You are on page 1of 2

PANDUAN PRAKTIK KLINIS (PPK

)
RS BUDI KEMULIAAN
JAKARTA
2013 – 2015
……………………………………………………………………………………………........................

1. Pengertian (Definisi)

…………………………………………………………………………………………………………………..

2. Anamnesis

…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..

3. Pemeriksaan Fisik

…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………

4. Kriteria Diagnosis

5. Diagnosis Kerja
6. Diagnosis Banding

7. Pemeriksaan Penunjang

1.
2.
3.
4.
5.

…………………………………………………………………………………………………….
……………………………………………………………………………………………………
……………………………………………………………………………………………………
…………………………………………………………………………………………………..
…………………………………………………………………………….........................

……………………………………………………………………………………………….
1.
2.
3.

………………………………………………………………………………………………….
………………………………………………………………………………………………….
…………………………………………………………………………………………………

1.
2.
3.
4.
5.

……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………........

1

8. Terapi

1.
2.
3.
4.
5.

……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………........

9. Edukasi

1.
2.
3.
4.
5.

……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………........

10. Prognosis
11. Tingkat Evidens
12. Tingkat Rekomendasi
13. Penelaah Kritis

14. Indikator Medis
15. Kepustakaan

Ad vitam
: dubia ad bonam/malam
Ad sanationam : dubia ad bonam/malam
Ad fumgsionam : dubia ad bonam/malam
I/II/III/IV
A/B/C
1.
2.
3.
4.

……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………

………………………………………………………………………………………………
……………………………………………………………………………………………..
……………………………………………………………………………………………..
1.
……………………………………………………………………………………
2.
……………………………………………………………………………………
3.
……………………………………………………………………………………
4.
……………………………………………………………………………………
5.
……………………………………………………………………………........

Jakarta ………………………………….2013
Ketua Komite Medik
....................................

Ketua SMF...............................................
......................................

Direktur RS Budi Kemuliaan Jakarta

....................................................................................
2