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INFECTION CONTROL RISK ASSESMENT

UNIT : ___________________ TAHUN :

Probability / Frekuensi Risk/Impact (Health, Financial, Legal, Regulatory) Current Systems/Preparedness

Potential
5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
Risks/

Problems

Clinical/ financial
(function/financi
limbFunction/j
Score

Loss of life/

Prolonged
Serious Loss

Moderate
Length of
financial

financial
Minimal

Clinical/
Expect it

Maybe

legal

stay
Likely

Never

Solid
al/

Poor
Rare

Good
none

Fair
Mengetahui , Pembuat,

Dr Lisa Retno Sp. THT IPCN / IPCLN


Skala Prioritas ICRA
No JENIS SKOR PRIORITAS TUJUAN UMUM TUJUAN KHUSUS STRATEGI EVALUASI PROGRESS/ANALISIS
KELOMPOK
RISIKO
IDENTIFIKASI MASALAH PENCEGAHAN DAN PENGENDALIAN INFEKSI

RS LNG BADAK

UNIT : ___________________ TANGGAL : ______________________

IPCN / IPCLN : ___________________

NO MASALAH PPI REKOMENDASI KET

Mengetahui , Pembuat,

Dr Lisa Retno Sp. THT IPCN / IPCLN