LAPORAN CEKLIST CLINICAL PATHW

BRPN
Bulan Maret
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1 An. Cahya Ramadan 16/6/2016 186637 5/3/17 8/3/2017 4

2 An. Lianu Sofi 6/6/16 172580 6/3/17 9-3-207 4

3 An. Denis 11/3/16 175608 5/3/17 9/3/2017 5

4 An. Hisyem 21/12/2014 187461 16-3-2017 20-3-2017 5

5 An. Satria Dirga 22/8/2011 174721 17-3-2017 21-3-2017 5
6 An. Kanaya 05/12/16 183253 29-3-2017 2/4/2017 5

LAPORAN CEKLIST CLINICAL PATHW

BRPN
Bulan April
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1 An. Nayla Rosidah 09/09/16 188520 1/4/17 4/4/2017 4

2 An. Hibar 18/7/2017 189044 8/4/17 11/4/2017 4

3 An. Alisha 09/19/15 159128 9/4/17 12/4/2017 4

4 An. Al Rafaeyza 19/8/2016 173304 15/4/2017 20/4/2017 6

5 An. Haris Atha 14/10/2014 163228 15/4/2017 19/4/2017 5

6 An. Griselda 23/11/2016 190127 24/4/2017 28/4/2017 5

LAPORAN CEKLIST CLINICAL PATHW

BRPN
Bulan Mei
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1 An.Fadlan M 29/3/2014 113700 10/5/17 13/5/2017 4
2 An.Tristan 16/3/2017 190659 2/5/17 12/5/2017 11

3 An.Zakra 2/4/16 163979 6/5/17 12/5/2017 7

4 An. Zain Arkan 24/9/2016 175441 9/5/2017 13/5/2017 5

5 An. Hafiz 30/6/2014 121314 6/5/2017 9/5/2017 4

6 An. Zakiyul 3/11/16 178715 2/5/2017 6/5/2017 5

7 An. Drajat Aryo 4/3/17 186627 10/5/2017 15/5/2017 6

8 An. Zahwa M 2/4/16 163979 6/5/2017 12/5/2017 7

9 An. Isnanda 12/3/15 151246 5/5/2017 8/5/2017 4

10 An. Firli 24/6/2016 191158 9/5/2017 12/5/2017 4

T CLINICAL PATHWAY
BRPN

DIAGNOSA
VARIAN KET
MASUK UTAMA
BrPn BrPn Inj. Dexamet,Inj.3A
Pct Drop,Citirizin srup
Brpn,Diare Coklat, BrPn Pct Infus,Zinc,Lactodia,dexamet
Tidak Sesek Puyer,Ambrocol,salbutamol
Obs dyspnew BrPn Venflow H III
Susp. BrPn
BrPn BrPn asupan gizi80% tdk tercapai
BrPn BrPn
BrPn BrPn Inj. Dexa,cefo,Gentanisin
Inj. Amikasin

T CLINICAL PATHWAY
BRPN

DIAGNOSA
VARIAN KET
MASUK UTAMA
DADR,BrPn BrPn Electrolit, GDS,Kalsium.Infus,
Zink,Lbio
BrPn BrPn Lab: GDS
Fisio 1x,Farmasi (-),Dietizen 1x
BrPn BrPn GDS,Inj. Dexamet,tremeza
Fisio (-),Farmasi (-),Dietizen 1x
BrPn,BAB tdk Berat BrPn Inj.Dexamet,Pct Infus,Zinc,Lactodia
Farmasi(-),Gizi(-),Lama hari 6 hri
Febria H4, BrPn Lab.GDS,Zink,Lactto-B,Cafixim.
Susp.BrPn
BrPn BrPn Lab. GDS,Tx.= Pct Infus,Kn3A Infus,
Cefixcin,

T CLINICAL PATHWAY
BRPN

DIAGNOSA
VARIAN KET
MASUK UTAMA
BrPn BrPn Lab =+GDS,Diet Gizi datang hrke 3
Farmasi (-),Tx=Inj Dexa met
Pct Infus.
BrPn BrPn Lab +GDS,CRP.lama rawat 11hr
Tx. =Inj.Dexamet,Pct Infus.
BrPn ISD Lab.+GDS,Lama Hari 7hr
Tx=Inj. Dexamet,Pct Infus,Pct Sirup
BrPn BrPn Lab. GDS,,Tx.=Inj. Dexamet,
Cefixcim,Pct Infs
BrPn BrPn Ro=Thorax tdk ada
Tx.=Inj Ranitidin,Inj.Ondarsetron,
Pct. Infus
BrPn BrPn Lab.GDS,Tx. Inj.Dexamet,Pct Infs
Inj. Ranitidin,Kn3A Infs, Zink,L-Bio.
BrPn BrPn Lab.GDS, Lama hari = 6 hari,
Saturasi O2(-)
BrPn, BrPn Lab.GDS, Lama hari = 7 hari
Tx=Inj Dexamet,Pct Infs,Pct Syrup,
Captofril.
BrPn, BrPn Ro.Tho tdk dilakukan,Saturasi O2(-)
Tx.=Inj.Dexamet,Inj.Ranitidin,Pct Inf
BrPn, BrPn Lab.=GDS
 LAPORAN CEKLIST CLINICAL PATHW
KPD
Bulan Maret
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1 Ny. Daryati 1/1/1982 157950 5/3/2017 9/3/2017 5
2 Ny. Sita Riyati 11/6/1994 187150 13/3/2017 18/3/2017 6

3 Ny. Julaikha 11/12/1993 184791 4/3/2017 5/3/2017 2

4 Ny. Isnaeni 17/6/1996 186566 5/3/2017 6/3/2017 2

5 Ny. Sumiati 10/8/1981 184856 5/3/17 9/3/2017 5

6 Ny. Kapsah 10/10/1986 187629 19/3/2017 20/3/2017 2
7 Ny. Kusmiati 30/8/1986 187961 24/3/2017 25/3/2017 2
8 Ny. Rina Rianti 3/15/1983 188125 27/3/2017 29/3/2017 3
9 Ny. Nita Jerni 1/13/1997 188424 30/3/2017 31/3/2017 2
10 Ny. Laela Lestari 2/14/1982 111138 26/3/2017 30/3/2017 5
11 Ny. Parniti 1/11/1994 188152 27/3/2017 29/3/2017 3
12 Ny. Supriani 3/10/1983 188095 25/3/2017 29/3/2017 5

LAPORAN CEKLIST CLINICAL PATHW

KPD
Bulan April
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1 Ny. Nur Amanah 16/12/1996 187496 3/4/2017 6/4/2017 4

2 Ny. Mujiati 10/12/1985 188396 4/4/2017 5/4/2017 2

3 Ny. Supriyatin 1/4/1984 188612 6/4/2017 7/4/2017 2

4 Ny. Puput Ristiani 9/29/1994 188886 5/4/2017 7/4/2017 3

5 Ny. Sivi Mutmainah 4/27/1998 188992 7/4/2017 8/4/2017 2

6 Ny. Casikem 10/5/1980 185436 11/4/2017 12/4/2017 2

7 Ny. Andiyah 4/26/1981 188981 11/4/2017 12/4/2017 2

8 Ny. Daryati 28/12/1976 189123 9/4/2017 10/4/2017 2

 9 Ny. Ria Ariyanti 9/15/1992 187178 8/4/2017 10/4/2017 3
10 Ny. Endah Aprianingsih 4/20/1993 189487 13/4/2017 15/4/2017 3

11 Ny. Ambar F 4/21/1987 148146 15/4/2017 18/4/2017 4

12 Ny. Wairoh 1/5/1982 188157 16/4/2017 18/4/2017 3

13 Ny. Sugesti P 9/4/1997 189520 14/4/2017 17/4/2017 4

14 Ny. Ismi Zahro 3/8/1997 186449 18/4/2017 19/4/2017 2

LAPORAN CEKLIST CLINICAL PATHW

KPD
Bulan Mei
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1
T CLINICAL PATHWAY
KPD

DIAGNOSA
VARIAN KET
MASUK UTAMA
g3p2a1H41+1, KPD KPD Inj. Ketorolac, Inj. Tramadol Cito
G2P1A2H33,KPD KPD Inj. Ketoralac,tramadol,
koltropen supp, Nijedipin,
Cefodroxil 2x1 (Bkn 3x1)?
KPD KPD
KPD KPD Apoteker (-)
Edukasi Kebidanan=ckup 1x
G1P2A2H37,KPD KPD
G4P2A1H38,KPD KPD Apoteker (-)
G2P1A0H38+1,KPD KPD Apoteker (-)
G4P1A2H38,KPD KPD Apoteker (-)
G1P0A0H39,KPD KPD
G2P1A0H39+3,KPD KPD Apoteker (-) SC
G1P0A0H40+2,KPD KPD Lab:Kimia Klinik,protein urin
g2p1a0h38,KPD KPD Lab: GDS,Inj.Keterolac, SC

T CLINICAL PATHWAY
KPD

DIAGNOSA
VARIAN KET
MASUK UTAMA
G1P0A0H40+3,KPD KPD,CPD Dietizen 1x,Inj. Ketorolac, SC Cito
Inj. Tramadol
Fiso+farmasi (-)
G1P0A0H42+4,KPD KPD Dietizen 1x
Fisio dan Farmasi (-)
G1P0A0,KPD KPD Dietizin 1x
Farmasi (-)
G1P0A0H36+6,KPD KPD Dietizen 1x,GDS.
Farmasi (-)
G1POAOH37,KPD KPD Dietizen 1x,GDS.
Farmasi (-)
G3P2A0H37,KPD KPD Lab.GDS,CRP Farmasi(-) Induksi
Dietizen 1x,oxitosin
G3P2A0H40+5,KPD KPD Dietizen 1x,oxitosin
Farmasi (-)
G3P1A1H38+1,KPD KPD Dietizen 1x Induksi
 Farmasi (-)
G1P0A0H38,KPD KPD inj.oxitosin Induksi
G1P0A0H39+6,KPD KPD GDS,Inj. Oxitosin.
Farmasi (-)
G4P1A2H38,KPD KPD Protein urin,gds,elektrolit SC
Inj.Tramadol,katarolac,oxitosin
G1P0A0H39+5,KPD KPD Misoprostol 1/8tab Intubasi
G1POAOH40+3,KPD KPD Inj. Tramadol,ketorolac SC Cito
Farmasi (-)
G1P0A0H37+5,KPD KPD Induksi

T CLINICAL PATHWAY
KPD

DIAGNOSA
VARIAN KET
MASUK UTAMA
 LAPORAN CEKLIST CLINICAL PATH
SNH
Bulan Maret
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1 Ny. Rasem 31/12/1936 187291 14/3/2017 20/3/2017 7

2 Ny. Kuslinah 16/4/1964 182310 14/3/2017 18/3/2017 5

3 Tn. Cahyono 31/12/1960 188241 28/3/2017 1/4/2017 5
4 Ny. Tumini 8/10/1953 188237 28/3/2017 3/4/2017 8
5 Ny. Karni 3/2/1965 187630 19/3/2017 25/3/2017 7

LAPORAN CEKLIST CLINICAL PATH

SNH
Bulan April
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1 Ny. Nasiyah 31/12/1945 188785 4/4/2017 11/4/2017 8
2 Tn. Suherman 25/4/1977 188708 4/4/2017 10/4/2017 7

3 Tn. Aswadi 7/9/1959 166770 5/4/2017 10/4/2017 6

4 Tn. Kaman 5/5/1937 19331 4/4/2017 10/4/2017 7

5 Tn. Rusmadi 31/12/1945 188977 7/4/2017 13/4/2017 7

LAPORAN CEKLIST CLINICAL PATH

SNH
Bulan Mei
TANGGAL JML HARI
No Nama Tgl Lahir RM
MASUK KELUAR DIRAWAT
1
LIST CLINICAL PATHWAY
SNH

DIAGNOSA
VARIAN KET
MASUK UTAMA
SNH SNH Inj. Furosemid (Extra)
Inj. Diphenhidramin
HT Emergency SNH
SNH SNH
SNH dg HT Emergency SNH
SNH SNH

LIST CLINICAL PATHWAY

SNH

DIAGNOSA
VARIAN KET
MASUK UTAMA
SNH,HT SNH SGOT, SGPT,Hari > 1
HT Emergency TIA SNH OMZ,Valseftan
Inj. Citicolin 500mg
Susp SH SNH Inj. Cefepim,manitol,valsartan
Depakote
SNH SNH Valsartan,Citaz 50mg
SNH SNH SGOT, SGPT, Inj. Ceftriaxon

LIST CLINICAL PATHWAY

SNH

DIAGNOSA
VARIAN KET
MASUK UTAMA