par\pard\ql \li1800\sb204\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 5. Ada bukti pelaksanaan program kendali
mutu. (D,W) \par\pard\qj \li1800\ri1250\sb185\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex100 6. Ada bukti pelaksanaan monitoring dan evaluasi
semua jenis pelayanan \line\tab \up0 \expndtw-3\charscalex100 radiodiagnostik,
imajing dan radiologi intervensional. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb168\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.6.2
\par\pard\qj \li1440\ri1250\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Semua staf Radiodiagnostik, Imajing Dan Radiologi
Intervensional mempunyai \up0 \expndtw0\charscalex102 pendidikan, pelatihan,
kualifikasi dan pengalaman yang dipersyaratkan untuk \up0 \expndtw-
3\charscalex100 mengerjakan pemeriksaan. \par\pard\ql \li1440\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan AP.6.2 \par\pard\qj \li1440\ri1238\sb212\sl-315\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan mereka yang
bekerja sebagai staf radiologi dan diagnostik \up0 \expndtw0\charscalex102 imajing
yang kompeten dan berwenang melakukan pemeriksaan Radiodiagnostik, \up0 \expndtw-
2\charscalex100 Imajing Dan Radiologi Intervensional, pembacaan diagnostik
imajing, pelayanan \up0 \expndtw0\charscalex102 pasien di tempat tidur
(\ul0\nosupersub\cf8\f9\fs24 point-of-care test)\ul0\nosupersub\cf7\f8\fs24 ,
membuat interpretasi dan memverifikasi \up0 \expndtw-3\charscalex100 serta
melaporkan hasilnya, serta mereka yang mengawasi prosesnya. \par\pard\qj
\li1440\ri1236\sb206\sl-315\slmult0 \up0 \expndtw0\charscalex103 Staf pengawas dan
staf pelaksana tehnikal mempunyai latar belakang pelatihan, \line \up0
\expndtw0\charscalex103 pengalaman, ketrampilan dan telah menjalani orientasi tugas
pekerjaannya. Staf \line \up0 \expndtw0\charscalex102 tehnikal diberi tugas
pekerjaan sesuai latar belakang pendidikan dan pengalaman \line \up0
\expndtw0\charscalex104 mereka. Sebagai tambahan, jumlah staf cukup tersedia untuk
melakukan tugas, \line \up0 \expndtw-2\charscalex100 membuat interpretasi, dan
melaporkan segera hasilnya untuk layanan darurat. \par\pard\ql \li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb91\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 127
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg128}
{\bkmkend Pg128}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb56\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.6.2 \par\pard\qj
\li1800\ri1241\sb188\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit melakukan analisis pola ketenagaan staf
radiodiagnostik, imajing \line\tab \up0 \expndtw-3\charscalex100 dan radiologi
intervensional \up0 \expndtw-3\charscalex100 (RIR) \up0 \expndtw-3\charscalex100
(RIR) yang adekuat untuk memenuhi \par\pard\ql \li2160\sb37\sl-276\slmult0 \up0
\expndtw-3\charscalex100 kebutuhan pasien (lihat juga TKRS 9.Ep2. PMKP 6 EP 2)
(D,W) \par\pard\ql \li1800\ri1184\sb168\sl-320\slmult0\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex100 2. Staf radiodiagnostik, imajing dan radiologi
intervensional (RIR) (RIR) dan staf \line\tab \up0 \expndtw-2\charscalex100 lain
yang melaksanakan tes termasuk yang mengerjakan pelayanan pasien di \line \tab \up0
\expndtw-3\charscalex100 tempat tidur (\ul0\nosupersub\cf8\f9\fs24 point-of-care
test)\ul0\nosupersub\cf7\f8\fs24 pasien, memenuhi persyaratan kredensial (lihat
\line \tab \up0 \expndtw-5\charscalex100 juga KKS.4, EP 1). (D,W) \par\pard\ql
\li1800\ri1241\sb169\sl-310\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex102 3.
Staf radiodiagnostik, imajing dan radiologi intervensional (RIR) (RIR) yang
\line\tab \up0 \expndtw-1\charscalex100 membuat interpretasi / ekpertise memenuhi
persyaratan kredensial (lihat juga \line \tab \up0 \expndtw-2\charscalex100 KKS.4,
EP 1). (D,W) \par\pard\qj \li1800\ri1245\sb162\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 4. Ada pelaksanaan supervisi pelayanan radiodiagnostik,
imajing dan radiologi \line\tab \up0 \expndtw-3\charscalex100 intervensional (RIR)
di rumah sakit. (R, D) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb165\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.6.3
\par\pard\qj \li1440\ri1188\sb214\sl-313\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyusun program manajemen risiko di
pelayanan Radiodiagnostik, \up0 \expndtw0\charscalex100 Imajing Dan Radiologi
Intervensional, dilaksanakan, dilakukan evaluasi, di \up0 \expndtw-
3\charscalex100 dokumentasikan dan program sejalan dengan program manajemen risiko
fasilitas dan \up0 \expndtw-4\charscalex100 program pencegahan dan pengendalian
infeksi( lihat juga MFK 5 ). \par\pard\ql \li1440\sb238\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.6.3.1
\par\pard\qj \li1440\ri1244\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan bagaimana mengidentifikasi dosis
maksimun radiasi untuk \up0 \expndtw-2\charscalex100 setiap pemeriksaan
Radiodiagnostik, Imajing Dan Radiologi Intervensional \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.6.3 dan AP.6.3.1 \par\pard\qj
\li1440\ri1249\sb214\sl-313\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Dalam pelayanan radiodiagnostik, imajing dan radiologi
intervensional (RIR) ada \up0 \expndtw0\charscalex102 pemeriksaan/tindakan life
saving yang banyak digunakan di rumah sakit. Paparan \up0 \expndtw0\charscalex102
radiasi dapat berpotensi risiko kerusakan dalam jangka panjang, tergantung dosis
\up0 \expndtw-3\charscalex100 radiasi dan jumlah pemeriksaan pada seorang
pasien. \par\pard\qj \li1440\ri1187\sb202\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Sebelum dilakukan pemeriksaan radiodiagnostik, imajing dan
radiologi intervensional \up0 \expndtw-3\charscalex100 (RIR) harus ada penjelasan
dari Radiolognya dan harus ada persetujuan dari pasien \up0 \expndtw-
4\charscalex100 atau keluarga. \par\pard\qj \li1440\ri1247\sb209\sl-310\slmult0
\up0 \expndtw0\charscalex100 Dosis yang lebih tinggi mengakibatkan risiko kerusakan
yang lebih besar, dan dosis \line \up0 \expndtw-1\charscalex100 yang berulang
mempunyai efek kumulatif yang juga mengakibatkan risiko yang lebih \line \up0
\expndtw-2\charscalex100 besar. \par\pard\ql \li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb252\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 128
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg129}
{\bkmkend Pg129}\par\pard\qj \li1440\sb0\sl-313\slmult0 \par\pard\qj\li1440\sb0\sl-
313\slmult0 \par\pard\qj\li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1185\sb223\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 profesional pemberi asuhan (PPA) harus memperhatikan
permintaan pemeriksaan \line \up0 \expndtw0\charscalex100 radiodiagnostik, imajing
dan radiologi intervensional (RIR) dan mempertimbangkan \line \up0 \expndtw-
3\charscalex100 rasio kebutuhan medis terhadap risiko radiasi, paparan radiasi yang
tidak perlu, harus \line \up0 \expndtw-4\charscalex100 dihindari. \par\pard\qj
\li1440\ri1187\sb202\sl-320\slmult0 \up0 \expndtw-4\charscalex100 Prosedur
diagnostik dan terapi yang terkait dgn dosis radiasi yang menggunakan sinar \up0
\expndtw-4\charscalex100 X atau radiasi pengion, agar ditempatkan staf yang
kompeten dan berwenang. \par\pard\qj \li1440\ri1189\sb200\sl-320\slmult0 \up0
\expndtw0\charscalex103 Rumah sakit mempunyai program keamanan radiasi aktif
mencakup semua \up0 \expndtw-2\charscalex100 komponen pelayanan radiodiagnostik,
imajing dan radiologi intervensional, termasuk \up0 \expndtw-5\charscalex100 antara
lain kateterisasi jantung. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Program keamanan radiasi menangani risiko dan bahaya yang
ada. \par\pard\qj \li1440\ri1183\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex100
Program ini menjabarkan langkah-langkah keselamatan dan pencegahan yang
\line \up0 \expndtw-3\charscalex100 terukur bagi staf dan pasien. Program ini
dikoordinasikan oleh manajemen fasilitas. \par\pard\ql \li1440\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Manajemen keamanan radiasi meliputi,
\par\pard\ql \li1800\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a)
Kepatuhan terhadap standar yang berlaku dan peraturan perundangan \par\pard\qj
\li1800\ri1247\sb168\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex104 b)
Kepatuhan terhadap standar dari manjemen fasilitas, radiasi dan program
\line\tab \up0 \expndtw-3\charscalex100 pencegahan dan pengendalian infeksi
\par\pard\ql \li1800\sb177\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c)
Tersedianya APD sesuai pekerjaan dan bahaya yang dihadapi \par\pard\qj
\li1800\ri1241\sb168\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103 d)
Orientasi bagi semua staf pelayanan radiodiagnostik, imajing dan radiologi
\line\tab \up0 \expndtw-3\charscalex100 intervensional (RIR) tentang praktek dan
prosedur keselamatan \par\pard\qj \li1800\ri1184\sb160\sl-320\slmult0\tx2160
\up0 \expndtw-3\charscalex100 e) Pelatihan\ul0\nosupersub\cf8\f9\fs24 (in service
training)\ul0\nosupersub\cf7\f8\fs24 bagi staf untuk pemeriksaan baru dan
menangani \line\tab \up0 \expndtw-4\charscalex100 bahan berbahaya produk baru
(lihat juga, MFK.4; MFK.4.1; MFK.5) \par\pard\ql \li1440\sb197\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian
AP.6.3 \par\pard\ql \li1800\ri1224\sb214\sl-313\slmult0\tx2160\tx2160\tx2160
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit
menetapkan program manajemen risiko menangani potensi risiko \line\tab \up0
\expndtw0\charscalex104 keamanan radiasi di pelayanan radiodiagnostik, imajing
dan radiologi \line \tab \up0 \expndtw0\charscalex100 intervensional (RIR) sesuai
butir a) sampai dengan e) di maksud dan tujuan ( \line \tab \up0 \expndtw-
3\charscalex100 lihat juga MFK 4 EP 1). (R) \par\pard\qj \li1800\ri1249\sb162\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 2. Ada bukti pelaksanaan program
manajemen risiko yang merupakan bagian \line\tab \up0 \expndtw0\charscalex100
dari manajemen risiko rumah sakit \up0 \expndtw0\charscalex100 (radiasi) dan
program pencegahan dan \par\pard\ql \li2160\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 pengendalian infeksi (D,W) \par\pard\qj \li1800\ri1187\sb168\sl-
320\slmult0\tx2160 \up0 \expndtw-3\charscalex100 3. Ada bukti laporan kepada
pimpinan rumah sakit paling sedikit satu tahun sekali \line\tab \up0 \expndtw-
4\charscalex100 dan bila ada kejadian (lihat juga MFK 3). (D,W) \par\pard\ql
\li1800\sb197\sl-276\slmult0\tx8119 \up0 \expndtw0\charscalex100 4. Diadakan
orientasi dan pelatihan berkelanjutan \tab \up0 \expndtw0\charscalex101
(ongoing) bagi staf \par\pard\qj \li2160\ri1238\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex102 radiodiagnostik, imajing dan radiologi intervensional (RIR)
tentang prosedur \line \up0 \expndtw-2\charscalex100 keselamatan dan keamanan untuk
mengurangi risiko serta pelatihan tentang \par\pard\ql \li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb198\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 129
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg130}
{\bkmkend Pg130}\par\pard\qj \li2160\sb0\sl-300\slmult0 \par\pard\qj\li2160\sb0\sl-
300\slmult0 \par\pard\qj\li2160\sb0\sl-300\slmult0
\par\pard\qj\li2160\ri1242\sb273\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 prosedur baru yang menggunakan bahan berbahaya
(lihat juga, MFK.11; \up0 \expndtw-3\charscalex100 TKRS.9; KKS.8). (D,O,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb168\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.6.3.1 \par\pard\qj
\li1800\ri1248\sb208\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi sebelum
dilakukan pemeriksaan \line\tab \up0 \expndtw0\charscalex101 radiodiagnostik,
imajing dan radiologi intervensional \up0 \expndtw0\charscalex103 (RIR)
harus ada \par\pard\qj \li2160\ri1190\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex103 penjelasan dari Radiolognya dan harus ada persetujuan
dari pasien atau \up0 \expndtw-7\charscalex100 keluarga ( R ) \par\pard\qj
\li1800\ri1245\sb177\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex100 2. Rumah
sakit melaksanakan identifikasi dosis maksimun radiasi untuk setiap \line\tab
\up0 \expndtw-2\charscalex100 pemeriksaan Radiodiagnostik, Imajing Dan Radiologi
Intervensional, (D,W). \par\pard\ql \li1800\sb200\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3. Ada pelaksanaan edukasi tentang dosis untuk pemeriksaan imaging
(D.W) \par\pard\ql \li1800\ri1186\sb168\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-
3\charscalex100 4. Ada bukti risiko radiasi diidentifikasi melalui proses yang
spesifik atau alat yang \line\tab \up0 \expndtw0\charscalex100 spesifik, untuk staf
dan pasien yang mengurangi risiko (apron, TLD dan yang \line \tab \up0 \expndtw-
3\charscalex100 sejenis) (lihat juga MFK 5 EP 3). (D,O,W) \par\pard\ql
\li1440\sb197\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar AP.6.4 \par\pard\qj \li1440\ri1189\sb208\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan kerangka waktu penyelesaian pemeriksaan radiodiagnostik, \up0 \expndtw-
4\charscalex100 imajing dan radiologi intervensional. \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.6.4 \par\pard\qj
\li1440\ri1187\sb191\sl-317\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan kerangka waktu penyelesaian
pemeriksaan radiologi dan \up0 \expndtw-1\charscalex100 diagnostik imajing.
Penyelesaian pemeriksaan radiodiagnostik, imajing dan radiologi \up0
\expndtw0\charscalex102 intervensional (RIR) dilaporkan sesuai kebutuhan pasien.
Hasil pemeriksaan cito, \up0 \expndtw-3\charscalex100 antara lain dari unit
darurat, kamar operasi, unit intensif diberi perhatian khusus terkait \up0
\expndtw0\charscalex100 kecepatan asuhan. Jika pemeriksaan dilakukan melalui
kontrak (pihak ketiga) atau \up0 \expndtw-1\charscalex100
laboratorium rujukan, kerangka waktu melaporkan hasil pemeriksaan juga
mengikuti \up0 \expndtw0\charscalex104 ketentuan rumah sakit dan MOU dgn
radiodiagnostik, imajing dan radiologi \up0 \expndtw-3\charscalex100
intervensional (RIR) rujukan \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.6.4
\par\pard\qj \li1800\ri1241\sb208\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
kerangka waktu penyelesaian pemeriksaan \line\tab \up0 \expndtw-3\charscalex100
Radiodiagnostik, Imajing Dan Radiologi Intervensional. (R) \par\pard\qj
\li1800\ri1243\sb160\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 2.
Dilakukan pencatatan dan evaluasi waktu penyelesaian pemeriksaan
\line\tab \up0 \expndtw-3\charscalex100 Radiodiagnostik, Imajing Dan Radiologi
Intervensional. (D,W) \par\pard\qj \li1800\ri1210\sb177\sl-300\slmult0\tx2160
\up0 \expndtw-2\charscalex100 3. Dilakukan pencatatan dan evaluasi waktu
penyelesaian pemeriksaan cito (lihat \line\tab \up0 \expndtw-3\charscalex100 juga,
PAB.7) (D,W) \par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-
253\slmult0 \par\pard\ql\li10132\sb187\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 130
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg131}
{\bkmkend Pg131}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.6.5 \par\pard\qj
\li1440\ri1246\sb225\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi yang mengatur
tentang uji fungsi, inspeksi, \line \up0 \expndtw-1\charscalex100 pemeliharaan,
kalibrasi secara tetap \up0 \expndtw-1\charscalex100 (regular) terhadap semua
peralatan yang \par\pard\qj \li1440\ri1248\sb4\sl-320\slmult0 \up0
\expndtw0\charscalex100 digunakan untuk pemeriksaan di bagian radiodiagnostik,
imajing dan radiologi \up0 \expndtw-3\charscalex100 intervensional (RIR) dan
hasil pemeriksaan didokumentasikan. \par\pard\ql \li1440\sb237\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
AP.6.5 \par\pard\qj \li1440\ri1223\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Staf radiodiagnostik, imajing
dan radiologi intervensional (RIR) harus memastikan \up0 \expndtw-2\charscalex100
semua peralatan radiodiagnostik, imajing dan radiologi intervensional (RIR)
berfungsi \up0 \expndtw-3\charscalex100 dengan baik dan aman bagi pengguna /petugas
dan pasien. \par\pard\qj \li1440\ri1235\sb180\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Pengadaan peralatan pelayanan radiodiagnostik, imajing dan
radiologi intervensional \up0 \expndtw0\charscalex100 (RIR) agar secara bertahap
kearah teknologi radiologi digital dan dapat dilakukan \up0 \expndtw-
3\charscalex100 dengan teleradiologi. \par\pard\ql \li1440\sb237\sl-
276\slmult0\tx7766 \up0 \expndtw0\charscalex102 Radiodiagnostik, imajing dan
radiologi intervensional \tab \up0 \expndtw0\charscalex102 (RIR) menetapkan
dan \par\pard\qj \li1440\ri1246\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100
melaksanakan program pengelolaan peralatan radiodiagnostik, imajing dan
radiologi \up0 \expndtw0\charscalex100 intervensional (RIR) termasuk peralatan yang
merupakan kerjasama dengan pihak \up0 \expndtw-3\charscalex100 ketiga yang
meliputi,, \par\pard\ql \li1800\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100
a) Uji fungsi \par\pard\ql \li1800\sb184\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 b) Inspeksi berkala \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw-2\charscalex100 c) Pemeliharaan berkala \par\pard\ql \li1800\sb204\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 d) Kaliberasi berkala \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e) Identifikasi dan
inventarisasi peralatan laboratorium \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0
\expndtw-2\charscalex100 f) Monitoring dan tindakan terhadap kegagalan fungsi alat
\par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 g) Proses
penarikan\ul0\nosupersub\cf8\f9\fs24 (recall) \par\pard\ql \li1800\sb204\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 h)
Pendokumentasian\ul0\nosupersub\cf6\f7\fs24 (lihat juga, MFK.8; MFK.8.1)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb152\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Elemen
Penilaian AP.6.5 \par\pard\qj \li1800\ri1242\sb208\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi dan
program untuk pengelolaan peralatan pelayanan \line\tab \up0
\expndtw0\charscalex100 radiodiagnostik, imajing dan radiologi intervensional (RIR)
yang meliputi butir \par\pard\ql \li2160\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 a) sampai dengan h) di maksud dan tujuan. (R) \par\pard\qj
\li1800\ri1249\sb8\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex102 2. Ada bukti
staf yang terlatih melaksanakan uji fungsi dan didokumentasikan. \line\tab \up0
\expndtw-2\charscalex100 (D,W) \par\pard\qj \li1800\ri1243\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex105 3. Ada bukti staf yang
terlatih melaksanakan inspeksi berkala dan \line\tab \up0 \expndtw-
3\charscalex100 didokumentasikan. (D,W) \par\pard\qj \li1800\ri1250\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex104 4. Ada bukti staf yang
terlatih melaksanakan pemeliharaan berkala dan \line\tab \up0 \expndtw-
3\charscalex100 didokumentasikan. (D,W) \par\pard\ql \li10132\sb176\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 131
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg132}
{\bkmkend Pg132}\par\pard\qj \li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\sb0\sl-
300\slmult0 \par\pard\qj\li1800\sb0\sl-300\slmult0
\par\pard\qj\li1800\ri2711\sb273\sl-300\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 5. Ada bukti staf yang terlatih
melaksanakan kaliberasi berkala dan \line\tab \up0 \expndtw-3\charscalex100
didokumentasikan. (D,W) \par\pard\qj \li1800\ri1246\sb164\sl-320\slmult0\tx2160
\up0 \expndtw0\charscalex103 6. Ada daftar inventaris peralatan pelayanan
radiodiagnostik, imajing dan \line\tab \up0 \expndtw-3\charscalex100 radiologi
intervensional (RIR) (lihat juga MFK.8, EP 2). (D.W) \par\pard\qj
\li1800\ri1189\sb120\sl-320\slmult0\tx2160 \up0 \expndtw-3\charscalex100 7. Ada
bukti pelaksanaan monitoring dan tindakan terhadap kegagalan fungsi alat
\line\tab \up0 \expndtw-4\charscalex100 dan didokumentasikan. (D,W)
\par\pard\li1800\sb163\sl-276\slmult0\fi0\tx9076 \up0 \expndtw0\charscalex101 8.
Ada bukti pelaksanaan bila terjadi proses penarikan\tab \up0
\expndtw0\charscalex101 \ul0\nosupersub\cf8\f9\fs24
(recall)\ul0\nosupersub\cf7\f8\fs24 dan\par\pard\li1800\sb43\sl-
276\slmult0\fi360 \up0 \expndtw0\charscalex101 didokumentasikan.
(D,W)\par\pard\qj \li1800\ri1247\sb123\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 9. Terhadap kegiatan a) sampai dengan h) dalam Maksud dan
tujuan dilakukan \line\tab \up0 \expndtw-3\charscalex100 evaluasi berkala dan
tindak lanjut ( D,W ) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb25\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.6.6 \par\pard\ql
\li1440\sb164\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Film X-ray dan bahan lainnya tersedia secara
teratur. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb52\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.6.6
\par\pard\qj \li1440\ri1241\sb128\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Bila menggunakan film, rumah sakit mengidentifikasi
film, reagensia\ul0\nosupersub\cf8\f9\fs24 (developer dan \up0
\expndtw0\charscalex102 fixer)\ul0\nosupersub\cf7\f8\fs24 , kontras media,
radiofarmaka dan perbekalan penting yang diperlukan untuk \up0 \expndtw-
3\charscalex100 pemeriksaan RDI. \par\pard\qj \li1440\ri1181\sb100\sl-
320\slmult0 \up0 \expndtw0\charscalex105 Ada regulasi memesan film, reagensia dan
perbekalan lain yang efektif. Semua \up0 \expndtw-3\charscalex100 perbekalan
disimpan, didistribusikan sesuai dengan regulasi dan rekomendasi pabrik. \up0
\expndtw-2\charscalex100 Dilakukan audit secara periodik semua perbekalan terkait
pemeriksaan, (seperti film, \up0 \expndtw0\charscalex100 kontras media, kertas USG,
developer fixer) untuk memastikan akurasi dan presisi \up0 \expndtw0\charscalex102
hasil pemeriksaan, antara lain tentang aspek penyimpanan, label, kadaluarsa dan
\up0 \expndtw-3\charscalex100 fisik. (lihat juga juga, MFK.5) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb45\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.6.6 \par\pard\qj
\li1800\ri1237\sb108\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan film x-ray dan bahan lain
yang diperlukan (lihat juga \line\tab \up0 \expndtw-3\charscalex100 MFK.5, EP 1).
(R) \par\pard\ql \li1800\ri1244\sb120\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex105 2. Ada regulasi tentang pengelolaan logistik Film x-ray,
reagens, dan bahan \line\tab \up0 \expndtw0\charscalex102 lainnya, termasuk
kondisi bila terjadi kekosongan sesuai peraturan \line \tab \up0
\expndtw-3\charscalex100 perundangan. (lihat juga MFK 5 EP 2). (R) \par\pard\ql
\li1800\ri1243\sb129\sl-310\slmult0\tx2160\tx2160 \up0 \expndtw-1\charscalex100 3.
Semua film x-ray disimpan dan diberi label, serta didistribusi sesuai pedoman
\line\tab \up0 \expndtw0\charscalex102 dari pembuatnya atau instruksi pada
kemasannya (lihat juga MFK.5, EP 2). \line \tab \up0 \expndtw-3\charscalex100
(D,O,W) \par\pard\ql \li1800\sb159\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4.
Ada bukti pelaksanaan evaluasi/audit semua reagen. (D,W) \par\pard\ql
\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb244\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 132
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg133}
{\bkmkend Pg133}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.6.7 \par\pard\qj
\li1440\ri1252\sb145\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan program kendali mutu,
dilaksanakan, divalidasi dan \up0 \expndtw-3\charscalex100 didokumentasikan.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb48\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.6.7 \par\pard\qj
\li1440\ri1224\sb128\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kendali mutu yang baik sangat penting untuk menjamin
pelayanan radiodiagnostik, \up0 \expndtw-2\charscalex100 imajing dan radiologi
intervensional (RIR) yang prima (lihat juga, TKRS.11). Prosedur \up0 \expndtw-
3\charscalex100 kendali mutu memuat: \par\pard\ql \li1800\sb157\sl-276\slmult0 \up0
\expndtw-3\charscalex100 a) Validasi metoda tes digunakan untuk presisi dan
akurasi \par\pard\qj \li1800\ri1246\sb145\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex102 b) Pengawasan harian hasil pemeriksaan imajing oleh
staf radiologi yang \line\tab \up0 \expndtw-3\charscalex100 kompeten dan
berwenang \par\pard\ql \li1800\sb160\sl-276\slmult0 \up0 \expndtw-2\charscalex100
c) Koreksi cepat jika diketemukan masalah \par\pard\ql \li1800\sb164\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 d) Audit terhadap antara lain: film,
kontras, kertas USG, cairan developer, fixer \par\pard\ql \li1800\sb164\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 e) Dokumentasi hasil dan tindakan
koreksi \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb52\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian AP.6.7
\par\pard\ql \li1800\ri1248\sb136\sl-310\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
program mutu pelayanan radiodiagnostik, imajing, \line\tab \up0
\expndtw0\charscalex106 dan radiologi intervensional meliputi a) sampai dengan e)
di maksud dan \line \tab \up0 \expndtw-3\charscalex100 tujuan. (lihat juga TKRS
11 ). (R) \par\pard\ql \li1800\sb159\sl-276\slmult0 \up0 \expndtw-3\charscalex100
2. Ada bukti pelaksanaan validasi tes metoda (D,W) \par\pard\qj
\li1800\ri1247\sb128\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103 3. Ada
bukti pengawasan harian hasil pemeriksaan imajing oleh staf radiologi \line\tab
\up0 \expndtw-3\charscalex100 yang kompeten dan berwenan. (D,W) \par\pard\ql
\li1800\sb157\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4. Ada bukti
pelaksanaan koreksi cepat jika diketemukan masalah. (D,W) \par\pard\ql
\li1800\sb164\sl-276\slmult0\tx6481 \up0 \expndtw-1\charscalex100 5. Ada bukti
audit terhadap antara lain \tab \up0 \expndtw-2\charscalex100 : film, kontras,
kertas USG, cairan \par\pard\ql \li2160\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 developer, fixer. (D,W) \par\pard\ql \li1800\sb144\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 6. Ada dokumentasi hasil dan tindakan
koreksi. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb52\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar AP.6.8 \par\pard\qj
\li1440\ri1244\sb128\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit bekerja sama dengan pelayanan
radiodiagnostik, imajing dan radiologi \up0 \expndtw-3\charscalex100 intervensional
rujukan yang sudah terakreditasi. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb45\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan AP.6.8
\par\pard\qj \li1440\ri1234\sb136\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Untuk pelayanan radiodiagnostik, imajing dan radiologi
intervensional rujukan maka \up0 \expndtw0\charscalex104 RS secara teratur menerima
laporan dan mereview kontrol mutu dari pelayanan \up0 \expndtw-3\charscalex100
rujukan tersebut. Individu yang kompeten mereview hasil kontrol mutu.
\par\pard\ql \li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb65\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 133
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg134}
{\bkmkend Pg134}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb252\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian AP.6.8 \par\pard\li1800\sb162\sl-276\slmult0\fi0\tx6098 \up0
\expndtw0\charscalex101 \ul0\nosupersub\cf7\f8\fs24 1. Ada bukti ijin atau
sertifikasi\tab \up0 \expndtw0\charscalex101 radiodiagnostik, imajing dan
radiologi\par\pard\li1800\sb43\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex101
intervensional (RIR) rujukan (R)\par\pard\qj \li1800\ri1244\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex102 2. Ada bukti pelaksanaan kontrol
mutu pelayanan radiodiagnostik, imajing dan \line\tab \up0 \expndtw-3\charscalex100
radiologi intervensional (RIR) rujukan. (D,W) \par\pard\qj \li1800\ri1242\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex105 3. Ada Staf yang bertanggung
jawab atas kontrol mutu dari pelayanan \line\tab \up0 \expndtw0\charscalex100
radiodiagnostik, imajing dan radiologi intervensional \up0
\expndtw0\charscalex101 (RIR) rujukan, dan \par\pard\ql \li2160\sb28\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 mereview hasil kontrol mutu (D,W)
\par\pard\ql \li1800\ri1184\sb16\sl-310\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex102 4. Laporan tahunan hasil kontrol mutu pelayanan
radiodiagnostik, imajing dan \line\tab \up0 \expndtw-3\charscalex100 radiologi
intervensional (RIR) rujukan diserahkan kepada pimpinan rumah sakit \line \tab \up0
\expndtw-4\charscalex100 untuk evaluasi kontrak klinis tahunan (D) \par\pard\ql
\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb18\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 134
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg135}
{\bkmkend Pg135}\par\pard\ql \li5608\sb0\sl-276\slmult0 \par\pard\ql\li5608\sb0\sl-
276\slmult0 \par\pard\ql\li5608\sb0\sl-276\slmult0 \par\pard\ql\li5608\sb0\sl-
276\slmult0 \par\pard\ql\li5608\sb88\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf17\f18\fs24 BAB 4 \par\pard\ql \li3928\sb44\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 PELAYANAN DAN
ASUHAN PASIEN \par\pard\ql \li5635\sb244\sl-276\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf17\f18\fs24 (PAP) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb212\sl-276\slmult0 \up0 \expndtw-4\charscalex100 GAMBARAN
UMUM \par\pard\qj \li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\ri1178\sb102\sl-315\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf18\f19\fs24 Tanggung jawab rumah
sakit dan staf yang terpenting adalah memberikan asuhan dan \line \up0 \expndtw-
2\charscalex100 pelayanan pasien yang efektif dan aman. Hal ini membutuhkan
komunikasi yg efektif, \line \up0 \expndtw-6\charscalex100 kolaborasi, dan
standardisasi proses untuk memastikan bahwa rencana, koordinasi, dan \line \up0
\expndtw-3\charscalex100 implementasi asuhan mendukung serta merespons setiap
kebutuhan unik pasien dan \line \up0 \expndtw-5\charscalex100 target.
\par\pard\qj \li1440\ri1179\sb201\sl-320\slmult0 \up0 \expndtw0\charscalex100
Asuhan tersebut dapat berupa upaya pencegahan, paliatif, kuratif, atau
rehabilitatif \up0 \expndtw-2\charscalex100 termasuk anestesia, tindakan bedah,
pengobatan, terapi suportif, atau kombinasinya, \up0 \expndtw-5\charscalex100 yang
berdasar atas asesmen dan asesmen ulang pasien. \par\pard\qj
\li1440\ri1185\sb180\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Area asuhan
risiko tinggi (termasuk resusitasi, transfusi, transplantasi organ/jaringan)
\up0 \expndtw0\charscalex100 dan asuhan untuk risiko tinggi atau kebutuhan populasi
khusus yang membutuhkan \up0 \expndtw-5\charscalex100 perhatian tambahan.
\par\pard\qj \li1440\ri1170\sb205\sl-315\slmult0 \up0 \expndtw-6\charscalex100
Asuhan pasien dilakukan oleh profesional pemberi asuhan (PPA) dengan banyak
disiplin \up0 \expndtw-5\charscalex100 dan staf klinis lain. Semua staf yg terlibat
dalam asuhan pasien harus memiliki peran yg \up0 \expndtw-3\charscalex100 jelas,
ditentukan oleh kompetensi dan kewenangan, kredensial, sertifikasi, hukum dan
\up0 \expndtw-3\charscalex100 regulasi, keterampilan individu, pengetahuan,
pengalaman, dan kebijakan rumah sakit \up0 \expndtw-5\charscalex100 ,atau uraian
tugas wewenang (UTW). \par\pard\qj \li1440\ri1251\sb201\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Beberapa asuhan dapat dilakukan
oleh pasien/keluarganya atau pemberi asuhan \up0 \expndtw-3\charscalex100 terlatih
(\ul0\nosupersub\cf8\f9\fs24 care
giver\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 . \par\pard\qj
\li1440\ri1249\sb200\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelaksanaan asuhan dan pelayanan harus dikoordinasikan
dan diintegrasikan oleh \up0 \expndtw-2\charscalex100 semua profesional pemberi
asuhan (PPA) dapat dibantu oleh staf klinis lainnya. \par\pard\ql \li1440\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Asuhan pasien terintegrasi dilaksanakan
dengan beberapa elemen. \par\pard\qj \li1440\ri1249\sb241\sl-280\slmult0\tx1800
\up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Dokter penanggung jawab pelayanan (DPJP)
sebagai pimpinan klinis/ketua tim \line\tab \up0 \expndtw-5\charscalex100 PPA
(\ul0\nosupersub\cf8\f9\fs24 clinical leader\ul0\nosupersub\cf7\f8\fs24 ).
\par\pard\ql \li1440\ri1238\sb81\sl-280\slmult0\tx1800\tx1800 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 PPA bekerja sebagai tim interdisiplin
dengan kolaborasi interprofesional, \line\tab \up0 \expndtw-1\charscalex100
menggunakan alur klinis/c\ul0\nosupersub\cf8\f9\fs24 linical
pathway\ul0\nosupersub\cf7\f8\fs24 , perencanaan pemulangan pasien \line \tab
\up0 \expndtw-2\charscalex100 terintegrasi/\ul0\nosupersub\cf8\f9\fs24 integrated
discharge planning. \par\pard\ql \li1440\ri1213\sb47\sl-320\slmult0\tx1800 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Manajer Pelayanan
Pasien/\ul0\nosupersub\cf8\f9\fs24 Case Manager\ul0\nosupersub\cf7\f8\fs24 menjaga
kesinambungan pelayanan. \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24
\u-3913?\ul0\nosupersub\cf7\f8\fs24 Keterlibatan serta pemberdayaan pasien dan
keluarga dalam asuhan bersama \line\tab \up0 \expndtw-3\charscalex100 PPA harus
memastikan: \par\pard\ql \li1800\sb57\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 asuhan
direncanakan untuk memenuhi kebutuhan pasien yang unik berdasar \par\pard\ql
\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb90\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 135
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg136}
{\bkmkend Pg136}\par\pard\ql \li2160\sb0\sl-276\slmult0 \par\pard\ql\li2160\sb0\sl-
276\slmult0 \par\pard\ql\li2160\sb0\sl-276\slmult0 \par\pard\ql\li2160\sb0\sl-
276\slmult0 \par\pard\ql\li2160\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 atas asesmen; \par\pard\qj
\li1800\ri4642\sb12\sl-340\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 rencana asuhan
diberikan kepada tiap pasien; \line \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 respons pasien
terhadap asuhan dimonitor; \par\pard\ql \li1800\sb53\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24
rencana asuhan dimodifikasi bila perlu berdasar atas respons pasien.
\par\pard\ql \li1543\sb0\sl-276\slmult0 \par\pard\ql\li1543\sb0\sl-276\slmult0
\par\pard\ql\li1543\sb32\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PEMBERIAN
PELAYANAN UNTUK SEMUA PASIEN \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb248\sl-276\slmult0 \up0 \expndtw-6\charscalex100 Standar PAP
1 \par\pard\qj \li1440\ri1498\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk pemberian asuhan
yang seragam kepada \up0 \expndtw-4\charscalex100 pasien. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb25\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf17\f18\fs24 Maksud dan Tujuan PAP 1 \par\pard\qj
\li1440\ri1195\sb0\sl-317\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf18\f19\fs24 Pasien dengan masalah kesehatan dan kebutuhan
pelayanan yang sama berhak \up0 \expndtw0\charscalex100 mendapat kualitas asuhan
yang sama di rumah sakit. Untuk melaksanakan prinsip \up0 \expndtw0\charscalex103
kualitas asuhan yang setingkat mengharuskan pimpinan merencanakan dan
\up0 \expndtw-1\charscalex100 mengoordinasi pelayanan pasien. Secara khusus,
pelayanan yang diberikan kepada \up0 \expndtw0\charscalex104 populasi pasien yang
sama pada berbagai unit kerja dipandu oleh regulasi yang \up0
\expndtw0\charscalex103 menghasilkan pelayanan yang seragam. Sebagai tambahan,
pimpinan harus \up0 \expndtw-3\charscalex100 menjamin bahwa rumah sakit
menyediakan tingkat kualitas asuhan yang sama setiap \up0 \expndtw0\charscalex100
hari dalam seminggu dan pada setiap\ul0\nosupersub\cf20\f21\fs24
shift\ul0\nosupersub\cf18\f19\fs24 . Regulasi tersebut harus sesuai dengan \up0
\expndtw0\charscalex102 peraturan perundang-undangan yang berlaku yang membentuk
proses pelayanan \up0 \expndtw-4\charscalex100 pasien dan dikembangkan secara
kolaboratif. \par\pard\ql \li1440\sb208\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Asuhan pasien yang seragam terefleksi
sebagai berikut: \par\pard\ql \li1800\ri1187\sb249\sl-270\slmult0\tx2160\tx2160
\up0 \expndtw0\charscalex100 a) akses untuk asuhan dan pengobatan yang memadai dan
diberikan oleh PPA \line\tab \up0 \expndtw-4\charscalex100 yang kompeten tidak
bergantung pada hari setiap minggu atau waktunya setiap \line \tab \up0 \expndtw-
5\charscalex100 hari (\u8220?3-24-7\u8221?); \par\pard\ql \li1800\ri1248\sb2\sl-
280\slmult0\tx2160\tx2160 \up0 \expndtw-2\charscalex100 b) penggunaan alokasi
sumber daya yang sama, antara lain staf klinis dan \line\tab \up0
\expndtw0\charscalex102 pemeriksaan diagnostik untuk memenuhi kebutuhan pasien pada
populasi \line \tab \up0 \expndtw-3\charscalex100 yang sama; \par\pard\qj
\li1800\ri1180\sb0\sl-280\slmult0\tx2160 \up0 \expndtw-4\charscalex100 c)
pemberian asuhan yang diberikan kepada pasien, contoh pelayanan anestesi
\line\tab \up0 \expndtw-5\charscalex100 sama di semua unit pelayanan di rumah
sakit; \par\pard\qj \li1800\ri1250\sb0\sl-280\slmult0\tx2160 \up0 \expndtw-
2\charscalex100 d) pasien dengan kebutuhan asuhan keperawatan yang sama menerima
asuhan \line\tab \up0 \expndtw-3\charscalex100 keperawatan yang setara di seluruh
rumah sakit; \par\pard\ql \li1440\ri1181\sb0\sl-
285\slmult0\fi360\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw-3\charscalex100 e)
penerapan serta penggunaan regulasi dan form dalam bidang klinis antara lain
\line\tab \up0 \expndtw0\charscalex102 metode asesmen IAR (Informasi, Analisis,
Rencana), form asesmen awal-\line \tab \up0 \expndtw0\charscalex102 asesmen ulang,
PPK, alur klinis terintegrasi/\ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 , pedoman \line \tab \up0
\expndtw0\charscalex102 manajemen nyeri, dan regulasi untuk berbagai tindakan
antara lain w\ul0\nosupersub\cf8\f9\fs24 ater \line \tab \up0 \expndtw-
2\charscalex100 sealed drainage\ul0\nosupersub\cf7\f8\fs24 , pemberian transfusi
darah, biopsi ginjal, pungsi lumbal, dsb. \line \up0 \expndtw-3\charscalex100
Asuhan pasien yang seragam menghasilkan penggunaan sumber daya secara efisien
\up0 \expndtw0\charscalex100 dan memungkinkan membuat evaluasi hasil asuhan
(\ul0\nosupersub\cf8\f9\fs24 outcome\ul0\nosupersub\cf7\f8\fs24 ) untuk asuhan yang
\up0 \expndtw-3\charscalex100 sama di seluruh rumah sakit. \par\pard\ql
\li10132\sb0\sl-253\slmult0 \par\pard\ql\li10132\sb0\sl-253\slmult0
\par\pard\ql\li10132\sb14\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 136
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg137}
{\bkmkend Pg137}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Elemen Penilaian
PAP1 \par\pard\ql \li1778\ri1205\sb9\sl-270\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi
bagi pimpinan unit pelayanan untuk bekerja \line\tab \up0 \expndtw-2\charscalex100
sama memberikan proses asuhan seragam dan mengacu pada peraturan \line \tab
\up0 \expndtw-3\charscalex100 perundang-undangan yang berlaku. (R) \par\pard\ql
\li1778\sb6\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Asuhan seragam
diberikan sesuai persyaratan sesuai butir a) sampai dengan \par\pard\ql
\li2138\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e) pada maksud dan tujuan
PAP 1. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-
276\slmult0 \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Standar PAP
2 \par\pard\qj \li1418\ri1230\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ditetapkan proses untuk melakukan integrasi serta
koordinasi pelayanan dan asuhan \up0 \expndtw-3\charscalex100 kepada setiap pasien.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb153\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf17\f18\fs24 Maksud dan Tujuan PAP 2 \par\pard\qj
\li1418\ri1160\sb0\sl-317\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf18\f19\fs24 Proses pelayanan dan asuhan pasien bersifat dinamis
dan melibatkan banyak PPA \line \up0 \expndtw0\charscalex102 yang dapat melibatkan
berbagai unit pelayanan. Integrasi dan koordinasi kegiatan \line \up0 \expndtw-
2\charscalex100 pelayanan dan asuhan pasien merupakan sasaran yang
menghasilkan efisiensi, \line \up0 \expndtw-4\charscalex100 penggunaan SDM dan
sumber lainnya efektif, dan hasil asuhan pasien yang lebih baik. \line \up0
\expndtw0\charscalex100 Kepala unit pelayanan menggunakan alat dan teknik untuk
melakukan integrasi dan \line \up0 \expndtw0\charscalex100 koordinasi pelayanan
serta asuhan lebih baik (contoh, asuhan secara tim oleh PPA, \line \up0
\expndtw0\charscalex100 ronde pasien multidisiplin, form catatan perkembangan
pasien terintegrasi, dan \line \up0 \expndtw-3\charscalex100 manajer pelayanan
pasien/\ul0\nosupersub\cf20\f21\fs24 case manager\ul0\nosupersub\cf18\f19\fs24 ).
(lihat juga AP 4, Maksud dan Tujuan) \par\pard\qj \li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1158\sb63\sl-
316\slmult0 \up0 \expndtw-1\charscalex100 Pelayanan berfokus pada pasien (PCC)
diterapkan dalam bentuk asuhan pasien \up0 \expndtw0\charscalex100 terintegrasi
yang bersifat integrasi horizontal dan vertikal. Pada integrasi horizontal \up0
\expndtw0\charscalex102 kontribusi profesi tiap-tiap PPA sama pentingnya/sederajat.
Pada integrasi vertikal \up0 \expndtw-3\charscalex100 pelayanan berjenjang
oleh/melalui berbagai unit pelayanan ke tingkat pelayanan yang \up0 \expndtw-
2\charscalex100 berbeda, di sini peran MPP penting untuk integrasi tersebut dengan
komunikasi yang \up0 \expndtw-4\charscalex100 memadai dengan PPA. \par\pard\qj
\li1418\ri1205\sb201\sl-320\slmult0 \up0 \expndtw0\charscalex103 Pelaksanaan Asuhan
Pasien Terintegrasi pusatnya adalah pasien dan mencakup \up0 \expndtw-
4\charscalex100 elemen sebagai berikut: \par\pard\ql \li1778\sb257\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf21\f22\fs24 \u-
3913?\ul0\nosupersub\cf18\f19\fs24 keterlibatan dan pemberdayaan pasien dan
keluarga. (lihat PAP 4, PAP 2, PAP \par\pard\ql \li2138\sb1\sl-256\slmult0 \up0
\expndtw-5\charscalex100 5); \par\pard\ql \li1778\sb28\sl-276\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf21\f22\fs24 \u-
3913?\ul0\nosupersub\cf18\f19\fs24 DPJP sebagai Ketua tim PPA
(C\ul0\nosupersub\cf20\f21\fs24 linical Leader\ul0\nosupersub\cf18\f19\fs24 );
\par\pard\ql \li1778\ri1162\sb21\sl-280\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf21\f22\fs24 \u-3913?\ul0\nosupersub\cf18\f19\fs24
PPA bekerja sebagai tim interdisiplin dengan kolaborasi interprofesional, antara
\line\tab \up0 \expndtw-1\charscalex100 lain memakai Panduan Praktik Klinis (PPK),
Panduan Asuhan PPA lainnya \line \tab \up0 \expndtw-1\charscalex100 disertai Alur
Klinis terintegrasi/\ul0\nosupersub\cf20\f21\fs24 Clinical
Pathway\ul0\nosupersub\cf18\f19\fs24 , dan Catatan Perkembangan \line \tab \up0
\expndtw-4\charscalex100 Pasien Terintegrasi/CPPT; \par\pard\qj
\li1778\ri2460\sb0\sl-300\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf21\f22\fs24 \u-3913?\ul0\nosupersub\cf18\f19\fs24 Perencanaan
Pemulangan Pasien/\ul0\nosupersub\cf20\f21\fs24 Discharge
Planning\ul0\nosupersub\cf18\f19\fs24 terintegrasi; \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf21\f22\fs24 \u-3913?\ul0\nosupersub\cf18\f19\fs24
Asuhan Gizi Terintegrasi (lihat PAP 5); \par\pard\ql \li1778\sb4\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf21\f22\fs24 \u-
3913?\ul0\nosupersub\cf18\f19\fs24 Manajer Pelayanan
Pasien/\ul0\nosupersub\cf20\f21\fs24 Case Manager. \par\pard\qj
\li1418\ri1220\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf18\f19\fs24 Pendokumentasian di rekam medis merupakan
alat utk memfasilitasi dan \line \up0 \expndtw-3\charscalex100 menggambarkan
integrasi serta koordinasi asuhan. Secara khusus, setiap PPA \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb111\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 137
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg138}
{\bkmkend Pg138}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1208\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf18\f19\fs24 mencatat observasi dan pengobatan di rekam medis
pasien. Demikian juga, setiap \up0 \expndtw0\charscalex102 hasil atau simpulan dari
rapat tim atau diskusi pasien dicatat dlm CPPT. (lihat juga \up0 \expndtw-
4\charscalex100 PAP5, EP 2) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb207\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Elemen Penilaian
PAP2 \par\pard\qj \li1778\ri1191\sb1\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf18\f19\fs24 1. Ada regulasi yang
mengatur pelayanan dan asuhan terintegrasi di dan \line\tab \up0 \expndtw-
4\charscalex100 antarberbagai unit pelayanan. (R) \par\pard\qj
\li1778\ri1311\sb17\sl-260\slmult0\tx2138 \up0 \expndtw-3\charscalex100 2. Rencana
asuhan diintegrasikan dan dikoordinasikan di dan antarberbagai unit \line\tab
\up0 \expndtw-4\charscalex100 pelayanan. (lihat juga ARK 2, EP 3). (D,O,W)
\par\pard\qj \li1778\ri1157\sb40\sl-260\slmult0\tx2138 \up0 \expndtw-
4\charscalex100 3. Pemberian asuhan diintegrasikan dan dikoordinasikan di dan
antar berbagai unit \line\tab \up0 \expndtw-5\charscalex100 pelayanan. (D,O,W)
\par\pard\qj \li1778\ri1189\sb4\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex104
4. Hasil atau simpulan rapat dari tim PPA atau diskusi lain tentang kerjasama
\line\tab \up0 \expndtw-4\charscalex100 didokumentasikan dalam CPPT. (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Standar PAP 2.1
\par\pard\ql \li1418\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rencana asuhan individual setiap pasien dibuat dan
didokumentasikan. \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 2.1
\par\pard\qj \li1418\ri1163\sb0\sl-313\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rencana asuhan menjelaskan asuhan dan
pengobatan/tindakan yang diberikan \line \up0 \expndtw-3\charscalex100 kepada
seorang pasien. Rencana asuhan memuat satu paket tindakan yang dilakukan \line \up0
\expndtw0\charscalex102 oleh PPA untuk memecahkan atau mendukung diagnosis yang
ditegakkan melalui \line \up0 \expndtw-3\charscalex100 asesmen. Tujuan utama
rencana asuhan adalah memperoleh hasil klinis yang optimal. \par\pard\qj
\li1418\ri1216\sb176\sl-320\slmult0 \up0 \expndtw0\charscalex102 Proses perencanaan
bersifat kolaboratif menggunakan data berasal dari asesmen \up0
\expndtw0\charscalex100 awal dan asesmen ulang yang dilakukan oleh dokter dan PPA
lainnya (perawat, ahli \up0 \expndtw-1\charscalex100 gizi, apoteker, dsb.) untuk
mengetahui dan menetapkan prioritas tindakan, prosedur, \up0 \expndtw-
3\charscalex100 dan asuhan PPA lainnya untuk memenuhi kebutuhan pasien.
\par\pard\qj \li1418\ri1217\sb205\sl-315\slmult0 \up0 \expndtw0\charscalex102
Pasien dan keluarga dilibatkan dalam proses perencanaan. Rencana asuhan
\up0 \expndtw0\charscalex100 diselesaikan dalam waktu 24 jam terhitung saat
diterima sebagai pasien rawat inap. \up0 \expndtw0\charscalex102 Berdasar atas
hasil assesmen ulang, rencana asuhan diperbaharui atau \up0 \expndtw-
2\charscalex100 disempurnakan untuk dapat menggambarkan kondisi pasien terkini.
Rencana asuhan \up0 \expndtw-3\charscalex100 didokumentasikan di rekam medik
pasien. \par\pard\qj \li1418\ri1215\sb240\sl-273\slmult0 \up0 \expndtw-
1\charscalex100 Rencana asuhan pasien harus terkait dengan kebutuhan pasien.
Kebutuhan ini \up0 \expndtw0\charscalex100 mungkin berubah sebagai hasil dari
proses penyembuhan klinis atau ada informasi \up0 \expndtw0\charscalex103 baru
hasil asesmen ulang (contoh, hilangnya kesadaran, hasil laboratorium yang \up0
\expndtw-3\charscalex100 abnormal). (lihat PAP 8.7; PAP 9). \par\pard\qj
\li1418\sb0\sl-270\slmult0 \par\pard\qj\li1418\ri1213\sb160\sl-270\slmult0
\up0 \expndtw0\charscalex107 Rencana asuhan direvisi berdasar atas
perubahan-perubahan ini dan \up0 \expndtw-1\charscalex100 didokumentasikan di
rekam medis pasien sebagai catatan dari rencana semula atau \up0 \expndtw-
3\charscalex100 hal ini dapat menghasilkan rencana asuhan baru. \par\pard\qj
\li1418\sb0\sl-260\slmult0 \par\pard\qj\li1418\ri1163\sb179\sl-260\slmult0 \up0
\expndtw-3\charscalex100 Salah satu cara untuk membuat rencana asuhan adalah
mengetahui dan menetapkan \line \up0 \expndtw-3\charscalex100 sasaran-sasaran.
Sasaran terukur dapat dipilih oleh DPJP dan bekerja sama dengan \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb133\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 138
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg139}
{\bkmkend Pg139}\par\pard\qj \li1418\sb0\sl-275\slmult0 \par\pard\qj\li1418\sb0\sl-
275\slmult0 \par\pard\qj\li1418\sb0\sl-275\slmult0 \par\pard\qj\li1418\sb0\sl-
275\slmult0 \par\pard\qj\li1418\ri1162\sb73\sl-275\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 perawat dan PPA lainnya.
Sasaran terukur dapat diamati dan dapat dicapai terkait \line \up0 \expndtw-
1\charscalex100 dengan asuhan pasien dan dari hasil klinis yang diharapkan.
Sasaran ini harus \line \up0 \expndtw-4\charscalex100 realistik, spesifik pada
pasien, dan harus terkait waktu untuk mengukur kemajuan serta \line \up0 \expndtw-
3\charscalex100 hasil terkait dengan encana asuhan. Contoh dari sasaran realistik
dan terukur sebagai \line \up0 \expndtw-4\charscalex100 berikut: \par\pard\qj
\li1778\ri1219\sb81\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 kondisi pasien
kembali dengan fungsi (\ul0\nosupersub\cf8\f9\fs24 out
put\ul0\nosupersub\cf7\f8\fs24 ) jantung stabil melalui detak \line\tab \up0
\expndtw-3\charscalex100 jantung, irama jantung, dan tekanan darah berada di
kisaran normal; \par\pard\qj \li1778\ri1219\sb97\sl-260\slmult0\tx2138 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 pasien dapat menunjukkan mampu memberi sendiri
suntikan insulin sebelum \line\tab \up0 \expndtw-5\charscalex100 pasien pulang
keluar dari rumah sakit; \par\pard\qj \li1778\ri1223\sb84\sl-280\slmult0\tx2138
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 pasien mampu berjalan
dengan\ul0\nosupersub\cf8\f9\fs24 \u8220?walker\u8221?\ul0\nosupersub\cf7\f8\fs24
(alat bantu untuk berjalan) menuju \line\tab \up0 \expndtw-3\charscalex100 ruangan
tamu dan kedua kakinya mampu menanggung beban berat badan. \par\pard\qj
\li1418\ri1171\sb61\sl-280\slmult0 \up0 \expndtw-2\charscalex100 DPJP sebagai ketua
tim PPA melakukan evaluasi/\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 berkala dan verifikasi harian \up0 \expndtw-
3\charscalex100 untuk menjaga terlaksananya asuhan terintegrasi dan membuat notasi
sesuai dengan \up0 \expndtw-4\charscalex100 kebutuhan. \par\pard\qj
\li1418\ri1212\sb61\sl-280\slmult0 \up0 \expndtw-2\charscalex100 Catatan: satu
rencana asuhan terintegrasi dengan sasaran-sasaran yang diharapkan \line \up0
\expndtw0\charscalex100 oleh PPA lebih baik daripada rencana terpisah oleh PPA
masing-masing. Rencana \line \up0 \expndtw-1\charscalex100 asuhan yang baik
menjelaskan asuhan individual, objektif, dan sasaran dapat diukur \line \up0
\expndtw-2\charscalex100 untuk memudahkan asesmen ulang serta revisi rencana
asuhan. (lihat PPK 4) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb128\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 2.1 \par\pard\ql
\li1778\ri1167\sb1\sl-280\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi asuhan untuk setiap pasien
direncanakan oleh dokter penanggung \line\tab \up0 \expndtw-1\charscalex100 jawab
pelayanan (DPJP), perawat, dan PPA lainnya dalam waktu 24 jam \line \tab
\up0 \expndtw-2\charscalex100 sesudah pasien masuk rawat inap. (R) \par\pard\qj
\li1778\ri1217\sb17\sl-260\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Rencana
asuhan dibuat untuk setiap pasien dan dicatat oleh PPA yang \line\tab \up0
\expndtw-3\charscalex100 memberikan asuhan di rekam medis pasien. (D,W)
\par\pard\qj \li1778\ri1177\sb4\sl-280\slmult0\tx2138 \up0 \expndtw-2\charscalex100
3. Rencana asuhan pasien terintegrasi dibuat dengan sasaran berdasar atas data
\line\tab \up0 \expndtw-3\charscalex100 asesmen awal dan kebutuhan pasien. (D,W)
\par\pard\qj \li1778\ri1220\sb1\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex104
4. Rencana asuhan dievaluasi secara berkala sesuai dengan kondisi pasien,
\line\tab \up0 \expndtw-2\charscalex100 dimutakhirkan, atau direvisi oleh tim PPA
berdasar atas asesmen ulang. (D,W) \par\pard\qj \li1778\ri1227\sb1\sl-
280\slmult0\tx2138 \up0 \expndtw0\charscalex102 5. Perkembangan tiap pasien
dievaluasi berkala dan dibuat notasi pada CPPT \line\tab \up0 \expndtw-
2\charscalex100 oleh DPJP sesuai dengan kebutuhan dan diverifikasi harian oleh
DPJP. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAP
2.2 \par\pard\ql \li1418\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi yang mengatur metode
memberi instruksi. \par\pard\ql \li1418\sb224\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 2.2
\par\pard\qj \li1418\ri1158\sb86\sl-274\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Banyak kegiatan asuhan pasien membutuhkan seorang PPA
yang kompeten dan \line \up0 \expndtw0\charscalex103 berwenang untuk menuliskan
instruksi yang harus dicatat di rekam medik pasien. \line \up0 \expndtw-
3\charscalex100 Kegiatan ini meliputi, misalnya instruksi untuk pemeriksaan di
laboratorium (antara lain \line \up0 \expndtw0\charscalex100 termasuk laboratorium
Patologi Anatomi), memesan obat, asuhan keperawatan \line \up0
\expndtw0\charscalex105 khusus, terapi nurtrisi, dsb. Instruksi ini harus dapat
tersedia dengan mudah jika \line \up0 \expndtw0\charscalex100 instruksi harus
dilaksanakan secepat-cepatnya. Menempatkan instruksi di lembar \line \up0
\expndtw0\charscalex104 umum atau di tempat tertentu di dalam berkas rekam
medik memudahkan \line \up0 \expndtw-3\charscalex100 pelaksanaan instruksi.
\par\pard\qj \li1418\sb0\sl-260\slmult0 \par\pard\qj\li1418\ri1161\sb178\sl-
260\slmult0 \up0 \expndtw0\charscalex104 Instruksi tertulis membantu staf
mengerti kekhususan perintah, kapan harus \line \up0 \expndtw-3\charscalex100
dilaksanakan, serta siapa harus melaksanakannya dan bersifat delegatif atau mandat.
\par\pard\ql \li10156\sb246\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 139
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg140}
{\bkmkend Pg140}\par\pard\qj \li1418\sb0\sl-260\slmult0 \par\pard\qj\li1418\sb0\sl-
260\slmult0 \par\pard\qj\li1418\sb0\sl-260\slmult0 \par\pard\qj\li1418\sb0\sl-
260\slmult0 \par\pard\qj\li1418\ri1223\sb146\sl-260\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Instruksi tertulis dapat juga diberikan
di form tersendiri atau diberikan dengan sistem \up0 \expndtw-3\charscalex100
elektronik sesuai dengan regulasi rumah sakit. \par\pard\ql \li1418\sb87\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Setiap rumah sakit harus mengatur
\par\pard\ql \li1778\sb64\sl-276\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 jenis instruksi harus
tertulis dan dicatat; \par\pard\ql \li1778\sb64\sl-276\slmult0\tx7835 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24
permintaan pemeriksaan semua laboratorium \tab \up0 \expndtw0\charscalex102
(antara lain termasuk \par\pard\qj \li2138\ri1216\sb1\sl-280\slmult0 \up0
\expndtw0\charscalex102 pemeriksaan laboratorium PA) dan diagnostik imajing
tertentu harus disertai \up0 \expndtw-3\charscalex100 indikasi klinik
\par\pard\qj \li1778\ri1194\sb77\sl-260\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24
pengecualian dalam keadaan khusus, seperti antara lain di unit darurat dan unit
\line\tab \up0 \expndtw-3\charscalex100 intensif; \par\pard\qj
\li1778\ri1193\sb100\sl-260\slmult0\tx2138 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 siapa yang diberi
kewenangan memberi instruksi dan perintah diletakkan di \line\tab \up0 \expndtw-
2\charscalex100 dalam berkas rekam medik pasien. (lihat juga SKP 2; PKPO 4; PKPO 1;
PKPO \par\pard\ql \li2138\sb7\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4.2;
PKPO 4.3; MIRM 1.10 MIRM 11) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb148\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf17\f18\fs24 Elemen Penilaian PAP 2.2 \par\pard\ql \li1778\sb4\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah
sakit menetapkan regulasi tata cara pemberian instruksi. (R) \par\pard\qj
\li1778\ri1338\sb0\sl-300\slmult0\tx2138 \up0 \expndtw-3\charscalex100 2.
Instruksi diberikan hanya oleh mereka yang kompeten dan berwenang. (lihat
\line\tab \up0 \expndtw-4\charscalex100 KKS 3). (D,W) \par\pard\qj
\li1778\ri1632\sb0\sl-280\slmult0\tx2138 \up0 \expndtw-3\charscalex100 3.
Permintaan untuk pemeriksaan laboratorium dan diagnostik imajing harus
\line\tab \up0 \expndtw-3\charscalex100 disertai indikasi klinik apabila meminta
hasilnya berupa interpretasi. (D,W) \par\pard\qj \li1778\ri1661\sb3\sl-
280\slmult0\tx2138 \up0 \expndtw-2\charscalex100 4. Instruksi didokumentasikan
di lokasi tertentu di dalam berkas rekam medik \line\tab \up0 \expndtw-
3\charscalex100 pasien. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf17\f18\fs24 Standar PAP 2.3 \par\pard\qj \li1418\ri1217\sb0\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi tindakan klinik dan diagnostik yang diminta, \line
\up0 \expndtw-2\charscalex100 dilaksanakan dan diterima hasilnya, serta disimpan di
berkas rekam medis pasien. \par\pard\ql \li1418\sb205\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Maksud dan Tujuan PAP 2.3
\par\pard\qj \li1418\ri1162\sb0\sl-316\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Contoh tindakan seperti ini adalah endoskopi,
kateterisasi jantung, terapi radiasi, CT \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf8\f9\fs24 scan\ul0\nosupersub\cf7\f8\fs24 , tindakan invasif
lain, serta pada pemeriksaan laboratorium (PK, PA) juga pada \up0
\expndtw0\charscalex100 radiologi intervensional dan noninvasif. Informasi
tentang siapa yang meminta \up0 \expndtw-3\charscalex100 prosedur/ tindakan ini
serta alasannya dicatat dan dimasukkan di dalam berkas rekam \up0 \expndtw-
2\charscalex100 medis pasien. Pada rawat jalan apabila dilakukan tindakan
diagnostik invasif/berisiko \up0 \expndtw0\charscalex103 termasuk pasien yang
dirujuk dari luar juga harus dilakukan asesmen serta \up0 \expndtw-
3\charscalex100 pencatatannya dalam rekam medis. \par\pard\ql \li1418\sb209\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Elemen
Penilaian PAP 2.3 \par\pard\qj \li1778\ri1686\sb1\sl-280\slmult0\tx2138 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
tindakan klinik dan diagnostik serta pencatatannya di \line\tab \up0 \expndtw-
3\charscalex100 rekam medis. (R) \par\pard\qj \li1778\ri1653\sb1\sl-
280\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Staf yang meminta beserta apa
alasan dilakukan tindakan dicatat di rekam \line\tab \up0 \expndtw-3\charscalex100
medis pasien. (D) \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 3. Hasil tindakan dicatat di rekam medis pasien. (D)
\par\pard\qj \li1778\ri1687\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-2\charscalex100
4. Pada pasien rawat jalan bila dilakukan tindakan diagnostik invasif/berisiko
\line\tab \up0 \expndtw-3\charscalex100 harus dilakukan asesmen serta pencatatannya
dalam rekam medis. (D,W) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb118\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 140
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg141}
{\bkmkend Pg141}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAP 2.4 \par\pard\qj
\li1418\ri1243\sb0\sl-300\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien dan keluarga diberi tahu tentang hasil asuhan
dan pengobatan termasuk hasil \up0 \expndtw-4\charscalex100 asuhan yg tidak
diharapkan. \par\pard\ql \li1418\sb225\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 2.4 \par\pard\qj
\li1418\ri1158\sb64\sl-277\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asuhan dan proses pengobatan merupakan siklus
berkesinambungan dari asesmen \line \up0 \expndtw-3\charscalex100 dan asesmen
ulang, perencanaan serta pemberian asuhan, dan evaluasi hasil. Pasien \line \up0
\expndtw-3\charscalex100 dan keluarga diberitahukan tentang hasil proses asesmen,
perencanaan asuhan dan \line \up0 \expndtw0\charscalex102 pengobatan, serta
diikutsertakan dalam pengambilan keputusan. Langkah asuhan \line \up0
\expndtw0\charscalex105 bersifat siklis sehingga pasien perlu diberi
informasi tentang hasil asuhan, \line \up0 \expndtw0\charscalex103 perkembangan
dan pengobatan, termasuk informasi hasil asuhan yang tidak \line \up0
\expndtw-2\charscalex100 diharapkan. Pemberian informasi tersebut dilakukan oleh
PPA terkait untuk KTD oleh \line \up0 \expndtw-3\charscalex100 DPJP.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb128\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP
2.4 \par\pard\qj \li1778\ri1166\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-
9\charscalex97 \ul0\nosupersub\cf7\f8\fs24 1. Pasien dan keluarga
diberikan informasi tentang hasil asuhan dan \line\tab \up0
\expndtw-10\charscalex97 pengobatan. (lihat juga HPK 2.1.1, EP 1). (D,W)
\par\pard\qj \li1778\ri1161\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-8\charscalex100
2. Pasien dan keluarga diberikan informasi tentang hasil
asuhan dan \line\tab \up0 \expndtw-9\charscalex100 pengobatan yg tidak
diharapkan. (lihat juga HPK 2.1.1, EP 2). (D,W) \par\pard\qj \li1562\sb0\sl-
280\slmult0 \par\pard\qj\li1562\ri1696\sb241\sl-280\slmult0\tx1922 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PELAYANAN PASIEN RISIKO TINGGI DAN PENYEDIAAN PELAYANAN \line\tab \up0 \expndtw-
5\charscalex100 RISIKO TINGGI \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb268\sl-276\slmult0 \up0 \expndtw-6\charscalex100 Standar PAP
3 \par\pard\qj \li1418\ri1225\sb216\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi bahwa asuhan pasien
risiko tinggi dan pemberian \up0 \expndtw0\charscalex100 pelayanan risiko tinggi
diberikan berdasar atas panduan praktik klinis dan peraturan \up0 \expndtw-
3\charscalex100 perundangan. \par\pard\ql \li1418\sb239\sl-276\slmult0 \up0
\expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 3
\par\pard\qj \li1418\ri1158\sb64\sl-277\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memberi asuhan kepada pasien untuk berbagai
kebutuhannya atau \line \up0 \expndtw0\charscalex100 kebutuhan pada keadaan kritis.
Beberapa pasien digolongan masuk dalam kategori \line \up0 \expndtw0\charscalex100
risiko tinggi karena umurnya, kondisinya, dan kebutuhan pada keadaan kritis.
Anak-\line \up0 \expndtw-3\charscalex100 anak dan lansia biasanya dimasukkan ke
dalam golongan ini karena mereka biasanya \line \up0 \expndtw0\charscalex102 tidak
dapat menyampaikan keinginannya, tidak mengerti proses asuhan yang \line
\up0 \expndtw-3\charscalex100 diberikan, dan tidak dapat ikut serta dalam mengambil
keputusan terkait dirinya. Sama \line \up0 \expndtw-1\charscalex100 juga halnya
dengan pasien darurat yang ketakutan, koma, dan bingung tidak mampu \line \up0
\expndtw0\charscalex102 memahami proses asuhannya apabila pasien harus diberikan
asuhan cepat dan \line \up0 \expndtw-3\charscalex100 efisien. \par\pard\qj
\li1418\ri1218\sb64\sl-276\slmult0 \up0 \expndtw0\charscalex100 Rumah sakit juga
memberikan berbagai pelayanan, beberapa dikenal sebagai \up0
\expndtw0\charscalex100 pelayanan risiko tinggi karena tersedia peralatan
medis yang kompleks untuk \up0 \expndtw0\charscalex102 kebutuhan pasien dengan
kondisi darurat yang mengancam jiwa (pasien dialisis), \up0
\expndtw0\charscalex102 karena sifat tindakan (pasien dengan pemberian
darah/produk darah), mengatasi \up0 \expndtw0\charscalex100 potensi bahaya bagi
pasien (pasien\ul0\nosupersub\cf8\f9\fs24 restrain\ul0\nosupersub\cf7\f8\fs24 ),
atau mengatasi akibat intoksikasi obat \up0 \expndtw-3\charscalex100 risiko tinggi
(contoh kemoterapi). \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb128\sl-276\slmult0 \up0 \expndtw0\charscalex100 Asuhan bagi
pasien risiko tinggi tersebut didukung oleh penggunaan PPK, regulasi \par\pard\ql
\li10156\sb183\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 141
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg142}
{\bkmkend Pg142}\par\pard\qj \li1418\sb0\sl-280\slmult0 \par\pard\qj\li1418\sb0\sl-
280\slmult0 \par\pard\qj\li1418\sb0\sl-280\slmult0 \par\pard\qj\li1418\sb0\sl-
280\slmult0 \par\pard\qj\li1418\ri1214\sb29\sl-280\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 lainnya dan rencana
asuhan,\ul0\nosupersub\cf8\f9\fs24 clinical pathway\ul0\nosupersub\cf7\f8\fs24 ,
dsb. (lihat PAP 2.1.). Hal ini berguna \up0 \expndtw-3\charscalex100 bagi staf
untuk memahami dan merespons dengan sikap profesional. \par\pard\qj
\li1418\ri1165\sb97\sl-260\slmult0 \up0 \expndtw-4\charscalex100 Dalam hal ini
pimpinan rumah sakit bertanggung jawab sesuai dengan populasi pasien \line \up0
\expndtw-5\charscalex100 untuk \par\pard\li1922\sb155\sl-276\slmult0\fi0\tx2282
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf22\f23\fs19 \u-3913?\tab \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 identifikasi pasien yang
digolongkan sebagai risiko tinggi;\par\pard\li1922\sb84\sl-
276\slmult0\fi0\tx2282 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf22\f23\fs19 \u-3913?\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 identifikasi pelayanan yang digolongkan sebagai risiko
tinggi;\par\pard\li1922\sb84\sl-276\slmult0\fi0\tx2282 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf22\f23\fs19 \u-3913?\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 melalui proses kolaborasi menetapkan
regulasi asuhan;\par\pard\li1922\sb84\sl-276\slmult0\fi0\tx2282 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf22\f23\fs19 \u-3913?\tab \up0 \expndtw-
3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 melatih staf untuk melaksanakan
regulasi.\par\pard\qj \li1418\sb0\sl-270\slmult0
\par\pard\qj\li1418\ri1214\sb91\sl-270\slmult0 \up0 \expndtw0\charscalex102
Regulasi untuk asuhan disesuaikan dengan populasi pasien risiko tinggi dan
\up0 \expndtw-1\charscalex100 pelayanan risiko tinggi yang berguna untuk menurunkan
risiko. Dalam hal ini penting \up0 \expndtw-3\charscalex100 dipahami bahwa prosedur
dapat mengindentifikasi \par\pard\qj \li1778\ri1225\sb82\sl-280\slmult0\tx2138 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 bagaimana rencana akan berjalan, termasuk
identifikasi perbedaan populasi \line\tab \up0 \expndtw-3\charscalex100 anak dengan
dewasa, atau pertimbangan khusus lainnya; \par\pard\qj \li1778\ri1224\sb81\sl-
280\slmult0\tx2138 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 dokumentasi yang dibutuhkan agar tim
asuhan dapat bekerja dan \line\tab \up0 \expndtw-3\charscalex100
berkomunikasi efektif; \par\pard\ql \li1778\ri3365\sb14\sl-360\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 keperluan\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ; \line \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 keperluan
monitor pasien; \par\pard\qj \li1778\ri3420\sb0\sl-360\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
kualifikasi khusus staf yang terlibat dalam proses asuhan; \line \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
teknologi medis khusus tersedia dan dapat digunakan. \par\pard\qj \li1418\sb0\sl-
280\slmult0 \par\pard\qj\li1418\ri1223\sb107\sl-280\slmult0 \up0 \expndtw-
2\charscalex100 Rumah sakit menetapkan dan melaksanakan regulasi untuk pasien
risiko tinggi dan \up0 \expndtw-3\charscalex100 pelayanan risiko tinggi. Untuk
pasien risiko tinggi meliputi \par\pard\ql \li1778\sb84\sl-276\slmult0 \up0
\expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 pasien emergensi; \par\pard\ql
\li1778\ri3114\sb15\sl-360\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pasien dengan
penyakit menular; \line \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pasien koma;
\par\pard\qj \li1778\ri5193\sb0\sl-360\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pasien dengan
alat bantuan hidup dasar; \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
pasien\ul0\nosupersub\cf8\f9\fs24 \u8220?immuno-suppressed\u8221?; \par\pard\ql
\li1778\sb70\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pasien
dialisis; \par\pard\ql \li1778\sb84\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pasien
dengan\ul0\nosupersub\cf8\f9\fs24 restrain; \par\pard\ql \li1778\sb84\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 pasien dengan risiko bunuh diri; \par\pard\ql
\li1778\sb84\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pasien yang
menerima
kemoterapi;\par\pard\sect\sectd\sbknone\cols2\colno1\colw7818\colsr110\colno2\colw3
832\colsr160\ql \li1778\sb102\sl-276\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 populasi
pasien rentan, lansia, anak-anak, dan\par\pard\ql \li2138\sb0\sl-273\slmult0
\up0 \expndtw-3\charscalex100 kekerasan atau diterlantarkan; dan\par\pard\ql
\li1778\sb88\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pasien risiko
tinggi lainnya.\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql
\li1418\sb134\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Untuk pelayanan risiko
tinggi meliputi\par\pard\ql \li1778\ri622\sb15\sl-360\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
pelayanan pasien dengan penyakit menular; \line \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pelayanan
pasien yang menerima dialisis; \line \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pelayanan
pasien yang menerima kemoterapi; \line \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pelayanan
pasien yang menerima radioterapi;\par\pard\column \ql \li20\sb102\sl-276\slmult0
\up0 \expndtw-3\charscalex100 pasien \up0 \expndtw-3\charscalex100 berisiko \up0
\expndtw-3\charscalex100 tindak\par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql \li2248\sb250\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 142

{\shp
{\*\shpinst\shpleft2114\shptop13827\shpright3218\shpbottom13847\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz1689\shplid0
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg143}{\bkmkend Pg143}\par\pard\li1778\sb0\sl-276\slmult0\par\pard\li1778\sb0\sl-
276\slmult0\par\pard\li1778\sb0\sl-276\slmult0\par\pard\li1778\sb0\sl-
276\slmult0\par\pard\li1778\sb87\sl-276\slmult0\fi0\tx6819 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 pelayanan pasien risiko tinggi
lainnya\tab \up0 \expndtw0\charscalex100 (misalnya terapi hiperbarik
dan\par\pard\li1778\sb0\sl-274\slmult0\fi360 \up0 \expndtw0\charscalex100 pelayanan
radiologi intervensi).\par\pard\qj \li1418\sb0\sl-275\slmult0
\par\pard\qj\li1418\ri1223\sb138\sl-275\slmult0 \up0 \expndtw-2\charscalex100 Rumah
sakit juga menetapkan risiko tambahan sebagai hasil tindakan atau rencana \line
\up0 \expndtw-3\charscalex100 asuhan (contoh, kebutuhan mencegah trombosis vena
dalam, luka dekubitus, infeksi \line \up0 \expndtw-4\charscalex100 terkait
penggunaan ventilator pada pasien, cedera neurologis dan pembuluh darah
\line \up0 \expndtw0\charscalex102 pada pasien\ul0\nosupersub\cf8\f9\fs24
restrain\ul0\nosupersub\cf7\f8\fs24 , infeksi melalui pembuluh darah pada pasien
dialisis, infeksi \line \up0 \expndtw-4\charscalex100 saluran/slang sentral, dan
pasien jatuh (lihat SKP VI). Risiko tersebut jika ada, diatasi \line \up0 \expndtw-
2\charscalex100 dan dicegah oleh edukasi staf serta regulasi yang memadai. (lihat
HPK 5.2). Rumah \line \up0 \expndtw-2\charscalex100 sakit menggunakan informasi
pengukuran untuk evaluasi pelayanan yang diberikan \line \up0 \expndtw-
1\charscalex100 kepada pasien risiko tinggi dan diintegrasikan ke dalam program
peningkatan mutu \line \up0 \expndtw-5\charscalex100 rumah sakit. \par\pard\qj
\li1418\sb0\sl-277\slmult0 \par\pard\qj\li1418\ri1161\sb127\sl-277\slmult0 \up0
\expndtw-2\charscalex100 Rumah sakit juga menetapkan risiko tambahan sebagai hasil
tindakan atau rencana \line \up0 \expndtw-3\charscalex100 asuhan (contoh, kebutuhan
mencegah trombosis vena dalam, luka decubitus, infeksi \line \up0 \expndtw-
4\charscalex100 terkait penggunaan ventilator pada pasien, cedera neurologis
dan pembuluh darah \line \up0 \expndtw0\charscalex102 pada pasien restrain, infeksi
melalui pembuluh darah pada pasien dialisis, infeksi \line \up0 \expndtw-
3\charscalex100 saluran / slang sentral, dan pasien jatuh (lihat SKP VI). Risiko
tsb, jika ada, diatasi dan \line \up0 \expndtw-2\charscalex100 dicegah oleh edukasi
staf dan regulasi yang memadai. (lihat HPK 5.2). Rumah sakit \line \up0 \expndtw-
3\charscalex100 menggunakan informasi pengukuran untuk evaluasi pelayanan yang
diberikan kepada \line \up0 \expndtw0\charscalex100 pasien risiko tinggi dan
diintegrasikan ke dalam program peningkatan mutu rumah \line \up0 \expndtw-
5\charscalex100 sakit. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb128\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 3 \par\pard\ql
\li1778\ri1199\sb1\sl-280\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi proses identifikasi pasien risiko
tinggi dan pelayanan risiko tinggi \line\tab \up0 \expndtw-2\charscalex100 sesuai
dengan populasi pasiennya serta penetapan risiko tambahan yang \line \tab
\up0 \expndtw-2\charscalex100 mungkin berpengaruh pada pasien risiko tinggi dan
pelayanan risiko tinggi. (R) \par\pard\qj \li1778\ri1166\sb1\sl-
280\slmult0\tx2138 \up0 \expndtw-3\charscalex100 2. Staf dilatih untuk pemberian
pelayanan pada pasien risiko tinggi dan pelayanan \line\tab \up0 \expndtw-
5\charscalex100 risiko tinggi. (lihat MKI 8.1, EP 3). (D,O,W) \par\pard\qj
\li1778\ri1229\sb37\sl-260\slmult0\tx2138 \up0 \expndtw0\charscalex102 3. Ada
bukti pelaksanaan pemberian pelayanan pada pasien risiko tinggi dan \line\tab
\up0 \expndtw-3\charscalex100 pelayanan risiko tinggi. (lihat MKI 8.1, EP 3).
(D,O,W) \par\pard\qj \li1778\ri1229\sb24\sl-280\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 4. Ada bukti pengembangan pelayanan risiko tinggi dimasukkan
ke dalam \line\tab \up0 \expndtw-5\charscalex100 program peningkatan mutu rumah
sakit. (D,W) \par\pard\ql \li1521\sb0\sl-276\slmult0 \par\pard\ql\li1521\sb0\sl-
276\slmult0 \par\pard\ql\li1521\sb0\sl-276\slmult0 \par\pard\ql\li1521\sb216\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf19\f20\fs19 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 DETEKSI (MENGENALI) PERUBAHAN KONDISI PASIEN
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0
\up0 \expndtw-4\charscalex100 Standar PAP 3.1 \par\pard\qj \li1418\ri1225\sb61\sl-
280\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Staf klinis
dilatih untuk mendeteksi (mengenali) perubahan kondisi pasien memburuk \up0
\expndtw-2\charscalex100 dan mampu melakukan tindakan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb128\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 3.1
\par\pard\qj \li1418\ri1224\sb1\sl-280\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Staf yang tidak bekerja di daerah pelayanan kritis/
intensif mungkin tidak mempunyai \line \up0 \expndtw-2\charscalex100 pengetahuan
dan pelatihan yang cukup untuk melakukan asesmen serta mengetahui \line \up0
\expndtw-2\charscalex100 pasien yang akan masuk dalam kondisi kritis. Padahal,
,banyak pasien di luar daerah \line \up0 \expndtw-2\charscalex100 pelayanan kritis
mengalami keadaan kritis selama dirawat inap. Sering kali pasien \par\pard\ql
\li10156\sb223\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 143
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg144}
{\bkmkend Pg144}\par\pard\qj \li1418\sb0\sl-270\slmult0 \par\pard\qj\li1418\sb0\sl-
270\slmult0 \par\pard\qj\li1418\sb0\sl-270\slmult0 \par\pard\qj\li1418\sb0\sl-
270\slmult0 \par\pard\qj\li1418\ri1218\sb97\sl-270\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 memperlihatkan tanda bahaya
dini (contoh, tanda-tanda vital yang memburuk dan \up0 \expndtw0\charscalex100
perubahan kecil status neurologisnya) sebelum mengalami penurunan kondisi klinis
\up0 \expndtw-3\charscalex100 yang meluas sehingga mengalami kejadian yang tidak
diharapkan. \par\pard\qj \li1418\sb0\sl-275\slmult0
\par\pard\qj\li1418\ri1215\sb31\sl-275\slmult0 \up0 \expndtw-2\charscalex100 Ada
kriteria fisiologis yang dapat membantu staf untuk mengenali sedini-dininya
\up0 \expndtw0\charscalex100 pasien yang kondisinya memburuk. Sebagian besar pasien
yang mengalami gagal \up0 \expndtw0\charscalex102 jantung atau gagal paru
sebelumnya memperlihatkan tanda-tanda fisiologis di luar \up0
\expndtw0\charscalex102 kisaran normal yang merupakan indikasi keadaan pasien
memburuk. Hal ini dapat \up0 \expndtw-3\charscalex100 diketahui
dengan\ul0\nosupersub\cf8\f9\fs24 early warning system\ul0\nosupersub\cf7\f8\fs24
(EWS). \par\pard\qj \li1418\sb0\sl-270\slmult0 \par\pard\qj\li1418\ri1220\sb40\sl-
270\slmult0 \up0 \expndtw-1\charscalex100 Penerapan\ul0\nosupersub\cf8\f9\fs24
early warning system\ul0\nosupersub\cf7\f8\fs24 (EWS) membuat staf mampu
mengidentifikasi \up0 \expndtw0\charscalex100 keadaan pasien memburuk sedini-
dininya dan bila perlu mencari bantuan staf yang \up0 \expndtw-3\charscalex100
kompeten. Dengan demikian, hasil asuhan akan lebih baik. \par\pard\qj
\li1418\sb0\sl-280\slmult0 \par\pard\qj\li1418\ri1160\sb22\sl-280\slmult0 \up0
\expndtw-3\charscalex100 Pelaksanaan\ul0\nosupersub\cf8\f9\fs24 early warning
system\ul0\nosupersub\cf7\f8\fs24 (EWS) dapat dilakukan menggunakan sistem
skor. \up0 \expndtw-4\charscalex100 Semua staf dilatih untuk
menggunakan\ul0\nosupersub\cf8\f9\fs24 early warning
system\ul0\nosupersub\cf7\f8\fs24 (EWS)\ul0\nosupersub\cf8\f9\fs24 .
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian
PAP3.1 \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pelaksanaan\ul0\nosupersub\cf8\f9\fs24
early warning system\ul0\nosupersub\cf7\f8\fs24 (EWS). (R) \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Ada bukti staf klinis
dilatih menggunakan\ul0\nosupersub\cf8\f9\fs24 early warning
system\ul0\nosupersub\cf7\f8\fs24 (EWS). (D,W) \par\pard\qj \li1778\ri1216\sb1\sl-
280\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3. Ada bukti staf klinis
mampu melaksanakan\ul0\nosupersub\cf8\f9\fs24 early warning
system\ul0\nosupersub\cf7\f8\fs24 (EWS). \line\tab \up0 \expndtw-2\charscalex100
(D,W,S) \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4.
Tersedia pencatatan hasil\ul0\nosupersub\cf8\f9\fs24 early warning
system\ul0\nosupersub\cf7\f8\fs24 (EWS). (D,W) \par\pard\ql \li1521\sb0\sl-
276\slmult0 \par\pard\ql\li1521\sb248\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PELAYANAN RESUSITASI \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-7\charscalex100 Standar PAP
3.2 \par\pard\ql \li1418\sb64\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelayanan resusitasi tersedia di seluruh area rumah
sakit. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb128\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PAP 3.2 \par\pard\qj \li1418\ri1216\sb0\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelayanan resusitasi diartikan sebagai
intervensi klinis pada pasien yang mengalami \up0 \expndtw-1\charscalex100 kejadian
mengancam hidupnya seperti henti jantung atau paru. Pada saat henti \up0
\expndtw0\charscalex100 jantung atau paru maka pemberian kompresi
pada dada atau bantuan pernapasan \up0 \expndtw-2\charscalex100 akan berdampak
pada hidup atau matinya pasien, setidak-tidaknya menghindari \up0 \expndtw-
3\charscalex100 kerusakan jaringan otak. \par\pard\qj \li1418\ri1216\sb174\sl-
313\slmult0\fi67 \up0 \expndtw0\charscalex100 Resusitasi yang berhasil pada pasien
dengan henti jantung-paru bergantung pada \up0 \expndtw-2\charscalex100 intervensi
yang kritikal/penting seperti secepat-cepatnya dilakukan defibrilasi dan \up0
\expndtw0\charscalex100 bantuan hidup lanjut (\ul0\nosupersub\cf8\f9\fs24
advance\ul0\nosupersub\cf7\f8\fs24 ) yang akurat (\ul0\nosupersub\cf8\f9\fs24 code
blue\ul0\nosupersub\cf7\f8\fs24 ). Pelayanan seperti ini harus \up0 \expndtw-
3\charscalex100 tersedia untuk semua pasien selama 24 jam setiap hari. \par\pard\qj
\li1418\ri1221\sb206\sl-315\slmult0 \up0 \expndtw0\charscalex104 Sangat penting
untuk dapat memberikan pelayanan intervensi yang kritikal, yaitu \line \up0
\expndtw0\charscalex102 tersedia dengan cepat peralatan medis terstandar, obat
resusitasi, dan staf terlatih \line \up0 \expndtw0\charscalex103 yang baik untuk
resusitasi. Bantuan hidup dasar harus dilakukan secepatnya saat \line \up0
\expndtw-1\charscalex100 diketahui ada tanda henti jantung-paru dan proses
pemberian bantuan hidup kurang \line \up0 \expndtw-3\charscalex100 dari \up0
\expndtw-1\charscalex100 5 (lima) menit. Hal ini
termasuk\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 terhadap
pelaksanaan sebenarnya \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb164\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 144
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg145}
{\bkmkend Pg145}\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1225\sb195\sl-315\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 resusitasi atau terhadap simulasi pelatihan resusitasi
di rumah sakit. Pelayanan \up0 \expndtw0\charscalex103 resusitasi tersedia di
seluruh area rumah sakit termasuk peralatan medis dan staf \up0
\expndtw0\charscalex100 terlatih, berbasis bukti klinis, dan populasi pasien yang
dilayani (contoh, jika rumah \up0 \expndtw0\charscalex100 sakit mempunyai populasi
pediatri, peralatan medis untuk resusitasi pediatri). (lihat \up0 \expndtw-
3\charscalex100 PAB 3; KPS 8.1; TKP 9; MFK 8). \par\pard\qj
\li1418\ri1166\sb201\sl-320\slmult0 \up0 \expndtw-3\charscalex100 Catatan: seluruh
area rumah sakit tempat tindakan dan pelayanan diberikan, termasuk \up0 \expndtw-
4\charscalex100 area tindakan diagnostik di gedung terpisah dari gedung rumah
sakit. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 3.2 \par\pard\ql
\li1778\ri1223\sb0\sl-280\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pelayanan resusitasi
yang tersedia dan diberikan selama 24 jam \line\tab \up0 \expndtw-1\charscalex100
setiap hari di seluruh area rumah sakit, serta peralatan medis untuk resusitasi
\line \tab \up0 \expndtw0\charscalex104 dan obat untuk bantuan hidup dasar
terstandar sesuai dengan kebutuhan \line \tab \up0 \expndtw-3\charscalex100
populasi pasien. (lihat PAB 3, EP 3).(R) \par\pard\qj \li1778\ri1165\sb0\sl-
260\slmult0\tx2138 \up0 \expndtw-3\charscalex100 2. Di seluruh area rumah sakit
bantuan hidup dasar diberikan segera saat dikenali \line\tab \up0 \expndtw-
3\charscalex100 henti jantung-paru dan tindak lanjut diberikan kurang dari 5 menit.
(W,S) \par\pard\ql \li1778\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3.
Staf diberi pelatihan pelayanan resusitasi. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb248\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 3.3 s.d. PAP
3.9 \par\pard\qj \li1418\ri1212\sb61\sl-280\slmult0 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 Regulasi harus dibuat secara khusus untuk kelompok
pasien yang berisiko atau \up0 \expndtw-2\charscalex100 pelayanan yang berisiko
tinggi agar tepat dan efektif dalam mengurangi risiko terkait. \up0 \expndtw-
3\charscalex100 Sangatlah penting bahwa kebijakan dan prosedur mengatur hal
tersebut. \par\pard\qj \li1778\ri1214\sb61\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex102 a. Bagaimana perencanaan dibuat termasuk identifikasi
perbedaan pasien \line\tab \up0 \expndtw-3\charscalex100 dewasa dengan anak atau
keadaan khusus lain. \par\pard\qj \li1778\ri1227\sb61\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex102 b. Dokumentasi yang diperlukan oleh pelayanan secara tim
untuk bekerja dan \line\tab \up0 \expndtw-3\charscalex100 berkomunikasi secara
efektif. \par\pard\ql \li1778\sb64\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c.
Pertimbangan persetujuan khusus bila diperlukan. \par\pard\ql \li1778\sb64\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 d. Persyaratan pemantauan pasien.
\par\pard\qj \li1778\ri1223\sb61\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex103
e. Kompetensi atau keterampilan yang khusus staf yg terlibat dalam proses
\line\tab \up0 \expndtw-3\charscalex100 asuhan. \par\pard\ql \li1778\sb64\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 f. Ketersediaan dan penggunaan peralatan
khusus. \par\pard\qj \li1418\ri1228\sb98\sl-260\slmult0 \up0
\expndtw0\charscalex100 Pengobatan risiko tinggi lainnya selain kemoterapi termasuk
antara lain radioterapi, \up0 \expndtw-3\charscalex100 KCl pekat, heparin, dsb.
\par\pard\qj \li1418\ri1178\sb64\sl-280\slmult0 \up0 \expndtw-2\charscalex100
Catatan: untuk standar PAP 3.3 s.d. PAP 3.9 maka elemen 1 s.d. 6 pada maksud dan
\up0 \expndtw-3\charscalex100 tujuan harus tercermin dalam kebijakan dan prosedur
yang disyaratkan. \par\pard\ql \li1521\sb0\sl-276\slmult0
\par\pard\ql\li1521\sb8\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN
DARAH \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb228\sl-
276\slmult0 \up0 \expndtw-7\charscalex100 Standar PAP 3.3 \par\pard\qj
\li1418\ri1330\sb21\sl-280\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Pelayanan darah dan produk darah dilaksanakan
sesuai dengan peraturan \up0 \expndtw-3\charscalex100 perundang-undangan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb108\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 3.3
\par\pard\qj \li1418\ri1224\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelayanan darah dan produk darah harus diberikan
sesuai dengan peraturan \up0 \expndtw-3\charscalex100 perundang-perundangan
meliputi antara lain \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb51\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 145
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg146}
{\bkmkend Pg146}\par\pard\ql \li2138\sb0\sl-276\slmult0 \par\pard\ql\li2138\sb0\sl-
276\slmult0 \par\pard\ql\li2138\sb0\sl-276\slmult0 \par\pard\ql\li2138\sb0\sl-
276\slmult0 \par\pard\ql\li2138\sb48\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1) pemberian persetujuan
(\ul0\nosupersub\cf8\f9\fs24 informed consent); \par\pard\ql \li2138\sb4\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2) pengadaan
darah; \par\pard\ql \li2138\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3)
identifikasi pasien; \par\pard\ql \li2138\sb4\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 4) pemberian darah; \par\pard\ql \li2138\sb4\sl-276\slmult0
\up0 \expndtw-2\charscalex100 5) monitoring pasien; \par\pard\ql \li2138\sb4\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 6) identifikasi dan respons terhadap
reaksi transfuse. \par\pard\qj \li1418\ri1226\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex102 Staf kompeten dan berwenang melaksanakan pelayanan darah
dan produk darah \up0 \expndtw-3\charscalex100 serta melakukan monitoring dan
evaluasi. \par\pard\ql \li1418\sb185\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 3.3
\par\pard\qj \li1778\ri1157\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pelayanan darah dan produk darah
meliputi butir 1 sampai dengan \line\tab \up0 \expndtw-4\charscalex100 6 pada
maksud dan tujuan. (lihat AP5.11 EP 2). (R) \par\pard\qj \li1778\ri1178\sb1\sl-
280\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Ada bukti pelaksanaan proses
meliputi butir 1) sampai dengan 6) pada maksud \line\tab \up0 \expndtw-
3\charscalex100 dan tujuan. (D,W) \par\pard\qj \li1778\ri1176\sb17\sl-
260\slmult0\tx2138 \up0 \expndtw-3\charscalex100 3. Ada bukti staf yang kompeten
dan berwenang melaksanakan pelayanan darah \line\tab \up0 \expndtw-3\charscalex100
dan produk darah serta melakukan monitoring dan evaluasi. (lihat AP 5.11, EP
\par\pard\ql \li2138\sb7\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1). (D,W)
\par\pard\ql \li1521\sb0\sl-276\slmult0 \par\pard\ql\li1521\sb248\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf19\f20\fs19 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN PASIEN KOMA DAN YANG MENGGUNAKAN
VENTILATOR \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PAP 3.4 \par\pard\qj
\li1418\ri1738\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi asuhan pasien yang
menggunakan alat bantu \up0 \expndtw-3\charscalex100 hidup dasar atau pasien
koma. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 3.4 \par\pard\ql \li1778\sb224\sl-
276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi asuhan
pasien alat bantu hidup dasar atau pasien koma. (R) \par\pard\qj
\li1778\ri1228\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Ada
bukti pelaksanaan asuhan pasien dengan alat bantu hidup sesuai dengan \line\tab
\up0 \expndtw-3\charscalex100 regulasi. (D,W). \par\pard\ql \li1778\sb4\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 3. Ada bukti pelaksanaan asuhan pasien
koma sesuai dengan regulasi. (D,W). \par\pard\qj \li1521\sb0\sl-280\slmult0
\par\pard\qj\li1521\ri1881\sb241\sl-280\slmult0\tx1881 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PELAYANAN PASIEN PENYAKIT MENULAR DAN PENURUNAN DAYA \line\tab \up0 \expndtw-
3\charscalex100 TAHAN (\ul0\nosupersub\cf16\f17\fs24 IMMUNO-
SUPPRESSED\ul0\nosupersub\cf6\f7\fs24 ) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PAP
3.5 \par\pard\qj \li1418\ri1523\sb43\sl-520\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Regulasi mengarahkan asuhan pasien
penyakit menular dan\ul0\nosupersub\cf8\f9\fs24 immuno-suppressed. \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 3.5
\par\pard\ql \li1778\sb182\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi suhan pasien penyakit menular
dan\ul0\nosupersub\cf8\f9\fs24 immuno-suppressed.\ul0\nosupersub\cf7\f8\fs24 (R).
\par\pard\qj \li1778\ri1221\sb1\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex100
2. Ada bukti pelaksanaan asuhan pasien penyakit menular sesuai dengan
\line\tab \up0 \expndtw-3\charscalex100 regulasi. (D,W). \par\pard\qj
\li1778\ri1221\sb1\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex103 3. Ada bukti
pelaksanaan asuhan pasien i\ul0\nosupersub\cf8\f9\fs24 mmuno-
suppressed\ul0\nosupersub\cf7\f8\fs24 sesuai dengan \line\tab \up0 \expndtw-
3\charscalex100 regulasi. (D,W). \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb104\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 146
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg147}
{\bkmkend Pg147}\par\pard\ql \li1521\sb0\sl-276\slmult0 \par\pard\ql\li1521\sb0\sl-
276\slmult0 \par\pard\ql\li1521\sb0\sl-276\slmult0 \par\pard\ql\li1521\sb0\sl-
276\slmult0 \par\pard\ql\li1521\sb0\sl-276\slmult0 \par\pard\ql\li1521\sb0\sl-
276\slmult0 \par\pard\ql\li1521\sb16\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PELAYANAN PASIEN DIALISIS \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb248\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PAP
3.6 \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Regulasi mengarahkan asuhan pasien dialisis (cuci
darah). \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 3.6 \par\pard\ql \li1778\sb244\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada
regulasi asuhan pasien dialisis. (R) \par\pard\ql \li1778\sb1\sl-256\slmult0
\up0 \expndtw-2\charscalex100 2. Ada bukti pelaksanaan asuhan pasien dialisis
sesuai dengan regulasi. (D,W). \par\pard\ql \li1778\sb8\sl-276\slmult0 \up0
\expndtw-3\charscalex100 3. Ada bukti dilakukan evaluasi kondisi pasien secara
berkala. (D,W) \par\pard\ql \li1521\sb0\sl-276\slmult0
\par\pard\ql\li1521\sb248\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN
PASIEN\ul0\nosupersub\cf16\f17\fs24 RESTRAIN \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb248\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAP 3.7 \par\pard\qj
\li1418\ri2054\sb23\sl-520\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan pelayanan penggunaan alat
penghalang (\ul0\nosupersub\cf8\f9\fs24
restraint\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 . \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 3.7
\par\pard\ql \li1778\sb202\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pelayanan penggunaan alat penghalang
(\ul0\nosupersub\cf8\f9\fs24 restraint\ul0\nosupersub\cf7\f8\fs24 ). (R).
\par\pard\qj \li1778\ri1218\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-2\charscalex100
2. Ada bukti pelaksanaan pelayanan penggunaan alat penghalang
(\ul0\nosupersub\cf8\f9\fs24 restraint\ul0\nosupersub\cf7\f8\fs24 ) \line\tab
\up0 \expndtw-3\charscalex100 sesuai dengan regulasi. (D,W) \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3. Ada bukti dilakukan
evaluasi pasien secara berkala. (D,W) \par\pard\ql \li1521\sb0\sl-276\slmult0
\par\pard\ql\li1521\sb0\sl-276\slmult0 \par\pard\ql\li1521\sb0\sl-276\slmult0
\par\pard\ql\li1521\sb196\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN
PASIEN POPULASI KHUSUS \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb248\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PAP
3.8 \par\pard\qj \li1418\ri1157\sb216\sl-310\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit memberikan pelayanan khusus
terhadap pasien usia lanjut, mereka yang \up0 \expndtw0\charscalex102 cacat, anak,
serta populasi yang berisiko disiksa dan risiko tinggi lainnya termasuk \up0
\expndtw-3\charscalex100 pasien dengan risiko bunuh diri. \par\pard\ql
\li1418\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 3.8 \par\pard\ql
\li1778\ri1160\sb241\sl-280\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pelayanan khusus terhadap pasien yang
lemah, lanjut usia, anak, \line\tab \up0 \expndtw-3\charscalex100 dan yang dengan
ketergantungan bantuan, serta populasi yang berisiko disiksa \line \tab \up0
\expndtw-3\charscalex100 dan risiko tinggi lainnya termasuk pasien dengan risiko
bunuh diri. (R) \par\pard\qj \li1778\ri1221\sb0\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex100 2. Ada bukti pelaksanaan asuhan pasien yang lemah dan
lanjut usia yang tidak \line\tab \up0 \expndtw-3\charscalex100 mandiri menerima
asuhan sesuai dengan regulasi. (D,W) \par\pard\qj \li1778\ri1224\sb0\sl-
280\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3. Ada bukti pelaksanaan asuhan
pasien anak dan anak dengan ketergantungan \line\tab \up0 \expndtw-2\charscalex100
sesuai dengan regulasi. (D,W) \par\pard\ql \li1778\sb1\sl-258\slmult0 \up0
\expndtw0\charscalex102 4. Ada bukti pelaksanaan asuhan terhadap populasi
pasien dengan risiko \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb34\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 147
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg148}
{\bkmkend Pg148}\par\pard\qj \li2138\sb0\sl-260\slmult0 \par\pard\qj\li2138\sb0\sl-
260\slmult0 \par\pard\qj\li2138\sb0\sl-260\slmult0 \par\pard\qj\li2138\sb0\sl-
260\slmult0 \par\pard\qj\li2138\ri1223\sb146\sl-260\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 kekerasan dan risiko tinggi
lainnya termasuk pasien dengan risiko bunuh diri \up0 \expndtw-3\charscalex100
sesuai dengan regulasi. (D,W) \par\pard\qj \li1521\sb0\sl-280\slmult0
\par\pard\qj\li1521\ri1220\sb244\sl-280\slmult0\tx1881 \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN
PASIEN KEMOTERAPI DAN TERAPI LAIN YANG BERISIKO \line\tab \up0 \expndtw-
3\charscalex100 TINGGI \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb248\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PP
3.9 \par\pard\qj \li1418\ri1213\sb188\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit memberikan
pelayanan khusus terhadap pasien yang mendapat \up0 \expndtw0\charscalex100
kemoterapi atau pelayanan lain yang berisiko tinggi (misalnya terapi hiperbarik dan
\up0 \expndtw-3\charscalex100 pelayanan radiologi intervensi). \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PP 3.9 \par\pard\qj
\li1778\ri1472\sb241\sl-280\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pelayanan khusus terhadap pasien yang
mendapat kemoterapi \line\tab \up0 \expndtw-3\charscalex100 atau pelayanan lain
yang berisiko tinggi. (R) \par\pard\qj \li1778\ri1456\sb17\sl-260\slmult0\tx2138
\up0 \expndtw-2\charscalex100 2. Ada bukti pelaksanaan pelayanan pasien yang
mendapat kemoterapi sesuai \line\tab \up0 \expndtw-3\charscalex100 dengan regulasi.
(D,W) \par\pard\qj \li1778\ri1380\sb4\sl-280\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 3. Ada bukti pelaksanaan pelayanan risiko tinggi lain (misalnya
terapi hiperbarik \line\tab \up0 \expndtw-3\charscalex100 dan pelayanan radiologi
intervensi) sesuai dengan regulasi. (D,W) \par\pard\ql \li1521\sb0\sl-
276\slmult0 \par\pard\ql\li1521\sb248\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24
MAKANAN DAN TERAPI GIZI \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb248\sl-276\slmult0 \up0 \expndtw-6\charscalex100 Standar PAP
4 \par\pard\qj \li1418\ri1455\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Tersedia berbagai pilihan makanan sesuai dengan status
gizi pasien dan konsisten \up0 \expndtw-3\charscalex100 dengan asuhan klinisnya.
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 4 \par\pard\qj
\li1418\ri1219\sb0\sl-316\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Makanan dan nutrisi yang sesuai sangat penting
bagi kesehatan pasien dan \up0 \expndtw0\charscalex100 penyembuhannya. Pilihan
makanan disesuaikan dengan usia, budaya, pilihan, \up0 \expndtw0\charscalex104
rencana asuhan, diagnosis pasien termasuk juga antara lain diet khusus seperti
\up0 \expndtw0\charscalex100 rendah kolesterol dan diet diabetes melitus. Berdasar
atas asesmen kebutuhan dan \up0 \expndtw0\charscalex100 rencana asuhan maka DPJP
atau PPA lain yang kompeten memesan makanan dan \up0 \expndtw-3\charscalex100
nutrisi lainnya untuk pasien. (lihat PAP 1.4) \par\pard\qj \li1418\ri1166\sb172\sl-
320\slmult0 \up0 \expndtw0\charscalex104 Pasien berhak menentukan makanan
sesuai dengan nilai yang dianut. Bila \line \up0 \expndtw-3\charscalex100
memungkinkan pasien ditawarkan pilihan makanan yang konsisten dengan status
gizi. \par\pard\qj \li1418\ri1161\sb205\sl-315\slmult0 \up0 \expndtw-
3\charscalex100 Jika keluarga pasien atau ada orang lain mau membawa makanan untuk
pasien maka \line \up0 \expndtw0\charscalex100 kepada mereka diberikan edukasi
tentang makanan yang merupakan kontraindikasi \line \up0 \expndtw0\charscalex103
terhadap rencana, kebersihan (\ul0\nosupersub\cf8\f9\fs24
hygiene\ul0\nosupersub\cf7\f8\fs24 ) makanan dan kebutuhan asuhan pasien \line \up0
\expndtw-2\charscalex100 termasuk informasi terkait interaksi antara obat dan
makanan. Makanan yang dibawa \line \up0 \expndtw-2\charscalex100 oleh keluarga atau
orang lain disimpan dengan benar untuk mencegah kontaminasi. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb231\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 148
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg149}
{\bkmkend Pg149}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 4 \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi yang berkaitan
dengan pelayanan gizi. (R) \par\pard\qj \li1778\ri1329\sb1\sl-
280\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Rumah sakit menyediakan
makanan sesuai dengan kebutuhan pasien. \line\tab \up0 \expndtw-3\charscalex100
(D,O,W) \par\pard\qj \li1778\ri1324\sb21\sl-280\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 3. Ada bukti proses pemesanan makanan pasien sesuai dengan status
gizi dan \line\tab \up0 \expndtw-3\charscalex100 kebutuhan pasien serta dicatat di
rekam medis. (D,W) \par\pard\qj \li1778\ri1320\sb21\sl-280\slmult0\tx2138 \up0
\expndtw-2\charscalex100 4. Makanan disiapkan dan disimpan dengan mengurangi
risiko kontaminasi dan \line\tab \up0 \expndtw-3\charscalex100 pembusukan. (O,W)
\par\pard\qj \li1778\ri1329\sb21\sl-280\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 5. Distribusi makanan dilaksanakan tepat waktu sesuai dengan
kebutuhan. \line\tab \up0 \expndtw-2\charscalex100 (D,O,W) \par\pard\ql
\li1778\ri1305\sb12\sl-290\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 6.
Jika keluarga membawa makanan bagi pasien, mereka diberi edukasi tentang
\line\tab \up0 \expndtw0\charscalex102 pembatasan diet pasien dan risiko
kontaminasi serta pembusukan sesuai \line \tab \up0 \expndtw-3\charscalex100
dengan regulasi. (D,O,W,S) \par\pard\qj \li1778\ri1384\sb0\sl-300\slmult0\tx2138
\up0 \expndtw-2\charscalex100 7. Makanan yang dibawa keluarga atau orang lain
disimpan secara benar untuk \line\tab \up0 \expndtw-3\charscalex100 mencegah
kontaminasi. (D,O,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb66\sl-276\slmult0 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PAP 5 \par\pard\ql \li1418\sb4\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien dengan
risiko nutrisi menerima terapi gizi terintegrasi. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb32\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PAP 5 \par\pard\qj \li1418\ri1161\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien pada asesmen awal
diskrining untuk risiko nutrisi. (Lihat AP 1.4). Pasien ini \up0 \expndtw-
3\charscalex100 dikonsultasikan ke ahli gizi untuk dilakukan asesmen lebih lanjut.
Jika ditemukan risiko \up0 \expndtw-1\charscalex100 nutrisi maka dibuat rencana
terapi gizi dan dilaksanakan. Kemajuan keadaan pasien \up0 \expndtw0\charscalex100
dimonitor dan dicatat di rekam medis pasien. DPJP, perawat, ahli gizi, dan keluarga
\up0 \expndtw-3\charscalex100 pasien bekerjasama dalam konteks asuhan gizi
terintegrasi. \par\pard\ql \li1418\sb185\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 5 \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi untuk terapi gizi
terintegrasi. (R) \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 2. Ada bukti pemberian terapi gizi terintegrasi pada pasien risiko
nutrisi. (D,W) \par\pard\qj \li1778\ri1171\sb18\sl-260\slmult0\tx2138 \up0
\expndtw-3\charscalex100 3. Asuhan gizi terintegrasi mencakup rencana, pemberian,
dan monitor terapi gizi. \line\tab \up0 \expndtw-4\charscalex100 (D,W) \par\pard\qj
\li1778\ri1227\sb4\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Evaluasi
dan monitoring terapi gizi dicatat di rekam medis pasien. (lihat AP 2 \line\tab
\up0 \expndtw-3\charscalex100 EP 1). (D) \par\pard\ql \li1562\sb0\sl-276\slmult0
\par\pard\ql\li1562\sb248\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PENGELOLAAN
NYERI \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-
276\slmult0 \up0 \expndtw-6\charscalex100 Standar PAP 6 \par\pard\ql
\li1418\sb64\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan pelayanan pasien untuk mengatasi
nyeri. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb128\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PAP 6 \par\pard\qj \li1418\ri1226\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Nyeri dapat diakibatkan oleh
kondisi, penyakit pasien, tindakan, atau pemeriksaan \line \up0
\expndtw0\charscalex100 yang dilakukan. Sebagai bagian dari rencana asuhan maka
pasien diberi informasi \line \up0 \expndtw0\charscalex100 tentang kemungkinan
timbul nyeri akibat tindakan, atau prosedur pemeriksaan, dan \line \up0 \expndtw-
1\charscalex100 pasien diberitahu pilihan yang tersedia untuk mengatasi nyeri.
Apapun yang menjadi \line \up0 \expndtw-1\charscalex100 sebab timbulnya nyeri jika
tidak dapat diatasi akan berpengaruh secara fisik maupun \par\pard\ql
\li10156\sb124\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 149
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg150}
{\bkmkend Pg150}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1166\sb253\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 psikologis. Pasien dengan nyeri dilakukan asesmen dan
pelayanan untuk mengatasi \up0 \expndtw-4\charscalex100 nyeri dengan tepat. (lihat
HPK 2.2 dan PAP 1.5) \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1225\sb84\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Berdasar atas cakupan asuhan yg diberikan
maka rumah sakit menetapkan proses \line \up0 \expndtw-2\charscalex100 untuk
melakukan skrining, asesmen, dan pelayanan untuk mengatasi nyeri meliputi
\par\pard\ql \li1778\sb257\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 identifikasi
pasien untuk rasa nyeri pada asesmen awal dan asesmen ulang; \par\pard\qj
\li1778\ri1168\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 memberi
informasi kepada pasien bahwa nyeri dapat disebabkan oleh tindakan \line\tab
\up0 \expndtw-5\charscalex100 atau pemeriksaan; \par\pard\qj
\li1778\ri1223\sb37\sl-260\slmult0\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 melaksanakan
pelayanan untuk mengatasi nyeri terlepas dari mana nyeri itu \line\tab \up0
\expndtw-5\charscalex100 berasal; \par\pard\ql \li1778\ri1216\sb24\sl-
280\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 melakukan
komunikasi dan edukasi kepada pasien dan keluarga perihal \line\tab
\up0 \expndtw-3\charscalex100 pelayanan untuk mengatasi nyeri sesuai dengan
latar belakang agama, \line \tab \up0 \expndtw-4\charscalex100 budaya, nilai-
nilai pasien, dan keluarga; \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
melatih PPA tentang asesmen dan pelayanan untuk mengatasi nyeri. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 6 \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi pelayanan pasien
untuk mengatasi
nyeri. (R) \par\pard\qj \li1778\ri1219\sb38\sl-260\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 2. Pasien nyeri menerima pelayanan untuk mengatasi nyeri
sesuai dengan \line\tab \up0 \expndtw-5\charscalex100 kebutuhan. (D,W)
\par\pard\ql \li1778\ri1219\sb32\sl-270\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 3. Pasien dan keluarga diberikan edukasi tentang pelayanan
untuk mengatasi \line\tab \up0 \expndtw0\charscalex100 nyeri sesuai dengan latar
belakang agama, budaya, nilai-nilai pasien, dan \line \tab \up0 \expndtw-
5\charscalex100 keluarga. (D,W) \par\pard\ql \li1778\ri1226\sb31\sl-
270\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 4. Pasien dan keluarga
diberikan edukasi tentang kemungkinan timbulnya nyeri \line\tab \up0 \expndtw-
3\charscalex100 akibat tindakan yang terencana, prosedur pemeriksaan, dan
pilihan yang \line \tab \up0 \expndtw-4\charscalex100 tersedia untuk mengatasi
nyeri. (D,W,S) \par\pard\qj \li1778\ri1218\sb39\sl-260\slmult0\tx2138 \up0
\expndtw-1\charscalex100 5. Rumah sakit melaksanakan pelatihan pelayanan mengatasi
nyeri untuk staf. \line\tab \up0 \expndtw-4\charscalex100 (D,W) \par\pard\ql
\li1562\sb0\sl-276\slmult0 \par\pard\ql\li1562\sb271\sl-276\slmult0 \up0 \expndtw-
7\charscalex100 \ul0\nosupersub\cf19\f20\fs19 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PELAYANAN DALAM TAHAP TERMINAL \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-6\charscalex100 Standar PAP 7
\par\pard\qj \li1418\ri1398\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Dilakukan asesmen dan asesmen ulang terhadap pasien
dalam tahap terminal dan \up0 \expndtw-3\charscalex100 keluarganya sesuai dengan
kebutuhan mereka. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb153\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP
7 \par\pard\qj \li1418\ri1164\sb89\sl-270\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asesmen dan asesmen ulang bersifat individual agar
sesuai dengan kebutuhan pasien \up0 \expndtw0\charscalex100 dalam tahap terminal
(\ul0\nosupersub\cf8\f9\fs24 dying\ul0\nosupersub\cf7\f8\fs24 ) dan keluarganya.
Asesmen dan asesmen ulang harus \up0 \expndtw-3\charscalex100 menilai kondisi
pasien seperti \par\pard\ql \li1778\sb86\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 a) gejala mual dan kesulitan pernapasan; \par\pard\ql
\li1778\sb64\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b) faktor yang
memperparah gejala fisik; \par\pard\ql \li1778\sb64\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 c) manajemen gejala sekarang dan respons pasien; \par\pard\ql
\li1778\sb64\sl-276\slmult0 \up0 \expndtw-1\charscalex100 d) orientasi spiritual
pasien dan keluarga serta keterlibatan dalam kelompok \par\pard\ql
\li10156\sb203\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 150
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg151}
{\bkmkend Pg151}\par\pard\ql \li2138\sb0\sl-276\slmult0 \par\pard\ql\li2138\sb0\sl-
276\slmult0 \par\pard\ql\li2138\sb0\sl-276\slmult0 \par\pard\ql\li2138\sb0\sl-
276\slmult0 \par\pard\ql\li2138\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 agama tertentu; \par\pard\qj
\li1778\ri1230\sb78\sl-260\slmult0\tx2138 \up0 \expndtw-1\charscalex100 e)
keprihatinan spiritual pasien dan keluarga seperti putus asa, penderitaan, dan
\line\tab \up0 \expndtw-3\charscalex100 rasa bersalah; \par\pard\ql
\li1778\ri1166\sb92\sl-270\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 f)
status psikososial pasien dan keluarganya seperti kekerabatan, kelayakan
\line\tab \up0 \expndtw-3\charscalex100 perumahan, pemeliharaan lingkungan, cara
mengatasi, serta reaksi pasien dan \line \tab \up0 \expndtw-4\charscalex100
keluarganya menghadapi penyakit; \par\pard\ql \li1778\sb86\sl-276\slmult0 \up0
\expndtw-2\charscalex100 g) kebutuhan bantuan atau penundaan layanan untuk pasien
dan keluarganya; \par\pard\ql \li1778\sb64\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 h) Kebutuhan alternatif layanan atau tingkat layanan; \par\pard\qj
\li1778\ri1223\sb61\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex104 i) Faktor
risiko bagi yang ditinggalkan dalam hal cara mengatasi dan potensi \line\tab
\up0 \expndtw-3\charscalex100 reaksi patologis atas kesedihan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb128\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAP 7 \par\pard\qj
\li1778\ri1324\sb1\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi asesmen awal dan ulang pasien dalam
tahap terminal meliputi \line\tab \up0 \expndtw-3\charscalex100 butir 1 sampai
dengan 9 pada maksud dan tujuan. (R) \par\pard\qj \li1778\ri1328\sb1\sl-
280\slmult0\tx2138 \up0 \expndtw0\charscalex103 2. Ada bukti skrining dilakukan
pada pasien yang diputuskan dengan kondisi \line\tab \up0 \expndtw-3\charscalex100
harapan hidup yang kecil sesuai dengan regulasi. (D,W) \par\pard\qj
\li1778\ri1330\sb17\sl-260\slmult0\tx2138 \up0 \expndtw0\charscalex102 3. Pasien
dalam tahap terminal dilakukan asesmen awal dan asesmen ulang. \line\tab \up0
\expndtw-2\charscalex100 (D,W) \par\pard\ql \li1778\sb27\sl-276\slmult0 \up0
\expndtw-3\charscalex100 4. Hasil asesmen menentukan asuhan dan layanan yang
diberikan. (D,W) \par\pard\qj \li1778\ri1329\sb18\sl-260\slmult0\tx2138 \up0
\expndtw0\charscalex102 5. Asuhan dalam tahap terminal memperhatikan rasa nyeri
pasien. (lihat juga \line\tab \up0 \expndtw-3\charscalex100 HPK 2.2). (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb15\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PAP 7.1 \par\pard\qj \li1418\ri1320\sb1\sl-
280\slmult0 \up0 \expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
memberikan pelayanan pasien dalam tahap terminal dengan \up0 \expndtw-
2\charscalex100 memperhatikan kebutuhan pasien dan keluarga serta mengoptimalkan
kenyamanan \up0 \expndtw-3\charscalex100 dan martabat pasien yang didokumentasikan
dalam rekam medis. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAP 7.1 \par\pard\qj
\li1418\ri1317\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien dalam tahap terminal membutuhkan asuhan dengan
rasa hormat dan empati \up0 \expndtw-1\charscalex100 yang terungkap dalam asesmen
(lihat PAP 1.7). Untuk melaksanakan ini, staf diberi \up0 \expndtw0\charscalex100
pemahaman tentang kebutuhan pasien yang unik saat dalam tahap terminal.
\up0 \expndtw0\charscalex100 Kepedulian staf terhadap kenyamanan dan
kehormatan pasien harus menjadi \up0 \expndtw-2\charscalex100 prioritas semua
aspek asuhan pasien selama pasien berada dalam tahap terminal. \line \up0 \expndtw-
2\charscalex100 Rumah sakit menetapkan proses untuk mengelola asuhan pasien
dalam tahap \up0 \expndtw-3\charscalex100 terminal. Proses ini meliputi
\par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a)
intervensi pelayanan pasien untuk mengatasi nyeri; \par\pard\qj
\li1778\ri1326\sb1\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex100 b)
memberikan pengobatan sesuai dengan gejala dan mempertimbangkan \line\tab
\up0 \expndtw-3\charscalex100 keinginan pasien dan keluarga; \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c) menyampaikan secara
hati-hati soal sensitif seperti autopsi atau donasi organ; \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) menghormati nilai,
agama, serta budaya pasien dan keluarga; \par\pard\ql \li1778\sb4\sl-276\slmult0
\up0 \expndtw-3\charscalex100 e) mengajak pasien dan keluarga dalam semua aspek
asuhan; \par\pard\qj \li1778\ri1327\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 f) memperhatikan keprihatinan psikologis, emosional,
spiritual, serta budaya \line\tab \up0 \expndtw-2\charscalex100 pasien dan
keluarga. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PAP 7.1 \par\pard\qj \li1778\ri1328\sb1\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
regulasi pelayanan pasien dalam tahap terminal \line\tab \up0 \expndtw-
3\charscalex100 meliputi butir 1 sampai dengan 6 pada maksud dan tujuan. (R)
\par\pard\ql \li10156\sb223\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 151
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg152}
{\bkmkend Pg152}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Staf diedukasi tentang kebutuhan
unik pasien dalam tahap terminal. (D,W) \par\pard\qj \li1778\ri1328\sb18\sl-
260\slmult0\tx2138 \up0 \expndtw0\charscalex100 3. Pelayanan pasien dalam tahap
terminal memperhatikan gejala, kondisi, dan \line\tab \up0 \expndtw-3\charscalex100
kebutuhan kesehatan atas hasil asesmen. (lihat PAP 1.7 EP 1). (D, W)
\par\pard\qj \li1778\ri1298\sb4\sl-280\slmult0\tx2138 \up0 \expndtw-2\charscalex100
4. Pelayanan pasien dalam tahap terminal memperhaikan upaya mengatasi rasa
\line\tab \up0 \expndtw-3\charscalex100 nyeri pasien. (lihat juga HPK 2.2).
(D,W) \par\pard\qj \li1778\ri1319\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 5. Pelayanan pasien dalam tahap terminal memperhatikan kebutuhan
biopsiko-\line\tab \up0 \expndtw-3\charscalex100
sosial, emosional, budaya, dan spiritual. (D,W) \par\pard\qj
\li1778\ri1331\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-2\charscalex100 6. Pasien
dan keluarga dilibatkan dalam keputusan asuhan termasuk keputusan \line\tab \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 do not
resuscitate/\ul0\nosupersub\cf7\f8\fs24 DNR. (lihat juga HPK 2). (D,W) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb25\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 152
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg153}
{\bkmkend Pg153}\par\pard\ql \li5608\sb0\sl-276\slmult0 \par\pard\ql\li5608\sb0\sl-
276\slmult0 \par\pard\ql\li5608\sb0\sl-276\slmult0 \par\pard\ql\li5608\sb0\sl-
276\slmult0 \par\pard\ql\li5608\sb68\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf17\f18\fs24 BAB 5 \par\pard\ql \li3784\sb44\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 PELAYANAN ANESTESI DAN BEDAH \par\pard\ql
\li5618\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 (PAB) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb236\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Gambaran Umum
\par\pard\qj \li1418\sb0\sl-260\slmult0 \par\pard\qj\li1418\ri1217\sb38\sl-
260\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Tindakan
anestesi, sedasi, dan intervensi bedah merupakan proses yang kompleks \up0
\expndtw-3\charscalex100 dan sering dilaksanakan di rumah sakit. Hal tersebut
memerlukan \par\pard\ql \li1778\sb7\sl-276\slmult0 \up0 \expndtw-3\charscalex100 1)
asesmen pasien yang lengkap dan menyeluruh; \par\pard\ql \li1778\sb4\sl-276\slmult0
\up0 \expndtw-3\charscalex100 2) perencanaan asuhan yang terintegrasi;
\par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3)
pemantauan yang terus menerus; \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0
\expndtw-3\charscalex100 4) transfer ke ruang perawatan berdasar atas kriteria
tertentu; \par\pard\ql \li1778\sb1\sl-256\slmult0 \up0 \expndtw-2\charscalex100 5)
rehabilitasi; \par\pard\ql \li1778\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100
6) transfer ke ruangan perawatan dan pemulangan. \par\pard\qj \li1418\sb0\sl-
276\slmult0 \par\pard\qj\li1418\ri1155\sb8\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 Anestesi dan sedasi umumnya merupakan suatu rangkaian proses yang
dimulai dari \up0 \expndtw0\charscalex100 sedasi minimal hingga anastesi penuh.
Oleh karena respons pasien dapat berubah\up0 \expndtw-2\charscalex100 ubah
sepanjang berlangsungnya rangkaian tersebut maka penggunaan anestesi dan \up0
\expndtw-3\charscalex100 sedasi diatur secara terpadu. Dalam bab ini dibahas
anestesi serta sedasi sedang dan \up0 \expndtw0\charscalex102 dalam yang keadaan
ketiganya berpotensi membahayakan refleks protektif pasien \up0 \expndtw-
3\charscalex100 terhadap fungsi pernapasan. Dalam bab ini tidak dibahas penggunaan
sedasi minimal \up0 \expndtw-4\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
anxiolysis\ul0\nosupersub\cf7\f8\fs24 ) atau penggunaan sedasi untuk penggunaan
ventilator. \par\pard\qj \li1418\ri1214\sb261\sl-280\slmult0 \up0
\expndtw0\charscalex102 Karena tindakan bedah juga merupakan tindakan yang berisiko
tinggi maka harus \up0 \expndtw-2\charscalex100 direncanakan dan dilaksanakan
secara hati-hati. Rencana prosedur operasi dan \up0 \expndtw-3\charscalex100
asuhan pascaoperasi dibuat berdasar atas asesmen dan didokumentasikan. \par\pard\qj
\li1418\ri1156\sb264\sl-276\slmult0 \up0 \expndtw0\charscalex100 Standar pelayanan
anestesi dan bedah berlaku di area manapun dalam rumah sakit \up0 \expndtw-
2\charscalex100 yang menggunakan anestesi, sedasi sedang dan dalam, dan
juga pada tempat \up0 \expndtw0\charscalex100 dilaksanakannya prosedur
pembedahan dan tindakan invasif lainnya yang \up0 \expndtw-
3\charscalex100 membutuhkan persetujuan tertulis (\ul0\nosupersub\cf8\f9\fs24
informed consent\ul0\nosupersub\cf7\f8\fs24 ) (lihat HPK.6.4). Area ini meliputi
\up0 \expndtw0\charscalex104 ruang operasi rumah sakit, rawat sehari, klinik gigi,
klinik rawat jalan, endoskopi, \up0 \expndtw-3\charscalex100 radiologi, gawat
darurat, perawatan intensif, dan tempat lainnya. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb48\sl-276\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf23\f24\fs24 \u10070?\ul0\nosupersub\cf17\f18\fs24 ORGANISASI DAN
MANAJEMEN \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-
276\slmult0 \up0 \expndtw0\charscalex101 Standar PAB 1 \par\pard\qj
\li1418\ri1223\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyediakan pelayanan anestesi (termasuk
sedasi sedang dan dalam) \up0 \expndtw0\charscalex103 untuk memenuhi kebutuhan
pasien dan pelayanan tersebut memenuhi peraturan \up0 \expndtw-3\charscalex100
perundang-undangan serta standar profesi. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb151\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 153
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg154}
{\bkmkend Pg154}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Maksud dan Tujuan PAB 1
\par\pard\qj \li1418\ri1161\sb188\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Sedasi dan anestesi biasanya diartikan sebagai satu
jalur layanan berkesinambungan \line \up0 \expndtw-2\charscalex100 dari sedasi
minimal sampai anestesi dalam. Respons pasien bergerak mengikuti jalur \line
\up0 \expndtw-4\charscalex100 ini dan selama menjalani perjalanan ini pasien
menghadapi risiko pada refleks protektif \line \up0 \expndtw0\charscalex103 jalan
napas pasien. Sedasi dan anestesi adalah proses kompleks sehingga harus \line
\up0 \expndtw0\charscalex102 diintegrasikan ke dalam rencana asuhan. Sedasi
dan anestesi membutuhkan \line \up0 \expndtw-2\charscalex100 asesmen lengkap dan
komprehensif serta monitoring pasien terus menerus. \par\pard\qj
\li1418\ri1158\sb206\sl-313\slmult0 \up0 \expndtw-4\charscalex100 Rumah sakit
mempunyai suatu sistem untuk pelayanan anestesi, serta sedasi moderat \up0
\expndtw-1\charscalex100 dan dalam untuk melayani kebutuhan pasien, kebutuhan
pelayanan klinis yang \up0 \expndtw0\charscalex100 ditawarkan, serta kebutuhan
para PPA yang memenuhi peraturan perundang\up0 \expndtw-3\charscalex100
undangan dan standar profesi. \par\pard\ql \li1418\sb238\sl-276\slmult0\tx7748 \up0
\expndtw-1\charscalex100 Pelayanan anestesi, serta sedasi moderat dan
dalam \tab \up0 \expndtw-1\charscalex100 (termasuk layanan yang \par\pard\ql
\li1418\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 diperlukan untuk
kegawatdaruratan) tersedia 24 jam. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Elemen Penilaian PAB
1 \par\pard\ql \li1778\ri1358\sb0\sl-290\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf18\f19\fs24 1. Rumah sakit menetapkan regulasi
pelayanan anestesi, serta sedasi moderat \line\tab \up0 \expndtw-1\charscalex100
dan dalam yang memenuhi standar profesi serta peraturan perundang-\line
\tab \up0 \expndtw-4\charscalex100 undangan. (R) \par\pard\qj
\li1778\ri1322\sb0\sl-280\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2.
Pelayanan anestesi, serta sedasi moderat dan dalam yang adekuat, regular, \line\tab
\up0 \expndtw-5\charscalex100 dan nyaman tersedia untuk memenuhi kebutuhan pasien,
(O,W) \par\pard\qj \li1778\ri1319\sb0\sl-300\slmult0\tx2138 \up0 \expndtw-
3\charscalex100
3. Pelayanan anestesi, serta sedasi moderat dan dalam (termasuk layanan yang
\line\tab \up0 \expndtw-4\charscalex100 diperlukan untuk kegawatdaruratan) tersedia
24 jam. (O,W) \par\pard\ql \li1418\sb276\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 2 \par\pard\qj
\li1418\ri1163\sb221\sl-280\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ada staf medis anestesi yang kompeten dan berwenang,
bertanggung jawab untuk \up0 \expndtw-4\charscalex100 mengelola pelayanan anestesi,
serta sedasi moderat dan dalam. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf17\f18\fs24 Maksud dan Tujuan PAB 2 \par\pard\qj
\li1418\ri1319\sb0\sl-290\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelayanan anestesi, serta sedasi moderat dan dalam
berada di bawah penanggung \line \up0 \expndtw0\charscalex104 jawab pelayanan
anestesi yang memenuhi peraturan perundang-undangan. \line \up0 \expndtw-
2\charscalex100 Tanggung jawab pelayanan anestesi, serta sedasi moderat dan dalam
meliputi \par\pard\ql \li1778\sb15\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a)
mengembangkan, menerapkan, dan menjaga regulasi; \par\pard\ql \li1778\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 b) melakukan pengawasan
administratif; \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 c) menjalankan program pengendalian mutu yang dibutuhkan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf17\f18\fs24
Elemen\ul0\nosupersub\cf6\f7\fs24 Penilaian PAB 2 \par\pard\ql
\li1778\ri1218\sb214\sl-313\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rumah sakit
yang mengatur pelayanan anestesi, serta sedasi \line\tab \up0
\expndtw0\charscalex102 moderat dan dalam seragam di seluruh rumah sakit (lihat PAP
1. EP 1) dan \line \tab \up0 \expndtw0\charscalex102 berada di bawah tanggung
jawab seorang dokter anestesi sesuai dengan \line \tab \up0 \expndtw-
3\charscalex100 peraturan perundangan. (lihat TKRS 5). (R) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb164\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 154
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg155}
{\bkmkend Pg155}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1227\sb214\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Ada bukti penanggung jawab
pelayanan anestesi untuk mengembangkan, \line\tab \up0 \expndtw0\charscalex102
melaksanakan, dan menjaga regulasi seperti butir 1 sampai dengan 4 pada \line
\tab \up0 \expndtw-3\charscalex100 maksud dan tujuan. (DW) \par\pard\ql
\li1778\sb39\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. Ada bukti penanggung
jawab menjalankan program pengendalian mutu. (DW). \par\pard\qj
\li1778\ri1158\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 4. Ada
bukti pelaksanaan supervisi dan evaluasi pelaksanaan pelayanan \line\tab \up0
\expndtw-3\charscalex100 anestesi, serta sedasi moderat dan dalam di seluruh
rumah sakit. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PAB 2.1 \par\pard\qj \li1418\ri1157\sb25\sl-
300\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Program mutu
dan keselamatan pasien pada pelayanan anestesi, serta sedasi moderat \up0 \expndtw-
5\charscalex100 dan dalam dilaksanakan dan didokumentasikan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb128\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan Standar 2.1 \par\pard\qj
\li1418\ri1318\sb235\sl-288\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Pelayanan anestesi, serta sedasi moderat dan dalam
merupakan tindakan yang \up0 \expndtw0\charscalex100 berisiko, oleh karena itu
perencanaan dan pelaksanaannya membutuhkan tingkat \up0 \expndtw0\charscalex104
kehati-hatian dan akurasi tinggi. Berhubungan dengan hal itu maka rumah sakit
\up0 \expndtw-2\charscalex100 menetapkan program mutu dan keselamatan pasien pada
pelayanan anestesi, serta \up0 \expndtw-1\charscalex100 sedasi moderat dan dalam
merupakan bagian dari program mutu dan keselamatan \up0 \expndtw-5\charscalex100
pasien, tetapi tidak terbatas pada \par\pard\ql \li1958\sb42\sl-276\slmult0 \up0
\expndtw-4\charscalex100 a) pelaksanaan asesmen prasedasi dan pra-anestesi;
\par\pard\ql \li1958\sb44\sl-276\slmult0 \up0 \expndtw-5\charscalex100 b) proses
monitoring status fisiologis selama anestesi; \par\pard\ql \li1958\sb44\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 c) proses monitoring proses pemulihan
anestesi dan sedasi dalam; \par\pard\ql \li1958\sb44\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 d) evaluasi ulang bila terjadi konversi tindakan dari
lokal/regional ke general. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 2.1 \par\pard\qj
\li1778\ri1320\sb205\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan program mutu dan
keselamatan pasien dalam \line\tab \up0 \expndtw-4\charscalex100 pelayanan
anestesi, serta sedasi moderat dan dalam. (lihat PMKP 2.1). (R) \par\pard\qj
\li1778\ri1356\sb37\sl-280\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2. Ada
bukti monitoring dan evaluasi pelaksanaan asesmen prasedasi dan pra-\line\tab
\up0 \expndtw-4\charscalex100 anestesi. (D,W) \par\pard\qj \li1778\ri1360\sb24\sl-
300\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3. Ada bukti monitoring dan
evaluasi proses monitoring status fisiologis selama \line\tab \up0 \expndtw-
4\charscalex100 anestesi. (D,W) \par\pard\qj \li1778\ri1325\sb37\sl-
280\slmult0\tx2138 \up0 \expndtw-1\charscalex100 4. Ada bukti monitoring dan
evaluasi proses monitoring serta proses pemulihan \line\tab \up0 \expndtw-
5\charscalex100 anestesi dan sedasi dalam. (D,W) \par\pard\qj
\li1778\ri1319\sb41\sl-280\slmult0\tx2138 \up0 \expndtw-3\charscalex100 5. Ada
bukti monitoring dan evaluasi evaluasi ulang bila terjadi konversi tindakan
\line\tab \up0 \expndtw-4\charscalex100 dari lokal/regional ke general. (D,W)
\par\pard\ql \li1778\ri1318\sb61\sl-280\slmult0\tx2138\tx2138 \up0 \expndtw-
4\charscalex100 6. Ada bukti pelaksanaan program mutu dan keselamatan pasien dalam
anestesi, \line\tab \up0 \expndtw0\charscalex100 serta sedasi moderat dan dalam
yang diintegrasikan dengan program mutu \line \tab \up0 \expndtw-5\charscalex100
rumah sakit. (lihat PMKP 2.1). (D,W) \par\pard\ql \li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb268\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN
SEDASI \par\pard\ql \li1418\sb224\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf17\f18\fs24 Standar PAB 3 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb24\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 155
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg156}
{\bkmkend Pg156}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1226\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pemberian sedasi moderat dan dalam dilakukan
sesuai dengan regulasi yang \up0 \expndtw-3\charscalex100 ditetapkan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb208\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 3 \par\pard\qj
\li1418\ri1178\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Prosedur pemberian sedasi moderat dan dalam yang
diberikan secara intravena tidak \up0 \expndtw-4\charscalex100 bergantung pada
berapa dosisnya. \par\pard\qj \li1418\ri1186\sb205\sl-315\slmult0 \up0 \expndtw-
2\charscalex100 Prosedur pemberian sedasi dilakukan seragam di tempat pelayanan di
dalam rumah \line \up0 \expndtw0\charscalex103 sakit termasuk unit di luar kamar
operasi oleh karena prosedur pemberian sedasi \line \up0 \expndtw-2\charscalex100
seperti layaknya anestesi mengandung risiko potensial pada pasien.
Pemberian \line \up0 \expndtw0\charscalex100 sedasi pada pasien harus dilakukan
seragam dan sama di semua tempat di rumah \line \up0 \expndtw-3\charscalex100
sakit. \par\pard\ql \li1418\sb238\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Pelayanan sedasi yang seragam meliputi \par\pard\ql \li1778\sb244\sl-276\slmult0
\up0 \expndtw-3\charscalex100 a) kualifikasi staf yang memberikan sedasi;
\par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b) peralatan
medis yang digunakan; \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 c) bahan yang dipakai; dan \par\pard\ql \li1778\sb1\sl-256\slmult0
\up0 \expndtw-3\charscalex100 d) cara monitoring di rumah sakit. \par\pard\qj
\li1418\ri1212\sb326\sl-520\slmult0 \up0 \expndtw-2\charscalex100 Oleh sebab itu,
rumah sakit harus menetapkan pedoman spesifik hal tersebut di
atas\ul0\nosupersub\cf6\f7\fs24 . \up0 \expndtw-3\charscalex100 Elemen Penilaian
PAB 3 \par\pard\ql \li1778\ri1388\sb194\sl-286\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rumah sakit
yang menetapkan pemberian sedasi
yang seragam \line\tab \up0 \expndtw-2\charscalex100 di semua tempat di rumah
sakit sesuai dengan peraturan perundangan \line \tab \up0
\expndtw0\charscalex102 ditetapkan dan dilaksanakan sesuai dengan elemen a) sampai
dengan d) \line \tab \up0 \expndtw-3\charscalex100 seperti yang dinyatakan pada
maksud dan tujuan PAB 3. (R) \par\pard\qj \li1778\ri1402\sb19\sl-280\slmult0\tx2138
\up0 \expndtw-1\charscalex100 2. Ada bukti pelaksanaan sedasi sesuai dengan
regulasi yang ditetapkan. \line\tab \up0 \expndtw-2\charscalex100 (D,O,W)
\par\pard\qj \li1778\ri1391\sb21\sl-280\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 3. Peralatan emergensi tersedia dan dipergunakan sesuai dengan
jenis sedasi, \line\tab \up0 \expndtw-3\charscalex100 usia, dan kondisi pasien.
(D,O) \par\pard\ql \li1778\ri1400\sb12\sl-290\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 4. Staf yang terlatih dan berpengalaman dalam
memberikan bantuan hidup \line\tab \up0 \expndtw-3\charscalex100 lanjut \up0
\expndtw0\charscalex103 (\ul0\nosupersub\cf8\f9\fs24
advance\ul0\nosupersub\cf7\f8\fs24 ) harus selalu tersedia dan siaga selama
tindakan sedasi \line \tab \up0 \expndtw-3\charscalex100 dikerjakan. (D,O,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb246\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 3.1
\par\pard\qj \li1418\ri1217\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Para profesional pemberi asuhan (PPA) kompeten
dan berwenang memberikan \up0 \expndtw-2\charscalex100 pelayanan sedasi moderat
dan dalam serta melaksanakan monitoring. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb158\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 156
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg157}
{\bkmkend Pg157}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 3.1
\par\pard\qj \li1418\ri1225\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Kualifikasi dokter, dokter gigi, atau petugas lain yang
bertanggung jawab terhadap \up0 \expndtw-3\charscalex100 pasien yang menerima
tindakan sedasi sangat penting. \par\pard\qj \li1418\ri1166\sb200\sl-320\slmult0
\up0 \expndtw-3\charscalex100 Pemahaman berbagai cara memberikan sedasi terkait
pasien dan jenis tindakan yang \up0 \expndtw-1\charscalex100 diberikan akan
menaikkan toleransi pasien terhadap rasa tidak nyaman, rasa sakit, \up0 \expndtw-
3\charscalex100 dan atau risiko komplikasi. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1164\sb80\sl-
320\slmult0 \up0 \expndtw-4\charscalex100 Komplikasi terkait pemberian sedasi
terutama gangguan jantung dan paru. Sertifikasi \up0 \expndtw-5\charscalex100
dalam bantuan hidup lanjut sangat penting. \par\pard\qj \li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1169\sb60\sl-320\slmult0 \up0 \expndtw-4\charscalex100
Sebagai tambahan, pengetahuan farmakologi zat sedasi yang digunakan termasuk zat
\up0 \expndtw-5\charscalex100 reversal mengurangi risiko terjadi kejadian yang
tidak diharapkan. \par\pard\qj \li1418\ri1225\sb200\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Oleh karena itu, orang yang bertanggung jawab memberikan sedasi
harus kompeten \up0 \expndtw-2\charscalex100 dan berwenang dalam hal
\par\pard\ql \li1778\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100 1) teknik
dan berbagai macam cara sedasi; \par\pard\ql \li1778\sb1\sl-256\slmult0 \up0
\expndtw-3\charscalex100 2) farmakologi obat sedasi dan penggunaaan zat reversal
(antidot); \par\pard\ql \li1778\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3)
memonitor pasien; dan \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 4) bertindak jika ada komplikasi. (lihat juga KKS 10)
\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\ri1161\sb181\sl-
313\slmult0 \up0 \expndtw-3\charscalex100 Petugas lain yang kompeten dapat
melakukan pemantauan di bawah supervisi secara \up0 \expndtw-1\charscalex100 terus
menerus terhadap parameter fisiologis pasien dan memberi bantuan dalam hal \up0
\expndtw0\charscalex100 tindakan resusitasi. Orang yang bertanggung jawab melakukan
monitoring harus \up0 \expndtw-3\charscalex100 kompeten dalam \par\pard\ql
\li1778\sb238\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5) monitoring yang
diperlukan; \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100
6) bertindak jika ada komplikasi; \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0
\expndtw-3\charscalex100 7) penggunaan zat reversal (antidot); \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 8) kriteria pemulihan.
(lihat juga KKS 3) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb228\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 3.1 \par\pard\ql \li1778\sb244\sl-
276\slmult0\tx5437 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Profesional pemberi asuhan \tab \up0 \expndtw-2\charscalex100 (PPA) yang
bertanggung jawab memberikan \par\pard\qj \li2138\ri1211\sb8\sl-320\slmult0
\up0 \expndtw0\charscalex100 sedasi adalah orang yang kompeten dalam hal paling
sedikit butir 1) sampai \up0 \expndtw-3\charscalex100 dengan 4) pada maksud dan
tujuan PAB 3.1. (R) \par\pard\ql \li1778\sb37\sl-276\slmult0\tx5506 \up0
\expndtw0\charscalex100 2. Profesional pemberi asuhan \tab \up0
\expndtw0\charscalex100 (PPA) yang bertanggung jawab melakukan \par\pard\qj
\li2138\ri1158\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100 pemantauan selama
diberikan sedasi adalah orang yang kompeten dalam hal \line \up0 \expndtw-
3\charscalex100 paling sedikit butir 5) sampai dengan 8) pada maksud dan tujuan
PAB 3.1. (R) \par\pard\qj \li1778\ri1226\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 3. Kompetensi semua staf yang terlibat dalam sedasi
tercatat dalam dokumen \line\tab \up0 \expndtw-3\charscalex100 kepegawaian. (lihat
KKS 5). (D,W) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb123\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 157
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg158}
{\bkmkend Pg158}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 3.2 \par\pard\qj
\li1418\ri1209\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk tindakan sedasi
(moderat dan dalam) baik \up0 \expndtw-3\charscalex100 cara memberikan dan memantau
berdasar atas panduan praktik klinis. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 3.2
\par\pard\qj \li1418\ri1164\sb208\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Tingkat kedalaman sedasi berlangsung serta berlanjut
dari mulai ringan sampai sedasi \up0 \expndtw-4\charscalex100 dalam dan pasien
dapat menjalaninya dari satu tingkat ke tingkat yang lain. \par\pard\qj
\li1418\ri1159\sb204\sl-316\slmult0 \up0 \expndtw0\charscalex103 Banyak faktor
berpengaruh terhadap respons pasien dan hal ini selanjutnya \up0 \expndtw-
3\charscalex100 memengaruhi tingkat sedasi pasien. Faktor-faktor yang berpengaruh
adalah obat yang \up0 \expndtw-3\charscalex100 dipakai, cara pemberian obat dan
dosis, usia pasien (anak, dewasa, serta lanjut usia), \up0 \expndtw0\charscalex103
dan riwayat kesehatan pasien. Contoh, ada riwayat kerusakan organ utama
\up0 \expndtw0\charscalex100 kemungkinan obat yang diminum berinteraksi dengan obat
sedasi, alergi obat, efek \up0 \expndtw-3\charscalex100 samping obat anestesi, atau
sedasi yang lalu. \par\pard\qj \li1418\ri1217\sb201\sl-320\slmult0 \up0
\expndtw0\charscalex102 Jika status fisik pasien berisiko tinggi maka
dipertimbangkan pemberian tambahan \up0 \expndtw-3\charscalex100 kebutuhan klinis
lainnya dan diberikan tindakan sedasi yang sesuai. \par\pard\qj
\li1418\ri1177\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex103 Asesmen prasedasi
membantu menemukan faktor yang dapat yang berpengaruh \up0 \expndtw-2\charscalex100
pada respons pasien terhadap tindakan sedasi dan juga dapat ditemukan hal
penting \up0 \expndtw-3\charscalex100 dari hasil monitor selama dan sesudah sedasi.
\par\pard\li1418\sb248\sl-276\slmult0\fi0\tx4741 \up0 \expndtw-2\charscalex100
Profesional pemberi asuhan\tab \up0 \expndtw-2\charscalex100 (PPA) yang
kompeten dan berwenang melakukan\par\pard\li1418\sb44\sl-276\slmult0\fi0 \up0
\expndtw-2\charscalex100 asesmen prasedasi sebagai berikut:\par\pard\qj
\li1778\ri1226\sb230\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex104 a)
mengidentifikasi setiap permasalahan saluran pernapasan yang dapat
\line\tab \up0 \expndtw-3\charscalex100 memengaruhi jenis sedasi; \par\pard\ql
\li1778\sb1\sl-255\slmult0 \up0 \expndtw-3\charscalex100 b) evaluasi pasien
terhadap risiko tindakan sedasi; \par\pard\qj \li1778\ri1222\sb5\sl-
280\slmult0\tx2138 \up0 \expndtw0\charscalex104 c) merencanakan
jenis sedasi dan tingkat kedalaman sedasi yang diperlukan \line\tab \up0 \expndtw-
3\charscalex100 pasien berdasar atassedasi yang diterapkan; \par\pard\ql
\li1778\sb4\sl-276\slmult0 \up0 \expndtw-4\charscalex100 d) pemberian sedasi
secara aman; dan \par\pard\qj \li1778\ri1219\sb18\sl-260\slmult0\tx2138 \up0
\expndtw0\charscalex100 e) mengevaluasi serta menyimpulkan temuan monitor
selama dan sesudah \line\tab \up0 \expndtw-3\charscalex100 sedasi.
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1226\sb171\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Cakupan dan isi asesmen dibuat berdasar
atas Panduan Praktik Klinis dan regulasi \up0 \expndtw-3\charscalex100 yang
ditetapkan oleh rumah sakit. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb152\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 158
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg159}
{\bkmkend Pg159}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1192\sb214\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien yang sedang menjalani tindakan sedasi
dimonitor tingkat kesadarannya, \up0 \expndtw-2\charscalex100 ventilasi dan
status oksigenasi, variabel hemodinamik berdasar atas jenis obat sedasi \up0
\expndtw-2\charscalex100 yang diberikan, jangka waktu sedasi, jenis kelamin, dan
kondisi pasien. \par\pard\qj \li1418\ri1221\sb202\sl-320\slmult0 \up0
\expndtw0\charscalex100 Perhatian khusus ditujukan pada kemampuan pasien
mempertahankan refleks \up0 \expndtw0\charscalex100 protektif, jalan napas yang
teratur dan lancar, serta respons terhadap stimulasi fisik \up0 \expndtw-
3\charscalex100 dan perintah verbal. \par\pard\qj \li1418\ri1226\sb200\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Seorang yang kompeten bertanggung jawab
melakukan monitoring status fisiologis \up0 \expndtw-1\charscalex100 pasien secara
terus menerus dan membantu memberikan bantuan resusitasi sampai \up0 \expndtw-
2\charscalex100 pasien pulih dengan selamat. \par\pard\qj \li1418\ri1164\sb180\sl-
320\slmult0\fi134 \up0 \expndtw-3\charscalex100 Setelah tindakan selesai
dikerjakan, pasien masih tetap berisiko terhadap komplikasi \up0
\expndtw0\charscalex102 karena keterlambatan absorsi obat sedasi, terdapat
depresi pernapasan, dan \up0 \expndtw-2\charscalex100 kekurangan stimulasi akibat
tindakan. Ditetapkan kriteria pemulihan pasien yang siap \up0 \expndtw-
3\charscalex100 untuk ditransfer. (lihat juga PMKP 8). \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PAB 3.2 \par\pard\qj \li1778\ri1215\sb208\sl-320\slmult0\tx2138 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Dilakukan asesmen
prasedasi dan dicatat dalam rekam medis yang sekurang-\line\tab \up0 \expndtw-
1\charscalex100 kurangnya berisikan butir a) sampai dengan e) pada maksud dan
tujuan PAB \par\pard\qj \li2138\ri1223\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex103 3.2 untuk evaluasi risiko dan kelayakan tindakan sedasi
bagi pasien sesuai \up0 \expndtw-3\charscalex100 dengan regulasi yang ditetapkan
oleh rumah sakit. (lihat AP 14). (D,W) \par\pard\qj \li1778\ri1226\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Seorang yang kompeten melakukan
pemantauan pasien selama sedasi dan \line\tab \up0 \expndtw-3\charscalex100
mencatat hasil monitor dalam rekam medis. (D,W) \par\pard\qj \li1778\ri1227\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 3. Kriteria pemulihan digunakan
dan didokumentasikan setelah selesai tindakan \line\tab \up0 \expndtw-
3\charscalex100 sedasi. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PAB 3.3 \par\pard\qj \li1418\ri1191\sb0\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Risiko,
manfaat, dan alternatif berhubungan dengan tindakan sedasi moderat dan \up0
\expndtw-2\charscalex100 didiskusikan dengan pasien dan keluarga pasien atau dengan
mereka yang membuat \up0 \expndtw-3\charscalex100 keputusan yang mewakili
pasien. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb269\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PAB 3.3 \par\pard\qj \li1418\ri1225\sb212\sl-315\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rencana tindakan sedasi memuat
pendidikan kepada pasien, keluarga pasien, atau \up0 \expndtw-2\charscalex100
mereka yang membuat keputusan mewakili pasien tentang risiko, manfaat, dan
\up0 \expndtw-1\charscalex100 alternatif terkait tindakan sedasi. Pembahasan
berlangsung sebagai bagian dari \up0 \expndtw-1\charscalex100 proses mendapat
persetujuan tindakan kedokteran untuk tindakan sedasi sesuai \up0 \expndtw-
3\charscalex100 dengan peraturan perundangan yang berlaku. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb232\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 159
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg160}
{\bkmkend Pg160}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 3.3
\par\pard\ql \li1778\ri1220\sb188\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Pasien dan atau keluarga
atau pihak lain yang berwenang yang memberikan \line\tab \up0
\expndtw0\charscalex103 keputusan dijelaskan tentang risiko, keuntungan, dan
alternatif tentang \line \tab \up0 \expndtw-3\charscalex100 tindakan sedasi.
( D,W) \par\pard\qj \li1778\ri1167\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 2. Pasien dan atau keluarga atau pihak lain yang
berwenang diberi edukasi \line\tab \up0 \expndtw-4\charscalex100 tentang pemberian
analgesi pascatindakan sedasi. (D,W) \par\pard\qj \li1778\ri1227\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 3. Dokter spesialis anestesi
melaksanakan edukasi dan mendokumentasikan. \line\tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb25\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf23\f24\fs24
\u10070?\ul0\nosupersub\cf6\f7\fs24 ASUHAN PASIEN ANESTESI \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb232\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PAB
4 \par\pard\qj \li1418\ri1227\sb225\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Profesional pemberi asuhan (PPA) yang kompeten dan
berwenang pada pelayanan \up0 \expndtw-3\charscalex100 anestesi melakukan asesmen
pra-anestesi. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb208\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB.4.1 \par\pard\qj
\li1418\ri1224\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Profesional pemberi asuhan (PPA) yang kompeten dan
berwenang pada pelayanan \up0 \expndtw-3\charscalex100 anestesi melakukan asesmen
prainduksi. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 4 dan PAB 4.1
\par\pard\qj \li1418\ri1217\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 Oleh karena anestesi mengandung risiko tinggi
maka pemberiannya harus \up0 \expndtw-1\charscalex100 direncanakan dengan hati-
hati. Asesmen pra-anestesi adalah dasar perencanaan ini \up0
\expndtw0\charscalex100 untuk mengetahui temuan apa pada monitor selama anestesi
dan setelah anestesi, \up0 \expndtw-3\charscalex100 dan juga untuk menentukan obat
analgesi apa untuk pascaoperasi. \par\pard\qj \li1418\ri1220\sb200\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Asesmen pra-anestesi berbasis IAR
(Informasi, Analisis, Rencana) juga memberikan \up0 \expndtw-2\charscalex100
informasi yang diperlukan untuk \par\pard\ql \li1778\sb237\sl-276\slmult0 \up0
\expndtw-1\charscalex100 \u8226? mengetahui masalah saluran pernapasan;
\par\pard\ql \li1778\sb1\sl-256\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
memilih anestesi dan rencana asuhan anestesi; \par\pard\qj \li1778\ri1227\sb5\sl-
280\slmult0\tx2138 \up0 \expndtw-1\charscalex100 \u8226? memberikan anestesi yang
aman berdasar atas asesmen pasien, risiko yang \line\tab \up0 \expndtw-
3\charscalex100 ditemukan, dan jenis tindakan; \par\pard\ql \li1778\sb4\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \u8226? menafsirkan temuan pada waktu
monitoring selama anestesi dan pemulihan; \par\pard\ql \li1778\sb4\sl-276\slmult0
\up0 \expndtw-1\charscalex100 \u8226? memberikan informasi obat analgesia yang
akan digunakan pascaoperasi. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1217\sb148\sl-320\slmult0 \up0 \expndtw0\charscalex100 Dokter
spesialis anestesi melakukan asesmen pra-anestesi.
Asesmen pra-anestesi \line \up0 \expndtw0\charscalex100 dapat dilakukan sebelum
masuk rawat inap atau sebelum dilakukan tindakan bedah \line \up0
\expndtw0\charscalex100 atau sesaat menjelang operasi, misalnya pada pasien
darurat. Asesmen prainduksi \par\pard\ql \li10156\sb176\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 160
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg161}
{\bkmkend Pg161}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1220\sb214\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 berbasis IAR, terpisah dari asesmen pra-anestesi, fokus
pada stabilitas fisiologis dan \up0 \expndtw0\charscalex100 kesiapan pasien untuk
tindakan anestesi, dan berlangsung sesaat sebelum induksi \up0 \expndtw-
3\charscalex100 anestesi. \par\pard\qj \li1418\ri1221\sb202\sl-320\slmult0 \up0
\expndtw0\charscalex102 Jika anestesi diberikan secara darurat maka asesmen pra-
anestesi dan prainduksi \line \up0 \expndtw0\charscalex100 dapat dilakukan
berurutan atau simultan, namun dicatat secara terpisah. (lihat juga \line \up0
\expndtw-3\charscalex100 PAB 6) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 4
\par\pard\qj \li1778\ri1163\sb225\sl-300\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Asesmen pra-anestesi dilakukan
untuk setiap pasien yang akan dioperasi. (lihat \line\tab \up0 \expndtw-
4\charscalex100 juga AP 1). (D,W) \par\pard\ql \li1778\sb40\sl-276\slmult0 \up0
\expndtw-3\charscalex100 2. Hasil asesmen didokumentasikan dalam rekam medis
pasien. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb12\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 4.1
\par\pard\qj \li1778\ri1266\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Asesmen prainduksi dilakukan untuk
setiap pasien sebelum dilakukan induksi. \line\tab \up0 \expndtw-3\charscalex100
(D,W) \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2.
Hasil asesmen didokumentasikan dalam rekam medis pasien. (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb268\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Standar\ul0\nosupersub\cf6\f7\fs24
PAB 5 \par\pard\qj \li1418\ri1150\sb208\sl-320\slmult0 \up0 \expndtw-
7\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rencana, tindakan anestesi, dan teknik
yang digunakan dicatat serta didokumentasikan di \up0 \expndtw-8\charscalex100
rekam medis pasien. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 5 \par\pard\qj
\li1418\ri1256\sb237\sl-285\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Tindakan anestesi direncanakan secara saksama dan
didokumentasikan dalam rekam \line \up0 \expndtw-2\charscalex100 medis. Perencanaan
mempertimbangkan informasi dari asesmen lainnya (misal dari \line \up0
\expndtw0\charscalex102 hasil pemeriksaan, konsul, dll.) dan mengidentifikasi
tindakan anestesi yang akan \line \up0 \expndtw-4\charscalex100 digunakan termasuk
metode pemberiannya, pemberian medikasi dan cairan lain, serta \line \up0 \expndtw-
4\charscalex100 prosedur monitorig dalam mengantisipasi pelayanan pasca-
anestesi \up0 \expndtw-5\charscalex100 dan \par\pard\ql \li1418\sb23\sl-276\slmult0
\up0 \expndtw-5\charscalex100 didokumentasikan di rekam medis. \par\pard\ql
\li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb248\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 5 \par\pard\qj
\li1778\ri1179\sb241\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pelayanan anestesi setiap pasien
yang direncanakan dan \line\tab \up0 \expndtw-5\charscalex100 didokumentasikan.
(R) \par\pard\qj \li1778\ri1177\sb1\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex100 2. Obat-obat anestesi, dosis, dan rute serta teknik
anestesi didokumentasikan di \line\tab \up0 \expndtw-4\charscalex100 rekam medis
pasien. (D,W) \par\pard\qj \li1778\ri1159\sb1\sl-280\slmult0\tx2138 \up0 \expndtw-
4\charscalex100 3. Dokter spesialis anestesi dan perawat yang mendampingi/penata
anestesi ditulis \line\tab \up0 \expndtw-5\charscalex100 dalam form anestesi. (D,W)
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb51\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 161
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg162}
{\bkmkend Pg162}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Standar PAB 5.1 \par\pard\qj
\li1418\ri1155\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf18\f19\fs24 Risiko, manfaat, dan alternatif tindakan anestesi
didiskusikan dengan pasien dan \up0 \expndtw-5\charscalex100 keluarga atau orang
yang dapat membuat keputusan mewakili pasien. \par\pard\ql \li1418\sb237\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf17\f18\fs24 Maksud dan
Tujuan PAB 5.1 \par\pard\qj \li1418\ri1163\sb0\sl-315\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Proses perencanaan anestesi mencakup
edukasi pasien dan keluarga atau pembuat \line \up0 \expndtw-3\charscalex100
keputusan atas risiko, manfaat, dan alternatif yang berhubungan dengan
perencanaan \line \up0 \expndtw0\charscalex104 anestesia dan analgesia
pascatindakan operatif. Edukasi ini sebagai bagian dari \line \up0 \expndtw-
3\charscalex100 proses untuk mendapatkan persetujuan anestesi sebagaimana
dipersyaratkan dalam \line \up0 \expndtw-4\charscalex100 HPK 6.4.EP 2. \par\pard\qj
\li1418\ri4540\sb8\sl-520\slmult0 \up0 \expndtw-3\charscalex100 Dokter spesialis
anestesi yang melakukan edukasi ini\ul0\nosupersub\cf24\f25\fs22 . \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 5.1
\par\pard\ql \li1778\ri1227\sb166\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Pasien dan atau keluarga
atau pihak lain yang berwenang yang memberikan \line\tab \up0
\expndtw0\charscalex100 keputusan dijelaskan tentang risiko, keuntungan, dan juga
alternatif tindakan \line \tab \up0 \expndtw-3\charscalex100 anestesi. (D,W)
\par\pard\qj \li1778\ri1222\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
2. Pasien dan atau keluarga atau pihak lain yang berwenang diberikan edukasi
\line\tab \up0 \expndtw-3\charscalex100 pemberian analgesi pascatindakan anestesi.
(D,W) \par\pard\qj \li1778\ri1219\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex104 3. Dokter spesialis anestesi melaksanakan proses
edukasi dan juga \line\tab \up0 \expndtw-3\charscalex100 mendokumentasikannya.
(R,D) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb261\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 6
\par\pard\qj \li1418\ri1216\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk menentukan
status fisiologis dimonitor \up0 \expndtw-1\charscalex100 selama proses
anestesi dan bedah sesuai dengan panduan praktik klinis serta \up0
\expndtw-2\charscalex100 didokumentasikan di dalam form anestesi. \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 6 \par\pard\qj
\li1418\ri1215\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Monitoring fisiologis memberikan informasi terpercaya
tentang status pasien selama \line \up0 \expndtw-2\charscalex100 anestesi berjalan
(umum, spinal, regional, lokal) dan pascaoperasi. Hasil monitoring \line \up0
\expndtw0\charscalex104 menjadi acuan pengambilan keputusan selama operasi
berlangsung atau pasca-\line \up0 \expndtw-2\charscalex100 operasi, misalnya
reoperasi, atau pindah ke tingkat asuhan lainnya, atau lanjut ruang \line \up0
\expndtw-3\charscalex100 pulih. \par\pard\qj \li1418\ri1218\sb209\sl-310\slmult0
\up0 \expndtw0\charscalex102 Informasi dari monitoring menentukan kebutuhan asuhan
medis dan keperawatan \up0 \expndtw0\charscalex103 serta kebutuhan diagnostik dan
pelayanan lainnya. Hasil monitorig dicatat di form \up0 \expndtw-2\charscalex100
anestesi, sedangkan untuk anestesi lokal dapat digunakan form tersendiri.
\par\pard\qj \li1418\ri1170\sb202\sl-320\slmult0 \up0 \expndtw0\charscalex102
Metode memonitor ditentukan oleh status pasien pada pra-anestesi, jenis anestesi
\up0 \expndtw0\charscalex103 yang akan dipergunakan, dan kompleksitas operasi
atau tindakan lain yang \up0 \expndtw-3\charscalex100 dilaksanakan selama
anestesi. Pelaksanaan monitorpng selama anestesi dan operasi \up0
\expndtw0\charscalex102 harus dijalankan sesuai dengan panduan praktik klinis.
Hasil monitoring dicatat di \up0 \expndtw-3\charscalex100 rekam medik pasien.
(lihat juga PAB 4) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb43\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 162
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg163}
{\bkmkend Pg163}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 6 \par\pard\ql
\li1778\ri1223\sb208\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi jenis dan frekuensi pemantauan selama
anestesi dan operasi \line\tab \up0 \expndtw0\charscalex104 dilakukan berdasar atas
status pasien pra-anestesi, metode anestesi yang \line \tab \up0 \expndtw-
3\charscalex100 dipakai, dan tindakan operasi yang dilakukan. (R) \par\pard\qj
\li1778\ri1225\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex104 2.
Pemantauan status fisiologis pasien sesuai dengan panduan praktik klinis. \line\tab
\up0 \expndtw-2\charscalex100 (D,W) \par\pard\ql \li1778\sb37\sl-276\slmult0
\up0 \expndtw-2\charscalex100 3. Hasil monitoring dicatat di form anestesi.
(D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 6
\par\pard\qj \li1418\ri1218\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi untuk memonitor status
pasca-anestesi setiap \up0 \expndtw0\charscalex100 pasien dan dicatat dalam
rekam medis pasien. Pasien dipindahkan dari ruang \up0 \expndtw-
1\charscalex100 pemulihan oleh staf yang kompeten dan berwenang atau berdasar atas
kriteria baku \up0 \expndtw-3\charscalex100 yang ditetapkan. \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 6.1 \par\pard\qj
\li1418\ri1221\sb225\sl-300\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Monitoring selama periode anestesi menjadi acuan untuk
monitoring pada periode \up0 \expndtw-3\charscalex100 pasca-anestesi.
\par\pard\qj \li1418\ri1213\sb204\sl-320\slmult0 \up0 \expndtw0\charscalex104
Pengumpulan data status pasien terus menerus secara sistematik menjadi dasar
\up0 \expndtw-2\charscalex100 memindahkan pasien ke ruangan intensif atau ke unit
rawat inap. Catatan monitoring \up0 \expndtw0\charscalex103 menjadi acuan untuk
menyelesaikan monitoring di ruang pemulihan atau sebagai \up0 \expndtw-
3\charscalex100 acuan untuk pindah dari ruang pemulihan. \par\pard\qj
\li1418\ri1225\sb200\sl-320\slmult0 \up0 \expndtw0\charscalex100 Jika pasien
dipindahkan langsung dari kamar operasi ke ruang intensif maka \line
\up0 \expndtw0\charscalex102 monitoring dan pendokumentasian diperlakukan sama
dengan monitoring di ruang \line \up0 \expndtw-3\charscalex100 pulih.
\par\pard\qj \li1418\ri1161\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex104
Keluar dari ruang pemulihan pasca-anestesi atau menghentikan monitoring pada
\line \up0 \expndtw-3\charscalex100 periode pemulihan dilakukan dengan mengacu pada
salah satu alternatif di bawah ini. \par\pard\li1778\sb248\sl-
276\slmult0\fi0\tx4521 \up0 \expndtw0\charscalex100 a) Pasien dipindahkan\tab
\up0 \expndtw0\charscalex100 (atau monitoring pemulihan dihentikan) oleh
dokter\par\pard\li1778\sb0\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex100
anestesi.\par\pard\ql \li1778\sb0\sl-273\slmult0\tx4504 \up0 \expndtw-
1\charscalex100 b) Pasien dipindahkan \tab \up0 \expndtw0\charscalex100 (atau
monitoring pemulihan dihentikan) oleh penata \par\pard\qj
\li2138\ri1223\sb0\sl-280\slmult0 \up0 \expndtw0\charscalex100 anestesi sesuai
dengan kriteria yang ditetapkan oleh rumah sakit dan rekam \up0 \expndtw-
3\charscalex100 medis pasien membuktikan bahwa kriteria yang dipakai dipenuhi.
\par\pard\qj \li1778\ri1219\sb0\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex100
c) Pasien dipindahkan ke unit yang mampu memberikan asuhan pasca-anestesi
\line\tab \up0 \expndtw-3\charscalex100 atau pascasedasi pasien tertentu, seperti
ICCU atau ICU. \par\pard\ql \li1418\sb1\sl-259\slmult0 \up0 \expndtw-
2\charscalex100 Waktu tiba di ruang pemulihan dan waktu keluar
didokumentasikan dalam form \par\pard\ql \li1418\sb47\sl-276\slmult0 \up0
\expndtw-3\charscalex100 anestesi. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb65\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 163
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg164}
{\bkmkend Pg164}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 6.1
\par\pard\ql \li1778\ri1164\sb188\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Pasien dipindahkan dari ruang
pemulihan (atau jika monitoring pemulihan \line\tab \up0 \expndtw-
3\charscalex100 dihentikan) sesuai dengan alternatif butir 1 sampai dengan 3 pada
maksud dan \line \tab \up0 \expndtw-4\charscalex100 tujuan PAB 6.1. (R)
\par\pard\qj \li1778\ri1346\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
2. Waktu masuk ruang pemulihan dan dipindahkan dari ruang pemulihan dicatat
\line\tab \up0 \expndtw-3\charscalex100 dalam form anestesi. (D,O,W)
\par\pard\qj \li1778\ri1220\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
3. Pasien dimonitor dalam masa pemulihan pasca-anestesi sesuai dengan
\line\tab \up0 \expndtw-3\charscalex100 regulasi rumah sakit. (D,O,W)
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4. Hasil
monitoring dicatat di form anestesi. (D) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb32\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf23\f24\fs24
\u10070?\ul0\nosupersub\cf6\f7\fs24 ASUHAN PASIEN BEDAH \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb232\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PAB
7 \par\pard\qj \li1418\ri1227\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asuhan setiap pasien bedah direncanakan berdasar atas
hasil asesmen dan dicatat \up0 \expndtw-3\charscalex100 dalam rekam medis
pasien. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 7 \par\pard\qj
\li1418\ri1218\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Karena prosedur bedah mengandung risiko tinggi
maka pelaksanaannya harus \up0 \expndtw0\charscalex100 direncanakan dengan
saksama. Asesmen prabedah (berbasis IAR) menjadi acuan \up0 \expndtw0\charscalex102
untuk menentukan jenis tindakan bedah yang tepat dan mencatat temuan penting.
\up0 \expndtw-3\charscalex100 Hasil asesmen memberikan informasi tentang
\par\pard\ql \li1778\sb217\sl-276\slmult0 \up0 \expndtw-4\charscalex100 a)
tindakan bedah yang sesuai dan waktu pelaksanaannya; \par\pard\ql \li1778\sb4\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 b) melakukan tindakan dengan aman; dan
\par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c)
menyimpulkan temuan selama monitoring. \par\pard\qj \li1418\ri1165\sb0\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 Pemilihan teknik operasi bergantung pada
riwayat pasien, status fisik, data diagnostik, \up0 \expndtw-4\charscalex100 serta
manfaat dan risiko tindakan yang dipilih. \par\pard\qj \li1418\ri1167\sb177\sl-
310\slmult0 \up0 \expndtw0\charscalex100 Pemilihan tindakan juga mempertimbangkan
asesmen waktu pasien masuk dirawat \up0 \expndtw-4\charscalex100 inap, pemeriksaan
diagnostik, dan sumber lainnya. Proses asesmen dikerjakan segera \up0 \expndtw-
5\charscalex100 pada pasien darurat. (lihat juga AP 1.2.1) \par\pard\qj
\li1418\ri1218\sb202\sl-320\slmult0 \up0 \expndtw0\charscalex103 Asuhan untuk
pasien bedah dicatat di rekam medis. Untuk pasien yang langsung \line \up0
\expndtw0\charscalex100 dilayani oleh dokter bedah, asesmen prabedah menggunakan
asesmen awal rawat \line \up0 \expndtw-2\charscalex100 inap, pada pasien yang
diputuskan dilakukan pembedahan dalam proses perawatan. \line \up0
\expndtw0\charscalex104 Asesmen dicatat dalam rekam medis, sedangkan pasien yang
dikonsultasikan di \line \up0 \expndtw0\charscalex100 tengah perawatan oleh
dokter penanggung jawab pelayanan \up0 \expndtw0\charscalex100 (DPJP) lain dan
\par\pard\qj \li1418\ri1165\sb9\sl-310\slmult0 \up0 \expndtw-1\charscalex100
diputuskan operasi maka asesmen prabedah juga dicatat di rekam medis (dengan isi
\line \up0 \expndtw0\charscalex100 berbasis IAR) sesuai dengan regulasi rumah
sakit. Hal ini termasuk diagnosis \line \up0 \expndtw-3\charscalex100
praoperasi dan pascaoperasi serta nama tindakan operasi. (lihat juga AP 1.3.1; MIRM
\par\pard\ql \li1418\sb39\sl-276\slmult0 \up0 \expndtw-3\charscalex100 10.1).
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb37\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 164
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg165}
{\bkmkend Pg165}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb260\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PAB 7 \par\pard\qj \li1778\ri1164\sb208\sl-320\slmult0\tx2138 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Ada regulasi asuhan setiap pasien bedah direncanakan berdasar atas informasi
\line\tab \up0 \expndtw-4\charscalex100 dari hasil asesmen. (R) \par\pard\qj
\li1778\ri1228\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2.
Diagnosis praoperasi dan rencana operasi dicatat di rekam medik pasien oleh
\line\tab \up0 \expndtw-2\charscalex100 dokter penanggung jawab pelayanan (DPJP)
sebelum operasi dimulai. (D,W) \par\pard\ql \li1778\ri1165\sb9\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 3. Hasil asesmen yang
digunakan untuk menentukan rencana operasi dicatat oleh \line\tab \up0 \expndtw-
1\charscalex100 dokter penanggung jawab pelayanan (DPJP) di rekam medis pasien
sebelum \line \tab \up0 \expndtw-6\charscalex100 operasi dimulai. (lihat juga
AP 1.2.1; AP 1.3.1). (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb7\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 7.1
\par\pard\qj \li1418\ri1229\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Risiko, manfaat dan alternatif didiskusikan dengan
pasien dan atau keluarga atau \up0 \expndtw-3\charscalex100 pihak lain yang
berwenang yang memberikan keputusan\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Maksud dan
Tujuan PAB 7.1 \par\pard\qj \li1418\ri1215\sb188\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien, keluarga, dan mereka yang
memutuskan menerima cukup penjelasan untuk \up0 \expndtw0\charscalex102
berpartisipasi dalam keputusan asuhan pasien dan memberikan persetujuan yang
\up0 \expndtw-1\charscalex100 dibutuhkan seperti di HPK 5.2. Untuk memenuhi
kebutuhan pasien maka penjelasan \up0 \expndtw0\charscalex102 tersebut diberikan
secara terintegrasi oleh para profesional pemberi asuhan (PPA) \up0 \expndtw-
3\charscalex100 terkait dibantu oleh manajer pelayanan pasien (MPP).
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Informasi
itu memuat \par\pard\ql \li1778\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
a) risiko dari rencana tindakan operasi; \par\pard\ql \li1778\sb1\sl-
256\slmult0 \up0 \expndtw-3\charscalex100 b) manfaat dari rencana tindakan
operasi; \par\pard\ql \li1778\sb8\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c)
kemungkinan komplikasi dan dampak; \par\pard\qj \li1778\ri1226\sb1\sl-
280\slmult0\tx2138 \up0 \expndtw0\charscalex103 d) pilihan operasi atau nonoperasi
(alternatif) yang tersedia untuk menangani \line\tab \up0 \expndtw-3\charscalex100
pasien; \par\pard\qj \li1778\ri1226\sb17\sl-260\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 e) sebagai tambahan jika dibutuhkan darah atau produk darah,
sedangkan risiko \line\tab \up0 \expndtw-3\charscalex100 dan alternatifnya
didiskusikan. \par\pard\qj \li1418\ri1227\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex102 Dokter bedah yang kompeten dan berwenang serta PPA yang
terkait memberikan \up0 \expndtw-3\charscalex100 informasi ini. \par\pard\ql
\li1418\sb208\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 7.1 \par\pard\ql
\li1778\ri1223\sb208\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Pasien, keluarga, dan mereka yang memutuskan
diberikan edukasi tentang \line\tab \up0 \expndtw-1\charscalex100 risiko, manfaat,
komplikasi, serta dampak dan alternatif prosedur/teknik terkait \line \tab \up0
\expndtw-2\charscalex100 dengan rencana operasi. (D,W) \par\pard\qj
\li1778\ri1191\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Edukasi
memuat kebutuhan, risiko, manfaat, dan alternatif penggunaan darah \line\tab
\up0 \expndtw-3\charscalex100 dan produk darah. (D,W) \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb83\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 165
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg166}
{\bkmkend Pg166}\par\pard\qj \li2138\sb0\sl-310\slmult0 \par\pard\qj\li2138\sb0\sl-
310\slmult0 \par\pard\qj\li2138\sb0\sl-310\slmult0
\par\pard\qj\li2138\ri1225\sb214\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Edukasi dilakukan oleh dokter penanggung jawab
pelayanan (DPJP) dan \up0 \expndtw0\charscalex104 dicatat pada bagian pemberian
informasi dalam form persetujuan tindakan \up0 \expndtw-3\charscalex100 kedokteran.
(D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb7\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PAB 7.2 \par\pard\qj \li1418\ri1214\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Informasi yang
terkait dengan operasi dicatat dalam laporan operasi dan digunakan \up0 \expndtw-
3\charscalex100 untuk menyusun rencana asuhan lanjutan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 7.2 \par\pard\qj
\li1418\ri1204\sb188\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Asuhan pasien pascaoperasi bergantung pada temuan
dalam operasi. Hal yang \up0 \expndtw-2\charscalex100 terpenting adalah semua
tindakan dan hasilnya dicatat di rekam medis pasien. \par\pard\qj
\li1418\ri1216\sb200\sl-320\slmult0 \up0 \expndtw0\charscalex102 Laporan ini dapat
dibuat dalam bentuk format\ul0\nosupersub\cf8\f9\fs24
template\ul0\nosupersub\cf7\f8\fs24 atau dalam bentuk laporan \up0 \expndtw-
3\charscalex100 operasi tertulis sesuai dengan regulasi rumah sakit.
\par\pard\qj \li1418\ri1217\sb200\sl-320\slmult0 \up0 \expndtw0\charscalex100 Untuk
mendukung kesinambungan asuhan pasien pascaoperasi maka laporan \up0
\expndtw-1\charscalex100 operasi dicatat segera setelah operasi selesai, sebelum
pasien dipindah dari daerah \up0 \expndtw-3\charscalex100 operasi atau dari area
pemulihan pasca-anestesi. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Laporan yang tercatat tentang operasi memuat paling sedikit
\par\pard\ql \li1778\sb224\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a)
diagnosis pascaoperasi; \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 b) nama dokter bedah dan asistennya; \par\pard\ql \li1778\sb4\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 c) prosedur operasi yang dilakukan dan
rincian temuan; \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 d) ada dan tidak ada komplikasi; \par\pard\ql \li1778\sb4\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 e) spesimen operasi yang dikirim untuk
diperiksa; \par\pard\ql \li1778\sb1\sl-256\slmult0 \up0 \expndtw-2\charscalex100 f)
jumlah darah yang hilang dan jumlah yang masuk lewat transfusi; \par\pard\ql
\li1778\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100 g) nomor pendaftaran alat
yang dipasang (implan); \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 h) tanggal, waktu, dan tanda tangan dokter yang bertanggung jawab.
\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\ri1222\sb181\sl-
313\slmult0 \up0 \expndtw0\charscalex100 Beberapa catatan mungkin ditempatkan di
lembar lain dalam rekam medik. Contoh, \line \up0 \expndtw-2\charscalex100 jumlah
darah yang hilang dan transfusi darah dicatat di catatan anestesi atau catatan
\line \up0 \expndtw0\charscalex103 tentang implan dapat ditunjukkan dengan
\u8220?\ul0\nosupersub\cf8\f9\fs24 sticker\ul0\nosupersub\cf7\f8\fs24 \u8221? yang
ditempelkan pada rekam \line \up0 \expndtw-3\charscalex100 medik. \par\pard\ql
\li1418\sb238\sl-276\slmult0\tx7728 \up0 \expndtw-1\charscalex100 Waktu selesai
membuat laporan didefinisikan sebagai \tab \up0 \expndtw-2\charscalex100 \u8220?
setelah selesai operasi, \par\pard\ql \li1418\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 sebelum pasien dipindah ke tempat asuhan biasa\u8221?. \par\pard\qj
\li1418\ri1219\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Definisi ini
penting untuk memastikan bahwa informasi yang tepat tersedia bagi \up0
\expndtw-3\charscalex100 pemberi asuhan berikutnya. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb18\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 166
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg167}
{\bkmkend Pg167}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1164\sb214\sl-310\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Jika dokter bedah mendampingi pasien dari ruang operasi
ke ruangan asuhan intensif \up0 \expndtw0\charscalex102 lanjutan (misalnya ICU,
ICCU, dsb.) maka laporan operasi dapat dibuat di daerah \up0 \expndtw-
3\charscalex100 asuhan lanjutan. (lihat juga ARK 3; PAP 2.3; PMKP 8)
\par\pard\ql \li1418\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 7.2 \par\pard\qj
\li1778\ri1213\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi laporan operasi yang meliputi
sekurang-kurangnya butir 1 sampai \line\tab \up0 \expndtw-3\charscalex100 dengan 8
pada maksud dan tujuan. (R) \par\pard\ql \li1778\ri1218\sb6\sl-
313\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-2\charscalex100 2. Ada bukti
laporan operasi memuat paling sedikit butir 1 sampai dengan 8 pada \line\tab
\up0 \expndtw-1\charscalex100
maksud dan tujuan serta dicatat pada form yang ditetapkan rumah sakit
\line \tab \up0 \expndtw0\charscalex100 tersedia segera setelah operasi selesai dan
sebelum pasien dipindah ke area \line \tab \up0 \expndtw-3\charscalex100 lain untuk
asuhan biasa. (D,W) \par\pard\ql \li1778\sb38\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 3. Laporan operasi dapat dicatat di area asuhan intensif
lanjutan. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb12\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 7.3 \par\pard\ql
\li1418\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ditetapkan rencana asuhan pascaoperasi dan dicatat
dalam rekam medis. \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 7.3
\par\pard\qj \li1418\ri1223\sb216\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kebutuhan asuhan medis, keperawatan, dan
profesional pemberi asuhan (PPA) \up0 \expndtw0\charscalex100 lainnya sesuai
dengan kebutuhan setiap pasien pascaoperasi berbeda bergantung \up0 \expndtw-
3\charscalex100 pada tindakan operasi dan riwayat kesehatan pasien. \par\pard\qj
\li1418\ri1160\sb202\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Beberapa pasien
mungkin membutuhkan pelayanan dari profesional pemberi asuhan \up0 \expndtw-
3\charscalex100 (PPA) lain atau unit lain seperti rehabilitasi medik atau terapi
fisik. Penting membuat \up0 \expndtw0\charscalex104 rencana asuhan tersebut
termasuk tingkat asuhan, metode asuhan, tindak lanjut \up0 \expndtw0\charscalex100
monitor atau tindak lanjut tindakan, kebutuhan obat, dan asuhan lain atau
tindakan \up0 \expndtw-3\charscalex100 serta layanan lain. \par\pard\qj
\li1418\ri1190\sb204\sl-316\slmult0 \up0 \expndtw-1\charscalex100 Rencana asuhan
pascaoperasi dapat dimulai sebelum tindakan operasi berdasarkan \up0
\expndtw0\charscalex102 asesmen kebutuhan dan kondisi pasien serta jenis operasi yg
dilakukan. Rencana \up0 \expndtw-2\charscalex100 asuhan pasca operasi juga memuat
kebutuhan pasien yang segera. Rencana asuhan \up0 \expndtw0\charscalex106 dicacat
di rekam medik pasien dalam waktu 24 jam dan diverifikasi oleh dokter \up0
\expndtw-1\charscalex100 penanggung jawab pelayanan (DPJP) sebagai pimpinan tim
klinis untuk memastikan \up0 \expndtw-2\charscalex100 kontuinitas asuhan selama
waktu pemulihan dan masa rehabilitasi. \par\pard\qj \li1418\ri1226\sb207\sl-
313\slmult0 \up0 \expndtw-2\charscalex100 Kebutuhan pascaoperasi dapat berubah
sebagai hasil perbaikan klinis atau informasi \up0 \expndtw0\charscalex100 baru
dari asesmen ulang rutin, atau dari perubahan kondisi pasien yang mendadak. \up0
\expndtw0\charscalex102 Rencana asuhan pascaoperasi direvisi berdasar atas
perubahan ini dan dicatat di \up0 \expndtw-3\charscalex100 rekam medis pasien
sebagai rencana asuhan baru. (lihat juga PAP 2.1) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb206\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PAB 7.3 \par\pard\ql \li1778\sb244\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rencana asuhan
pascaoperasi dibuat oleh dokter penanggung \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb130\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 167
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg168}
{\bkmkend Pg168}\par\pard\qj \li2138\sb0\sl-300\slmult0 \par\pard\qj\li2138\sb0\sl-
300\slmult0 \par\pard\qj\li2138\sb0\sl-300\slmult0
\par\pard\qj\li2138\ri1167\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 jawab pelayanan (DPJP), perawat, dan profesional
pemberi asuhan (PPA) \up0 \expndtw-4\charscalex100 lainnya untuk memenuhi
kebutuhan segera pasien pascaoperasi. (R) \par\pard\ql \li1778\ri1298\sb4\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-2\charscalex100 2. Ada bukti
pelaksanaan rencana asuhan pascaoperasi dicatat di rekam medis \line\tab \up0
\expndtw-2\charscalex100 pasien dalam waktu 24 jam oleh dokter penanggung jawab
pelayanan (DPJP) \line \tab \up0 \expndtw-2\charscalex100 atau diverifikasi oleh
dokter penanggung jawab pelayanan (DPJP) bila ditulis \line \tab \up0 \expndtw-
3\charscalex100 oleh dokter bedah yg didelegasikan. (D,W) \par\pard\ql
\li1778\ri1167\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 3.
Ada bukti pelaksanaan rencana asuhan pascaoperasi termasuk rencana
\line\tab \up0 \expndtw-4\charscalex100 asuhan medis, keperawatan, dan PPA lainnya
berdasar atas kebutuhan pasien. \line \tab \up0 \expndtw-5\charscalex100 (D,O,W)
\par\pard\qj \li1778\ri1216\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
4. Ada bukti pelaksanaan rencana asuhan pascaoperasi diubah berdasar atas
\line\tab \up0 \expndtw-3\charscalex100 asesmen ulang pasien. (D,O,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb261\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 7.4
\par\pard\qj \li1418\ri1223\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi yang mengatur
asuhan pasien operasi yang \up0 \expndtw0\charscalex100 menggunakan implan dan
harus memperhatikan pertimbangan khusus tentang \up0 \expndtw-3\charscalex100
tindakan yang dimodifikasi. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 7.4
\par\pard\qj \li1418\ri1166\sb188\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Banyak tindakan bedah menggunakan implan prostetik
antara lain panggul, lutut, pacu \line \up0 \expndtw0\charscalex104 jantung, dan
pompa insulin. Tindakan operasi seperti ini mengharuskan tindakan \line \up0
\expndtw-2\charscalex100 operasi rutin yang dimodifikasi dengan mempertimbangkan
faktor khusus seperti \par\pard\ql \li1778\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 a) pemilihan implan berdasar atas peraturan perundangan;
\par\pard\qj \li1778\ri1213\sb18\sl-260\slmult0\tx2138 \up0 \expndtw0\charscalex100
b) modifikasi\ul0\nosupersub\cf8\f9\fs24 surgical safety
checklist\ul0\nosupersub\cf7\f8\fs24 untuk memastikan ketersediaan implan di
\line\tab \up0 \expndtw-3\charscalex100 kamar operasi dan pertimbangan khusus untuk
penandaan lokasi operasi; \par\pard\qj \li1778\ri1224\sb4\sl-280\slmult0\tx2138
\up0 \expndtw0\charscalex106 c) kualifikasi dan pelatihan setiap staf dari
luar yang dibutuhkan untuk \line\tab \up0 \expndtw0\charscalex101 pemasangan
implan \up0 \expndtw0\charscalex106 (staf dari pabrik atau perusahaan implan
untuk \par\pard\ql \li2138\sb4\sl-276\slmult0 \up0 \expndtw-3\charscalex100
mengkalibrasi); \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 d) proses pelaporan jika ada kejadian yang tidak diharapkan
terkait implan; \par\pard\ql \li1778\sb1\sl-256\slmult0 \up0 \expndtw-
2\charscalex100 e) proses pelaporan malfungsi implan sesuai dengan standar/aturan
pabrik; \par\pard\ql \li1778\sb8\sl-276\slmult0 \up0 \expndtw-2\charscalex100 f)
pertimbangan pengendalian infeksi yang khusus; \par\pard\ql \li1778\sb4\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 g) instruksi khusus kepada pasien
setelah operasi; \par\pard\ql \li1778\sb4\sl-276\slmult0\tx5102 \up0 \expndtw-
2\charscalex100 h) kemampuan penelusuran \tab \up0 \expndtw-1\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 traceability\ul0\nosupersub\cf7\f8\fs24 ) alat jika
terjadi penarikan kembali \par\pard\qj \li2138\ri1161\sb18\sl-260\slmult0 \up0
\expndtw-3\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
recall\ul0\nosupersub\cf7\f8\fs24 ) alat dengan melakukan antara lain
menempelkan\ul0\nosupersub\cf8\f9\fs24 barcode\ul0\nosupersub\cf7\f8\fs24 alat di
rekam \up0 \expndtw-4\charscalex100 medis\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb251\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Elemen Penilaian PAB 7.4 \par\pard\ql \li1778\sb244\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada
regulasi yang meliputi butir a) sampai dengan h) pada maksud dan tujuan.
\par\pard\ql \li2138\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 (R)
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada
daftar alat implan yang digunakan di rumah sakit. (D,W) \par\pard\qj
\li1778\ri1217\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Bila
implan yang dipasang dilakukan penarikan kembali (\ul0\nosupersub\cf8\f9\fs24
recall\ul0\nosupersub\cf7\f8\fs24 ) ada bukti \line\tab \up0 \expndtw-
3\charscalex100 rumah sakit dapat melakukan telusur terhadap pasien terkait.
(D,O,W) \par\pard\ql \li1778\sb17\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4.
Ada bukti alat implan dimasukkan dalam prioritas monitoring unit terkait. (D,W)
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb90\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 168
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg169}
{\bkmkend Pg169}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb176\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf23\f24\fs24 \u10070?\ul0\nosupersub\cf6\f7\fs24
RUANG OPERASI \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb32\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar PAB 8 \par\pard\qj
\li1418\ri1219\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Desain tata ruang operasi harus memenuhi syarat sesuai
dengan peraturan dan \up0 \expndtw-3\charscalex100 perundang-undangan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb69\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB
8 \par\pard\qj \li1418\ri1222\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Tindakan bedah merupakan tindakan yang berisiko
tinggi dan rumit sehingga \up0 \expndtw0\charscalex102 memerlukan ruang operasi
yang mendukung terlaksananya tindakan bedah untuk \up0 \expndtw-3\charscalex100
mengurangi risiko infeksi. \par\pard\ql \li1418\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Selain itu, untuk mengurangi risiko infeksi \par\pard\qj
\li1869\ri1224\sb0\sl-320\slmult0\tx2229 \up0 \expndtw0\charscalex102 a) alur
masuk barang-barang steril harus terpisah dari alur keluar barang dan \line\tab
\up0 \expndtw-3\charscalex100 pakaian kotor; \par\pard\qj \li1869\ri1225\sb0\sl-
320\slmult0\tx2229 \up0 \expndtw0\charscalex100 b) koridor steril dipisahkan dan
tidak boleh bersilangan alurnya dengan koridor \line\tab \up0 \expndtw-
3\charscalex100 kotor; \par\pard\qj \li1869\ri1216\sb0\sl-320\slmult0\tx2229
\up0 \expndtw0\charscalex104 c) desain tata ruang operasi harus memenuhi ketentuan
zona berdasar atas \line\tab \up0 \expndtw-3\charscalex100 tingkat sterilitas
ruangan yang terdiri atas \par\pard\ql \li2589\sb25\sl-276\slmult0 \up0
\expndtw0\charscalex100 \u8226? zona steril rendah; \par\pard\ql \li2589\sb44\sl-
276\slmult0 \up0 \expndtw0\charscalex100 \u8226? zona steril sedang; \par\pard\ql
\li2589\sb24\sl-276\slmult0 \up0 \expndtw0\charscalex100 \u8226? zona steril
tinggi; dan \par\pard\ql \li2589\sb44\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \u8226? zona steril sangat tinggi. \par\pard\qj
\li1418\ri1228\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102 Selain itu, desain
tata ruang operasi harus memperhatikan risiko keselamatan dan \up0 \expndtw-
3\charscalex100 keamanan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 8 \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah
sakit menetapkan jenis pelayanan bedah yang dapat dilaksanakan. (R) \par\pard\qj
\li1778\ri1157\sb25\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Kamar
operasi memenuhi persyaratan tentang pengaturan zona berdasar atas \line\tab
\up0 \expndtw-3\charscalex100 tingkat sterilitas ruangan sesuai dengan peraturan
perundang-undangan. (O,W) \par\pard\qj \li1778\ri1217\sb4\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex100 3. Kamar operasi memenuhi persyaratan alur masuk
barang-barang steril harus \line\tab \up0 \expndtw-3\charscalex100 terpisah dari
alur keluar barang dan pakaian kotor. (O,W) \par\pard\qj \li1778\ri1227\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Kamar operasi memenuhi
persyaratan koridor steril dipisahkan/tidak boleh \line\tab \up0 \expndtw-
3\charscalex100 bersilangan alurnya dengan koridor kotor. (O,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PAB 8.1 \par\pard\qj
\li1418\ri1221\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Program mutu dan keselamatan pasien dalam pelayanan
bedah dilaksanakan dan \up0 \expndtw-3\charscalex100 didokumentasikan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PAB 8.1
\par\pard\qj \li1418\ri1220\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelayanan bedah merupakan tindakan berisiko, oleh
karena itu perencanaan dan \line \up0 \expndtw-1\charscalex100 pelaksanaannya
membutuhkan tingkat kehati-hatian dan akurasi tinggi. Sehubungan \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb110\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 169
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg170}
{\bkmkend Pg170}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1228\sb253\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 dengan hal itu rumah sakit menetapkan program mutu dan
keselamatan pasien yang \up0 \expndtw-3\charscalex100 meliputi \par\pard\ql
\li1778\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a) pelaksanaan asesmen
prabedah; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b)
penandaan lokasi operasi; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 c) pelaksanaan\ul0\nosupersub\cf8\f9\fs24 surgical safety check
List\ul0\nosupersub\cf7\f8\fs24 (lihat juga SKP 4); \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 d) pemantauan diskrepansi diagnosis pre
dan posoperasi. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PAB 8.1 \par\pard\qj
\li1778\ri1226\sb25\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan program mutu dan
keselamatan pasien dalam \line\tab \up0 \expndtw-3\charscalex100 pelayanan bedah.
(R) \par\pard\ql \li1778\sb40\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Ada
bukti monitoring dan evaluasi pelaksanaan asesmen prabedah. (D,W) \par\pard\qj
\li1778\ri1222\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 3. Ada bukti
monitoring dan evaluasi pelaksanaan penandaan lokasi operasi. \line\tab \up0
\expndtw-2\charscalex100 (D,W) \par\pard\qj \li1778\ri1179\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 4. Ada bukti monitoring dan
evaluasi pelaksanaan\ul0\nosupersub\cf8\f9\fs24 surgical safety check
List\ul0\nosupersub\cf7\f8\fs24 ; (lihat \line\tab \up0 \expndtw-3\charscalex100
juga SKP 4). (D.W) \par\pard\qj \li1778\ri1227\sb0\sl-320\slmult0\tx2138 \up0
\expndtw-1\charscalex100 5. Ada bukti monitoring dan evaluasi pemantauan
diskrepansi diagnosis pre dan \line\tab \up0 \expndtw-3\charscalex100 posoperasi.
(D,W) \par\pard\qj \li1778\ri1222\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 6. Program mutu pelayanan bedah diintegrasikan dengan
program mutu rumah \line\tab \up0 \expndtw-3\charscalex100 sakit (lihat PMKP 2.1 ).
(D,W) \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb60\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 170
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg171}
{\bkmkend Pg171}\par\pard\ql \li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb68\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAB 6 \par\pard\ql \li2265\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 PELAYANAN KEFARMASIAN DAN PENGGUNAAN OBAT
(PKPO) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb212\sl-276\slmult0 \up0 \expndtw-3\charscalex100
GAMBARAN UMUM \par\pard\ql \li1418\ri1219\sb208\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelayanan kefarmasian adalah pelayanan
langsung dan bertanggung jawab kepada \up0 \expndtw0\charscalex100 pasien yang
berkaitan dengan sediaan farmasi dan alat kesehatan dengan maksud \up0 \expndtw-
3\charscalex100 mencapai hasil yang pasti untuk meningkatkan mutu kehidupan pasien.
\line \up0 \expndtw-3\charscalex100 Pelayanan kefarmasian di rumah sakit bertujuan
untuk \par\pard\qj \li1778\ri1220\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex102 \u8226? menjamin mutu, manfaat, keamanan, serta khasiat
sediaan farmasi dan alat \line\tab \up0 \expndtw-3\charscalex100 kesehatan;
\par\pard\ql \li1778\sb40\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
menjamin kepastian hukum bagi tenaga kefarmasian; \par\pard\qj
\li1778\ri1226\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex105 \u8226?
melindungi pasien, masyarakat, dan staf dari penggunaan obat yang tidak
\line\tab \up0 \expndtw-3\charscalex100 rasional dalam rangka keselamatan pasien
(\ul0\nosupersub\cf8\f9\fs24 patient safety\ul0\nosupersub\cf7\f8\fs24
); \par\pard\qj \li1778\ri1221\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex104 \u8226? menjamin sistem pelayanan kefarmasian dan
penggunaan obat yang lebih \line\tab \up0 \expndtw-3\charscalex100 aman
(\ul0\nosupersub\cf8\f9\fs24 medication safety\ul0\nosupersub\cf7\f8\fs24 );
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
menurunkan angka kesalahan penggunaan obat. \par\pard\qj \li1418\ri1166\sb308\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Pelayanan kefarmasian dan penggunaan obat
merupakan komponen yang penting \up0 \expndtw0\charscalex103 dalam pengobatan
simtomatik, preventif, kuratif, paliatif, dan rehabilitatif terhadap \up0
\expndtw0\charscalex100 penyakit dan berbagai kondisi, serta mencakup sistem dan
proses yang digunakan \up0 \expndtw-3\charscalex100 rumah sakit dalam memberikan
farmakoterapi kepada pasien. Pelayanan kefarmasian \up0 \expndtw-3\charscalex100
dilakukan secara multidisiplin dalam koordinasi para staf di rumah sakit.
\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\ri1171\sb10\sl-
315\slmult0 \up0 \expndtw0\charscalex104 Rumah sakit menerapkan prinsip rancang
proses yang efektif, implementasi dan \line \up0 \expndtw0\charscalex100
peningkatan mutu terhadap seleksi, pengadaan, penyimpanan, peresepan atau
\line \up0 \expndtw-1\charscalex100 permintaan obat atau instruksi pengobatan,
penyalinan (\ul0\nosupersub\cf8\f9\fs24 transcribe\ul0\nosupersub\cf7\f8\fs24 ),
pendistribusian, \line \up0 \expndtw-3\charscalex100 penyiapan
(\ul0\nosupersub\cf8\f9\fs24 dispensing\ul0\nosupersub\cf7\f8\fs24 ), pemberian,
pendokumentasian, dan pemantauan terapi obat. \line \up0 \expndtw-4\charscalex100
Praktik penggunaan obat yang tidak aman \up0 \expndtw-4\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 unsafe medication
practices\ul0\nosupersub\cf7\f8\fs24 ) dan \par\pard\qj \li1418\ri1158\sb6\sl-
315\slmult0 \up0 \expndtw-1\charscalex100 kesalahan penggunaan obat
(\ul0\nosupersub\cf8\f9\fs24 medication errors\ul0\nosupersub\cf7\f8\fs24 ) adalah
penyebab utama cedera dan \up0 \expndtw-4\charscalex100 bahaya yang dapat dihindari
dalam sistem pelayanan kesehatan di seluruh dunia. Oleh \up0
\expndtw0\charscalex100 karena itu, rumah sakit diminta untuk mematuhi
peraturan perundang-undangan, \up0 \expndtw-3\charscalex100 membuat sistem
pelayanan kefarmasian, dan penggunaan obat yang lebih aman yang \up0 \expndtw-
4\charscalex100 senantiasa berupaya menurunkan kesalahan pemberian obat.
\par\pard\qj \li1778\ri1962\sb156\sl-520\slmult0\fi429 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 STANDAR, MAKSUD DAN TUJUAN, SERTA
ELEMEN PENILAIAN \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PENGORGANISASIAN \par\pard\ql \li1418\sb202\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PKPO 1 \par\pard\qj
\li1418\ri1163\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pengorganisasian pelayanan kefarmasian dan penggunaan
obat di rumah sakit harus \up0 \expndtw0\charscalex100 sesuai dengan peraturan
perundangan-undangan dan diorganisir untuk memenuhi \up0 \expndtw-3\charscalex100
kebutuhan pasien. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb243\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 171
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg172}
{\bkmkend Pg172}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 1 \par\pard\qj
\li1418\ri1159\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelayanan kefarmasian dan penggunaan obat merupakan
bagian penting dalam \up0 \expndtw-3\charscalex100 pelayanan pasien sehingga
organisasinya harus efektif dan efisien, serta bukan hanya \line \up0
\expndtw0\charscalex102 tanggung jawab apoteker, tetapi juga profesional pemberi
asuhan dan staf klinis \line \up0 \expndtw0\charscalex100 pemberi asuhan lainnya.
Pengaturan pembagian tanggung jawab bergantung pada \line \up0 \expndtw-
3\charscalex100 struktur organisasi dan\ul0\nosupersub\cf8\f9\fs24
staffing\ul0\nosupersub\cf7\f8\fs24 . Struktur organisasi dan operasional sistem
pelayanan \line \up0 \expndtw0\charscalex102 kefarmasian serta penggunaan obat
di rumah sakit mengacu pada peraturan \line \up0 \expndtw-3\charscalex100
perundang-undangan. \par\pard\qj \li1418\ri1227\sb288\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Pelayanan kefarmasian dilakukan oleh apoteker yang melakukan
pengawasan dan \line \up0 \expndtw0\charscalex102 supervisi semua aktivitas
pelayanan kefarmasian serta penggunaan obat di rumah \line \up0 \expndtw-
3\charscalex100 sakit. \par\pard\qj \li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\ri1213\sb8\sl-316\slmult0 \up0 \expndtw0\charscalex103 Untuk
memastikan keefektifannya maka rumah sakit melakukan kajian sekurang\up0
\expndtw0\charscalex103 kurangnya sekali setahun. Kajian tahunan mengumpulkan
semua informasi dan \up0 \expndtw0\charscalex103 pengalaman yang berhubungan dengan
pelayanan kefarmasian dan penggunaan \up0 \expndtw0\charscalex105 obat, termasuk
angka kesalahan penggunaan obat serta upaya untuk \up0
\expndtw0\charscalex100 menurunkannya. Kajian bertujuan membuat rumah sakit
memahami kebutuhan dan \up0 \expndtw0\charscalex100 prioritas perbaikan sistem
berkelanjutan dalam hal mutu, keamanan, manfaat, serta \up0 \expndtw-
3\charscalex100 khasiat obat dan alat kesehatan. \par\pard\qj \li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\ri1217\sb1\sl-320\slmult0 \up0
\expndtw0\charscalex100 Kajian tahunan mengumpulkan semua data, informasi,
dan pengalaman yang \up0 \expndtw-1\charscalex100 berhubungan dengan pelayanan
kefarmasian serta penggunaan obat, termasuk \up0 \expndtw-3\charscalex100
antara lain \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100
1) seberapa baik sistem telah bekerja terkait dengan \par\pard\ql \li2498\sb24\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 \u8226? seleksi dan pengadaan obat;
\par\pard\ql \li2498\sb44\sl-276\slmult0 \up0 \expndtw0\charscalex101 \u8226?
penyimpanan; \par\pard\ql \li2498\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\u8226? peresepan/permintaan obat dan instruksi pengobatan; \par\pard\ql
\li2498\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \u8226? penyiapan dan
penyerahan; dan \par\pard\ql \li2498\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex101 \u8226? pemberian obat. \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 2) pendokumentasian dan pemantauan efek
obat; \par\pard\ql \li1778\ri1157\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 3) monitor seluruh angka kesalahan penggunaan obat
(\ul0\nosupersub\cf8\f9\fs24 medication error\ul0\nosupersub\cf7\f8\fs24 ) meliputi
\line\tab \up0 \expndtw0\charscalex100 kejadian tidak diharapkan, kejadian
sentinel, kejadian nyaris cedera, kejadian \line \tab \up0 \expndtw-4\charscalex100
tidak cedera. dan upaya mencegah dan menurunkannya; \par\pard\ql \li1778\sb25\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 4) kebutuhan pendidikan dan
pelatihan; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
5) pertimbangan melakukan kegiatan baru berbasis bukti
(\ul0\nosupersub\cf8\f9\fs24 evidence
based\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 . \par\pard\qj
\li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\ri1218\sb26\sl-310\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Dengan kajian ini rumah sakit
dapat memahami kebutuhan dan prioritas peningkatan \up0 \expndtw0\charscalex103
mutu serta keamanan penggunaan obat. Sumber informasi obat yang tepat harus \up0
\expndtw-3\charscalex100 tersedia di semua unit pelayanan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb127\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 1 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb57\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 172
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg173}
{\bkmkend Pg173}\par\pard\ql \li1778\sb0\sl-313\slmult0 \par\pard\ql\li1778\sb0\sl-
313\slmult0 \par\pard\ql\li1778\sb0\sl-313\slmult0
\par\pard\ql\li1778\ri1223\sb203\sl-313\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex106 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi organisasi
yang mengelola pelayanan kefarmasian dan \line\tab \up0 \expndtw0\charscalex101
penggunaan obat yang menyeluruh atau mengarahkan semua tahapan \line \tab
\up0 \expndtw0\charscalex103 pelayanan kefarmasian serta penggunaan obat yang aman
sesuai dengan \line \tab \up0 \expndtw-3\charscalex100 peraturan perundang-
undangan. (R) \par\pard\qj \li1778\ri1219\sb2\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 2. Ada bukti seluruh apoteker memiliki izin dan
melakukan supervisi sesuai \line\tab \up0 \expndtw-3\charscalex100 dengan
penugasannya. (D,W) \par\pard\qj \li1778\ri1162\sb0\sl-320\slmult0\tx2138 \up0
\expndtw-3\charscalex100 3. Ada bukti pelaksanaan sekurang-kurangnya satu kajian
pelayanan kefarmasian \line\tab \up0 \expndtw-3\charscalex100 dan penggunaan obat
yang didokumentasikan selama 12 bulan terakhir. (D,W) \par\pard\qj
\li1778\ri1220\sb17\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex102 4. Ada
bukti sumber informasi obat yang tepat, terkini, dan selalu tersedia bagi \line\tab
\up0 \expndtw-3\charscalex100 semua yang terlibat dalam penggunaan obat. (D,O,W)
\par\pard\qj \li1778\ri1226\sb4\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex100 5. Terlaksana pelaporan kesalahan penggunaan obat
sesuai dengan peraturan \line\tab \up0 \expndtw-3\charscalex100 perundang-undangan.
(D,W) \par\pard\ql \li1778\ri1218\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex105 6. Terlaksana tindak lanjut terhadap kesalahan
penggunaan obat untuk \line\tab \up0 \expndtw0\charscalex102 memperbaiki sistem
manajemen dan penggunaan obat sesuai dengan \line \tab \up0 \expndtw-
3\charscalex100 peraturan perundang-undangan. (D,W) \par\pard\ql \li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
SELEKSI DAN PENGADAAN \par\pard\ql \li1418\sb224\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Standar PKPO 2 \par\pard\qj \li1418\ri1161\sb8\sl-320\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Ada proses seleksi obat
dengan benar yang menghasilkan formularium dan digunakan \line \up0 \expndtw-
3\charscalex100 untuk permintaan obat serta instruksi pengobatan. Obat dalam
formularium senantiasa \line \up0 \expndtw-3\charscalex100 tersedia dalam stok di
rumah sakit atau sumber di dalam atau di luar rumah sakit. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 2 \par\pard\qj
\li1418\ri1159\sb11\sl-317\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit harus menetapkan formularium obat yang
mengacu pada peraturan \line \up0 \expndtw0\charscalex100 perundang-undangan.
Formularium ini didasarkan atas misi rumah sakit, kebutuhan \line \up0
\expndtw0\charscalex100 pasien, dan jenis pelayanan yang diberikan. Seleksi obat
adalah suatu proses kerja \line \up0 \expndtw0\charscalex103 sama yang
mempertimbangkan baik kebutuhan dan keselamatan pasien maupun \line \up0 \expndtw-
3\charscalex100 kondisi ekonominya. Apabila terjadi kehabisan obat karena
keterlambatan pengiriman, \line \up0 \expndtw-4\charscalex100 stok nasional kurang,
atau sebab lain yang tidak diantisipasi sebelumnya maka tenaga \line \up0
\expndtw0\charscalex100 kefarmasian harus menginformasikan kepada profesional
pemberi asuhan dan staf \line \up0 \expndtw0\charscalex102 klinis pemberi asuhan
lainnya tentang kekosongan obat tersebut serta saran \line \up0 \expndtw-
3\charscalex100 substitusinya atau mengadakan perjanjian kerjasama dengan pihak
luar. \par\pard\ql \li1418\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 2 \par\pard\ql
\li1778\ri1158\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi organisasi yang menyusun formularium
rumah sakit berdasar atas \line\tab \up0 \expndtw0\charscalex100 kriteria yang
disusun secara kolaboratif sesuai dengan peraturan perundang-\line \tab \up0
\expndtw-3\charscalex100 undangan. (R) \par\pard\ql \li1778\ri1227\sb6\sl-
313\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex100 2. Ada bukti
pelaksanaan apabila ada obat yang baru ditambahkan dalam \line\tab \up0
\expndtw-1\charscalex100 formularium maka ada proses untuk memantau bagaimana
penggunaan obat \line \tab \up0 \expndtw0\charscalex100 tersebut dan bila terjadi
efek obat yang tidak diharapkan, efek samping serta \line \tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 medication
error\ul0\nosupersub\cf7\f8\fs24 . (D,W) \par\pard\qj \li1778\ri1219\sb2\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Ada bukti implementasi untuk
memantau kepatuhan terhadap formularium baik \line\tab \up0 \expndtw-
3\charscalex100 dari persediaan maupun penggunaanya. (D,W) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb170\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 173
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg174}
{\bkmkend Pg174}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1220\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 4. Ada bukti pelaksanaan formularium sekurang-
kurangnya dikaji setahun sekali \line\tab \up0 \expndtw-3\charscalex100 berdasar
atas informasi tentang keamanan dan efektivitas. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb8\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO
2.1 \par\pard\qj \li1418\ri1228\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses pengadaan sediaan
farmasi, alat kesehatan, dan \up0 \expndtw0\charscalex102 bahan medis habis pakai
yang aman, bermutu, bermanfaat, dan berkhasiat sesuai \up0 \expndtw-3\charscalex100
dengan peraturan perundang-undangan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PKPO 2.1.1 \par\pard\qj \li1418\ri1218\sb0\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi untuk mendapatkan obat bila sewaktu-waktu obat \up0 \expndtw-
3\charscalex100 tidak tersedia. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 2.1 sampai dengan PKPO 2.1.1
\par\pard\qj \li1418\ri1157\sb11\sl-316\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi dan proses
pengadaan sediaan farmasi, alat \up0 \expndtw-1\charscalex100 kesehatan, dan
bahan medis habis pakai sesuai dengan peraturan perundang\up0 \expndtw-
4\charscalex100 undangan. Ada kalanya sediaan farmasi, alat kesehatan, dan bahan
medis habis pakai \up0 \expndtw-1\charscalex100 tidak ada dalam stok atau
tidak tersedia saat dibutuhkan. Rumah sakit harus \up0
\expndtw0\charscalex100 menetapkan regulasi dan proses untuk pengadaan sediaan
farmasi, alat kesehatan, \up0 \expndtw0\charscalex104 dan bahan medis habis pakai
yang aman, bermutu, bermanfaat, serta berkhasiat \up0 \expndtw-4\charscalex100
sesuai dengan peraturan perundang-undangan. (lihat juga TKRS 7) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 2.1
\par\pard\ql \li1778\ri1224\sb16\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pengadaan
sediaan farmasi, alat kesehatan, dan bahan medis \line\tab \up0 \expndtw-
1\charscalex100 habis pakai yang aman, bermutu, bermanfaat, serta berkhasiat sesuai
dengan \line \tab \up0 \expndtw-2\charscalex100 peraturan perundang-undangan.
(lihat juga TKRS 7). (R) \par\pard\qj \li1778\ri1204\sb2\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 2. Ada bukti bahwa manajemen rantai pengadaan
(\ul0\nosupersub\cf8\f9\fs24 supply chain
management\ul0\nosupersub\cf7\f8\fs24 ) \line\tab \up0 \expndtw-2\charscalex100
dilaksanakan sesuai dengan peraturan perundang-undangan. (lihat juga TKRS
\par\pard\ql \li2138\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 7.1)
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. Ada
bukti pengadaan obat berdasar atas kontrak. (lihat juga TKRS 7) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 2.1.1 \par\pard\qj
\li1778\ri1165\sb25\sl-300\slmult0\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pengadaan bila sediaan farmasi, alat
kesehatan, dan bahan medis \line\tab \up0 \expndtw-3\charscalex100 habis pakai
tidak ada dalam stok atau tidak tersedia saat dibutuhkan. (R) \par\pard\ql
\li1778\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada bukti
pemberitahuan kepada staf medis serta saran substitusinya. (D,W) \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. Ada bukti bahwa staf
memahami dan mematuhi regulasi tersebut. (D, W) \par\pard\ql \li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb12\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PENYIMPANAN \par\pard\ql \li1418\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PKPO 3 \par\pard\qj
\li1418\ri1159\sb25\sl-300\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan tata laksana pengaturan
penyimpanan sediaan farmasi, alat \up0 \expndtw-4\charscalex100 kesehatan, dan
bahan medis habis pakai yang baik, benar, serta aman. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb213\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 174
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg175}
{\bkmkend Pg175}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 3
\par\pard\qj \li1418\ri1217\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Sediaan farmasi, alat kesehatan, dan bahan medis habis
pakai disimpan di tempat \up0 \expndtw0\charscalex102 yang sesuai, dapat di gudang
logistik, di instalasi farmasi, atau di satelit atau depo \up0 \expndtw-
2\charscalex100 farmasi serta diharuskan memiliki pengawasan di
semua lokasi penyimpanan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 3 \par\pard\qj
\li1778\ri1220\sb208\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang pengaturan penyimpanan
sediaan farmasi, alat \line\tab \up0 \expndtw-3\charscalex100 kesehatan, dan
bahan medis habis pakai yang baik, benar, dan aman. (R) \par\pard\ql
\li1778\ri1204\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 2.
Ada bukti obat dan zat kimia yang digunakan untuk mempersiapkan obat diberi
\line\tab \up0 \expndtw-1\charscalex100 label yang terdiri atas isi/nama obat,
tanggal kadaluarsa, dan peringatan \line \tab \up0 \expndtw-2\charscalex100
khusus. (lihat juga MFK 5 EP 6). (O,W) \par\pard\qj \li1778\ri1205\sb2\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Ada bukti implementasi proses
penyimpanan obat yang tepat agar kondisi obat \line\tab \up0 \expndtw-
2\charscalex100 tetap stabil, termasuk obat yang disimpan di luar instalasi
farmasi. (D,W) \par\pard\qj \li1778\ri1227\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 4. Ada bukti pelaksanaan dilakukan supervisi secara teratur oleh
apoteker untuk \line\tab \up0 \expndtw-3\charscalex100 memastikan penyimpanan obat
dilakukan dengan baik. (D,W) \par\pard\qj \li1778\ri1158\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 5. Ada bukti pelaksanaan obat
dilindungi dari kehilangan serta pencurian di semua \line\tab \up0 \expndtw-
4\charscalex100 tempat penyimpanan dan pelayanan. (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb261\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO 3.1 \par\pard\qj
\li1418\ri1220\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengatur tata kelola bahan berbahaya,
seta obat narkotika dan \up0 \expndtw-1\charscalex100 psikotropika yang baik,
benar, dan aman sesuai dengan peraturan perundang\up0 \expndtw-
3\charscalex100 undangan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 3.1 \par\pard\qj
\li1418\ri1215\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Beberapa macam obat seperti obat radioaktif dan obat
yang dibawa pasien sebelum \up0 \expndtw0\charscalex100 rawat inap mungkin memiliki
risiko keamanan. Obat program pemerintah atau obat \up0 \expndtw-2\charscalex100
darurat dimungkinkan ada kesempatan penyalahgunaan atau karena ada kandungan
\up0 \expndtw-1\charscalex100 khusus (misalnya nutrisi), memerlukan ketentuan
khusus untuk menyimpan dan \up0 \expndtw-1\charscalex100 mengawasi
penggunaannya. Rumah sakit menetapkan prosedur yang mengatur \up0
\expndtw0\charscalex100 tentang penerimaan, identifikasi, tempat penyimpanan, dan
distribusi macam obat\up0 \expndtw-3\charscalex100 obat ini. (lihat juga MFK
4.1) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb249\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PKPO 3.1 \par\pard\ql \li1778\ri1175\sb8\sl-320\slmult0\tx2138\tx2138
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi
pengaturan tata kelola bahan berbahaya, serta obat narkotika dan \line\tab \up0
\expndtw-2\charscalex100 psikotropika yang baik, benar, dan aman sesuai dengan
peraturan perundang-\line \tab \up0 \expndtw-3\charscalex100 undangan. (R)
\par\pard\qj \li1778\ri1223\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100
2. Ada bukti penyimpanan bahan berbahaya yang baik, benar, dan aman sesuai
\line\tab \up0 \expndtw-3\charscalex100 dengan egulasi. (O,W) \par\pard\qj
\li1778\ri1191\sb17\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Ada
bukti penyimpanan obat narkotika serta psikotropika yang baik, benar, dan \line\tab
\up0 \expndtw-3\charscalex100 aman sesuai dengan regulasi. (O,W) \par\pard\qj
\li1778\ri1218\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 4. Ada bukti
pelaporan obat narkotika serta psikotropika secara akurat sesuai \line\tab \up0
\expndtw-3\charscalex100 dengan peraturan dan perundang-undangan. (D,W)
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb23\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 175
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg176}
{\bkmkend Pg176}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO 3.2 \par\pard\qj
\li1418\ri1157\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengatur tata kelola penyimpanan elektrolit
konsentrat yang baik, benar, \up0 \expndtw-4\charscalex100 dan aman sesuai dengan
peraturan perundang-undangan. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 3.2
\par\pard\qj \li1418\ri1157\sb10\sl-318\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Jika ada pasien emerjensi maka akses cepat ke tempat
obat yang diperlukan menjadi \up0 \expndtw0\charscalex102 sangat penting dan obat
harus siap pakai bila sewaktu-waktu diperlukan. Setiap \up0 \expndtw-
2\charscalex100 rumah sakit harus membuat rencana lokasi penyimpanan obat
emerjensi, contoh troli \up0 \expndtw-1\charscalex100 obat emerjensi yang tersedia
di berbagai unit pelayanan, obat untuk mengatasi syok \up0 \expndtw0\charscalex100
anafilatik di tempat penyuntikan, dan obat untuk pemulihan anestesi ada di
kamar \up0 \expndtw0\charscalex100 operasi. Obat emerjensi dapat disimpan di lemari
emerjensi, troli, tas/ransel, kotak, \up0 \expndtw-1\charscalex100 dan lainnya
sesuai dengan kebutuhan di tempat tersebut. Rumah sakit diminta \up0
\expndtw0\charscalex100 menetapkan prosedur untuk memastikan ada kemudahan untuk
mencapai dengan \up0 \expndtw-4\charscalex100 cepat tempat penyimpanan obat
emerjensi jika dibutuhkan, termasuk obat selalu harus \up0 \expndtw-2\charscalex100
segera diganti kalau digunakan, bila rusak atau kadaluarsa, selain itu keamanan
obat \up0 \expndtw-3\charscalex100 emergensi harus
diperhatikan.\ul0\nosupersub\cf15\f16\fs24 (lihat juga MFK 4.1) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 3.2
\par\pard\ql \li1778\ri1158\sb8\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rumah sakit
tentang proses larangan menyimpan elektrolit \line\tab \up0 \expndtw-
2\charscalex100 konsentrat di tempat rawat inap kecuali bila dibutuhkan
secara klinik dan \line \tab \up0 \expndtw-2\charscalex100 apabila terpaksa
disimpan di area rawat inap harus diatur keamanannya untuk \line \tab \up0
\expndtw-4\charscalex100 menghindari kesalahan. (lihat juga SKP 3.1). (R)
\par\pard\qj \li1778\ri1159\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
2. Ada bukti penyimpanan elektrolit konsentrat yang baik, benar, dan aman
sesuai \line\tab \up0 \expndtw-4\charscalex100 dengan egulasi. (O,W)
\par\pard\qj \li1778\ri1215\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
3. Elektrolit konsentrat diberi label obat yang harus diwaspadai
(\ul0\nosupersub\cf8\f9\fs24 high alert\ul0\nosupersub\cf7\f8\fs24 ) sesuai
\line\tab \up0 \expndtw-3\charscalex100 dengan regulasi. (O,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb229\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO 3.3
\par\pard\qj \li1418\ri1220\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan pengaturan penyimpanan dan
pengawasan penggunaan \up0 \expndtw-3\charscalex100 obat tertentu. \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 3.3 \par\pard\qj
\li1418\ri1224\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Beberapa macam obat memerlukan ketentuan khusus
untuk menyimpan dan \up0 \expndtw-3\charscalex100 mengawasi penggunaannya seperti
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a) produk
nutrisi; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b)
obat dan bahan radioaktif; \par\pard\qj \li1778\ri1222\sb8\sl-320\slmult0\tx2138
\up0 \expndtw-2\charscalex100 c) obat yang dibawa pasien sebelum rawat inap
mungkin memiliki risiko terhadap \line\tab \up0 \expndtw-3\charscalex100
keamanan; \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d)
obat program atau bantuan pemerintah/pihak lain; \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb170\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 176
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg177}
{\bkmkend Pg177}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 e) obat yang digunakan untuk
penelitian. \par\pard\qj \li1418\ri1226\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex100 Rumah sakit menetapkan prosedur yang mengatur penerimaan,
identifikasi, tempat \up0 \expndtw-3\charscalex100 penyimpanan, dan distribusi
macam obat-obat ini. (lihat juga MFK 5). \par\pard\ql \li1485\sb0\sl-276\slmult0
\par\pard\ql\li1485\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 3.3 \par\pard\qj
\li1778\ri1225\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pengaturan penyimpanan obat dengan
ketentuan khusus meliputi \line\tab \up0 \expndtw-3\charscalex100 butir 1 sampai
dengan 5 pada maksud dan tujuan. (R) \par\pard\qj \li1778\ri1223\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex105 2. Ada bukti penyimpanan produk
nutrisi yang baik, benar, dan aman sesuai \line\tab \up0 \expndtw-3\charscalex100
dengan regulasi. (lihat juga PAP 4). (O,W) \par\pard\qj \li1778\ri1221\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3. Ada bukti penyimpanan obat dan
bahan radioaktif yang baik, benar, dan aman \line\tab \up0 \expndtw-2\charscalex100
sesuai dengan regulasi. (O,W) \par\pard\qj \li1778\ri1221\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex103 4. Ada bukti penyimpanan obat yang dibawa pasien
sebelum rawat inap yang \line\tab \up0 \expndtw-3\charscalex100 baik, benar, dan
aman sesuai dengan regulasi. (O,W) \par\pard\qj \li1778\ri1191\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 5. Ada bukti penyimpanan obat
program atau bantuan pemerintah/pihak lain yang \line\tab \up0 \expndtw-
3\charscalex100 baik, benar, dan aman sesuai dengan regulasi. (O,W) \par\pard\qj
\li1778\ri1166\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 6. Ada
bukti penyimpanan obat yang digunakan untuk penelitian yang baik, benar,
\line\tab \up0 \expndtw-4\charscalex100 dan aman sesuai dengan regulasi. (O,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb85\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PKPO 3.4 \par\pard\qj \li1418\ri1219\sb8\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi untuk memastikan obat emergensi yang tersimpan \up0 \expndtw-
2\charscalex100 di dalam maupun di luar unit farmasi tersedia, tersimpan aman, dan
dimonitor. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PKPO 3.4 \par\pard\qj \li1418\ri1157\sb0\sl-318\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Jika ada pasien emergensi maka akses
cepat ke tempat obat yang diperlukan menjadi \line \up0 \expndtw0\charscalex102
sangat penting dan obat harus siap pakai bila sewaktu-waktu diperlukan.
Setiap \line \up0 \expndtw-3\charscalex100 rumah sakit harus membuat rencana lokasi
penyimpanan obat emergensi, contoh troli \line \up0 \expndtw-2\charscalex100 obat
emergensi yang tersedia di berbagai unit pelayanan, obat untuk mengatasi syok \line
\up0 \expndtw0\charscalex100 anafilatik di tempat penyuntikan, dan obat untuk
pemulihan anestesi ada di kamar \line \up0 \expndtw-1\charscalex100 operasi. Obat
emergensi dapat disimpan di lemari emergensi, troli, tas/ransel, kotak, \line
\up0 \expndtw-1\charscalex100 dan lainnya sesuai dengan kebutuhan di tempat
tersebut. Rumah sakit diminta \line \up0 \expndtw0\charscalex100 menetapkan
prosedur untuk memastikan ada kemudahan untuk mencapai dengan \line \up0
\expndtw0\charscalex103 cepat tempat penyimpanan obat emergensi jika dibutuhkan,
termasuk obat selalu \line \up0 \expndtw0\charscalex100 harus segera diganti
kalau digunakan, bila rusak, atau kadaluarsa. Selain itu, \line \up0
\expndtw-3\charscalex100 keamanan obat emergensi harus diperhatikan. (lihat juga
MFK 4.1) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb71\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PKPO 3.4 \par\pard\ql \li1778\ri1217\sb14\sl-
313\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pengelolaan obat emergensi yang
tersedia di unit-unit layanan \line\tab \up0 \expndtw0\charscalex102 agar dapat
segera dipakai untuk memenuhi kebutuhan darurat serta upaya \line \tab \up0
\expndtw-2\charscalex100 pemeliharaan dan pengamanan dari kemungkinan pencurian dan
kehilangan. \line \tab \up0 \expndtw-3\charscalex100 (lihat juga TKRS\u8230?.). (R)
\par\pard\ql \li1778\sb38\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Ada
bukti persediaan obat emergensi lengkap dan siap pakai. (D,O,W) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb177\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 177
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg178}
{\bkmkend Pg178}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1220\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 3. Ada bukti pelaksanaan supervisi terhadap
penyimpanan obat emergensi dan \line\tab \up0 \expndtw-3\charscalex100 segera
diganti apabila dipakai, kadaluwarsa, atau rusak. (D,O,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO 3.5 \par\pard\qj
\li1418\ri1158\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memiliki sistem penarikan kembali
(\ul0\nosupersub\cf8\f9\fs24 recall\ul0\nosupersub\cf7\f8\fs24 ), pemusnahan
sediaan farmasi, \up0 \expndtw0\charscalex102 alat kesehatan, dan bahan medis habis
pakai tidak layak digunakan karena rusak, \up0 \expndtw-3\charscalex100 mutu
substandar, atau kadaluwarsa. \par\pard\qj \li1418\ri1217\sb217\sl-300\slmult0 \up0
\expndtw0\charscalex102 Rumah sakit menetapkan dan melaksanakan identifikasi dalam
proses penarikan \up0 \expndtw-3\charscalex100 kembali
(\ul0\nosupersub\cf8\f9\fs24 recall\ul0\nosupersub\cf7\f8\fs24 ) oleh Pemerintah,
pabrik, atau pemasok. \par\pard\qj \li1418\ri1163\sb204\sl-320\slmult0 \up0
\expndtw-3\charscalex100 Rumah sakit juga harus menjamin bahwa sediaan farmasi,
alat kesehatan, dan bahan \up0 \expndtw-4\charscalex100 medis habis yang tidak
layak pakai karena rusak, mutu substandard, atau kadaluwarsa \up0 \expndtw-
5\charscalex100 tidak digunakan serta dimusnahkan. \par\pard\ql \li1418\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PKPO 3.5 \par\pard\ql \li1778\ri1220\sb208\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24
1. Ada regulasi penarikan kembali (\ul0\nosupersub\cf8\f9\fs24
recall\ul0\nosupersub\cf7\f8\fs24 ) dan pemusnahan sediaan farmasi, alat
\line\tab \up0 \expndtw-2\charscalex100 kesehatan, dan bahan medis habis pakai yang
tidak layak pakai karena rusak, \line \tab \up0 \expndtw-3\charscalex100 mutu
substandard, atau kadaluwarsa. (R) \par\pard\qj \li1778\ri1222\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Ada bukti pelaksanaan
penarikan kembali (\ul0\nosupersub\cf8\f9\fs24 recall\ul0\nosupersub\cf7\f8\fs24 )
sesuai dengan regulasi yang \line\tab \up0 \expndtw-3\charscalex100 ditetapkan.
(D,W) \par\pard\qj \li1778\ri1222\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 3. Ada bukti pelaksanaan pemusnahan sesuai dengan regulasi yang
ditetapkan. \line\tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb261\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PERESEPAN DAN PENYALINAN \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Standar PKPO 4 \par\pard\ql \li1418\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Ada regulasi
peresepan/permintaan obat dan instruksi pengobatan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb112\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PKPO 4 \par\pard\qj \li1418\ri1157\sb8\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan staf medis yang
kompeten dan berwenang untuk melakukan \line \up0 \expndtw-1\charscalex100
peresepan/permintaan obat serta instruksi pengobatan. Staf medis dilatih
untuk \line \up0 \expndtw-2\charscalex100 peresepan/permintaan obat dan
instruksi pengobatan dengan \up0 \expndtw-2\charscalex100 benar.
\par\pard\qj \li1418\ri1164\sb6\sl-313\slmult0 \up0 \expndtw-3\charscalex100
Peresepan/permintaan obat dan instruksi pengobatan yang tidak benar, tidak terbaca,
\up0 \expndtw0\charscalex104 dan tidak lengkap dapat membahayakan pasien serta
menunda kegiatan asuhan \up0 \expndtw0\charscalex100 pasien. Rumah sakit memiliki
regulasi peresepan/permintaan obat serta instruksi \up0 \expndtw-3\charscalex100
pengobatan dengan benar, lengkap, dan terbaca tulisannya. \par\pard\qj
\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1218\sb2\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Rumah sakit menetapkan proses rekonsiliasi obat,
yaitu proses membandingkan \line \up0 \expndtw0\charscalex107 daftar obat yang
dipergunakan oleh pasien sebelum dirawat inap dengan \line \up0 \expndtw-
1\charscalex100 peresepan/permintaan obat dan instruksi pengobatan yang dibuat
pertama kali sejak \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb230\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 178
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg179}
{\bkmkend Pg179}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0
\par\pard\qj\li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\ri1220\sb253\sl-
300\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 pasien masuk,
saat pemindahan pasien antarunit pelayanan (\ul0\nosupersub\cf8\f9\fs24
transfer\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 dan sebelum \up0 \expndtw-3\charscalex100 pasien
pulang. \par\pard\ql \li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb84\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PKPO 4 \par\pard\ql \li1778\ri1191\sb208\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi peresepan/permintaan obat dan
instruksi pengobatan secara \line\tab \up0 \expndtw-2\charscalex100 benar,
lengkap, dan terbaca, serta menetapkan staf medis yang kompeten dan \line \tab \up0
\expndtw0\charscalex104 berwenang untuk melakukan peresepan/permintaan obat
dan instruksi \line \tab \up0 \expndtw-3\charscalex100 pengobatan. (lihat juga PAP
2.2 EP 1; AP 3 EP 1; dan SKP 2 EP 1). (R) \par\pard\qj \li1778\ri1220\sb17\sl-
300\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Ada bukti peresepan/permintaan
obat dan instruksi pengobatan dilaksanakan \line\tab \up0 \expndtw-3\charscalex100
oleh staf medis yang kompeten serta berwenang. (D,O,W) \par\pard\qj
\li1778\ri1226\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Ada
bukti pelaksanaan apoteker melakukan rekonsiliasi obat pada saat pasien
\line\tab \up0 \expndtw-3\charscalex100 masuk, pindah unit pelayanan, dan sebelum
pulang. (D,W) \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 4. Rekam medis memuat riwayat penggunaan obat pasien. (D,O)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO 4.1
\par\pard\qj \li1418\ri1158\sb225\sl-300\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Regulasi ditetapkan untuk menentukan pengertian dan
syarat kelengkapan resep atau \up0 \expndtw-4\charscalex100 pemesanan. \par\pard\ql
\li1418\sb240\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 4.1 \par\pard\qj
\li1418\ri1223\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Untuk menghindari keragaman dan menjaga keselamatan
pasien maka rumah sakit \up0 \expndtw0\charscalex102 menetapkan persyaratan atau
elemen penting kelengkapan suatu resep atau \up0 \expndtw0\charscalex102
permintaan obat dan instruksi pengobatan. Persyaratan atau elemen kelengkapan
\up0 \expndtw-3\charscalex100 paling sedikit meliputi \par\pard\ql \li1778\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 a) data identitas pasien secara akurat
(dengan stiker); \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 b) elemen pokok di semua resep atau permintaan obat atau instruksi
pengobatan; \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100
c) kapan diharuskan menggunakan nama dagang atau generik; \par\pard\qj
\li1778\ri1159\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 d) kapan
diperlukan penggunaan indikasi seperti pada PRN (\ul0\nosupersub\cf8\f9\fs24 pro
re nata\ul0\nosupersub\cf7\f8\fs24 atau \u8220?jika \line\tab \up0 \expndtw-
4\charscalex100 perlu\u8221?) atau instruksi pengobatan lain; \par\pard\qj
\li1778\ri1219\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 e) jenis
instruksi pengobatan yang berdasar atas berat badan seperti untuk anak \line\tab
\up0 \expndtw-3\charscalex100 anak, lansia yang rapuh, dan populasi khusus sejenis
lainnya; \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-1\charscalex100 f)
kecepatan pemberian (jika berupa infus); \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 g) instruksi khusus, sebagai contoh:
titrasi,\ul0\nosupersub\cf8\f9\fs24 tapering\ul0\nosupersub\cf7\f8\fs24 , rentang
dosis. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Ditetapkan proses untuk menangani atau
mengelola hal-hal di bawah ini: \par\pard\qj \li1778\ri1218\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 1) resep atau permintaan obat dan
instruksi pengobatan yang tidak benar, tidak \line\tab \up0 \expndtw-
3\charscalex100 lengkap, dan tidak terbaca; \par\pard\qj \li1778\ri1224\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 2) resep atau permintaan obat dan
instruksi pengobatan yang NORUM (Nama \line\tab \up0 \expndtw-3\charscalex100 Obat
Rupa Ucapan Mirip) atau LASA (\ul0\nosupersub\cf8\f9\fs24 Look Alike Sound
Alike); \par\pard\qj \li1778\ri1219\sb17\sl-300\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3) jenis resep khusus, seperti
emergensi, cito, berhenti automatis (\ul0\nosupersub\cf8\f9\fs24 automatic stop
\line\tab \up0 \expndtw-3\charscalex100
order\ul0\nosupersub\cf7\f8\fs24 ),\ul0\nosupersub\cf8\f9\fs24
tapering,\ul0\nosupersub\cf7\f8\fs24 dan lainnya; \par\pard\qj
\li1778\ri1221\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 4) instruksi
pengobatan secara lisan atau melalui telepon wajib dilakukan tulis \line\tab
\up0 \expndtw-3\charscalex100 lengkap, baca ulang, dan meminta konfirmasi. (lihat
juga SKP 2) \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb143\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 179
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg180}
{\bkmkend Pg180}\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\ri1215\sb156\sl-320\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Standar ini berlaku untuk resep
atau permintaan obat dan instruksi pengobatan di \up0 \expndtw-3\charscalex100
semua unit pelayanan di rumah sakit. \par\pard\qj \li1418\ri1165\sb0\sl-320\slmult0
\up0 \expndtw-4\charscalex100 Rumah sakit diminta memiliki proses untuk menjamin
penulisan resep atau permintaan \line \up0 \expndtw-4\charscalex100 obat dan
instruksi pengobatan sesuai dengan kriteria butir 1 sampai dengan 4 di atas.
\par\pard\ql \li1552\sb0\sl-276\slmult0 \par\pard\ql\li1552\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 4.1
\par\pard\ql \li1778\ri1190\sb212\sl-315\slmult0\tx2138\tx2138\tx2138\tx2138
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi syarat
elemen resep lengkap yang meliputi butir 1 sampai dengan \line\tab \up0
\expndtw0\charscalex100 7 pada maksud dan tujuan serta penetapan dan penerapan
langkah langkah \line \tab \up0 \expndtw0\charscalex102 untuk pengelolaan
peresepan/permintaan obat, instruksi pengobatan yang \line \tab \up0
\expndtw0\charscalex100 tidak benar, tidak lengkap, dan tidak terbaca agar hal
tersebut tidak terulang \line \tab \up0 \expndtw-3\charscalex100 kembali. (R)
\par\pard\qj \li1778\ri1228\sb1\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
2. Ada bukti pelaksanaan evaluasi syarat elemen resep lengkap yang meliputi
\line\tab \up0 \expndtw-3\charscalex100 butir 1 sampai dengan 7 pada maksud dan
tujuan. (D,W) \par\pard\qj \li1778\ri1221\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 3. Ada bukti pelaksanaan proses pengelolaan resep yang
tidak benar, tidak \line\tab \up0 \expndtw-3\charscalex100 lengkap, dan tidak
terbaca. (D,W) \par\pard\ql \li1778\ri1160\sb9\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw-1\charscalex100 4. Ada bukti pelaksanaan proses untuk mengelola resep
khusus, seperti darurat, \line\tab \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf8\f9\fs24 standing order\ul0\nosupersub\cf7\f8\fs24 , berhenti
automatis (\ul0\nosupersub\cf8\f9\fs24 automatic stop order),
tapering,\ul0\nosupersub\cf7\f8\fs24 dan lainnya. \line \tab \up0 \expndtw-
5\charscalex100 (D,W) \par\pard\ql \li1509\sb0\sl-276\slmult0
\par\pard\ql\li1509\sb0\sl-276\slmult0 \par\pard\ql\li1509\sb7\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO 4.2
\par\pard\qj \li1509\ri1218\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan individu yang kompeten yang
diberi kewenangan untuk \up0 \expndtw-3\charscalex100 menulis resep/permintaan obat
atau instruksi pengobatan. \par\pard\ql \li1485\sb0\sl-276\slmult0
\par\pard\ql\li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb185\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO
4.2 \par\pard\qj \li1418\ri1166\sb208\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Untuk memilih dan menentukan obat yang
dibutuhkan pasien diperlukan pengetahuan \up0 \expndtw-4\charscalex100 dan
pengalaman spesifik. \par\pard\qj \li1418\ri1214\sb200\sl-320\slmult0 \up0
\expndtw0\charscalex100 Rumah sakit bertanggungjawab menentukan staf medis dengan
pengalaman cukup \up0 \expndtw-2\charscalex100 dan pengetahuan spesifik sesuai
dengan peraturan perundang-undangan yang diberi \up0 \expndtw-3\charscalex100 izin
membuat/menulis resep atau membuat permintaan obat. \par\pard\qj
\li1418\ri1218\sb205\sl-315\slmult0 \up0 \expndtw0\charscalex104 Rumah sakit
membatasi penulisan resep meliputi jenis dan jumlah obat oleh staf \up0
\expndtw0\charscalex102 medis, misalnya resep obat berbahaya, obat kemoterapi, obat
radioaktif, dan obat \up0 \expndtw-2\charscalex100 untuk keperluan investigasi.
Staf medis yang kompeten dan diberi kewenangan \up0 \expndtw0\charscalex100
membuat atau menulis resep harus dikenal dan diketahui oleh unit layanan farmasi
\up0 \expndtw-3\charscalex100 atau lainnya yang memberikan atau menyalurkan
obat. \par\pard\qj \li1418\ri1227\sb201\sl-320\slmult0
\up0 \expndtw-1\charscalex100 Dalam situasi darurat maka rumah sakit menentukan
tambahan PPA yang diberi izin \line \up0 \expndtw-2\charscalex100 untuk membuat
atau menulis resep atau permintaan obat dan instruksi pengobatan. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb150\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 180
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg181}
{\bkmkend Pg181}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 4.2
\par\pard\qj \li1778\ri1210\sb188\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada daftar staf medis yang kompeten
dan berwenang membuat atau menulis \line\tab \up0 \expndtw-2\charscalex100 resep
yang tersedia di semua unit pelayanan. (D) \par\pard\ql \li1778\ri1220\sb200\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex103 2. Ada bukti
pelaksanaan rumah sakit menetapkan dan melaksanakan proses \line\tab \up0
\expndtw0\charscalex102 untuk membatasi jika diperlukan jumlah resep atau jumlah
pemesanan obat \line \tab \up0 \expndtw-2\charscalex100 yang dapat dilakukan oleh
staf medis yang diberi kewenangan. (lihat juga KKS \line \tab \up0 \expndtw-
3\charscalex100 10 EP 1). (R) \par\pard\ql \li1778\ri1191\sb209\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 3. Ada bukti staf medis
yang kompeten dan berwenang membuat atau menulis \line\tab \up0 \expndtw-
2\charscalex100 resep atau memesan obat dikenal dan diketahui oleh unit layanan
farmasi atau \line \tab \up0 \expndtw-3\charscalex100 oleh lainnya yang menyalurkan
obat. (D) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb7\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PKPO 4.3 \par\pard\ql \li1418\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Obat yang
diresepkan dan diberikan tercatat di rekam medis pasien. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 4.3 \par\pard\qj
\li1418\ri1219\sb216\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rekam medis pasien memuat daftar obat yang
diinstruksikan yang memuat identitas \up0 \expndtw-2\charscalex100 pasien, nama
obat, dosis, rute pemberian, waktu pemberian, nama dan tanda tangan \up0 \expndtw-
2\charscalex100 dokter serta keterangan bila perlu\ul0\nosupersub\cf8\f9\fs24
tapering off\ul0\nosupersub\cf7\f8\fs24 , titrasi, dan rentang dosis.
\par\pard\qj \li1418\ri1217\sb202\sl-320\slmult0 \up0 \expndtw0\charscalex100
Pencatatan juga termasuk obat yang diberikan \u8220?jika
perlu\u8221?/\ul0\nosupersub\cf8\f9\fs24 prorenata\ul0\nosupersub\cf7\f8\fs24 .
Pencatatan \up0 \expndtw-2\charscalex100 dibuat di formulir obat yang tersendiri
dan dimasukkan ke dalam berkas rekam medis \up0 \expndtw0\charscalex100 serta
disertakan pada waktu pasien pulang dari rumah sakit atau dipindahkan. (lihat
\up0 \expndtw-3\charscalex100 juga PAP 2.2?) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PKPO 4.3 \par\pard\ql \li1778\ri1216\sb214\sl-
313\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada bukti pelaksanaan obat yang diberikan dicatat
dalam satu daftar di rekam \line\tab \up0 \expndtw0\charscalex100 medis untuk
setiap pasien berisi: identitas pasien, nama obat, dosis, rute \line \tab
\up0 \expndtw-1\charscalex100 pemberian, waktu pemberian, nama dokter dan
keterangan bila perlu\ul0\nosupersub\cf8\f9\fs24 tapering \line \tab \up0
\expndtw-3\charscalex100 off\ul0\nosupersub\cf7\f8\fs24 , titrasi, dan rentang
dosis. (D) \par\pard\ql \li1778\ri1158\sb202\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 2. Ada bukti pelaksanaan daftar tersebut di atas disimpan
dalam rekam medis \line\tab \up0 \expndtw-3\charscalex100 pasien dan menyertai
pasien ketika pasien dipindahkan. Salinan daftar tersebut \line \tab \up0 \expndtw-
4\charscalex100 diserahkan kepada pasien saat pulang. (D) \par\pard\ql
\li1418\sb0\sl-520\slmult0 \par\pard\ql\li1418\ri3018\sb15\sl-520\slmult0\fi360
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PERSIAPAN DAN PENYERAHAN \line \up0 \expndtw-
3\charscalex100 Standar PKPO 5 \par\pard\ql \li1418\sb202\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Obat disiapkan dan diserahkan
di dalam lingkungan aman dan bersih. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 181
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg182}
{\bkmkend Pg182}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 5
\par\pard\qj \li1418\ri1164\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Untuk menjamin keamanan, mutu, manfaat, dan khasiat
obat yang disiapkan dan \up0 \expndtw-4\charscalex100 diserahkan pada pasien maka
rumah sakit diminta menyiapkan dan menyerahkan obat \up0 \expndtw-2\charscalex100
dalam lingkungan yang aman bagi pasien, petugas, dan lingkungan serta
untuk \up0 \expndtw0\charscalex100 mencegah kontaminasi tempat penyiapan obat
harus sesuai dengan peraturan \up0 \expndtw-3\charscalex100 perundang-undangan
dan praktik profesi seperti \par\pard\ql \li1869\ri1217\sb6\sl-
313\slmult0\tx2229\tx2229\tx2229 \up0 \expndtw0\charscalex103 a. pencampuran obat
kemoterapi harus dilakukan di dalam ruang yang bersih \line\tab \up0
\expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 clean
room\ul0\nosupersub\cf7\f8\fs24 ) yang dilengkapi dengan\ul0\nosupersub\cf8\f9\fs24
cytotoxic handling drug safety cabinet \line \tab \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 dengan petugas sudah terlatih dengan teknik aseptik
serta menggunakan alat \line \tab \up0 \expndtw-3\charscalex100 perlindung diri
yang sesuai; \par\pard\ql \li1869\ri1217\sb2\sl-
320\slmult0\tx2229\tx2229\tx2229\tx2229 \up0 \expndtw0\charscalex103 b. pencampuran
obat intravena, epidural, dan nutrisi parenteral serta \line\tab
\up0 \expndtw0\charscalex101 pengemasan kembali obat suntik harus dilakukan dalam
ruang yang bersih \line \tab \up0 \expndtw0\charscalex102
(\ul0\nosupersub\cf8\f9\fs24 clean room\ul0\nosupersub\cf7\f8\fs24 ) yang
dilengkapi dengan\ul0\nosupersub\cf8\f9\fs24 laminary airflow
cabinet\ul0\nosupersub\cf7\f8\fs24 dan petugas \line \tab \up0
\expndtw0\charscalex100 sudah terlatih dengan teknik aseptik serta menggunakan alat
perlindung diri \line \tab \up0 \expndtw-3\charscalex100 yang sesuai;
\par\pard\qj \li1869\ri1227\sb0\sl-320\slmult0\tx2229 \up0 \expndtw-1\charscalex100
c. staf yang menyiapkan produk steril terlatih dengan prinsip penyiapan obat dan
\line\tab \up0 \expndtw-2\charscalex100 teknik aseptik. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb261\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 5 \par\pard\qj
\li1778\ri1218\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi penyiapan dan penyerahan obat yang
sesuai dengan peraturan \line\tab \up0 \expndtw-3\charscalex100 perundang-undangan
dan praktik profesi. (R) \par\pard\ql \li1778\ri1218\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 2. Ada bukti pelaksanaan
staf yang menyiapkan produk steril dilatih, memahami, \line\tab \up0
\expndtw0\charscalex103 serta mempraktikkan prinsip penyiapan obat dan teknik
aseptik (lihat juga \line \tab \up0 \expndtw-3\charscalex100 PPI\u8230?..).
(D,W) \par\pard\qj \li1778\ri1166\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 3. Ada bukti pelaksanaan pencampuran obat kemoterapi dilakukan
sesuai dengan \line\tab \up0 \expndtw-4\charscalex100 praktik profesi. (lihat juga
PPI\u8230?..). (O,W) \par\pard\qj \li1778\ri1156\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 4. Ada bukti pencampuran obat intravena, epidural, dan
nutrisi parenteral serta \line\tab \up0 \expndtw-3\charscalex100 pengemasan kembali
obat suntik dilakukan sesuai dengan raktik profesi. (O,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb261\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO 5.1 \par\pard\qj
\li1418\ri1220\sb25\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi yang mengatur semua
resep/permintaan obat dan \up0 \expndtw-3\charscalex100 instruksi pengobatan obat
ditelaah ketepatannya. \par\pard\ql \li1485\sb0\sl-276\slmult0
\par\pard\ql\li1485\sb84\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 5.1 \par\pard\qj
\li1418\ri1164\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Manajemen obat yang baik melakukan dua hal untuk
dinilai di setiap resep atau setiap \up0 \expndtw-2\charscalex100 ada pesanan obat.
Pengkajian resep untuk menilai ketepatan baik administratif, klinis \up0 \expndtw-
3\charscalex100 maupun
farmasetik obat untuk pasien dan kebutuhan kliniknya pada saat resep dibuat
\up0 \expndtw-4\charscalex100 atau obat dipesan. \par\pard\ql \li1418\sb217\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Pengkajian resep dilakukan oleh apoteker
meliputi \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb70\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 182
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg183}
{\bkmkend Pg183}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1226\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 a) ketepatan identitas pasien, obat, dosis, frekuensi,
aturan minum/makan obat, \line\tab \up0 \expndtw-3\charscalex100 dan waktu
pemberian; \par\pard\ql \li1775\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100
b) duplikasi pengobatan; \par\pard\ql \li1775\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 c) potensi alergi atau sensitivitas; \par\pard\ql \li1775\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 d) interaksi antara obat dan obat lain
atau dengan makanan; \par\pard\ql \li1775\sb44\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 e) variasi kriteria penggunaan dari rumah sakit; \par\pard\ql
\li1775\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 f) berat badan pasien
dan atau informasi fisiologik lainnya; \par\pard\ql \li1775\sb44\sl-276\slmult0
\up0 \expndtw-3\charscalex100 g) kontra indikasi. \par\pard\qj \li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\ri1228\sb188\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Telaah obat dilakukan terhadap obat yang telah siap dan telaah
dilakukan meliputi 5 \up0 \expndtw-3\charscalex100 (lima) informasi, yaitu
\par\pard\ql \li1778\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1)
identitas pasien; \par\pard\ql \li1775\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 2) ketepatan obat; \par\pard\ql \li1775\sb44\sl-276\slmult0
\up0 \expndtw-2\charscalex100 3) dosis; \par\pard\ql \li1775\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 4) rute pemberian; dan \par\pard\ql
\li1775\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5) waktu pemberian.
\par\pard\ql \li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb268\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 5.1
\par\pard\qj \li1778\ri1223\sb208\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi penetapan
sistem yang seragam untuk penyiapan dan \line\tab \up0 \expndtw-
3\charscalex100 penyerahan obat. (R) \par\pard\qj \li1778\ri1228\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Ada bukti pelaksanaan proses
pengkajian resep yang meliputi butir 1 sampai \line\tab \up0 \expndtw-
3\charscalex100 dengan 7 pada maksud dan tujuan. (D,W) \par\pard\ql
\li1778\ri1229\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 3.
Setelah persiapan, obat diberi label meliputi identitas pasien, nama obat, dosis
\line\tab \up0 \expndtw0\charscalex100 atau konsentrasi, cara pemakaian, waktu
pemberian, tanggal disiapkan, dan \line \tab \up0 \expndtw-3\charscalex100 tanggal
kadaluarsa. (D,O,W) \par\pard\qj \li1778\ri1219\sb2\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 4. Ada bukti pelaksanaan telaah obat meliputi butir 1
sampai dengan 5 pada \line\tab \up0 \expndtw-3\charscalex100 maksud dan tujuan.
(D,W) \par\pard\qj \li1778\ri1229\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 5. Ada bukti pelaksanaan penyerahan obat dalam bentuk yang
siap diberikan. \line\tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 6. Ada bukti penyerahan
obat tepat waktu. (D,O,W) \par\pard\ql \li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb12\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PEMBERIAN (\ul0\nosupersub\cf16\f17\fs24
ADMINISTRATION\ul0\nosupersub\cf6\f7\fs24 ) OBAT \par\pard\ql \li1418\sb224\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PKPO 6 \par\pard\qj
\li1418\ri1222\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan staf klinis yang kompeten
dan berwenang untuk \up0 \expndtw-3\charscalex100 memberikan obat.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 6 \par\pard\qj
\li1418\ri1218\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Pemberian obat untuk pengobatan pasien memerlukan
pengetahuan spesifik dan \line \up0 \expndtw0\charscalex103 pengalaman. Rumah
sakit bertanggung jawab menetapkan staf klinis dengan \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb163\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 183
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg184}
{\bkmkend Pg184}\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\sb0\sl-
316\slmult0 \par\pard\qj\li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\ri1157\sb191\sl-316\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 pengetahuan dan pengalaman yang diperlukan, memiliki
izin, dan sertifikat berdasar \up0 \expndtw0\charscalex103 atas peraturan
perundang-undangan untuk memberikan obat. Rumah sakit dapat \up0
\expndtw0\charscalex105 membatasi kewenangan individu dalam melakukan
pemberian obat, seperti \up0 \expndtw0\charscalex102 pemberian obat narkotika dan
psikotropika, radioaktif, atau obat penelitian. Dalam \up0 \expndtw-
3\charscalex100 keadaan darurat maka rumah sakit dapat menetapkan tambahan staf
klinis yang diberi \up0 \expndtw-4\charscalex100 izin memberikan obat. (lihat juga
PKPO 1.1, KKS 3, dan KKS 10) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb6\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO
6 \par\pard\qj \li1778\ri1216\sb225\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada penetapan staf klinis
yang kompeten dan berwenang untuk memberikan \line\tab \up0 \expndtw-
3\charscalex100 obat termasuk pembatasannya. (R) \par\pard\ql
\li1778\ri1226\sb4\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104 2.
Ada bukti pelaksanaan pemberian obat oleh staf klinis yang kompeten dan
\line\tab \up0 \expndtw0\charscalex105 berwenang sesuai dengan surat izin
terkait profesinya dan peraturan \line \tab \up0 \expndtw-3\charscalex100
perundang-undangan .(D,W) \par\pard\ql \li1778\ri1218\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex106 3. Ada bukti pelaksanaan
pemberian obat dilaksanakan sesuai dengan \line\tab \up0
\expndtw0\charscalex100 pembatasan yang ditetapkan, misalnya obat kemoterapi, obat
radioaktif, atau \line \tab \up0 \expndtw-3\charscalex100 obat untuk penelitian.
(D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb261\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO
6.1 \par\pard\qj \li1418\ri1222\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Proses pemberian obat termasuk proses verifikasi apakah
obat yang akan diberikan \up0 \expndtw-3\charscalex100 telah sesuai
resep/permintaan obat. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO
6.1 \par\pard\qj \li1418\ri1219\sb16\sl-310\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Agar obat diserahkan pada orang yang
tepat, dosis yang tepat dan waktu yang tepat \up0 \expndtw0\charscalex100 maka
sebelum pemberian obat kepada pasien dilakukan verifikasi kesesuaian obat \up0
\expndtw-3\charscalex100 dengan instruksi pengobatan yang meliputi \par\pard\ql
\li1778\sb39\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a) identitas pasien;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b) nama
obat; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw0\charscalex100 c)
dosis; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d)
rute pemberian; dan \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 e) waktu pemberian. \par\pard\ql \li1418\sb0\sl-315\slmult0
\par\pard\ql\li1418\ri1157\sb17\sl-315\slmult0 \up0 \expndtw-2\charscalex100 Rumah
sakit menetapkan ketentuan yang digunakan untuk verifikasi pemberian obat. \up0
\expndtw-4\charscalex100 Jika obat disiapkan dan diserahkan di unit rawat inap
pasien maka verifikasi harus juga \up0 \expndtw-2\charscalex100 dilakukan oleh
orang yang kompeten.(lihat juga maksud dan tujuan PKPO 5.1) \line \up0 \expndtw-
2\charscalex100 Terhadap obat yang harus diwaspadai (\ul0\nosupersub\cf8\f9\fs24
high alert\ul0\nosupersub\cf7\f8\fs24 ) harus dilakukan\ul0\nosupersub\cf8\f9\fs24
double check\ul0\nosupersub\cf7\f8\fs24 oleh \up0 \expndtw-3\charscalex100 minimal
2 orang. \par\pard\ql \li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb0\sl-
276\slmult0 \par\pard\ql\li1485\sb6\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 6.1 \par\pard\qj
\li1778\ri1224\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi verifikasi sebelum penyerahan obat
kepada pasien yang meliputi \line\tab \up0 \expndtw-3\charscalex100 butir 1 sampai
dengan 5 pada maksud dan tujuan. (R) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb243\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 184
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg185}
{\bkmkend Pg185}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1228\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 2. Ada bukti pelaksanaan verifikasi sebelum obat
diserahkan kepada pasien. \line\tab \up0 \expndtw-3\charscalex100 (D,W,S)
\par\pard\qj \li1778\ri1218\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
3. Ada bukti pelaksanaan\ul0\nosupersub\cf8\f9\fs24 double
check\ul0\nosupersub\cf7\f8\fs24 untuk obat yang harus diwaspadai
(\ul0\nosupersub\cf8\f9\fs24 high \line\tab \up0 \expndtw-3\charscalex100
alert\ul0\nosupersub\cf7\f8\fs24 ). (D,O,W,S) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO
6.2 \par\pard\qj \li1418\ri1218\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ada regulasi tentang obat yang dibawa oleh pasien ke
rumah sakit untuk digunakan \up0 \expndtw-3\charscalex100 sendiri. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb261\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 6.2 \par\pard\qj
\li1418\ri1166\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit harus mengetahui sumber dan penggunaan obat
yang tidak diadakan \up0 \expndtw0\charscalex102 dari instalasi farmasi rumah
sakit seperti obat yang dibawa oleh pasien dan \up0 \expndtw-3\charscalex100
keluarganya. Obat semacam ini harus diketahui oleh dokter yang merawat dan
dicatat \up0 \expndtw0\charscalex100 di rekam medik. Pemberian obat oleh pasien
sendiri, baik yang dibawa sendiri atau \up0 \expndtw0\charscalex104 yang diresepkan
dari rumah sakit harus diketahui oleh dokter yang merawat dan \up0 \expndtw-
3\charscalex100 dicatat di rekam medis pasien. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 6.2
\par\pard\ql \li1778\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pengobatan oleh pasien sendiri.
(R) \par\pard\qj \li1778\ri1219\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 2. Ada bukti pelaksanaan pengobatan obat oleh pasien
sendiri sesuai dengan \line\tab \up0 \expndtw-3\charscalex100 regulasi. (D,W)
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. Ada
proses monitoring terhadap pengobatan oleh pasien sendiri. (D,W) \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PEMANTAUAN
(MONITOR) \par\pard\ql \li1418\sb224\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar PKPO 7 \par\pard\ql \li1418\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Efek obat dan efek samping obat
terhadap pasien dipantau. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb12\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 7
\par\pard\qj \li1418\ri1165\sb11\sl-316\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Standar ini bertujuan agar apabila timbul efek samping
obat dapat dilaporkan oleh \up0 \expndtw0\charscalex100 profesional pemberi asuhan
(PPA) kepada tim farmasi dan terapi yang selanjutnya \up0 \expndtw-1\charscalex100
dilaporkan pada Pusat Meso Nasional. Apoteker mengevaluasi efek obat untuk
\up0 \expndtw0\charscalex100 memantau secara ketat respons pasien dengan melakukan
pemantauan terapi obat \up0 \expndtw-3\charscalex100 (PTO). Apoteker bekerjasama
dengan pasien, dokter, perawat, dan tenaga kesehatan \up0 \expndtw0\charscalex100
lainnya untuk memantau pasien yang diberi obat. Rumah sakit menetapkan regulasi
\up0 \expndtw-3\charscalex100 untuk efek samping obat yang harus dicatat dan
dilaporkan. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb6\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 7 \par\pard\qj
\li1778\ri1218\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pemantauan efek obat dan efek samping
obat serta dicatat dalam \line\tab \up0 \expndtw-3\charscalex100 status pasien.
(lihat juga AP 2 EP 1). (R) \par\pard\ql \li10156\sb216\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 185
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg186}
{\bkmkend Pg186}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Ada bukti pelaksanaan pemantauan
terapi obat. (D,W) \par\pard\qj \li1778\ri1230\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 3. Ada bukti pemantauan efek samping obat dan pelaporannya
sesuai dengan \line\tab \up0 \expndtw-3\charscalex100 peraturan perundang-undangan.
(D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb269\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PKPO
7.1 \par\pard\qj \li1418\ri1191\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan dan menerapkan proses pelaporan
serta tindakan terhadap \line \up0 \expndtw-2\charscalex100 kesalahan penggunaan
obat (\ul0\nosupersub\cf8\f9\fs24 medication error\ul0\nosupersub\cf7\f8\fs24 )
serta upaya menurunkan angkanya. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PKPO 7.1 \par\pard\qj
\li1418\ri1157\sb0\sl-317\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses identifikasi dan
pelaporan bila terjadi kesalahan \line \up0 \expndtw-2\charscalex100 penggunaan
obat (\ul0\nosupersub\cf8\f9\fs24 medication error),\ul0\nosupersub\cf7\f8\fs24
kejadian yang tidak diharapkan (KTD) termasuk \line \up0 \expndtw0\charscalex100
kejadian sentinel, serta kejadian tidak cedera (KTC) maupun kejadian nyaris
cedera \line \up0 \expndtw0\charscalex102 (KNC). Proses pelaporan kesalahan
penggunaan obat (\ul0\nosupersub\cf8\f9\fs24 medication
error)\ul0\nosupersub\cf7\f8\fs24 menjadi \line \up0 \expndtw0\charscalex104
bagian dari program kendali mutu dan keselamatan pasien rumah sakit. Laporan
\line \up0 \expndtw-4\charscalex100 ditujukan kepada tim keselamatan pasien rumah
sakit dan laporan ini digunakan untuk \line \up0 \expndtw0\charscalex100 mencegah
kesalahan di kemudian hari. Terdapat tindak lanjut dan pelatihan dalam \line
\up0 \expndtw0\charscalex100 rangka upaya perbaikan untuk mencegah kesalahan
obat agar tidak terjadi di \line \up0 \expndtw-2\charscalex100 kemudian hari.
PPA berpartisipasi dalam pelatihan ini. (lihat juga PMKP 5) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb72\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PKPO 7.1
\par\pard\ql \li1778\ri1204\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada
regulasi\ul0\nosupersub\cf8\f9\fs24 medication safety\ul0\nosupersub\cf7\f8\fs24
yang bertujuan mengarahkan penggunaan obat \line\tab \up0 \expndtw0\charscalex100
yang aman dan meminimalisasi kemungkinan terjadi kesalahan penggunaan \line \tab
\up0 \expndtw-3\charscalex100 obat sesuai dengan peraturan perundang-undangan.
(R) \par\pard\ql \li1778\ri1218\sb9\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex103 2. Ada bukti pelaksanaan rumah sakit mengumpulkan dan
memonitor seluruh \line\tab \up0 \expndtw0\charscalex100 angka kesalahan
penggunaan obat termasuk kejadian tidak diharapkan, \line \tab \up0 \expndtw-
2\charscalex100 kejadian sentinel, kejadian nyaris cedera, dan kejadian tidak
cedera. (D,W) \par\pard\qj \li1778\ri1223\sb2\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 3. Ada bukti instalasi farmasi mengirimkan laporan
kesalahan penggunaan obat \line\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf8\f9\fs24 (medication error)\ul0\nosupersub\cf7\f8\fs24 kepada
tim keselamatan pasien rumah sakit. (D,W) \par\pard\ql \li1778\ri1164\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex102 4. Ada bukti tim
keselamatan pasien rumah sakit menerima laporan kesalahan \line\tab \up0 \expndtw-
3\charscalex100 penggunaan obat (\ul0\nosupersub\cf8\f9\fs24 medication
error)\ul0\nosupersub\cf7\f8\fs24 dan mencari akar masalah atau investigasi
\line \tab \up0 \expndtw-1\charscalex100 sederhana, solusi dan tindak
lanjutnya, serta melaporkan kepada Komite \line \tab \up0 \expndtw-
2\charscalex100 Nasional Keselamatan Pasien. (lihat juga PMKP 7). (D,W)
\par\pard\ql \li1778\ri1219\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex104 5. Ada bukti pelaksanaan rumah sakit melakukan upaya
mencegah dan \line\tab \up0 \expndtw-2\charscalex100 menurunkan kesalahan
penggunaan obat (\ul0\nosupersub\cf8\f9\fs24 medication
error\ul0\nosupersub\cf7\f8\fs24 ). (lihat juga PMKP \line \tab \up0 \expndtw-
3\charscalex100 7 EP 1).(D,W) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb93\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 186
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg187}
{\bkmkend Pg187}\par\pard\ql \li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb68\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAB 7 \par\pard\ql \li3127\sb224\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 MANAJEMEN KOMUNIKASI DAN EDUKASI (MKE)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb180\sl-276\slmult0 \up0 \expndtw-3\charscalex100 GAMBARAN
UMUM \par\pard\qj \li1418\ri1162\sb211\sl-317\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Memberikan asuhan pasien merupakan upaya yang kompleks
dan sangat bergantung \up0 \expndtw0\charscalex103 pada komunikasi dari informasi.
Komunikasi tersebut adalah kepada dan dengan \up0 \expndtw0\charscalex100
komunitas, pasien dan keluarganya, serta antarstaf klinis, terutama
Profesional \up0 \expndtw-2\charscalex100 Pemberi Asuhan (PPA). Kegagalan dalam
berkomunikasi merupakan salah satu akar \up0 \expndtw0\charscalex100 masalah yang
paling sering menyebabkan insiden keselamatan pasien. Komunikasi \up0
\expndtw0\charscalex104 dapat efektif apabila pesan diterima dan dimengerti
sebagaimana dimaksud oleh \up0 \expndtw0\charscalex102 pengirim pesan/komunikator,
pesan ditindaklanjuti dengan sebuah perbuatan oleh \up0 \expndtw-3\charscalex100
penerima pesan/komunikan, dan tidak ada hambatan untuk hal itu. \par\pard\qj
\li1418\ri1217\sb201\sl-320\slmult0 \up0 \expndtw0\charscalex104 Komunikasi efektif
sebagai dasar untuk memberikan edukasi kepada pasien dan \up0
\expndtw0\charscalex102 keluarga agar mereka memahami kondisi
kesehatannya sehingga pasien \up0 \expndtw-2\charscalex100 berpartisipasi lebih
baik dalam asuhan yang diberikan dan mendapat informasi dalam \up0 \expndtw-
3\charscalex100 mengambil keputusan tentang asuhannya. \par\pard\qj
\li1418\ri1218\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex102 Edukasi kepada
pasien dan keluarga diberikan oleh staf klinis terutama PPA yang \up0
\expndtw0\charscalex100 sudah terlatih (dokter, perawat, nutrisionis, apoteker,
dll.). Mengingat banyak profesi \up0 \expndtw0\charscalex100 yang terlibat dalam
edukasi pasien dan keluarganya maka perlu koordinasi kegiatan \up0 \expndtw-
3\charscalex100 dan fokus pada kebutuhan edukasi pasien. \par\pard\qj
\li1418\ri1162\sb204\sl-316\slmult0 \up0 \expndtw0\charscalex100 Edukasi yang
efektif diawali dengan asesmen kebutuhan edukasi pasien dan \up0 \expndtw-
1\charscalex100 keluarganya. Asesmen ini menentukan bukan hanya
kebutuhan akan \up0 \expndtw-4\charscalex100 pembelajaran, tetapi juga
proses edukasi dapat dilaksanakan dengan baik. Edukasi \up0
\expndtw0\charscalex107 paling efektif apabila sesuai dengan pilihan
pembelajaran yang tepat dan \up0 \expndtw-1\charscalex100 mempertimbangkan
agama, nilai budaya, juga kemampuan membaca serta bahasa. \up0 \expndtw-
3\charscalex100 Edukasi akan berdampak positif bila diberikan selama proses asuhan.
\par\pard\qj \li1418\ri1190\sb205\sl-316\slmult0 \up0 \expndtw-1\charscalex100
Edukasi termasuk pengetahuan yang diperlukan selama proses asuhan maupun \up0
\expndtw-2\charscalex100 pengetahuan yang dibutuhkan setelah pasien dipulangkan
(\ul0\nosupersub\cf8\f9\fs24 discharged\ul0\nosupersub\cf7\f8\fs24 ) ke
pelayanan \up0 \expndtw-1\charscalex100 kesehatan lain atau ke rumah. Dengan
demikian, edukasi dapat mencakup informasi \up0 \expndtw-2\charscalex100 sumber-
sumber di komunitas untuk tambahan pelayanan dan tindak lanjut pelayanan \up0
\expndtw-1\charscalex100 apabila diperlukan, serta bagaimana akses ke pelayanan
emergensi bila dibutuhkan. \up0 \expndtw-2\charscalex100 Edukasi yang efektif dalam
suatu rumah sakit hendaknya menggunakan format visual \up0 \expndtw-3\charscalex100
dan elektronik, serta berbagai edukasi jarak jauh dan teknik lainnya.
\par\pard\ql \li1778\sb238\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 KOMUNIKASI
DENGAN KOMUNITAS MASYARAKAT (Standar MKE 1-1.1) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb12\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar MKE 1 \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb10\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 187
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg188}
{\bkmkend Pg188}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1224\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit berkomunikasi dengan masyarakat
untuk memfasilitasi akses \up0 \expndtw0\charscalex100 masyarakat ke
pelayanan di rumah sakit dan informasi tentang pelayanan yang \up0 \expndtw-
3\charscalex100 disediakan oleh rumah sakit. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb207\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MKE 1 \par\pard\qj \li1418\ri1157\sb211\sl-316\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengenali komunitas
dan populasi pasiennya, serta merencanakan \up0 \expndtw0\charscalex100
komunikasi berkelanjutan dengan kelompok kunci (\ul0\nosupersub\cf8\f9\fs24
keygroup\ul0\nosupersub\cf7\f8\fs24 ) tersebut. Komunikasi \up0 \expndtw-
2\charscalex100 dapat dilakukan kepada individu secara langsung atau melalui media
publik dan agen \up0 \expndtw0\charscalex103 yang ada di komunitas atau pihak
ketiga melalui komunikasi efektif. Tujuan \up0 \expndtw0\charscalex103
komunikasi efektif dengan masyarakat adalah memfasilitasi akses masyarakat ke
\up0 \expndtw-1\charscalex100 pelayanan di rumah sakit. \par\pard\qj
\li1418\ri1213\sb201\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Dalam memenuhi
kebutuhan pelayanan di rumah sakit maka rumah sakit juga harus \up0
\expndtw0\charscalex102 mengembangkan pendekatan untuk meningkatkan komunikasi
efektif pada pasien \up0 \expndtw0\charscalex107 dan keluarga. Komunikasi efektif
harus tepat waktu, akurat, lengkap, jelas, dan \up0 \expndtw-1\charscalex100
dipahami oleh penerima. \par\pard\ql \li1485\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE 1 \par\pard\ql
\li1778\ri1224\sb216\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi tentang pedoman komunikasi
efektif yang meliputi \line\tab \up0 \expndtw0\charscalex100 komunikasi dengan
masyarakat, dengan pasien dan keluarga, serta antarstaf \line \tab \up0 \expndtw-
3\charscalex100 klinis. (R) \par\pard\qj \li1778\ri1228\sb2\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex103 2. Terdapat bukti pelaksanaan
komunikasi efektif antara rumah sakit dan \line\tab \up0 \expndtw-
3\charscalex100 masyarakat. (D, W) (Lihat juga TKRS.3.2) \par\pard\qj
\li1778\ri1222\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 3. Terdapat
bukti pelaksanaan komunikasi efektif dengan pasien dan keluarga. \line\tab \up0
\expndtw-3\charscalex100 (D,W) (dahulu HPK 2.1; HPK 2.2; AP 4.1; APK 1.2; PP
2.4) \par\pard\qj \li1778\ri1193\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 4. Terdapat bukti pelaksanaan komunikasi efektif antarstaf klinis.
(D,W) (lihat juga \line\tab \up0 \expndtw-3\charscalex100 AP; PAP; SKP 2; TKRS 1.2)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MKE 1.1
\par\pard\qj \li1418\ri1217\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Strategi komunikasi dengan masyarakat, pasien, dan
keluarga didasarkan pada \up0 \expndtw-2\charscalex100 pengenalan populasi yang
dilayani rumah sakit. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 1.1
\par\pard\qj \li1418\ri1212\sb212\sl-315\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan populasi yang dilayani
berdasar atas demografi yang \up0 \expndtw0\charscalex100 diuraikan menurut
usia, etnis, agama, tingkat pendidikan, serta bahasa yang \up0
\expndtw0\charscalex102 digunakan termasuk hambatan komunikasi. Berdasar atas
analisis data populasi \up0 \expndtw0\charscalex103 yang dilayani, rumah sakit
menetapkan strategi komunikasi dengan masyarakat \up0 \expndtw-1\charscalex100
menggunakan pedoman komunikasi efektif. \par\pard\ql \li1694\sb238\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 Jenis informasi yang dikomunikasikan
kepada masyarakat meliputi: \par\pard\ql \li1775\sb244\sl-276\slmult0 \up0
\expndtw0\charscalex106 \u8226? informasi tentang pelayanan, jam pelayanan,
serta akses dan proses \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb10\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 188
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg189}
{\bkmkend Pg189}\par\pard\ql \li2001\sb0\sl-276\slmult0 \par\pard\ql\li2001\sb0\sl-
276\slmult0 \par\pard\ql\li2001\sb0\sl-276\slmult0 \par\pard\ql\li2001\sb0\sl-
276\slmult0
\par\pard\ql\li2001\sb68\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 mendapatkan pelayanan; \par\pard\qj
\li1775\ri1228\sb25\sl-300\slmult0 \up0 \expndtw-1\charscalex100 \u8226? informasi
tentang kualitas pelayanan yang diberikan kepada publik dan kepada \up0 \expndtw-
2\charscalex100 sumber rujukan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb8\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE
1.1 \par\pard\qj \li1778\ri1221\sb208\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Terdapat demografi
populasi sebagai dasar strategi komunikasi dengan \line\tab \up0 \expndtw-
3\charscalex100 komunitas dan populasi yang dilayani rumah sakit. (D,W).
\par\pard\ql \li1778\ri1224\sb9\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 2. Demografi sekurang-kurangnya dapat menggambarkan usia,
etnis, agama, \line\tab \up0 \expndtw0\charscalex100 serta tingkat pendidikan
termasuk buta huruf dan bahasa yang dipergunakan \line \tab \up0 \expndtw-
3\charscalex100 antara lain hambatan dalam berkomunikasi. (D,W) \par\pard\qj
\li1778\ri1225\sb2\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 3. Rumah
sakit menyediakan informasi jenis pelayanan, waktu pelayanan, serta \line\tab
\up0 \expndtw-3\charscalex100 akses dan proses untuk mendapatkan pelayanan.
(D,W) \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4.
Rumah sakit menyediakan informasi kualitas pelayanan. (D,W) \par\pard\qj
\li1418\ri1688\sb400\sl-620\slmult0\fi360 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 KOMUNIKASI
DENGAN PASIEN DAN KELUARGA (Standar MKE 2-3) \up0 \expndtw-3\charscalex100
Standar MKE 2 \par\pard\qj \li1418\ri1168\sb268\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit memberikan informasi kepada
pasien dan keluarga tentang jenis asuhan \up0 \expndtw-4\charscalex100 dan
pelayanan, serta akses untuk mendapatkan pelayanan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 2 \par\pard\qj
\li1418\ri1212\sb211\sl-317\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Pasien dan keluarga membutuhkan informasi lengkap
mengenai asuhan dan \up0 \expndtw0\charscalex103 pelayanan yang disediakan oleh
rumah sakit, serta bagaimana untuk mengakses \up0 \expndtw-1\charscalex100
pelayanan tersebut. Memberikan informasi ini penting untuk membangun komunikasi
\up0 \expndtw0\charscalex104 yang terbuka dan terpercaya antara pasien, keluarga,
dan rumah sakit. Informasi \up0 \expndtw-1\charscalex100 tersebut membantu
mencocokkan harapan pasien dengan kemampuan rumah sakit. \up0
\expndtw0\charscalex103 Informasi sumber alternatif asuhan dan pelayanan diberikan
jika rumah sakit tidak \up0 \expndtw-1\charscalex100 dapat menyediakan asuhan serta
pelayanan yang dibutuhkan pasien di luar misi dan \up0 \expndtw-2\charscalex100
kemampuan rumah sakit. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen penilaian MKE 2 \par\pard\ql
\li1778\ri1215\sb216\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Tersedia informasi untuk pasien dan keluarga
tentang asuhan dan pelayanan \line\tab \up0 \expndtw-1\charscalex100 yang
disediakan oleh rumah sakit dalam bentuk\ul0\nosupersub\cf8\f9\fs24
website\ul0\nosupersub\cf7\f8\fs24 atau brosur. (D,O,W) \line \tab \up0 \expndtw-
3\charscalex100 (lihat juga TKRS 12.1 EP 2). \par\pard\qj \li1778\ri1226\sb2\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 2. Informasi untuk pasien dan
keluarga juga menjelaskan akses terhadap \line\tab \up0 \expndtw-
3\charscalex100 pelayanan yang disediakan oleh rumah sakit. (D,O,W) \par\pard\ql
\li1778\ri1189\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 3.
Rumah sakit menyediakan informasi alternatif asuhan dan pelayanan di tempat
\line\tab \up0 \expndtw-2\charscalex100 lain apabila rumah sakit tidak dapat
menyediakan asuhan dan pelayanan yang \line \tab \up0 \expndtw-3\charscalex100
dibutuhkan pasien. (D,W) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb243\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 189
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg190}
{\bkmkend Pg190}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MKE 3 \par\pard\qj
\li1418\ri1236\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Komunikasi dan edukasi kepada pasien dan keluarga
diberikan dalam format serta \up0 \expndtw-1\charscalex100 bahasa yang mudah
dimengerti. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb69\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MKE 3 \par\pard\qj \li1418\ri1177\sb212\sl-315\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pasien hanya dapat membuat keputusan
yang dikemukakan dan berpartisipasi dalam \line \up0 \expndtw-1\charscalex100
proses asuhan apabila mereka memahami informasi yang diberikan kepada mereka. \line
\up0 \expndtw0\charscalex100 Oleh karena itu, perhatian khusus perlu diberikan
terhadap format dan bahasa yang \line \up0 \expndtw0\charscalex100 digunakan dalam
berkomunikasi serta pemberian edukasi kepada pasien dan \line \up0 \expndtw-
3\charscalex100 keluarga. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1213\sb81\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Respons pasien akan berbeda terhadap
format edukasi berupa instruksi lisan, materi \line \up0 \expndtw0\charscalex104
tertulis, video, demonstrasi/peragaan, dan lain-lain. Demikian juga, penting
untuk \line \up0 \expndtw-1\charscalex100 mengerti bahasa yang dipilih. Ada
kalanya, anggota keluarga atau penerjemah \line \up0 \expndtw-2\charscalex100
mungkin dibutuhkan untuk membantu dalam edukasi atau menerjemahkan materi.
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE 3 \par\pard\ql
\li1778\ri1205\sb188\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Sesuai dengan demografi komunitas dan populasi,
komunikasi dan edukasi \line\tab \up0 \expndtw-2\charscalex100 pasien serta
keluarga menggunakan format yang praktis dan mudah dipahami. \line \tab \up0
\expndtw-3\charscalex100 (D,W) \par\pard\qj \li1778\ri1225\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2. Materi komunikasi dan edukasi
pasien serta keluarga diberikan dalam bahasa \line\tab \up0 \expndtw-
3\charscalex100 yang dimengerti. (D,O) \par\pard\ql \li1778\ri1160\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 3. Rumah sakit menyediakan
penerjemah sesuai dengan kebutuhan dan bila di \line\tab \up0 \expndtw-
3\charscalex100 rumah sakit tidak ada petugas penerjemah maka diperlukan kerja sama
dengan \line \tab \up0 \expndtw-4\charscalex100 pihak terkait. (D,W)
\par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1993\sb60\sl-
320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 KOMUNIKASI ANTARTENAGA KESEHATAN PEMBERI ASUHAN
DI \line\tab \up0 \expndtw-3\charscalex100 DALAM DAN LUAR RS (Standar MKE 4-5)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar MKE
4 \par\pard\qj \li1418\ri1227\sb225\sl-300\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Terdapat komunikasi efektif untuk menyampaikan
informasi yang akurat dan tepat \up0 \expndtw-3\charscalex100 waktu di seluruh
rumah sakit termasuk yang \u8220?\ul0\nosupersub\cf8\f9\fs24
urgent\ul0\nosupersub\cf7\f8\fs24 \u8221?. \par\pard\ql \li1418\sb240\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MKE 4 \par\pard\qj \li1418\ri1161\sb208\sl-320\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Ada kalanya di rumah sakit memerlukan
penyampaian informasi yang akurat dan tepat \up0 \expndtw0\charscalex103 waktu,
khususnya keadaan yang\ul0\nosupersub\cf8\f9\fs24
urgent\ul0\nosupersub\cf7\f8\fs24 seperti\ul0\nosupersub\cf8\f9\fs24 code
blue\ul0\nosupersub\cf7\f8\fs24 ,\ul0\nosupersub\cf8\f9\fs24 code
red\ul0\nosupersub\cf7\f8\fs24 , dan perintah \up0 \expndtw-3\charscalex100
evakuasi. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb70\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 190
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg191}
{\bkmkend Pg191}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE 4 \par\pard\qj
\li1778\ri1179\sb188\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan informasi yang harus
disampaikan secara akurat dan \line\tab \up0 \expndtw-4\charscalex100 tepat waktu
ke seluruh rumah sakit. (R) \par\pard\ql \li1778\ri1220\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100
2. Terdapat bukti proses penyampaian informasi yang akurat dan tepat waktu di
\line\tab \up0 \expndtw-2\charscalex100 seluruh rumah sakit termasuk
yang\ul0\nosupersub\cf8\f9\fs24 urgent\ul0\nosupersub\cf7\f8\fs24 antara
lain\ul0\nosupersub\cf8\f9\fs24 code blue\ul0\nosupersub\cf7\f8\fs24
dan\ul0\nosupersub\cf8\f9\fs24 code red. \line \tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (D,W,S) (lihat juga PAP 3.2)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MKE 5 \par\pard\qj \li1418\ri1224\sb225\sl-
300\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Informasi
asuhan pasien dan hasil asuhan dikomunikasikan antarstaf klinis selama \up0
\expndtw-3\charscalex100 bekerja dalam sif atau antarsif. \par\pard\ql
\li1418\sb240\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 5 \par\pard\qj
\li1418\ri1197\sb211\sl-316\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Komunikasi dan pertukaran informasi di antara dan antar
staf klinis selama bekerja \up0 \expndtw0\charscalex102 dalam sif atau antar sif
penting untuk berjalan mulusnya proses asuhan. Informasi \line \up0
\expndtw0\charscalex103 penting dapat dikomunikasikan dengan cara lisan, tertulis,
atau elektronik. Setiap \line \up0 \expndtw0\charscalex104 rumah sakit menentukan
informasi yang akan dikomunikasikan dengan cara dan \up0 \expndtw-2\charscalex100
informasi tersebut sering dikomunikasikan dari satu staf klinis kepada
staf klinis \line \up0 \expndtw-3\charscalex100 lainnya, meliputi: \par\pard\qj
\li1778\ri1204\sb201\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 1. status
kesehatan pasien antara lain catatan perkembangan pasien terintegrasi \line\tab
\up0 \expndtw-3\charscalex100 (CPPT); \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0
\expndtw-3\charscalex100 2. ringkasan asuhan yang diberikan (ringkasan pulang dan
ringkasan rawat jalan); \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 3. informasi klinis pasien saat ditransfer dan rujukan; serta
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 4. serah
terima. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian MKE 5 \par\pard\ql \li1778\sb244\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi tentang tata cara
berkomunikasi. (R) \par\pard\ql \li1778\ri1234\sb0\sl-320\slmult0\tx2138\tx2138
\up0 \expndtw0\charscalex100 2. Informasi kondisi pasien antarstaf klinis termasuk
PPA berdasar atas proses \line\tab \up0 \expndtw0\charscalex102 yang sedang
berjalan atau pada saat penting tertentu dalam proses asuhan \line \tab \up0
\expndtw-1\charscalex100 ditulis dalam rekam medis. (D,O) \par\pard\qj
\li1778\ri1223\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 3. Setiap
pasien setelah rawat inap dibuat ringkasan pulang. (D,W) (lihat juga \line\tab
\up0 \expndtw-2\charscalex100 MIRM 15) \par\pard\qj \li1778\ri1220\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex104 4. Setiap pasien rawat jalan
dengan diagnosis kompleks dibuat profil ringkas \line\tab \up0 \expndtw-
1\charscalex100 medis rawat jalan. (D,O,W) (lihat juga ARK 4.3) \par\pard\qj
\li1778\ri1227\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 5.
Informasi yang dikomunikasikan termasuk ringkasan asuhan dan pelayanan \line\tab
\up0 \expndtw-1\charscalex100 yang telah diberikan pada proses transfer dan
rujukan. (D,O) (lihat juga PKPO \par\pard\ql \li2138\sb5\sl-276\slmult0 \up0
\expndtw-1\charscalex100 4.3 EP 2) \par\pard\qj \li1778\ri1220\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex103 6. Terdapat bukti dokumentasi pada
proses serah terima (\ul0\nosupersub\cf8\f9\fs24 hand
over\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
.\ul0\nosupersub\cf7\f8\fs24 (D,W) \line\tab \up0 \expndtw-1\charscalex100 (lihat
juga SKP 2.2) \par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb5\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 EDUKASI PASIEN
DAN KELUARGA (Standar MKE 6-12) \par\pard\ql \li10156\sb223\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 191
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg192}
{\bkmkend Pg192}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MKE 6 \par\pard\qj
\li1418\ri1229\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyediakan edukasi untuk menunjang
partisipasi pasien dan keluarga \up0 \expndtw-2\charscalex100 dalam proses
asuhan. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 6 \par\pard\qj
\li1418\ri1191\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan edukasi terhadap pasien
dan keluarganya sehingga \line \up0 \expndtw-2\charscalex100 mereka mendapat
pengetahuan serta keterampilan untuk berpartisipasi dalam proses
\par\pard\li1418\sb37\sl-
276\slmult0\fi0\tx2380\tx4313\tx5979\tx7325\tx8658\tx9992 \up0 \expndtw-
3\charscalex100 dan\tab \up0 \expndtw-3\charscalex100 pengambilan\tab \up0
\expndtw-3\charscalex100 keputusan\tab \up0 \expndtw-3\charscalex100 asuhan\tab
\up0 \expndtw-3\charscalex100 pasien.\tab \up0 \expndtw-3\charscalex100
Rumah\tab \up0 \expndtw-3\charscalex100 sakit\par\pard\qj \li1418\ri1178\sb0\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 mengembangkan/memasukkan edukasi ke dalam
proses asuhan sesuai dengan misi, \line \up0 \expndtw0\charscalex102 jenis
pelayanan yang diberikan, dan populasi pasien. Edukasi direncanakan untuk \line
\up0 \expndtw-2\charscalex100 menjamin bahwa setiap pasien diberikan edukasi sesuai
dengan kebutuhannya. \par\pard\qj \li1418\ri1161\sb188\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Rumah sakit menetapkan pengorganisasian sumber daya
edukasi secara efektif dan \up0 \expndtw-3\charscalex100 efisien. Oleh karena itu,
rumah sakit perlu menetapkan organisasi Promosi Kesehatan \up0
\expndtw0\charscalex102 Rumah Sakit (PKRS), menciptakan pelayanan edukasi, dan
mengatur penugasan \up0 \expndtw-3\charscalex100 seluruh staf yang memberikan
edukasi secara terkoordinasi. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE 6
\par\pard\ql \li1778\ri1165\sb188\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 1. Terdapat penetapan
organisasi promosi kesehatan rumah sakit yang \line\tab \up0 \expndtw-
3\charscalex100 mengoordinasikan pemberian edukasi kepada pasien sesuai dengan
peraturan \line \tab \up0 \expndtw-4\charscalex100 perundang-undangan. (R)
\par\pard\qj \li1778\ri1158\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
2. Terdapat bukti organisasi promosi kesehatan rumah sakit telah berfungsi
sesuai \line\tab \up0 \expndtw-4\charscalex100 dengan peraturan perundang-undangan.
(D,W) \par\pard\qj \li1778\ri1165\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 3. Edukasi dilaksanakan sesuai dengan kebutuhan pasien dan
keluarga di seluruh \line\tab \up0 \expndtw-4\charscalex100 rumah sakit. (D,O,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MKE 7 \par\pard\li1418\sb242\sl-
276\slmult0\fi0\tx4839 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24
Profesional pemberi asuhan\tab \up0 \expndtw0\charscalex100 (PPA) yang
memberikan edukasi harus mampu\par\pard\li1418\sb41\sl-276\slmult0\fi0 \up0
\expndtw0\charscalex100 memberikan edukasi secara efektif.\par\pard\ql
\li1418\sb229\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 7 \par\pard\qj
\li1418\ri1243\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Profesional pemberi asuhan (PPA) yang dapat dibantu
oleh staf klinis lainnya yang \up0 \expndtw0\charscalex104 memberi asuhan
memahami kontribusinya masing-masing dalam pemberian \up0
\expndtw0\charscalex100 edukasi pasien. Informasi yang diterima pasien dan keluarga
adalah komprehensif, \up0 \expndtw0\charscalex100 konsisten, dan efektif.
\par\pard\qj \li1418\ri1242\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex100 Agar
profesional pemberi asuhan (PPA) mampu memberikan edukasi secara efektif \line \up0
\expndtw0\charscalex105 dilakukan pelatihan sehingga terampil melaksanakan
komunikasi efektif. \line \up0 \expndtw0\charscalex100 Pengetahuan tentang materi
yang diberikan dan kemampuan berkomunikasi secara \par\pard\ql \li10156\sb176\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 192
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg193}
{\bkmkend Pg193}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 efektif adalah pertimbangan penting
dalam edukasi yang efektif. \par\pard\ql \li1418\sb224\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE
7 \par\pard\qj \li1778\ri1333\sb208\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Profesional pemberi asuhan
sudah terampil melakukan komunikasi efektif. \line\tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\qj \li1778\ri1312\sb0\sl-320\slmult0\tx2138 \up0
\expndtw-2\charscalex100 2. Profesional pemberi asuhan memiliki pengetahuan yang
cukup tentang materi \line\tab \up0 \expndtw-3\charscalex100 yang diberikan. (W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MKE 8 \par\pard\qj \li1418\ri1219\sb208\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Agar edukasi
pasien dan keluarga dapat efektif maka staf harus melakukan asesmen \line \up0
\expndtw0\charscalex100 kemampuan, kemauan belajar, dan kebutuhan edukasi yang
dicatat di dalam rekam \line \up0 \expndtw-3\charscalex100 medis. \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 8 \par\pard\qj
\li1418\ri1185\sb211\sl-317\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Edukasi berfokus pada pengetahuan dan keterampilan
spesifik yang dibutuhkan \up0 \expndtw0\charscalex100 pasien dan keluarga
dalam pengambilan keputusan, serta berpartisipasi dalam \up0 \expndtw-
2\charscalex100 asuhan dan asuhan berkelanjutan di rumah. Hal tersebut di atas
berbeda dengan alur \up0 \expndtw-2\charscalex100 informasi pada umumnya antara
staf dan pasien yang bersifat informatif, tetapi bukan \up0 \expndtw-
1\charscalex100 bersifat edukasi seperti lazimnya. Pengetahuan dan
keterampilan yang menjadi \up0 \expndtw0\charscalex100 kekuatan dan kekurangan
diidentifikasi serta digunakan untuk membuat rencana \up0 \expndtw0\charscalex102
edukasi. Terdapat banyak variabel yang menentukan apakah pasien dan keluarga
\up0 \expndtw-3\charscalex100 mau dan mampu untuk belajar. \par\pard\ql
\li1418\sb217\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Dengan demikian, untuk
merencanakan edukasi dilakukan asesmen: \par\pard\ql \li2138\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 1. keyakinan serta nilai-nilai pasien
dan keluarga; \par\pard\ql \li2138\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 2. kemampuan membaca, tingkat pendidikan, dan bahasa yang
digunakan; \par\pard\ql \li2138\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
3. hambatan emosional dan motivasi; \par\pard\ql \li2138\sb44\sl-276\slmult0
\up0 \expndtw-2\charscalex100 4. keterbatasan fisik dan kognitif; \par\pard\ql
\li2138\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5. kesediaan pasien
untuk menerima informasi. \par\pard\qj \li1418\ri1227\sb14\sl-313\slmult0 \up0
\expndtw-1\charscalex100 Untuk memahami kebutuhan edukasi setiap pasien dan
keluarganya,dibutuhkan \line \up0 \expndtw0\charscalex103 proses asesmen untuk
identifikasi jenis operasi, prosedur invasif lainnya, rencana \line \up0
\expndtw0\charscalex100 tindakan, kebutuhan perawatannya, dan kesinambungan asuhan
setelah keluar dari \line \up0 \expndtw0\charscalex100 rumah sakit. Asesmen ini
memungkinkan profesional pemberi asuhan \up0 \expndtw-1\charscalex100 (PPA)
\par\pard\ql \li1418\sb38\sl-276\slmult0 \up0 \expndtw-3\charscalex100 merencanakan
dan melaksanakan edukasi yang dibutuhkan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian MKE 8 \par\pard\ql \li1778\ri1222\sb208\sl-320\slmult0\tx2138\tx2138
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Dilakukan asesmen
kemampuan dan kemauan belajar pasien serta keluarga \line\tab \up0
\expndtw0\charscalex100 yang meliputi a) sampai dengan e) maksud dan tujuan yang
dicatat di rekam \line \tab \up0 \expndtw-3\charscalex100 medis. (D,O) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 193
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg194}
{\bkmkend Pg194}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1225\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 2. Dilakukan asesmen kebutuhan edukasi untuk pasien
dan dicatat di rekam \line\tab \up0 \expndtw-3\charscalex100 medis. (D,O).
\par\pard\qj \li1778\ri1218\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
3. Hasil asesmen digunakan untuk membuat perencanaan kebutuhan edukasi.
\line\tab \up0 \expndtw-3\charscalex100 (D,O) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MKE 9
\par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pemberian edukasi merupakan bagian penting dalam proses
asuhan kepada pasien. \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 9 \par\pard\qj
\li1418\ri1220\sb212\sl-315\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Edukasi difokuskan pada pengetahuan dan keterampilan
spesifik yang dibutuhkan \up0 \expndtw0\charscalex103 pasien dalam rangka
memberdayakan pasien dalam proses asuhan dengan \up0 \expndtw0\charscalex100
memahami diagnosis dan perkembangan kondisi kesehatannya, ikut terlibat dalam
\up0 \expndtw-2\charscalex100 pembuatan keputusan dan berpartisipasi dalam
asuhannya, serta dapat melanjutkan \up0 \expndtw-3\charscalex100 asuhan di
rumah. \par\pard\qj \li1418\ri1219\sb205\sl-316\slmult0\fi67 \up0
\expndtw0\charscalex100 Edukasi yang diberikan sebagai bagian dari proses
memperoleh\ul0\nosupersub\cf8\f9\fs24 informed consent \line \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 untuk pengobatan (misalnya pembedahan
dan anestesi) didokumentasikan di rekam \line \up0 \expndtw0\charscalex104 medis
pasien. Sebagai tambahan, bila pasien atau keluarganya secara langsung \line
\up0 \expndtw0\charscalex102 berpartisipasi dalam pemberian pelayanan (contoh:
mengganti balutan, menyuapi \line \up0 \expndtw-1\charscalex100 pasien, memberikan
obat, dan tindakan pengobatan) maka mereka perlu diberi \line \up0 \expndtw-
2\charscalex100 edukasi. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb206\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE 9
\par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1205\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Terdapat bukti terhadap pasien dijelaskan mengenai hasil asesmen, diagnosis,
\line\tab \up0 \expndtw-3\charscalex100 dan rencana asuhan yang akan diberikan.
(D,W) (lihat juga HPK 2.1) \par\pard\ql \li1778\ri1163\sb9\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 2. Terdapat bukti
terhadap pasien dijelaskan hasil asuhan dan pengobatan \line\tab \up0
\expndtw-4\charscalex100 termasuk hasil asuhan dan pengobatan yang tidak
diharapkan. (D,W) (lihat juga \line \tab \up0 \expndtw-5\charscalex100 PAP 2.4 dan
HPK 2.1) \par\pard\ql \li1778\sb39\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3.
Terdapat bukti edukasi asuhan lanjutan di rumah. (D,W) \par\pard\ql
\li1778\ri1219\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104 4.
Bila dilakukan tindakan medik yang memerlukan persetujuan tindakan \line\tab
\up0 \expndtw-1\charscalex100 kedokteran (\ul0\nosupersub\cf8\f9\fs24 informed
consent\ul0\nosupersub\cf7\f8\fs24 ), pasien dan keluarga belajar tentang risiko
dan \line \tab \up0 \expndtw-1\charscalex100 komplikasi yang dapat terjadi untuk
dapat memberikan persetujuan. (D,W) \par\pard\qj \li1778\ri1229\sb17\sl-
300\slmult0\tx2138 \up0 \expndtw0\charscalex103 5. Pasien dan keluarga diberikan
edukasi mengenai hak dan tanggung jawab \line\tab \up0 \expndtw-2\charscalex100
mereka untuk berpartisipasi pada proses asuhan. (D,W) (lihat juga HPK 2.2)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MKE 10 \par\pard\qj \li1418\ri1222\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Edukasi pasien
dan keluarga termasuk topik berikut ini, terkait dengan pelayanan \line \up0
\expndtw0\charscalex103 pasien: penggunaan obat yang aman, penggunaan peralatan
medis yang aman, \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb150\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 194
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg195}
{\bkmkend Pg195}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1231\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 potensi interaksi antara obat dan makanan, pedoman
nutrisi, manajemen nyeri, dan \up0 \expndtw-3\charscalex100 teknik rehabilitasi.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb208\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 10 \par\pard\qj
\li1418\ri1221\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menggunakan materi
dan proses edukasi pasien yang standar paling \up0 \expndtw-3\charscalex100
sedikit pada topik-topik tertera di bawah ini: \par\pard\ql
\li1778\ri1219\sb200\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 1)
penggunaan obat-obatan yang didapat pasien secara efektif dan aman (bukan \line\tab
\up0 \expndtw0\charscalex104 hanya obat yang diresepkan untuk dibawa pulang),
termasuk potensi efek \line \tab \up0 \expndtw-3\charscalex100 samping obat;
\par\pard\ql \li1778\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2)
penggunaan peralatan medis secara efektif dan aman; \par\pard\qj
\li1778\ri1225\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3) potensi
interaksi antara obat yang diresepkan dan obat lainnya termasuk obat \line\tab \up0
\expndtw-3\charscalex100 yang tidak diresepkan serta makanan. \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4) diet dan nutrisi;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5)
manajemen nyeri; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 6) teknik rehabilitasi; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 7) cara cuci tangan yang benar.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE
10 \par\pard\ql \li1778\ri1218\sb8\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Pemberian edukasi kepada
pasien dan keluarga terkait dengan asuhan yang \line\tab \up0
\expndtw0\charscalex100 diberikan meliputi penggunaan obat-obatan secara efektif
dan aman, potensi \line \tab \up0 \expndtw-1\charscalex100 efek samping obat,
potensi interaksi obat antarobat konvensional, obat bebas, \line \tab \up0
\expndtw-2\charscalex100 serta suplemen atau makanan. (D,W) \par\pard\ql
\li1778\ri1205\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 2.
Pemberian edukasi kepada pasien dan keluarga terkait dengan asuhan yang
\line\tab \up0 \expndtw-2\charscalex100 diberikan meliputi keamanan dan
efektivitas penggunaan peralatan medis. \line \tab \up0 \expndtw-3\charscalex100
(D,W) \par\pard\qj \li1778\ri1157\sb2\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 3. Pemberian edukasi kepada pasien dan keluarga terkait
dengan asuhan yang \line\tab \up0 \expndtw-3\charscalex100 diberikan meliputi diet
dan nutrisi yang memadai. (D,W) (lihat juga PAP.4 EP 7) \par\pard\qj
\li1778\ri1218\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Pemberian
edukasi kepada pasien dan keluarga terkait dengan asuhan yang \line\tab \up0
\expndtw-2\charscalex100 diberikan meliputi manajemen nyeri. (D,W) (lihat juga HPK
2.5 dan PAP 6 ; AP \par\pard\ql \li2138\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 1.3) \par\pard\qj \li1778\ri1218\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 5. Pemberian edukasi kepada pasien dan keluarga terkait
dengan asuhan yang \line\tab \up0 \expndtw-3\charscalex100 diberikan meliputi
teknik rehabilitasi. (D,W) \par\pard\ql \li1778\ri1217\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 6. Pemberian edukasi kepada
pasien dan keluarga terkait dengan asuhan yang \line\tab \up0 \expndtw-
1\charscalex100 diberikan meliputi cara cuci tangan yang aman. (D,W,S) (lihat juga
SKP 5 dan \line \tab \up0 \expndtw-3\charscalex100 PPI 9 EP 6) \par\pard\ql
\li1418\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MKE 11 \par\pard\qj \li1418\ri1157\sb208\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Metode
edukasi mempertimbangkan nilai-nilai dan pilihan pasien dan keluarga, serta
\up0 \expndtw-3\charscalex100 memperkenankan interaksi yang memadai antara pasien-
keluarga dan staf klinis agar \up0 \expndtw-4\charscalex100 edukasi efektif
dilaksanakan\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql \li1418\sb217\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Maksud dan Tujuan MKE 11 \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb70\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 195
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg196}
{\bkmkend Pg196}\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1157\sb203\sl-313\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Proses edukasi berlangsung dengan baik bila mengunakan
metode yang tepat dalam \line \up0 \expndtw-3\charscalex100 proses pemberian
edukasi. Dalam proses edukasi pasien dan keluarga didorong untuk \line \up0
\expndtw-1\charscalex100 bertanya/ berdiskusi agar dapat berpartisipasi dalam
proses asuhan. Perlu kepastian \line \up0 \expndtw-6\charscalex100 bahwa materi
edukasi yang diberikan dapat dipahami oleh pasien dan keluarga. \par\pard\qj
\li1418\ri1154\sb205\sl-316\slmult0 \up0 \expndtw-5\charscalex100 Kesempatan untuk
interaksi antara staf, pasien, dan keluarga pasien dapat memberikan \up0 \expndtw-
5\charscalex100 umpan balik (\ul0\nosupersub\cf8\f9\fs24 feed
back\ul0\nosupersub\cf7\f8\fs24 ) untuk memastikan bahwa informasi dimengerti,
berfaedah, dan \up0 \expndtw-4\charscalex100 dapat digunakan. Profesional pemberi
asuhan (PPA) memahami kontribusinya masing\up0 \expndtw0\charscalex102 masing
dalam pemberian pendidikan pasien, dengan demikian mereka dapat \up0
\expndtw-6\charscalex100 berkolaborasi lebih efektif. Kolaborasi, pada gilirannya
dapat membantu menjamin bahwa \up0 \expndtw-6\charscalex100 informasi yang diterima
pasien dan keluarga adalah komprehensif, konsisten, dan efektif. \up0 \expndtw-
7\charscalex100 Dalam pemberian edukasi harus dilengkapi dengan materi tertulis.
\par\pard\ql \li1418\sb238\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE 11 \par\pard\qj
\li1778\ri1227\sb208\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Profesional pemberi asuhan (PPA) harus menyediakan
waktu yang adekuat \line\tab \up0 \expndtw-2\charscalex100 dalam memberikan
edukasi. (W) \par\pard\qj \li1778\ri1223\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 2. Bila diperlukan, pemberian edukasi kepada pasien dan
keluarga diberikan \line\tab \up0 \expndtw-2\charscalex100 secara kolaboratif oleh
PPA terkait. (D,W) \par\pard\qj \li1778\ri1205\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 3. Pada proses pemberian edukasi, staf harus mendorong
pasien dan keluarga \line\tab \up0 \expndtw-2\charscalex100 untuk bertanya dan
memberi pendapat agar dapat sebagai peserta aktif. (W,S) \par\pard\qj
\li1778\ri1234\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex104 4. Terdapat
bukti dilakukan verifikasi untuk memastikan pasien dan keluarga \line\tab \up0
\expndtw-2\charscalex100 dapat memahami materi edukasi yang diberikan. (D,W)
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 5.
Informasi verbal diperkuat dengan materi tertulis. (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MKE 12 \par\pard\qj \li1418\ri1222\sb225\sl-
300\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Dalam
menunjang keberhasilan asuhan yang berkesinambungan, upaya promosi \up0
\expndtw-3\charscalex100 kesehatan harus dilakukan berkelanjutan. \par\pard\ql
\li1418\sb240\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MKE 12 \par\pard\qj
\li1418\ri1218\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pasien sering membutuhkan pelayanan tindak lanjut
guna memenuhi kebutuhan \up0 \expndtw-2\charscalex100 kesehatan berkesinambungan
atau untuk mencapai sasaran kesehatan mereka. \par\pard\qj \li1418\ri1161\sb205\sl-
315\slmult0 \up0 \expndtw-3\charscalex100 Informasi kesehatan umum diberikan oleh
rumah sakit atau oleh sumber di komunitas, \up0 \expndtw0\charscalex103 dan dapat
dimasukkan bila membuat ringkasan pasien pulang. Informasi tersebut \up0
\expndtw0\charscalex103 mengenai praktik pencegahan yang relevan dengan kondisi
pasien atau sasaran \up0 \expndtw-2\charscalex100 kesehatannya, serta edukasi
untuk mengatasi penyakit atau kecacatannya yang \up0 \expndtw-3\charscalex100
relevan dengan kondisi pasien. \par\pard\qj \li1418\ri1220\sb201\sl-320\slmult0
\up0 \expndtw0\charscalex100 Rumah sakit mengidentifikasi sumber-sumber yang dapat
memberikan edukasi dan \up0 \expndtw0\charscalex100 pelatihan yang tersedia di
komunitas, khususnya organisasi dan fasilitas kesehatan \up0
\expndtw0\charscalex100 yang ada di komunitas yang memberikan dukungan
promosi kesehatan serta \up0 \expndtw-3\charscalex100 pencegahan penyakit.
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb150\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 196
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg197}
{\bkmkend Pg197}\par\pard\ql \li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb0\sl-
276\slmult0 \par\pard\ql\li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb0\sl-
276\slmult0 \par\pard\ql\li1485\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MKE 12 \par\pard\ql
\li1879\ri1215\sb188\sl-320\slmult0\tx2239\tx2239 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mengidentifikasi sumber-sumber yang ada
di komunitas untuk \line\tab \up0 \expndtw-1\charscalex100 mendukung promosi
kesehatan berkelanjutan dan edukasi untuk menunjang \line \tab \up0 \expndtw-
3\charscalex100 asuhan pasien yang berkelanjutan. (D) \par\pard\ql
\li1879\ri1152\sb0\sl-320\slmult0\tx2239\tx2239\tx2239
\up0 \expndtw0\charscalex100 2. Pasien dan keluarga dirujuk agar mendapatkan
edukasi dan pelatihan yang \line\tab \up0 \expndtw0\charscalex102 diperlukan untuk
menunjang asuhan pasien berkelanjutan, agar mencapai \line \tab \up0 \expndtw-
3\charscalex100 hasil asuhan yang optimal setelah meninggalkan rumah sakit. (D,W)
(lihat juga \line \tab \up0 \expndtw-4\charscalex100 ARK 4.1) \par\pard\qj
\li1879\ri1224\sb17\sl-300\slmult0\tx2239 \up0 \expndtw0\charscalex102 3. Edukasi
berkelanjutan tersebut diberikan kepada pasien yang rencana \line\tab \up0
\expndtw-3\charscalex100 pemulangannya kompleks. (D,W) (lihat juga ARK 3)
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb213\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 197
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg198}
{\bkmkend Pg198}\par\pard\ql \li10233\sb0\sl-276\slmult0
\par\pard\ql\li10233\sb0\sl-276\slmult0 \par\pard\ql\li10233\sb0\sl-276\slmult0
\par\pard\ql\li10233\sb0\sl-276\slmult0 \par\pard\ql\li10233\sb0\sl-276\slmult0
\par\pard\ql\li10233\sb92\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 III \par\pard\ql \li8887\ri1272\sb43\sl-
520\slmult0\fi372\tx9540 \up0 \expndtw-3\charscalex100 STANDAR \line \up0 \expndtw-
3\charscalex100 MANAJEMEN \line\tab \up0 \expndtw-3\charscalex100 RUMAH
\par\pard\ql \li9712\sb202\sl-276\slmult0 \up0 \expndtw-3\charscalex100 SAKIT
\par\pard\ql \li5565\sb0\sl-276\slmult0 \par\pard\ql\li5565\sb0\sl-276\slmult0
\par\pard\ql\li5565\sb212\sl-276\slmult0 \up0 \expndtw-4\charscalex100 BAB 1
\par\pard\ql \li2510\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 PENINGKATAN
MUTU DAN KESELAMATAN PASIEN (PMKP) \par\pard\ql \li1740\sb0\sl-276\slmult0
\par\pard\ql\li1740\sb0\sl-276\slmult0 \par\pard\ql\li1740\sb192\sl-276\slmult0
\up0 \expndtw-3\charscalex100 GAMBARAN UMUM, STANDAR, MAKSUD DAN TUJUAN, SERTA
ELEMEN \par\pard\ql \li5277\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
PENILAIAN \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb180\sl-276\slmult0 \up0 \expndtw-3\charscalex100
GAMBARAN UMUM \par\pard\qj \li1418\ri1275\sb216\sl-310\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Dalam rangka meningkatkan mutu
pelayanan pasien dan menjamin keselamatan \line \up0 \expndtw0\charscalex103 pasien
maka rumah sakit perlu mempunyai program peningkatan mutu dan \line \up0
\expndtw-2\charscalex100 keselamatan pasien (PMKP) yang menjangkau ke seluruh unit
kerja di rumah sakit. \par\pard\qj \li1418\ri1220\sb202\sl-320\slmult0 \up0
\expndtw0\charscalex104 Untuk melaksanakan program tersebut tidaklah mudah
karena memerlukan \line \up0 \expndtw-3\charscalex100 koordinasi dan komunikasi
yang baik antara kepala bidang/divisi medis, keperawatan, \par\pard\li1418\sb46\sl-
276\slmult0\fi0\tx3036\tx4238\tx6082\tx6981\tx8235\tx9722 \up0 \expndtw-
3\charscalex100 penunjang\tab \up0 \expndtw-3\charscalex100 medis,\tab \up0
\expndtw-3\charscalex100 administrasi,\tab \up0 \expndtw-3\charscalex100 dan\tab
\up0 \expndtw-3\charscalex100 lainnya\tab \up0 \expndtw-3\charscalex100
termasuk\tab \up0 \expndtw-3\charscalex100 kepala\par\pard\ql \li1418\sb35\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 unit/departemen/instalasi pelayanan.
\par\pard\qj \li1418\ri1278\sb214\sl-313\slmult0 \up0 \expndtw0\charscalex100 Rumah
sakit perlu menetapkan komite/tim atau bentuk organisasi lainnya untuk \up0
\expndtw0\charscalex103 mengelola program peningkatan mutu dan keselamatan pasien
agar mekanisme \up0 \expndtw0\charscalex100 koordinasi pelaksanaan program
peningkatan mutu dan keselamatan pasien dapat \up0 \expndtw-3\charscalex100
berjalan lebih baik. \par\pard\qj \li1418\ri1218\sb202\sl-320\slmult0 \up0
\expndtw-3\charscalex100 Standar ini menjelaskan pendekatan yang komprehensif untuk
peningkatan mutu dan \up0 \expndtw-4\charscalex100 keselamatan pasien yang
berdampak pada semua aspek pelayanan. \par\pard\ql \li1418\sb237\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Pendekatan ini mencakup \par\pard\ql
\li1778\sb244\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \u8226? setiap unit
terlibat dalam program peningkatan mutu dan keselamatan pasien; \par\pard\qj
\li1778\ri1274\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102 \u8226?
rumah sakit menetapkan tujuan, mengukur seberapa baik proses kerja
\line\tab \up0 \expndtw-3\charscalex100 dilaksanakan, dan validasi datanya;
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb183\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 198
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg199}
{\bkmkend Pg199}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 \u8226? menggunakan data secara
efektif dan fokus pada tolok ukur program; dan \par\pard\qj \li1778\ri1282\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex104 \u8226? bagaimana menerapkan
dan mempertahankan perubahan yang telah \line\tab \up0 \expndtw-3\charscalex100
menghasilkan perbaikan. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1231\sb188\sl-320\slmult0 \up0 \expndtw-3\charscalex100 Agar
peningkatan mutu dan keselamatan pasien dapat berjalan baik, Direktur Rumah
\line \up0 \expndtw-3\charscalex100 Sakit, para kepala bidang/divisi, serta kepala
unit dan departemen di rumah sakit: \par\pard\qj \li1778\ri1287\sb200\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 \u8226? wajib mendorong
pelaksanaan program peningkatan mutu dan keselamatan \line\tab \up0 \expndtw-
3\charscalex100 pasien (PMKP); \par\pard\qj \li1778\ri1278\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 \u8226? berupaya mendorong
pelaksanaan budaya mutu dan keselamatan (\ul0\nosupersub\cf8\f9\fs24 quality and
\line\tab \up0 \expndtw-3\charscalex100 safety
culture\ul0\nosupersub\cf7\f8\fs24 ); \par\pard\ql \li1778\sb17\sl-276\slmult0 \up0
\expndtw-2\charscalex100 \u8226? secara proaktif melakukan identifikasi dan
menurunkan variasi; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \u8226? menggunakan data agar fokus kepada prioritas isu;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
berupaya menunjukkan perbaikan yang berkelanjutan. \par\pard\qj \li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\ri1267\sb208\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Mutu dan keselamatan sejatinya berakar dari pekerjaan sehari-hari
dari seluruh staf \up0 \expndtw-2\charscalex100 di unit pelayanan seperti staf
klinis melakukan asesmen kebutuhan pasien dan \up0 \expndtw-3\charscalex100
memberikan pelayanan. \par\pard\qj \li1418\ri1284\sb180\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Standar PMKP ini membantu mereka untuk memahami
bagaimana melakukan \up0 \expndtw-2\charscalex100 peningkatan nyata dalam
memberikan asuhan pasien dan menurunkan risiko. \par\pard\qj
\li1418\ri1245\sb200\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Demikian pula
staf nonklinis dapat memasukkan standar dalam pekerjaan sehari-hari \up0
\expndtw0\charscalex100 mereka untuk memahami bagaimana suatu proses dapat lebih
efisien, sumberdaya \up0 \expndtw-2\charscalex100 dapat digunakan dengan lebih
bijaksana, dan risiko fisik dapat dikurangi. \par\pard\qj \li1418\ri1255\sb200\sl-
320\slmult0 \up0 \expndtw0\charscalex103 Standar PMKP ini mempunyai kegiatan dengan
spektrum yang sangat luas pada \line \up0 \expndtw-2\charscalex100 rumah sakit
termasuk kerangka untuk meningkatkan kegiatan dan menurunkan risiko \line \up0
\expndtw-2\charscalex100 yang terkait dengan munculnya variasi (ketidakseragaman)
dalam proses pelayanan. \par\pard\qj \li1418\ri1220\sb180\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Dengan demikian, kerangka yang ada dalam standar
ini sangat sesuai dengan \up0 \expndtw-4\charscalex100 berbagai variasi dalam
struktur program dan pendekatan yang kurang
formal terhadap \up0 \expndtw-5\charscalex100 peningkatan mutu serta keselamatan
pasien. \par\pard\qj \li1418\ri1221\sb200\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 Kerangka standar ini juga dapat terintegrasi dengan program
pengukuran yang sudah \up0 \expndtw0\charscalex104 dilaksanakan seperti hal-hal
yang terkait dengan kejadian yang tidak diantisipasi \up0 \expndtw-3\charscalex100
(manajemen risiko) dan pemanfaatan sumberdaya (manajemen utilisasi).
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Seiring
berjalannya waktu maka rumah sakit yang mengikuti kerangka ini akan \par\pard\ql
\li1485\ri1256\sb200\sl-330\slmult0\tx1845 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 mengembangkan
dukungan Direktur dan Kepala Bidang/Divisi serta Kepala \line\tab \up0
\expndtw-3\charscalex100 Unit/Instalasi pelayanan terhadap program keseluruhan
rumah sakit; \line \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 melatih dan melibatkan lebih banyak staf;
\par\pard\qj \li1485\ri2058\sb0\sl-340\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 menetapkan
prioritas yang lebih jelas tentang apa yang yang akan diukur \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
dan dievaluasi; \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb121\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 199
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg200}
{\bkmkend Pg200}\par\pard\ql \li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb0\sl-
276\slmult0 \par\pard\ql\li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb0\sl-
276\slmult0 \par\pard\ql\li1485\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
membuat keputusan berdasar atas pengukuran data; dan \par\pard\qj
\li1485\ri1282\sb28\sl-320\slmult0\tx1845 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 melakukan
perbaikan berdasar atas perbandingan dengan rumah sakit lainnya, \line\tab \up0
\expndtw-3\charscalex100 baik nasional dan internasional. \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-4\charscalex100 Fokus area standar
peningkatan mutu dan keselamatan pasien adalah \par\pard\ql \li1920\sb244\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 1. pengelolaan kegiatan peningkatan mutu
dan keselamatan pasien; \par\pard\ql \li1920\sb44\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 2. pemilihan, pengumpulan, analisis, dan validasi data indikator
mutu; \par\pard\ql \li1920\sb24\sl-276\slmult0 \up0 \expndtw-5\charscalex100 3.
pelaporan dan analisis insiden keselamatan pasien; \par\pard\ql \li1920\sb44\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 4. pencapaian dan mempertahankan
perbaikan; \par\pard\ql \li1920\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100
5. manajemen risiko. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1578\sb208\sl-320\slmult0\tx1778 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PENGELOLAAN KEGIATAN PENINGKATAN MUTU DAN KESELAMATAN \line\tab \up0 \expndtw-
4\charscalex100 PASIEN \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar PMKP 1 \par\pard\qj \li1418\ri1214\sb188\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
mempunyai Komite/Tim atau bentuk organisasi lainnya yang kompeten \up0 \expndtw-
3\charscalex100 untuk mengelola kegiatan Peningkatan Mutu dan Keselamatan Pasien
(PMKP) sesuai \up0 \expndtw-4\charscalex100 dengan peraturan perundang-undangan.
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 1 \par\pard\qj
\li1418\ri1293\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Peningkatan mutu dan keselamatan pasien yang
selanjutnya disingkat PMKP \up0 \expndtw0\charscalex100 merupakan proses kegiatan
yang berkesinambungan (\ul0\nosupersub\cf8\f9\fs24 never ending process).
\par\pard\qj \li1418\ri1290\sb205\sl-315\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Di sisi lain, kegiatan PMKP harus dilaksanakan di
setiap unit kerja yang memerlukan \up0 \expndtw0\charscalex102 mekanisme koordinasi
antarunit dan juga antarkepala unit kerja termasuk dengan \up0
\expndtw0\charscalex100 komite medis dan komite keperawatan sehingga kegiatan
PMKP tetap sesuai \up0 \expndtw-1\charscalex100 dengan program PMKP yang sudah
disetujui oleh pemilik atau representasi pemilik. \up0 \expndtw-2\charscalex100
(lihat juga TKRS 11.2). \par\pard\qj \li1418\ri1293\sb201\sl-320\slmult0 \up0
\expndtw0\charscalex104 Karena itu, rumah sakit perlu menetapkan organisasi yang
mengelola kegiatan \up0 \expndtw-1\charscalex100 PMKP yang dapat berbentuk Komite
atau Tim PMKP atau bentuk organisasi lainnya \up0 \expndtw-2\charscalex100 sesuai
dengan peraturan perundang-undangan. \par\pard\qj \li1418\ri1272\sb203\sl-
317\slmult0 \up0 \expndtw-2\charscalex100 Perlu diingat bahwa kegiatan peningkatan
mutu dan keselamatan pasien tidak dapat \up0 \expndtw0\charscalex105 dipisahkan
secara tegas karena ada kegiatan yang sering tumpang tindih \up0
\expndtw0\charscalex103 (\ul0\nosupersub\cf8\f9\fs24
overlapping\ul0\nosupersub\cf7\f8\fs24 ), misalnya terkait dengan pemilihan
indikator mutu untuk pelayanan \up0 \expndtw0\charscalex103 bedah, yaitu salah
operasi, salah orang, dan salah prosedur. Data tersebut juga \up0 \expndtw-
2\charscalex100 merupakan data insiden keselamatan pasien. Karena itu, kegiatan
peningkatan mutu \up0 \expndtw0\charscalex100 dan kegiatan keselamatan pasien
sebaiknya dilaksanakan secara terintegrasi yang \up0 \expndtw0\charscalex104
dikelola oleh komite/tim atau bentuk organisasi lainnya sesuai dengan peraturan
\up0 \expndtw-2\charscalex100 perundang-undangan. \par\pard\ql \li1418\sb237\sl-
276\slmult0 \up0 \expndtw0\charscalex100 Mengingat yang dikelola adalah data mutu
dan data insiden maka di bawah komite \par\pard\ql \li10156\sb223\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 200
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg201}
{\bkmkend Pg201}\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1288\sb195\sl-315\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 dapat dibentuk subkomite/subtim/penanggung jawab
yang mengelola mutu dan \up0 \expndtw0\charscalex103 keselamatan pasien yang
disesuaikan dengan kondisi rumah sakit dan peraturan \up0 \expndtw0\charscalex104
perundang-undangan. Selain komite/tim, rumah sakit juga perlu mempunyai \up0
\expndtw0\charscalex100 penanggungjawab data di setiap unit kerja yang
diharapkan dapat membantu \up0 \expndtw-1\charscalex100 komite/tim dalam
pengumpulan dan analisis data. \par\pard\ql \li1418\sb238\sl-276\slmult0 \up0
\expndtw0\charscalex100 Komite/tim PMKP mempunyai tugas sebagai berikut:
\par\pard\li1778\sb251\sl-276\slmult0\fi0\tx2138 \up0 \expndtw0\charscalex100
a)\tab \up0 \expndtw0\charscalex100 sebagai motor penggerak penyusunan program PMKP
rumah sakit;\par\pard\li1778\sb40\sl-276\slmult0\fi0\tx2138 \up0
\expndtw0\charscalex100 b)\tab \up0 \expndtw0\charscalex100 melakukan monitoring
dan memandu penerapan program PMKP di unit\par\pard\li1778\sb41\sl-
276\slmult0\fi360 \up0 \expndtw0\charscalex100 kerja;\par\pard\ql
\li1778\ri1280\sb0\sl-320\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw-1\charscalex100 c) \tab \up0 \expndtw0\charscalex102 membantu dan
melakukan koordinasi dengan pimpinan unit pelayanan \line\tab \up0
\expndtw0\charscalex104 dalam memilih prioritas perbaikan, pengukuran
mutu/indikator mutu, dan \line \tab \up0 \expndtw0\charscalex100 menindaklanjuti
hasil capaian indikator. (lihat juga TKRS 11 dan TKRS 11.2) \line \up0
\expndtw0\charscalex100 d) \up0 \expndtw0\charscalex102 melakukan koordinasi dan
pengorganisasian pemilihan prioritas program di \line\tab \up0
\expndtw0\charscalex100 tingkat unit kerja serta menggabungkan menjadi prioritas
rumah sakit secara \line \tab \up0 \expndtw0\charscalex103 keseluruhan. Prioritas
program rumah sakit ini harus terkoordinasi dengan \line \tab \up0
\expndtw0\charscalex100 baik dalam pelaksanaanya; \par\pard\qj
\li1778\ri1279\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 e)
\tab \up0 \expndtw0\charscalex106 menentukan profil indikator mutu, metode
analisis, dan validasi data dari \line\tab \up0 \expndtw0\charscalex100 data
indikator mutu yang dikumpulkan dari seluruh unit kerja di rumah sakit; \line
\up0 \expndtw-1\charscalex100 f) \up0 \expndtw0\charscalex100 menyusun formulir
untuk mengumpulkan data, menentukan jenis data, serta \par\pard\ql \li2138\sb5\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 bagaimana alur data dan pelaporan
dilaksanakan; \par\pard\ql \li1778\ri1274\sb8\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-4\charscalex100 g) \tab \up0
\expndtw0\charscalex103 menjalin komunikasi yang baik dengan semua
pihak terkait serta \line\tab \up0 \expndtw-3\charscalex100 menyampaikan
masalah terkait perlaksanaan program mutu dan keselamatan \line \tab \up0 \expndtw-
3\charscalex100 pasien; \par\pard\li1778\sb39\sl-276\slmult0\fi0\tx2138 \up0
\expndtw-2\charscalex100 h)\tab \up0 \expndtw-2\charscalex100 terlibat secara penuh
dalam kegiatan pendidikan dan pelatihan PMKP;\par\pard\li1778\sb41\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100 i)\tab \up0 \expndtw-
2\charscalex100
bertanggung jawab untuk mengomunikasikan masalah-masalah mutu
secara\par\pard\li1778\sb40\sl-276\slmult0\fi360 \up0 \expndtw-2\charscalex100
rutin kepada semua staf;\par\pard\li1778\sb44\sl-276\slmult0\fi0\tx2138 \up0
\expndtw-2\charscalex100 j)\tab \up0 \expndtw-1\charscalex100 menyusun regulasi
terkait dengan pengawasan dan penerapan program\par\pard\li1778\sb40\sl-
276\slmult0\fi360 \up0 \expndtw-2\charscalex100 PMKP.\par\pard\qj \li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\ri1216\sb206\sl-315\slmult0 \up0
\expndtw0\charscalex104 Komite/tim PMKP dan juga penanggung jawab data di unit
kerja perlu mendapat \up0 \expndtw0\charscalex104 pelatihan terkait manajemen data
rumah sakit, yaitu pengumpulan, analisis, dan \up0 \expndtw-4\charscalex100 rencana
perbaikan. Selain itu, agar komite/tim PMKP dapat melakukan koordinasi dan \up0
\expndtw-2\charscalex100 pengorganisasian yang baik maka diperlukan pelatihan
manajemen komunikasi. \up0 \expndtw-3\charscalex100 Pelatihan tersebut dapat
dilaksanakan di rumah sakit. \par\pard\ql \li1418\sb238\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 1
\par\pard\ql \li1778\ri1213\sb208\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Direktur rumah sakit telah
membentuk komite/tim PMKP atau bentuk organisasi \line\tab \up0
\expndtw0\charscalex100 lainnya untuk mengelola kegiatan sesuai dengan
peraturan perundang-\line \tab \up0 \expndtw-4\charscalex100 undangan termasuk
uraian tugas yang meliputi butir 1 sampai dengan 10 yang \line \tab \up0 \expndtw-
5\charscalex100 ada ada maksud dan tujuan. (R) \par\pard\qj \li1778\ri1276\sb17\sl-
300\slmult0\tx2138 \up0 \expndtw0\charscalex103 2. Direktur rumah sakit
menetapkan penanggung jawab data di tiap-tiap unit \line\tab \up0 \expndtw-
3\charscalex100 kerja. (R) \par\pard\ql \li10156\sb199\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 201
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg202}
{\bkmkend Pg202}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1277\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 3. Individu di dalam komite/tim PMKP atau bentuk
organisasi lainnya dan \line\tab \up0 \expndtw-3\charscalex100 penanggung jawab
data telah dilatih serta kompeten. (D) \par\pard\qj \li1778\ri1284\sb4\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Komite/tim PMKP atau
bentuk organisasi lainnya telah melaksanakan \line\tab \up0 \expndtw-
3\charscalex100 kegiatannya. (D, W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PMKP 2 \par\pard\qj \li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\ri1284\sb26\sl-310\slmult0 \up0
\expndtw0\charscalex108 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai
referensi terkini tentang peningkatan mutu dan \up0 \expndtw0\charscalex104
keselamatan pasien berdasar atas ilmu pengetahuan dan informasi terkini serta
\up0 \expndtw-1\charscalex100 perkembangan konsep peningkatan mutu dan keselamatan
pasien. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb83\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PMKP 2 \par\pard\qj \li1418\sb0\sl-318\slmult0
\par\pard\qj\li1418\ri1216\sb12\sl-318\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Kegiatan peningkatan mutu dan keselamatan pasien
memerlukan regulasi yang \line \up0 \expndtw0\charscalex103 didasarkan atas
referensi ilmiah terikini. Karena ilmu pengetahuan terus \line \up0
\expndtw0\charscalex102 berkembang maka rumah sakit wajib menyediakan referensi
yang sesuai dengan \line \up0 \expndtw0\charscalex104 perkembangan ilmu pengetahuan
dan teknologi yang dapat dipergunakan untuk \line \up0 \expndtw0\charscalex104
mendukung pelaksanaan program peningkatan mutu serta keselamatan pasien. \line \up0
\expndtw0\charscalex100 Referensi yang harus disediakan oleh rumah sakit dapat
berupa literatur ilmiah \line \up0 \expndtw0\charscalex100 terkait asuhan pasien
dan manajemen,\ul0\nosupersub\cf8\f9\fs24 international clinical
guidelines\ul0\nosupersub\cf7\f8\fs24 , pedoman \line \up0 \expndtw-4\charscalex100
nasional praktik kedokteran, pedoman praktik klinis
(\ul0\nosupersub\cf8\f9\fs24 clinical practice
guidelines\ul0\nosupersub\cf7\f8\fs24 ), \line \up0 \expndtw-6\charscalex100 temuan
penelitian dan metodologi pendidikan, fasilitas internet, bahan cetak
di \line \up0 \expndtw0\charscalex102 perpustakaan, sumber-sumber
pencarian\ul0\nosupersub\cf8\f9\fs24 online\ul0\nosupersub\cf7\f8\fs24 , bahan-
bahan pribadi, serta \line \up0 \expndtw0\charscalex104 peraturan perundang-
undangan adalah sumber informasi terkini yang berharga. \line \up0 \expndtw-
1\charscalex100 (lihat juga TKRS 7) \par\pard\qj \li1418\ri1294\sb181\sl-
320\slmult0 \up0 \expndtw0\charscalex103 Secara rinci referensi dan informasi
terkini yang diperlukan rumah sakit dalam \up0 \expndtw-1\charscalex100
meningkatkan mutu dan keselamatan pasien meliputi \par\pard\ql
\li1778\ri1290\sb200\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104 a)
literatur ilmiah dan informasi lainnya yang dapat dipergunakan untuk
\line\tab \up0 \expndtw0\charscalex100 mendukung asuhan pasien terkini, misalnya
pedoman nasional pelayanan \line \tab \up0 \expndtw-1\charscalex100 kedokteran
dan\ul0\nosupersub\cf8\f9\fs24 international clinical
guidelines\ul0\nosupersub\cf7\f8\fs24 ; \par\pard\qj \li1778\ri1276\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex104 b) literatur ilmiah dan
informasi lainnya yang dapat dipergunakan untuk \line\tab \up0 \expndtw-
1\charscalex100 mendukung penelitian (khusus untuk rumah sakit pendidikan);
\par\pard\qj \li1778\ri1290\sb17\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex104
c) literatur ilmiah dan informasi lainnya yang dapat dipergunakan untuk
\line\tab \up0 \expndtw-2\charscalex100 mendukung terselenggaranya manajemen yang
baik; \par\pard\qj \li1778\ri1291\sb4\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 d) informasi lainnya sesuai dengan kebutuhan rumah
sakit, misalnya data \line\tab \up0 \expndtw-2\charscalex100 indikator mutu di
tingkat nasional atau internasional; \par\pard\ql \li1778\ri1283\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 e) peraturan perundang-
undangan terkait dengan mutu dan keselamatan pasien \line\tab \up0
\expndtw0\charscalex107 di rumah sakit termasuk pedoman-pedoman yang
dikeluarkan oleh \line \tab \up0 \expndtw-2\charscalex100 pemerintah. \par\pard\qj
\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1280\sb200\sl-320\slmult0 \up0
\expndtw0\charscalex105 Referensi di atas agar dipergunakan dalam menyusun regulasi
proses kegiatan \up0 \expndtw-1\charscalex100 asuhan klinis pada pasien dan proses
kegiatan manajemen yang baik. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb3\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 202
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg203}
{\bkmkend Pg203}\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1266\sb203\sl-313\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Di sisi lain, untuk melaksanakan program peningkatan
mutu dan keselamatan pasien \up0 \expndtw0\charscalex104 maka rumah sakit agar
mempunyai regulasi peningkatan mutu dan keselamatan \up0 \expndtw0\charscalex100
pasien sebagai acuan dalam meningkatkan mutu serta keselamatan pasien rumah \up0
\expndtw-1\charscalex100 sakit yang dapat dilengkapi dengan SPO sesuai dengan
kebutuhan. \par\pard\ql \li1418\sb238\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 2 \par\pard\qj
\li1778\ri1245\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai pedoman peningkatan mutu dan
keselamatan pasien \line\tab \up0 \expndtw-3\charscalex100 sesuai dengan referensi
terkini. (lihat juga TKRS 4 EP 1). (R) \par\pard\ql \li1778\ri1282\sb6\sl-
313\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex102 2. Rumah sakit
mempunyai referensi yang dipergunakan untuk meningkatkan \line\tab \up0
\expndtw0\charscalex103 mutu asuhan klinis dan proses kegiatan manajemen lebih
baik, antara lain \line \tab \up0 \expndtw0\charscalex100 meliputi butir 1 sampai
dengan 5 yang ada pada maksud tujuan untuk rumah \line \tab \up0 \expndtw-
2\charscalex100 sakit pendidikan dan kecuali butir 2 untuk rumah sakit
nonpendidikan. (D,W) \par\pard\qj \li1778\ri1223\sb2\sl-320\slmult0\tx2138 \up0
\expndtw-3\charscalex100 3. Komite medis dan komite keperawatan mempunyai
referensi peningkatan mutu \line\tab \up0 \expndtw-4\charscalex100 asuhan klinis
terkini. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PMKP 2.1 \par\pard\qj \li1418\ri1279\sb216\sl-
310\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menyediakan teknologi dan dukungan lainnya untuk mendukung sistem \up0
\expndtw0\charscalex100 manajemen data pengukuran mutu terintegrasi sesuai
dengan perkembangan \up0 \expndtw-3\charscalex100 teknologi informasi.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 2.1 \par\pard\qj
\li1418\ri1274\sb211\sl-317\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pengukuran fungsi klinis dan fungsi manajemen di rumah
sakit akan menghasilkan \up0 \expndtw-2\charscalex100 akumulasi data serta
informasi. Untuk memahami seberapa baik kemampuan rumah \up0
\expndtw0\charscalex102 sakit bergantung pada hasil analisis data dan informasi
yang terkumpul dibanding \up0 \expndtw-1\charscalex100 dengan rumah sakit lain.
Pada rumah sakit besar dan kompleks sifatnya dibutuhkan \up0
\expndtw0\charscalex100 teknologi dan/atau staf yang mempunyai kompetensi mengelola
data. Rumah sakit \up0 \expndtw0\charscalex103 memahami prioritas pengukuran dan
perbaikan sebagai dukungan yang penting. \up0 \expndtw-2\charscalex100 Mereka
memberikan dukungan secara konsisten sesuai dengan sumber daya rumah \up0 \expndtw-
3\charscalex100 sakit dan peningkatan mutu. \par\pard\ql \li1869\ri1275\sb205\sl-
315\slmult0\tx2229\tx2229\tx2229\tx2229 \up0 \expndtw-1\charscalex100 a) Karena
itu rumah sakit perlu mempunyai sistem manajemen data yang \line\tab
\up0 \expndtw0\charscalex105 didukung dengan teknologi informasi yang mulai
dari pengumpulan, \line \tab \up0 \expndtw0\charscalex100 pelaporan, analisis,
validasi, serta publikasi data untuk internal rumah sakit \line \tab \up0
\expndtw0\charscalex102 dan eksternal rumah sakit. Publikasi data tetap
harus memperhatikan \line \tab \up0 \expndtw-3\charscalex100 kerahasiaan pasien
sesuai dengan peraturan perundang-undangan. \par\pard\ql \li1869\sb38\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 b) Data yang dimaksud meliputi
\par\pard\ql \li2220\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 data dari
indikator mutu unit dan indikator mutu prioritas rumah sakit; \par\pard\ql
\li1869\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c) data dari pelaporan
insiden keselamatan pasien; dan \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb157\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 203
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg204}
{\bkmkend Pg204}\par\pard\qj \li1869\sb0\sl-300\slmult0 \par\pard\qj\li1869\sb0\sl-
300\slmult0 \par\pard\qj\li1869\sb0\sl-300\slmult0
\par\pard\qj\li1869\ri1278\sb253\sl-300\slmult0\tx2229 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 d) data hasil monitoring kinerja staf
klinis (bila monitoring kinerja menggunakan \line\tab \up0 \expndtw-3\charscalex100
indikator mutu); \par\pard\ql \li1869\sb40\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 e) data hasil pengukuran budaya keselamatan; \par\pard\qj
\li1869\ri1248\sb0\sl-340\slmult0\tx2498 \up0 \expndtw-2\charscalex100 f)
integrasi seluruh data di atas baik di tingkat rumah sakit dan unit kerja
meliputi \line\tab \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 pengumpulan, \par\pard\ql
\li2498\ri3953\sb9\sl-320\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 pelaporan,
\line \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 analisis. \par\pard\ql \li2498\sb57\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Validasi, dan \par\pard\ql \li2498\sb64\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 publikasi indikator mutu. \par\pard\qj
\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1274\sb188\sl-320\slmult0 \up0
\expndtw-3\charscalex100 Rumah sakit seyogianya mempunyai sistem manajemen
data secara elektronik \up0 \expndtw-4\charscalex100 sehingga memudahkan
komite/tim PMKP dalam mengelola data tersebut. \par\pard\ql \li1418\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PMKP 2.1 \par\pard\ql \li1778\ri1281\sb208\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24
1. Rumah sakit mempunyai regulasi sistem manajemen data program PMKP
\line\tab \up0 \expndtw0\charscalex100 yang terintegrasi meliputi data butir 1
sampai dengan 6 pada maksud dan \line \tab \up0 \expndtw-5\charscalex100 tujuan.
(R) \par\pard\ql \li1778\ri1275\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 2. Rumah sakit menyediakan teknologi, fasilitas, dan
dukungan lain untuk \line\tab \up0 \expndtw-1\charscalex100 menerapkan sistem
manajemen data di rumah sakit sesuai dengan sumber \line \tab \up0 \expndtw-
5\charscalex100 daya yang ada di rumah sakit. (D,O,W) \par\pard\qj
\li1778\ri1274\sb2\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 3. Ada bukti
pelaksanaan program PMKP yang meliputi data butir 1 sampai \line\tab \up0
\expndtw-3\charscalex100 dengan 6 pada maksud dan tujuan. (D,O,) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PMKP 3 \par\pard\qj
\li1418\ri1292\sb16\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai program pelatihan peningkatan
mutu dan keselamatan \up0 \expndtw0\charscalex104 pasien untuk pimpinan rumah
sakit serta semua staf yang terlibat dalam \up0 \expndtw-3\charscalex100
pengumpulan, analisis, dan validasi data mutu. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb127\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PMKP 3 \par\pard\qj \li1418\ri1266\sb211\sl-316\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Staf yang berada di unit kerja
maupun di komite/tim PMKP yang bertugas dalam \up0 \expndtw0\charscalex100
mengumpulkan data akan menentukan jenis data, validasi, serta analisis data
\up0 \expndtw0\charscalex100 memerlukan peningkatan pengetahuan dan
ketrampilan. Pelatihan staf perlu \up0 \expndtw0\charscalex100 direncanakan dan
dilaksanakan sesuai dengan peran staf dalam program PMKP. \up0 \expndtw-
2\charscalex100 Rumah sakit mengidentifikasi dan menyediakan pelatih kompeten untuk
pendidikan \up0 \expndtw-2\charscalex100 dan pelatihan ini. Kompeten di sini, yaitu
pelatih tersebut pernah mengikuti pelatihan/ \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf8\f9\fs24 workshop\ul0\nosupersub\cf7\f8\fs24 peningkatan mutu
serta keselamatan pasien dan atau telah mendapat \up0 \expndtw-3\charscalex100
pendidikan tentang peningkatan mutu dan keselamatan pasien. Di sisi
lainnya, \up0 \expndtw-1\charscalex100 pelatihan juga diperlukan untuk pimpinan
termasuk komite medis dan komite \up0 \expndtw-2\charscalex100 keperawatan
karena perlu memahami konsep dan program peningkatan mutu serta \up0
\expndtw0\charscalex100 keselamatan pasien rumah sakit sehingga dapat melaksanakan
perbaikan sesuai \up0 \expndtw-3\charscalex100 bidang tugasnya menjadi lebih
baik. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb64\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 204
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg205}
{\bkmkend Pg205}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen penilaian PMKP 3 \par\pard\qj
\li1778\ri1282\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai program pelatihan PMKP
yang diberikan oleh \line\tab \up0 \expndtw-3\charscalex100 narasumber yang
kompeten. (R) \par\pard\qj \li1778\ri1233\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 2. Pimpinan di rumah sakit termasuk komite medis dan komite
keperawatan telah \line\tab \up0 \expndtw-4\charscalex100 mengikuti pelatihan PMKP.
(D,W) \par\pard\ql \li1778\ri1278\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 3. Semua individu yang terlibat dalam pengumpulan, analisis, dan
validasi data \line\tab \up0 \expndtw-1\charscalex100 telah mengikuti pelatihan
PMKP, khususnya tentang sistem manajemen data. \line \tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\qj \li1778\ri1276\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 4. Staf di semua unit kerja termasuk staf klinis dilatih
sesuai dengan pekerjaan \line\tab \up0 \expndtw-3\charscalex100 mereka sehari-hari.
(D,W) \par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1699\sb180\sl-
320\slmult0\tx1778 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PROSES PEMILIHAN, PENGUMPULAN, ANALISIS, DAN
VALIDASI DATA \line\tab \up0 \expndtw-3\charscalex100 INDIKATOR MUTU
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PMKP 4
\par\pard\qj \li1418\ri1215\sb188\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Komite/tim PMKP atau bentuk organisasi lain
terlibat proses pemilihan prioritas \up0 \expndtw0\charscalex100 pengukuran
pelayanan klinis yang akan dievaluasi serta melakukan koordinasi dan \up0 \expndtw-
4\charscalex100 integrasi kegiatan pengukuran di seluruh unit di rumah sakit.
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 4 \par\pard\qj
\li1418\ri1275\sb211\sl-317\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Pemilihan indikator menjadi tanggung
jawab pimpinan program. Standar TKRS 5 \line \up0 \expndtw0\charscalex103
menjelaskan bagaimana rumah sakit menetapkan daerah (lokasi) prioritas untuk \line
\up0 \expndtw0\charscalex102 diukur di tingkat rumah sakit, sedangkan standar
TKRS 11 menjelaskan proses \line \up0 \expndtw0\charscalex100 pemilihan indikator
di tingkat unit pelayanan. Pemilihan indikator di unit pelayanan \line \up0
\expndtw0\charscalex100 klinis maupun manajemen dipilih berdasar atas prioritasnya.
Jika prioritas indikator \line \up0 \expndtw0\charscalex102 yang dipilih
pelayanan sama oleh beberapa unit pelayanan maka diperlukan \line \up0
\expndtw0\charscalex100 koordinasi dan integrasi dalam pengumpulan data. Integrasi
semua sistem ukuran \line \up0 \expndtw-1\charscalex100 akan memberikan kesempatan
penyelesaian dan perbaikan terintegrasi. (lihat TKRS \par\pard\ql \li1418\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 4). \par\pard\qj \li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1272\sb108\sl-313\slmult0 \up0 \expndtw-1\charscalex100
Integrasi indikator oleh beberapa unit pelayanan dapat dilaksanakan di rumah
sakit \up0 \expndtw-2\charscalex100 besar seperti kegiatan pengurangan
penggunaan antibiotik di rumah sakit yang \up0 \expndtw-1\charscalex100
merupakan integrasi pelayanan farmasi serta pencegahan pengendalian
infeksi \up0 \expndtw-3\charscalex100 termasuk integrasi dengan indikator sasaran
keselamatan pasien. \par\pard\qj \li1418\ri1280\sb202\sl-320\slmult0 \up0
\expndtw0\charscalex102 Komite/tim PMKP terlibat dalam pemilihan pengukuran
prioritas rumah sakit serta \up0 \expndtw0\charscalex100 melakukan koordinasi dan
integrasi pengukuran mutu di unit pelayanan serta \up0 \expndtw-
3\charscalex100 melakukan supervisi dalam proses pengumpulan data. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb203\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 205
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg206}
{\bkmkend Pg206}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 4 \par\pard\ql
\li1778\ri1284\sb208\sl-320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1 \tab \up0 \expndtw-2\charscalex100
Komite/tim peningkatan mutu dan keselamatan pasien atau bentuk organisasi \line\tab
\up0 \expndtw0\charscalex103 lainnya memfasilitasi pemilihan prioritas pengukuran
pelayanan klinis yang \line \tab \up0 \expndtw-3\charscalex100 akan dievaluasi.
(D,W) \par\pard\ql \li1778\ri1232\sb0\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw-3\charscalex100 2 \tab \up0 \expndtw-2\charscalex100 Komite/tim
peningkatan mutu dan keselamatan pasien atau bentuk organisasi \line\tab \up0
\expndtw-3\charscalex100 lainnya melakukan koordinasi dan integrasi kegiatan
pengukuran mutu di unit \line \tab \up0 \expndtw-4\charscalex100 pelayanan serta
pelaporannya. (D,W) \par\pard\ql \li1778\ri1274\sb9\sl-
310\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-3\charscalex100 3 \tab \up0
\expndtw-2\charscalex100 Komite/tim peningkatan mutu dan keselamatan pasien atau
bentuk organisasi \line\tab \up0 \expndtw0\charscalex100 lainnya melaksanakan
supervisi terhadap progres pengumpulan data sesuai \line \tab \up0 \expndtw-
3\charscalex100 dengan yang direncanakan. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb7\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PMKP
5 \par\pard\qj \li1418\ri1282\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memilih dan menetapkan prioritas pengukuran
mutu pelayanan klinis \up0 \expndtw-2\charscalex100 yang akan dievaluasi dan
indikator-indikator berdasar atas prioritas tersebut. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PMKP 5 \par\pard\qj \li1418\ri1215\sb188\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Peningkatan mutu dan keselamatan pasien
dilakukan berdasar atas tersedianya data. \up0 \expndtw-1\charscalex100 Penggunaan
data secara efektif dapat dilakukan berdasar atas\ul0\nosupersub\cf8\f9\fs24
evidence-based \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 praktik
klinik dan\ul0\nosupersub\cf8\f9\fs24 evidence based\ul0\nosupersub\cf7\f8\fs24
praktik manajemen. \par\pard\qj \li1418\ri1272\sb200\sl-320\slmult0 \up0
\expndtw0\charscalex100 Setiap tahun rumah sakit harus memilih fokus perbaikan,
proses serta hasil praktik \line \up0 \expndtw-1\charscalex100 klinis dan manajemen
mengacu pada misi rumah sakit, kebutuhan pasien, dan jenis \line \up0 \expndtw-
2\charscalex100 pelayanan. Pemilihan ini didasarkan atas proses yang
berimplikasi risiko tinggi, \line \up0 \expndtw0\charscalex100 diberikan dalam
volume besar, atau cenderung menimbulkan masalah. Fokus \line \up0 \expndtw-
2\charscalex100 perbaikan praktik klinis melibatkan komite medis dan kelompok staf
medis terkait. \par\pard\qj \li1418\ri1271\sb180\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Direktur rumah sakit bersama-sama dengan pelayanan dan manajemen
memilih dan \up0 \expndtw0\charscalex100 menetapkan pengukuran mutu pelayanan
klinis yang prioritas untuk dilakukan \up0 \expndtw0\charscalex102 evaluasi.
Pengukuran mutu prioritas tersebut dilakukan menggunakan indikator\up0 \expndtw-
3\charscalex100 indikator mutu sebagai berikut: \par\pard\qj
\li1778\ri1224\sb200\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 1)
Indikator mutu area klinik (IAK) yaitu indikator mutu yang bersumber dari area
\line\tab \up0 \expndtw-4\charscalex100 pelayanan \par\pard\qj
\li1778\ri1215\sb17\sl-300\slmult0\tx2138 \up0 \expndtw-4\charscalex100 2)
Indikator mutu area manajemen (IAM) yaitu indikator mutu yang bersumber dari
\line\tab \up0 \expndtw-5\charscalex100 area manajemen \par\pard\ql
\li1778\ri1285\sb4\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 3)
Indikator mutu Sasaran Keselamatan Pasien yaitu indikator mutu yang
\line\tab \up0 \expndtw-2\charscalex100 mengukur kepatuhan staf dalam penerapan
sasaran keselamatan pasien dan \line \tab \up0 \expndtw-2\charscalex100 budaya
keselamatan \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb164\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 206
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg207}
{\bkmkend Pg207}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1216\sb253\sl-300\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap indikator agar dibuat profilnya atau gambaran
singkat tentang indikator tersebut \up0 \expndtw-5\charscalex100 namun tidak
terbatas meliputi \par\pard\ql \li1778\sb240\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 a) judul indikator; \par\pard\ql \li1778\sb44\sl-276\slmult0
\up0 \expndtw-2\charscalex100 b) definisi operasional; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c) tujuan dan dimensi
mutu; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d)
dasar pemikiran/alasan pemilihan indicator; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 e) numerator, denominator, dan formula
pengukuran; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100
f) metodologi pengumpulan data; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 g) cakupan data; \par\pard\ql \li1778\sb24\sl-276\slmult0
\up0 \expndtw-3\charscalex100 h) frekuensi pengumpulan data; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 i) frekuensi analisis
data; \par\pard\li1778\sb58\sl-276\slmult0\fi0\tx2205 \up0 \expndtw-3\charscalex100
j)\tab \up0 \expndtw-3\charscalex100 metodologi analisis data;\par\pard\ql
\li1778\sb30\sl-276\slmult0 \up0 \expndtw-1\charscalex100 k) sumber data;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 l)
penanggung jawab pengumpul data; dan \par\pard\ql \li1778\sb44\sl-276\slmult0
\up0 \expndtw-2\charscalex100 m) publikasi data. \par\pard\qj
\li1418\ri1278\sb16\sl-310\slmult0 \up0 \expndtw-1\charscalex100 Indikator mutu
yang sudah dipilih bila sudah tercapai terus menerus selama setahun \up0 \expndtw-
2\charscalex100 tidak bermanfaat untuk melakukan perbaikan karena sudah tidak ada
lagi yang perlu \up0 \expndtw-2\charscalex100 diperbaiki, dengan demikian sebaiknya
diganti dengan indikator mutu baru. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb207\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP
5 \par\pard\ql \li1778\ri1284\sb208\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Direktur rumah sakit
berkoordinasi dengan para kepala bidang/divisi dalam \line\tab \up0
\expndtw0\charscalex102 memilih dan menetapkan prioritas pengukuran mutu pelayanan
klinis yang \line \tab \up0 \expndtw-3\charscalex100 akan dievaluasi. (R)
\par\pard\qj \li1778\ri1285\sb17\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
2. Berdasar atas prioritas tersebut ditetapkan pengukuran mutu menggunakan
\line\tab \up0 \expndtw-3\charscalex100 indikator area klinis. (D,W)
\par\pard\qj \li1778\ri1285\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
3. Berdasar atas prioritas tersebut ditetapkan pengukuran mutu menggunakan
\line\tab \up0 \expndtw-3\charscalex100 indikator area manajemen. (D,W)
\par\pard\qj \li1778\ri1285\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
4. Berdasar atasn prioritas tersebut ditetapkan pengukuran mutu menggunakan
\line\tab \up0 \expndtw-3\charscalex100 indikator sasaran keselamatan pasien. (D,W)
\par\pard\qj \li1778\ri1280\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
5. Setiap indikator yang ditetapkan dilengkapi dengan profil indikator
yang \line\tab \up0 \expndtw-1\charscalex100 meliputi butir 1 sampai dengan 13 pada
maksud dan tujuan. (lihat juga TKRS \par\pard\ql \li2138\sb37\sl-276\slmult0
\up0 \expndtw-3\charscalex100 5). (D) \par\pard\qj \li1778\ri1284\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 6. Direktur rumah sakit dan
komite/tim PMKP melakukan supervisi terhadap \line\tab \up0 \expndtw-
2\charscalex100 proses pengumpulan data. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb269\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PMKP 5.1 \par\pard\qj
\li1418\ri1276\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Dilakukan evaluasi proses pelaksanaan panduan praktik
klinik, alur klinis (\ul0\nosupersub\cf8\f9\fs24 clinical \up0
\expndtw0\charscalex103 pathway\ul0\nosupersub\cf7\f8\fs24 ), dan/atau protokol
klinis, dan/atau prosedur, dan/atau\ul0\nosupersub\cf8\f9\fs24 standing
order\ul0\nosupersub\cf7\f8\fs24 di \up0 \expndtw-3\charscalex100 prioritas
pengukuran mutu pelayanan klinis. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb110\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 207
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg208}
{\bkmkend Pg208}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 5.1 \par\pard\qj
\li1418\ri1218\sb208\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ketua Kelompok Staf Medis telah menetapkan paling
sedikit 5 (lima) prioritas panduan \up0 \expndtw-1\charscalex100 praktik klinis-
alur klinis dan/atau protokol klinis dan atau prosedur
dan/atau\ul0\nosupersub\cf8\f9\fs24 standing \up0 \expndtw-4\charscalex100
order\ul0\nosupersub\cf7\f8\fs24 sebagai panduan standardisasi proses asuhan
klinik yang dimonitor oleh Komite \up0 \expndtw-5\charscalex100 Medik dengan tujuan
sebagai berikut: \par\pard\ql \li1778\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 1. melakukan standardisasi proses asuhan klinik; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. mengurangi risiko
dalam proses asuhan terutama yang berkaitan asuhan kritis; \par\pard\qj
\li1778\ri1245\sb25\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3.
memanfaatkan sumber daya yang tersedia dengan efisien dalam memberikan
\line\tab \up0 \expndtw-3\charscalex100 asuhan klinik tepat waktu dan efektif;
\par\pard\qj \li1778\ri1276\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
4. memanfaatkan indikator prioritas sebagai indikator dalam penilaian kepatuhan
\line\tab \up0 \expndtw-2\charscalex100 penerapan alur klinis di area yang akan
diperbaiki di tingkat rumah sakit; \par\pard\qj \li1778\ri1275\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 5. secara konsisten menggunakan
praktik berbasis bukti (\u8220?\ul0\nosupersub\cf8\f9\fs24 evidence based
\line\tab \up0 \expndtw-3\charscalex100 practices\ul0\nosupersub\cf7\f8\fs24
\u8221?) dalam memberikan asuhan bermutu tinggi. \par\pard\qj
\li1418\ri1274\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Penerapan panduan
praktik klinis-\ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 dipilih oleh tiap-tiap kelompok staf \up0
\expndtw-3\charscalex100 medis adalah di unit-unit pelayanan di tempat DPJP
memberikan asuhan. \par\pard\qj \li1418\ri1216\sb209\sl-310\slmult0 \up0 \expndtw-
4\charscalex100 Mengacu pada prioritas pengukuran mutu pelayanan klinis yang akan
dievaluasi maka \up0 \expndtw-2\charscalex100 selain ditetapkan indikator mutu,
juga diperlukan standardisasi proses asuhan klinis \up0 \expndtw-3\charscalex100
pada prioritas pengukuran mutu di rumah sakit. \par\pard\qj
\li1418\ri1275\sb206\sl-316\slmult0 \up0 \expndtw-1\charscalex100 Karena itu,
pimpinan medis bersama-sama dengan komite medis dan kelompok staf \up0
\expndtw0\charscalex102 medis agar memilih dan menetapkan 5 (lima) panduan
praktik klinis, alur klinis \up0 \expndtw0\charscalex103
(\ul0\nosupersub\cf8\f9\fs24 clinical pathway\ul0\nosupersub\cf7\f8\fs24 ),
dan/atau protokol klinis, dan/atau prosedur, dan/atau\ul0\nosupersub\cf8\f9\fs24
standing \up0 \expndtw0\charscalex103 order\ul0\nosupersub\cf7\f8\fs24 yang
dipergunakan untuk pengukuran mutu prioritas rumah sakit dengan \up0
\expndtw0\charscalex104 mengacu pada panduan praktik klinis dan alur klinis yang
sudah diterapkan oleh \up0 \expndtw-3\charscalex100 kelompok staf medis di unit-
unit pelayanan. \par\pard\qj \li1418\ri1215\sb201\sl-320\slmult0 \up0
\expndtw0\charscalex103 Evaluasi dapat dilakukan melalui audit medis dan atau
audit klinis untuk menilai \line \up0 \expndtw-2\charscalex100 efektivitas
penerapan panduan praktik klinik dan alur klinis sehingga dapat dibuktikan \line
\up0 \expndtw-3\charscalex100 bahwa penggunaan panduan praktik klinis serta alur
klinis telah mengurangi variasi i \line \up0 \expndtw-1\charscalex100 proses dan
hasil\ul0\nosupersub\cf8\f9\fs24 .\ul0\nosupersub\cf7\f8\fs24 (TKRS 11.2).
Indikator area klinis (IAK), indikator area manajemen \line \up0
\expndtw0\charscalex102 (IAK), dan indikator sasaran keselamatan pasien (ISKP)
dapat digunakan sebagai \line \up0 \expndtw-3\charscalex100 indikator audit medis
dan atau audit klinis sesuai dengan dimensi mutu WHO. \par\pard\qj
\li1418\ri1217\sb204\sl-316\slmult0 \up0 \expndtw0\charscalex102 Sesuai peraturan
perundangan panduan praktik klinis (PPK) adalah istilah teknis \line \up0
\expndtw-1\charscalex100 sebagai pengganti standar prosedur operasional (SPO)
yang merupakan istilah \line \up0 \expndtw-2\charscalex100 administratif.
Penggantian ini perlu untuk menghindarkan kesalahpahaman yang \line \up0
\expndtw0\charscalex100 mungkin terjadi bahwa \u8220?standar\u8221? merupakan hal
yang harus dilakukan pada semua \line \up0 \expndtw-3\charscalex100 keadaan. Jadi
secara teknis SPO dibuat berupa PPK yang dapat berupa atau disertai \line \up0
\expndtw-4\charscalex100 dengan salah satu atau lebih: alur klinis \up0
\expndtw-4\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 ), protokol, prosedur, \par\pard\ql
\li1418\sb38\sl-276\slmult0 \up0 \expndtw-3\charscalex100 algoritme,
dan\ul0\nosupersub\cf8\f9\fs24 standing order\ul0\nosupersub\cf7\f8\fs24 .
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb237\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 208
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg209}
{\bkmkend Pg209}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1219\sb214\sl-310\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Dalam PPK mungkin terdapat hal-hal yang memerlukan
rincian langkah demi langkah. \line \up0 \expndtw0\charscalex100 Untuk ini, sesuai
dengan karakteristik permasalahan serta kebutuhan dapat dibuat \line \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 (alur klinis), algoritme, protokol, prosedur,
maupun\ul0\nosupersub\cf8\f9\fs24 standing order\ul0\nosupersub\cf7\f8\fs24 .
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Contoh: \par\pard\ql \li1778\ri1273\sb212\sl-
315\slmult0\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 \u8226? Dalam PPK dinyatakan bahwa tata laksana
strok nonhemoragik harus \line\tab \up0 \expndtw0\charscalex100 dilakukan secara
multidisiplin dan dengan pemeriksaan serta intervensi dari \line \tab \up0
\expndtw-2\charscalex100 hari ke hari dengan urutan tertentu. Karakteristik
penyakit strok nonhemoragik \line \tab \up0 \expndtw-2\charscalex100 sesuai untuk
dibuat alur klinis (\ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 , CP) sehingga perlu dibuat CP \line \tab
\up0 \expndtw-3\charscalex100 untuk strok nonhemoragik. \par\pard\ql
\li1778\ri1281\sb1\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100
\u8226? Dalam PPK dinyatakan bahwa pada pasien gagal ginjal kronik perlu
dilakukan \line\tab \up0 \expndtw0\charscalex104 hemodialisis. Uraian rinci
tentang hemodialisis dimuat dalam protokol \line \tab \up0 \expndtw-
3\charscalex100 hemodialisis pada dokumen terpisah. \par\pard\ql
\li1778\ri1222\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex101
\u8226? Dalam PPK dinyatakan bahwa pada anak dengan kejang demam kompleks
\line\tab \up0 \expndtw-3\charscalex100 perlu dilakukan pungsi lumbal. Uraian
pelaksanaan
pungsi lumbal tidak dimuat \line \tab \up0 \expndtw-3\charscalex100 dalam PPK
melainkan dalam prosedur pungsi lumbal dalam dokumen terpisah. \par\pard\ql
\li1778\ri1239\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105
\u8226? Dalam tata laksana kejang demam diperlukan pemberian diazepam rektal
\line\tab \up0 \expndtw-2\charscalex100 dengan dosis tertentu yang harus diberikan
oleh perawat bila dokter tidak ada, \line \tab \up0 \expndtw-3\charscalex100 hal
ini diatur dalam \u8220?\ul0\nosupersub\cf8\f9\fs24 standing
order\ul0\nosupersub\cf7\f8\fs24 \u8221?. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb261\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 5.1
\par\pard\qj \li1778\ri1281\sb208\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
evaluasi pelayanan kedokteran dengan panduan \line\tab \up0 \expndtw-
3\charscalex100 praktik klinis, alur klinis, atau protokol. (R) \par\pard\qj
\li1778\ri1283\sb17\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex103 2. Hasil
evaluasi dapat menunjukkan perbaikan variasi dalam lima fokus area \line\tab
\up0 \expndtw-3\charscalex100 pada pemberian pelayanan. (D,W) \par\pard\qj
\li1778\ri1284\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Rumah
sakit telah melaksanakan audit klinis dan atau audit medis pada
\line\tab \up0 \expndtw-3\charscalex100 panduan praktik klinis/alur klinis
prioritas di tingkat rumah sakit. \up0 \expndtw-3\charscalex100 (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PMKP 6 \par\pard\qj \li1418\ri1278\sb208\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Setiap unit
kerja di rumah sakit memilih dan menetapkan indikator mutu yang \up0
\expndtw-3\charscalex100 dipergunakan untuk mengukur mutu unit kerja.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb185\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 6 \par\pard\qj
\li1418\ri1232\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pemilihan indikator adalah tanggung jawab dari
pimpinan. TKRS 5 menjelaskan \line \up0 \expndtw-1\charscalex100 bagaimana
pimpinan rumah sakit memutuskan area prioritas untuk pengukuran di \line \up0
\expndtw-3\charscalex100 seluruh rumah sakit dan TKRS 11 menjelaskan proses
pemilihan indikator untuk \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb3\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 209
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg210}
{\bkmkend Pg210}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1277\sb253\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 setiap unit pelayanan/unit kerja. Semua unit
pelayanan baik klinis dan manajerial \up0 \expndtw-3\charscalex100 memilih
indikator yang terkait dengan prioritas mereka. \par\pard\qj
\li1418\ri1282\sb204\sl-320\slmult0 \up0 \expndtw0\charscalex103 Di rumah sakit
yang besar dapat diantisipasi kemungkinan indikator yang serupa \up0 \expndtw-
3\charscalex100 dipilih oleh beberapa unit pelayanan. \par\pard\qj
\li1418\ri1233\sb204\sl-316\slmult0 \up0 \expndtw0\charscalex102 Indikator mutu
di unit pelayanan/kerja dipergunakan untuk menilai mutu unit \up0
\expndtw0\charscalex100 pelayanan/kerja. Komite/tim PMKP melakukan koordinasi
dan mengorganisasi \up0 \expndtw-2\charscalex100 pemilihan indikator mutu di unit
kerja tersebut sehingga indikator yang dipilih tersebut \up0
\expndtw0\charscalex100 valid,\ul0\nosupersub\cf8\f9\fs24
reliable\ul0\nosupersub\cf7\f8\fs24 , sensitive, dan spesifik. Pengukuran mutu
perlu juga memperhatikan \up0 \expndtw0\charscalex102 dimensi mutu dari WHO,
yaitu\ul0\nosupersub\cf8\f9\fs24 effective, efficient, accessible,
accepted\ul0\nosupersub\cf7\f8\fs24 (\ul0\nosupersub\cf8\f9\fs24 patient\up0
\expndtw-3\charscalex100
centred\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 , equity, and safe.
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1228\sb81\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Pimpinan unit kerja terlibat langsung dalam pemilihan
dan penetapan yang ingin \up0 \expndtw-3\charscalex100 diukur di unit kerja.
Indikator mutu unit kerja dapat menggunakan indikator mutu yang \up0
\expndtw0\charscalex102 tercantum di dalam standar pelayanan minimal. Indikator
mutu di unit pelayanan \up0 \expndtw0\charscalex100 dapat meliputi indikator mutu
area klinis, indikator mutu area manajemen, indikator \up0 \expndtw0\charscalex103
mutu penerapan sasaran keselamatan pasien, dan indikator mutu unit
kerja \up0 \expndtw-3\charscalex100 (nonpelayanan), minimal meliputi indikator area
manajemen. \par\pard\qj \li1418\ri1285\sb180\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Dalam memilih indikator mutu maka kepala unit kerja dan
unit pelayanan agar \up0 \expndtw-3\charscalex100 memperhatikan hal-hal sebagai
berikut: \par\pard\ql \li1778\ri1220\sb200\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw-3\charscalex100 a) prioritas pengukuran mutu pelayanan klinis di rumah
sakit. Indikator mutu yang \line\tab \up0 \expndtw-3\charscalex100 dipergunakan
untuk mengukur mutu di prioritas pengukuran mutu rumah sakit, \line \tab \up0
\expndtw-4\charscalex100 sumber data pasti dari unit, dan menjadi indikator mutu
unit; \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b)
fokus mengukur hal-hal yang ingin diperbaiki; \par\pard\ql \li1418\ri1278\sb16\sl-
310\slmult0\fi360\tx2138 \up0 \expndtw-2\charscalex100 c) melakukan koordinasi
dengan komite medis bila evaluasi penerapan panduan \line\tab \up0 \expndtw-
3\charscalex100 praktik klinis dan evaluasi kinerja dokter menggunakan indikator
mutu. \line \up0 \expndtw-3\charscalex100 Komite/Tim PMKP agar memfasilitasi
pemilihan indikator mutu unit. \par\pard\qj \li1418\ri1219\sb202\sl-320\slmult0
\up0 \expndtw0\charscalex102 \ul0\nosupersub\cf6\f7\fs24 Sebagai
contoh\ul0\nosupersub\cf7\f8\fs24 , unit pelayanan farmasi maka pengendalian
infeksi dan penyakit \up0 \expndtw-2\charscalex100 menular mungkin masing-masing
memilih prioritas yang terkait dengan pengurangan \up0 \expndtw0\charscalex100
penggunaan antibiotik di rumah sakit. Program mutu dan keselamatan pasien yang \up0
\expndtw0\charscalex103 dijabarkan dalam standar-standar PMKP ini mempunyai
peran yang penting \up0 \expndtw-3\charscalex100 membantu unit pelayanan
menyetujui pendekatan bersama terhadap pengukuran dan \up0 \expndtw-4\charscalex100
memudahkan pengambilan data untuk pengukuran yang ditetapkan. \par\pard\qj
\li1418\ri1281\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex106 Setiap indikator
yang sudah dipilih agar dilengkapi dengan profil indikator \up0 \expndtw-
3\charscalex100 sebagaimana diatur pada maksud dan tujuan di PMKP 5.
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb45\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 210
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg211}
{\bkmkend Pg211}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 6 \par\pard\ql
\li1778\ri1280\sb188\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi pengukuran mutu
dan cara pemilihan \line\tab \up0 \expndtw0\charscalex100 indikator mutu di unit
kerja yang antara lain meliputi butir 1 sampai dengan 3 \line \tab \up0 \expndtw-
3\charscalex100 yang ada pada maksud dan tujuan. (R) \par\pard\qj
\li1778\ri1280\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2. Setiap
unit kerja dan pelayanan telah memilih dan menetapkan indikator mutu \line\tab \up0
\expndtw-2\charscalex100 unit. (lihat juga TKRS 11 EP 1). (D,W) \par\pard\qj
\li1778\ri1283\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102 3. Setiap
indikator mutu telah dilengkapi profil indikator meliputi butir 1 sampai
\line\tab \up0 \expndtw-3\charscalex100 dengan 13 yang ada padai maksud dan tujuan
di PMKP 5. (D,W) \par\pard\qj \li1778\ri1279\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex104 4. Setiap unit kerja melaksanakan proses pengumpulan data
dan pelaporan. \line\tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\ql
\li1778\ri1284\sb4\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 5.
Pimpinan unit kerja melakukan supervisi terhadap proses pengumpulan data
\line\tab \up0 \expndtw0\charscalex100 dan pelaporan serta melakukan perbaikan mutu
berdasar atas hasil capaian \line \tab \up0 \expndtw-3\charscalex100 indikator
mutu. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PMKP 7 \par\pard\qj \li1418\ri1221\sb216\sl-
310\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pengumpulan
data merupakan salah satu kegiatan program peningkatan mutu dan \up0 \expndtw-
3\charscalex100
keselamatan pasien untuk mendukung asuhan pasien serta manajemen rumah sakit
\up0 \expndtw-4\charscalex100 lebih baik. \par\pard\ql \li1418\sb239\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP
7 \par\pard\qj \li1418\ri1221\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Dalam program peningkatan mutu dan keselamatan pasien
maka pengumpulan data \up0 \expndtw-4\charscalex100 merupakan bagian penting dari
penilaian kinerja untuk mendukung asuhan pasien dan \up0 \expndtw-5\charscalex100
manajemen yang lebih baik. \par\pard\qj \li1418\ri1233\sb205\sl-315\slmult0\fi67
\up0 \expndtw0\charscalex102 Profil rumah sakit dapat dilihat dari data yang
terkumpul. Kumpulan data ini perlu \up0 \expndtw0\charscalex100 dianalisis dan
dibanding dengan rumah sakit lain yang sejenis. Jadi, pengumpulan \up0 \expndtw-
2\charscalex100 data merupakan bagian penting dari kegiatan meningkatkan perbaikan
kinerja. Data \up0 \expndtw0\charscalex103 yang dimaksud adalah sesuai dengan
butir 1 sampai dengan 7 yang ada pada \up0 \expndtw-3\charscalex100 maksud dan
tujuan PMKP 2.1. \par\pard\qj \li1418\ri1218\sb201\sl-320\slmult0 \up0
\expndtw0\charscalex100 Pengumpulan data dari manajemen risiko, manajemen sistem
utilitas, pencegahan \up0 \expndtw-4\charscalex100 dan pengendalian infeksi dapat
membantu rumah sakit memahami kinerja rumah sakit \up0 \expndtw-4\charscalex100
saat ini, apa yang masih menjadi masalah dan perlu dilakukan perbaikan.
\par\pard\qj \li1418\ri1223\sb200\sl-320\slmult0 \up0 \expndtw-4\charscalex100 Bank
data dari luar juga berharga untuk memonitor praktik profesional yang dijelaskan
\up0 \expndtw-5\charscalex100 di KKS 11. \par\pard\qj \li1418\ri1273\sb180\sl-
320\slmult0 \up0 \expndtw0\charscalex103 Dengan berpartisipasi menggunakan bank
data dari luar maka rumah sakit dapat \up0 \expndtw0\charscalex100 membandingkan
dirinya sendiri dengan rumah sakit lain yang sama tingkatannya di \up0
\expndtw0\charscalex104 tingkat lokal, nasional, dan internasional. Perbandingan
adalah alat efektif untuk \up0 \expndtw0\charscalex100 menemukan langkah-langkah
perbaikan dan mencatat tingkat kinerjanya. Jaringan \up0 \expndtw-2\charscalex100
pelayanan kesehatan dan mereka yang membayar pelayanan kesehatan sering
\up0 \expndtw-3\charscalex100 membutuhkan informasi ini. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb83\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 211
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg212}
{\bkmkend Pg212}\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1221\sb195\sl-315\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Bank data dari luar banyak bentuknya mulai bank data
asuransi sampai perkumpulan \up0 \expndtw-2\charscalex100 profesional dan dapat
juga indikator-indikator mutu yang diwajibkan oleh pemerintah. \up0
\expndtw0\charscalex100 Sesuai dengan peraturan perundangan mungkin ada rumah sakit
yang diharuskan \up0 \expndtw0\charscalex103 ikut sebagai peserta bank data. Dalam
semua kasus, seharusnya keamanan dan \up0 \expndtw-3\charscalex100 kerahasiaan data
serta informasi dijaga. \par\pard\ql \li1418\sb238\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 Berdasar atas hal tersebut di atas rumah sakit agar mempunyai
regulasi tentang \par\pard\qj \li1778\ri1286\sb208\sl-320\slmult0\tx2138 \up0
\expndtw-1\charscalex100 a) sistem manajemen data yang meliputi pengumpulan,
pelaporan, analisis, \line\tab \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf8\f9\fs24 feedback,\ul0\nosupersub\cf7\f8\fs24 dan publikasi.
(PMKP 2.1); \par\pard\qj \li1778\ri1277\sb17\sl-300\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 b) menetapkan data-data yang akan dibandingkan dengan rumah sakit
lain atau \line\tab \up0 \expndtw-2\charscalex100 menggunakan database ekternal;
\par\pard\qj \li1778\ri1283\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
c) menjamin keamanan dan kerahasian data dalam berkontribusi dengan
\line\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24
database\ul0\nosupersub\cf7\f8\fs24 eksternal. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PMKP 7 \par\pard\qj \li1778\ri1284\sb208\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai
regulasi manajemen data yang meliputi butir 1 \line\tab \up0 \expndtw-
3\charscalex100 sampai dengan 3 pada maksud dan tujuan. (lihat juga PMKP 2.1).
(R) \par\pard\qj \li1778\ri1280\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 2. Komite/tim PMKP atau bentuk organisasi lainnya
melakukan koordinasi \line\tab \up0 \expndtw-3\charscalex100 dengan unit pelayanan
dalam pengumpulan data. (D,W) \par\pard\ql \li1778\ri1278\sb4\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex103 3. Rumah sakit
telah melakukan pengumpulan data dan informasi untuk \line\tab \up0
\expndtw0\charscalex100 mendukung asuhan pasien, manajemen rumah sakit,
pengkajian praktik \line \tab \up0 \expndtw-1\charscalex100 profesional, serta
program mutu dan keselamatan pasien secara menyeluruh. \line \tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\qj \li1778\ri1285\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 4. Kumpulan data dan informasi disampaikan kepada badan di
luar rumah sakit \line\tab \up0 \expndtw-3\charscalex100 sesuai dengan peraturan
dan perundangan-undangan. (D,W) \par\pard\qj \li1778\ri1278\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 5. Rumah sakit berkontribusi
terhadap\ul0\nosupersub\cf8\f9\fs24 database\ul0\nosupersub\cf7\f8\fs24
ekternal dengan menjamin \line\tab \up0 \expndtw-3\charscalex100 keamanan dan
kerahasiaan. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb261\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PMKP 7.1 \par\pard\qj \li1418\ri1284\sb208\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Analisis
data merupakan salah satu kegiatan program peningkatan mutu serta \line
\up0 \expndtw-2\charscalex100 keselamatan pasien untuk mendukung asuhan pasien dan
manajemen rumah sakit. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP
7.1 \par\pard\qj \li1418\ri1222\sb188\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Untuk mencapai simpulan dan
membuat keputusan maka data harus digabungkan, \line \up0 \expndtw-1\charscalex100
dianalisis, dan diubah menjadi informasi yang berguna. Analisis data
melibatkan \line \up0 \expndtw-1\charscalex100 individu di dalam Komite/tim
PMKP yang memahami manajemen informasi, \line \up0 \expndtw-
2\charscalex100 mempunyai keterampilan dalam metode pengumpulan data,
dan mengetahui \line \up0 \expndtw-6\charscalex100 cara menggunakan berbagai
alat statistik. Hasil analisis data harus dilaporkan \line \up0
\expndtw-6\charscalex100 kepada para pimpinan yang bertanggung jawab akan
proses atau hasil yang \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb83\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 212
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg213}
{\bkmkend Pg213}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1276\sb214\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 diukur dan yang mampu menindaklanjuti. Dengan
demikian, data menyediakan \up0 \expndtw-1\charscalex100 masukan berkesinambungan
yang membantu individu itu mengambil keputusan dan \up0 \expndtw-2\charscalex100
terus-menerus memperbaiki proses klinis serta manajerial. \par\pard\qj
\li1418\ri1218\sb202\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Pengertian
terhadap teknik statistik dapat berguna dalam proses analisis data, \up0
\expndtw0\charscalex103 khususnya dalam menafsirkan variasi dan memutuskan
area yang paling \up0 \expndtw-3\charscalex100 membutuhkan
perbaikan\ul0\nosupersub\cf8\f9\fs24 . Run charts\ul0\nosupersub\cf7\f8\fs24 ,
diagram kontrol (\ul0\nosupersub\cf8\f9\fs24 control
charts\ul0\nosupersub\cf7\f8\fs24 ), histogram, dan \up0 \expndtw0\charscalex103
diagram Pareto adalah\ul0\nosupersub\cf6\f7\fs24
contoh\ul0\nosupersub\cf7\f8\fs24 metode statistik yang sangat berguna untuk
\up0 \expndtw-3\charscalex100 memahami pola dan variasi dalam pelayanan
kesehatan. \par\pard\qj \li1418\ri1214\sb205\sl-315\slmult0 \up0
\expndtw0\charscalex102 Program mutu berpartisipasi dalam menetapkan seberapa
sering data harus \up0 \expndtw-2\charscalex100 dikumpulkan dan dianalisis.
Frekuensi proses ini bergantung pada kegiatan program \up0 \expndtw0\charscalex100
tersebut dan area yang diukur serta frekuensi
pengukuran.\ul0\nosupersub\cf6\f7\fs24 Sebagai contoh\ul0\nosupersub\cf7\f8\fs24
, \up0 \expndtw0\charscalex103 pemeriksaan data mutu dari laboratorium klinis
mungkin dianalisis setiap minggu \up0 \expndtw0\charscalex102 untuk mematuhi
peraturan perundangan-undangan dan data tentang pasien jatuh \up0
\expndtw0\charscalex100 mungkin dianalisis setiap bulan apabila jatuhnya
pasien jarang terjadi. Maka, \up0 \expndtw0\charscalex103 pengumpulan data pada
titik-titik waktu tertentu akan memungkinkan rumah sakit \up0 \expndtw-
5\charscalex100 menilai stabilitas
proses tertentu atau dapat menilai prediksi hasil tertentu terkait
\up0 \expndtw-6\charscalex100 dengan ekspektasi yang ada. \par\pard\ql
\li1418\sb238\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Tujuan analisis data
adalah dapat membandingkan rumah sakit dalam empat hal: \par\pard\qj
\li1778\ri1284\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 1) dengan
rumah sakit tersebut sendiri dari waktu ke waktu, misalnya dari bulan \line\tab
\up0 \expndtw-3\charscalex100 ke bulan atau dari tahun ke tahun; \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2) dengan rumah sakit
sejenis seperti melalui\ul0\nosupersub\cf8\f9\fs24
database\ul0\nosupersub\cf7\f8\fs24 referensi; \par\pard\ql \li1778\ri1272\sb8\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 3) dengan standar-standar
seperti yang ditentukan oleh badan akreditasi atau \line\tab \up0 \expndtw-
1\charscalex100 organisasi profesional ataupun standar-standar yang ditentukan oleh
undang-\line \tab \up0 \expndtw-2\charscalex100 undang atau peraturan; \par\pard\ql
\li1778\ri1274\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 4)
dengan praktik-praktik yang diinginkan yang dalam literatur digolongkan
\line\tab \up0 \expndtw0\charscalex100 sebagai\ul0\nosupersub\cf8\f9\fs24 best
practice\ul0\nosupersub\cf7\f8\fs24 (praktik terbaik)
atau\ul0\nosupersub\cf8\f9\fs24 better practice\ul0\nosupersub\cf7\f8\fs24
(praktik yang lebih \line \tab \up0 \expndtw-3\charscalex100 baik)
atau\ul0\nosupersub\cf8\f9\fs24 practice guidelines\ul0\nosupersub\cf7\f8\fs24
(panduan praktik klinik). \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1285\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex103
Perbandingan tersebut membantu rumah sakit dalam memahami perubahan dan \up0
\expndtw0\charscalex102 penyebab perubahan yang tidak diinginkan serta membantu
memfokuskan upaya \up0 \expndtw-3\charscalex100 perbaikan. (lihat juga TKRS 5)
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Oleh karena
itu, rumah sakit agar menyusun regulasi analisis data yang meliputi \par\pard\ql
\li1778\sb224\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a) penggunaan statistik
dalam melakukan analisis data; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 b) analisis yang harus dilakukan, yaitu \par\pard\ql
\li2116\ri1224\sb8\sl-320\slmult0\tx2551\tx2551 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 membandingkan
data di rumah sakit dari waktu ke waktu data (analisis \line\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 trend\ul0\nosupersub\cf7\f8\fs24 ),
misalnya dari bulanan ke bulan atau dari tahun ke tahun; \line \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24
membandingkan dengan rumah sakit lain bila mungkin yang sejenis seperti
\line\tab \up0 \expndtw-4\charscalex100 melalui\ul0\nosupersub\cf8\f9\fs24
database\ul0\nosupersub\cf7\f8\fs24 eksternal baik nasional maupun
internasional; \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb230\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 213
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg214}
{\bkmkend Pg214}\par\pard\ql \li2116\sb0\sl-310\slmult0 \par\pard\ql\li2116\sb0\sl-
310\slmult0 \par\pard\ql\li2116\sb0\sl-310\slmult0
\par\pard\ql\li2116\ri1281\sb214\sl-310\slmult0\tx2551\tx2551 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 membandingkan dengan standar seperti yang
ditentukan oleh badan \line\tab \up0 \expndtw0\charscalex102 akreditasi atau
organisasi profesional ataupun standar yang ditentukan \line \tab \up0 \expndtw-
3\charscalex100 oleh peraturan perundang-undangan; \par\pard\ql
\li2116\ri1278\sb2\sl-320\slmult0\tx2551\tx2551 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 membandingkan
dengan praktik yang diinginkan yang dalam literatur \line\tab \up0
\expndtw0\charscalex103 digolongkan sebagai\ul0\nosupersub\cf8\f9\fs24 best
practice\ul0\nosupersub\cf7\f8\fs24 (praktik terbaik)
atau\ul0\nosupersub\cf8\f9\fs24 better practice \line \tab \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (praktik yang lebih baik)
atau\ul0\nosupersub\cf8\f9\fs24 practice guidelines\ul0\nosupersub\cf7\f8\fs24
(panduan praktik klinik). \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 7.1
\par\pard\qj \li1778\ri1293\sb225\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai
regulasi analisis data yang meliputi butir 1 dan 2 \line\tab \up0 \expndtw-
1\charscalex100 yang ada padai maksud dan tujuan. (R) \par\pard\qj
\li1778\ri1291\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Rumah
sakit telah melakukan pengumpulan data, analisis, dan menyediakan \line\tab \up0
\expndtw0\charscalex100 informasi yang berguna untuk mengidentifikasi kebutuhank
perbaikan. (D,W) \par\pard\qj \li1778\ri1290\sb0\sl-320\slmult0\tx2138 \up0
\expndtw-1\charscalex100 3. Analisis data telah dilakukan menggunakan metode dan
teknik statistic yang \line\tab \up0 \expndtw-2\charscalex100 sesuai dengan
kebutuhan. (D,W) \par\pard\ql \li1778\ri1281\sb5\sl-
315\slmult0\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex102 4. Analisis
data telah dilakukan dengan melakukan perbadingan dari waktu ke \line\tab \up0
\expndtw-1\charscalex100 waktu di dalam rumah sakit, dengan melakukan
perbandingan\ul0\nosupersub\cf8\f9\fs24 database \line \tab \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 eksternal dari rumah sakit
sejenis atau data nasional/internasional, dan \line \tab \up0
\expndtw0\charscalex100 melakukan perbandingan dengan standar serta praktik terbaik
berdasar atas \line \tab \up0 \expndtw-1\charscalex100 referensi terkini. (D,W)
\par\pard\ql \li1778\ri1285\sb1\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 5. Pelaksana analisis data, yaitu staf komite/tim PMKP dan
penanggung jawab \line\tab \up0 \expndtw0\charscalex101 data di unit
pelayanan/kerja sudah mempunyai pengalaman, pengetahuan, \line \tab \up0
\expndtw0\charscalex104 dan keterampilan yang tepat sehingga dapat berpartisipasi
dalam proses \line \tab \up0 \expndtw-1\charscalex100 tersebut dengan baik.
(D,W) \par\pard\qj \li1778\ri1280\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex107 6. Hasil analisis data telah disampaikan kepada
direktur, para kepala \line\tab \up0 \expndtw-1\charscalex100 bidang/divisi, dan
kepala unit untuk ditindaklanjuti. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb8\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PMKP 7.2
\par\pard\qj \li1418\ri1279\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Program PMKP prioritas di rumah sakit telah dianalisis
dan mempunyai dampak \up0 \expndtw-3\charscalex100 terhadap peningkatan mutu serta
efisiensi biaya per tahun. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 7.2 \par\pard\qj
\li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1280\sb116\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Direktur rumah sakit memprioritaskan proses di rumah
sakit yang diukur, program \up0 \expndtw0\charscalex100 perbaikan dan kegiatan
keselamatan pasien yang diterapkan, dan bagaimana \up0 \expndtw-
3\charscalex100 mengukur keberhasilan dalam upaya di seluruh rumah sakit ini.
\par\pard\qj \li1418\ri1214\sb202\sl-320\slmult0 \up0 \expndtw0\charscalex103
Program mutu dan keselamatan pasien mencakup analisis atas dampak prioritas
\line \up0 \expndtw-3\charscalex100 perbaikan yang didukung oleh pimpinan (lihat
juga TKRS 5, EP 4). Staf program mutu \line \up0 \expndtw-2\charscalex100 dan
keselamatan pasien menyusun sarana untuk mengevaluasi penggunaan sumber \line
\up0 \expndtw-1\charscalex100 daya untuk proses yang telah diperbaiki. Sumber daya
dapat sumber daya manusia \line \up0 \expndtw-1\charscalex100 (sebagai contoh,
waktu yang dipakai untuk setiap langkah dalam proses tersebut) \par\pard\ql
\li10156\sb216\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 214
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg215}
{\bkmkend Pg215}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1224\sb214\sl-310\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 atau dapat pula melibatkan penggunaan teknologi dan
sumber daya lainnya. Analisis \up0 \expndtw-2\charscalex100 ini memberikan
informasi yang berguna atas perbaikan mana yang berdampak \up0 \expndtw-
3\charscalex100 terhadap efisiensi dan biaya. \par\pard\qj \li1418\ri1275\sb202\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Contoh: rumah sakit menetapkan pelayanan
jantung merupakan program prioritas \line \up0 \expndtw0\charscalex100 maka rumah
sakit menyusun panduan klinis dan clinical pathway untuk
kasus\ul0\nosupersub\cf8\f9\fs24 acut \line \up0 \expndtw-1\charscalex100 myocard
infarc \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (AMI), dari hasil
analisis implementasi AMI didapatkan variasi \par\pard\qj
\li1418\ri1277\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100 pelayanan Dokter
Penanggung Jawab Pelayanan (DPJP) telah berkurang dan ada \up0
\expndtw0\charscalex100
kecenderungan kepatuhan DPJP meningkat dan dari hasil analisis dapat diketahui
\up0 \expndtw-2\charscalex100 bahwa biaya untuk pasien AMI juga cenderung turun
sesuai dengan standar. \par\pard\qj \li1418\ri1214\sb180\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Dalam melakukan analisis tersebut Komite PMKP
berkoordinasi dengan Komite \up0 \expndtw-4\charscalex100 Medik karena terkait
dengan audit medis, bagian keuangan rumah sakit, dan teknologi \up0 \expndtw-
3\charscalex100 informasi \up0 \expndtw-1\charscalex100
(i\ul0\nosupersub\cf8\f9\fs24 nformation technology\ul0\nosupersub\cf7\f8\fs24 )
rumah sakit khususnya untuk\ul0\nosupersub\cf8\f9\fs24 billing system \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 sehingga dapat diketahui telah
terjadi kendali biaya. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 Direktur rumah sakit mengukur keberhasilan program PMKP prioritas
melalui: \par\pard\ql \li1778\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a)
pengukuran capaian-capaian indikator area klinik dan area manajemen;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 b)
pengukuran kepatuhan penerapan sasaran keselamatan pasien; \par\pard\qj
\li1778\ri1280\sb25\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex102 c)
pengukuran kepatuhan pelaksanaan PPK-CP sehingga mengurangi variasi \line\tab
\up0 \expndtw-3\charscalex100 dalam pemberian pelayanan; \par\pard\qj
\li1778\ri1275\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102 d)
pengukuran penggunaan sumber daya termasuk biaya yang dipergunakan \line\tab
\up0 \expndtw-3\charscalex100 untuk perbaikan di program prioritas rumah sakit
tersebut. \par\pard\qj \li1418\ri1274\sb0\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Melalui pengukuran-pengukuran tersebut di atas dapat diketahui
dampak perbaikan \line \up0 \expndtw-2\charscalex100 di rumah sakit secara
keseluruhan termasuk efisiensi penggunaan sumber daya. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PMKP 7.2 \par\pard\ql \li1778\ri1222\sb211\sl-
316\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1 \tab \up0 \expndtw0\charscalex101 Komite/tim PMKP
atau bentuk organisasi lainnya telah mengumpulkan dan \line\tab \up0 \expndtw-
1\charscalex100 menganalisis data program PMKP prioritas yang meliputi butir
1 sampai \line \tab \up0 \expndtw-4\charscalex100 dengan 4 yang ada pada maksud
dan tujuan. (lihat juga PMKP 5). (D,W) \line \up0 \expndtw-3\charscalex100 2
\up0 \expndtw0\charscalex100 Ada bukti direktur rumah sakit telah menindaklanjuti
hasil analisis data yang \line\tab \up0 \expndtw-3\charscalex100 meliputi butir 1
sampai 4 yang ada pada maksud dan tujuan. (D,W) \line \up0 \expndtw-3\charscalex100
3 \up0 \expndtw-4\charscalex100 Ada bukti program PMKP prioritas telah menghasilkan
perbaikan di rumah sakit \line\tab \up0 \expndtw-5\charscalex100 secara
keseluruhan. (D,W) \par\pard\li1778\sb40\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
4\charscalex100 4\tab \up0 \expndtw-3\charscalex100 Ada bukti program PMKP
prioritas telah menghasilkan efisiensi penggunaan\par\pard\li1778\sb41\sl-
276\slmult0\fi360 \up0 \expndtw-4\charscalex100 sumber daya. (D,W)\par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb269\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PMKP 8 \par\pard\qj
\li1418\ri1282\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai regulasi validasi data indikator
area klinik yang baru atau \up0 \expndtw0\charscalex102 mengalami perubahan dan
data yang akan dipublikasikan. Regulasi ini diterapkan \up0 \expndtw-
3\charscalex100 menggunakan proses internal validasi data. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb83\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 215
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg216}
{\bkmkend Pg216}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMK. 8
\par\pard\qj \li1418\ri1261\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Validasi data adalah alat penting untuk memahami mutu
data dan untuk menetapkan \line \up0 \expndtw0\charscalex100 tingkat kepercayaan
(\ul0\nosupersub\cf8\f9\fs24 confidence level\ul0\nosupersub\cf7\f8\fs24 ) para
pengambil keputusan terhadap data itu \line \up0 \expndtw-2\charscalex100 sendiri.
Validasi data menjadi salah satu langkah dalam proses menetapkan prioritas \line
\up0 \expndtw0\charscalex104 penilaian, memilih apa yang harus dinilai,
memilih dan mengetes indikator, \line \up0 \expndtw-2\charscalex100 mengumpulkan
data, validasi data, serta menggunakan data untuk peningkatan. \par\pard\qj
\li1418\ri1217\sb206\sl-313\slmult0 \up0 \expndtw-1\charscalex100 Keabsahan dan
ketepercayaan pengukuran adalah inti dari semua perbaikan dalam \up0
\expndtw0\charscalex104 program peningkatan mutu. Proses validasi data secara
internal perlu dilakukan \up0 \expndtw-4\charscalex100 karena program mutu dianggap
valid jika data yang dikumpulkan sudah sesuai, benar, \up0 \expndtw-5\charscalex100
dan bermanfaat . \par\pard\qj \li1418\ri1279\sb202\sl-320\slmult0 \up0
\expndtw0\charscalex100 Untuk memastikan bahwa data yang dikumpulkan baik maka
proses validasi perlu \up0 \expndtw-3\charscalex100 dilakukan. \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Rumah sakit agar
menetapkan regulasi validasi data antara lain meliputi \par\pard\ql
\li1778\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1. kebijakan data yang
harus divalidasi, yaitu \par\pard\ql \li2229\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24
merupakan pengukuran area klinik baru; \par\pard\qj \li2229\ri1275\sb25\sl-
300\slmult0\tx2589 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 bila ada perubahan sistem pencatatan pasien
dari manual ke elektronik \line\tab \up0 \expndtw-3\charscalex100 sehingga sumber
data berubah; \par\pard\qj \li2229\ri1276\sb4\sl-320\slmult0\tx2589 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 bila data dipublikasi ke masyarakat baik
melalui\ul0\nosupersub\cf8\f9\fs24 web site\ul0\nosupersub\cf7\f8\fs24 rumah
sakit \line\tab \up0 \expndtw-3\charscalex100 atau media lain; \par\pard\ql
\li2229\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 bila ada
perubahan pengukuran; \par\pard\ql \li2229\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24
bila ada perubahan data pengukuran tanpa diketahui sebabnya; \par\pard\ql
\li2229\ri1275\sb8\sl-320\slmult0\tx2589\tx2589 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 bila ada
perubahan subjek data seperti perubahan umur rata-rata pasien, \line\tab \up0
\expndtw-1\charscalex100 protokol riset diubah, panduan praktik klinik baru
diberlakukan, serta \line \tab \up0 \expndtw-2\charscalex100 terdapat teknologi
dan metodologi pengobatan baru. \par\pard\ql \li1845\sb17\sl-276\slmult0 \up0
\expndtw-3\charscalex100 2. proses validasi data mencakup, namun tidak terbatas
sebagai berikut: \par\pard\qj \li2229\ri1277\sb208\sl-320\slmult0\tx2589 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 mengumpulkan ulang data oleh orang kedua yang
tidak terlibat dalam \line\tab \up0 \expndtw-3\charscalex100 proses pengumpulan
data sebelumnya (data asli); \par\pard\ql \li2229\ri1271\sb0\sl-
320\slmult0\tx2589\tx2589 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 menggunakan
sampel tercatat, kasus, dan data lainnya yang sahih secara \line\tab \up0 \expndtw-
1\charscalex100 statistik. Sampel 100% hanya dibutuhkan jika jumlah pencatatan,
kasus, \line \tab \up0 \expndtw-3\charscalex100 atau data lainnya sangat kecil
jumlahnya; \par\pard\ql \li2229\sb37\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24
membandingkan data asli dengan data yang dikumpulkan ulang; \par\pard\ql
\li2229\ri1218\sb0\sl-320\slmult0\tx2589\tx2589 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 menghitung
keakuratan dengan membagi jumlah elemen data yang \line\tab \up0 \expndtw-
3\charscalex100 ditemukan dengan total jumlah data elemen dikalikan dengan 100.
Tingkat \line \tab \up0 \expndtw-4\charscalex100 akurasi 90% adalah patokan yang
baik; \par\pard\ql \li2229\ri1282\sb0\sl-320\slmult0\tx2589\tx2589 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24
jika elemen data yang diketemukan ternyata tidak sama dengan catatan \line\tab
\up0 \expndtw0\charscalex100 alasannya (misalnya data tidak jelas definisinya) dan
dilakukan tindakan \line \tab \up0 \expndtw-3\charscalex100 koreksi;
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb218\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 216
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg217}{\bkmkend Pg217}\par\pard\ql \li2229\sb0\sl-310\slmult0
\par\pard\ql\li2229\sb0\sl-310\slmult0 \par\pard\ql\li2229\sb0\sl-310\slmult0
\par\pard\ql\li2229\ri1214\sb214\sl-310\slmult0\tx2589\tx2589 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24
koleksi sampel baru setelah semua tindakan koreksi dilakukan untuk
\line\tab \up0 \expndtw-3\charscalex100 memastikan tindakan menghasilkan tingkat
akurasi yang diharapkan. (lihat \line \tab \up0 \expndtw-4\charscalex100 juga KKS
11, EP 4) \par\pard\ql \li1778\sb0\sl-320\slmult0
\par\pard\ql\li1778\ri1278\sb202\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 c) proses validasi data yang akan dipublikasi
di\ul0\nosupersub\cf8\f9\fs24 web site\ul0\nosupersub\cf7\f8\fs24 atau media
lainnya agar \line\tab \up0 \expndtw0\charscalex103 diatur tersendiri dan dapat
menjamin kerahasiaan pasien serta keakuratan \line \tab \up0 \expndtw-
3\charscalex100 data. \par\pard\qj \li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1215\sb219\sl-310\slmult0 \up0 \expndtw0\charscalex100 Proses
validasi data mencakup, namun tidak terbatas pada butir 2 tersebut di atas, \up0
\expndtw-3\charscalex100 oleh karena itu dalam melakukan validasi data maka rumah
sakit dapat menggunakan \up0 \expndtw-4\charscalex100 cara/proses lain sesuai
dengan referensi ilmiah terkini. \par\pard\qj \li1418\ri1285\sb202\sl-
320\slmult0 \up0 \expndtw0\charscalex104 Proses validasi data yang akan dipublikasi
diatur tersendiri dan dapat menjamin \up0 \expndtw-3\charscalex100 kerahasiaan
pasien serta keakuratan data. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 8
\par\pard\qj \li1778\ri1226\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi
validasi data sesuai dengan butir 1 sampai \line\tab \up0 \expndtw-
4\charscalex100 dengan 3 yang ada pada maksud dan tujuan. (R) \par\pard\qj
\li1778\ri1232\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 2. Rumah
sakit telah melakukan validasi data pada pengukuran mutu area klinik \line\tab
\up0 \expndtw-4\charscalex100 yang baru dan bila terjadi perubahan sesuai dengan
regulasi. (D,W) \par\pard\ql \li1778\ri1273\sb0\sl-320\slmult0\tx2138\tx2138
\up0 \expndtw0\charscalex100 3. Rumah sakit telah melakukan validasi data yang
akan dipublikasikan di\ul0\nosupersub\cf8\f9\fs24 web \line\tab \up0
\expndtw0\charscalex100 site\ul0\nosupersub\cf7\f8\fs24 atau media lainnya
termasuk kerahasiaan pasien dan keakuratan sesuai \line \tab \up0 \expndtw-
3\charscalex100 dengan regulasi. (D,W) \par\pard\ql \li1778\sb17\sl-276\slmult0
\up0 \expndtw-3\charscalex100 4. Rumah sakit telah melakukan perbaikan berdasarkan
hasil validasi data (D,W) \par\pard\qj \li1418\ri1987\sb363\sl-
520\slmult0\fi765 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PELAPORAN DAN ANALISIS INSIDEN KESELAMATAN
PASIEN \up0 \expndtw-3\charscalex100 Standar PMKP 9 \par\pard\qj
\li1418\ri1278\sb146\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan sistem pelaporan insiden
keselamatan pasien baik internal \up0 \expndtw-3\charscalex100 maupun eksternal.
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 9 \par\pard\qj
\li1418\ri1279\sb212\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Insiden keselamatan pasien yang selanjutnya disebut
insiden ialah setiap kejadian \up0 \expndtw0\charscalex103 yang tidak disengaja
dan kondisi yang mengakibatkan atau berpotensi \up0
\expndtw0\charscalex100 mengakibatkan cedera yang dapat dicegah pada pasien,
terdiri atas kejadian tidak \up0 \expndtw-1\charscalex100 diharapkan, kejadian
nyaris cedera, kejadian tidak cedera, ejadian potensial cedera, \up0 \expndtw-
2\charscalex100 dan kejadian sentinel. \par\pard\qj \li1418\ri1283\sb201\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Pelaporan insiden keselamatan pasien yang
selanjutnya disebut pelaporan insiden \line \up0 \expndtw0\charscalex100 ialah
suatu sistem untuk mendokumentasikan laporan insiden keselamatan pasien, \line \up0
\expndtw0\charscalex102 analisis, dan solusi untuk pembelajaran. Sistem
pelaporan diharapkan dapat \line \up0 \expndtw0\charscalex102 mendorong individu
di dalam rumah sakit untuk peduli akan bahaya atau potensi \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb3\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 217
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg218}
{\bkmkend Pg218}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1278\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 bahaya yang dapat terjadi pada pasien. Pelaporan juga
penting digunakan untuk \line \up0 \expndtw0\charscalex101 memonitor upaya
pencegahan kesalahan \up0 \expndtw0\charscalex103 (\ul0\nosupersub\cf8\f9\fs24
error\ul0\nosupersub\cf7\f8\fs24 ) sehingga dapat mendorong \par\pard\qj
\li1418\ri1281\sb4\sl-320\slmult0 \up0 \expndtw-2\charscalex100 dilakukan
investigasi. Di sisi lain, pelaporan akan menjadi awal proses pembelajaran \up0
\expndtw-3\charscalex100 untuk mencegah kejadian yang sama terulang kembali.
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Rumah sakit
perlu menetapkan sistem pelaporan insiden antara lain meliputi \par\pard\ql
\li2498\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a) kebijakan;
\par\pard\ql \li2498\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b) alur
pelaporan, \par\pard\ql \li2498\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
c) formulir pelaporan; \par\pard\ql \li2498\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 d) prosedur pelaporan; \par\pard\qj \li2498\ri1285\sb0\sl-
320\slmult0\tx2858 \up0 \expndtw0\charscalex100 e) insiden yang harus
dilaporkan, yaitu kejadian yang sudah terjadi, \line\tab \up0 \expndtw-
3\charscalex100 potensial terjadi, ataupun yang nyaris terjadi; \par\pard\ql
\li2498\sb25\sl-276\slmult0 \up0 \expndtw-1\charscalex100 f) siapa saja yang
membuat laporan; \par\pard\ql \li2498\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 g) batas waktu pelaporan. \par\pard\qj \li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\ri1273\sb221\sl-313\slmult0 \up0 \expndtw-
2\charscalex100 Selain laporan internal, rumah sakit juga wajib membuat laporan ke
Komite Nasional \up0 \expndtw0\charscalex100 Keselamatan Pasien sesuai dengan
peraturan perundangan-undangan dan dijamin \up0 \expndtw-1\charscalex100
keamanannya, bersifat rahasia, anonim (tanpa identitas), serta tidak mudah
diakses \up0 \expndtw-3\charscalex100 oleh yang tidak berhak. \par\pard\qj
\li1418\ri1226\sb202\sl-320\slmult0 \up0 \expndtw-3\charscalex100 Dengan pelaporan
ekternal tersebut maka berarti rumah sakit telah ikut berpartisipasi \line \up0
\expndtw0\charscalex100 dalam penyediaan data nasional angka insiden keselamatan
pasien, pembelajaran \line \up0 \expndtw-1\charscalex100 untuk meningkatkan mutu
pelayanan dan keselamatan pasien bagi rumah sakit lain, \line \up0 \expndtw-
2\charscalex100 dan ditetapkannya langkah-langkah praktis keselamatan pasien untuk
rumah sakit di \line \up0 \expndtw-3\charscalex100 Indonesia. \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 9 \par\pard\ql
\li1778\ri1276\sb216\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi sistem
pelaporan insiden internal dan \line\tab \up0 \expndtw-2\charscalex100 eksternal
sesuai dengan peraturan perundang-undangan yang meliputi butir 1 \line \tab \up0
\expndtw-3\charscalex100 sampai dengan 7) pada maksud dan tujuan. (R)
\par\pard\ql \li1778\sb39\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Ada
bukti unit kerja telah melaporkan insiden keselamatan pasien. (D,W);
\par\pard\qj \li1778\ri1258\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
3. Rumah sakit mengintegrasikan pelaporan kejadian dan pengukuran mutu agar
\line\tab \up0 \expndtw-3\charscalex100 solusi serta perbaikan yang dilakukan
terintegrasi. (D,W) \par\pard\ql \li1778\ri1284\sb9\sl-310\slmult0\tx2138\tx2138
\up0 \expndtw0\charscalex100 4. Ada bukti rumah sakit telah melaporan insiden
keselamatan pasien setiap 6 \line\tab \up0 \expndtw0\charscalex100 bulan kepada
representasi pemilik dan bila ada kejadian sentinel telah \line \tab \up0
\expndtw-3\charscalex100 dilaporkan di setiap kejadian. (lihat juga TKRS 4.1).
(D,W) \par\pard\ql \li1778\ri1275\sb2\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 5. Ada bukti rumah sakit telah melaporkan insiden
keselamatan pasien kepada \line\tab \up0 \expndtw0\charscalex100 Komite Nasional
Keselamatan Pasien sesuai dengan peraturan perundang-\line \tab \up0 \expndtw-
3\charscalex100 undangan. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PMKP 9.1
\par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit telah menetapkan jenis kejadian
sentinel, serta melaporkan dan \par\pard\ql \li10156\sb223\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 218
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg219}
{\bkmkend Pg219}\par\pard\qj \li1418\sb0\sl-500\slmult0
\par\pard\qj\li1418\ri4505\sb487\sl-500\slmult0 \up0 \expndtw-6\charscalex100
\ul0\nosupersub\cf7\f8\fs24 melakukan
analisis akar masalah (\ul0\nosupersub\cf8\f9\fs24 root cause
analysis\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 . \up0 \expndtw-
6\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 9.1 \par\pard\qj
\li1418\ri1234\sb169\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kejadian sentinel ialah suatu KTD yang mengakibatkan
kematian atau cedera yang \up0 \expndtw0\charscalex100 serius. Setiap rumah sakit
menetapkan definisi operasional kejadian sentinel paling \up0 \expndtw-
6\charscalex100 sedikit meliputi \par\pard\ql \li1778\sb237\sl-276\slmult0
\up0 \expndtw-1\charscalex100 1. kematian yang tidak diduga, termasuk, dan tidak
tidak terbatas hanya \par\pard\ql \li2126\ri1288\sb8\sl-
320\slmult0\tx2411\tx2411 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 kematian yang
tidak berhubungan dengan perjalanan penyakit pasien atau \line\tab \up0
\expndtw0\charscalex100 kondisi pasien (contoh, kematian setelah infeksi
pascaoperasi atau emboli \line \tab \up0 \expndtw-1\charscalex100 paru-paru);
\par\pard\ql \li2126\ri3621\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3929?\ul0\nosupersub\cf7\f8\fs24 kematian bayi
aterm; \line \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 bunuh diri. \par\pard\qj \li1778\ri1229\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. kehilangan permanen fungsi yang
tidak terkait dengan penyakit pasien atau \line\tab \up0 \expndtw-6\charscalex100
kondisi pasien; \par\pard\ql \li1778\sb17\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3. operasi salah tempat, salah prosedur, dan salah pasien;
\par\pard\qj \li1778\ri1245\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
4. terjangkit penyakit kronik atau penyakit fatal akibat transfusi darah atau
produk \line\tab \up0 \expndtw-4\charscalex100 darah atau transplantasi organ atau
jaringan ; \par\pard\qj \li1778\ri1288\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex104 5. penculikan anak termasuk bayi atau anak termasuk bayi
dikirim ke rumah \line\tab \up0 \expndtw-2\charscalex100 bukan rumah
orangtuanya; \par\pard\ql \li1778\sb40\sl-276\slmult0\tx9345 \up0
\expndtw0\charscalex102 6. perkosaan, kekejaman di tempat kerja seperti
penyerangan \tab \up0 \expndtw-2\charscalex100 (berakibat \par\pard\qj
\li2138\ri1279\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100 kematian atau
kehilangan fungsi secara permanen), atau pembunuhan (yang \up0
\expndtw0\charscalex103 isengaja) atas pasien, anggota staf, dokter, mahasiswa
kedokteran, siswa \up0 \expndtw0\charscalex100 latihan, serta pengunjung atau
vendor/pihak ketiga ketika berada dalam \up0 \expndtw-1\charscalex100
lingkungan rumah sakit. (lihat juga KKS 8.2) \par\pard\qj \li1418\ri1274\sb0\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Definisi kejadian sentinel termasuk yang
ditetapkan seperti diuraikan mulai dari butir \up0 \expndtw-3\charscalex100 1
\up0 \expndtw-2\charscalex100 sampai huruf \up0 \expndtw-3\charscalex100 6 \up0
\expndtw-2\charscalex100 dapat ditambahkan sesuai dengan ketentuan
peraturan \par\pard\qj \li1418\ri1271\sb0\sl-317\slmult0 \up0
\expndtw0\charscalex100 perundangan-undangan yang ada atau kejadian yang menurut
pandangan rumah \line \up0 \expndtw0\charscalex103 sakit harus ditambahkan sebagai
kejadian sentinel. Semua kejadian yang sesuai \line \up0 \expndtw0\charscalex100
dengan definisi harus dilakukan analisis akar masalah
(RCA=\ul0\nosupersub\cf8\f9\fs24 root cause
analysis\ul0\nosupersub\cf7\f8\fs24 ). \line \up0 \expndtw-1\charscalex100 Analisis
dan rencana tindakan selesai dalam waktu 45 hari setelah kejadian. Tujuan \line
\up0 \expndtw0\charscalex100 AAM (analisis akar masalah) adalah agar rumah sakit
dapat mengerti dengan baik \line \up0 \expndtw0\charscalex100 dan komprehensif asal
kejadian. Apabila AAM menunjukkan perbaikan sistem atau \line \up0 \expndtw-
1\charscalex100 tindakan lain dapat mengurangi risiko seperti itu terjadi lagi,
rumah sakit merancang \line \up0 \expndtw-2\charscalex100 ulang proses dan
mengambil tindakan yang perlu dilakukan. Kejadian sentinel bukan \line \up0
\expndtw-3\charscalex100 indikator terkait dengan pelanggaran hukum (lihat juga
TKRS 4.1). \par\pard\qj \li1418\ri1275\sb184\sl-320\slmult0 \up0
\expndtw0\charscalex100 Penting untuk diperhatikan bahwa
istilah\ul0\nosupersub\cf6\f7\fs24 kejadian sentinel tidak
selalu\ul0\nosupersub\cf7\f8\fs24 mengarah \up0 \expndtw0\charscalex100 pada
kepada kekeliruan (\ul0\nosupersub\cf8\f9\fs24 error)\ul0\nosupersub\cf7\f8\fs24
atau kesalahan (\ul0\nosupersub\cf8\f9\fs24 mistake\ul0\nosupersub\cf7\f8\fs24 )
maupun memberi kesan \up0 \expndtw-3\charscalex100 pertanggungjawaban legal
(\ul0\nosupersub\cf8\f9\fs24 liability\ul0\nosupersub\cf7\f8\fs24 ) tertentu.
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb138\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 219
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg220}
{\bkmkend Pg220}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 9.1
\par\pard\ql \li1778\ri1278\sb188\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Pimpinan rumah sakit menetapkan
regulasi jenis kejadian sentinel sekurang-\line\tab \up0 \expndtw-1\charscalex100
kurangnya seperti diuraikan pada butir 1 sampai dengan 6 pada Maksud dan \line
\tab \up0 \expndtw-2\charscalex100 Tujuan. (lihat juga PMKP 9 EP1). (R)
\par\pard\ql \li1778\ri1259\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 2. Rumah sakit telah melakukan RCA/AAM setiap ada kejadian
sentinel di rumah \line\tab \up0 \expndtw0\charscalex103 sakit dan tidak melewati
waktu 45 hari terhitung sejak terjadi kejadian atau \line \tab \up0 \expndtw-
2\charscalex100 sejak diberi tahu tentang terdapat kejadian. \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\qj \li1778\ri1242\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 3. Ada bukti rencana tindaklanjut dan pelaksanaan
langkah-langkah sesuai \line\tab \up0 \expndtw-4\charscalex100 dengan hasil
AAM/RCA. (D,O,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb261\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PMKP 9.2 \par\pard\qj \li1418\ri1218\sb208\sl-
320\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi untuk melakukan analisis data KTD dan mengambil \up0 \expndtw-
5\charscalex100 langkah tindaklanjut. \par\pard\ql \li1418\sb237\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP
9.2 \par\pard\qj \li1418\ri1278\sb216\sl-310\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Ketika rumah sakit mendeteksi
atau mencurigai perubahan yang tidak diinginkan \line \up0 \expndtw0\charscalex103
atau tidak sesuai dengan harapan maka rumah sakit memulai analisis mendalam
\line \up0 \expndtw0\charscalex100 untuk menentukan perbaikan paling baik
difokuskan di area mana (lihat juga PKPO \par\pard\qj \li1418\ri1293\sb2\sl-
320\slmult0 \up0 \expndtw0\charscalex103 7.1). Secara khusus, analisis mendalam
dimulai jika tingkat, pola, atau tren yang \up0 \expndtw-1\charscalex100 tidak
diinginkan bervariasi secara signifikan dari \par\pard\ql \li1778\sb257\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 apa yang diharapkan; \par\pard\ql
\li1778\ri3078\sb0\sl-340\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 apa yang ada di
rumah sakit; dan \line \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 standar-standar
yang diakui. \par\pard\ql \li1519\sb0\sl-276\slmult0 \par\pard\ql\li1519\sb269\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Analisis dilakukan untuk semua hal
berikut ini: \par\pard\qj \li1778\ri1283\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-
4\charscalex100 a) semua reaksi transfusi yang sudah dikonfirmasi jika sesuai
untuk rumah sakit. \line\tab \up0 \expndtw-5\charscalex100 (lihat AP 5.11);
\par\pard\qj \li1778\ri1232\sb17\sl-300\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 b) semua kejadian serius akibat efek samping obat jika sesuai dan
sebagaimana \line\tab \up0 \expndtw-4\charscalex100 yang didefinisikan oleh rumah
sakit; \par\pard\qj \li1778\ri1279\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 c) semua kesalahan pengobatan yang signifikan jika sesuai dan
sebagaimana \line\tab \up0 \expndtw-3\charscalex100 yang didefinisikan oleh rumah
sakit; \par\pard\qj \li1778\ri1285\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 d) semua perbedaan besar antara diagnosis
praoperasi dan diagnosis \line\tab \up0 \expndtw-5\charscalex100 pascaoperasi;
\par\pard\qj \li1778\ri1274\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
e) efek samping atau pola efek samping selama sedasi moderat atau mendalam
\line\tab \up0 \expndtw-4\charscalex100 dan pemakaian anestesi; \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 f) kejadian-kejadian
lain;\ul0\nosupersub\cf6\f7\fs24 misalnya \par\pard\qj \li2126\ri1289\sb0\sl-
320\slmult0\tx2551 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 infeksi yang berkaitan
dengan pelayanan kesehatan atau wabah penyakit \line\tab \up0 \expndtw-
3\charscalex100 menular; \par\pard\qj \li2126\ri1281\sb0\sl-320\slmult0\tx2551 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf12\f13\fs24 \u-
3929?\ul0\nosupersub\cf7\f8\fs24 pasien jiwa yang melarikan diri dari ruang
perawatan keluar lingkungan \line\tab \up0 \expndtw0\charscalex100 rumah sakit yang
tidak meninggal/tidak cedera serius. (khusus untuk RS \par\pard\ql
\li10156\sb164\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 220
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg221}
{\bkmkend Pg221}\par\pard\ql \li2551\sb0\sl-276\slmult0 \par\pard\ql\li2551\sb0\sl-
276\slmult0 \par\pard\ql\li2551\sb0\sl-276\slmult0 \par\pard\ql\li2551\sb0\sl-
276\slmult0 \par\pard\ql\li2551\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Jiwa dan RS Umum yang mempunyai ruang
perawatan jiwa). \par\pard\ql \li1519\sb0\sl-276\slmult0
\par\pard\ql\li1519\sb268\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 9.2 \par\pard\qj
\li1778\ri1259\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi jenis kejadian yang
tidak diharapkan, proses \line\tab \up0 \expndtw-3\charscalex100 pelaporan, dan
analisisnya. (lihat juga PMKP 9 EP 1). (R) \par\pard\qj \li1778\ri1224\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2. Semua reaksi transfusi yang
sudah dikonfirmasi jika sesuai yang didefinisikan \line\tab \up0 \expndtw-
4\charscalex100 untuk rumah sakit, sudah dianalisis. (lihat juga PAP 3.3).
(D,W) \par\pard\ql \li1778\ri1252\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex103 3. Semua kejadian serius akibat efek samping obat
(\ul0\nosupersub\cf8\f9\fs24 adverse drug event\ul0\nosupersub\cf7\f8\fs24 )
jika \line\tab \up0 \expndtw-2\charscalex100 sesuai dan sebagaimana yang
didefinisikan oleh rumah sakit sudah dianalisis \line \tab \up0 \expndtw-
3\charscalex100 (lihat juga PKPO 7). (D,W) \par\pard\ql \li1778\ri1216\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 4. Semua kesalahan
pengobatan (\ul0\nosupersub\cf8\f9\fs24 medication error\ul0\nosupersub\cf7\f8\fs24
) yang signifikan jika sesuai \line\tab \up0 \expndtw0\charscalex100 dan
sebagaimana yang didefinisikan oleh rumah sakit sudah dianalisis. (lihat \line \tab
\up0 \expndtw-6\charscalex100 juga PKPO 7.1). (D,W) \par\pard\ql \li1778\sb37\sl-
276\slmult0\tx5126 \up0 \expndtw0\charscalex100 5. Semua perbedaan besar \tab
\up0 \expndtw-1\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
discrepancy\ul0\nosupersub\cf7\f8\fs24 ) antara diagnosis praoperasi dan
\par\pard\ql \li2138\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 diagnosis
pascaoperasi sudah dianalisis. (lihat juga PAB 7.2). (D,W) \par\pard\ql
\li1778\ri1277\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 6.
Efek samping atau pola efek samping selama sedasi moderat atau mendalam
\line\tab \up0 \expndtw0\charscalex104 dan pemakaian anestesi sudah dianalisis.
(lihat juga PAB 3.2 dan PAB 5). \line \tab \up0 \expndtw-2\charscalex100 (D,W)
\par\pard\qj \li1778\ri1285\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
7. Semua kejadian lain yang ditetapkan oleh rumah sakit sesuai dengan butir 6
\line\tab \up0 \expndtw-3\charscalex100 pada maksud dan tujuan sudah dianalisis.
(D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb261\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PMKP
9.3 \par\pard\qj \li1418\ri1277\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi
untuk analisis kejadian nyaris cedera (KNC) dan \up0 \expndtw-3\charscalex100
kejadian tidak cedera (KTC). \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb173\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP
9.3 \par\pard\qj \li1418\ri1259\sb216\sl-310\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan definisi KNC dan
sistem pelaporan, proses mengumpulkan \up0 \expndtw-1\charscalex100 dan analisis
data untuk dilakukan kajian perubahan proses agar dapat mengurangi \up0 \expndtw-
3\charscalex100 atau menghilangkan KNC dan KTC. (lihat juga PKPO 7.1)
\par\pard\ql \li1418\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 9.3 \par\pard\qj
\li1778\ri1222\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan definisi, jenis yang
dilaporkan, dan sistem pelaporan \line\tab \up0 \expndtw-4\charscalex100 KNC dan
KTC. (lihat juga PMKP 9 EP1). (R) \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0
\expndtw-2\charscalex100 2. Ada analisis data KNC dan KTC. (D,W) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb118\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 221
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg222}
{\bkmkend Pg222}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PMKP 10 \par\pard\ql
\li1418\sb224\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ada pengukuran dan evaluasi budaya keselamatan
pasien. \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 10 \par\pard\qj
\li1418\ri1216\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Pengukuran budaya keselamatan juga perlu dilakukan oleh
rumah sakit. Budaya \line \up0 \expndtw0\charscalex100 keselamatan juga dikenal
sebagai budaya yang aman, yakni sebuah budaya \line \up0 \expndtw-
3\charscalex100 organisasi yang mendorong setiap individu anggota staf \up0
\expndtw-6\charscalex100 (klinis atau administratif) \par\pard\qj
\li1418\ri1223\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex103 melaporkan hal-hal
yang menghawatirkan tentang keselamatan atau mutu \up0 \expndtw-
6\charscalex100 pelayanan tanpa imbal jasa dari rumah sakit. \par\pard\qj
\li1418\ri1279\sb209\sl-310\slmult0 \up0 \expndtw0\charscalex105 Direktur rumah
sakit melakukan evaluasi rutin sesuai jadwal yang tetap dengan \up0
\expndtw0\charscalex102 menggunakan beberapa metode, survei resmi, wawancara staf,
analisis data, dan \up0 \expndtw-3\charscalex100 diskusi kelompok. \par\pard\ql
\li1418\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 10 \par\pard\ql \li1778\sb244\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada
regulasi pengukuran budaya keselamatan. (lihat juga TKRS 13). (R) \par\pard\qj
\li1778\ri1285\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Direktur
rumah sakit telah melaksanakan pengukuran budaya keselamatan. \line\tab \up0
\expndtw-2\charscalex100 (D,W) \par\pard\ql \li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb5\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PENCAPAIAN DAN MEMPERTAHANKAN PERBAIKAN
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb268\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar PMKP 11 \par\pard\ql \li1418\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Peningkatan
mutu dan keselamatan pasien dicapai dan dipertahankan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PMKP 11 \par\pard\qj \li1418\ri1262\sb211\sl-316\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Informasi dari analisis data yang
digunakan untuk mengidentifikasi potensi perbaikan \line \up0 \expndtw-
1\charscalex100 atau untuk mengurangi atau mencegah kejadian yang merugikan. Data
pengukuran \line \up0 \expndtw0\charscalex100 rutin dan data penilaian intensif
memberikan kontribusi untuk pemahaman di mana \line \up0 \expndtw0\charscalex102
perbaikan harus direncanakan dan prioritas apa yang harus diberikan
untuk \line \up0 \expndtw0\charscalex100 peningkatan/perbaikan. Khususnya,
perbaikan yang direncanakan untuk area/ \line \up0 \expndtw0\charscalex100
daerah prioritas pengumpulan data yang sudah diidentifikasi oleh pimpinan rumah
\line \up0 \expndtw-3\charscalex100 sakit. \par\pard\qj \li1418\ri1271\sb201\sl-
320\slmult0 \up0 \expndtw0\charscalex102 Setelah perbaikan direncanakan, dilakukan
uji perubahan dengan mengumpulkan \up0 \expndtw0\charscalex103 data lagi selama
masa uji yang ditentukan dan dilakukan re-evaluasi untuk \up0 \expndtw-
3\charscalex100 membuktikan bahwa perubahan adalah benar menghasilkan perbaikan.
\par\pard\qj \li1418\ri1222\sb180\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Hal
ini untuk memastikan bahwa ada perbaikan berkelanjutan dan ada pengumpulan \line
\up0 \expndtw0\charscalex104 data untuk analisis berkelanjutan. Perubahan yang
efektif dimasukkan ke dalam \line \up0 \expndtw-3\charscalex100 standar prosedur
operasional, prosedur operasi, dan ke dalam setiap pendidikan staf \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb43\sl-253\slmult0 \up0 \expndtw-
3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 222
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg223}
{\bkmkend Pg223}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1281\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 yang perlu dilakukan. Perbaikan-perbaikan yang dicapai
dan dipertahankan oleh \up0 \expndtw0\charscalex102 rumah sakit didokumentasikan
sebagai bagian dari manajemen peningkatan mutu \up0 \expndtw-3\charscalex100 serta
keselamatan pasien dan program perbaikan. (TKRS 11, EP2) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb207\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 11 \par\pard\qj
\li1418\ri1272\sb208\sl-320\slmult0\tx1845 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit telah membuat rencana perbaikan
terhadap mutu dan keselamatan \line\tab \up0 \expndtw-3\charscalex100 berdasar atas
hasil capaian mutu. (D,W) \par\pard\qj \li1418\ri1284\sb0\sl-320\slmult0\tx1845
\up0 \expndtw0\charscalex103 2. Rumah sakit telah melakukan uji coba rencana
perbaikan terhadap mutu dan \line\tab \up0 \expndtw-3\charscalex100 keselamatan
pasien. (D,W) \par\pard\qj \li1418\ri1221\sb0\sl-320\slmult0\tx1845 \up0 \expndtw-
3\charscalex100 3. Rumah sakit telah menerapkan/melaksanakan rencana perbaikan
terhadap mutu \line\tab \up0 \expndtw-5\charscalex100 dan keselamatan pasien.
(D,W) \par\pard\qj \li1418\ri1284\sb0\sl-320\slmult0\tx1845 \up0
\expndtw0\charscalex105 4. Tersedia data yang menunjukkan bahwa perbaikan
bersifat efektif dan \line\tab \up0 \expndtw-3\charscalex100 berkesinambungan.
(Lihat juga TKRS 11, EP 2). (D,W) \par\pard\qj \li1418\ri1220\sb0\sl-
320\slmult0\tx1845 \up0 \expndtw-4\charscalex100 5. Ada bukti perubahan-
perubahan regulasi yang diperlukan dalam membuat \line\tab \up0 \expndtw-
5\charscalex100 rencana, melaksanakan, dan mempertahankan perbaikan. (D,W)
\par\pard\ql \li1418\sb17\sl-276\slmult0 \up0 \expndtw-2\charscalex100 6.
Keberhasilan telah didokumentasikan dan dijadikan laporan PMKP. (D,W)
\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb268\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 MANAJEMEN RISIKO \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb12\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PMKP 12 \par\pard\qj
\li1418\ri1219\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Program manajemen risiko berkelanjutan digunakan untuk
melakukan identifikasi dan \line \up0 \expndtw0\charscalex100 mengurangi cedera
serta mengurangi risiko lain terhadap keselamatan pasien dan \line \up0 \expndtw-
3\charscalex100 staf. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PMKP 12
\par\pard\qj \li1418\ri1286\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ada beberapa kategori risiko yang dapat berdampak pada
rumah sakit. Katagori ini \up0 \expndtw-3\charscalex100 antara lain dan tidak
terbatas pada risiko \par\pard\ql \li1778\sb237\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \u8226? strategis (terkait dengan tujuan organisasi);
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \u8226?
operasional (rencana pengembangan untuk mencapai tujuan organisasi);
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \u8226?
keuangan (menjaga aset); \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \u8226? kepatuhan (kepatuhan terhadap hukum dan peraturan);
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
reputasi (\ul0\nosupersub\cf8\f9\fs24 image\ul0\nosupersub\cf7\f8\fs24 yang
dirasakan oleh masyarakat). \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1215\sb188\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Rumah
sakit perlu memakai pendekatan proaktif untuk manajemen risiko. Salah satu \up0
\expndtw-3\charscalex100 caranya adalah dengan program manajemen risiko formal yang
komponen-komponen \up0 \expndtw-4\charscalex100 pentingnya meliputi \par\pard\ql
\li1869\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1) identifikasi risiko;
\par\pard\ql \li1869\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2)
prioritas risiko; \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb10\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 223
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg224}
{\bkmkend Pg224}\par\pard\ql \li1869\sb0\sl-276\slmult0 \par\pard\ql\li1869\sb0\sl-
276\slmult0 \par\pard\ql\li1869\sb0\sl-276\slmult0 \par\pard\ql\li1869\sb0\sl-
276\slmult0 \par\pard\ql\li1869\sb68\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3) pelaporan risiko; \par\pard\ql
\li1869\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4) manajemen risiko;
\par\pard\ql \li1869\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5)
invesigasi kejadian yang tidak diharapkan (KTD); \par\pard\ql \li1869\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 6) manajemen terkait tuntutan
(klaim). \par\pard\qj \li1418\ri1218\sb211\sl-317\slmult0 \up0 \expndtw-
2\charscalex100 Elemen penting manajemen risiko adalah analisis risiko,
misalnya proses untuk \line \up0 \expndtw-1\charscalex100
mengevaluasi\ul0\nosupersub\cf8\f9\fs24 near miss\ul0\nosupersub\cf7\f8\fs24
(KNC) dan proses berisiko tinggi lainnya karena kegagalan \line \up0 \expndtw-
1\charscalex100 proses tersebut dapat menyebabkan kejadian sentinel. Satu
alat/metode yang dapat \line \up0 \expndtw-1\charscalex100 menyediakan analisis
proaktif semacam itu terhadap proses kritis dan berisiko tinggi \line \up0
\expndtw0\charscalex102 adalah\ul0\nosupersub\cf8\f9\fs24 failure mode effect
analysis\ul0\nosupersub\cf7\f8\fs24 (analisis efek modus kegagalan). Rumah
sakit \line \up0 \expndtw-3\charscalex100 dapat pula mengidentifikasi dan
menggunakan alat-alat serupa untuk mengidentifikasi \line \up0 \expndtw-
2\charscalex100 dan mengurangi risiko, seperti\ul0\nosupersub\cf8\f9\fs24
hazard vulnerability analysis\ul0\nosupersub\cf7\f8\fs24 (analisis
kerentanan \line \up0 \expndtw-3\charscalex100 terhadap bahaya). \par\pard\qj
\li1418\ri1213\sb203\sl-317\slmult0 \up0 \expndtw0\charscalex100 Untuk menggunakan
alat ini atau alat-alat lainnya yang serupa secara efektif maka \up0
\expndtw0\charscalex100 direktur rumah sakit harus mengetahui dan mempelajari
pendekatan tersebut, \up0 \expndtw-3\charscalex100 menyepakati daftar proses yang
berisiko tinggi dari segi keselamatan pasien dan staf, \up0 \expndtw-
3\charscalex100 kemudian menerapkan alat tersebut pada proses prioritas risiko.
Setelah analisis hasil \up0 \expndtw0\charscalex103 maka pimpinan rumah sakit
mengambil tindakan untuk mendesain ulang proses\up0 \expndtw0\charscalex102 proses
yang ada atau mengambil tindakan serupa untuk mengurangi risiko dalam \up0
\expndtw-1\charscalex100 proses-proses yang ada. Proses pengurangan risiko ini
dilaksanakan minimal sekali \up0 \expndtw-3\charscalex100 dalam setahun dan
didokumentasikan pelaksanaannya. \par\pard\qj \li1418\ri1273\sb201\sl-
320\slmult0 \up0 \expndtw0\charscalex104 Dalam menerapkan manajemen risiko rumah
sakit perlu memperhatikan proses\up0 \expndtw-3\charscalex100 proses berisiko yang
dapat terjadi pada pasien, antara lain meliputi \par\pard\ql \li1778\sb237\sl-
276\slmult0 \up0 \expndtw0\charscalex100 \u8226? manajemen pengobatan;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw0\charscalex102 \u8226?
risiko jatuh; \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw0\charscalex100
\u8226? pengendalian infeksi; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex107 \u8226? gizi; \par\pard\ql \li1778\sb44\sl-276\slmult0
\up0 \expndtw0\charscalex100 \u8226? risiko peralatan; dan \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? risiko sebagai
akibat kondisi yang sudah lama berlangsung. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1275\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex102 Dalam
menyusun daftar risiko diharapkan rumah sakit agar memperhatikan ruang \up0
\expndtw0\charscalex104 lingkup manajemen risiko rumah sakit yang meliputi
beberapa hal, namun tidak \up0 \expndtw-3\charscalex100 terbatas pada \par\pard\ql
\li1778\sb217\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a) pasien; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b) staf medis;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c) tenaga
kesehatan dan tenaga lainnya yang bekerja di rumah sakit; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 d) fasilitas rumah
sakit; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e)
lingkungan rumah sakit; dan \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex101 f) bisnis rumah sakit. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb184\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 224
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg225}
{\bkmkend Pg225}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PMKP 12
\par\pard\qj \li1778\ri1260\sb0\sl-320\slmult0\tx2138
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit
mempunyai program manajemen risiko rumah sakit yang meliputi \line\tab \up0
\expndtw-3\charscalex100 butir 1 sampai dengan 6 yang ada pada maksud dan tujuan.
(R) \par\pard\ql \li1778\ri1273\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 2. Rumah sakit mempunyai daftar risiko di tingkat rumah
sakit yang sekurang-\line\tab \up0 \expndtw-2\charscalex100 kurangnya meliputi
risiko yang ada di butir 1 sampai 6 yang ada pada maksud \line \tab \up0 \expndtw-
3\charscalex100 dan tujuan. (D,W) \par\pard\qj \li1778\ri1276\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Rumah sakit telah membuat
strategi untuk mengurangi risiko yang ada di butir \line\tab \up0 \expndtw-
3\charscalex100 1 sampai dengan 6. (D,W) \par\pard\ql \li1778\ri1274\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 4. Ada bukti rumah sakit
telah melakukan\ul0\nosupersub\cf8\f9\fs24 failure mode effect
analysis\ul0\nosupersub\cf7\f8\fs24 (analisis \line\tab \up0 \expndtw-
1\charscalex100 efek modus kegagalan) setahun sekali pada proses berisiko
tinggi yang \line \tab \up0 \expndtw-2\charscalex100 diprioritaskan. (D,W)
\par\pard\qj \li1778\ri1282\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
5. Rumah sakit telah melaksanakan tindak lanjut hasil analisis modus dampak
\line\tab \up0 \expndtw-3\charscalex100 kegagalan. (FMEA). (D,W) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb177\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 225
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg226}
{\bkmkend Pg226}\par\pard\ql \li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAB 2 \par\pard\ql \li3307\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 PENCEGAHAN DAN PENGENDALIAN INFEKSI
\par\pard\ql \li5680\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 (PPI)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 GAMBARAN UMUM \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1161\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Tujuan pengorganisasian program PPI adalah
mengidentifikasi dan menurunkan risiko \up0 \expndtw0\charscalex100 infeksi yang
didapat serta ditularkan di antara pasien, staf, tenaga profesional \up0
\expndtw-3\charscalex100 kesehatan, tenaga kontrak, tenaga sukarela, mahasiswa, dan
pengunjung. \par\pard\qj \li1418\ri1215\sb180\sl-320\slmult0 \up0
\expndtw0\charscalex100 Risiko infeksi dan kegiatan program dapat berbeda dari
satu rumah sakit ke rumah \up0 \expndtw0\charscalex100 sakit lainnya bergantung
pada kegiatan klinis dan pelayanan rumah sakit, populasi \up0 \expndtw-
2\charscalex100 pasien yang dilayani, lokasi geografi, jumlah pasien, serta jumlah
pegawai. \par\pard\qj \li1418\ri1160\sb200\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 Program PPI akan efektif apabila mempunyai pimpinan yang
ditetapkan, pelatihan dan \up0 \expndtw-1\charscalex100 pendidikan staf yang baik,
metode untuk mengidentifikasi serta proaktif pada tempat \up0 \expndtw-
3\charscalex100 berisiko infeksi, kebijakan dan prosedur yang memadai, juga
melakukan koordinasi ke \up0 \expndtw-4\charscalex100 seluruh rumah sakit.
\par\pard\qj \li1418\ri2930\sb356\sl-640\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 STANDAR, MAKSUD DAN TUJUAN, SERTA ELEMEN PENILAIAN \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 KEPEMIMPINAN DAN TATA KELOLA \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PPI 1
\par\pard\qj \li1418\ri1167\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Ditetapkan organisasi untuk melakukan koordinasi
semua kegiatan PPI yang \up0 \expndtw0\charscalex100 melibatkan pemimpin rumah
sakit, staf klinis dan nonklinis sesuai dengan ukuran, \up0 \expndtw-
4\charscalex100 serta kompleksitas rumah sakit dan peraturan perundang-
undangan. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb69\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI
1.1 \par\pard\qj \li1418\ri1160\sb208\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Ditetapkan organisasi untuk
melakukan koordinasi semua kegiatan PPI secara \up0 \expndtw0\charscalex104
terstruktur yang melibatkan, staf klinis dan nonklinis sesuai dengan ukuran,
serta \up0 \expndtw-4\charscalex100 kompleksitas rumah sakit dan peraturan
perundang- undangan. \par\pard\ql \li1418\sb217\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 1 dan PPI 1.1
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1225\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Kegiatan PPI
menjangkau ke dalam setiap unit di rumah sakit dan melibatkan staf \line \up0
\expndtw0\charscalex105 klinis dan nonklinis di berbagai unit kerja, antara lain
departemen klinik, fasilitas \line \up0 \expndtw0\charscalex100 pemeliharaan,
dapur, kerumahtanggaan, laboratorium, farmasi, dan unit sterilisasi. \line \up0
\expndtw-2\charscalex100 Rumah sakit menetapkan mekanisme untuk mengatur koordinasi
kegiatan PPI. \par\pard\qj \li1418\ri1221\sb209\sl-310\slmult0 \up0
\expndtw0\charscalex100 Sesuai dengan peraturan perundang-undangan, pimpinan rumah
sakit membentuk \up0 \expndtw-1\charscalex100 organisasi pengelola kegiatan PPI
di rumah sakit dan menetapkan tanggung jawab \up0 \expndtw-3\charscalex100 dan
tugas meliputi \par\pard\ql \li10156\sb198\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 226
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg227}
{\bkmkend Pg227}\par\pard\ql \li1958\sb0\sl-276\slmult0 \par\pard\ql\li1958\sb0\sl-
276\slmult0 \par\pard\ql\li1958\sb0\sl-276\slmult0 \par\pard\ql\li1958\sb0\sl-
276\slmult0 \par\pard\ql\li1958\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1) menetapkan definisi infeksi terkait
layanan kesehatan; \par\pard\ql \li1958\sb224\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 2) metode pengumpulan data (surveilans); \par\pard\ql
\li1958\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3) membuat
strategi/program menangani risiko PPI; \par\pard\ql \li1958\sb244\sl-276\slmult0
\up0 \expndtw-2\charscalex100 4) proses pelaporan. \par\pard\qj
\li1418\ri1226\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex102 Dalam koordinasi
termasuk komunikasi dengan semua pihak di rumah sakit untuk \up0 \expndtw-
3\charscalex100 memastikan program berjalan efektif dan berkesinambungan.
\par\pard\qj \li1418\ri1221\sb206\sl-313\slmult0 \up0 \expndtw-1\charscalex100
Didalam organisasi tersebut, pemimpin rumah sakit, staf klinis dan nonklinis
terwakili \up0 \expndtw-2\charscalex100 dan terlibat dalam kegiatan PPI. Bergantung
pada besar kecilnya ukuran rumah sakit \up0 \expndtw0\charscalex102 dan
kompleksitas layanan maka tenaga lain juga terlibat sesuai dengan peraturan \up0
\expndtw-3\charscalex100 perundang-undangan. \par\pard\qj \li1418\ri1158\sb202\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 Koordinasi antara ketua organisasi dan
perawat PPI/IPCN dilakukan secara terstruktur \up0 \expndtw-3\charscalex100 dalam
pelaksanaan kegiatan pencegahan serta pengendalian infeksi antara lain untuk
\up0 \expndtw-4\charscalex100 menetapkan \par\pard\ql \li1778\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 a) angka infeksi yang akan diukur;
\par\pard\ql \li1778\ri1191\sb8\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 b) sistem pelaporan perawat PPI/IPCN kepada ketua
organisasi PPI yang akan \line\tab \up0 \expndtw-2\charscalex100 dibahas di
organisasi dengan melibatkan semua anggota untuk mendapatkan \line \tab \up0
\expndtw-3\charscalex100 hasil yang akurat. \par\pard\ql \li1485\sb0\sl-276\slmult0
\par\pard\ql\li1485\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 1 \par\pard\ql \li1778\sb0\sl-320\slmult0
\par\pard\ql\li1778\ri1220\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada penetapan organisasi pencegahan
pengendalian infeksi bergantung pada \line\tab \up0 \expndtw0\charscalex105 ukuran
serta kompleksitas rumah sakit dan sesuai dengan peraturan \line \tab
\up0 \expndtw-3\charscalex100 perundang-undangan. (R) \par\pard\qj
\li1778\ri1165\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 2. Ada
bukti kegiatan pelaksanaan koordinasi ketua organisasi dengan IPCN yang
\line\tab \up0 \expndtw-4\charscalex100 sesuai dengan ukuran dan kompleksitas
pelayanan rumah sakit. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb105\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI
1.1 \par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1227\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1.
Rumah sakit menetapkan regulasi yang meliputi 1 dan 2 pada maksud dan \line\tab
\up0 \expndtw-3\charscalex100 tujuan. (R) \par\pard\qj \li1778\ri1225\sb17\sl-
300\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Ada bukti pelaporan pelaksanaan
kegiatan PPI oleh ketua organisasi kepada \line\tab \up0 \expndtw-3\charscalex100
pimpinan rumah sakit setiap 3 bulan. (D,W). \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PPI 2 \par\pard\qj \li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\ri1219\sb8\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 itetapkan perawat PPI/ IPCN
(\ul0\nosupersub\cf8\f9\fs24 Infection Prevention and Control
nurse\ul0\nosupersub\cf7\f8\fs24 ) yang memiliki \up0 \expndtw0\charscalex100
kompetensi untuk mengawasi serta supervisi semua kegiatan pencegahan dan
\up0 \expndtw-3\charscalex100 pengendalian infeksi. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb163\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 227
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg228}
{\bkmkend Pg228}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb92\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan PPI 2 \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-
276\slmult0\tx8193 \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Tujuan
program pencegahan dan pengendalain infeksi \tab \up0 \expndtw0\charscalex105
(PPI) adalah untuk \par\pard\qj \li1418\ri1221\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 mengidentifikasi dan menurunkan risiko terkena penularan
infeksi di antara pasien, \up0 \expndtw0\charscalex103 staf klinis dan
nonklinis, pekerja kontrak, petugas sukarela, mahasiswa, dan \up0 \expndtw-
3\charscalex100 pengunjung. \par\pard\qj \li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\ri1220\sb8\sl-316\slmult0 \up0 \expndtw-1\charscalex100 Program
PPI bergantung pada risiko infeksi yang dihadapi tiap-tiap rumah sakit yang
\line \up0 \expndtw0\charscalex100 mungkin berbeda antara satu rumah sakit dan
rumah sakit lainnya bergantung pada \line \up0 \expndtw0\charscalex103 kegiatan
klinik dan layanan yang ada, populasi pasien yang dilayani, lokasi, serta \line
\up0 \expndtw-2\charscalex100 jumlah pasien dan jumlah pegawai. Jadi pengawasan
program PPI berkaitan dengan \line \up0 \expndtw0\charscalex100 besar kecilnya
rumah sakit, kompleksitas kegiatan, tingkat risiko, dan cakupan \line
\up0 \expndtw-3\charscalex100 program. \par\pard\qj \li1418\ri1223\sb207\sl-
313\slmult0 \up0 \expndtw0\charscalex102 Rumah sakit menetapkan satu orang atau
lebih perawat PPI/IPCN adalah staf \up0 \expndtw0\charscalex103 perawat yang
bekerja penuh waktu sesuai dengan ketentuan. Kualifikasi perawat \up0 \expndtw-
1\charscalex100 tersebut mempunyai pendidikan minimal D-3 keperawatan dan
sudah mengikuti \up0 \expndtw-2\charscalex100 pelatihan untuk perawat PPI/IPCN.
\par\pard\ql \li1418\sb238\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 2 \par\pard\qj \li1778\sb0\sl-
320\slmult0 \par\pard\qj\li1778\ri1218\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan perawat
PPI/IPCN (\ul0\nosupersub\cf8\f9\fs24 Infection Prevention and Control \line\tab
\up0 \expndtw-3\charscalex100 Nurse\ul0\nosupersub\cf7\f8\fs24 ) dengan jumlah dan
kualifikasi sesuai dengan regulasi. (R ) \par\pard\qj \li1778\ri1158\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 2. Ada bukti perawat PPI/IPCN
melaksanakan pengawasan serta supervisi semua \line\tab \up0 \expndtw-
4\charscalex100 kegiatan pencegahan dan pengendalian infeksi. (D,W )
\par\pard\qj \li1778\ri1225\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103
3. Ada bukti terlaksana pelaporan perawat PPI/IPCN kepada ketua organisasi
\line\tab \up0 \expndtw-3\charscalex100 PPI. (D,W) \par\pard\ql \li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb29\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 SUMBERDAYA \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb132\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PPI 3 \par\pard\qj
\li1418\ri1219\sb216\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai perawat penghubung PPI/IPCLN
(\ul0\nosupersub\cf8\f9\fs24 Infection Prevention and \up0 \expndtw0\charscalex102
Control Link Nurse\ul0\nosupersub\cf7\f8\fs24 ) yang jumlah dan
kualifikasinya sesuai dengan peraturan \up0 \expndtw-3\charscalex100 perundang-
undangan. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb159\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 228
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg229}
{\bkmkend Pg229}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 3 \par\pard\qj
\li1418\ri1226\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Dalam melaksanakan program PPI dibutuhkan tenaga agar
sasaran program dapat \up0 \expndtw-2\charscalex100 tercapai. Jumlah tenaga yang
dibutuhkan bergantung pada ukuran rumah sakit, \up0 \expndtw-3\charscalex100
kompleksitas kegiatan, tingkat risiko, dan cakupan program. \par\pard\qj
\li1418\ri1199\sb308\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Dalam bekerja
perawat PPI/IPCN dapat dibantu beberapa perawat penghubung/ \up0
\expndtw0\charscalex103 IPCLN (\ul0\nosupersub\cf8\f9\fs24 Infection Prevention and
Control Link Nurse\ul0\nosupersub\cf7\f8\fs24 ) dari tiap unit, terutama yang
\up0 \expndtw-3\charscalex100 berisiko terjadi infeksi. \par\pard\qj
\li1418\ri1220\sb300\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Perawat
penghubung PPI/IPCLN sebagai perawat pelaksana harian/penghubung \up0
\expndtw-3\charscalex100 bertugas \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0
\expndtw-2\charscalex100 a) mencatat data surveilans dari setiap pasien di unit
rawat inap masing-masing; \par\pard\qj \li1778\ri1225\sb8\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex103 b) memberikan motivasi dan mengingatkan pelaksanaan
kepatuhan PPI pada \line\tab \up0 \expndtw-3\charscalex100 setiap personil ruangan
di unitnya masing-masing; \par\pard\qj \li1778\ri1221\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex104 c) memonitor kepatuhan petugas kesehatan yang
lain dalam penerapan \line\tab \up0 \expndtw-3\charscalex100 kewaspadaan isolasi;
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 d)
memberitahukan kepada IPCN apabila ada kecurigaan HAIs pada pasien; \par\pard\qj
\li1778\ri1168\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 e) bila
terdapat infeksi potensial KLB melakukan penyuluhan bagi pengunjung dan
\line\tab \up0 \expndtw-4\charscalex100 konsultasi prosedur PPI, serta
berkoordinasi dengan IPCN; \par\pard\qj \li1778\ri1221\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex102 f) memantau pelaksanaan penyuluhan bagi pasien,
keluarga dan pengunjung, \line\tab \up0 \expndtw-3\charscalex100 serta konsultasi
prosedur yang harus dilaksanakan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb113\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 3
\par\pard\ql \li1778\sb24\sl-276\slmult0\tx9493 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan perawat penghubung
PPI/IPCLN \tab \up0 \expndtw-2\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 Infection
\par\pard\ql \li2138\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Prevention
and Control Link Nurse\ul0\nosupersub\cf7\f8\fs24 ) dengan jumlah dan kualifikasi.
(R ) \par\pard\qj \li1778\ri1228\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 2. Ada bukti pelaksanaan tugas perawat
penghubung PPI/IPCLN sesuai dengan \line\tab \up0 \expndtw-3\charscalex100 1
sampai dengan 6 pada maksud dan tujuan. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb169\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 4 \par\pard\qj
\li1418\ri1217\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Pimpinan rumah sakit menyediakan sumber daya untuk
mendukung pelaksanaan \up0 \expndtw-3\charscalex100 program PPI. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb69\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 4 \par\pard\qj
\li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\ri1226\sb26\sl-310\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Untuk melaksanakan program PPI
diperlukan sumber daya yang memadai. Sumber \up0 \expndtw0\charscalex103 daya
tersebut meliputi tenaga, anggaran, fasilitas, dan sumber informasi/referensi
\up0 \expndtw-3\charscalex100 yang diperlukan. \par\pard\qj \li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\ri1221\sb2\sl-320\slmult0 \up0
\expndtw0\charscalex102 Untuk menerapkan program pencegahan dan pengendalian
infeksi diperlukan \line \up0 \expndtw0\charscalex100 anggaran, karena itu rumah
sakit perlu menyediakan anggaran antara lain meliputi \line \up0
\expndtw0\charscalex100 anggaran untuk pengadaan disinfektan, misalnya
untuk\ul0\nosupersub\cf8\f9\fs24 handrub\ul0\nosupersub\cf7\f8\fs24 dan
anggaran \par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 229
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg230}
{\bkmkend Pg230}\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1227\sb195\sl-315\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 pelatihan PPI (dasar maupun lanjutan) yang
dilaksanakan internal maupun di luar \line \up0 \expndtw0\charscalex100 rumah
sakit. Selain itu, anggaran juga diperlukan untuk pemeriksaan kuman/kultur,
\line \up0 \expndtw0\charscalex100 pengadaan alat pelindung diri, dan lainnya
sesuai dengan kebutuhan. Rumah sakit \line \up0 \expndtw0\charscalex100 menjamin
tersedia anggaran yang cukup untuk melaksanakan program PPI dengan \line \up0
\expndtw-3\charscalex100 efektif. \par\pard\qj \li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1213\sb11\sl-315\slmult0 \up0 \expndtw-2\charscalex100
Terdapat sistem informasi sangat mendukung kegiatan PPI rumah sakit.
Sistem \up0 \expndtw0\charscalex100 manajemen informasi merupakan sumber
daya penting untuk mendukung \up0 \expndtw-2\charscalex100 pengumpulan data
serta analisis untuk mengetahui tingkat risiko dan kecenderungan \up0
\expndtw0\charscalex105 infeksi terkait dengan layanan kesehatan. Data dan
informasi program PPI \up0 \expndtw-3\charscalex100 diintegrasikan dengan program
peningkatan mutu rumah sakit. \par\pard\qj \li1418\ri1159\sb1\sl-320\slmult0
\up0 \expndtw0\charscalex100 Pencegahan serta pengendalian infeksi terus
berkembang sejalan dengan \up0 \expndtw0\charscalex103 perkembangan ilmu,
teknologi kedokteran, dan kesehatan, karena itu rumah sakit \up0 \expndtw-
3\charscalex100 diharapkan selalu mencari informasi perkembangan ilmu dan teknologi
serta peraturan \up0 \expndtw-2\charscalex100 perundangan terkait dengan program
pencegahan dan pengendalian infeksi. Sumber \up0 \expndtw-2\charscalex100 informasi
dan referensi diperlukan dalam melaksanakan surveilans dapat secara \up0
\expndtw-3\charscalex100 efektif serta melakukan pengawasan terhadap kegiatan
PPI. \par\pard\qj \li1418\ri1221\sb300\sl-320\slmult0 \up0 \expndtw0\charscalex100
Sumber informasi dan referensi dapat diperoleh dari sumber nasional maupun
\up0 \expndtw-2\charscalex100 internasional, misalnya tentang ilmu pengetahuan
terkini dapat diperoleh dari sumber \up0 \expndtw-3\charscalex100 nasional maupun
internasional yang dapat diperoleh dari \par\pard\ql \li1778\sb37\sl-276\slmult0
\up0 \expndtw-3\charscalex100 a)\ul0\nosupersub\cf8\f9\fs24 United States Centers
for Disease Control and Prevention\ul0\nosupersub\cf7\f8\fs24 (USCDC);
\par\pard\qj \li1778\ri1154\sb25\sl-300\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 b)\ul0\nosupersub\cf8\f9\fs24 World Health
Organization\ul0\nosupersub\cf7\f8\fs24 (WHO) dan organisasi lain yang dapat
memberikan \line\tab \up0 \expndtw-4\charscalex100 informasi
\u8220?\ul0\nosupersub\cf8\f9\fs24 evidence based practice and
guidelines\ul0\nosupersub\cf7\f8\fs24 \u8221?; \par\pard\qj \li1778\ri1164\sb41\sl-
300\slmult0\tx2138 \up0 \expndtw0\charscalex103 c) berbagai publikasi serta
penetapan standar oleh organisasi profesi bidang \line\tab \up0 \expndtw-
4\charscalex100 kesehatan lingkungan dan kebersihan rumah sakit; \par\pard\qj
\li1778\ri1219\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex104 d) pedoman
dari pemerintah yang memuat praktik pencegahan infeksi terkait \line\tab \up0
\expndtw-3\charscalex100 dengan layanan klinik dan layanan penunjang;
\par\pard\qj \li1778\ri1223\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
e) peraturan perundang-undangan terutama yang berkaitan dengan ledakan
\line\tab \up0 \expndtw-3\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
outbreak\ul0\nosupersub\cf7\f8\fs24 ) penyakit; \par\pard\ql \li1778\sb37\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 f) infeksi dan ketentuan pelaporan
lainnya. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 4 \par\pard\ql \li1778\sb244\sl-276\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Tersedia anggaran yang
cukup untuk menunjang pelaksanaan program PPI. \par\pard\ql \li2138\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 (R) \par\pard\qj \li1778\ri1229\sb208\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex104 2. Tersedia fasilitas yang cukup
untuk menunjang pelaksanaan program PPI. \line\tab \up0 \expndtw-2\charscalex100
(O,W) \par\pard\qj \li1778\ri1220\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex104 3. Rumah sakit mempunyai sistem informasi untuk mendukung
program PPI, \line\tab \up0 \expndtw-3\charscalex100 khususnya terkait dengan data
dan analisis angka infeksi. (D,O,W) \par\pard\qj \li1778\ri1217\sb17\sl-
300\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Rumah sakit menyediakan sumber
informasi dan referensi terkini yang dapat \line\tab \up0 \expndtw-3\charscalex100
diperoleh dari 1 sampai dengan 6 pada maksud dan tujuan. (D,O,W) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb40\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 230
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg231}
{\bkmkend Pg231}\par\pard\qj \li1418\sb0\sl-620\slmult0
\par\pard\qj\li1418\ri1729\sb268\sl-620\slmult0\fi360 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 TUJUAN
PROGRAM PENCEGAHAN DAN PENGENDALIAN INFEKSI \up0 \expndtw-4\charscalex100 Standar
PPI 5 \par\pard\qj \li1418\ri1217\sb268\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai program PPI dan
kesehatan kerja secara menyeluruh untuk \up0 \expndtw0\charscalex100 mengurangi
risiko tertular infeksi yang berkaitan dengan pelayanan kesehatan pada \up0
\expndtw-3\charscalex100 pasien, staf klinis, dan nonklinis. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 5 \par\pard\qj
\li1418\ri1201\sb308\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Program PPI efektif jika program dilaksanakan secara
komprehensif meliputi seluruh \line \up0 \expndtw-2\charscalex100 unit maupun
individu yang berada di rumah sakit. Program PPI juga mencakup upaya \line \up0
\expndtw0\charscalex102 kesehatan kerja, melakukan identifikasi, dan menangani
masalah-masalah infeksi \line \up0 \expndtw0\charscalex104 yang sangat penting bagi
rumah sakit dari segi epidemiologik. Program PPI juga \line \up0
\expndtw0\charscalex103 membutuhkan berbagai strategi yang mencakup semua tingkat
unit atau layanan \line \up0 \expndtw-2\charscalex100 berdasar atas ukuran rumah
sakit, lokasi geografik, layanan, dan pasien. \par\pard\ql \li1418\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Program PPI meliputi \par\pard\ql
\li1778\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a) kebersihan tangan;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b)
surveilans risiko infeksi; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 c) investigasi wabah (\ul0\nosupersub\cf8\f9\fs24
outbreak\ul0\nosupersub\cf7\f8\fs24 ) penyakit infeksi; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) meningkatkan
pegawasan terhadap penggunaan antimikrob secara aman; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 e) asesmen berkala terhadap risiko;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 f)
menetapkan sasaran penurunan risiko (lihat juga AP 5.3); \par\pard\ql
\li1778\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 g) mengukur dan
me-\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 risiko
infeksi. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 5 \par\pard\ql \li1778\sb0\sl-320\slmult0
\par\pard\ql\li1778\ri1155\sb8\sl-320\slmult0\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada program PPI dan
kesehatan kerja yang komprehensif di seluruh rumah \line\tab \up0 \expndtw-
3\charscalex100 sakit untuk menurunkan risiko infeksi terkait dengan pelayanan
kesehatan pada \line \tab \up0 \expndtw-1\charscalex100 pasien yang mengacu dan
sesuai dengan ilmu pengetahuan terkini, pedoman \line \tab \up0 \expndtw-
2\charscalex100 praktik terkini, standar kesehatan lingkungan terkini, dan
peraturan perundang-\line \tab \up0 \expndtw-3\charscalex100 undangan. (R)
\par\pard\qj \li1778\ri1228\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
2. Ada bukti pelaksanaan program PPI untuk menurunkan risiko tertular infeksi
\line\tab \up0 \expndtw-3\charscalex100 pada pasien. (D,O,W,S) \par\pard\qj
\li1778\ri1220\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 3. Ada bukti
pelaksanaan program PPI untuk menurunkan risiko tertular infeksi \line\tab \up0
\expndtw-2\charscalex100 pada staf klinis dan nonklinis (kesehatan kerja). (lihat
juga KKS 8.4). (D,O,WS) \par\pard\qj \li1778\ri1167\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex103 4. Ada bukti pelaksanaan program PPI yang meliputi
butir 1 sampai dengan 7 \line\tab \up0 \expndtw-5\charscalex100 pada maksud dan
tujuan. (D,W ) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb41\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 6
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1164\sb8\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Program
surveilans rumah sakit menggunakan pendekatan berdasar atas risiko dalam \up0
\expndtw-4\charscalex100 menetapkan fokus program terkait dengan pelayanan
kesehatan. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 231
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg232}
{\bkmkend Pg232}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 6.1 \par\pard\qj
\li1418\ri1166\sb308\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menelusuri risiko infeksi, tingkat infeksi,
dan kecenderungan dari infeksi \up0 \expndtw-4\charscalex100 terkait layanan
kesehatan untuk menurunkan angka infeksi tersebut. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 6.2 \par\pard\qj
\li1418\ri1222\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit secara proaktif melakukan asesmen risiko
infeksi yang dapat terjadi dan \up0 \expndtw-3\charscalex100 menyusun strategi
untuk menurunkan risiko infeksi tersebut. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 6, PPI 6.1, dan
PPI 6.2 \par\pard\qj \li1418\ri1157\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit harus melakukan surveilans infeksi berdasar
atas data epidemiologis \up0 \expndtw-3\charscalex100 yang penting dan berfokus
pada daerah infeksi, penggunaan peralatan, prosedur serta \up0
\expndtw0\charscalex103 praktik untuk mencegah dan menurunkan angka infeksi.
Surveilans berdasar atas \up0 \expndtw0\charscalex102 risiko secara proaktif dapat
digunakan untuk identifikasi risiko infeksi dan program \up0 \expndtw-
1\charscalex100 berfokus pada daerah infeksi. Selanjutnya, dengan surveilans
dikumpulkan data dan \up0 \expndtw-3\charscalex100 analisisnya untuk membuat
asesmen risiko. \par\pard\qj \li1418\ri1165\sb17\sl-300\slmult0 \up0 \expndtw-
3\charscalex100 Rumah sakit mengumpulkan dan mengevaluasi data mengenai infeksi
serta lokasinya \up0 \expndtw-4\charscalex100 yang relevan sebagai berikut:
\par\pard\qj \li1869\ri1224\sb4\sl-320\slmult0\tx2229 \up0 \expndtw0\charscalex100
a) saluran pernapasan seperti prosedur dan tindakan terkait intubasi, bantuan
\line\tab \up0 \expndtw-3\charscalex100 ventilasi mekanik, trakeostomi, dan lain
lain; \par\pard\ql \li1869\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b)
saluran kencing seperti pada kateter, pembilasan urine, dan lain lain;
\par\pard\qj \li1869\ri1228\sb8\sl-320\slmult0\tx2229 \up0 \expndtw0\charscalex100
c) alat invasif intravaskular, saluran vena verifer, saluran vena sentral, dan
lain \line\tab \up0 \expndtw-3\charscalex100 lain; \par\pard\ql \li1869\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 d) lokasi operasi, perawatan,
pembalutan luka, prosedur aseptik, dan lain-lain; \par\pard\qj
\li1869\ri1219\sb25\sl-300\slmult0\tx2229 \up0 \expndtw0\charscalex102 e) penyakit
dan organisme yang penting dari sudut epidemiologik seperti \line\tab
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 multidrug resistant
organism\ul0\nosupersub\cf7\f8\fs24 dan infeksi yang virulen; \par\pard\ql
\li1869\sb40\sl-276\slmult0 \up0 \expndtw-2\charscalex100 f) timbul infeksi baru
atau timbul kembali infeksi di masyarakat. \par\pard\qj \li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\ri1167\sb17\sl-315\slmult0 \up0
\expndtw0\charscalex104 Sebagai tambahan, penggunaan ilmu pengetahuan yang
terhubung dengan \up0 \expndtw-3\charscalex100 pengendalian infeksi melalui
pedoman praktik klinik, program pengawasan antibiotik, \up0 \expndtw-
1\charscalex100 program menurunkan infeksi terkait rumah sakit, dan langkah
untuk membatasi \up0 \expndtw0\charscalex100 penggunaan peralatan invasif yang
tidak perlu dapat menurunkan tingkat infeksi \up0 \expndtw-3\charscalex100
secara signifikan. (lihat juga TKRS 11.2) \par\pard\qj \li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\ri1216\sb1\sl-320\slmult0 \up0
\expndtw0\charscalex102 Pencegahan dan pengendalian infeksi dirancang untuk
menurunkan risiko terkena \up0 \expndtw0\charscalex100 infeksi pada pasien, staf,
dan lainya. Untuk mencapai sasaran ini rumah sakit harus \up0 \expndtw-
1\charscalex100 proaktif menelusuri risiko serta tingkatan dan kecenderungan
infeksi terkait dengan \up0 \expndtw-3\charscalex100 layanan kesehatan. (lihat juga
TKRS 5 dan PMKP 4) \par\pard\qj \li1418\ri1220\sb300\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Rumah sakit menggunakan informasi pengukuran untuk
meningkatkan kegiatan \line \up0 \expndtw0\charscalex102 pencegahan serta
pengendalian infeksi dan mengurangi angka infeksi yang terkait \line \up0 \expndtw-
1\charscalex100 dengan pelayanan kesehatan ke level serendah-rendahnya. Rumah
sakit dapat \line \up0 \expndtw-2\charscalex100 menggunakan data indikator
\up0 \expndtw-2\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 measurement
data\ul0\nosupersub\cf7\f8\fs24 ) dan informasi sebaik-baiknya \par\pard\ql
\li1418\sb37\sl-276\slmult0 \up0 \expndtw0\charscalex105 dengan memahami angka
serta kecenderungan serupa di rumah sakit lain yang \par\pard\ql \li10156\sb243\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 232
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg233}
{\bkmkend Pg233}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1220\sb253\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 sejenis dan memberikan kontribusi data
ke\ul0\nosupersub\cf8\f9\fs24 database\ul0\nosupersub\cf7\f8\fs24 terkait
infeksi. (juga lihat PMKP \up0 \expndtw-2\charscalex100 4, EP 4 dan TKRS 5)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 6
\par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1212\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1.
Rumah sakit menetapkan regulasi tentang pelaksanaan surveilans meliputi
\line\tab \up0 \expndtw-3\charscalex100 butir 1 sampai dengan 7 pada maksud dan
tujuan. (R) \par\pard\ql \li1778\ri1159\sb9\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw-4\charscalex100 2. Ada bukti pelaksanaan pengumpulan data dari butir 1
sampai dengan 7, analisis \line\tab \up0 \expndtw-4\charscalex100 dan interpretasi
data, serta membuat prioritas untuk menurunkan tingkat infeksi. \line \tab \up0
\expndtw-5\charscalex100 (D,W ) \par\pard\qj \li1778\ri1223\sb2\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex103 3. Ada bukti pelaksanaan strategi
pengendalian infeksi berdasar atas prioritas \line\tab \up0 \expndtw-
3\charscalex100 untuk menurunkan tingkat infeksi. (D,W ) \par\pard\qj
\li1778\ri1225\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex104 4. Ada bukti
rumah sakit membandingkan angka kejadian infeksi rumah sakit \line\tab \up0
\expndtw-3\charscalex100 dengan kejadian di rumah sakit lain. (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb149\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI
6.1 \par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1219\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada
bukti rumah sakit telah melakukan investigasi dan analisis risiko infeksi \line\tab
\up0 \expndtw-3\charscalex100 serta diintegrasikan dengan program mutu dan
keselamatan pasien. (D,W) \par\pard\qj \li1778\ri1213\sb0\sl-320\slmult0\tx2138
\up0 \expndtw-1\charscalex100 2. Ada bukti rumah sakit telah
merancang ulang penurunan infeksi berdasar atas \line\tab \up0 \expndtw-
2\charscalex100 investigasi dan hasil analisis. \up0 \expndtw-2\charscalex100 (D,W)
\par\pard\qj \li1778\ri1218\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
3. Paling sedikit setahun sekali ada bukti rumah sakit secara proaktif
melakukan \line\tab \up0 \expndtw-3\charscalex100 asesmen risiko infeksi yang dapat
terjadi. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 6.2 \par\pard\qj \li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\ri1224\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada bukti rumah sakit
secara proaktif melakukan asesmen risiko infeksi yang \line\tab \up0 \expndtw-
3\charscalex100 dapat terjadi paling sedikit setahun sekali. (D,W) \par\pard\qj
\li1778\ri1228\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2. Ada
bukti rumah sakit menyusun strategi untuk menurunkan risiko infeksi
\line\tab \up0 \expndtw-2\charscalex100 tersebut. (D,W) \par\pard\qj
\li1418\ri2795\sb356\sl-640\slmult0\fi360 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PERALATAN MEDIS
DAN ALAT KESEHATAN HABIS PAKAI \up0 \expndtw-3\charscalex100 Standar PPI 7
\par\pard\qj \li1418\ri1225\sb281\sl-300\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan identifikasi prosedur dan
proses asuhan invasif yang \up0 \expndtw-2\charscalex100 berisiko infeksi serta
menerapkan strategi untuk menurunkan risiko infeksi. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 7.1 \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb124\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 233
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg234}
{\bkmkend Pg234}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1226\sb253\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan identifikasi prosedur dan
kegiatan penunjang pelayanan \up0 \expndtw-2\charscalex100 yang berisiko infeksi
serta menerapkan strategi untuk menurunkan risiko infeksi. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 7 dan PPI 7.1
\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1178\sb15\sl-
316\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
melakukan asesmen dan memberi asuhan kepada pasien dengan \up0
\expndtw0\charscalex100 menggunakan banyak proses sederhana maupun kompleks masing-
masing dengan \up0 \expndtw-1\charscalex100 tingkatan risiko infeksi terhadap
pasien dan staf, misalnya pencampuran obat suntik, \up0 \expndtw0\charscalex104
pemberian suntikan, terapi cairan, pungsi lumbal, dan sebagainya. Dalam hal ini
\up0 \expndtw-2\charscalex100 sangat penting mengukur dan mengkaji proses tersebut
serta melaksanakan regulasi, \up0 \expndtw0\charscalex102 pelatihan, edukasi, dan
kegiatan berdasar atas bukti pelaksanaan yang telah \up0 \expndtw-
3\charscalex100 dirancang untuk menurunkan risiko infeksi. (lihat juga ARK 6)
\par\pard\qj \li1418\ri1157\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex100 Rumah
sakit juga melakukan asesmen risiko terhadap kegiatan penunjang di rumah \line \up0
\expndtw-2\charscalex100 sakit yang harus mengikuti prinsip-prinsip pencegahan dan
pengendalian infeksi serta \line \up0 \expndtw-2\charscalex100 melaksanakan
strategi untuk menurunkan risiko infeksi, namun tidak terbatas pada
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a)
sterilisasi alat; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 b) pengelolaan linen/londri; \par\pard\ql \li1778\sb24\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 c) pengelolaan sampah; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) penyediaan
makanan; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 e)
kamar jenazah. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 7 \par\pard\qj \li1778\ri1223\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
risiko infeksi pada prosedur dan proses asuhan \line\tab \up0 \expndtw-
2\charscalex100 invasif yang berisiko infeksi serta strategi untuk menurunkan
risiko infeksi. (R) \par\pard\qj \li1778\ri1220\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 2. Ada bukti identifikasi prosedur dan proses asuhan
invasif serta strategi untuk \line\tab \up0 \expndtw-3\charscalex100 menurunkan
risiko infeksi. (D,W) \par\pard\qj \li1778\ri1218\sb4\sl-320\slmult0\tx2138 \up0
\expndtw-1\charscalex100 3. Rumah sakit melaksanakan strategi untuk menurunkan
risiko infeksi pada \line\tab \up0 \expndtw-2\charscalex100 prosedur dan proses
asuhan invasif yang berisiko infeksi. (D,O,W,S) \par\pard\qj \li1778\ri1223\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Rumah sakit telah melaksanakan
kegiatan pelatihan untuk menurunkan risiko \line\tab \up0 \expndtw-3\charscalex100
infeksi di dalam proses-proses kegiatan tersebut. (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 7.1
\par\pard\ql \li1778\ri1159\sb308\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
risiko infeksi pada proses kegiatan penunjang \line\tab \up0
\expndtw0\charscalex102 pelayanan (medik dan nonmedik) yang berisiko terjadi
infeksi serta strategi \line \tab \up0 \expndtw-3\charscalex100 pencegahannya
meliputi butir 1 sampai dengan 4 pada maksud dan tujuan. (R) \par\pard\qj
\li1778\ri1167\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-4\charscalex100 2. Ada
bukti identifikasi dan strategi untuk menurunkan risiko infeksi pada kegiatan
\line\tab \up0 \expndtw-5\charscalex100 sterilisasi alat. (D,W) \par\pard\qj
\li1778\ri1167\sb17\sl-300\slmult0\tx2138 \up0 \expndtw-4\charscalex100 3. Ada
bukti identifikasi dan strategi untuk menurunkan risiko infeksi pada kegiatan
\line\tab \up0 \expndtw-5\charscalex100 pengelolaan linen/londri. (D,W)
\par\pard\qj \li1778\ri1165\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-4\charscalex100
4. Ada bukti identifikasi dan strategi untuk menurunkan risiko infeksi pada
kegiatan \line\tab \up0 \expndtw-5\charscalex100 pengelolaan sampah. (D,W)
\par\pard\qj \li1778\ri1167\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-4\charscalex100
5. Ada bukti identifikasi dan strategi untuk menurunkan risiko infeksi pada
kegiatan \line\tab \up0 \expndtw-5\charscalex100 penyediaan makanan. (D,W)
\par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 234
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg235}
{\bkmkend Pg235}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1157\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 6. Ada bukti identifikasi dan strategi untuk
menurunkan risiko infeksi di kamar \line\tab \up0 \expndtw-7\charscalex100 jenazah.
(D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 7.2 \par\pard\qj
\li1418\ri1166\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menurunkan risiko infeksi dengan melakukan
pembersihan dan sterilisasi \up0 \expndtw-4\charscalex100 peralatan dengan baik
serta mengelola dengan benar. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb105\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 7.2.1
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1217\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Bila
sterilisasi dilakukan melalui kerjasama dengan pihak di luar rumah sakit harus \up0
\expndtw-3\charscalex100 dilakukan oleh lembaga yang memiliki sertifikasi mutu.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 7.2.2
\par\pard\qj \li1418\ri1219\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengidentifikasi dan menerapkan proses
untuk mengelola perbekalan \up0 \expndtw-1\charscalex100 farmasi habis pakai
(\ul0\nosupersub\cf8\f9\fs24 supplies\ul0\nosupersub\cf7\f8\fs24 ) yang sudah
kadaluwarsa dan penggunaan ulang \up0 \expndtw-1\charscalex100 peralatan sekali-
pakai apabila diizinkan oleh peraturan perundang-undangan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb125\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 7.2, PPI 7.2.1 dan PPI 7.2.2
\par\pard\qj \li1418\ri1217\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Risiko infeksi dapat ditekan melalui kegiatan
dekontaminasi,\ul0\nosupersub\cf8\f9\fs24 pre-cleaning\ul0\nosupersub\cf7\f8\fs24
,\ul0\nosupersub\cf8\f9\fs24
cleaning\ul0\nosupersub\cf7\f8\fs24 , \up0 \expndtw0\charscalex100 disinfeksi,
dan sterilisasi. Pembersihan alat kesehatan dilaksanakan sesuai dengan \up0
\expndtw-3\charscalex100 peraturan perundangan-undangan meliputi \par\pard\qj
\li1778\ri1223\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 a)
kritikal, untuk alat kesehatan yang digunakan untuk jaringan steril atau sistem
\line\tab \up0 \expndtw-3\charscalex100 darah dengan menggunakan teknik sterilisasi
seperti instrumen operasi; \par\pard\qj \li1778\ri1221\sb0\sl-320\slmult0\tx2138
\up0 \expndtw-1\charscalex100 b) semikritikal, berkaitan dengan mukosa
menggunakan disinfeksi tingkat tinggi \line\tab \up0 \expndtw-3\charscalex100 (DTT)
seperti\ul0\nosupersub\cf8\f9\fs24 naso gastric tube\ul0\nosupersub\cf7\f8\fs24
(NGT) dan alat endoskopi; \par\pard\qj \li1778\ri1227\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex103 c) nonkritikal, untuk peralatan yang dipergunakan
pada permukaan tubuh \line\tab \up0 \expndtw-3\charscalex100 memakai disinfeksi
tingkat rendah seperti tensimeter dan termometer. \par\pard\qj
\li1418\ri1178\sb300\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Bahan medis habis
pakai (BMHP) yang steril seperti kateter, benang, dan sebagainya \up0
\expndtw0\charscalex104 ditentukan tanggal habis pakainya. Jika waktu habis
pakainya sudah lewat maka \up0 \expndtw0\charscalex100 produsen barang tidak
menjamin sterilitas, keamanan, atau stabilitasnya. Beberapa \up0
\expndtw0\charscalex105 bahan medis habis pakai berisi pernyataan bahwa barang
tetap steril sepanjang \up0 \expndtw-3\charscalex100 kemasan masih utuh tidak
terbuka. \par\pard\qj \li1418\ri1158\sb17\sl-300\slmult0 \up0 \expndtw-
3\charscalex100 Rumah sakit menetapkan regulasi untuk melaksanakan proses mengelola
BMHP yang \up0 \expndtw-4\charscalex100 sudah habis waktu pakainya. \par\pard\qj
\li1418\ri1221\sb4\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Beberapa alat
sekali pakai tertentu dapat digunakan lagi dengan persyaratan spesifik \up0
\expndtw-3\charscalex100 tertentu. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb157\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 235
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg236}
{\bkmkend Pg236}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1220\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan ketentuan tentang penggunaan
kembali alat sekali pakai \up0 \expndtw0\charscalex102 sesuai dengan peraturan
perundang-undangan dan standar profesional, termasuk \up0 \expndtw-3\charscalex100
penetapan meliputi \par\pard\ql \li1778\sb39\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 a) alat dan material yang dapat dipakai kembali; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b) jumlah maksimum
pemakaian ulang dari setiap alat secara spesifik; \par\pard\qj
\li1778\ri1221\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 c)
identifikasi kerusakan akibat pemakaian dan keretakan yang menandakan alat
\line\tab \up0 \expndtw-2\charscalex100 tidak dapat dipakai; \par\pard\qj
\li1778\ri1167\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 d) proses
pembersihan setiap alat yang segera dilakukan sesudah pemakaian dan \line\tab
\up0 \expndtw-4\charscalex100 mengikuti protokol yang jelas; \par\pard\qj
\li1778\ri1221\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 e)
pencantuman identifikasi pasien pada bahan medis habis pakai untuk
\line\tab \up0 \expndtw-3\charscalex100 hemodialisis; \par\pard\ql \li1778\sb17\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 f) pencatatan bahan medis habis pakai
yang\ul0\nosupersub\cf8\f9\fs24 reuse\ul0\nosupersub\cf7\f8\fs24 di rekam
medis; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw0\charscalex103 g)
evaluasi untuk menurunkan risiko infeksi bahan medis habis pakai yang
di-\par\pard\ql \li2138\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf8\f9\fs24 reuse. \par\pard\qj \li2138\ri1158\sb8\sl-
320\slmult0\fi67 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Ada 2
(dua) risiko jika menggunakan lagi (\ul0\nosupersub\cf8\f9\fs24
reuse\ul0\nosupersub\cf7\f8\fs24 ) alat sekali pakai. Terdapat \up0 \expndtw-
3\charscalex100 risiko tinggi terkena infeksi dan juga terdapat risiko kinerja alat
tidak cukup atau \up0 \expndtw-4\charscalex100 tidak dapat terjamin sterilitas
serta fungsinya. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 7.2 \par\pard\qj \li1778\sb0\sl-
320\slmult0 \par\pard\qj\li1778\ri1224\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi
tentang pelayanan sterilisasi sesuai dengan \line\tab \up0 \expndtw-3\charscalex100
peraturan perundang-undangan. (R) \par\pard\ql \li1778\ri1219\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 2. Ada bukti alur
dekontaminasi,\ul0\nosupersub\cf8\f9\fs24
precleaning\ul0\nosupersub\cf7\f8\fs24 ,\ul0\nosupersub\cf8\f9\fs24
cleaning\ul0\nosupersub\cf7\f8\fs24 , disinfeksi, dan sterilisasi \line\tab \up0
\expndtw0\charscalex100 peralatan medis di pusat sterilisasi sudah sesuai dengan
prinsip-prinsip PPI. \line \tab \up0 \expndtw-3\charscalex100 (D,O,W)
\par\pard\qj \li1778\ri1164\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
3. Rumah sakit mengoordinasikan pelayanan sterilisasi dan disinfeksi di luar pusat
\line\tab \up0 \expndtw-4\charscalex100 sterilisasi. (D,O,W) \par\pard\qj
\li1778\ri1225\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Rumah
sakit menjamin proses sterilisasi dan disinfeksi di luar pusat sterilisasi
\line\tab \up0 \expndtw-3\charscalex100 seragam. (D,O,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 7.2.1 \par\pard\ql
\li1778\ri1224\sb308\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Bila sterilisasi dilaksanakan di luar rumah sakit
harus dilakukan oleh lembaga \line\tab \up0 \expndtw0\charscalex100 yang memiliki
sertifikasi mutu dan ada kerjasama yang menjamin kepatuhan \line \tab \up0
\expndtw-3\charscalex100 proses sterilisasi sesuai dengan peraturan perundang-
undangan. (R) \par\pard\qj \li1778\ri1220\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 2. Ada bukti pelaksanaan monitoring kepatuhan PPI dalam
pelayanan sterilisasi \line\tab \up0 \expndtw-3\charscalex100 yang dilaksanakan
oleh pihak luar rumah sakit. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 7.2.2 \par\pard\ql
\li1778\ri1161\sb308\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang penetapan batas kadaluarsa
bahan medis habis pakai \line\tab \up0 \expndtw-3\charscalex100 yang digunakan
kembali (\ul0\nosupersub\cf8\f9\fs24 reuse)\ul0\nosupersub\cf7\f8\fs24 meliputi
butir 1 sampai dengan 7 pada maksud \line \tab \up0 \expndtw-4\charscalex100 dan
tujuan. (R) \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 236
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg237}
{\bkmkend Pg237}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1192\sb214\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 2. Ada bukti monitoring,
evaluasi, dan tindak lanjut pelaksanaan penggunaan \line\tab \up0 \expndtw-
2\charscalex100 kembali (\ul0\nosupersub\cf8\f9\fs24
reuse\ul0\nosupersub\cf7\f8\fs24 ) bahan medis habis pakai sesuai butir 1 sampai
dengan 7 pada \line \tab \up0 \expndtw-3\charscalex100 maksud dan tujuan.
(D,O,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb127\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 7.3 \par\pard\qj
\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1216\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menurunkan risiko
infeksi pada pengelolaan linen/londri dengan benar \up0 \expndtw-3\charscalex100
sesuai dengan peraturan perundang-undangan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb185\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 7.3.1
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1220\sb88\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pengelolan linen/londri dilaksanakan sesuai dengan
prinsip-prinsip pencegahan dan \up0 \expndtw-3\charscalex100 pengendalian infeksi
(PPI). \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 7.3 dan PPI 7.3.1 \par\pard\qj
\li1418\ri1218\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memiliki unit pengelola
linen/londri yang menyelenggarakan \up0 \expndtw0\charscalex100 penatalaksanaan
sesuai dengan peraturan perundang-undangan. Penatalaksanaan \up0 \expndtw-
1\charscalex100 linen kotor dan linen terkontaminasi yang
sudah digunakan harus dilakukan dengan \up0 \expndtw0\charscalex103 benar dan
mencakup penggunaan perlengkapan alat pelindung diri (APD) sesuai \up0 \expndtw-
3\charscalex100 dengan prinsip-prinsip PPI. \par\pard\qj \li1418\ri1218\sb0\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Petugas yang menangani linen kotor dan
linen terkontaminasi harus menggunakan \up0 \expndtw-3\charscalex100 alat pelindung
diri (APD) sesuai dengan peraturan perundang-undangan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 7.3
\par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1204\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Ada unit kerja pengelola linen/londri yang menyelenggarakan penatalaksanaan
\line\tab \up0 \expndtw-3\charscalex100 sesuai dengan peraturan perundang-undangan.
(R) \par\pard\qj \li1778\ri1218\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 2. Bangunan, alur, dan fasilitas laundri sesuai dengan
peraturan perundang-\line\tab \up0 \expndtw-3\charscalex100 undangan. (O,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI
7.3.1 \par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1220\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Ada
regulasi pengelolaan linen/londri sesuai dengan peraturan perundang-\line\tab
\up0 \expndtw-3\charscalex100 undangan. (R) \par\pard\ql \li1778\ri1192\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104 2. Prinsip-prinsip PPI
diterapkan pada pengelolaan linen/londri, termasuk \line\tab \up0 \expndtw-
2\charscalex100 pemilahan, transportasi, pencucian, pengeringan, penyimpanan, dan
distribusi. \line \tab \up0 \expndtw-3\charscalex100 (O,W) \par\pard\qj
\li1778\ri1164\sb17\sl-300\slmult0\tx2138 \up0 \expndtw-3\charscalex100 3. Petugas
pada unit londri menggunakan alat pelindung diri (APD) sesuai dengan \line\tab \up0
\expndtw-4\charscalex100 ketentuan. (O,W) \par\pard\ql \li10156\sb199\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 237
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg238}
{\bkmkend Pg238}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1218\sb214\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 4. Ada bukti pelaksanaan
supervisi dan monitoring oleh IPCN terhadap \line\tab \up0 \expndtw-
2\charscalex100 pengelolaan linen/londri sesuai dengan prinsip PPI termasuk bila
dilaksanakan \line \tab \up0 \expndtw-3\charscalex100 oleh pihak luar rumah sakit.
(D,O,W) \par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb127\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
LIMBAH INFEKSIUS \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar PPI
7.4 \par\pard\qj \li1418\ri1226\sb308\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengurangi risiko
infeksi melalui pengelolaan limbah infeksius dengan \up0 \expndtw-3\charscalex100
benar. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI
7.4.1 \par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1224\sb8\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan pengelolaan kamar mayat dan kamar bedah mayat sesuai \up0 \expndtw-
3\charscalex100 dengan peraturan perundang-undangan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 7.4 dan PPI 7.4.1
\par\pard\qj \li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\ri1157\sb14\sl-
317\slmult0 \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Setiap hari
rumah sakit banyak menghasilkan limbah, termasuk limbah infeksius. \line \up0
\expndtw-3\charscalex100 Pembuangan limbah infeksius dengan tidak benar dapat
menimbulkan risiko infeksi di \line \up0 \expndtw-2\charscalex100 rumah sakit
(lihat juga AP 5.3.1 dan MFK 5.1). Hal ini nyata terjadi pada pembuangan \line \up0
\expndtw0\charscalex100 cairan tubuh dan material terkontaminasi dengan cairan
tubuh, pembuangan darah \line \up0 \expndtw-1\charscalex100 dan komponen darah,
serta pembuangan limbah dari lokasi kamar mayat dan kamar \line \up0
\expndtw0\charscalex100 bedah mayat (\ul0\nosupersub\cf8\f9\fs24 post
mortem\ul0\nosupersub\cf7\f8\fs24 ). (lihat juga AP 5.3.1). Pemerintah mempunyai
regulasi \line \up0 \expndtw-1\charscalex100 terkait dengan penanganan limbah
infeksius dan limbah cair, sedangkan rumah sakit \line \up0 \expndtw-
1\charscalex100 diharapkan melaksanakan ketentuan tersebut sehingga dapat
mengurangi risiko \line \up0 \expndtw-2\charscalex100 infeksi di rumah sakit.
\par\pard\qj \li1418\ri1216\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex103 Rumah
sakit menyelenggaraan pengelolaan limbah dengan benar untuk \up0
\expndtw-3\charscalex100 meminimalkan risiko infeksi melalui kegiatan sebagai
berikut: \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a)
pengelolaan limbah cairan tubuh infeksius; \par\pard\ql \li1778\sb44\sl-276\slmult0
\up0 \expndtw-3\charscalex100 b) penanganan dan pembuangan darah serta komponen
darah; \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c)
pemulasaraan jenazah dan bedah mayat; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 d) pengelolaan limbah cair; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 e) pelaporan pajanan limbah
infeksius. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 7.4 \par\pard\qj \li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1221\sb45\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang
pengelolaan limbah rumah sakit untuk meminimalkan \line\tab \up0
\expndtw0\charscalex100 risiko infeksi yang meliputi butir 1 sampai dengan 5 pada
maksud dan tujuan. \par\pard\ql \li2138\sb40\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 (R) \par\pard\qj \li1778\ri1227\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 2. Pengelolaan limbah cairan tubuh infeksius sesuai
dengan regulasi dan \line\tab \up0 \expndtw-3\charscalex100 dilaksanakan
monitoring, evaluasi, serta tindak lanjutnya. (D,O,W) \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb50\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 238
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg239}
{\bkmkend Pg239}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1226\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf7\f8\fs24 3. Penanganan dan pembuangan darah serta komponen
darah sesuai dengan \line\tab \up0 \expndtw-2\charscalex100 regulasi dan
dilaksanakan monitoring, evaluasi, juga tindak lanjutnya. (D,O,W) \par\pard\ql
\li1778\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4. Pengelolaan limbah
cair sesuai dengan regulasi. (D,O,W) \par\pard\qj \li1778\ri1225\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 5. Pelaporan pajanan limbah
infeksius sesuai dengan regulasi dan dilaksanakan \line\tab \up0 \expndtw-
3\charscalex100 monitoring, evaluasi, serta tindak lanjutnya. (D,O,W)
\par\pard\qj \li1778\ri1222\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
6. Ada bukti penanganan (\ul0\nosupersub\cf8\f9\fs24
handling\ul0\nosupersub\cf7\f8\fs24 ) serta pembuangan darah dan komponen \line\tab
\up0 \expndtw-3\charscalex100 darah sudah dikelola sesuai dengan peraturan
perundang-undangan. (O,W) \par\pard\qj \li1778\ri1226\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex104 7. Ada bukti pelaksanaan supervisi dan monitoring
terhadap kegiatan butir 1 \line\tab \up0 \expndtw-3\charscalex100 sampai dengan 5
pada maksud dan tujuan. (D,O,W) \par\pard\ql \li1778\ri1222\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 8. Bila pengelolaan
limbah dilaksanakan oleh pihak luar rumah sakit harus \line\tab \up0
\expndtw-1\charscalex100 berdasar atas kerjasama dengan pihak yang memiliki izin
dan sertifikasi mutu \line \tab \up0 \expndtw-2\charscalex100 sesuai dengan
peraturan perundang-undangan. (lihat MFK 5.1 EP 4). (D,O,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 7.4.1 \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Pemulasaraan jenazah dan bedah
mayat sesuai dengan regulasi. (D,O,W) \par\pard\qj \li1778\ri1165\sb25\sl-
300\slmult0\tx2138 \up0 \expndtw-4\charscalex100 2. Ada bukti kegiatan kamar mayat
dan kamar bedah mayat sudah dikelola sesuai \line\tab \up0 \expndtw-
5\charscalex100 dengan peraturan perundang-undangan. (O,W) \par\pard\qj
\li1778\ri1167\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3. Ada
bukti pelaksanaan monitoring, evaluasi, dan tindak lanjut kepatuhan
\line\tab \up0 \expndtw-3\charscalex100 prinsip-prinsip PPI sesuai dengan
peraturan perundang-undangan. (D,W )
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb125\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PPI 7.5 \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan pengelolaan limbah benda tajam
dan jarum secara aman. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 7.5 \par\pard\qj
\li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\ri1160\sb17\sl-315\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Salah satu bahaya luka karena
tertusuk jarum suntik adalah terjadi penularan penyakit \up0
\expndtw0\charscalex100 melalui darah (\ul0\nosupersub\cf8\f9\fs24 blood borne
diseases\ul0\nosupersub\cf7\f8\fs24 ). Pengelolaan limbah benda tajam dan
jarum \up0 \expndtw0\charscalex100 yang tidak benar merupakan kekhawatiran staf
terhadap keamanannya. Kebiasaan \up0 \expndtw-1\charscalex100 bekerja sangat
memengaruhi timbulnya risiko menderita luka dan kemungkinan \up0 \expndtw-
3\charscalex100 terpapar penyakit secara potensial. \par\pard\qj \li1418\sb0\sl-
317\slmult0 \par\pard\qj\li1418\ri1158\sb7\sl-317\slmult0 \up0
\expndtw0\charscalex100 Identifikasi dan melaksanakan kegiatan praktik berdasar
atas bukti sahih (\ul0\nosupersub\cf8\f9\fs24 evidence \line \up0 \expndtw-
1\charscalex100 based\ul0\nosupersub\cf7\f8\fs24 ) menurunkan risiko luka karena
tertusuk jarum dan benda tajam. Rumah sakit \line \up0 \expndtw0\charscalex100
perlu mengadakan edukasi kepada staf bagaimana mengelola dengan aman benda \line
\up0 \expndtw0\charscalex103 tajam dan jarum. Pembuangan yang benar adalah dengan
menggunakan wadah \line \up0 \expndtw-3\charscalex100 menyimpan khusus
(\ul0\nosupersub\cf8\f9\fs24 safety box\ul0\nosupersub\cf7\f8\fs24 ) yang dapat
ditutup, antitertusuk, dan antibocor baik di \line \up0 \expndtw0\charscalex103
dasar maupun di sisinya sesuai dengan peraturan perundangan. Wadah ini harus
\line \up0 \expndtw0\charscalex102 tersedia dan mudah dipergunakan oleh staf serta
wadah tersebut tidak boleh terisi \line \up0 \expndtw-3\charscalex100 terlalu
penuh. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb117\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 239
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg240}
{\bkmkend Pg240}\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1210\sb195\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pembuangan jarum yang tidak terpakai, pisau bedah
(\ul0\nosupersub\cf8\f9\fs24 scalpel\ul0\nosupersub\cf7\f8\fs24 ), dan limbah benda
\line \up0 \expndtw0\charscalex102 tajam lainnya jika tidak dilakukan dengan benar
akan berisiko terhadap kesehatan \line \up0 \expndtw0\charscalex100 masyarakat
umumnya dan terutama pada mereka yang bekerja di pengelolaan \line \up0
\expndtw0\charscalex104 sampah. Pembuangan wadah berisi limbah benda tajam di
laut, misalnya akan \line \up0 \expndtw-2\charscalex100 menyebabkan risiko pada
masyarakat karena wadah dapat rusak atau terbuka. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Rumah sakit menetapkan regulasi yang memadai mencakup \par\pard\ql
\li1778\ri1162\sb16\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 a)
semua tahapan proses termasuk identifikasi jenis dan penggunaan wadah
\line\tab \up0 \expndtw-3\charscalex100 secara tepat, pembuangan wadah, dan
surveilans proses pembuangan. (lihat \line \tab \up0 \expndtw-4\charscalex100
juga ARK 6); \par\pard\ql \li1778\sb39\sl-276\slmult0 \up0 \expndtw-3\charscalex100
b) laporan tertusuk jarum dan benda tajam. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 7.5 \par\pard\ql \li1778\sb0\sl-
320\slmult0 \par\pard\ql\li1778\ri1204\sb8\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
regulasi tentang pengelolaan benda tajam dan jarum \line\tab \up0 \expndtw-
2\charscalex100 untuk menurunkan cedera serta mengurangi risiko infeksi yang
meliputi butir 1 \line \tab \up0 \expndtw-3\charscalex100 sampai dengan 3 yang ada
pada maksud dan tujuan. (R) \par\pard\ql \li1778\ri1218\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex102 2. Benda tajam dan
jarum sudah dikumpulkan, disimpan di dalam wadah yang \line\tab \up0
\expndtw0\charscalex102 tidak tembus, tidak bocor, berwarna kuning, diberi
label infeksius, dan \line \tab \up0 \expndtw0\charscalex103 dipergunakan hanya
sekali pakai sesuai dengan peraturan perundang-\line \tab \up0 \expndtw-
3\charscalex100 undangan. (O,W) \par\pard\qj \li1778\ri1229\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex103 3. Pengelolaan benda tajam dan
jarum dilaksanakan sesuai dengan regulasi. \line\tab \up0 \expndtw-2\charscalex100
(O,W) \par\pard\ql \li1778\ri1218\sb0\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 4. Bila pengelolaan benda tajam dan jarum dilaksanakan
oleh pihak luar rumah \line\tab \up0 \expndtw0\charscalex105 sakit harus berdasar
atas kerjasama dengan pihak yang memiliki izin dan \line \tab \up0 \expndtw-
3\charscalex100 sertifikasi mutu sesuai dengan peraturan perundang-undangan.
(D,O,W) \par\pard\qj \li1778\ri1218\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 5. Ada bukti data dokumen limbah benda tajam dan jarum. (lihat
juga di PPI 7.2). \line\tab \up0 \expndtw-3\charscalex100 (D,W) \par\pard\ql
\li1778\ri1224\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105 6.
Ada bukti pelaksanaan supervisi dan monitoring oleh IPCN terhadap \line\tab
\up0 \expndtw-1\charscalex100 pengelolaan benda tajam dan jarum sesuai dengan
prinsip PPI, termasuk bila \line \tab \up0 \expndtw-3\charscalex100 dilaksanakan
oleh pihak luar rumah sakit. (D,O,W) \par\pard\ql \li1778\sb28\sl-276\slmult0
\up0 \expndtw-3\charscalex100 7. Ada bukti pelaksanaan monitoring kepatuhan
prinsip-prinsip PPI. (D,W) \par\pard\ql \li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PELAYANAN
MAKANAN \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PPI 7.6 \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengurangi risiko infeksi
terkait penyelenggaraan pelayanan makanan. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb57\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 240
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg241}
{\bkmkend Pg241}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 7.6
\par\pard\qj \li1418\ri1165\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Penyimpanan dan persiapan makanan dapat
menimbulkan penyaklit seperti \line \up0 \expndtw-2\charscalex100 keracunan
makanan atau infeksi makanan. Penyakit yang berhubungan dengan \line \up0
\expndtw-3\charscalex100 makanan dapat sangat berbahaya bahkan mengancam jiwa pada
pasien yang kondisi \line \up0 \expndtw-2\charscalex100 tubuhnya sudah lemah karena
penyakit atau cedera. Rumah sakit harus memberikan \line \up0
\expndtw0\charscalex102 makanan dan juga produk nutrisi dengan aman, yaitu
melakukan peyimpanan dan \line \up0 \expndtw0\charscalex100 penyiapan makanan
pada suhu tertentu yang dapat mencegah perkembangan \line \up0 \expndtw-
3\charscalex100 bakteri. \par\pard\qj \li1418\ri1158\sb303\sl-317\slmult0 \up0
\expndtw-3\charscalex100 Kontaminasi silang, terutama dari makanan mentah ke
makanan yang sudah dimasak \up0 \expndtw-3\charscalex100 adalah salah satu sumber
infeksi makanan. Kontaminasi silang dapat juga disebabkan \up0
\expndtw0\charscalex104 oleh tangan yang terkontaminasi, permukaan meja, papan alas
untuk memotong \up0 \expndtw-2\charscalex100 makanan, ataupun kain yang
digunakan untuk mengelap permukaan meja atau \up0 \expndtw-1\charscalex100
mengeringkan piring. Selain itu, permukaan yang digunakan untuk
menyiapkan \up0 \expndtw-1\charscalex100 makanan; alat makan, perlengkapan masak,
panci, dan wajan yang digunakan untuk \up0 \expndtw0\charscalex102 menyiapkan
makanan; dan juga nampan, piring, serta alat makan yang digunakan \up0 \expndtw-
1\charscalex100 untuk menyajikan makanan juga dapat menimbulkan risiko
infeksi apabila tidak \up0 \expndtw-2\charscalex100 dibersihkan dan disanitasi
secara tepat. \par\pard\qj \li1418\ri1224\sb1\sl-320\slmult0 \up0
\expndtw0\charscalex104 Bangunan dapur harus sesuai dengan ketentuan yang meliputi
alur mulai bahan \up0 \expndtw-1\charscalex100 makanan masuk sampai makanan jadi
keluar, tempat penyimpanan bahan makanan \up0 \expndtw0\charscalex102 kering dan
basah
dengan temperatur yang dipersyaratkan, tempat persiapan \up0 \expndtw-
1\charscalex100 pengolahan, tempat pengolahan, pembagian dan distribusi sesuai
dengan peraturan \up0 \expndtw-3\charscalex100 dan perundangan termasuk kebersihan
lantai. \par\pard\qj \li1418\ri1228\sb300\sl-320\slmult0\fi67 \up0 \expndtw-
2\charscalex100 Berdasar atas hal tersebut di atas maka rumah sakit agar menetapkan
regulasi yang \up0 \expndtw-3\charscalex100 meliputi \par\pard\ql
\li1778\ri1160\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 a)
pelayanan makanan di rumah sakit mulai dari pengelolaan bahan makanan, \line\tab
\up0 \expndtw-3\charscalex100 sanitasi dapur, makanan, alat masak, serta alat makan
untuk mengurangi risiko \line \tab \up0 \expndtw-4\charscalex100 infeksi dan
kontaminasi silang; \par\pard\ql \li1778\ri1220\sb9\sl-310\slmult0\tx2138\tx2138
\up0 \expndtw0\charscalex100 b) standar bangunan, fasilitas dapur,
dan\ul0\nosupersub\cf8\f9\fs24 pantry\ul0\nosupersub\cf7\f8\fs24 sesuai dengan
peraturan \line\tab \up0 \expndtw0\charscalex102 perundangan termasuk bila makanan
diambil dari sumber lain di luar rumah \line \tab \up0 \expndtw-3\charscalex100
sakit. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb83\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 7.6 \par\pard\qj \li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\ri1218\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi
tentang pelayanan makanan di rumah sakit \line\tab \up0 \expndtw-3\charscalex100
yang meliputi butir 1 dan 2 yang ada pada maksud dan tujuan. (R ) \par\pard\ql
\li1778\ri1160\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 2.
Ada bukti pelaksanaan yang penyimpanan bahan makanan, pengolahan,
\line\tab \up0 \expndtw-3\charscalex100 pembagian/pemorsian, dan distribusi makanan
sudah sesuai dengan peraturan \line \tab \up0 \expndtw-4\charscalex100 perundang-
undangan. (O,W) \par\pard\ql \li1778\ri1166\sb2\sl-320\slmult0\tx2138\tx2138
\up0 \expndtw-1\charscalex100 3. Ada bukti pelaksanaan penyimpanan makanan dan
produk nutrisi dengan \line\tab \up0 \expndtw0\charscalex100 memperhatikan
kesehatan lingkungan meliputi sanitasi, suhu, pencahayaan, \line \tab \up0
\expndtw-3\charscalex100 kelembapan, ventilasi, dan keamanan untuk mengurangi
risiko infeksi. (O,W) \par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 241
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg242}
{\bkmkend Pg242}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1160\sb253\sl-300\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 4. Ada bukti pelaksanaan monitoring
kepatuhan prinsip-prinsip PPI sesuai dengan \line\tab \up0 \expndtw-4\charscalex100
peraturan perundang-undangan. (D,W ) \par\pard\ql \li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb152\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 RISIKO
KONSTRUKSI \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PPI 7.7 \par\pard\qj
\li1418\ri1211\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menurunkan risiko infeksi pada
fasilitas yang terkait dengan \up0 \expndtw0\charscalex100 pengendalian mekanis
dan teknis (\ul0\nosupersub\cf8\f9\fs24 mechanical\ul0\nosupersub\cf7\f8\fs24
dan\ul0\nosupersub\cf8\f9\fs24 enginering controls\ul0\nosupersub\cf7\f8\fs24 )
serta pada \up0 \expndtw-3\charscalex100 saat melakukan pembongkaran, konstruksi,
dan renovasi gedung. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 7.7 \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0\tx5418 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pengendalian mekanis dan teknis \tab
\up0 \expndtw-1\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
mechanical\ul0\nosupersub\cf7\f8\fs24 dan\ul0\nosupersub\cf8\f9\fs24 enginering
controls\ul0\nosupersub\cf7\f8\fs24 ) seperti \par\pard\qj \li1418\ri1182\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex102 sistem ventilasi bertekanan
positif,\ul0\nosupersub\cf8\f9\fs24 biological safety
cabinet\ul0\nosupersub\cf7\f8\fs24 ,\ul0\nosupersub\cf8\f9\fs24 laminary airflow
hood\ul0\nosupersub\cf7\f8\fs24 , \line \up0 \expndtw-2\charscalex100 termostat di
lemari pendingin, serta pemanas air untuk sterilisasi piring dan alat dapur
\line \up0 \expndtw-2\charscalex100 adalah contoh peran penting standar
pengendalian lingkungan harus diterapkan agar \line \up0 \expndtw0\charscalex104
dapat diciptakan sanitasi yang baik yang selanjutnya mengurangi risiko infeksi
di \line \up0 \expndtw-3\charscalex100 rumah sakit. \par\pard\qj \li1418\sb0\sl-
317\slmult0 \par\pard\qj\li1418\ri1159\sb6\sl-317\slmult0 \up0 \expndtw-
1\charscalex100 Pembongkaran, konstruksi, renovasi gedung di area mana saja di
rumah sakit dapat \line \up0 \expndtw0\charscalex100 merupakan sumber infeksi.
Pemaparan terhadap debu dan kotoran konstruksi, \line \up0
\expndtw0\charscalex102 kebisingan, getaran, kotoran, dan bahaya lain dapat
merupakan bahaya potensial \line \up0 \expndtw0\charscalex100 terhadap fungsi
paru paru serta keamanan staf dan pengunjung. Rumah sakit \line \up0
\expndtw0\charscalex103 meggunakan kriteria risiko untuk menangani dampak renovasi
dan pembangunan \line \up0 \expndtw-1\charscalex100 gedung baru, terhadap
persyaratan mutu udara, pencegahan dan pengendalian \line \up0 \expndtw-
4\charscalex100 infeksi, standar peralatan, syarat kebisingan, getaran, dan
prosedur darurat. (lihat juga \line \up0 \expndtw-5\charscalex100 MFK 4)
\par\pard\qj \li1418\ri1219\sb301\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Untuk menurunkan risiko infeksi maka rumah sakit perlu mempunyai regulasi
tentang \up0 \expndtw-2\charscalex100 penilaian risiko pengendalian infeksi
(\ul0\nosupersub\cf8\f9\fs24 infection control risk
assessment\ul0\nosupersub\cf7\f8\fs24 / ICRA) untuk \up0 \expndtw-1\charscalex100
pembongkaran, konstruksi, serta renovasi gedung di area mana saja di rumah
sakit \up0 \expndtw-2\charscalex100 yang meliputi \par\pard\ql \li1598\sb37\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 1) identifikasi tipe/jenis konstruksi
kegiatan proyek dengan kriteria; \par\pard\ql \li1624\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 2) identifikasi kelompok risiko pasien; \par\pard\qj
\li1624\ri1228\sb8\sl-320\slmult0\tx1984 \up0 \expndtw0\charscalex100 3) matriks
pengendalian infeksi antara kelompok risiko pasien dan tipe kontruksi \line\tab
\up0 \expndtw-3\charscalex100 kegiatan; \par\pard\ql \li1624\sb17\sl-276\slmult0
\up0 \expndtw-3\charscalex100 4) proyek untuk menetapkan kelas/tingkat infeksi;
\par\pard\ql \li1624\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100 5) tindak
pengendalian infeksi berdasar atas tingkat/kelas infeksi; \par\pard\ql
\li1624\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 6) monitoring
pelaksanaan. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb144\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 242
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg243}
{\bkmkend Pg243}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1160\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Karena itu, rumah sakit agar mempunyai
regulasi\ul0\nosupersub\cf8\f9\fs24 pengendalian mekanis dan teknis \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (\ul0\nosupersub\cf8\f9\fs24
mechanical\ul0\nosupersub\cf7\f8\fs24 dan\ul0\nosupersub\cf8\f9\fs24 engineering
controls\ul0\nosupersub\cf7\f8\fs24 ) fasilitas yang antara lain meliputi
\par\pard\ql \li1778\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a) sistem
ventilasi bertekanan positif; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 b)\ul0\nosupersub\cf8\f9\fs24 biological safety
cabinet\ul0\nosupersub\cf7\f8\fs24 ; \par\pard\ql \li1778\sb44\sl-276\slmult0
\up0 \expndtw-2\charscalex100 c)\ul0\nosupersub\cf8\f9\fs24 laminary airflow
hood\ul0\nosupersub\cf7\f8\fs24 ; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 d) termostat di lemari pendingin; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e) pemanas air untuk
sterilisasi piring dan alat dapur. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 7.7 \par\pard\ql
\li1778\ri1160\sb308\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex106
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi pengendalian
mekanis dan teknis \line\tab \up0 \expndtw0\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 mechanical dan engineering
control\ul0\nosupersub\cf7\f8\fs24 ) minimal untuk fasilitas yang tercantum
\line \tab \up0 \expndtw-4\charscalex100 pada butir 1 sampai dengan 5 yang ada
pada maksud dan tujuan. (R) \par\pard\ql \li1778\ri1190\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 2. Rumah sakit menetapkan
regulasi tentang penilaian risiko pengendalian infeksi \line\tab \up0
\expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 infection control risk
assessment\ul0\nosupersub\cf7\f8\fs24
/ICRA) yang minimal meliputi butir 1 sampai \line \tab \up0 \expndtw-
3\charscalex100 dengan 6 yang ada pada maksud dan tujuan. (R) \par\pard\ql
\li1778\ri1158\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 3.
Fasilitas yang tercantum pada butir 1 sampai dengan 5 sudah dilakukan
\line\tab \up0 \expndtw-4\charscalex100 pengendalian mekanis dan teknis
(\ul0\nosupersub\cf8\f9\fs24 mechanical\ul0\nosupersub\cf7\f8\fs24
dan\ul0\nosupersub\cf8\f9\fs24 engineering control\ul0\nosupersub\cf7\f8\fs24 ).
(D, O, \line \tab \up0 \expndtw-5\charscalex100 W) \par\pard\ql
\li1778\ri1222\sb2\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104 4.
Rumah sakit telah melaksanakan penilaian risiko pengendalian infeksi
\line\tab \up0 \expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 infection
control risk assessment\ul0\nosupersub\cf7\f8\fs24 /ICRA) pada semua renovasi,
kontruksi dan \line \tab \up0 \expndtw-3\charscalex100 demolisi sesuai dengan
regulasi. (D,O,W) \par\pard\ql \li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 TRANSMISI
INFEKSI \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar PPI 8 \par\pard\qj
\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1155\sb8\sl-320\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyediakan alat
pelindung diri untuk kewaspadaan (\ul0\nosupersub\cf8\f9\fs24 barrier
precautions\ul0\nosupersub\cf7\f8\fs24 ) \line \up0 \expndtw-3\charscalex100 dan
prosedur isolasi yang melindungi pasien, pengunjung, dan staf dari penyakit
\par\pard\li1418\sb44\sl-276\slmult0\fi0\tx5069\tx8568 \up0 \expndtw0\charscalex102
menular serta melindungi\tab \up0 \expndtw0\charscalex102 pasien yang
mengalami\tab \up0 \expndtw0\charscalex102 imunitas rendah\par\pard\ql
\li1418\sb37\sl-276\slmult0 \up0 \expndtw-4\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 immunocompromised\ul0\nosupersub\cf7\f8\fs24 ) dari
infeksi yang rentan mereka alami. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar PPI 8.1 \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1216\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan penempatan dan proses transfer
pasien dengan\ul0\nosupersub\cf8\f9\fs24 airborne \up0 \expndtw-3\charscalex100
diseases\ul0\nosupersub\cf7\f8\fs24 di dalam rumah sakit dan keluar rumah
sakit. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI
8.2 \par\pard\qj \li1418\ri1165\sb308\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan penempatan
pasien infeksi \u8220?\ul0\nosupersub\cf8\f9\fs24 air
borne\ul0\nosupersub\cf7\f8\fs24 \u8221? dalam waktu singkat \up0
\expndtw0\charscalex100 jika rumah sakit tidak mempunyai kamar dengan tekanan
negatif (ventilasi alamiah \up0 \expndtw-3\charscalex100 dan mekanik). \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 8.3 \par\pard\ql
\li10156\sb243\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 243
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg244}
{\bkmkend Pg244}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1225\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengembangkan dan menerapkan sebuah proses
untuk menangani \up0 \expndtw-3\charscalex100 lonjakan mendadak
(\ul0\nosupersub\cf8\f9\fs24 outbreak\ul0\nosupersub\cf7\f8\fs24 ) penyakit
infeksi\ul0\nosupersub\cf8\f9\fs24 air borne\ul0\nosupersub\cf7\f8\fs24 .
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 8,
PPI 8.1, PPI 8.2, dan PPI 8.3 \par\pard\qj \li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1159\sb17\sl-315\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan regulasi isolasi dan pemberian
penghalang pengaman serta \up0 \expndtw0\charscalex103 menyediakan fasilitasnya.
Regulasi ditetapkan berdasar atas bagaimana penyakit \up0 \expndtw-2\charscalex100
menular dan cara menangani pasien infeksius atau
pasien\ul0\nosupersub\cf8\f9\fs24 immuno-
suppressed\ul0\nosupersub\cf7\f8\fs24 . \up0 \expndtw0\charscalex102 Regulasi
isolasi juga memberikan perlindungan kepada staf dan pengunjung serta \up0
\expndtw-3\charscalex100 lingkungan pasien. (lihat juga PP 3) \par\pard\qj
\li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1214\sb9\sl-316\slmult0 \up0
\expndtw0\charscalex100 Kewaspadaan terhadap udara penting untuk mencegah penularan
bakteri infeksius \line \up0 \expndtw0\charscalex104 yang dapat bertahan lama di
udara. Pasien dengan infeksi \u8220?\ul0\nosupersub\cf8\f9\fs24
airborne\ul0\nosupersub\cf7\f8\fs24 \u8221? sebaiknya \line \up0 \expndtw-
2\charscalex100 ditempatkan di kamar dengan tekanan negatif
(\ul0\nosupersub\cf8\f9\fs24 negative pressure room\ul0\nosupersub\cf7\f8\fs24 ).
Jika struktur \line \up0 \expndtw0\charscalex100 bangunan tidak memungkinkan
membangun ruangan dengan tekanan negatif maka \line \up0 \expndtw-1\charscalex100
rumah sakit dapat mengalirkan udara lewat sistem penyaring HEPA
(\ul0\nosupersub\cf8\f9\fs24 high effieciency \line \up0 \expndtw-1\charscalex100
particulate air\ul0\nosupersub\cf7\f8\fs24 ) pada tingkat paling sedikit 12 kali
pertukaran udara per jam. \par\pard\qj \li1418\ri1218\sb1\sl-320\slmult0 \up0
\expndtw0\charscalex102 Rumah sakit sebaiknya menetapkan program untuk menangani
pasien infeksi \u8220?\ul0\nosupersub\cf8\f9\fs24 air \line \up0
\expndtw0\charscalex102 borne\ul0\nosupersub\cf7\f8\fs24 \u8221? dalam waktu
singkat jika sistem HEPA tidak ada, termasuk jika ada banyak \line \up0 \expndtw-
1\charscalex100 pasien masuk menderita infeksi menular. Pembersihan kamar dengan
benar setiap \line \up0 \expndtw0\charscalex100 hari selama pasien tinggal di rumah
sakit dan pembersihan kembali setelah pasien \line \up0 \expndtw0\charscalex103
keluar pulang harus dilakukan sesuai dengan standar atau pedoman pengedalian
\line \up0 \expndtw-3\charscalex100 infeksi. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb105\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 8 \par\pard\qj \li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\ri1221\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
regulasi penempatan pasien dengan penyakit \line\tab \up0 \expndtw-
2\charscalex100 menular dan pasien yang mengalami imunitas rendah
(\ul0\nosupersub\cf8\f9\fs24 immunocompromised\ul0\nosupersub\cf7\f8\fs24 ).
\par\pard\ql \li2138\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 (R)
\par\pard\li1778\sb47\sl-276\slmult0\fi0 \up0 \expndtw0\charscalex100 2. Rumah
sakit menyediakan ruangan untuk pasien yang mengalami
imunitas\par\pard\li1778\sb39\sl-276\slmult0\fi360\tx3118\tx9263 \up0
\expndtw0\charscalex100 rendah\tab \up0 \expndtw0\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 immunocompromised\ul0\nosupersub\cf7\f8\fs24 )
sesuai dengan peraturan\tab \up0 \expndtw0\charscalex100
perundang-\par\pard\li1778\sb43\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex100
undangan. (O,W)\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb71\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 8.1 \par\pard\qj \li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\ri1222\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
regulasi penempatan dan proses transfer pasien \line\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 airborne
diseases\ul0\nosupersub\cf7\f8\fs24 di dalam rumah sakit dan keluar rumah sakit.
(R) \par\pard\ql \li1778\ri1220\sb9\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 2. Penempatan dan transfer
pasien\ul0\nosupersub\cf8\f9\fs24 airborne diseases\ul0\nosupersub\cf7\f8\fs24
sesuai dengan peraturan \line\tab \up0 \expndtw0\charscalex102 perundang-undangan
termasuk di ruang gawat darurat dan ruang lainnya. \line \tab \up0 \expndtw-
2\charscalex100 (O,W) \par\pard\ql \li1778\ri1205\sb2\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105 3. Ada bukti pelaksanaan
supervisi dan monitoring oleh IPCN terhadap \line\tab \up0 \expndtw-
2\charscalex100 penempatan dan proses transfer
pasien\ul0\nosupersub\cf8\f9\fs24 airborne diseases\ul0\nosupersub\cf7\f8\fs24
sesuai dengan \line \tab \up0 \expndtw-3\charscalex100 prinsip PPI. (D,O,W)
\par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 244
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg245}
{\bkmkend Pg245}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb92\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 8.2 \par\pard\ql \li1778\sb0\sl-320\slmult0
\par\pard\ql\li1778\ri1158\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi
penempatan pasien infeksi \u8220?\ul0\nosupersub\cf8\f9\fs24
air borne\ul0\nosupersub\cf7\f8\fs24 \u8221? dalam \line\tab \up0 \expndtw-
2\charscalex100 waktu singkat jika rumah sakit tidak mempunyai kamar dengan tekanan
negatif \line \tab \up0 \expndtw-3\charscalex100 (ventilasi alamiah dan mekanik).
(R) \par\pard\ql \li1778\ri1221\sb6\sl-313\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex102 2. Penempatan pasien infeksi
\u8220?\ul0\nosupersub\cf8\f9\fs24 air borne\ul0\nosupersub\cf7\f8\fs24 \u8221?
dalam waktu singkat jika rumah sakit \line\tab \up0 \expndtw0\charscalex102 tidak
mempunyai kamar dengan tekanan negatif sesuai dengan peraturan \line \tab \up0
\expndtw0\charscalex102 perundang-undangan termasuk di ruang gawat darurat dan
ruang lainnya. \line \tab \up0 \expndtw-2\charscalex100 (O,W) \par\pard\ql
\li1778\ri1156\sb2\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105 3.
Ada bukti pelaksanaan supervisi dan monitoring oleh IPCN terhadap \line\tab
\up0 \expndtw-3\charscalex100 penempatan pasien infeksi\ul0\nosupersub\cf8\f9\fs24
air borne\ul0\nosupersub\cf7\f8\fs24 dalam waktu singkat jika rumah sakit tidak
\line \tab \up0 \expndtw-3\charscalex100 mempunyai kamar dengan tekanan negatif
sesuai dengan prinsip PPI. (D,O,W) \par\pard\qj \li1778\ri1227\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex103 4. Ada bukti pelaksanaan
monitoring ruang tekanan negatif dan penempatan \line\tab \up0 \expndtw-
3\charscalex100 pasien secara rutin. (D,O,W) \par\pard\ql \li1778\ri1225\sb9\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 5. Ada bukti dilakukan
edukasi kepada staf tentang pengelolaan pasien infeksius \line\tab \up0
\expndtw0\charscalex100 jika terjadi lonjakan pasien masuk dengan penyakit menular
atau rumah sakit \line \tab \up0 \expndtw-1\charscalex100 tidak mempunyai kamar
dengan tekanan negatif \up0 \expndtw-1\charscalex100 (ventilasi alamiah dan
\par\pard\ql \li2138\sb39\sl-276\slmult0 \up0 \expndtw-3\charscalex100 mekanik).
(D,W) \par\pard\qj \li1778\ri1219\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 6. Rumah sakit mempunyai jejaring rujukan dengan rumah sakit lain
untuk pasien \line\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24
air borne disease.\ul0\nosupersub\cf7\f8\fs24 (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 8.3
\par\pard\li1778\sb0\sl-276\slmult0\par\pard\li1778\sb86\sl-
276\slmult0\fi0\tx9391 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Rumah sakit menetapkan regulasi bila terjadi ledakan pasien\tab \up0
\expndtw-1\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
outbreak\ul0\nosupersub\cf7\f8\fs24 )\par\pard\li1778\sb41\sl-276\slmult0\fi360
\up0 \expndtw-1\charscalex100 penyakit infeksi\ul0\nosupersub\cf8\f9\fs24 air
borne.\ul0\nosupersub\cf7\f8\fs24 (R)\par\pard\qj \li1778\ri1160\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 2. Rumah sakit menyediakan ruang
isolasi dengan tekanan negatif bila terjadi \line\tab \up0 \expndtw-4\charscalex100
ledakan pasien (\ul0\nosupersub\cf8\f9\fs24 outbreak\ul0\nosupersub\cf7\f8\fs24 )
sesuai dengan peraturan perundangan. (O,W) \par\pard\qj \li1778\ri1226\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Ada bukti dilakukan edukasi
kepada staf tentang pengelolaan pasien infeksius \line\tab \up0 \expndtw-
2\charscalex100 jika terjadi ledakan pasien (\ul0\nosupersub\cf8\f9\fs24
outbreak\ul0\nosupersub\cf7\f8\fs24 ) penyakit infeksi\ul0\nosupersub\cf8\f9\fs24
air borne\ul0\nosupersub\cf7\f8\fs24 . (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb98\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 9
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1225\sb8\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Kebersihan
tangan menggunakan sabun dan desinfektan adalah sarana efektif untuk \up0 \expndtw-
3\charscalex100 mencegah dan mengendalikan infeksi. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 9.1 \par\pard\qj
\li1418\ri1191\sb308\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Sarung tangan, masker, pelindung mata, serta alat
pelindung diri lainnya tersedia dan \up0 \expndtw-3\charscalex100 digunakan secara
tepat apabila disyaratkan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 9 dan PPI 9.1 \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb57\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 245
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg246}
{\bkmkend Pg246}\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\sb0\sl-
316\slmult0 \par\pard\qj\li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\ri1163\sb191\sl-316\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kebersihan tangan, menggunakan alat pelindung diri,
serta disinfektan adalah sarana \up0 \expndtw-2\charscalex100 efektif untuk
mencegah dan mengendalikan infeksi. Oleh karena itu, harus tersedia di \up0
\expndtw-4\charscalex100 setiap tempat asuhan pasien yang membutuhkan barang ini.
Rumah sakit menetapkan \up0 \expndtw-2\charscalex100 ketentuan tentang tempat di
mana alat pelindung diri ini harus tersedia dan dilakukan \up0 \expndtw-
3\charscalex100 pelatihan cara memakainya. Sabun, disinfektan, handuk/tissu, serta
alat lainnya untuk \up0 \expndtw-2\charscalex100 mengeringkan ditempatkan di
lokasi tempat cuci tangan dan prosedur disinfeksi \up0 \expndtw-
3\charscalex100 tangan dilakukan. (lihat juga SKP 5 dan ARK 6) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 9 \par\pard\ql
\li1778\ri1219\sb308\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
regulasi\ul0\nosupersub\cf8\f9\fs24 hand hygiene\ul0\nosupersub\cf7\f8\fs24 yang
mencakup kapan, di \line\tab \up0 \expndtw-1\charscalex100 mana, dan bagaimana
melakukan cuci tangan mempergunakan sabun (\ul0\nosupersub\cf8\f9\fs24 hand
\line \tab \up0 \expndtw0\charscalex102 wash\ul0\nosupersub\cf7\f8\fs24 ) dan atau
dengan disinfektan (\ul0\nosupersub\cf8\f9\fs24 hand
rubs\ul0\nosupersub\cf7\f8\fs24 ) serta ketersediaan fasilitas \line \tab \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 hand
hygiene.\ul0\nosupersub\cf7\f8\fs24 (R) \par\pard\qj \li1778\ri1218\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex104 2. Sabun, disinfektan, serta
tissu/handu\ul0\nosupersub\cf8\f9\fs24 k\ul0\nosupersub\cf7\f8\fs24 sekali pakai
tersedia di tempat cuci \line\tab \up0 \expndtw-3\charscalex100 tangan dan tempat
melakukan disinfeksi tangan. (O) \par\pard\ql \li1778\sb17\sl-276\slmult0 \up0
\expndtw-3\charscalex100 3.\ul0\nosupersub\cf8\f9\fs24 Hand
hygiene\ul0\nosupersub\cf7\f8\fs24 sudah dilaksanakan dengan baik. (S,O)
\par\pard\qj \li1778\ri1223\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
4. Ada bukti pelaksanaan pelatihan\ul0\nosupersub\cf8\f9\fs24 hand
hygiene\ul0\nosupersub\cf7\f8\fs24 kepada semua pegawai \line\tab \up0
\expndtw-3\charscalex100 termasuk tenaga kontrak. (D,W) \par\pard\ql
\li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian PPI 9.1
\par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1168\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Rumah sakit menetapkan regulasi penggunaan alat pelindung diri, tempat yang
\line\tab \up0 \expndtw-3\charscalex100 harus menyediakan alat pelindung diri, dan
pelatihan cara memakainya. (R) \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0
\expndtw-3\charscalex100 2. Alat pelindung diri sudah digunakan secara tepat dan
benar. (O,W) \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100
3. Ketersediaan alat pelindung diri sudah cukup sesuai dengan regulasi. (O)
\par\pard\qj \li1778\ri1160\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
4. Ada bukti pelaksanaan pelatihan penggunaan alat pelindung diri kepada semua
\line\tab \up0 \expndtw-4\charscalex100 pegawai termasuk tenaga kontrak. (D,W)
\par\pard\qj \li1418\sb0\sl-620\slmult0 \par\pard\qj\li1418\ri4003\sb93\sl-
620\slmult0\fi360 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PENINGKATAN MUTU DAN PROGRAM EDUKASI \up0
\expndtw-3\charscalex100 Standar PPI 10 \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb29\sl-276\slmult0\tx7750 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Kegiatan PPI diintegrasikan dengan program PMKP
\tab \up0 \expndtw0\charscalex101 (Peningkatan Mutu dan \par\pard\qj
\li1418\ri1204\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Keselamatan
Pasien) dengan menggunakan indikator yang secara epidemiologik \up0 \expndtw-
3\charscalex100 penting bagi rumah sakit. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 10
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1223\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menggunakan indikator sebagai informasi untuk memperbaiki kegiatan \line \up0
\expndtw0\charscalex102 PPI dan mengurangi tingkat infeksi yang terkait layanan
kesehatan sampai tingkat \line \up0 \expndtw-1\charscalex100 serendah-rendahnya.
Rumah sakit dapat menggunakan data indikator dan informasi \par\pard\ql
\li10156\sb236\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 246
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg247}
{\bkmkend Pg247}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1223\sb214\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 dan membandingkan dengan tingkat dan kecenderungan di
rumah sakit lain. Semua \up0 \expndtw0\charscalex100 departemen/unit layanan
diharuskan ikut serta menentukan prioritas yang diukur di \up0 \expndtw-
3\charscalex100 tingkat rumah sakit dan tingkat departemen/unit layanan program
PPI. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb83\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 10 \par\pard\qj \li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\ri1227\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi sistem
manajemen data terintegrasi antara data surveilans dan \line\tab \up0 \expndtw-
3\charscalex100 data indikator mutu. (lihat PMKP 2.1 EP 1). (R) \par\pard\ql
\li1778\ri1221\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex103 2.
Ada bukti pertemuan berkala antara Komite PMKP (Peningkatan Mutu dan \line\tab
\up0 \expndtw0\charscalex100 Keselamatan Pasien) serta Organisasi PPI untuk
membahas hasil surveilans \line \tab \up0 \expndtw-3\charscalex100 dan merancang
ulang untuk perbaikan. (D,W) \par\pard\ql \li1778\ri1226\sb2\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 3. Ada bukti data
dikumpulkan dan dianalisis untuk mendukung kegiatan PPI \line\tab \up0 \expndtw-
1\charscalex100 termasuk data infeksi berdasar atas epidemiologik penting
dimonitor dan \line \tab \up0 \expndtw-3\charscalex100 didokumentasikan. (lihat
PPI 6 EP 2 dan EP 3). (D,W) \par\pard\qj \li1778\ri1225\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 4. Ada bukti penyampaian hasil
analisis data dan rekomendasi kepada Komite \line\tab \up0 \expndtw-
2\charscalex100 PMKP setiap tiga bulan. (lihat PPI 6 EP 2 dan EP 3). (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar PPI 11
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1211\sb8\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
melakukan edukasi tentang PPI kepada staf klinis dan nonklinis, pasien, \up0
\expndtw-2\charscalex100 keluarga pasien, serta petugas lainnya yang terlibat dalam
pelayanan pasien. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan PPI 11 \par\pard\qj \li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\ri1216\sb17\sl-315\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Agar program PPI efektif harus
dilakukan edukasi kepada staf klinis dan nonkliniks \up0 \expndtw0\charscalex100
tentang program PPI pada waktu mereka baru bekerja di rumah sakit dan diulangi
\up0 \expndtw0\charscalex104 secara teratur. Edukasi diikuti oleh staf klinik dan
staf nonklinik, pasien, keluarga \up0 \expndtw-1\charscalex100 pasien, pedagang,
dan juga pengunjung. Pasien dan keluarga didorong untuk \up0 \expndtw-
2\charscalex100 berpartisipasi dalam implementasi program PPI. \par\pard\qj
\li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\ri1164\sb11\sl-315\slmult0 \up0
\expndtw-1\charscalex100 Pelatihan diberikan sebagai bagian dari orientasi
kepada semua staf baru dan \line \up0 \expndtw0\charscalex102 dilakukan
pelatihan kembali secara berkala, atau paling sedikit jika ada perubahan \line \up0
\expndtw0\charscalex102 kebijakan, prosedur, dan praktik yang menjadi panduan
program PPI. Dalam \line \up0 \expndtw-3\charscalex100 pendidikan juga
disampaikan temuan dan kecenderungan ukuran kegiatan. (lihat juga \line \up0
\expndtw-4\charscalex100 KKS 7) \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1227\sb1\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Berdasar atas hal di atas maka rumah sakit agar menetapkan Program Pelatihan PPI
\up0 \expndtw-3\charscalex100 yang meliputi pelatihan untuk \par\pard\qj
\li1418\ri1228\sb17\sl-300\slmult0\tx1778 \up0 \expndtw0\charscalex103 a)
orientasi pegawai baru baik staf klinis maupun nonklinis di tingkat rumah sakit
\line\tab \up0 \expndtw-3\charscalex100 maupun di unit pelayanan; \par\pard\ql
\li1485\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b) staf klinis
(profesional pemberi asuhan) secara berkala; \par\pard\ql \li1485\sb44\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 c) staf nonklinis; \par\pard\ql
\li1485\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) pasien dan keluarga;
dan \par\pard\ql \li1485\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 e)
pengunjung. \par\pard\ql \li10156\sb243\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 247
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg248}
{\bkmkend Pg248}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb92\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian PPI 11 \par\pard\qj \li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\ri1226\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan regulasi
program pelatihan dan edukasi tentang PPI \line\tab \up0 \expndtw-1\charscalex100
yang meliputi butir 1 sampai dengan 5 yang ada pada maksud dan tujuan. (R)
\par\pard\ql \li1778\ri1166\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 2. Ada bukti pelaksanaan pelatihan untuk semua staf klinik dan
nonklinik sebagai \line\tab \up0 \expndtw0\charscalex100 bagian dari orientasi
pegawai baru tentang regulasi dan praktik program PPI. \line \tab \up0 \expndtw-
5\charscalex100 (lihat KKS 7 dan TKRS 5.4). (D,W) \par\pard\ql
\li1778\ri1217\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 3.
Ada bukti pelaksanaan edukasi secara berkala bila ada perubahan kebijakan,
\line\tab \up0 \expndtw-2\charscalex100 prosedur, serta praktik program PPI
dan bila ada kecenderungan khusus \line \tab \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf8\f9\fs24 (new/re-emerging diseases)\ul0\nosupersub\cf7\f8\fs24
data infeksi untuk staf klinis dan nonklinis. (D,W) \par\pard\qj
\li1778\ri1219\sb2\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Ada
bukti pelaksanaan edukasi untuk pasien, keluarga, dan pengunjung
\line\tab \up0 \expndtw-3\charscalex100 tentang program PPI. (D,W) \par\pard\ql
\li1778\ri1179\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex103 5.
Ada bukti pelaksanan penyampaian temuan dan data berasal dari kegiatan \line\tab
\up0 \expndtw-3\charscalex100 pengukuran mutu/indikator mutu
(\ul0\nosupersub\cf8\f9\fs24 measurement\ul0\nosupersub\cf7\f8\fs24 ) ke seluruh
unit di rumah sakit \line \tab \up0 \expndtw-4\charscalex100 sebagai bagian dari
edukasi berkala rumah sakit. (D) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb8\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 248
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg249}
{\bkmkend Pg249}\par\pard\ql \li5404\sb0\sl-276\slmult0 \par\pard\ql\li5404\sb0\sl-
276\slmult0 \par\pard\ql\li5404\sb0\sl-276\slmult0 \par\pard\ql\li5404\sb0\sl-
276\slmult0 \par\pard\ql\li5404\sb0\sl-276\slmult0 \par\pard\ql\li5404\sb92\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAB 3
\par\pard\ql \li3604\sb0\sl-276\slmult0 \par\pard\ql\li3604\sb48\sl-276\slmult0
\up0 \expndtw-3\charscalex100 TATA KELOLA RUMAH SAKIT (TKRS) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb96\sl-276\slmult0 \up0
\expndtw-3\charscalex100 GAMBARAN UMUM \par\pard\qj \li1418\ri1591\sb288\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
adalah institusi pelayanan kesehatan yang menyelenggarakan \up0 \expndtw-
2\charscalex100
pelayanan kesehatan perorangan secara paripurna yang menyediakan pelayanan \up0
\expndtw-3\charscalex100 rawat inap, rawat jalan, dan gawat darurat.
\par\pard\qj \li1418\ri1537\sb283\sl-317\slmult0 \up0 \expndtw0\charscalex102 Untuk
dapat memberikan pelayanan prima kepada pasien, rumah sakit dituntut \line \up0
\expndtw0\charscalex104 memiliki kepemimpinan yang efektif. Kepemimpinan efektif
ini ditentukan oleh \line \up0 \expndtw-3\charscalex100 sinergi yang positif antara
pemilik rumah sakit, direktur rumah sakit, para pimpinan \line \up0 \expndtw-
2\charscalex100 di rumah sakit, dan kepala unit kerja unit pelayanan. Direktur
rumah sakit secara \line \up0 \expndtw-2\charscalex100 kolaboratif
mengoperasionalkan rumah sakit bersama dengan para pimpinan, \line \up0
\expndtw0\charscalex102 kepala unit kerja, dan unit pelayanan untuk mencapai visi
misi yang ditetapkan \line \up0 \expndtw-1\charscalex100 serta memiliki tanggung
jawab dalam pengeloaan manajemen peningkatan mutu \line \up0 \expndtw-
2\charscalex100 dan keselamatan pasien, manajemen kontrak, serta manajemen sumber
daya. \par\pard\qj \li1418\ri1603\sb181\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Standar pada bab ini dikelompokan dengan menggunakan hieraki
kepemimpinan \up0 \expndtw-2\charscalex100 sebagai berikut: \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 PEMILIK \par\pard\qj \li1418\sb0\sl-
320\slmult0 \par\pard\qj\li1418\ri1591\sb8\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Sesuai dengan peraturan dan
perundang-undangan, kepemilikan rumah sakit \up0 \expndtw-3\charscalex100 diatur
sebagai berikut: \par\pard\ql \li1778\ri1565\sb9\sl-310\slmult0\tx2138\tx2138
\up0 \expndtw0\charscalex104 1. rumah sakit dapat didirikan oleh Pemerintah,
Pemerintah Daerah, atau \line\tab \up0 \expndtw0\charscalex101 swasta. Rumah sakit
yang didirikan oleh swasta harus berbentuk badan \line \tab \up0 \expndtw-
3\charscalex100 hukum yang kegiatan usahanya hanya bergerak di bidang
perumahsakitan; \par\pard\ql \li1778\ri1553\sb2\sl-320\slmult0\tx2138\tx2138
\up0 \expndtw0\charscalex103 2. berdasar atas pengelolaannya rumah sakit dapat
dibagi menjadi rumah \line\tab \up0 \expndtw-3\charscalex100 Sakit publik dan rumah
sakit privat. Rumah sakit publik dapat dikelola oleh \line \tab \up0 \expndtw-
4\charscalex100 Pemerintah, Pemerintah Daerah, dan badan hukum yang bersifat
nirlaba; \par\pard\qj \li1778\ri1600\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 3. rumah sakit privat dapat dikelola oleh badan hukum
dengan tujuan profit \line\tab \up0 \expndtw-3\charscalex100 yang berbentuk
Perseroan Terbatas atau Persero; \par\pard\ql \li1778\ri1591\sb9\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex103 4. pemilik rumah sakit
dapat membentuk Dewan Pengawas Rumah Sakit, \line\tab \up0 \expndtw0\charscalex102
yaitu merupakan suatu unit nonstruktural yang bersifat independen dan \line \tab
\up0 \expndtw-3\charscalex100 bertanggung jawab kepada pemilik rumah sakit;
\par\pard\ql \li1778\sb39\sl-276\slmult0 \up0 \expndtw-2\charscalex100 5. pemilik
rumah sakit tidak dapat menjabat sebagai Direktur Rumah Sakit. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb238\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 249

{\shp
{\*\shpinst\shpleft7020\shptop6451\shpright7082\shpbottom6461\shpfhdr0\shpbxpage\sh
pbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz516\shplid0
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 62}}{\sp{\sn geoBottom}{\sv 10}}
{\sp{\sn pVerticies}{\sv 8;4;(0,10);(62,10);(62,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg250}{\bkmkend Pg250}\par\pard\qj \li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1599\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pemilik yang dimaksud dalam standar ini adalah pemilik
rumah sakit dan badan \up0 \expndtw-2\charscalex100 representasi yang mewakili
pemilik dan sesuai dengan bentuk badan hukum \up0 \expndtw-3\charscalex100
kepemilikan rumah sakit tersebut. \par\pard\ql \li1418\sb239\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Representasi dari pemilik dapat sebagai berikut:
\par\pard\qj \li1778\ri1607\sb208\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 a) rumah sakit yang dimiliki oleh yayasan maka
representasi pemilik adalah \line\tab \up0 \expndtw-3\charscalex100 pengurus
yayasan; \par\pard\qj \li1778\ri1594\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 b) rumah sakit yang dimiliki oleh perkumpulan maka
representasi pemilik \line\tab \up0 \expndtw-3\charscalex100 adalah pengurus
perkumpulan; \par\pard\qj \li1778\ri1605\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 c) rumah sakit berbadan hukum perseroan terbatas (PT) maka
representasi \line\tab \up0 \expndtw-3\charscalex100 pemilik adalah direksi PT;
\par\pard\qj \li1778\ri1598\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
d) rumah sakit pemerintah yang sudah menjadi badan layanan umum dapat \line\tab
\up0 \expndtw-3\charscalex100 menunjuk dewan pengawas sebagai representasi pemilik;
\par\pard\ql \li1778\ri1601\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 e) rumah sakit pemerintah yang belum menjadi badan layanan
umum maka \line\tab \up0 \expndtw0\charscalex100 ketentuan siapa yang dapat
menjadi representasi pemilik diserahkan \line \tab \up0 \expndtw-3\charscalex100
kepada pemilik rumah sakit untuk menetapkannya. \par\pard\qj \li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\ri1597\sb237\sl-300\slmult0 \up0
\expndtw0\charscalex103 Organisasi, kewenangan, serta akuntabilitas dan
representasi pemilik diatur di \up0 \expndtw-3\charscalex100 dalam standar ini.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb208\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 DIREKSI RUMAH SAKIT \par\pard\qj \li1418\sb0\sl-
316\slmult0 \par\pard\qj\li1418\ri1539\sb15\sl-316\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Untuk melaksanakan kegiatan
operasional rumah sakit sehari-hari maka pemilik \up0 \expndtw-3\charscalex100
rumah sakit menetapkan Direktur Rumah Sakit. Nama jabatan direktur rumah sakit \up0
\expndtw0\charscalex105 adalah Kepala Rumah Sakit atau Direktur Utama Rumah Sakit,
atau Direktur \up0 \expndtw-4\charscalex100 Rumah Sakit. Bila direktur rumah sakit
diberi nama jabatan Direktur Utama Rumah \up0 \expndtw0\charscalex100 Sakit, dapat
dibantu dengan direktur dan bila nama jabatan direktur rumah sakit \up0 \expndtw-
2\charscalex100 disebut Direktur maka dapat dibantu dengan Wakil Direktur,
sedangkan kelompok \up0 \expndtw-3\charscalex100 tersebut disebut Direksi.
\par\pard\qj \li1418\ri1545\sb1\sl-320\slmult0 \up0 \expndtw-3\charscalex100 Rumah
sakit agar menetapkan tanggung jawab dan tugas direktur utama dan para \up0
\expndtw-4\charscalex100 direktur/wakil direktur secara tertulis. \par\pard\qj
\li1418\ri1599\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100 Dalam standar ini
jabatan kepala rumah sakit untuk selanjutnya disebut Direktur \up0 \expndtw-
3\charscalex100 Rumah Sakit \par\pard\ql \li1418\sb17\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Direktur Rumah Sakit merupakan pimpinan tertinggi di rumah
sakit. \par\pard\ql \li1418\ri1537\sb11\sl-317\slmult0 \up0 \expndtw-
3\charscalex100 Sesuai dengan peraturan perundang-undangan tentang Rumah Sakit,
persyaratan \line \up0 \expndtw0\charscalex103 sebagai Direktur Rumah Sakit
adalah harus seorang tenaga medis yang \line \up0 \expndtw-1\charscalex100
mempunyai kemampuan dan keahlian di bidang perumahsakitan dan tidak boleh \line
\up0 \expndtw-3\charscalex100 dirangkap oleh pemilik rumah sakit serta
berkewarganegaraan Indonesia. \line \up0 \expndtw0\charscalex102 Persyaratan
Direktur Rumah Sakit harus sesuai dengan Peraturan Perundang-\line \up0 \expndtw-
1\charscalex100 undangan, sedangkan wakil direktur atau direktur (bila pimpinan
tertinggi disebut \line \up0 \expndtw0\charscalex100 Direktur Utama), sesuai dengan
peraturan perundang-undangan dapat dipimpin \line \up0 \expndtw0\charscalex100 oleh
unsur medis, keperawatan, penunjang medis, dan adminitrasi keuangan.
\par\pard\ql \li10156\sb196\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 250
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg251}
{\bkmkend Pg251}\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1539\sb203\sl-313\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pemilik mempunyai kewenangan untuk menetapkan
organisasi rumah sakit, nama \up0 \expndtw0\charscalex103 jabatan, dan pengangkatan
pejabat direksi rumah sakit. Hal ini diatur di dalam \up0 \expndtw0\charscalex103
peraturan internal atau\ul0\nosupersub\cf8\f9\fs24 corporate
bylaws\ul0\nosupersub\cf7\f8\fs24 atau dokumen serupa sesuai dengan \up0 \expndtw-
3\charscalex100 peraturan perundang-undangan \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 KEPALA BIDANG/DIVISI DI RUMAH SAKIT
\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\ri1597\sb21\sl-
313\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Organisasi
rumah sakit sesuai dengan peraturan perundang-undangan paling \up0
\expndtw0\charscalex104 sedikit terdiri atas direktur rumah sakit, unsur pelayanan
medis, keperawatan, \up0 \expndtw0\charscalex100 penunjang medis, administrasi umum
dan keuangan, komite medis, serta satuan \up0 \expndtw-3\charscalex100 pengawas
internal. \par\pard\qj \li1418\ri1576\sb2\sl-320\slmult0 \up0
\expndtw0\charscalex102 Unsur organisasi rumah sakit selain Kepala Rumah Sakit atau
Direktur Rumah \up0 \expndtw-2\charscalex100 Sakit dapat berupa direktorat,
departemen, divisi, instalasi, unit kerja, serta komite \up0
\expndtw0\charscalex100 dan/atau satuan sesuai dengan kebutuhan dan beban kerja
rumah sakit. Unsur \up0 \expndtw0\charscalex102 organisasi rumah sakit tersebut
dapat digabungkan sesuai dengan kebutuhan, \up0 \expndtw-3\charscalex100 beban
kerja, dan/atau klasifikasi rumah sakit \par\pard\qj \li1418\ri1550\sb4\sl-
316\slmult0 \up0 \expndtw0\charscalex104 Beberapa standar di Bab TKRS ini
memberikan para pimpinan di rumah sakit \line \up0 \expndtw0\charscalex100 sejumlah
tanggung jawab secara keseluruhan untuk membimbing rumah sakit \line \up0
\expndtw-1\charscalex100 mencapai misinya. Para pimpinan tersebut dimaksud adalah
kepala bidang/divisi \line \up0 \expndtw0\charscalex103 di rumah sakit, dan dalam
standar ini digunakan nama jabatan sebagai kepala \line \up0 \expndtw-
2\charscalex100 bidang/divisi. Dengan demikian, dalam standar ini pimpinan
unsur pelayanan \line \up0 \expndtw0\charscalex100 medis diberi nama kepala
bidang/divisi medis yang bertanggung jawab terhadap \line \up0
\expndtw0\charscalex100 pelayanan medis rumah sakit. Pimpinan unsur
keperawatan disebut kepala \line \up0 \expndtw0\charscalex100 bidang/divisi
keperawatan yang bertanggung jawab terhadap pelayanan \line \up0
\expndtw0\charscalex102 keperawatan. Pimpinan unsur umum dan keuangan dapat
disebut kepala \line \up0 \expndtw-3\charscalex100 bidang/divisi umum dan
keuangan. Pimpinan lainnya, yaitu semua orang lain yang \line \up0
\expndtw0\charscalex100 ditentukan rumah sakit, seperti ketua komite medik, ketua
komite keperawatan, \line \up0 \expndtw-3\charscalex100 serta komite peningkatan
mutu dan keselamatan pasien. \par\pard\qj \li1418\ri1536\sb1\sl-320\slmult0 \up0
\expndtw0\charscalex100 Rumah sakit juga perlu menjelaskan tanggung jawab staf
klinis dan pengaturan \line \up0 \expndtw-4\charscalex100 staf klinis ini dapat
secara formal sesuai dengan regulasi yang berlaku di Indonesia. \par\pard\qj
\li1418\ri1578\sb209\sl-310\slmult0 \up0 \expndtw-2\charscalex100 Direktur rumah
sakit agar menetapkan lingkup pelayanan dan atau unit kerja yang \up0
\expndtw0\charscalex100 masuk dalam pimpinan pelayanan medis, keperawatan,
penunjang medis, serta \up0 \expndtw-3\charscalex100 administrasi dan keuangan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb207\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 KEPALA UNIT KERJA DAN UNIT LAYANAN \par\pard\qj
\li1418\ri1536\sb211\sl-316\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Agar pelayanan klinis dan manajemen rumah sakit sehari-
hari menjadi efektif dan \line \up0 \expndtw0\charscalex103 efisien maka rumah
sakit umumnya dibagi menjadi subkelompok yang kohesif \line \up0 \expndtw-
4\charscalex100 seperti departemen/instalasi/unit, atau jenis layanan tertentu yang
berada di bawah \line \up0 \expndtw-3\charscalex100 arahan pimpinan pelayanan yang
dapat disebut Kepala unit/instalasi/ departemen, \line \up0 \expndtw0\charscalex100
Standar ini menjelaskan ekspektasi kepala departemen atau pelayanan tertentu. \line
\up0 \expndtw0\charscalex100 Biasanya subgrup terdiri atas departemen klinis
seperti medis, bedah, obstetrik, \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb144\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 251
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg252}{\bkmkend Pg252}\par\pard\qj \li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\ri1535\sb188\sl-317\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 anak, dan lain sebagainya; satu atau lebih subgrup
keperawatan; pelayanan atau \line \up0 \expndtw-3\charscalex100 departemen
diagnostik seperti radiologi dan laboratorium klinis; pelayanan farmasi, \line \up0
\expndtw0\charscalex100 baik yang tersentralisasi maupun yang terdistribusi di
seluruh rumah sakit; serta \line \up0 \expndtw-2\charscalex100 pelayanan penunjang
yang di antaranya meliputi bagian transportasi, umum, \line \up0 \expndtw-
3\charscalex100 keuangan, pembelian, manajemen fasilitas, dan sumber daya manusia.
Umumnya \line \up0 \expndtw0\charscalex100 rumah sakit besar juga mempunyai
manajer/kepala ruang di dalam subgrup ini. \line \up0 \expndtw-2\charscalex100
Sebagai contoh, perawat dapat memiliki satu manajer/kepala ruang di
kamar \line \up0 \expndtw0\charscalex102 operasi dan satu manajer/kepala ruang di
unit rawat jalan; departemen medis \line \up0 \expndtw0\charscalex100 dapat
mempunyai manajer-manajer untuk setiap unit klinis pasien; dan bagian \line
\up0 \expndtw0\charscalex100 bisnis r umah sakit dapat mempunyai beberapa
manajer untuk fungsi bisnis \line \up0 \expndtw0\charscalex103 yang berbeda, di
antaranya seperti untuk kontrol tempat tidur, penagihan, dan \line \up0 \expndtw-
3\charscalex100 pembelian. Akhirnya, terdapat persyaratan di bab TKRS yang
bersentuhan dengan \line \up0 \expndtw0\charscalex104 semua level di atas.
Persyaratan ini dapat ditemukan pada bab TKRS ini dan \line \up0 \expndtw-
2\charscalex100 mencakup budaya keselamatan, etika, serta pendidikan dan penelitian
profesional \line \up0 \expndtw-3\charscalex100 kesehatan, apabila ada.
\par\pard\qj \li1418\ri1592\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex103 Dalam
standar ini, kepala departemen/instalasi/unit/layanan tersebut yang \up0
\expndtw-3\charscalex100 selanjutnya disebut sebagai berikut:
\par\pard\li1778\sb37\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf25\f26\fs24 -\tab \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 unit-unit yang di berada bawah bidang/divisi
medis, keperawatan, dan\par\pard\li1778\sb43\sl-276\slmult0\fi360 \up0 \expndtw-
3\charscalex100 penunjang medis disebut unit pelayanan;\par\pard\ql
\li1778\ri1544\sb0\sl-320\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf25\f26\fs24 -\tab \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 unit-unit yang berada di bawah
bidang/divisi umum dan keuangan disebut \line\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 unit kerja,\ul0\nosupersub\cf7\f8\fs24 seperti
ketatausahaan, kerumahtanggan, pelayanan hukum dan \line \tab \up0
\expndtw0\charscalex100 kemitraan, pemasaran, kehumasan, pencatatan, pelaporan dan
evaluasi, \line \tab \up0 \expndtw0\charscalex100 penelitian dan pengembangan,
sumber daya manusia, pendidikan serta \line \tab \up0 \expndtw-3\charscalex100
pelatihan, dan lain sebagainya. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb70\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Di bawah ini
adalah fokus area standar tata kelola rumah sakit. \par\pard\ql \li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-1\charscalex100
a. Pemilik. \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100
b. Direksi. \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
c. Kepala bidang/divisi. \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 d. Manajemen sumber daya manusia. \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 e. Manajemen peningkatan mutu dan
keselamatan pasien. \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex101 f. Manajemen kontrak. \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 g. Manajemen sumber daya \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 h. Organisasi dan
tanggung jawab staf. \par\pard\li1778\sb41\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
3\charscalex100 i.\tab \up0 \expndtw-3\charscalex100 Unit
pelayanan.\par\pard\li1778\sb41\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
3\charscalex100 j.\tab \up0 \expndtw-3\charscalex100 Manajemen etis.\par\pard\ql
\li1778\sb30\sl-276\slmult0 \up0 \expndtw-2\charscalex100 k. Budaya
keselamatan. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb119\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 252
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg253}
{\bkmkend Pg253}\par\pard\ql \li2051\sb0\sl-276\slmult0 \par\pard\ql\li2051\sb0\sl-
276\slmult0 \par\pard\ql\li2051\sb0\sl-276\slmult0 \par\pard\ql\li2051\sb0\sl-
276\slmult0 \par\pard\ql\li2051\sb0\sl-276\slmult0 \par\pard\ql\li2051\sb0\sl-
276\slmult0 \par\pard\ql\li2051\sb0\sl-276\slmult0 \par\pard\ql\li2051\sb180\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 STANDAR ,
MAKSUD DAN TUJUAN, SERTA ELEMEN PENILAIAN \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 PEMILIK \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar TKRS 1 \par\pard\qj
\li1418\ri1594\sb225\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Organisasi serta wewenang pemilik dan representasi
pemilik dijelaskan di dalam \up0 \expndtw-3\charscalex100 regulasi yang ditetapkan
oleh pemilik rumah sakit. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb208\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 1.1
\par\pard\qj \li1418\ri1597\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Tanggung jawab dan akuntabilitas pemilik dan
representasi pemilik telah \up0 \expndtw0\charscalex100 dilaksanakan sesuai
regulasi yang ditetapkan dan sesuai peraturan perundang\up0 \expndtw-
3\charscalex100 undangan\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar TKRS 1.2 \par\pard\qj
\li1418\ri1566\sb188\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memiliki misi, rencana strategis, rencana
kerja, program peningkatan \up0 \expndtw-1\charscalex100 mutu dan keselamatan
pasien, pengawasan mutu pendidikan, serta laporan \up0 \expndtw-
3\charscalex100 akuntabilitas representasi pemilik. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan TKRS 1, TKRS 1.1, dan TKRS 1.2 \par\pard\qj \li1418\ri1552\sb225\sl-
300\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Regulasi dari
pemilik tersebut dapat berbentuk peraturan internal rumah sakit atau \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf8\f9\fs24 corporat
bylaws\ul0\nosupersub\cf7\f8\fs24 atau dokumen lainnya yang serupa.
\par\pard\qj \li1418\ri1562\sb4\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Struktur organisasi pemilik termasuk representasi pemilik terpisah dengan
struktur \up0 \expndtw-2\charscalex100 organisasi rumah sakit sesuai dengan bentuk
badan hukum pemilik dan peraturan \up0 \expndtw-3\charscalex100 perundang-undangan.
\par\pard\qj \li1418\ri1589\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex104 Pemilik
rumah sakit tidak diperbolehkan menjadi Direktur Rumah Sakit, tetapi \line \up0
\expndtw0\charscalex103 posisinya berada di atas representasi pemilik, serta mereka
mengembangkan \line \up0 \expndtw0\charscalex102 sebuah proses untuk melakukan
komunikasi dan kerja sama dengan Direktur \line \up0 \expndtw-3\charscalex100
Rumah Sakit dalam rangka mencapai misi dan perencanaan rumah sakit. \par\pard\qj
\li1418\ri1607\sb300\sl-320\slmult0 \up0 \expndtw0\charscalex102 Representasi
pemilik, sesuai dengan bentuk badan hukum kepemilikan rumah \line \up0
\expndtw0\charscalex102 sakit memiliki wewenang dan tanggung jawab untuk memberi
persetujuan, dan \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb110\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 253
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg254}
{\bkmkend Pg254}\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1596\sb203\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 pengawasan agar rumah sakit mempunyai kepemimpinan yang
jelas, dijalankan \up0 \expndtw-2\charscalex100 secara efisien, serta memberikan
pelayanan kesehatan yang bermutu dan aman. \up0 \expndtw0\charscalex104 Di samping
itu rumah sakit harus memiliki struktur organisasi yang ditetapkan \up0 \expndtw-
3\charscalex100 sesuai dengan peraturan perundang-undangan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb126\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Ada penetapan siapa yang bertanggung jawab dan
berwenang untuk
\par\pard\ql \li1778\ri1604\sb16\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1) menyediakan modal serta
dana operasional dan sumber daya lain yang \line\tab \up0 \expndtw-1\charscalex100
diperlukan untuk menjalankan rumah sakit dalam memenuhi visi dan misi \line \tab
\up0 \expndtw-3\charscalex100 serta rencana strategis rumah sakit; \par\pard\ql
\li1778\ri1599\sb2\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 2)
menunjuk atau menetapkan direksi rumah sakit, dan melakukan evaluasi \line\tab \up0
\expndtw0\charscalex101 tahunan terhadap kinerja tiap-tiap individu direksi dengan
menggunakan \line \tab \up0 \expndtw-3\charscalex100 proses dan kriteria yang sudah
baku; \par\pard\ql \li1778\ri1600\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 3) menunjuk atau menetapkan representasi pemilik,
tanggung jawab dan \line\tab \up0 \expndtw0\charscalex100 wewenang, serta melakukan
penilaian kinerja representasi pemilik secara \line \tab \up0 \expndtw-
3\charscalex100 berkala minimal setahun sekali; \par\pard\ql \li1778\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 4) menetapkan struktur organisasi rumah
sakit; \par\pard\qj \li1778\ri1605\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 5) menetapkan regulasi pengelolaan keuangan rumah sakit dan
pengelolaan \line\tab \up0 \expndtw-3\charscalex100 sumber daya manusia rumah
sakit; \par\pard\qj \li1778\ri1602\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 6) tanggung jawab dan kewenangan memberikan arahan
kebijakan rumah \line\tab \up0 \expndtw-3\charscalex100 sakit; \par\pard\ql
\li1778\ri1543\sb0\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 7)
tanggung jawab dan kewenangan menetapkan visi serta misi rumah sakit, \line\tab
\up0 \expndtw-3\charscalex100 memastikan bahwa masyarakat mengetahui visi dan misi
rumah sakit, serta \line \tab \up0 \expndtw-4\charscalex100
me-\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 secara berkala
misi rumah sakit; \par\pard\qj \li1778\ri1605\sb36\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 8) tanggung jawab serta kewenangan menilai dan
menyetujui rencana \line\tab \up0 \expndtw-3\charscalex100 anggaran;
\par\pard\ql \li1778\ri1603\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
9) tanggung jawab dan kewenangan menyetujui rencana strategi rumah sakit; \up0
\expndtw-3\charscalex100 10)tanggung jawab dan kewenangan mengawasi serta membina
pelaksanaan \line\tab \up0 \expndtw-3\charscalex100 rencana strategis; \par\pard\ql
\li1778\ri1596\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100
11)tanggung jawab dan kewenangan menyetujui diselenggarakan pendidikan \line\tab
\up0 \expndtw0\charscalex100 profesional kesehatan dan penelitian serta mengawasi
kualitas program-\line \tab \up0 \expndtw-3\charscalex100 program tersebut;
\par\pard\ql \li1778\ri1603\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 12)tanggung jawab dan kewenangan menyetujui program
peningkatan mutu \line\tab \up0 \expndtw-1\charscalex100 dan keselamatan pasien
serta menindaklanjuti laporan peningkatan mutu \line \tab \up0 \expndtw-
2\charscalex100 dan keselamatan yang diterima; \par\pard\qj \li1778\ri1604\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 13) tanggung jawab dan kewenangan
mengawasi pelaksanaan kendali mutu \line\tab \up0 \expndtw-3\charscalex100 dan
kendali biaya; \par\pard\qj \li1778\ri1603\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 14)tanggung jawab dan kewenangan mengawasi dan menjaga hak
dan \line\tab \up0 \expndtw-3\charscalex100 kewajiban pasien dilaksanakan rumah
sakit; \par\pard\qj \li1778\ri1594\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 15)tanggung jawab dan kewenangan mengawasi serta menjaga hak
dan \line\tab \up0 \expndtw-2\charscalex100 kewajiban rumah sakit dilaksanakan oleh
rumah sakit; \par\pard\qj \li1778\ri1606\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 16)tanggung jawab dan kewenangan mengawasi kepatuhan penerapan
etika \line\tab \up0 \expndtw-3\charscalex100 rumah sakit, etika profesi, dan
peraturan perundang-undangan. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb10\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 254
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg255}
{\bkmkend Pg255}\par\pard\qj \li1560\sb0\sl-313\slmult0 \par\pard\qj\li1560\sb0\sl-
313\slmult0 \par\pard\qj\li1560\sb0\sl-313\slmult0
\par\pard\qj\li1560\ri1552\sb203\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pengaturan tanggung jawab dan kewenangan antara pemilik
dan\ul0\nosupersub\cf6\f7\fs24 r\ul0\nosupersub\cf7\f8\fs24 epresentasi \up0
\expndtw-3\charscalex100 pemilik yang meliputi butir 1 sampai dengan 16 diatur di
dalam peraturan internal \up0 \expndtw0\charscalex105
atau\ul0\nosupersub\cf8\f9\fs24 corporate bylaws\ul0\nosupersub\cf7\f8\fs24
atau dokumen lainnya sesuai dengan peraturan \up0 \expndtw-3\charscalex100
perundang-undangan. \par\pard\qj \li1560\ri1582\sb202\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Bila tanggung jawab dan wewenang pemilik ada yang didelegasikan
maka diatur \line \up0 \expndtw0\charscalex102 di dalam regulasi yang dikeluarkan
oleh pemilik rumah sakit. Sebagai contoh: \line \up0 \expndtw0\charscalex100
persetujuan anggaran modal dan operasional rumah sakit yang semula ada di \line
\up0 \expndtw0\charscalex103 pemilik rumah didelegasikan kepada representasi
pemilik atau didelegasikan \line \up0 \expndtw-3\charscalex100 kepada tim anggaran
sesuai dengan peraturan perundang-undangan. \par\pard\qj \li1560\ri1602\sb180\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Tugas dan wewenang yang diatur di maksud
dan tujuan ini merupakan minimal \up0 \expndtw0\charscalex103 yang harus diatur dan
rumah sakit dapat menambah regulasi tersebut sesuai \up0 \expndtw-3\charscalex100
dengan yang diperlukan rumah sakit. \par\pard\qj \li1560\ri1596\sb200\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Pengaturan tanggung jawab dan kewenangan
antara pemilik dan\ul0\nosupersub\cf6\f7\fs24 r\ul0\nosupersub\cf7\f8\fs24
epresentasi \up0 \expndtw0\charscalex104 pemilik yang meliputi point 1) sampai
dengan 16) diatur di dalam peraturan \up0 \expndtw0\charscalex102 internal
atau\ul0\nosupersub\cf8\f9\fs24 corporat bylaws\ul0\nosupersub\cf7\f8\fs24 atau
dokumen lainnya sesuai dengan peraturan \up0 \expndtw-3\charscalex100 perundang-
undangan. \par\pard\qj \li1560\ri1536\sb205\sl-315\slmult0\fi67 \up0 \expndtw-
3\charscalex100 Bila tanggung jawab dan wewenang pemilik ada yang didelegasikan
maka diatur \line \up0 \expndtw0\charscalex102 di dalam regulasi yang dikeluarkan
oleh pemilik rumah sakit. Sebagai contoh: \line \up0 \expndtw0\charscalex100
persetujuan anggaran modal dan operasional rumah sakit yang semula ada di \line
\up0 \expndtw0\charscalex103 pemilik rumah didelegasikan kepada representasi
pemilik atau didelegasikan \line \up0 \expndtw-3\charscalex100 kepada tim anggaran
sesuai dengan peraturan perundang-undangan. \par\pard\qj \li1560\ri1602\sb201\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Tugas dan wewenang yang diatur di maksud
dan tujuan ini merupakan minimal \up0 \expndtw0\charscalex103 yang harus diatur dan
rumah sakit dapat menambah regulasi tersebut sesuai \up0 \expndtw-3\charscalex100
dengan yang diperlukan rumah sakit. \par\pard\qj \li1560\ri1597\sb217\sl-
300\slmult0 \up0 \expndtw-2\charscalex100 Struktur Organisasi Rumah Sakit yang
disebut pada butir 7 sesuai dengan \up0 \expndtw-3\charscalex100 peraturan
perundang-undangan paling sedikit meliputi: \par\pard\ql \li1778\sb260\sl-
276\slmult0 \up0 \expndtw-7\charscalex100 \u8226? kepala rumah sakit atau
direktur rumah sakit;\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\ql
\li1778\sb264\sl-276\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 \u8226? unsur pelayanan medis; \par\pard\ql
\li1778\sb184\sl-276\slmult0 \up0 \expndtw0\charscalex100 \u8226? unsur
keperawatan; \par\pard\ql \li1778\sb184\sl-276\slmult0 \up0 \expndtw0\charscalex100
\u8226? unsur penunjang medis; \par\pard\ql \li1778\sb184\sl-276\slmult0 \up0
\expndtw-1\charscalex100 \u8226? unsur administrasi umum dan keuangan;
\par\pard\ql \li1778\sb184\sl-276\slmult0 \up0 \expndtw0\charscalex100 \u8226?
komite medis; dan \par\pard\ql \li1778\sb164\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \u8226? satuan pemeriksaan internal. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb138\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 255
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg256}
{\bkmkend Pg256}\par\pard\qj \li1560\sb0\sl-315\slmult0 \par\pard\qj\li1560\sb0\sl-
315\slmult0 \par\pard\qj\li1560\sb0\sl-315\slmult0
\par\pard\qj\li1560\ri1535\sb195\sl-315\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Unsur Organisasi Rumah Sakit sebagaimana tersebut dapat
digabungkan sesuai \up0 \expndtw-3\charscalex100 dengan kebutuhan, beban kerja,
dan/atau klasifikasi rumah sakit. Selain itu, perlu \up0 \expndtw0\charscalex102
juga ditetapkan lingkup pelayanan atau unit kerja yang masuk dalam unsur
\up0 \expndtw-1\charscalex100 pelayanan medis, unsur keperawatan, unsur
penunjang medis, serta unsur \up0 \expndtw-2\charscalex100 administrasi umum dan
keuangan. \par\pard\ql \li1560\sb0\sl-276\slmult0 \par\pard\ql\li1560\sb0\sl-
276\slmult0 \par\pard\ql\li1560\sb0\sl-276\slmult0 \par\pard\ql\li1560\sb0\sl-
276\slmult0 \par\pard\ql\li1560\sb0\sl-276\slmult0 \par\pard\ql\li1560\sb0\sl-
276\slmult0
\par\pard\ql\li1560\sb142\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 1 \par\pard\ql
\li1778\ri1538\sb205\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Pemilik menetapkan regulasi yang mengatur a) sampai
dengan g) yang ada \line\tab \up0 \expndtw0\charscalex103 di dalam maksud dan
tujuan yang dapat berbentuk\ul0\nosupersub\cf8\f9\fs24 corporate by-laws,
\line \tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 peraturan
internal, atau dokumen lainnya yang serupa. (R) \par\pard\ql
\li1778\ri1597\sb161\sl-300\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 2. Ada penetapan struktur organisasi pemilik termasuk
representasi pemilik \line\tab \up0 \expndtw-2\charscalex100 sesuai dengan bentuk
badan hukum kepemilikan rumah sakit dan sesuai \line \tab \up0
\expndtw0\charscalex101 dengan peraturan perundang-undangan. Nama jabatan di dalam
strukur \line \tab \up0 \expndtw-3\charscalex100 organisasi tersebut harus secara
jelas disebutkan. (R) \par\pard\qj \li1778\ri1597\sb177\sl-280\slmult0\tx2138
\up0 \expndtw0\charscalex102 3. Ada penetapan struktur organisasi rumah sakit
sesuai dengan peraturan \line\tab \up0 \expndtw-3\charscalex100 perundang-undangan.
(R) \par\pard\qj \li1778\ri1599\sb164\sl-300\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 4. Ada penetapan Direktur Rumah Sakit sesuai dengan peraturan
perundang-\line\tab \up0 \expndtw-3\charscalex100 undangan. (R) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb148\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 1 \par\pard\ql
\li1778\ri1538\sb225\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Pemilik menetapkan regulasi yang mengatur a) sampai
dengan g) yang ada \line\tab \up0 \expndtw0\charscalex103 di dalam maksud dan
tujuan yang dapat berbentuk\ul0\nosupersub\cf8\f9\fs24 corporate by-
laws\ul0\nosupersub\cf7\f8\fs24 , \line \tab \up0 \expndtw-3\charscalex100
peraturan internal, atau dokumen lainnya yang serupa. (R) \par\pard\ql
\li1778\ri1597\sb166\sl-293\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 2. Ada penetapan struktur organisasi pemilik termasuk
representasi pemilik \line\tab \up0 \expndtw-2\charscalex100 sesuai dengan bentuk
badan hukum kepemilikan rumah sakit dan sesuai \line \tab \up0
\expndtw0\charscalex101 dengan peraturan perundang-undangan. Nama jabatan di dalam
strukur \line \tab \up0 \expndtw-3\charscalex100 organisasi tersebut harus secara
jelas disebutkan. (R) \par\pard\qj \li1778\ri1597\sb162\sl-300\slmult0\tx2138
\up0 \expndtw0\charscalex102 3. Ada penetapan struktur organisasi rumah sakit
sesuai dengan peraturan \line\tab \up0 \expndtw-3\charscalex100 perundang-undangan.
(R) \par\pard\qj \li1778\ri1599\sb161\sl-300\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 4. Ada penetapan Direktur Rumah Sakit sesuai dengan peraturan
perundang-\line\tab \up0 \expndtw-3\charscalex100 undangan. (R) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb148\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 1.2 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb137\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 256
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg257}
{\bkmkend Pg257}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1599\sb253\sl-300\slmult0\fi67 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Ada bukti
persetujuan,\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24
berkala, dan publikasi/sosialisasi ke masyarakat \up0 \expndtw-3\charscalex100
tentang misi rumah sakit sesuai dengan regulasi. (D,W) \par\pard\qj
\li1778\ri1597\sb204\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 1. Ada
persetujuan rencana strategis, rencana kerja, dan anggaran rumah \line\tab \up0
\expndtw-3\charscalex100 sakit sehari-hari sesuai dengan regulasi. (D,W)
\par\pard\ql \li1778\ri1538\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 2. Ada persetujuan atas strategi dan program pendidikan,
penelitian staf klinis, \line\tab \up0 \expndtw-3\charscalex100 dan pengawasan
mutu program pendidikan tersebut.\ul0\nosupersub\cf8\f9\fs24 Elemen penilaian ini
\line \tab \up0 \expndtw-4\charscalex100 hanya untuk rumah sakit
pendidikan.\ul0\nosupersub\cf7\f8\fs24 (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb193\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS
1.3 \par\pard\qj \li1418\ri1592\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pemilik dan atau representasi pemilik memberi
persetujuan program peningkatan \up0 \expndtw0\charscalex100 mutu dan keselamatan
pasien rumah sakit, menerima laporan pelaksanaan \up0 \expndtw0\charscalex107
program secara berkala, dan memberi respons terhadap laporan yang \up0
\expndtw-3\charscalex100 disampaikan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 1.3 \par\pard\qj \li1418\sb0\sl-
317\slmult0 \par\pard\qj\li1418\ri1538\sb14\sl-317\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pemilik atau representasi pemilik
mempunyai tanggung jawab dalam pengawasan \line \up0 \expndtw0\charscalex103
kendali mutu dan kendali biaya. Dalam rangka pelaksanaan kendali mutu dan \line
\up0 \expndtw0\charscalex102 biaya rumah sakit maka rumah sakit membuat program
peningkatan mutu dan \line \up0 \expndtw0\charscalex100 keselamatan pasien (PMKP).
Pemilik dan atau representasi pemilik mempunyai \line \up0 \expndtw0\charscalex100
kewajiban untuk mengkaji program PMKP yang diusulkan oleh Direktur Rumah \line \up0
\expndtw-2\charscalex100 Sakit dan menyetujui bila sudah sesuai dengan misi rumah
sakit dan melakukan \line \up0 \expndtw0\charscalex100 pengawasan implementasi
program PMKP secara berkesinambungan serta \line \up0 \expndtw0\charscalex100
berkelanjutan. Investasi mutu ini membutuhkan perencanaan sumber daya dan \line
\up0 \expndtw-3\charscalex100 perlu dievaluasi serta dimonitor melalui sistem yang
ditetapkan. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1602\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex103 Pemilik
atau representasi pemilik memberi persetujuan dan menerima laporan \up0 \expndtw-
3\charscalex100 pelaksanaan program mutu sebagai berikut: \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a) laporan capaian
indikator dan analisisnya setiap 3 bulan; \par\pard\ql \li1778\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 b) laporan kejadian tidak diharapkan
(KTD) setiap 6 bulan; \par\pard\ql \li1778\ri1591\sb8\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 c) laporan kejadian
sentinel setiap ada kejadian dan laporan ulang setelah \line\tab \up0 \expndtw-
2\charscalex100 kejadian sentinel. Selesai dilakukan analisis dengan menggunakan
metode \line \tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 root
cause analysis\ul0\nosupersub\cf7\f8\fs24 (RCA)\ul0\nosupersub\cf8\f9\fs24 .
\par\pard\qj \li1418\ri1595\sb4\sl-316\slmult0\fi67 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Pemilik atau representasi pemilik wajib memberikan
respons terhadap laporan \up0 \expndtw0\charscalex103 tersebut, khususnya bila
terjadi insiden keselamatan pasien dan capaian \up0 \expndtw0\charscalex102
pemenuhan indikator yang masih rendah, termasuk juga untuk perbaikan/
\up0 \expndtw0\charscalex100 memenuhi standar diperlukan dana/anggaran tambahan
maka representasi \up0 \expndtw0\charscalex104 pemilik diharapkan dapat
memperhatikan usulan tersebut dan membantu \up0 \expndtw-3\charscalex100
mengupayakan dana/anggaran tambahan tersebut. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb171\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 257
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg258}
{\bkmkend Pg258}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 1.3
\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\ri1545\sb25\sl-
300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Program peningkatan mutu dan keselamatan pasien rumah sakit telah \line\tab
\up0 \expndtw-4\charscalex100 disetujui oleh pemilik atau representasi pemilik.
(D,W) \par\pard\ql \li1778\ri1538\sb1\sl-300\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 2. Pemilik atau representasi pemilik telah
menerima laporan program \line\tab \up0 \expndtw-3\charscalex100 peningkatan mutu
dan keselamatan pasien tepat waktu sesuai dengan butir \line \tab \up0 \expndtw-
1\charscalex100 1 sampai dengan 3 yang ada di maksud dan tujuan. (lihat juga TKRS
4.1, \line \tab \up0 \expndtw-3\charscalex100 PMKP 5.EP 5) (D,W) \par\pard\ql
\li1778\sb20\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3. Representasi pemilik
menindaklanjuti laporan dari RS. (D,W) \par\pard\ql \li1485\sb0\sl-276\slmult0
\par\pard\ql\li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb0\sl-276\slmult0
\par\pard\ql\li1485\sb136\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
DIREKTUR/DIREKSI RUMAH SAKIT \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb132\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar TKRS 2 \par\pard\qj \li1418\ri1537\sb216\sl-
310\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Direktur
Rumah Sakit sebagai pimpinan tertinggi di rumah sakit bertanggung jawab \up0
\expndtw0\charscalex103 untuk menjalankan rumah sakit dan mematuhi peraturan
dan perundang\up0 \expndtw-3\charscalex100 undangan. \par\pard\ql
\li1418\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 2 \par\pard\qj
\li1418\ri1540\sb208\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pimpinan tertinggi organisasi rumah sakit adalah kepala
atau Direktur Rumah Sakit \line \up0 \expndtw0\charscalex100 dengan nama jabatan
kepala, direktur utama atau direktur, dalam standar \line \up0 \expndtw-
4\charscalex100 akreditasi ini disebut Direktur Rumah Sakit. Dalam menjalankan
operasional rumah \line \up0 \expndtw-4\charscalex100 sakit, direktur dapat dibantu
oleh wakil direktur atau direktur (bila pimpinan tertinggi \line \up0 \expndtw-
4\charscalex100 disebut direktur utama) sesuai dengan kebutuhan, kelompok ini
disebut direksi. \par\pard\qj \li1418\ri1598\sb180\sl-320\slmult0 \up0
\expndtw0\charscalex100 Kepemimpinan yang efektif sebuah rumah sakit sangat penting
agar rumah sakit \up0 \expndtw-3\charscalex100 dapat beroperasi secara efisien
serta memenuhi visi dan misinya. \par\pard\qj \li1418\ri1593\sb200\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Kepemimpinan rumah sakit dapat
dilaksanakan secara bersama-sama (direksi) \up0 \expndtw-3\charscalex100 atau
individual (direktur). \par\pard\qj \li1418\ri1598\sb205\sl-315\slmult0 \up0
\expndtw-2\charscalex100 Pendidikan dan pengalaman individu-individu tersebut
memenuhi persyaratan \up0 \expndtw-2\charscalex100 untuk melaksanakan tugas yang
termuat dalam uraian tugas serta sesuai dengan \up0 \expndtw0\charscalex103
peraturan dan perundang-undangan. Persyaratan untuk Direktur Rumah Sakit \up0
\expndtw0\charscalex104 sesuai dengan peraturan perundang-undangan adalah
tenaga medis ahli \up0 \expndtw-3\charscalex100 perumahsakitan. \par\pard\qj
\li1418\ri1600\sb201\sl-320\slmult0 \up0 \expndtw0\charscalex102 Direktur/Direksi
bertanggung jawab untuk menjalankan misi rumah sakit yang \up0 \expndtw-
1\charscalex100 sudah ditetapkan oleh pemilik atau representasi pemilik serta
menyusun regulasi \up0 \expndtw-3\charscalex100 pelayanan dan manajemen untuk
menjalankan rumah sakit. \par\pard\qj \li1418\ri1570\sb200\sl-320\slmult0 \up0
\expndtw0\charscalex103 Direktur/Direksi Rumah Sakit mempunyai uraian tugas,
tanggung jawab, dan \up0 \expndtw-4\charscalex100 wewenang antara lain
meliputi \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb103\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 258
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg259}
{\bkmkend Pg259}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1597\sb253\sl-300\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1) mengetahui dan memahami semua
peraturan perundang-undangan terkait \line\tab \up0 \expndtw-2\charscalex100 dengan
rumah sakit; \par\pard\qj \li1778\ri1606\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 2) menjalankan operasional rumah sakit dengan berpedoman pada
peraturan \line\tab \up0 \expndtw-3\charscalex100 perundang-undangan;
\par\pard\qj \li1778\ri1599\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
3) menjamin kepatuhan rumah sakit terhadap peraturan
perundang-\line\tab \up0 \expndtw-3\charscalex100 undangan; \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4) menetapkan regulasi
rumah sakit; \par\pard\qj \li1778\ri1601\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 5) menjamin kepatuhan staf rumah sakit dalam implementasi semua
regulasi \line\tab \up0 \expndtw-3\charscalex100 rumah sakit yang telah ditetapkan
dan disepakati bersama; \par\pard\qj \li1778\ri1602\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex102 6) menindaklanjuti terhadap semua laporan hasil
pemeriksaan badan audit \line\tab \up0 \expndtw-3\charscalex100 eksternal.
\par\pard\qj \li1778\ri1609\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex101
7) menetapkan proses untuk mengelola serta mengendalikan sumber daya \line\tab
\up0 \expndtw-3\charscalex100 manusia dan keuangan sesuai dengan peraturan
perundang-undangan. \par\pard\ql \li1418\sb217\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 2 \par\pard\ql
\li1778\ri1543\sb216\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang kualifikasi Direktur Rumah
Sakit dan uraian tugas, \line\tab \up0 \expndtw-2\charscalex100 tanggung jawab,
dan wewenang sebagaimana tercantum pada butir 1 \line \tab \up0 \expndtw-
4\charscalex100 sampai dengan 7 di maksud dan tujuan. (R) \par\pard\qj
\li1778\ri1605\sb2\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 2.
Kualifikasi Direktur Rumah Sakit sudah sesuai dengan persyaratan dan \line\tab \up0
\expndtw-3\charscalex100 peraturan perundang-undangan. (D,W) \par\pard\qj
\li1778\ri1597\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 3.
Direktur/Direksi Rumah Sakit patuh terhadap peraturan
perundang-\line\tab \up0 \expndtw-3\charscalex100 undangan. (D,W) \par\pard\ql
\li1778\ri1596\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104 4.
Direktur Rumah Sakit telah mengatur operasional rumah sakit setiap \line\tab
\up0 \expndtw0\charscalex100 hari termasuk semua tanggung jawab yang
dijelaskan dalam uraian \line \tab \up0 \expndtw-3\charscalex100 tugas. (D,W)
\par\pard\ql \li1778\sb17\sl-276\slmult0 \up0 \expndtw-1\charscalex100 5.
Direktur/Direksi Rumah Sakit telah menyusun dan mengusulkan rencana \par\pard\ql
\li2138\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 strategis serta anggaran
biaya kepada pemilik atau representasi pemilik \par\pard\ql \li2138\sb44\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 sesuai dengan regulasi. (lihat juga TKRS
1, TKRS 1.1, dan TKRS 1.2).(D,W) \par\pard\qj \li1778\ri1595\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 6. Direktur/Direksi Rumah Sakit
telah memastikan kepatuhan staf rumah sakit \line\tab \up0 \expndtw-3\charscalex100
terhadap regulasi rumah sakit yang sudah ditetapkan. (D,W) \par\pard\ql
\li1778\ri1600\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104 7.
Direktur/Direksi Rumah Sakit menindaklanjuti semua hasil laporan
\line\tab \up0 \expndtw0\charscalex102 pemeriksaan internal dari pemerintah atau
badan ekternal lainnya yang \line \tab \up0 \expndtw-3\charscalex100 mempunyai
kewenangan melakukan pemeriksaan rumah sakit. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb185\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 KEPALA
BIDANG/DIVISI DI RUMAH SAKIT \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar TKRS 3 \par\pard\qj \li1418\ri1591\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Para Kepala
Bidang/Divisi Rumah Sakit ditetapkan dan secara bersama, \up0 \expndtw-
1\charscalex100 bertanggung jawab untuk menjalankan misi dan membuat rencana serta
regulasi \up0 \expndtw-3\charscalex100 yang dibutuhkan untuk melaksanakan misi
tersebut. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb163\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 259
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg260}
{\bkmkend Pg260}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 3
\par\pard\qj \li1418\ri1537\sb188\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Dalam organisasi rumah sakit harus ditetapkan jabatan
pimpinan yang di bawah \up0 \expndtw-1\charscalex100 dan bertanggung jawab
kepada direktur rumah sakit. Sesuai peraturan dan \up0 \expndtw-
3\charscalex100 perundang-undangan-undangan pimpinan tersebut meliputi \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 a) unsur pimpinan pelayanan medis; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 b) unsur pimpinan keperawatan;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c) unsur
pimpinan penunjang medis; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 d) unsur pimpinan administrasi umum dan keuangan. \par\pard\qj
\li1418\ri1598\sb308\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Pimpinan pada
butir 1 sampai dengan 4 yang di atas di dalam standar tata kelola \up0 \expndtw-
3\charscalex100 rumah sakit ini selanjutnya disebut Kepala Bidang/Divisi.
\par\pard\qj \li1418\ri1603\sb200\sl-320\slmult0\fi67 \up0 \expndtw-1\charscalex100
Rumah sakit agar menetapkan persyaratan kualifikasi jabatan untuk para kepala
\up0 \expndtw-1\charscalex100 bidang/divisi tersebut serta menunjuk dan atau
mengusulkan pejabatnya yang \up0 \expndtw-3\charscalex100
sesuai dengan persyaratan dan kualifikasi tersebut. \par\pard\qj
\li1418\ri1593\sb206\sl-313\slmult0 \up0 \expndtw0\charscalex103 Para kepala
bidang/divisi tersebut agar dilibatkan dalam mendefinisi\up0
\expndtw0\charscalex102 operasionalkan misi RS. Berdasar atas misi tersebut, para
kepala bidang/divisi \up0 \expndtw0\charscalex102 bekerja-sama mengembangkan
berbagai rencana/program serta regulasi yang \up0 \expndtw-3\charscalex100
dibutuhkan untuk mencapai visi dan misi. \par\pard\qj \li1418\ri1600\sb202\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Misi dan regulasi yang ditetapkan oleh
pemilik harus dilaksanakan oleh direktur \up0 \expndtw-1\charscalex100 bersama sama
dengan para kepala bidang/divisi RS tersebut. (lihat juga APK 1, \up0 \expndtw-
2\charscalex100 EP 2, dan EP3) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS
3 \par\pard\qj \li1778\ri1544\sb225\sl-300\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit telah menetapkan
persyaratan jabatan, uraian tugas, tanggung \line\tab \up0 \expndtw-3\charscalex100
jawab, dan wewenang Kepala bidang/divisi Rumah Sakit secara tertulis. (R)
\par\pard\qj \li1778\ri1605\sb4\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
2. Kualifikasi kepala bidang/divisi sudah sesuai dengan persyaratan jabatan
\line\tab \up0 \expndtw-3\charscalex100 serta tugas pokoknya. (D,W) \par\pard\qj
\li1778\ri1605\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Ada
bukti koordinasi antarkepala bidang/divisi dalam menjalankan misi
\line\tab \up0 \expndtw-3\charscalex100 rumah sakit. (D,W) \par\pard\ql
\li1778\ri1605\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 4.
Ada bukti peran serta secara kolaboratif para kepala bidang/divisi dalam
\line\tab \up0 \expndtw0\charscalex102 menyusun berbagai regulasi yang
diperlukan untuk menjalankan misi. \line \tab \up0 \expndtw-2\charscalex100
(D,W) \par\pard\ql \li1778\ri1537\sb2\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 5. Ada bukti pelaksanaan pengawasan oleh para kepala bidang/divisi
untuk \line\tab \up0 \expndtw-4\charscalex100 menjamin kepatuhan staf terhadap
pelaksanaan regulasi rumah sakit sesuai \line \tab \up0 \expndtw-5\charscalex100
dengan misi rumah sakit. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 3.1
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb90\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 260
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg261}
{\bkmkend Pg261}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1541\sb214\sl-310\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Direktur Rumah Sakit dan para kepala bidang/divisi di
rumah sakit mengidentifikasi \up0 \expndtw-1\charscalex100 dan merencanakan jenis
pelayanan klinis yang dibutuhkan untuk memenuhi \up0 \expndtw-3\charscalex100
kebutuhan pasien yang dilayani rumah sakit tersebut. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb207\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan TKRS 3.1 \par\pard\qj \li1418\ri1535\sb211\sl-316\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelayanan pasien perlu direncanakan dan
dirancang untuk merespons kebutuhan \up0 \expndtw-2\charscalex100 pasien. Jenis
pelayanan yang diberikan harus tertulis dan harus konsisten dengan \up0
\expndtw0\charscalex100 misi rumah sakit. Kepala bidang/divisi menentukan
kualifikasi kepala dari setiap \up0 \expndtw0\charscalex100 departemen klinis dan
unit/instalasi pelayanan yang ada di r umah sakit, baik \up0 \expndtw-
3\charscalex100 pelayanan diagnostik, terapeutik, rehabilitatif, dan pelayanan
penting lainnya untuk \up0 \expndtw-4\charscalex100 kepentingan pasien.
\par\pard\qj \li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\ri1536\sb7\sl-
317\slmult0 \up0 \expndtw0\charscalex100 Para kepala bidang/divisi rumah sakit
juga membuat rencana bersama dengan \up0 \expndtw-2\charscalex100 para kepala unit
pelayanan tentang cakupan dan jenis pelayanan-pelayanan yang \up0 \expndtw-
1\charscalex100 disediakan oleh rumah sakit, baik secara langsung maupun
tidak langsung. \up0 \expndtw0\charscalex102 Direktur Rumah Sakit merencanakan dan
mengikut sertakan masyarakat/tokoh \up0 \expndtw-2\charscalex100 masyarakat,
fasilitas pelayanan kesehatan sekitar rumah sakit, dan pihak-pihak \up0
\expndtw-2\charscalex100 lainnya dalam merencanakan kebutuhan pelayanan kesehatan
untuk masyarakat. \up0 \expndtw-3\charscalex100 Bentuk pelayanan yang direncanakan
ini mencerminkan arah strategis rumah sakit \up0 \expndtw-4\charscalex100 dan
perspektif pasien yang dirawat di rumah sakit. \par\pard\qj \li1418\sb0\sl-
316\slmult0 \par\pard\qj\li1418\ri1536\sb8\sl-316\slmult0 \up0
\expndtw0\charscalex103 Para kepala bidang/divisi juga terlibat merencanakan
pelayanan pasien dalam \line \up0 \expndtw0\charscalex104 menentukan komunitas
dan populasi pasien untuk rumah sakit tersebut, \line \up0
\expndtw0\charscalex100 mengidentifikasi kepentingan pelayanan yang dibutuhkan oleh
masyarakat, dan \line \up0 \expndtw0\charscalex104 merencanakan komunikasi
berkelanjutan dengan kelompok pemangku \line \up0 \expndtw-3\charscalex100
kepentingan utama dalam komunitas. Komunikasi dapat secara langsung ditujukan \line
\up0 \expndtw-3\charscalex100 kepada individu atau melalui media massa atau melalui
lembaga dalam komunitas \line \up0 \expndtw-4\charscalex100 ataupun pihak ketiga.
Jenis informasi yang disampaikan meliputi \par\pard\qj \li1418\ri1582\sb1\sl-
320\slmult0 \up0 \expndtw0\charscalex102 informasi tentang layanan, jam kegiatan
kerja, dan proses untuk mendapatkan \up0 \expndtw0\charscalex100 perawatan; dan
informasi tentang kualitas layanan yang disediakan kepada \up0 \expndtw-
3\charscalex100 masyarakat dan sumber rujukan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian TKRS 3.1 \par\pard\qj \li1418\ri1612\sb208\sl-320\slmult0\tx1778 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 1. Ada penetapan jenis
pelayanan yang diberikan sesuai dengan misi rumah \line\tab \up0 \expndtw-
3\charscalex100 sakit. (lihat juga ARK 1, EP 1). (R) \par\pard\ql
\li1418\ri1611\sb9\sl-310\slmult0\tx1778\tx1778 \up0 \expndtw0\charscalex103 2.
Ada penetapan kualifikasi kepala unit pelayanan termasuk koordinator
\line\tab \up0 \expndtw0\charscalex106 pelayanan baik untuk unit pelayanan
diagnostik, terapeutik, maupun \line \tab \up0 \expndtw-1\charscalex100
rehabilitatif. (R) \par\pard\ql \li1418\ri1597\sb2\sl-320\slmult0\tx1778\tx1778
\up0 \expndtw0\charscalex103 3. Kepala bidang/divisi Rumah Sakit bersama dengan
kepala unit pelayanan \line\tab \up0 \expndtw-2\charscalex100 telah menyusun
cakupan dan jenis pelayanan yang disediakan di tiap-tiap unit \line \tab \up0
\expndtw-2\charscalex100 sesuai dengan kebutuhan pasien yang dilayani di rumah
sakit. (lihat juga ARK \par\pard\ql \li10156\sb176\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 261
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg262}
{\bkmkend Pg262}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1, EP 1). (D,W) \par\pard\ql
\li1418\ri1544\sb0\sl-320\slmult0\tx1778\tx1778\tx1778 \up0 \expndtw-
3\charscalex100 4. Rumah sakit memberikan informasi tentang pelayanan yang
disediakan kepada \line\tab \up0 \expndtw0\charscalex100 tokoh masyarakat, pemangku
kepentingan, fasilitas pelayanan kesehatan di \line \tab \up0
\expndtw0\charscalex103 sekitar rumah sakit, dan dapat menerima masukan
untuk peningkatan \line \tab \up0 \expndtw-3\charscalex100 pelayanannya. (D,W)
\par\pard\ql \li1418\sb25\sl-276\slmult0 \up0 \expndtw0\charscalex100 5. Direktur
Rumah Sakit memberikan data dan informasi sesuai dengan a) dan \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 b) pada maksud dan
tujuan. (lihat juga MKE 1.1, EP 4). (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb244\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 3.2 \par\pard\qj
\li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1542\sb8\sl-320\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai regulasi
untuk memastikan terselenggaranya komunikasi \up0 \expndtw-4\charscalex100 efektif
di rumah sakit. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 3.2 \par\pard\qj
\li1418\ri1536\sb10\sl-318\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Para kepala bidang/divisi Rumah Sakit bertanggung
jawab bahwa di seluruh \line \up0 \expndtw0\charscalex103 tempat di rumah sakit
terselenggara komunikasi yang efektif, yaitu komunikasi \line \up0
\expndtw0\charscalex103 antarkelompok profesional,
antarunit struktural, antara profesional dan \line \up0
\expndtw0\charscalex103 manajemen, juga profesional dengan organisasi di luar.
Direktur Rumah Sakit \line \up0 \expndtw0\charscalex100 memperhatikan akurasi dan
ketepatan waktu penyampaian informasi ke seluruh \line \up0 \expndtw0\charscalex100
tempat di rumah sakit. Direktur Rumah Sakit membentuk budaya kerjasama dan \line
\up0 \expndtw0\charscalex102 komunikasi untuk melakukan koordinasi serta integrasi
asuhan pasien. Metode \line \up0 \expndtw0\charscalex103 secara formal (contoh,
pembentukan komite atau tim gabungan) dan informal \line \up0
\expndtw0\charscalex102 (contoh, poster, surat kabar) digunakan untuk meningkatkan
peran pentingnya \line \up0 \expndtw-2\charscalex100 komunikasi antara berbagai
layanan dan anggota staf. Pengembangan koordinasi \line \up0 \expndtw-
4\charscalex100 layanan klinik yang baik diperoleh karena ada pengertian dari
setiap unit pelayanan \line \up0 \expndtw-5\charscalex100 untuk berkolaborasi
menyusun kebijakan dan prosedur. \par\pard\qj \li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\ri1593\sb6\sl-317\slmult0 \up0 \expndtw-1\charscalex100 Dalam
mengembangkan komunikasi dan koordinasi yang baik, rumah sakit perlu \up0
\expndtw0\charscalex102 mengatur pertemuan di setiap tingkat rumah sakit, misalnya
pertemuan direksi, \up0 \expndtw-1\charscalex100 pertemuan para kepala
bidang/divisi, dan pertemuan antarunit pelayanan. Selain \up0
\expndtw0\charscalex100 itu, perlu juga pertemuan antartingkat, misalnya pertemuan
direksi dengan para \up0 \expndtw-1\charscalex100 kepala bidang/divisi dengan
Kepala Unit Pelayanan. Di sisi lain, rumah sakit juga \up0 \expndtw0\charscalex103
perlu mengembangkan pertemuan antara profesi, misalnya pertemuan dokter, \up0
\expndtw-1\charscalex100 perawat, dan PPA lainnya dalam membahas pengembangan
pelayanan,\ul0\nosupersub\cf8\f9\fs24 update \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 ilmu pengetahuan, dan lain sebagainya. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 3.2
\par\pard\qj \li1778\ri1565\sb25\sl-300\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mengatur
pertemuan di setiap dan antartingkat di rumah \line\tab \up0 \expndtw-
3\charscalex100 sakit. (R) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb73\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 262
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg263}
{\bkmkend Pg263}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1544\sb253\sl-300\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Ada regulasi komunikasi efektif
antarprofesional pemberi pelayanan (PPA) \line\tab \up0 \expndtw-4\charscalex100
dan antarunit/instalasi/departemen pelayanan. (R) \par\pard\qj
\li1778\ri1598\sb0\sl-300\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3. Ada
bukti terselenggaranya pertemuan di setiap danantar tingkat di rumah \line\tab \up0
\expndtw-3\charscalex100 sakit. (D,W) \par\pard\qj \li1778\ri1552\sb0\sl-
300\slmult0\tx2138 \up0 \expndtw-3\charscalex100 4. Ada bukti komunikasi efektif
antarprofesional pemberi pelayanan (PPA) dan \line\tab \up0 \expndtw-
4\charscalex100 antarunit/instalasi/departemen pelayanan sudah dilaksanakan \up0
\expndtw-4\charscalex100 (D,W) \par\pard\qj \li1778\ri1607\sb0\sl-
300\slmult0\tx2138 \up0 \expndtw-1\charscalex100 5. Ada bukti pelaksanaan
pemberian informasi yang tepat waktu, akurat, dan \line\tab \up0 \expndtw-
3\charscalex100 relevan di lingkungan rumah sakit. (D,W) \par\pard\ql
\li1778\sb3\sl-276\slmult0\tx4113 \up0 \expndtw-2\charscalex100 6.
Direktur/direksi \tab \up0 \expndtw0\charscalex103 dan para kepala bidang/divisi
Rumah Sakit sudah \par\pard\qj \li2138\ri1596\sb5\sl-300\slmult0 \up0
\expndtw0\charscalex101 menyampaikan informasi tentang capaian program sesuai visi,
misi, dan \up0 \expndtw-3\charscalex100 rencana strategik kepada staf rumah sakit.
(lihat MKE 4) (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 MANAJEMEN SUMBER DAYA
MANUSIA \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar TKRS 3.3 \par\pard\qj
\li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\ri1591\sb21\sl-313\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan
proses yang seragam untuk melaksanakan \up0 \expndtw-2\charscalex100
penerimaan/pengangkatan (\ul0\nosupersub\cf8\f9\fs24
recruitment\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 retensi, pengembangan, dan pendidikan \up0 \expndtw-
1\charscalex100 berkelanjutan semua staf dengan melibatkan kepala bidang/divisi dan
kepala unit \up0 \expndtw-2\charscalex100 pelayanan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 3.3 \par\pard\qj
\li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1529\sb15\sl-316\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Kemampuan rumah sakit dalam
memberikan asuhan pasien berkaitan langsung \line \up0 \expndtw-8\charscalex100
dengan kemampuan rumah sakit menarik dan mempertahankan staf yang bermutu
\line \up0 \expndtw0\charscalex100 dan kompeten. Direktur Rumah Sakit sadar
bahwa mempertahankan staf lebih \line \up0 \expndtw-7\charscalex100 bermanfaat
dalam jangka waktu lama dibanding dengan jika menerima staf yang baru. \line
\up0 \expndtw-5\charscalex100 Mempertahankan (retensi) staf dapat bermanfaat untuk
Direktur Rumah Sakit dalam \line \up0 \expndtw-3\charscalex100 mendukung proses
pengembangan staf yang berkelanjutan. Direktur Rumah Sakit \line \up0 \expndtw-
5\charscalex100 membuat rencana/program serta melaksanakan program dan proses yang
berkaitan \line \up0 \expndtw-3\charscalex100 dengan penerimaan, retensi,
pengembangan, dan pendidikan berkelanjutan setiap \line \up0 \expndtw-
6\charscalex100 kategori staf\ul0\nosupersub\cf6\f7\fs24 dengan melibatkan para
kepala bidang/divisi dan unit pelayanan. \line \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Regulasi tentang kesempatan staf untuk mengikuti
pendidikan dan latihan harus \line \up0 \expndtw-7\charscalex100 sesuai dengan
peraturan perundang-undangan yang berlaku (60% pegawai @ 20 jam \line \up0
\expndtw-8\charscalex100 per tahun). \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 3.3 \par\pard\ql \li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\ri1601\sb26\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit memiliki
regulasi proses perencanaan dan pelaksanaan \line\tab \up0 \expndtw-
2\charscalex100 rekruimen, pengembangan staf, serta kompensasi yang melibatkan
kepala \line \tab \up0 \expndtw-2\charscalex100 bidang/divisi dan kepala unit
pelayanan. (R) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb86\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 263
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg264}
{\bkmkend Pg264}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1599\sb214\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 2. Ada bukti proses
perencanaan dan pelaksanaan rekrutmen, telah \line\tab \up0 \expndtw-
1\charscalex100 melibatkan kepala bidang/divisi dan kepala unit pelayanan. (lihat
juga KKS \line \tab \up0 \expndtw-2\charscalex100 2 dan KKS 8) (D,W)
\par\pard\qj \li1778\ri1600\sb2\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100
3. Ada bukti rumah sakit telah melaksanakan proses kompensasi untuk
\line\tab \up0 \expndtw-2\charscalex100 retensi staf. (D,W) \par\pard\ql
\li1778\ri1596\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 4.
Ada bukti pengembangan diri setiap staf dan pendidikan melibatkan kepala
\line\tab \up0 \expndtw-1\charscalex100 bidang/bagian/diklat dan kepala unit
pelayanan Rumah Sakit sesuai \line \tab \up0 \expndtw-3\charscalex100 dengan
profesi yang dibutuhkan. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb93\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 MANAJEMEN PENINGKATAN MUTU DAN KESELAMATAN PASIEN
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar TKRS 4 \par\pard\qj \li1418\ri1594\sb8\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Direktur
Rumah Sakit merencanakan, mengembangkan, serta melaksanakan \up0 \expndtw-
3\charscalex100 program peningkatan mutu dan keselamatan pasien. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 4.1 \par\pard\qj
\li1418\ri1602\sb16\sl-310\slmult0
\up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Direktur Rumah Sakit
memberikan laporan pelaksanaan program peningkatan \up0 \expndtw0\charscalex102
mutu dan keselamatan pasien kepada pemilik atau representasi pemilik sesuai \up0
\expndtw-3\charscalex100 dengan regulasi rumah sakit. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 4 dan TKRS
4.1 \par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1538\sb15\sl-
316\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Bila rumah
sakit ingin berhasil dalam memulai dan mempertahankan perbaikan \line \up0
\expndtw0\charscalex102 serta mengurangi risiko bagi pasien dan staf, kepemimpinan
dan perencanaan \line \up0 \expndtw-3\charscalex100 merupakan hal yang penting.
Kepemimpinan dan perencanaan dimulai dari pemilik \line \up0 \expndtw-
2\charscalex100 dan representasi pemilik, Direktur Rumah Sakit, para
pimpinan klinis, dan \line \up0 \expndtw-1\charscalex100 pimpinan manajerial
secara bersama-sama menyusun dan mengembangkan \line \up0 \expndtw-
1\charscalex100 program peningkatan mutu serta keselamatan pasien. Direktur
Rumah Sakit \line \up0 \expndtw0\charscalex102 bertanggung jawab untuk memulai
dan menyediakan dukungan berkelanjutan \line \up0 \expndtw0\charscalex104 dalam
hal komitmen rumah sakit terhadap mutu. Direktur Rumah Sakit \line
\up0 \expndtw0\charscalex100 mengembangkan program peningkatan mutu dan
keselamatan pasien serta \line \up0 \expndtw0\charscalex100 mengajukan
persetujuan program kepada representasi pemilik, dan melalui misi \line \up0
\expndtw-3\charscalex100 rumah sakit serta dukungan pemilik rumah sakit membentuk
suatu budaya mutu di \line \up0 \expndtw-4\charscalex100 rumah sakit. (lihat juga
KKS.1) \par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1552\sb1\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 Direktur Rumah Sakit memilih pendekatan
yang digunakan oleh rumah sakit untuk \line \up0 \expndtw-3\charscalex100 mengukur,
menilai, serta meningkatkan mutu dan keselamatan pasien.
\par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 264
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg265}
{\bkmkend Pg265}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1606\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pengukuran mutu dilakukan menggunakan indikator mutu di
tingkat rumah sakit \up0 \expndtw0\charscalex100 dan di tingkat unit pelayanan
yang merupakan kesatuan yang tidak dapat \up0 \expndtw-3\charscalex100
dipisahkan. \par\pard\qj \li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\ri1535\sb8\sl-317\slmult0 \up0 \expndtw-2\charscalex100 Di
samping itu, Direktur Rumah Sakit juga menetapkan bagaimana program
\line \up0 \expndtw-1\charscalex100 peningkatan mutu serta keselamatan pasien
diarahkan dan diatur setiap harinya, \line \up0 \expndtw-3\charscalex100 karena itu
Direktur Rumah Sakit perlu menetapkan organisasi yang mengelola dan \line \up0
\expndtw0\charscalex100 melaksanakan program peningkatan mutu serta keselamatan
pasien. Direktur \line \up0 \expndtw0\charscalex102 Rumah Sakit dapat membentuk
komite/tim peningkatan mutu dan keselamatan \line \up0 \expndtw0\charscalex100
pasien atau bentuk organisasi lainnya sesuai kondisi rumah sakit dan peraturan
\line \up0 \expndtw0\charscalex100 perundang-undangan. Pimpinan perlu memastikan
bahwa program tersebut \line \up0 \expndtw-3\charscalex100 mempunyai sumber daya
termasuk tenaga yang cukup agar dapat berjalan efektif. \par\pard\qj
\li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\ri1537\sb6\sl-317\slmult0 \up0
\expndtw-4\charscalex100 Direktur Rumah Sakit juga menerapkan suatu struktur dan
proses untuk memantau \line \up0 \expndtw-3\charscalex100 dan melakukan koordinasi
menyeluruh terhadap program yang ada di rumah sakit. \line \up0 \expndtw-
1\charscalex100 Tindakan ini memastikan koordinasi di seluruh unit pelayanan
dalam upaya \line \up0 \expndtw-2\charscalex100 pengukuran dan perbaikan.
Koordinasi ini dapat tercapai melalui pemantauan dari \line \up0
\expndtw0\charscalex102 unit/departemen mutu atau komite/tim peningkatan mutu, atau
struktur lainnya. \line \up0 \expndtw0\charscalex103 Koordinasi ini mendukung
pendekatan sistem untuk pemantauan kualitas dan \line \up0 \expndtw-1\charscalex100
aktivitas perbaikan sehingga mengurangi duplikasi upaya peningkatan mutu.
\line \up0 \expndtw0\charscalex101 Misalnya terdapat dua departemen
yang\ul0\nosupersub\cf6\f7\fs24 secara independen\ul0\nosupersub\cf7\f8\fs24
mengukur suatu \line \up0 \expndtw-3\charscalex100 proses atau luaran yang sama
(lihat juga KKS 2 dan PPI 10, EP 1). \par\pard\qj \li1418\ri1599\sb1\sl-320\slmult0
\up0 \expndtw-1\charscalex100 Direktur Rumah Sakit bertanggung jawab
melaporkan pelaksanaan program \line \up0 \expndtw0\charscalex100 peningkatan
mutu dan keselamatan pasien kepada representasi pemilik sebagai \up0 \expndtw-
3\charscalex100 berikut: \par\pard\ql \li1778\ri1602\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex103 1) setiap tiga bulan
yang meliputi capaian dan analisis indikator mutu area \line\tab \up0
\expndtw0\charscalex105 klinis, area manajemen, sasaran keselamatan
pasien, capaian \line \tab \up0 \expndtw0\charscalex100 implementasi panduan
praktik klinik, dan alur klinis serta penerapan \line \tab \up0 \expndtw-
3\charscalex100 sasaran keselamatan pasien; \par\pard\ql \li1778\ri1596\sb0\sl-
313\slmult0\tx2941\tx2138\tx2270\tx2551 \up0 \expndtw-2\charscalex100 2) setiap
\tab \up0 \expndtw0\charscalex100 6 (enam) bulan Direktur Rumah Sakit
melaporkan penerapan \line\tab \up0 \expndtw-3\charscalex100 keselamatan pasien
kepada representasi pemilik antara lain mencakup \line \tab \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf7\f8\fs24
jumlah dan jenis kejadian tidak diharapkan/insiden keselamatan pasien \line \tab
\up0 \expndtw-3\charscalex100 serta analisis akar masalahnya; \par\pard\qj
\li2270\ri1604\sb0\sl-320\slmult0\tx2551 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf7\f8\fs24 apakah pasien
dan keluarga telah mendapatkan informasi tentang \line\tab \up0 \expndtw-
2\charscalex100 kejadian tersebut; \par\pard\qj \li2270\ri1605\sb0\sl-
320\slmult0\tx2551 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf7\f8\fs24 tindakan yang telah diambil untuk meningkatkan
keselamatan sebagai \line\tab \up0 \expndtw-3\charscalex100 respons terhadap
kejadian tersebut; \par\pard\ql \li2270\sb25\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf7\f8\fs24
apakah tindakan perbaikan tersebut dipertahankan. \par\pard\ql
\li1778\ri1604\sb14\sl-313\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex103 3) khusus untuk kejadian sentinel, Direktur Rumah Sakit
wajib melaporkan \line\tab \up0 \expndtw-1\charscalex100 kejadian kepada pemilik
dan representasi pemilik paling lambat 2 x 24 jam \line \tab \up0 \expndtw-
2\charscalex100 setelah kejadian dan melaporkan ulang hasil analisis akar masalah
setelah \line \tab \up0 \expndtw-3\charscalex100 45 hari. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb118\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 265
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg266}
{\bkmkend Pg266}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1540\sb214\sl-310\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Representasi pemilik mengkaji dan merespons laporan
program peningkatan mutu \line \up0 \expndtw-2\charscalex100 dan keselamatan
pasien, khususnya terkait dengan capaian indikator yang masih \line \up0 \expndtw-
3\charscalex100 rendah. \par\pard\qj \li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\ri1536\sb8\sl-317\slmult0 \up0 \expndtw-3\charscalex100
Komunikasi informasi tentang program peningkatan mutu dan keselamatan pasien
\line \up0 \expndtw-2\charscalex100 secara berkala kepada staf merupakan hal yang
penting. Alur komunikasi mutu ini \line \up0 \expndtw0\charscalex102 dilakukan
melalui jalur yang efektif, seperti buletin, poster, pertemuan staf, dan \line \up0
\expndtw-1\charscalex100 proses sumber daya manusia. Informasi yang diberikan
antara lain dapat berupa \line \up0 \expndtw0\charscalex100 program baru atau
program yang baru saja selesai, perkembangan dalam \line \up0
\expndtw0\charscalex102 pencapaian Sasaran Keselamatan Pasien, hasil analisis
kejadian sentinel atau \line \up0 \expndtw-2\charscalex100 kejadian tidak
diinginkan lainnya, ataupun penelitian terkini maupun program \line \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24
benchmark\ul0\nosupersub\cf7\f8\fs24 . \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1597\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex100 Berdasar
atas hal di atas maka Direktur Rumah Sakit perlu menetapkan regulasi \up0 \expndtw-
1\charscalex100 peningkatan mutu dan keselamatan pasien yang dapat berbentuk
pedoman \up0 \expndtw0\charscalex100 peningkatan mutu sertakeselamatan pasien
dan prosedur-prosedur lainnya, \up0 \expndtw-3\charscalex100 antara lain berisi
sebagai berikut: \par\pard\ql \li1869\ri1600\sb0\sl-
320\slmult0\tx2229\tx2229\tx2229 \up0 \expndtw-3\charscalex100 a) \tab \up0
\expndtw0\charscalex101
penetapan organisasi yang mempunyai tugas mengarahkan, mengatur, \line\tab \up0
\expndtw-2\charscalex100 serta mengoordinasikan pelaksanaan program peningkatan
mutu dan \line \tab \up0 \expndtw-3\charscalex100 keselamatan pasien; \par\pard\qj
\li1869\ri1535\sb0\sl-320\slmult0\tx2229\tx2229 \up0 \expndtw-3\charscalex100 b)
\tab \up0 \expndtw-4\charscalex100 peran Direkktur Rumah Sakit dan para pimpinan
dalam merencanakan dan \line\tab \up0 \expndtw-3\charscalex100 mengembangkan
program peningkatan mutu serta keselamatan pasien; \line \up0 \expndtw-
3\charscalex100 c) \up0 \expndtw-3\charscalex100 peran Direktur Rumah Sakit dan
para pimpinan dalam pemilihan indikator \par\pard\qj \li2229\ri1602\sb0\sl-
310\slmult0 \up0 \expndtw0\charscalex102 mutu di tingkat rumah sakit (indikator
area klinik, area manajemen, dan \up0 \expndtw-1\charscalex100 sasaran keselamatan
pasien) serta keterlibatnnya dalam menindaklanjuti \up0 \expndtw-3\charscalex100
capaian indikator yang masih rendah; \par\pard\qj \li1869\ri1599\sb0\sl-
320\slmult0\tx2229\tx2229 \up0 \expndtw-3\charscalex100 d) \tab \up0 \expndtw-
1\charscalex100 peran Direktur Rumah Sakit dan para pimpinan dalam memilih
area \line\tab \up0 \expndtw-3\charscalex100 prioritas sebagai area fokus untuk
perbaikan; \par\pard\ql \li1869\ri1600\sb0\sl-320\slmult0\tx2229\tx2229\tx2229 \up0
\expndtw-3\charscalex100 e) \tab \up0 \expndtw-2\charscalex100 monitoring
pelaksanaan program peningkatan mutu dan keselamatan \line\tab \up0 \expndtw-
2\charscalex100 pasien, siapa saja yang melakukan monitoring, kapan
dilakukan, dan \line \tab \up0 \expndtw-3\charscalex100 bagaimana melakukan
monitoringnya; \par\pard\li1869\sb26\sl-276\slmult0\fi0\tx2296 \up0
\expndtw0\charscalex100 f)\tab \up0 \expndtw0\charscalex100 proses pengumpulan
data, analisis,\ul0\nosupersub\cf8\f9\fs24 feedback\ul0\nosupersub\cf7\f8\fs24 ,
dan pemberian informasi\par\pard\li1869\sb43\sl-276\slmult0\fi360 \up0
\expndtw0\charscalex100 kepada staf;\par\pard\qj \li1869\ri1543\sb0\sl-
320\slmult0\tx2229\tx2229 \up0 \expndtw-4\charscalex100 g) \tab \up0 \expndtw-
4\charscalex100 bagaimana alur laporan pelaksanaan pengukuran mutu rumah sakit,
mulai \line\tab \up0 \expndtw-4\charscalex100 dari unit sampai kepada pemilik rumah
sakit; \par\pard\ql \li1869\ri1600\sb0\sl-320\slmult0\tx2229\tx2229\tx2229 \up0
\expndtw-3\charscalex100 h) \tab \up0 \expndtw-1\charscalex100 bantuan
teknologi/sistem informasi rumah sakit yang akan diterapkan \line\tab \up0
\expndtw0\charscalex101 untuk pengumpulan dan analisis data mutu, keselamatan
pasien, dan \line \tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24
surveilance\ul0\nosupersub\cf7\f8\fs24 infeksi. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb52\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 4 \par\pard\qj
\li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1605\sb8\sl-320\slmult0\tx2138
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Direktur Rumah Sakit
menetapkan regulasi berupa pedoman peningkatan \line\tab \up0 \expndtw-
3\charscalex100 mutu dan keselamatan pasien yang meliputi butir 1 sampai dengan 8
di \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 266
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg267}
{\bkmkend Pg267}\par\pard\qj \li2138\sb0\sl-300\slmult0 \par\pard\qj\li2138\sb0\sl-
300\slmult0 \par\pard\qj\li2138\sb0\sl-300\slmult0
\par\pard\qj\li2138\ri1539\sb253\sl-300\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 maksud dan tujuan beserta programnya serta penetapan
indikatornya. (lihat \up0 \expndtw-4\charscalex100 PMKP 2 dan PMKP 2.1) (R)
\par\pard\ql \li1778\ri1604\sb4\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 2. Ada bukti Direktur Rumah Sakit dan para kepala
bidang/divisi telah \line\tab \up0 \expndtw0\charscalex101 berpartisipasi dalam
upaya merencanakan, mengembangkan, serta \line \tab \up0 \expndtw-
2\charscalex100 melaksanakan program peningkatan mutu dan keselamatan pasien
di \line \tab \up0 \expndtw-2\charscalex100 rumah sakit. (D,W) \par\pard\ql
\li1778\ri1543\sb5\sl-315\slmult0\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 3. Ada bukti keterlibatan Direktur Rumah Sakit dan para
kepala bidang/divisi \line\tab \up0 \expndtw-2\charscalex100 dalam memilih
indikator mutu di tingkat rumah sakit, merencanakan \line \tab \up0 \expndtw-
2\charscalex100 perbaikan serta mempertahankan perbaikan mutu dan
keselamatan \line \tab \up0 \expndtw-3\charscalex100 pasien, juga menyediakan staf
terlatih untuk program peningkatan mutu dan \line \tab \up0 \expndtw-
4\charscalex100 keselamatan pasien. (lihat PMKP 1, PMKP 3, PMKP 4.1, PMKP 4.2,
PMKP \par\pard\ql \li2138\sb38\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4.3)
(D,W) \par\pard\ql \li1778\ri1579\sb8\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex103 4. Direktur Rumah Sakit telah menyediakan teknologi
informasi (IT) untuk \line\tab \up0 \expndtw-3\charscalex100 sistem manajemen data
indikator mutu dan sumber daya yang cukup untuk \line \tab \up0 \expndtw-
1\charscalex100 pelaksanaan program peningkatan mutu serta keselamatan pasien
setiap \line \tab \up0 \expndtw-3\charscalex100 harinya. (D,O,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb105\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 4.1 \par\pard\ql \li1778\sb0\sl-
320\slmult0 \par\pard\ql\li1778\ri1612\sb8\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Direktur Rumah Sakit telah
melaksanakan pemantauan dan koordinasi \line\tab \up0 \expndtw0\charscalex100
program peningkatan mutu dan keselamatan pasien pada perbaikan \line \tab
\up0 \expndtw-3\charscalex100 struktur dan proses serta hasil. (D, O, W)
\par\pard\ql \li1778\ri1604\sb6\sl-313\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 2. Direktur Rumah Sakit melaporkan pelaksanaan
program peningkatan \line\tab \up0 \expndtw0\charscalex102 mutu dan keselamatan
pasien kepada pemilik atau representasi pemilik \line \tab \up0
\expndtw0\charscalex104 sebagaimana diatur di 1) sampai dengan 3) yang ada di
maksud dan \line \tab \up0 \expndtw-1\charscalex100 tujuan. \up0 \expndtw-
1\charscalex100 (lihat juga PMKP 5, EP 5.) (D,W) \par\pard\ql
\li1778\ri1551\sb2\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104 3.
Informasi tentang program peningkatan mutu dan keselamatan pasien \line\tab \up0
\expndtw-6\charscalex100 secara berkala dikomunikasikan kepada staf, antara
lain mencakup \line \tab \up0 \expndtw-7\charscalex100 perkembangan dalam
pencapaian sasaran keselamatan pasien. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 5 \par\pard\qj
\li1418\ri1590\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Direktur rumah sakit memprioritaskan proses di rumah
sakit yang akan diukur, \line \up0 \expndtw-2\charscalex100 program peningkatan
mutu dan keselamatan pasien yang akan diterapkan, serta \line \up0 \expndtw-
2\charscalex100 bagaimana mengukur keberhasilan dalam upaya di seluruh rumah sakit
ini. \par\pard\ql \li1418\sb265\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 5 \par\pard\qj
\li1418\ri1392\sb0\sl-320\slmult0 \up0 \expndtw-7\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Karena terdapat keterbatasan staf dan sumber daya,
tidak semua proses di rumah sakit \line \up0 \expndtw-1\charscalex100 dapat diukur
dan diperbaiki pada saat yang bersamaan. Oleh karena itu, tanggung \line \up0
\expndtw-4\charscalex100 jawab utama Direktur Rumah Sakit adalah menetapkan
prioritas pengukuran dan \line \up0 \expndtw-1\charscalex100 perbaikan di
seluruh rumah sakit. Prioritas ini meliputi upaya pengukuran dan \line
\up0 \expndtw-5\charscalex100 perbaikan yang memengaruhi atau mencerminkan
aktivitas yang terdapat di berbagai \line \up0 \expndtw-2\charscalex100 unit
pelayanan. Direktur Rumah Sakit berfokus pada upaya pengukuran dan
\line \up0 \expndtw-5\charscalex100 peningkatan mutu rumah sakit, termasuk
pengukuran dan aktivitas yang berhubungan \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb51\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 267
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg268}
{\bkmkend Pg268}\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1394\sb195\sl-315\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf7\f8\fs24 dengan kepatuhan penuh terhadap sasaran
keselamatan pasien. Prioritas dapat \up0 \expndtw-1\charscalex100 berfokus pada
pencapaian tujuan strategis; misalnya, untuk menjadi pusat rujukan \up0
\expndtw0\charscalex100 regional. Sebagai contoh: suatu rumah sakit menjadi pusat
rujukan regional maka \up0 \expndtw-4\charscalex100 Direktur Rumah Sakit akan
meningkatkan mutu pelayanan rumah sakit tersebut \up0 \expndtw-7\charscalex100
sehingga mampu menjadi rujukan di tingkat regional tersebut. \par\pard\qj
\li1418\ri1470\sb50\sl-310\slmult0 \up0 \expndtw0\charscalex104 Direktur Rumah
Sakit dengan para pimpinan dan komite/tim peningkatan mutu \up0
\expndtw0\charscalex100 dan keselamatan pasien merancang upaya peningkatan mutu
pelayanan prioritas \up0 \expndtw-1\charscalex100 rumah sakit dengan memperhatikan
beberapa hal. \par\pard\ql
\li1519\sb79\sl-276\slmult0\tx1879 \up0 \expndtw-3\charscalex100 a) \tab \up0
\expndtw0\charscalex100 Misi Rumah Sakit. \par\pard\ql \li1519\ri1470\sb11\sl-
316\slmult0\tx1879\tx1879\tx1879\tx1879\tx1879\tx1879 \up0 \expndtw-3\charscalex100
b) \tab \up0 \expndtw0\charscalex102 Data-data permasalahan yang ada, misalnya
komplain pasien, capaian \line\tab \up0 \expndtw0\charscalex101 indikator mutu
yang masih rendah, terdapat kejadian tidak diharapkan. \line \up0 \expndtw-
3\charscalex100 c) \up0 \expndtw0\charscalex103 Terdapat sistem serta proses yang
memperlihatkan variasi penerapan dan \line\tab \up0 \expndtw0\charscalex104 hasil
yang paling banyak, misalnya pelayanan pasien strok yang dilakukan \line \tab
\up0 \expndtw0\charscalex100 oleh lebih satu dokter spesialis saraf dan
memperlihatkan proses pelayanan \line \tab \up0 \expndtw0\charscalex100 yang masih
bervariasi atau belum terstandardisasi sehingga hasil pelayanan \line \tab \up0
\expndtw0\charscalex100 juga bervariasi. \par\pard\ql \li1519\ri1393\sb5\sl-
316\slmult0\tx1879\tx1879\tx1879\tx1879\tx1879\tx1879\tx1879 \up0 \expndtw-
3\charscalex100 d) \tab \up0 \expndtw0\charscalex102 Dampak dari perbaikan misalnya
penilaian perbaikan efisiensi suatu proses \line\tab \up0 \expndtw0\charscalex102
klinis yang kompleks pada pelayanan strok, pelayanan jantung dan lainnya, \line
\tab \up0 \expndtw0\charscalex102 dan/atau identifikasi pengurangan biaya serta
sumber daya yang digunakan \line \tab \up0 \expndtw-4\charscalex100 dengan
perbaikan suatu proses. Penilaian dampak dari perbaikan tersebut akan \line \tab
\up0 \expndtw0\charscalex100 menunjang pemahaman tentang biaya relatif yang
dikeluarkan demi investasi \line \tab \up0 \expndtw0\charscalex100 mutu dan sumber
daya manusia, finansial, dan keuntungan lain dari investasi \line \tab \up0
\expndtw-1\charscalex100 tersebut. Untuk ini perlu pembuatan program \up0
\expndtw-1\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
tool\ul0\nosupersub\cf7\f8\fs24 ) sederhana untuk \par\pard\qj
\li1879\ri1447\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex100 menghitung sumber
daya yang digunakan pada proses yang lama dan pada \up0 \expndtw-3\charscalex100
proses yang baru. \par\pard\ql \li1519\ri1455\sb6\sl-
313\slmult0\tx1879\tx1879\tx1879 \up0 \expndtw-3\charscalex100 e) \tab \up0
\expndtw-1\charscalex100 Dampak pada perbaikan sistem sehingga efek perbaikan
dapat terjadi di \line\tab \up0 \expndtw-3\charscalex100 seluruh rumah sakit,
misalnya sistem manajemen obat di rumah sakit. \line \up0 \expndtw-1\charscalex100
f) \up0 \expndtw0\charscalex103 Riset klinik dan program pendidikan profesi
kesehatan merupakan prioritas \line\tab \up0 \expndtw-3\charscalex100 untuk rumah
sakit pendidikan. \par\pard\qj \li1519\sb0\sl-320\slmult0
\par\pard\qj\li1519\ri1397\sb62\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Berdasar atas hal tersebut di atas, Direktur Rumah Sakit membuat
program \up0 \expndtw-1\charscalex100 peningkatan mutu pelayanan prioritas
dengan mengembangkan standardisasi \up0 \expndtw0\charscalex102 proses dan
hasil asuhan klinis pelayanan prioritas serta mengembangkan \up0 \expndtw-
1\charscalex100 pengukuran mutu klinis, manajerial, dan penerapan sasaran
keselamatan pasien. \up0 \expndtw-6\charscalex100 (lihat juga PMKP 5)
\par\pard\ql \li1485\sb0\sl-276\slmult0 \par\pard\ql\li1485\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS
5 \par\pard\ql \li1778\ri1604\sb308\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai
program peningkatan mutu prioritas dengan \line\tab \up0
\expndtw0\charscalex100 memperhatikan butir 1 sampai dengan 6 yang ada di maksud
dan tujuan. \line \tab \up0 \expndtw-3\charscalex100 (lihat juga PMKP 5) (R)
\par\pard\qj \li1778\ri1566\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
2. Ada bukti peran Direktur Rumah Sakit dan para Kepala Bidang/Divisi dalam
\line\tab \up0 \expndtw-2\charscalex100 proses penyusunan program peningkatan
mutu, prioritas, monitoring \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb163\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 268
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg269}
{\bkmkend Pg269}\par\pard\li2138\sb0\sl-276\slmult0\par\pard\li2138\sb0\sl-
276\slmult0\par\pard\li2138\sb0\sl-276\slmult0\par\pard\li2138\sb0\sl-
276\slmult0\par\pard\li2138\sb71\sl-276\slmult0\fi0\tx7253 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 pelaksanaan, dan rencana perbaikan
mutu.\tab \up0 \expndtw-2\charscalex100 (lihat PMKP 4.2, 4.3,
4.4)\par\pard\ql \li2138\sb21\sl-276\slmult0 \up0 \expndtw-2\charscalex100 (D,W)
\par\pard\ql \li1778\ri1599\sb8\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 3. Ada bukti riset klinik dan program pendidikan profesi
kesehatan sebagai \line\tab \up0 \expndtw0\charscalex100 salah satu program
peningkatan mutu prioritas di rumah sakit pendidikan. \line \tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\qj \li1778\ri1547\sb0\sl-320\slmult0\tx2138 \up0
\expndtw-2\charscalex100 4. Ada pengukuran pelaksanaan sasaran keselamatan
pasien tercantum \line\tab \up0 \expndtw-4\charscalex100 pada program
peningkatan mutu prioritas. (lihat PMKP 4.4) (D,W) \par\pard\ql
\li1778\ri1543\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf6\f7\fs24 5.\ul0\nosupersub\cf7\f8\fs24 Ada bukti kajian dampak
perbaikan di rumah sakit secara keseluruhan dan \line\tab \up0 \expndtw-
3\charscalex100 juga pada tingkatan departemen/unit layanan terhadap efisiensi dan
sumber \line \tab \up0 \expndtw-4\charscalex100 daya yang digunakan. (lihat juga
PMKP 7) (D) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb259\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 MANAJEMEN
KONTRAK \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar TKRS 6 \par\pard\qj
\li1418\ri1598\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Para kepala bidang/divisi di RS bertanggung jawab
untuk mengkaji/\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 ,
\up0 \expndtw-2\charscalex100 memilih, serta memantau kontrak klinis dan kontrak
manajerial. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 6
\par\pard\qj \li1418\ri1538\sb212\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Sesuai dengan peraturan perundang-undangan, rumah sakit
wajib menyediakan \up0 \expndtw-2\charscalex100 pelayanan klinis dan manajemen.
Rumah sakit dapat mempunyai pilihan memberi \up0 \expndtw-3\charscalex100 pelayanan
klinis dan manajemen ini secara langsung atau dapat melalui kontrak \up0
\expndtw-2\charscalex100 atau perjanjian lainnya. Kontrak pelayanan klinis
disebut kontrak klinis dan untuk \up0 \expndtw-3\charscalex100 kontrak pelayanan
manajemen disebut kontrak manajemen. \par\pard\qj \li1418\ri1590\sb201\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Kontrak dapat juga berhubungan dengan
staf profesional kesehatan. Apabila \line \up0 \expndtw-3\charscalex100 kontrak
berhubungan dengan staf profesional kesehatan \up0 \expndtw-3\charscalex100
(misalnya\ul0\nosupersub\cf6\f7\fs24 ,\ul0\nosupersub\cf7\f8\fs24 kontrak
\par\pard\qj \li1418\ri1538\sb5\sl-315\slmult0 \up0 \expndtw-2\charscalex100
perawat untuk perawatan kritis,\ul0\nosupersub\cf8\f9\fs24 home
care,\ul0\nosupersub\cf7\f8\fs24 dokter tamu/dokter paruh waktu, \line \up0
\expndtw-3\charscalex100 profesional pemberi asuhan lainnya, dll.) maka kontrak
harus menyebutkan bahwa \line \up0 \expndtw-1\charscalex100 staf profesional
tersebut memenuhi persyaratan yang ditetapkan rumah sakit dan \line \up0
\expndtw0\charscalex100 peraturan perundang-undangan. Rumah sakit mempunyai
regulasi kontrak klinis \line \up0 \expndtw-2\charscalex100 yang antara lain
meliputi kredensial, rekredensial, dan penilaian kinerja. \par\pard\qj
\li1418\ri1597\sb201\sl-320\slmult0 \up0 \expndtw0\charscalex103 Kontrak manajemen
dapat meliputi kontrak untuk alat laboratorium, pelayanan \up0
\expndtw0\charscalex103 akuntansi keuangan, kerumahtanggaaan seperti sekuriti,
parkir, makanan, \up0 \expndtw-2\charscalex100 linen/\ul0\nosupersub\cf8\f9\fs24
laundry\ul0\nosupersub\cf7\f8\fs24 , dan pengolah limbah sesuai dengan kebutuhan
rumah sakit. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb244\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 269
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg270}
{\bkmkend Pg270}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1586\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelayanan yang dikontrakkan dapat meliputi pelayanan
radiologi dan pencitraan \up0 \expndtw-2\charscalex100 diagnostik hingga pelayanan
akuntansi keuangan dan pelayanan yang disediakan \up0 \expndtw-3\charscalex100
untuk\ul0\nosupersub\cf8\f9\fs24 housekeeping,\ul0\nosupersub\cf7\f8\fs24
makanan, dan linen. \par\pard\qj \li1418\ri1536\sb202\sl-320\slmult0 \up0 \expndtw-
4\charscalex100 Direktur Rumah Sakit menjabarkan secara tertulis jenis
dan ruang lingkup
\up0 \expndtw-5\charscalex100 pelayanan yang disediakan melalui perjanjian
kontrak. \par\pard\qj \li1418\ri1603\sb200\sl-320\slmult0 \up0
\expndtw0\charscalex100 Direktur Rumah Sakit menjabarkan secara tertulis, sifat dan
cakupan pelayanan \up0 \expndtw-3\charscalex100 yang disediakan melalui perjanjian
kontrak. \par\pard\qj \li1418\ri1539\sb206\sl-313\slmult0 \up0 \expndtw-
3\charscalex100 Dalam semua hal, Direktur Rumah Sakit bertanggung jawab terhadap
kontrak atau \up0 \expndtw-2\charscalex100 pengaturan lain untuk memastikan bahwa
pelayanan dapat memenuhi kebutuhan \line \up0 \expndtw-2\charscalex100 pasien dan
merupakan bagian dari kegiatan manajemen serta peningkatan mutu \line \up0
\expndtw-3\charscalex100 rumah sakit. \par\pard\qj \li1418\ri1542\sb204\sl-
317\slmult0 \up0 \expndtw-1\charscalex100 Kepala bidang/divisi pelayanan klinis dan
kepala unit/instalasi/departemen terkait \up0 \expndtw0\charscalex100
berpartisipasi dalam seleksi kontrak klinis dan bertanggung jawab untuk kontrak
\up0 \expndtw0\charscalex100 klinis. Kepala bidang/divisi manajemen dan kepala
unit/instalasi/departemen \up0 \expndtw-3\charscalex100 terkait berpartisipasi
dalam seleksi terhadap kontrak manajemen dan bertanggung \up0
\expndtw0\charscalex103 jawab atas kontrak manajemen tersebut. Kepala
bidang/divisi dan kepala \up0 \expndtw-3\charscalex100 unit/instalasi/departemen
selain berpartisipasi dalam meninjau dan memilih semua \up0 \expndtw-
2\charscalex100 kontrak klinis atau kontrak manajemen, juga bertanggung jawab untuk
memantau \up0 \expndtw-3\charscalex100 kontrak tersebut. (lihat juga ARK 1 dan MKRM
6) \par\pard\qj \li1418\ri1604\sb201\sl-320\slmult0 \up0 \expndtw-1\charscalex100
Berdasar atas hal di atas maka kontrak atau perjanjian lainnya perlu
diatur \up0 \expndtw-2\charscalex100 regulasinya yang antara lain meliputi
\par\pard\qj \li1778\ri1577\sb200\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 a) penunjukan penanggung jawab untuk kontrak klinis dan penanggung
jawab \line\tab \up0 \expndtw-3\charscalex100 untuk kontrak manajemen; \par\pard\qj
\li1778\ri1596\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 b) seleksi
kontrak berdasar atas kepatuhan peraturan perundang-undangan \line\tab \up0
\expndtw-3\charscalex100 yang terkait; \par\pard\ql \li1778\sb17\sl-276\slmult0
\up0 \expndtw-3\charscalex100 c) penetapan kontrak dan dokumen kontraknya;
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) dokumen
menyebutkan pengalihan tanggung jawab pada pihak kedua; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e) monitoring mutu
kontrak; \par\pard\qj \li1778\ri1606\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 f) teguran dan pemutusan kontrak bila mutu pelayanan yang
disediakan \line\tab \up0 \expndtw-3\charscalex100 melalui kontrak tidak sesuai
dengan kontrak; \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 g)\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24
kontrak untuk perpanjangan. \par\pard\qj \li1418\ri1547\sb216\sl-310\slmult0
\up0 \expndtw-1\charscalex100 Selain kontrak atau perjanjian lainnya terkait
dengan pelayanan yang harus \line \up0 \expndtw-3\charscalex100 disediakan,
rumah sakit juga perlu mengatur terkait dengan kontrak atau perjanjian \line
\up0 \expndtw-3\charscalex100 lainnya yang terkait dengan sumber daya manusia,
khususnya untuk staf medis. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb207\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS
6 \par\pard\ql \li1778\sb244\sl-276\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi tentang kontrak atau
perjanjian lainnya \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb210\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 270
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg271}
{\bkmkend Pg271}\par\pard\qj \li2138\sb0\sl-300\slmult0 \par\pard\qj\li2138\sb0\sl-
300\slmult0 \par\pard\qj\li2138\sb0\sl-300\slmult0
\par\pard\qj\li2138\ri2061\sb253\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 yang antara lain meliputi 1 sampai dengan 7 yang ada di
maksud dan \up0 \expndtw-1\charscalex100 tujuan. (R) \par\pard\ql \li1778\sb40\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 2. Rumah sakit mempunyai regulasi
tentang perjanjian kerja staf medis \par\pard\ql \li2138\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex100 yang antara lain meliputi kredensial, rekredensial, dan
penilaian kinerja. \par\pard\ql \li2138\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 (R) \par\pard\qj \li1778\ri2029\sb8\sl-320\slmult0\tx2138 \up0
\expndtw-1\charscalex100 3. Rumah sakit mempunyai dokumen kontrak untuk semua
kontrak yang \line\tab \up0 \expndtw-1\charscalex100 sudah dilaksanakan. (D,W)
\par\pard\qj \li1778\ri1551\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex106
4. Setiap dokter yang memberikan pelayanan di rumah sakit sudah
\line\tab \up0 \expndtw-3\charscalex100 menandatangani perjanjian sesuai dengan
regulasi rumah sakit. (D,W) \par\pard\qj \li1778\ri1613\sb0\sl-320\slmult0\tx2138
\up0 \expndtw-1\charscalex100 5. Ada bukti Kepala bidang/divisi pelayanan klinis
dan Kepala unit pelayanan \line\tab \up0 \expndtw-2\charscalex100 telah
berpartisipasi dan \up0 \expndtw-4\charscalex100 bertanggung jawab terhadap
peninjauan, \par\pard\qj \li2138\ri1604\sb0\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 pemilihan, dan pemantauan kontrak pelayanan klinis termasuk
kontrak \line \up0 \expndtw-1\charscalex100 peralatan medis dan telah dilaksanakan.
(lihat juga AP 5.1, EP 5, dan AP \par\pard\ql \li2138\sb17\sl-276\slmult0 \up0
\expndtw-1\charscalex100 6.1, EP 5). (D,W) \par\pard\ql \li1778\ri1538\sb25\sl-
300\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex106 6. Ada bukti Kepala
bidang/divisi manajemen dan Kepala unit kerja \line\tab \up0 \expndtw-
3\charscalex100 berpartisasi dan bertanggung jawab terhadap peninjauan,
pemilihan, \line \tab \up0 \expndtw-4\charscalex100 dan pemantauan kontrak
manajemen. (D,W) \par\pard\qj \li1778\ri1613\sb0\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 7. Ada bukti apabila kontrak dinegosiasikan ulang atau
dihentikan maka \line\tab \up0 \expndtw-1\charscalex100 rumah sakit tetap menjaga
kontinuitas dari pelayanan pasien. (D,O,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb45\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 6.1 \par\pard\qj
\li1418\ri1595\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex106
\ul0\nosupersub\cf7\f8\fs24 Kontrak dan perjanjian lainnya dievaluasi sebagai
bagian dari program \up0 \expndtw-3\charscalex100 peningkatan mutu dan
keselamatan pasien rumah sakit. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 6.1
\par\pard\qj \li1418\ri1540\sb211\sl-316\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit perlu melakukan evaluasi mutu pelayanan dan
keselamatan pasien \line \up0 \expndtw0\charscalex103 pada semua pelayanan di rumah
sakit, baik yang secara langsung disediakan \line \up0 \expndtw0\charscalex104
sendiri oleh rumah sakit maupun yang disediakan berdasar atas kontrak atau \line
\up0 \expndtw-3\charscalex100 perjanjian lainnya. Rumah sakit perlu mendapatkan
informasi mutu dari pelayanan \line \up0 \expndtw-1\charscalex100 yang disediakan
berdasar atas kontrak atau perjanjian lainnya, lalu menganalisis \line \up0
\expndtw-3\charscalex100 informati tersebut, kemudian mengambil tindakan berdasar
atas data dan informasi \line \up0 \expndtw-3\charscalex100 tersebut. Pelayanan
yang disediakan berdasar atas kontrak dan perjanjian lainnya \line \up0
\expndtw0\charscalex102 perlu mencantumkan indikator mutu yang dapat dipergunakan
untuk mengukur \line \up0 \expndtw0\charscalex100 mutu pelayanan yang disediakan
berdasar atas kontrak tersebut. Data indikator \line \up0 \expndtw-4\charscalex100
mutu apa saja yang harus dikumpulkan dan dilaporkan ke Komite/Tim Mutu rumah \line
\up0 \expndtw-5\charscalex100 sakit, frekuensi pengumpulan data, dan format
pengumpulan data. \par\pard\qj \li1418\ri1535\sb201\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Kepala unit pelayanan/departemen menerima laporan mutu dari
penyedia kontrak \up0 \expndtw-3\charscalex100 yang kemudian ditindaklanjuti dan
memastikan bahwa laporan-laporan tersebut di\up0 \expndtw-3\charscalex100
integrasikan ke dalam proses penilaian mutu rumah sakit. (lihat juga APK 4.1,
EP \up0 \expndtw-4\charscalex100 , dan APK.5, EP 4 dan 6). \par\pard\qj
\li1418\ri1606\sb200\sl-320\slmult0 \up0 \expndtw0\charscalex100 Sebagai contoh:
makanan pasien di rumah sakit disediakan berdasar atas kerja \line \up0
\expndtw0\charscalex100 sama dengan pihak ketiga. Dengan demikian, pelayanan
makanan yang \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb23\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 271
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg272}
{\bkmkend Pg272}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1607\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 disediakan pihak ketiga tersebut perlu diukur mutunya
menggunakan indikator \up0 \expndtw-2\charscalex100 mutu. Penanggung Jawab Gizi
secara berkala melaporkan hasil capaian indikator \up0 \expndtw-3\charscalex100
mutu kepada Komite/Tim Mutu Rumah Sakit. \par\pard\ql \li1418\sb239\sl-
276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen dan Tujuan TKRS 6.1 \par\pard\qj
\li1778\ri1604\sb208\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi tentang monitoring
mutu pelayanan yang \line\tab \up0 \expndtw-3\charscalex100 disediakan berdasar
atas kontrak atau perjanjian lainnya. \par\pard\qj \li1778\ri1605\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex106 2. Semua kontrak mempunyai
indikator mutu yang harus dilaporkan \line\tab \up0 \expndtw-3\charscalex100
kepada RS sesuai dengan mekanisme pelaporan mutu di RS. (R ) \par\pard\qj
\li1778\ri1599\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex104 3.
Komite/Tim mutu telah melakukan analisis data dan\ul0\nosupersub\cf8\f9\fs24
feedback\ul0\nosupersub\cf7\f8\fs24 data dan \line\tab \up0 \expndtw-
3\charscalex100 laporan. \up0 \expndtw-2\charscalex100 (D,W) \par\pard\ql
\li1778\ri1599\sb0\sl-320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 4. Kepala bidang/kepala divisi klinis dan manajemen ikut
berpartisipasi dalam \line\tab \up0 \expndtw-2\charscalex100 program peningkatan
mutu dengan menindaklanjuti hasil analisis informasi \line \tab \up0 \expndtw-
1\charscalex100 mutu pelayanan yang yang dilaksanakan melalui kontrak/pihak
ketiga. \line \tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\ql
\li1778\ri1596\sb0\sl-313\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 5. Kepala bidang/kepala divisi klinis dan manajemen ikut
berpartisipasi dalam \line\tab \up0 \expndtw-2\charscalex100 program peningkatan
mutu dengan menindaklanjuti hasil analisis informasi \line \tab \up0 \expndtw-
1\charscalex100 mutu pelayanan yang yang dilaksanakan melalui kontrak/pihak
ketiga. \line \tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb152\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS
6.2 \par\pard\qj \li1418\ri1606\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Kepala bidang/kepala divisi
pelayanan klinis memastikan bahwa dokter praktik \up0 \expndtw0\charscalex100
mandiri yang bukan merupakan staf RS memiliki izin dan kredensial yang tepat
\up0 \expndtw0\charscalex100 sesuai dengan pelayanan yang diberikan kepada
pasien RS dan peraturan \up0 \expndtw-3\charscalex100 perundang-undangan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS
6.2 \par\pard\qj \li1418\ri1581\sb211\sl-317\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Kepala bidang/divisi pelayanan
klinis dapat merekomendasikan kontrak atau \up0 \expndtw-2\charscalex100
mengatur pelayanan dari staf profesional pemberi asuhan (PPA) seperti
dokter, \up0 \expndtw0\charscalex104 dokter gigi, dan para praktisi independen
lainnya di luar rumah sakit. Dalam \up0 \expndtw0\charscalex100 beberapa kasus
dokter praktik mandiri tersebut dapat berada di luar rumah sakit \up0
\expndtw0\charscalex102 atau bahkan dari luar negeri. Pelayanan itu dapat
mencakup\ul0\nosupersub\cf8\f9\fs24 telemedicine\ul0\nosupersub\cf7\f8\fs24
atau \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf8\f9\fs24
teleradiology\ul0\nosupersub\cf7\f8\fs24 . Apabila dari pelayanan praktisi
tersebut, pasien membutuhkan \up0 \expndtw-1\charscalex100 perawatan atau alur
perawatan maka praktisi tersebut harus melalui proses \up0 \expndtw-
3\charscalex100 kredensial dan pengurusan izin praktik di rumah sakit. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 6.2 \par\pard\qj
\li1778\ri1612\sb208\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Direktur Rumah Sakit menentukan pelayanan yang akan
diberikan oleh \line\tab \up0 \expndtw-3\charscalex100 dokter praktik mandiri
dari luar rumah sakit. (R) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb123\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 272
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg273}
{\bkmkend Pg273}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1605\sb214\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Dokter praktik mandiri dari
luar rumah sakit yang memberikan pelayanan \line\tab \up0 \expndtw0\charscalex100
diagnostik, konsultasi, dan layanan perawatan dari luar rumah sakit,
\line \tab \up0 \expndtw0\charscalex100 seperti kedokteran jarak jauh \up0
\expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
telemedicine\ul0\nosupersub\cf7\f8\fs24 ), radiologi jarak jauh \par\pard\qj
\li2138\ri1610\sb2\sl-320\slmult0 \up0 \expndtw-1\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 teleradiology\ul0\nosupersub\cf7\f8\fs24 ), dan
interpretasi untuk pemeriksaan diagnostik lain seperti \line \up0 \expndtw-
2\charscalex100 elektrokardiogram \up0 \expndtw-2\charscalex100 (EKG),
elektroensefalogram \up0 \expndtw-2\charscalex100 (EEG), elektromiogram
\par\pard\qj \li2138\ri1614\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100 (EMG),
serta pemeriksaan lain yang serupa telah dilakukan proses \up0
\expndtw0\charscalex104 kredensial dan pemberian kewenangan klinik oleh rumah
sakit sesuai \up0 \expndtw-1\charscalex100 dengan peraturan perundang-undangan.
(D,W) \par\pard\ql \li1778\ri1565\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf6\f7\fs24 3.\ul0\nosupersub\cf7\f8\fs24 Mutu
pelayanan yang diberikan oleh dokter praktik mandiri tersebut pada \line\tab
\up0 \expndtw-3\charscalex100 EP 2 telah dipantau sebagai bagian dari program
peningkatan mutu rumah \line \tab \up0 \expndtw-4\charscalex100 sakit. (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb111\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 MANAJEMEN SUMBER DAYA \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb192\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar TKRS 7 \par\pard\qj
\li1418\ri1602\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Direktur Rumah Sakit membuat keputusan terkait
pengadaan dan penggunaan \up0 \expndtw-3\charscalex100 sumber daya dengan
mempertimbangkan mutu dan keselamatan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS
7 \par\pard\qj \li1418\ri1538\sb211\sl-316\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Direktur Rumah Sakit dapat membuat keputusan lebih baik
bila mempunyai data \line \up0 \expndtw0\charscalex100 sebagai dasar membuat
keputusan. Sebagai contoh, jika rumah sakit ingin \line \up0
\expndtw0\charscalex102 mengganti atau menambah pompa infus, informasi tidak hanya
tentang harga, \line \up0 \expndtw0\charscalex100 tetapi juga tentang persyaratan
pemeliharaannya, pelatihan orangnya, informasi \line \up0 \expndtw-3\charscalex100
tentang kegagalaan fungsi, dan insiden keselamatan pasien terkait dengan pompa
\line \up0 \expndtw-1\charscalex100 infus tersebut. Sama juga halnya, jika harus
memutuskan tentang pengurangan \line \up0 \expndtw-2\charscalex100 atau
memperkerjakan kembali seorang staf keperawatan, implikasi mutu dan \line
\up0 \expndtw-4\charscalex100 keselamatan asuhan pasien menjadi pertimbangan
(periksa juga, KKS 6). Direktur \line \up0 \expndtw0\charscalex100 Rumah Sakit
menetapkan proses mengumpulkan data dan informasi dalam \line \up0
\expndtw0\charscalex104 pengadaan dalam jumlah besar serta rujukan informasi agar
dapat dipastikan \line \up0 \expndtw-3\charscalex100 faktor mutu dan keselamatan
pasien ada dalam informasi. \par\pard\qj \li1418\ri1599\sb201\sl-320\slmult0
\up0 \expndtw0\charscalex102 Satu komponen pengumpulan data yang dipakai membuat
keputusan terkait \line \up0 \expndtw0\charscalex100 sumber daya adalah memahami
persyaratan atau yang direkomendasikan pada \line \up0 \expndtw0\charscalex100
teknologi medik dan obat yang diperlukan untuk memberikan pelayanan.
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb123\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 273
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg274}
{\bkmkend Pg274}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1602\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rekomendasi dapat berasal dari pemerintah, organisasi
profesi nasional atau \up0 \expndtw-3\charscalex100 internasional, atau dari sumber
lain yang dapat dipercaya \par\pard\qj \li1418\ri1607\sb204\sl-320\slmult0 \up0
\expndtw0\charscalex102 Berdasar atas hal tersebut di atas, rumah sakit perlu
mempunyai regulasi yang \up0 \expndtw-3\charscalex100 mengatur pemilihan teknologi
medik dan obat-obatan sebagai berikut: \par\pard\ql \li1778\ri1606\sb200\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 a) data dan informasi
mengenai mutu serta implikasi keselamatan pasien dari \line\tab \up0
\expndtw0\charscalex100
penggunaan teknologi medik dan obat tersebut, jadi tidak hanya berdasar \line \tab
\up0 \expndtw-3\charscalex100 atas harga; \par\pard\qj \li1778\ri1593\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 b) rekomendasi dari staf klinis
rumah sakit atau pemerintah atau organisasi \line\tab \up0 \expndtw-3\charscalex100
profesi nasional maupun internasional atau sumber lain yang akurat. \par\pard\qj
\li1418\ri1536\sb183\sl-317\slmult0 \up0 \expndtw-3\charscalex100 Jika pihak ketiga
yang membuat keputusan, seperti Kementerian Kesehatan maka \up0 \expndtw-
3\charscalex100 Direktur Rumah Sakit harus memberikan data dan informasi tersebut
kepada pihak \up0 \expndtw-4\charscalex100 ketiga ini. Jika rumah sakit akan
menggunakan teknologi medik dan atau obat yang \up0 \expndtw0\charscalex103 masih
bersifat\ul0\nosupersub\cf8\f9\fs24 \u8220?
trial\u8221?\ul0\nosupersub\cf7\f8\fs24 baik secara nasional maupun internasional
pada asuhan \up0 \expndtw-1\charscalex100 pasien maka rumah sakit harus menetapkan
proses untuk mengkaji, kemudian \up0 \expndtw0\charscalex102 menyetujui
penggunaannya. Persetujuan ini harus diberikan sebelum teknologi \up0 \expndtw-
2\charscalex100 maupun obat-obatan tersebut digunakan dalam asuhan pasien. Harus
diputuskan \up0 \expndtw-3\charscalex100 apakah penggunaan teknologi medik dan atau
obat-obatan tersebut membutuhkan \up0 \expndtw-4\charscalex100 persetujuan khusus
dari pasien. \par\pard\qj \li1418\ri1591\sb201\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Rumah sakit perlu menyusun regulasi penggunaan teknologi medik dan
obat baru \up0 \expndtw-3\charscalex100 yang masih dalam taraf uji coba
(\ul0\nosupersub\cf8\f9\fs24 trial\ul0\nosupersub\cf7\f8\fs24 ) sebagai
berikut\ul0\nosupersub\cf8\f9\fs24 : \par\pard\qj \li1778\ri1605\sb200\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1)
perlu melakukan kajian implikasi terhadap mutu dan keselamatan pasien \line\tab
\up0 \expndtw-3\charscalex100 dari pelaksanaan uji coba\ul0\nosupersub\cf8\f9\fs24
(trial\ul0\nosupersub\cf7\f8\fs24 ) tersebut; \par\pard\ql \li1778\sb37\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 2) pelaksanaan uji coba
(\ul0\nosupersub\cf8\f9\fs24 trial\ul0\nosupersub\cf7\f8\fs24 ) dapat dilakukan
bila persetujuan sudah keluar; \par\pard\qj \li1778\ri1603\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3) dalam melaksanakan uji coba
(\ul0\nosupersub\cf8\f9\fs24 trial\ul0\nosupersub\cf7\f8\fs24 ) membutuhkan
persetujuan khusus dari \line\tab \up0 \expndtw-3\charscalex100 pasien.
\par\pard\ql \li1418\sb225\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 7 \par\pard\ql
\li1778\ri1537\sb208\sl-320\slmult0\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai
regulasi pemilihan teknologi medik dan obat \line\tab \up0
\expndtw0\charscalex103 sesuai dengan a) dan b) yang ada di maksud dan tujuan serta
regulasi \line \tab \up0 \expndtw-3\charscalex100 penggunaan teknologi medik dan
obat baru yang masih dalam taraf uji coba \line \tab \up0 \expndtw0\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 trial\ul0\nosupersub\cf7\f8\fs24 ) sesuai dengan 1)
sampai dengan 3) yang ada di maksud dan tujuan \line \tab \up0 \expndtw-
3\charscalex100 serta memiliki tim penapisan teknologi bidang kesehatan. (R)
\par\pard\ql \li1778\ri1596\sb9\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 2. Tim penapisan teknologi bidang kesehatan telah
menggunakan data dan \line\tab \up0 \expndtw0\charscalex100 informasi dalam
pemilihan teknologi medik serta obat sesuai dengan \line \tab \up0 \expndtw-
3\charscalex100 regulasi rumah sakit yang ada di EP 1. (D,W) \par\pard\ql
\li1778\ri1597\sb2\sl-320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex104
3. Tim penapisan teknologi bidang kesehatan telah menggunakan
\line\tab \up0 \expndtw0\charscalex103 rekomendasi dari staf klinis dan atau
pemerintah dan organisasi profesi \line \tab \up0 \expndtw0\charscalex102 nasional
atau internasional dalam pemilihan teknologi medik dan obat di \line \tab \up0
\expndtw-3\charscalex100 rumah sakit. (D,W) \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb230\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 274
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg275}
{\bkmkend Pg275}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1545\sb214\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 4. Direktur Rumah Sakit
telah melaksanakan regulasi terkait dengan \line\tab \up0 \expndtw-
3\charscalex100 penggunaan teknologi medik dan obat baru yang masih dalam taraf uji
coba \line \tab \up0 \expndtw-4\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
trial\ul0\nosupersub\cf7\f8\fs24 ). (D,W) \par\pard\ql \li1778\ri1596\sb2\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex100 5. Kepala
bidang/divisi telah melakukan evaluasi mutu dan keselamatan \line\tab \up0
\expndtw0\charscalex102 pasien terhadap hasil dari pengadaan dan penggunaan
teknologi medik \line \tab \up0 \expndtw-1\charscalex100 serta obat menggunakan
indikator mutu dan laporan insiden keselamatan \line \tab \up0 \expndtw-
3\charscalex100 pasien. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb5\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 7.1
\par\pard\qj \li1418\ri1545\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Direktur Rumah Sakit mencari dan menggunakan data,
informasi tentang rantai \line \up0 \expndtw-3\charscalex100 distribusi obat,
serta perbekalan farmasi yang aman untuk melindungi pasien dan \line \up0 \expndtw-
3\charscalex100 staf dari produk yang berasal dari pasar gelap, palsu,
terkontaminasi, atau cacat. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 7.1
\par\pard\qj \li1418\ri1578\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Manajemen rantai distribusi obat adalah faktor
yang sangat penting dalam \up0 \expndtw-2\charscalex100 menjamin pengadaan
perbekalan rumah sakit yang aman dan berkualitas. Rantai \up0 \expndtw-
2\charscalex100 distribusi obat ini meliputi tahapan bagaimana perbekalan
dikirim dari pabrik ke \up0 \expndtw-3\charscalex100 distributor dan akhirnya
sampai ke rumah sakit. \par\pard\qj \li1418\ri1593\sb183\sl-317\slmult0 \up0
\expndtw-2\charscalex100 Rangkaian distribusi ini merupakan komponen sangat
penting untuk memastikan \up0 \expndtw0\charscalex100 tersedia perbekalan yang
dibutuhkan datang tepat waktu, mencegah obat serta \up0 \expndtw0\charscalex102
teknologi medik yang tercemar, palsu, sampai dipergunakan kepada pasien di \up0
\expndtw0\charscalex102 rumah sakit. Hal ini merupakan masalah global yang sudah
dikenal dan untuk \up0 \expndtw-1\charscalex100 mengatasinya harus diketahui
tentang reputasi, kredibilitas, kegiatan operasional \up0 \expndtw0\charscalex100
setiap komponen, dari rantai distribusi. Mungkin informasi yang ada tidak dapat
\up0 \expndtw0\charscalex100 lengkap dan sukar untuk mengkaitkan satu sama lain,
tetapi rumah sakit paling \up0 \expndtw-1\charscalex100 sedikit dapat memutuskan
letak risiko yang signifikan berada dan kemudian \up0 \expndtw-
2\charscalex100 melakukan pemilihan berdasar atas informasi. \par\pard\qj
\li1418\ri1539\sb203\sl-318\slmult0 \up0 \expndtw0\charscalex105 Penelusuran
produk melalui\ul0\nosupersub\cf8\f9\fs24 bar-coding\ul0\nosupersub\cf7\f8\fs24
serta cara lain dapat membantu \up0 \expndtw-2\charscalex100 manajemen dan
staf mengerti bagaimana gambaran rantai suplai dan dapat \up0
\expndtw0\charscalex103 mencegah penggelapan. Meskipun tidak ada standar tunggal
secara nasional \up0 \expndtw-1\charscalex100 maupun global mengatur rantai
distribusi ini, bahkan bila tidak ada standar \up0 \expndtw-2\charscalex100
nasional, Direktur Rumah Sakit tetap bertanggung jawab untuk mengetahui isu ini
\up0 \expndtw-2\charscalex100 dan melaksanakan strategi melindungi rantai
disribusinya. Jika perbekalan rumah \up0 \expndtw-2\charscalex100 sakit dibeli,
disimpan, dan didistribusi oleh instansi pemerintah maka rumah sakit \up0
\expndtw-1\charscalex100 ikut melaksanakan program untuk deteksi dan
melaporkan perbekalan yang \up0 \expndtw0\charscalex100 diduga tercemar atau
palsu, serta mengambil tindakan mencegah kerugian \up0 \expndtw-
1\charscalex100 potensial pada pasien. Jika sebuah rumah sakit tidak
mengetahui informasi \up0 \expndtw0\charscalex100 tentang integritas setiap
pemasok (\ul0\nosupersub\cf8\f9\fs24 supplier\ul0\nosupersub\cf7\f8\fs24 ) di
rantai distribusi maka rumah sakit \up0 \expndtw-3\charscalex100 dapat minta
informasi untuk mengetahui bagaimaan perbekalan dibeli dan dikelola \up0 \expndtw-
4\charscalex100 oleh pemerintah atau badan nonpemerintah. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb110\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 275
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg276}
{\bkmkend Pg276}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1580\sb214\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Khusus untuk pembelian alat kesehatan, bahan medis
habis pakai, dan obat yang \line \up0 \expndtw0\charscalex100 berisiko termasuk
vaksin maka rumah sakit agar
memperhatikan hal-hal sebagai \line \up0 \expndtw-3\charscalex100 berikut:
\par\pard\qj \li1778\ri1599\sb2\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
1) akte pendirian perusahaan dan pengesahan dari Kementerian Hukum dan
\line\tab \up0 \expndtw-3\charscalex100 Hak Azasi Manusia; \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2) Surat Izin Usaha
Perusahaan (SIUP); \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3) NPWP; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 4) Izin Pedagang Besar Farmasi-Penyalur Alat Kesehatan (PBF-
PAK); \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 5)
Perjanjian Kerja Sama antara distributor dan prinsipal serta rumah sakit;
\par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-4\charscalex100 6) nama dan
Surat izin Kerja Apoteker untuk apoteker penanggung jawab PBF; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 7) alamat dan denah
kantor PBF; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
8) surat garansi jaminan keaslian produk yang didistribusikan (dari prinsipal).
\par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 7.1 \par\pard\ql
\li1778\ri1602\sb214\sl-313\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi
tentang pengelolaan pengadaan alat \line\tab \up0 \expndtw0\charscalex103
kesehatan, bahan medis habis pakai, dan obat yang berisiko termasuk \line \tab \up0
\expndtw0\charscalex104 vaksin dengan memperhatikan alur rantai distribusi
sesuai dengan \line \tab \up0 \expndtw-3\charscalex100 peraturan perundang-
undangan. (lihat juga PKPO 2). (R) \par\pard\ql \li1778\ri1566\sb2\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 2. Rumah sakit telah
melakukan identifikasi risiko penting dari rantai distribusi \line\tab \up0
\expndtw-2\charscalex100 alat kesehatan, bahan medis habis pakai, dan obat yang
berisiko termasuk \line \tab \up0 \expndtw-2\charscalex100 vaksin serta
melaksanakan tindak lanjut untuk menghindari risiko. (D,W) \par\pard\qj
\li1778\ri1592\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Rumah
sakit telah melakukan evaluasi tentang integritas setiap pemasok di \line\tab
\up0 \expndtw-3\charscalex100 rantai distribusi. (D,W) \par\pard\ql
\li1778\ri1604\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex106 4.
Direktur Rumah Sakit menelusuri rantai distribusi pengadaan alat
\line\tab \up0 \expndtw0\charscalex103 kesehatan, bahan medis habis pakai, dan obat
yang berisiko termasuk \line \tab \up0 \expndtw-3\charscalex100 vaksin untuk
mencegah penggelapan dan pemalsuan. (D,W) \par\pard\ql \li2731\sb0\sl-
276\slmult0 \par\pard\ql\li2731\sb0\sl-276\slmult0 \par\pard\ql\li2731\sb7\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 ORGANISASI
STAF KLINIS DAN TANGGUNG JAWAB \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar TKRS 8 \par\pard\qj \li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\ri1602\sb26\sl-310\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan
struktur organisasi pelayanan medis, pelayanan \up0 \expndtw-1\charscalex100
keperawatan, dan pelayanan klinis lainnya secara efektif, lengkap dengan uraian
\up0 \expndtw-3\charscalex100 tugas dan tanggung jawabnya. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 8
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1594\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Tata kelola
klinik harus berjalan dengan baik di rumah sakit, karena itu selain \up0
\expndtw0\charscalex100 terdapat pimpinan klinis, rumah sakit juga perlu
membentuk Komite Medik dan \up0 \expndtw0\charscalex100 Komite Keperawatan dengan
tujuan dapat menjaga mutu, kompetensi, etik, dan \up0 \expndtw-3\charscalex100
disiplin para staf profesional tersebut. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb243\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 276
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg277}
{\bkmkend Pg277}\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\sb0\sl-
316\slmult0 \par\pard\qj\li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\ri1537\sb191\sl-316\slmult0\fi67 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit agar menetapkan lingkup
pelayanan yang dikoordinasikan oleh \up0 \expndtw-3\charscalex100 pimpinan
pelayanan medis, lingkup pelayanan yang dikoordinasikan oleh pimpinan \up0
\expndtw0\charscalex102 pelayanan keperawatan, dan lingkup pelayanan yang
dikoordinasikan oleh \up0 \expndtw0\charscalex100 pimpinan penunjang medik.
Kepala unit pelayanan dengan staf klinisnya \up0 \expndtw0\charscalex102
mempunyai tanggung jawab khusus terhadap pasien di rumah sakit. Staf klinis \up0
\expndtw-1\charscalex100 yang ditempatkan di unit-unit pelayanan secara fungsi
dikoordinasikan oleh para \up0 \expndtw-3\charscalex100 pimpinan pelayanan (kepala
bidang/divisi). \par\pard\qj \li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1598\sb14\sl-313\slmult0 \up0 \expndtw-2\charscalex100 Dalam
melakukan koordinasi tersebut pimpinan pelayanan medis juga melakukan \line \up0
\expndtw0\charscalex104 koordinasi dengan komite medis dan pimpinan keperawatan
serta melakukan \line \up0 \expndtw0\charscalex100 koordinasi dengan komite
keperawatan sehingga unit pelayanan di bawah \line \up0 \expndtw-
2\charscalex100 koordinasi para pimpinan klinis \up0 \expndtw-2\charscalex100
(kepala bidang/divisi pelayanan klinis) dapat \par\pard\ql \li1418\sb38\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 mempunyai fungsi \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1. mendorong agar
antarstaf profesional terjalin komunikasi yang baik; \par\pard\ql
\li1778\ri1543\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 2.
membuat rencana bersama dan menyusun kebijakan, panduan praktik klinik \line\tab
\up0 \expndtw0\charscalex102 dan protokol,\ul0\nosupersub\cf8\f9\fs24
pathways\ul0\nosupersub\cf7\f8\fs24 , serta ketentuan sebagai panduan memberikan
\line \tab \up0 \expndtw-3\charscalex100 layanan klinik; \par\pard\qj
\li1778\ri1597\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 3.
menetapkan etik dan melaksanakan sesuai dengan profesinya masing-\line\tab \up0
\expndtw-3\charscalex100 masing; \par\pard\ql \li1778\sb17\sl-276\slmult0 \up0
\expndtw-3\charscalex100 4. mengawasi mutu asuhan pasien (periksa juga TKRS10);
\par\pard\qj \li1778\ri1544\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
5. Kepala unit pelayanan menetapkan struktur organisasi unit pelayanan untuk
\line\tab \up0 \expndtw-4\charscalex100 dapat melaksanakan tanggung jawabnya.
\par\pard\ql \li1701\sb0\sl-276\slmult0 \par\pard\ql\li1701\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Secara umum struktur organisasi unit pelayanan yang
ditetapkan \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
a) terdiri atas staf klinik yang relevan; \par\pard\qj \li1778\ri1604\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 b) didasarkan atas kepemilikan
rumah sakit, misi, dan struktur organisasi \line\tab \up0 \expndtw-
2\charscalex100 rumah sakit; \par\pard\qj \li1778\ri1606\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex105 c) sesuai dengan kompleksitas
layanan rumah sakit dan jumlah staf \line\tab \up0 \expndtw-3\charscalex100
profesional; \par\pard\li1778\sb32\sl-276\slmult0\fi0\tx4883 \up0 \expndtw-
2\charscalex100 d) efektif melaksanakan 5\tab \up0 \expndtw-2\charscalex100
(lima) fungsi tersebut di paragraf terdahulu di\par\pard\li1778\sb40\sl-
276\slmult0\fi360 \up0 \expndtw-2\charscalex100 Maksud dan Tujuan TKRS 8
ini.\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb65\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS
8 \par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1605\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada
penetapan struktur organisasi rumah sakit sampai dengan unit \line\tab
\up0 \expndtw-3\charscalex100 pelayanan. (R) \par\pard\qj \li1778\ri1601\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Ada penetapan struktur
organisasi komite medis dan komite keperawatan \line\tab \up0 \expndtw-
3\charscalex100 serta tata hubungan kerja dengan para pimpinan di rumah sakit.
(R) \par\pard\qj \li1778\ri1543\sb17\sl-300\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 3. Struktur organisasi dapat mendukung proses budaya keselamatan
di rumah \line\tab \up0 \expndtw-4\charscalex100 sakit dan komunikasi antarprofesi.
(R) \par\pard\qj \li1778\ri1578\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 4. Struktur organisasi dapat mendukung proses perencanaan
pelayanan klinik \line\tab \up0 \expndtw-3\charscalex100 dan penyusunan regulasi
pelayanan. (R) \par\pard\qj \li1778\ri1600\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 5. Struktur organisasi dapat mendukung proses pengawasan atas
berbagai \line\tab \up0 \expndtw-2\charscalex100 isu etika profesi. (R)
\par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 277
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg278}
{\bkmkend Pg278}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1604\sb253\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 6. Struktur organisasi dapat
mendukung proses pengawasan atas mutu \line\tab \up0 \expndtw-3\charscalex100
pelayanan klinis. (R) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 UNIT PELAYANAN \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar TKRS 9 \par\pard\qj \li1418\ri1599\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Satu atau lebih individu yang
kompeten ditetapkan sebagai kepala unit di setiap \up0 \expndtw-3\charscalex100
pelayanan di rumah sakit sesuai dengan peraturan perundang-undangan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS
9 \par\pard\qj \li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\ri1569\sb14\sl-
317\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelayanan
klinis, hasil asuhan klinis pasien, dan manajemen suatu rumah sakit \line \up0
\expndtw-2\charscalex100 secara keseluruhan dihasilkan dari kegiatan klinis dan
manajerial tiap departemen \line \up0 \expndtw0\charscalex103 serta unit
pelayanan. Kinerja departemen atau unit pelayanan yang baik \line \up0
\expndtw-2\charscalex100 membutuhkan kepemimpinan yang jelas dari individu
yang kompeten. Dalam \line \up0 \expndtw0\charscalex102 departemen atau unit
layanan yang lebih besar maka kepemimpinannya dapat \line \up0
\expndtw0\charscalex100 dipisah-pisahkan. Dalam hal semacam itu maka tanggung jawab
masing-masing \line \up0 \expndtw0\charscalex102 didefinisikan secara tertulis.
Sebagai contoh Departemen laboratorium, \line \up0 \expndtw-2\charscalex100
mempunyai kepala Departemen dan mempunyai kepala unit laboratorium patologi
\line \up0 \expndtw0\charscalex100 klinik, kepala unit laboratorium anatomi,
laboratorium, dan lainnya. Kepala \line \up0 \expndtw-2\charscalex100
Departemen dalam standar ini untuk selanjutnya disebut Koordinator Pelayanan.
\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1536\sb8\sl-
316\slmult0 \up0 \expndtw0\charscalex104 Tiap koordinator dan kepala unit pelayanan
melakukan identifikasi kebutuhan \line \up0 \expndtw-2\charscalex100 sumber daya
manusia dan sumber daya lainnya serta mengusulkan kepada \line \up0 \expndtw-
1\charscalex100 direksi rumah sakit. Hal ini dilakukan untuk memastikan
bahwa staf, ruang, \line \up0 \expndtw-4\charscalex100 peralatan, dan sumber daya
lainnya tersedia memadai setiap saat untuk memenuhi \line \up0
\expndtw0\charscalex100 kebutuhan pasien. Meskipun para Koordinator Pelayanan
atau Kepala Unit \line \up0 \expndtw-4\charscalex100 Pelayanan telah membuat
rekomendasi atau usulan mengenai kebutuhan sumber \line \up0 \expndtw-
2\charscalex100 daya manusia dan sumber daya lainnya, kebutuhan tersebut
kadang-kadang \line \up0 \expndtw-1\charscalex100 berubah atau tidak terpenuhi.
Karena itu, Koordiantor pelayanan/Kepala unit \line \up0
\expndtw0\charscalex100 pelayanan harus memiliki proses untuk merespons
kekurangan sumber daya \line \up0 \expndtw-4\charscalex100 supaya pelayanan di
unit pelayanan tetap aman dan efektif terjamin mutunya bagi \line \up0 \expndtw-
5\charscalex100 semua pasien. \par\pard\qj \li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\ri1601\sb7\sl-317\slmult0 \up0 \expndtw0\charscalex103
Koordinator pelayanan dan unit layanan mempertimbangkan pelayanan yang \up0
\expndtw0\charscalex103 diberikan dan direncanakan oleh departemen atau unit
layanan tersebut serta \up0 \expndtw0\charscalex102 pendidikan, keahlian,
pengetahuan, dan pengalaman yang diperlukan oleh staf \up0 \expndtw0\charscalex100
profesional dari departemen tersebut dalam melakukan pelayanan. Koordinator \up0
\expndtw-2\charscalex100 pelayanan dan unit layanan menyusun kriteria yang
mencerminkan pertimbangan \up0 \expndtw0\charscalex104 ini dan kemudian memilih
staf berdasar atas kriteria tersebut. Pemimpin \up0 \expndtw-1\charscalex100
departemen dan unit layanan juga dapat bekerja sama dengan departemen \up0
\expndtw0\charscalex102 sumber daya manusia dan departemen lainnya dalam proses
seleksi berdasar \up0 \expndtw-2\charscalex100 atas rekomendasi mereka.
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 278
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg279}
{\bkmkend Pg279}\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\sb0\sl-
316\slmult0 \par\pard\qj\li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\ri1597\sb191\sl-316\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pemimpin departemen dan unit layanan
memastikan bahwa semua staf \line \up0 \expndtw0\charscalex100 dalam
departemen atau unit layanan memahami tanggung jawab mereka dan \line \up0
\expndtw0\charscalex103 mengadakan kegiatan orientasi dan pelatihan bagi karyawan
baru. Kegiatan \line \up0 \expndtw-1\charscalex100 orientasi mencakup misi rumah
sakit dan departemen/unit layanan, lingkup dari \line \up0 \expndtw-1\charscalex100
pelayanan yang diberikan, serta kebijakan dan prosedur yang terkait
dalam \line \up0 \expndtw0\charscalex102 memberikan pelayanan. Sebagai contoh,
semua staf memahami prosedur \line \up0 \expndtw0\charscalex107 pencegahan
serta pengendalian infeksi dalam rumah sakit dan dalam \line \up0
\expndtw0\charscalex103 departemen/unit layanan tersebut. Bila ada revisi
maupun kebijakan atau \line \up0 \expndtw0\charscalex100 prosedur yang baru maka
para staf akan diberikan pelatihan yang sesuai. (lihat \line \up0 \expndtw-
1\charscalex100 juga ARK 3, EP 1; AP 5.1; AP 6.1; AP 5.11, EP 1; PAB 2; PKPO 1;
PMKP 1; dan \line \up0 \expndtw-2\charscalex100 PPI 1) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 9 \par\pard\ql
\li1778\ri1544\sb8\sl-320\slmult0\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. \tab \up0 \expndtw0\charscalex101
Ada regulasi tentang persyaratan jabatan, uraian tugas, tanggung jawab \line\tab
\up0 \expndtw-2\charscalex100 dan wewenang untuk setiap kepala unit pelayanan serta
termasuk bila ada \line \tab \up0 \expndtw-3\charscalex100 koordinator pelayanan
yang tertuang di dalam pedoman pengorganisasian \line \tab \up0 \expndtw-
3\charscalex100 unit pelayanan tersebut (lihat juga AP 5.1, EP 1; AP 6.1, EP 1; dan
PKPO \par\pard\ql \li2138\sb17\sl-276\slmult0 \up0 \expndtw-7\charscalex100 1.1, EP
1). (R) \par\pard\ql \li1778\ri1540\sb11\sl-
317\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 2. \tab \up0 \expndtw0\charscalex102 Setiap kepala unit pelayanan
dan koordinator pelayanan (bila ada) telah \line\tab \up0 \expndtw-3\charscalex100
sesuai dengan persyaratan jabatan yang ditetapkan. (D,W) \line \up0 \expndtw-
3\charscalex100 3. \up0 \expndtw-3\charscalex100 Setiap kepala unit pelayanan telah
melakukan identifikasi dan mengusulkan \line\tab \up0 \expndtw0\charscalex101
kebutuhan ruangan, teknologi medis, peralatan, ketenagakerjaan sesuai \line \tab
\up0 \expndtw-4\charscalex100 dengan standar kepada Direktur Rumah Sakit, dan telah
mempunyai proses \line \tab \up0 \expndtw-1\charscalex100 yang dapat diterapkan
untuk menanggapi kekurangan (catatan: bila di unit \line \tab \up0 \expndtw-
4\charscalex100 pelayanan ada koordinator pelayanan maka usulan kepada Direktur
Rumah \line \tab \up0 \expndtw-4\charscalex100 Sakit diajukan melalui koordinator
pelayanan). (D,W) \par\pard\ql \li1778\ri1603\sb1\sl-
320\slmult0\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-3\charscalex100 4. \tab
\up0 \expndtw0\charscalex100 Setiap kepala unit pelayanan telah menyusun pola
ketenagaan yang \line\tab \up0 \expndtw0\charscalex102 dipergunakan untuk
rekruitmen yang akan ditugaskan di unit pelayanan \line \tab \up0 \expndtw-
2\charscalex100 tersebut sesuai dengan peraturan perundang-undangan. (lihat juga
KKS 2 \line \tab \up0 \expndtw-3\charscalex100 EP 1 dan EP 2). (D,W)
\par\pard\ql \li1778\ri1544\sb9\sl-310\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 5. \tab \up0 \expndtw-3\charscalex100 Setiap kepala unit pelayanan
telah menyelenggarakan orientasi bagi semua \line\tab \up0 \expndtw-4\charscalex100
staf baru mengenai tugas dan tanggung jawab serta wewenang mereka di \line
\tab \up0 \expndtw-4\charscalex100 unit pelayanan tempat mereka bekerja. (lihat
juga KKS 7 EP 1, EP 2 dan EP \par\pard\li2138\sb55\sl-276\slmult0\fi0\tx2553
\up0 \expndtw-3\charscalex100 3).\tab \up0 \expndtw-3\charscalex100
(D,W)\par\pard\ql \li1778\ri1595\sb0\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw-3\charscalex100 6. \tab \up0 \expndtw0\charscalex102 Dalam orientasi itu
diberikan materi tentang Peningkatan Mutu dan \line\tab \up0
\expndtw0\charscalex100 Keselamatan Pasien serta Pencegahan dan Pengendalian
Infeksi. (lihat \line \tab \up0 \expndtw-3\charscalex100 juga KKS 7 EP 1, EP 2 dan
EP 3). (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb73\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS
10 \par\pard\qj \li1418\ri1602\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kepala unit mengidentifikasi secara tertulis pelayanan
yang diberikan oleh unit, \up0 \expndtw0\charscalex100 serta mengintegrasikan dan
mengkoordinasikan pelayanan tersebut dengan \up0 \expndtw-3\charscalex100
pelayanan dari unit lain. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb50\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 279
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg280}
{\bkmkend Pg280}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 10
\par\pard\qj \li1418\ri1593\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kepala dari unit pelayanan klinis rumah sakit
bekerja-sama untuk menetapkan \up0 \expndtw0\charscalex104 format dan isi yang
seragam untuk dokumen perencanaan unit yang spesifik. \up0 \expndtw0\charscalex100
Secara umum, dokumen yang disiapkan oleh tiap-tiap unit pelayanan
klinis \up0 \expndtw0\charscalex102 menetapkan tujuan maupun mengidentifikasi
pelayanan saat ini dan yang \up0 \expndtw-1\charscalex100 direncanakan.
Regulasi di unit mencerminkan tujuan dan pelayanan unitnya \up0
\expndtw0\charscalex102 termasuk persyaratan jabatan staf yang dibutuhkan untuk
melakukan asesmen \up0 \expndtw-3\charscalex100 serta memenuhi kebutuhan pelayanan
pasien. \par\pard\qj \li1418\ri1548\sb300\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 Pelayanan klinis yang diberikan kepada pasien dikoordinasikan dan
diintegrasikan \up0 \expndtw0\charscalex107 di dalam setiap unit pelayanan.
Selain itu, setiap unit pelayanan \up0 \expndtw-2\charscalex100
mengkoordinasikan dan mengintegrasikan pelayanannya dengan unit pelayanan \up0
\expndtw0\charscalex102 yang lain. Duplikasi pelayanan yang tidak perlu dihindari
atau dihilangkan agar \up0 \expndtw-3\charscalex100 menghemat sumber daya.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb237\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS
10 \par\pard\ql \li1778\sb0\sl-320\slmult0 \par\pard\ql\li1778\ri1592\sb8\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24
1. Setiap unit pelayanan telah mempunyai pedoman pelayanan yang
\line\tab \up0 \expndtw-2\charscalex100 menguraikan pelayanan saat ini dan
program kerja yang menguraikan \line \tab \up0 \expndtw-3\charscalex100
pelayanan yang direncanakan dan \up0 \expndtw-3\charscalex100 mengatur
pengetahuan serta \par\pard\qj \li2138\ri1545\sb0\sl-320\slmult0 \up0
\expndtw0\charscalex100 keterampilan staf klinis yang melakukan asesmen pasien dan
kebutuhan \up0 \expndtw-8\charscalex100 pasien. (R) \par\pard\qj
\li1778\ri1599\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex103 2. Rumah
sakit mempunyai regulasi untuk unit pelayanan yang mengatur \line\tab \up0
\expndtw-3\charscalex100 format dan isi yang seragam untuk dokumen perencanaan. (R)
\par\pard\qj \li1778\ri1609\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
3. Kepala unit pelayanan telah menggunakan format dan isi yang seragam \line\tab
\up0 \expndtw-3\charscalex100 untuk dokumen perencanaan. (D,O,W) \par\pard\qj
\li1778\ri1601\sb0\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex102 4. Rumah
sakit mempunyai regulasi yang mengatur sistem pengaduan \line\tab \up0
\expndtw-3\charscalex100 pelayanan di unit pelayanan. (R) \par\pard\qj
\li1778\ri1602\sb1\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex104 5.
Pengetahuan dan ketrampilan staf klinis di unit pelayanan telah sesuai \line\tab
\up0 \expndtw-3\charscalex100 dengan regulasi. (D,W) \par\pard\qj
\li1778\ri1591\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 6.
Pelayanan yang disediakan di unit pelayanan telah sesuai dengan regulasi. \line\tab
\up0 \expndtw-3\charscalex100 (D,W) \par\pard\qj \li1778\ri1608\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 7. Pengaduan pelayanan di unit
pelayanan telah sesuai dengan regulasi. \line\tab \up0 \expndtw-2\charscalex100
(D,W) \par\pard\ql \li1778\sb17\sl-276\slmult0 \up0 \expndtw-2\charscalex100 8.
Ada koordinasi dan integrasi pelayanan dalam tiap unit pelayanan. (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 11 (Program
Mutu Unit Pelayanan) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb124\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 280
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg281}
{\bkmkend Pg281}\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1596\sb203\sl-313\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kepala Unit pelayanan meningkatkan mutu dan
keselamatan pasien dengan \up0 \expndtw0\charscalex100 berpartisipasi dalam
program peningkatan mutu dan keselamatan pasien rumah \up0 \expndtw0\charscalex103
sakit, melakukan monitoring, serta meningkatkan asuhan pasien yang spesifik \up0
\expndtw-3\charscalex100 berlaku di unitnya. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 11
\par\pard\qj \li1418\ri1596\sb14\sl-313\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Kepala unit pelayanan melibatkan semua stafnya dalam
kegiatan peningkatan \up0 \expndtw0\charscalex100 mutu dan keselamatan pasien yang
mencerminkan prioritas rumah sakit secara \up0 \expndtw0\charscalex102 menyeluruh
(TKRS 5) serta melakukan monitoring kegiatan klinis dan nonklinis \up0 \expndtw-
3\charscalex100 yang spesifik untuk unit pelayanan tersebut. \par\pard\qj
\li1418\ri1595\sb2\sl-320\slmult0 \up0 \expndtw0\charscalex100 Sebagai contoh,
unit layanan dapat berpartisipasi dalam upaya menyeluruh di \line \up0
\expndtw0\charscalex103 rumah sakit untuk memperbaiki komunikasi serah terima
dan dapat juga \line \up0 \expndtw0\charscalex105 memonitor serta mengurangi
variasi dalam suatu proses internal seperti \line \up0 \expndtw0\charscalex103
pemesanan uji diagnostik untuk pasien dengan kondisi yang sama. Selain itu,
\line \up0 \expndtw0\charscalex102 unit juga dapat terlibat dalam proyek automasi
untuk memperbaiki komunikasi \line \up0 \expndtw-1\charscalex100 serah terima dan
dapat memonitor serta memperbaiki akurasi untuk pembayaran \line \up0 \expndtw-
3\charscalex100 pasien. \par\pard\qj \li1418\ri1596\sb300\sl-320\slmult0 \up0
\expndtw0\charscalex100 Oleh karena itu, kepala unit pelayanan menerapkan pemilihan
dan pengawasan \line \up0 \expndtw-2\charscalex100 penilaian secara spesifik
terhadap unit pelayanan yang mencakup beberapa hal. \par\pard\ql
\li1778\ri1547\sb4\sl-316\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 a) Penilaian rumah sakit secara menyeluruh dan
perbaikan prioritas yang \line\tab \up0 \expndtw0\charscalex100 ditetapkan oleh
Direktur Rumah Sakit yang terkait secara spesifik dengan \line \tab \up0
\expndtw0\charscalex100 departemen atau unit layanan mereka. Sebagai
contoh:\ul0\nosupersub\cf6\f7\fs24 r\ul0\nosupersub\cf7\f8\fs24 umah sakit \line
\tab \up0 \expndtw-3\charscalex100 melakukan penilaian asesmen rehabilitasi medis
pada pasien strok maka di \line \tab \up0 \expndtw-2\charscalex100 unit pelayanan
strok untuk penilaian mutunya wajib menggunakan indikator \line \tab \up0 \expndtw-
3\charscalex100 tersebut. \par\pard\ql \li1778\ri1536\sb5\sl-
316\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex103
b) Penilaian yang terkait dengan prioritas departemen/unit layanan secara
\line\tab \up0 \expndtw-1\charscalex100 spesifik untuk mengurangi variasi,
meningkatkan keselamatan untuk \line \tab \up0 \expndtw0\charscalex102
tindakan/tata laksana berisiko tinggi, meningkatkan tingkat kepuasan \line
\tab \up0 \expndtw-3\charscalex100 pasien, dan meningkatkan efisiensi. Sebagai
contoh: di unit pelayanan anak \line \tab \up0 \expndtw0\charscalex101 terdapat
variasi dalam penanganan penyakit A, khususnya penggunaan \line \tab \up0 \expndtw-
2\charscalex100 obat maka indikator mutu yang dikembangkan di unit tersebut
adalah \line \tab \up0 \expndtw-3\charscalex100 penggunaan obat X untuk penyakit A
tersebut. \par\pard\ql \li1778\ri1590\sb1\sl-
320\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-2\charscalex100 c)
Penilaian spesifik di unit pelayanan ini juga diharapkan dapat dipergunakan
\line\tab \up0 \expndtw0\charscalex100 untuk melakukan evaluasi praktik
profesional berkelanjutan dari para \line \tab \up0 \expndtw0\charscalex100
profesional pemberi asuhan (PPA). Sebagai contoh:\ul0\nosupersub\cf6\f7\fs24
s\ul0\nosupersub\cf7\f8\fs24 alah satu penilaian \line \tab \up0
\expndtw0\charscalex100 kinerja dokter bedah adalah
pelaksanaan\ul0\nosupersub\cf8\f9\fs24 time-out\ul0\nosupersub\cf7\f8\fs24
berdasar atas hal \line \tab \up0 \expndtw0\charscalex100 tersebut
maka\ul0\nosupersub\cf6\f7\fs24 salah satu\ul0\nosupersub\cf7\f8\fs24 penilaian
mutu dan keselamatan pasien di unit \line \tab \up0 \expndtw-3\charscalex100 kamar
operasi adalah pelaksanaan\ul0\nosupersub\cf8\f9\fs24 time
out\ul0\nosupersub\cf7\f8\fs24 . \par\pard\qj \li1778\ri1614\sb320\sl-
320\slmult0 \up0 \expndtw0\charscalex102 Berdasar atas butir 1 sampai dengan 3 maka
jumlah minimal indikator mutu \up0 \expndtw0\charscalex100 di unit pelayanan klinis
diserahkan
ke rumah sakit, yang penting di sini sudah \up0 \expndtw-1\charscalex100 memenuhi
kriteria 1 sampai dengan 3. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb30\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 281
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg282}
{\bkmkend Pg282}\par\pard\qj \li1778\sb0\sl-317\slmult0 \par\pard\qj\li1778\sb0\sl-
317\slmult0 \par\pard\qj\li1778\sb0\sl-317\slmult0
\par\pard\qj\li1778\ri1534\sb188\sl-317\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pemilihan unsur penilaian sebaiknya berdasar atas
kegiatan dan proses yang \line \up0 \expndtw-3\charscalex100 membutuhkan perbaikan
di setiap departemen/unit layanan. Untuk setiap unsur \line \up0 \expndtw-
1\charscalex100 penilaian harus ada suatu target yang ditetapkan. Tidak menjadi
masalah jika \line \up0 \expndtw-1\charscalex100 pada penilaian pertama didapatkan
bahwa target tidak terpenuhi, namun saat \line \up0 \expndtw-2\charscalex100
strategi perbaikan telah dilaksanakan maka pimpinan departemen/unit layanan
\line \up0 \expndtw0\charscalex100 berharap dapat melihat perbaikan menuju
tercapainya target tersebut. Ketika \line \up0 \expndtw0\charscalex100 target
telah tercapai dan dipertahankan untuk setidaknya empat periode \line
\up0 \expndtw-3\charscalex100 penilaian akan diadakan pemilihan untuk unsur
penilaian yang baru. \par\pard\qj \li1778\ri1569\sb301\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Kepala departemen/unit layanan klinis bertanggung jawab
untuk memastikan \up0 \expndtw-1\charscalex100 bahwa kegiatan penilaian dapat
memberikan kesempatan untuk evaluasi bagi \up0 \expndtw0\charscalex100 para staf
maupun proses pelayanan. Karena itu, seiring dengan berjalannya \up0 \expndtw-
1\charscalex100 waktu, penilaian harus mencakup semua pelayanan yang tersedia.
Hasil dari \up0 \expndtw0\charscalex100 data dan informasi yang didapatkan dalam
penilaian adalah hal yang penting \up0 \expndtw0\charscalex100 dalam upaya
perbaikan di setiap departemen/unit layanan, serta juga penting \up0
\expndtw0\charscalex102 terhadap peningkatan mutu rumah sakit dan program
keselamatan pasien. \up0 \expndtw-3\charscalex100 (lihat juga PMKP 1, EP 3; PMKP
4.1; dan PPI 10, EP 1) \par\pard\qj \li1778\ri1536\sb300\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Catatan: Komite pencegahan dan pengendalian infeksi,
unit fasilitas, unit \up0 \expndtw0\charscalex100 radiologi dan laboratorium
klinis mempunyai program berkala untuk upaya \up0 \expndtw-2\charscalex100
pengawasan serta pengendalian yang tercantum dalam prioritas penilaian dan \up0
\expndtw-3\charscalex100 dijabarkan dalam standar terkait dengan pelayanan
tersebut. (lihat juga AP 5.9, \up0 \expndtw-4\charscalex100 AP 6.7, PPI10, dan MFK
10) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb105\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen penilaian TKRS 11
\par\pard\qj \li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\ri1603\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.
Rumah sakit mempunyai regulasi tentang kriteria pemilihan indikator mutu
\line\tab \up0 \expndtw-3\charscalex100 unit seperti di 1 sampai dengan 3 penilaian
di unit. \par\pard\ql \li1778\ri1537\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw-3\charscalex100 2. Kepala unit mengusulkan indikator mutu untuk setiap
unit pelayanan sesuai \line\tab \up0 \expndtw-3\charscalex100 dengan \up0
\expndtw0\charscalex102 1 sampai dengan 3 yang ada di maksud dan tujuan. (lihat
juga \line \tab \up0 \expndtw-5\charscalex100 PMKP 4.1 EP 1 dan PAB 8.1).
(D,W) \par\pard\qj \li1778\ri1599\sb17\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 3. Kepala unit telah melakukan pengumpulan data dan
membuat laporan \line\tab \up0 \expndtw-3\charscalex100 terintegrasi secara
berkala. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb8\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar TKRS 11.1 \par\pard\qj \li1418\sb0\sl-
316\slmult0 \par\pard\qj\li1418\ri1564\sb15\sl-316\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Kepala Unit Pelayanan Klinis
memilih serta menerapkan penilaian mutu dan \up0 \expndtw-1\charscalex100
keselamatan pasien secara spesifik terhadap cakupan pelayanan yang diberikan
\up0 \expndtw0\charscalex104 oleh unit pelayanan tersebut, juga menyediakan data
dan informasi dari hasil \up0 \expndtw0\charscalex100 kegiatan tersebut yang dapat
dipergunakan untuk melakukan evaluasi dokter, \up0 \expndtw-2\charscalex100
perawat, dan staf klinis pemberi asuhan lainnya yang memberikan asuhan pasien \up0
\expndtw-3\charscalex100 di unit pelayanan tersebut. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb104\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 282
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg283}
{\bkmkend Pg283}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb92\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan TKRS 11.1 \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1587\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kepala unit bertanggung jawab menjamin bahwa
kegiatan pengukuran \line \up0 \expndtw-2\charscalex100 memberikan kesempatan
untuk mengevaluasi staf maupun proses pelayanannya. \line \up0
\expndtw0\charscalex103 Dengan demikian, dari waktu ke waktu pengukuran meliputi
semua pelayanan \line \up0 \expndtw0\charscalex104 yang diberikan. Data dan
informasi yang dihasilkan tidak hanya penting untuk \line \up0
\expndtw0\charscalex102 upaya peningkatan mutu unit pelayanannya, tetapi juga
penting untuk program \line \up0 \expndtw-2\charscalex100 peningkatan mutu dan
keselamatan pasien rumah sakit. (lihat juga PAB 2, EP 7) \par\pard\qj
\li1418\ri1548\sb300\sl-320\slmult0 \up0 \expndtw0\charscalex103 Kepala unit
pelayanan bertanggung jawab untuk memastikan bahwa kegiatan \up0 \expndtw-
3\charscalex100 pengukuran tentang cakupan layanan yang diberikan oleh unit
pelayanan berguna \up0 \expndtw-1\charscalex100 untuk melakukan evaluasi
terhadap staf termasuk evaluasi terhadap proses \up0 \expndtw0\charscalex100
asuhan klinik. Dalam beberapa hal, pengukuran mutu di dalam Departemen/Unit \up0
\expndtw-3\charscalex100 pelayanan dibandingkan juga dengan organisasi lain.
\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\ri1538\sb10\sl-
315\slmult0 \up0 \expndtw-1\charscalex100 Data juga di butuhkan untuk melakukan
evaluasi terhadap perawat dan staf klinis \up0 \expndtw-3\charscalex100 pemberi
asuhan lainnya. Walaupun staf klinis pemberi asuhan lainnya ini sudah \up0
\expndtw-3\charscalex100 mempunyai rincian tugas serta fungsi dan kewajiban, kepala
unit pelayanan masih \up0 \expndtw-2\charscalex100 bertanggung jawab untuk
menyediakan data yang digunakan untuk pelaksanaan \up0 \expndtw-3\charscalex100
evaluasi terhadap tenaga-tenaga ini. \par\pard\qj \li1418\ri1606\sb1\sl-320\slmult0
\up0 \expndtw0\charscalex105 Sistem penilaian kinerja staf ini mengacu kepada
regulasi di rumah sakit dan \up0 \expndtw-3\charscalex100 peraturan perundang-
undangan. \par\pard\qj \li1418\ri1597\sb9\sl-310\slmult0 \up0
\expndtw0\charscalex102 Sebagai contoh: salah satu penilaian kinerja dokter bedah
adalah pelaksanaan \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf8\f9\fs24 time-
out\ul0\nosupersub\cf7\f8\fs24 dan berdasar atas hal tersebut maka salah satu
penilaian mutu serta \up0 \expndtw-3\charscalex100 keselamatan pasien di unit kamar
operasi adalah pelaksanaan\ul0\nosupersub\cf8\f9\fs24 time
out\ul0\nosupersub\cf7\f8\fs24 . \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 11.1 \par\pard\ql \li1778\sb0\sl-
313\slmult0 \par\pard\ql\li1778\ri1551\sb21\sl-313\slmult0\tx2138\tx2138\tx2138
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Kepala unit pelayanan
menyediakan data yang digunakan untuk melakukan \line\tab \up0
\expndtw0\charscalex102 evaluasi terhadap praktik profesional berkelanjutan
dari dokter yang \line \tab \up0 \expndtw-1\charscalex100 memberikan layanan di
Unit tersebut sesuai dengan regulasi rumah sakit \line \tab \up0 \expndtw-
2\charscalex100 (lihat juga KKS 11 EP 2 dan PMKP 4.1). (D,W) \par\pard\ql
\li1778\ri1551\sb2\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 2.
Kepala unit pelayanan menyediakan data yang digunakan untuk melakukan \line\tab
\up0 \expndtw-1\charscalex100 evaluasi terhadap kinerja staf perawat sesuai dengan
regulasi rumah sakit \line \tab \up0 \expndtw-3\charscalex100 (periksa juga KKS15
EP 2 dan PMKP 4.1)\ul0\nosupersub\cf8\f9\fs24 .\ul0\nosupersub\cf7\f8\fs24
(D,W) \par\pard\ql \li1778\ri1551\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 3. Kepala unit pelayanan menyediakan data yang digunakan untuk
melakukan \line\tab \up0 \expndtw0\charscalex100 evaluasi staf klinis pemberi
asuhan lainnya sesuai dengan regulasi rumah \line \tab \up0 \expndtw-
3\charscalex100 sakit (lihat juga KKS18 EP 2 dan PMKP
4.1\ul0\nosupersub\cf8\f9\fs24 )\ul0\nosupersub\cf7\f8\fs24 . (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb105\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar TKRS 11.2 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb124\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 283
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg284}
{\bkmkend Pg284}\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1592\sb203\sl-313\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap Kelompok Staf Medis (KSM) memilih dan menetapkan
panduan praktik \up0 \expndtw-2\charscalex100 klinik yang dapat dilengkapi dengan
alur klinis (\ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 ) dan/atau protokol \up0 \expndtw0\charscalex100
klinis dan/atau prosedur dan/atau\ul0\nosupersub\cf8\f9\fs24 standing
order\ul0\nosupersub\cf7\f8\fs24 sebagai panduan asuhan klinik \up0 \expndtw-
3\charscalex100 yang akan dilakukan evaluasi. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan Standar TKRS 11.2
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Sasaran RS adalah
\par\pard\ql \li1624\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 1.
standardisasi proses asuhan klinik; \par\pard\qj \li1624\ri2341\sb0\sl-
320\slmult0\tx1984 \up0 \expndtw-1\charscalex100 2. mengurangi risiko dalam proses
asuhan, teristimewa yang berkaitan \line\tab \up0 \expndtw-3\charscalex100 dengan
keputusan tentang asuhan yang kritikal; \par\pard\qj \li1624\ri2345\sb0\sl-
320\slmult0\tx1984 \up0 \expndtw0\charscalex103 3. memberikan asuhan klinik tepat
waktu, efektif, dan menggunakan \line\tab \up0 \expndtw-3\charscalex100 sumber daya
yang tersedia dengan efisien; \par\pard\qj \li1624\ri2339\sb0\sl-320\slmult0\tx1984
\up0 \expndtw0\charscalex100 4. memberikan asuhan bermutu tinggi secara konsisten
menggunakan \line\tab \up0 \expndtw-3\charscalex100
\u8220?\ul0\nosupersub\cf8\f9\fs24 evidence based
practices.\ul0\nosupersub\cf7\f8\fs24 \u8221? \par\pard\qj \li1418\ri1430\sb312\sl-
316\slmult0 \up0 \expndtw-2\charscalex100 Rumah sakit dapat menggunakan berbagai
sarana untuk mencapai tujuan-tujuan di \line \up0 \expndtw0\charscalex100 atas
maupun tujuan lainnya. Sebagai contoh yang diupayakan para tenaga medis \line
\up0 \expndtw0\charscalex100 adalah mengembangkan proses asuhan klinis dan membuat
keputusan berdasar \line \up0 \expndtw0\charscalex105 atas bukti ilmiah terbaik
yang tersedia. Untuk upaya ini, panduan praktik klinis \line \up0 \expndtw-
2\charscalex100 merupakan sarana yang bermanfaat untuk memahami serta
menerapkan ilmu \line \up0 \expndtw-2\charscalex100 terbaik pada diagnosis dan
kondisi-kondisi tertentu. (lihat juga PPI 6.1) \par\pard\ql \li1418\sb0\sl-
315\slmult0 \par\pard\ql\li1418\ri1594\sb10\sl-315\slmult0 \up0 \expndtw-
2\charscalex100 Rumah sakit dapat menyusun standar pelayanan kedokteran dengan
memakai \up0 \expndtw-2\charscalex100 referensi pedoman nasional pelayanan
kedokteran atau referensi dari organisasi \up0 \expndtw-3\charscalex100 profesi
internasional sesuai dengan peraturan perundang-undangan. \line \up0
\expndtw0\charscalex100 Panduan praktik klinis, alur klinis
(\ul0\nosupersub\cf8\f9\fs24 clinical pathway\ul0\nosupersub\cf7\f8\fs24 ) atau
protokol yang diseleksi \up0 \expndtw-3\charscalex100 untuk dilakukan evaluasi
memenuhi kriteria: \par\pard\ql \li1778\sb38\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 a. sesuai dengan populasi pasien yang ada dan misi rumah
sakit; \par\pard\qj \li1778\ri1607\sb8\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 b. disesuaikan dengan teknologi, obat, sumber daya lain di
rumah sakit atau \line\tab \up0 \expndtw-3\charscalex100 norma profesional yang
berlaku secara nasional; \par\pard\qj \li1778\ri1603\sb17\sl-300\slmult0\tx2138
\up0 \expndtw-1\charscalex100 c. dilakukan asesmen terhadap bukti ilmiahnya
dan disahkan oleh pihak \line\tab \up0 \expndtw-3\charscalex100 berwewenang;
\par\pard\ql \li1778\sb40\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d.
disetujui resmi atau digunakan oleh rumah sakit; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 e. dilaksanakan dan diukur
efektivitasnya; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 f. dijalankan oleh staf yang terlatih menerapkan pedoman
atau\ul0\nosupersub\cf8\f9\fs24 pathways\ul0\nosupersub\cf7\f8\fs24 ; \par\pard\qj
\li1778\ri1604\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 g. secara
berkala diperbaharui berdasar atas bukti serta evaluasi proses dan \line\tab
\up0 \expndtw-3\charscalex100 hasil proses. \par\pard\qj \li1418\ri1538\sb300\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Karena panduan, alur, dan protokol
terkait dapat memberikan dampak bagi \up0 \expndtw0\charscalex104 beberapa unit
pelayanan klinis maka setiap Kelompok Staf Medis diharapkan \up0 \expndtw-
3\charscalex100 terlibat dalam pemilihan, penerapan dan evaluasi panduan, serta
alur dan protokol \up0 \expndtw-4\charscalex100 klinis di Kelompok Staf Medis
masing-masing. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb50\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 284
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg285}
{\bkmkend Pg285}\par\pard\qj \li1418\sb0\sl-313\slmult0 \par\pard\qj\li1418\sb0\sl-
313\slmult0 \par\pard\qj\li1418\sb0\sl-313\slmult0
\par\pard\qj\li1418\ri1596\sb203\sl-313\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Mengingat penerapan panduan, alur, dan protokol di
unit-unit pelayanan klinis \up0 \expndtw0\charscalex100 maka Kepala Unit
Pelayanan Klinis agar terlibat dalam evaluasi penerapan \up0
\expndtw0\charscalex103 panduan, alur, dan protokol tersebut dengan menggunakan
indikator-indikator \up0 \expndtw-3\charscalex100 mutu sebagaimana diatur di TKRS
11. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Setiap Kelompok Staf Medis setiap tahun diharapkan
mencapai beberapa hal. \par\pard\ql \li1958\ri1540\sb10\sl-
318\slmult0\tx2318\tx2318\tx2318\tx2318\tx2318\tx2318\tx2318\tx2318\tx2318\tx2318 \
up0 \expndtw0\charscalex100 1) Setiap Ketua Kelompok Staf Medis menetapkan secara
bersama paling \line\tab \up0 \expndtw-4\charscalex100 sedikit 5 (lima) panduan
praktik klinis prioritas untuk diimplementasikan di \line \tab \up0 \expndtw-
4\charscalex100 unit pelayanan dengan memilih proses yang diimplementasikan,
misalnya \line \tab \up0 \expndtw0\charscalex100 sebuah diagnosis seperti strok,
tindakan seperti transplantasi, populasi \line \tab \up0 \expndtw-2\charscalex100
pasien seperti geriatri, penyakit seperti diabetes melitus yang selanjutnya
\line \tab \up0 \expndtw0\charscalex101 panduan ditetapkan berdampak terhadap
keamanan dan mutu asuhan \line \tab \up0 \expndtw0\charscalex100 pasien serta
mengurangi variasi hasil yang tidak diinginkan. Mengingat \line \tab \up0
\expndtw0\charscalex104 penerapan panduan, alur, dan protokol klinis di unit
pelayanan maka \line \tab \up0 \expndtw0\charscalex101 dalam pemilihan dan
penetapan panduan, alur, dan protokol agar \line \tab \up0 \expndtw-
3\charscalex100 melakukan komunikasi dan koordinasi dengan unit pelayanan terkait
agar \line \tab \up0 \expndtw-3\charscalex100 dapat membantu penerapan dan evaluasi
penerapannya. \par\pard\ql \li1958\ri1567\sb0\sl-
320\slmult0\tx2318\tx2318\tx2318 \up0 \expndtw-1\charscalex100 2) Menetapkan
panduan pemilihan dan penyusunan panduan praktik klinik, \line\tab \up0
\expndtw0\charscalex100 alur klinis (\ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 ), dan/atau protokol klinis, dan/atau
prosedur, \line \tab \up0 \expndtw-3\charscalex100
dan/atau\ul0\nosupersub\cf8\f9\fs24 standing order\ul0\nosupersub\cf7\f8\fs24
sebagai panduan asuhan klinik dengan mengacu \line \tab \up0 \expndtw-
3\charscalex100 pada butir 1 sampai dengan 7 di atas. \par\pard\qj
\li1418\ri1540\sb305\sl-316\slmult0 \up0 \expndtw-1\charscalex100 Komite medis
bersama-sama dengan pimpinan pelayanan medis melakukan \line \up0 \expndtw-
3\charscalex100 monitoring kepatuhan staf medis/DPJP terhadap panduan praktik
klinis. Monitoring \line \up0 \expndtw0\charscalex102 dapat dilakukan dengan
melakukan evaluasi ketepatan penggunaan obat, \line \up0 \expndtw-
4\charscalex100 pemeriksaan penunjang medik, dan\ul0\nosupersub\cf8\f9\fs24 length
of stay\ul0\nosupersub\cf7\f8\fs24 (LOS) walau harus diakui bahwa \line \up0
\expndtw0\charscalex103 perpanjangan LOS banyak faktor yang terkait dan
tidak murni mengukur \line \up0 \expndtw-3\charscalex100 kepatuhan DPJP.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS
11.2 \par\pard\ql \li1778\sb0\sl-313\slmult0 \par\pard\ql\li1778\ri1544\sb21\sl-
313\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang mengatur bahwa setiap Kelompok
Staf Medis (KSM) \line\tab \up0 \expndtw-4\charscalex100 setiap tahun memilih 5
(lima) panduan praktik klinis, alur, atau protokol klinis \line \tab \up0
\expndtw0\charscalex100 prioritas untuk dievaluasi sesuai dengan kriteria yang ada
di maksud dan \line \tab \up0 \expndtw-3\charscalex100 panduan butir 1 sampai
dengan 7 serta butir 1 dan 2. (R) \par\pard\qj \li1778\ri1602\sb2\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2. Ada bukti bahwa setiap
tahun, panduan praktik klinis, alur klinis, atau \line\tab \up0 \expndtw-
2\charscalex100 protokol dipilih sesuai dengan regulasi. (D,W) \par\pard\qj
\li1778\ri1603\sb0\sl-320\slmult0\tx2138
\up0 \expndtw-1\charscalex100 3. Ada bukti bahwa panduan praktik klinis,
alur klinis, dan atau protokol \line\tab \up0 \expndtw-2\charscalex100 tersebut
telah dilaksanakan sesuai dengan regulasi. (D,W) \par\pard\ql
\li1778\ri1547\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 4.
Ada bukti bahwa Komite Medik telah melakukan monitoring dan evaluasi \line\tab \up0
\expndtw-3\charscalex100 penerapan panduan praktik klinik, alur, dan atau
protokol klinis sehingga \line \tab \up0 \expndtw-4\charscalex100 berhasil
menekan keberagaman proses dan hasil. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 ETIKA ORGANISASI DAN ETIKA KLINIS
\par\pard\ql \li10156\sb243\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 285
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg286}
{\bkmkend Pg286}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb92\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS
12 \par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1905\sb8\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan tata kelola untuk manajemen etis dan etika pegawai \up0 \expndtw-
3\charscalex100 agar menjamin bahwa asuhan pasien diberikan di dalam norma-norma
bisnis, \up0 \expndtw-4\charscalex100 finansial, etis, serta hukum yang melindungi
pasien dan hak mereka. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar TKRS 12.1 \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kerangka kerja rumah sakit untuk manajemen etis
meliputi pemasaran, admisi/ \par\pard\li1418\sb57\sl-
276\slmult0\fi0\tx5178\tx9072 \up0 \expndtw0\charscalex100 penerimaan pasien
rawat inap\tab \up0 \expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
admission\ul0\nosupersub\cf7\f8\fs24 ), pemindahan pasien\tab \up0
\expndtw0\charscalex100 (transfer),\par\pard\li1418\sb41\sl-
276\slmult0\fi0\tx3895\tx7842 \up0 \expndtw0\charscalex100 pemulangan
pasien\tab \up0 \expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
discharge\ul0\nosupersub\cf7\f8\fs24 ), dan pemberitahuan\tab \up0
\expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
disclosure\ul0\nosupersub\cf7\f8\fs24 ) tentang\par\pard\qj \li1418\ri1605\sb0\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 kepemilikan serta konflik bisnis
maupun profesional yang bukan kepentingan \up0 \expndtw-3\charscalex100 pasien.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb79\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar TKRS 12.2
\par\pard\qj \li1418\ri2185\sb308\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kerangka kerja rumah sakit untuk manajemen etis
mendukung pengambilan \line \up0 \expndtw-2\charscalex100 keputusan secara etis di
dalam pelayanan klinis dan pelayanan nonklinis. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb169\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan TKRS 12 sampai dengan
TKRS 12.2 \par\pard\qj \li1418\ri1573\sb11\sl-316\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menghadapi
banyak tantangan dalam memberikan pelayanan \up0 \expndtw0\charscalex100
kesehatan yang aman dan berkualitas. Kemajuan dalam bidang teknologi \up0
\expndtw-1\charscalex100 kedokteran, dana/anggaran rumah sakit yang terbatas, dan
harapan pasien yang \up0 \expndtw-2\charscalex100 terus meningkat sejalan dengan
semakin meningkatnya pendidikan di masyarakat \up0 \expndtw-2\charscalex100 serta
dilema etis dan kontroversi yang sering terjadi telah menjadi hal yang sering
\up0 \expndtw-3\charscalex100 dihadapi oleh rumah sakit. \par\pard\qj
\li1418\ri1597\sb5\sl-316\slmult0 \up0 \expndtw0\charscalex102 Berdasar atas hal
tersebut maka rumah sakit harus mempunyai kerangka etika \line \up0
\expndtw0\charscalex103 yang menjamin bahwa asuhan pasien diberikan di dalam norma-
norma bisnis, \line \up0 \expndtw0\charscalex102 finansial, etis, serta hukum yang
melindungi pasien dan hak mereka. Kerangka \line \up0 \expndtw-2\charscalex100
etika yang dapat berbentuk pedoman atau bentuk regulasi lainnya
termasuk \line \up0 \expndtw0\charscalex100 referensi atau sumber etikanya dari
mana, dan diperlukan edukasi untuk seluruh \line \up0 \expndtw-3\charscalex100
staf. \par\pard\ql \li1418\sb38\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Kerangka etika atau pedoman etik rumah sakit tersebut antara lain mengatur
\par\pard\ql \li1958\ri1598\sb8\sl-320\slmult0\tx2318\tx2318 \up0
\expndtw0\charscalex103 1) tanggung jawab Direktur Rumah Sakit secara profesional
dan hukum \line\tab \up0 \expndtw-3\charscalex100 dalam menciptakan dan mendukung
lingkungan serta budaya kerja yang \line \tab \up0 \expndtw-3\charscalex100
berpedoman pada etika dan perilaku etis termasuk etika pegawai; \par\pard\qj
\li1958\ri1610\sb0\sl-320\slmult0\tx2318 \up0 \expndtw0\charscalex108 2) penerapan
etika dengan bobot yang sama pada kegiatan \line\tab \up0 \expndtw-
1\charscalex100 bisnis/manajemen maupun kegiatan klinis/pelayanan rumah sakit;
\par\pard\ql \li1958\ri1600\sb0\sl-320\slmult0\tx2318\tx2318 \up0
\expndtw0\charscalex102 3) kerangka etika (pedoman etik) ini dapat untuk acuan
kinerja dan sikap \line\tab \up0 \expndtw0\charscalex102 organisasi selaras dengan
visi, misi, pernyataan nilai-nilai rumah sakit, \line \tab \up0
\expndtw0\charscalex102 kebijakan sumber daya manusia, serta poran tahunan dan
dokumen \par\pard\ql \li10156\sb216\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 286
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg287}
{\bkmkend Pg287}\par\pard\ql \li2318\sb0\sl-276\slmult0 \par\pard\ql\li2318\sb0\sl-
276\slmult0 \par\pard\ql\li2318\sb0\sl-276\slmult0 \par\pard\ql\li2318\sb0\sl-
276\slmult0 \par\pard\ql\li2318\sb68\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 lainnya; \par\pard\ql
\li1958\ri1605\sb0\sl-
320\slmult0\tx2318\tx2318\tx2318\tx2318\tx2318\tx2318\tx2318 \up0
\expndtw0\charscalex100 4) kerangka etika (pedoman etik) ini dapat membantu
tenaga kesehatan, \line\tab \up0 \expndtw0\charscalex103 staf, serta pasien dan
keluarga pasien ketika menghadapi dilema etis \line \tab \up0
\expndtw0\charscalex105 dalam asuhan pasien seperti perselisihan
antarprofesional serta \line \tab \up0 \expndtw0\charscalex100 perselisihan pasien
dengan dokter mengenai keputusan dalam asuhan \line \tab \up0
\expndtw0\charscalex102 dan pelayanan. Sesuai dengan regulasi maka rumah
sakit dapat \line \tab \up0 \expndtw0\charscalex101 menetapkan Komite/Panitia/Tim
yang mengelola etik rumah sakit \line \tab \up0 \expndtw0\charscalex101
termasuk melakukan koordinasi Komite etik RS dengan subkomite etik \line \tab
\up0 \expndtw-3\charscalex100 profesi medis dan subkomite etik keperawatan;
\par\pard\ql \li1958\ri1599\sb0\sl-320\slmult0\tx2318\tx2318\tx2318\tx2318 \up0
\expndtw0\charscalex100 5) mempertimbangkan norma-norma nasional dan
internasional terkait \line\tab \up0 \expndtw-1\charscalex100 dengan hak asasi
manusia serta etika profesional dalam menyusun \line \tab \up0
\expndtw0\charscalex103 kerangka etika dan dokumen pedoman lainnya. Selain hal
tersebut di \line \tab \up0 \expndtw-2\charscalex100 atas, untuk menerapkan etik di
rumah sakit maka perlu ada regulasi yang \line \tab \up0 \expndtw-3\charscalex100
mengatur. \par\pard\li1418\sb0\sl-276\slmult0\par\pard\li1418\sb51\sl-
276\slmult0\fi0 \up0 \expndtw-2\charscalex100 Rumah sakit dalam menjalankan
kegiatannya secara etika harus\par\pard\li1418\sb43\sl-276\slmult0\fi360\tx2138
\up0 \expndtw-2\charscalex100 a.\tab \up0 \expndtw-2\charscalex100 mengungkapkan
kepemilikan dan konflik kepentingan;\par\pard\li1418\sb41\sl-
276\slmult0\fi360\tx2138 \up0 \expndtw-2\charscalex100 b.\tab \up0 \expndtw-
2\charscalex100 menjelaskan pelayanannya pada pasien secara
jujur;\par\pard\li1418\sb41\sl-276\slmult0\fi360\tx2138 \up0 \expndtw-
2\charscalex100 c.\tab \up0 \expndtw-2\charscalex100 melindungi kerahasiaan
informasi pasien;\par\pard\li1418\sb40\sl-276\slmult0\fi360\tx2138 \up0 \expndtw-
2\charscalex100 d.\tab \up0 \expndtw-1\charscalex100 menyediakan kebijakan
yang jelas mengenai pendaftaran pasien,\par\pard\li1418\sb44\sl-
276\slmult0\fi720 \up0 \expndtw-2\charscalex100 transfer, dan pemulangan
pasien;\par\pard\li1418\sb40\sl-276\slmult0\fi360\tx2138 \up0 \expndtw-
2\charscalex100 e.\tab \up0 \expndtw-2\charscalex100 menagih biaya untuk
pelayanan yang diberikan secara akurat dan\par\pard\li1418\sb41\sl-
276\slmult0\fi720 \up0 \expndtw-2\charscalex100 memastikan bahwa insentif finansial
dan pengaturan pembayaran tidak\par\pard\li1418\sb41\sl-276\slmult0\fi720 \up0
\expndtw-2\charscalex100 mengganggu pelayanan pasien;\par\pard\li1418\sb43\sl-
276\slmult0\fi360\tx2138 \up0 \expndtw-2\charscalex100 f.\tab \up0 \expndtw-
2\charscalex100 mendukung transparansi dalam melaporkan pengukuran kinerja klinis
dan\par\pard\li1418\sb41\sl-276\slmult0\fi720 \up0 \expndtw-2\charscalex100 kinerja
organisasi;\par\pard\ql \li1778\ri1589\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-4\charscalex100 g. \tab
\up0 \expndtw0\charscalex100 menetapkan sebuah mekanisme agar tenaga kesehatan dan
staf lainnya \line\tab \up0 \expndtw-2\charscalex100 dapat melaporkan kesalahan
klinis atau mengajukan kekhawatiran etis \line \tab \up0 \expndtw-
2\charscalex100 dengan bebas dari hukuman, termasuk melaporkan perilaku staf
yang \line \tab \up0 \expndtw-3\charscalex100 merugikan terkait dengan masalah
klinis ataupun operasional; \par\pard\qj \li1778\ri1597\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 h. \tab \up0
\expndtw0\charscalex100 mendukung lingkungan yang memperkenankan diskusi
secara bebas \line\tab \up0 \expndtw-3\charscalex100 mengenai masalah/isu etis
tanpa ada ketakutan atas sanksi; \par\pard\qj \li1778\ri1541\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-4\charscalex100 i. \tab \up0 \expndtw-
3\charscalex100 menyediakan resolusi yang efektif dan tepat waktu untuk masalah
etis yang \line\tab \up0 \expndtw-4\charscalex100 ada; \par\pard\ql
\li1778\ri1564\sb0\sl-320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
4\charscalex100 j. \tab \up0 \expndtw-1\charscalex100 memastikan praktik
nondiskriminasi dalam hubungan kerja dan ketentuan \line\tab \up0 \expndtw-
4\charscalex100 atas asuhan pasien dengan mengingat norma hukum serta budaya
negara \line \tab \up0 \expndtw-4\charscalex100 Indonesia; \par\pard\qj
\li1778\ri1991\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 k.
\tab \up0 \expndtw-3\charscalex100 mengurangi kesenjangan dalam akses untuk
pelayanan kesehatan dan \line\tab \up0 \expndtw-3\charscalex100 hasil klinis.
(lihat juga PP 1, HPK 1.1, dan TKRS 8) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb32\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 12 \par\pard\qj \li1778\sb0\sl-
320\slmult0 \par\pard\qj\li1778\ri1541\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Direktur rumah sakit menetapkan
regulasi tentang tata kelola etik rumah \line\tab \up0 \expndtw-4\charscalex100
sakit yang mengacu pada kode etik rumah sakit nasional, membentuk komite
\par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 287
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg288}
{\bkmkend Pg288}\par\pard\qj \li2138\sb0\sl-300\slmult0 \par\pard\qj\li2138\sb0\sl-
300\slmult0 \par\pard\qj\li2138\sb0\sl-300\slmult0
\par\pard\qj\li2138\ri1540\sb253\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 etik yang mengelola etika rumah sakit, dan
mengkoordinasikan subkomite \up0 \expndtw-4\charscalex100 etik profesi dan
menetapkan kode etik pegawai rumah sakit. (R) \par\pard\qj \li1778\ri1549\sb4\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Direktur rumah sakit memastikan
asuhan pasien tidak melanggar norma-\line\tab \up0 \expndtw-4\charscalex100 norma
bisnis, norma keuangan, etik, dan hukum. (D,W) \par\pard\ql \li1778\ri1588\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 3. Direktur rumah sakit
memastikan praktek nondiskriminatif dalam hubungan \line\tab \up0 \expndtw-
1\charscalex100 kerja dan ketentuan atas asuhan pasien dengan mengingat norma hukum
\line \tab \up0 \expndtw-4\charscalex100 serta budaya. (D,W) \par\pard\qj
\li1778\ri1590\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102 4. Direktur
rumah sakit memastikan kepatuhan staf terhadap etika pegawai \line\tab \up0
\expndtw-4\charscalex100 rumah sakit. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 12.1 \par\pard\ql \li1778\sb0\sl-
320\slmult0 \par\pard\ql\li1778\ri1602\sb8\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit
mengungkapkan kepemilikannya serta mencegah konflik \line\tab \up0
\expndtw0\charscalex100 kepentingan bila melakukan rujukan. (lihat juga AP 5.1, EP
5, dan AP 6.1. \line \tab \up0 \expndtw-3\charscalex100 EP 2). (D,O,W )
\par\pard\qj \li1778\ri1691\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
2. Rumah sakit secara jujur menjelaskan pelayanan yang disediakan kepada \line\tab
\up0 \expndtw-3\charscalex100 pasien. (lihat MKE ...). (D,O,W) \par\pard\ql
\li1778\ri1547\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-4\charscalex100 3.
Rumah sakit membuat tagihan yang akurat untuk layanannya serta
\line\tab \up0 \expndtw0\charscalex100 memastikan bahwa insentif finansial dan
pengaturan pembayaran tidak \line \tab \up0 \expndtw-3\charscalex100 memengaruhi
asuhan pasien. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 12.2 \par\pard\qj \li1869\sb0\sl-
320\slmult0 \par\pard\qj\li1869\ri1841\sb8\sl-320\slmult0\tx2229 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai sistem
pelaporan bila terjadi dilema etis dalam \line\tab \up0 \expndtw-3\charscalex100
asuhan pasien dan dalam pelayanan nonklinis. (R) \par\pard\ql
\li1869\ri1597\sb0\sl-320\slmult0\tx2229\tx2229 \up0 \expndtw0\charscalex103 2.
Regulasi tentang manajemen etis yang mendukung hal-hal yang \line\tab
\up0 \expndtw0\charscalex100 dikonfrontasi pada dilema etis dalam asuhan pasien
telah dilaksanakan. \line \tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\ql
\li1869\ri1600\sb0\sl-320\slmult0\tx2229\tx2229 \up0 \expndtw0\charscalex102 3.
Regulasi untuk manajemen etis yang mendukung hal-hal yang
\line\tab \up0 \expndtw0\charscalex103 dikonfrontasikan pada dilema etis dalam
pelayanan nonklinis telah \line \tab \up0 \expndtw-3\charscalex100 dilaksanakan.
(D,W) \par\pard\qj \li1869\ri1601\sb0\sl-300\slmult0\tx2229 \up0
\expndtw0\charscalex102 4. Pelaporan bila terjadi dilema etis dalam asuhan
pasien dan dalam \line\tab \up0 \expndtw-3\charscalex100 pelayanan nonklinis
telah dilaksanakan. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 BUDAYA KESELAMATAN \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar TKRS 13 \par\pard\qj \li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1604\sb45\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Direktur Rumah Sakit menciptakan dan mendukung
budaya keselamatan di \up0 \expndtw-3\charscalex100 seluruh area rumah sakit
sesuai dengan peraturan perundang-undangan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar TKRS 13.1 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb124\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 288
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg289}
{\bkmkend Pg289}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1546\sb253\sl-300\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Direktur Rumah Sakit melaksanakan, melakukan monitor,
dan mengambil tindakan \line \up0 \expndtw-3\charscalex100 untuk memperbaiki
program budaya keselamatan di seluruh area rumah sakit. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud TKRS 13 dan TKRS 13.1
\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1596\sb15\sl-
316\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Budaya
keselamatan dapat diartikan sebagai berikut: \u8220?Budaya keselamatan di \up0
\expndtw0\charscalex102 rumah sakit adalah sebuah lingkungan yang kolaboratif
karena staf klinis \up0 \expndtw0\charscalex105 memperlakukan satu sama lain
secara hormat dengan melibatkan serta \up0 \expndtw0\charscalex100
memberdayakan pasien dan keluarga. Pimpinan mendorong staf klinis pemberi \up0
\expndtw-1\charscalex100 asuhan bekerja sama dalam tim yang efektif dan mendukung
proses kolaborasi \up0 \expndtw-3\charscalex100 interprofesional dalam asuhan
berfokus pada pasien. \par\pard\qj \li1418\ri1535\sb4\sl-317\slmult0 \up0
\expndtw0\charscalex102 Budaya keselamatan juga merupakan hasil dari nilai-
nilai, sikap, persepsi, \line \up0 \expndtw-1\charscalex100 kompetensi, dan
pola perilaku individu maupun kelompok yang menentukan \line \up0 \expndtw-
2\charscalex100 komitmen terhadap, serta kemampuan manajemen pelayanan kesehatan
maupun \line \up0 \expndtw0\charscalex100 keselamatan. Budaya keselamatan dicirikan
dengan komunikasi yang berdasar \line \up0 \expndtw0\charscalex100 atas rasa
saling percaya dengan persepsi yang sama tentang pentingnya \line \up0
\expndtw-2\charscalex100 keselamatan dan dengan keyakinan akan manfaat langkah-
langkah pencegahan. \line \up0 \expndtw-2\charscalex100 Tim belajar dari kejadian
tidak diharapkan dan kejadian nyaris cedera. Staf klinis \line \up0 \expndtw-
2\charscalex100 pemberi asuhan menyadari keterbatasan kinerja manusia dalam
sistem yang \line \up0 \expndtw0\charscalex100 kompleks dan ada proses yang
terlihat dari belajar serta menjalankan perbaikan \line \up0 \expndtw-
7\charscalex100 melalui brifing. \par\pard\qj \li1418\ri1534\sb5\sl-315\slmult0
\up0 \expndtw-5\charscalex100 Keselamatan dan mutu berkembang dalam suatu
lingkungan yang mendukung kerja \up0 \expndtw-6\charscalex100 sama dan rasa hormat
terhadap sesama tanpa melihat jabatan mereka dalam rumah \up0 \expndtw-
4\charscalex100 sakit. Direktur rumah sakit menunjukkan komitmennya tentang budaya
keselamatan \up0 \expndtw-3\charscalex100
dan medorong budaya keselamatan untuk seluruh staf rumah sakit. Perilaku yang
\up0 \expndtw-6\charscalex100 tidak mendukung budaya keselamatan adalah:
\par\pard\ql \li1778\ri1595\sb21\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 perilaku yang tidak layak
(\ul0\nosupersub\cf8\f9\fs24 inappropriate\ul0\nosupersub\cf7\f8\fs24 ) seperti
kata-kata atau bahasa \line\tab \up0 \expndtw-2\charscalex100 tubuh yang
merendahkan atau menyinggung perasaan sesama staf, \line \tab \up0 \expndtw-
3\charscalex100 misalnya mengumpat dan memaki; \par\pard\ql \li1778\ri1540\sb3\sl-
317\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 perilaku yang mengganggu
(\ul0\nosupersub\cf8\f9\fs24 disruptive)\ul0\nosupersub\cf7\f8\fs24 antara lain
perilaku tidak layak yang \line\tab \up0 \expndtw0\charscalex102 dilakukan secara
berulang, bentuk tindakan verbal atau nonverbal yang \line \tab \up0 \expndtw-
2\charscalex100 membahayakan atau mengintimidasi staf lain, dan \u8220?celetukan
maut\u8221? adalah \line \tab \up0 \expndtw0\charscalex102 komentar sembrono di
depan pasien yang berdampak menurunkan \line \tab \up0 \expndtw-2\charscalex100
kredibilitas staf klinis lain. Contoh mengomentari negatif hasil tindakan atau
\line \tab \up0 \expndtw-2\charscalex100 pengobatan staf lain di depan pasien,
misalnya \u8220?obatnya ini salah, tamatan \line \tab \up0 \expndtw-2\charscalex100
mana dia...?\u8221?, melarang perawat untuk membuat laporan tentang kejadian
\line \tab \up0 \expndtw-2\charscalex100 tidak diharapkan, memarahi staf klinis
lainnya di depan pasien, kemarahan \line \tab \up0 \expndtw0\charscalex103 yang
ditunjukkan dengan melempar alat bedah di kamar operasi, serta \line \tab \up0
\expndtw-3\charscalex100 membuang rekam medis di ruang rawat; \par\pard\qj
\li1778\ri1599\sb21\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 perilaku yang
melecehkan (\ul0\nosupersub\cf8\f9\fs24 harassment\ul0\nosupersub\cf7\f8\fs24 )
terkait dengan ras, agama, dan \line\tab \up0 \expndtw-3\charscalex100 suku
termasuk gender; \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
pelecehan seksual. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Hal-hal
penting menuju budaya keselamatan. \par\pard\ql \li10156\sb183\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 289
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\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1) Staf rumah sakit mengetahui
bahwa kegiatan operasional rumah sakit \line\tab \up0 \expndtw-2\charscalex100
berisiko tinggi dan bertekad untuk melaksanakan tugas dengan konsisten \line
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lingkungan kerja mendorong staf tidak takut mendapat \line\tab \up0
\expndtw0\charscalex102 hukuman bila membuat laporan tentang kejadian tidak
diharapkan dan \line \tab \up0 \expndtw-3\charscalex100 kejadian nyaris cedera.
\par\pard\ql \li1869\ri1604\sb0\sl-320\slmult0\tx2229\tx2229 \up0
\expndtw0\charscalex102 3) Direktur Rumah Sakit mendorong tim keselamatan pasien
melaporkan \line\tab \up0 \expndtw-1\charscalex100 insiden keselamatan pasien ke
tingkat nasional sesuai dengan peraturan \line \tab \up0 \expndtw-3\charscalex100
perundang-undangan. \par\pard\qj \li1869\ri1592\sb0\sl-320\slmult0\tx2229 \up0
\expndtw0\charscalex103 4) Mendorong kolaborasi antarstaf klinis dengan pimpinan
untuk mencari \line\tab \up0 \expndtw-3\charscalex100 penyelesaian masalah
keselamatan pasien. \par\pard\qj \li1418\ri1555\sb303\sl-317\slmult0 \up0
\expndtw0\charscalex100 Komitmen organisasi menyediakan sumber daya, seperti staf,
pelatihan, metode \up0 \expndtw-2\charscalex100 pelaporan yang aman, dan sebagainya
untuk menangani masalah keselamatan. \up0 \expndtw-2\charscalex100 Masih banyak
rumah sakit yang masih memiliki budaya untuk menyalahkan suatu \up0 \expndtw-
1\charscalex100 pihak yang akhirnya merugikan kemajuan budaya
keselamatan.\ul0\nosupersub\cf8\f9\fs24 Just culture \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 adalah model terkini mengenai
pembentukan suatu budaya yang terbuka, adil dan \up0 \expndtw-1\charscalex100
pantas, menciptakan budaya belajar, merancang sistem-sistem yang aman, serta
\up0 \expndtw0\charscalex100 mengelola perilaku yang terpilih
(\ul0\nosupersub\cf8\f9\fs24 human error, at risk
behavior\ul0\nosupersub\cf7\f8\fs24 , dan\ul0\nosupersub\cf8\f9\fs24 reckless \up0
\expndtw-1\charscalex100 behavior\ul0\nosupersub\cf7\f8\fs24 ). Model ini melihat
peristiwa-peristiwa bukan sebagai hal-hal yang perlu \up0 \expndtw0\charscalex100
diperbaiki, tetapi sebagai peluang-peluang untuk memperbaiki pemahaman baik \up0
\expndtw-3\charscalex100 terhadap risiko dari sistem maupun risiko perilaku.
\par\pard\qj \li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\ri1536\sb6\sl-
317\slmult0 \up0 \expndtw-3\charscalex100 Ada saat-saat individu seharusnya tidak
disalahkan atas suatu kekeliruan; sebagai \line \up0 \expndtw0\charscalex103
contoh, ketika ada komunikasi yang buruk antara pasien dan staf, ketika perlu \line
\up0 \expndtw-1\charscalex100 pengambilan keputusan secara cepat, dan ketika ada
kekurangan faktor manusia \line \up0 \expndtw0\charscalex104 dalam pola proses
pelayanan. Namun, terdapat juga kesalahan tertentu yang \line \up0
\expndtw0\charscalex104 merupakan hasil dari perilaku yang sembrono dan hal
ini membutuhkan \line \up0 \expndtw-2\charscalex100 pertanggungjawaban. Contoh
dari perilaku sembrono mencakup kegagalan dalam \line \up0 \expndtw0\charscalex102
mengikuti pedoman kebersihan tangan, tidak
melakukan\ul0\nosupersub\cf8\f9\fs24 time-out\ul0\nosupersub\cf7\f8\fs24
sebelum \line \up0 \expndtw-3\charscalex100 mulainya operasi, atau tidak memberi
tanda pada lokasi pembedahan. \par\pard\qj \li1418\ri1539\sb301\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Budaya keselamatan mencakup mengenali dan menujukan
masalah yang terkait \line \up0 \expndtw0\charscalex100 dengan sistem yang mengarah
pada perilaku yang tidak aman. Pada saat yang \line \up0 \expndtw0\charscalex104
sama, rumah sakit harus memelihara pertanggungjawaban dengan tidak \line
\up0 \expndtw0\charscalex100 mentoleransi perilaku sembrono. Pertanggungjawaban
membedakan kesalahan \line \up0 \expndtw-3\charscalex100 unsur manusia (seperti
kekeliruan), perilaku yang berisiko (contohnya mengambil \line \up0 \expndtw-
4\charscalex100 jalan pintas), dan perilaku sembrono \up0 \expndtw-
4\charscalex100 (seperti mengabaikan langkah-langkah \par\pard\ql
\li1418\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 keselamatan yang sudah
ditetapkan). \par\pard\qj \li1418\ri1592\sb308\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Direktur Rumah Sakit melakukan evaluasi rutin dengan jadwal yang
tetap dengan \up0 \expndtw-2\charscalex100 menggunakan beberapa metode, survei
resmi, wawancara staf, analisis data, dan \up0 \expndtw-3\charscalex100 diskusi
kelompok. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 290
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg291}
{\bkmkend Pg291}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1544\sb214\sl-310\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Direktur Rumah Sakit mendorong agar dapat terbentuk
kerja sama untuk membuat \up0 \expndtw-3\charscalex100 struktur, proses, dan
program yang memberikan jalan bagi perkembangan budaya \up0 \expndtw-
4\charscalex100 positif ini. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1542\sb2\sl-320\slmult0 \up0 \expndtw0\charscalex102 Direktur
Rumah Sakit harus menanggapi perilaku yang tidak terpuji dari semua \line \up0
\expndtw-1\charscalex100 individu dari semua jenjang rumah sakit, termasuk
manajemen, staf administrasi, \line \up0 \expndtw-3\charscalex100 staf klinis,
dokter tamu atau dokter\ul0\nosupersub\cf8\f9\fs24 part
time\ul0\nosupersub\cf7\f8\fs24 , serta anggota representasi pemilik.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb105\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 13 \par\pard\qj
\li1778\ri1543\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Direktur Rumah Sakit mendukung terciptanya
budaya keterbukaan yang \line\tab \up0 \expndtw-4\charscalex100 dilandalasi
akuntabilitas. (W) \par\pard\qj \li1778\ri1599\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 2. Direktur Rumah Sakit mengidentifikasi,
mendokumentasikan, dan \line\tab \up0 \expndtw-3\charscalex100 melaksanakan
perbaikan perilaku yang tidak dapat diterima. (D,O,W) \par\pard\ql
\li1778\ri1542\sb0\sl-320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
5\charscalex100 3. Direktur rumah sakit menyelenggarakan pendidikan dan
menyediakan \line\tab \up0 \expndtw-4\charscalex100 informasi (seperti bahan
pustaka dan laporan) yang terkait dengan budaya \line \tab \up0
\expndtw0\charscalex100 keselamatan rumah sakit bagi semua individu yang bekerja
dalam rumah \line \tab \up0 \expndtw-3\charscalex100 sakit. (D,O,W )
\par\pard\qj \li1778\ri1608\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
4. Direktur Rumah Sakit menjelaskan bagaimana masalah terkait budaya
\line\tab \up0 \expndtw-2\charscalex100 keselamatan dalam rumah sakit dapat
diidentifikasi dan dikendalikan. (W) \par\pard\qj \li1778\ri1546\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-4\charscalex100 5. Direktur Rumah Sakit
menyediakan sumber daya untuk mendukung dan \line\tab \up0 \expndtw-
5\charscalex100 mendorong budaya keselamatan di dalam rumah sakit. (D,O,W)
\par\pard\ql \li1519\sb0\sl-276\slmult0 \par\pard\ql\li1519\sb0\sl-276\slmult0
\par\pard\ql\li1519\sb105\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian TKRS 13.1 \par\pard\ql
\li2138\ri1548\sb0\sl-320\slmult0\tx2498\tx2498\tx2498 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Direktur Rumah Sakit
menetapkan regulasi pengaturan sistem \line\tab \up0 \expndtw-
2\charscalex100 menjaga kerahasiaan, sederhana, dan mudah diakses oleh
pihak \line \tab \up0 \expndtw-2\charscalex100 yang mempunyai kewenangan untuk
melaporkan masalah yang terkait \line \tab \up0 \expndtw-4\charscalex100 dengan
budaya keselamatan dalam rumah sakit secara tepat waktu. (R) \par\pard\ql
\li2138\ri1545\sb0\sl-320\slmult0\tx2498\tx2498\tx2498 \up0 \expndtw-
3\charscalex100 2. Sistem yang rahasia, sederhana, dan mudah diakses
oleh pihak \line\tab \up0 \expndtw-2\charscalex100 yang mempunyai kewenangan untuk
melaporkan masalah yang terkait \line \tab \up0 \expndtw0\charscalex100 dengan
budaya keselamatan dalam rumah sakit telah disediakan. (O, \line \tab \up0
\expndtw-1\charscalex100 W) \par\pard\qj \li2138\ri1608\sb0\sl-
320\slmult0\tx2498 \up0 \expndtw0\charscalex100 3. Semua laporan terkait dengan
budaya keselamatan rumah sakit telah \line\tab \up0 \expndtw-3\charscalex100
diinvestigasi secara tepat waktu. (D,W) \par\pard\ql \li2138\ri1602\sb0\sl-
320\slmult0\tx2498\tx2498 \up0 \expndtw-1\charscalex100 4. Ada bukti bahwa
iidentifikasi masalah pada sistem yang menyebabkan \line\tab \up0
\expndtw0\charscalex102 tenaga kesehatan melakukan perilaku yang
berbahaya telah \line \tab \up0 \expndtw-3\charscalex100 dilaksanakan. (D, W)
\par\pard\ql \li2138\ri1543\sb0\sl-313\slmult0\tx2498\tx2498\tx2498 \up0 \expndtw-
3\charscalex100 5. Direktur Rumah Sakit telah menggunakan
pengukuran/indikator mutu \line\tab \up0 \expndtw-1\charscalex100 untuk
mengevaluasi dan memantau budaya keselamatan dalam \line \tab
\up0 \expndtw-2\charscalex100 rumah sakit serta melaksanakan perbaikan yang
telah teridentifikasi \line \tab \up0 \expndtw-3\charscalex100 dari pengukuran dan
evaluasi tersebut. (D,W ) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb92\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 291
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg292}
{\bkmkend Pg292}\par\pard\ql \li2138\sb0\sl-310\slmult0 \par\pard\ql\li2138\sb0\sl-
310\slmult0 \par\pard\ql\li2138\sb0\sl-310\slmult0
\par\pard\ql\li2138\ri1606\sb214\sl-310\slmult0\tx2498\tx2498 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 6. Direktur Rumah Sakit menerapkan
sebuah proses untuk mencegah \line\tab \up0 \expndtw0\charscalex101
kerugian/dampak terhadap individu yang melaporkan masalah terkait \line \tab
\up0 \expndtw-3\charscalex100 dengan budaya keselamatan tersebut. (D,O,W)
\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb127\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Referensi \par\pard\li1778\sb50\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24
1.\tab \up0 \expndtw-2\charscalex100 Undang-Undang Nomor 44 Tahun 2009 tentang
Rumah Sakit.\par\pard\li1778\sb43\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
2\charscalex100 2.\tab \up0 \expndtw-2\charscalex100 Peraturan Presiden Republik
Indonesia Nomor 77 Tahun 2015 tentang\par\pard\li1778\sb41\sl-
276\slmult0\fi360 \up0 \expndtw-2\charscalex100 Pedoman Organisasi Rumah
Sakit.\par\pard\li1778\sb41\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100
3.\tab \up0 \expndtw-2\charscalex100 KMK No.129/Menkes/SK/II/2008 tentang
Standar Pelayanan Minimal\par\pard\li1778\sb40\sl-276\slmult0\fi360 \up0
\expndtw-2\charscalex100 Rumah Sakit.\par\pard\li1778\sb41\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100 4.\tab \up0 \expndtw-
1\charscalex100 Konsil Kedokteran Indonesia Komunikasi Efektif Dokter-Pasien, tahun
2006.\par\pard\li1778\sb43\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100
5.\tab \up0 \expndtw-2\charscalex100 Pedoman Pengorganisasian Komite Etik Rumah
Sakit dan Majelis\par\pard\li1778\sb41\sl-276\slmult0\fi360 \up0 \expndtw-
2\charscalex100 Kehormatan Etik Rumah Sakit Indonesia, Persi - Makersi,
tahun...\par\pard\li1778\sb41\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
2\charscalex100 6.\tab \up0 \expndtw-1\charscalex100 Konsil Kedokteran
Indonesia,Manual Persetujuan Tindakan Kedokteran\par\pard\li1778\sb41\sl-
276\slmult0\fi360 \up0 \expndtw-2\charscalex100 Tahun
2006.\par\pard\li1778\sb43\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100
7.\tab \up0 \expndtw-1\charscalex100 Supply Chain Identifying Critical Supplies
and Technology, Evaluating\par\pard\li1778\sb41\sl-276\slmult0\fi360 \up0
\expndtw-1\charscalex100 Integrity. Making Decisions, Tracking Critical Items John
C. Wocher, M.H.A,\par\pard\li1778\sb41\sl-276\slmult0\fi360 \up0 \expndtw-
2\charscalex100 LFACHE Consultant Joint Commission
International.\par\pard\li1778\sb40\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
2\charscalex100 8.\tab \up0 \expndtw-2\charscalex100 Peraturan Perundang-Undangan
untuk PPK BLUD.\par\pard\li1778\sb44\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
2\charscalex100 a.\tab \up0 \expndtw-2\charscalex100 Undang-Undang Nomor 17 Tahun
2003 tentang Keuangan Negara.\par\pard\li1778\sb40\sl-276\slmult0\fi0\tx2138
\up0 \expndtw-2\charscalex100 b.\tab \up0 \expndtw-2\charscalex100 Undang-Undang
Nomor 1 Tahun 2004 tentang Perbendaharaan Negara.\par\pard\li1778\sb240\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100 c.\tab \up0 \expndtw-
2\charscalex100 Peraturan Pemerintah Nomor 23 Tahun 2005 yang diubah dengan
PP\par\pard\li1778\sb44\sl-276\slmult0\fi360 \up0 \expndtw-2\charscalex100 Nomor 74
Tahun 2012.\par\pard\li1778\sb40\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
2\charscalex100 d.\tab \up0 \expndtw-2\charscalex100 Peraturan Pemerintah Nomor 58
Tahun 2005 tentang Keuangan Daerah.\par\pard\li1778\sb41\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100 e.\tab \up0 \expndtw-
1\charscalex100 Permendagri nomor 13 tahun 2005 yang diubah keduakalinya
dengan\par\pard\li1778\sb41\sl-276\slmult0\fi360 \up0 \expndtw-2\charscalex100
Permendagri nomor 21 Tahun 2011.\par\pard\li1778\sb43\sl-
276\slmult0\fi0\tx2138\tx4567 \up0 \expndtw-2\charscalex100 f.\tab \up0 \expndtw-
2\charscalex100 Permenkeu Nomor\tab \up0 \expndtw-2\charscalex100 09/PMK.02/2006
tentang Pembentukan Dewan\par\pard\li1778\sb41\sl-276\slmult0\fi360 \up0
\expndtw-2\charscalex100 Pengawas pada Badan Layanan Umum.\par\pard\li1778\sb41\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100 g.\tab \up0 \expndtw-
2\charscalex100 Permendagri Nomor 61 Tahun 2007 tentang Pedoman Teknis
Pengelolaan\par\pard\li1778\sb41\sl-276\slmult0\fi360 \up0 \expndtw-2\charscalex100
Keuangan BLUD.\par\pard\li1778\sb242\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
2\charscalex100 9.\tab \up0 \expndtw-2\charscalex100 Peraturan Perundangan-Undangan
unuk Organisasi Rumah Sakit Daerah.\par\pard\li1778\sb41\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-2\charscalex100 a.\tab \up0 \expndtw-
2\charscalex100 Undang-Undang 23/2014 tentang Pemerintahan
Daerah.\par\pard\li1778\sb41\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
2\charscalex100 b.\tab \up0 \expndtw-2\charscalex100 PP 18/2016 tentang Perangkat
Daerah.\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb225\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 292
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg293}
{\bkmkend Pg293}\par\pard\ql \li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb260\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAB 4
\par\pard\ql \li2906\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 MANAJEMEN
FASILITAS DAN KESELAMATAN (MFK) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-276\slmult0
\up0 \expndtw-3\charscalex100 GAMBARAN UMUM \par\pard\qj \li1418\ri1221\sb214\sl-
313\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
dalam kegiatannya harus menyediakan fasilitas yang aman, berfungsi, \up0
\expndtw0\charscalex102 dan suportif bagi pasien, keluarga, staf, dan pengunjung.
Untuk mencapai tujuan \up0 \expndtw0\charscalex100 tersebut fasilitas fisik,
peralatan medis, dan peralatan lainnya harus dikelola secara \up0 \expndtw-
3\charscalex100 efektif. Secara khusus, manajemen harus berupaya keras \par\pard\ql
\li1778\sb238\sl-276\slmult0 \up0 \expndtw-4\charscalex100 1. mengurangi dan
mengendalikan bahaya dan risiko; \par\pard\ql \li1778\sb184\sl-276\slmult0
\up0 \expndtw-2\charscalex100 2. mencegah kecelakaan dan cidera; dan
\par\pard\ql \li1778\sb184\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3.
memelihara kondisi aman. \par\pard\qj \li1418\ri1658\sb148\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Manajemen yang efektif melibatkan multidisiplin dalam
perencanaan, pendidikan, \up0 \expndtw-3\charscalex100 dan pemantauan. \par\pard\ql
\li1778\ri1228\sb217\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Pimpinan
merencanakan ruangan, peralatan, dan sumber daya yang \line\tab \up0
\expndtw0\charscalex101 dibutuhkan yang aman dan efektif untuk menunjang pelayanan
klinis yang \line \tab \up0 \expndtw-5\charscalex100 diberikan. \par\pard\qj
\li1778\ri1214\sb181\sl-300\slmult0\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Seluruh staf
dididik tentang fasilitas, cara mengurangi risiko, serta bagaimana \line\tab
\up0 \expndtw-4\charscalex100 memonitor dan melaporkan situasi yang dapat
menimbulkan risiko. \par\pard\qj \li1778\ri1219\sb197\sl-280\slmult0\tx2138 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Kriteria kinerja digunakan untuk
mengevaluasi sistem yang penting dan \line\tab \up0 \expndtw-3\charscalex100
mengidentifikasi perbaikan yang diperlukan. \par\pard\qj \li1418\ri1300\sb147\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Rumah sakit agar
menyusun\ul0\nosupersub\cf6\f7\fs24 program manajemen risiko fasilitas dan
lingkungan \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf7\f8\fs24 yang mencakup
enam bidang. \par\pard\ql \li1778\sb237\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 1. Keselamatan dan Keamanan
\par\pard\ql \li2229\ri1165\sb165\sl-300\slmult0\tx2589\tx2589 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf25\f26\fs24 \u8226?\ul0\nosupersub\cf7\f8\fs24
Keselamatan adalah keadaan tertentu karena gedung, lantai, halaman, dan
\line\tab \up0 \expndtw0\charscalex100 peralatan rumah sakit tidak menimbulkan
bahaya atau risiko bagi pasien, \line \tab \up0 \expndtw-3\charscalex100 staf, dan
pengunjung. \par\pard\qj \li2229\ri1218\sb161\sl-300\slmult0\tx2589 \up0
\expndtw0\charscalex101 \ul0\nosupersub\cf25\f26\fs24
\u8226?\ul0\nosupersub\cf7\f8\fs24 Keamanan adalah
perlindungan terhadap kehilangan, pengrusakan dan \line\tab \up0 \expndtw-
3\charscalex100 kerusakan, atau penggunaan akses oleh mereka yang tidak
berwenang. \par\pard\ql \li1778\ri1158\sb169\sl-290\slmult0\tx2138\tx2138 \up0
\expndtw-1\charscalex100 2.\ul0\nosupersub\cf6\f7\fs24 Bahan berbahaya dan
beracun (B3) serta limbahnya\ul0\nosupersub\cf7\f8\fs24 meliputi penanganan,
\line\tab \up0 \expndtw0\charscalex100 penyimpanan, dan penggunaan bahan
radioaktif serta bahan berbahaya \line \tab \up0 \expndtw-3\charscalex100
lainnya harus dikendalikan dan limbah bahan berbahaya dibuang secara aman.
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb42\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 293
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg294}
{\bkmkend Pg294}\par\pard\ql \li1778\sb0\sl-293\slmult0 \par\pard\ql\li1778\sb0\sl-
293\slmult0 \par\pard\ql\li1778\sb0\sl-293\slmult0
\par\pard\ql\li1778\ri1159\sb279\sl-293\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3.\ul0\nosupersub\cf6\f7\fs24
Manajemen Penanggulangan Bencana\ul0\nosupersub\cf7\f8\fs24 meliputi risiko
kemungkinan terjadi \line\tab \up0 \expndtw-1\charscalex100 bencana
diidentifikasi, juga respons bila tejadi wabah, serta bencana dan \line
\tab \up0 \expndtw-3\charscalex100 keadaan emergensi direncanakan dengan efektif
termasuk evaluasi lingkungan \line \tab \up0 \expndtw-4\charscalex100 pasien secara
terintegrasi. \par\pard\qj \li1778\ri1225\sb162\sl-300\slmult0\tx2138 \up0
\expndtw-1\charscalex100 4.\ul0\nosupersub\cf6\f7\fs24 Sistem Proteksi
Kebakaran\ul0\nosupersub\cf7\f8\fs24 meliputi properti dan penghuninya dilindungi
dari \line\tab \up0 \expndtw-2\charscalex100 kebakaran dan asap. \par\pard\qj
\li1778\ri1220\sb161\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex105
5.\ul0\nosupersub\cf6\f7\fs24 Peralatan Medis\ul0\nosupersub\cf7\f8\fs24
meliputi peralatan dipilih, dipelihara, dan digunakan \line\tab \up0 \expndtw-
3\charscalex100 sedemikian rupa untuk mengurangi risiko. \par\pard\qj
\li1778\ri1163\sb161\sl-300\slmult0\tx2138 \up0 \expndtw-3\charscalex100
6.\ul0\nosupersub\cf6\f7\fs24 Sistem Penunjang\ul0\nosupersub\cf7\f8\fs24
meliputi listrik, air, dan sistem pendukung lainnya dipelihara \line\tab \up0
\expndtw-4\charscalex100 untuk meminimalkan risiko kegagalan pengoperasian.
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1218\sb4\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Bila di
rumah sakit ada\ul0\nosupersub\cf8\f9\fs24 tenant\ul0\nosupersub\cf7\f8\fs24
/penyewa lahan (seperti sebuah restauran, kantin, caf�, \up0
\expndtw0\charscalex100 dan toko souvenir) maka rumah sakit memiliki kewajiban
untuk memastikan bahwa \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf8\f9\fs24
tenant\ul0\nosupersub\cf7\f8\fs24 /penyewa lahan tersebut mematuhi program
manajemen dan keselamatan \up0 \expndtw-3\charscalex100 fasilitas sebagai
berikut: \par\pard\ql \li1778\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a.
program keselamatan dan keamanan; \par\pard\ql \li1778\sb184\sl-276\slmult0 \up0
\expndtw-2\charscalex100 b. program penanganan B3 dan limbahnya; \par\pard\ql
\li1778\sb184\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c. program manajemen
penanggulangan bencana; \par\pard\ql \li1778\sb164\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 d. program proteksi kebakaran. \par\pard\qj
\li1418\ri1163\sb148\sl-320\slmult0 \up0 \expndtw0\charscalex100 Peraturan
perundang-undangan dan pemeriksaan/inspeksi oleh yang berwenang di \up0 \expndtw-
3\charscalex100 daerah banyak menentukan bagaimana fasilitas dirancang, digunakan,
dan dipelihara. \up0 \expndtw0\charscalex103 Seluruh rumah sakit tanpa
memperdulikan ukuran dan sumber daya yang dimiliki \up0 \expndtw-2\charscalex100
harus mematuhi ketentuan yang berlaku sebagai bagian dari tanggung jawab mereka
\up0 \expndtw-3\charscalex100 terhadap pasien, keluarga, staf, dan para pengunjung.
\par\pard\qj \li1418\ri1162\sb206\sl-313\slmult0 \up0 \expndtw0\charscalex102 Rumah
sakit harus mematuhi peraturan perundang-undangan termasuk mengenai \up0 \expndtw-
4\charscalex100 bangunan dan\ul0\nosupersub\cf6\f7\fs24 proteksi
kebakaran.\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memahami fasilitas fisik yang
dimiliki \up0 \expndtw0\charscalex100 dan secara proaktif mengumpulkan data serta
membuat strategi untuk mengurangi \up0 \expndtw-3\charscalex100 risiko dan
meningkatkan keamanan lingkungan pasien. \par\pard\qj \li1418\sb0\sl-520\slmult0
\par\pard\qj\li1418\ri2930\sb37\sl-520\slmult0\tx1778 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 STANDAR, MAKSUD DAN TUJUAN, SERTA ELEMEN PENILAIAN
\line\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 KEPEMIMPINAN DAN PERENCANAAN \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb110\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar MFK1
\par\pard\qj \li1418\ri1838\sb225\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mematuhi peraturan dan perundang-undangan
tentang bangunan, \up0 \expndtw-3\charscalex100 perlindungan kebakaran, dan
persyaratan pemeriksaan fasilitas. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb106\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 294
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg295}
{\bkmkend Pg295}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb260\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MFK 1 \par\pard\qj \li1418\ri1158\sb211\sl-317\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Di tingkat nasional,
pemerintah telah mengeluarkan peraturan dan perundang-\line \up0 \expndtw-
3\charscalex100 undangan serta pedoman-pedoman tentang persyaratan bangunan secara
umum dan \line \up0 \expndtw0\charscalex100 secara khusus untuk bangunan rumah
sakit. Persyaratan tersebut antara lain \line \up0 \expndtw-2\charscalex100
termasuk sistem kelistrikan dan sistem keamanan kebakaran, serta sistem gas
medis \line \up0 \expndtw-2\charscalex100 sentral. Selain di tingkat nasional,
pemerintah provinsi/kabupaten/kota ada juga yang \line \up0 \expndtw-
1\charscalex100 mengeluarkan peraturan daerah mengatur persyaratan bangunan secara
umum dan \line \up0 \expndtw-1\charscalex100 sistem pengamanan kebakaran. Semua
rumah sakit tanpa memperhatikan kelas \line \up0 \expndtw0\charscalex100 rumah
sakit dan sumber daya wajib mematuhi peraturan perundang-undangan \line \up0
\expndtw0\charscalex100 tersebut, yaitu menyediakan bangunan dan fasilitas yang
aman sebagai tanggung \line \up0 \expndtw-2\charscalex100 jawab kepada pasien,
keluarga, pengunjung, dan staf/pegawai rumah sakit. \par\pard\ql \li1485\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Pimpinan dan para Direktur rumah sakit
bertanggung jawab untuk \par\pard\ql \li1778\ri1165\sb253\sl-
290\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex80
\ul0\nosupersub\cf9\f10\fs24 \u-3913? \tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 memahami peraturan perundang-undangan dan
persyaratan lainnya yang \line\tab \up0 \expndtw0\charscalex103 berlaku bagi
fasilitas rumah sakit baik yang merupakan regulasi di tingkat \line \tab \up0
\expndtw-3\charscalex100 nasional maupun tingkat daerah; \par\pard\ql
\li1778\ri1158\sb182\sl-300\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex80 \ul0\nosupersub\cf9\f10\fs24 \u-3913? \tab \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 menerapkan persyaratan yang
berlaku termasuk mempunyai izin dan atau \line\tab \up0 \expndtw-4\charscalex100
sertifikasi sesuai dengan peraturan perundang-undangan, antara lain izin-izin
\line \tab \up0 \expndtw-5\charscalex100 tersebut di bawah ini: \par\pard\ql
\li2138\sb180\sl-276\slmult0 \up0 \expndtw-5\charscalex100 a) izin mendirikan
bangunan; \par\pard\ql \li2138\sb184\sl-276\slmult0 \up0 \expndtw-5\charscalex100
b) izin operasional rumah sakit yang masih berlaku; \par\pard\qj
\li2138\ri1756\sb181\sl-280\slmult0\tx2498 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf8\f9\fs24 c)\ul0\nosupersub\cf7\f8\fs24 sertifikat laik fungsi
(SLF) bila pemerintah daerah di lokasi rumah sakit \line\tab \up0 \expndtw-
5\charscalex100 telah menerapkan ketentuan ini; \par\pard\ql \li2138\sb184\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 d) instalasi pengelolaan air limbah
(IPAL); \par\pard\ql \li2138\sb184\sl-276\slmult0 \up0 \expndtw-4\charscalex100 e)
izin genset; \par\pard\ql \li2138\sb184\sl-276\slmult0 \up0 \expndtw0\charscalex100
f) izin radiologi; \par\pard\ql \li2138\sb184\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 g) sertifikat sistem pengamanan/pemadaman kebakaran;
\par\pard\ql \li2138\sb184\sl-276\slmult0 \up0 \expndtw-4\charscalex100 h) sistem
kelistrikan; \par\pard\ql \li2138\sb184\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 i) izin insenerator (bila ada); \par\pard\qj
\li2138\ri1437\sb181\sl-280\slmult0\tx2498 \up0 \expndtw-5\charscalex100 j) izin
tempat pembuangan sementara bahan berbahaya dan beracun (TPS \line\tab \up0
\expndtw-5\charscalex100 B-3); \par\pard\ql \li2138\sb184\sl-276\slmult0 \up0
\expndtw-4\charscalex100 k) Izin lift (bila ada); \par\pard\ql \li2138\sb184\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 l) Izin instalasi petir; \par\pard\ql
\li2138\sb184\sl-276\slmult0 \up0 \expndtw-4\charscalex100 m) Izin lingkungan.
\par\pard\ql \li10156\sb223\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 295
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg296}
{\bkmkend Pg296}\par\pard\ql \li1778\sb0\sl-300\slmult0 \par\pard\ql\li1778\sb0\sl-
300\slmult0 \par\pard\ql\li1778\sb0\sl-300\slmult0
\par\pard\ql\li1778\ri1214\sb253\sl-300\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
merencanakan dan membuat anggaran untuk peningkatan atau penggantian \line\tab \up0
\expndtw0\charscalex100 yang diperlukan berdasar atas hasil pemeriksaan
fasilitas atau untuk \line \tab \up0 \expndtw-2\charscalex100 memenuhi
persyaratan yang berlaku serta menunjukkan pelaksanaan rencana \line \tab \up0
\expndtw-5\charscalex100 tersebut. (lihat juga MFK 4.2) \par\pard\qj
\li1418\ri1220\sb144\sl-320\slmult0 \up0 \expndtw0\charscalex100 Bila rumah sakit
dianggap tidak memenuhi syarat maka direktur rumah sakit yang \up0 \expndtw-
3\charscalex100 bertanggung jawab merencanakan dan memenuhi persyaratan tersebut
dalam kurun \up0 \expndtw-4\charscalex100 waktu yang ditentukan. \par\pard\ql
\li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 1 \par\pard\ql
\li1778\ri1220\sb205\sl-300\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 1. Direktur rumah sakit dan
mereka yang bertanggung jawab terhadap \line\tab \up0 \expndtw-1\charscalex100
manajemen fasilitas di rumah sakit seharusnya mempunyai dan memahami \line \tab
\up0 \expndtw-1\charscalex100 peraturan perundang-undangan dan persyaratan lainnya
yang berlaku untuk \line \tab \up0 \expndtw-5\charscalex100 bangunan dan fasilitas
rumah sakit. (D,W) \par\pard\qj \li1778\ri1229\sb161\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex102 2. Direktur rumah sakit menerapkan persyaratan yang
berlaku dan peraturan \line\tab \up0 \expndtw-5\charscalex100 perundang-undangan.
(D,W) \par\pard\ql \li1778\ri1191\sb169\sl-290\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 3. Rumah sakit mempunyai izin-izin sebagaimana diuraikan
butir a. sampai \line\tab \up0 \expndtw-2\charscalex100 dengan m. pada maksud dan
tujuan sesuai dengan fasilitas yang ada di rumah \line \tab \up0 \expndtw-
5\charscalex100 sakit serta sesuai dengan peraturan perundang-undangan. (D,W)
\par\pard\ql \li1778\ri1218\sb162\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 4. Direktur rumah sakit memastikan rumah sakit memenuhi kondisi
seperti hasil \line\tab \up0 \expndtw-1\charscalex100 pemeriksaan fasilitas atau
catatan pemeriksaan yang dilakukan oleh otoritas \line \tab \up0 \expndtw-
5\charscalex100 setempat di luar rumah sakit. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb192\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK 2 \par\pard\qj
\li1418\ri1158\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai\ul0\nosupersub\cf6\f7\fs24
program manajemen risiko fasilitas dan lingkungan\ul0\nosupersub\cf7\f8\fs24
yang \up0 \expndtw-4\charscalex100 menggambarkan proses pengelolaan risiko yang
dapat terjadi pada pasien, keluarga, \up0 \expndtw-5\charscalex100 pengunjung, dan
staf. \par\pard\ql \li1418\sb217\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 2 \par\pard\qj
\li1418\ri1216\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Program manajemen risiko diperlukan untuk mengelola
risiko-risiko di lingkungan \up0 \expndtw-3\charscalex100 pelayanan pasien dan
tempat kerja staf. Rumah sakit menyusun satu program induk \up0 \expndtw-
4\charscalex100 atau beberapa program terpisah yang meliputi sebagai berikut:
\par\pard\ql \li2858\sb237\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 1. Keselamatan dan Keamanan \par\pard\qj
\li3218\ri1224\sb156\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf27\f28\fs24 -\ul0\nosupersub\cf16\f17\fs24
Keselamatan\ul0\nosupersub\cf8\f9\fs24 -\ul0\nosupersub\cf7\f8\fs24 sejauh mana
bangunan, area, dan peralatan rumah \up0 \expndtw0\charscalex100 sakit tidak
menimbulkan bahaya atau risiko bagi pasien, staf, atau \up0 \expndtw-
3\charscalex100 pengunjung \par\pard\ql \li3309\ri1221\sb162\sl-320\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf27\f28\fs24
-\ul0\nosupersub\cf16\f17\fs24 Keamanan-\ul0\nosupersub\cf7\f8\fs24 perlindungan
terhadap kerugian, kerusakan, \up0 \expndtw0\charscalex103 gangguan atau
akses, atau penggunaan oleh pihak yang tidak \up0 \expndtw-3\charscalex100
berwenang. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb3\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 296
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg297}
{\bkmkend Pg297}\par\pard\ql \li2858\sb0\sl-310\slmult0 \par\pard\ql\li2858\sb0\sl-
310\slmult0 \par\pard\ql\li2858\sb0\sl-310\slmult0
\par\pard\ql\li2858\ri1207\sb214\sl-310\slmult0\tx3218\tx3218 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2.\ul0\nosupersub\cf6\f7\fs24 Bahan
Berbahaya dan Beracun (B3) dan limbahnya\ul0\nosupersub\cf7\f8\fs24 -penanganan,
\line\tab \up0 \expndtw0\charscalex101 penyimpanan, penggunaan bahan
radioaktif dan lainnya \line \tab \up0 \expndtw-3\charscalex100 dikendalikan,
serta limbah berbahaya ditangani secara aman. \par\pard\ql \li2858\sb59\sl-
276\slmult0\tx6494 \up0 \expndtw-1\charscalex100 3.\ul0\nosupersub\cf6\f7\fs24
Penanggulangan Bencana \tab \up0 \expndtw0\charscalex100
(emergensi)\ul0\nosupersub\cf7\f8\fs24 -respons pada wabah, \par\pard\ql
\li3218\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 bencana, dan keadaan
darurat direncanakan dan berjalan efektif. \par\pard\ql \li2858\ri1215\sb28\sl-
320\slmult0\tx3218 \up0 \expndtw-1\charscalex100 4.\ul0\nosupersub\cf6\f7\fs24
Proteksi Kebakaran (\ul0\nosupersub\cf16\f17\fs24 Fire
Safety\ul0\nosupersub\cf6\f7\fs24 )\ul0\nosupersub\cf7\f8\fs24
-297\ul0\nosupersub\cf8\f9\fs24 property\ul0\nosupersub\cf7\f8\fs24 dan para
penghuni \line\tab \up0 \expndtw-3\charscalex100 dilindungi dari bahaya kebakaran
dan asap. \par\pard\ql \li2858\ri1214\sb37\sl-300\slmult0\tx3218 \up0
\expndtw0\charscalex101 5.\ul0\nosupersub\cf6\f7\fs24 Peralatan
medis\ul0\nosupersub\cf7\f8\fs24 -pemilihan, pemeliharaan, dan penggunaan
\line\tab \up0 \expndtw-3\charscalex100 teknologi dengan cara yang aman untuk
mengurangi risiko. \par\pard\ql \li2858\ri1220\sb164\sl-
320\slmult0\tx3218\tx3218 \up0 \expndtw0\charscalex101
6.\ul0\nosupersub\cf6\f7\fs24 Sistem penunjang
(utilitas)\ul0\nosupersub\cf7\f8\fs24 -pemeliharaan sistem listrik, air, dan
\line\tab \up0 \expndtw0\charscalex100 sistem penunjang lainnya dengan
tujuan mengurangi risiko \line \tab \up0 \expndtw-3\charscalex100 kegagalan
operasional. \par\pard\qj \li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\ri1172\sb166\sl-317\slmult0 \up0 \expndtw-2\charscalex100
Program manajemen risiko di atas harus tertulis dan selalu diperbarui
sehingga \up0 \expndtw0\charscalex102 mencerminkan kondisi lingkungan rumah sakit
yang terkini. Terdapat proses untuk \up0 \expndtw-1\charscalex100 meninjau dan
memperbarui program tersebut. Apabila di dalam rumah sakit terdapat \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 tenant\ul0\nosupersub\cf7\f8\fs24
/penyewa lahan yang tidak terkait dengan pelayanan rumah sakit dan berada di
\up0 \expndtw-1\charscalex100 dalam fasilitas pelayanan pasien yang akan disurvei
(misalnya rumah makan, kantin, \up0 \expndtw-2\charscalex100 kafe, toko roti, toko
souvenir, atau toko lainnya) maka rumah sakit memiliki kewajiban \up0 \expndtw-
1\charscalex100 k memastikan bahwa\ul0\nosupersub\cf8\f9\fs24
tenant\ul0\nosupersub\cf7\f8\fs24 /penyewa lahan tersebut mematuhi program
Manajemen \up0 \expndtw-2\charscalex100 Fasilitas dan Keselamatan. \par\pard\qj
\li1418\ri1221\sb201\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Dalam menerapkan
program manajemen risiko di atas maka rumah sakit perlu \up0 \expndtw-
2\charscalex100 mempunyai regulasi sebagai berikut: \par\pard\qj
\li1778\ri1220\sb234\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex100 1)
regulasi peninjauan dan pembaharuan program-program tersebut bila terjadi \line\tab
\up0 \expndtw-2\charscalex100 perubahan lingkungan rumah sakit atau sekurang-
kurangnya setahun sekali; \par\pard\ql \li1778\ri1163\sb164\sl-
300\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 2) regulasi
bahwa\ul0\nosupersub\cf8\f9\fs24 tenant\ul0\nosupersub\cf7\f8\fs24 /penyewa lahan
tersebut wajib mematuhi semua aspek \line\tab \up0 \expndtw-4\charscalex100 program
manajemen fasilitas yang teridentifikasi dalam maksud dan tujuan butir \line
\tab \up0 \expndtw-5\charscalex100 1 sampai 4 tersebut di atas. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb148\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 2 \par\pard\ql
\li1560\ri1163\sb229\sl-295\slmult0\tx1984\tx1984\tx1984\tx1984 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada program manajemen risiko
fasilitas dan lingkungan yang dapat terjadi pada \line\tab \up0
\expndtw0\charscalex100 pasien, keluarga, staf, dan pengunjung secara tertulis
meliputi risiko yang ada \line \tab \up0 \expndtw-3\charscalex100 pada butir 1
sampai 6 pada maksud dan tujuan. Hal ini merupakan satu program \line \tab \up0
\expndtw0\charscalex103 induk atau beberapa program terpisah serta ada regulasi
untuk menerapkan
\line \tab \up0 \expndtw-3\charscalex100 program manajemen meliputi butir 1 dan 2
pada maksud dan tujuan. (R) \par\pard\ql \li1560\sb181\sl-276\slmult0 \up0
\expndtw-2\charscalex100 2. Program tersebut masih berlaku dan sudah diterapkan
sepenuhnya. (D,W) \par\pard\ql \li1560\ri1158\sb165\sl-300\slmult0\tx1984\tx1984
\up0 \expndtw-4\charscalex100 3. Ada bukti peninjauan dan pembaharuan
program-program tersebut bila terjadi \line\tab \up0 \expndtw-3\charscalex100
perubahan dalam lingkungan rumah sakit atau sekurang-kurangnya setiap tahun.
\line \tab \up0 \expndtw-4\charscalex100 (D,W) \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb6\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 297
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg298}
{\bkmkend Pg298}\par\pard\ql \li1560\sb0\sl-290\slmult0 \par\pard\ql\li1560\sb0\sl-
290\slmult0 \par\pard\ql\li1560\sb0\sl-290\slmult0 \par\pard\ql\li1560\sb0\sl-
290\slmult0 \par\pard\ql\li1560\ri1166\sb1\sl-290\slmult0\tx1984\tx1984 \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 4. Ada bukti
bahwa\ul0\nosupersub\cf8\f9\fs24 tenant\ul0\nosupersub\cf7\f8\fs24 /penyewa lahan
di dalam lingkungan rumah sakit sudah \line\tab \up0 \expndtw-3\charscalex100
mematuhi semua aspek program manajemen risiko fasilitas dan lingkungan yang
\line \tab \up0 \expndtw-4\charscalex100 teridentifikasi dalam butir 1 sampai 4
pada maksud dan tujuan. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb150\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK 3
\par\pard\qj \li1418\ri1227\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ada individu atau bentuk organisasi kompeten yang
ditugasi melakukan pengawasan \up0 \expndtw0\charscalex102 terhadap perencanaan
serta pelaksanaan program manajemen risiko fasilitas dan \up0 \expndtw-
3\charscalex100 lingkungan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK
3 \par\pard\qj \li1418\ri1159\sb188\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit berkewajiban menyediakan fasilitas yang
aman, fungsional, dan fasilitas \up0 \expndtw0\charscalex103 pendukung untuk
pasien, keluarga, staf, dan pengunjung. Untuk mencapai tujuan \up0 \expndtw-
3\charscalex100 tersebut maka fasilitas fisik, peralatan, medis, dan sumber daya
lainnya harus dikelola \up0 \expndtw-4\charscalex100 secara efektif.
\par\pard\ql \li1418\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Secara
khusus, pihak manajemen rumah sakit harus berupaya \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 1. mengurangi dan mengendalikan sumber
bahaya dan risiko; \par\pard\ql \li1778\sb184\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 2. menghindari kecelakaan dan cedera; \par\pard\ql
\li1778\sb204\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. memelihara kondisi
yang aman. \par\pard\qj \li1418\ri1225\sb168\sl-320\slmult0 \up0
\expndtw0\charscalex105 Manajemen yang efektif mencakup perencanaan
multidisiplin, edukasi, dan \up0 \expndtw-3\charscalex100 pemantauan sebagai
berikut: \par\pard\ql \li1778\ri1167\sb0\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 1. direktur rumah sakit merencanakan kebutuhan ruangan,
teknologi, peralatan \line\tab \up0 \expndtw-4\charscalex100 medis, dan sumber daya
lainnya untuk mendukung pelayanan klinis yang efektif \line \tab \up0 \expndtw-
5\charscalex100 dan aman; \par\pard\qj \li1778\ri1206\sb20\sl-320\slmult0\tx2138
\up0 \expndtw-2\charscalex100 2. seluruh staf diberikan edukasi mengenai
fasilitas, cara mengurangi risiko, serta \line\tab \up0 \expndtw-3\charscalex100
cara memantau dan melaporkan situasi yang berisiko dan insiden cedera; \par\pard\ql
\li1778\ri1218\sb160\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 3.
untuk mengevaluasi sistem-sistem yang penting dan mengidentifikasi
\line\tab \up0 \expndtw0\charscalex101 perbaikan-perbaikan yang dibutuhkan maka
rumah sakit dapat menetapkan \line \tab \up0 \expndtw-3\charscalex100 kriteria atau
indikator kinerja. \par\pard\qj \li1418\ri1159\sb163\sl-317\slmult0 \up0 \expndtw-
3\charscalex100 Rumah sakit perlu menyusun program manajemen risiko fasilitas dan
lingkungan yang \up0 \expndtw-2\charscalex100 membahas pengelolaan risiko fasilitas
serta lingkungan melalui penyusunan rencana \up0 \expndtw0\charscalex102 manajemen
fasilitas dan penyediaan ruangan, teknologi, peralatan medis, sumber \up0 \expndtw-
2\charscalex100 daya, serta melakukan pengawasan terhadap
perencanan/pelaksanakan program \up0 \expndtw0\charscalex100 manajemen risiko
fasilitas dan lingkungan tersebut. Oleh karena itu, direktur rumah \up0
\expndtw0\charscalex102 sakit perlu menetapkan organisasi/satu orang atau lebih
dengan tugas melakukan \up0 \expndtw-1\charscalex100 pengawasan perencanaan dan
pelaksanaan proses untuk mengelola risiko terhadap \up0 \expndtw-3\charscalex100
fasilitas dan lingkungan tersebut secara berkesinambungan. \par\pard\ql
\li1418\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Pengawasan yang dilakukan
organisasi/satu orang atau lebih tersebut meliputi \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb17\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 298
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg299}
{\bkmkend Pg299}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1221\sb214\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 a) mengawasi semua aspek
program manajemen risiko seperti pengembangan \line\tab \up0
\expndtw0\charscalex100 rencana dan memberikan rekomendasi untuk ruangan,
peralatan medis, \line \tab \up0 \expndtw-3\charscalex100 teknologi, dan sumber
daya; \par\pard\ql \li1778\sb59\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b)
mengawasi pelaksanaan program secara konsisten dan berkesinambungan;
\par\pard\ql \li1778\sb64\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c)
melakukan edukasi staf; \par\pard\ql \li1778\sb64\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 d) mengawasi pelaksanaan pengujian/testing dan pemantauan
program; \par\pard\qj \li1778\ri1223\sb28\sl-320\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 e) secara berkala menilai ulang dan merevisi program manajemen
risiko fasilitas \line\tab \up0 \expndtw-3\charscalex100 dan lingkungan;
\par\pard\ql \li1778\sb57\sl-276\slmult0 \up0 \expndtw-2\charscalex100 f)
menyerahkan laporan tahunan kepada direktur rumah sakit; \par\pard\qj
\li1778\ri1226\sb28\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 g)
mengorganisasi dan mengelola laporan kejadian/insiden, melakukan analisis,
\line\tab \up0 \expndtw-3\charscalex100 dan upaya perbaikan. \par\pard\qj
\li1418\ri1161\sb320\sl-320\slmult0 \up0 \expndtw0\charscalex103 Dalam rangka
pengawasan, rumah sakit agar mengembangkan sistem pelaporan \up0 \expndtw-
3\charscalex100 insiden/kejadian/kecelakaan yang terjadi di rumah sakit akibat
fasilitas dan lingkungan \up0 \expndtw0\charscalex102 yang tidak aman. Individu
atau organisasi yang ditunjuk mengawasi program \up0 \expndtw0\charscalex100
manajemen risiko fasilitas dan lingkungan agar mendorong pelaporan insiden,
\up0 \expndtw-3\charscalex100 melakukan analisis, dan rencana perbaikan.
\par\pard\ql \li1418\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 3 \par\pard\ql
\li1598\ri1217\sb229\sl-295\slmult0\tx1958\tx1958\tx1958\tx1958 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada program manajemen risiko
fasilitas dan lingkungan yang dapat terjadi pada \line\tab \up0
\expndtw0\charscalex103 pasien, keluarga, sta, dan pengunjung tertulis meliputi
risiko yang ada butir 1 \line \tab \up0 \expndtw-2\charscalex100 sampai dengan 6
pada maksud dan tujuan yang merupakan satu program induk \line \tab \up0 \expndtw-
1\charscalex100 atau beberapa program terpisah serta ada regulasi untuk menerapkan
program \line \tab \up0 \expndtw-3\charscalex100 manajemen meliputi butir 1 dan 2
pada maksud dan tujuan. (R) \par\pard\ql \li1598\sb21\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 2. Program tersebut masih berlaku dan sudah diterapkan sepenuhnya.
(D,W) \par\pard\ql \li1598\ri1160\sb5\sl-300\slmult0\tx1958\tx1958 \up0
\expndtw0\charscalex100 3. Ada bukti peninjauan dan pembaharuan program-program
tersebut bila terjadi \line\tab \up0 \expndtw-3\charscalex100 perubahan dalam
lingkungan rumah sakit atau sekurang-kurangnya setiap tahun. \line \tab \up0
\expndtw-4\charscalex100 (D,W) \par\pard\ql \li1598\ri1162\sb9\sl-
290\slmult0\tx1958\tx1958 \up0 \expndtw0\charscalex102 4. Ada
bukti\ul0\nosupersub\cf8\f9\fs24 tenant\ul0\nosupersub\cf7\f8\fs24 /penyewa
lahan di dalam lingkungan rumah sakit sudah \line\tab \up0 \expndtw-
3\charscalex100 mematuhi semua aspek program manajemen risiko fasilitas dan
lingkungan yang \line \tab \up0 \expndtw-4\charscalex100 teridentifikasi dalam
butir 1 sampai 4 pada maksud dan tujuan. (D,W) \par\pard\ql \li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb194\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 KESELAMATAN DAN KEAMANAN \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb152\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar MFK
4 \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb144\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 299
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg300}
{\bkmkend Pg300}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1224\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai program pengelolaan keselamatan
dan keamanan melalui \up0 \expndtw0\charscalex100 penyediaan fasilitas fisik dan
menciptakan lingkungan yang aman bagi pasien, \up0 \expndtw-3\charscalex100
keluarga, pengunjung, dan staf. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb207\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK
4 \par\pard\qj \li1418\ri1157\sb211\sl-316\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Keselamatan dan keamanan mempunyai arti yang berbeda
walaupun masih ada yang \up0 \expndtw-1\charscalex100 menganggap sama.
K\ul0\nosupersub\cf6\f7\fs24 eselamatan\ul0\nosupersub\cf7\f8\fs24 dalam standar
ini adalah memberi jaminan bahwa \up0 \expndtw0\charscalex100 gedung, properti,
teknologi medik dan informasi, peralatan, serta sistem tidak \up0
\expndtw0\charscalex102 berpotensi mendatangkan risiko terhadap pasien, keluarga,
staf, dan pengunjung. \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf6\f7\fs24
Keamanan\ul0\nosupersub\cf7\f8\fs24 mempunyai arti
melindungi\ul0\nosupersub\cf8\f9\fs24 property\ul0\nosupersub\cf7\f8\fs24 milik
rumah sakit, pasien, staf, \up0 \expndtw-3\charscalex100 keluarga, dan
pengunjung dari bahaya kehilangan, kerusakan, atau pengrusakan oleh \up0 \expndtw-
4\charscalex100 orang yang tidak berwenang. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1229\sb1\sl-320\slmult0 \up0 \expndtw0\charscalex100 Rumah
sakit perlu mempunyai program pengelolaan keselamatan keamanan yang \up0 \expndtw-
3\charscalex100 kegiatannya meliputi \par\pard\ql \li1778\ri1158\sb220\sl-
297\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw-3\charscalex100 a) \tab \up0 \expndtw0\charscalex102 melakukan asesmen
risiko secara komprehensif dan proaktif untuk \line\tab \up0
\expndtw0\charscalex100 mengidentifikasi bangunan, ruangan/area, peralatan,
perabotan, dan fasilitas \line \tab \up0 \expndtw0\charscalex105 lainnya yang
berpotensi menimbulkan cedera. Sebagai contoh, risiko \line \tab \up0
\expndtw0\charscalex100 keselamatan yang dapat menimbulkan cedera atau bahaya
termasuk di \line \tab \up0 \expndtw0\charscalex102 antaranya perabotan yang
tajam dan rusak, kaca jendela yang pecah, \line \tab \up0 \expndtw-
3\charscalex100 kebocoran air di atap,serta lokasi tidak ada jalan keluar saat
terjadi kebakaran. \line \tab \up0 \expndtw-1\charscalex100 Karena itu, rumah sakit
perlu melakukan pemeriksaan fasilitas secara berkala \line \tab \up0
\expndtw0\charscalex103 dan terdokumentasi agar rumah sakit dapat melakukan
perbaikan dan \line \tab \up0 \expndtw-3\charscalex100 menyediakan anggaran untuk
mengadakan pergantian atau \u8220?\ul0\nosupersub\cf8\f9\fs24
upgrading\ul0\nosupersub\cf7\f8\fs24 \u8221?; \par\pard\li1778\sb181\sl-
276\slmult0\fi0\tx2138\tx7639\tx8447\tx10116 \up0 \expndtw0\charscalex102 b)\tab
\up0 \expndtw0\charscalex102 melakukan asesmen risiko prakontruksi\tab
\up0 \expndtw0\charscalex102 (\ul0\nosupersub\cf8\f9\fs24 pra\tab \up0
\expndtw0\charscalex102 construction\tab \up0 \expndtw0\charscalex102
risk\par\pard\qj \li2138\ri1224\sb0\sl-300\slmult0 \up0 \expndtw0\charscalex104
assessmen/\ul0\nosupersub\cf7\f8\fs24 PCRA) setiap ada kontruksi, renovasi,
atau penghancuran \up0 \expndtw-3\charscalex100
bangunan/\ul0\nosupersub\cf8\f9\fs24 demolish\ul0\nosupersub\cf7\f8\fs24 ;
\par\pard\ql \li1778\ri1213\sb146\sl-300\slmult0\tx2138\tx2138\tx2138\tx2138
\up0 \expndtw-3\charscalex100 c) \tab \up0 \expndtw-1\charscalex100 merencanakan
dan melakukan pencegahan dengan menyediakan fasilitas \line\tab \up0
\expndtw0\charscalex101 pendukung yang aman dengan tujuan mencegah kecelakaan
dan cedera, \line \tab \up0 \expndtw-2\charscalex100 mengurangi bahaya dan
risiko, serta mempertahankan kondisi aman bagi \line \tab \up0 \expndtw-
3\charscalex100 pasien, keluarga, staf, dan pengunjung; \par\pard\ql
\li1778\ri1218\sb161\sl-300\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 d) \tab \up0 \expndtw-2\charscalex100 menciptakan lingkungan yang
aman dengan memberikan identitas (\ul0\nosupersub\cf8\f9\fs24 badge
\line\tab \up0 \expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 nama sementara
atau tetap) pada pasien, staf, pekerja kontrak, \line \tab \up0
\expndtw-2\charscalex100 \ul0\nosupersub\cf8\f9\fs24
tenant\ul0\nosupersub\cf7\f8\fs24 /penyewa lahan, keluarga \up0 \expndtw-
1\charscalex100 (penunggu pasien), atau pengunjung \par\pard\qj
\li2138\ri1226\sb17\sl-280\slmult0 \up0 \expndtw0\charscalex100 (pengunjung di luar
jam besuk dan tamu rumah sakit) sesuai dengan regulasi \up0 \expndtw-
3\charscalex100 rumah sakit; \par\pard\li1778\sb200\sl-276\slmult0\fi0\tx2138
\up0 \expndtw0\charscalex100 e)\tab \up0 \expndtw0\charscalex100 melindungi dari
kejahatan perorangan, kehilangan, kerusakan, atau\par\pard\li1778\sb19\sl-
276\slmult0\fi360 \up0 \expndtw0\charscalex100 pengrusakan barang milik
pribadi;\par\pard\qj \li1778\ri1228\sb154\sl-300\slmult0\tx2138\tx2138 \up0
\expndtw-1\charscalex100 f) \tab \up0 \expndtw0\charscalex103 melakukan monitoring
pada daerah terbatas seperti ruang bayi dan kamar \line\tab \up0 \expndtw-
2\charscalex100 operasi serta daerah yang berisiko lainnya seperti ruang anak,
lanjut usia, dan \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb126\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 300
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg301}
{\bkmkend Pg301}\par\pard\qj \li2138\sb0\sl-297\slmult0 \par\pard\qj\li2138\sb0\sl-
297\slmult0 \par\pard\qj\li2138\sb0\sl-297\slmult0
\par\pard\qj\li2138\ri1157\sb264\sl-297\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 kelompok pasien rentan yang tidak dapat melindungi diri
sendiri atau memberi \line \up0 \expndtw0\charscalex100 tanda minta bantuan bila
terjadi bahaya. Monitoring dapat dilakukan dengan \line \up0 \expndtw-
4\charscalex100 memasang kamera sistem CCTV yang dapat dipantau di ruang sekuriti.
Namun, \line \up0 \expndtw-1\charscalex100 harus diingat pemasangan kamera CCTV
tidak diperbolehkan di ruang pasien \line \up0 \expndtw-2\charscalex100 dan tetap
harus memperhatikan hak privasi pasien.\ul0\nosupersub\cf6\f7\fs24
Pengecualian untuk \line \up0 \expndtw-4\charscalex100 pasien jiwa yang gaduh
gelisah maka pemasangan dapat di kamar pasien, \line \up0 \expndtw-1\charscalex100
tetapi hanya dipantau di\ul0\nosupersub\cf16\f17\fs24 nurse
station\ul0\nosupersub\cf6\f7\fs24 tidak di\ul0\nosupersub\cf16\f17\fs24
security\ul0\nosupersub\cf6\f7\fs24 .\ul0\nosupersub\cf7\f8\fs24 Monitoring
melalui \line \up0 \expndtw0\charscalex100 pemasangan kamera CCTV juga
diperlukan untuk daerah terpencil atau \line \up0 \expndtw0\charscalex105
terisolasi, area parking, dan area lainnya yang sering terjadi kehilangan di
\line \up0 \expndtw-3\charscalex100 rumah sakit. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb129\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian MFK 4 \par\pard\li1560\sb260\sl-276\slmult0\fi0\tx2126 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1.\tab \up0 \expndtw-1\charscalex100
Rumah sakit mempunyai regulasi termasuk program pengelolaan
keselamatan\par\pard\li1560\sb22\sl-276\slmult0\fi566 \up0 \expndtw-1\charscalex100
dan keamanan yang meliputi butir 1 sampai dengan 6 pada maksud dan
tujuan.\par\pard\li1560\sb19\sl-276\slmult0\fi566 \up0 \expndtw-2\charscalex100
(R)\par\pard\li1560\sb185\sl-276\slmult0\fi0\tx2126 \up0 \expndtw-2\charscalex100
2.\tab \up0 \expndtw-2\charscalex100 Ada unit kerja yang bertanggung jawab terhadap
pengelolaan keselamatan\par\pard\li1560\sb19\sl-276\slmult0\fi566 \up0 \expndtw-
2\charscalex100 dan keamanan. (D,W)\par\pard\li1560\sb182\sl-276\slmult0\fi0\tx2126
\up0 \expndtw-2\charscalex100 3.\tab \up0 \expndtw-1\charscalex100 Rumah sakit
telah melakukan identifikasi area-area yang berisiko
mempunyai\par\pard\li1560\sb20\sl-276\slmult0\fi566\tx3640 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf8\f9\fs24 risk register\tab \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (daftar risiko) yang berhubungan
dengan keselamatan dan\par\pard\li1560\sb24\sl-276\slmult0\fi566 \up0 \expndtw-
2\charscalex100 keamanan fasilitas. (D,W)\par\pard\ql \li1560\sb165\sl-
276\slmult0\tx2126 \up0 \expndtw-3\charscalex100 4. \tab \up0
\expndtw0\charscalex100 Regulasi pemberian identitas pada penunggu pasien,
pengunjung (termasuk \par\pard\qj \li2126\ri1228\sb5\sl-300\slmult0 \up0
\expndtw0\charscalex102 tamu), staf rumah sakit, pegawai kontrak, dan semua orang
yang bekerja di \up0 \expndtw-3\charscalex100 rumah sakit sudah dimplementasikan.
(lihat juga SKPm1).(D,O,W) \par\pard\ql \li1560\sb180\sl-276\slmult0\tx2126 \up0
\expndtw-3\charscalex100 5. \tab \up0 \expndtw-2\charscalex100 Rumah sakit telah
melakukan pemeriksaan fasilitas secara berkala, membuat \par\pard\ql
\li2126\sb24\sl-276\slmult0
\up0 \expndtw-3\charscalex100 rencana perbaikan, dan telah melaksanakan perbaikan.
(D,O,W) \par\pard\li1560\sb191\sl-276\slmult0\fi0\tx2126 \up0 \expndtw-
3\charscalex100 6.\tab \up0 \expndtw-3\charscalex100 Rumah sakit telah memasang
monitoring pada area yang berisiko\par\pard\li1560\sb19\sl-276\slmult0\fi566
\up0 \expndtw-3\charscalex100 keselamatan dan keamanan.
(O,W)\par\pard\li1560\sb185\sl-276\slmult0\fi0\tx2126 \up0 \expndtw-3\charscalex100
7.\tab \up0 \expndtw-2\charscalex100 Rumah sakit telah menyediakan fasilitas yang
aman sesuai dengan peraturan\par\pard\li1560\sb19\sl-276\slmult0\fi566 \up0
\expndtw-3\charscalex100 perundang-undangan. (O,W)\par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb70\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK
4.1 \par\pard\ql \li1418\sb244\sl-276\slmult0\tx8043 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit melakukan
asesmen risiko prakontruksi \tab \up0 \expndtw-1\charscalex100 (PCRA) pada
waktu \par\pard\ql \li1418\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
merencanakan pembangunan/kontruksi, pembongkaran, atau renovasi. \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb131\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 301
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg302}
{\bkmkend Pg302}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 4.1
\par\pard\qj \li1418\ri1211\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Kontruksi/pembangunan baru di sebuah rumah sakit akan
berdampak pada setiap \line \up0 \expndtw-2\charscalex100 orang di rumah sakit
dan pasien dengan kerentanan tubuhnya dapat menderita \line \up0 \expndtw-
1\charscalex100 dampak terbesar. Kebisingan dan getaran yang terkait dengan
kontruksi dapat \line \up0 \expndtw0\charscalex100 memengaruhi tingkat
kenyamanan pasien dan istirahat/tidur pasien dapat pula \line \up0
\expndtw0\charscalex104 terganggu. Debu konstruksi dan bau dapat mengubah kualitas
udara yang dapat \line \up0 \expndtw-2\charscalex100 menimbulkan ancaman khususnya
bagi pasien dengan ganggungan pernapasan. \par\pard\qj \li1418\ri1158\sb5\sl-
315\slmult0 \up0 \expndtw-3\charscalex100 Karena itu, rumah sakit perlu melakukan
asesmen risiko setiap ada kegiatan kontruksi, \up0 \expndtw0\charscalex100
renovasi, maupun demolisi/pembongkaran bangunan. Asesmen risiko harus sudah \up0
\expndtw0\charscalex100 dilakukan pada waktu perencanan atau sebelum pekerjaan
kontruksi, renovasi, dan \up0 \expndtw-2\charscalex100 demolisi dilakukan sehingga
pada waktu pelaksanaan sudah ada upaya pengurangan \up0 \expndtw-3\charscalex100
risiko terhadap dampak kontruksi, renovasi, dan demolis tersebut. \par\pard\qj
\li1418\ri1173\sb205\sl-316\slmult0 \up0 \expndtw-3\charscalex100 Dalam rangka
melakukan asesmen risiko yang terkait dengan proyek konstruksi baru, \up0 \expndtw-
2\charscalex100 rumah sakit perlu melibatkan semua unit/instalasi pelayanan
klinis yang terkena \up0 \expndtw-2\charscalex100 dampak dari kontruksi baru
tersebut, konsultan perencana, atau manajer desain \up0
\expndtw0\charscalex102 proyek, Komite Kesehatan dan Keselamatan Kerja Rumah Sakit
(K-3 RS), Komite \up0 \expndtw-1\charscalex100 Pencegahan dan Pengendalian Infeksi
(PPI), Bagian Rumah Tangga/Bagian Umum, \up0 \expndtw0\charscalex100 Bagian
Teknologi Informasi, Bagian Sarana Prasarana/IPSRS, dan unit atau bagian \up0
\expndtw-3\charscalex100 lainnya yang diperlukan. \par\pard\qj \li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\ri1221\sb10\sl-315\slmult0 \up0
\expndtw0\charscalex104 Risiko terhadap pasien, keluarga, staf, pengunjung, vendor,
pekerja kontrak, dan \up0 \expndtw0\charscalex103 entitas di luar pelayanan akan
bervariasi bergantung pada sejauh mana kegiatan \up0 \expndtw0\charscalex100
konstruksi serta dampaknya terhadap infrastruktur dan utilitas. Sebagai
tambahan, \up0 \expndtw0\charscalex104 kedekatan pembangunan ke area pelayanan
pasien akan berdampak pada \up0 \expndtw-3\charscalex100 meningkatnya tingkat
risiko. \par\pard\qj \li1418\ri1164\sb1\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 Misalnya, jika konstruksi melibatkan gedung baru yang terletak
terpisah dari bangunan \up0 \expndtw0\charscalex105 yang menyediakan pelayanan saat
ini maka risiko untuk pasien dan pengunjung \up0 \expndtw-3\charscalex100 cenderung
akan menjadi minimal. \par\pard\qj \li1418\ri1160\sb204\sl-316\slmult0 \up0
\expndtw-1\charscalex100 Risiko dievaluasi dengan melakukan asesmen risiko
prakonstruksi, juga dikenal \line \up0 \expndtw0\charscalex102 sebagai PCRA
(\ul0\nosupersub\cf8\f9\fs24 Pra-Contruction Risk
Assessment\ul0\nosupersub\cf7\f8\fs24 ). Asesmen risiko prakonstruksi \line \up0
\expndtw-3\charscalex100 secara komprehensif dan proaktif digunakan untuk
mengevaluasi risiko dan kemudian \line \up0 \expndtw0\charscalex102 mengembangkan
rencana agar dapat meminimalkan dampak kontruksi, renovasi, \line \up0 \expndtw-
1\charscalex100 atau penghancuran (\ul0\nosupersub\cf8\f9\fs24
demolish\ul0\nosupersub\cf7\f8\fs24 ) sehingga pelayanan pasien tetap terjaga
kualitas dan \line \up0 \expndtw-2\charscalex100 keamanannya. \par\pard\ql
\li1418\sb238\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Asesmen risiko
prakonstruksi (PCRA) meliputi area-area sebagai berikut: \par\pard\ql
\li1418\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 1. kualitas udara;
\par\pard\ql \li1418\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2.
pengendalian infeksi (ICRA); \par\pard\ql \li1418\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 3. utilitas; \par\pard\ql \li1418\sb44\sl-276\slmult0
\up0 \expndtw-3\charscalex100 4. kebisingan; \par\pard\ql \li1418\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 5. getaran; \par\pard\ql \li1418\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 6. bahan berbahaya; \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb150\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 302

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{\shp
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\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 7. layanan darurat, seperti
respons terhadap kode; dan \par\pard\ql \li1418\sb24\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 8. bahaya lain yang memengaruhi perawatan, pengobatan, dan layanan.
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1157\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex102 Selain itu, rumah sakit bersama dengan
manajemen konstruksi (MK) memastikan \up0 \expndtw0\charscalex100 bahwa kepatuhan
kontraktor dipantau, ditegakkan, dan didokumentasikan. Sebagai \up0 \expndtw-
4\charscalex100 bagian dari penilaian risiko maka risiko pasien infeksi dari
konstruksi dievaluasi melalui \up0 \expndtw0\charscalex104 infeksi penilaian risiko
kontrol yang dikenal sebagai ICRA (\ul0\nosupersub\cf8\f9\fs24 Infection Control
Risk \up0 \expndtw-3\charscalex100
Assessment\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
.\ul0\nosupersub\cf7\f8\fs24 (juga lihat PPI 7.5) \par\pard\qj
\li1418\ri1178\sb6\sl-313\slmult0 \up0 \expndtw0\charscalex102 Dalam menyusun PCRA
maka individu atau organisasi yang ditunjuk melakukan \up0
\expndtw0\charscalex102 pengawasan dan penerapan manajemen risiko fasilitas yang
ada di MFK 3 agar \up0 \expndtw-2\charscalex100 melakukan koordinasi dengan
organisasi PPI karena PCRA dengan ICRA merupakan \up0 \expndtw-3\charscalex100
kesatuan yang tidak dapat dipisahkan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 4.1 \par\pard\qj
\li1778\ri1220\sb225\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi yang mengatur
asesmen risiko prakonstruksi \line\tab \up0 \expndtw-3\charscalex100 (PCRA). (lihat
juga PPI 7.5). (R) \par\pard\ql \li1778\ri1216\sb169\sl-
290\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 2. Rumah sakit melakukan
asesmen risiko prakontruksi (PCRA) bila ada rencana \line\tab \up0
\expndtw0\charscalex100 kontruksi, renovasi, atau demolis/pembongkaran yang
meliputi butir 1 sampai \line \tab \up0 \expndtw-3\charscalex100 dengan 8 pada
maksud dan tujuan. (D,W) \par\pard\qj \li1778\ri1162\sb162\sl-300\slmult0\tx2138
\up0 \expndtw0\charscalex103 3. Rumah sakit mengambil tindakan berdasar atas hasil
asesmen risiko untuk \line\tab \up0 \expndtw-3\charscalex100 meminimalkan risiko
selama pembongkaran, konstruksi, dan renovasi. (D,O,W) \par\pard\qj
\li1778\ri1217\sb161\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Rumah
sakit memastikan bahwa kepatuhan kontraktor dipantau, ditegakkan, \line\tab \up0
\expndtw-3\charscalex100 dan didokumentasikan. (lihat juga MFK 3). (D,O,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb116\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MFK 4.2 \par\pard\qj \li1418\ri1215\sb188\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
merencanakan dan menyediakan anggaran untuk perbaikan sistem\up0
\expndtw0\charscalex100 sistem penting bangunan atau komponen-komponen
lainnya berdasar atas hasil \up0 \expndtw-1\charscalex100 pemeriksaan fasilitas
dan peraturan perundang-undangan serta anggaran untuk \up0
\expndtw0\charscalex109 mengurangi risiko sebagai dampak dari
renovasi, kontruksi, dan \up0 \expndtw-3\charscalex100 penghancuran/demolis
bangunan. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 4.2
\par\pard\qj \li1418\ri1220\sb188\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit wajib mematuhi peraturan dan perundang-
undangan yang berhubungan \line \up0 \expndtw0\charscalex106 dengan keamanan
fasilitas dan keselamatan lingkungan. Sistem-sistem \line \up0
\expndtw0\charscalex100 utama/penting, bangunan, atau komponen-komponen lainnya
harus sesuai dengan \line \up0 \expndtw0\charscalex100 peraturan perundang-
undangan, karena itu harus dilakukan pemeriksaan fasilitas \line \up0
\expndtw0\charscalex100 secara berkala serta dilakukan perbaikan dan atau
penggantian bila ada kerusakan. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb23\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 303

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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,315);(9127,315);(9127,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv
16777215}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}
{\sv 1}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg304}{\bkmkend Pg304}\par\pard\qj \li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\ri1158\sb191\sl-316\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Di sisi lain, otoritas setempat juga melakukan
pemeriksaan secara berkala dan bila \up0 \expndtw-3\charscalex100 ditemukan masih
ada yang belum sesuai dengan peraturan perundang-undangan dan \up0 \expndtw-
1\charscalex100 persyaratan lainnya maka rumah sakit wajib melakukan perbaikan
serta peningkatan \up0 \expndtw0\charscalex100 sesuai dengan rekomendasi hasil
pemeriksaan tersebut. Peraturan dan perundang\up0 \expndtw-2\charscalex100 undangan
juga mengatur perlunya izin untuk bangunan atau fasilitas tertentu dan izin \up0
\expndtw-3\charscalex100 tersebut harus diperbaharui secara berkala.
\par\pard\qj \li1418\ri1220\sb205\sl-315\slmult0 \up0 \expndtw-1\charscalex100
Berdasar atas hal tersebut di atas maka rumah sakit perlu merencanakan
dan \line \up0 \expndtw0\charscalex100 menyediakan anggaran/budget untuk
perbaikan, penggantian, peningkatan, dan \line \up0 \expndtw0\charscalex100
perizinan sehingga bangunan, properti, fasilitas, serta komponen-komponen
lainnya \line \up0 \expndtw0\charscalex103 di rumah sakit dapat memenuhi peraturan
perundang-undangan dan persyaratan \line \up0 \expndtw-3\charscalex100 lainnya.
\par\pard\qj \li1418\ri1166\sb201\sl-320\slmult0 \up0 \expndtw-3\charscalex100
Mengingat setiap ada kontruksi maka renovasi dan demolisi harus dilakukan
asesmen \line \up0 \expndtw-4\charscalex100 risiko prakontruksi \up0 \expndtw-
4\charscalex100 (PCRA) yang harus juga diikuti dengan rencana/pelaksanaan
\par\pard\qj \li1418\ri1197\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex103
pengurangan risiko dampak keselamatan serta. keamanan bagi pasien, keluarga,
\line \up0 \expndtw-2\charscalex100 pengunjung, dan staf. Hal ini berdampak
memerlukan biaya maka rumah sakit juga \line \up0 \expndtw-3\charscalex100 perlu
menyediakan anggaran untuk penerapan PCRA \up0 \expndtw-3\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 Pra Contruction Risk \par\pard\ql \li1418\sb17\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Assessment)\ul0\nosupersub\cf7\f8\fs24
dan ICRA (\ul0\nosupersub\cf8\f9\fs24 Infection Control Risk
Assessment\ul0\nosupersub\cf7\f8\fs24 ). \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK
4.2 \par\pard\ql \li1778\ri1189\sb225\sl-300\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menyediakan
anggaran untuk memenuhi peraturan perundang-\line\tab \up0 \expndtw-2\charscalex100
undangan yang terkait dengan fasilitas rumah sakit. (lihat juga AP 5 dan AP 6).
\line \tab \up0 \expndtw-3\charscalex100 (D,W) \par\pard\ql
\li1778\ri1223\sb169\sl-290\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 2.
Rumah sakit menyediakan anggaran untuk meningkatkan, memperbaiki, atau \line\tab
\up0 \expndtw0\charscalex102 mengganti sistem, bangunan, atau komponen yang
diperlukan agar fasilitas \line \tab \up0 \expndtw-3\charscalex100 tetap dapat
beroperasi secara aman dan efektif. (D,O,W) \par\pard\qj \li1778\ri1519\sb199\sl-
280\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Rumah sakit menyediakan
anggaran untuk penerapan PCRA dan ICRA bila \line\tab \up0 \expndtw-3\charscalex100
ada renovasi, kontruksi, dan pembongkaran. (D,W) \par\pard\ql \li1778\sb184\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 4. \par\pard\ql \li1620\sb184\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAHAN
BERBAHAYA \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar MFK 5 \par\pard\qj \li1418\ri1227\sb16\sl-310\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit memiliki
regulasi inventarisasi, penanganan, penyimpanan dan \up0
\expndtw0\charscalex100 penggunaan, serta pengendalian/pengawasan bahan berbahaya
dan beracun (B3) \up0 \expndtw-3\charscalex100 serta limbahnya sesuai dengan
peraturan perundang-undangan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 5 \par\pard\qj
\li1418\ri1163\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengidentifikasi dan mengendalikan secara
aman bahan berbahaya dan \line \up0 \expndtw-3\charscalex100 beracun dan limbahnya
(lihat juga AP 5.1, EP 1, dan AP 6 EP 1 serta PPI 7.2) sesuai \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb223\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 304
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg305}
{\bkmkend Pg305}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1223\sb253\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 dengan peraturan dan perundang-undangan. WHO telah
mengidentifikasi bahan \up0 \expndtw-2\charscalex100 berbahaya dan beracun serta
limbahnya dengan katagori sebagai berikut: \par\pard\ql \li1778\sb240\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 1) infeksius; \par\pard\ql
\li1778\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2) patologis dan
anatomi; \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3)
farmasi; \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4)
bahan kimia; \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100
5) logam berat; \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 6) kontainer bertekanan; \par\pard\ql \li1778\sb24\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 7) benda tajam; \par\pard\ql
\li1778\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 8)
genotoksik/sitotoksik; \par\pard\ql \li1778\sb4\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 9) radioaktif. \par\pard\qj \li1418\ri1160\sb228\sl-320\slmult0
\up0 \expndtw-4\charscalex100 Dalam melakukan identifikasi dan inventarisasi B3
serta limbahnya di rumah sakit agar \up0 \expndtw0\charscalex100 mengacu kepada
katagori B3 dan limbahnya dari WHO ini. Rumah sakit diharapkan \up0
\expndtw0\charscalex103 melakukan identifikasi area/unit mana saja yang menyimpan
B3 serta limbahnya. \up0 \expndtw-1\charscalex100 Sesudah itu, menginventarisasi
meliputi lokasi, jenis, dan jumlah B3 serta limbahnya \up0 \expndtw-2\charscalex100
disimpan. Daftar inventarisasi ini selalu mutahir (di-\ul0\nosupersub\cf8\f9\fs24
update\ul0\nosupersub\cf7\f8\fs24 ) sesuai dengan perubahan \up0 \expndtw-
3\charscalex100 yang terjadi di tempat penyimpanan. \par\pard\ql \li1418\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Rumah sakit perlu mempunyai regulasi yang
mengatur \par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a)
data inventarisasi B3 serta limbahnya yang meliputi jenis, jumlah, dan lokasi;
\par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b)
penanganan, penyimpanan, dan penggunaan B3 serta limbahnya; \par\pard\qj
\li1778\ri1191\sb5\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 c)
penggunaan alat pelindung diri (APD) dan prosedur penggunaan, prosedur bila
\line\tab \up0 \expndtw-3\charscalex100 terjadi tumpahan, atau paparan/pajanan;
\par\pard\ql \li1778\sb20\sl-276\slmult0 \up0 \expndtw-4\charscalex100 d)
pemberian label/rambu-rambu yang tepat pada B3 serta limbahnya; \par\pard\qj
\li1778\ri1221\sb5\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex103 e) pelaporan
dan investigasi dari tumpahan, eksposur (terpapar), dan insiden \line\tab \up0
\expndtw-3\charscalex100 lainnya; \par\pard\ql \li1778\sb20\sl-276\slmult0 \up0
\expndtw-1\charscalex100 f) dokumentasi, termasuk izin, lisensi, atau persyaratan
peraturan lainnya; \par\pard\ql \li1778\sb4\sl-276\slmult0\tx7103 \up0 \expndtw-
1\charscalex100 g) pengadaan/pembelian B3 dan pemasok \tab \up0 \expndtw-
1\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 supplier\ul0\nosupersub\cf7\f8\fs24 )
wajib melampirkan \par\pard\ql \li2138\sb24\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 MSDS/LDP. \par\pard\qj \li1418\ri1197\sb311\sl-316\slmult0 \up0
\expndtw-2\charscalex100 Mengingat informasi mengenai penanganan, penyimpanan,
dan penggunaan B3 \up0 \expndtw0\charscalex100 termasuk data fisik seperti titik
didih, titik nyala, dan sejenisnya tercantum di dalam \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf8\f9\fs24 \u8220?Material Safety Data
Sheet\ul0\nosupersub\cf7\f8\fs24 (MSDS)\ul0\nosupersub\cf8\f9\fs24
\u8221?\ul0\nosupersub\cf7\f8\fs24 atau Lembar Data Pengaman (LDP) maka \up0
\expndtw-1\charscalex100 rumah sakit agar membuat regulasi bahwa setiap
pembelian/pengadaan B3,\ul0\nosupersub\cf8\f9\fs24 supplier \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 wajib melampirkan MSDS atau
LDP. Informasi yang tercantum di MSDS/LDP agar \up0 \expndtw-2\charscalex100
diedukasi kepada staf rumah sakit, terutama kepada staf terdapat penyimpanan B3
di \up0 \expndtw-3\charscalex100 unitnya. \up0 \expndtw-3\charscalex100 (lihat juga
AP 5.3; AP 5.6; AP 6.6; MPO 3; dan MPO 3.1) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb6\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 5
\par\pard\ql \li1778\ri1216\sb225\sl-300\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai
regulasi yang mengatur B3 serta limbahnya
sesuai \line\tab \up0 \expndtw0\charscalex100 dengan katagori WHO dan peraturan
perundang-undangan, meliputi butir 1 \line \tab \up0 \expndtw0\charscalex100 sampai
dengan 7 pada maksud dan tujuan. (lihat juga AP 5.3.1; AP 5.6; AP \par\pard\ql
\li2138\sb20\sl-276\slmult0 \up0 \expndtw-3\charscalex100 6.3; AP 6.6; dan PKPO
3)\ul0\nosupersub\cf8\f9\fs24 .\ul0\nosupersub\cf7\f8\fs24 (R) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb10\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 305

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serta limbahnya lengkap dan terbaru sesuai \line\tab \up0 \expndtw-1\charscalex100
dengan kategori WHO dan peraturan perundang-undangan meliputi jenis,
\line \tab \up0 \expndtw-3\charscalex100 lokasi, dan jumlah semua bahan berbahaya
dan beracun serta limbahnya. (lihat \line \tab \up0 \expndtw-4\charscalex100 juga
AP 5.5 dan AP 6.6). (D,O,W) \par\pard\qj \li1778\ri1158\sb162\sl-300\slmult0\tx2138
\up0 \expndtw0\charscalex102 3. Ada bukti bahwa untuk pengadaan/pembelian B3 dan
pemasok (\ul0\nosupersub\cf8\f9\fs24 supplier\ul0\nosupersub\cf7\f8\fs24 )
\line\tab \up0 \expndtw-5\charscalex100 sudah melampirkan MSDS. (D,O,W)
\par\pard\ql \li1778\ri1165\sb1\sl-300\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex103 4. Petugas telah menggunakan APD yang benar pada
waktu menangani \line\tab \up0 \expndtw-3\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 handling\ul0\nosupersub\cf7\f8\fs24 ) B3 serta
limbahnya dan di area tertentu juga sudah ada\ul0\nosupersub\cf8\f9\fs24 eye
washer. \line \tab \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (lihat
juga AP 5.3.1). (O,W) \par\pard\qj \li1778\ri1221\sb17\sl-280\slmult0\tx2138
\up0 \expndtw0\charscalex100 5. B3 serta limbahnya sudah diberi label/rambu-rambu
sesuai dengan peraturan \line\tab \up0 \expndtw-3\charscalex100 dan perundang-
undangan. (lihat juga PKPO 3 EP 2). (O,W) \par\pard\qj \li1778\ri1219\sb4\sl-
300\slmult0\tx2138 \up0 \expndtw-1\charscalex100 6. Ada laporan dan analisis
tumpahan, paparan/pajanan (\ul0\nosupersub\cf8\f9\fs24
exposure\ul0\nosupersub\cf7\f8\fs24 ), dan insiden \line\tab \up0 \expndtw-
2\charscalex100 lainnya. (D,W) \par\pard\qj \li1778\ri1218\sb1\sl-
300\slmult0\tx2138 \up0 \expndtw-1\charscalex100 7. Ada bukti dokumentasi
persyaratan yang meliputi izin, lisensi, atau ketentuan \line\tab \up0 \expndtw-
2\charscalex100 persyaratan lainnya. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb152\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK 5.1 \par\pard\qj
\li1418\ri1223\sb308\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai sistem penyimpanan dan
pengolahan limbah bahan \up0 \expndtw0\charscalex100 berbahaya dan beracun
cair dan padat yang benar sesuai dengan peraturan \up0 \expndtw-
3\charscalex100 perundang-undangan\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Maksud dan
Tujuan MFK 5.1 \par\pard\qj \li1418\ri1205\sb216\sl-310\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Penyimpanan limbah B3 dapat
dilakukan secara baik dan benar apabila limbah B3 \line \up0 \expndtw-
2\charscalex100 telah dilakukan pemilahan yang baik dan benar, termasuk memasukkan
limbah B3 ke \line \up0 \expndtw-2\charscalex100 dalam wadah atau kemasan yang
sesuai serta dilekati simbol dan label limbah B3. \par\pard\qj
\li1418\ri1222\sb202\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Untuk
penyimpanan limbah B-3 maka rumah sakit agar memenuhi persyaratan \up0
\expndtw-3\charscalex100 fasilitas penyimpanan limbah B-3 sebagai berikut:
\par\pard\li1778\sb264\sl-276\slmult0\fi0\tx3662\tx9679 \up0 \expndtw-
3\charscalex100 1) lantai kedap\tab \up0 \expndtw-3\charscalex100
(i\ul0\nosupersub\cf8\f9\fs24 mpermeable\ul0\nosupersub\cf7\f8\fs24 ), berlantai
beton atau semen dengan\tab \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf26\f27\fs24 \u8232?\ul0\nosupersub\cf7\f8\fs24
sistem\par\pard\li1778\sb60\sl-276\slmult0\fi360 \up0 \expndtw-2\charscalex100
drainase yang baik, serta mudah dibersihkan dan dilakukan
desinfeksi;\ul0\nosupersub\cf26\f27\fs24 \u8232?\par\pard\li1778\sb43\sl-
276\slmult0\fi0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2)
tersedia sumber air atau kran air untuk pembersihan yang dilengkapi
dengan\par\pard\li1778\sb21\sl-276\slmult0\fi360 \up0 \expndtw-3\charscalex100
sabun cair;\par\pard\ql \li1778\sb25\sl-276\slmult0 \up0 \expndtw-8\charscalex100
3) mudah diakses untuk penyimpanan limbah;\ul0\nosupersub\cf26\f27\fs24
\u8232? \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 4) dapat dikunci untuk menghindari akses oleh pihak
yang tidak berkepentingan; \par\pard\qj \li1778\ri1162\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex100 5) mudah diakses oleh kendaraan yang akan
mengumpulkan atau mengangkut \line\tab \up0 \expndtw-10\charscalex80
limbah;\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\qj \li1778\ri1168\sb5\sl-
300\slmult0\tx2138 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 6)
terlindungi dari sinar matahari, hujan, angin kencang, banjir, dan faktor lain yang
\line\tab \up0 \expndtw-7\charscalex100 berpotensi menimbulkan kecelakaan atau
bencana kerja;\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\ql \li1778\sb60\sl-
276\slmult0 \up0 \expndtw-7\charscalex100 \ul0\nosupersub\cf7\f8\fs24 7) tidak
dapat diakses oleh hewan, serangga, dan burung;\ul0\nosupersub\cf26\f27\fs24
\u8232? \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb70\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 306
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg307}
{\bkmkend Pg307}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
7\charscalex100 \ul0\nosupersub\cf7\f8\fs24 8) dilengkapi dengan ventilasi dan
pencahayaan yang baik serta\ul0\nosupersub\cf26\f27\fs24
\u8232?\ul0\nosupersub\cf7\f8\fs24 memadai;\ul0\nosupersub\cf26\f27\fs24
\u8232? \par\pard\ql \li1778\sb64\sl-276\slmult0 \up0 \expndtw-7\charscalex100
\ul0\nosupersub\cf7\f8\fs24 9) berjarak jauh dari tempat penyimpanan atau
penyiapan makanan;\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\ql
\li1778\ri1161\sb20\sl-306\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 10)peralatan pembersihan, alat
pelindung diri/APD (antara lain masker, sarung \line\tab \up0
\expndtw0\charscalex103 tangan, penutup kepala,\ul0\nosupersub\cf8\f9\fs24
goggle\ul0\nosupersub\cf7\f8\fs24 , sepatu boot, serta pakaian pelindung) dan \line
\tab \up0 \expndtw-1\charscalex100 wadah atau kantong limbah harus diletakkan
sedekat-dekatnya dengan lokasi \line \tab \up0 \expndtw-10\charscalex94 fasilitas
penyimpanan;\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\qj
\li1778\ri1161\sb23\sl-320\slmult0\tx2138 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 11)dinding, lantai, dan juga langit-langit fasilitas
penyimpanan senantiasa\ul0\nosupersub\cf26\f27\fs24
\u8232?\ul0\nosupersub\cf7\f8\fs24 dalam \line\tab \up0 \expndtw-7\charscalex100
keadaan bersih termasuk pembersihan lantai setiap
hari.\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\qj \li1418\ri1164\sb316\sl-
326\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pengolahan
limbah B3 adalah proses untuk mengurangi dan/atau menghilangkan sifat \line \up0
\expndtw0\charscalex103 bahaya dan/atau sifat racun. Dalam pelaksanaannya,
pengolahan limbah B3 dari \line \up0 \expndtw0\charscalex100 fasilitas pelayanan
kesehatan dapat dilakukan pengolahan secara termal atau \line \up0 \expndtw-
10\charscalex86 nontermal.\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\qj
\li1418\ri1162\sb259\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Untuk limbah berwujud cair dapat dilakukan di Instalasi
Pengolahan Air Limbah (IPAL) \up0 \expndtw-10\charscalex100 dari fasilitas
pelayanan kesehatan.\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\qj
\li1418\ri1166\sb260\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Tujuan pengolahan limbah medis adalah mengubah
karakteristik biologis dan/atau \line \up0 \expndtw-4\charscalex100 kimia limbah
sehingga potensi bahayanya terhadap manusia berkurang atau tidak ada.
\par\pard\ql \li1418\sb57\sl-276\slmult0 \up0 \expndtw0\charscalex80
\ul0\nosupersub\cf26\f27\fs24 \u8232? \par\pard\qj \li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1217\sb37\sl-315\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Bila rumah sakit mengolah limbah B-3 sendiri maka wajib
mempunyai izin mengolah \line \up0 \expndtw-1\charscalex100 limbah B-3. Namun, bila
pengolahan B-3 dilaksanakan oleh pihak ketiga maka pihak \line \up0 \expndtw-
1\charscalex100 ketiga tersebut wajib mempunyai izin sebagai transporter B-3 dan
izin pengolah B-3. \line \up0 \expndtw0\charscalex100 Pengangkut/transporter dan
pengolah limbah B3 dapat dilakukan oleh institusi yang \line \up0 \expndtw-
3\charscalex100 berbeda. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb50\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 5.1 \par\pard\ql
\li1778\ri1218\sb225\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi untuk penyimpanan
dan pengolahan limbah \line\tab \up0 \expndtw0\charscalex100 B3 secara benar dan
aman sesuai dengan ketentuan peraturan perundang-\line \tab \up0 \expndtw-
3\charscalex100 undangan. (lihat juga AP 6.2; EP
4; MFK 1 EP 3). (R) \par\pard\qj \li1778\ri1228\sb161\sl-300\slmult0\tx2138
\up0 \expndtw0\charscalex100 2. Penyimpanan limbah B3 sudah mempunyai izin TPS
B3 yang masih berlaku \line\tab \up0 \expndtw-3\charscalex100 dan sesuai dengan
perundang-undangan. (D,O,W) \par\pard\ql \li1778\ri1158\sb169\sl-
290\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 3. Rumah sakit sudah
mempunyai Instalasi Pengolahan Air Limbah (IPAL) dengan \line\tab \up0
\expndtw0\charscalex100 izin yang masih berlaku sesuai dengan peraturan
perundang-undangan. \line \tab \up0 \expndtw-3\charscalex100 (D,O,W)
\par\pard\ql \li1778\ri1163\sb162\sl-300\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw-3\charscalex100 4. Rumah sakit mempunyai Instalasi Pengolah B3 dengan
izin yang masih berlaku \line\tab \up0 \expndtw0\charscalex103 atau melakukan
kerja sama dengan pihak ketiga dengan izin sebagai \line \tab \up0
\expndtw0\charscalex102 transporter dan pengolah B3 yang masih berlaku sesuai
dengan peraturan \line \tab \up0 \expndtw-3\charscalex100 perundang- undangan.
(D,O,W) \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb13\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 307
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg308}
{\bkmkend Pg308}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
KESIAPAN PENANGGULANGAN BENCANA \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb152\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar MFK 6 \par\pard\qj \li1418\ri1178\sb208\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
mengembangkan dan memelihara program manajemen disaster untuk \up0 \expndtw-
2\charscalex100 menanggapi keadaan disaster serta bencana alam atau lainnya yang
memiliki potensi \up0 \expndtw-3\charscalex100 terjadi dimasyarakat.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 6 \par\pard\qj
\li1418\ri1168\sb211\sl-317\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Situasi darurat yang terjadi di masyarakat, kejadian
epidemi, atau bencana alam akan \up0 \expndtw0\charscalex102 melibatkan rumah sakit
seperti gempa bumi yang menghancurkan area rawat inap \up0 \expndtw0\charscalex100
pasien atau ada epidemi flu yang akan menghalangi staf masuk kerja. Penyusunan \up0
\expndtw0\charscalex104 program harus dimulai dengan identifikasi jenis bencana
yang mungkin terjadi di \up0 \expndtw-3\charscalex100 daerah rumah sakit berada
dan dampaknya terhadap rumah sakit. Contohnya, angin \up0 \expndtw0\charscalex102
topan (\ul0\nosupersub\cf8\f9\fs24 hurricane\ul0\nosupersub\cf7\f8\fs24 ) atau
tsunami kemungkinan akan terjadi di daerah dekat laut dan \up0
\expndtw0\charscalex104 tidak terjadi di daerah yang jauh dari laut. Kerusakan
fasilitas atau korban masal \up0 \expndtw-3\charscalex100 sebaliknya dapat terjadi
di rumah sakit manapun. \par\pard\qj \li1418\ri1160\sb183\sl-317\slmult0 \up0
\expndtw0\charscalex103 Melakukan identifikasi dampak bencana sama pentingnya
dengan mencatat jenis \line \up0 \expndtw-2\charscalex100 bencana yang terjadi.
Sebagai contoh, kemungkinan dampak yang dapat terjadi pada \line \up0
\expndtw0\charscalex105 air dan tenaga listrik jika terjadi bencana alam seperti
gempa bumi. Mungkinkah \line \up0 \expndtw-3\charscalex100 gempa bumi akan
menghambat anggota staf untuk merespons bencana hanya karena \line \up0
\expndtw0\charscalex103 jalan terhalang atau keluarga mereka menjadi koban gempa
bumi? Dalam situasi \line \up0 \expndtw0\charscalex102 demikian, mungkin akan
terjadi konflik kepentingan dengan keharusan merespons \line \up0 \expndtw-
3\charscalex100 kejadian bencana di rumah sakit. Rumah sakit juga harus mengetahui
peranan staf ini \line \up0 \expndtw-1\charscalex100 di masyarakat. Sebagai contoh,
sumber daya apa yang perlu disediakan rumah sakit \line \up0
\expndtw0\charscalex103 untuk masyarakat dalam situasi bencana dan metode
komunikasi apa yang harus \line \up0 \expndtw-3\charscalex100 dipakai di
masyarakat? \par\pard\qj \li1418\ri1227\sb201\sl-320\slmult0 \up0
\expndtw0\charscalex103 Untuk merespons secara efektif maka rumah sakit
perlu menyusun program \up0 \expndtw-3\charscalex100
manajemen\ul0\nosupersub\cf8\f9\fs24 disaster\ul0\nosupersub\cf7\f8\fs24
tersebut. Program tersebut menyediakan proses untuk \par\pard\qj
\li1778\ri1225\sb17\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex103 a)
menentukan jenis yang kemungkinan terjadi dan konsekuensi bahaya,
\line\tab \up0 \expndtw-3\charscalex100 ancaman, dan kejadian; \par\pard\qj
\li1778\ri1228\sb21\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 b)
menentukan integritas struktural di ingkungan pelayanan pasien yang ada dan
\line\tab \up0 \expndtw-3\charscalex100 bagaimana bila terjadi bencana;
\par\pard\ql \li1778\sb20\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c)
menentukan peran rumah sakit dalam peristiwa/kejadian tersebut; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) menentukan strategi
komunikasi pada waktu kejadian; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 e) mengelola sumber daya selama kejadian termasuk sumber-
sumber alternatif; \par\pard\qj \li1778\ri1223\sb25\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex103 f) mengelola kegiatan klinis selama kejadian termasuk
tempat pelayanan \line\tab \up0 \expndtw-3\charscalex100 alternatif pada waktu
kejadian; \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb206\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 308
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg309}
{\bkmkend Pg309}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1224\sb253\sl-300\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 g) mengidentifikasi dan penetapan
peran serta tanggung jawab staf selama \line\tab \up0 \expndtw-3\charscalex100
kejadian. (juga lihat MFK 11.1 EP 4); dan \par\pard\ql \li1778\ri1195\sb1\sl-
300\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 h) proses mengelola
keadaan darurat ketika terjadi konflik antara tanggung jawab \line\tab \up0
\expndtw0\charscalex102 pribadi staf dan tanggung jawab rumah sakit untuk
tetap menyediakan \line \tab \up0 \expndtw-3\charscalex100 pelayanan pasien.
\par\pard\qj \li1418\sb0\sl-318\slmult0 \par\pard\qj\li1418\ri1166\sb8\sl-
318\slmult0 \up0 \expndtw0\charscalex100 Dalam keadaan darurat, bencana, dan krisis
lainnya maka masyarakat harus dapat \up0 \expndtw0\charscalex102 melindungi
kehidupan dan kesejahteraan penduduk yang terkena dampaknya \up0
\expndtw0\charscalex100 terutama dalam hitungan menit dan jam segera setelah dampak
atau keterpaparan \up0 \expndtw-1\charscalex100 tersebut. Kemampuan pelayanan
kesehatan untuk berfungsi tanpa gangguan dalam \up0 \expndtw-3\charscalex100
situasi ini adalah masalah antara hidup dan mati. Kelanjutan fungsi layanan
kesehatan \up0 \expndtw-1\charscalex100 bergantung pada sejumlah faktor kunci,
yaitu bahwa layanan ditempatkan di struktur \up0 \expndtw0\charscalex100 (seperti
rumah sakit atau fasilitas) yang dapat menahan paparan dan kekuatan dari \up0
\expndtw0\charscalex100 semua jenis bahaya; peralatan medis dalam keadaan
baik dan terlindung dari \up0 \expndtw-2\charscalex100 kerusakan; infrastruktur
masyarakat dan layanan penting (seperti air, listrik, dll.) \up0 \expndtw-
2\charscalex100 tersedia bagi layanan kesehatan; dan petugas kesehatan dapat
memberikan bantuan \up0 \expndtw-3\charscalex100 medis dalam situasi aman saat
mereka sangat dibutuhkan. \par\pard\qj \li1418\ri1158\sb303\sl-317\slmult0 \up0
\expndtw-3\charscalex100 Mendefinisikan istilah "rumah sakit yang aman" akan
membantu memberikan panduan \up0 \expndtw0\charscalex102 pendekatan untuk menilai
keamanan rumah sakit. Rumah sakit yang aman adalah \up0 \expndtw0\charscalex100
rumah sakit yang fasilitas layanannya tetap dapat diakses dan berfungsi
pada \up0 \expndtw0\charscalex100 kapasitas maksimum, serta dengan infrastruktur
yang sama, sebelum, selama, dan \up0 \expndtw-3\charscalex100 segera setelah dampak
keadaan darurat dan bencana. Fungsi rumah sakit yang terus \up0 \expndtw-
3\charscalex100 berlanjut bergantung pada berbagai faktor termasuk keamanan
bangunan, sistem dan \up0 \expndtw-1\charscalex100 peralatan pentingnya,
ketersediaan persediaan, serta kapasitas penanganan darurat \up0
\expndtw0\charscalex103 dan bencana di rumah sakit terutama tanggapan dan pemulihan
dari bahaya atau \up0 \expndtw-3\charscalex100 kejadian yang mungkin terjadi.
\par\pard\qj \li1418\ri1161\sb4\sl-316\slmult0 \up0 \expndtw-1\charscalex100 Unsur
kunci pengembangan menuju rumah sakit yang aman adalah pengembangan \line \up0
\expndtw0\charscalex100 dan penerapan indeks keamanan rumah sakit
(h\ul0\nosupersub\cf8\f9\fs24 ospital safety index\ul0\nosupersub\cf7\f8\fs24 )-
alat diagnostik \line \up0 \expndtw0\charscalex100 cepat serta murah untuk
menilai kemungkinan bahwa rumah sakit akan tetap \line \up0
\expndtw0\charscalex103 beroperasi dalam keadaan darurat dan bencana. Evaluasi
tersebut menghasilkan \line \up0 \expndtw0\charscalex100 informasi yang berguna
mengenai kekuatan
dan kelemahan rumah sakit serta akan \line \up0 \expndtw-3\charscalex100
menunjukkan tindakan yang diperlukan untuk memperbaiki kapasitas manajemen dan
\line \up0 \expndtw-4\charscalex100 keamanan kerja dalam keadaan darurat serta
bencana di rumah sakit. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1173\sb1\sl-320\slmult0 \up0 \expndtw-3\charscalex100 Untuk
mengukur kesiapsiagaan rumah sakit dalam menghadap bencana maka rumah \up0
\expndtw0\charscalex104 sakit agar melakukan\ul0\nosupersub\cf8\f9\fs24 self
assessment\ul0\nosupersub\cf7\f8\fs24 dengan
menggunakan\ul0\nosupersub\cf8\f9\fs24 instrument hospital \up0
\expndtw0\charscalex100 safety index\ul0\nosupersub\cf7\f8\fs24 dari WHO tersebut.
Dengan melakukan\ul0\nosupersub\cf8\f9\fs24 self
assessment\ul0\nosupersub\cf7\f8\fs24 tersebut maka \up0 \expndtw0\charscalex102
rumah sakit diharapkan dapat mengetahui kekurangan yang harus dipenuhi untuk
\up0 \expndtw-3\charscalex100 menghadapi bencana. \par\pard\qj
\li1418\ri1192\sb260\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Untuk menyiapkan
Instalasi Gawat Darurat Rumah Sakit dalam menghadapi bencana \up0
\expndtw0\charscalex104 ekternal maka di Instalasi Gawat Darurat perlu ada ruang
dekontaminasi sesuai \up0 \expndtw-3\charscalex100 dengan peraturan perundang-
undangan sebagai berikut: \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb83\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 309
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg310}
{\bkmkend Pg310}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1224\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1) ruangan ini ditempatkan di sisi depan/luar ruang
gawat darurat atau terpisah \line\tab \up0 \expndtw-3\charscalex100 dengan ruang
gawat darurat; \par\pard\qj \li1778\ri1227\sb4\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex104 2) pintu masuk menggunakan jenis pintu swing membuka ke
arah dalam dan \line\tab \up0 \expndtw-3\charscalex100 dilengkapi dengan alat
penutup pintu automatis; \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3) bahan penutup pintu harus dapat mengantisipasi benturan-
benturan brankar; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 4) bahan penutup lantai tidak licin dan tahan terhadap air;
\par\pard\qj \li1778\ri1228\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
5) konstruksi dinding tahan terhadap air sampai dengan ketinggian 120 cm dari
\line\tab \up0 \expndtw-3\charscalex100 permukaan lantai; \par\pard\ql
\li1778\sb17\sl-276\slmult0 \up0 \expndtw-2\charscalex100 6) ruangan dilengkapi
dengan\ul0\nosupersub\cf8\f9\fs24 sink\ul0\nosupersub\cf7\f8\fs24 dan pancuran
air (\ul0\nosupersub\cf8\f9\fs24 shower\ul0\nosupersub\cf7\f8\fs24 ).
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb92\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 6 \par\pard\qj
\li1778\ri1165\sb25\sl-300\slmult0\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi manajemen disaster
meliputi butir 1 sampai \line\tab \up0 \expndtw-4\charscalex100 dengan 8 pada
maksud dan tujuan. (R) \par\pard\ql \li1778\ri1158\sb166\sl-
293\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-1\charscalex100 2. Rumah sakit
mengidentifikasi bencana internal dan eksternal yang besar \line\tab \up0
\expndtw-4\charscalex100 seperti keadaan darurat di masyarakat, wabah dan bencana
alam atau bencana \line \tab \up0 \expndtw0\charscalex103 lainnya, serta kejadian
wabah besar yang dapat menyebabkan risiko yang \line \tab \up0 \expndtw-
3\charscalex100 signifikan. \up0 \expndtw-2\charscalex100 (D,W) \par\pard\qj
\li1778\ri1234\sb162\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Rumah
sakit telah melakukan\ul0\nosupersub\cf8\f9\fs24 self
assessment\ul0\nosupersub\cf7\f8\fs24 kesiapan menghadapi bencana \line\tab
\up0 \expndtw-3\charscalex100 dengan menggunakan\ul0\nosupersub\cf8\f9\fs24
hospital safety index\ul0\nosupersub\cf7\f8\fs24 dari WHO. (D,W) \par\pard\qj
\li1778\ri1345\sb161\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 4.
Instalasi gawat darurat telah mempunyai ruang dekontaminasi sesuai dengan \line\tab
\up0 \expndtw-3\charscalex100 butir 1 sampai dengan 6 pada maksud dan tujuan.
(D,O,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb148\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK 6.1 \par\pard\qj
\li1418\ri1224\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melakukan simulasi penanganan/menanggapi
kedaruratan, wabah, dan \up0 \expndtw-2\charscalex100 bencana. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb185\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 6.1 \par\pard\ql
\li1418\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Program kesiapan menghadapi bencana
diujicoba/disimulasikan: \par\pard\qj \li1778\ri1224\sb25\sl-300\slmult0\tx2138
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf25\f26\fs24
1.\ul0\nosupersub\cf7\f8\fs24 melakukan simulasi tahunan secara menyeluruh di
tingkat internal rumah sakit \line\tab \up0 \expndtw-3\charscalex100 atau sebagai
bagian dari simulasi di tingkat masyarakat; \par\pard\qj \li1778\ri1162\sb41\sl-
300\slmult0\tx2138 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf25\f26\fs24
2.\ul0\nosupersub\cf7\f8\fs24 simulasi terhadap unsur-unsur kritis rencana
program dari butir 3 hingga 8 yang \line\tab \up0 \expndtw-4\charscalex100
dilaksanakan setiap tahun. \par\pard\qj \li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1211\sb2\sl-310\slmult0 \up0 \expndtw0\charscalex102 Jika
rumah sakit menghadapi kejadian bencana yang sebenarnya dan rumah sakit \up0
\expndtw-1\charscalex100 menjalankan program tersebut serta melakukan diskusi
(\ul0\nosupersub\cf8\f9\fs24 debriefing\ul0\nosupersub\cf7\f8\fs24 ) setelah
kejadian \up0 \expndtw-2\charscalex100 maka situasi tersebut dapat mewakili atau
setara dengan simulasi tahunan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 6.1 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb210\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 310
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg311}
{\bkmkend Pg311}\par\pard\ql \li1778\sb0\sl-300\slmult0 \par\pard\ql\li1778\sb0\sl-
300\slmult0 \par\pard\ql\li1778\sb0\sl-300\slmult0 \par\pard\ql\li1778\sb0\sl-
300\slmult0 \par\pard\ql\li1778\ri1224\sb253\sl-300\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Seluruh program atau
setidaknya elemen-elemen kritis program dari butir 3 \line\tab \up0 \expndtw-
1\charscalex100 sampai dengan 8 pada maksud dan tujuan MFK 6 disimulasikan setiap
tahun. \line \tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\qj
\li1778\ri1217\sb161\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex102 2. Pada
akhir setiap simulasi dilakukan diskusi (\ul0\nosupersub\cf8\f9\fs24
debriefing\ul0\nosupersub\cf7\f8\fs24 ) mengenai simulasi \line\tab \up0 \expndtw-
3\charscalex100 tersebut serta dibuat laporan dan tindak lanjut. (D,W) \par\pard\qj
\li1778\ri1166\sb161\sl-300\slmult0\tx2138 \up0 \expndtw-3\charscalex100 3.
Peserta simulasi adalah semua pegawai/staf rumah sakit, pegawai kontrak, dan
\line\tab \up0 \expndtw-4\charscalex100 pegawai dari\ul0\nosupersub\cf8\f9\fs24
tenant\ul0\nosupersub\cf7\f8\fs24 /penyewa lahan. (D,W) \par\pard\qj
\li1418\sb0\sl-460\slmult0 \par\pard\qj\li1418\ri4942\sb68\sl-460\slmult0\fi360
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PROTEKSI KEBAKARAN
(\ul0\nosupersub\cf16\f17\fs24 FIRE SAFETY\ul0\nosupersub\cf6\f7\fs24 ) \up0
\expndtw-3\charscalex100 Standar MFK.7 \par\pard\qj \li1418\ri1167\sb176\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
merencanakan dan menerapkan suatu program untuk pencegahan, \line \up0 \expndtw-
3\charscalex100 penanggulangan bahaya kebakaran, serta penyediaan sarana jalan
keluar yang aman \line \up0 \expndtw-3\charscalex100 dari fasilitas sebagai respons
terhadap kebakaran dan keadaan darurat lainnya. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MFK 7 \par\pard\qj \li1418\ri1160\sb211\sl-316\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit harus waspada
terhadap keselamatan kebakaran karena kebakaran \up0 \expndtw-2\charscalex100
adalah risiko yang selalu dapat terjadi di rumah sakit. Dengan demikian, setiap
rumah \up0 \expndtw-3\charscalex100 sakit perlu merencanakan bagaimana agar
penghuni rumah sakit aman apabila terjadi \up0 \expndtw-2\charscalex100 kebakaran
termasuk bahaya dari asap. Rumah sakit perlu melakukan asesmen terus \up0
\expndtw0\charscalex103 menerus untuk memenuhi regulasi keamanan kebakaran
sehingga secara efektif \up0 \expndtw-3\charscalex100 dapat mengidentifikasi risiko
dan meminimalkan risiko. \par\pard\ql \li1418\sb238\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Asesmen risiko meliputi \par\pard\ql \li1778\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 a) tekanan dan risiko lainnya di kamar
operasi; \par\pard\qj \li1778\ri1570\sb181\sl-280\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 b)
sistem pemisahan (pengisolasian) dan kompartemenisasi pengendalian api
\line\tab \up0 \expndtw-3\charscalex100 dan asap; \par\pard\ql
\li1778\ri1699\sb164\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 c)
daerah berbahaya (dan ruang di atas langit-langit di seluruh area) seperti
\line\tab \up0 \expndtw-3\charscalex100 kamar linen kotor, tempat pengumpulan
sampah, dan ruang penyimpanan \line \tab \up0 \expndtw-3\charscalex100 oksigen;
\par\pard\ql \li1778\sb180\sl-276\slmult0 \up0 \expndtw-2\charscalex100 d) sarana
jalan keluar/\ul0\nosupersub\cf8\f9\fs24 exit\ul0\nosupersub\cf7\f8\fs24 ;
\par\pard\ql \li1778\sb184\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e) dapur
yang berproduksi dan peralatan masak; \par\pard\ql \li1778\sb184\sl-276\slmult0
\up0 \expndtw0\charscalex101 f)\ul0\nosupersub\cf8\f9\fs24
laundry\ul0\nosupersub\cf7\f8\fs24 dan linen; \par\pard\ql \li1778\sb184\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 g) sistem tenaga listrik darurat dan
peralatan; \par\pard\ql \li1778\sb184\sl-276\slmult0 \up0 \expndtw-3\charscalex100
h) gas medis dan komponen sistem vakum. \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb97\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 311
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg312}
{\bkmkend Pg312}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Berdasar atas hasil asesmen risiko
rumah sakit agar menyusun program untuk \par\pard\ql \li1778\ri1218\sb5\sl-
300\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 1) pencegahan kebakaran
melalui pengurangan risiko seperti penyimpanan dan \line\tab \up0
\expndtw0\charscalex101 penanganan bahan-bahan mudah terbakar secara aman, termasuk
gas-gas \line \tab \up0 \expndtw-3\charscalex100 medis yang mudah terbakar seperti
oksigen; \par\pard\qj \li1778\ri1221\sb41\sl-300\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 2) penanganan bahaya yang terkait dengan konstruksi apapun
di atau yang \line\tab \up0 \expndtw-3\charscalex100 berdekatan dengan bangunan
yang ditempati pasien; \par\pard\qj \li1778\ri1228\sb21\sl-300\slmult0\tx2138
\up0 \expndtw0\charscalex100 3) penyediaan jalan keluar yang aman dan tidak
terhalangi apabila terjadi \line\tab \up0 \expndtw-3\charscalex100 kebakaran;
\par\pard\qj \li1778\ri1228\sb57\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex102
4) penyediaan sistem peringatan dini, deteksi dini seperti detektor asap, alarm
\line\tab \up0 \expndtw-3\charscalex100 kebakaran, dan patroli kebakaran
(\ul0\nosupersub\cf8\f9\fs24 fire patrols\ul0\nosupersub\cf7\f8\fs24 ); dan
\par\pard\qj \li1778\ri1229\sb44\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
5) penyediaan mekanisme pemadaman api seperti selang air, bahan kimia
\line\tab \up0 \expndtw-3\charscalex100 pemadam api (c\ul0\nosupersub\cf8\f9\fs24
hemical suppressants\ul0\nosupersub\cf7\f8\fs24 ), atau
sistem\ul0\nosupersub\cf8\f9\fs24 sprinkler. \par\pard\qj \li1418\ri1213\sb307\sl-
316\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Penggabungan
tindakan-tindakan tersebut saat terjadi kebakaran atau asap akan \line \up0
\expndtw0\charscalex103 membantu memberi waktu yang memadai bagi pasien, keluarga
pasien, staf, dan \line \up0 \expndtw0\charscalex100 pengunjung untuk keluar dengan
selamat dari fasilitas. Tindakan-tindakan tersebut \line \up0
\expndtw0\charscalex103 harus efektif tanpa memandang usia, ukuran, maupun bentuk
bangunan fasilitas. \line \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24
Sebagai contoh\ul0\nosupersub\cf7\f8\fs24 , rumah sakit kecil bertingkat satu dari
batu bata akan menggunakan \line \up0 \expndtw-2\charscalex100 metode berbeda dari
rumah sakit besar bertingkat banyak yang terbuat dari kayu. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb198\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 7
\par\pard\ql \li1778\sb244\sl-276\slmult0\tx8505 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai program proteksi
kebakaran \tab \up0 \expndtw0\charscalex100 (\ul0\nosupersub\cf8\f9\fs24 fire
safety\ul0\nosupersub\cf7\f8\fs24 ) yang \par\pard\qj \li2138\ri1221\sb5\sl-
300\slmult0 \up0 \expndtw0\charscalex103 memastikan bahwa semua penghuni rumah
sakit selamat dari bahaya api, \up0 \expndtw0\charscalex104 asap, atau keadaan
darurat nonkebakaran lainnya meliputi butir 1 sampai \up0 \expndtw-3\charscalex100
dengan 5 yang ada pada maksud dan tujuan. (R) \par\pard\ql \li1778\ri1163\sb161\sl-
300\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 2. Rumah sakit telah
melakukan asesmen risiko kebakaran yang tertulis termasuk \line\tab \up0 \expndtw-
1\charscalex100 saat terdapat proyek pembangunan di dalam atau berdekatan dengan
fasilitas \line \tab \up0 \expndtw-1\charscalex100 rumah sakit meliputi butir 1
sampai dengan 8 pada maksud dan tujuan. (D,W) \par\pard\ql \li1778\sb160\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 3. Rumah sakit telah menindaklanjuti
hasil asesmen risiko kebakaran. (D,O,W) \par\pard\ql \li1778\ri2112\sb165\sl-
300\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 4. Rumah sakit mempunyai
sistem deteksi dini (\ul0\nosupersub\cf8\f9\fs24 smoke
detector\ul0\nosupersub\cf7\f8\fs24 dan\ul0\nosupersub\cf8\f9\fs24 heat \line\tab
\up0 \expndtw-3\charscalex100 detector\ul0\nosupersub\cf7\f8\fs24 ) dan alarm
kebakaran sesuai dengan peraturan perundang-\line \tab \up0 \expndtw-
3\charscalex100 undangan. (O,W) \par\pard\ql \li1778\sb180\sl-276\slmult0 \up0
\expndtw-2\charscalex100 5. Rumah sakit mempunyai sistem kebakaran aktif yang
meliputi\ul0\nosupersub\cf8\f9\fs24 sprinkle\ul0\nosupersub\cf7\f8\fs24 ,
\par\pard\qj \li2138\ri1451\sb5\sl-300\slmult0 \up0 \expndtw-4\charscalex100 APAR,
hidran, dan pompa kebakaran sesuai dengan peraturan perundang\up0 \expndtw-
6\charscalex100 undangan. (O,W) \par\pard\qj \li1778\ri1222\sb177\sl-
280\slmult0\tx2138 \up0 \expndtw0\charscalex100 6. Rumah sakit mempunyai jalur
evakuasi yang aman dan bebas hambatan bila \line\tab \up0 \expndtw-3\charscalex100
terjadi kebakaran serta kedaruratan bukan kebakaran. (O,W) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb117\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 312
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg313}
{\bkmkend Pg313}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb16\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK 7.1 \par\pard\qj
\li1418\ri1219\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menguji secara berkala rencana proteksi
kebakaran dan asap termasuk \up0 \expndtw0\charscalex107 semua alat yang
terkait dengan deteksi dini dan pemadaman serta \up0 \expndtw-
3\charscalex100 mendokumentasikan hasil ujinya. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MFK 7.1 \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Program proteksi kebakaran
(\ul0\nosupersub\cf8\f9\fs24 fire safety\ul0\nosupersub\cf7\f8\fs24 ) rumah sakit
mengidentifikasi: \par\pard\qj \li1778\ri1165\sb25\sl-300\slmult0\tx2138 \up0
\expndtw-3\charscalex100 1. frekuensi dilakukan inspeksi, pengujian, serta
pemeliharaan sistem pencegahan \line\tab \up0 \expndtw-4\charscalex100 dan
keselamatan kebakaran secara konsisten sesuai dengan persyaratan; \par\pard\ql
\li1778\sb80\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. program evakuasi yang
aman jika terjadi kebakaran atau asap; \par\pard\qj \li1778\ri1224\sb25\sl-
300\slmult0\tx2138 \up0 \expndtw0\charscalex103 3. proses pengujian setiap bagian
dari program dalam setiap kurun waktu 12 \line\tab \up0 \expndtw-3\charscalex100
bulan; \par\pard\qj \li1778\ri1227\sb41\sl-300\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 4. edukasi yang diperlukan bagi staf untuk melindungi dan
mengevakuasi pasien \line\tab \up0 \expndtw-2\charscalex100 secara efektif jika
terjadi keadaan darurat. \par\pard\qj \li1778\ri1165\sb21\sl-300\slmult0\tx2138
\up0 \expndtw-3\charscalex100 5. partisipasi anggota staf dalam ujicoba/simulasi
penanganan kebakaran minimal \line\tab \up0 \expndtw-4\charscalex100 sekali tiap
tahunnya. \par\pard\qj \li1418\ri1155\sb0\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Pengujian program dapat dicapai dengan beberapa
metode.\ul0\nosupersub\cf6\f7\fs24 Sebagai contoh\ul0\nosupersub\cf7\f8\fs24 ,
rumah \up0 \expndtw-3\charscalex100 sakit dapat menugaskan \u8216?komandan regu
pemadam kebakaran\u8217? untuk setiap unit yang \up0 \expndtw-1\charscalex100
kemudian menanyakan secara acak kepada staf apa yang akan mereka lakukan bila
\up0 \expndtw-2\charscalex100 terjadi kebakaran di unit mereka. \par\pard\qj
\li1418\ri3071\sb0\sl-340\slmult0\tx1778 \up0 \expndtw-3\charscalex100 Kepada staf
dapat diberikan pertanyaan-pertanyaan spesifik seperti \line\tab \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Di mana letak katup
penutup aliran oksigen? \par\pard\qj \li1778\ri1221\sb0\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Jika harus menutup katup oksigen, bagaimana
Anda merawat pasien yang \line\tab \up0 \expndtw-3\charscalex100 membutuhkan
oksigen? \par\pard\qj \li1778\ri4634\sb0\sl-320\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Di mana letak alat pemadam api di unit Anda? \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Bagaimana
melaporkan kebakaran? \par\pard\qj \li1778\ri1178\sb0\sl-300\slmult0\tx2138 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Bagaimana melindungi pasien jika terjadi
kebakaran? Bila perlu mengevakuasi \line\tab \up0 \expndtw-4\charscalex100 pasien,
proses apa yang harus diikuti? \par\pard\qj \li1418\ri1222\sb247\sl-320\slmult0
\up0 \expndtw0\charscalex103 Staf harus mampu menjawab pertanyaan-pertanyaan
tersebut dengan tepat. Jika \up0 \expndtw0\charscalex105 tidak, hal ini harus
didokumentasikan dan rencana untuk pendidikan ulang perlu \up0
\expndtw0\charscalex100 disusun. \u8220?Komandan Regu penanggulangan pemadam
kebakaran\u8221? harus memiliki \up0 \expndtw0\charscalex100 catatan orang-orang
yang berpartisipasi. Salah satu bagian dari pengujian program \up0
\expndtw0\charscalex102 juga dapat berupa ujian tertulis untuk staf mengenai
penanganan kebakaran yang \up0 \expndtw0\charscalex105 dilakukan oleh rumah
sakit. Semua inspeksi, pengujian, dan pemeliharaan \up0 \expndtw-
3\charscalex100 didokumentasikan. (lihat juga HPK 1.5) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 7.1
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb144\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 313
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg314}
{\bkmkend Pg314}\par\pard\qj \li1778\sb0\sl-280\slmult0 \par\pard\qj\li1778\sb0\sl-
280\slmult0 \par\pard\qj\li1778\sb0\sl-280\slmult0 \par\pard\qj\li1778\sb0\sl-
280\slmult0 \par\pard\qj\li1778\ri1227\sb49\sl-280\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Semua staf mengikuti latihan
penanggulangan kebakaran minimal 1 (satu) kali \line\tab \up0 \expndtw-
2\charscalex100 dalam setahun. (lihat juga MFK 11-MFK 11.3). (D,W) \par\pard\qj
\li1778\ri1228\sb24\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Staf
dapat memperagakan bagaimana cara membawa pasien ke tempat aman \line\tab \up0
\expndtw-3\charscalex100 dan demonstrasikan bagaimana cara menyelamatkan pasien.
(S,W) \par\pard\qj \li1778\ri1227\sb21\sl-300\slmult0\tx2138 \up0 \expndtw-
2\charscalex100 3. Sistem dan peralatan pemadam kebakaran diperiksa, diujicoba,
dan dipelihara \line\tab \up0 \expndtw-3\charscalex100 sesuai dengan peraturan
perundang-undangan dan didokumentasikan. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK 7.2 \par\pard\qj
\li1418\ri1218\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit adalah kawasan tanpa rokok dan asap rokok
sesuai dengan peraturan \up0 \expndtw-2\charscalex100 perundang-undangan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 7.2 \par\pard\qj
\li1418\ri1163\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Sesuai dengan peraturan perundang-undangan, rumah sakit
adalah kawasan tanpa \up0 \expndtw-3\charscalex100 rokok dan asap rokok, karena itu
direktur rumah sakit agar membuat regulasi larangan \up0 \expndtw-4\charscalex100
merokok di rumah sakit termasuk larangan menjual rokok di rumah sakit. \par\pard\qj
\li1418\ri1221\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex104 Larangan merokok
penting dilaksanakan di rumah sakit karena rumah sakit \up0
\expndtw0\charscalex100 merupakan daerah yang berisiko terjadi kebakaran dan banyak
bahan yang mudah \up0 \expndtw-3\charscalex100 terbakar di rumah sakit (misalnya
gas oksigen). \par\pard\qj \li1418\ri1216\sb200\sl-320\slmult0 \up0
\expndtw0\charscalex104 Regulasi larangan merokok tidak hanya untuk staf rumah
sakit, tetapi juga untuk \up0 \expndtw0\charscalex104 pasien, keluarga, dan
pengunjung. Rumah sakit secara berkala perlu melakukan \up0 \expndtw-
3\charscalex100 monitoring pelaksanaan larangan merokok di lingkungan rumah
sakit. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 7.2 \par\pard\ql
\li1778\ri1213\sb205\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi rumah sakit sebagai
kawasan tanpa rokok \line\tab \up0 \expndtw0\charscalex100 dan asap rokok, serta
larangan merokok bagi pasien, keluarga, pengunjung, \line \tab \up0 \expndtw-
2\charscalex100 dan staf termasuk larangan menjual rokok di lingkungan rumah sakit.
(R) \par\pard\ql \li1778\sb180\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2.
Regulasi larangan merokok telah dilaksanakan dan dievaluasi. (D,O,W)
\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb152\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PERALATAN MEDIS
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb152\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar MFK
8 \par\pard\qj \li1418\ri1244\sb225\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit merencanakan dan mengimplementasikan
program untuk pemeriksaan, \up0 \expndtw-2\charscalex100 uji coba, serta
pemeliharaan peralatan medis dan mendokumentasikan hasilnya. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb128\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 8 \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb57\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 314
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg315}
{\bkmkend Pg315}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1222\sb253\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Untuk menjamin peralatan medis dapat digunakan dan
layak pakai maka rumah sakit \up0 \expndtw-3\charscalex100 perlu melakukan
\par\pard\ql \li1778\ri1223\sb221\sl-300\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 a) melakukan inventarisasi peralatan medis yang meliputi
peralatan medis yang \line\tab \up0 \expndtw0\charscalex102 dimilik oleh rumah
sakit dan peralatan medis kerja sama operasional (KSO) \line \tab \up0 \expndtw-
3\charscalex100 milik pihak ketiga; \par\pard\qj \li1778\ri1221\sb161\sl-
300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 b) melakukan pemeriksaan
peralatan medis sesuai dengan penggunaan dan \line\tab \up0 \expndtw-
3\charscalex100 ketentuan pabrik; \par\pard\ql \li1778\sb180\sl-276\slmult0 \up0
\expndtw-3\charscalex100 c) melaksanakan pemeliharaan preventif dan kalibrasi.
\par\pard\qj \li1418\ri1157\sb151\sl-316\slmult0 \up0 \expndtw-1\charscalex100 Staf
yang kompeten melaksanakan kegiatan ini. Peralatan diperiksa dan diuji fungsi
\line \up0 \expndtw-1\charscalex100 sejak masih baru dan seterusnya sesuai umur,
penggunaan peralatan tersebut, atau \line \up0 \expndtw-4\charscalex100 sesuai
dengan ketentuan pabrik. Pemeriksaan, hasil uji fungsi, dan setiap kali tindakan
\line \up0 \expndtw-3\charscalex100 pemeliharaan didokumentasikan. Hal ini membantu
memastikan kelangsungan proses \line \up0 \expndtw-1\charscalex100 pemeliharaan dan
juga membantu bila menyusun rencana biaya untuk penggantian, \line \up0 \expndtw-
3\charscalex100 perbaikan, peningkatan (\ul0\nosupersub\cf8\f9\fs24
upgrade\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 dan perubahan lain. (lihat juga AP 6.5, maksud dan
\line \up0 \expndtw-4\charscalex100 tujuan) \par\pard\qj \li1418\ri1226\sb207\sl-
313\slmult0 \up0 \expndtw-1\charscalex100 Rumah sakit mempunyai proses
identifikasi, penarikan dan pengembalian, atau \up0 \expndtw-2\charscalex100
pemusnahan produk dan peralatan medis yang ditarik kembali oleh pabrik
atau \up0 \expndtw0\charscalex102 pemasok. Ada kebijakan atau prosedur yang
mengatur penggunaan setiap produk \up0 \expndtw-3\charscalex100 atau peralatan yang
ditarik kembali\ul0\nosupersub\cf8\f9\fs24 (under
recall\ul0\nosupersub\cf7\f8\fs24 ). \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb206\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 8
\par\pard\ql \li1778\ri1163\sb225\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi
pengelolaan peralatan medis yang digunakan \line\tab \up0 \expndtw0\charscalex100
di rumah sakit yang meliputi butir 1 sampai dengan 4 yang ada pada maksud \line
\tab \up0 \expndtw-3\charscalex100 dan tujuan. (lihat juga AP 5.4; EP 1; dan AP
6.5; EP 1). (R) \par\pard\qj \li1778\ri1223\sb161\sl-300\slmult0\tx2138 \up0
\expndtw-2\charscalex100
2. Ada daftar inventaris dan identifikasi risiko untuk seluruh peralatan medis
yang \line\tab \up0 \expndtw-2\charscalex100 digunakan di rumah sakit. (lihat juga
AP 5.4; EP 3; dan AP 6.5; EP 4). (D,W) \par\pard\qj \li1778\ri1167\sb141\sl-
300\slmult0\tx2138 \up0 \expndtw-3\charscalex100 3. Ada bukti peralatan medis
diperiksa secara teratur. (lihat juga AP 5.4; EP 4; dan \line\tab \up0 \expndtw-
4\charscalex100 AP 6.5, EP 4). (D,O,W) \par\pard\qj \li1778\ri1213\sb161\sl-
300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 4. Peralatan medis diuji fungsi
sejak baru dan sesuai dengan umur, penggunaan, \line\tab \up0 \expndtw-
2\charscalex100 dan rekomendasi pabrik .(lihat juga AP 5.4; EP 5; dan AP 6.5, EP
5). (D,W) \par\pard\qj \li1778\ri1167\sb161\sl-300\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 5. Ada program pemeliharaan preventif dan kalibrasi. (lihat juga
AP 5.4; EP 6; dan \line\tab \up0 \expndtw-4\charscalex100 AP 6.5, EP 6). (D,O,W)
\par\pard\ql \li1778\sb180\sl-276\slmult0 \up0 \expndtw-2\charscalex100 6. Staf
yang kompeten melaksanakan kegiatan ini. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb152\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK
8.1 \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb44\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 315
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg316}
{\bkmkend Pg316}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1225\sb253\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memiliki sistem untuk memantau dan
bertindak bila ada pemberitahuan \line \up0 \expndtw-1\charscalex100 peralatan
medis yang berbahaya,\ul0\nosupersub\cf8\f9\fs24 re-
call\ul0\nosupersub\cf7\f8\fs24 , laporan insiden, masalah, dan kegagalan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 8.1
\par\pard\qj \li1418\ri1211\sb11\sl-316\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mencari informasi terkait dengan peralatan
medis yang telah di-\ul0\nosupersub\cf8\f9\fs24 re-call \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 dari sumber-sumber tepercaya. Rumah
sakit memiliki sebuah sistem yang diterapkan \up0 \expndtw0\charscalex103 untuk
pemantauan dan pengambilan tindakan terhadap pemberitahuan mengenai \up0
\expndtw0\charscalex100 peralatan medis yang berbahaya,\ul0\nosupersub\cf8\f9\fs24
re-call\ul0\nosupersub\cf7\f8\fs24 (cacat produksi), laporan insiden, masalah,
\up0 \expndtw0\charscalex100 dan kegagalan yang dikirimkan oleh produsen, pemasok
atau agen yang mengatur. \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24
Re-call\ul0\nosupersub\cf7\f8\fs24 adalah penarikan kembali oleh produsen karena
ada cacat. \par\pard\qj \li1418\ri1218\sb201\sl-320\slmult0 \up0
\expndtw0\charscalex100 Sejumlah negara mempersyaratkan pelaporan perlatan medis
yang mengakibatkan \up0 \expndtw-1\charscalex100 kematian, cedera serius, atau
penyakit. Rumah sakit harus mengidentifikasi dan \up0 \expndtw0\charscalex103
mematuhi peraturan dan perundang-undangan yang berlaku dalam hal pelaporan \up0
\expndtw0\charscalex105 insiden peralatan medis. Program pengelolaan peralatan
medis membahas \up0 \expndtw0\charscalex100 penggunaan semua peralatan medis yang
sudah dilaporkan memiliki masalah atau \up0 \expndtw-1\charscalex100 kegagalan,
atau alat dalam kondisi bahaya bila digunakan, atau dalam proses \up0
\expndtw-3\charscalex100 penarikan. (lihat juga AP 5.5 dan AP 6.5) \par\pard\ql
\li1418\sb217\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 8.1 \par\pard\ql
\li1778\ri1213\sb208\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai sistem pemantauan dan
bertindak terhadap \line\tab \up0 \expndtw0\charscalex100 pemberitahuan mengenai
peralatan medis yang berbahaya,\ul0\nosupersub\cf8\f9\fs24
recall\ul0\nosupersub\cf7\f8\fs24 /penarikan \line \tab \up0 \expndtw-
2\charscalex100 kembali, laporan insiden, masalah, dan kegagalan pada peralatan
medis. (R) \par\pard\ql \li1778\ri1217\sb20\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw-2\charscalex100 2. Rumah sakit membahas pemberitahuan peralatan medis
yang berbahaya, alat \line\tab \up0 \expndtw0\charscalex104 medis dalam
penarikan\ul0\nosupersub\cf8\f9\fs24 (under recall),\ul0\nosupersub\cf7\f8\fs24
laporan insiden, serta masalah dan \line \tab \up0 \expndtw-3\charscalex100
kegagalan pada peralatan medis. (D,W) \par\pard\ql \li1778\ri1225\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex103 3. Rumah sakit telah
melaporkan seluruh insiden keselamatan sesuai dengan \line\tab \up0 \expndtw-
1\charscalex100 peraturan perundang-undangan bila terjadi kematian, cedera
serius, atau \line \tab \up0 \expndtw-3\charscalex100 penyakit yang disebabkan
oleh peralatan medis. (D,W) \par\pard\ql \li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb121\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 SISTEM UTILITAS
(SISTEM PENUNJANG) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb152\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar MFK 9 \par\pard\qj \li1418\ri1226\sb225\sl-
300\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan dan melaksanakan program untuk memastikan semua \line \up0 \expndtw-
2\charscalex100 sistem utilitas \up0 \expndtw-2\charscalex100 (sistem pendukung)
berfungsi efisien dan efektif yang meliputi \par\pard\ql \li1418\sb40\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 pemeriksaan, pemeliharaan, dan perbaikan
sistem utilitas. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb12\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 9
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1228\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Definisi
utilitas adalah sistem dan peralatan untuk mendukung layanan penting bagi \line
\up0 \expndtw-2\charscalex100 keselamatan pasien. Sistem utilitas sering
disebut sistem penunjang. Sistem ini \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb143\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 316
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg317}
{\bkmkend Pg317}\par\pard\qj \li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\sb0\sl-
317\slmult0 \par\pard\qj\li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\ri1167\sb188\sl-317\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 mencakup jaringan listrik, air, ventilasi dan aliran
udara, gas medik, perpipaan, uap \up0 \expndtw-3\charscalex100 panas, limbah, serta
sistem komunikasi dan data. Sistem utilitas yang berfungsi efektif \up0
\expndtw0\charscalex100 di semua tempat di rumah sakit menciptakan lingkungan
asuhan pasien yang baik. \up0 \expndtw0\charscalex103 Untuk memenuhi kebutuhan
pasien, keluarga pasien, pengunjung, dan staf maka \up0 \expndtw-2\charscalex100
sistem utilitas harus dapat berfungsi efisien. Asuhan pasien rutin dan darurat
berjalan \up0 \expndtw-1\charscalex100 selama 24 jam terus menerus, setiap hari,
dalam waktu 7 hari dalam seminggu. Jadi, \up0 \expndtw0\charscalex100 kesinambungan
fungsi utilitas merupakan hal esensial untuk memenuhi kebutuhan \up0
\expndtw0\charscalex100 pasien. Termasuk listrik dan air harus tersedia selama 24
jam terus menerus, setiap \up0 \expndtw-3\charscalex100 hari, dalam waktu 7 hari
dalam seminggu. \par\pard\qj \li1418\ri1176\sb183\sl-317\slmult0 \up0
\expndtw0\charscalex100 Manajemen utilitas yang baik dapat menghasilkan sistem
utilitas berjalan efektif dan \up0 \expndtw0\charscalex104 mengurangi potensi
risiko yang timbul. Sebagai contoh, kontaminasi berasal dari \up0
\expndtw0\charscalex103 sampah di daerah persiapan makanan, kurangnya ventilasi di
laboratorium klinik, \up0 \expndtw-2\charscalex100 tabung oksigen yang disimpan
tidak terjaga dengan baik, kabel listrik bergelantungan, \up0
\expndtw0\charscalex100 serta dapat menimbulkan bahaya. Untuk menghindari kejadian
ini maka rumah sakit \up0 \expndtw-1\charscalex100 harus melakukan pemeriksaan
berkala, pemeliharan preventif, dan pemeliharan \up0 \expndtw0\charscalex100
lainnya. Sewaktu pengujian perhatian ditujukan pada komponen kritikal
sistem \up0 \expndtw-3\charscalex100 (contoh, sakelar,\ul0\nosupersub\cf8\f9\fs24
relay\ul0\nosupersub\cf7\f8\fs24 /penyambung, dll.). \par\pard\qj
\li1418\ri1220\sb201\sl-320\slmult0 \up0 \expndtw0\charscalex104 Karena itu, rumah
sakit perlu regulasi pengelolaan sistem utilitas yang sekurang\up0 \expndtw-
3\charscalex100 kurangnya meliputi \par\pard\qj \li1778\ri1179\sb217\sl-
300\slmult0\tx2138 \up0 \expndtw-3\charscalex100 a) ketersediaan air dan listrik
24 jam setiap hari dan dalam waktu tujuh hari dalam \line\tab \up0 \expndtw-
4\charscalex100 seminggu secara terus menerus; \par\pard\qj
\li1778\ri1222\sb161\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex102 b) membuat
daftar inventaris komponen-komponen sistem utilitas, memetakan \line\tab \up0
\expndtw-3\charscalex100 pendistribusiannya, dan
melakukan\ul0\nosupersub\cf8\f9\fs24 update\ul0\nosupersub\cf7\f8\fs24 secara
berkala; \par\pard\qj \li1778\ri1226\sb177\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex102
c) pemeriksaan, pemeliharaan, serta perbaikan semua komponen utilitas yang
\line\tab \up0 \expndtw-3\charscalex100 ada di daftar inventaris; \par\pard\ql
\li1778\ri1222\sb192\sl-290\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 d)
jadwal pemeriksaan, testing, dan pemeliharaan semua sistem utilitas berdasar
\line\tab \up0 \expndtw0\charscalex102 atas kriteria seperti rekomendasi dari
pabrik, tingkat risiko, dan pengalaman \line \tab \up0 \expndtw-3\charscalex100
rumah sakit; \par\pard\qj \li1778\ri1221\sb162\sl-300\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 e) pelabelan pada tuas-tuas kontrol sistem utilitas untuk membantu
pemadaman \line\tab \up0 \expndtw-3\charscalex100 darurat secara keseluruhan atau
sebagian. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb148\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 9 \par\pard\ql
\li1778\ri1213\sb233\sl-290\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai sistem pemantauan dan
bertindak terhadap \line\tab \up0 \expndtw0\charscalex100 pemberitahuan mengenai
peralatan medis yang berbahaya,\ul0\nosupersub\cf8\f9\fs24
recall\ul0\nosupersub\cf7\f8\fs24 /penarikan \line \tab \up0 \expndtw-
2\charscalex100 kembali, laporan insiden, masalah, dan kegagalan pada peralatan
medis. (R) \par\pard\ql \li1778\ri1224\sb2\sl-300\slmult0\tx2138\tx2138 \up0
\expndtw-2\charscalex100 2. Rumah sakit membahas pemberitahuan peralatan medis
yang berbahaya, alat \line\tab \up0 \expndtw0\charscalex104 medis dalam penarikan
(\ul0\nosupersub\cf8\f9\fs24 under
recall\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 laporan insiden, serta masalah dan \line \tab \up0
\expndtw-3\charscalex100 kegagalan pada peralatan medis. (D,W) \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb153\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 317
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg318}
{\bkmkend Pg318}\par\pard\ql \li1778\sb0\sl-290\slmult0 \par\pard\ql\li1778\sb0\sl-
290\slmult0 \par\pard\ql\li1778\sb0\sl-290\slmult0 \par\pard\ql\li1778\sb0\sl-
290\slmult0 \par\pard\ql\li1778\ri1225\sb1\sl-290\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 3. Rumah sakit telah
melaporkan seluruh insiden keselamatan sesuai dengan \line\tab \up0
\expndtw0\charscalex100 peraturan perundang-undangan apabila terjadi kematian,
cedera serius, atau \line \tab \up0 \expndtw-3\charscalex100 penyakit yang
disebabkan oleh peralatan medis. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb110\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK 9.1
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Dilakukan pemeriksaan,
pemeliharaan, dan perbaikan sistem utilitas. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 9.1
\par\pard\qj \li1418\ri1221\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit harus mempunyai daftar inventaris
lengkap sistem utilitas dan \line \up0 \expndtw-1\charscalex100 menentukan
komponen yang berdampak pada bantuan hidup, pengendalian infeksi, \line \up0
\expndtw0\charscalex102 pendukung lingkungan, dan komunikasi. Program menajemen
utilitas menetapkan \line \up0 \expndtw-2\charscalex100 pemeliharaan utilitas
untuk memastikan utilitas pokok/penting seperti air, listrik, \line \up0
\expndtw0\charscalex104 sampah, ventilasi, gas medik, lift agar dijaga,
diperiksa berkala, dipelihara, dan \line \up0 \expndtw-3\charscalex100
diperbaiki. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb185\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 9.1
\par\pard\ql \li1778\ri1222\sb225\sl-300\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai
regulasi inventarisasi, pemeliharaan, dan inspeksi \line\tab \up0
\expndtw0\charscalex102 dengan kriteria yang ditentukan untuk sistem utilitas
penting yang dilakukan \line \tab \up0 \expndtw-3\charscalex100 secara berkala. (R)
\par\pard\qj \li1778\ri1227\sb161\sl-300\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 2. Rumah sakit mempunyai daftar sistem utilitas di rumah sakit dan
daftar sistem \line\tab \up0 \expndtw-2\charscalex100 utilitas penting. (D,W)
\par\pard\qj \li1778\ri1225\sb161\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex103 3. Sistem utilitas dan komponen telah diinspeksi secara
teratur/berdasar atas \line\tab \up0 \expndtw-3\charscalex100 kriteria yang disusun
rumah sakit. (D,O) \par\pard\qj \li1778\ri1230\sb177\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex100 4. Sistem utilitas dan komponen diuji secara teratur
berdasar atas kriteria yang \line\tab \up0 \expndtw-3\charscalex100 sudah
ditetapkan. (D,W) \par\pard\qj \li1778\ri1227\sb164\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex104 5. Sistem utilitas dan komponen dipelihara berdasar atas
kriteria yang sudah \line\tab \up0 \expndtw-3\charscalex100 ditetapkan. (D,O)
\par\pard\ql \li1778\sb180\sl-276\slmult0 \up0 \expndtw-3\charscalex100 6. Sistem
utilitas dan komponen diperbaiki bila diperlukan. (D,O) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb152\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MFK 9.2 \par\pard\qj \li1418\ri1162\sb208\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Sistem
utilitas rumah sakit menjamin tersedianya air bersih dan listrik sepanjang waktu
\up0 \expndtw0\charscalex105 serta menyediakan sumber alternatif persediaan air dan
tenaga listrik jika terjadi \up0 \expndtw-3\charscalex100 terputusnya sistem,
kontaminasi, atau kegagalan. \par\pard\ql \li1418\sb217\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 9.2
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb217\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 318
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg319}
{\bkmkend Pg319}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0\tx5666 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pelayanan pasien dilakukan selama
\tab \up0 \expndtw0\charscalex100 24 jam terus menerus, setiap hari dalam
\par\pard\qj \li1418\ri1156\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex103
seminggu di rumah sakit. Rumah sakit mempunyai kebutuhan sistem utilitas yang \line
\up0 \expndtw0\charscalex103 berbeda-beda bergantung pada misi rumah sakit,
kebutuhan pasien, dan sumber \line \up0 \expndtw0\charscalex100 daya. Walaupun
begitu, pasokan sumber air bersih dan listrik terus menerus sangat \line \up0
\expndtw-3\charscalex100 penting untuk memenuhi kebutuhan pasien. Rumah sakit harus
melindungi pasien dan \line \up0 \expndtw0\charscalex103 staf dalam keadaan darurat
seperti jika terjadi kegagalan sistem, pemutusan, dan \line \up0 \expndtw-
3\charscalex100 kontaminasi. \par\pard\qj \li1418\ri1175\sb191\sl-317\slmult0
\up0 \expndtw0\charscalex103 Sistem tenaga listrik darurat dibutuhkan oleh
semua rumah sakit yang ingin \line \up0 \expndtw0\charscalex104 memberikan
asuhan kepada pasien tanpa putus dalam keadaan darurat. Sistem \line \up0 \expndtw-
2\charscalex100 darurat ini memberikan cukup tenaga listrik untuk
mempertahankan fungsi yang \line \up0 \expndtw-2\charscalex100 esensial dalam
keadaan darurat dan juga menurunkan risiko terkait terjadi kegagalan. \line \up0
\expndtw0\charscalex100 Tenaga listrik cadangan dan darurat harus dites sesuai
dengan rencana yang dapat \line \up0 \expndtw-1\charscalex100 membuktikan beban
tenaga listrik memang seperti yang dibutuhkan. Perbaikan \line \up0
\expndtw0\charscalex104 dilakukan jika dibutuhkan
seperti\ul0\nosupersub\cf6\f7\fs24 menambah kapasitas listrik di area dengan
\line \up0 \expndtw-3\charscalex100 peralatan baru. \par\pard\qj
\li1418\ri1158\sb207\sl-313\slmult0 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 Mutu air dapat berubah mendadak karena banyak sebab,
tetapi sebagian besar \up0 \expndtw-2\charscalex100 karena terjadi di luar rumah
sakit seperti ada kebocoran di jalur suplai ke rumah sakit. \up0 \expndtw-
3\charscalex100 Jika terjadi suplai air ke rumah sakit terputus maka persediaan air
bersih darurat harus \up0 \expndtw-4\charscalex100 tersedia segera. \par\pard\qj
\li1418\ri1224\sb202\sl-320\slmult0 \up0 \expndtw0\charscalex100 Untuk
mempersiapkan diri terhadap keadaan darurat seperti ini, rumah sakit agar \up0
\expndtw-3\charscalex100 mempunyai regulasi yang antara lain meliputi
\par\pard\ql \li1778\ri1219\sb17\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 a) mengidentifikasi peralatan, sistem, serta area yang memiliki
risiko paling tinggi \line\tab \up0 \expndtw0\charscalex100 terhadap pasien dan
staf (sebagai contoh, rumah sakit mengidentifikasi area \line \tab \up0
\expndtw0\charscalex100 yang membutuhkan penerangan, pendinginan \up0
\expndtw0\charscalex100 (lemari es),\ul0\nosupersub\cf6\f7\fs24 bantuan
\par\pard\ql \li2138\sb20\sl-276\slmult0 \up0 \expndtw-2\charscalex100
hidup/ventilator\ul0\nosupersub\cf7\f8\fs24 ,
serta air bersih untuk membersihkan dan sterilisasi alat); \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
b)\ul0\nosupersub\cf6\f7\fs24 menyediakan air bersih dan listrik 24 jam setiap
hari dan 7 hari seminggu; \par\pard\qj \li1778\ri1226\sb61\sl-280\slmult0\tx2138
\up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 c) menguji ketersediaan
serta kehandalan sumber tenaga listrik dan air bersih \line\tab \up0 \expndtw-
3\charscalex100 darurat/pengganti/\ul0\nosupersub\cf8\f9\fs24 back-
up\ul0\nosupersub\cf7\f8\fs24 ; \par\pard\ql \li1778\sb64\sl-276\slmult0 \up0
\expndtw-3\charscalex100 d) mendokumentasikan hasil-hasil pengujian;
\par\pard\ql \li1778\ri1219\sb9\sl-295\slmult0\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw-1\charscalex100 e) memastikan bahwa pengujian sumber alternatif air
bersih dan listrik dilakukan \line\tab \up0 \expndtw-1\charscalex100 setidaknya
setiap 6 bulan atau lebih sering jika dipersyaratkan oleh peraturan \line \tab \up0
\expndtw0\charscalex100 perundang-undangan di daerah, rekomendasi produsen, atau
kondisi sumber \line \tab \up0 \expndtw-2\charscalex100 listrik dan air. Kondisi
sumber listrik dan air yang mungkin dapat meningkatkan \line \tab \up0 \expndtw-
3\charscalex100 frekuensi pengujian mencakup \par\pard\qj \li2138\ri3301\sb0\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf13\f14\fs24
o\ul0\nosupersub\cf7\f8\fs24 perbaikan sistem air bersih yang terjadi berulang-
ulang; \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf13\f14\fs24
o\ul0\nosupersub\cf7\f8\fs24 sumber air bersih sering terkontaminasi;
\par\pard\ql \li2138\sb22\sl-276\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24 jaringan listrik yang
tidak dapat diandalkan \par\pard\ql \li2138\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf13\f14\fs24 o\ul0\nosupersub\cf7\f8\fs24
pemadaman listrik yang tidak terduga dan berulang-ulang. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb248\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 9.2
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb144\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 319
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg320}
{\bkmkend Pg320}\par\pard\qj \li1778\sb0\sl-280\slmult0 \par\pard\qj\li1778\sb0\sl-
280\slmult0 \par\pard\qj\li1778\sb0\sl-280\slmult0 \par\pard\qj\li1778\sb0\sl-
280\slmult0 \par\pard\qj\li1778\ri1225\sb49\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai
regulasi sistem utilitas yang meliputi butir 1 sampai \line\tab \up0 \expndtw-
3\charscalex100 dengan 5 pada maksud dan tujuan. (R) \par\pard\qj
\li1778\ri1230\sb164\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex102 2. Air
bersih harus tersedia selama 24 jam setiap hari, 7 hari dalam seminggu.
\line\tab \up0 \expndtw-2\charscalex100 (O,W) \par\pard\ql \li1778\sb180\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 3. Listrik tersedia 24 jam setiap hari,
7 hari dalam seminggu. (O,W) \par\pard\ql \li1778\ri1223\sb165\sl-
300\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 4. Rumah sakit
mengidentifikasi area dan pelayanan yang berisiko paling tinggi \line\tab \up0
\expndtw0\charscalex104 bila terjadi kegagalan listrik atau air bersih
terkontaminasi atau terganggu. \line \tab \up0 \expndtw-2\charscalex100 (D,W)
\par\pard\qj \li1778\ri1226\sb177\sl-280\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 5. Rumah sakit berupaya mengurangi risiko bila hal itu terjadi
(tata kelola risiko). \line\tab \up0 \expndtw-2\charscalex100 (D,W) \par\pard\qj
\li1778\ri1220\sb201\sl-280\slmult0\tx2138 \up0 \expndtw-2\charscalex100 6. Rumah
sakit mempunyai sumber listrik dan air bersih alternatif dalam keadaan \line\tab
\up0 \expndtw-3\charscalex100 emergensi. (D,W,O) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb152\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK
9.2.1 \par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melakukan uji coba/uji beban sumber
listrik dan sumber air alternatif. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb212\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK
9.2.1 \par\pard\qj \li1418\ri1225\sb208\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit melakukan asesmen risiko
dan meminimalisasi risiko kegagalan sistem \up0 \expndtw-3\charscalex100 utilitas
di area-area tersebut. \par\pard\qj \li1418\ri1158\sb22\sl-318\slmult0 \up0
\expndtw0\charscalex100 Rumah sakit merencanakan tenaga listrik darurat (dengan
menyiapkan genset) dan \line \up0 \expndtw0\charscalex100 penyediaan sumber air
bersih darurat untuk area-area yang membutuhkan. Untuk \line \up0 \expndtw-
3\charscalex100 memastikan kapasitas beban yang dapat dicapai oleh unit genset
apakah benar-benar \line \up0 \expndtw-2\charscalex100 mampu mencapai beban
tertinggi maka pada waktu pembelian unit genset, dilakukan \line \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Test
Loading\ul0\nosupersub\cf7\f8\fs24 dengan menggunakan alat yang
bernama\ul0\nosupersub\cf6\f7\fs24 Dummy Load.\ul0\nosupersub\cf7\f8\fs24 Selain
itu, \line \up0 \expndtw-3\charscalex100 rumah sakit melaksanakan uji coba sumber
listrik alternatif sekurangnya 6 bulan sekali \line \up0 \expndtw-2\charscalex100
atau lebih sering bila diharuskan oleh peraturan perundang-undangan atau
oleh \line \up0 \expndtw0\charscalex100 kondisi sumber listrik. Jika sistem listrik
darurat membutuhkan sumber bahan bakar \line \up0 \expndtw-1\charscalex100 maka
jumlah tempat penyimpanan bahan bakar perlu dipertimbangkan. Rumah sakit \line \up0
\expndtw-3\charscalex100 dapat menentukan jumlah bahan bakar yang disimpan, kecuali
ada ketentuan lain dari \line \up0 \expndtw-4\charscalex100 pihak berwenang.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb141\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK
9.2.1 \par\pard\ql \li1778\ri1166\sb233\sl-290\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi uji
coba sumber air bersih dan listrik alternatif \line\tab \up0
\expndtw0\charscalex102 sekurangnya 6 bulan sekali atau lebih sering bila
diharuskan oleh peraturan \line \tab \up0 \expndtw-3\charscalex100 perundang-
undanganan yang berlaku atau oleh kondisi sumber air. (R)
\par\pard\li1778\sb196\sl-276\slmult0\fi0 \up0 \expndtw0\charscalex100 2. Rumah
sakit mendokumentasi hasil uji coba sumber air bersih
alternatif\par\pard\li1778\sb19\sl-276\slmult0\fi360\tx3206 \up0 \expndtw-
1\charscalex100 tersebut.\tab \up0 \expndtw-1\charscalex100 (D,W)\par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb101\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 320
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg321}
{\bkmkend Pg321}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Rumah sakit mendokumentasi hasil
uji sumber listrik alternatif tersebut. (D,W) \par\pard\qj \li1778\ri1228\sb181\sl-
280\slmult0\tx2138 \up0 \expndtw0\charscalex100 4. Rumah sakit mempunyai tempat
dan jumlah bahan bakar untuk sumber listrik \line\tab \up0 \expndtw-3\charscalex100
alternatif yang mencukupi. (O,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb152\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK 9.3
\par\pard\qj \li1418\ri1218\sb208\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melakukan pemeriksaan air bersih dan air
limbah secara berkala sesuai \up0 \expndtw-3\charscalex100 dengan peraturan dan
perundang-undangan. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 9.3
\par\pard\qj \li1418\ri1166\sb212\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Seperti dijelaskan di MFK 9.2 dan MFK 9.2.1, mutu air
rentan terhadap perobahan \line \up0 \expndtw-3\charscalex100 yang mendadak,
termasuk perobahan di luar kontrol rumah sakit. Mutu air juga kritikal \line
\up0 \expndtw0\charscalex103 di dalam proses asuhan klinik seperti pada
dialisis ginjal. Jadi, rumah sakit \line \up0 \expndtw0\charscalex102
menetapkan proses monitor mutu air termasuk tes (pemeriksaan) biologik air yang
\line \up0 \expndtw-2\charscalex100 dipakai untuk dialisis ginjal. Tindakan
dilakukan jika mutu air ditemukan tidak aman. \par\pard\qj \li1418\ri1164\sb204\sl-
317\slmult0 \up0 \expndtw0\charscalex100 Monitor dilakukan paling
sedikit\ul0\nosupersub\cf6\f7\fs24 3 bulan sekali\ul0\nosupersub\cf7\f8\fs24 atau
lebih cepat mengikuti peraturan \line \up0 \expndtw-3\charscalex100 perundang-
undangan, kondisi sumber air, dan pengalaman yang lalu dengan masalah \line \up0
\expndtw-4\charscalex100 mutu air. Monitor dapat dilakukan oleh perorangan yang
ditetapkan rumah sakit seperti \line \up0 \expndtw-3\charscalex100 staf dari
laboratorium klinik, atau oleh dinas kesehatan, atau pemeriksa air pemerintah \line
\up0 \expndtw-2\charscalex100 di luar rumah sakit yang kompeten untuk melakukan
pemeriksaan seperti itu. Apakah \line \up0 \expndtw0\charscalex100
diperiksa oleh staf rumah sakit atau oleh otoritas di luar rumah sakit maka
tanggung \line \up0 \expndtw0\charscalex104 jawab rumah sakit adalah memastikan
pemeriksaan (tes) dilakukan lengkap dan \line \up0 \expndtw-3\charscalex100
tercatat dalam dokumen. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 Karena itu, rumah sakit perlu mempunyai regulasi sekurang-kurangnya
meliputi \par\pard\ql \li1778\ri1221\sb229\sl-
295\slmult0\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-1\charscalex100 a)
pelaksanaan monitoring mutu air bersih paling sedikit satu tahun sekali. Untuk
\line\tab \up0 \expndtw0\charscalex100 pemeriksaan kimia minimal setiap 6 bulan
atau lebih sering bergantung pada \line \tab \up0 \expndtw0\charscalex103 ketentuan
peraturan perundang-undangan, kondisi sumber air, dan \line \tab \up0
\expndtw0\charscalex100 pengalaman sebelumnya dengan masalah mutu air.
Hasil pemeriksaan \line \tab \up0 \expndtw-3\charscalex100 didokumentasikan;
\par\pard\ql \li1778\ri1217\sb161\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 b) pemeriksaan air limbah dilakukan setiap 3 bulan atau lebih
sering bergantung \line\tab \up0 \expndtw0\charscalex100 pada peraturan
perundang-undangan, kondisi sumber air, dan hasil \line \tab \up0
\expndtw-2\charscalex100 pemeriksaan air terakhir bermasalah. Hasil pemeriksaan
didokumentasikan; \par\pard\ql \li1778\ri1219\sb161\sl-300\slmult0\tx2138\tx2138
\up0 \expndtw0\charscalex100 c) pemeriksaan mutu air yang digunakan untuk dialisis
ginjal setiap bulan untuk \line\tab \up0 \expndtw-2\charscalex100 menilai
pertumbuhan bakteri dan endotoksin. Pemeriksaan tahunan untuk \line \tab \up0
\expndtw-3\charscalex100 menilai kontaminasi zat kimia. Hasil pemeriksaan
didokumentasikan. \par\pard\ql \li1778\sb160\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 d) melakukan monitoring hasil pemeriksaan air dan perbaikan bila
diperlukan. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb152\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 9.3 \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb17\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 321
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg322}
{\bkmkend Pg322}\par\pard\qj \li1778\sb0\sl-280\slmult0 \par\pard\qj\li1778\sb0\sl-
280\slmult0 \par\pard\qj\li1778\sb0\sl-280\slmult0 \par\pard\qj\li1778\sb0\sl-
280\slmult0 \par\pard\qj\li1778\ri1218\sb49\sl-280\slmult0\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi
sekurang-kurangnya meliputi butir 1 sampai \line\tab \up0 \expndtw-3\charscalex100
dengan 4 pada maksud dan tujuan. (R) \par\pard\qj \li1778\ri1226\sb164\sl-
300\slmult0\tx2138 \up0 \expndtw0\charscalex103 2. Rumah sakit telah melakukan
monitoring mutu air sesuai dengan peraturan \line\tab \up0 \expndtw-3\charscalex100
perundang-undangan dan terdokumentasi. (D,W) \par\pard\qj \li1778\ri1179\sb161\sl-
300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Rumah sakit telah melakukan
pemeriksaan air limbah sesuai dengan peraturan \line\tab \up0 \expndtw-
3\charscalex100 perundang-undangan dan terdokumentasi. (D,W) \par\pard\ql
\li1778\ri1219\sb161\sl-300\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex103 4. Rumah sakit telah melakukan pemeriksaan mutu air yang
digunakan untuk \line\tab \up0 \expndtw0\charscalex103 dialisis ginjal yang
meliputi pertumbuhan bakteri dan endotoksin serta \line \tab \up0 \expndtw-
2\charscalex100 kontaminasi zat kimia sesuai dengan peraturan perundang-
undangan dan \line \tab \up0 \expndtw-3\charscalex100 terdokumentasi. (D,W)
\par\pard\qj \li1778\ri1228\sb141\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex100 5. Rumah sakit telah menindaklanjuti hasil
pemeriksaan mutu air yang \line\tab \up0 \expndtw-3\charscalex100 bermasalah dan
didokumentasikan. (D,W) \par\pard\qj \li1418\sb0\sl-460\slmult0
\par\pard\qj\li1418\ri1290\sb88\sl-460\slmult0\fi360 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
MONITORING PROGRAM MANAJEMEN FASILITAS DAN KESELAMATAN \up0 \expndtw-
3\charscalex100 Standar MFK 10 \par\pard\qj \li1418\ri1155\sb176\sl-320\slmult0
\up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengumpulkan
data dari setiap program manajemen risiko fasilitas dan \up0 \expndtw-
3\charscalex100 lingkungan untuk mendukung rencana mengganti atau meningkatkan
fungsi (\ul0\nosupersub\cf8\f9\fs24 upgrade\ul0\nosupersub\cf7\f8\fs24 ) \up0
\expndtw-4\charscalex100 teknologi medik. \par\pard\ql \li1485\sb237\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK
10 \par\pard\qj \li1418\ri1218\sb188\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Monitoring program manajemen risiko
fasilitas dan lingkungan melalui pengumpulan \line \up0 \expndtw-1\charscalex100
data dan analisisnya memberikan informasi yang dapat membantu rumah
sakit \line \up0 \expndtw0\charscalex100 mencegah masalah, menurunkan risiko,
membuat keputusan sistem perbaikannya, \line \up0 \expndtw0\charscalex100 serta
membuat rencana untuk meningkatkan fungsi \up0 \expndtw0\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 upgrade\ul0\nosupersub\cf7\f8\fs24 ) teknologi
medik, \par\pard\qj \li1418\ri1162\sb0\sl-320\slmult0 \up0 \expndtw-3\charscalex100
peralatan, dan sistem utilitas. Persyaratan monitor untuk program manajemen
fasilitas \line \up0 \expndtw0\charscalex100 dikoordinasikan dengan persyaratan
yang dijelaskan di Standar TKRS11. Data hasil \line \up0 \expndtw-4\charscalex100
monitoring dicatat di dokumen dan laporan setiap 3 bulan disampaikan kepada
direktur \line \up0 \expndtw-5\charscalex100 rumah sakit. \par\pard\ql
\li1418\sb217\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 10 \par\pard\qj
\li1778\ri1221\sb225\sl-300\slmult0\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai regulasi sistem
pelaporan data insiden/kejadian/ \line\tab \up0 \expndtw-2\charscalex100
kecelakaan setiap program manajemen risiko fasilitas. (R) \par\pard\qj
\li1778\ri1229\sb161\sl-300\slmult0\tx2138 \up0 \expndtw-1\charscalex100 2. Ada
laporan data insiden/kejadian/kecelakaan setiap program manajemen \line\tab
\up0 \expndtw-2\charscalex100 risiko fasilitas dan sudah dianalisis. (D,W)
\par\pard\ql \li1778\ri1225\sb161\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 3. Hasil analisis sudah ditindaklanjuti dengan mengganti
atau meningkatkan \line\tab \up0 \expndtw-1\charscalex100 fungsi
(\ul0\nosupersub\cf8\f9\fs24 upgrade\ul0\nosupersub\cf7\f8\fs24 ) teknologi medis,
peralatan, sistem, dan menurunkan risiko di \line \tab \up0 \expndtw-
2\charscalex100 lingkungan. (D,W,O) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb220\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 322
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg323}
{\bkmkend Pg323}\par\pard\ql \li1778\sb0\sl-290\slmult0 \par\pard\ql\li1778\sb0\sl-
290\slmult0 \par\pard\ql\li1778\sb0\sl-290\slmult0 \par\pard\ql\li1778\sb0\sl-
290\slmult0 \par\pard\ql\li1778\ri1219\sb1\sl-290\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 4. Seorang atau lebih individu
yang ditunjuk mengawasi pelaksanaan program \line\tab \up0 \expndtw-1\charscalex100
manajemen risiko fasilitas telah membuat laporan kepada direktur rumah sakit
\line \tab \up0 \expndtw-2\charscalex100 setiap 3 bulan. (lihat juga MFK
3)\ul0\nosupersub\cf8\f9\fs24 .\ul0\nosupersub\cf7\f8\fs24 (D,W) \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb150\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PENDIDIKAN STAF
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb92\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar MFK
11 \par\pard\qj \li1418\ri1228\sb208\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyelenggarakan edukasi,
pelatihan, serta tes (ujian) bagi semua staf \up0 \expndtw-1\charscalex100 tentang
peranan mereka dalam menyediakan fasilitas yang aman dan efektif. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb185\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 11 \par\pard\qj
\li1418\ri1225\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Staf rumah sakit merupakan sumber kontak utama dengan
pasien, keluarga pasien, \up0 \expndtw0\charscalex100 dan pengunjung. Dengan
demikian, mereka perlu dibekali edukasi dan dilatih untuk \up0
\expndtw0\charscalex104 menjalankan peran mereka dalam mengidentifikasi serta
mengurangi risiko, \up0 \expndtw-1\charscalex100 melindungi orang lain dan diri
mereka sendiri, serta menciptakan fasilitas yang aman \up0 \expndtw-2\charscalex100
dan terlindung. (lihat juga MFK 7.1, ME 1)\ul0\nosupersub\cf8\f9\fs24 .
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 11 \par\pard\qj
\li1778\ri1227\sb241\sl-280\slmult0\tx2138 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit mempunyai program pelatihan
manajemen fasilitas dan \line\tab \up0 \expndtw-3\charscalex100 keselamatan.
(R) \par\pard\ql \li1778\ri1156\sb164\sl-300\slmult0\tx2138\tx2138\tx2138
\up0 \expndtw-1\charscalex100 2. Edukasi diadakan setiap tahun mengenai
setiap komponen dari program \line\tab \up0 \expndtw0\charscalex100 manajemen
fasilitas dan keselamatan untuk menjamin semua staf dapat \line \tab \up0
\expndtw-3\charscalex100 melaksanakan tanggung jawabnya dengan efektif. (liihat
juga AP 5.3; AP 6.3). \line \tab \up0 \expndtw-4\charscalex100 (D,W) \par\pard\qj
\li1778\ri1216\sb161\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100 3. Edukasi
diikuti oleh pengunjung, suplier, pekerja kontrak, dan lain-lain sesuai
\line\tab \up0 \expndtw-3\charscalex100 dengan regulasi rumah sakit. (D,W)
\par\pard\ql \li1778\ri1221\sb169\sl-290\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 4. Pengetahuan staf dites dan disimulasikan sesuai dengan peran
mereka dalam \line\tab \up0 \expndtw0\charscalex103 setiap program manajamen
fasilitas. Kegiatan pelatihan dan hasil pelatihan \line \tab \up0 \expndtw-
3\charscalex100 setiap staf didokumentasikan. (D,W) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb150\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MFK
11.1 \par\pard\qj \li1418\ri1166\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Staf dilatih dan diberi pengetahuan peranan mereka
dalam program rumah sakit untuk \up0 \expndtw-4\charscalex100 proteksi kebakaran,
keamanan, dan penanggulangan bencana. \par\pard\ql \li1418\sb237\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK
11.1 \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb164\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 323
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg324}
{\bkmkend Pg324}\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\sb0\sl-
316\slmult0 \par\pard\qj\li1418\sb0\sl-316\slmult0
\par\pard\qj\li1418\ri1164\sb191\sl-316\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap rumah sakit harus memutuskan sendiri jenis dan
tingkat pelatihan bagi stafnya, \up0 \expndtw-1\charscalex100 kemudian
melaksanakannya melalui program pendidikan dan pelatihan. Program \up0
\expndtw-1\charscalex100 dapat memuat misalnya diskusi kelompok, mencetak materi,
orientasi bagi staf baru, \up0 \expndtw0\charscalex100 atau bentuk lainnya untuk
memenuhi kebutuhan rumah sakit. Program juga memuat \up0 \expndtw-1\charscalex100
proses dan prosedur pelaporan tentang risiko potensial, pelaporan insiden
dan \up0 \expndtw-3\charscalex100 kecelakaan, serta penanganan bahan/barang
berbahaya yang merupakan risiko pada \up0 \expndtw-4\charscalex100 dirinya sendiri
dan lainnya. \par\pard\ql \li1418\sb238\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 11.1
\par\pard\qj \li1778\ri1227\sb241\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Staf dapat menjelaskan
dan/atau memperagakan peran mereka dalam \line\tab \up0 \expndtw-
3\charscalex100 menghadapi kebakaran. (W,S) \par\pard\ql \li1778\ri1225\sb164\sl-
300\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex107 2. Staf dapat
menjelaskan dan/atau memperagakan tindakan untuk \line\tab \up0 \expndtw-
1\charscalex100 menghilangkan, mengurangi/meminimalisir, atau melaporkan
keselamatan, \line \tab \up0 \expndtw-2\charscalex100 keamanan, dan risiko lainnya.
(W,S) \par\pard\ql \li1778\ri1218\sb161\sl-300\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 3. Staf dapat menjelaskan dan/atau memperagakan tindakan,
kewaspadaan, \line\tab \up0 \expndtw-1\charscalex100 prosedur dan partisipasi dalam
penyimpanan, penanganan dan pembuangan \line \tab \up0 \expndtw-3\charscalex100 gas
medis serta limbah B3. (W,S) \par\pard\ql \li1778\ri1182\sb169\sl-
290\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 4. Staf dapat menjelaskan
dan/atau memperagakan prosedur dan peran mereka \line\tab \up0
\expndtw0\charscalex104 dalam penanganan kedaruratan serta bencana internal
atau eksternal \line \tab \up0 \expndtw-3\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 community\ul0\nosupersub\cf7\f8\fs24 ). (W,S)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb150\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MFK 11.2 \par\pard\ql \li1418\sb244\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Staf dilatih
untuk menjalankan dan memelihara peralatan medis dan sistem utilitas.
\par\pard\ql \li1418\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MFK 11.2 \par\pard\qj
\li1418\ri1216\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Staf yang bertanggung jawab menjalankan atau
memelihara peralatan medik \up0 \expndtw-1\charscalex100 menerima pelatihan
secara khusus. Pelatih dapat berasal dari rumah sakit, produsen \up0 \expndtw-
2\charscalex100 teknologi, atau tenaga ahli sebagai narasumber pelatihan.
\par\pard\qj \li1418\ri1158\sb180\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Rumah sakit membuat program dengan cara melakukan tes secara berkala pada staf \up0
\expndtw-3\charscalex100 tentang pengetahuannya soal prosedur darurat, proteksi
kebakaran, respons terhadap \up0 \expndtw0\charscalex103 B3 termasuk tumpahan bahan
tersebut dan penggunaan teknologi medik berisiko \up0 \expndtw0\charscalex102
terhadap pasien serta staf. Pengetahuan yang dimiliki peserta tes dapat
dilakukan \up0 \expndtw-2\charscalex100 dengan beragai cara seperti demonstrasi
kelompok atau individual dan simulasi \up0 \expndtw0\charscalex100 kejadian
seperti kalau ada epidemi di masyarakat. Tes tertulis atau lewat komputer, \up0
\expndtw-3\charscalex100 serta mendokumentasikan peserta dan hasil tes.
\par\pard\ql \li1418\sb217\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MFK 11.2 \par\pard\qj
\li1778\ri1227\sb225\sl-300\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Staf diberi pelatihan untuk menjalankan peralatan
medis sesuai dengan uraian \line\tab \up0 \expndtw-3\charscalex100 tugas dan
dilakukan tes secara berkala. (D,W,S) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb73\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 324
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg325}
{\bkmkend Pg325}\par\pard\qj \li1778\sb0\sl-280\slmult0 \par\pard\qj\li1778\sb0\sl-
280\slmult0 \par\pard\qj\li1778\sb0\sl-280\slmult0 \par\pard\qj\li1778\sb0\sl-
280\slmult0 \par\pard\qj\li1778\ri1222\sb49\sl-280\slmult0\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 2. Staf diberi pelatihan untuk
menjalankan sistem utilitas sesuai dengan uraian \line\tab \up0 \expndtw-
3\charscalex100 tugas dan dilakukan tes secara berkala. (D,W,S) \par\pard\qj
\li1778\ri1229\sb164\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100 3. Staf
diberi pelatihan untuk memelihara peralatan medis sesuai dengan uraian \line\tab
\up0 \expndtw-3\charscalex100 tugas dan dilakukan tes secara berkala. (D,W,S)
\par\pard\qj \li1778\ri1229\sb161\sl-300\slmult0\tx2138 \up0
\expndtw0\charscalex103 4. Staf diberi pelatihan untuk memelihara sistem utilitas
sesuai dengan uraian \line\tab \up0 \expndtw-3\charscalex100 tugas dan dilakukan
tes secara berkala. (D,W,S) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb188\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 325
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg326}
{\bkmkend Pg326}\par\pard\ql \li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0 \par\pard\ql\li5594\sb0\sl-276\slmult0 \par\pard\ql\li5594\sb0\sl-
276\slmult0
\par\pard\ql\li5594\sb68\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 BAB 5 \par\pard\ql \li3602\sb24\sl-276\slmult0 \up0
\expndtw-3\charscalex100 KOMPETENSI DAN KEWENANGAN STAF \par\pard\ql
\li5620\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 (KKS) \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb176\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 PERENCANAAN \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar KKS 1 \par\pard\ql \li1418\sb24\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Pimpinan rumah sakit menetapkan
perencanaan kebutuhan staf rumah sakit. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 1 \par\pard\qj
\li1418\ri1213\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Pimpinan unit layanan menetapkan persyaratan
pendidikan, kompetensi, \up0 \expndtw-1\charscalex100 kewenangan, keterampilan,
pengetahuan, dan pengalaman staf untuk memenuhi \up0 \expndtw0\charscalex100
kebutuhan memberikan asuhan kepada pasien. Untuk menghitung jumlah staf yang
\up0 \expndtw-3\charscalex100 dibutuhkan digunakan faktor sebagai berikut:
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a) misi
rumah sakit; \par\pard\qj \li1778\ri1167\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 b) keragaman pasien yang harus dilayani, kompleksitas, dan
intensitas kebutuhan \line\tab \up0 \expndtw-4\charscalex100 pasien;
\par\pard\ql \li1778\sb25\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c) layanan
diagnostik dan klinis yang disediakan rumah sakit; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 d) volume pasien rawat inap dan rawat
jalan; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e)
teknologi medis yang digunakan untuk pasien. \par\pard\qj \li1418\ri1217\sb14\sl-
313\slmult0 \up0 \expndtw0\charscalex102 Rumah sakit memenuhi ketentuan peraturan
perundang-undangan tentang syarat \up0 \expndtw0\charscalex102 tingkat pendidikan,
kompetensi, kewenangan, keterampilan, pengetahuan dan \up0
\expndtw0\charscalex102 pengalaman untuk setiap anggota staf, serta ketentuan yang
mengatur jumlah staf \up0 \expndtw-3\charscalex100 yang dibutuhkan di setiap unit
layanan. (lihat juga PMKP 1; TKP 8) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 1 \par\pard\ql
\li1778\ri1220\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada penetapan perencanaan kebutuhan staf rumah
sakit yang berdasar atas \line\tab \up0 \expndtw0\charscalex101 perencanaan
strategis dan perencanaan tahunan sesuai dengan kebutuhan \line \tab \up0 \expndtw-
3\charscalex100 rumah sakit. (R) \par\pard\qj \li1778\ri1226\sb17\sl-
300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Ada kejelasan hubungan antara
perencanaan strategis, perencanaan tahunan, \line\tab \up0 \expndtw-3\charscalex100
dan perencanaan kebutuhan staf. (D,W) \par\pard\qj \li1778\ri1295\sb4\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Ada bukti perencanaan
kebutuhan staf berdasar atas kebutuhan tiap-tiap unit \line\tab \up0 \expndtw-
3\charscalex100 kerja khususnya unit kerja pelayanan. (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 2 \par\pard\qj
\li1418\ri1189\sb14\sl-313\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Perencanaan kebutuhan staf rumah sakit terus menerus
dimutakhirkan oleh pimpinan \up0 \expndtw0\charscalex100 rumah sakit dengan
menetapkan jumlah, jenis, kualifikasi yang meliputi pendidikan, \up0
\expndtw0\charscalex100 kompetensi, pelatihan, dan pengalaman yang dibutuhkan
sesuai dengan peraturan \up0 \expndtw-3\charscalex100 perundang-undangan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 2.1
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb57\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 326
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg327}
{\bkmkend Pg327}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1218\sb253\sl-300\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan evaluasi dan pemutakhiran
terus menerus perencanaan \up0 \expndtw-3\charscalex100 kebutuhan staf rumah sakit.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb172\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 2.2
\par\pard\qj \li1418\ri1219\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan jumlah staf rumah sakit berdasar
atas kebutuhan tiap-tiap \line \up0 \expndtw-2\charscalex100 unit termasuk
pengembangannya sesuai dengan peraturan perundang-undangan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 2.3 \par\pard\qj
\li1418\ri1170\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Dalam perencanaan kebutuhan staf rumah sakit ditetapkan
persyaratan pendidikan, \up0 \expndtw-3\charscalex100 keterampilan, pengetahuan,
dan persyaratan lain dari seluruh staf rumah sakit. Setiap \up0 \expndtw-
4\charscalex100 staf rumah sakit mempunyai uraian tugas, tanggung jawab, dan
wewenang. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS
2.4 \par\pard\qj \li1418\ri1220\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Perencanaan kebutuhan staf rumah sakit juga
dengan mempertimbangkan \line \up0 \expndtw-2\charscalex100 penempatan atau
penempatan kembali harus memperhatikan faktor kompetensi. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 2 sampai dengan
KKS 2.4 \par\pard\ql \li1418\ri1217\sb11\sl-317\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Perencanaan kebutuhan yang tepat dengan
jumlah yang mencukupi adalah hal yang \up0 \expndtw0\charscalex100 sangat penting
bagi asuhan pasien termasuk keterlibatan rumah sakit dalam semua \up0
\expndtw0\charscalex100 kegiatan pendidikan dan riset. Penempatan
(\ul0\nosupersub\cf8\f9\fs24 placement\ul0\nosupersub\cf7\f8\fs24 ) atau penempatan
kembali \up0 \expndtw0\charscalex100 (re\ul0\nosupersub\cf8\f9\fs24
placement\ul0\nosupersub\cf7\f8\fs24 ) harus memperhatikan faktor kompetensi.
Sebagai contoh, seorang \up0 \expndtw-2\charscalex100 perawat yang memiliki
kompetensi hemodialisis tidak dirotasi ke rawat jalan lain. \line \up0
\expndtw0\charscalex103 Pimpinan unit layanan membuat rencana pola ketenagaan
dengan menggunakan \up0 \expndtw0\charscalex103 proses yang sudah diakui untuk
menentukan jenjang kepegawaian. Perencanaan \up0 \expndtw-3\charscalex100
kepegawaian meliputi hal-hal sebagai berikut: \par\pard\qj \li1778\ri1215\sb1\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 a) penempatan kembali dari satu
unit layanan ke lain unit layanan karena alasan \line\tab \up0 \expndtw-
3\charscalex100 kompetensi, kebutuhan pasien, atau kekurangan staf; \par\pard\qj
\li1778\ri1228\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 b)
mempertimbangkan keinginan staf untuk ditempatkan kembali karena alasan
\line\tab \up0 \expndtw-3\charscalex100 nilai-nilai, kepercayaan, dan agama;
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c) memenuhi
ketentuan peraturan perundang-undangan. \par\pard\qj \li1418\ri1178\sb308\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Rencana dan pelaksanaan strategi dimonitor
secara berkelanjutan dan diperbaharui \up0 \expndtw-2\charscalex100 jika
dibutuhkan. Dilakukan proses koordinasi oleh pimpinan unit layanan
untuk\ul0\nosupersub\cf8\f9\fs24 update \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 perencanaan staf ini. (lihat juga TKP 7; TKP 9)
\par\pard\ql \li1418\sb0\sl-313\slmult0 \par\pard\ql\li1418\ri1211\sb13\sl-
313\slmult0 \up0 \expndtw0\charscalex100 Setiap staf mempunyai tanggung jawab
sesuai dengan uraian tugas dan fungsinya. \up0 \expndtw0\charscalex100 Dalam hal
ini kompetensi dan kewenangan menjadi dasar dalam menentukan \up0 \expndtw-
2\charscalex100 penempatan, uraian pekerjaan, dan kriteria untuk evaluasi kinerja
staf. \line \up0 \expndtw-3\charscalex100 Uraian tugas juga diperlukan untuk tenaga
kesehatan profesional jika \par\pard\ql \li1778\ri1161\sb2\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex103 a) seseorang yang bekerja
terutama di bidang manajemen mempunyai uraian \line\tab \up0
\expndtw0\charscalex104 tugas jabatan dan uraian tugas fungsional. Contoh, dokter
spesialis bedah \line \tab \up0 \expndtw-3\charscalex100 merangkap sebagai Kepala
Instalasi Kamar Operasi dan sebagai dokter bedah \par\pard\ql \li10156\sb236\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 327
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg328}
{\bkmkend
Pg328}\par\pard\qj \li2138\sb0\sl-300\slmult0 \par\pard\qj\li2138\sb0\sl-
300\slmult0 \par\pard\qj\li2138\sb0\sl-300\slmult0
\par\pard\qj\li2138\ri1209\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf7\f8\fs24 harus mempunyai STR, SIP, SPK, RKK dan sebagai kepala
instalasi kamar \up0 \expndtw-3\charscalex100 operasi mempunyai uraian tugas,
wewenang, dan tanggung jawab; \par\pard\ql \li1778\ri1226\sb4\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 b) seseorang dalam program
pendidikan dan bekerja di bawah supervisi maka \line\tab \up0
\expndtw0\charscalex102 program pendidikan menentukan apa yang boleh dan apa yang
tidak boleh \line \tab \up0 \expndtw-3\charscalex100 dikerjakan sesuaidengan
tingkat pendidikannya; \par\pard\ql \li1778\ri1218\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex100 c) bagi mereka
yang diizinkan menurut peraturan perundang-undangan \line\tab \up0
\expndtw0\charscalex100 melakukan praktik mandiri harus dilakukan proses
untuk identifikasi dan \line \tab \up0 \expndtw-1\charscalex100 memberikan
wewenang melaksanakan praktik dengan dasar latar belakang \line \tab \up0
\expndtw-1\charscalex100 pendidikan, kompetensi, pelatihan, dan pengalaman.
\up0 \expndtw-1\charscalex100 (lihat juga KKS \up0 \expndtw-3\charscalex100 9)
\par\pard\qj \li2138\ri1224\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100
Persyaratan standar ini berlaku untuk semua jenis staf yang harus ada uraian
\up0 \expndtw-3\charscalex100 tugasnya. \up0 \expndtw0\charscalex100 (contoh,
penugasan penuh waktu, paruh waktu, dipekerjakan, \up0 \expndtw-
3\charscalex100 sukarela, sementara, lihat juga PPI 1) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 2 \par\pard\ql
\li1778\ri1217\sb14\sl-313\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 1. Ada kebijakan dan
prosedur yang ditetapkan rumah sakit tentang pola \line\tab \up0
\expndtw0\charscalex102 ketenagaan dan kebutuhan jumlah staf sesuai dengan yang
dijadikan dasar \line \tab \up0 \expndtw0\charscalex100 untuk menyusun
perencanaan staf. Panduan mengatur penempatan dan \line \tab \up0 \expndtw-
3\charscalex100 penempatan kembali staf. (R) \par\pard\qj \li1778\ri1165\sb2\sl-
320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 2. Ada pelaksanaan pola
ketenagaan secara kolaborasi dengan perencanaan staf \line\tab \up0 \expndtw-
3\charscalex100 yang meliputi jumlah, jenis, dan kualifikasi. (lihat juga AP 6.2).
(D,W) \par\pard\qj \li1778\ri1228\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 3. Ada pelaksanaan pengaturan penempatan dan
penempatan kembali staf \line\tab \up0 \expndtw-3\charscalex100 sesuai dengan
panduan. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian KKS 2.1 \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi evaluasi dan
pemutakhiran terus menerus pola ketenagaan. (R) \par\pard\qj \li1778\ri1218\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Ada pelaksanaan perencanaan
staf yang efektif dan selalu dievaluasi berdasar \line\tab \up0 \expndtw-
3\charscalex100 atas kebutuhan. (D,W) \par\pard\qj \li1778\ri1156\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 3. Ada revisi dan pembaharuan
perencanaan staf bila dibutuhkan minimal 1 (satu) \line\tab \up0 \expndtw-
4\charscalex100 tahun sekali. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 2.2 \par\pard\ql
\li1778\ri1223\sb16\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan jumlah staf rumah sakit
dengan mempertimbangkan \line\tab \up0 \expndtw0\charscalex102 misi rumah sakit,
keragaman pasien, jenis pelayanan, dan teknologi yang \line \tab \up0 \expndtw-
3\charscalex100 digunakan dalam asuhan pasien. (R) \par\pard\ql \li1778\sb39\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 2. Ada dokumen kebutuhan staf dari unit
kerja masing-masing. (D,W) \par\pard\qj \li1778\ri1227\sb8\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex101 3. Perencanaan jumlah staf juga mempertimbangkan
rencana pengembangan \line\tab \up0 \expndtw-3\charscalex100 pelayanan. (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS
2.3 \par\pard\ql \li1778\ri1162\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan pendidikan,
keterampilan, dan pengetahuan disertai \line\tab \up0 \expndtw-1\charscalex100
dengan penetapan uraian tugas, tanggung jawab, dan wewenang sesuai \line
\tab \up0 \expndtw-3\charscalex100 dengan peraturan perundang-undangan. (lihat juga
TKRS 3).(R) \par\pard\qj \li1778\ri1227\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex106 2. Setiap nama jabatan ada persyaratan pendidikan,
keterampilan, dan \line\tab \up0 \expndtw-3\charscalex100 pengetahuan. (D,W)
\par\pard\ql \li10156\sb224\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 328
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg329}
{\bkmkend Pg329}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1227\sb214\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Setiap staf rumah sakit memiliki
uraian tugas, tanggung jawab, dan wewenang \line\tab \up0 \expndtw0\charscalex103
termasuk staf klinis yang melaksanakan tugas manajemen dan yang tidak \line \tab
\up0 \expndtw-3\charscalex100 diizinkan melakukan praktik mandiri. (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb127\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 2.4 \par\pard\ql
\li1778\ri1159\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi pengaturan penempatan kembali dari
satu unit layanan ke lain unit \line\tab \up0 \expndtw0\charscalex100 layanan
karena alasan kompetensi, kebutuhan pasien, atau kekurangan staf \line \tab \up0
\expndtw-2\charscalex100 termasuk mempertimbangkan nilai-nilai, kepercayaan, dan
agama staf. (R) \par\pard\qj \li1778\ri1226\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex103 2. Ada dokumen perencanaan kebutuhan staf rumah
sakit berdasar atas \line\tab \up0 \expndtw-3\charscalex100 pengaturan penempatan
kembali. (D,W) \par\pard\qj \li1778\ri1219\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 3. Ada dokumen pengaturan penempatan kembali berdasar atas
pertimbangan \line\tab \up0 \expndtw-3\charscalex100 nilai kepercayaan dan agama.
(D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb105\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 3 \par\pard\qj
\li1418\ri1214\sb25\sl-300\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan dan melaksanakan
proses rekrutmen, evaluasi, \up0 \expndtw-3\charscalex100 penempatan staf, dan
prosedur lain. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan KKS 3 \par\pard\qj \li1418\ri1219\sb8\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses rekrutmen
yang terpusat, efisien, dan terkoordinasi \up0 \expndtw0\charscalex100 agar
terlaksana proses yang seragam di seluruh rumah sakit. Kebutuhan rekrutmen \up0
\expndtw0\charscalex100 berdasar atas rekomendasi jumlah dan kualifikasi staf
yang dibutuhkan untuk \up0 \expndtw-3\charscalex100 memberikan layanan klinis
kepada pasien dari pimpinan unit kerja. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 3 \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada
regulasi proses rekrutmen staf. (lihat juga KRS 3.3).(R) \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2. Proses rekrutmen
dilaksanakan sesuai dengan regulasi. (D,W) \par\pard\ql \li1778\sb44\sl-276\slmult0
\up0 \expndtw-2\charscalex100 3. Proses rekrutmen dilaksanakan seragam. (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 4
\par\pard\qj \li1418\ri1215\sb25\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses seleksi untuk menjamin
bahwa pengetahuan dan \up0 \expndtw-3\charscalex100 keterampilan staf klinis sesuai
dengan kebutuhan pasien. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 4 \par\pard\qj
\li1418\ri1213\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Anggota staf klinis yang kompeten direkrut melalui
proses yang seragam dengan \up0 \expndtw0\charscalex100 proses rekrutmen staf
lainnya. Proses ini menjamin bahwa pendidikan, kompetensi, \up0
\expndtw0\charscalex100 kewenangan, keterampilan, pengetahuan, dan pengalaman staf
klinis pada awalnya \up0 \expndtw-3\charscalex100 dan seterusnya dapat memenuhi
kebutuhan
pasien. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb105\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 4 \par\pard\qj
\li1778\ri1165\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang menetapkan proses seleksi untuk
memastikan pengetahuan, \line\tab \up0 \expndtw-3\charscalex100 keterampilan, dan
kompetensi staf klinis sesuai dengan kebutuhan pasien. (R) \par\pard\ql
\li10156\sb236\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 329
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg330}
{\bkmkend Pg330}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Proses seleksi dilaksanakan seragam
sesuai dengan regulasi. (lihat juga TKRS \par\pard\ql \li2138\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 3.3). (D,W) \par\pard\qj
\li1778\ri1218\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex104 3. Anggota
staf klinis baru dievaluasi pada saat mulai bekerja sesuai dengan \line\tab \up0
\expndtw-3\charscalex100 tanggung jawabnya. (D,W) \par\pard\qj
\li1778\ri1227\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 4. Unit
kerja menyediakan data yang digunakan untuk evaluasi kinerja staf klinis. \line\tab
\up0 \expndtw-2\charscalex100 (lihat TKRS 11.1). (D,W) \par\pard\qj
\li1778\ri1220\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 5. Evaluasi
staf klinis dilakukan dan didokumentasikan secara berkala minimal 1 \line\tab
\up0 \expndtw-3\charscalex100 (satu) tahun sekali sesuai dengan regulasi. (lihat
juga KKS 11). (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb105\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 5
\par\pard\qj \li1418\ri1219\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses seleksi untuk menjamin
bahwa pengetahuan dan \up0 \expndtw-3\charscalex100 keterampilan staf nonklinis
sesuai dengan persyaratan yang ditetapkan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 5 \par\pard\qj
\li1418\ri1218\sb14\sl-313\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Anggota staf nonklinis yang kompeten direkrut melalui
proses yang seragam dengan \up0 \expndtw0\charscalex100 proses rekrutmen staf
lainnya. Proses ini menjamin bahwa pendidikan, kompetensi, \up0
\expndtw0\charscalex100 kewenangan, keterampilan, pengetahuan, dan pengalaman
staf nonklinis pada \up0 \expndtw-3\charscalex100 awalnya dan seterusnya sesuai
dengan persyaratan yang ditetapkan. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1160\sb2\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Staf
nonklinis meliputi seluruh tenaga yang tidak memberikan asuhan pasien secara
\up0 \expndtw0\charscalex100 langsung. Pimpinan unit menjabarkan kualifikasi staf
nonklinis yang diperlukan dan \up0 \expndtw-3\charscalex100 memastikan bahwa staf
nonklinis dapat memenuhi tanggung jawabnya sesuai dengan \up0
\expndtw0\charscalex100 penugasannya. Semua staf disupervisi dan dievaluasi
berkala untuk menjamin \up0 \expndtw-3\charscalex100 kontinuitas kompetensi di
posisinya. \par\pard\qj \li1418\ri1160\sb300\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 Rumah sakit mencari staf yang kompeten dan memenuhi kualifikasi
staf nonklinis. Staf \up0 \expndtw-2\charscalex100 nonklinis meliputi seluruh
tenaga yang tidak memberikan asuhan pasien secara \up0
\expndtw0\charscalex100 langsung. Staf secara berkala dilakukan evaluasi untuk
memastikan terpeliharanya \up0 \expndtw-3\charscalex100 kompetensi pada jabatan.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 5
\par\pard\ql \li1778\ri1158\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang menetapkan proses
seleksi untuk memastikan pengetahuan, \line\tab \up0 \expndtw0\charscalex100
keterampilan, dan kompetensi staf nonklinis sesuai dengan kebutuhan rumah \line
\tab \up0 \expndtw-3\charscalex100 sakit. (R) \par\pard\qj \li1778\ri1227\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 2. Proses seleksi staf nonklinis
dilaksanakan seragam sesuai dengan regulasi. \line\tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\qj \li1778\ri1219\sb0\sl-320\slmult0\tx2138 \up0
\expndtw-1\charscalex100 3. Anggota staf nonklinis baru dievaluasi pada saat mulai
bekerja sesuai dengan \line\tab \up0 \expndtw-3\charscalex100 tanggung jawabnya.
(D,W) \par\pard\ql \li1778\sb5\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4.
Unit kerja melaksanakan evaluasi kinerja staf nonklinis. (D,W) \par\pard\qj
\li1778\ri1163\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 5. Evaluasi
staf nonklinis dilakukan dan didokumentasikan secara berkala minimal \line\tab \up0
\expndtw-4\charscalex100 satu tahun sekali sesuai dengan regulasi. (lihat juga KKS
11). (D,W) \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb117\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 330
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg331}
{\bkmkend Pg331}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb136\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 6 \par\pard\qj
\li1418\ri1219\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyediakan dan
memelihara\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24 kepegawaian
untuk setiap staf rumah \up0 \expndtw-3\charscalex100 sakit dan selalu
diperbaharui. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan KKS 6 \par\pard\ql \li1418\ri1160\sb12\sl-315\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Setiap staf rumah sakit mempunyai
dokumen catatan memuat informasi tentang \up0 \expndtw-3\charscalex100
kualifikasi, pendidikan, pelatihan, kompetensi, uraian tugas, proses rekrutmen,
riwayat \up0 \expndtw-3\charscalex100 pekerjaan, hasil evaluasi, dan penilaian
kinerja individual tahunan. \line \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf8\f9\fs24 File\ul0\nosupersub\cf7\f8\fs24 kepegawaian dibuat
terstandar dan selalu diperbaharui sesuai dengan regulasi. \up0 \expndtw-
3\charscalex100 (lihat juga KKS 9; KKS 13; dan KKS 15) \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 6 \par\pard\qj
\li1778\ri1217\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1.\ul0\nosupersub\cf8\f9\fs24
File\ul0\nosupersub\cf7\f8\fs24 kepegawaian memuat kualifikasi, pendidikan,
pelatihan, dan kompetensi \line\tab \up0 \expndtw-3\charscalex100 staf. (D,W)
\par\pard\ql \li1778\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100
2.\ul0\nosupersub\cf8\f9\fs24 File\ul0\nosupersub\cf7\f8\fs24 kepegawaian memuat
uraian tugas anggota staf. (D,W) \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 3.\ul0\nosupersub\cf8\f9\fs24
File\ul0\nosupersub\cf7\f8\fs24 kepegawaian memuat proses rekrutmen staf. (D,W)
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100
4.\ul0\nosupersub\cf8\f9\fs24 File\ul0\nosupersub\cf7\f8\fs24 kepegawaian memuat
riwayat pekerjaan staf. (D,W) \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 5.\ul0\nosupersub\cf8\f9\fs24
File\ul0\nosupersub\cf7\f8\fs24 kepegawaian memuat hasil evaluasi dan penilaian
kinerja staf. (D,W) \par\pard\qj \li1778\ri1219\sb8\sl-320\slmult0\tx2138 \up0
\expndtw-1\charscalex100 6.\ul0\nosupersub\cf8\f9\fs24
File\ul0\nosupersub\cf7\f8\fs24 kepegawaian memuat salinan sertifikat pelatihan di
dalam maupun di luar \line\tab \up0 \expndtw-3\charscalex100 RS. (D,W) \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100
7.\ul0\nosupersub\cf8\f9\fs24 File\ul0\nosupersub\cf7\f8\fs24 kepegawaian selalu
diperbaharui. (D,W) \par\pard\ql \li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb156\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 ORIENTASI
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Standar KKS 7 \par\pard\qj \li1418\ri1218\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Semua staf
klinis dan nonklinis diberi orientasi di rumah sakit dan unit kerja tempat \up0
\expndtw-2\charscalex100 staf akan bekerja dan tanggung jawab spesifik pada saat
diterima bekerja. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 7 \par\pard\qj
\li1418\ri1160\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Keputusan untuk menempatkan seseorang sebagai staf
rumah sakit dilakukan
melalui \up0 \expndtw0\charscalex100 berbagai proses. Agar dapat berperan dan
berfungsi dengan baik, semua staf baru \up0 \expndtw-2\charscalex100 harus
mengetahui dengan benar segala sesuatu tentang rumah sakit dan memahami \up0
\expndtw-1\charscalex100 tanggung jawab pekerjaan klinis atau nonklinis untuk
mencapai misi rumah sakit. Hal \up0 \expndtw-2\charscalex100 ini dapat dicapai
melalui orientasi umum dan orientasi khusus. \par\pard\qj \li1418\ri1224\sb300\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Orientasi umum tentang rumah sakit, mutu,
keselamatan pasien, serta pencegahan \up0 \expndtw-3\charscalex100 dan pengendalian
infeksi. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb184\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 331
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg332}
{\bkmkend Pg332}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1158\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Orientasi khusus tentang unit kerja, uraian
tugas, dan tanggung jawab dalam \up0 \expndtw0\charscalex102 pekerjaannya.
Demikian pula berlaku untuk staf kontrak, staf magang, dan peserta \up0 \expndtw-
4\charscalex100 didik. (lihat juga PPI 11; IPPK 6; dan TKRS 9) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 7 \par\pard\qj
\li1778\ri1217\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang menetapkan orientasi umum dan
khusus bagi staf klinis dan \line\tab \up0 \expndtw-3\charscalex100 nonklinis baru.
(R) \par\pard\qj \li1778\ri1221\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 2. Ada bukti staf klinis dan nonklinis baru diberikan
orientasi umum dan khusus. \line\tab \up0 \expndtw-2\charscalex100 (D,W)
\par\pard\qj \li1778\ri1225\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100
3. Staf kontrak, magang, dan peserta didik mendapat pelatihan tentang orientasi
\line\tab \up0 \expndtw-3\charscalex100 umum dan khusus. (D,W) \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb105\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PENDIDIKAN DAN
PELATIHAN \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar KKS 8 \par\pard\qj
\li1418\ri1217\sb16\sl-310\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Setiap staf mengikuti pendidikan atau pelatihan di
dalam atau di luar rumah sakit \up0 \expndtw0\charscalex106 termasuk pendidikan
profesi berkelanjutan untuk mempertahankan atau \up0 \expndtw-
3\charscalex100 meningkatkan kompetensinya. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 8 \par\pard\qj
\li1418\ri1217\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengumpulkan data dari berbagai
sumber untuk dapat memahami \up0 \expndtw0\charscalex100 pendidikan dan
pelatihan yang dibutuhkan oleh staf. Sumber data yang dapat \up0 \expndtw-
3\charscalex100 digunakan adalah: \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0
\expndtw-3\charscalex100 a) hasil kegiatan pengukuran mutu dan keselamatan;
\par\pard\ql \li1778\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b) monitor
program manajemen fasilitas; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw-2\charscalex100 c) penggunaan teknologi medis baru; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 d) keterampilan dan
pengetahuan yang diperoleh melalui evalusi kinerja; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 e) prosedur klinis baru; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 f) rencana memberikan
layanan baru di kemudian hari. \par\pard\qj \li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1160\sb26\sl-310\slmult0 \up0 \expndtw0\charscalex100 Rumah
sakit menentukan staf yang diharuskan menerima pendidikan berkelanjutan \line
\up0 \expndtw-3\charscalex100 untuk mempertahankan kredibilitasnya. Rumah sakit
juga menetapkan keharusan ada \line \up0 \expndtw-3\charscalex100 dokumen pelatihan
staf yang dimonitor dan didokumentasikan. (lihat juga TKRS..) \par\pard\qj
\li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\ri1217\sb8\sl-317\slmult0 \up0
\expndtw-1\charscalex100 Untuk mempertahankan kinerja staf, memberikan pendidikan
keterampilan baru, dan \up0 \expndtw0\charscalex102 memberi pelatihan tentang
teknologi serta prosedur medis baru maka rumah sakit \up0 \expndtw-2\charscalex100
menyediakan fasilitas, pendidik, serta waktu untuk memberi pendidikan dan pelatihan
\up0 \expndtw-1\charscalex100 di dalam dan di luar rumah sakit. Pelatihan ini harus
sesuai dengan perkembangan \up0 \expndtw0\charscalex104 kebutuhan pasien. Sebagai
contoh, anggota staf medis menerima pelatihan \up0 \expndtw-1\charscalex100
pencegahan dan pengendalian infeksi, pengembangan praktik medis tingkat
lanjut, \up0 \expndtw0\charscalex102 budaya keselamatan pasien, atau teknologi
medis baru. Hasil capaian pelatihan \up0 \expndtw-3\charscalex100
didokumentasikan dalam\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24
kepegawaian. \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 332
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg333}
{\bkmkend Pg333}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1220\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pimpinan rumah sakit membantu pelatihan di dalam
rumah sakit dengan cara \up0 \expndtw0\charscalex102 menyediakan ruangan,
peralatan, waktu untuk program pendidikan dan pelatihan, \up0 \expndtw-
3\charscalex100 serta biayanya. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1216\sb2\sl-320\slmult0 \up0 \expndtw0\charscalex100
Pelaksanaan pelatihan di dalam rumah sakit dilakukan juga agar dapat mendukung \up0
\expndtw0\charscalex100 pengembangan profesional berkelanjutan. Teknologi informasi
yang tersedia dapat \up0 \expndtw0\charscalex100 membantu penyelenggaraan
pendidikan dan pelatihan. Pelatihan diatur sedemikian \up0 \expndtw-3\charscalex100
rupa agar tidak mengganggu pelayanan pasien. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 8 \par\pard\qj
\li1778\ri1215\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada program pendidikan dan pelatihan berdasar
atas sumber data yang \line\tab \up0 \expndtw-3\charscalex100 meliputi butir 1
sampai dengan 6 pada maksud dan tujuan. (R) \par\pard\ql \li1778\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 2. Pendidikan dan pelatihan dilaksanakan
sesuai dengan program. (D,W) \par\pard\qj \li1778\ri1157\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 3. Staf rumah sakit diberi
pendidikan dan pelatihan berkelanjutan di dalam dan di \line\tab \up0 \expndtw-
3\charscalex100 luar rumah sakit yang relevan untuk meningkatkan kemampuannya.
(D,W) \par\pard\ql \li1778\ri1219\sb9\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex103 4. Rumah sakit menyediakan waktu, anggaran, dan fasilitas
untuk semua staf \line\tab \up0 \expndtw-1\charscalex100 dalam berpartisipasi
mengikuti pendidikan dan pelatihan yang diperlukan. \line \tab \up0 \expndtw-
2\charscalex100 (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar KKS 8.1 \par\pard\qj \li1418\ri1216\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Setiap staf
yang memberikan asuhan kepada pasien dan staf yang ditentukan oleh \line \up0
\expndtw0\charscalex100 rumah sakit dilatih dan dapat melaksanakan secara benar
teknik resusitasi jantung \line \up0 \expndtw-3\charscalex100 paru. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 8.1
\par\pard\qj \li1418\ri1165\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengadakan pelatihan teknik resusitasi
tingkat dasar untuk seluruh staf \line \up0 \expndtw0\charscalex100 dan tingkat
lanjut untuk staf yang telah ditentukan seperti staf kamar operasi,
\line \up0 \expndtw-3\charscalex100 pelayanan intensif, dan gawat darurat.
Pelatihan tersebut dilakukan ulang setiap dua \line \up0 \expndtw-2\charscalex100
tahun bila program pelatihan yang diakui tidak digunakan. Diharapkan agar staf
yang \line \up0 \expndtw0\charscalex100 mengikuti pelatihan dapat mencapai tingkat
kompetensi yang ditentukan. (lihat juga \line \up0 \expndtw-3\charscalex100 PAP
3.2) \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb49\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian KKS 8.1 \par\pard\ql \li1778\ri1178\sb8\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi yang
menetapkan pelatihan teknik resusitasi jantung paru tingkat \line\tab
\up0 \expndtw-2\charscalex100 dasar pada seluruh staf dan tingkat lanjut bagi staf
yang ditentukan oleh rumah \line \tab \up0 \expndtw-3\charscalex100 sakit. (R)
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. Staf
yang menjadi tim kode biru diberi latihan bantuan hidup lanjut. (D,W)
\par\pard\ql \li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. Ada
bukti staf telah lulus dari pelatihan dan dapat memperagakan. (D,W,S)
\par\pard\qj \li1778\ri1217\sb25\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
4. Pelatihan untuk setiap staf diulang sesuai dengan program atau minimal dua
\line\tab \up0 \expndtw-3\charscalex100 tahun sekali. (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 8.2 \par\pard\ql
\li1418\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyelenggarakan pelayanan kesehatan dan
keselamatan staf. \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb57\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 333
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg334}
{\bkmkend Pg334}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 8.2
\par\pard\qj \li1418\ri1168\sb0\sl-317\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Staf rumah sakit mempunyai risiko terpapar
infeksi karena pekerjaannya yang \line \up0 \expndtw-1\charscalex100 langsung
dan tidak langsung kepada pasien. Pelayanan kesehatan dan keselamatan \line \up0
\expndtw0\charscalex102 staf merupakan hal penting bagi rumah sakit untuk
menjaga kesehatan fisik, \line \up0 \expndtw0\charscalex103 kesehatan mental,
kepuasan, produktivitas, dan keselamatan staf dalam bekerja. \line \up0
\expndtw0\charscalex104 Karena hubungan staf dengan pasien dan kontak dengan bahan
infeksius maka \line \up0 \expndtw0\charscalex100 banyak petugas kesehatan
berisiko terpapar penularan infeksi. Identifikasi sumber \line \up0 \expndtw-
2\charscalex100 infeksi berdasar atas epidemilogi sangat penting untuk menemukan
staf yang berisiko \line \up0 \expndtw0\charscalex100 terpapar infeksi. Pelaksanaan
program pencegahan serta skrining seperti imunisasi, \line \up0 \expndtw-
3\charscalex100 vaksinasi, dan profilaksis dapat menurunkan secara signifikan
insiden infeksi penyakit \line \up0 \expndtw-4\charscalex100 menular. (lihat juga
PPI.5) \par\pard\qj \li1418\ri1178\sb312\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Staf rumah sakit juga dapat mengalami kekerasan di tempat kerja.
Anggapan bahwa \up0 \expndtw0\charscalex104 kekerasan tidak terjadi di rumah sakit
tidak sepenuhnya benar mengingat jumlah \up0 \expndtw0\charscalex102 tindak
kekerasan di rumah sakit semakin meningkat. Untuk itu rumah sakit diminta \up0
\expndtw-3\charscalex100 menyusun program pencegahan kekerasan. (lihat juga TKRS
13) \par\pard\qj \li1418\ri1158\sb303\sl-317\slmult0 \up0 \expndtw-2\charscalex100
Kesehatan dan keselamatan staf harus menjadi bagian dari program mutu dan
\line \up0 \expndtw-3\charscalex100 keselamatan pasien rumah sakit. Cara rumah
sakit melakukan orientasi dan pelatihan \line \up0 \expndtw-1\charscalex100 staf,
penyediaan lingkungan kerja yang aman, pemeliharaan peralatan dan teknologi
\line \up0 \expndtw0\charscalex100 medis, pencegahan atau pengendalian infeksi
terkait perawatan kesehatan (\ul0\nosupersub\cf8\f9\fs24 health \line \up0
\expndtw-3\charscalex100 care-associated infections\ul0\nosupersub\cf7\f8\fs24 ),
serta beberapa faktor lainnya menentukan kesehatan dan \line \up0
\expndtw0\charscalex100 kesejahteraan staf. (lihat juga PCI 5.1; EP 2) Program
kesehatan dan keselamatan \line \up0 \expndtw-1\charscalex100 staf dapat berada
di dalam rumah sakit atau diintegrasikan ke dalam program \line \up0
\expndtw-2\charscalex100 eksternal. Dalam pelaksanaan program kesehatan dan
keselamatan maka staf harus \line \up0 \expndtw-3\charscalex100 memahami
\par\pard\ql \li1778\ri1214\sb1\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 \u8226? cara pelaporan dan mendapatkan pengobatan,
menerima konseling, dan \line\tab \up0 \expndtw-1\charscalex100 menangani cedera
yang mungkin terjadi akibat tertusuk jarum suntik, terpapar \line \tab \up0
\expndtw-2\charscalex100 penyakit menular, atau mendapat kekerasan di tempat kerja;
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226?
identifikasi risiko dan kondisi berbahaya di rumah sakit; \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \u8226? masalah
kesehatan dan keselamatan lainnya. \par\pard\qj \li1418\ri1225\sb308\sl-320\slmult0
\up0 \expndtw0\charscalex102 Program tersebut dapat juga mencakup skrining
kesehatan awal saat penerimaan \up0 \expndtw-2\charscalex100 pegawai, imunisasi
pencegahan, dan pemeriksaan kesehatan berkala serta tata \up0 \expndtw-
2\charscalex100 laksana kondisi terkait pekerjaan yang umum dijumpai seperti cedera
punggung atau \up0 \expndtw-3\charscalex100 cedera lain yang lebih darurat.
\par\pard\qj \li1418\ri1221\sb320\sl-320\slmult0 \up0 \expndtw0\charscalex100
Penyusunan program mempertimbangkan masukan dari staf serta penggunaan
\up0 \expndtw-3\charscalex100 sumber daya klinis yang ada di rumah sakit dan di
komunitas. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb105\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 8.2
\par\pard\qj \li1778\ri1222\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi kesehatan dan keselamatan staf serta
penanganan kekerasan di \line\tab \up0 \expndtw-2\charscalex100 tempat kerja.
(R) \par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 334
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg335}
{\bkmkend Pg335}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1217\sb214\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Berdasar atas epidemologi penyakit
infeksi maka rumah sakit mengidentifikasi \line\tab \up0 \expndtw0\charscalex100
risiko staf terpapar atau tertular serta melaksanakan pemeriksaan kesehatan
\line \tab \up0 \expndtw-3\charscalex100 dan vaksinasi. (lihat juga PPI 5).
(D,W) \par\pard\ql \li1778\ri1218\sb2\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
1\charscalex100 3. Rumah sakit melaksanakan evaluasi, memberikan konseling, dan
tindak lanjut \line\tab \up0 \expndtw-1\charscalex100 kepada staf yang terpapar
penyakit infeksi serta dikoordinasikan dengan \line \tab \up0 \expndtw-
3\charscalex100 program pencegahan dan pengendalian infeksi. (lihat juga PPI 5).
(D,W) \par\pard\ql \li1778\ri1159\sb0\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 4. Rumah sakit mengidentifikasi area yang berpotensi terjadi
kekerasan di tempat \line\tab \up0 \expndtw-3\charscalex100 kerja dan melaksanakan
upaya yang terukur untuk mengurangi risiko tersebut. \line \tab \up0 \expndtw-
4\charscalex100 (D,O,W) \par\pard\ql \li1778\ri1218\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex106 5. Rumah sakit
melaksanakan evaluasi, memberikan konseling, dan \line\tab \up0
\expndtw0\charscalex103 melaksanakan tindak lanjut terhadap staf yang cedera
akibat kekerasan di \line \tab \up0 \expndtw-3\charscalex100 tempat kerja. (D,W)
\par\pard\qj \li1778\ri1221\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex104
6. Kejadian staf terpapar infeksi dan mengalami kekerasan dicatat serta
\line\tab \up0 \expndtw-3\charscalex100 didokumentasikan. (D,W) \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb105\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 MENENTUKAN
PENUGASAN STAF MEDIS \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar KKS 9
\par\pard\qj \li1418\ri1217\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyelenggarakan pengumpulan dokumen
kredensial dari anggota staf \up0 \expndtw-3\charscalex100 medis yang diberi izin
memberikan asuhan kepada pasien secara mandiri. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 9.1 \par\pard\qj
\li1418\ri1222\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan verifikasi terkini terhadap
pendidikan, registrasi, izin, \up0 \expndtw-3\charscalex100 pengalaman, dan
lainnya dalam kredensialing staf medis. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar KKS 9.2 \par\pard\qj \li1418\ri1224\sb8\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
melaksanakan proses seragam dan transparan untuk menentukan \up0 \expndtw-
2\charscalex100 penerimaaan staf medis. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 9 sampai KKS 9.2 \par\pard\ql
\li1418\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24
Istilah yang digunakan di standar dijelaskan sebagai berikut: \par\pard\qj
\li1418\ri1159\sb308\sl-320\slmult0 \up0 \expndtw-4\charscalex100 Kredensial adalah
proses evaluasi oleh suatu rumah sakit terhadap seorang staf medis \up0
\expndtw0\charscalex103 untuk menentukan apakah yang bersangkutan layak diberi
penugasan klinis dan \up0 \expndtw0\charscalex103 kewenangan klinis untuk
menjalankan asuhan/tindakan medis tertentu dalam \up0 \expndtw-3\charscalex100
lingkungan rumah sakit tersebut untuk periode tertentu. \par\pard\qj
\li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1212\sb8\sl-316\slmult0 \up0
\expndtw-2\charscalex100 Dokumen kredensial adalah dokumen yang dikeluarkan
oleh badan resmi untuk \line \up0 \expndtw0\charscalex103 menunjukkan bukti
telah dipenuhinya persyaratan seperti ijazah dari fakultas \line \up0
\expndtw0\charscalex100 kedokteran, surat tanda registrasi, izin
praktik,\ul0\nosupersub\cf8\f9\fs24 fellowship\ul0\nosupersub\cf7\f8\fs24 , atau
bukti pendidikan dan \line \up0 \expndtw0\charscalex100 pelatihan yang telah
mendapat pengakuan dari organisasi profesi kedokteran. \line \up0 \expndtw-
1\charscalex100 Dokumen dokumen ini harus diverifikasi dari sumber utama
yang mengeluarkan \line \up0 \expndtw-1\charscalex100 dokumen. Dokumen kredensial
dapat juga diperoleh dari rumah sakit, perorangan, \par\pard\ql \li10156\sb237\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 335
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg336}
{\bkmkend Pg336}\par\pard\qj \li1418\sb0\sl-315\slmult0 \par\pard\qj\li1418\sb0\sl-
315\slmult0 \par\pard\qj\li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1156\sb195\sl-315\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 badan hukum yang terkait dengan riwayat profesional,
atau riwayat kompetensi dari \line \up0 \expndtw0\charscalex100 pelamar seperti
surat rekomendasi, semua riwayat pekerjaan sebagai staf medis di \line \up0
\expndtw0\charscalex100 tempat kerja yang lalu ,catatan asuhan klinis yang lalu,
riwayat kesehatan, dan foto. \line \up0 \expndtw0\charscalex103 Dokumen ini akan
diminta rumah sakit sebagai bagian dari proses kredensial dan \line \up0 \expndtw-
2\charscalex100 ijazah serta STR harus diverifikasi ke sumber utamanya.
Syarat untuk verifikasi \line \up0 \expndtw0\charscalex100 kredensial
disesuaikan dengan posisi pelamar. Sebagai contoh, pelamar untuk \line
\up0 \expndtw0\charscalex102 kedudukan kepala departemen/unit layanan di rumah
sakit dapat diminta verifikasi \line \up0 \expndtw-4\charscalex100 terkait jabatan
dan pengalaman administrasi di masa lalu. Juga untuk posisi staf medis \line
\up0 \expndtw-4\charscalex100 di rumah sakit dapat diminta verifikasi riwayat
pengalaman kerja beberapa tahun yang \line \up0 \expndtw-5\charscalex100 lalu.
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1164\sb1\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Staf medis adalah semua dokter dan dokter
gigi yang memberikan layanan promotif, \up0 \expndtw-3\charscalex100 preventif,
kuratif, rehabilitatif, bedah, atau layanan medis/gigi lain kepada pasien, atau
\up0 \expndtw-2\charscalex100 yang memberikan layanan interpretatif terkait
pasien seperti patologi, radiologi, \up0 \expndtw-2\charscalex100
laboratorium, serta memiliki surat tanda registrasi dan surat izin praktik.
\par\pard\qj \li1418\sb0\sl-316\slmult0 \par\pard\qj\li1418\ri1213\sb8\sl-
316\slmult0 \up0 \expndtw0\charscalex103 Verifikasi adalah sebuah proses untuk
memeriksa validitas dan kelengkapan \up0 \expndtw0\charscalex100 kredensial dari
sumber yang mengeluarkan kredensial. Proses dapat dilakukan ke\up0 \expndtw-
2\charscalex100 fakultas/rumah sakit/perhimpunan di dalam maupun di luar negeri
melalui email/surat \up0 \expndtw0\charscalex100
konvensional/pertanyaan\ul0\nosupersub\cf8\f9\fs24 on
line\ul0\nosupersub\cf7\f8\fs24 /atau melalui telepon. Verifikasi dengan email maka
\up0 \expndtw-1\charscalex100 alamat email harus sesuai dengan alamat email
yang ada pada\ul0\nosupersub\cf8\f9\fs24 website\ul0\nosupersub\cf7\f8\fs24
resmi \up0 \expndtw0\charscalex102 universitas/rumahsakit/perhimpunan profesi
tersebut dan bila melalui surat \up0 \expndtw-3\charscalex100 konvensional
harus dengan pos tercatat. \par\pard\qj \li1418\sb0\sl-315\slmult0
\par\pard\qj\li1418\ri1165\sb10\sl-315\slmult0 \up0 \expndtw-2\charscalex100
Kredensial adalah sebuah proses memeriksa dokumendari pelamar, wawancara, dan
\up0 \expndtw0\charscalex104 ketentuan lain sesuai dengan kebutuhan rumah sakit
untuk memutuskan apakah \up0 \expndtw-1\charscalex100 seorang memenuhi syarat
diberi rekomendasi kewenangan klinis untuk memberikan \up0 \expndtw-3\charscalex100
asuhan pasien yang dibutuhkan pasien. Untuk pelamar baru, informasi yang
diperiksa \up0 \expndtw-4\charscalex100 terutama berasal dari sumber luar.
\par\pard\qj \li1418\sb0\sl-320\slmult0 \par\pard\qj\li1418\ri1218\sb1\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Rekredensial merupakan sebuah proses
kredensial ulang setiap 3 tahun. Dokumen \up0 \expndtw-3\charscalex100 kredensial
dan rekredensial meliputi \par\pard\ql \li1778\sb17\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 a. STR, izin praktik yang masih berlaku; \par\pard\qj
\li1778\ri1223\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
b.\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24 pelanggaran etik
atau disiplin termasuk infomasi dari sumber luar seperti \line\tab \up0 \expndtw-
3\charscalex100 dari MKEK dan MKDKI; \par\pard\qj \li1778\ri1219\sb0\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 c. rekomendasi mampu secara fisik
maupun mental memberikan asuhan kepada \line\tab \up0 \expndtw-2\charscalex100
pasien tanpa supervisi dari profesi dokter yang ditentukan; \par\pard\ql
\li1778\ri1217\sb9\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 d.
bila staf medis mengalami gangguan kesehatan, kecacatan tertentu, atau
\line\tab \up0 \expndtw0\charscalex103 proses penuaan yang menghambat pelaksanaan
kerja maka kepada yang \line \tab \up0 \expndtw-3\charscalex100 bersangkutan
dilakukan penugasan klinis ulang; \par\pard\ql \li1778\ri1164\sb2\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-3\charscalex100 e. jika seorang
anggota staf medis mengajukan kewenangan baru terkait pelatihan \line\tab \up0
\expndtw-1\charscalex100 spesialisasi canggih atau subspesialisasi maka dokumen
kredensial harus \line \tab \up0 \expndtw0\charscalex104 segera diverifikasi
dari sumber yang mengeluarkan sertifikat tersebut. \line \tab \up0
\expndtw0\charscalex100 Keanggotaan staf medis mungkin tidak dapat diberikan jika
rumah sakit tidak \par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 336
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg337}
{\bkmkend Pg337}\par\pard\qj \li2138\sb0\sl-313\slmult0 \par\pard\qj\li2138\sb0\sl-
313\slmult0 \par\pard\qj\li2138\sb0\sl-313\slmult0
\par\pard\qj\li2138\ri1198\sb203\sl-313\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 mempunyai teknologi medis khusus untuk mendukung
kewenangan klinis \line \up0 \expndtw0\charscalex100 tertentu. Sebagai contoh,
seorang nefrolog melamar untuk memberikan \line \up0 \expndtw0\charscalex103
layanan dialisis di rumah sakit bila rumah sakit tidak memiliki pelayanan ini \line
\up0 \expndtw-2\charscalex100 maka kewenangan klinis untuk melakukan haemodialisis
tidak dapat diberikan. \par\pard\ql \li1754\sb0\sl-276\slmult0
\par\pard\ql\li1754\sb82\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 9 \par\pard\qj
\li1778\ri1221\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Proses penerimaan, kredensial, penilaian kinerja,
dan rekredensial staf medis \line\tab \up0 \expndtw-3\charscalex100 diatur dalam
peraturan internal staf medis (\ul0\nosupersub\cf8\f9\fs24 medical staf
bylaws\ul0\nosupersub\cf7\f8\fs24 ). (R) \par\pard\ql \li1778\ri1223\sb9\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105 2. Setiap dokter yang
memberikan pelayanan di rumah sakit wajib \line\tab \up0
\expndtw0\charscalex103 menandatangani perjanjian sesuai dengan regulasi rumah
sakit. (lihat juga \line \tab \up0 \expndtw-3\charscalex100 TKRS 6 EP 4). (D,W)
\par\pard\ql \li1778\ri1216\sb2\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex104 3. Ada proses kredensial dan pemberian kewenangan klinis
oleh rumah sakit \line\tab \up0 \expndtw0\charscalex100 untuk pelayanan diagnostik,
konsultasi, dan tata laksana yang diberikan oleh \line \tab \up0 \expndtw-
2\charscalex100 dokter praktik mandiri dari luar rumah sakit seperti
kedokteran jarak jauh \line \tab \up0 \expndtw-3\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 telemedicine\ul0\nosupersub\cf7\f8\fs24 ), radiologi
jarak jauh \up0 \expndtw-3\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
teleradiology\ul0\nosupersub\cf7\f8\fs24 ), dan interpretasi untuk
\par\pard\qj \li2138\ri1217\sb9\sl-310\slmult0 \up0 \expndtw0\charscalex100
pemeriksaan diagnostik lain: elektrokardiogram (EKG), elektroensefalogram \up0
\expndtw-2\charscalex100 (EEG), elektromiogram (EMG), serta pemeriksaan lain yang
serupa. (lihat juga \up0 \expndtw-3\charscalex100 TKRS 6.2 EP 2). (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb83\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS
9.1 \par\pard\ql \li1778\ri1166\sb8\sl-320\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada bukti dilaksanakan
verifikasi dari sumber utama terhadap kredensial terkait \line\tab \up0
\expndtw0\charscalex100 pendidikan, izin/sertifikat,
dan kredensial lain sesuai dengan peraturan \line \tab \up0 \expndtw-
2\charscalex100 perundang-undangan atau yang dikeluarkan oleh instansi
pendidikan atau \line \tab \up0 \expndtw-3\charscalex100 organisasi profesional
yang diakui. (D,W) \par\pard\ql \li1778\ri1223\sb9\sl-310\slmult0\tx2138\tx2138
\up0 \expndtw-1\charscalex100 2. Ada bukti dilaksanakan kredensial tambahan dari
sumber yang mengeluarkan \line\tab \up0 \expndtw0\charscalex100 kredensial apabila
staf medis meminta kewenangan klinis canggih atau \line \tab \up0 \expndtw-
3\charscalex100 subspesialisasi. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 9.2 \par\pard\ql
\li1778\ri1220\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf7\f8\fs24 1. Pengangkatan staf medis dibuat berdasar atas
kebijakan rumah sakit dan \line\tab \up0 \expndtw0\charscalex100 konsisten dengan
populasi pasien rumah sakit, misi, dan pelayanan yang \line \tab \up0
\expndtw-3\charscalex100 diberikan untuk memenuhi kebutuhan pasien. \par\pard\ql
\li1778\ri1216\sb0\sl-320\slmult0\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex103 2. Pengangkatan tidak dilakukan sampai setidaknya
izin/surat tanda registrasi \line\tab \up0 \expndtw0\charscalex100 sudah
diverifikasi dari sumber primer dan anggota staf medis kemudian \line
\tab \up0 \expndtw0\charscalex102 melakukan pelayanan perawatan pasien di bawah
supervisi sampai semua \line \tab \up0 \expndtw0\charscalex100 kredensial yang
disyaratkan undang-undang dan peraturan sudah diverifikasi \line \tab \up0
\expndtw-3\charscalex100 dari sumber asli. \par\pard\ql \li1778\ri1218\sb0\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 3. Untuk staf medis yang
belum mendapatkan kewenangan mandiri, dilakukan \line\tab \up0
\expndtw0\charscalex102 metode supervisi, frekuensi supervisi, dan
supervisor yang ditunjuk \line \tab \up0 \expndtw-3\charscalex100
didokumentasikan di arsip kredensial individu tersebut. \par\pard\ql
\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb116\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 PEMBERIAN
KEWENANGAN KLINIS STAF MEDIS \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb57\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 337
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg338}
{\bkmkend Pg338}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 10 \par\pard\qj
\li1418\ri1160\sb0\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses yang seragam, objektif,
dan berdasar bukti (\ul0\nosupersub\cf8\f9\fs24 evidence \up0 \expndtw-
3\charscalex100 based\ul0\nosupersub\cf7\f8\fs24 ) untuk memberikan wewenang kepada
staf medis untuk menerima, menangani, \up0 \expndtw-3\charscalex100 dan memberikan
layanan kliniks kepada pasien sesuai dengan kualifikasinya. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb69\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 10
\par\pard\qj \li1418\ri1166\sb14\sl-313\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penentuan kompetensi seorang anggota staf medis terkait
keputusan tentang layanan \up0 \expndtw0\charscalex100 klinis yang diizinkan sering
disebut dengan istilah pemberian kewenangan klinis dan \up0 \expndtw-
2\charscalex100 penentuan ini merupakan keputusan yang sangat kritis bagi
rumah sakit untuk \up0 \expndtw-3\charscalex100 melindungi keselamatan pasien dan
juga mengembangkan mutu. \par\pard\qj \li1418\sb0\sl-320\slmult0
\par\pard\qj\li1418\ri1214\sb2\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Pertimbangan pemberian kewenangan klinis pada penugasan
(\ul0\nosupersub\cf8\f9\fs24 appointment\ul0\nosupersub\cf7\f8\fs24 ) pertama
\up0 \expndtw-3\charscalex100 adalah sebagai berikut: \par\pard\ql
\li2138\ri1156\sb2\sl-
318\slmult0\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\t
x2498 \up0 \expndtw-3\charscalex100 a. \tab \up0 \expndtw-3\charscalex100 keputusan
tentang kewenangan klinis yang akan diberikan kepada seorang \line\tab \up0
\expndtw0\charscalex102 staf medis didasarkan terutama atas informasi dan
dokumentasi yang \line \tab \up0 \expndtw0\charscalex102 diterima dari sumber luar
rumah sakit. Sumber luar ini dapat berasal dari \line \tab \up0 \expndtw-
3\charscalex100 program pendidikan spesialis, surat rekomendasi dari penempatan
sebagai \line \tab \up0 \expndtw-1\charscalex100 staf medis yang lalu, atau dari
organisasi profesi, kolega dekat, dan setiap \line \tab \up0 \expndtw-
3\charscalex100 data informasi yang mungkin diberikan kepada rumah sakit. Secara
umum, \line \tab \up0 \expndtw0\charscalex100 sumber informasi ini terpisah dari
yang diberikan oleh institusi pendidikan \line \tab \up0 \expndtw0\charscalex103
seperti program dokter spesialis, tidak diverifikasi dari sumber kecuali
\line \tab \up0 \expndtw0\charscalex100 ditentukan lain oleh kebijakan rumah sakit,
paling sedikit area kompetensi \line \tab \up0 \expndtw-4\charscalex100 sudah dapat
dianggap benar. Evaluasi praktik profesionalnya akan menjadi \line \tab \up0
\expndtw-5\charscalex100 bahan validasi tentang kebenaran anggapan kompetensi ini.
(KKS 11) \par\pard\ql \li2138\ri1215\sb4\sl-
316\slmult0\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498 \up0 \expndtw-3\charscalex100
b. \tab \up0 \expndtw-2\charscalex100 program pendidikan spesialis menentukan
dan membuat daftar secara \line\tab \up0 \expndtw-1\charscalex100 umum tentang
kompetensinya di area diagnosis dan tindakan profesi dan \line \tab \up0
\expndtw0\charscalex101 Konsil kedokteran Indonesia mengeluarkan standar
kompetensi atau \line \tab \up0 \expndtw-1\charscalex100 kewenangan klinis.
Perhimpunan profesi lain membuat daftar secara detail \line \tab \up0
\expndtw0\charscalex102 jenis/tindak medis yang dapat dipakai sebagai acuan
dalam proses \line \tab \up0 \expndtw-3\charscalex100 pemberian kewenangan klinis;
\par\pard\li2138\sb41\sl-276\slmult0\fi0\tx2498 \up0 \expndtw0\charscalex101 c.\tab
\up0 \expndtw0\charscalex101 di idalam setiap area spesialisasi proses untuk
merinci kewenangan ini\par\pard\li2138\sb41\sl-276\slmult0\fi360 \up0
\expndtw0\charscalex101 seragam;\par\pard\li2138\sb41\sl-276\slmult0\fi0\tx2498
\up0 \expndtw0\charscalex101 d.\tab \up0 \expndtw0\charscalex101 verifikasi peran
administrasi ini;\par\pard\ql \li2138\ri1161\sb0\sl-
320\slmult0\tx2498\tx2498\tx2498\tx2498 \up0 \expndtw-3\charscalex100 e. \tab
\up0 \expndtw-2\charscalex100 seorang dokter dengan spesialisasi yang sama
dimungkinkan memiliki \line\tab \up0 \expndtw0\charscalex100 kewenangan klinis
berbeda yang disebabkan oleh perbedaan pendidikan \line \tab \up0 \expndtw-
3\charscalex100 dan pelatihan tambahan, pengalaman, atau hasil kinerja yang
bersangkutan \line \tab \up0 \expndtw-4\charscalex100 selama bekerja, serta
kemampuan motoriknya; \par\pard\ql \li2138\ri1161\sb0\sl-
310\slmult0\tx2498\tx2498\tx2498 \up0 \expndtw-1\charscalex100 f. \tab \up0
\expndtw0\charscalex100 keputusan kewenangan klinis dirinci dan akan
direkomendasikan kepada \line\tab \up0 \expndtw-3\charscalex100 pimpinan rumah
sakit dalam sebuah area spesialisasi terkait dengan proses \line \tab \up0
\expndtw-4\charscalex100 lain, di antaranya: \par\pard\ql \li2138\ri1225\sb2\sl-
320\slmult0\tx2498\tx2498\tx2498 \up0 \expndtw-4\charscalex100 g. \tab \up0
\expndtw0\charscalex102 Penilaian kinerja staf medis berkelanjutan setiap tahun
yang dikeluarkan \line\tab \up0 \expndtw0\charscalex104 oleh rumah sakit yang
berisi jumlah pasien per penyakit/tindakan yang \line \tab \up0 \expndtw-
1\charscalex100 ditangani per tahun, rerata lama dirawat, serta angka kematiannya.
Angka \par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb50\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 338
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg339}
{\bkmkend Pg339}\par\pard\qj \li2498\sb0\sl-300\slmult0 \par\pard\qj\li2498\sb0\sl-
300\slmult0 \par\pard\qj\li2498\sb0\sl-300\slmult0
\par\pard\qj\li2498\ri1215\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf7\f8\fs24 ILO dan kepatuhan terhadap PPK meliputi penggunaan
obat, penunjang \up0 \expndtw-3\charscalex100 diagnostik, darah, produk darah, dan
lainnya; \par\pard\li2138\sb56\sl-276\slmult0\fi0\tx2498\tx8089 \up0 \expndtw-
1\charscalex100 h.\tab \up0 \expndtw-1\charscalex100 hasil evaluasi praktik
professional berkelanjutan\tab \up0 \expndtw-1\charscalex100 (OPPE) dan
terfokus\par\pard\li2138\sb43\sl-276\slmult0\fi360 \up0 \expndtw-1\charscalex100
(FPPE);\par\pard\ql \li2138\ri1220\sb0\sl-320\slmult0\tx2498\tx2498\tx2498 \up0
\expndtw-4\charscalex100 i. \tab \up0 \expndtw-1\charscalex100 hasil pendidikan dan
pelatihan tambahan dari pusat pendidikan, kolegium, \line\tab \up0
\expndtw0\charscalex100 perhimpunan profesi, dan rumah sakit yang kompeten
mengeluarkan \line \tab \up0 \expndtw-3\charscalex100 sertifikat; \par\pard\ql
\li2138\ri1158\sb0\sl-
316\slmult0\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\t
x2498\tx2498 \up0 \expndtw-4\charscalex100 j. \tab \up0 \expndtw0\charscalex102
untuk kewenangan tambahan pada pelayanan risiko tinggi maka rumah \line\tab \up0
\expndtw0\charscalex103 sakit
menentukan area pelayanan risiko tinggi seperti
prosedur\ul0\nosupersub\cf8\f9\fs24 cathlab\ul0\nosupersub\cf7\f8\fs24 , \line
\tab \up0 \expndtw0\charscalex101 penggantian sendi lutut dan panggul, pemberian
obat kemoterapi, obat \line \tab \up0 \expndtw-3\charscalex100 radioaktif, obat
anestesi, dan lainnya. Prosedur dengan risiko tinggi tersebut \line \tab \up0
\expndtw0\charscalex102 maka staf medis dapat diberikan kewenangan klinis
secara khusus. \line \tab \up0 \expndtw-2\charscalex100 Prosedur risiko tinggi,
obat-obat, atau layanan yang lain ditentukan di \line \tab \up0 \expndtw-
1\charscalex100 kelompok spesialisasi dan dirinci kewenangannya secara jelas.
Beberapa \line \tab \up0 \expndtw0\charscalex101 prosedur mungkin digolongkan
berisiko tinggi disebabkan oleh peralatan \line \tab \up0 \expndtw-1\charscalex100
yang digunakan seperti dalam kasus penggunaan robot atau penggunaan \line \tab \up0
\expndtw-1\charscalex100 tindakan dari jarak jauh melalui komputer. Juga pemasangan
implan yang \line \tab \up0 \expndtw0\charscalex103 memerlukan kaliberasi,
presisi, dan monitor jelas membutuhkan \line \tab \up0 \expndtw-
3\charscalex100 kewenangan klinis secara spesifik. (periksa juga LAB 7.4);
\par\pard\ql \li2138\ri1160\sb1\sl-
317\slmult0\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498\tx2498 \
up0 \expndtw-3\charscalex100 k. \tab \up0 \expndtw0\charscalex100 kewenangan klinis
tidak dapat diberikan jika rumah sakit tidak mempunyai \line\tab \up0
\expndtw0\charscalex103 peralatan khusus atau staf khusus untuk mendukung
pelaksanaan \line \tab \up0 \expndtw-4\charscalex100 kewenangan klinis. Sebagai
contoh, seorang nefrolog kompeten melakukan \line \tab \up0 \expndtw0\charscalex103
dialisis atau kardiolog kompeten memasang sten tidak dapat diberi \line
\tab \up0 \expndtw-3\charscalex100 kewenangan klinis jika rumah sakit tidak
memiliki peralatannya. \line \tab \up0 \expndtw0\charscalex103 Catatan: jika
anggota staf medis juga mempunyai tanggung jawab \line \tab \up0 \expndtw-
2\charscalex100 administrasi seperti ketua kelompok staf medis (KSM), administrator
rumah \line \tab \up0 \expndtw0\charscalex103 sakit, atau posisi lain maka tanggung
jawab peran ini diuraikan di uraian \line \tab \up0 \expndtw0\charscalex101 tugas
atau\ul0\nosupersub\cf8\f9\fs24 job description.\ul0\nosupersub\cf7\f8\fs24
(lihat juga KKS1.1) Rumah sakit menetapkan \line \tab \up0 \expndtw-3\charscalex100
sumber utama untuk memverifikasi peran administrasi ini. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Proses pemberian rincian kewenangan klinis.
\par\pard\li1538\sb42\sl-276\slmult0\fi120\tx2138 \up0 \expndtw-3\charscalex100
i.\tab \up0 \expndtw-3\charscalex100 Terstandar, objektif, berdasar atas bukti
(\ul0\nosupersub\cf8\f9\fs24 evidence
based\ul0\nosupersub\cf7\f8\fs24 ).\par\pard\li1538\sb43\sl-276\slmult0\fi67\tx2138
\up0 \expndtw-3\charscalex100 ii.\tab \up0 \expndtw-3\charscalex100 Terdokumentasi
di kebijakan rumah sakit.\par\pard\li1538\sb43\sl-276\slmult0\fi14\tx2138 \up0
\expndtw-3\charscalex100 iii.\tab \up0 \expndtw-3\charscalex100 Aktif dan
berkelanjutan mengikuti perubahan kredensial staf medis.\par\pard\li1538\sb41\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-3\charscalex100 iv.\tab \up0 \expndtw-
3\charscalex100 Diikuti semua lapisan keanggotaan staf
medis.\par\pard\li1538\sb41\sl-276\slmult0\fi52\tx2138 \up0 \expndtw-
3\charscalex100 v.\tab \up0 \expndtw-3\charscalex100 Dapat dibuktikan bahwa
prosedur yang digunakan efektif.\par\pard\qj \li1418\ri1222\sb0\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Surat penugasan klinis dan rincian kewenangan klinis
tersedia dan diumumkan \up0 \expndtw-2\charscalex100 kepada setiap staf medis
serta ke semua unit pelayanan. \par\pard\qj \li1418\ri1160\sb4\sl-313\slmult0
\up0 \expndtw-2\charscalex100 Surat penugasan klinis dan rincian kewenangan klinis
tersedia dalam bentuk tercetak \up0 \expndtw-3\charscalex100 maupun elektronik
(\ul0\nosupersub\cf8\f9\fs24 softcopy\ul0\nosupersub\cf7\f8\fs24 ) pada semua unit
pelayanan untuk menjawab pertanyaan \up0 \expndtw0\charscalex102 dari berbagai
pihak termasuk pasien, apakah seorang staf medis berwenang \up0 \expndtw-
3\charscalex100 melakukan tindakan klinis tertentu. (lihat juga TKP 5.2; KKS 3)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS
10 \par\pard\ql \li10156\sb243\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 339
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg340}
{\bkmkend Pg340}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1223\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Direktur menetapkan kewenangan klinis setelah
mendapat rekomendasi dari \line\tab \up0 \expndtw-3\charscalex100 Komite Medik
termasuk kewenangan tambahan. (R) \par\pard\qj \li1778\ri1227\sb4\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Ada bukti pemberian
kewenangan klinis berdasar atas rekomendasi \line\tab \up0 \expndtw-
3\charscalex100 kewenangan klinis dari Komite Medik. (D,W) \par\pard\qj
\li1778\ri1226\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3. Ada
bukti pelaksanaan pemberian kewenangan tambahan setelah melakukan \line\tab \up0
\expndtw-3\charscalex100 verifikasi dari sumber yang mengeluarkan kredensial. (D,W)
\par\pard\ql \li1778\ri1215\sb6\sl-313\slmult0\tx2138\tx2138\tx2138 \up0
\expndtw0\charscalex103 4. Surat penugasan klinis dan rincian kewenangan klinis
anggota staf medis \line\tab \up0 \expndtw0\charscalex103 dalam bentuk tercetak
atau elektronik (\ul0\nosupersub\cf8\f9\fs24 softcopy\ul0\nosupersub\cf7\f8\fs24 )
atau media lain tersedia di \line \tab \up0 \expndtw0\charscalex103 semua unit
pelayanan (contoh, kamar operasi, unit darurat,\ul0\nosupersub\cf8\f9\fs24 nurse
station\ul0\nosupersub\cf7\f8\fs24 ) \line \tab \up0 \expndtw-3\charscalex100
tempat anggota staf medis tersebut memberikan pelayanan. (D,W) \par\pard\qj
\li1778\ri1218\sb2\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 5. Setiap
anggota staf medis hanya memberikan pelayanan spesifik yang \line\tab \up0
\expndtw-3\charscalex100 ditentukan oleh rumah sakit. (D,W) \par\pard\qj
\li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\ri1967\sb0\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
MONITORING DAN EVALUASI BERKELANJUTAN ANGGOTA STAF \line\tab \up0 \expndtw-
3\charscalex100 MEDIS \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar KKS
11 \par\pard\qj \li1418\ri1161\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan proses yang seragam untuk
melaksanakan evaluasi mutu \up0 \expndtw-3\charscalex100 dan keselamatan asuhan
pasien yang diberikan oleh setiap anggota staf medis. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 11
\par\pard\ql \li1418\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penjelasan dari istilah yang dimuat di standar ini
sebagai berikut: \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb88\sl-276\slmult0 \up0 \expndtw-5\charscalex100 Monitoring
dan evaluasi berkelanjutan \par\pard\qj \li1418\ri1158\sb0\sl-318\slmult0\tx2993
\up0 \expndtw-3\charscalex100 Monitoring \tab \up0 \expndtw0\charscalex100 dan
evaluasi adalah proses dengan kegiatan terus menerus \line\up0
\expndtw-1\charscalex100 mengumpulkan dan menganalisis data serta informasi tentang
sikap, perkembangan \line \up0 \expndtw0\charscalex103 profesional, dan hasil dari
layanan klinis anggota staf medis. Pimpinan medik/unit \line \up0 \expndtw-
1\charscalex100 layanan bersama komite medis bertanggungjawab untuk
mengintegrasikan data dan \line \up0 \expndtw-2\charscalex100 informasi tentang
staf medis dan mengambil tindakan bilamana diperlukan. Tindakan \line \up0
\expndtw0\charscalex100 segera, dapat dalam bentuk nasehat menempatkan kewenangan
tertentu di bawah \line \up0 \expndtw0\charscalex100 supervisi, pembatasan
kewenangan, atau tindakan lain untuk membatasi risiko \line \up0 \expndtw-
1\charscalex100 terhadap pasien, dan untuk meningkatkan mutu serta keselamatan
pasien. Tindakan \line \up0 \expndtw0\charscalex102 yang lebih lama adalah
menggabungkan data dan informasi menjadi rekomendasi \line \up0
\expndtw0\charscalex102 terkait kelanjutan keanggotaan staf medis dan
kewenangan klinis. Proses ini \line \up0 \expndtw-3\charscalex100 berlangsung
paling kurang 3 tahun. Tindakan lain mungkin memberi tahu anggota staf \line
\up0 \expndtw-1\charscalex100 medis yang lain tentang sikap dan hasil layanan
klinis yang ada buktinya di data dan \line \up0 \expndtw-3\charscalex100 informasi
dari anggota staf medis. \par\pard\qj \li1418\ri1163\sb291\sl-320\slmult0 \up0
\expndtw0\charscalex102 Monitor dan evaluasi berkelanjutan staf medis menghasilkan
informasi kritikal dan \line \up0 \expndtw0\charscalex100 penting terhadap proses
mempertahankan keanggotaan staf medis dan proses \line \up0 \expndtw-
3\charscalex100 pemberian kewenangan klinis. (lihat juga KKS 9 dan KKS 9.2).
Walaupun dibutuhkan \line \up0 \expndtw0\charscalex100 3 tahun untuk memperpanjang
keanggotaan staf medis dan kewenangan kliniknya, \line \up0 \expndtw-
2\charscalex100 prosesnya dimaksudkan berlangsung sebagai proses berkelanjutan
dan dinamis. \par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 340
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg341}
{\bkmkend Pg341}\par\pard\qj \li1418\sb0\sl-300\slmult0 \par\pard\qj\li1418\sb0\sl-
300\slmult0 \par\pard\qj\li1418\sb0\sl-300\slmult0
\par\pard\qj\li1418\ri1214\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Masalah mutu dan insiden keselamatan pasien dapat
terjadi jika isu kinerja klinis \up0 \expndtw-3\charscalex100 anggota staf medis
tidak dikomunikasikan dan dilakukan tindakan. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Proses monitor dan evaluasi berkelanjutan dimaksudkan untuk \par\pard\ql
\li1778\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 1) meningkatkan praktik
individual terkait mutu dan asuhan pasien yang aman; \par\pard\ql
\li1778\ri1218\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex102 2)
digunakan sebagai dasar mengurangi variasi di dalam KSM (kelompok staf
\line\tab \up0 \expndtw-1\charscalex100 medis)/unit layanan dengan cara
membandingkan antara kolega, penyusunan \line \tab \up0 \expndtw-2\charscalex100
PPK (panduan praktik klinis), dan\ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 ; \par\pard\ql \li1778\ri1218\sb9\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100 3) digunakan sebagai
dasar memperbaiki kinerja kelompok staf medis/unit \line\tab \up0
\expndtw0\charscalex103 layanan dengan cara membandingkan acuan praktik di luar
rumah sakit, \line \tab \up0 \expndtw-3\charscalex100 publikasi riset, dan
indikator kinerja klinis nasional bila tersedia. \par\pard\qj
\li1418\ri1226\sb2\sl-320\slmult0 \up0 \expndtw0\charscalex100 Monitoring dan
evaluasi berkelanjutan dari staf medis memuat 3 (tiga) area umum, \up0 \expndtw-
3\charscalex100 yaitu perilaku, pengembangan profesional, dan kinerja klinis.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb81\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Perilaku \par\pard\qj \li1418\ri1173\sb11\sl-
317\slmult0 \up0 \expndtw0\charscalex103 Anggota staf medis ialah model atau mentor
dalam menumbuhkan budaya aman \up0 \expndtw0\charscalex103
(\ul0\nosupersub\cf8\f9\fs24 safety culture\ul0\nosupersub\cf7\f8\fs24 ) di rumah
sakit. Budaya aman ditandai dengan partisipasi penuh \up0
\expndtw0\charscalex102 semua staf untuk melaporkan bila ada insiden keselamatan
pasien tanpa ada rasa \up0 \expndtw-2\charscalex100 takut untuk melaporkan dan
disalahkan (\ul0\nosupersub\cf8\f9\fs24 no blame
culture).\ul0\nosupersub\cf7\f8\fs24 Budaya aman juga sangat \up0 \expndtw-
3\charscalex100 menghormati satu sama lain, antarkelompok profesional, dan tidak
terjadi sikap saling \up0 \expndtw0\charscalex103 mengganggu. Umpan balik staf
dalam bentuk survei atau mekanisme lain dapat \up0 \expndtw0\charscalex102
membentuk sikap dan perilaku yang diharapkan dapat mendukung anggota staf
\up0 \expndtw-3\charscalex100 menjadi model untuk menumbuhkan budaya aman.
\par\pard\ql \li1418\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Evaluasi
perilaku memuat: \par\pard\ql \li1778\ri1160\sb16\sl-310\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex100 a) evaluasi apakah seorang staf medis mengerti dan
mendukung kode etik dan \line\tab \up0 \expndtw-4\charscalex100 disiplin profesi
dan rumah sakit serta dilakukan identifikasi perilaku yang dapat \line \tab \up0
\expndtw-5\charscalex100 atau tidak dapat diterima maupun perilaku yang mengganggu;
\par\pard\qj \li1778\ri1191\sb2\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100
b) tidak ada laporan dari anggota staf medis tentang perilaku yang dianggap
tidak \line\tab \up0 \expndtw-3\charscalex100 dapat diterima atau mengganggu;
\par\pard\ql \li1418\ri1158\sb4\sl-316\slmult0\fi360\tx2138 \up0
\expndtw0\charscalex100 c) mengumpulkan, analisis, serta menggunakan data dan
informasi berasal dari \line\tab \up0 \expndtw-3\charscalex100 survei staf serta
survei lainnya tentang budaya aman di rumah sakit. \line \up0 \expndtw-
4\charscalex100 Proses monitoring dan evaluasi bekelanjutan harus dapat mengenali
hasil pencapaian, \line \up0 \expndtw0\charscalex104 pengembangan potensial terkait
kewenangan klinis dari anggota staf medis, dan \line \up0 \expndtw0\charscalex103
layanan yang diberikan. Evaluasi perilaku dilaksanakan secara kolaboratif
antara \line \up0 \expndtw-2\charscalex100 subkomite etik dan disiplin, manajer
SDM, manajer pelayanan, dan kepala unit kerja. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb170\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Pengembangan Profesional \par\pard\ql \li1778\ri1223\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-1\charscalex100 a) Anggota staf
medis berkembang dengan menerapkan teknologi baru dan \line\tab \up0
\expndtw-2\charscalex100 pengetahuan klinis baru. Setiap anggota staf medis dari
segala tingkatan akan \line \tab \up0 \expndtw-2\charscalex100 merefleksikan
perkembangan dan perbaikan pelayanan kesehatan dan praktik \line \tab \up0
\expndtw-3\charscalex100 profesional sebagai berikut: \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb38\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 341
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg342}
{\bkmkend Pg342}\par\pard\ql \li1778\sb0\sl-313\slmult0 \par\pard\ql\li1778\sb0\sl-
313\slmult0 \par\pard\ql\li1778\sb0\sl-313\slmult0
\par\pard\ql\li1778\ri1222\sb203\sl-313\slmult0\tx2138\tx2138\tx2138\tx2138 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 b) \tab \up0 \expndtw-
2\charscalex100 Asuhan pasien, penyediaan asuhan penuh kasih, tepat dan
efektif dalam \line\tab \up0 \expndtw-2\charscalex100 promosi kesehatan,
pencegahan penyakit, pengobatan penyakit, dan asuhan \line \tab \up0
\expndtw0\charscalex100 di akhir hidup. Alat ukurnya adalah layanan preventif dan
laporan dari pasien \line \tab \up0 \expndtw-3\charscalex100 serta keluarga. (lihat
juga HPK 3) \par\pard\ql \li1778\ri1190\sb2\sl-320\slmult0\tx2138\tx2138\tx2138
\up0 \expndtw-3\charscalex100 c) \tab \up0 \expndtw0\charscalex102 Pengetahuan
medik/klinik termasuk pengetahuan biomedik, klinis, \line\tab \up0
\expndtw-2\charscalex100 epidemiologi, ilmu pengetahuan sosial budaya, dan
pendidikan kepada pasien. \line \tab \up0 \expndtw-3\charscalex100 Alat ukurnya
adalah penerapan panduan praktik klinis \up0 \expndtw-3\charscalex100
(\ul0\nosupersub\cf8\f9\fs24 clinical practice \par\pard\qj \li2138\ri1163\sb0\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 guidelines\ul0\nosupersub\cf7\f8\fs24 )
termasuk revisi pedoman hasil pertemuan profesional dan publikasi. \up0 \expndtw-
4\charscalex100 (lihat juga TKP 11.2) \par\pard\ql \li1778\ri1159\sb0\sl-
317\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 d) \tab \up0 \expndtw0\charscalex100 Praktik belajar berdasar
bukti (\ul0\nosupersub\cf8\f9\fs24 practice-bases
learning\ul0\nosupersub\cf7\f8\fs24 ) dan pengembangan, \line\tab \up0
\expndtw0\charscalex100 penggunaan bukti ilmiah dan metode pemeriksaan, evaluasi,
serta perbaikan \line \tab \up0 \expndtw-3\charscalex100 asuhan pasien
berkelanjutan berdasar atas evaluasi dan belajar terus menerus \line \tab \up0
\expndtw-1\charscalex100 (contoh alat ukur survei klinis, memperoleh kewenangan
berdasar atas studi \line \tab \up0 \expndtw-2\charscalex100 dan keterampilan
klinis baru, dan partisipasi penuh pada pertemuan ilmiah). \line \up0 \expndtw-
3\charscalex100 e) \up0 \expndtw0\charscalex103 Kepandaian berkomunikasi
antarpersonal termasuk menjaga dan \line\tab \up0 \expndtw0\charscalex100
meningkatkan pertukaran informasi dengan pasien, keluarga pasien, dan
\line \tab \up0 \expndtw0\charscalex103 anggota tim layanan kesehatan yang lain
(contoh, partisipasi aktif di ronde \line \tab \up0 \expndtw-3\charscalex100
ilmiah, konsultasi tim, dan kepemimpinan tim). \par\pard\ql \li1778\ri1218\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-1\charscalex100 f) \tab \up0
\expndtw-1\charscalex100 Profesionalisme, janji mengembangkan profesionalitas terus
menerus, praktik \line\tab \up0 \expndtw0\charscalex102 etik, pengertian terhadap
perbedaan, serta perilaku bertanggung jawab \line \tab \up0
\expndtw0\charscalex102 terhadap pasien, profesi, dan masyarakat \up0
\expndtw0\charscalex102 (contoh, alat ukur: pendapat \par\pard\qj
\li2138\ri1226\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100 pimpinan di staf
medis terkait isu klinis dan isu profesi, aktif membantu diskusi \up0
\expndtw0\charscalex102 panel tentang etik, ketepatan waktu pelayanan di rawat
jalan maupun rawat \up0 \expndtw-3\charscalex100 inap, dan partisipasi di
masyarakat). \par\pard\ql \li1778\ri1200\sb0\sl-
315\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-4\charscalex100 g)
\tab \up0 \expndtw-1\charscalex100 Praktik berbasis sistem, serta sadar dan
tanggap terhadap jangkauan sistem \line\tab \up0 \expndtw-1\charscalex100 pelayanan
kesehatan yang lebih luas (contoh alat ukur: pemahaman terhadap \line \tab \up0
\expndtw0\charscalex104 regulasi rumah sakit yang terkait dengan tugasnya seperti
sistem asuransi \line \tab \up0 \expndtw-2\charscalex100 medis, asuransi kesehatan
(JKN), sistem kendali mutu, dan biaya. Peduli pada \line \tab \up0 \expndtw-
3\charscalex100 masalah resistensi antimikrob). \par\pard\ql \li1778\ri1219\sb0\sl-
316\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 h) \tab \up0 \expndtw0\charscalex103 Mengelola sumber daya,
memahami pentingnya
sumber daya dan \line\tab \up0 \expndtw0\charscalex100 berpartisipasi
melaksanakan asuhan yang efisien, serta menghindari \line \tab \up0
\expndtw-2\charscalex100 penyalahgunaan pemeriksaan untuk diagnostik dan
terapi yang tidak ada \line \tab \up0 \expndtw0\charscalex100 manfaatnya bagi
pasien serta meningkatkan biaya pelayanan kesehatan \line \tab \up0
\expndtw0\charscalex104 (contoh alat ukur: berpartisipasi dalam kendali mutu dan
biaya, kepedulian \line \tab \up0 \expndtw-2\charscalex100 terhadap biaya yang
ditanggung pasien, serta berpatisipasi dalam proses \line \tab \up0 \expndtw-
3\charscalex100 seleksi pengadaan) \par\pard\ql \li1778\ri1167\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138 \up0 \expndtw-3\charscalex100 i) \tab \up0
\expndtw0\charscalex103 Sebagai bagian dari proses penilaian, proses
monitoring dan evaluasi \line\tab \up0 \expndtw-3\charscalex100 berkelanjutan,
serta harus mengetahui kinerja anggota staf medis yang relevan \line \tab \up0
\expndtw-4\charscalex100 dengan potensi pengembangan kemampuan profesional staf
medis. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb56\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Kinerja
klinis \par\pard\qj \li1418\ri1163\sb8\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Proses monitoring dan evaluasi berkelanjutan staf medis
harus dapat memberi indikasi \up0 \expndtw-4\charscalex100 sebagai bagian dari
proses peninjauan bahwa kinerja anggota staf medis terkait upaya \up0 \expndtw-
5\charscalex100 mendukung budaya aman/keselamatan. \par\pard\ql \li10156\sb236\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 342
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg343}
{\bkmkend Pg343}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1220\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penilaian atas informasi bersifat umum berlaku bagi
semua anggota staf medis dan \up0 \expndtw0\charscalex100 juga tentang informasi
spesifik terkait kewenangan anggota staf medis dalam \up0 \expndtw-
3\charscalex100 memberikan pelayanannya. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb83\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Sumber data rumah sakit \par\pard\qj
\li1418\ri1220\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengumpulkan berbagai data untuk keperluan
manajemen, misalnya \up0 \expndtw-1\charscalex100 membuat laporan ke pimpinan rumah
sakit tentang alokasi sumber daya atau sistem \up0 \expndtw0\charscalex100
pembiayaan rumah sakit. Agar bermanfaat bagi evaluasi berkelanjutan seorang staf
\up0 \expndtw-3\charscalex100 medis maka sumber data rumah sakit \par\pard\ql
\li1778\ri1161\sb0\sl-326\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 harus
dikumpulkan sedemikian rupa agar teridentifikasi staf medis yang
\line\tab \up0 \expndtw-3\charscalex100 berperan. Harus terkait dengan praktik
klinis seorang anggota staf medis; \line \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 dapat menjadi
rujukan (\ul0\nosupersub\cf8\f9\fs24 benchmark\ul0\nosupersub\cf7\f8\fs24 ) di
dalam KSM/Unit layanan atau di luarnya \line\tab \up0 \expndtw-4\charscalex100
untuk mengetahui pola individu staf medis. \par\pard\qj \li1418\ri1213\sb0\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Contoh, sumber data potensial seperti itu
adalah lama hari rawat (\ul0\nosupersub\cf8\f9\fs24 length of
stay\ul0\nosupersub\cf7\f8\fs24 ), \line \up0 \expndtw-3\charscalex100 frekuensi
(jumlah pasien yang ditangani), angka kematian, pemeriksaan diagnostik, \line
\up0 \expndtw-3\charscalex100 pemakaian darah, pemakaian obat-obat tertentu, angka
ILO, dan lain sebagainya. \par\pard\ql \li1418\ri1222\sb295\sl-320\slmult0 \up0
\expndtw0\charscalex102 Monitoring dan evaluasi anggota staf medis berdasar atas
berbagai sumber data \up0 \expndtw-2\charscalex100 termasuk data cetak, data
elektronik, observasi dan, interaksi teman sejawat. \line \up0 \expndtw-
3\charscalex100 Simpulan proses monitor dan evaluasi anggota staf medis:
\par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-4\charscalex100 1. jenis
anggota staf medis, jenis KSM, jenis unit layanan terstandar; \par\pard\qj
\li1778\ri1208\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. data
monitor dan informasi dipergunakan untuk perbandingan internal, \line\tab
\up0 \expndtw-2\charscalex100 mengurangi variasi perilaku, serta pengembangan
profesional dan hasil klinis; \par\pard\ql \li1778\ri1158\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 3. data monitor dan
informasi dipergunakan untuk melakukan perbandingan \line\tab \up0 \expndtw-
3\charscalex100 eksternal dengan praktik berdasar bukti
(\ul0\nosupersub\cf8\f9\fs24 evidence based practice\ul0\nosupersub\cf7\f8\fs24 )
atau sumber \line \tab \up0 \expndtw-4\charscalex100 rujukan tentang data dan
informasi hasil klinis; \par\pard\qj \li1778\ri1227\sb0\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex100 4. dipimpin oleh ketua KSM/unit layanan, manajer
medis, atau unit kajian staf \line\tab \up0 \expndtw-5\charscalex100 medis;
\par\pard\qj \li1778\ri1218\sb5\sl-300\slmult0\tx2138 \up0 \expndtw-3\charscalex100
5. monitor dan evaluasi terhadap kepala bidang pelayanan dan kepala KSM oleh
\line\tab \up0 \expndtw-4\charscalex100 profesional yang kompeten. (lihat juga TKP
1.1) \par\pard\qj \li1418\ri1157\sb4\sl-320\slmult0 \up0 \expndtw-3\charscalex100
Kebijakan rumah sakit mengharuskan ada tinjauan (\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 ) paling sedikit selama 12 \line \up0 \expndtw-
4\charscalex100 bulan.\ul0\nosupersub\cf8\f9\fs24
Review\ul0\nosupersub\cf7\f8\fs24 dilakukan secara kolaborasi di antaranya oleh
kepala KSM/unit layanan, \line \up0 \expndtw-3\charscalex100 kepala bidang
pelayanan medis, subkomite mutu profesi komite medis, dan bagian IT. \line \up0
\expndtw-3\charscalex100 Temuan, simpulan, dan tindakan yang dijatuhkan atau yang
direkomendasikan dicatat \line \up0 \expndtw0\charscalex102
di\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24 praktisi serta
tercermin di kewenangan kliniknya. Pemberitahuan diberikan \line \up0 \expndtw-
2\charscalex100 kepada tempat di tempat praktisi memberikan layanan. (lihat juga
PMKP 4 dan KKS \line \up0 \expndtw-5\charscalex100 3) \par\pard\qj
\li1418\ri1164\sb300\sl-320\slmult0 \up0 \expndtw-3\charscalex100 Informasi yang
dibutuhkan untuk tinjauan ini dikumpulkan dari internal dan dari \up0
\expndtw-3\charscalex100 monitoring serta evaluasi berkelanjutan setiap anggota
staf termasuk juga dari sumber \up0 \expndtw-4\charscalex100 luar seperti
organisasi profesi atau sumber instansi resmi. \par\pard\qj
\li1418\ri1179\sb320\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf8\f9\fs24 File\ul0\nosupersub\cf7\f8\fs24 kredensial dari
seorang anggota staf medis harus menjadi sumber informasi yang \line \up0 \expndtw-
2\charscalex100 dinamis dan selalu ditinjau secara teratur. Contohnya, jika seorang
anggota staf \par\pard\ql \li10156\sb196\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 343
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg344}
{\bkmkend Pg344}\par\pard\qj \li1418\sb0\sl-317\slmult0 \par\pard\qj\li1418\sb0\sl-
317\slmult0 \par\pard\qj\li1418\sb0\sl-317\slmult0
\par\pard\qj\li1418\ri1157\sb188\sl-317\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 menyerahkan sertifikat kelulusan sebagai hasil dari
pelatihan spesialisasi khusus \up0 \expndtw0\charscalex102 maka kredensial baru ini
harus diverifikasi segera dari sumber yang mengeluarkan \up0
\expndtw0\charscalex102 sertifikat. Sama halnya, jika instansi dari luar
(MKEK/MKDKI) menyelidiki kejadian \up0 \expndtw0\charscalex100 sentinel terkait
seorang anggota staf medis dan memberi sanksi maka informasi ini \up0 \expndtw-
3\charscalex100 harus digunakan untuk evaluasi muatan kewenangan klinis anggota
staf medis. Untuk \up0 \expndtw-3\charscalex100 menjamin
bahwa\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24 staf medis
lengkap dan akurat,\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24
diperiksa paling sedikit 3 (tiga) \up0 \expndtw-1\charscalex100 tahun sekali dan
ada catatan di\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24
tindakan yang diberikan atau tindakan yang tidak \up0 \expndtw-3\charscalex100
diperlukan sehingga penempatan staf medis dapat berlanjut. \par\pard\qj
\li1418\ri1219\sb301\sl-320\slmult0 \up0 \expndtw0\charscalex100 Pertimbangan untuk
merinci kewenangan klinis waktu penempatan kembali sebagai \up0 \expndtw-
3\charscalex100 berikut: \par\pard\ql \li1778\ri1161\sb0\sl-
320\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-3\charscalex100 a)
anggota staf medis dapat diberikan kewenangan klinis tambahan berdasar atas
\line\tab \up0 \expndtw0\charscalex102 pendidikan dan pelatihan lanjutan.
Pendidikan dan pelatihan diverifikasi dari \line \tab \up0 \expndtw0\charscalex100
sumber utamanya. Pemberian penuh kewenangan klinis tambahan mungkin \line \tab \up0
\expndtw0\charscalex100 ditunda sampai proses verifikasi lengkap atau jika
dibutuhkan waktu harus \line \tab \up0 \expndtw-1\charscalex100 dilakukan
supervisi sebelum kewenangan klinis diberikan. Contoh, jumlah \line \tab \up0
\expndtw-2\charscalex100 kasus yang harus disupervisi dari kardiologi
intervensi; \par\pard\qj \li1778\ri1226\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 b) kewenangan klinis anggota
staf medis dapat dilanjutkan, dibatasi, atau \line\tab \up0 \expndtw-
3\charscalex100 dihentikan berdasar: \par\pard\ql \li2498\sb17\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3880?\ul0\nosupersub\cf7\f8\fs24 hasil dari proses tinjauan praktik profesional
berkelanjutan; \par\pard\qj \li2498\ri1218\sb8\sl-320\slmult0\tx2858 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3880?\ul0\nosupersub\cf7\f8\fs24
pembatasan kewenangan klinik dari organisasi profesi, KKI, MKEK,
\line\tab \up0 \expndtw-3\charscalex100 MKDKI, atau badan resmi lainnya;
\par\pard\qj \li2498\ri1226\sb0\sl-320\slmult0\tx2858 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3880?\ul0\nosupersub\cf7\f8\fs24 temuan rumah sakit dari hasil evaluasi kejadian
sentinel atau kejadian \line\tab \up0 \expndtw-3\charscalex100 lain;
\par\pard\ql \li2498\ri3306\sb17\sl-300\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3880?\ul0\nosupersub\cf7\f8\fs24 kesehatan staf
medis; \line \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3880?\ul0\nosupersub\cf7\f8\fs24 permintaan staf medis. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb84\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 11 \par\pard\ql
\li1778\ri1160\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi penilaian kinerja untuk evaluasi
mutu praktik profesional \line\tab \up0 \expndtw-3\charscalex100 berkelanjutan,
etik, dan disiplin staf medis. (lihat juga TKRS 11 EP 2 dan TKRS \line \tab \up0
\expndtw-7\charscalex100 12 EP 1). (R) \par\pard\ql \li1778\ri1220\sb9\sl-
310\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 2. Ada bukti monitoring
dan evaluasi mutu praktik profesional berkelanjutan, etik, \line\tab \up0
\expndtw0\charscalex102 dan disiplin staf medis untuk peningkatan mutu pelayanan
dan keselamatan \line \tab \up0 \expndtw-3\charscalex100 pasien. (D,W) \par\pard\ql
\li1778\ri1158\sb2\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-4\charscalex100 3.
Data dan informasi hasil pelayanan klinis dari staf klinis
di-\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 secara
objektif \line\tab \up0 \expndtw-1\charscalex100 dan berdasar atas bukti, jika
ada dilakukan\ul0\nosupersub\cf8\f9\fs24 benchmarking\ul0\nosupersub\cf7\f8\fs24
dengan pihak \line \tab \up0 \expndtw-3\charscalex100 eksternal rumah sakit.
(lihat juga TKRS 11.1). (D,W) \par\pard\ql \li1778\ri1158\sb5\sl-
315\slmult0\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw0\charscalex100 4. Data dan
informasi berasal dari proses monitoring dikaji sekurang-kurangnya \line\tab
\up0 \expndtw-4\charscalex100 setiap 12 bulan oleh kepala unit layanan, ketua
kelompok staf medis, subkomite \line \tab \up0 \expndtw-2\charscalex100 mutu,
manajer pelayanan medis. Hasil, simpulan, dan tindakan yang dilakukan \line \tab
\up0 \expndtw0\charscalex100 didokumentasikan di dalam\ul0\nosupersub\cf8\f9\fs24
file\ul0\nosupersub\cf7\f8\fs24 kredensial staf medis atau dokumen lain yang \line
\tab \up0 \expndtw-3\charscalex100 relevan. (D,W) \par\pard\qj
\li1778\ri1188\sb1\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 5. Bila ada
temuan yang berdampak pada pemberian kewenangan staf klinis, ada \line\tab \up0
\expndtw-2\charscalex100 proses untuk tindak lanjut terhadap temuan dan
tindakan tersebut \par\pard\ql \li10156\sb236\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 344
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg345}
{\bkmkend Pg345}\par\pard\qj \li2138\sb0\sl-300\slmult0 \par\pard\qj\li2138\sb0\sl-
300\slmult0 \par\pard\qj\li2138\sb0\sl-300\slmult0
\par\pard\qj\li2138\ri1217\sb253\sl-300\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 didokumentasi dalam\ul0\nosupersub\cf8\f9\fs24
file\ul0\nosupersub\cf7\f8\fs24 staf medis dan disampaikan ke tempat staf medis
\up0 \expndtw-3\charscalex100 memberikan pelayanan. (D,W) \par\pard\qj
\li1778\sb0\sl-320\slmult0 \par\pard\qj\li1778\sb0\sl-320\slmult0
\par\pard\qj\li1778\ri2899\sb4\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
PENEMPATAN ULANG STAF MEDIS DAN PEMBAHARUAN \line\tab \up0 \expndtw-3\charscalex100
KEWENANGAN KLINIS \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Standar KKS
12 \par\pard\qj \li1418\ri1218\sb14\sl-313\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan proses penetapan ulang
staf medis dan pmbaharuan \up0 \expndtw-2\charscalex100 kewenangan klinis paling
sedikit setiap 3 (tiga) tahun. Untuk penetapan kewenangan \up0
\expndtw0\charscalex100 klinis dilanjutkan dengan atau tanpa modifikasi
kewenangan klinis sesuai hasil \up0 \expndtw-3\charscalex100 monitoring dan
evaluasi berkelanjutan setiap anggota staf medis. \par\pard\ql \li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb82\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 12
\par\pard\ql \li1418\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penjelasan istilah distandar sebagai berikut:
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Penetapan ulang \par\pard\qj \li1418\ri1218\sb0\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Penetapan ulang adalah proses tinjauan
terhadap dokumentasi anggota staf medis \up0 \expndtw-3\charscalex100 untuk
verifikasi: \par\pard\li1778\sb34\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
3\charscalex100 a.\tab \up0 \expndtw-3\charscalex100 kelanjutan izin
(\ul0\nosupersub\cf8\f9\fs24
licence\ul0\nosupersub\cf7\f8\fs24 );\par\pard\li1778\sb46\sl-
276\slmult0\fi0\tx2138 \up0 \expndtw-3\charscalex100 b.\tab \up0 \expndtw-
2\charscalex100 apakah anggota staf medis tidak terkena tindakan etik dan disiplin
dari MKEK\par\pard\li1778\sb40\sl-276\slmult0\fi360 \up0 \expndtw-3\charscalex100
dan MKDKI;\par\pard\li1778\sb41\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-
3\charscalex100 c.\tab \up0 \expndtw-3\charscalex100 apakah tersedia dokumen untuk
mendukung penambahan kewenangan klinis\par\pard\li1778\sb41\sl-276\slmult0\fi360
\up0 \expndtw-3\charscalex100 atau tanggung jawab di rumah
sakit;\par\pard\li1778\sb43\sl-276\slmult0\fi0\tx2138 \up0 \expndtw-3\charscalex100
d.\tab \up0 \expndtw-2\charscalex100 apakah anggota staf medis mampu secara fisik
dan mental memberikan asuhan\par\pard\li1778\sb41\sl-276\slmult0\fi360 \up0
\expndtw-3\charscalex100 dan pengobatan tanpa supervisi;\par\pard\ql
\li1778\ri1177\sb0\sl-
316\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\t
x2138\tx2138\tx2138\tx2138 \up0 \expndtw-3\charscalex100 e. \tab \up0
\expndtw0\charscalex102 informasi yang dibutuhkan untuk tinjauan ini
dikumpulkan dari internal, \line\tab \up0 \expndtw-1\charscalex100 monitoring,
dan evaluasi berkelanjutan setiap anggota staf termasuk juga dari \line \tab
\up0 \expndtw0\charscalex102 sumber luar seperti organisasi profesi atau
sumber instansi resmi.\ul0\nosupersub\cf8\f9\fs24 File \line \tab \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 kredensial dari seorang anggota
staf medis harus menjadi sumber informasi \line \tab \up0 \expndtw-1\charscalex100
yang dinamis dan selalu ditinjau secara teratur. Contohnya, jika
seorang \line \tab \up0 \expndtw0\charscalex102 anggota staf menyerahkan
sertifikat kelulusan sebagai hasil dari pelatihan \line \tab \up0
\expndtw0\charscalex100 spesialisasi khusus, kredensial baru ini harus diverifikasi
segera dari sumber \line \tab \up0 \expndtw0\charscalex103 yang mengeluarkan
sertifikat. Sama halnya, jika instansi dari luar \line \tab \up0
\expndtw-1\charscalex100 (MKEK/MKDKI) menyelidiki kejadian sentinel terkait
seorang anggota staf \line \tab \up0 \expndtw-1\charscalex100 medis dan memberi
sanksi maka informasi ini harus digunakan untuk evaluasi \line \tab \up0 \expndtw-
2\charscalex100 muatan kewenangan klinis anggota staf medis. Untuk menjamin
bahwa\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24 staf \line
\tab \up0 \expndtw-1\charscalex100 medis lengkap dan
akurat,\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24 diperiksa
paling sedikit 3 (tiga) tahun sekali dan \line \tab \up0 \expndtw0\charscalex104
ada catatan di\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24
tindakan yang diberikan atau tindakan tidak diperlukan \line \tab \up0 \expndtw-
3\charscalex100 sehingga penempatan staf medis dapat berlanjut. \par\pard\qj
\li1418\ri1218\sb315\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Pertimbangan
untuk merinci kewenangan klinis saat penetapan ulang mencakup hal\up0 \expndtw-
3\charscalex100 hal sebagai berikut: \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb50\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 345
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg346}
{\bkmkend Pg346}\par\pard\ql \li1778\sb0\sl-310\slmult0 \par\pard\ql\li1778\sb0\sl-
310\slmult0 \par\pard\ql\li1778\sb0\sl-310\slmult0
\par\pard\ql\li1778\ri1159\sb214\sl-310\slmult0\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 a) anggota staf medis dapat diberikan
kewenangan klinis tambahan berdasar atas \line\tab \up0 \expndtw0\charscalex102
pendidikan dan pelatihan lanjutan. Pendidikan dan pelatihan diverifikasi dari \line
\tab \up0 \expndtw-1\charscalex100 sumber aslinya \up0 \expndtw0\charscalex102
(lembaga pemerintah atau kolegium). Pemberian penuh \par\pard\qj
\li2138\ri1204\sb2\sl-320\slmult0
\up0 \expndtw0\charscalex100 kewenangan klinis tambahan mungkin ditunda
sampai proses verifikasi \up0 \expndtw0\charscalex102 lengkap atau jika
dibutuhkan waktu harus dilakukan supervisi sebelum \up0 \expndtw-
2\charscalex100 kewenangan klinis diberikan. Contoh, jumlah kasus yang harus
disupervisi dari \up0 \expndtw-3\charscalex100 kardiologi intervensi;
\par\pard\qj \li1778\ri1223\sb0\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
b) kewenangan klinis anggota staf medis dapat dilanjutkan, dibatasi,
atau \line\tab \up0 \expndtw-3\charscalex100 dihentikan berdasar atas: \par\pard\ql
\li1778\sb17\sl-276\slmult0 \up0 \expndtw-4\charscalex100 c) Hasil dari proses
tinjauan praktik profesional berkelanjutan; \par\pard\qj \li1778\ri1218\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex102 d) pembatasan kewenangan klinis
dari organisasi profesi, KKI, MKEK, MKDKI, \line\tab \up0 \expndtw-3\charscalex100
atau badan resmi lainnya; \par\pard\ql \li1778\sb37\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 e) temuan rumah sakit dari hasil evaluasi kejadian sentinel atau
kejadian lain; \par\pard\ql \li1778\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex100 f) kesehatan staf medis; \par\pard\ql \li1778\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 g) permintaan staf medis.
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS
12 \par\pard\qj \li1778\ri1218\sb0\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Berdasar atas monitoring
dan evaluasi berkelanjutan kredensial anggota staf \line\tab \up0
\expndtw0\charscalex100 medis yang dilaksanakan paling sedikit setiap \up0
\expndtw0\charscalex100 3 (tiga) tahun ditetapkan \par\pard\ql \li2138\sb25\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 kewenangan klinisnya apakah tetap,
bertambah, atau berkurang. (R) \par\pard\qj \li1778\ri1220\sb8\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Ada bukti dokumen setiap
anggota staf medis selalu diperbaharui secara \line\tab \up0 \expndtw-
3\charscalex100 periodik. (D,W) \par\pard\ql \li1778\ri1218\sb0\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-1\charscalex100 3. Ada bukti pemberian
kewenangan tambahan didasarkan atas kredensial yang \line\tab \up0
\expndtw0\charscalex104 telah diverifikasi dari sumber aslinya sesuai dengan
peraturan perundang-\line \tab \up0 \expndtw-3\charscalex100 undangan. (D)
\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0
\par\pard\ql\li1778\sb105\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 STAF
KEPERAWATAN \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb148\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Standar KKS 13 \par\pard\qj
\li1418\ri1226\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai proses yang efektif untuk
mengumpulkan, verifikasi, dan \up0 \expndtw-1\charscalex100 mengevaluasi kredensial
staf keperawatan (pendidikan, registrasi, izin, kewenangan, \up0 \expndtw-
2\charscalex100 pelatihan, dan pengalaman). \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb205\sl-276\slmult0
\up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS
13 \par\pard\qj \li1418\ri1219\sb71\sl-316\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit perlu memastikan untuk mempunyai staf
keperawatan yang kompeten \line \up0 \expndtw0\charscalex103 sesuai dengan misi,
sumber daya, dan kebutuhan pasien. Staf keperawatan \line \up0 \expndtw-
1\charscalex100 bertanggungjawab untuk memberikan asuhan keperawatan pasien secara
langsung. \line \up0 \expndtw0\charscalex100 Sebagai tambahan, asuhan keperawatan
memberikan kontribusi terhadap\ul0\nosupersub\cf8\f9\fs24 outcome \line \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 pasien secara keseluruhan.
Rumah sakit harus memastikan bahwa perawat yang \line \up0 \expndtw-1\charscalex100
kompeten untuk memberikan asuhan keperawatan dan harus spesifik terhadap jenis
\line \up0 \expndtw-1\charscalex100 asuhan keperawatan sesuai dengan peraturan
perundang-undangan. Rumah sakit \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb84\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 346
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg347}
{\bkmkend Pg347}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1226\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 memastikan bahwa setiap perawat yang kompeten
untuk memberikan asuhan \up0 \expndtw-1\charscalex100 keperawatan, baik mandiri,
kolaborasi, delegasi, serta mandat kepada pasien secara \up0 \expndtw-
2\charscalex100 aman dan efektif dengan cara \par\pard\qj \li1778\ri1577\sb99\sl-
300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 a) memahami peraturan dan
perundang-undangan terkait perawat dan praktik \line\tab \up0 \expndtw-
3\charscalex100 keperawatan; \par\pard\qj \li1778\ri1443\sb84\sl-320\slmult0\tx2138
\up0 \expndtw-2\charscalex100 b) mengumpulkan semua kredensial yang ada untuk
setiap perawat, sekurang-\line\tab \up0 \expndtw-3\charscalex100 kurangnya meliputi
\par\pard\qj \li2498\ri1221\sb60\sl-320\slmult0\tx2858 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3844?\ul0\nosupersub\cf7\f8\fs24 bukti
pendidikan, registrasi, izin, kewenangan, pelatihan, serta \line\tab \up0
\expndtw-3\charscalex100 pengalaman terbaru dan diverifikasi dari sumber
aslinya; \par\pard\qj \li2498\ri1222\sb60\sl-320\slmult0\tx2858 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf12\f13\fs24 \u-
3844?\ul0\nosupersub\cf7\f8\fs24 bukti kompetensi terbaru melalui informasi dari
sumber lain di tempat \line\tab \up0 \expndtw-3\charscalex100 perawat pernah
bekerja sebelumnya; \par\pard\qj \li2498\ri1168\sb60\sl-320\slmult0\tx2858 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3844?\ul0\nosupersub\cf7\f8\fs24 surat rekomendasi dan/atau informasi lain yang
mungkin diperlukan \line\tab \up0 \expndtw-4\charscalex100 rumahsakit, antara lain
riwayat kesehatan dan sebagainya; \par\pard\ql \li1778\ri1159\sb64\sl-
316\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-1\charscalex100
c) rumah sakit perlu melakukan setiap upaya untuk memverifikasi
informasi \line\tab \up0 \expndtw-4\charscalex100 penting dari berbagai sumber
dengan jalan mengecek ke\ul0\nosupersub\cf8\f9\fs24
website\ul0\nosupersub\cf7\f8\fs24 resmi institusi \line \tab \up0
\expndtw0\charscalex104 pendidikan pelatihan melalui email dan surat tercatat.
Pemenuhan standar \line \tab \up0 \expndtw-2\charscalex100 mensyaratkan verifikasi
sumber utama dilaksanakan untuk perawat yang akan \line \tab \up0 \expndtw-
1\charscalex100 dan sedang bekerja. Bila verifikasi tidak mungkin dilakukan
seperti hilang \line \tab \up0 \expndtw0\charscalex102 karena bencana atau
sekolahnya tutup maka hal ini didapatkan dari sumber \line \tab \up0 \expndtw-
3\charscalex100 resmi lain. \par\pard\ql \li1509\sb0\sl-276\slmult0
\par\pard\ql\li1509\sb222\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 13 \par\pard\qj
\li1778\ri1224\sb68\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rumah sakit dengan proses yang efektif
untuk mengumpulkan, \line\tab \up0 \expndtw-1\charscalex100 verifikasi dan
mengevaluasi kredensial staf keperawatan \up0 \expndtw-3\charscalex100
(pendidikan, \par\pard\ql \li2138\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100
registrasi, izin, kewenangan, pelatihan, dan pengalaman). (R) \par\pard\qj
\li1778\ri1226\sb68\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Tersedia
dokumentasi pendidikan, registrasi, sertifikasi, izin, pelatihan, dan \line\tab
\up0 \expndtw-3\charscalex100 pengalaman. (D,W) \par\pard\ql \li1778\sb117\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 3. Terdapat pelaksanaan verifikasi dari
sumber aslinya yang seragam. (D,W) \par\pard\qj \li1778\ri1168\sb68\sl-
320\slmult0\tx2138 \up0 \expndtw-3\charscalex100 4. Ada dokumen kredensial yang
dipelihara dari setiap anggota staf keperawatan. \line\tab \up0 \expndtw-
4\charscalex100 (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb29\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar KKS 14 \par\pard\qj \li1418\ri1618\sb96\sl-
310\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
melaksanakan identifikasi tanggungjawab pekerjaan dan penugasan \up0 \expndtw-
2\charscalex100 klinis berdasar atas kredensial staf perawat sesuai dengan
peraturan perundang\up0 \expndtw-3\charscalex100 undangan. \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb223\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 14
\par\pard\ql \li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb164\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 347
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg348}
{\bkmkend Pg348}\par\pard\qj \li1418\sb0\sl-310\slmult0 \par\pard\qj\li1418\sb0\sl-
310\slmult0 \par\pard\qj\li1418\sb0\sl-310\slmult0
\par\pard\qj\li1418\ri1157\sb214\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Hasil kredensial perawat berupa rincian kewenangan
klinis menjadi landasan untuk
\up0 \expndtw-3\charscalex100 membuat uraian tugas, wewenang, dan tanggungjawab
klinis di unit pelayanan tempat \up0 \expndtw-4\charscalex100 perawat tersebut
ditugaskan. \par\pard\ql \li1418\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 14 \par\pard\qj
\li1778\ri1159\sb8\sl-320\slmult0\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada penetapan rincian kewenangan klinis perawat
berdasar atas pendidikan, \line\tab \up0 \expndtw-4\charscalex100 registrasi,
sertifikasi, izin, pelatihan, dan pengalaman anggota staf keperawatan. \par\pard\ql
\li2138\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 (R) \par\pard\qj
\li1778\ri1197\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Ada
pelaksanaan proses pembuatan rincian kewenangan klinis sesuai dengan \line\tab \up0
\expndtw-4\charscalex100 peraturan perundang-undangan.(D,W) \par\pard\ql
\li1778\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3. Ada berkas
kredensial yang dipelihara dari setiap staf keperawatan. (D,W) \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb12\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar KKS 15 \par\pard\qj \li1418\ri1220\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
melakukan evaluasi kinerja staf keperawatan berdasar atas partisipasi \up0
\expndtw-3\charscalex100 dalam kegiatan peningkatan mutu rumah sakit.
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud danTujuan KKS 15 \par\pard\qj
\li1418\ri1158\sb0\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Peran klinis yang penting staf keperawatan mengharuskan
staf tersebut berpartisipasi \up0 \expndtw-7\charscalex100 secara proaktif dalam
program peningkatan mutu klinis rumah sakit. \par\pard\qj \li1418\ri1158\sb188\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Rumah sakit melakukan evaluasi kinerja
individu staf perawat bila ada temuan dalam \up0 \expndtw-7\charscalex100 aktivitas
peningkatan mutu. \par\pard\qj \li1418\ri1157\sb200\sl-320\slmult0 \up0 \expndtw-
4\charscalex100 Hasil kajian, tindakan yang diambil, dan setiap dampak atas
tanggung jawab pekerjaan \up0 \expndtw-6\charscalex100 didokumentasikan
dalam\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24 kredensial
perawat tersebut atau\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24
lainnya. \par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS 15 \par\pard\qj
\li1778\ri1158\sb8\sl-320\slmult0\tx2138 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada dokumentasi penilaian mutu staf
keperawatan berpatisipasi di dalam \line\tab \up0 \expndtw-5\charscalex100
program peningkatan mutu rumah sakit. (D,W) \par\pard\qj \li1778\ri1183\sb17\sl-
300\slmult0\tx2138 \up0 \expndtw-2\charscalex100 2. Kinerja individual staf
keperawatan dikaji bila ada temuan dalam aktivitas \line\tab \up0 \expndtw-
4\charscalex100 peningkatan mutu. (D,W) \par\pard\qj \li1778\ri1159\sb4\sl-
320\slmult0\tx2138 \up0 \expndtw-1\charscalex100 3. Seluruh data
proses\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 kinerja staf
keperawatan didokumentasikan dalam \line\tab \up0 \expndtw-5\charscalex100
kredesial perawat atau dokumen lainnya. (D,W) \par\pard\ql \li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb217\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24
STAF KLINIS PEMBERI ASUHAN LAINNYA DAN STAF KLINIS LAINNYA \par\pard\ql
\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb208\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Standar KKS 16 \par\pard\qj \li1418\ri1216\sb8\sl-320\slmult0
\up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai
proses yang efektif untuk mengumpulkan, verifikasi, dan \line \up0
\expndtw0\charscalex102 mengevaluasi kredensial profesional pemberi asuhan (PPA)
lainnya dan staf klinis \line \up0 \expndtw-2\charscalex100 lainnya (pendidikan,
registrasi, izin, kewenangan, pelatihan, dan pengalaman). \par\pard\ql
\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb243\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 348
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg349}
{\bkmkend Pg349}\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb68\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 16
\par\pard\qj \li1418\ri1157\sb70\sl-318\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit perlu memastikan mempunyai profesional
pemberi asuhan (PPA) lainnya \line \up0 \expndtw0\charscalex100 dan staf klinis
lainnya yang kompeten sesuai dengan misi, sumber daya, dan \line \up0
\expndtw0\charscalex100 kebutuhan pasien. Profesional pemberi asuhan (PPA) lainnya
dan staf klinis lainnya \line \up0 \expndtw-2\charscalex100 bertanggungjawab
memberikan asuhan pasien secara langsung. Sebagai tambahan, \line \up0 \expndtw-
2\charscalex100 asuhan memberikan kontribusi terhadap\ul0\nosupersub\cf8\f9\fs24
outcome\ul0\nosupersub\cf7\f8\fs24 pasien secara keseluruhan. Rumah \line \up0
\expndtw0\charscalex100 sakit harus memastikan bahwa profesional pemberi asuhan
(PPA) lainnya dan staf \line \up0 \expndtw-1\charscalex100 klinis lainnya yang
kompeten untuk memberikan asuhan dan harus spesifik terhadap \line \up0
\expndtw0\charscalex100 jenis asuhan sesuai dengan peraturan perundang-
undangan. Rumah sakit \line \up0 \expndtw0\charscalex100 memastikan bahwa
setiap profesional pemberi asuhan (PPA) lainnya dan staf klinis \line \up0
\expndtw-2\charscalex100 lainnya yang kompeten memberikan asuhan, baik mandiri,
kolaborasi, delegasi, serta \line \up0 \expndtw-3\charscalex100 mandat kepada
pasien secara aman dan efektif dengan cara: \par\pard\qj \li1778\ri1216\sb61\sl-
320\slmult0\tx2138\tx2138 \up0 \expndtw-3\charscalex100 a) \tab \up0
\expndtw0\charscalex101 memahami peraturan dan perundang-undangan terkait
profesional pemberi \line\tab \up0 \expndtw-3\charscalex100 asuhan (PPA) lainnya
dan staf klinis lainnya dan praktik profesinya; \par\pard\qj
\li2498\ri1217\sb60\sl-320\slmult0\tx2858 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf12\f13\fs24 \u-3844?\ul0\nosupersub\cf7\f8\fs24 mengumpulkan
semua kredensial yang ada untuk setiap profesional \line\tab \up0
\expndtw0\charscalex100 pemberi asuhan \up0 \expndtw0\charscalex104 (PPA) lainnya
dan staf klinis lainnya sekurang-\par\pard\ql \li2858\sb37\sl-276\slmult0
\up0 \expndtw-3\charscalex100 kurangnya meliputi \par\pard\qj
\li2498\ri1221\sb68\sl-320\slmult0\tx2858 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf12\f13\fs24 \u-3844?\ul0\nosupersub\cf7\f8\fs24 bukti
pendidikan, registrasi, izin, kewenangan, pelatihan serta \line\tab
\up0 \expndtw-3\charscalex100 pengalaman terbaru, dan diverifikasi dari sumber
aslinya; \par\pard\ql \li2498\ri1192\sb60\sl-320\slmult0\tx2858\tx2858 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf12\f13\fs24 \u-
3844?\ul0\nosupersub\cf7\f8\fs24 bukti kompetensi terbaru melalui informasi dari
sumber lain di tempat \line\tab \up0 \expndtw-2\charscalex100 profesional pemberi
asuhan (PPA) lainnya dan staf klinis lainnya pernah \line \tab \up0 \expndtw-
3\charscalex100 bekerja sebelumnya; \par\pard\qj \li2498\ri1228\sb60\sl-
320\slmult0\tx2858 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3844?\ul0\nosupersub\cf7\f8\fs24 surat rekomendasi dan/atau informasi lain yang
mungkin diperlukan \line\tab \up0 \expndtw-3\charscalex100 rumah sakit, antara
lain riwayat kesehatan dan sebagainya; \par\pard\ql \li1778\sb0\sl-320\slmult0
\par\pard\ql\li1778\ri1157\sb120\sl-
320\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-
3\charscalex100 b) \tab \up0 \expndtw-1\charscalex100 rumah sakit perlu
melakukan setiap upaya untuk memverifikasi informasi \line\tab \up0
\expndtw0\charscalex102 penting dari berbagai sumber dengan jalan mengecek
ke\ul0\nosupersub\cf8\f9\fs24 website\ul0\nosupersub\cf7\f8\fs24 resmi dari \line
\tab \up0 \expndtw-3\charscalex100 institusi pendidikan pelatihan, melalui email,
surat tercatat. Pemenuhan standar \line \tab \up0 \expndtw-3\charscalex100
mensyaratkan verifikasi sumber utama dilaksanakan untuk profesional pemberi
\line \tab \up0 \expndtw0\charscalex100 asuhan (PPA) lainnya dan staf klinis
lainnya yang akan dan sedang bekerja. \line \tab \up0 \expndtw0\charscalex104 Bila
verifikasi tidak mungkin dilakukan seperti hilang karena bencana atau \line \tab
\up0 \expndtw-3\charscalex100 sekolahnya tutup maka hal ini didapat dari sumber
resmi lain. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-
276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb29\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian KKS 16 \par\pard\ql \li1778\ri1220\sb88\sl-320\slmult0\tx2138\tx2138 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rumah sakit
untuk proses yang efektif untuk mengumpulkan, \line\tab \up0 \expndtw-
2\charscalex100 verifikasi dan mengevaluasi kredensial profesional pemberi
asuhan (PPA) \line \tab \up0 \expndtw-3\charscalex100 lainnya dan staf klinis
lainnya \up0 \expndtw-3\charscalex100 (pendidikan, registrasi, izin, kewenangan,
\par\pard\ql \li2138\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100
pelatihan, dan pengalaman). (R) \par\pard\qj \li1778\ri1226\sb88\sl-
320\slmult0\tx2138 \up0 \expndtw0\charscalex100 2. Tersedia dokumentasi
pendidikan, registrasi, sertifikasi, izin, pelatihan, dan \line\tab \up0 \expndtw-
3\charscalex100 pengalaman. (D,W) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb43\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 349
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg350}
{\bkmkend Pg350}\par\pard\ql \li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb0\sl-276\slmult0 \par\pard\ql\li1778\sb0\sl-
276\slmult0 \par\pard\ql\li1778\sb68\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Terdapat pelaksanaan verifikasi
dari sumber aslinya yang seragam. (D,W) \par\pard\qj \li1778\ri1219\sb68\sl-
320\slmult0\tx2138 \up0 \expndtw-2\charscalex100 4. Ada dokumen kredensial
yang dipelihara dari setiap anggota profesional \line\tab \up0 \expndtw-
3\charscalex100 pemberi asuhan (PPA) lainnya dan staf klinis lainnya. (D,W)
\par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb201\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar KKS 17
\par\pard\qj \li1418\ri1226\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan identifikasi tanggungjawab
pekerjaan dan penugasan \up0 \expndtw0\charscalex102 klinis berdasar atas
kredensial profesional pemberi asuhan (PPA) lainnya dan staf \up0 \expndtw-
3\charscalex100 klinis lainnya sesuai dengan peraturan perundang-undangan.
\par\pard\ql \li1418\sb237\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 17 \par\pard\qj
\li1418\ri1152\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempekerjakan atau dapat mengizinkan
berbagai profesional pemberi \up0 \expndtw-3\charscalex100 asuhan (PPA) lainnya dan
staf klinis lainnya untuk memberikan asuhan dan pelayanan \up0
\expndtw0\charscalex103 kepada pasien atau berpartisipasi dalam proses asuhan
pasien. Contohnya, para \up0 \expndtw-4\charscalex100 profesional ini termasuk
bidan, nutrisionis, apoteker, fisioterapis, teknisi transfusi darah, \up0 \expndtw-
5\charscalex100 penata anestesi, dan lainnya. \par\pard\qj \li1418\ri1151\sb180\sl-
320\slmult0 \up0 \expndtw-5\charscalex100 Bila pendidikannya profesi maka termasuk
golongan profesional pemberi asuhan (PPA), \line \up0 \expndtw-2\charscalex100
sedangkan bila pendidikannya vokasi maka kewenangannya adalah sebagai PPA
\line \up0 \expndtw-5\charscalex100 lainnya. \par\pard\qj \li1418\ri1153\sb200\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Bila profesional pemberi asuhan (PPA)
lainnya dan staf klinis lainnya tersebut yang \up0 \expndtw-1\charscalex100
diizinkan bekerja atau berpraktik di rumah sakit maka rumah sakit
bertanggungjawab \up0 \expndtw-5\charscalex100 untuk melakukan proses
kredensialing. \par\pard\qj \li1418\ri1151\sb206\sl-313\slmult0 \up0 \expndtw-
3\charscalex100 Rumah sakit harus memastikan bahwa profesional pemberi asuhan (PPA)
lainnya dan \up0 \expndtw-1\charscalex100 staf klinis lainnya tersebut kompeten
untuk ikut memberikan asuhan dan harus \up0 \expndtw0\charscalex102 menetapkan
jenis asuhan serta pengobatan yang diizinkan bila tidak bertentangan \up0 \expndtw-
5\charscalex100 dengan peraturan perundang-undangan. \par\pard\qj
\li1418\ri1219\sb202\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Rumah sakit
memastikan bahwa profesional pemberi asuhan (PPA) lainnya dan staf \up0
\expndtw0\charscalex102 klinis lainnya tersebut kompeten untuk memberikan asuhan
yang aman dan efektif \up0 \expndtw-3\charscalex100 kepada pasien dengan
\par\pard\qj \li1778\ri1216\sb200\sl-320\slmult0\tx2138 \up0
\expndtw0\charscalex102 a) memahami peraturan dan perundang-undangan terkait
profesional pemberi \line\tab \up0 \expndtw-3\charscalex100 asuhan (PPA) lainnya
dan staf klinis lainnya; \par\pard\qj \li1778\ri1168\sb180\sl-320\slmult0\tx2138
\up0 \expndtw0\charscalex100 b) mengumpulkan semua kredensial yang ada untuk
setiap profesional pemberi \line\tab \up0 \expndtw-3\charscalex100 asuhan (PPA)
lainnya dan staf klinis lainnya sekurang-kurangnya meliputi: \par\pard\qj
\li2498\ri1219\sb200\sl-320\slmult0\tx2858 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf12\f13\fs24 \u-3844?\ul0\nosupersub\cf7\f8\fs24 bukti
pendidikan, registrasi, izin, kewenangan, pelatihan, dan \line\tab
\up0 \expndtw-3\charscalex100 pengalaman terbaru serta diverifikasi dari sumber
aslinya; \par\pard\ql \li2498\ri1192\sb200\sl-320\slmult0\tx2858\tx2858 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf12\f13\fs24 \u-
3844?\ul0\nosupersub\cf7\f8\fs24 bukti kompetensi terbaru melalui informasi dari
sumber lain di tempat \line\tab \up0 \expndtw-2\charscalex100 profesional pemberi
asuhan (PPA) lainnya dan staf klinis lainnya pernah \line \tab \up0 \expndtw-
3\charscalex100 bekerja sebelumnya; \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb250\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 350
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg351}
{\bkmkend Pg351}\par\pard\qj \li2498\sb0\sl-300\slmult0 \par\pard\qj\li2498\sb0\sl-
300\slmult0 \par\pard\qj\li2498\sb0\sl-300\slmult0
\par\pard\qj\li2498\ri1222\sb253\sl-300\slmult0\tx2858 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3844?\ul0\nosupersub\cf7\f8\fs24 surat
rekomendasi dan/atau informasi lain yang mungkin diperlukan \line\tab \up0
\expndtw-3\charscalex100 rumah sakit, antara lain riwayat kesehatan dan sebagainya;
\par\pard\ql \li1778\ri1157\sb206\sl-
317\slmult0\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138\tx2138 \up0 \expndtw-
2\charscalex100 c) melakukan setiap upaya memverifikasi informasi penting dari
berbagai sumber \line\tab \up0 \expndtw0\charscalex102 dengan jalan mengecek
ke\ul0\nosupersub\cf8\f9\fs24 website\ul0\nosupersub\cf7\f8\fs24 resmi dari
institusi pendidikan pelatihan \line \tab \up0 \expndtw0\charscalex100 melalui
email dan surat tercatat. Pemenuhan standar mensyaratkan verifikasi \line \tab \up0
\expndtw-2\charscalex100 sumber aslinya dilaksanakan untuk profesional pemberi
asuhan dan PPA \line \tab \up0 \expndtw-1\charscalex100 lainnya yang akan dan
sedang bekerja. Bila verifikasi tidak mungkin dilakukan \line \tab \up0 \expndtw-
3\charscalex100 seperti hilangnya dokumen karena bencana atau sekolahnya tutup maka
hal ini \line \tab \up0 \expndtw-1\charscalex100 dapat diperoleh dari sumber
resmi lain.\ul0\nosupersub\cf8\f9\fs24 File\ul0\nosupersub\cf7\f8\fs24
kredensial setiap profesional \line \tab \up0 \expndtw0\charscalex103 pemberi
asuhan dan PPA lainnya harus tersedia dan dipelihara serta \line \tab
\up0 \expndtw-2\charscalex100 diperbaharui secara berkala sesuai dengan peraturan
perundang-undangan\ul0\nosupersub\cf6\f7\fs24 . \par\pard\ql \li1485\sb237\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Elemen Penilaian KKS 17 \par\pard\ql
\li1778\ri1161\sb208\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada penetapan rincian kewenangan klinis profesional
pemberi asuhan (PPA) \line\tab \up0 \expndtw0\charscalex100 lainnya dan staf klinis
lainnya berdasar atas pendidikan, registrasi, sertifikasi, \line \tab \up0
\expndtw-4\charscalex100 izin, pelatihan, dan pengalaman anggota staf klinis
lainnya. (R) \par\pard\qj \li1778\ri1258\sb60\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 2. Ada pelaksanaan proses pembuatan rincian kewenangan klinis
sesuai dengan \line\tab \up0 \expndtw-4\charscalex100 peraturan perundang-undangan.
(D,W) \par\pard\qj \li1778\ri1251\sb60\sl-320\slmult0\tx2138 \up0 \expndtw-
3\charscalex100 3. Ada berkas kredensial yang dipelihara dari setiap profesional
pemberi asuhan \line\tab \up0 \expndtw-4\charscalex100 (PPA) lainnya dan staf
klinis lainnya. (D,W) \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb221\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar KKS 18 \par\pard\qj \li1418\ri1221\sb68\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
melaksanakan identifikasi tanggungjawab pekerjaan dan penugasan \up0
\expndtw0\charscalex102 klinis berdasar atas kredensial profesional pemberi asuhan
(PPA) lainnya dan staf \up0 \expndtw-3\charscalex100 klinis lainnya sesuai dengan
peraturan perundang-undangan. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb201\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan KKS 18 \par\pard\qj
\li1418\ri1149\sb68\sl-320\slmult0 \up0 \expndtw-7\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Peran klinis yang penting profesional pemberi asuhan
(PPA) lainnya dan staf klinis lainnya \up0 \expndtw-3\charscalex100 mengharuskan
staf tersebut berpartisipasi secara proaktif dalam program peningkatan \up0
\expndtw-7\charscalex100 mutu klinis rumah sakit. \par\pard\qj
\li1418\ri1149\sb60\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Rumah sakit
melakukan evaluasi kinerja individu profesional pemberi asuhan (PPA) \up0
\expndtw-6\charscalex100 lainnya dan staf klinis lainnya bila ada temuan dalam
aktivitas peningkatan mutu. \par\pard\qj \li1418\ri1148\sb60\sl-320\slmult0 \up0
\expndtw-4\charscalex100 Hasil kajian, tindakan yang diambil, dan setiap dampak
atas tanggung jawab pekerjaan \up0 \expndtw-3\charscalex100 didokumentasikan
dalam\ul0\nosupersub\cf8\f9\fs24 file\ul0\nosupersub\cf7\f8\fs24 kredensial
profesional pemberi asuhan (PPA) lainnya dan \up0 \expndtw-7\charscalex100 staf
klinis lainnya tersebut atau\ul0\nosupersub\cf8\f9\fs24
file\ul0\nosupersub\cf7\f8\fs24 lainnya. \par\pard\ql \li1418\sb0\sl-276\slmult0
\par\pard\ql\li1418\sb161\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian KKS18 \par\pard\ql
\li1778\ri1252\sb8\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada dokumentasi penilaian mutu profesional pemberi
asuhan (PPA) lainnya dan \line\tab \up0 \expndtw-5\charscalex100 staf klinis
lainnya berpatisipasi di dalam program peningkatan mutu rumah sakit. \line \tab
\up0 \expndtw-6\charscalex100 (D,W) \par\pard\ql \li10156\sb0\sl-253\slmult0
\par\pard\ql\li10156\sb203\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 351
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg352}
{\bkmkend Pg352}\par\pard\qj \li1778\sb0\sl-300\slmult0 \par\pard\qj\li1778\sb0\sl-
300\slmult0 \par\pard\qj\li1778\sb0\sl-300\slmult0
\par\pard\qj\li1778\ri1258\sb253\sl-300\slmult0\tx2138 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 2. Kinerja individual profesional pemberi asuhan
(PPA) lainnya dan staf klinis \line\tab \up0 \expndtw-5\charscalex100 lainnya
dikaji bila ada temuan dalam aktivitas peningkatan mutu. (D,W) \par\pard\ql
\li1778\ri1258\sb24\sl-320\slmult0\tx2138\tx2138 \up0 \expndtw-2\charscalex100 3.
Seluruh data proses\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24
kinerja profesional pemberi asuhan (PPA) lainnya \line\tab \up0 \expndtw-
1\charscalex100 dan staf klinis lainnya didokumentasikan dalam kredesial
profesional pemberi \line \tab \up0 \expndtw-4\charscalex100 asuhan (PPA) lainnya
dan staf klinis lainnya atau dokumen lainnya. (D,W) \par\pard\ql \li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb0\sl-253\slmult0 \par\pard\ql\li10156\sb0\sl-
253\slmult0 \par\pard\ql\li10156\sb199\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 352
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg353}
{\bkmkend Pg353}\par\pard\ql \li5592\sb0\sl-276\slmult0 \par\pard\ql\li5592\sb0\sl-
276\slmult0 \par\pard\ql\li5592\sb0\sl-276\slmult0 \par\pard\ql\li5592\sb0\sl-
276\slmult0 \par\pard\ql\li5592\sb0\sl-276\slmult0 \par\pard\ql\li5592\sb0\sl-
276\slmult0 \par\pard\ql\li5592\sb0\sl-276\slmult0 \par\pard\ql\li5592\sb0\sl-
276\slmult0 \par\pard\ql\li5592\sb124\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 BAB 6 \par\pard\ql \li2853\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 MANAJEMEN INFORMASI DAN REKAM MEDIK
(MIRM) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb180\sl-276\slmult0 \up0 \expndtw-3\charscalex100
GAMBARAN UMUM \par\pard\qj \li1440\ri1181\sb212\sl-315\slmult0 \up0
\expndtw0\charscalex105 \ul0\nosupersub\cf7\f8\fs24 Informasi diperlukan
untuk memberikan, mengordinasikan, dan juga \line \up0
\expndtw0\charscalex100 mengintegrasikan pelayanan rumah sakit. Hal ini meliputi
ilmu pengasuhan pasien \line \up0 \expndtw-3\charscalex100 secara individual,
asuhan yang diberikan. dan kinerja staf klinis. Informasi merupakan \line \up0
\expndtw0\charscalex102 sumber daya yang harus dikelola secara efektif oleh
pimpinan rumah sakit seperti \line \up0 \expndtw0\charscalex100 halnya sumber daya
manusia, material, dan finansial. Setiap rumah sakit berupaya
\par\pard\li1440\sb48\sl-276\slmult0\fi0\tx3530\tx5275\tx6244\tx8335\tx9877 \up0
\expndtw-3\charscalex100 mendapatkan,\tab \up0 \expndtw-3\charscalex100
mengelola,\tab \up0 \expndtw-3\charscalex100 dan\tab \up0 \expndtw-3\charscalex100
menggunakan\tab \up0 \expndtw-3\charscalex100 informasi\tab \up0 \expndtw-
3\charscalex100 untuk\par\pard\qj \li1440\ri1196\sb0\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 meningkatkan/memperbaiki hasil asuhan pasien, kinerja
individual, serta kinerja \up0 \expndtw-3\charscalex100 rumah sakit secara
keseluruhan. Seiring dengan perjalanan waktu, rumah sakit harus \up0 \expndtw-
4\charscalex100 lebih efektif dalam: \par\pard\ql \li1908\sb215\sl-276\slmult0 \up0
\expndtw-2\charscalex100 - mengidentifikasi kebutuhan informasi; \par\pard\ql
\li1908\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100 - merancang suatu
sistem manajemen informasi; \par\pard\ql \li1908\ri3604\sb43\sl-520\slmult0 \up0
\expndtw-2\charscalex100 - mendefinisikan serta mendapatkan data dan informasi;
\line \up0 \expndtw-2\charscalex100 - menganalisis data dan mengolahnya menjadi
informasi; \line \up0 \expndtw-2\charscalex100 - mengirim serta melaporkan data
dan informasi; juga \line \up0 \expndtw-2\charscalex100 - mengintegrasikan dan
menggunakan informasi. \par\pard\qj \li1440\ri1245\sb171\sl-313\slmult0 \up0
\expndtw0\charscalex100 Walaupun komputerisasi dan teknologi lainnya
meningkatkan efisiensi, prinsip \up0 \expndtw0\charscalex102 manajemen informasi
yang baik tetap berlaku untuk semua metode, baik berbasis \up0 \expndtw-
1\charscalex100 kertas maupun elektronik. Standar-standar ini dirancang menjadi
kompatibel dengan \up0 \expndtw-2\charscalex100 sistem non-komputerisasi dan
teknologi masa depan. \par\pard\qj \li1440\ri1243\sb202\sl-320\slmult0 \up0
\expndtw0\charscalex100 Informasi rumah sakit terkait asuhan pasien sangat
penting untuk komunikasi \up0 \expndtw-3\charscalex100 antarstaf klinis yang
didokumentasikan dalam rekam medis. \par\pard\qj \li1440\ri1187\sb205\sl-
315\slmult0 \up0 \expndtw-3\charscalex100 Rekam medis adalah bukti tertulis
(kertas/eletronik) yang merekam berbagai informasi \line \up0
\expndtw0\charscalex106 kesehatan pasien seperti temuan hasil asesmen,
rencana asuhan, rincian \line \up0 \expndtw0\charscalex102 pelaksanaan asuhan dan
pengobatan, catatan perkembangan pasien terintegrasi, \line \up0
\expndtw0\charscalex103 serta ringkasan kepulangan pasien yang dibuat oleh
profesional pemberi asuhan \line \up0 \expndtw-3\charscalex100 (PPA).
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb11\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 353
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg354}
{\bkmkend Pg354}\par\pard\qj \li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-
315\slmult0 \par\pard\qj\li1440\sb0\sl-315\slmult0 \par\pard\qj\li1440\sb0\sl-
315\slmult0 \par\pard\qj\li1440\sb0\sl-315\slmult0
\par\pard\qj\li1440\ri1184\sb105\sl-315\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penyelenggaraan rekam medis merupakan proses kegiatan
yang dimulai saat pasien \up0 \expndtw-3\charscalex100 diterima di rumah sakit
sampai dengan pencatatan data medis, keperawatan, manajer \up0 \expndtw-
1\charscalex100 pelayanan pasien (MPP), serta PPA lainnya selama pasien
mendapat asuhan. \up0 \expndtw0\charscalex100 Kegiatan dilanjutkan dengan
penanganan rekam medis yang meliputi penyimpanan \up0 \expndtw-3\charscalex100 dan
penggunaan untuk kepentingan pasien atau keperluan lainnya. \par\pard\ql
\li1440\sb238\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Rekam medis memiliki
aspek-aspek yang sangat penting. \par\pard\ql \li1800\ri1180\sb211\sl-
316\slmult0\tx2160\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw-3\charscalex100 1.
\tab \up0 \expndtw0\charscalex102 Aspek Administrasi: karena isi rekam medis
menyangkut tindakan berdasar \line\tab \up0 \expndtw0\charscalex101 atas wewenang
dan tanggung jawab sebagai tenaga kesehatan profesional \line \tab \up0 \expndtw-
4\charscalex100 pemberi asuhan (PPA) dalam mencapai tujuan pelayanan
kesehatan. \line \up0 \expndtw-3\charscalex100 2. \up0 \expndtw0\charscalex100
Aspek Medis: karena catatan/rekaman tersebut dipergunakan sebagai dasar
\line\tab \up0 \expndtw0\charscalex101 merencanakan pengobatan/asuhan yg harus
diberikan kepada seorang \line \tab \up0 \expndtw-3\charscalex100 pasien.
\par\pard\ql \li1800\ri1243\sb1\sl-320\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw-
3\charscalex100 3. \tab \up0 \expndtw0\charscalex101 Aspek Hukum: karena menyangkut
masalah jaminan kepastian
hukum atas \line\tab \up0 \expndtw0\charscalex102 dasar keadilan dalam rangka
upaya menegakkan hukum serta penyediaan \line \tab \up0 \expndtw-3\charscalex100
bahan tanda bukti untuk menegakkan keadilan. \par\pard\li1800\sb40\sl-
276\slmult0\fi0\tx2160 \up0 \expndtw0\charscalex101 4.\tab \up0
\expndtw0\charscalex102 Aspek Keuangan: karena mengandung data/informasi
yang dapat\par\pard\li1800\sb40\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex101
dipergunakan sebagai dasar pembiayaan.\par\pard\ql \li1800\ri1187\sb0\sl-
320\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw-3\charscalex100 5. \tab \up0
\expndtw-3\charscalex100 Aspek Penelitian: karena menyangkut data/informasi yang
dapat dipergunakan \line\tab \up0 \expndtw0\charscalex103 sebagai dasar penelitian
dan pengembangan ilmu pengetahuan di bidang \line \tab \up0 \expndtw-
3\charscalex100 kesehatan. \par\pard\ql \li1800\ri1244\sb0\sl-
320\slmult0\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw-3\charscalex100 6. \tab
\up0 \expndtw0\charscalex100 Aspek Pendidikan: karena menyangkut
data/informasi perkembangan \line\tab \up0 \expndtw-2\charscalex100 kronologis
dan kegiatan pelayanan medik yang diberikan kepada pasien. \line \tab
\up0 \expndtw-2\charscalex100 Informasi tersebut dapat dipergunakan sebagai bahan
referensi pengajaran di \line \tab \up0 \expndtw-3\charscalex100 bidang
kesehatan. \par\pard\ql \li1800\ri1241\sb0\sl-320\slmult0\tx2160\tx2160\tx2160 \up0
\expndtw-3\charscalex100 7. \tab \up0 \expndtw0\charscalex103 Aspek Dokumentasi:
karena menyangkut sumber ingatan yang harus \line\tab \up0
\expndtw0\charscalex100 didokumentasikan dan dipakai sebagai bahan
pertanggungjawaban serta \line \tab \up0 \expndtw-3\charscalex100 laporan rumah
sakit. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb250\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Rekam medis memiliki kegunaan sebagai:
\par\pard\qj \li1800\ri1248\sb208\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 1. alat komunikasi antara profesional pemberi asuhan (PPA)
yang memberikan \line\tab \up0 \expndtw-3\charscalex100 asuhan
pasien\ul0\nosupersub\cf8\f9\fs24 (communication\ul0\nosupersub\cf7\f8\fs24 );
\par\pard\ql \li1800\sb17\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. dasar
dalam perhitungan biaya pelayanan kepada pasien (\ul0\nosupersub\cf8\f9\fs24
financial billing\ul0\nosupersub\cf7\f8\fs24 ); \par\pard\qj \li1800\ri1250\sb8\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex102 3. penyedia data khusus yang
sangat berguna untuk keperluan penelitian dan \line\tab \up0 \expndtw-
3\charscalex100 pendidikan (\ul0\nosupersub\cf8\f9\fs24
research\ul0\nosupersub\cf7\f8\fs24 &\ul0\nosupersub\cf8\f9\fs24
education\ul0\nosupersub\cf7\f8\fs24 ); \par\pard\qj \li1800\ri1250\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 4. dasar untuk merencanakan
asuhan yang harus diberikan kepada pasien \line\tab \up0 \expndtw-
3\charscalex100 (\ul0\nosupersub\cf8\f9\fs24
assessment\ul0\nosupersub\cf7\f8\fs24 ); \par\pard\qj \li1800\ri1182\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw-3\charscalex100 5. bahan yang berguna untuk
analisis, penelitian, dan evaluasi kualitas pelayanan \line\tab \up0 \expndtw-
4\charscalex100 yang diberikan kepada pasien (audit klinis); \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb157\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 354
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg355}
{\bkmkend Pg355}\par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\sb0\sl-
320\slmult0 \par\pard\qj\li1800\sb0\sl-320\slmult0
\par\pard\qj\li1800\ri1247\sb196\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 6. sumber ingatan yang harus didokumentasikan
serta sebagai bahan \line\tab \up0 \expndtw-3\charscalex100 pertanggungjawaban
dan pelaporan; \par\pard\qj \li1800\ri1189\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 7. bukti tertulis/terekam atas segala tindakan pelayanan,
perkembangan penyakit, \line\tab \up0 \expndtw-4\charscalex100 dan pengobatan
selama pasien berkunjung/dirawat di rumah sakit; \par\pard\qj
\li1800\ri1189\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 8. pelindung
kepentingan hukum bagi pasien, rumah sakit, maupun profesional \line\tab \up0
\expndtw-5\charscalex100 pemberi asuhan (\ul0\nosupersub\cf8\f9\fs24 legal
documentation\ul0\nosupersub\cf7\f8\fs24 ). \par\pard\qj \li1440\ri1188\sb0\sl-
315\slmult0 \up0 \expndtw0\charscalex100 Tujuan pengelolaan rekam medis dan
informasi kesehatan adalah menunjang tertib \up0 \expndtw0\charscalex100
administrasi dalam rangka upaya peningkatan pelayanan kesehatan di rumah sakit \up0
\expndtw-4\charscalex100 yang didukung oleh suatu sistem pengelolaan rekam medis
yang cepat, tepat, bernilai, \up0 \expndtw-1\charscalex100 dapat
dipertanggungjawabkan, serta berfokus pada pasien dan keselamatan pasien \up0
\expndtw-3\charscalex100 secara terintegrasi. \par\pard\qj \li1440\ri1247\sb186\sl-
320\slmult0 \up0 \expndtw0\charscalex100 Standar MIRM meliputi organisasi dan
manajemen, akses serta penyimpanan RM, \up0 \expndtw-3\charscalex100 dan RM pasien.
\par\pard\ql \li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0
\par\pard\ql\li1800\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf12\f13\fs24 \u-3978?\ul0\nosupersub\cf6\f7\fs24 MANAJEMEN
INFORMASI (STANDAR MIRM 1 - MIRM 7 ) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb12\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Standar MIRM 1 \par\pard\qj \li1440\ri1188\sb225\sl-
300\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24
Penyelenggaraan sistem informasi manajemen rumah sakit (SIM RS) harus mengacu
\up0 \expndtw-4\charscalex100 peraturan perundang-undangan. \par\pard\ql
\li1440\sb240\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MIRM 1.1 \par\pard\ql \li1440\sb244\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
mengelola data dan informasi klinik serta manajerial. \par\pard\ql
\li1440\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 1 dan MIRM 1.1 \par\pard\qj
\li1440\ri1239\sb212\sl-315\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Sistem informasi manajemen rumah sakit yang selanjutnya
disingkat SIMRS adalah \up0 \expndtw0\charscalex100 sistem teknologi informasi
komunikasi yang memproses dan mengintegrasikan \up0 \expndtw0\charscalex100
seluruh alur proses pelayanan rumah sakit dalam bentuk jaringan
koordinasi, \up0 \expndtw0\charscalex105 pelaporan, dan prosedur administrasi untuk
memperoleh informasi secara tepat \up0 \expndtw-1\charscalex100 serta akurat, dan
merupakan bagian dari Sistem Informasi Kesehatan. \par\pard\qj
\li1440\ri1248\sb201\sl-320\slmult0 \up0 \expndtw0\charscalex103 Sistem informasi
kesehatan adalah seperangkat tatanan yang meliputi data, \up0
\expndtw0\charscalex104 informasi, indikator, prosedur, teknologi, perangkat, serta
sumber daya manusia \up0 \expndtw-2\charscalex100 yang saling berkaitan dan
dikelola secara terpadu untuk mengarahkan tindakan atau \up0 \expndtw-
3\charscalex100 keputusan yang berguna dalam mendukung pembangunan kesehatan.
\par\pard\qj \li1440\ri1251\sb209\sl-310\slmult0\fi69 \up0 \expndtw0\charscalex102
Rumah sakit menetapkan unit kerja yang mengelola SIMRS dan memiliki sumber \up0
\expndtw0\charscalex105 daya manusia yang terdiri atas kepala unit serta staf
dengan kualifikasi analisis \up0 \expndtw-1\charscalex100
sistem,\ul0\nosupersub\cf8\f9\fs24 programmer\ul0\nosupersub\cf7\f8\fs24
,\ul0\nosupersub\cf8\f9\fs24 hardware\ul0\nosupersub\cf7\f8\fs24 , dan
pemeliharaan jaringan. \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb53\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 355
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg356}
{\bkmkend Pg356}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 1 \par\pard\ql
\li1800\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Terdapat unit kerja yang mengelola SIMRS. (R)
\par\pard\qj \li1800\ri1250\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100
2. Sumber daya manusia dalam unit kerja SIMRS yang memiliki kompetensi dan
\line\tab \up0 \expndtw-2\charscalex100 sudah terlatih. (D,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 1.1
\par\pard\ql \li1800\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi tentang pengelolaan data dan
informasi. (R) \par\pard\qj \li1800\ri1247\sb8\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 2. Data serta informasi klinik dan manajerial
diintegrasikan sesuai dengan \line\tab \up0 \expndtw-3\charscalex100 kebutuhan
untuk mendukung pengambilan keputusan. (D,W) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM 2 \par\pard\qj
\li1440\ri1249\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit merencanakan dan merancang proses
manajemen informasi
untuk \up0 \expndtw-3\charscalex100 memenuhi kebutuhan informasi internal maupun
eksternal. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MIRM 2 \par\pard\qj \li1440\ri1237\sb14\sl-313\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Informasi dikumpulkan dan
digunakan selama asuhan pasien untuk mengelola \up0 \expndtw-2\charscalex100
sebuah rumah sakit yang aman dan efektif. Kemampuan menerima dan memberikan \up0
\expndtw0\charscalex105 informasi memerlukan perencanaan yang efektif.
Perencanaan rumah sakit \up0 \expndtw-1\charscalex100 menggabungkan masukan dari
berbagai sumber, antara lain: \par\pard\ql \li1800\sb238\sl-276\slmult0 \up0
\expndtw-1\charscalex100 1. para profesional pemberi asuhan (PPA); \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. para kepala
bidang/divisi dan kepala unit pelayanan; \par\pard\qj \li1800\ri1249\sb8\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 3. badan/pihak lain di luar rumah
sakit yang membutuhkan data atau informasi \line\tab \up0 \expndtw-3\charscalex100
tentang operasional dan pelayanan rumah sakit. \par\pard\qj
\li1440\ri1249\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Perencanaan juga
mempertimbangkan misi rumah sakit, pelayanan yang \up0
\expndtw0\charscalex103 diberikan, sumber daya, akses teknologi yang dapat
dicapai, dan dukungan \up0 \expndtw-1\charscalex100 komunikasi efektif antara
pemberi pelayanan. \par\pard\qj \li1440\ri1244\sb217\sl-300\slmult0 \up0
\expndtw0\charscalex105 Permintaan terhadap data dan informasi harus selalu mengacu
pada ketentuan \up0 \expndtw-1\charscalex100 dalam peraturan perundangan, misalnya
tentang rahasia kedokteran. \par\pard\qj \li1440\ri1240\sb204\sl-320\slmult0
\up0 \expndtw0\charscalex104 Prioritas kebutuhan informasi dari sumber-
sumber memengaruhi strategi \line \up0 \expndtw0\charscalex100 manajemen
informasi rumah sakit dan kemampuan mengimplementasikan strategi \line \up0
\expndtw-1\charscalex100 tersebut, sesuai dengan ukuran rumah sakit, kompleksitas
pelayanan, ketersediaan \line \up0 \expndtw0\charscalex102 staf terlatih, dan
sumber daya manusia serta tekhnikal lainnya.Perencanaan yang \line \up0
\expndtw0\charscalex100 komprehensif meliputi seluruh unit kerja dan pelayanan yang
ada di rumah sakit. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb5\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM
2 \par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\ri1248\sb188\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1.
Proses perencanaan kebutuhan informasi melibatkan a) sampai dengan c) \line\tab
\up0 \expndtw-3\charscalex100 sesuai dengan maksud dan tujuan. (D,W)
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb77\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 356
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg357}
{\bkmkend Pg357}\par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\sb0\sl-
320\slmult0 \par\pard\qj\li1800\sb0\sl-320\slmult0
\par\pard\qj\li1800\ri1249\sb196\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 2. Proses perencanaan kebutuhan informasi
mengacu pada peraturan \line\tab \up0 \expndtw-3\charscalex100 perundang-
undangan. (D,W) \par\pard\ql \li1800\sb17\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3. Perencanaan disesuaikan dengan besar dan kompleksitas rumah
sakit. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar
MIRM 3 \par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1260\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Para
profesional pemberi asuhan (PPA) dan para kepala bidang/divisi serta kepala \up0
\expndtw-1\charscalex100 unit pelayanan berpartisipasi dalam memilih,
mengintegrasikan, dan menggunakan \up0 \expndtw-2\charscalex100 teknologi manajemen
informasi. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MIRM 3 \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1247\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Teknologi manajemen informasi membutuhkan sumber daya
yang besar sebagai \line \up0 \expndtw0\charscalex102 investasi untuk rumah
sakit. Oleh karena itu, teknologi harus secara cermat \line \up0
\expndtw0\charscalex100 disesuaikan dengan kebutuhan rumah sakit saat ini dan masa
depan, serta sumber \line \up0 \expndtw-3\charscalex100 dayanya. \par\pard\qj
\li1440\ri1237\sb205\sl-315\slmult0 \up0 \expndtw0\charscalex102 Kebutuhan
teknologi yang tersedia diintegrasikan dengan proses manajemen \line \up0
\expndtw0\charscalex100 informasi yang ada saat ini serta membantu mengintegrasikan
aktivitas seluruh unit \line \up0 \expndtw0\charscalex103 kerja dan pelayanan rumah
sakit. Proses seleksi teknologi informasi yang sesuai \line \up0
\expndtw0\charscalex100 dengan kebutuhan RS dilakukan melalui koordinasi dan
partisipasi para profesional \line \up0 \expndtw-2\charscalex100 pemberi asuhan
(PPA), para kepala bidang/divisi, dan kepala unit pelayanan. \par\pard\ql
\li1440\sb238\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 3 \par\pard\qj
\li1800\ri1247\sb208\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Dalam membangun sistem informasi rumah sakit
melibatkan profesional \line\tab \up0 \expndtw-3\charscalex100 pemberi asuhan
(PPA). (D,W) \par\pard\qj \li1800\ri1244\sb17\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex104 2. Dalam membangun sistem informasi rumah sakit
melibatkan kepala \line\tab \up0 \expndtw-3\charscalex100 bidang/divisi dan
kepala unit pelayanan. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb84\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MIRM 4 \par\pard\qj \li1440\ri1237\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Sistem
manajemen data dan informasi rumah sakit menyiapkan kumpulan serta \up0 \expndtw-
2\charscalex100 menentukan data dan informasi yang secara rutin (reguler)
dikumpulkan sesuai \up0 \expndtw0\charscalex100 dengan kebutuhan profesional
pemberi asuhan (PPA), kepala bidang/divisi, kepala \up0 \expndtw-3\charscalex100
unit pelayanan, serta badan/pihak lain di luar rumah sakit. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb185\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 4 \par\pard\qj
\li1440\ri1181\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kumpulan data merupakan bagian penting dalam kegiatan
peningkatan kinerja rumah \up0 \expndtw-3\charscalex100 sakit karena dapat
memberikan gambaran atau profil rumah sakit selama kurun waktu \up0 \expndtw-
4\charscalex100 tertentu dan dapat membandingkan kinerja dengan RS lain.
\par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Kumpulan
data terdiri atas: \par\pard\ql \li1800\sb244\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 1. data mutu dan insiden keselamatan pasien; \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb70\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 357
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg358}
{\bkmkend Pg358}\par\pard\ql \li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. data surveilans infeksi;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 3. data
kecelakaan kerja. \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1245\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex104 Data
tersebut membantu rumah sakit untuk mengetahui kinerja terkini dan \up0
\expndtw-3\charscalex100 mengidentifikasi peluang untuk peningkatan/perbaikan.
\par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 4 \par\pard\ql
\li1800\ri1186\sb8\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menyediakan kumpulan data a) s.d. c)
sesuai dengan maksud dan \line\tab \up0 \expndtw-3\charscalex100 tujuan yang harus
tersedia untuk memenuhi kebutuhan pengguna, yaitu PPA, \line \tab \up0 \expndtw-
3\charscalex100 kepala bidang/divisi, dan kepala unit pelayanan. (D,W) (lihat juga
MFK.10) \par\pard\ql \li1800\ri1176\sb9\sl-310\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 2. Rumah sakit memberikan data yang dibutuhkan oleh
badan/pihak lain di luar \line\tab \up0 \expndtw-1\charscalex100 rumah sakit sesuai
dengan peraturan perundang-undangan. (D,W) (lihat juga \line \tab \up0 \expndtw-
6\charscalex100 PMKP 6 dan TKRS 5) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb7\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM 5
\par\pard\qj \li1440\ri1249\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Data dianalisis diubah menjadi informasi untuk
mendukung asuhan pasien, \up0 \expndtw0\charscalex100
manajemen rumah sakit dan program manajemen mutu, serta pendidikan dan
\up0 \expndtw-3\charscalex100 penelitian. \par\pard\ql \li1440\sb217\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM
5 \par\pard\qj \li1440\ri1183\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit mengumpulkan dan menganalisis data
menjadi informasi untuk \line \up0 \expndtw0\charscalex102 mendukung asuhan
pasien serta manajemen rumah sakit. Informasi tersebut \line \up0
\expndtw0\charscalex103 memberikan gambaran/profil rumah sakit selama kurun waktu
tertentu dan dapat \line \up0 \expndtw0\charscalex100 digunakan untuk membandingkan
kinerja dengan rumah sakit lain. Jadi, kumpulan \line \up0 \expndtw-4\charscalex100
data merupakan bagian penting dalam upaya peningkatan kinerja rumah
sakit. \par\pard\qj \li1440\ri1182\sb206\sl-313\slmult0 \up0 \expndtw-
4\charscalex100 Secara khusus, kumpulan data terdiri atas data mutu dan insiden
keselamatan pasien, \line \up0 \expndtw-2\charscalex100 data surveilans infeksi,
data kecelakaan kerja, manajemen risiko, sistem manajemen \line \up0 \expndtw-
1\charscalex100 utilitas, pencegahan dan pengendalian infeksi, serta tinjauan
pemanfaatan/utilisasi \line \up0 \expndtw-2\charscalex100 dapat membantu rumah
sakit \up0 \expndtw-2\charscalex100 untuk mengetahui kinerjanya terkini dan
\par\pard\ql \li1440\sb38\sl-276\slmult0 \up0 \expndtw-3\charscalex100
mengidentifikasi peluang untuk peningkatan/perbaikan. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb12\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian MIRM 5 \par\pard\qj \li1800\ri1247\sb8\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Terdapat bukti bahwa data
dianalisis diubah menjadi informasi mendukung \line\tab \up0 \expndtw-
3\charscalex100 asuhan pasien. (D,W) \par\pard\qj \li1800\ri1248\sb17\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex103 2. Terdapat bukti bahwa data
dianalisis diubah menjadi informasi mendukung \line\tab \up0 \expndtw-
3\charscalex100 manajemen rumah sakit. (D,W) \par\pard\qj \li1800\ri1240\sb4\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 3. Terdapat bukti bahwa data
dianalisis diubah menjadi informasi mendukung \line\tab \up0 \expndtw-
3\charscalex100 program manajemen mutu. (D,W) \par\pard\qj \li1800\ri1247\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 4. Terdapat bukti bahwa data
dianalisis diubah menjadi informasi mendukung \line\tab \up0 \expndtw-
3\charscalex100 pendidikan dan penelitian. (D,W) \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb24\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 358
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg359}
{\bkmkend Pg359}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb156\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM 6 \par\pard\qj
\li1440\ri1251\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penyampaian data dan informasi secara tepat waktu dalam
format yang memenuhi \up0 \expndtw-3\charscalex100 harapan pengguna dan dengan
frekuensi yang dikehendaki. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb5\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM
6 \par\pard\qj \li1440\ri1188\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Format dan metode penyampaian data dan informasi kepada
pengguna yang menjadi \line \up0 \expndtw-3\charscalex100 sasaran dibuat agar
memenuhi harapan pengguna. Strategi penyampaian meliputi \par\pard\qj
\li1800\ri1246\sb217\sl-300\slmult0\tx2160 \up0 \expndtw-2\charscalex100 1.
memberikan data dan informasi hanya atas permintaan dan kebutuhan
\line\tab \up0 \expndtw-3\charscalex100 pengguna; \par\pard\qj
\li1800\ri1246\sb4\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex105 2. membuat
format laporan untuk membantu pengguna dalam proses \line\tab \up0
\expndtw-3\charscalex100 pengambilan keputusan; \par\pard\ql \li1800\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 3. memberikan laporan dengan frekuensi
sesuai yang dibutuhkan oleh pengguna; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0
\expndtw-3\charscalex100 4. mengaitkan sumber data dan informasi; dan \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 5. memberikan
interpretasi atau klarifikasi atas data. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 6 \par\pard\ql \li1860\sb24\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Data dan
informasi disampaikan sesuai kebutuhan pengguna. (D,W) \par\pard\qj
\li1860\ri1247\sb8\sl-320\slmult0\tx2220 \up0 \expndtw0\charscalex102 2. Pengguna
menerima data dan informasi dalam format yang sesuai dengan \line\tab \up0
\expndtw-3\charscalex100 yang dibutuhkan. (D,W) \par\pard\ql \li1860\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 3. Pengguna menerima data dan informasi
tepat waktu. (D,W) \par\pard\qj \li1860\ri1230\sb8\sl-320\slmult0\tx2220 \up0
\expndtw-2\charscalex100 4. Staf pengolah data memiliki hak akses ke data dan
informasi yang dibutuhkan \line\tab \up0 \expndtw-3\charscalex100 sesuai dengan
tanggung jawabnya. (W,S) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MIRM 7 \par\pard\qj \li1440\ri1245\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
mendukung asuhan pasien, pendidikan, serta riset dan manajemen \up0 \expndtw-
2\charscalex100 melalui penyediaan informasi yang tepat waktu dari sumber data
terkini. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 7 \par\pard\qj
\li1440\ri1272\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 PPA, peneliti, pendidik, kepala bidang/divisi, dan
kepala unit pelayanan sering kali \line \up0 \expndtw0\charscalex103 membutuhkan
informasi untuk membantu mereka dalam pelaksanaan tanggung \line \up0 \expndtw-
2\charscalex100 jawab. \par\pard\qj \li1440\ri1269\sb206\sl-313\slmult0 \up0
\expndtw-1\charscalex100 Informasi demikian termasuk literatur ilmiah dan
manajemen, panduan praktik klinis, \up0 \expndtw0\charscalex100 hasil penelitian,
metode pendidikan. Internet, materi cetakan di perpustakaan, \up0
\expndtw0\charscalex102 sumber pencarian daring (\ul0\nosupersub\cf8\f9\fs24 on-
line\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24
,\ul0\nosupersub\cf7\f8\fs24 dan materi pribadi yang semuanya merupakan \up0
\expndtw-1\charscalex100 sumber yang bernilai sebagai informasi terkini.
\par\pard\ql \li1440\sb238\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 7 \par\pard\ql
\li1800\ri1291\sb8\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menyediakan fasilitas untuk mendapatkan
informasi ilmiah terkini \line\tab \up0 \expndtw0\charscalex100 dan informasi lain
secara tepat waktu untuk mendukung asuhan pasien. \line \tab \up0 \expndtw-
3\charscalex100 (D,O,W) \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb90\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 359
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg360}
{\bkmkend Pg360}\par\pard\ql \li1800\sb0\sl-310\slmult0 \par\pard\ql\li1800\sb0\sl-
310\slmult0 \par\pard\ql\li1800\sb0\sl-310\slmult0
\par\pard\ql\li1800\ri1298\sb234\sl-310\slmult0\tx2160\tx2160 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Rumah sakit menyediakan fasilitas
untuk mendapatkan Informasi ilmiah terkini \line\tab \up0 \expndtw0\charscalex103
dan informasi lain secara tepat waktu untuk mendukung pendidikan klinik. \line \tab
\up0 \expndtw-3\charscalex100 (D,O,W) \par\pard\qj \li1800\ri1297\sb39\sl-
300\slmult0\tx2160 \up0 \expndtw-3\charscalex100 3. Rumah sakit menyediakan
fasilitas untuk mendapatkan informasi ilmiah terkini \line\tab \up0 \expndtw-
3\charscalex100 dan informasi lain secara tepat waktu untuk mendukung penelitian.
(D,O,W) \par\pard\ql \li1800\ri1358\sb32\sl-310\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex103 4. Rumah sakit menyediakan fasilitas internet untuk
mendapatkan informasi \line\tab \up0 \expndtw0\charscalex100 ilmiah terkini dan
informasi lain secara tepat waktu untuk mendukung \line \tab \up0 \expndtw-
3\charscalex100 manajemen (D,O,W) \par\pard\ql \li1800\sb0\sl-276\slmult0
\par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb7\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf12\f13\fs24 \u-
3978?\ul0\nosupersub\cf6\f7\fs24 MANAJEMEN REKAM MEDIS (Standar 8-15)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb12\sl-276\slmult0 \up0 \expndtw-5\charscalex100 Standar
MIRM 8 \par\pard\qj \li1440\ri1249\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyelenggarakan
pengelolaan rekam medis terkait asuhan pasien \up0 \expndtw-3\charscalex100 sesuai
dengan peraturan perundang-undangan. \par\pard\ql \li1440\sb237\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM
8 \par\pard\qj \li1440\ri1245\sb12\sl-315\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Penyelenggaraan rekam medis merupakan proses kegiatan
yang dimulai sejak saat \up0 \expndtw0\charscalex100 pasien diterima rumah
sakit, dilakukan pencatatan data medis, selama pasien \up0
\expndtw0\charscalex103 mendapat asuhan medis, keperawatan, dan profesional pemberi
asuhan lainnya. \up0 \expndtw0\charscalex100 Kegiatan dilanjutkan dengan penanganan
rekam medis yang meliputi penyimpanan \up0 \expndtw-3\charscalex100 dan penggunaan
untuk kepentingan isendiri atau kepentingan lainnya. \par\pard\qj
\li1440\ri1182\sb205\sl-316\slmult0 \up0 \expndtw-3\charscalex100 Rumah sakit
menetapkan organisasi yang mengelola sistem rekam medis yang tepat, \line \up0
\expndtw0\charscalex100 benar, bernilai, dan dapat dipertanggungjawabkan. Informasi
kesehatan baik kertas \line \up0 \expndtw-2\charscalex100 maupun elektronik harus
dijaga keamanan dan kerahasiaannya sehingga harus \line \up0
\expndtw0\charscalex100 disimpan sesuai dengan peraturan dan perundangan. Untuk
informasi kesehatan \line \up0 \expndtw0\charscalex102 elektronik harus dijamin
keamanan dan kerahasiaan dalam 3 (tiga) tempat, yaitu \line \up0 \expndtw-
2\charscalex100 server di dalam rumah sakit, salinan (\ul0\nosupersub\cf8\f9\fs24
backup\ul0\nosupersub\cf7\f8\fs24 ) data rutin, dan data virtual
(\ul0\nosupersub\cf8\f9\fs24
cloud\ul0\nosupersub\cf7\f8\fs24 )\ul0\nosupersub\cf8\f9\fs24 . \par\pard\ql
\li1440\sb238\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 8 \par\pard\ql \li1800\sb0\sl-
320\slmult0 \par\pard\ql\li1800\ri1247\sb8\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Terdapat unit kerja yang
mengelola rekam medis yang memiliki regulasi dan \line\tab \up0
\expndtw0\charscalex104 program untuk mengelola rekam medis sesuai
dengan peraturan \line \tab \up0 \expndtw-3\charscalex100 perundangan-undangan.
(R) \par\pard\ql \li1800\ri1182\sb0\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-
3\charscalex100 2. Organisasi pengelola rekam medis dipimpin tenaga rekam medis
yang memiliki \line\tab \up0 \expndtw0\charscalex103 kompetensi dan kewenangan
mengelola rekam medis sesuai dengan \line \tab \up0 \expndtw-3\charscalex100
peraturan perundangan-undangan. (D, W) \par\pard\qj \li1800\ri1250\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex101 3. Tersedia tempat penyimpanan
rekam medis yang menjamin keamanan dan \line\tab \up0 \expndtw-3\charscalex100
kerahasiaan rekam medis. (D,O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb261\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MIRM 9 \par\pard\ql \li1440\sb24\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Setiap pasien memiliki
rekam medis yang formatnya selalu diperbaharui (terkini). \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb217\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 360
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg361}
{\bkmkend Pg361}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 9
\par\pard\qj \li1440\ri1186\sb12\sl-315\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap pasien memiliki berkas rekam medis, baik
dalam bentuk kertas maupun \up0 \expndtw0\charscalex100 elektronik yang
merupakan sumber informasi utama mengenai proses asuhan dan \up0 \expndtw-
1\charscalex100 perkembangan pasien sehingga menjadi media komunikasi yang
penting. Oleh \up0 \expndtw-4\charscalex100 karena itu, berkas rekam medis
dievaluasi dan diperbaharui sesuai dengan kebutuhan \up0 \expndtw-5\charscalex100
dan secara periodik. \par\pard\qj \li1440\ri1183\sb204\sl-317\slmult0 \up0
\expndtw-4\charscalex100 Agar informasi ini berguna dan mendukung asuhan pasien
secara berkelanjutan maka \up0 \expndtw-3\charscalex100 rekam medis harus tersedia
selama asuhan pasien rawat inap, rawat jalan, dan setiap \up0
\expndtw0\charscalex102 saat dibutuhkan, serta dijaga untuk selalu mencatat
perkembangan pasien terkini. \up0 \expndtw0\charscalex100 Catatan medis,
keperawatan, dan catatan profesional pemberi asuhan lainnya \up0
\expndtw0\charscalex100 tersedia untuk semua tenaga kesehatan yang memberikan
asuhan kepada pasien \up0 \expndtw0\charscalex100 terkait. Rumah sakit mempunyai
regulasi yang menetapkan tenaga kesehatan yang \up0 \expndtw-2\charscalex100
mempunyai akses ke berkas rekam medis pasien untuk menjamin kerahasiaan
\up0 \expndtw-2\charscalex100 informasi pasien. Sebagai contoh, pasien rawat
jalan yang memerlukan riwayat \up0 \expndtw-3\charscalex100 sebelumnya di rawat
inap atau sebaliknya. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 9 \par\pard\qj
\li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\ri1247\sb45\sl-300\slmult0\tx2160
\up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi yang
menetapkan tenaga kesehatan yang mempunyai hak \line\tab \up0 \expndtw-
3\charscalex100 akses pada berkas rekam medis. (R) \par\pard\qj
\li1800\ri1246\sb4\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 2. Berkas
rekam medis tersedia bagi semua profesional pemberi asuhan (PPA) \line\tab \up0
\expndtw-3\charscalex100 sesuai dengan regulasi rumah sakit.
(D,O)\ul0\nosupersub\cf15\f16\fs24 (lihat juga AP 1) \par\pard\qj
\li1800\ri1249\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 3. Terdapat bukti bahwa form rekam medis dievaluasi
dan diperbaharui (terkini) \line\tab \up0 \expndtw-3\charscalex100 sesuai dengan
kebutuhan dan secara periodik. (D,O,W) \par\pard\qj \li1800\ri1250\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 4. Rekam medis pasien terisi
dengan lengkap dan dengan tulisan yang dapat \line\tab \up0 \expndtw-
3\charscalex100 dibaca. (D,O) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MIRM 10 \par\pard\ql \li1440\sb44\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
mempunyai regulasi tentang retensi rekam medis. \par\pard\ql \li1440\sb244\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MIRM 10 \par\pard\qj \li1440\ri1235\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit mempunyai regulasi
menentukan jangka waktu retensi rekam medis, \up0 \expndtw-1\charscalex100 data,
dan informasi lainnya terkait pasien sesuai dengan peraturan
perundang\up0 \expndtw0\charscalex103 undangan untuk mendukung asuhan pasien,
manajemen, dokumentasi yang sah \up0 \expndtw-3\charscalex100 secara hukum, serta
pendidikan dan penelitian. \par\pard\qj \li1440\ri1181\sb180\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Untuk rekam medis dalam bentuk kertas dilakukan pemilahan
rekam medis aktif dan \line \up0 \expndtw-3\charscalex100 rekam medis yang tidak
aktif serta disimpan secara terpisah. Penentuan jangka waktu \line \up0
\expndtw0\charscalex103 retensi berkas rekam medis ditentukan atas dasar nilai
kegunaan tiap-tiap berkas \line \up0 \expndtw0\charscalex103 rekam medis yang
konsisten dengan kerahasiaan dan keabsahan informasi. Bila \line \up0 \expndtw-
1\charscalex100 jangka waktu retensi sudah habis maka rekam medis, serta data dan
informasi yang \line \up0 \expndtw-1\charscalex100 terkait dengan pasien
dimusnahkan sesuai dengan peraturan perundang-undangan. \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb104\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 361
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg362}
{\bkmkend Pg362}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 10
\par\pard\qj \li1800\ri1248\sb308\sl-320\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi tentang jangka
waktu penyimpanan berkas rekam medis \line\tab \up0 \expndtw-3\charscalex100
pasien, serta data dan informasi lainnya terkait dengan pasien. (R) \par\pard\qj
\li1800\ri1249\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103 2. Dalam
rentang waktu penyimpanan berkas rekam medis, rumah sakit \line\tab \up0
\expndtw-3\charscalex100 menjamin keamanan dan kerahasiaan rekam medis. (O,W)
\par\pard\ql \li1800\ri1203\sb0\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-
2\charscalex100 3. Dokumen, serta data dan informasi dalam bentuk berkas
dimusnahkan setelah \line\tab \up0 \expndtw-2\charscalex100 melampaui periode waktu
penyimpanan sesuai dengan peraturan perundang-\line \tab \up0 \expndtw-
2\charscalex100 undangan. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar MIRM 11 \par\pard\qj \li1440\ri1247\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Berkas
rekam medis dilindungi dari kehilangan, kerusakan, gangguan, serta akses \up0
\expndtw-3\charscalex100 dan penggunaan yang tidak berhak. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb5\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 11 \par\pard\qj
\li1440\ri1179\sb16\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rekam medis pasien dan data serta informasi lain
terkait pasien harus dijaga dan \up0 \expndtw-5\charscalex100 dilindungi sepanjang
waktu. Sebagai contoh, rekam medis pasien yang aktif disimpan di \up0 \expndtw-
6\charscalex100 area yang hanya tenaga kesehatan mempunyai otorisasi untuk
akses. \par\pard\qj \li1440\ri1180\sb202\sl-320\slmult0 \up0 \expndtw-
4\charscalex100 Dokumen disimpan di lokasi yang terhindar dari air, api, panas, dan
kerusakan lainnya. \up0 \expndtw-4\charscalex100 Di rumah sakit yang menyimpan
rekam medis secara elektronik terdapat regulasi untuk \up0 \expndtw-3\charscalex100
mencegah akses mempergunakan rekam medis tanpa izin dan melaksanakan proses \up0
\expndtw-6\charscalex100 pencegahan penggunaan yang tidak berhak. \par\pard\ql
\li1440\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 11 \par\pard\qj
\li1800\ri1239\sb8\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi yang ditetapkan untuk mencegah
akses penggunaan rekam \line\tab \up0 \expndtw-3\charscalex100 medis bentuk kertas
dan atau elektronik tanpa izin. (R) \par\pard\qj \li1800\ri1249\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 2. Rekam medis dalam bentuk
kertas dan atau elektronik dilindungi dari \line\tab \up0 \expndtw-
2\charscalex100 kehilangan dan kerusakan. (O,W) \par\pard\qj \li1800\ri1249\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 3. Rekam medis dalam bentuk
kertas dan atau elektronik dilindungi dari \line\tab \up0 \expndtw-
2\charscalex100 gangguan dan akses serta penggunaan yang tidak sah. (D,S,W)
\par\pard\qj \li1800\ri1251\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100
4. Ruang dan tempat penyimpanan berkas rekam medis menjamin perlindungan \line\tab
\up0 \expndtw-2\charscalex100 terhadap akses dari yang tidak berhak. (O,W)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM 12
\par\pard\qj \li1440\ri1245\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan standar kode diagnosis, kode
prosedur/tindakan, simbol, \up0 \expndtw-3\charscalex100 singkatan, dan artinya.
\par\pard\ql \li1440\sb225\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 12 \par\pard\qj
\li1440\ri1222\sb12\sl-315\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Terminologi, arti, kamus, serta nomenklatur memudahkan
untuk membandingkan \line \up0 \expndtw0\charscalex104 data dan informasi di dalam
rumah sakit dan membandingkan antarrumah sakit. \line \up0 \expndtw0\charscalex102
Standardisasi berguna untuk mencegah terjadi salah komunikasi dan
potensi \line \up0 \expndtw-2\charscalex100 kesalahan. Penggunaan secara seragam
kode diagnosis dan prosedur memudahkan \line \up0 \expndtw-2\charscalex100
pengumpulan data serta analisisnya sesuai dengan peraturan perundang-undangan.
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb244\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 362
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg363}
{\bkmkend Pg363}\par\pard\qj \li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\sb0\sl-
316\slmult0 \par\pard\qj\li1440\sb0\sl-316\slmult0
\par\pard\qj\li1440\ri1240\sb211\sl-316\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Singkatan dapat menjadi masalah dan mungkin
berbahaya, terutama berkaitan \up0 \expndtw0\charscalex100 dengan penulisan resep
obat. Sebagai tambahan, jika satu singkatan dipakai untuk \up0
\expndtw0\charscalex100 bermacam- macam istilah medik akan terjadi kebingungan dan
dapat menghasilkan \up0 \expndtw0\charscalex103 kesalahan medik. Singkatan dan
simbol juga digunakan termasuk daftar \u8220?jangan \up0 \expndtw0\charscalex100
digunakan\u8221? (\ul0\nosupersub\cf8\f9\fs24 do-not-
use\ul0\nosupersub\cf7\f8\fs24 ). Ketentuan ini harus sesuai dengan standar
lokal dan \up0 \expndtw-3\charscalex100 nasional yang diakui. \par\pard\ql
\li1440\sb238\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 12 \par\pard\ql
\li1800\ri1240\sb214\sl-313\slmult0\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi
standardisasi kode diagnosis, kode prosedur/tindakan, \line\tab \up0
\expndtw0\charscalex102 definisi, simbol yang digunakan dan yang tidak boleh
digunakan, singkatan \line \tab \up0 \expndtw0\charscalex103 yang digunakan dan
yang tidak boleh digunakan, serta dimonitor \line \tab \up0 \expndtw-
3\charscalex100 pelaksanaannya. (R) \par\pard\ql \li1800\sb38\sl-276\slmult0
\up0 \expndtw-3\charscalex100 2. Ketentuan tersebut dilaksanakan dan dievaluasi.
(D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb248\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM
13 \par\pard\ql \li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyediakan rekam medis untuk setiap
pasien. \par\pard\ql \li1440\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 13 \par\pard\qj
\li1440\ri1195\sb14\sl-313\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap pasien yang menjalani asuhan dan pelayanan yang
terdiri atas hasil asesmen, \up0 \expndtw-2\charscalex100 rencana asuhan, dan
perkembangan kondisi pasien, baik sebagai pasien rawat inap, \up0
\expndtw0\charscalex100 rawat jalan dan gawat darurat, serta pasien yang
datang untuk pemeriksaan \up0 \expndtw-3\charscalex100 penunjang harus mempunyai
rekam medis. \par\pard\qj \li1440\ri1184\sb202\sl-320\slmult0\fi67 \up0 \expndtw-
4\charscalex100 Setiap pasien memiliki satu nomor rekam medis dan pengaturan urutan
berkas rekam \up0 \expndtw0\charscalex105 medis untuk memudahkan menemukan
rekam medis pasien serta \up0 \expndtw-3\charscalex100 mendokumentasikan
pelayanan pasien setiap saat/sewaktu-waktu. \par\pard\ql \li1440\sb237\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian MIRM 13 \par\pard\ql \li1800\ri1210\sb0\sl-
320\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi bahwa setiap pasien memiliki
rekam medis dengan satu \line\tab \up0 \expndtw-2\charscalex100 nomor rekam medis
sesuai dengan sistem penomoran unit, pengaturan urutan \line \tab \up0
\expndtw0\charscalex102 berkas rekam medis, baik untuk rawat jalan, rawat inap,
gawat darurat, dan \line \tab \up0 \expndtw-3\charscalex100 pemeriksaan penunjang.
(R) \par\pard\qj \li1800\ri1249\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 2. Rekam medis pasien digunakan untuk mencatat hasil
asesmen, rencana \line\tab \up0 \expndtw-2\charscalex100 asuhan, dan perkembangan
kondisi pasien. (D,O) \par\pard\qj \li1800\ri1251\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex104 3. Ada bukti rekam medis pasien menggunakan satu unit
penomoran rekam \line\tab \up0 \expndtw-3\charscalex100 medis untuk setiap pasien.
(D,W,O) \par\pard\qj \li1800\ri1248\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex102 4. Rekam medis pasien tersedia untuk rawat jalan, rawap
inap, gawat darurat, \line\tab \up0 \expndtw-3\charscalex100 dan pemeriksaan
penunjang. (D,O) \par\pard\ql \li1800\sb5\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 5. Berkas rekam medis pasien tersusun sesuai regulasi. (D,O)
(lihat juga AP) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb12\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM 13.1 \par\pard\qj
\li1440\ri1188\sb8\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rekam medis pasien memuat informasi yang memadai untuk
mengidentifikasi pasien, \line \up0 \expndtw-3\charscalex100 mendukung diagnosis,
justifikasi pengobatan, dokumen pemeriksaan dan hasil \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb50\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 363
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg364}
{\bkmkend Pg364}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1239\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 pengobatan, serta meningkatkan kesinambungan asuhan
di antara profesional \up0 \expndtw-3\charscalex100 pemberi asuhan (PPA) termasuk
manajer pelayanan pasien (MPP). \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb185\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM
13.1 \par\pard\ql \li1440\ri1186\sb8\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan data dan
informasi spesifik yang dicatat dalam rekam medis \line \up0 \expndtw-
2\charscalex100 setiap pasien yang dilakukan asesmen atau diobati oleh profesional
pemberi asuhan \line \up0 \expndtw-3\charscalex100 (PPA), baik sebagai pasien rawat
jalan, rawat inap,
dan gawat darurat. \line \up0 \expndtw-2\charscalex100 Rekam medis memuat
informasi yang memadai untuk mengidentifikasi pasien,
\par\pard\li1440\sb41\sl-276\slmult0\fi0\tx3286\tx4958\tx7188\tx9126 \up0 \expndtw-
3\charscalex100 mendukung\tab \up0 \expndtw-3\charscalex100 diagnosis,\tab \up0
\expndtw-3\charscalex100 justifikasi/dasar\tab \up0 \expndtw-3\charscalex100
pembenaran\tab \up0 \expndtw-3\charscalex100 pengobatan,\par\pard\qj
\li1440\ri1241\sb21\sl-300\slmult0 \up0 \expndtw0\charscalex102 mendokumentasikan
pemeriksaan dan hasil pengobatan, serta meningkatkan \up0 \expndtw-
3\charscalex100 kesinambungan pelayanan antara profesional pemberi asuhan (PPA).
\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1238\sb4\sl-
320\slmult0 \up0 \expndtw0\charscalex106 Format dan isi rekam medis pasien
sesuai standar yang terintegrasi dan \up0 \expndtw-2\charscalex100
kesinambungan asuhan antarprofesional pemberi asuhan (PPA) termasuk untuk
\up0 \expndtw-3\charscalex100 manajer pelayanan pasien (MPP). \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 13.1 \par\pard\qj
\li1440\ri1189\sb25\sl-300\slmult0\fi67 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ada regulasi tentang isi spesifik dari berkas rekam
medis pasien yang ditentukan oleh \up0 \expndtw-5\charscalex100 rumah sakit untuk
kesinambungan asuhan oleh PPA. (R) \par\pard\qj \li1800\ri1245\sb204\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 1. Rekam medis berisi informasi
yang memadai untuk mengidentifikasi pasien. \line\tab \up0 \expndtw-3\charscalex100
(D,O) \par\pard\qj \li1800\ri1248\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex103 2. Rekam medis berisi informasi yang memadai untuk
mendukung diagnosis. \line\tab \up0 \expndtw-3\charscalex100 (D,O) \par\pard\qj
\li1800\ri1238\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 3. Rekam
medis berisi informasi yang memadai untuk memberi justifikasi asuhan \line\tab \up0
\expndtw-3\charscalex100 dan pengobatan. (D,O) \par\pard\qj \li1800\ri1241\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 4. Rekam medis berisi informasi
yang memadai untuk mendokumentasikan \line\tab \up0 \expndtw-3\charscalex100
pemberian dan hasil pengobatan. (D,O) \par\pard\li1800\sb29\sl-
276\slmult0\fi0\tx6390 \up0 \expndtw0\charscalex100 5. Aktivitas manajer
pelayanan pasien\tab \up0 \expndtw0\charscalex100 (MPP) dicatat dalam rekam
medis.\par\pard\li1800\sb43\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex100
(D,O,W)\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb77\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM
13.1.1 \par\pard\qj \li1440\ri1186\sb8\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rekam medis setiap pasien gawat darurat memuat jam
kedatangan, ringkasan kondisi \line \up0 \expndtw-4\charscalex100 pasien saat
keluar dari gawat darurat, dan instruksi tindak lanjut asuhan. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb261\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 13.1.1
\par\pard\qj \li1440\ri1237\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rekam medis pasien gawat darurat memuat waktu
kedatangan dan keluar unit \up0 \expndtw0\charscalex100 pelayanan gawat darurat.
Informasi ini berlaku bagi semua pasien yang keluar dari \up0 \expndtw-
2\charscalex100 rumah sakit maupun yang dipindahkan ke unit lain atau ke unit rawat
inap. \par\pard\qj \li1440\ri1253\sb200\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Saat keluar dari gawat darurat diartikan pasien secara fisik keluar
meninggalkan unit \line \up0 \expndtw-1\charscalex100 gawat darurat, dapat pulang
ke rumah atau dipindahkan ke unit lain atau unit rawat \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb90\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 364
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg365}
{\bkmkend Pg365}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1237\sb234\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 inap atau dirujuk ke rumah sakit lain. Rekam medis juga
memuat simpulan pada saat \up0 \expndtw0\charscalex102 asuhan pasien selesai,
kondisi pasien saat pindah atau dipulangkan, dan instruksi \up0 \expndtw-
3\charscalex100 yang diberikan sebagai tindak lanjut pelayanan. \par\pard\ql
\li1440\sb239\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 13.1.1 \par\pard\ql
\li1800\ri1186\sb8\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi tentang RM pasien gawat
darurat yang memuat waktu \line\tab \up0 \expndtw-3\charscalex100 kedatangan dan
keluar pasien, ringkasan kondisi pasien saat keluar dari gawat \line \tab \up0
\expndtw-4\charscalex100 darurat, dan instruksi tindak lanjut asuhan. (R)
\par\pard\qj \li1800\ri1197\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-3\charscalex100
2. Rekam medis pasien gawat darurat memuat waktu kedatangan dan keluar dari
\line\tab \up0 \expndtw-4\charscalex100 unit pelayanan gawat darurat. (D,O)
\par\pard\qj \li1800\ri1242\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103
3. Rekam medis pasien gawat darurat memuat ringkasan kondisi pasien saat \line\tab
\up0 \expndtw-3\charscalex100 keluar dari unit pelayanan gawat darurat. (D,O)
\par\pard\qj \li1800\ri1249\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103
4. Rekam medis pasien gawat darurat memuat instruksi tindak lanjut asuhan.
\line\tab \up0 \expndtw-3\charscalex100 (D,O) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb261\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM 13.2 \par\pard\qj
\li1440\ri1243\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Regulasi rumah sakit mengidentifikasi mereka yang
berhak untuk mengisi rekam \up0 \expndtw-3\charscalex100 medis pasien serta
menentukan isi rekam medis dan format rekam medis. \par\pard\ql \li1440\sb217\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan MIRM 13.2 \par\pard\qj \li1440\ri1184\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menetapkan
regulasi untuk mengidentifikasi individu yang berhak \up0
\expndtw0\charscalex100 memperoleh hak akses dan mengisi (memasukkan catatan) ke
dalam rekam medis \up0 \expndtw-3\charscalex100 pasien sesuai dengan peraturan
perundang-undangan. Hal ini penting untuk menjaga \up0 \expndtw-4\charscalex100
keamanan informasi pasien. Proses yang efektif menentukan \par\pard\ql
\li1800\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100 1. individu yang
mempunyai hak akses ke informasi dalam rekam medis; \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 2. jenis informasi yang dapat
diakses; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3.
kewajiban pengguna untuk menjaga kerahasiaan informasi; \par\pard\ql
\li1800\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4. proses yang
dijalankan ketika kerahasiaan dan keamanan dilanggar. \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1243\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex103 Rumah sakit menetapkan format dan isi rekam medis yang
terstandardisasi guna \up0 \expndtw0\charscalex104 membantu meningkatkan
integrasi dan kesinambungan pelayanan di antara \up0 \expndtw0\charscalex100
profesional pemberi asuhan (PPA) dalam asuhan pasien, di samping itu ditetapkan
\up0 \expndtw-3\charscalex100 juga proses pengisian dan koreksi/pembetulan.
\par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 13.2 \par\pard\qj
\li1800\ri1239\sb25\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi yang menetapkan individu yang
berwenang mengisi rekam \line\tab \up0 \expndtw-3\charscalex100 medis dan memahami
cara melakukan koreksi. (R) \par\pard\qj \li1800\ri1249\sb4\sl-
320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 2. Terdapat bukti yang mengisi RM
hanya individu yang mendapat otoritas untuk \line\tab \up0 \expndtw-3\charscalex100
mengisi rekam medis. (D.W) \par\pard\qj \li1800\ri1248\sb0\sl-320\slmult0\tx2160
\up0 \expndtw-2\charscalex100 3. Terdapat bukti individu yang berwenang mengisi
rekam medis dan memahami \line\tab \up0 \expndtw-3\charscalex100 cara melakukan
koreksi. (W,O) \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb24\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 365
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg366}
{\bkmkend Pg366}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM 13.3 \par\pard\qj
\li1440\ri1184\sb25\sl-300\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap profesional pemberi asuhan (PPA) yang mengisi
rekam medis menulis identitas \up0 \expndtw-5\charscalex100 setelah pencatatan
dibuat. \par\pard\ql \li1440\sb240\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 13.3 \par\pard\qj
\li1440\ri1187\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Terdapat proses untuk menjamin bahwa hanya profesional
pemberi asuhan (PPA) \up0 \expndtw-1\charscalex100 yang diberi kewenangan yang
mengisi rekam medis pasien dan bahwa setiap \up0 \expndtw-3\charscalex100
pengisian ditulis tanggal dan jam, serta identifikasi profesional pemberi asuhan
(PPA) \up0 \expndtw-4\charscalex100 berupa nama jelas dan tandatangan/paraf.
\par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 13.3 \par\pard\qj
\li1800\ri1183\sb25\sl-300\slmult0\tx2160 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Pada setiap pengisian rekam medis dapat
diidentifikasi dengan jelas PPA yang \line\tab \up0 \expndtw-4\charscalex100
mengisi. (D,O) \par\pard\ql \li1800\sb40\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 2. Tanggal dan jam pengisian rekam medis dapat diidentifikasi.
(D,O) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb256\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM
13.4 \par\pard\qj \li1440\ri1250\sb25\sl-300\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Dalam upaya perbaikan kinerja, rumah
sakit secara teratur melakukan evaluasi atau \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 rekam medis.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb208\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 13.4 \par\pard\qj
\li1440\ri1244\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Setiap rumah sakit sudah menetapkan isi dan
format rekam medis pasien dan \up0 \expndtw-1\charscalex100 mempunyai proses
untuk melakukan asesmen terhadap isi dan kelengkapan berkas \up0
\expndtw0\charscalex100 rekam medis. Proses tersebut merupakan bagian dari kegiatan
peningkatan kinerja \up0 \expndtw-3\charscalex100 rumah sakit yang dilaksanakan
secara berkala. \par\pard\qj \li1440\ri1179\sb203\sl-317\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf8\f9\fs24
Review\ul0\nosupersub\cf7\f8\fs24 rekam medis berdasar atas sampel yang mewakili
PPA yang memberikan \line \up0 \expndtw-2\charscalex100 pelayanan dan jenis
pelayanan yang diberikan. Proses\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 melibatkan staf medis, \line \up0 \expndtw-
3\charscalex100 keperawatan, serta PPA lainnya yang relevan dan mempunyai otorisasi
untuk mengisi \line \up0 \expndtw-2\charscalex100 rekam medis pasien. (Lihat juga
PMKP 4.1).\ul0\nosupersub\cf8\f9\fs24 Review\ul0\nosupersub\cf7\f8\fs24 berfokus
pada ketepatan waktu, \line \up0 \expndtw0\charscalex100 kelengkapan, dapat
terbaca, keabsahan, dan lain-lain dari rekam medis serta \line \up0
\expndtw-2\charscalex100 informasi klinis. Isi rekam medis yang dipersyaratkan oleh
peraturan dan perundang-\line \up0 \expndtw-2\charscalex100 undangan dimasukkan ke
dalam proses\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 rekam
medis.\ul0\nosupersub\cf8\f9\fs24 Review\ul0\nosupersub\cf7\f8\fs24 rekam medis
di \line \up0 \expndtw0\charscalex105 rumah sakit tersebut termasuk rekam medis
pasien yang saat ini sedang dalam \line \up0 \expndtw0\charscalex102 perawatan dan
pasien yang sudah pulang. Hasil\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 dilaporkan secara berkala \line \up0 \expndtw-
3\charscalex100 kepada Pimpinan RS. \par\pard\ql \li1440\sb217\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM
13.4 \par\pard\qj \li1800\ri1238\sb8\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit menetapkan
individu atau tim yang melakukan\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 rekam \line\tab \up0 \expndtw-3\charscalex100
medis secara berkala. (R) \par\pard\ql \li1800\sb37\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 2. Rekam medis pasien di-\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 secara berkala. (D,W) \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
3.\ul0\nosupersub\cf8\f9\fs24 Review\ul0\nosupersub\cf7\f8\fs24 menggunakan
sampel yang mewakili. (D,W) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex102 4. Fokus\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 adalah pada ketepatan waktu, keterbacaan, dan
kelengkapan \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb70\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 366
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg367}
{\bkmkend Pg367}\par\pard\ql \li2160\sb0\sl-276\slmult0 \par\pard\ql\li2160\sb0\sl-
276\slmult0 \par\pard\ql\li2160\sb0\sl-276\slmult0 \par\pard\ql\li2160\sb0\sl-
276\slmult0 \par\pard\ql\li2160\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 rekam medis. (D,W) \par\pard\qj
\li1800\ri1248\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 5.
Proses\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 termasuk isi
rekam medis harus sesuai dengan peraturan dan \line\tab \up0 \expndtw-
3\charscalex100 perundang-undangan. (D,W) \par\pard\qj \li1800\ri1247\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 6.
Proses\ul0\nosupersub\cf8\f9\fs24 review\ul0\nosupersub\cf7\f8\fs24 termasuk
rekam medis pasien yang masih dirawat dan pasien \line\tab \up0 \expndtw-
3\charscalex100 yang sudah pulang. (D,W) \par\pard\ql \li1800\sb25\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 7. Hasil\ul0\nosupersub\cf8\f9\fs24
review\ul0\nosupersub\cf7\f8\fs24 dilaporkan secara berkala kepada direktur rumah
sakit. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb12\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM 14 \par\pard\ql
\li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Kerahasiaan dan privasi informasi dijaga.
\par\pard\ql \li1440\sb244\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 14 \par\pard\qj
\li1440\ri1234\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menjaga privasi dan kerahasiaan data
serta informasi secara khusus \line \up0 \expndtw-2\charscalex100 dalam menjaga
data dan informasi yang bersifat sensitif. Keseimbangan antara \line \up0
\expndtw0\charscalex102 berbagi data dan kerahasiaannya diatur, termasuk data
yang dapat diakses oleh \line \up0 \expndtw-1\charscalex100 pasien. Rumah sakit
menetapkan tingkat privasi dan kerahasiaan yang dijaga untuk \line \up0 \expndtw-
2\charscalex100 kategori beragam informasi (misalnya: rekam medis pasien, data
riset, dan lainnya). \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb269\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 14 \par\pard\ql
\li1800\ri1249\sb0\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 1. Terdapat regulasi mengenai privasi dan kerahasiaan
informasi terkait data \line\tab \up0 \expndtw0\charscalex105 pasien dan hak akses
terhadap isi rekam medis berdasar atas peraturan \line \tab \up0 \expndtw-
3\charscalex100 perundang-undangan. (R) \par\pard\ql \li1800\sb25\sl-276\slmult0
\up0 \expndtw-2\charscalex100 2. Terdapat bukti regulasi dilaksanakan. (D, W)
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3.
Kepatuhan pelaksanaan regulasi dimonitor. (D,W) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb12\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar MIRM
15 \par\pard\ql \li1440\sb24\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Ringkasan pasien pulang (\ul0\nosupersub\cf8\f9\fs24
discharge summary\ul0\nosupersub\cf7\f8\fs24 ) dibuat untuk semua pasien rawat
inap. \par\pard\ql \li1440\sb264\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan MIRM 15 \par\pard\qj
\li1440\ri1380\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf7\f8\fs24 Ringkasan pasien pulang memberikan gambaran tentang
pasien yang tinggal di \up0 \expndtw0\charscalex104 rumah sakit. Ringkasan dapat
digunakan oleh praktisi yang bertanggung jawab \up0 \expndtw-2\charscalex100
memberikan tindak lanjut asuhan. Ringkasan memuat hal \par\pard\ql
\li1800\sb225\sl-276\slmult0 \up0 \expndtw-3\charscalex100 1. indikasi pasien
masuk dirawat, diagnosis, dan komorbiditas lain; \par\pard\ql \li1800\sb4\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 2. temuan fisik penting dan temuan-
temuan lain; \par\pard\ql \li1800\sb1\sl-256\slmult0 \up0 \expndtw-2\charscalex100
3. tindakan diagnostik dan prosedur terapi yang telah dikerjakan; \par\pard\ql
\li1800\ri1381\sb5\sl-280\slmult0\tx2160\tx2160 \up0 \expndtw-2\charscalex100 4.
Obat yang diberikan selama dirawat inap dengan potensi akibat efek residual
\line\tab \up0 \expndtw0\charscalex105 setelah obat tidak diteruskan dan semua
obat yang harus digunakan di \line \tab \up0 \expndtw-3\charscalex100 rumah;
\par\pard\ql \li1800\sb1\sl-255\slmult0 \up0 \expndtw-1\charscalex100 5. kondisi
pasien (\ul0\nosupersub\cf8\f9\fs24 status present\ul0\nosupersub\cf7\f8\fs24 );
\par\pard\ql \li1800\sb8\sl-276\slmult0 \up0 \expndtw-2\charscalex100 6. ringkasan
memuat instruksi tindak lanjut; \par\pard\ql \li1800\sb4\sl-276\slmult0 \up0
\expndtw-2\charscalex100 7. ringkasan pasien pulang dijelaskan dan ditandatangani
oleh pasien/keluarga. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb48\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian MIRM 15 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb24\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 367
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg368}
{\bkmkend Pg368}\par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\sb0\sl-
320\slmult0 \par\pard\qj\li1800\sb0\sl-320\slmult0
\par\pard\qj\li1800\ri1253\sb196\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 1. Ringkasan pulang memuat riwayat kesehatan,
pemeriksaan fisis, dan \line\tab \up0 \expndtw-2\charscalex100 pemeriksaan
diagnostik. (D,W) \par\pard\qj \li1800\ri1246\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 2. Ringkasan pulang memuat indikasi pasien dirawat
inap, diagnosis, dan \line\tab \up0 \expndtw-2\charscalex100 komorbiditas lain.
(D,W) \par\pard\qj \li1800\ri1196\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 3. Ringkasan pulang memuat prosedur terapi dan tindakan yang telah
dikerjakan. \line\tab \up0 \expndtw-4\charscalex100 (D,W) \par\pard\qj
\li1800\ri1252\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 4.
Ringkasan pulang memuat obat yang diberikan, termasuk obat setelah pasien \line\tab
\up0 \expndtw-3\charscalex100 keluar rumah sakit. (D,W) \par\pard\qj
\li1800\ri1246\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103 5. Ringkasan
pulang memuat kondisi kesehatan pasien (\ul0\nosupersub\cf8\f9\fs24 status
present\ul0\nosupersub\cf7\f8\fs24 ) saat \line\tab \up0 \expndtw-2\charscalex100
akan pulang rumah sakit. (D,W) \par\pard\qj \li1800\ri1249\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex103 6. Ringkasan pulang memuat
instruksi tindak lanjut, serta dijelaskan dan \line\tab \up0 \expndtw-
2\charscalex100 ditandatangani oleh pasien dan keluarga. (D,W) \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb83\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 368
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg369}
{\bkmkend Pg369}\par\pard\ql \li10202\sb0\sl-322\slmult0
\par\pard\ql\li10202\sb0\sl-322\slmult0 \par\pard\ql\li10202\sb0\sl-322\slmult0
\par\pard\ql\li10202\sb228\sl-322\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf28\f29\fs28 IV \par\pard\qj \li9004\ri1204\sb25\sl-580\slmult0
\up0 \expndtw-4\charscalex100 PROGRAM \line \up0 \expndtw-4\charscalex100
NASIONAL \par\pard\ql \li4665\sb0\sl-276\slmult0 \par\pard\ql\li4665\sb0\sl-
276\slmult0 \par\pard\ql\li4665\sb160\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 PROGRAM NASIONAL \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb212\sl-276\slmult0 \up0 \expndtw-3\charscalex100 GAMBARAN
UMUM \par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\ri1243\sb26\sl-
310\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Untuk
meningkatkan derajat kesehatan masyarakat Indonesia, Pemerintah \up0
\expndtw0\charscalex102 menetapkan beberapa program nasional yang menjadi
prioritas. Program prioritas \up0 \expndtw-3\charscalex100 tersebut meliputi:
\par\pard\qj \li1800\ri1246\sb2\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex103
a) menurunkan angka kematian ibu dan bayi serta meningkatkan angka
\line\tab \up0 \expndtw-3\charscalex100 kesehatan ibu dan bayi \par\pard\ql
\li1800\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b) menurunkan angka
kesakitan HIV/AIDS \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 c) menurunkan angka kesakitan tuberkulosis \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d) pengendalian
resistensi antimikroba \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 e) pelayanan geriatri \par\pard\qj \li1440\ri1248\sb0\sl-
320\slmult0 \up0 \expndtw-2\charscalex100 Implementasi program ini di rumah
sakit dapat berjalan baik apabila mendapat \up0 \expndtw-2\charscalex100
dukungan penuh dari pimpinan/direktur rumah sakit berupa penetapan
regulasi, \up0 \expndtw-1\charscalex100 pembentukan organisasi pengelola,
penyediaan fasilitas, sarana dan dukungan \up0 \expndtw-3\charscalex100
finansial untuk mendukung pelaksanaan program. \par\pard\ql \li1612\sb0\sl-
276\slmult0 \par\pard\ql\li1612\sb69\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 SASARAN, STANDAR, MAKSUD DAN TUJUAN,
SERTA ELEMEN PENILAIAN \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb112\sl-276\slmult0
\up0 \expndtw-3\charscalex100 SASARAN I: \par\pard\qj \li1440\ri2041\sb8\sl-
320\slmult0 \up0 \expndtw-3\charscalex100 PENURUNAN ANGKA KEMATIAN IBU DAN BAYI
SERTA PENINGKATAN \up0 \expndtw-3\charscalex100 KESEHATAN IBU DAN BAYI \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Standar 1 \par\pard\li1440\sb47\sl-276\slmult0\fi0\tx6817 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan
program PONEK\tab \up0 \expndtw0\charscalex100 24 jam di rumah sakit
beserta\par\pard\li1440\sb44\sl-276\slmult0\fi0 \up0 \expndtw0\charscalex100
monitoring dan evaluasinya.\par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb65\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar 1.1 \par\pard\ql \li1440\sb44\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyiapkan
sumber daya untuk penyelenggaraan pelayanan PONEK. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar 1.2 \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb191\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 369
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg370}
{\bkmkend Pg370}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1244\sb234\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan pelayanan rawat gabung,
mendorong pemberian ASI \up0 \expndtw0\charscalex102 ekslusif, melaksanakan edukasi
dan perawatan metode kangguru pada bayi berat \up0 \expndtw-3\charscalex100 badan
lahir rendah (BBLR). \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb127\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan Standar
1, Standar 1.1 dan Standar 1.2 \par\pard\ql \li1440\sb0\sl-316\slmult0
\par\pard\ql\li1440\ri1241\sb15\sl-316\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Mengingat kematian bayi mempunyai hubungan erat
dengan mutu penanganan \line \up0 \expndtw-1\charscalex100 ibu hamil dan
melahirkan, maka proses antenatal care, persalinan dan perawatan \line \up0
\expndtw0\charscalex100 bayi harus dilakukan dalam sistem terpadu di tingkat
nasional dan regional. \line \up0 \expndtw0\charscalex100 Pelayanan obstetri dan
neonatal regional merupakan upaya penyediaan pelayanan \line \up0 \expndtw-
1\charscalex100 bagi ibu dan bayi baru lahir secara terpadu dalam bentuk
Pelayanan Obstetri \line \up0 \expndtw-2\charscalex100 Neonatal Emergensi
Komprehensif \up0 \expndtw-2\charscalex100 (PONEK) di Rumah Sakit dan
Pelayanan \par\pard\ql \li1440\sb38\sl-276\slmult0 \up0 \expndtw-1\charscalex100
Obstetri Neonatal Emergensi Dasar (PONED) di tingkat Puskesmas. \par\pard\qj
\li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\ri1190\sb26\sl-310\slmult0 \up0
\expndtw-4\charscalex100 Rumah Sakit PONEK 24 Jam merupakan bagian dari
sistem rujukan dalam \up0 \expndtw-1\charscalex100 pelayanan kedaruratan
dalam maternal dan neonatal, yang sangat berperan dalam \up0 \expndtw-
2\charscalex100
menurunkan angka kematian ibu dan bayi baru lahir. \par\pard\qj \li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\ri1238\sb2\sl-320\slmult0 \up0
\expndtw0\charscalex104 Kunci keberhasilan PONEK adalah ketersediaan tenaga-tenaga
kesehatan yang \up0 \expndtw-1\charscalex100 sesuai kompetensi, prasarana, sarana
dan manajemen yang handal. \par\pard\qj \li1440\ri1251\sb320\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Rumah sakit dalam melaksanakan program PONEK
sesuai dengan pedoman \up0 \expndtw-1\charscalex100 PONEK yang berlaku, dengan
langkah-langkah pelaksanaan sebagai berikut: \par\pard\qj \li1800\ri1245\sb17\sl-
300\slmult0\tx2160 \up0 \expndtw-1\charscalex100 a) melaksanakan dan menerapkan
standar pelayanan perlindungan ibu dan bayi \line\tab \up0 \expndtw-2\charscalex100
secara terpadu dan paripurna. \par\pard\ql \li1800\sb40\sl-276\slmult0 \up0
\expndtw-1\charscalex100 b) mengembangkan kebijakan dan SPO pelayanan sesuai
dengan standar \par\pard\qj \li1800\ri1247\sb8\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex107 c) meningkatkan kualitas pelayanan kesehatan ibu dan
bayi termasuk \line\tab \up0 \expndtw-1\charscalex100 kepedulian terhadap ibu dan
bayi. \par\pard\ql \li1800\ri1246\sb0\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 d) meningkatkan kesiapan rumah sakit dalam melaksanakan
fungsi pelayanan \line\tab \up0 \expndtw0\charscalex100 obstetrik dan neonatus
termasuk pelayanan kegawat daruratan (PONEK 24 \line \tab \up0 \expndtw-
1\charscalex100 jam) \par\pard\qj \li1800\ri1251\sb17\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex102 e) meningkatkan fungsi rumah sakit sebagai model dan
pembina teknis dalam \line\tab \up0 \expndtw-2\charscalex100 pelaksanaan IMD dan
pemberian ASI Eksklusif \par\pard\qj \li1800\ri1246\sb4\sl-320\slmult0\tx2160
\up0 \expndtw-1\charscalex100 f) meningkatkan fungsi rumah sakit sebagai pusat
rujukan pelayanan kesehatan \line\tab \up0 \expndtw-2\charscalex100 ibu dan bayi
bagi sarana pelayanan kesehatan lainnya. \par\pard\qj \li1800\ri1245\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 g) meningkatkan fungsi rumah sakit
dalam Perawatan Metode Kangguru (PMK) \line\tab \up0 \expndtw-1\charscalex100 pada
BBLR. \par\pard\qj \li1800\ri1238\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 h) melaksanakan sistem monitoring dan evaluasi pelaksanaan
program RSSIB \line\tab \up0 \expndtw-1\charscalex100 10 langkah menyusui dan
peningkatan kesehatan ibu \par\pard\ql \li1800\ri1238\sb6\sl-
313\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex102 i) ada regulasi
rumah sakit yang menjamin pelaksanaan PONEK 24 jam, \line\tab \up0
\expndtw0\charscalex102 meliputi pula pelaksanaan rumah sakit sayang ibu dan bayi,
pelayanan ASI \line \tab \up0 \expndtw-1\charscalex100 eksklusif (termasuk IMD),
pelayanan metode kangguru, dan SPO Pelayanan \line \tab \up0 \expndtw-
1\charscalex100 Kedokteran untuk pelayanan PONEK (lihat juga PAP 3.1)
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb84\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 370
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg371}
{\bkmkend Pg371}\par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\sb0\sl-
320\slmult0 \par\pard\qj\li1800\sb0\sl-320\slmult0
\par\pard\qj\li1800\ri1254\sb196\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 j) dalam rencana strategis (Renstra), rencana kerja
anggaran (RKA) rumah \line\tab \up0 \expndtw-2\charscalex100 sakit, termasuk upaya
peningkatan pelayanan PONEK 24 jam \par\pard\qj \li1800\ri1237\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 k) tersedia ruang pelayanan yang
memenuhi persyaratan untuk PONEK antara \line\tab \up0 \expndtw0\charscalex100 lain
rawat gabung \par\pard\ql \li1800\sb17\sl-276\slmult0 \up0 \expndtw0\charscalex101
l) pembentukan tim PONEK \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 m) tim PONEK mempunyai program kerja dan bukti pelaksanaannya
\par\pard\qj \li1800\ri1250\sb8\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100
n) terselenggara pelatihan untuk meningkatan kemampuan pelayanan PONEK
\line\tab \up0 \expndtw-1\charscalex100 24 jam, termasuk stabilisasi sebelum
dipindahkan \par\pard\ql \li1800\sb37\sl-276\slmult0 \up0 \expndtw-1\charscalex100
o) pelaksanaan rujukan sesuai peraturan perundangan \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 p) pelaporan dan analisis meliputi :
\par\pard\qj \li2520\ri1251\sb8\sl-320\slmult0\tx2880 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 angka keterlambatan operasi operasi section
caesaria (SC) ( > 30 \line\tab \up0 \expndtw-1\charscalex100 menit)
\par\pard\qj \li2520\ri3090\sb20\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 angka
keterlambatan penyediaan darah ( > 60 menit) \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 angka kematian
ibu dan bayi \par\pard\qj \li2520\ri1224\sb20\sl-320\slmult0\tx2880 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
kejadian tidak dilakukannya inisiasi menyusui dini (IMD) pada bayi baru
\line\tab \up0 \expndtw-3\charscalex100 lahir \par\pard\ql \li1509\sb0\sl-
276\slmult0 \par\pard\ql\li1509\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 1 \par\pard\qj
\li1800\ri1355\sb25\sl-300\slmult0\tx2160 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rumah sakit tentang pelaksanaan PONEK
24 jam di rumah sakit \line\tab \up0 \expndtw-5\charscalex100 dan ada rencana
kegiatan PONEK dalam perencanaan rumah sakit. (R) \par\pard\qj
\li1800\ri1773\sb4\sl-320\slmult0\tx2160 \up0 \expndtw-4\charscalex100 2. Ada
bukti keterlibatan pimpinan rumah sakit di dalam menyusun kegiatan \line\tab
\up0 \expndtw-5\charscalex100 PONEK. (D,W) \par\pard\ql \li1800\ri1783\sb0\sl-
320\slmult0\tx2160\tx2160 \up0 \expndtw-4\charscalex100 3. Ada bukti upaya
peningkatan kesiapan rumah sakit dalam melaksanakan \line\tab \up0 \expndtw-
3\charscalex100 fungsi pelayanan obstetrik dan neonatus termasuk pelayanan
kegawat \line \tab \up0 \expndtw-5\charscalex100 daruratan (PONEK 24 Jam). (D,W)
\par\pard\qj \li1800\ri1717\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
4. Ada bukti pelaksanaan rujukan dalam rangka PONEK (lihat juga ARK.5).
\line\tab \up0 \expndtw-3\charscalex100 (D,W) \par\pard\qj \li1800\ri1489\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw-4\charscalex100 5. Ada bukti pelaksanaan sistem
monitoring dan evaluasi program rumah sakit \line\tab \up0 \expndtw-5\charscalex100
sayang ibu dan bayi (RSSIB). (D,W) \par\pard\qj \li1800\ri1337\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw-4\charscalex100 6. Ada bukti pelaporan dan
analisis yang meliputi 1 sampai dengan 4 di maksud \line\tab \up0 \expndtw-
5\charscalex100 dan tujuan. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 1.1 \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada bukti terbentuknya tim PONEK dan program
kerjanya. (R) \par\pard\ql \li1800\sb24\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 2. Ada bukti pelatihan pelayanan PONEK. (D,W) \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-5\charscalex100 3. Ada bukti pelaksanaan
program tim PONEK. (D,W) \par\pard\qj \li1800\ri2032\sb8\sl-320\slmult0\tx2160 \up0
\expndtw-5\charscalex100 4. Tersedia ruang pelayanan yang memenuhi persyaratan
untuk PONEK. \line\tab \up0 \expndtw-5\charscalex100 (D,O,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 1.2
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Terlaksananya rawat gabung. (O,W) \par\pard\qj
\li1800\ri1660\sb25\sl-300\slmult0\tx2160 \up0 \expndtw-4\charscalex100 2. Ada
bukti RS melaksanakan IMD dan mendorong pemberian ASI Ekslusif. \line\tab \up0
\expndtw-5\charscalex100 (O,W) \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb93\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 371
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg372}
{\bkmkend Pg372}\par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\sb0\sl-
320\slmult0 \par\pard\qj\li1800\sb0\sl-320\slmult0
\par\pard\qj\li1800\ri1288\sb196\sl-320\slmult0\tx2160 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Ada bukti pelaksanaan edukasi dan
perawatan metode kangguru (PMK) pada \line\tab \up0 \expndtw-3\charscalex100 bayi
berat badan lahir rendah (BBLR). (D,O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 SASARAN II: \par\pard\ql \li1440\sb44\sl-276\slmult0
\up0 \expndtw-3\charscalex100 PENURUNAN ANGKA KESAKITAN HIV/AIDS (Standar 2)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0
\up0 \expndtw-8\charscalex100 Standar 2 \par\pard\qj \li1440\ri1241\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
melaksanakan penanggulangan HIV/AIDS sesuai dengan peraturan \up0 \expndtw-
3\charscalex100 perundang-undangan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan Standar 2 \par\pard\ql
\li1440\sb44\sl-276\slmult0\tx9201 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24
Dalam waktu yang singkat virus\ul0\nosupersub\cf8\f9\fs24 human
immunodeficiency virus \tab \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf7\f8\fs24 (HIV) telah \par\pard\qj \li1440\ri1252\sb8\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 mengubah keadaan sosial, moral, ekonomi
dan kesehatan dunia. Saat ini HIV/AIDS \up0 \expndtw-1\charscalex100 merupakan
masalah kesehatan terbesar yang dihadapi oleh komunitas global. \par\pard\qj
\li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\ri1237\sb8\sl-316\slmult0 \up0
\expndtw0\charscalex100 Saat ini, Pemerintah telah mengeluarkan kebijakan dengan
melakukan peningkatan \up0 \expndtw-1\charscalex100 fungsi pelayanan kesehatan bagi
orang hidup dengan HIV/AIDS (ODHA). Kebijakan \up0 \expndtw0\charscalex104 ini
menekankan kemudahan akses bagi orang hidup dengan HIV/AIDS (ODHA) \up0
\expndtw0\charscalex100 untuk mendapatkan layanan pencegahan, pengobatan, dukungan
dan perawatan, \up0 \expndtw0\charscalex104 sehingga diharapkan lebih banyak orang
hidup dengan HIV/AIDS (ODHA) yang \up0 \expndtw-1\charscalex100 memperoleh
pelayanan yang berkualitas. \par\pard\qj \li1440\ri1238\sb1\sl-320\slmult0 \up0
\expndtw0\charscalex102 Rumah sakit dalam melaksanakan penanggulangan HIV/AIDS
sesuai dengan \up0 \expndtw0\charscalex104 standar pelayanan bagi rujukan orang
dengan HIV/AIDS (ODHA) dan satelitnya \up0 \expndtw-1\charscalex100 dengan
langkah-langkah pelaksanaan sebagai berikut: \par\pard\ql \li1800\sb17\sl-
276\slmult0 \up0 \expndtw0\charscalex100 \u8226? meningkatkan fungsi
pelayanan\ul0\nosupersub\cf8\f9\fs24 Voluntary Counseling and
Testing\ul0\nosupersub\cf7\f8\fs24 (VCT); \par\pard\qj \li1800\ri1238\sb8\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex104 \u8226? meningkatkan fungsi
pelayanan\ul0\nosupersub\cf8\f9\fs24 Prevention Mother to Child Transmision
\line\tab \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (PMTCT);
\par\pard\li1800\sb47\sl-276\slmult0\fi0\tx9079 \up0 \expndtw0\charscalex102
\u8226? meningkatkan fungsi pelayanan\ul0\nosupersub\cf8\f9\fs24
Antiretroviral Therapy\tab \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 (ART) atau\par\pard\li1800\sb45\sl-
276\slmult0\fi360 \up0 \expndtw0\charscalex102 bekerjasama dengan RS yang
ditunjuk;\par\pard\ql \li1800\sb33\sl-276\slmult0 \up0 \expndtw0\charscalex100
\u8226? meningkatkan fungsi pelayanan Infeksi Oportunistik (IO); \par\pard\qj
\li1800\ri1237\sb8\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex104 \u8226?
meningkatkan fungsi pelayanan pada ODHA dengan faktor
risiko\ul0\nosupersub\cf8\f9\fs24 Injection \line\tab \up0 \expndtw-
1\charscalex100 Drug Use\ul0\nosupersub\cf7\f8\fs24 (IDU); dan \par\pard\qj
\li1800\ri1252\sb17\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex104 \u8226?
meningkatkan fungsi pelayanan penunjang, yang meliputi: pelayanan gizi,
\line\tab \up0 \expndtw-1\charscalex100 laboratorium, dan radiologi, pencatatan dan
pelaporan. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb128\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 2 \par\pard\qj
\li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\ri1247\sb8\sl-320\slmult0\tx2160
\up0 \expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 1. Adanya regulasi
rumah sakit dan dukungan penuh manajemen dalam \line\tab \up0 \expndtw-
3\charscalex100 pelayanan penanggulangan HIV/AIDS. (R) \par\pard\qj
\li1800\ri1187\sb17\sl-300\slmult0\tx2160 \up0 \expndtw-1\charscalex100 2.
Pimpinan rumah sakit berpartisipasi dalam menyusun rencana pelayanan
\line\tab \up0 \expndtw-5\charscalex100 penanggulangan HIV/AIDS. (D,W)
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb220\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 372
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg373}
{\bkmkend Pg373}\par\pard\ql \li1800\sb0\sl-310\slmult0 \par\pard\ql\li1800\sb0\sl-
310\slmult0 \par\pard\ql\li1800\sb0\sl-310\slmult0
\par\pard\ql\li1800\ri1247\sb234\sl-310\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3. Pimpinan rumah sakit
berpartisipasi dalam menetapkan keseluruhan \line\tab \up0 \expndtw-
2\charscalex100 proses/mekanisme dalam pelayanan penanggulangan HIV/AIDS
termasuk \line \tab \up0 \expndtw-3\charscalex100 pelaporannya. (D,W)
\par\pard\ql \li1800\sb39\sl-276\slmult0 \up0 \expndtw-3\charscalex100 4.
Terbentuk dan berfungsinya Tim HIV/AIDS rumah sakit ( D,W ) \par\pard\qj
\li1800\ri1244\sb8\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex105 5.
Terlaksananya pelatihan untuk meningkatkan kemampuan teknis Tim \line\tab
\up0 \expndtw-3\charscalex100 HIV/AIDS sesuai standar. (D,W) \par\pard\qj
\li1800\ri1243\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 6.
Terlaksananya fungsi rujukan HIV/AIDS pada rumah sakit sesuai dengan
\line\tab \up0 \expndtw-3\charscalex100 kebijakan yang berlaku. (D) \par\pard\qj
\li1800\ri1242\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 7.
Terlaksananya pelayanan VCT, ART, PMTCT, IO, ODHA dengan faktor risiko \line\tab
\up0 \expndtw-3\charscalex100 IDU, penunjang sesuai dengan kebijakan. (D)
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb149\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 SASARAN III: \par\pard\ql
\li1440\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 PENURUNAN ANGKA KESAKITAN
TUBERKULOSIS \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 Standar 3 \par\pard\qj
\li1440\ri1258\sb0\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit melaksanakan program penanggulangan
tuberkulosis di rumah sakit \up0 \expndtw-1\charscalex100 beserta monitoring dan
evaluasinya melalui kegiatan: \par\pard\ql \li1800\sb25\sl-276\slmult0 \up0
\expndtw-1\charscalex100 a) promosi kesehatan; \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 b) surveilans tuberkulosis; \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 c) pengendalian faktor
risiko; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 d)
penemuan dan penanganan kasus tuberkulosis; \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 e) pemberian kekebalan; dan \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw0\charscalex101 f) pemberian obat
pencegahan. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb112\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar 3.1 \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1244\sb8\sl-320\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyiapkan
sumber daya untuk penyelenggaraan pelayanan dan \up0 \expndtw-3\charscalex100
penanggulangan tuberkulosis. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar 3.2 \par\pard\qj \li1440\ri1257\sb308\sl-
320\slmult0 \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menyediakan sarana dan prasarana pelayanan tuberkulosis sesuai \up0 \expndtw-
1\charscalex100 peraturan perundang-undangan. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar 3.3 \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1252\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit telah melaksanakan
pelayanan tuberkulosis dan upaya pengendalian \up0 \expndtw-3\charscalex100 faktor
risiko tuberkulosis sesuai peraturan perundang-undangan. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan Standar 3 sampai
dengan Standar 3.3 \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb157\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 373
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg374}
{\bkmkend Pg374}\par\pard\qj \li1440\sb0\sl-316\slmult0 \par\pard\qj\li1440\sb0\sl-
316\slmult0 \par\pard\qj\li1440\sb0\sl-316\slmult0
\par\pard\qj\li1440\ri1253\sb211\sl-316\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Pemerintah telah mengeluarkan kebijakan
penanggulangan tuberkolosis berupa \up0 \expndtw0\charscalex102 upaya
kesehatan yang mengutamakan aspek promotif, preventif, tanpa \up0
\expndtw0\charscalex103 mengabaikan aspek kuratif dan rehabilitatif yang
ditujukan untuk melindungi \up0 \expndtw0\charscalex102 kesehatan masyarakat ,
menurunkan angka kesakitan , kecatatan atau kematian, \up0 \expndtw0\charscalex100
memutuskan penularan mencegah resistensi obat dan mengurangi dampak negatif \up0
\expndtw-1\charscalex100 yang ditimbulkan akibat tubekulosis. \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1258\sb1\sl-320\slmult0 \up0
\expndtw0\charscalex103 Rumah sakit dalam melaksanakan penanggulangan tubekulosis
melalui kegiatan \up0 \expndtw-1\charscalex100 yang meliputi: \par\pard\ql
\li1800\ri1242\sb303\sl-
317\slmult0\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw-
2\charscalex100 a) \tab \up0 \expndtw0\charscalex100 Promosi kesehatan yang
diarahkan untuk meningkatkan pengetahuan yang \line\tab \up0 \expndtw-
1\charscalex100 benar dan komprehensif mengenai pencegahan penularan, penobatan ,
pola \line \tab \up0 \expndtw-2\charscalex100
hidup bersih dan sehat (PHBS) sehingga terjadi perubahan sikap dan perilaku
\line \tab \up0 \expndtw-1\charscalex100 sasaran yaitu pasien dan keluarga,
pengunjung serta staf rumah sakit \line \up0 \expndtw-2\charscalex100 b) \up0
\expndtw-2\charscalex100 Surveilans tuberkulosis, merupakan kegiatan memperoleh
data epidemiologi \line\tab \up0 \expndtw0\charscalex104 yang diperlukan dalam
sistem informasi program penanggulangan \line \tab \up0
\expndtw0\charscalex100 tuberkulosis, seperti pencatatan dan pelaporan
tuberkulosis sensitif obat, \line \tab \up0 \expndtw-1\charscalex100 pencatatan
dan pelaporan tuberkulosis resistensi obat. \par\pard\ql \li1800\ri1244\sb1\sl-
320\slmult0\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw-
2\charscalex100 c) \tab \up0 \expndtw0\charscalex103 Pengendalian faktor risiko
tuberkulosis, ditujukan untuk mencegah, \line\tab \up0
\expndtw0\charscalex107 mengurangi penularan dan kejadian penyakit
tuberkulosis, yang \line \tab \up0 \expndtw0\charscalex100 pelaksanaannya sesuai
dengan pedoman pengendalian pencegahan infeksi \line \tab \up0
\expndtw0\charscalex100 tuberkulosis di rumah sakit pengendalian faktor risiko
tuberkulosis, ditujukan \line \tab \up0 \expndtw0\charscalex100 untuk mencegah,
mengurangi penularan dan kejadian penyakit tuberkulosis, \line \tab \up0
\expndtw0\charscalex102 yang pelaksanaannya sesuai dengan pedoman pengendalian
pencegahan \line \tab \up0 \expndtw-1\charscalex100 infeksi tuberkulosis di rumah
sakit \par\pard\ql \li1800\sb17\sl-276\slmult0\tx2160 \up0 \expndtw-2\charscalex100
d) \tab \up0 \expndtw-2\charscalex100 Penemuan dan penanganan kasus
tuberkulosis. \par\pard\qj \li2160\ri1241\sb8\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 Penemuan kasus tuberkulosis dilakukan melalui pasienyang datang
kerumah \line \up0 \expndtw0\charscalex100 sakit, setelah pemeriksaan, penegakan
diagnosis, penetapan klarifikasi dan \line \up0 \expndtw0\charscalex100 tipe pasien
tuberkulosis. Sedangkan untuk penanganan kasus dilaksanakan \line \up0
\expndtw0\charscalex106 sesuai tata laksana pada pedoman nasional pelayanan
kedokteran \line \up0 \expndtw0\charscalex105 tuberkulosis dan standar lainnya
sesuai dengan peraturanperundang-\line \up0 \expndtw-2\charscalex100 undangan.
\par\pard\ql \li1800\sb37\sl-276\slmult0\tx2160 \up0 \expndtw-2\charscalex100 e)
\tab \up0 \expndtw-2\charscalex100 Pemberian kekebalan \par\pard\qj
\li2160\ri1255\sb0\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Pemberian kekebalan
dilakukan melalui pemberian imunisasi BCG terhadap \up0 \expndtw0\charscalex102
bayi dalam upaya penurunan risiko tingkat pemahaman tuberkulosis sesuai \up0
\expndtw-1\charscalex100 dengan peraturan perundang-undangan. \par\pard\ql
\li1800\sb25\sl-276\slmult0\tx2160 \up0 \expndtw0\charscalex100 f) \tab \up0
\expndtw-2\charscalex100 Pemberian obat pencegahan. \par\pard\qj
\li2160\ri1244\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex101 Pemberian obat
pencegahan selama 6 (enam) bulan yang ditujukan pada \line \up0
\expndtw0\charscalex102 anak usia dibawah \up0 \expndtw-3\charscalex100 5 \up0
\expndtw0\charscalex102 (lima) tahun yang kontak erat dengan pasien
\par\pard\ql \li2160\sb37\sl-276\slmult0\tx8171 \up0 \expndtw0\charscalex104
tuberkulosisi aktif; orang dengan HIV dan AIDS \tab \up0
\expndtw0\charscalex103 (ODHA) yang tidak \par\pard\qj \li2160\ri1257\sb25\sl-
300\slmult0 \up0 \expndtw0\charscalex102 terdiagnosa tuberkulosis; pupulasi
tertentu lainnya sesuai peraturan \up0 \expndtw-2\charscalex100 perundang-
undangan. \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb220\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 374
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg375}
{\bkmkend Pg375}\par\pard\li1440\sb0\sl-276\slmult0\par\pard\li1440\sb0\sl-
276\slmult0\par\pard\li1440\sb0\sl-276\slmult0\par\pard\li1440\sb0\sl-
276\slmult0\par\pard\li1440\sb92\sl-276\slmult0\fi0\tx9734 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Kunci keberhasilan
penanggulangan tuberkulosis di rumah sakit\tab \up0 \expndtw0\charscalex102
adalah\par\pard\qj \li1440\ri1255\sb21\sl-300\slmult0 \up0 \expndtw-1\charscalex100
ketersediaan tenaga-tenaga kesehatan yang sesuai kompetensi, prasarana, sarana \up0
\expndtw-2\charscalex100 dan manajemen yang handal. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb128\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian Standar 3 \par\pard\ql \li1800\sb0\sl-320\slmult0
\par\pard\ql\li1800\ri1254\sb8\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi rumah sakit
tentang pelaksanaan penanggulangan tuberkulosis \line\tab \up0
\expndtw0\charscalex100 di rumah sakit dan ada rencana kegiatan
penanggulangan tuberkulosis \line \tab \up0 \expndtw-1\charscalex100 dengan
strategi DOTS dalam perencanaan rumah sakit. (R) \par\pard\ql
\li1800\ri1243\sb0\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex100 2.
Pimpinan rumah sakit berpartisipasi dalam menetapkan keseluruhan
\line\tab \up0 \expndtw0\charscalex102 proses/mekanisme dalam program
pelayanan tuberkulosis termasuk \line \tab \up0 \expndtw-1\charscalex100
pelaporannya. (D,W) \par\pard\ql \li1800\sb17\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 3. Ada bukti upaya pelaksanaan promosi kesehatan tentang
tuberkulosis. (D,W) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0
\expndtw0\charscalex100 4. Ada bukti pelaksanaan surveilans tuberkulosis dan
pelaporannya. (D,W) \par\pard\qj \li1800\ri1245\sb8\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex103 5. Ada bukti pelaksanaan upaya pencegahan tuberkulosis
melalui pemberian \line\tab \up0 \expndtw-1\charscalex100 kekebalan dengan
vaksinasi atau obat pencegahan. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 3.1 \par\pard\ql
\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada bukti terbentuknya tim DOTS dan
program kerjanya. (R) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 2. Ada bukti pelatihan pelayanan dan upaya penanggulangan
tuberkulosis. (D,W) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 3. Ada bukti pelaksanaan program tim DOTS. (D,W) \par\pard\qj
\li1800\ri1246\sb8\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex106 4. Ada
bukti pelaksanaan sistem monitoring dan evaluasi program \line\tab \up0
\expndtw-3\charscalex100 penanggulangan tuberkulosis. (D,W) \par\pard\qj
\li1800\ri1246\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 5. Ada
bukti pelaporan dan analisis yang meliputi a) sampai dengan f) di maksud
\line\tab \up0 \expndtw-3\charscalex100 dan tujuan. (D,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb105\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 3.2 \par\pard\qj
\li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\ri1243\sb8\sl-320\slmult0\tx2160
\up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Tersedia ruang
pelayanan rawat jalan yang memenuhi pedoman pencegahan \line\tab \up0 \expndtw-
3\charscalex100 dan pengendalian infeksi tuberkulosis. (O,W) \par\pard\ql
\li1800\ri1178\sb0\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw0\charscalex100 2.
Bila rumah sakit memberikan pelayanan rawat inap bagi pasien tuberkulosis \line\tab
\up0 \expndtw0\charscalex100 paru dewasa maka rumah sakit harus memiliki
ruang rawat inap yang \line \tab \up0 \expndtw-3\charscalex100 memenuhi pedoman
pencegahan dan pengendalian infeksi tuberkulosis. (O,W) \par\pard\qj
\li1800\ri1247\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 3. Tersedia
ruang pengambilan specimen sputum yang memenuhi pedoman \line\tab \up0
\expndtw-3\charscalex100 pencegahan dan pengendalian infeksi tuberkulosis. (O,W)
\par\pard\qj \li1800\ri1248\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex104
4. Tersedia ruang laboratorarium tuberkulosis yang memenuhi pedoman
\line\tab \up0 \expndtw-3\charscalex100 pencegahan dan pengendalian infeksi
tuberkulosis. (O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb41\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 3.3 \par\pard\ql
\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Rumah sakit memiliki panduan
praktek klinis tuberkulosis. (R) \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb90\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 375
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg376}
{\bkmkend Pg376}\par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\sb0\sl-
320\slmult0 \par\pard\qj\li1800\sb0\sl-320\slmult0
\par\pard\qj\li1800\ri1251\sb196\sl-320\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 2. Ada bukti kepatuhan staf medis
terhadap panduan praktek klinis tuberkulosis. \line\tab \up0 \expndtw-
2\charscalex100 (D,O,W) \par\pard\ql \li1800\sb17\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 3. Terlaksana proses skrining pasien tuberkulosis saat
pendaftaran. (D,O,W) \par\pard\qj \li1800\ri1250\sb8\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex103 4. Ada bukti staf mematuhi penggunaan alat pelindung diri
(APD) saat kontak \line\tab \up0 \expndtw-3\charscalex100 dengan
pasien atau specimen. (O,W) \par\pard\qj \li1800\ri1246\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex102 5. Ada bukti pengunjung mematuhi
penggunaan alat pelindung diri (APD) saat \line\tab \up0 \expndtw-3\charscalex100
kontak dengan pasien. (O,W) \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb125\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 SASARAN IV:
\par\pard\ql \li1440\sb24\sl-276\slmult0 \up0 \expndtw-3\charscalex100 PENGENDALIAN
RESISTENSI ANTIMIKROBA \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb132\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Gambaran Umum \par\pard\qj \li1440\sb0\sl-316\slmult0
\par\pard\qj\li1440\ri1200\sb15\sl-316\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Resistensi terhadap antimikroba (disingkat: resistensi
antimikroba, dalam bahasa \up0 \expndtw0\charscalex100 Inggris antimicrobial
resistance, AMR) telah menjadi masalah kesehatan yang \up0
\expndtw0\charscalex100 mendunia, dengan berbagai dampak merugikan yang dapat
menurunkan mutu dan \up0 \expndtw-2\charscalex100 meningkatkan risiko pelayanan
kesehatan khususnya biaya dan keselamatan pasien. \up0 \expndtw-1\charscalex100
Yang dimaksud dengan resistensi antimikroba adalah ketidak mampuan antimikroba \up0
\expndtw0\charscalex100 membunuh atau menghambat pertumbuhan mikroba sehingga
penggunaannya \up0 \expndtw-3\charscalex100 sebagai terapi penyakit infeksi menjadi
tidak efektif lagi. \par\pard\qj \li1440\sb0\sl-313\slmult0
\par\pard\qj\li1440\ri1182\sb14\sl-313\slmult0 \up0 \expndtw-2\charscalex100
Meningkatnya masalah resistensi antimikroba terjadi akibat penggunaan
antimikroba \up0 \expndtw-3\charscalex100 yang tidak bijak dan bertanggung jawab
dan penyebaran mikroba resisten dari pasien \up0 \expndtw0\charscalex100 ke
lingkungannya karena tidak dilaksanakannya praktik pengendalian dan
\up0 \expndtw-3\charscalex100 pencegahan infeksi dengan baik. \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1233\sb2\sl-320\slmult0 \up0
\expndtw0\charscalex100 Dalam rangka mengendalikan mikroba resisten di rumah sakit,
perlu dikembangkan \up0 \expndtw-2\charscalex100 program pengendalian resistensi
antimikroba di rumah sakit. Pengendalian resistensi \up0 \expndtw0\charscalex100
antimikroba adalah aktivitas yang ditujukan untuk mencegah dan/atau menurunkan \up0
\expndtw-3\charscalex100 adanya kejadian mikroba resisten. \par\pard\qj
\li1440\ri1244\sb300\sl-320\slmult0 \up0 \expndtw-1\charscalex100 Dalam rangka
pengendalian resistensi antimikroba secara luas baik di fasilitas \line \up0
\expndtw-2\charscalex100 pelayanan kesehatan maupun di komunitas di tingkat
nasional telah dibentuk Komite \line \up0 \expndtw0\charscalex100 Pengendalian
Antimikroba yang selanjutnya disingkat KPRA oleh Kementerian \line \up0
\expndtw0\charscalex102 Kesehatan. Disamping itu telah ditetapkan program aksi
nasional / national action \line \up0 \expndtw0\charscalex102 plans on
antimicrobial resistance (NAP AMR) yang didukung oleh WHO. Program \line \up0
\expndtw0\charscalex102 pengendalian resistensi antimikroba \up0
\expndtw0\charscalex102 (PPRA) merupakan upaya pengendalian \par\pard\ql
\li1440\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 resistensi antimikroba
secara terpadu dan paripurna di fasilitas pelayanan kesehatan. \par\pard\qj
\li1440\ri1240\sb308\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Implementasi
program ini di rumah sakit dapat berjalan baik apabila mendapat \line \up0
\expndtw-2\charscalex100 dukungan penuh dari pimpinan/direktur rumah sakit
berupa penetapan regulasi \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb150\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 376
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg377}
{\bkmkend Pg377}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1209\sb196\sl-320\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 pengendalian resistensi antimikroba, pembentukan
organisasi pengelola, penyediaan \up0 \expndtw-2\charscalex100 fasilitas, sarana
dan dukungan finansial untuk mendukung pelaksanaan PPRA. \par\pard\qj
\li1440\ri1222\sb300\sl-320\slmult0 \up0 \expndtw0\charscalex102 Penggunaan
antimikroba secara bijak ialah penggunaan antimikroba yang sesuai \up0
\expndtw0\charscalex100 dengan penyakit infeksi dan penyebabnya dengan rejimen
dosis optimal, durasi \up0 \expndtw0\charscalex103 pemberian optimal, efek samping
dan dampak munculnya mikroba resisten yang \up0 \expndtw0\charscalex103 minimal
pada pasien. Oleh sebab itu diagnosis dan pemberian antimikroba harus \up0
\expndtw-2\charscalex100 disertai dengan upaya menemukan penyebab infeksi dan
kepekaan mikroba patogen \up0 \expndtw-3\charscalex100 terhadap antimikroba.
\par\pard\qj \li1440\ri1186\sb300\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Penggunaan antimikroba secara bijak memerlukan regulasi dalam penerapan dan
\line \up0 \expndtw0\charscalex102 pengendaliannya. Pimpinan rumah sakit harus
membentuk komite atau tim PPRA \line \up0 \expndtw-3\charscalex100 sesuai peraturan
perundang-undangan sehingga PPRA dapat dilakukan dengan baik. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar 4 \par\pard\qj
\li1440\ri1248\sb8\sl-320\slmult0 \up0 \expndtw0\charscalex104
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyelenggarakan pengendalian
resistensi antimikroba sesuai \up0 \expndtw-3\charscalex100 peraturan perundang-
undangan. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb105\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan Standar 4
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Tersedia regulasi
pengendalian resistensi antimikroba di rumah sakit yang meliputi: \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a. Pengendalian
resistensi antimikroba. \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 b. Panduan penggunaan antibiotik untuk terapi dan profilaksis
pembedahan. \par\pard\qj \li1800\ri1250\sb25\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex100 c. Organisasi pelaksana, Tim/ Komite PPRA terdiri dari
tenaga kesehatan yang \line\tab \up0 \expndtw-3\charscalex100 kompeten dari
unsur: \par\pard\ql \li2160\sb60\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Staf Medis
\par\pard\ql \li2160\sb64\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Staf
Keperawatan \par\pard\ql \li2160\sb44\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24
Staf Instalasi Farmasi \par\pard\qj \li2160\ri1931\sb12\sl-340\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Staf Laboratorium yang melaksanakan pelayanan
mikrobiologi klinik \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Komite Farmasi dan Terapi \par\pard\ql
\li2160\sb33\sl-276\slmult0 \up0 \expndtw-5\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Komite PPIT
\par\pard\ql \li2160\ri3243\sb12\sl-340\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Komite Farmasi
dan Terapi \line \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Komite PPI \par\pard\qj \li1440\ri1187\sb0\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 Organisasi PRA dipimpin oleh staf medis
yang sudah mendapat sertifikat pelatihan \up0 \expndtw-3\charscalex100 PPRA. Rumah
sakit menyusun program pengendalian resistensi antimikroba di rumah \up0 \expndtw-
4\charscalex100 sakit terdiri dari: \par\pard\qj \li1800\ri1249\sb0\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 a) peningkatan pemahaman dan
kesadaran seluruh staf,pasien dan keluarga \line\tab \up0 \expndtw-3\charscalex100
tentang masalah resistensi anti mikroba; \par\pard\ql \li1800\sb14\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 b) pengendalian penggunaan antibiotik
di rumah sakit; \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 c) surveilans pola penggunaan antibiotik di rumah sakit;
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-5\charscalex100 d)
surveilans pola resistensi antimikroba di rumah sakit \par\pard\ql \li1800\sb44\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 e) forum kajian penyakit infeksi
terintegrasi \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb17\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 377
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg378}
{\bkmkend Pg378}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb132\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian Standar 4 \par\pard\qj \li1800\ri1663\sb308\sl-320\slmult0\tx2160 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi dan program
tentang pengendalian resistensi antimikroba di \line\tab \up0 \expndtw-
4\charscalex100 rumah
sakit sesuai peraturan perundang-undangan.(R) \par\pard\ql \li1800\sb37\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 2. Ada bukti pimpinan rumah sakit
terlibat dalam menyusun program. (D,W) \par\pard\qj \li1800\ri1256\sb8\sl-
320\slmult0\tx2160 \up0 \expndtw-2\charscalex100 3. Ada bukti dukungan anggaran
operasional, kesekretariatan, sarana prasarana \line\tab \up0 \expndtw-
3\charscalex100 untuk menunjang kegiatan fungsi, dan tugas organisasi PPRA. (D,O,W)
\par\pard\qj \li1800\ri2070\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-2\charscalex100
4. Ada bukti pelaksanaan pengendalian penggunaan antibiotik terapi dan
\line\tab \up0 \expndtw-3\charscalex100 profilaksis pembedahan pada seluruh proses
asuhan pasien. (D,O,W) \par\pard\ql \li1800\sb17\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 5. Direktur melaporkan kegiatan PPRA secara berkala kepada KPRA.
(D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar
4.1 \par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1243\sb8\sl-
320\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
(Tim/Komite PPRA) melaksanakan kegiatan pengendalian resistensi \up0 \expndtw-
3\charscalex100 antimikroba. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan Standar 4.1 \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1250\sb8\sl-320\slmult0 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit (Tim/Komite PPRA)
membuat laporan pelaksanaan program/ kegiatan \up0 \expndtw-3\charscalex100 PRA
meliputi: \par\pard\qj \li1800\ri1189\sb0\sl-320\slmult0\tx2160 \up0 \expndtw-
3\charscalex100 a) kegiatan sosialisasi dan pelatihan staf tenaga kesehatan
tentang pengendalian \line\tab \up0 \expndtw-4\charscalex100 resistensi antimikroba
\par\pard\qj \li1800\ri1246\sb0\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100
b) surveilans pola penggunaan antibiotik di RS (termasuklaporan pelaksanaan
\line\tab \up0 \expndtw-3\charscalex100 pengendalian antibiotik) \par\pard\ql
\li1800\sb17\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c) surveilans pola
resistensi antimikroba \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 d) forum kajian penyakit infeksi terintegrasi \par\pard\qj
\li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1241\sb8\sl-320\slmult0 \up0
\expndtw-1\charscalex100 Rumah sakit (Tim/Komite PPRA) menetapkan dan
melaksanakan evaluasi dan \up0 \expndtw-2\charscalex100 analisis indikator mutu
PPRA sesuai peraturan perundang-undangan meliputi: \par\pard\ql \li1800\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 a) perbaikan kuantitas penggunaan
antibiotik \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100
b) perbaikan kualitas penggunaan antibiotik \par\pard\qj \li1800\ri1249\sb25\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex105 c) peningkatan mutu penanganan
kasus infeksi secara multidisiplin dan \line\tab \up0 \expndtw-3\charscalex100
terintegrasi \par\pard\ql \li1800\sb40\sl-276\slmult0 \up0 \expndtw-2\charscalex100
d) penurunan angka infeksi rumah sakit yang disebabkan oleh mikroba resisten
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e)
indikator mutu PPRA terintegrasi pada indikator mutu PMKP \par\pard\qj
\li1440\sb0\sl-313\slmult0 \par\pard\qj\li1440\ri1182\sb21\sl-313\slmult0 \up0
\expndtw-3\charscalex100 Rumah sakit melaporkan perbaikan pola sensitivitas
antibiotik dan penurunan mikroba \line \up0 \expndtw0\charscalex100 resisten sesuai
indikator bakteri\ul0\nosupersub\cf8\f9\fs24 multi-drug resistant
organism\ul0\nosupersub\cf7\f8\fs24 (MDRO), antara lain: \line \up0
\expndtw0\charscalex100 bakteri penghasil\ul0\nosupersub\cf8\f9\fs24 extended
spectrum beta-lactamase (ESBL), Methicillin resistant \line \up0 \expndtw-
1\charscalex100 Staphylococcus aureus \up0 \expndtw-1\charscalex100 (MRSA),
Carbapenemase resistant enterobacteriaceae \par\pard\ql \li1440\sb38\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 (CRE) dan\ul0\nosupersub\cf7\f8\fs24
bakteri pan-resisten lainnyA (Lihat juga PPI.6). \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb224\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 378
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg379}
{\bkmkend Pg379}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 4.1
\par\pard\ql \li1800\ri1244\sb308\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada organisasi yang mengelola
kegiatan pengendalian resistensi antimikroba \line\tab \up0 \expndtw-
1\charscalex100 dan melaksanakan program pengendalian resistensi antimikroba rumah
sakit \line \tab \up0 \expndtw-3\charscalex100 meliputi a) sampai dengan d) di
maksud dan tujuan. (R) \par\pard\qj \li1800\ri1247\sb0\sl-320\slmult0\tx2160
\up0 \expndtw0\charscalex100 2. Ada bukti kegiatan organisasi yang meliputi a)
sampai dengan d) di maksud \line\tab \up0 \expndtw-3\charscalex100 dan tujuan.
(D,W) \par\pard\qj \li1800\ri1250\sb0\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 3. Ada penetapan indikator mutu yang meliputi a) sampai
dengan e) di maksud \line\tab \up0 \expndtw-3\charscalex100 dan tujuan. (D,W)
\par\pard\qj \li1800\ri1246\sb17\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex100
4. Ada monitoring dan evaluasi terhadap program pengendalian resistensi
\line\tab \up0 \expndtw0\charscalex100 antimikroba yang mengacu pada indikator
pengendalian \up0 \expndtw-3\charscalex100 resistensi \par\pard\ql \li2160\sb40\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 antimikroba (D,W) \par\pard\qj
\li1800\ri1188\sb8\sl-320\slmult0\tx2160 \up0 \expndtw-4\charscalex100 5. Ada
bukti pelaporan kegiatan PPRA secara berkala dan meliputi butir a) sampai \line\tab
\up0 \expndtw-5\charscalex100 dengan e) di maksud dan tujuan. (D,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb125\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 SASARAN V: \par\pard\ql \li1440\sb24\sl-276\slmult0
\up0 \expndtw-3\charscalex100 PELAYANAN GERIATRI \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Standar 5 \par\pard\qj \li1440\ri1247\sb8\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyediakan pelayanan
geriatri rawat jalan, rawat inap akut dan rawat \up0 \expndtw-3\charscalex100 inap
kronis sesuai dengan tingkat jenis pelayanan. \par\pard\ql \li1440\sb37\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar
5.1 \par\pard\qj \li1440\ri1242\sb16\sl-310\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah Sakit melakukan promosi dan edukasi sebagai
bagian dari Pelayanan \up0 \expndtw-1\charscalex100 Kesehatan Warga Lanjut usia
di Masyarakat Berbasis Rumah Sakit (\ul0\nosupersub\cf8\f9\fs24 Hospital Based \up0
\expndtw-3\charscalex100 Community Geriatric
Service\ul0\nosupersub\cf7\f8\fs24 ). \par\pard\ql \li1440\sb39\sl-276\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan Standar 5
dan Standar 5.1 \par\pard\qj \li1440\ri1194\sb11\sl-317\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Pasien geriatri adalah pasien
lanjut usia dengan multi penyakit/gangguan akibat \line \up0
\expndtw0\charscalex100 penurunan fungsi organ, psikologi, sosial,
ekonomi dan lingkungan yang \line \up0 \expndtw-2\charscalex100 membutuhkan
pelayanan kesehatan secara tepadu dengan pendekatan multi disiplin \line \up0
\expndtw0\charscalex100 yang bekerja sama secara interdisiplin. Dengan meningkatnya
sosial ekonomi dan \line \up0 \expndtw-3\charscalex100 pelayanan kesehatan maka
usia harapan hidup semakin meningkat, sehingga secara \line \up0
\expndtw0\charscalex102 demografi terjadi peningkatan populasi lanjut usia.
Sehubungan dengan itu rumah \line \up0 \expndtw0\charscalex102 sakit perlu
menyelenggarakan pelayanan geriatri sesuai dengan tingkat jenis \line \up0
\expndtw-3\charscalex100 pelayanan geriatri: \par\pard\ql \li1800\sb37\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 a) tingkat sederhana \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b) tingkat lengkap
\par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c) tingkat
sempurna \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 d)
tingkat paripurna \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 5 \par\pard\qj
\li1800\ri1186\sb308\sl-320\slmult0\tx2160 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang penyelenggaraan pelayanan
geriatri di rumah sakit sesuai \line\tab \up0 \expndtw-4\charscalex100 dengan
tingkat jenis layanan. (R) \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb83\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 379
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg380}
{\bkmkend Pg380}\par\pard\qj \li1800\sb0\sl-320\slmult0 \par\pard\qj\li1800\sb0\sl-
320\slmult0 \par\pard\qj\li1800\sb0\sl-320\slmult0
\par\pard\qj\li1800\ri1251\sb196\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 2. Terbentuk
dan berfungsinya tim terpadu geriatri sesuai tingkat jenis layanan. \line\tab \up0
\expndtw-3\charscalex100 (R,D,W) \par\pard\ql \li1800\sb17\sl-276\slmult0 \up0
\expndtw-3\charscalex100 3. Terlaksananya proses pemantauan dan evaluasi kegiatan.
(D,O,W) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4.
Ada pelaporan penyelenggaraan pelayanan geriatri di rumah sakit. (D,W) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian Standar 5.1
\par\pard\ql \li1800\sb0\sl-310\slmult0 \par\pard\ql\li1800\ri1186\sb26\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24
1. Ada regulasi tentang edukasi sebagai bagian dari Pelayanan Kesehatan Warga
\line\tab \up0 \expndtw-1\charscalex100 Lanjut usia di Masyarakat Berbasis Rumah
Sakit (\ul0\nosupersub\cf8\f9\fs24 Hospital Based Community \line \tab \up0
\expndtw-3\charscalex100 Geriatric Service\ul0\nosupersub\cf7\f8\fs24 ). (R)
\par\pard\ql \li1800\ri1246\sb2\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 2. Ada program PPRS terkait Pelayanan Kesehatan
Warga Lanjut usia di \line\tab \up0 \expndtw0\charscalex100 Masyarakat Berbasis
Rumah Sakit (\ul0\nosupersub\cf8\f9\fs24 Hospital Based Community Geriatric
\line \tab \up0 \expndtw-3\charscalex100 Service\ul0\nosupersub\cf7\f8\fs24 ).
(D,W) \par\pard\ql \li1800\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 3.
Ada leaflet atau alat bantu kegiatan (brosur, leaflet dll). (D,W) \par\pard\ql
\li1800\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4. Ada bukti pelaksanaan
kegiatan. (D,O,W) \par\pard\ql \li1800\sb44\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 5. Ada evaluasi dan laporan kegiatan pelayanan. (D,W) \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb115\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 380
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg381}
{\bkmkend Pg381}\par\pard\ql \li10305\sb0\sl-276\slmult0
\par\pard\ql\li10305\sb0\sl-276\slmult0 \par\pard\ql\li10305\sb0\sl-276\slmult0
\par\pard\ql\li10305\sb0\sl-276\slmult0 \par\pard\ql\li10305\sb88\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 V \par\pard\ql
\li7603\ri1239\sb59\sl-500\slmult0\tx8040 \up0 \expndtw-3\charscalex100 INTEGRASI
PENDIDIKAN \line\tab \up0 \expndtw-3\charscalex100 KESEHATAN DALAM \par\pard\ql
\li6439\sb206\sl-276\slmult0 \up0 \expndtw-3\charscalex100 PELAYANAN RUMAH SAKIT
(IPKP) \par\pard\ql \li1620\sb0\sl-276\slmult0 \par\pard\ql\li1620\sb0\sl-
276\slmult0 \par\pard\ql\li1620\sb0\sl-276\slmult0 \par\pard\ql\li1620\sb0\sl-
276\slmult0 \par\pard\ql\li1620\sb180\sl-276\slmult0 \up0 \expndtw-3\charscalex100
INTEGRASI PENDIDIKAN KESEHATAN DALAM PELAYANAN RUMAH SAKIT \par\pard\ql
\li5592\sb44\sl-276\slmult0 \up0 \expndtw-3\charscalex100 (IPKP) \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb160\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Gambaran
Umum \par\pard\qj \li1440\ri1207\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf7\f8\fs24 Undang-Undang Republik
Indonesia Nomor 44 Tahun 2009 tentang Rumah Sakit \up0 \expndtw-2\charscalex100
Pasal 22 dan 23 menetapkan pengaturan tentang rumah sakit pendidikan yang diatur
\up0 \expndtw-3\charscalex100 lebih lanjut dalam Peraturan Pemerintah Nomor 93
Tahun 2015. \par\pard\ql \li1440\sb237\sl-276\slmult0\tx6546\tx10202 \up0 \expndtw-
1\charscalex100 Undang-Undang Republik Indonesia Nomor \tab \up0
\expndtw0\charscalex101 20 Tahun 2013 Pasal 1 butir \tab \up0 \expndtw-
4\charscalex100 15 \par\pard\qj \li1440\ri1248\sb14\sl-313\slmult0 \up0
\expndtw0\charscalex100 menjelaskan bahwa Rumah Sakit Pendidikan adalah rumah sakit
yang mempunyai \up0 \expndtw-1\charscalex100 fungsi sebagai tempat pendidikan,
penelitian, dan pelayanan kesehatan secara \up0 \expndtw0\charscalex103 terpadu
dalam bidang pendidikan kedokteran, pendidikan berkelanjutan, dan \up0
\expndtw-3\charscalex100 pendidikan kesehatan lainnya secara multiprofesi.
\par\pard\qj \li1440\ri1237\sb202\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Undang-Undang Republik Indonesia Nomor 20 Tahun 2013 Pasal 1 butir 16, 17, dan \up0
\expndtw0\charscalex100 18 menjelaskan pengertian rumah sakit pendidikan utama,
rumah sakit pendidikan \up0 \expndtw-3\charscalex100 afiliasi, dan rumah sakit
pendidikan satelit. \par\pard\qj \li1440\ri1187\sb200\sl-320\slmult0 \up0 \expndtw-
3\charscalex100 Pasal 3: rumah sakit pendidikan memiliki fungsi pelayanan,
pendidikan, dan penelitian \up0 \expndtw-4\charscalex100 bidang kedokteran,
kedokteran gigi, dan kesehatan lain. \par\pard\qj \li1440\ri1183\sb204\sl-
316\slmult0 \up0 \expndtw-1\charscalex100 UU Nomor 44 Pasal 4 (1): dalam
menjalankan fungsi pelayanan bidang kedokteran, \up0 \expndtw0\charscalex100
kedokteran gigi, dan kesehatan lain sebagaimana dimaksud dalam Pasal 3, rumah
\up0 \expndtw0\charscalex100 sakit pendidikan bertugas menyelenggarakan
pelayanan kesehatan terintegrasi \up0 \expndtw-3\charscalex100 dengan
mengutamakan tata kelola klinis yang baik, perkembangan ilmu dan teknologi \up0
\expndtw0\charscalex102 kedokteran, kedokteran gigi, serta kesehatan lain
berbasis bukti dengan \up0 \expndtw-3\charscalex100 memperhatikan aspek etika
profesi dan hukum kesehatan. \par\pard\qj \li1440\ri1245\sb201\sl-320\slmult0
\up0 \expndtw0\charscalex102 Pasal 9: jenis rumah sakit pendidikan, yaitu rumah
sakit pendidikan utama, rumah \up0 \expndtw-3\charscalex100 sakit pendidikan
afiliasi, dan rumah sakit pendidikan satelit. \par\pard\qj \li1440\ri1239\sb217\sl-
300\slmult0 \up0 \expndtw-1\charscalex100 Rumah sakit pendidikan harus mempunyai
mutu dan keselamatan pasien yang lebih \up0 \expndtw-2\charscalex100 tinggi
daripada rumah sakit nonpendidikan. \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb66\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 381
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg382}
{\bkmkend Pg382}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1190\sb196\sl-320\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Agar mutu dan keselamatan pasien di rumah sakit
pendidikan tetap terjaga maka perlu \up0 \expndtw-5\charscalex100 ditetapkan
standar akreditasi untuk rumah sakit pendidikan. \par\pard\qj
\li1440\ri1215\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex100 Pada rumah sakit
yang ditetapkan sebagai rumah sakit pendidikan, akreditasi perlu \up0 \expndtw-
2\charscalex100 dilengkapi dengan standar dan elemen penilaian untuk menjaga mutu
pelayanan dan \up0 \expndtw-3\charscalex100 menjamin keselamatan pasien.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Standar IPKP.1 \par\pard\qj \li1440\ri1246\sb208\sl-
320\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Rumah sakit
menetapkan regulasi tentang persetujuan pemilik dan pengelola dalam \line \up0
\expndtw-2\charscalex100 pembuatan perjanjian kerja sama penyelenggaraan pendidikan
klinis di rumah sakit. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb185\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
IPKP.1 \par\pard\qj \li1440\ri1234\sb208\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Keputusan penetapan rumah sakit
pendidikan merupakan kewenangan kementerian \up0 \expndtw-2\charscalex100 yang
membidangi masalah kesehatan setelah ada keputusan bersama dalam bentuk \up0
\expndtw0\charscalex100 perjanjian kerja sama pemilik dan pengelola rumah sakit
dengan pimpinan institusi \up0 \expndtw-3\charscalex100 pendidikan. \par\pard\qj
\li1440\ri1235\sb206\sl-313\slmult0 \up0 \expndtw0\charscalex100 Mengintegrasikan
penyelenggaraan pendidikan klinis ke dalam operasional rumah \line \up0 \expndtw-
1\charscalex100 sakit memerlukan komitmen dalam pengaturan, antara lain
waktu, tenaga, dan \line \up0 \expndtw0\charscalex100 sumber daya. Peserta
pendidikan klinis termasuk\ul0\nosupersub\cf8\f9\fs24
trainee\ul0\nosupersub\cf7\f8\fs24
 /\ul0\nosupersub\cf8\f9\fs24 fellow\ul0\nosupersub\cf7\f8\fs24 , peserta
pendidikan \line \up0 \expndtw-2\charscalex100 dokter spesialis, dan peserta
pendidikan tenaga kesehatan profesional lainnya. \par\pard\qj
\li1440\ri1242\sb202\sl-320\slmult0 \up0 \expndtw0\charscalex102 Keputusan untuk
mengintegrasikan operasional rumah sakit dan pendidikan klinis \up0
\expndtw0\charscalex100 paling baik dibuat oleh jenjang pimpinan tertinggi yang
berperan sebagai pengambil \up0 \expndtw-2\charscalex100 keputusan di suatu rumah
sakit bersama institusi pendidikan kedokteran, kedokteran \up0 \expndtw-
2\charscalex100 gigi, dan profesi kesehatan lainnya yang didelegasikan
kepada organisasi yang \up0 \expndtw-3\charscalex100 mengoordinasi pendidikan
klinis. \par\pard\qj \li1440\ri1181\sb203\sl-317\slmult0 \up0
\expndtw0\charscalex102 Untuk penyelenggaraan pendidikan klinis di rumah sakit maka
semua pihak harus \up0 \expndtw-2\charscalex100 mendapat informasi lengkap tentang
hubungan dan tanggung jawab masing-masing. \up0 \expndtw0\charscalex100 Pemilik dan
atau representasi pemilik memberikan persetujuan terhadap keputusan \up0
\expndtw0\charscalex100 tentang visi-misi, rencana strategis, alokasi sumber daya,
dan program mutu rumah \up0 \expndtw0\charscalex102 sakit (lihat TKRS 1.1 sampai
TKRS 1.3) sehingga dapat ikut bertanggung jawab \up0 \expndtw-3\charscalex100
terhadap seluruh proses penyelenggaraan pendidikan klinis di rumah sakit yang harus
\up0 \expndtw-1\charscalex100 konsisten dengan visi-misi rumah sakit dan
komitmen pada mutu, keselamatan \up0 \expndtw-2\charscalex100 pasien, serta
kebutuhan pasien. \par\pard\qj \li1440\ri1184\sb181\sl-320\slmult0 \up0
\expndtw0\charscalex103 Rumah sakit mendapatkan informasi
tentang\ul0\nosupersub\cf8\f9\fs24 output\ul0\nosupersub\cf7\f8\fs24 dengan
kriteria-kriteria yang \line \up0 \expndtw-3\charscalex100 diharapkan dari
institusi pendidikan dari pendidikan klinis yang dilaksanakan di rumah \line
\up0 \expndtw-1\charscalex100 sakit untuk mengetahui mutu pelayanan dalam
penyelenggaraan pendidikan klinis di \line \up0 \expndtw-2\charscalex100 rumah
sakit. \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb170\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 382
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg383}
{\bkmkend Pg383}\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\sb0\sl-
320\slmult0 \par\pard\qj\li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1242\sb196\sl-320\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit menyetujui\ul0\nosupersub\cf8\f9\fs24
output\ul0\nosupersub\cf7\f8\fs24 serta kriteria penilaian pendidikan dan
harus \up0 \expndtw-3\charscalex100 dimasukkan dalam perjanjian kerja sama.
\par\pard\qj \li1440\ri1222\sb180\sl-320\slmult0 \up0 \expndtw0\charscalex105
Organisasi yang mengoordinasi pendidikan klinis bertanggung jawab untuk \up0
\expndtw-2\charscalex100 merencanakan, memonitor, dan mengevaluasi penyelenggaraan
program pendidikan \up0 \expndtw-3\charscalex100 klinis di rumah sakit.
\par\pard\qj \li1440\ri1249\sb200\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Organisasi yang mengoordinasi pendidikan klinis melakukan penilaian berdasar
atas \up0 \expndtw-3\charscalex100 kriteria yang sudah disetujui bersama.
\par\pard\qj \li1440\ri1241\sb200\sl-320\slmult0 \up0 \expndtw0\charscalex102
Organisasi yang mengoordinasi pendidikan klinis harus melaporkan hasil evaluasi
\up0 \expndtw0\charscalex103 penerimaan, pelaksanaan, dan
penilaian\ul0\nosupersub\cf8\f9\fs24 output\ul0\nosupersub\cf7\f8\fs24 dari
program pendidikan kepada \up0 \expndtw-3\charscalex100 pimpinan rumah sakit dan
pimpinan institusi pendidikan. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb185\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian
IPKP.1 \par\pard\ql \li1800\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada penetapan rumah sakit pendidikan yang masih
berlaku. (D) \par\pard\qj \li1800\ri1247\sb168\sl-320\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 2. Ada kerja sama antara rumah sakit dan institusi
pendidikan yang sudah \line\tab \up0 \expndtw-2\charscalex100 terakreditasi.
(D) \par\pard\qj \li1800\ri1247\sb177\sl-300\slmult0\tx2160 \up0 \expndtw-
1\charscalex100 3. Jumlah penerimaan peserta didik sesuai dengan kapasitas rumah
sakit harus \line\tab \up0 \expndtw-3\charscalex100 dicantumkan dalam perjanjian
kerja sama. (D) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb168\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar IPKP.2 \par\pard\qj
\li1440\ri1186\sb208\sl-320\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelaksanaan pelayanan dalam pendidikan klinis yang
diselenggarakan di rumah sakit \up0 \expndtw-3\charscalex100 mempunyai
akuntabilitas manajemen, koordinasi, dan prosedur yang jelas. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb205\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan IPKP.2 \par\pard\qj
\li1440\ri1221\sb216\sl-310\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Organisasi yang mengoordinasi pendidikan di rumah sakit
menetapkan kewenangan, \up0 \expndtw-2\charscalex100 perencanaan, monitoring
implementasi program pendidikan klinis, serta evaluasi dan \up0 \expndtw-
3\charscalex100 analisisnya. \par\pard\qj \li1440\ri1184\sb202\sl-320\slmult0
\up0 \expndtw-3\charscalex100 Kesepakatan antara rumah sakit dan institusi
pendidikan kedokteran, kedokteran gigi, \up0 \expndtw0\charscalex104 dan pendidikan
tenaga kesehatan lainnya harus tercermin dalam organisasi dan \up0 \expndtw-
3\charscalex100 kegiatan organisasi yang mengoordinasi pendidikan di rumah
sakit. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Rumah sakit memiliki regulasi yang mengatur: \par\pard\qj \li1800\ri1185\sb208\sl-
320\slmult0\tx2160 \up0 \expndtw-3\charscalex100 1) kapasitas penerimaan peserta
didik sesuai dengan kapasitas rumah sakit yang \line\tab \up0 \expndtw-
4\charscalex100 dicantumkan dalam perjanjian kerja sama; \par\pard\ql
\li1800\sb177\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2) persyaratan
kualifikasi pendidik/dosen klinis; \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb150\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 383
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg384}
{\bkmkend Pg384}\par\pard\ql \li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb0\sl-276\slmult0 \par\pard\ql\li1800\sb0\sl-
276\slmult0 \par\pard\ql\li1800\sb88\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 3) peserta pendidikan klinis di
rumah sakit. \par\pard\qj \li1440\ri1248\sb185\sl-300\slmult0 \up0
\expndtw0\charscalex100 Rumah sakit mendokumentasikan daftar akurat yang
memuat semua peserta \up0 \expndtw-3\charscalex100 pendidikan klinis di rumah
sakit. \par\pard\qj \li1440\ri1246\sb204\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 Untuk setiap peserta pendidikan klinis dilakukan pemberian
kewenangan klinis untuk \up0 \expndtw-2\charscalex100 menentukan sejauh mana
kewenangan yang diberikan secara mandiri atau di bawah \up0 \expndtw-
3\charscalex100 supervisi. \par\pard\ql \li1440\sb237\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Rumah sakit harus mempunyai dokumentasi \par\pard\ql
\li1800\sb244\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a) surat keterangan
peserta didik dari institusi pendidikan; \par\pard\qj \li1800\ri1252\sb185\sl-
300\slmult0\tx2160 \up0 \expndtw0\charscalex100 b) ijazah, surat tanda registrasi,
dan surat izin praktik yang menjadi persyaratan \line\tab \up0 \expndtw-
3\charscalex100 sesuai dengan peraturan perundang-undangan; \par\pard\ql
\li1800\sb200\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c) klasifikasi
akademik; \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100
d) identifikasi kompetensi peserta pendidikan klinis; dan \par\pard\ql
\li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e) laporan pencapaian
kompetensi. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb172\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian IPKP.2 \par\pard\ql
\li1800\ri1240\sb216\sl-310\slmult0\tx2160\tx2160 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada regulasi tentang pengelolan dan pengawasan
pelaksananaan pendidikan \line\tab \up0 \expndtw0\charscalex100 klinis yang telah
disepakati bersama meliputi 1) sampai dengan 3) di maksud \line \tab \up0 \expndtw-
3\charscalex100 dan tujuan. (R) \par\pard\qj \li1800\ri1253\sb162\sl-
320\slmult0\tx2160 \up0 \expndtw-1\charscalex100 2. Ada daftar lengkap memuat nama
semua peserta pendidikan klinis yang saat \line\tab \up0 \expndtw-3\charscalex100
ini ada di rumah sakit. (D) \par\pard\qj \li1800\ri1236\sb160\sl-320\slmult0\tx2160
\up0 \expndtw-2\charscalex100 3. Untuk setiap peserta pendidikan klinis terdapat
dokumentasi yang berisi paling \line\tab \up0 \expndtw-3\charscalex100 sedikit
meliputi a) sampai dengan e) di maksud dan tujuan. (D) \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb241\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar IPKP.3 \par\pard\qj
\li1440\ri1247\sb216\sl-310\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 Tujuan dan sasaran program pendidikan klinis di rumah
sakit disesuaikan dengan \up0 \expndtw-1\charscalex100 jumlah
staf yang memberikan pendidikan klinis, variasi dan jumlah pasien, teknologi, \up0
\expndtw-2\charscalex100 serta fasilitas rumah sakit. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb207\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan IPKP.3 \par\pard\qj \li1440\ri1180\sb208\sl-320\slmult0 \up0
\expndtw0\charscalex104 \ul0\nosupersub\cf7\f8\fs24 Pendidikan klinis di rumah
sakit harus mengutamakan keselamatan pasien serta \line \up0
\expndtw0\charscalex103 memperhatikan kebutuhan pelayanan sehingga pelayanan
rumah sakit tidak \line \up0 \expndtw-2\charscalex100 terganggu, akan tetapi
justru menjadi lebih baik dengan terdapat program pendidikan \line \up0 \expndtw-
2\charscalex100 klinis ini. Pendidikan harus dilaksanakan secara terintegrasi
dengan pelayanan dalam \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb70\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 384
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg385}
{\bkmkend Pg385}\par\pard\qj \li1440\sb0\sl-310\slmult0 \par\pard\qj\li1440\sb0\sl-
310\slmult0 \par\pard\qj\li1440\sb0\sl-310\slmult0
\par\pard\qj\li1440\ri1244\sb234\sl-310\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 rangka memperkaya pengalaman dan kompetensi
peserta didik, termasuk juga \up0 \expndtw-1\charscalex100 pengalaman pendidik
klinis untuk selalu memperhatikan prinsip pelayanan berfokus \up0 \expndtw-
3\charscalex100 pada pasien. \par\pard\ql \li1891\ri1190\sb222\sl-
320\slmult0\tx2251\tx2251 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf9\f10\fs24 \u-3913?\ul0\nosupersub\cf7\f8\fs24 Variasi dan
jumlah pasien harus selaras dengan kebutuhan untuk berjalannya \line\tab \up0
\expndtw-3\charscalex100 program, demikian juga fasilitas pendukung pembelajaran
harus disesuaikan \line \tab \up0 \expndtw-4\charscalex100 dengan teknologi
berbasis bukti yang harus tersedia. \par\pard\qj \li1891\ri1240\sb160\sl-
320\slmult0\tx2251 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf9\f10\fs24 \u-
3913?\ul0\nosupersub\cf7\f8\fs24 Jumlah peserta pendidikan klinis di rumah sakit
harus memperhatikan jumlah \line\tab \up0 \expndtw-3\charscalex100 staf pendidik
klinis serta ketersediaan sarana dan prasarana. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb165\sl-
276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen
Penilaian IPKP.3 \par\pard\ql \li1800\ri1244\sb208\sl-
320\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada perhitungan rasio peserta pendidikan
dengan staf yang memberikan \line\tab \up0 \expndtw-4\charscalex100 pendidikan
klinis untuk seluruh peserta dari setiap program pendidikan profesi \line \tab \up0
\expndtw-4\charscalex100 yang disepakati oleh rumah sakit dan institusi
pendidikan sesuai dengan \line \tab \up0 \expndtw-5\charscalex100 peraturan
perundang-undangan. (D) \par\pard\ql \li1800\ri1243\sb169\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw-1\charscalex100 2. Ada dokumentasi
perhitungan peserta didik yang diterima di rumah sakit per \line\tab \up0
\expndtw0\charscalex100 periode untuk proses pendidikan disesuaikan dengan jumlah
pasien untuk \line \tab \up0 \expndtw-5\charscalex100 menjamin mutu dan keselamatan
pasien. (D,W) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb167\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar IPKP.4 \par\pard\qj
\li1440\ri1249\sb208\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Seluruh staf yang memberikan pendidikan klinis
mempunyai kompetensi sebagai \line \up0 \expndtw0\charscalex100 pendidik klinis dan
mendapatkan kewenangan dari institusi pendidikan dan rumah \line \up0 \expndtw-
5\charscalex100 sakit. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb185\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
IPKP.4 \par\pard\qj \li1440\ri1181\sb208\sl-320\slmult0 \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Seluruh staf yang memberikan pendidikan
klinis telah mempunyai kompetensi dan \up0 \expndtw-3\charscalex100 kewenangan
klinis untuk dapat mendidik dan memberikan pembelajaran klinis kepada \up0
\expndtw-1\charscalex100 peserta pendidikan klinis di rumah sakit sesuai
dengan peraturan perundang\up0 \expndtw-2\charscalex100 undangan. (lihat juga KKS
10, KKS 13, dan KKS 16) \par\pard\qj \li1440\ri1244\sb205\sl-315\slmult0 \up0
\expndtw-1\charscalex100 Daftar staf yang memberikan pendidikan klinis dengan
seluruh gelar akademis dan \up0 \expndtw-2\charscalex100 profesinya tersedia di
rumah sakit. Seluruh staf yang memberikan pendidikan klinis \up0 \expndtw-
3\charscalex100 harus memenuhi persyaratan kredensial dan memiliki kewenangan
klinis untuk \up0 \expndtw-1\charscalex100 melaksanakan pendidikan klinis yang
sesuai dengan tuntutan tanggung jawabnya. \up0 \expndtw-5\charscalex100 (lihat juga
KKS 9, KKS 13, dan KKS 16) \par\pard\ql \li1440\sb238\sl-276\slmult0 \up0 \expndtw-
5\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian IPKP.4 \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb84\sl-253\slmult0 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 385
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg386}
{\bkmkend Pg386}\par\pard\qj \li1800\sb0\sl-300\slmult0 \par\pard\qj\li1800\sb0\sl-
300\slmult0 \par\pard\qj\li1800\sb0\sl-300\slmult0
\par\pard\qj\li1800\ri1245\sb273\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1. Ada penetapan staf klinis yang memberikan
pendidikan klinis dan penetapan \line\tab \up0 \expndtw-3\charscalex100 penugasan
klinis serta rincian kewenangan klinis dari rumah sakit. (R) \par\pard\ql
\li1800\ri1243\sb164\sl-320\slmult0\tx2160\tx2160 \up0 \expndtw-1\charscalex100 2.
Ada daftar staf klinis yang memberikan pendidikan klinis secara lengkap
\line\tab \up0 \expndtw0\charscalex100 (akademik dan profesi) sesuai dengan jenis
pendidikan yang dilaksanakan di \line \tab \up0 \expndtw-3\charscalex100 RS.
(D,W) \par\pard\qj \li1800\ri1211\sb160\sl-320\slmult0\tx2160 \up0 \expndtw-
2\charscalex100 3. Ada uraian tugas, tanggung jawab, dan juga wewenang untuk
setiap staf yang \line\tab \up0 \expndtw-2\charscalex100 memberikan pendidikan
klinis. (lihat juga KKS 10, KKS 13, dan KKS 16) (D,W) \par\pard\qj
\li1800\ri1240\sb160\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 4. Ada
bukti staf klinis yang memberikan pendidikan klinis telah mengikuti
\line\tab \up0 \expndtw-3\charscalex100 pendidikan keprofesian berkelanjutan.
(D) \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb145\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar IPKP.5 \par\pard\qj
\li1440\ri1246\sb208\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Rumah sakit memastikan pelaksanaan supervisi yang
berlaku untuk setiap jenis dan \up0 \expndtw-2\charscalex100 jenjang pendidikan
staf klinis di rumah sakit. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb205\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan Tujuan
IPKP.5 \par\pard\qj \li1440\ri1234\sb212\sl-315\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf7\f8\fs24 Supervisi dalam pendidikan
menjadi tanggung jawab staf klinis yang memberikan \line \up0 \expndtw-
1\charscalex100 pendidikan klinis untuk menjadi acuan pelayanan rumah sakit agar
pasien, staf, dan \line \up0 \expndtw-1\charscalex100 peserta didik terlindungi
secara hukum. Supervisi diperlukan untuk memastikan \line \up0 \expndtw-
1\charscalex100 asuhan pasien yang aman dan merupakan bagian proses belajar
bagi peserta \line \up0 \expndtw-1\charscalex100 pendidikan klinis sesuai dengan
jenjang pembelajaran dan level kompetensinya. \par\pard\qj \li1440\ri1234\sb201\sl-
320\slmult0 \up0 \expndtw0\charscalex104 Setiap peserta pendidikan klinis di rumah
sakit mengerti proses supervisi klinis, \up0 \expndtw-1\charscalex100 meliputi
siapa saja yang melakukan supervisi dan frekuensi supervisi oleh staf klinis
\up0 \expndtw-2\charscalex100 yang memberikan pendidikan klinis. Pelaksanaan
supervisi didokumentasikan dalam \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf8\f9\fs24 log book\ul0\nosupersub\cf7\f8\fs24 peserta didik dan
staf klinis yang memberikan pendidikan klinis. \par\pard\qj
\li1440\ri1248\sb217\sl-300\slmult0 \up0 \expndtw-2\charscalex100 Dikenal 4 (empat)
tingkatan supervisi yang disesuaikan dengan kompetensi dan juga \up0 \expndtw-
3\charscalex100 kewenangan peserta didik sebagai berikut: \par\pard\ql
\li1800\ri1189\sb204\sl-320\slmult0\tx2160\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex104 \u8226? supervisi tinggi: kemampuan asesmen peserta didik
belum sahih sehingga \line\tab \up0 \expndtw0\charscalex101 keputusan dalam membuat
diagnosis dan rencana asuhan harus dilakukan \line \tab \up0 \expndtw-
2\charscalex100 oleh dokter penanggung jawab pelayanan (DPJP). Begitu pula tindakan
medis \line \tab \up0 \expndtw-3\charscalex100 dan operatif hanya boleh dilakukan
oleh DPJP. Pencatatan pada berkas rekam \line \tab \up0 \expndtw-4\charscalex100
medis harus dilakukan oleh DPJP; \par\pard\ql \li1800\ri1188\sb166\sl-
313\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex100 \u8226? supervisi
moderat tinggi: kemampuan asesmen peserta didik sudah dianggap \line\tab
\up0 \expndtw-4\charscalex100 sahih, namun kemampuan membuat keputusan belum sahih
sehingga rencana \line \tab \up0 \expndtw-3\charscalex100 asuhan yang dibuat
peserta didik harus disupervisi oleh DPJP. Tindakan medis \line \tab \up0 \expndtw-
3\charscalex100 dan operatif dapat dikerjakan oleh peserta didik dengan supervisi
langsung \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb38\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 386
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg387}
{\bkmkend Pg387}\par\pard\qj \li2160\sb0\sl-300\slmult0 \par\pard\qj\li2160\sb0\sl-
300\slmult0 \par\pard\qj\li2160\sb0\sl-300\slmult0
\par\pard\qj\li2160\ri1248\sb273\sl-300\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 (\ul0\nosupersub\cf8\f9\fs24
onsite\ul0\nosupersub\cf7\f8\fs24 ) oleh DPJP. Pencatatan pada berkas rekam medis
oleh peserta didik \up0 \expndtw-3\charscalex100 dan diverifikasi dan divalidasi
oleh DPJP; \par\pard\ql \li1800\ri1185\sb164\sl-
320\slmult0\tx2160\tx2160\tx2160\tx2160\tx2160\tx2160 \up0
\expndtw0\charscalex100 \u8226? supervisi moderat: kemampuan melakukan
asesmen sudah sahih, tetapi \line\tab \up0 \expndtw0\charscalex100 kemampuan
membuat keputusan belum sahih sehingga keputusan rencana \line \tab \up0 \expndtw-
1\charscalex100 asuhan harus mendapat persetujuan DPJP sebelum dijalankan, kecuali
pada \line \tab \up0 \expndtw0\charscalex102 kasus gawat darurat. Tindakan medis
dan operatif dapat dilaksanakan oleh \line \tab \up0 \expndtw0\charscalex100
peserta didik dengan supervisi tidak langsung oleh DPJP (dilaporkan setelah
\line \tab \up0 \expndtw-4\charscalex100 pelaksanaan). Pencatatan pada berkas rekam
medis oleh peserta didik dengan \line \tab \up0 \expndtw-5\charscalex100 verifikasi
dan validasi oleh DPJP; \par\pard\ql \li1800\ri1243\sb140\sl-
320\slmult0\tx2160\tx2160\tx2160\tx2160 \up0 \expndtw-2\charscalex100 \u8226?
supervisi rendah: kemampuan asesmen dan kemampuan membuat keputusan \line\tab
\up0 \expndtw-3\charscalex100 sudah sahih sehingga dapat membuat diagnosis dan
rencana asuhan, namun \line \tab \up0 \expndtw0\charscalex100 karena belum
mempunyai legitimasi tetap harus melapor kepada DPJP. \line \tab \up0
\expndtw-2\charscalex100 Tindakan medis dan operatif dapat dilakukan dengan
supervisi tidak langsung \line \tab \up0 \expndtw-3\charscalex100 oleh DPJP.
\par\pard\ql \li1440\sb197\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Pencatatan
pada berkas rekam medis oleh peserta didik dengan validasi oleh DPJP.
\par\pard\qj \li1440\ri1191\sb216\sl-310\slmult0 \up0 \expndtw-2\charscalex100
Penetapan tingkat supervisi peserta didik dilakukan oleh staf klinis yang
memberikan \up0 \expndtw-3\charscalex100 pendidikan klinis setelah melakukan
evaluasi kompetensi peserta didik menggunakan \up0 \expndtw-4\charscalex100
perangkat evaluasi pendidikan yang dibuat oleh institusi pendidikan.
\par\pard\ql \li1440\sb239\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Beberapa
alat evaluasi antara lain: \par\pard\ql \li1980\sb244\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 1.\ul0\nosupersub\cf8\f9\fs24 bed site
teaching\ul0\nosupersub\cf7\f8\fs24 ; \par\pard\ql \li1980\sb204\sl-276\slmult0
\up0 \expndtw-3\charscalex100 2.\ul0\nosupersub\cf8\f9\fs24 mini-clinical
evaluation exercise for trainee\ul0\nosupersub\cf7\f8\fs24 (Mini-CEX);
\par\pard\ql \li1980\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100
3.\ul0\nosupersub\cf8\f9\fs24 direct observation of procedure and
supervision\ul0\nosupersub\cf7\f8\fs24 (DOPS); \par\pard\ql \li1980\sb204\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 4.\ul0\nosupersub\cf8\f9\fs24 case base
discussion\ul0\nosupersub\cf7\f8\fs24 (CBD); \par\pard\ql \li1980\sb184\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 5. portofolio dan buku
Log\ul0\nosupersub\cf8\f9\fs24 . \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb192\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian
IPKP.5 \par\pard\qj \li1800\ri1252\sb188\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada tingkat supervisi yang
diperlukan oleh setiap peserta pendidikan klinis di \line\tab \up0 \expndtw-
3\charscalex100 rumah sakit untuk setiap jenjang pendidikan. (D,O,W)
\par\pard\qj \li1800\ri1241\sb160\sl-320\slmult0\tx2160 \up0
\expndtw0\charscalex100 2. Setiap peserta pendidikan klinis mengetahui
tingkat, frekuensi, dan \line\tab \up0 \expndtw-3\charscalex100 dokumentasi
untuk supervisinya. (D,W) \par\pard\ql \li1800\ri1250\sb169\sl-
310\slmult0\tx2160\tx2160 \up0 \expndtw-1\charscalex100 4. Ada format spesifik
untuk mendokumentasikan supervisi yang sesuai dengan \line\tab \up0 \expndtw-
2\charscalex100 kebijakan rumah sakit, sasaran program, serta mutu dan keselamatan
asuhan \line \tab \up0 \expndtw-3\charscalex100 pasien. (D) \par\pard\qj
\li1800\ri1239\sb162\sl-320\slmult0\tx2160 \up0 \expndtw0\charscalex100 5. Ada
batasan kewenangan peserta pendidikan yang mempunyai akses dalam \line\tab \up0
\expndtw-3\charscalex100 mengisi rekam medis. (lihat juga MIRM 13.4) (D)
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb183\sl-253\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 387
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg388}
{\bkmkend Pg388}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb56\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Standar IPKP.6 \par\pard\qj
\li1440\ri1251\sb188\sl-320\slmult0 \up0 \expndtw0\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Pelaksanaan pendidikan klinis di rumah sakit harus
mematuhi regulasi rumah sakit \up0 \expndtw0\charscalex105 dan pelayanan yang
diberikan berada dalam upaya mempertahankan atau \up0 \expndtw-3\charscalex100
meningkatkan mutu dan keselamatan pasien. \par\pard\ql \li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb205\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Maksud dan
Tujuan IPKP.6 \par\pard\qj \li1440\ri1234\sb212\sl-315\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Dalam pelaksanaannya program
pendidikan klinis tersebut senantiasa menjamin \up0 \expndtw0\charscalex103
mutu dan keselamatan pasien. Rumah sakit memiliki rencana dan melaksanakan \up0
\expndtw0\charscalex100 program orientasi dengan menerapkan konsep mutu dan
keselamatan pasien yang \up0 \expndtw0\charscalex100 harus diikuti oleh seluruh
peserta pendidikan klinis serta mengikutsertakan peserta \up0 \expndtw-
3\charscalex100 didik dalam semua pemantauan mutu dan keselamatan pasien.
\par\pard\ql \li1440\sb238\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Orientasi
peserta pendidikan klinis minimal mencakup \par\pard\qj \li1800\ri1246\sb208\sl-
320\slmult0\tx2160 \up0 \expndtw0\charscalex100 a) program rumah sakit tentang
mutu dan keselamatan pasien (lihat juga TKRS \line\tab \up0 \expndtw-
3\charscalex100 4; TKRS 4.1; TKRS 5; TKRS 11; dan TKRS 11.2); \par\pard\ql
\li1800\sb197\sl-276\slmult0 \up0 \expndtw-3\charscalex100 b) program pengendalian
infeksi (lihat juga PPI 5); \par\pard\ql \li1800\sb184\sl-276\slmult0 \up0
\expndtw-3\charscalex100 c) program keselamatan penggunaan obat (lihat juga PKPO
1); \par\pard\ql \li1800\sb204\sl-276\slmult0 \up0 \expndtw-3\charscalex100 d)
sasaran keselamatan pasien. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb172\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Elemen Penilaian
IPKP.6 \par\pard\ql \li1800\ri1241\sb208\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 1. Ada program orientasi
peserta pendidikan staf klinis dengan materi orientasi \line\tab \up0
\expndtw0\charscalex102 yang meliputi a) sampai dengan d) mengenai maksud dan
tujuan (lihat juga \line \tab \up0 \expndtw-3\charscalex100 KKS 7 EP 1).(R)
\par\pard\qj \li1800\ri1251\sb177\sl-300\slmult0\tx2160 \up0
\expndtw0\charscalex103 2. Ada bukti pelaksanaan dan sertifikat program orientasi
peserta pendidikan \line\tab \up0 \expndtw-3\charscalex100 klinis. (D,W)
\par\pard\ql \li1800\ri1242\sb164\sl-320\slmult0\tx2160\tx2160 \up0
\expndtw0\charscalex103 4. Ada bukti pelaksanaan dan dokumentasi peserta didik
yang diikutsertakan \line\tab \up0 \expndtw0\charscalex100 dalam semua program
peningkatan mutu dan keselamatan pasien di rumah \line \tab \up0 \expndtw-
3\charscalex100 sakit. (D,W) \par\pard\ql \li1800\ri1241\sb160\sl-
320\slmult0\tx2160\tx2160\tx2160 \up0 \expndtw0\charscalex104 5. Ada pemantauan
dan evaluasi bahwa pelaksanaan pendidikan klinis tidak \line\tab \up0 \expndtw-
1\charscalex100 menurunkan mutu dan keselamatan pasien yang dilaksanakan
sekurang-\line \tab \up0 \expndtw0\charscalex102 kurangnya sekali setahun yang
terintegrasi dengan program mutu dan \line \tab \up0 \expndtw-3\charscalex100
keselamatan pasien. (D) (lihat TKRS 1.2 dan TKRS 5 EP 3) \par\pard\qj
\li1800\ri1250\sb177\sl-300\slmult0\tx2160 \up0 \expndtw0\charscalex100 6. Ada
survei mengenai kepuasan pasien terhadap pelayanan rumah sakit atas \line\tab
\up0 \expndtw-2\charscalex100 dilaksanakannya pendidikan klinis sekurang-kurangnya
sekali setahun. (D,W) \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb186\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 388
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg389}
{\bkmkend
Pg389}\par\pard\ql \li3746\sb0\sl-276\slmult0 \par\pard\ql\li3746\sb0\sl-
276\slmult0 \par\pard\ql\li3746\sb0\sl-276\slmult0 \par\pard\ql\li3746\sb0\sl-
276\slmult0 \par\pard\ql\li3746\sb0\sl-276\slmult0 \par\pard\ql\li3746\sb0\sl-
276\slmult0 \par\pard\ql\li3746\sb56\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Daftar Singkatan dan Istilah
(Glossary)\par\pard\sect\sectd\sbknone\cols2\colno1\colw4771\colsr160\colno2\colw68
29\colsr160\ql \li1605\sb250\sl-276\slmult0\tx2250 \up0 \expndtw-3\charscalex100
No\tab \up0 \expndtw-3\charscalex100 Singkatan dan Istilah\par\pard\ql
\li1696\sb33\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 1\tab \up0 \expndtw-3\charscalex100
ADIME\par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-
276\slmult0 \par\pard\ql \li1696\sb12\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 2\tab \up0 \expndtw-3\charscalex100 akreditasi\par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 3\tab \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 alur klinis atau
clinical\par\pard\ql \li2193\sb1\sl-273\slmult0 \up0 \expndtw-3\charscalex100
pathway\par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-
276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-
276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-
276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-
276\slmult0 \par\pard\ql \li1696\sb13\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 4\tab \up0 \expndtw-3\charscalex100
AMR\par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-
276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-
276\slmult0 \par\pard\ql \li1696\sb9\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 5\tab \up0 \expndtw-3\charscalex100 anestesi dan sedasi\par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb10\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 6\tab \up0 \expndtw-3\charscalex100 AP\par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb0\sl-276\slmult0 \par\pard\ql \li1696\sb0\sl-276\slmult0 \par\pard\ql
\li1696\sb9\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 7\tab \up0
\expndtw-3\charscalex100 APD\par\pard\column \ql \li1511\sb250\sl-276\slmult0
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf6\f7\fs24 Pengertian dan
Penjelasan\par\pard\qj \li21\ri695\sb33\sl-276\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 ADIME disingkat dari Asesmen, Diagnosis, Intervensi,
\up0 \expndtw0\charscalex105 Monitoring dan Evaluasi, yang merupakan proses
\up0 \expndtw-3\charscalex100 asesmen yg dilakukan oleh profesi
gizi.\par\pard\qj \li21\ri691\sb11\sl-276\slmult0\tx1285\tx2616\tx3922\tx5254
\up0 \expndtw-3\charscalex100 Akreditasi, dalam standar ini adalah akreditasi
rumah \line \up0 \expndtw-2\charscalex100 sakit, merupakan pengakuan terhadap rumah
sakit yang \line \up0 \expndtw0\charscalex102 diberikan oleh lembaga independen
penyelenggara \line \up0 \expndtw0\charscalex101 akreditasi yang ditetapkan oleh
Menteri Kesehatan, \line \up0 \expndtw-2\charscalex100 setelah dinilai bahwa
rumah sakit tersebut memenuhi \line \up0 \expndtw0\charscalex101 standar
pelayanan rumah sakit yang berlaku untuk \line \up0 \expndtw0\charscalex103
meningkatkan mutu pelayanan rumah sakit secara \line \up0 \expndtw-
3\charscalex100 berkesinambungan. Dalam standar ini, status akreditasi \line \up0
\expndtw0\charscalex105 merupakan penetapan yang diberikan oleh KARS \line
\up0 \expndtw0\charscalex101 sebagai lembaga yang diberi kewenangan untuk
\line \up0 \expndtw0\charscalex101 menyelenggarakan akreditasi rumah sakit di
Indonesia \line \up0 \expndtw0\charscalex101 atas kepatuhan rumah sakit tersebut
dalam memenuhi \line \up0 \expndtw-3\charscalex100 standar nasional akreditasi
rumah sakit yang ditetapkan. \line \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf8\f9\fs24 Clinical pathway\ul0\nosupersub\cf7\f8\fs24 atau alur
klinis adalah suatu regimen \line \up0 \expndtw0\charscalex102 (rangkaian)
pengobatan yang disepakati yang meliputi \line \up0 \expndtw-3\charscalex100
semua \tab \up0 \expndtw-3\charscalex100 elemen \tab \up0 \expndtw-3\charscalex100
(unsur) \tab \up0 \expndtw-3\charscalex100 asuhan \tab \up0 \expndtw-
3\charscalex100 dengan\par\pard\qj \li21\ri690\sb1\sl-275\slmult0 \up0
\expndtw0\charscalex100 mengorganisasikan, mengurutkan dan menjadwalkan \up0
\expndtw-4\charscalex100 intervensi-intervensi utama oleh para profesional
pemberi \up0 \expndtw-2\charscalex100 asuhan (PPA) dan staf lainnya. Dalam
implementasi \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf8\f9\fs24 clinical
pathway\ul0\nosupersub\cf7\f8\fs24 dapat berupa pakem\ul0\nosupersub\cf8\f9\fs24
(template)\ul0\nosupersub\cf7\f8\fs24 asuhan \up0 \expndtw-2\charscalex100 atau
daftar tilik\ul0\nosupersub\cf8\f9\fs24
(checklist\ul0\nosupersub\cf7\f8\fs24 ).\ul0\nosupersub\cf8\f9\fs24 Clinical
pathway\ul0\nosupersub\cf7\f8\fs24 juga dikenal \up0 \expndtw0\charscalex103
sebagai\ul0\nosupersub\cf8\f9\fs24 critical paths\ul0\nosupersub\cf7\f8\fs24
(alur utama, alur kritis) dan\ul0\nosupersub\cf8\f9\fs24 care \up0 \expndtw-
3\charscalex100 maps\ul0\nosupersub\cf7\f8\fs24 (peta asuhan).\par\pard\qj
\li21\ri692\sb13\sl-276\slmult0 \up0 \expndtw-3\charscalex100 AMR singkatan dari
Anti Microbial Resistance adalah \up0 \expndtw0\charscalex101 ketidak mampuan
antimikroba membunuh atau \up0 \expndtw0\charscalex104 menghambat
pertumbuhan mikroba sehingga \up0 \expndtw-1\charscalex100 penggunaannya
sebagai terapi penyakit infeksi menjadi \up0 \expndtw-3\charscalex100 tidak efektif
lagi.\par\pard\qj \li21\ri694\sb9\sl-276\slmult0 \up0 \expndtw0\charscalex103
Anestesi dan sedasi adalah pemberian obat pada \up0 \expndtw-3\charscalex100
seorang individu, di tempat pelayanan apapun, untuk \up0
\expndtw0\charscalex104 tindakan invasif melalui cara \up0
\expndtw0\charscalex104 (rute) apapun untuk\par\pard\qj \li21\ri695\sb1\sl-
275\slmult0 \up0 \expndtw0\charscalex103 menimbulkan kehilangan sensasi,
sebagian atau \up0 \expndtw0\charscalex100 seluruhnya, dalam rangka melakukan
prosedur operatif \up0 \expndtw-3\charscalex100 atau prosedur
lainnya.\par\pard\qj \li21\ri693\sb12\sl-275\slmult0 \up0 \expndtw-3\charscalex100
AP atau asesmen pasien adalah suatu proses untuk \line \up0
\expndtw0\charscalex100 mengetahui kebutuhan klinis pasien melalui metode
\line \up0 \expndtw-2\charscalex100 pengumpulan informasi (anamnesis, pemeriksaaan
fisik, \line \up0 \expndtw-1\charscalex100 pemeriksaan penunjang diagnostik, dan
seterusnya), \line \up0 \expndtw-1\charscalex100 melakukan analisis (menghasilkan
diagnosis, masalah, \line \up0 \expndtw-2\charscalex100 kondisi dan risiko), dan
membuat rencana asuhan. Lihat \line \up0 \expndtw-3\charscalex100 bab
AP\par\pard\ql \li21\sb10\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Alat
pelindung diri\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li875\sb179\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 389

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\expndtw-3\charscalex100 audit medis\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0
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12\tab \up0 \expndtw-3\charscalex100 B3\par\pard\ql \li1631\sb33\sl-
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\expndtw-3\charscalex100 berbahaya\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb11\sl-
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\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 17\tab \up0
\expndtw-3\charscalex100 budaya keselamatan\par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb9\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 18\tab \up0 \expndtw-3\charscalex100 CDOB\par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 19\tab \up0
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\li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql
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\expndtw0\charscalex104 keadaan atau suatu proses pemilihan \up0 \expndtw-
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\expndtw0\charscalex100 pelayanan yg dilakukan pasien dan keluarga, biasanya
\up0 \expndtw-3\charscalex100 dalam keadaan pasien pulang APS.\par\pard\qj
\li21\ri697\sb10\sl-275\slmult0 \up0 \expndtw-2\charscalex100 Akses ke Rumah Sakit
dan Kontinuitas Pelayanan. Lihat \up0 \expndtw-3\charscalex100 bab
ARK\par\pard\ql \li21\ri690\sb10\sl-277\slmult0 \up0 \expndtw-2\charscalex100
Asuhan keperawatan merupakan proses atau rangkaian \up0 \expndtw0\charscalex101
kegiatan dalam praktik keperawatan langsung pada \up0 \expndtw0\charscalex102
pasien/klien di berbagai tatanan pelayanan kesehatan \up0 \expndtw0\charscalex102
yang pelaksanaannya didasarkan pada kaidah profesi \up0 \expndtw-3\charscalex100
keperawatan dan merupakan inti praktik keperawatan. \up0 \expndtw0\charscalex102
Audit medis adalah upaya evaluasi secara profesional \up0 \expndtw-1\charscalex100
terhadap mutu pelayanan medis yang diberikan kepada \up0 \expndtw-2\charscalex100
pasien dengan menggunakan rekam medisnya, yang \up0 \expndtw-3\charscalex100
dilaksanakan oleh profesi medis.\par\pard\ql \li21\ri694\sb8\sl-281\slmult0 \up0
\expndtw-3\charscalex100 B3 singkatan dari bahan beracun dan berbahaya \line
\up0 \expndtw0\charscalex104 Bahan dan limbah berbahaya adalah bahan yang
\up0 \expndtw0\charscalex101 penanganan, penggunaan, dan penyimpanannya
\up0 \expndtw-2\charscalex100 dipandu atau ditentukan dengan regulasi di tingkat
lokal, \up0 \expndtw-2\charscalex100 regional, atau nasional, uap berbahaya,
dan sumber \up0 \expndtw0\charscalex103 energi yang berbahaya. Limbah infeksius
atau limbah \up0 \expndtw-3\charscalex100 medis termasuk dalam limbah
berbahaya.\par\pard\qj \li21\ri692\sb10\sl-275\slmult0 \up0 \expndtw-
3\charscalex100 Bahan obat adalah bahan yang berkhasiat dan tidak \up0
\expndtw0\charscalex101 berkhasiat yang digunakan dalam pengolahan obat
\up0 \expndtw0\charscalex101 dengan standar dan mutu sebagai bahan baku farmasi
\up0 \expndtw-3\charscalex100 termasuk baku pembanding.\par\pard\qj
\li21\ri690\sb10\sl-276\slmult0 \up0 \expndtw0\charscalex107 Bahan medis
habis pakai misalnya dialisat \up0 \expndtw0\charscalex101 hemodialisasis,
sarung tangan, alat suntik, kateter dan \up0 \expndtw-3\charscalex100
sebagainya.\par\pard\qj \li21\ri695\sb11\sl-275\slmult0 \up0 \expndtw-
1\charscalex100 Behavior Pain Scale adalah suatu alat/metode yang \up0
\expndtw0\charscalex102 dapat dipakai untuk mengukur atau menilai nyeri pada
\up0 \expndtw0\charscalex100 pasien dengan penurunan kesadaran atau pasien yang
\up0 \expndtw-3\charscalex100 menggunakan ventilator\par\pard\qj
\li21\ri691\sb8\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Budaya keselamatan
atau\ul0\nosupersub\cf8\f9\fs24 culture of safety,\ul0\nosupersub\cf7\f8\fs24
dikenal juga \up0 \expndtw-4\charscalex100 sebagai\ul0\nosupersub\cf8\f9\fs24 safe
culture\ul0\nosupersub\cf7\f8\fs24 , merupakan budaya organisasi yang \up0
\expndtw0\charscalex100 mendukung anggota staf (klinis dan administratif) untuk
\up0 \expndtw0\charscalex100 melaporkan\ul0\nosupersub\cf8\f9\fs24
concerns\ul0\nosupersub\cf7\f8\fs24 (antara lain insiden keselamatan \up0
\expndtw-1\charscalex100 pasien, keluhan) terkait keselamatan atau mutu asuhan \up0
\expndtw-3\charscalex100 tanpa takut mendapat sanksi dari rumah
sakit.\par\pard\qj \li21\ri694\sb9\sl-276\slmult0\tx1430 \up0
\expndtw0\charscalex109 Cara Distribusi Obat yang Baik adalah cara \up0
\expndtw-1\charscalex100 distribusi/penyaluran obat dan/atau bahan obat
yang \line \up0 \expndtw-3\charscalex100 bertujuan \tab \up0
\expndtw0\charscalex107 memastikan mutu sepanjang jalur\par\pard\qj
\li21\ri696\sb1\sl-275\slmult0 \up0 \expndtw0\charscalex102 distribusi/penyaluran
sesuai persyaratan dan tujuan \up0 \expndtw-3\charscalex100
penggunaannya.\par\pard\qj \li21\ri694\sb8\sl-276\slmult0 \up0
\expndtw0\charscalex103 \ul0\nosupersub\cf8\f9\fs24 Clinical
trial\ul0\nosupersub\cf7\f8\fs24 atau uji klinis adalah salah satu jenis
\up0 \expndtw-3\charscalex100 penelitian eksperimental, terencana yang dilakukan
pada \up0 \expndtw-2\charscalex100 manusia dimana peneliti memberikan perlakuan
atau \up0 \expndtw-2\charscalex100 intervensi pada subjek penelitian kemudian
efek dari \up0 \expndtw-3\charscalex100 penelitian tersebut diukur dan
dianalisis.\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li875\sb103\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 390

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\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 26\tab \up0 \expndtw-3\charscalex100 direktur
RS\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 27\tab \up0 \expndtw-
3\charscalex100 disaster\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb11\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 28\tab \up0
\expndtw-3\charscalex100 disinfeksi\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
29\tab \up0 \expndtw-3\charscalex100 DNR\par\pard\column \ql \li4931\sb0\sl-
276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-
276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb59\sl-
276\slmult0 \up0 \expndtw0\charscalex100 Catatan Perkembangan Pasien Terintegrasi
(\ul0\nosupersub\cf8\f9\fs24 integrated\par\pard\qj \li21\ri695\sb0\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 note)\ul0\nosupersub\cf7\f8\fs24 adalah
dokumentasi para profesional pemberi \line \up0 \expndtw-2\charscalex100
asuhan tentang perkembangan kondisi pasien dalam \line \up0 \expndtw-
4\charscalex100 bentuk terintegrasi pada format baku dalam rekam medis \line
\up0 \expndtw-3\charscalex100 pasien.\par\pard\ql \li21\sb9\sl-
276\slmult0\tx3556 \up0 \expndtw-3\charscalex100 Cardiopulmonary\tab \up0 \expndtw-
3\charscalex100 resuscitation (resusitasi\par\pard\qj \li21\ri693\sb1\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 kardiopulmoner) adalah sebuah langkah
darurat yang \up0 \expndtw0\charscalex103 dapat menjaga pernapasan dan
denyut jantung \up0 \expndtw-1\charscalex100 seseorang. CPR membantu sistem
peredaran darah \up0 \expndtw0\charscalex105 pasien dengan memberikan kompresi
dada untuk \up0 \expndtw0\charscalex101 membantu jantung memompa darah dan
memasok \up0 \expndtw-3\charscalex100 oksigen melalui mulut pasien.\par\pard\qj
\li21\ri696\sb10\sl-275\slmult0 \up0 \expndtw-2\charscalex100 Carbapenem Resistant
Enterobacteriaceae adalah jenis \up0 \expndtw-3\charscalex100 kuman yang resisten
terhadap antimikroba carbapenem. \up0 \expndtw-3\charscalex100 Lihat bab PPRA dan
PPI\par\pard\qj \li4931\sb0\sl-275\slmult0 \par\pard\qj \li21\ri691\sb32\sl-
275\slmult0 \up0 \expndtw0\charscalex100 Merupakan satu unit/departemen dari rumah
sakit yang \up0 \expndtw-2\charscalex100 secara terpusat menyelenggarakan proses
pencucian, \up0 \expndtw-3\charscalex100 pengemasan, sterilisasi terhadap semua
alat atau bahan \up0 \expndtw-3\charscalex100 yang dibutuhkan dalam kondisi
steril.\par\pard\qj \li4931\sb0\sl-276\slmult0 \par\pard\qj \li21\ri691\sb30\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Curriculum Vitae disebut juga Daftar
Riwayat Hidup yang \up0 \expndtw-4\charscalex100 memuat riwayat pendidikan dan
pengalaman kerja. (Lihat \up0 \expndtw-3\charscalex100 Bab KPS)\par\pard\qj
\li21\ri697\sb10\sl-275\slmult0 \up0 \expndtw-2\charscalex100 Data adalah fakta,
observasi klinis, atau pengukuran \up0 \expndtw-2\charscalex100 yang dikumpulkan
selama aktivitas penilaian. Data yang \up0 \expndtw0\charscalex102 belum dianalisis
disebut data mentah. Data yang telah \up0 \expndtw-3\charscalex100 dianalis disebut
informasi.\par\pard\qj \li21\ri695\sb11\sl-276\slmult0 \up0 \expndtw0\charscalex101
Merupakan jabatan tertinggi, dengan sebutan CEO, \up0 \expndtw0\charscalex100
Direktur, Kepala rumah sakit, kepala UPT. Di beberapa \up0 \expndtw0\charscalex101
rumah sakit jabatan ini disebut sebagai senior manajer \up0 \expndtw-
3\charscalex100 rumah sakit, dll.\par\pard\qj \li21\ri698\sb11\sl-275\slmult0
\up0 \expndtw-3\charscalex100 adalah keadaan bencana atau kejadian luar biasa
(KLB). \up0 \expndtw-3\charscalex100 Lihat bab MFK\par\pard\qj \li21\ri696\sb14\sl-
275\slmult0 \up0 \expndtw0\charscalex101 adalah upaya mengurangi atau menghilangkan
kuman \up0 \expndtw-3\charscalex100 dengan jalan menggunakan prosedur kimia
meskipun \up0 \expndtw0\charscalex103 tidak menghilangkan seluruh kuman pada lokasi
yang \up0 \expndtw-3\charscalex100 akan dilakukan tindakan.\par\pard\qj
\li21\ri694\sb13\sl-276\slmult0\tx2307\tx4607\tx5401 \up0 \expndtw-2\charscalex100
Do Not Resuscitate adalah sebuah perintah jangan \line \up0
\expndtw0\charscalex101 dilakukan resusitasi, adalah pesan untuk
tenaga \line \up0 \expndtw0\charscalex101 kesehatan untuk tidak mencoba
melakukan atau \line \up0 \expndtw0\charscalex101 memberikan tindakan
pertolongan berupa CPR \line \up0 \expndtw-3\charscalex100
(cardiopulmonary \tab \up0 \expndtw-3\charscalex100 resuscitation) \tab \up0
\expndtw-4\charscalex100 jika \tab \up0 \expndtw-3\charscalex100
terjadi\par\pard\qj \li21\ri693\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex101
permasalahan darurat pada jantung pasien atau \up0
\expndtw0\charscalex102 terjadinya henti napas pada pasien. Perintah ini ditulis
\up0 \expndtw0\charscalex102 atas permintaan pasien atau keluarga tetapi
harus \up0 \expndtw-1\charscalex100 ditanda tangani dan diputuskan melalui
konsultasi pada \up0 \expndtw-3\charscalex100 dokter yang berwenang.\par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql \li875\sb131\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 391

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\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
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\expndtw-3\charscalex100 fellow\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
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\expndtw-3\charscalex100 Sakit\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-
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\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
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276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb62\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 Dokter Penanggung Jawab Pelayanan
adalah dokter\par\pard\qj \li21\ri690\sb0\sl-276\slmult0 \up0 \expndtw-
1\charscalex100 yang bertanggung jawab terhadap asuhan pasien sejak \up0
\expndtw0\charscalex106 pasien masuk sampai pulang dan mempunyai \up0
\expndtw0\charscalex102 kompetensi dan kewenangan klinis sesuai surat
\up0 \expndtw-3\charscalex100 penugasan klinisnya.\par\pard\ql \li21\sb9\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Elemen Penilaian\par\pard\ql
\li21\sb34\sl-276\slmult0 \up0 \expndtw0\charscalex101 Extended Spectrum Beta
Lactamase \up0 \expndtw0\charscalex104 : enzim yang\par\pard\qj
\li21\ri695\sb1\sl-275\slmult0 \up0 \expndtw-3\charscalex100 mempunyai kemampuan
untuk menghidrolisis antibiotika \up0 \expndtw0\charscalex100 golongan penicillin,
cephalosporin generasi satu, dua, \up0 \expndtw0\charscalex103 dan tiga, serta
golonganaztreonam \up0 \expndtw0\charscalex102 (namun bukan\par\pard\qj
\li21\ri695\sb1\sl-276\slmult0\tx1556\tx2477\tx5025 \up0 \expndtw0\charscalex100
cephamycin dan carbapenem). ESBL paling banyak \line \up0 \expndtw-
3\charscalex100 dihasilkan \tab \up0 \expndtw-4\charscalex100 oleh \tab \up0
\expndtw-3\charscalex100 Enterobacteriaceae \tab \up0 \expndtw-3\charscalex100
(terutama\par\pard\ql \li21\ri696\sb0\sl-278\slmult0 \up0 \expndtw-4\charscalex100
Escherichia coli) dan Klebsiella pneumoniae \line \up0 \expndtw0\charscalex105
merupakan pendidikan singkat yang diikuti dokter \up0 \expndtw0\charscalex100
spesialis untuk menambah kompetensi sebagai contoh \up0 \expndtw0\charscalex101
fellow spesialis mata yang mengikuti pelatihan operasi \up0 \expndtw-
3\charscalex100 menggunakan phaco emulsion.\par\pard\qj \li21\ri693\sb12\sl-
275\slmult0 \up0 \expndtw0\charscalex105 FMEA atau failure mode and
effects analysis \up0 \expndtw0\charscalex105 merupakan cara sistematik untuk
meneliti sebuah \up0 \expndtw0\charscalex100 rancangan secara prospektif
atas cara-cara yang \up0 \expndtw0\charscalex101 memungkinkan terjadinya
kesalahan. Diasumsikan \up0 \expndtw0\charscalex104 bahwa, betapapun pandai
dan hati-hatinya orang, \up0 \expndtw0\charscalex100 kesalahan (errors) akan
terjadi pada beberapa situasi \up0 \expndtw-3\charscalex100 tertentu dan mungkin
saja terjadi.\par\pard\qj \li21\ri696\sb13\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 Formularium adalah himpunan daftar obat yang diterima \up0
\expndtw-3\charscalex100 atau disetujui oleh Panitia Farmasi dan Terapi
untuk \up0 \expndtw-1\charscalex100 digunakan di rumah sakit dan dapat direvisi
pada setiap \up0 \expndtw-3\charscalex100 batas waktu yang
ditentukan.\par\pard\qj \li21\ri694\sb11\sl-275\slmult0 \up0 \expndtw-
4\charscalex100 Focused Professional Practice Evaluation (FPPE) adalah \up0
\expndtw0\charscalex100 alat yang digunakan untuk memvalidasi (memastikan)
\up0 \expndtw-1\charscalex100 temuan-temuan yang diperoleh lewat OPPE.
Karena \up0 \expndtw0\charscalex100 itulah, proses yang dilakukan dengan
menggunakan \up0 \expndtw-2\charscalex100 FPPE ini hanya diterapkan pada
sebagian kecil staf \up0 \expndtw-2\charscalex100 medis yang sebelumnya telah
teridentifikasi (melampaui \up0 \expndtw-3\charscalex100 trigger) pada
OPPE.\par\pard\qj \li21\ri692\sb11\sl-275\slmult0 \up0 \expndtw0\charscalex100 Gas
medis adalah gas dengan spesifikasi khusus yang \line \up0 \expndtw0\charscalex102
dipergunakan untuk pelayanan medis pada sarana \line \up0 \expndtw-
2\charscalex100 kesehatan. Instalasi pipa gas medis adalah seperangkat \line
\up0 \expndtw0\charscalex106 prasarana perpipaan beserta peralatan yang
\line \up0 \expndtw-2\charscalex100 menyediakan gas medis tertentu yang dibutuhkan
untuk \line \up0 \expndtw0\charscalex100 menyalurkan gas medis ke
titik\ul0\nosupersub\cf8\f9\fs24 outlet\ul0\nosupersub\cf7\f8\fs24 di ruang
tindakan \line \up0 \expndtw-3\charscalex100 dan perawatan.\par\pard\ql
\li21\sb11\sl-276\slmult0 \up0 \expndtw0\charscalex100 governing body diartikan
sebagai individual \up0 \expndtw-3\charscalex100 (atau\par\pard\qj
\li21\ri692\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex100 individu-individu),
kelompok, atau badan, yang memiliki \line \up0 \expndtw0\charscalex101 kewenangan
dan tanggungjawab sesungguhnya untuk \line \up0 \expndtw-1\charscalex100 menetapkan
kebijakan, menjaga kualitas asuhan, dan \line \up0 \expndtw-3\charscalex100
mendukung manajemen dan perencanaan organisasi. \line \up0
\expndtw0\charscalex100 Beberapa nama atau istilah yang digunakan adalah
\line \up0 \expndtw0\charscalex100 komissioner, dewan pengawas, dan lain-lain.
Dalam \line \up0 \expndtw0\charscalex101 standar akreditasi rumah sakit ini
selanjutnya akan\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql
\li875\sb109\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 392

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{\shp
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{\shp
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{\shp
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
{\*\shpinst\shpleft2090\shptop13107\shpright4816\shpbottom13127\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(2726,20);(2726,0);(0,0)}}
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{\shp
{\*\shpinst\shpleft4819\shptop13107\shpright4826\shpbottom13114\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
{\*\shpinst\shpleft4828\shptop13107\shpright11071\shpbottom13127\shpfhdr0\shpbxpage
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(6243,20);(6243,0);(0,0)}}
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{\shp
{\*\shpinst\shpleft11073\shptop13107\shpright11080\shpbottom13114\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
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}}

{\shp
{\*\shpinst\shpleft1440\shptop13116\shpright1460\shpbottom15322\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 2206}}
{\sp{\sn pVerticies}{\sv 8;4;(0,2206);(20,2206);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
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{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}
{\shp
{\*\shpinst\shpleft1440\shptop15324\shpright1447\shpbottom15332\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,8);(7,8);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1440\shptop15324\shpright1447\shpbottom15332\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,8);(7,8);(7,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1449\shptop15324\shpright2078\shpbottom15344\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(629,20);(629,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop13116\shpright2100\shpbottom15322\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz1998\shplid92
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 2206}}
{\sp{\sn pVerticies}{\sv 8;4;(0,2206);(20,2206);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop15324\shpright2088\shpbottom15332\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz2000\shplid93
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 8}}{\sp{\sn geoBottom}{\sv 8}}
{\sp{\sn pVerticies}{\sv 8;4;(0,8);(8,8);(8,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2090\shptop15324\shpright4816\shpbottom15344\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(2726,20);(2726,0);(0,0)}}
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}}

{\shp
{\*\shpinst\shpleft4819\shptop13116\shpright4839\shpbottom15322\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,2206);(20,2206);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
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{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4819\shptop15324\shpright4826\shpbottom15332\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,8);(7,8);(7,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
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}}

{\shp
{\*\shpinst\shpleft4828\shptop15324\shpright11071\shpbottom15344\shpfhdr0\shpbxpage
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(6243,20);(6243,0);(0,0)}}
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}}

{\shp
{\*\shpinst\shpleft11073\shptop13116\shpright11093\shpbottom15322\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,2206);(20,2206);(20,0);(0,0)}}
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
{\*\shpinst\shpleft11073\shptop15324\shpright11080\shpbottom15332\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg393}{\bkmkend Pg393}\par\pard\qj \li4931\sb0\sl-273\slmult0
\par\pard\qj\li4931\sb0\sl-273\slmult0 \par\pard\qj\li4931\sb0\sl-273\slmult0
\par\pard\qj\li4931\sb0\sl-273\slmult0 \par\pard\qj\li4931\ri720\sb103\sl-
273\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 digunakan
istilah umum, yaitu representasi pemilik, yang \up0 \expndtw-3\charscalex100 dapat
merupakan satu orang atau lebih pemilik, atau \up0 \expndtw-1\charscalex100
dapat juga \up0 \expndtw-2\charscalex100 (milik) pemerintah, misalnya
Kementerian \up0 \expndtw-2\charscalex100 Kesehatan. Lihat juga bab
TKRS\par\pard\sect\sectd\sbknone\cols2\colno1\colw4771\colsr160\colno2\colw6829\col
sr160\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb40\sl-276\slmult0\tx2188
\up0 \expndtw-3\charscalex100 39\tab \up0 \expndtw-3\charscalex100 HAIs\par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb9\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 40\tab \up0 \expndtw-3\charscalex100 HEPA\par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 41\tab \up0
\expndtw-3\charscalex100 HPK\par\pard\ql \li1631\sb33\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 42\tab \up0 \expndtw-3\charscalex100 HVA\par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb12\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 43\tab \up0 \expndtw-3\charscalex100 IADP\par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 44\tab \up0 \expndtw-3\charscalex100 IADS\par\pard\ql
\li1631\sb34\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 45\tab \up0
\expndtw-3\charscalex100 IAK\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb9\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 46\tab \up0
\expndtw-3\charscalex100 IAM\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb58\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 47\tab \up0
\expndtw-3\charscalex100 IAR\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb9\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 48\tab \up0
\expndtw-3\charscalex100 ICRA\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 49\tab \up0 \expndtw-
3\charscalex100 IDO\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb19\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 50\tab \up0
\expndtw-3\charscalex100 IKI\par\pard\ql \li1631\sb34\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 51\tab \up0 \expndtw-3\charscalex100 IKU\par\pard\ql
\li1631\sb33\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 52\tab \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 informed
consent\par\pard\column \ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb40\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Health care-
associated infection(s) yaitu infeksi yang\par\pard\qj \li21\ri692\sb0\sl-
276\slmult0 \up0 \expndtw0\charscalex100 didapatkan seseorang yang sedang
mendapatkan \up0 \expndtw0\charscalex100 asuhan atau pelayanan dalam organisasi
pelayanan \up0 \expndtw-2\charscalex100 kesehatan, termasuk di rumah sakit. Hal
yang sering \up0 \expndtw-2\charscalex100 terjadi adalah infeksi saluran kemih,
infeksi luka operasi, \up0 \expndtw-3\charscalex100 pneumonia, dan infeksi aliran
darah.\par\pard\qj \li21\ri690\sb9\sl-276\slmult0\tx4261 \up0
\expndtw0\charscalex101 High Effieciency Particulated Air merupakan filter yang
\line \up0 \expndtw-2\charscalex100 dibuat, diuji dan disertifikasi sehingga
sesuai dengan \line \up0 \expndtw0\charscalex104 standar Institute of
Environmental Sciences and \line \up0 \expndtw-3\charscalex100 Technology
(IEST), yang berfungsi menyaring udara dari \line \up0 \expndtw0\charscalex100
lingkungan agar bersih untuk disalurkan ke dalam area \line \up0 \expndtw-
1\charscalex100 bersih ruangan yang membutuhkan. Dalam sistem \line \up0
\expndtw0\charscalex104 heating ventilation air condition \tab \up0
\expndtw0\charscalex102 (HVAC), udara\par\pard\qj \li21\ri695\sb0\sl-
280\slmult0 \up0 \expndtw-3\charscalex100 sebelumnya disaring melalui prefilter
kemudian melewati \up0 \expndtw-5\charscalex100 medium filter, baru kemudian
disaring melalui HEPA filter. \up0 \expndtw-3\charscalex100 Hak Pasien dan
Keluarga. Lihat bab HPK\par\pard\qj \li21\ri692\sb30\sl-276\slmult0 \up0
\expndtw0\charscalex103 HVA disingkat dari hazard vulnerability
analysis \line \up0 \expndtw-3\charscalex100 (assessment), merupakan identifikasi
atas potensi akibat \line \up0 \expndtw-3\charscalex100 kedaruratan dan akibat
langsung maupun tidak langsung \line \up0 \expndtw-2\charscalex100 dari kedaruratan
tersebut yang mungkin dapat menimpa \line \up0 \expndtw0\charscalex101 operasional
rumah sakit dan terhadap kesinambungan \line \up0 \expndtw-3\charscalex100
pelayanan.\par\pard\qj \li21\ri697\sb13\sl-275\slmult0 \up0 \expndtw-
2\charscalex100 Infeksi Aliran Darah Primer adalah kejadian infeksi Lihat \up0
\expndtw-3\charscalex100 juga HAIs dan bab PPI\par\pard\ql \li21\ri697\sb0\sl-
309\slmult0 \up0 \expndtw-3\charscalex100 Infeksi Aliran Darah Sentral. Lihat HAIs
dan bab PPI \up0 \expndtw-2\charscalex100 Indikator Area Klinis \up0 \expndtw-
2\charscalex100 (IAK) yaitu indikator mutu yang\par\pard\ql \li21\sb1\sl-
248\slmult0 \up0 \expndtw-3\charscalex100 mengukur mutu pelayanan
klinis\par\pard\ql \li21\ri695\sb0\sl-295\slmult0 \up0 \expndtw-3\charscalex100
Indikator Area Manajemen (IAM) yaitu indikator mutu \up0 \expndtw-
3\charscalex100 yang mengukur mutu pelayanan manajemen \line \up0
\expndtw0\charscalex101 Informasi, Analisis, Rencana adalah sistimatika proses \up0
\expndtw-3\charscalex100 melakukan asesmen pasien\par\pard\qj \li21\ri694\sb6\sl-
275\slmult0 \up0 \expndtw-3\charscalex100 Infection Control Risk Assessment (ICRA)
adalah proses \up0 \expndtw0\charscalex102 identifikasi risiko, analisis risiko,
evaluasi risiko infeksi, \up0 \expndtw-3\charscalex100 dan dilanjutkan dengan
pengelolaan risiko.\par\pard\ql \li21\sb11\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Infeksi Daerah Operasi (IDO). Lihat HAIs dan bab PPI\par\pard\ql
\li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb19\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Indikator Kinerja Individu\par\pard\ql \li21\sb34\sl-276\slmult0
\up0 \expndtw-3\charscalex100 adalah singkatan dari indikator kinerja
unit\par\pard\qj \li21\ri695\sb33\sl-276\slmult0 \up0 \expndtw0\charscalex104
adalah pernyataan sepihak pasien atau yang sah \up0 \expndtw-1\charscalex100
mewakilinya yang isinya berupa persetujuan atas \up0
\expndtw0\charscalex102 rencana tindakan kedokteran atau kedokteran gigi, \up0
\expndtw-2\charscalex100 setelah menerima informasi yang cukup untuk dapat
\up0 \expndtw-3\charscalex100 membuat persetujuan atau penolakan.\par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql
\li875\sb202\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 393

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,1377);(20,1377);(20,0);(0,0)}}
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1449\shptop14979\shpright2078\shpbottom14999\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 629}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(629,20);(629,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop13599\shpright2100\shpbottom14976\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz2346\shplid158
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 1377}}
{\sp{\sn pVerticies}{\sv 8;4;(0,1377);(20,1377);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
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{\shp
{\*\shpinst\shpleft2080\shptop14979\shpright2088\shpbottom14986\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz2348\shplid159
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 8}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(8,7);(8,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2090\shptop14979\shpright4816\shpbottom14999\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 2726}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(2726,20);(2726,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4819\shptop13599\shpright4839\shpbottom14976\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 1377}}
{\sp{\sn pVerticies}{\sv 8;4;(0,1377);(20,1377);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4819\shptop14979\shpright4826\shpbottom14986\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4828\shptop14979\shpright11071\shpbottom14999\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz2356\shplid163
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 6243}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(6243,20);(6243,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop13599\shpright11093\shpbottom14976\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 1377}}
{\sp{\sn pVerticies}{\sv 8;4;(0,1377);(20,1377);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop14979\shpright11080\shpbottom14986\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop14979\shpright11080\shpbottom14986\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg394}{\bkmkend
Pg394}\par\pard\sect\sectd\sbknone\cols2\colno1\colw4771\colsr160\colno2\colw6829\c
olsr160\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb62\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 53\tab \up0 \expndtw-3\charscalex100 instalasi pipa
gas\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0 \expndtw-3\charscalex100 medis
.\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
54\tab \up0 \expndtw-3\charscalex100 internship\par\pard\ql \li1631\sb34\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 55\tab \up0 \expndtw-
3\charscalex100 IPCLN\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 56\tab \up0
\expndtw-3\charscalex100 IPCN\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb12\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
57\tab \up0 \expndtw-3\charscalex100 IPKP\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb16\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
58\tab \up0 \expndtw-3\charscalex100 ISK\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb17\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
59\tab \up0 \expndtw-3\charscalex100 ISKP\par\pard\ql \li1631\sb34\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 60\tab \up0 \expndtw-
3\charscalex100 Just Culture\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb9\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 61\tab \up0 \expndtw-3\charscalex100 Kapasitas RS
dalam\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0 \expndtw-3\charscalex100
pendidikan klinis\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb11\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 62\tab \up0
\expndtw-3\charscalex100 KARS\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 63\tab \up0 \expndtw-
3\charscalex100 keamanan\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb9\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 64\tab \up0 \expndtw-3\charscalex100 kejadian
sentinel\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb60\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 65\tab \up0 \expndtw-
3\charscalex100 keluarga\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 66\tab \up0
\expndtw-3\charscalex100 keselamatan\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb9\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 67\tab \up0 \expndtw-
3\charscalex100 kesinambungan\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0 \expndtw-
3\charscalex100 asuhan\par\pard\column \ql \li4931\sb0\sl-276\slmult0
\par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0
\par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb62\sl-276\slmult0 \up0
\expndtw0\charscalex100 instalasi pipa gas medis adalah seperangkat
prasarana\par\pard\qj \li21\ri696\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex100
perpipaan beserta peralatan yang menyediakan gas \up0 \expndtw-1\charscalex100
medis tertentu yang dibutuhkan untuk menyalurkan gas \up0 \expndtw-3\charscalex100
medis ke titik outlet di ruang tindakan dan perawatan\par\pard\ql
\li21\ri696\sb3\sl-284\slmult0 \up0 \expndtw-3\charscalex100 adalah proses
pemandirian dokter yang baru tamat \line \up0 \expndtw0\charscalex100 Infection
Prevention and Control Link Nurse adalah \line \up0 \expndtw0\charscalex102
Perawat Penghubung dari tiap unit, terutama yang \line \up0 \expndtw-
3\charscalex100 berisiko terjadinya Infeksi yang membantu kerja Perawat \line
\up0 \expndtw-3\charscalex100 PPI/IPCN .\par\pard\qj \li21\ri695\sb10\sl-
275\slmult0 \up0 \expndtw-2\charscalex100 Infection Prevention and Control Nurse
adalah seorang \up0 \expndtw-3\charscalex100 staf perawat yang bekerja penuh
waktu untuk melakukan \up0 \expndtw0\charscalex101 koordinasi dan pengawasan
pengawasan pencegahan \up0 \expndtw-3\charscalex100 pengendalian infeksi di rumah
sakit.\par\pard\qj \li21\ri697\sb14\sl-275\slmult0 \up0 \expndtw0\charscalex100
Integrasi Pendidikan Kesehatan dalam Pelayanan \up0 \expndtw-
3\charscalex100 Rumah Sakit. Lihat bab IPKP\par\pard\ql \li21\sb17\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Infeksi Saluran Kemih. Lihat HAIs dan bab
PPI\par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb17\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Indikator Sasaran Keselamatan
Pasien\par\pard\qj \li21\ri690\sb35\sl-275\slmult0 \up0 \expndtw0\charscalex101
adalah model terkini mengenai pembentukan suatu \up0 \expndtw-5\charscalex100
budaya yang terbuka, adil dan pantas, menciptakan suatu \up0
\expndtw0\charscalex102 budaya belajar, merancang sistem-sistem yang aman, \up0
\expndtw-4\charscalex100 dan mengelola perilaku yang
terpilih\ul0\nosupersub\cf8\f9\fs24 (human error, at risk \up0
\expndtw0\charscalex100 behavior dan reckless
behavior.\ul0\nosupersub\cf7\f8\fs24 Model ini melihat \up0 \expndtw-
1\charscalex100 peristiwa-peristiwa bukan sebagai hal-hal yang perlu \up0
\expndtw0\charscalex103 diperbaiki, tetapi sebagai peluang-peluang untuk
\up0 \expndtw0\charscalex102 memperbaiki pemahaman baik terhadap risiko
dari \up0 \expndtw-3\charscalex100 sistem maupun risiko perilaku\par\pard\qj
\li21\ri692\sb10\sl-276\slmult0 \up0 \expndtw0\charscalex101 Ratio TT dengan jumlah
peserta didik, ratio dan variasi \up0 \expndtw0\charscalex101 kasus dengan jumlah
dan tuntutan peserta didik dalam \up0 \expndtw-3\charscalex100 kaitannya dengan
PMKP.\par\pard\ql \li21\sb10\sl-276\slmult0\tx4410 \up0 \expndtw0\charscalex102
Komisi Akreditasi Rumah Sakit\tab \up0 \expndtw0\charscalex101 adalah
badan\par\pard\qj \li21\ri695\sb1\sl-275\slmult0 \up0 \expndtw-2\charscalex100
independen yag melakukan akreditasi rumah sakit di \up0 \expndtw-
3\charscalex100 Indonesia\par\pard\qj \li21\ri694\sb12\sl-275\slmult0 \up0
\expndtw0\charscalex102 Proteksi dari kehilangan, kerusakan, gangguan, akses
\up0 \expndtw-3\charscalex100 dan penggunaan oleh pihak yang tidak berwenang. Lihat
\up0 \expndtw-3\charscalex100 bab MFK 4\par\pard\ql \li21\ri695\sb0\sl-
288\slmult0 \up0 \expndtw-2\charscalex100 adalah kejadian tidak terduga yang
melibatkan kematian \up0 \expndtw-3\charscalex100 atau kehilangan fungsi utama
fisik secara permanen. \line \up0 \expndtw-1\charscalex100 adalah individu
dengan peran penting dalam hidup \up0 \expndtw-4\charscalex100 pasien, mungkin
termasuk orang yang tidak berhubungan \up0 \expndtw0\charscalex105 secara hukum
dengan pasien yang membantu \up0 \expndtw-3\charscalex100 kelancaran
asuhan.\par\pard\qj \li21\ri692\sb9\sl-275\slmult0 \up0 \expndtw-1\charscalex100
Suatu kondisi dimana bangunan, dan peralatan rumah \up0 \expndtw-1\charscalex100
sakit tidak menimbulkan risiko bagi pasien, staf dan \up0 \expndtw-
3\charscalex100 pengunjung. Lihat bab MFK 4\par\pard\qj \li21\ri690\sb7\sl-
277\slmult0 \up0 \expndtw0\charscalex101 Kesinambungan asuhan
atau\ul0\nosupersub\cf8\f9\fs24 continuity of care\ul0\nosupersub\cf7\f8\fs24
adalah \line \up0 \expndtw0\charscalex100 tingkat asuhan individu yang
terkoordinasi antara \line \up0 \expndtw0\charscalex103 profesional pemberi
asuhan, antar unit, dapat dibantu\par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql \li875\sb9\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 394

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{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop14091\shpright2100\shpbottom14916\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz2577\shplid158
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 825}}
{\sp{\sn pVerticies}{\sv 8;4;(0,825);(20,825);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop14919\shpright2088\shpbottom14926\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 8}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(8,7);(8,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
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{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 2726}}{\sp{\sn geoBottom}{\sv 20}}
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{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
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{\shp
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{\shp
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{\shp
{\*\shpinst\shpleft4828\shptop14919\shpright11071\shpbottom14939\shpfhdr0\shpbxpage
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft11073\shptop14091\shpright11093\shpbottom14916\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 825}}
{\sp{\sn pVerticies}{\sv 8;4;(0,825);(20,825);(20,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop14919\shpright11080\shpbottom14926\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop14919\shpright11080\shpbottom14926\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg395}{\bkmkend Pg395}\par\pard\qj \li4931\sb0\sl-260\slmult0
\par\pard\qj\li4931\sb0\sl-260\slmult0 \par\pard\qj\li4931\sb0\sl-260\slmult0
\par\pard\qj\li4931\sb0\sl-260\slmult0 \par\pard\qj\li4931\ri740\sb166\sl-
260\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 oleh manajer
pelayanan pasien (MPP). Lihat juga serah \up0 \expndtw-1\charscalex100
terima\par\pard\sect\sectd\sbknone\cols2\colno1\colw4771\colsr160\colno2\colw6829\c
olsr160\ql \li1631\sb38\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
68\tab \up0 \expndtw-3\charscalex100 kesinambungan\par\pard\ql \li2193\sb1\sl-
275\slmult0 \up0 \expndtw-3\charscalex100 pelayanan\par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 69\tab \up0 \expndtw-3\charscalex100 KKI\par\pard\ql
\li1631\sb34\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 70\tab \up0
\expndtw-3\charscalex100 KKS\par\pard\ql \li1631\sb36\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 71\tab \up0 \expndtw-3\charscalex100 KMK\par\pard\ql
\li1631\sb33\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 72\tab \up0
\expndtw-3\charscalex100 KNC\par\pard\ql \li1631\sb34\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 73\tab \up0 \expndtw-3\charscalex100
KODERSI\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 74\tab \up0 \expndtw-
3\charscalex100 Komite Etik Rumah\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0
\expndtw-3\charscalex100 Sakit\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
75\tab \up0 \expndtw-3\charscalex100 Komite Medis\par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 76\tab \up0 \expndtw-
3\charscalex100 Komkordik\par\pard\ql \li1631\sb33\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 77\tab \up0 \expndtw-3\charscalex100
kompetensi\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb12\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 78\tab \up0 \expndtw-
3\charscalex100 kontaminasi\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql
\li1631\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 79\tab \up0
\expndtw-3\charscalex100 KPC\par\pard\ql \li1631\sb34\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 80\tab \up0 \expndtw-3\charscalex100
kredensial\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-
276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb9\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 81\tab \up0 \expndtw-
3\charscalex100 kredensialing\par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb0\sl-276\slmult0
\par\pard\ql \li1631\sb0\sl-276\slmult0 \par\pard\ql \li1631\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 82\tab \up0 \expndtw-
3\charscalex100 KSM\par\pard\ql \li1631\sb33\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 83\tab \up0 \expndtw-3\charscalex100 KTC\par\pard\ql
\li1631\sb34\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 84\tab \up0
\expndtw-3\charscalex100 KTD\par\pard\column \ql \li21\sb35\sl-276\slmult0 \up0
\expndtw0\charscalex102 Kesinambungan pelayanan atau\ul0\nosupersub\cf8\f9\fs24
continuum of care\par\pard\qj \li21\ri690\sb3\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 dideskripsikan sebagai memenuhi
kebutuhan individu \up0 \expndtw0\charscalex104 pasien yang sesuai dengan tingkat
dan jenis asuhan, \up0 \expndtw-4\charscalex100 pengobatan, dan pelayanan dalam
rumah sakit dan antar \up0 \expndtw-3\charscalex100 rumah sakit
(rujukan).\par\pard\ql \li21\sb9\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Konsil Kedokteran Indonesia\par\pard\qj \li21\ri852\sb6\sl-311\slmult0 \up0
\expndtw-3\charscalex100 Kompetensi dan Kewenangan Staf. Lihat juga bab KKS \up0
\expndtw-3\charscalex100 Kepetusan Menteri Kesehatan\par\pard\ql \li21\sb27\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Kejadian Nyaris Cedera\par\pard\qj
\li21\ri693\sb35\sl-275\slmult0 \up0 \expndtw-3\charscalex100 Kode Etik Rumah
Sakit Indonesia adalah rangkuman \up0 \expndtw0\charscalex100 norma-norma moral
yang telah dikodifikasi oleh PERSI \up0 \expndtw-1\charscalex100 sebagai
organisasi profesi bidang perumahsakitan di \up0 \expndtw-3\charscalex100
Indonesia\par\pard\qj \li21\ri691\sb12\sl-275\slmult0 \up0 \expndtw0\charscalex101
adalah suatu perangkat organisasi non struktural yang \up0 \expndtw0\charscalex101
dibentuk dalam rumah sakit untuk membantu pimpinan \up0 \expndtw-3\charscalex100
rumah sakit dalam melaksanakan KODERSI\par\pard\qj \li21\ri693\sb12\sl-
273\slmult0 \up0 \expndtw0\charscalex103 adalah perangkat rumah sakit untuk
menerapkan tata \up0 \expndtw-2\charscalex100 kelola klinis \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf8\f9\fs24 (clinical
governance)\ul0\nosupersub\cf7\f8\fs24 agar staf medis di\par\pard\qj
\li21\ri691\sb3\sl-276\slmult0 \up0 \expndtw0\charscalex101 rumah sakit
terjaga profesionalismenya melalui \up0 \expndtw0\charscalex101 mekanisme
kredensial, penjagaan mutu profesi medis, \up0 \expndtw-3\charscalex100 dan
pemeliharaan etika dan disiplin profesi medis.\par\pard\ql \li21\ri695\sb0\sl-
309\slmult0\tx1733\tx3301\tx4613 \up0 \expndtw-3\charscalex100 Komite Koordinasi
Pendidikan. Lihat juga bab IPKP \line \up0 \expndtw-3\charscalex100 merupakan
\tab \up0 \expndtw-3\charscalex100 ketentuan \tab \up0 \expndtw-3\charscalex100
tentang \tab \up0 \expndtw-3\charscalex100 keterampilan,\par\pard\qj
\li21\ri695\sb0\sl-276\slmult0 \up0 \expndtw-1\charscalex100 pengetahuan,
kemampuan individu dalam memenuhi \up0 \expndtw0\charscalex101 harapan yang
ditentukan, yang sering dicantumkan \up0 \expndtw-3\charscalex100 dalam uraian
tugas.\par\pard\qj \li21\ri700\sb0\sl-275\slmult0 \up0 \expndtw0\charscalex100
adanya agen infeksius pada makhluk hidup atau benda \line \up0 \expndtw-
2\charscalex100 mati\par\pard\ql \li21\sb2\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Kondisi Potensial Cedera\par\pard\qj \li21\ri695\sb34\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 adalah bukti kompetensi, izin yang
terkait dan masih \up0 \expndtw-3\charscalex100 berlaku, pendidikan, pelatihan,
dan pengalaman. Kriteria \up0 \expndtw-5\charscalex100 lain dapat ditambahkan oleh
suatu rumah sakit. Lihat juga \up0 \expndtw-3\charscalex100 kompetensi,
kredensialing.\par\pard\qj \li21\ri695\sb9\sl-276\slmult0 \up0
\expndtw0\charscalex100 adalah proses memperoleh, memverifikasi, dan menilai
\up0 \expndtw0\charscalex100 kualifikasi dasi seorang profesional pemberi
asuhan \up0 \expndtw-1\charscalex100 untuk memberikan asuhan pelayanan
kesehatan di \up0 \expndtw0\charscalex103 rumah sakit. Proses penilaian ulang
kualifikasi staf ini \up0 \expndtw-3\charscalex100 secara berkala disebut
rekredensialing.\par\pard\ql \li21\sb10\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Kelompok Staf Medis\par\pard\ql \li21\sb33\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Kejadian Tidak Cedera\par\pard\qj \li21\ri691\sb34\sl-
276\slmult0 \up0 \expndtw0\charscalex102 KTD adalah singkatan dari kejadian
yang tidak \up0 \expndtw-4\charscalex100 diharapkan, disebut
juga\ul0\nosupersub\cf8\f9\fs24 adverse event\ul0\nosupersub\cf7\f8\fs24 . KTD
merupakan \up0 \expndtw0\charscalex101 kejadian yang tidak diantisipasi, tidak
diharapkan yang \up0 \expndtw-3\charscalex100 terjadi di rumah
sakit.\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li875\sb190\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 395

{\shp
{\*\shpinst\shpleft1440\shptop1421\shpright1460\shpbottom1978\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,557);(20,557);(20,0);(0,0)}}
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{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop1421\shpright2100\shpbottom1978\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,557);(20,557);(20,0);(0,0)}}
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}}

{\shp
{\*\shpinst\shpleft4819\shptop1421\shpright4839\shpbottom1978\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 557}}
{\sp{\sn pVerticies}{\sv 8;4;(0,557);(20,557);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,557);(20,557);(20,0);(0,0)}}
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 6243}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(6243,20);(6243,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop12752\shpright11080\shpbottom12759\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,298);(20,298);(20,0);(0,0)}}
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{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 298}}
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{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}
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{\*\shpinst\shpleft11073\shptop12761\shpright11093\shpbottom13059\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(2726,20);(2726,0);(0,0)}}
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{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}
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{\*\shpinst\shpleft4819\shptop13061\shpright4826\shpbottom13068\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft11073\shptop13061\shpright11080\shpbottom13068\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
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}}

{\shp
{\*\shpinst\shpleft1440\shptop13071\shpright1460\shpbottom13368\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 297}}
{\sp{\sn pVerticies}{\sv 8;4;(0,297);(20,297);(20,0);(0,0)}}
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{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
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}}

{\shp
{\*\shpinst\shpleft2080\shptop13071\shpright2100\shpbottom13368\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,297);(20,297);(20,0);(0,0)}}
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{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4819\shptop13071\shpright4839\shpbottom13368\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,297);(20,297);(20,0);(0,0)}}
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}}

{\shp
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}}

{\shp
{\*\shpinst\shpleft1440\shptop13371\shpright1447\shpbottom13378\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(629,20);(629,0);(0,0)}}
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}}

{\shp
{\*\shpinst\shpleft2080\shptop13371\shpright2088\shpbottom13378\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft2090\shptop13371\shpright4816\shpbottom13391\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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}}

{\shp
{\*\shpinst\shpleft4828\shptop13371\shpright11071\shpbottom13391\shpfhdr0\shpbxpage
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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mirip (NORUM)\par\pard\qj \li21\ri689\sb10\sl-275\slmult0 \up0
\expndtw0\charscalex100 Lembar Data Pengaman, dikenal juga
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Data Sheet\ul0\nosupersub\cf7\f8\fs24 (MSDS)\par\pard\ql \li21\sb13\sl-276\slmult0
\up0 \expndtw-3\charscalex100 adalah sisa proses produksi.\par\pard\qj
\li21\ri691\sb36\sl-276\slmult0 \up0 \expndtw-1\charscalex100 adalah pembuatan,
penggunaan, penyebaran (sharing) \up0 \expndtw-3\charscalex100 dan pemusnahan data
atau informasi dalam keseluruhan \up0 \expndtw-4\charscalex100 organisasi.
pelaksanaan manajemen informasi ini penting \up0 \expndtw0\charscalex101 untuk
operasional kegiatan organisasi yang efektif dan \up0 \expndtw0\charscalex107
efisien. Hal ini meliputi peran manajemen dalam \up0 \expndtw0\charscalex101
membuat dan mengontrol penggunaan data dan \up0 \expndtw-3\charscalex100
informasi dalam kegiatan pekerjaan, manajemen sumber \up0 \expndtw-4\charscalex100
informasi\ul0\nosupersub\cf8\f9\fs24 (information resources
management)\ul0\nosupersub\cf7\f8\fs24 , teknologi \up0 \expndtw-3\charscalex100
informasi dan pelayanan informasi. Lihat juga bab MIRM \up0 \expndtw-
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\expndtw-3\charscalex100 ditransportasikan dari TPS ke TPA.\par\pard\qj
\li21\ri697\sb18\sl-275\slmult0 \up0 \expndtw-3\charscalex100 Manjemen Fasilitas
dan Keselamatan. Lihat juga bab \up0 \expndtw-3\charscalex100
MFK\par\pard\qj \li21\ri697\sb11\sl-276\slmult0 \up0 \expndtw-2\charscalex100
Manajemen Informasi dan Rekam Medik. Lihat juga bab \up0 \expndtw-3\charscalex100
MIRM\par\pard\qj \li21\ri691\sb10\sl-275\slmult0 \up0 \expndtw0\charscalex100
adalah sekelompok staf medis dengan reputasi dan \up0 \expndtw-
1\charscalex100 kompetensi profesi yang sama dan diakui, berperan \up0
\expndtw0\charscalex100 untuk menelaah segala hal yang terkait dengan profesi
\up0 \expndtw-3\charscalex100 medis yang bersangkutan\par\pard\qj
\li21\ri696\sb12\sl-275\slmult0 \up0 \expndtw-2\charscalex100 Manajemen Komunikasi
dan Edukasi. Lihat juga bab \up0 \expndtw-3\charscalex100 MKE\par\pard\ql
\li21\sb10\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Monitoring dan
Evaluasi\par\pard\ql \li21\sb34\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Memorandum of understanding\par\pard\ql \li21\ri696\sb18\sl-298\slmult0 \up0
\expndtw-3\charscalex100 Manajer Pelayanan Pasien (Case Manager) \line \up0
\expndtw-3\charscalex100 Manchester Patient Safety Assessment Framework \line
\up0 \expndtw-1\charscalex100 Methicilllin Resistant Staphylococcus Aureus. Lihat
juga \up0 \expndtw-3\charscalex100 dan bab PPRA\par\pard\ql \li21\sb7\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Medical Staff Bylaws, ditetapkan oleh
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276\slmult0 \up0 \expndtw-1\charscalex100 Material Safety Data Sheet atau
LDP \up0 \expndtw-2\charscalex100 (Lembar Data\par\pard\ql \li21\sb1\sl-
275\slmult0 \up0 \expndtw-3\charscalex100 Pengaman)\par\pard\ql \li21\sb10\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Malnutrition Screening
Tool\par\pard\ql \li21\sb36\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Malnutrition Universal Screening Tool\par\pard\ql \li21\sb34\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Neonatus Pain Scale\par\pard\qj \li21\ri695\sb34\sl-
275\slmult0\tx1318\tx3018\tx4666 \up0 \expndtw-1\charscalex100 adalah bahan atau
paduan bahan, termasuk produk \line \up0 \expndtw0\charscalex103 biologi, yang
digunakan untuk memengaruhi atau \line \up0 \expndtw-2\charscalex100
menyelidiki sistem fisiologi atau keadaan patologi dalam \line \up0 \expndtw-
3\charscalex100 rangka \tab \up0 \expndtw-3\charscalex100 penetapan \tab \up0
\expndtw-3\charscalex100 diagnosis, \tab \up0 \expndtw-3\charscalex100
pencegahan,\par\pard\qj \li21\ri698\sb1\sl-276\slmult0 \up0 \expndtw0\charscalex100
penyembuhan, pemulihan, peningkatan kesehatan dan \up0 \expndtw-3\charscalex100
kontrasepsi untuk manusia.\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 629}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(629,20);(629,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop13685\shpright2088\shpbottom13692\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 8}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(8,7);(8,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2090\shptop13685\shpright4816\shpbottom13705\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 2726}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(2726,20);(2726,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4819\shptop13685\shpright4826\shpbottom13692\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
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{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4828\shptop13685\shpright11071\shpbottom13705\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3036\shplid218
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 6243}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(6243,20);(6243,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}
{\shp
{\*\shpinst\shpleft11073\shptop13685\shpright11080\shpbottom13692\shpfhdr0\shpbxpag
e\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3038\shplid219
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1440\shptop13695\shpright1460\shpbottom15348\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 1653}}
{\sp{\sn pVerticies}{\sv 8;4;(0,1653);(20,1653);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1440\shptop15351\shpright1447\shpbottom15358\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3042\shplid221
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1440\shptop15351\shpright1447\shpbottom15358\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3044\shplid222
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft1449\shptop15351\shpright2078\shpbottom15371\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3046\shplid223
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 629}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(629,20);(629,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop13695\shpright2100\shpbottom15348\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3048\shplid224
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 1653}}
{\sp{\sn pVerticies}{\sv 8;4;(0,1653);(20,1653);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2080\shptop15351\shpright2088\shpbottom15358\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3050\shplid225
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 8}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(8,7);(8,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft2090\shptop15351\shpright4816\shpbottom15371\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3052\shplid226
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 2726}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(2726,20);(2726,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4819\shptop13695\shpright4839\shpbottom15348\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3054\shplid227
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 1653}}
{\sp{\sn pVerticies}{\sv 8;4;(0,1653);(20,1653);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4819\shptop15351\shpright4826\shpbottom15358\shpfhdr0\shpbxpage\
shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3056\shplid228
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft4828\shptop15351\shpright11071\shpbottom15371\shpfhdr0\shpbxpage
\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3058\shplid229
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 6243}}{\sp{\sn geoBottom}{\sv 20}}
{\sp{\sn pVerticies}{\sv 8;4;(0,20);(6243,20);(6243,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop13695\shpright11093\shpbottom15348\shpfhdr0\shpbxpag
e\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3060\shplid230
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 20}}{\sp{\sn geoBottom}{\sv 1653}}
{\sp{\sn pVerticies}{\sv 8;4;(0,1653);(20,1653);(20,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop15351\shpright11080\shpbottom15358\shpfhdr0\shpbxpag
e\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3062\shplid231
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
{\*\shpinst\shpleft11073\shptop15351\shpright11080\shpbottom15358\shpfhdr0\shpbxpag
e\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz3064\shplid232
{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 7}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(7,7);(7,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg397}{\bkmkend
Pg397}\par\pard\sect\sectd\sbknone\cols2\colno1\colw4771\colsr160\colno2\colw6829\c
olsr160\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb62\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 106\tab \up0 \expndtw-3\charscalex100 obat yang
perlu\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0 \expndtw-3\charscalex100
diwaspadai\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 107\tab \up0 \expndtw-3\charscalex100 ODHA\par\pard\ql
\li1564\sb34\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 108\tab \up0
\expndtw-3\charscalex100 OPPE\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb58\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
109\tab \up0 \expndtw-3\charscalex100 OPPE\par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb12\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 110\tab \up0 \expndtw-3\charscalex100 PAB\par\pard\ql
\li1564\sb33\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 111\tab \up0
\expndtw-3\charscalex100 PAP\par\pard\ql \li1564\sb34\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 112\tab \up0 \expndtw-3\charscalex100 PCC\par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb9\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 113\tab \up0
\expndtw-3\charscalex100 PCRA\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 114\tab \up0 \expndtw-
3\charscalex100 Pelayanan\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0 \expndtw-
3\charscalex100 laboratorium\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb11\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 115\tab \up0
\expndtw-3\charscalex100 pelayanan yang\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0
\expndtw-3\charscalex100 dikontrakkan\par\pard\ql \li1564\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 116\tab \up0 \expndtw-
3\charscalex100 pemilik rumah sakit\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 117\tab \up0 \expndtw-
3\charscalex100 pemimpin\par\pard\column \ql \li4931\sb0\sl-276\slmult0
\par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0
\par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb62\sl-276\slmult0 \up0
\expndtw0\charscalex102 Obat yang perlu diwaspadai atau obat high alert
(high\par\pard\qj \li21\ri691\sb1\sl-275\slmult0 \up0 \expndtw0\charscalex105 alert
drugs), merupakan obat yang karena sering \line \up0 \expndtw0\charscalex102
menyebabkan kejadian yang tidak diharapkan atau \line \up0 \expndtw-
3\charscalex100 kejadian sentinel, perlu diwaspadai penyimpanan dan \line \up0
\expndtw-1\charscalex100 penggunaannya. Yang termasuk dalam kelompok ini \line
\up0 \expndtw-1\charscalex100 adalah obat yang nama obat, rupa dan atau
ucapannya \line \up0 \expndtw-3\charscalex100 mirip \up0 \expndtw-1\charscalex100
(NORUM) atau kelompok obat yang\ul0\nosupersub\cf8\f9\fs24 look
alike\par\pard\qj \li21\ri836\sb0\sl-288\slmult0 \up0 \expndtw-3\charscalex100
sound alike\ul0\nosupersub\cf7\f8\fs24 (LASA), dan kelompok elektrolit konsentrat.
\up0 \expndtw-3\charscalex100 Orang dengan HIV/AIDS\par\pard\ql \li21\ri691\sb8\sl-
295\slmult0\tx1874 \up0 \expndtw0\charscalex101 Ongoing Professional Practice
Evaluation disebut juga \up0 \expndtw-3\charscalex100 Evaluasi Praktik Profesional
Berkelanjutan (EPPB) \up0 \expndtw-3\charscalex100 Ongoing Professional Practice
Evaluation adalah sebuah \line \up0 \expndtw0\charscalex101 alat skrining
\tab \up0 \expndtw0\charscalex105 (penapis) yang digunakan untuk\par\pard\qj
\li21\ri688\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex103 mengevaluasi kewenangan
klinis dari para staf medis \up0 \expndtw-4\charscalex100 rumah sakit dalam
melakukan pelayanan medis di rumah \up0 \expndtw0\charscalex108 sakit tersebut.
Alat ini juga digunakan untuk \up0 \expndtw0\charscalex100 mengidentifikasi
dan menemukan para staf medis yang \up0 \expndtw-3\charscalex100 melaksanakan
\up0 \expndtw0\charscalex106 - atau yang diduga melaksanakan-\par\pard\ql
\li21\ri695\sb0\sl-298\slmult0 \up0 \expndtw-4\charscalex100 pelayanan medis di
bawah standar yang telah ditetapkan. \up0 \expndtw-3\charscalex100 Pelayanan
Anestesi dan Bedah. Lihat bab PAB \up0 \expndtw-3\charscalex100 Pelayanan Asuhan
Pasien. Lihat bab PAP\par\pard\qj \li21\ri691\sb10\sl-276\slmult0 \up0 \expndtw-
2\charscalex100 Patient Centered Care adalah suatu metode asuhan \line
\up0 \expndtw-3\charscalex100 pasien dengan fokus utama pasien dilaksanakan melalui
\line \up0 \expndtw-1\charscalex100 asuhan terintegrasi oleh profesional
pemberi asuhan \line \up0 \expndtw-3\charscalex100 (PPA) yang melibatkan dan
memberdayakan pasien dan \line \up0 \expndtw-3\charscalex100
keluarga.\par\pard\ql \li21\sb7\sl-276\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf8\f9\fs24 Pre-Construction Risk Assessment \up0 \expndtw-
1\charscalex100 \ul0\nosupersub\cf7\f8\fs24 (PCRA) adalah\par\pard\qj
\li21\ri692\sb2\sl-276\slmult0 \up0 \expndtw-3\charscalex100 reasesmen yang
dilakukan sebelum konstruksi dilakukan \line \up0 \expndtw0\charscalex104 yang
meliputi kualitas udara, pengendalian infeksi \line \up0
\expndtw0\charscalex100 (ICRA), utilitas, kebisingan, getaran layanan
darurat \line \up0 \expndtw0\charscalex100 seperti respon terhadap kode,
bahaya lain yang \line \up0 \expndtw-2\charscalex100 mempengarhi asuhan dan
pelayanan. Lihat juga bab \line \up0 \expndtw-3\charscalex100
MFK.\par\pard\qj \li21\ri691\sb10\sl-276\slmult0 \up0 \expndtw0\charscalex100
Pelayanan laboratorium mencakup kegiatan pelayanan \line \up0
\expndtw0\charscalex100 laboratorium klinik, patologi anatomi,
mikrobiologi, \line \up0 \expndtw-2\charscalex100 parasitologi, yang
pelaksanaannya diintegrasikan dan \line \up0 \expndtw0\charscalex100
dikoordinasikan oleh seorang koordinator, dll. Lihat bab \line \up0 \expndtw-
3\charscalex100 AP 5\par\pard\qj \li21\ri696\sb11\sl-275\slmult0 \up0 \expndtw-
3\charscalex100 merupakan pelayanan yang disediakan oleh pihak ketiga \up0
\expndtw-3\charscalex100 melalui perjanjian.\par\pard\ql \li21\sb10\sl-
276\slmult0\tx5392 \up0 \expndtw0\charscalex102 merupakan sekelompok individu
atau\tab \up0 \expndtw-3\charscalex100 badan\par\pard\qj \li21\ri697\sb1\sl-
275\slmult0 \up0 \expndtw-3\charscalex100 penyelenggara rumah rumah sakit misalnya,
dewan atau \up0 \expndtw-3\charscalex100 Dewan Penyantun, lihat juga JCI Ed
5).\par\pard\qj \li21\ri689\sb12\sl-275\slmult0 \up0 \expndtw-2\charscalex100
Pemimpin adalah individu yang menetapkan ekspektasi, \line \up0 \expndtw-
2\charscalex100 mengembangkan rencana, dan mengimplementasikan \line \up0
\expndtw0\charscalex101 prosedur untuk menilai dan meningkatkan kualitas tata \line
\up0 \expndtw0\charscalex105 kelola, manajemen, klinis, dan fungsi dan proses
\line \up0 \expndtw-3\charscalex100 pendukung organisasi. Istilah pemimpin
digunakan untuk\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li875\sb31\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 397

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg398}{\bkmkend Pg398}\par\pard\qj \li4931\sb0\sl-260\slmult0
\par\pard\qj\li4931\sb0\sl-260\slmult0 \par\pard\qj\li4931\sb0\sl-260\slmult0
\par\pard\qj\li4931\sb0\sl-260\slmult0 \par\pard\qj\li4931\ri653\sb166\sl-
260\slmult0 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 menunjukkan
bahwa satu atau lebih individu bertanggung \line \up0 \expndtw-4\charscalex100
jawab atas ekspektasi yang tercantum di dalam
standar.\par\pard\sect\sectd\sbknone\cols2\colno1\colw4771\colsr160\colno2\colw6829
\colsr160\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb150\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 118\tab \up0 \expndtw-
3\charscalex100 pendidikan in-service\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
119\tab \up0 \expndtw-3\charscalex100 penugasan klinis atau\par\pard\ql
\li2193\sb1\sl-273\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf8\f9\fs24 clinical appointment\par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb13\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 120\tab \up0 \expndtw-3\charscalex100
peraturan internal\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0 \expndtw-
3\charscalex100 korporat\par\pard\ql \li1564\sb61\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 121\tab \up0 \expndtw-3\charscalex100 pimpinan\par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb9\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 121\tab \up0
\expndtw-3\charscalex100 PKPO\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
122\tab \up0 \expndtw-3\charscalex100 PME\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb9\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 123\tab \up0 \expndtw-
3\charscalex100 PMI\par\pard\column \ql \li4931\sb0\sl-276\slmult0 \par\pard\ql
\li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql
\li21\sb150\sl-276\slmult0 \up0 \expndtw0\charscalex102 adalah pendidikan yang
terorganisasikan, biasanya\par\pard\ql \li21\ri690\sb0\sl-280\slmult0 \up0
\expndtw0\charscalex101 diselenggarakan di tempat kerja, dirancang untuk
\line \up0 \expndtw-1\charscalex100 meningkatkan keterampilan staf atau atau
keterampilan \line \up0 \expndtw-3\charscalex100 baru yang sesuai dengan pekerjaan
dan disiplin ilmunya. \line \up0 \expndtw0\charscalex104 Penugasan klinis
atau\ul0\nosupersub\cf8\f9\fs24 clinical appointment\ul0\nosupersub\cf7\f8\fs24
adalah \line \up0 \expndtw-1\charscalex100 penugasan kepala/direktur rumah sakit
kepada seorang \line \up0 \expndtw0\charscalex100 staf medis untuk melakukan
sekelompok pelayanan \line \up0 \expndtw0\charscalex101 medis dirumah sakit
tersebut berdasarkan daftar \line \up0 \expndtw-3\charscalex100 kewenangan
klinis yang telah ditetapkan baginya. \line \up0 \expndtw0\charscalex100 mengatur
tanggungjawab dan kewenangan antara \line \up0 \expndtw-3\charscalex100
pemilik dan pengelola rumah sakit. Lihat juga bab TKRS \line \up0
\expndtw0\charscalex102 Istilah pimpinan digunakan untuk menunjukkan bahwa \line
\up0 \expndtw-4\charscalex100 sekelompok pemimpin secara kolektif bertanggung jawab
\line \up0 \expndtw0\charscalex103 atas ekspektasi yang tercantum di dalam
standar. \line \up0 \expndtw-3\charscalex100 Pimpinan yang dijelaskan dalam
SNARS edisi 1 ini \line \up0 \expndtw0\charscalex102 mencakup setidaknya
Direktur/Direksi RS, kepala \line \up0 \expndtw-5\charscalex100 bidang/kepala
divisi, kepala unit kerja/unit pelayanan, dan \line \up0 \expndtw-3\charscalex100
kepala departemen.\par\pard\qj \li21\ri696\sb8\sl-275\slmult0 \up0 \expndtw-
1\charscalex100 Pelayanan Kefarmasian dan Pelayanan Obat. Lihat bab \up0 \expndtw-
3\charscalex100 PKPO\par\pard\qj \li21\ri691\sb11\sl-276\slmult0 \up0
\expndtw0\charscalex101 Pemantapan mutu eksternal di laboratorium adalah \line
\up0 \expndtw-3\charscalex100 kegiatan pemantapan mutu yang diselenggaralan
secara \line \up0 \expndtw0\charscalex104 periodik oleh pihak lain di luar
laboratorium yang \line \up0 \expndtw-1\charscalex100 bersangkutan untuk memantau
dan menilai penampilan \line \up0 \expndtw0\charscalex102 suatu laboratorium di
bidang pemeriksaan tertentu. \line \up0 \expndtw0\charscalex104 Penyelenggaraan
PME dilaksanakan oleh pihak \line \up0 \expndtw0\charscalex103 pemerintah,
swasta atau internasional dan diikuti oleh \line \up0 \expndtw0\charscalex101 semua
laboratorium, baik milik pemerintah maupun \line \up0 \expndtw-1\charscalex100
swasta dan dikaitkan dengan akreditasi laboratorium \line \up0
\expndtw0\charscalex100 kesehatan serta perizinan laboratorium kesehatan
\line \up0 \expndtw-3\charscalex100 swasta.\par\pard\qj \li21\ri692\sb9\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 Pemantapan mutu internal adalah kegiatan
pencegahan \line \up0 \expndtw0\charscalex101 dan pengawasan yang
dilaksanakan oleh setiap \line \up0 \expndtw-1\charscalex100 laboratorium
secara terus-menerus agar diperoleh hasil \line \up0 \expndtw-2\charscalex100
pemeriksaan yang tepat. Kegiatan ini mencakup tiga \line \up0 \expndtw-
2\charscalex100 tahapan proses, yaitu pra-analitik, analitik dan paska
\line \up0 \expndtw-3\charscalex100 analitik.\par\pard\qj \li21\ri689\sb0\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 Beberapa kegiatan pemantapan mutu
internal antara lain: \up0 \expndtw0\charscalex102 persiapan penderita,
pengambilan dan penanganan \up0 \expndtw-1\charscalex100 spesimen, kalibrasi
peralatan, uji kualitas air, uji kualitas \up0 \expndtw0\charscalex101 reagen, uji
kualitas media, uji kualitas antigen-antisera, \up0 \expndtw-1\charscalex100
pemeliharaan strain kuman, uji ketelitian dan ketepatan, \up0 \expndtw-
3\charscalex100 pencatatan dan pelaporan hasil\par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li875\sb21\sl-253\slmult0 \up0 \expndtw-
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\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
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128\tab \up0 \expndtw-3\charscalex100 PPA\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
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\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 133\tab \up0
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\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
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134\tab \up0 \expndtw-3\charscalex100 PRN\par\pard\ql \li1564\sb34\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 135\tab \up0 \expndtw-
3\charscalex100 Profil Ringkas Medis\par\pard\ql \li2193\sb1\sl-275\slmult0 \up0
\expndtw-3\charscalex100 Rawat Jalan\par\pard\ql \li1564\sb61\sl-276\slmult0\tx2188
\up0 \expndtw-3\charscalex100 136\tab \up0 \expndtw-3\charscalex100
Program\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb9\sl-
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\par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0
\par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb62\sl-276\slmult0 \up0
\expndtw0\charscalex101 Peningkatan Mutu dan Keselamatan Pasien. Lihat
bab\par\pard\ql \li21\sb1\sl-275\slmult0 \up0 \expndtw-3\charscalex100
PMKP\par\pard\qj \li21\ri692\sb11\sl-275\slmult0 \up0 \expndtw0\charscalex103
Pedoman Nasional Pelayanan Kedokteran adalah \up0 \expndtw-2\charscalex100
pedoman yang diikuti oleh dokter atau dokter gigi dalam \up0 \expndtw-
3\charscalex100 menyelenggarakan praktik kedokteran.\par\pard\ql \li21\sb11\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Point of Care Testing\par\pard\qj
\li21\ri695\sb34\sl-276\slmult0 \up0 \expndtw0\charscalex102 POCT atau point-of-
care testing atau disebut juga bed \up0 \expndtw0\charscalex104 site test
merupakan pemeriksaan kesehatan yang \up0 \expndtw0\charscalex101 dilakukan di
dekat atau disamping tempat tidur pasien. \up0 \expndtw0\charscalex103 POCT
merupakan pemeriksaan sederhana dengan \up0 \expndtw0\charscalex100 menggunakan
sampel dalam jumlah sedikit yang dapat \up0 \expndtw-3\charscalex100 dilakukan
disamping tempat tidur pasien.\par\pard\qj \li21\ri694\sb13\sl-275\slmult0 \up0
\expndtw-4\charscalex100 Profesional Pemberi Asuhan adalah staf klinis
profesional \up0 \expndtw0\charscalex100 yang langsung memberikan asuhan kepada
pasien, \up0 \expndtw-2\charscalex100 misalnya staf medis, keperawatan,
farmasi, gizi, staf \up0 \expndtw0\charscalex106 psikologi klinis, dll, dan
memiliki kompetensi dan \up0 \expndtw-3\charscalex100 kewenangan\par\pard\qj
\li21\ri697\sb11\sl-275\slmult0 \up0 \expndtw-3\charscalex100 Peserta Pendidikan
Dokter Spesialis disingkat PPDS. \up0 \expndtw-3\charscalex100 Lihat trainee,
medical.\par\pard\qj \li21\ri697\sb12\sl-275\slmult0 \up0 \expndtw0\charscalex102
Pencegahan dan Pengendalian Infeksi. Lihat juga bab \line \up0 \expndtw-
3\charscalex100 PPI\par\pard\ql \li21\sb10\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Perawat Penanggung Jawab Asuhan\par\pard\ql \li21\sb32\sl-
276\slmult0 \up0 \expndtw0\charscalex101 Panduan Praktik Klinik \up0
\expndtw0\charscalex102 (PPK) atau\ul0\nosupersub\cf8\f9\fs24 clinical
practice\par\pard\ql \li21\sb1\sl-275\slmult0 \up0 \expndtw-2\charscalex100
guidelines m\ul0\nosupersub\cf7\f8\fs24 erupakan pernyataan \up0 \expndtw-
2\charscalex100 (acuan,\ul0\nosupersub\cf8\f9\fs24 statement)\par\pard\qj
\li21\ri693\sb3\sl-276\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf7\f8\fs24 yang sistematis yang membantu para praksi dan pasien
\up0 \expndtw-1\charscalex100 memilih asuhan yang tepat untuk suatu kondisi
klinis \up0 \expndtw-3\charscalex100 tertentu \up0 \expndtw0\charscalex102
(misalnya, rekomendasi dalam manajemen\par\pard\ql \li21\sb1\sl-275\slmult0 \up0
\expndtw0\charscalex102 kasus diare pada anak dibawah \up0
\expndtw0\charscalex102 5 tahun). Praktisi\par\pard\qj \li21\ri694\sb1\sl-
276\slmult0 \up0 \expndtw0\charscalex100 tersebut dipandu dengan semua tahapan
konsultasi \up0 \expndtw0\charscalex102 (pertanyaan yang harus disampaikan, tanda
fisik yang \up0 \expndtw0\charscalex102 harus dicari, pemeriksaan laboratorium
yang harus \up0 \expndtw-1\charscalex100 diminta, penilaian keadaan, dan
pengobatanuyang \up0 \expndtw-3\charscalex100 harusdiresepkan).\par\pard\qj
\li21\ri692\sb7\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Praktik terbaik
atau\ul0\nosupersub\cf8\f9\fs24 best practice\ul0\nosupersub\cf7\f8\fs24 adalah
teknik, metoda, \up0 \expndtw0\charscalex103 atau proses klinis, ilmiah atau
profesional yang diakui \up0 \expndtw0\charscalex102 oleh para profesional dalam
suatu bidang tertentu, \up0 \expndtw0\charscalex104 sebagai memberikan
hasil yang lebih efektif \up0 \expndtw0\charscalex102 dibandingkan praktik
lainnya. Praktik ini sering disebut \up0 \expndtw-5\charscalex100 juga sebagai
proktik yang baik (good practice)atau praktik \up0 \expndtw-3\charscalex100 yang
lebih baik (better practice), yang berbasis bukti dan \up0 \expndtw-3\charscalex100
didukung adanya konsensus.\par\pard\ql \li21\sb9\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Pro re nata\par\pard\qj \li21\ri696\sb35\sl-275\slmult0 \up0
\expndtw0\charscalex104 Ringkasan tentang kondisi penting pasien dengan
\up0 \expndtw-3\charscalex100 diagnosis yang kompleks\par\pard\qj
\li21\ri696\sb61\sl-276\slmult0 \up0 \expndtw-1\charscalex100 merupakan rencana
rumah sakit atau unit kerja yang \up0 \expndtw-3\charscalex100 ditetapkan oleh
direktur RS\par\pard\qj \li21\ri693\sb10\sl-275\slmult0 \up0 \expndtw-
1\charscalex100 adalah prosedur medis yang memasuki tubuh biasanya \up0 \expndtw-
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\expndtw-3\charscalex100 asing ke dalam tubuh.\par\pard\ql \li5786\sb0\sl-
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\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
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\ul0\nosupersub\cf7\f8\fs24 138\tab \up0 \expndtw-3\charscalex100 proses
akreditasi\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb9\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 139\tab \up0 \expndtw-
3\charscalex100 PTO\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb17\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 140\tab \up0
\expndtw-3\charscalex100 RAB\par\pard\ql \li1564\sb34\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 141\tab \up0 \expndtw-3\charscalex100 RCA\par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb9\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 142\tab \up0 \expndtw-3\charscalex100 RDOWS\par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb12\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 143\tab \up0 \expndtw-3\charscalex100
Recall\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 144\tab \up0 \expndtw-
3\charscalex100 Rekredensialing\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb10\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 145\tab \up0
\expndtw-3\charscalex100 rencana asuhan\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb9\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
146\tab \up0 \expndtw-3\charscalex100 RIR\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb17\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
147\tab \up0 \expndtw-3\charscalex100 RKA\par\pard\ql \li1564\sb34\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 148\tab \up0 \expndtw-
3\charscalex100 RKK\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql
\li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb9\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 149\tab \up0 \expndtw-3\charscalex100 Rumah
sakit\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 150\tab \up0 \expndtw-
3\charscalex100 Sampah\par\pard\ql \li1564\sb36\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 151\tab \up0 \expndtw-3\charscalex100 SBAR\par\pard\column
\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql
\li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql
\li21\sb62\sl-276\slmult0 \up0 \expndtw0\charscalex103 Proses akreditasi
merupakan upaya terus-menerus\par\pard\qj \li21\ri690\sb1\sl-275\slmult0 \up0
\expndtw-4\charscalex100 dimana suatu rumah sakit diwajibkan untuk menunjukkan
\line \up0 \expndtw-1\charscalex100 kepada KARS bahwa rumah sakit tersebut
memberikan \line \up0 \expndtw-4\charscalex100 pelayanan yang aman, bermutu tinggi
sebagai gambaran \line \up0 \expndtw-1\charscalex100 kepatuhannya terhadap standar
akreditasi nasional dan \line \up0 \expndtw-4\charscalex100 rekomendasi yang
diberikan. Komponen utama proses ini \line \up0 \expndtw0\charscalex100 adalah
evaluasi yang dilakukan di rumah sakit oleh \line \up0 \expndtw-
3\charscalex100 surveior KARS.\par\pard\ql \li21\sb10\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Pemantauan Terapi Obat\par\pard\ql \li4931\sb0\sl-276\slmult0
\par\pard\ql \li21\sb17\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Rencana
Anggaran Belanja\par\pard\qj \li21\ri695\sb34\sl-276\slmult0 \up0
\expndtw0\charscalex103 RCA atau Root Cause Analysis adalah teknik analisis \up0
\expndtw0\charscalex104 yang bertahap dan terfokus pada penemuan akar \up0
\expndtw-1\charscalex100 penyebab suatu masalah, dan bukan hanya melihat \up0
\expndtw-3\charscalex100 gejala-gejala dari suatu masalah\par\pard\qj
\li21\ri692\sb9\sl-276\slmult0 \up0 \expndtw0\charscalex102 adalah cara penilaian
dan pembuktian yang dilakukan \up0 \expndtw-1\charscalex100 surveior pada saat
survei di lapangan, yaitu melalui \up0 \expndtw0\charscalex100 telaah regulasi
(R), telaah dokumentasi (D), observasi \up0 \expndtw-3\charscalex100 (O),
wawancara (W), dan atau simulasi (S)\par\pard\qj \li21\ri699\sb13\sl-275\slmult0
\up0 \expndtw0\charscalex101 adalah penarikan kembali oleh produsen alat dan
obat \up0 \expndtw-3\charscalex100 karena ada cacat produksi\par\pard\qj
\li21\ri693\sb11\sl-276\slmult0 \up0 \expndtw-3\charscalex100 adalah proses
reevaluasi terhadap staf medis yang telah \up0 \expndtw0\charscalex100 memiliki
kewenangan klinis \up0 \expndtw0\charscalex101 (clinical privilege)
untuk\par\pard\qj \li21\ri697\sb0\sl-276\slmult0 \up0 \expndtw-2\charscalex100
menentukan kelayakan pemberian kewenangan klinis \up0 \expndtw-3\charscalex100
tersebut.\par\pard\qj \li21\ri690\sb6\sl-278\slmult0 \up0 \expndtw-5\charscalex100
Rencana asuhan disebut juga\ul0\nosupersub\cf8\f9\fs24 care
plan\ul0\nosupersub\cf7\f8\fs24 atau\ul0\nosupersub\cf8\f9\fs24 plan of care.
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Lihat juga bab
PAP\par\pard\ql \li21\sb9\sl-276\slmult0\tx1462\tx3016\tx4225 \up0 \expndtw-
3\charscalex100 Radiologi\tab \up0 \expndtw-3\charscalex100 Diagnostik\tab \up0
\expndtw-3\charscalex100 Imajing\tab \up0 \expndtw0\charscalex103 dan
Radiologi\par\pard\ql \li21\sb1\sl-275\slmult0 \up0 \expndtw-3\charscalex100
Intervensional. Lihat bab RIR\par\pard\ql \li21\sb18\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Rencana Kerja dan Anggaran\par\pard\qj \li21\ri691\sb31\sl-
276\slmult0 \up0 \expndtw-1\charscalex100 Rincian Kewenangan Klinis (RKK)
atau\ul0\nosupersub\cf8\f9\fs24 clinical privilege \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf7\f8\fs24 yaitu hak khusus seorang staf medis untuk melakukan
\up0 \expndtw-2\charscalex100 sekelompok pelayanan medis tertentu dalam
lingkungan \up0 \expndtw0\charscalex100 rumah sakit untuk periode tertentu.
Hak ini didapat \up0 \expndtw-1\charscalex100 seorang dokter/ dokter gigi
setelah melalui proses \up0 \expndtw-3\charscalex100 evaluasi
(kredensial/rekredensial) yang dilakukan oleh \up0 \expndtw-3\charscalex100
komite medik rumah sakit\par\pard\ql \li21\sb9\sl-
276\slmult0\tx1193\tx2435\tx3993\tx5544 \up0 \expndtw-3\charscalex100 adalah\tab
\up0 \expndtw-3\charscalex100 institusi\tab \up0 \expndtw-3\charscalex100
pelayanan\tab \up0 \expndtw-3\charscalex100 kesehatan\tab \up0 \expndtw-
3\charscalex100 yang\par\pard\qj \li21\ri697\sb1\sl-275\slmult0 \up0
\expndtw0\charscalex100 menyelenggarakan pelayanan kesehatan perorangan \up0
\expndtw-3\charscalex100 secara paripurna yang menyediakan pelayanan rawat
\up0 \expndtw-3\charscalex100 inap, rawat jalan, dan gawat darurat\par\pard\ql
\li21\sb11\sl-276\slmult0 \up0 \expndtw-3\charscalex100 adalah barang yang tidak
dipakai lagi.\par\pard\qj \li21\ri695\sb36\sl-276\slmult0 \up0
\expndtw0\charscalex103 singkatan dari Situation, Background, Assessment, \line
\up0 \expndtw0\charscalex101 Recommendation adalah suatu teknik atau cara yang
\line \up0 \expndtw0\charscalex102 dapat digunakan untuk memfasilitasi komunikasi
yang \line \up0 \expndtw0\charscalex100 cepat dan tepat. Komunikasi ini
semakin populer di \line \up0 \expndtw0\charscalex100 bidang pelayanan kesehatan,
khususnya diantara para \line \up0 \expndtw0\charscalex100 profesional, misalnya
antara profesi kedokteran dan\par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0
\par\pard\ql \li875\sb42\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 400

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
geoRight}{\sv 8}}{\sp{\sn geoBottom}{\sv 7}}
{\sp{\sn pVerticies}{\sv 8;4;(0,7);(8,7);(8,0);(0,0)}}
{\sp{\sn pSegmentInfo}{\sv 2;10;16384;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}
{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
{\*\shpinst\shpleft11073\shptop4517\shpright11093\shpbottom5619\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,1102);(20,1102);(20,0);(0,0)}}
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}}

{\shp
{\*\shpinst\shpleft1440\shptop5621\shpright1447\shpbottom5628\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\*\shpinst\shpleft1449\shptop5621\shpright2078\shpbottom5641\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
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{\shp
{\*\shpinst\shpleft2090\shptop5621\shpright4816\shpbottom5641\shpfhdr0\shpbxpage\sh
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{\shp
{\*\shpinst\shpleft4819\shptop5621\shpright4826\shpbottom5628\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft4828\shptop5621\shpright11071\shpbottom5641\shpfhdr0\shpbxpage\s
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}
{\shp
{\*\shpinst\shpleft11073\shptop5621\shpright11080\shpbottom5628\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft1440\shptop5631\shpright1460\shpbottom6732\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft2080\shptop5631\shpright2100\shpbottom6732\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft4819\shptop5631\shpright4839\shpbottom6732\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft11073\shptop5631\shpright11093\shpbottom6732\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft1440\shptop6735\shpright1447\shpbottom6742\shpfhdr0\shpbxpage\sh
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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}}

{\shp
{\*\shpinst\shpleft2080\shptop6735\shpright2088\shpbottom6742\shpfhdr0\shpbxpage\sh
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{\*\shpinst\shpleft4819\shptop6735\shpright4826\shpbottom6742\shpfhdr0\shpbxpage\sh
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}}

{\shp
{\*\shpinst\shpleft4828\shptop6735\shpright11071\shpbottom6755\shpfhdr0\shpbxpage\s
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\shp
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{\shp
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{\shp
{\*\shpinst\shpleft4828\shptop9543\shpright11071\shpbottom9563\shpfhdr0\shpbxpage\s
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{\shp
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{\shp
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{\shp
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}
{\shp
{\*\shpinst\shpleft11073\shptop9552\shpright11093\shpbottom9850\shpfhdr0\shpbxpage\
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}}

{\shp
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{\shp
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{\shp
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\expndtw-3\charscalex100 SPO\par\pard\ql \li1564\sb36\sl-276\slmult0\tx2188 \up0
\expndtw-3\charscalex100 162\tab \up0 \expndtw-3\charscalex100 staf
klinis\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 163\tab \up0 \expndtw-
3\charscalex100 Staf non-klinis\par\pard\column \ql \li4931\sb0\sl-276\slmult0
\par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0
\par\pard\ql \li21\sb150\sl-276\slmult0 \up0 \expndtw0\charscalex100 Sertifikasi
adalah adalah proses pemberian pengakuan\par\pard\qj \li21\ri697\sb2\sl-275\slmult0
\up0 \expndtw-2\charscalex100 oleh lembaga non pemerintah atau asosiasi
pemberi \up0 \expndtw-3\charscalex100 sertifikat yang menyatakan bahwa seorang
individu telah \up0 \expndtw-1\charscalex100 memenuhi standar kualifikasi yang
telah ditentukanoleh \up0 \expndtw-3\charscalex100 sebuah lembaga atau
asosiasi.\par\pard\qj \li21\ri690\sb12\sl-275\slmult0 \up0 \expndtw-4\charscalex100
Sistem Informasi Manajemen Rumah Sakit adalah suatu \up0 \expndtw-1\charscalex100
sistem teknologi informasi komunikasi yang memproses \up0 \expndtw-2\charscalex100
dan mengintegrasikan seluruh alur proses pelayanan \up0
\expndtw0\charscalex103 Rumah Sakit dalam bentuk jaringan koordinasi,
\up0 \expndtw-2\charscalex100 pelaporan dan prosedur administrasi untuk
memperoleh \up0 \expndtw-5\charscalex100 informasi secara tepat dan akurat, dan
merupakan bagian \up0 \expndtw-3\charscalex100 dari Sistem Informasi
Kesehatan\par\pard\ql \li21\sb11\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Surat
Izin Praktik\par\pard\ql \li21\sb36\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Surat Izin Praktik Apoteker\par\pard\ql \li21\sb33\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Surat Keputusan\par\pard\ql \li21\sb34\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Sasaran Keselamatan Pasien\par\pard\ql
\li21\ri693\sb33\sl-277\slmult0 \up0 \expndtw-4\charscalex100 Standar Nasional
Akreditasi Rumah Sakit adalah Standar \up0 \expndtw0\charscalex100 yg digunakan
untuk mengukur kepatuhan rumah sakit \up0 \expndtw-2\charscalex100 dalam proses
memberi pengakuan terhadap Rumah \up0 \expndtw0\charscalex102 Sakit oleh
lembaga independen penyelenggara \up0 \expndtw-4\charscalex100 Akreditasi
yang diresmikan oleh Menteri kesehatan . \up0 \expndtw-3\charscalex100 Subjektif,
Objektif , Asesment, Plan\par\pard\ql \li21\sb34\sl-276\slmult0 \up0
\expndtw0\charscalex100 Surat Penugasan Klinis Penugasan klinis \up0
\expndtw-3\charscalex100 (clinical\par\pard\qj \li21\ri693\sb0\sl-278\slmult0
\up0 \expndtw0\charscalex101 appointment) adalah penugasan kepala/direktur rumah
\up0 \expndtw0\charscalex102 sakit kepada staf medis untuk melakukan sekelompok
\up0 \expndtw0\charscalex103 pelayanan medis di rumah sakit tersebut berdasarkan
\up0 \expndtw-3\charscalex100 daftar kewenangan klinis yang telah ditetapkan
baginya \up0 \expndtw-3\charscalex100 Standar Prosedur Operasional\par\pard\qj
\li21\ri694\sb36\sl-275\slmult0\tx1515\tx3491\tx4974 \up0 \expndtw0\charscalex102
Staf klinis adalah tenaga kesehatan yang memberikan \line \up0
\expndtw0\charscalex101 asuhan langsung pada pasien (misalnya dokter, dokter
\line \up0 \expndtw-3\charscalex100 gigi, \tab \up0 \expndtw-3\charscalex100
perawat, \tab \up0 \expndtw-4\charscalex100 gizi, \tab \up0 \expndtw-
3\charscalex100 apoteker).\par\pard\qj \li21\ri694\sb2\sl-275\slmult0 \up0
\expndtw0\charscalex100 Staf non klinis adalah tenaga yang
memberikan \up0 \expndtw0\charscalex103 pelayanan pasien tidak langsung \up0
\expndtw0\charscalex101 (petugas admisi,\par\pard\ql \li21\sb1\sl-276\slmult0 \up0
\expndtw-3\charscalex100 pelayanan makanan, dll.)\par\pard\qj \li21\ri696\sb11\sl-
275\slmult0 \up0 \expndtw0\charscalex104 Semua tenaga yang tidak memberikan
pelayanan \up0 \expndtw-3\charscalex100 langsung pada pasien, misalnya tenaga
perekam medis, \up0 \expndtw-3\charscalex100 manajemen, dan tenaga
administrasi.\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-
253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql \li875\sb13\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 401

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{\shp
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}}

{\shp
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}}

{\shp
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}}

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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
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{\shp
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
{\*\shpinst\shpleft2090\shptop13397\shpright4816\shpbottom13417\shpfhdr0\shpbxpage\
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(2726,20);(2726,0);(0,0)}}
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(6243,20);(6243,0);(0,0)}}
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}}

{\shp
{\*\shpinst\shpleft11073\shptop12569\shpright11093\shpbottom13395\shpfhdr0\shpbxpag
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}

{\shp
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{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg402}{\bkmkend
Pg402}\par\pard\sect\sectd\sbknone\cols2\colno1\colw4771\colsr160\colno2\colw6829\c
olsr160\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb62\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 164\tab \up0 \expndtw-3\charscalex100 status
fungsional\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb9\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 165\tab \up0 \expndtw-
3\charscalex100 STR\par\pard\ql \li1564\sb34\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 166\tab \up0 \expndtw-3\charscalex100 STRA\par\pard\ql
\li1564\sb34\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 167\tab \up0
\expndtw-3\charscalex100 survei akreditasi\par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb12\sl-276\slmult0\tx2188 \up0 \expndtw-
3\charscalex100 168\tab \up0 \expndtw-3\charscalex100 Teknologi
medis\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-
276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb9\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 169\tab \up0 \expndtw-
3\charscalex100 telusur pasien\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb10\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 170\tab \up0 \expndtw-
3\charscalex100 telusur sistem\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb0\sl-276\slmult0 \par\pard\ql \li1564\sb9\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 171\tab \up0 \expndtw-
3\charscalex100 tindakan invasif\par\pard\ql \li1564\sb0\sl-276\slmult0
\par\pard\ql \li1564\sb58\sl-276\slmult0\tx2188 \up0 \expndtw-3\charscalex100
172\tab \up0 \expndtw-3\charscalex100 TKRS\par\pard\ql \li1564\sb34\sl-
276\slmult0\tx2188 \up0 \expndtw-3\charscalex100 173\tab \up0 \expndtw-
3\charscalex100 TTV\par\pard\column \ql \li4931\sb0\sl-276\slmult0 \par\pard\ql
\li4931\sb0\sl-276\slmult0 \par\pard\ql \li4931\sb0\sl-276\slmult0 \par\pard\ql
\li4931\sb0\sl-276\slmult0 \par\pard\ql \li21\sb62\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Status fungsional adalah kemampuan orang-orang untuk\par\pard\qj
\li21\ri692\sb0\sl-276\slmult0\tx1951\tx3283\tx5055 \up0 \expndtw-1\charscalex100
membantu diri mereka sendiri ability themselves secara \line \up0
\expndtw0\charscalex101 fisik dan emosional sesuai dengan norma yang
\line \up0 \expndtw-3\charscalex100 diharapkan \tab \up0 \expndtw-3\charscalex100
untuk \tab \up0 \expndtw-3\charscalex100 kelompok \tab \up0 \expndtw-
3\charscalex100 umurnya.\par\pard\qj \li21\ri694\sb0\sl-276\slmult0 \up0
\expndtw0\charscalex102 Status fungsional mungkin dikelompokkan kedalam \up0
\expndtw0\charscalex104 fungsi-fungsi sosial, fisik dan psikologis.
Status \up0 \expndtw0\charscalex100 fungsional dapat dinilai dengan cara
mengajukan \up0 \expndtw-3\charscalex100 pertanyaan selama pemeriksaan kesehatan
yang teratur \up0 \expndtw-3\charscalex100 atau menggunakan instrumen skrining yang
formal. Lihat \up0 \expndtw-3\charscalex100 juga pengukuran.\par\pard\ql
\li21\sb9\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Surat Tanda
Registrasi\par\pard\ql \li21\sb34\sl-276\slmult0 \up0 \expndtw-3\charscalex100
Surat Tanda Registrasi Apoteker\par\pard\qj \li21\ri693\sb34\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Survei akreditasi merupakan proses evaluasi oleh KARS \up0
\expndtw0\charscalex100 atas sebuah rumah sakit untuk menilai kepatuhannya
\up0 \expndtw-4\charscalex100 terhadap standar yang ditetapkan dan untuk menetapkan
\up0 \expndtw-3\charscalex100 status akreditasinya.\par\pard\qj
\li21\ri690\sb13\sl-275\slmult0\tx911\tx2415\tx5536 \up0 \expndtw0\charscalex104
adalah perangkat dan peralatan medis, baik yang \line \up0 \expndtw-
3\charscalex100 portabel maupun non-portabel, yang digunakan untuk \line
\up0 \expndtw-3\charscalex100 menunjang diagnosis, tata laksana, pemantauan,
dan \line \up0 \expndtw0\charscalex104 perawatan individu. Terminologi serupa
meliputi \line \up0 \expndtw0\charscalex101 peralatan medis dan perangkat medis.
teknologi medis \line \up0 \expndtw0\charscalex100 diklasifikasi menjadi 3 golongan
utama : (1) Perbekalan \line \up0 \expndtw-3\charscalex100 medis atau medical
supplies misalnya benang jahit untuk \line \up0 \expndtw-3\charscalex100 operasi,
prostesis, macam-macam kateter, film X-ray, \line \up0 \expndtw-2\charscalex100
macam-macam perban dan sebagainya. (2) peralatan \line \up0
\expndtw0\charscalex106 medis atau medical devices misalnya alat-alat
\line \up0 \expndtw-3\charscalex100 laboratorium klinik, alat-alat bedah,
mikroskop, CT-Scan, \line \up0 \expndtw-3\charscalex100 MRI \tab \up0 \expndtw-
3\charscalex100 (Magnetic \tab \up0 \expndtw0\charscalex102 Resonance Imaging),
\tab \up0 \expndtw-3\charscalex100 USG\par\pard\qj \li21\ri690\sb1\sl-
276\slmult0 \up0 \expndtw-4\charscalex100 (Ultrasonografi), EKG ( Elektro
Kardiografi), elektroterapi, \up0 \expndtw-2\charscalex100 alat pengukur tekanan
darah dan sebagainya (3) bahan-\line \up0 \expndtw-1\charscalex100 bahan kimia
medis (medical chemical), seperti bahan \up0 \expndtw-3\charscalex100 obat,
vaksin, reagen diagnostik\par\pard\qj \li21\ri690\sb12\sl-276\slmult0 \up0
\expndtw-1\charscalex100 adalah proses yang digunakan JCI untuk mengevaluasi
\up0 \expndtw0\charscalex102 keseluruhan pengalaman perawatan masing-masing \up0
\expndtw-3\charscalex100 pasien dalam suatu rumah sakit.\par\pard\qj
\li21\ri690\sb10\sl-276\slmult0\tx3039 \up0 \expndtw0\charscalex104 adalah suatu
sesi dalam survei di lapangan yang \up0 \expndtw0\charscalex103 ditujukan
untuk mengevaluasi masalah-masalah \up0 \expndtw-1\charscalex100 keselamatan
dan mutu perawatan prioritas tinggi dalam \up0 \expndtw0\charscalex105 tingkat
sistem di seluruh rumah sakit. Contoh \up0 \expndtw-1\charscalex100
masalahmasalah tersebut termasuk pencegahan dan \line \up0
\expndtw0\charscalex103 pengendalian infeksi, \tab \up0 \expndtw0\charscalex102
manajemen obat-obatan,\par\pard\ql \li21\ri696\sb0\sl-298\slmult0 \up0 \expndtw-
3\charscalex100 efektivitas kepegawaian, dan penggunaan data. \line \up0
\expndtw0\charscalex102 adalah suatu tindakan medis yang langsung dapat
\up0 \expndtw-3\charscalex100 mempengaruhi keutuhan jaringan tubuh pasien. \line
\up0 \expndtw-3\charscalex100 Tata Kelola Rumah Sakit\par\pard\ql \li21\sb13\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Tanda Tanda Vital\par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql \li875\sb95\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 402

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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
Pg403}{\bkmkend Pg403}\par\pard\li1564\sb0\sl-276\slmult0\par\pard\li1564\sb0\sl-
276\slmult0\par\pard\li1564\sb0\sl-276\slmult0\par\pard\li1564\sb0\sl-
276\slmult0\par\pard\li1564\sb90\sl-276\slmult0\fi0\tx2193\tx4931 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf7\f8\fs24 174\tab \up0 \expndtw-2\charscalex100
Uji klinis\tab \up0 \expndtw-2\charscalex100 Uji klinis dilakukan untuk
membandingkan satu jenis\par\pard\qj \li4931\ri727\sb0\sl-276\slmult0 \up0
\expndtw0\charscalex103 pengobatan dengan pengobatan lainnya dalam hal ini \line
\up0 \expndtw-3\charscalex100 pengobatan dapat berarti medikamentosa, perasat beda,
\line \up0 \expndtw0\charscalex105 terapi psikologis, diet, akupuntur,
pendidikan atau \line \up0 \expndtw0\charscalex100 intervensi kesehatan masyarakat
dan lain-lain. Uji klinis \line \up0 \expndtw0\charscalex104 pada dasarnya
merupakan satu rangkaian proses \line \up0 \expndtw-2\charscalex100 pengembangan
pengobatan baru. Uji klinis dibagi dalam \par\pard\li4931\sb0\sl-
276\slmult0\fi0\tx7264\tx10394 \up0 \expndtw-3\charscalex100 2\tab \up0 \expndtw-
3\charscalex100 tahapan,\tab \up0 \expndtw-3\charscalex100
yaitu:\par\pard\li4931\sb276\sl-276\slmult0\fi360\tx5652 \up0 \expndtw-
3\charscalex100 1.\tab \up0 \expndtw-3\charscalex100 Tahapan 1\par\pard\qj
\li5652\ri673\sb1\sl-273\slmult0 \up0 \expndtw-4\charscalex100 Pada tahapan ini
dilakukan penelitian laboratorium \line \up0 \expndtw-4\charscalex100 yang disebut
juga sebagai uji pre-klinis, dikerjakan \line \up0 \expndtw-4\charscalex100 in
vitro dengan menggunakan benatan percobaan. \line \up0 \expndtw-4\charscalex100
Tujuan penelitian tahapan \up0 \expndtw-4\charscalex100 1 ini adalah untuk
\par\pard\ql \li5652\sb5\sl-276\slmult0 \up0 \expndtw0\charscalex102 mengumpulkan
informasi farmakologi dan \par\pard\li5292\sb6\sl-
276\slmult0\fi360\tx7513\tx8909\tx10381 \up0 \expndtw-2\charscalex100
toksikologi\tab \up0 \expndtw-2\charscalex100 dalam\tab \up0 \expndtw-
2\charscalex100 rangka\tab \up0 \expndtw-2\charscalex100
untuk\par\pard\li5292\sb0\sl-276\slmult0\fi360 \up0 \expndtw-2\charscalex100
mempersiapkankan penelitian selanjutnya yakni\par\pard\li5292\sb0\sl-
276\slmult0\fi360 \up0 \expndtw-2\charscalex100 dengan menggunakan manusia
sebagai subjek\par\pard\li5292\sb0\sl-276\slmult0\fi360 \up0 \expndtw-
2\charscalex100 penelitan,\par\pard\li5292\sb0\sl-276\slmult0\fi0\tx5652 \up0
\expndtw-2\charscalex100 2.\tab \up0 \expndtw-2\charscalex100 Tahapan
2\par\pard\li5292\sb0\sl-276\slmult0\fi360\tx8451 \up0 \expndtw-2\charscalex100
Pada uji klinis tahapan\tab \up0 \expndtw-2\charscalex100 2, digunakan
manusia\par\pard\qj \li5652\ri738\sb0\sl-280\slmult0 \up0 \expndtw0\charscalex106
sebagai subjek penelitian. Tahapan ini \up0 \expndtw-2\charscalex100
berdasarkan tujuannya dapat dibagi menjadi 4 \up0 \expndtw-2\charscalex100
fase, yaitu: \par\pard\ql \li6012\ri742\sb0\sl-280\slmult0\tx6372 \up0 \expndtw-
3\charscalex100 a. Fase 1 :bertujuan untuk meneliti keamanan \line\tab \up0
\expndtw-3\charscalex100 serta toleransi pengobatan, dengan
\par\pard\li6012\sb1\sl-253\slmult0\fi360\tx8483 \up0 \expndtw0\charscalex100
mengikutsertakan\tab \up0 \expndtw0\charscalex100 20-100 orang
subjek\par\pard\li6012\sb4\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex100
penelitian.\par\pard\li6012\sb0\sl-276\slmult0\fi0 \up0 \expndtw0\charscalex100 b.
Fase II : bertujuan untuk menilai system\par\pard\li6012\sb0\sl-
276\slmult0\fi360 \up0 \expndtw0\charscalex100 atau dosis pengobatan yang paling
efektif,\par\pard\li6012\sb0\sl-276\slmult0\fi360\tx8050\tx10168 \up0
\expndtw0\charscalex100 biasanya\tab \up0 \expndtw0\charscalex100
dilaksanakan\tab \up0 \expndtw0\charscalex100 dengan\par\pard\li6012\sb0\sl-
276\slmult0\fi360\tx10088 \up0 \expndtw0\charscalex100 mengikutsertakan
sebanyak\tab \up0 \expndtw0\charscalex100 100-200\par\pard\ql \li6372\sb1\sl-
259\slmult0 \up0 \expndtw-3\charscalex100 subjek penelitian. \par\pard\ql
\li6012\ri737\sb7\sl-
276\slmult0\tx7397\tx6372\tx6372\tx6372\tx6372\tx6372\tx6372 \up0
\expndtw0\charscalex101 c. Fase III \tab \up0 \expndtw-2\charscalex100 :
bertujuan untuk mengevaluasi \line\tab \up0 \expndtw0\charscalex106 obat atau
cara pengobatan baru \line \tab \up0 \expndtw0\charscalex101 dibandingkan
dengan pengobatan yang \line \tab \up0 \expndtw0\charscalex101 telah ada
(pengobatan standal). Uji klinis \line \tab \up0 \expndtw-1\charscalex100 yang
banyak dilakukan termasuk dalam \line \tab \up0 \expndtw-3\charscalex100 fase
ini. Baku emas uji klinis fase III adalah \line \tab \up0 \expndtw-3\charscalex100
uji klinis acak terkontrol \par\pard\ql \li6012\ri739\sb6\sl-
274\slmult0\tx6372\tx6372\tx6372\tx6372\tx6372\tx6372\tx6372 \up0
\expndtw0\charscalex101 d. Fase IV : bertujuan untuk mengevaluasi \line\tab
\up0 \expndtw-1\charscalex100 obat baru yang telah dipakai dimasyarakat \line
\tab \up0 \expndtw0\charscalex101 dalam jangka waktu yang relative lama (5 \line
\tab \up0 \expndtw0\charscalex101 tahun atau lebih). Fase ini penting karena
\line \tab \up0 \expndtw0\charscalex101 terdapat kemungkinan efek samping obat
\line \tab \up0 \expndtw-2\charscalex100 timbul setelah lebih banyak pemakai.
Fase \line \tab \up0 \expndtw-3\charscalex100 ini \up0 \expndtw0\charscalex108
disebut juga sebagai uji klinis \line \tab \up0 \expndtw-3\charscalex100
pascapasar (post marketing). \par\pard\li1564\sb24\sl-276\slmult0\fi0\tx2193\tx4931
\up0 \expndtw-3\charscalex100 175\tab \up0 \expndtw-3\charscalex100 VAP\tab \up0
\expndtw-3\charscalex100 Ventilator-Associated Pneumonia lihat bab
PPI\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-
253\slmult0 \par\pard\ql\li5786\sb218\sl-253\slmult0 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 403

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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
{\*\shpinst\shpleft4828\shptop14979\shpright11071\shpbottom14999\shpfhdr0\shpbxpage
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\sp{\sn pVerticies}{\sv 8;4;(0,20);(6243,20);(6243,0);(0,0)}}
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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}}\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart
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276\slmult0\par\pard\li1564\sb0\sl-276\slmult0\par\pard\li1564\sb0\sl-
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4\charscalex100 \ul0\nosupersub\cf7\f8\fs24 176\tab \up0 \expndtw-4\charscalex100
variasi\tab \up0 \expndtw-4\charscalex100 Variasi adalah perbedaan dalam hasil yang
diperoleh dari\par\pard\qj \li4931\ri654\sb0\sl-276\slmult0 \up0
\expndtw0\charscalex103 pengukuran kejadian yang sama yang dilakukan lebih \line
\up0 \expndtw0\charscalex101 dari satu kali. Sumber variasi dapat
dikelompokkan \line \up0 \expndtw-4\charscalex100 menjadi dua kategori: penyebab
umum (common causes) \line \up0 \expndtw0\charscalex100 dan penyebab khusus
(special causes). Terlalu banyak \line \up0 \expndtw0\charscalex101 variasi sering
menyebabkan kerugian, misalnya hasil \line \up0 \expndtw0\charscalex101 pasien
yang tidak diharapkan dan meningkatnya biaya \line \up0 \expndtw0\charscalex102
pelayanan. \par\pard\li1564\sb5\sl-276\slmult0\fi0\tx2193\tx4931 \up0
\expndtw0\charscalex101 177\tab \up0 \expndtw0\charscalex101 VAS\tab \up0
\expndtw0\charscalex101 Visual Analog Scale adalah alat untuk mengukur
nyeri\par\pard\qj \li4931\ri746\sb0\sl-280\slmult0 \up0 \expndtw0\charscalex101
yang menggunakan tingkat respons ekspresi wajah \up0 \expndtw0\charscalex102
sebagai variabel \par\pard\li1564\sb3\sl-276\slmult0\fi0\tx2193\tx4931 \up0
\expndtw0\charscalex101 178\tab \up0 \expndtw0\charscalex101 verifikasi\tab \up0
\expndtw0\charscalex101 adalah proses pemeriksaan validitas dan
kelengkapan\par\pard\qj \li4931\ri740\sb0\sl-280\slmult0 \up0 \expndtw-
1\charscalex100 kredensial klinis atau yang lainnya, langsung ke sumber \up0
\expndtw-1\charscalex100 yang mengeluarkan kredensial tersebut. \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb247\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 404

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}}

{\shp
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}}
{\shp
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{\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn
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Development of Health and Social Care Standards, Ed 4th \par\pard\qj
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Menteri Kesehatan \line\tab \up0 \expndtw-3\charscalex100 Republik Indonesia Nomor
11 Tahun 2017 Tentang Keselamatan Pasien \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb1\sl-276\slmult0 \up0 \expndtw-2\charscalex100 An effective
internal audit program is indispensable for continuous improvement A
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Simple Tool to Improve High Reliability ;Jun 02, 2017 | 2400
Views\ul0\nosupersub\cf26\f27\fs24 \u8232?\ul0\nosupersub\cf7\f8\fs24 By Coleen
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Commission Center for Transforming Healthcare \par\pard\qj \li1440\ri2183\sb237\sl-
320\slmult0\tx1800 \up0 \expndtw-2\charscalex100 Menteri Kesehatan Republik
Indonesia, 2017, Peraturan Menteri Kesehatan \line\tab \up0 \expndtw-
3\charscalex100 Republik Indonesia Nomor 11 Tahun 2017 Tentang Keselamatan
Pasien \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb1\sl-
276\slmult0 \up0 \expndtw-2\charscalex100 An effective internal audit program is
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450\slmult0 \up0 \expndtw-3\charscalex100 Simple Tool to Improve High
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Republik Indonesia Nomor 755 Tahun 2011 Tentang Penyelenggaraan Komite \up0
\expndtw-3\charscalex100 Medik di Rumah Sakit \par\pard\ql \li1507\sb0\sl-
276\slmult0 \par\pard\ql\li1507\sb4\sl-276\slmult0 \up0 \expndtw-2\charscalex100
Menteri Kesehatan Republik Indonesia, 2013, Peraturan Menteri Kesehatan
\par\pard\qj \li1867\ri1329\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100
Republik Indonesia Nomor 49 tahun 2013 Tentang Komite Keperawatan Rumah \up0
\expndtw-3\charscalex100 Sakit \par\pard\ql \li1507\sb0\sl-276\slmult0
\par\pard\ql\li1507\sb1\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Menteri
Kesehatan Republik Indonesia, 2015, Peraturan Menteri Kesehatan \par\pard\qj
\li1867\ri1329\sb8\sl-320\slmult0 \up0 \expndtw-2\charscalex100 Republik Indonesia
Nomor 10 tahun 2015 Tentang Komite Keperawatan Rumah \up0 \expndtw-3\charscalex100
Sakit \par\pard\ql \li1507\ri2143\sb246\sl-313\slmult0\tx1867\tx1867\tx1867 \up0
\expndtw-2\charscalex100 Menteri Kesehatan Republik Indonesia, 2004, Peraturan
Menteri Kesehatan \line\tab \up0 \expndtw-3\charscalex100 Republik Indonesia Nomor
81/MENKES/SK/I/2004 Tentang Pedoman \line \tab \up0 \expndtw-3\charscalex100
Penyusunan Perencanaan Sumber Daya Manusia Kesehatan di Tingkat \line \tab \up0
\expndtw-3\charscalex100 Propinsi, Kabupaten/Kota serta Rumah Sakit \par\pard\qj
\li1440\ri1689\sb242\sl-320\slmult0\tx1867 \up0 \expndtw-2\charscalex100 Republik
Indonesia, 2009, Undang-Undang Republik Indonesia Nomor 44 Tahun \line\tab \up0
\expndtw-3\charscalex100 2009 tentang Rumah Sakit Pasal 21-22. \par\pard\qj
\li1440\ri1689\sb240\sl-320\slmult0\tx1867 \up0 \expndtw-2\charscalex100 Republik
Indonesia, 2013, Undang-Undang Republik Indonesia Nomor 20 Tahun \line\tab \up0
\expndtw-3\charscalex100 2013 tentang Pendidikan Kedokteran. \par\pard\qj
\li1440\ri1956\sb220\sl-320\slmult0\tx1867 \up0 \expndtw-2\charscalex100 Presiden
Republik Indonesia, 2015, Peraturan Pemerintah Republik Indonesia \line\tab \up0
\expndtw-3\charscalex100 Nomor 93 Tahun 2015 tentang Rumah Sakit Pendidikan.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb1\sl-276\slmult0 \up0
\expndtw-2\charscalex100 Republik Indonesia, 2004, Undang-Undang Republik Indonesia
Nomor 29 Tahun \par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb70\sl-
253\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs22 414
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg415}
{\bkmkend Pg415}\par\pard\ql \li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb0\sl-
276\slmult0
\par\pard\ql\li1867\sb0\sl-276\slmult0 \par\pard\ql\li1867\sb0\sl-276\slmult0
\par\pard\ql\li1867\sb88\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 2004 tentang Praktik Kedokteran. \par\pard\ql
\li1440\ri2204\sb256\sl-310\slmult0\tx1867\tx1867 \up0 \expndtw-2\charscalex100
Menteri Kesehatan Republik Indonesia, 2011, Peraturan Menteri Kesehatan
\line\tab \up0 \expndtw-3\charscalex100 Republik Indonesia Nomor 2052 Tahun 2011
tentang Izin Praktik dan \line \tab \up0 \expndtw-3\charscalex100 Pelaksanaan
Praktik Kedokteran. \par\pard\qj \li1440\ri2129\sb242\sl-320\slmult0\tx1867 \up0
\expndtw-2\charscalex100 Menteri Kesehatan Republik Indonesia, 2017, Peraturan
Menteri Kesehatan \line\tab \up0 \expndtw-3\charscalex100 Republik Indonesia Nomor
11 Tahun 2017 tentang Keselamatan Pasien. \par\pard\ql \li1440\ri1449\sb240\sl-
320\slmult0\tx1867\tx1867 \up0 \expndtw-2\charscalex100 Konsil Kedokteran
Indonesia, 2014, Peraturan Konsil Kedokteran Indonesia Nomor \line\tab \up0
\expndtw-2\charscalex100 21 Tahun 2014 tentang Registrasi Dokter dan Dokter Gigi
Peserta Program \line \tab \up0 \expndtw-3\charscalex100 Pendidikan Dokter
Spesialis dan Dokter Gigi Spesialis \par\pard\qj \li1440\ri1299\sb220\sl-
320\slmult0\tx1867 \up0 \expndtw-2\charscalex100 Departemen Kesehatan Republik
Indonesia, 2009, Pedoman klasifikasi dan standar \line\tab \up0 \expndtw-
3\charscalex100 rumah sakit pendidikan \par\pard\qj \li1440\ri1451\sb240\sl-
320\slmult0\tx1867 \up0 \expndtw-2\charscalex100 Joint Commission International,
2011, Joint Commission International Accreditation \line\tab \up0 \expndtw-
3\charscalex100 Standard for Hospital, 4\ul0\super\cf29\f30\fs24
th\ul0\nosupersub\cf7\f8\fs24 ed., \par\pard\qj \li1440\ri1439\sb240\sl-
320\slmult0\tx1867 \up0 \expndtw-2\charscalex100 Joint Commission International,
2013, Joint Commission International Accreditation \line\tab \up0 \expndtw-
3\charscalex100 Standard for Hospital, 5\ul0\super\cf29\f30\fs24
th\ul0\nosupersub\cf7\f8\fs24 ed., \par\pard\ql \li1440\ri1238\sb209\sl-
310\slmult0\tx2006\tx2006 \up0 \expndtw-1\charscalex100 Biro Hukum dan
Organisasi Kementerian Kesehatan Republik Indonesia, 2013, \line\tab \up0
\expndtw0\charscalex100 Peraturan Menteri Kesehatan No. 82 Tahun 2013
Tentang:\ul0\nosupersub\cf8\f9\fs24 Sistem Informasi \line \tab \up0 \expndtw-
3\charscalex100 Manajemen Rumah Sakit\ul0\nosupersub\cf7\f8\fs24 , Kementerian
Kesehatan Republik Indonesia. \par\pard\ql \li1440\ri1237\sb202\sl-
320\slmult0\tx2006\tx2006 \up0 \expndtw-1\charscalex100 Biro Hukum dan
Organisasi Kementerian Kesehatan Republik Indonesia, 2016, \line\tab \up0
\expndtw-1\charscalex100 Peraturan Menteri Kesehatan No. 67 Tahun 2016
Tentang\ul0\nosupersub\cf8\f9\fs24 Penanggulangan \line \tab \up0 \expndtw-
3\charscalex100 Tuberkolosis,\ul0\nosupersub\cf7\f8\fs24 Kementerian Kesehatan
Republik Indonesia \par\pard\ql \li1440\ri1183\sb200\sl-
320\slmult0\tx2006\tx2006 \up0 \expndtw-1\charscalex100 Biro Hukum dan
Organisasi Kementerian Kesehatan Republik Indonesia, 2012, \line\tab \up0
\expndtw-3\charscalex100 Peraturan Menteri Kesehatan No. 004 Tahun 2012
Tentang\ul0\nosupersub\cf8\f9\fs24 Promosi Kesehatan \line \tab \up0 \expndtw-
4\charscalex100 Rumah Sakit,\ul0\nosupersub\cf7\f8\fs24 Kementrian Kesehatan
Republik Indonesia. \par\pard\ql \li1440\ri1238\sb209\sl-
310\slmult0\tx2006\tx2006 \up0 \expndtw-1\charscalex100 Biro Hukum dan
Organisasi Kementerian Kesehatan Republik Indonesia, 2012, \line\tab \up0
\expndtw0\charscalex100 Peraturan Menteri Kesehatan No. 67 Tahun 2016
Tentang\ul0\nosupersub\cf8\f9\fs24 Penanggulangan \line \tab \up0 \expndtw-
3\charscalex100 Tuberkolosis,\ul0\nosupersub\cf7\f8\fs24 Kementerian Kesehatan
Republik Indonesia \par\pard\ql \li1440\ri1182\sb202\sl-
320\slmult0\tx2006\tx2006 \up0 \expndtw-3\charscalex100 Direktorat Jenderal Gizi
dan Kesehatan Ibu dan Anak Direktorat Kesehatan Ibu, 2012, \line\tab \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf8\f9\fs24 Pedoman Penyelenggaraan PONEK 24
JAM di Rumah Sakit,\ul0\nosupersub\cf7\f8\fs24 Kementerian \line \tab \up0
\expndtw-3\charscalex100 Kesehatan Republik Indonesia, \par\pard\ql \li1440\sb0\sl-
313\slmult0 \par\pard\ql\li1440\ri1511\sb13\sl-313\slmult0\tx2006\tx2006\tx2006
\up0 \expndtw-2\charscalex100 Department of Child and Adolescent Health and
Development (CAH), 2009,\ul0\nosupersub\cf8\f9\fs24 Buku \line\tab \up0 \expndtw-
4\charscalex100 Saku Pelayanan Kesehatan Anak di Rumah Sakit:
P\ul0\nosupersub\cf31\f32\fs19 EDOMAN\ul0\nosupersub\cf8\f9\fs24
B\ul0\nosupersub\cf31\f32\fs19 AGI\ul0\nosupersub\cf8\f9\fs24
R\ul0\nosupersub\cf31\f32\fs19 UMAH \line \tab \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf8\f9\fs24 S\ul0\nosupersub\cf31\f32\fs19
AKIT\ul0\nosupersub\cf8\f9\fs24 R\ul0\nosupersub\cf31\f32\fs19
UJUKAN\ul0\nosupersub\cf8\f9\fs24 T\ul0\nosupersub\cf31\f32\fs19
INGKAT\ul0\nosupersub\cf8\f9\fs24 P\ul0\nosupersub\cf31\f32\fs19 ERTAMA
DI\ul0\nosupersub\cf8\f9\fs24 K\ul0\nosupersub\cf31\f32\fs19
ABUPATEN\ul0\nosupersub\cf8\f9\fs24 /K\ul0\nosupersub\cf31\f32\fs19
OTA\ul0\nosupersub\cf8\f9\fs24 .\ul0\nosupersub\cf7\f8\fs24
W\ul0\nosupersub\cf32\f33\fs19 OLD\ul0\nosupersub\cf7\f8\fs24
H\ul0\nosupersub\cf32\f33\fs19 EALTH \line \tab \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf7\f8\fs24 O\ul0\nosupersub\cf32\f33\fs19 RGANIZATION \par\pard\ql
\li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb251\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 415
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg416}
{\bkmkend Pg416}\par\pard\ql \li1440\sb0\sl-310\slmult0 \par\pard\ql\li1440\sb0\sl-
310\slmult0 \par\pard\ql\li1440\sb0\sl-310\slmult0
\par\pard\ql\li1440\ri1180\sb234\sl-310\slmult0\tx2006\tx2006 \up0 \expndtw-
3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Direktorat Jenderal Gizi dan Kesehatan
Ibu dan Anak Direktorat Kesehatan Ibu, 2012, \line\tab \up0 \expndtw0\charscalex103
\ul0\nosupersub\cf8\f9\fs24 Buku Saku Pelayanan Kesehatan Neonatal Esensial
di Rumah Sakit\ul0\nosupersub\cf7\f8\fs24 , \line \tab \up0 \expndtw-
3\charscalex100 Kementerian Kesehatan Republik Indonesia \par\pard\ql
\li1440\sb0\sl-320\slmult0 \par\pard\ql\li1440\ri1182\sb2\sl-
320\slmult0\tx2006\tx2006 \up0 \expndtw-3\charscalex100 Direktorat Jenderal Gizi
dan Kesehatan Ibu dan Anak Direktorat Kesehatan Ibu, 2015, \line\tab \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf8\f9\fs24 Pedoman Pelayanan Antenatal
Terpadu di Rumah sakit, Ed.2\ul0\nosupersub\cf7\f8\fs24 Kementerian \line \tab
\up0 \expndtw-3\charscalex100 Kesehatan Republik Indonesia. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-276\slmult0 \up0 \expndtw-
3\charscalex100 Direktorat Jenderal Gizi dan Kesehatan Ibu dan Anak Direktorat
Kesehatan Ibu, 2012, \par\pard\qj \li2006\ri1243\sb0\sl-320\slmult0 \up0 \expndtw-
2\charscalex100 \ul0\nosupersub\cf8\f9\fs24 P e d o m a n Peralatan Medik bagi
pelayanan Kesehatan Bayi Baru Lahir, Bayi \up0 \expndtw0\charscalex104 dan Balita,
Pengoperasian dan Pemeliharaan,\ul0\nosupersub\cf7\f8\fs24 Kesehatan
Kementerian \up0 \expndtw-3\charscalex100 Kesehatan Republik Indonesia \par\pard\qj
\li1440\ri1186\sb308\sl-320\slmult0\tx2006 \up0 \expndtw-3\charscalex100 Direktorat
Jenderal Gizi dan Kesehatan Ibu dan Anak Direktorat Kesehatan Ibu, 2015,
\line\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf8\f9\fs24 Pedoman Audit
Maternal Neonatal\ul0\nosupersub\cf7\f8\fs24 , Kementerian Kesehatan Republik
Indonesia. \par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb81\sl-
276\slmult0 \up0 \expndtw-3\charscalex100 Direktorat Jenderal Gizi dan Kesehatan
Ibu dan Anak Direktorat Kesehatan Ibu, 2015, \par\pard\qj \li2006\ri1190\sb0\sl-
320\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf8\f9\fs24 Panduan
Operasional Pelayanan persalinan dan nifas Normal bagi Tenaga \up0 \expndtw-
4\charscalex100 kesehatan,\ul0\nosupersub\cf7\f8\fs24 Kementerian Kesehatan
Republik Indonesia. \par\pard\ql \li1440\sb0\sl-276\slmult0
\par\pard\ql\li1440\sb69\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Direktorat
Jenderal Gizi dan Kesehatan Ibu dan Anak Direktorat Kesehatan Ibu, 2009,
\par\pard\qj \li2006\ri1241\sb8\sl-320\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf8\f9\fs24 Pedoman Pelayanan Kesehatan Bayi Berat Lahir
Rendah dengan Metoda \line \up0 \expndtw-1\charscalex100 Kanguru di RS dan
Jejaringnya.\ul0\nosupersub\cf7\f8\fs24 Departemen Kesehatan Republik
IndonesiaI. \par\pard\ql \li1440\sb0\sl-320\slmult0
\par\pard\ql\li1440\ri1187\sb300\sl-320\slmult0\tx2006\tx2006 \up0 \expndtw-
3\charscalex100 Direktorat Jenderal Gizi dan Kesehatan Ibu dan Anak Direktorat
Kesehatan Ibu, 2009, \line\tab \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf8\f9\fs24 Program Rumah sakit Sayang Ibu dan
Bayi\ul0\nosupersub\cf7\f8\fs24 , Departemen Kesehatan Rumah \line \tab \up0
\expndtw-3\charscalex100 sakit. \par\pard\ql \li1440\ri1184\sb320\sl-
320\slmult0\tx2006\tx2006 \up0 \expndtw-3\charscalex100 Direktorat Jenderal Gizi
dan Kesehatan Ibu dan Anak Direktorat Kesehatan Ibu, 2010, \line\tab \up0 \expndtw-
1\charscalex100 Keputusan Menkes RI No: 230/SK/II/2010
tentang:\ul0\nosupersub\cf8\f9\fs24 Pedoman Rawat Gabung, \line \tab \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Departemen Kesehatan Republik
Indonesia. \par\pard\ql \li1440\ri1242\sb300\sl-320\slmult0\tx2006\tx2006 \up0
\expndtw0\charscalex102 Direktorat Jenderal Bina Pelayanan Medik,
2010,\ul0\nosupersub\cf8\f9\fs24 Pedoman Manajerial Pelayanan \line\tab \up0
\expndtw0\charscalex100 Tuberkulosis dengan strategi DOTS di Rumah
Sakit\ul0\nosupersub\cf7\f8\fs24 , Departemen Kesehatan \line \tab \up0 \expndtw-
3\charscalex100 Republik Indonesia. \par\pard\ql \li1440\ri1242\sb320\sl-
320\slmult0\tx2006\tx2006
\up0 \expndtw0\charscalex100 Direktorat Bina Upaya Kesehatan,
2012,\ul0\nosupersub\cf8\f9\fs24 Pedoman Pencegahan dan Pengendalian \line\tab
\up0 \expndtw-1\charscalex100 Infeksi Tuberkulosis di Fasilitas Pelayanan
Kesehatan\ul0\nosupersub\cf7\f8\fs24 , Departemen Kesehatan \line \tab \up0
\expndtw-2\charscalex100 Republik Indonesia. \par\pard\qj \li1440\ri1181\sb300\sl-
320\slmult0\tx2006 \up0 \expndtw-4\charscalex100 Joint Commission International
Accreditation Standard for Hospital, 2011, 4\ul0\super\cf29\f30\fs24
th\ul0\nosupersub\cf7\f8\fs24 ed., Joint \line\tab \up0 \expndtw-4\charscalex100
Commission International, A division of Joint Commission Resources, Inc.
\par\pard\ql \li5786\sb0\sl-253\slmult0 \par\pard\ql\li5786\sb0\sl-253\slmult0
\par\pard\ql\li5786\sb150\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 416
\par\pard\sect\sectd\fs24\paperw11900\paperh16820\pard\sb0\sl-240{\bkmkstart Pg417}
{\bkmkend Pg417}\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb0\sl-
276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0\tx9724 \up0
\expndtw0\charscalex100 \ul0\nosupersub\cf7\f8\fs24 Joint Commission International
Accreditation Standard for Hospital, 2013, \tab \up0 \expndtw-2\charscalex100
5\ul0\super\cf29\f30\fs24 th\ul0\nosupersub\cf7\f8\fs24 ed., \par\pard\ql
\li2006\sb44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 Joint Commission
International, A division of Joint Commission Resources, Inc.
\par\pard\li1440\sb0\sl-276\slmult0\par\pard\li1440\sb85\sl-
276\slmult0\fi0\tx3074\tx4358\tx5990\tx7410\tx9000\tx10086 \up0 \expndtw-
1\charscalex100 Keputusan\tab \up0 \expndtw-1\charscalex100 Menteri\tab \up0
\expndtw-1\charscalex100 Kesehatan\tab \up0 \expndtw-1\charscalex100
Republik\tab \up0 \expndtw-1\charscalex100 Indonesia,\tab \up0 \expndtw-
1\charscalex100 2007,\tab \up0 \expndtw-1\charscalex100
No.\par\pard\li1440\sb38\sl-276\slmult0\fi566\tx6650 \up0 \expndtw-1\charscalex100
1035/MENKES/SK/IX/2007, tentang:\tab \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf8\f9\fs24 Pedoman Tata Naskah Dinas,\par\pard\ql
\li2006\sb33\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf7\f8\fs24 Departemen Kesehatan Republik Indonesia.
\par\pard\ql \li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb88\sl-276\slmult0
\up0 \expndtw-4\charscalex100 Keputusan Kementerian Kesehatan, 2008,
No.129/Menkes/SK/II/2008 \par\pard\qj \li2006\ri1242\sb8\sl-320\slmult0 \up0
\expndtw-2\charscalex100 Tentang:\ul0\nosupersub\cf8\f9\fs24 Standar Pelayanan
Minimal di Rumah Sakit,\ul0\nosupersub\cf16\f17\fs24 ,\ul0\nosupersub\cf7\f8\fs24
Departemen Kesehatan \up0 \expndtw-3\charscalex100 Republik Indonesia. \par\pard\ql
\li1440\sb0\sl-276\slmult0 \par\pard\ql\li1440\sb61\sl-276\slmult0 \up0 \expndtw-
4\charscalex100 Keputusan Kementerian Kesehatan, 2014, No. HK.
02.02/MenKes/305/2014 \par\pard\qj \li2006\ri1245\sb8\sl-320\slmult0\tx3467 \up0
\expndtw-3\charscalex100 Tentang: \tab \up0 \expndtw0\charscalex101
\ul0\nosupersub\cf8\f9\fs24 Pedoman Nasional Pelayanan Kedokteran Tata
Laksana \line\up0 \expndtw-3\charscalex100 Tuberkulosis,\ul0\nosupersub\cf7\f8\fs24
Departemen Kesehatan Republik Indonesia. \par\pard\qj \li1440\ri1223\sb320\sl-
320\slmult0\tx2006 \up0 \expndtw-2\charscalex100 Konsil Kedokteran Indonesia,
2006,\ul0\nosupersub\cf8\f9\fs24 Manual Rekam
Medis,\ul0\nosupersub\cf7\f8\fs24 Indonesian Medical \line\tab \up0 \expndtw-
3\charscalex100 Council \par\pard\qj \li1440\ri1236\sb300\sl-320\slmult0\tx2006
\up0 \expndtw0\charscalex102 Pedoman Pelayanan Perinatal Pada Rumah Sakit Umum
Kelas C dan D, Depkes, \line\tab \up0 \expndtw-3\charscalex100 1991, Departemen
Kesehatan Republik Indonesia. \par\pard\qj \li1440\ri1247\sb320\sl-
320\slmult0\tx2006 \up0 \expndtw0\charscalex105 Pedoman Pelayanan Maternal dan
Perinatal Pada RS Umum kelas B, C dan D, \line\tab \up0 \expndtw-3\charscalex100
Depkes, 2009, Departemen Kesehatan Republik Indonesia. \par\pard\qj \li1440\sb0\sl-
300\slmult0 \par\pard\qj\li1440\ri1240\sb37\sl-300\slmult0\tx2006 \up0
\expndtw0\charscalex100 Panduan Manajemen Masalah Bayi Baru Lahir untuk Dokter,
Bidan, dan Perawat di \line\tab \up0 \expndtw-1\charscalex100 Rumah Sakit, IDAI -
Depkes, 2004 \par\pard\qj \li1440\sb0\sl-320\slmult0
\par\pard\qj\li1440\ri1248\sb4\sl-320\slmult0\tx2006 \up0 \expndtw0\charscalex103
Pedoman Pelayanan Maternal Perinatal Pada Rumah Sakit Umum Kelas B (non
\line\tab \up0 \expndtw0\charscalex103 pendidikan), C dan D, Depkes, \up0
\expndtw0\charscalex100 2006, Departemen Kesehatan Republik \par\pard\ql
\li2006\sb37\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Indonesia.
\par\pard\qj \li1440\sb0\sl-320\slmult0 \par\pard\qj\li1440\ri1239\sb8\sl-
320\slmult0\tx2006 \up0 \expndtw0\charscalex100 Pedoman Pelaksanaan Program Rumah
Sakit Sayang Ibu dan Bayi, 2009, Depkes, \line\tab \up0 \expndtw-3\charscalex100
Departemen Kesehatan Republik Indonesia. \par\pard\ql \li1440\ri1251\sb300\sl-
320\slmult0\tx2006\tx2006 \up0 \expndtw0\charscalex100 Pedoman Nasional
Pengendalian Tubercolosis Kemkes RI Dirjen Pengendalian \line\tab \up0 \expndtw-
1\charscalex100 Penyakit dan Penyehatan Lingkungan 2014, Departemen Kesehatan
Republik \line \tab \up0 \expndtw-3\charscalex100 Indonesia. \par\pard\ql
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\line \tab \up0 \expndtw-3\charscalex100 Departemen Kesehatan Republik
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79 Tahun 2014 \line\tab \up0 \expndtw-3\charscalex100
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Departemen Kesehatan Republik Indonesia. \par\pard\ql \li1440\ri2336\sb300\sl-
320\slmult0\tx1908\tx1908 \up0 \expndtw-3\charscalex100 Peraturan Menteri Kesehatan
Republik Indonesia, 2015, No. 8 tahun 2015 \line\tab \up0 \expndtw-3\charscalex100
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3\charscalex100 tahun 2010 tentang Persyaratan Kualitas air minum \par\pard\qj
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Kesehatan No 54 thn \line\tab \up0 \expndtw-5\charscalex100 2015 tentang Pengujian
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Pedoman perencanaan dan penyiagaan bencana bagi \line\tab \up0 \expndtw-
4\charscalex100 Rumah Sakit \par\pard\ql \li5786\sb0\sl-253\slmult0
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\par\pard\ql\li5786\sb73\sl-253\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs22 421 \par\pard\sect\sectd\fs24}