JADWAL DINAS RAWAT INAP II BULAN MARET 2019

TANGGAL
NO NAMA PEND P S M SO L JAM
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Saadah AMK P P L P P P L P P L P P P P P P L P P P P P P L P P P P P P L 25 0 0 0 6 175
TIM I
1 Dwi Agustini D3 Kep M L S S L P P M M L L P S S S S L S M M L P P SO L S S S M M L 5 10 7 1 8 182
2 Wiyoso D3 Kep P S S L P L M M L P P S S L M M L P P L S S M M L P P L S P M 9 7 7 0 8 182
3 Yulianti D3 Kep L M M L P P S M M L S P P P L M M L L P P M L L S S P P L S M 9 5 8 0 9 178
4 Imam Subhan D3 Kep L P L P S M M L P P S M M L P P L M M L P P M M L S S P P L SO 10 4 8 1 8 185
5 Maulida D3 Kep P L SO S M M L P S SO P S L M M L P P S S S L S L M M L S S S P 6 10 6 2 7 186
6 Ragil Trimartono Skep.Ners L P P M M L P L S L M M L S S S S L P S M M L S P P M M L L P 7 7 8 0 9 178
TIM II
7 Sofiati D3 Kep M M L S S S L S S M M L L P P S M M L P S S S L P L M L S C C 4 10 7 0 8 182
8 Parmini D3 Kep S L P M M L S P P S P L M M L P P S S S L S P P M M L L P P S 10 8 6 0 7 186
9 Hidayaturrohmah D3 Kep S S L P S S SO S L M M L P S S C C C C M M L L P S L M M L S S 3 10 6 1 7 186
10 Wahyuningsih D3 Kep S S M M L S L S L S S S S M M L S S S M L L S S S L S S M M L 0 16 7 0 8 182
11 Orientasi P P SO L SO SO L S SO SO SO SO SO L P P SO SO P SO L P SO SO SO SO SO L 6 1 0 16 5 161
0 0 0 0 0 0
0 0 0 0 0 0

11 Insriyati SLTA P P L P P P L P P L P P P P P P L P P P P C P L P P P P P P L 24 0 0 0 6 175

12 Rina Hidayat SLTA P P L P P P L P P L P P P P P P L P P P P P P L P P P P P P L 25 0 0 0 6 175
Catatan : SHIFT 181
PJ shif PAGI 5 5 2 6 6 5 2 5 5 2 6 5 5 5 5 5 2 6 6 5 5 5 5 2 6 5 5 5 5 5 2
HARI MINGGU SIANG 3 3 2 3 3 3 2 3 3 2 4 3 3 3 3 3 2 3 3 3 3 3 3 2 3 3 3 3 3 3 2
Rujuk MALAM 2 2 2 3 3 2 2 3 2 2 3 2 2 3 3 2 2 2 2 3 2 2 2 2 2 2 3 2 2 2 2
Cadangan SO 0 0 1 0 0 1 1 1 1 1 0 1 1 1 1 1 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1
SO : 11 - 18 CUTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 0 0 0 0 0 1 1
LIBUR 3 3 6 2 2 3 7 2 3 7 1 3 3 2 2 2 7 2 2 2 3 3 3 7 3 3 2 3 3 2 6
JUMLAH 13 13 13 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14

SISTEM PENUGASAN SHIFT PAGI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 DWI: D IMAM: I SAADAH:S

1 DALAM & SYARAF K I P I Y Y D P P W P Y Y Y F P P K K Y Y D P P F K Y Y P K M YOSO: K MAULIDA:M
2 ANAK & THT M R R H W D R M II I W D H F I I M M R F I I D H R R K I I I R YULI: Y RAGIL : R
3 BEDAH & MATA M R R H W D R M R I W D H F I I M M R F I I D H R R K I I I R SOFI:F HIDA : H
MINI:P WAHYUNI:W
Mengetahui
Bidang Keperawatan Kepala Ruang Rawat Inap III

Johar Nuraini, Skep.Ners Sa'adah, AMK

 JADWAL DINAS RAWAT INAP II BULAN APRIL 2019
TANGGAL
NO NAMA PEND P S M SO L JAM
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
1 Saadah AMK P P L P P P L P P P P P P L P P P P L P L P P P P P P L P P 24 0 0 0 6 168
TIM I
1 Dwi Agustini D3 Kep P P S S L P S M M L S S L P M L S S S M L L S M L L P S M M 5 10 7 0 8 175
2 Wiyoso D3 Kep M L L P I I I L P P M L P S S M L L P P M M L P S S S M L L 7 5 6 0 9 144
3 Yulianti D3 Kep L C P P M M L C P S C P P S S S M L M L S S S L C P M L P P 8 7 5 0 6 183
4 Maulida D3 Kep M M L L P P L S S M L S S L P S P M L P P P M L S S S L S M 7 9 6 0 8 172
5 Ragil Trimartono Skep.Ners S P P L S S M M L L L S M M L P C C C C C C P P M M L L P L 6 4 6 0 8 172
6 Lailatul Husna Skep.Ners M L P S S M L S L P M M L P P M L S S S S M M L P P S L P S 7 9 7 0 7 182

TIM II
7 Imam Subhan D3 Kep L M M L P S P L S L P M M L P P M M L S L P S S P L P P M L 9 5 7 0 9 168
8 Ida Novita Sari D3 Kep S S L M M L P P L P M L S S M M L P P S S S L M M L L S L P 6 8 7 0 9 168
9 Puji Lestari D3 Kep P L M M L L C P S S P M L L L P P P M M L L P C P P M M L S 9 3 7 0 9 168
10 Wahyuningsih D3 Kep S S S M L S S S M M L L C P L S S C C L M M L S L M L P S S 2 11 6 0 8 172
11 Abdul khamid Skep.Ners P L L P P L SO M M L S P S M M L P S S L P S M M L C C C L P 7 5 6 1 8 172
12 Siti Nur Farida D3 Kep L S S S M M L P P S S P P L S L S P P L P P P S S S L SO S M 9 11 3 1 6 177
0 0 0 0 0 0

11 Insriyati SLTA P P L P P P L P P P P P P L P P P P L P L P P P P P P L P P 24 0 0 0 6 168

12 Rina Hidayat SLTA P P L P P P L P P P P P P L P P P P L P L P P P P P P L P P 24 0 0 0 6 168
Catatan : SHIFT 170
PJ shif PAGI 6 5 3 6 6 5 2 6 6 6 5 6 6 3 6 6 6 6 3 5 3 6 6 5 6 6 5 2 6 6 0
HARI MINGGU SIANG 3 3 3 3 2 3 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 2 3 3 0
Rujuk MALAM 3 2 2 3 3 3 1 3 3 2 3 3 2 2 3 3 2 2 2 2 2 3 3 3 2 2 2 2 2 3 0
Cadangan SO 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
SO : 11 - 18 CUTI 0 1 0 0 0 0 1 1 0 0 1 0 1 0 0 0 1 2 2 1 1 1 0 1 1 1 1 1 0 0 0
LIBUR 3 4 7 3 3 3 7 2 3 4 3 3 3 7 3 3 3 2 5 4 6 2 3 3 3 3 4 7 4 3 0
JUMLAH 15 15 15 15 14 14 14 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15

SISTEM PENUGASAN SHIFT PAGI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 DWI: D IMAM: I SAADAH:S

1 DALAM & SYARAF D D Y Y I D N P Y H D Y M P P P Y P Y H Y M P H P P D I R Y YOSO: H MAULIDA:M IDA :N
2 ANAK & THT P R R K M M L L H N I H H W R M F N L M F F F R L L I W L N YULI: Y RAGIL : R PUJI:P
3 BEDAH & MATA K R L H K M I N F L I K H L L R P N N M K I R R I Y I F K N Kamid:K HIDA : H LAILATUL:L
WAHYUNI:W FARIDA:F
Mengetahui
Bidang Keperawatan Kepala Ruang Rawat Inap III
Johar Nuraini, Skep.Ners Sa'adah, AMK
 7 7 10 7 7
PAGI SIANG MALAM SO CUTI JUMLAH
168 0 0 0 0 168
0 0 0 0 0
35 70 70 0 0 175
49 35 60 0 0 144
56 49 50 0 28 183
49 63 60 0 0 172
42 28 60 0 42 172
49 63 70 0 0 182

63 35 70 0 0 168
42 56 70 0 0 168
63 21 70 0 14 168
14 77 60 0 21 172
49 35 60 7 21 172
63 77 30 7 0 177
0 0 0 0 0 0

168 0 0 0 0 168
168 0 0 0 0 168
 JADWAL DINAS RAWAT INAP II BULAN MEI 2019
TANGGAL
NO NAMA PEND P S M SO L JAM
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Saadah AMK L P P P L P P P P P P L P P P P P P L P P P P P P L P P P L P 25 0 0 0 6 175
TIM I
1 Dwi Agustini D3 Kep L L P S S L P S S M L L P P M M L C C C P P S L P P M L L M M 8 5 6 0 9 172
2 Wiyoso D3 Kep P S L M M L C P S S L M M L L P P P M M L L P S L M L C C P L 7 4 7 0 10 168
3 Yulianti D3 Kep P P L P M M L P P P S L S M M L L S S S L S M M L S S L P P P 9 8 6 0 8 179
4 Maulida D3 Kep M L S S L S M M L L P P L S S S S S L P M M L P P L P M M L S 6 9 7 0 9 175
5 Ragil Trimartono Skep.Ners S M M L P P S L S S M M L L P S S L P M M L P P S L P S M L L 7 8 7 0 9 175
6 Lailatul Husna Skep.Ners L S M M L P P S L S S S M M L P P S S L P L M M L L P P L SO S 7 8 6 1 9 172

TIM II
7 Imam Subhan D3 Kep L P P C C C P M M L L P S L P M M L L P S S L M M L L P P S M 8 4 7 0 9 175
8 Ida Novita Sari D3 Kep L S M L L S S L M L C C P P L P S M M L P S S L M M L S S C P 5 8 6 0 9 172
9 Puji Lestari D3 Kep S L S P S M M L P P P L M M L C P P L S L P S S L P M M L L P 9 6 6 0 9 172
10 Wahyuningsih D3 Kep M M L L P S S S L M L S S S S L M M L S S M M L S L S S S S L 1 14 7 0 9 175
11 Abdul khamid Skep.Ners SO L L S SO M L L P M M L P P P S L P SO M M L P P S SO L P S M L 8 4 6 3 9 172
12 Siti Nur Farida D3 Kep L P S P L P M M L P S SO L S S M M L P P S L L S L S S M M L S 6 9 6 1 9 172
0 0 0 0 0 0

11 Insriyati SLTA L P P P L C P P P P P L P P P P P P L P P P P P P L P P P L P 24 0 0 0 6 175

12 Rina Hidayat SLTA L P P P L P P P P P P L P P P P P P L P P P P P P L P P P L P 25 0 0 0 6 175
Catatan : SHIFT 174
PJ shif PAGI 2 6 5 6 2 5 6 5 6 6 5 2 6 6 6 6 6 6 2 6 6 5 6 6 5 2 6 6 5 2 6
HARI MINGGU SIANG 2 3 3 3 2 3 3 3 3 3 3 2 3 3 3 3 3 3 2 3 3 3 3 3 3 2 3 3 3 2 3
Rujuk MALAM 2 2 3 2 2 3 3 3 2 3 2 2 3 3 2 3 3 2 2 3 3 2 3 3 2 2 2 3 3 2 2
Cadangan SO 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0
SO : 11 - 18 CUTI 0 0 0 1 1 2 1 0 0 0 1 1 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 1 1 1 0
LIBUR TAMBAHAN LIBUR 8 4 4 3 7 2 2 4 4 3 4 7 3 3 4 2 3 3 7 2 3 5 3 3 5 8 4 2 3 7 4
JUMLAH 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15
SISTEM PENUGASAN SHIFT PAGI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 DWI: D IMAM: I SAADAH:S
1 DALAM & SYARAF Y H D D W R D Y Y Y P M D M I H Y Y Y M Y Y H M D P M I Y Y YOSO: HMAULIDA:M IDA :N
2 ANAK & THT H N P F R L L H P P M N N N R L P P L I L P F K M D L L I H YULI: Y RAGIL : R PUJI:P
3 BEDAH & MATA H N I P R F N H K F M F K L R N L K N F N N R R M D R K I H Kamid:K HIDA : H LAILATUL:L
LAILA L WAHYUNI:WFARIDA:F
Mengetahui
Bidang Keperawatan Kepala Ruang Rawat Inap III
Johar Nuraini, Skep.Ners Sa'adah, AMK
 JADWAL DINAS RAWAT INAP II BULAN JANUARI

TANGGAL
NO NAMA PEND
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Saadah AMK L P P P P L P P P P P P L P P P P P
TIM I
1 Dwi Agustini D3 Kep S S M M L L P S S S L P M M L P P P
2 Wiyoso D3 Kep P S C P P C P S M M L L P P M M L L
3 Yulianti D3 Kep L P P L S P M M L P P S L S S S L P
4 Imam Subhan D3 Kep L S S L P M M L P P P L SO P M L P P
5 Maulida D3 Kep P L S M M L L P S S S S L M M L P S
6 Ragil Trimartono Skep.Ners S M M L P SO S P P L M M L L P P S M
TIM II
7 Sofiati D3 Kep I I I P L S M M L P S S S L S M M L
8 Parmini D3 Kep C P S S M M L L P S S M M L L P S S
9 Hidayaturrohmah D3 Kep M M L S L P S M M L P P P S L S S S
10 Wahyuningsih D3 Kep C C M L S S S S L M M L S S S S M M
11 Tony Arifianto Skep.Ners M L P S S L P P S M M L L P P M M L

12 Insriyati SLTA L P P P P L P P P P P P L P P C P P
13 Rina Hidayat SLTA L P P P P L P P P P P P L P P P P P
Catatan : SHIFT
PJ shif PAGI 2 5 5 5 6 2 6 6 6 6 6 5 2 6 5 5 6 6
HARI MINGGU SIANG 2 3 3 3 3 2 3 3 3 3 3 3 2 3 3 3 3 3
Rujuk MALAM 2 2 3 2 2 2 3 3 2 3 3 2 2 2 3 3 3 2
Cadangan SO 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0
SO : 11 - 18 CUTI 2 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0
LIBUR 5 2 1 4 3 6 2 2 3 2 2 4 7 3 3 2 2 3
JUMLAH 13 13 13 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14

Mengetahui
Bidang Keperawatan

Johar Nuraini, Skep.Ners

 II BULAN JANUARI 2018
RUMUS BAKU KRITERIA P
NGGAL 7
P S M SO L JAM
19 20 21 22 23 24 25 26 27 28 29 30 31 PAGI
P L P P P P P P L P P P P 26 0 0 0 5 182 182
0
L P P S L S S M M L P P P 10 8 6 0 7 186 70
S S L P M L S S L C P P M 9 6 6 0 7 186 63
S M M L S P P L M M L S M 8 8 7 0 8 182 56
P L P S S M M L L P S M M 10 5 7 1 8 182 70
S L S M M L L P P M M L S 5 9 8 0 9 178 35
M L L P P S M L L P S S S 8 7 7 1 8 182 56
0
L SO S L P P M M L P P M L 6 6 7 1 8 161 42
L P P P L M L P P M M L P 9 6 7 0 8 182 63
M M L L P S S L SO S M L S 5 10 7 1 8 182 35
L L S S S M L S S S S S L 0 16 6 0 7 186 0
P S M M L P P S S S L P P 10 7 7 0 7 189 70
0 0 0 0 0 0 0
0 0 0 0 0 0 0

P L P P P P P P L P P P P 25 0 0 0 5 182 175
P L P P P P P P L P P P P 26 0 0 0 5 182 182
181
5 2 6 6 6 6 5 5 2 6 6 6 6
3 2 3 3 3 3 3 3 2 3 3 3 3
2 2 2 2 2 3 3 2 2 3 3 2 3
0 1 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0
4 6 3 3 3 2 3 4 7 1 2 3
14 13 14 14 14 14 14 14 14 14 14 14

Kepala Ruang Rawat I InapII

Sa'adah, AMK
RUMUS BAKU KRITERIA PENGHITUNGAN JAM KERJA
7 10 7 7
SIANG MALAM SO CUTI JUMLAH
0 0 0 0 182
0 0 0 0
56 60 0 0 186
42 60 0 21 186
56 70 0 0 182
35 70 7 0 182
63 80 0 0 178
49 70 7 0 182
0 0 0 0 0
42 70 7 0 161
42 70 0 7 182
70 70 7 0 182
112 60 0 14 186
49 70 0 0 189
0 0 0 0 0
0 0 0 0 0

0 0 0 7 182
0 0 0 0 182
 JADWAL DINAS RAWAT INAP II BULAN DESEMBER

TANGGAL
NO NAMA PEND
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Saadah AMK P L P P P P P P L P P P P P C L P P
TIM I
1 Dwi Agustini D3 Kep L P L M M L S P M M L S S S S L S S
2 Wiyoso D3 Kep M M L S S M M L P P S L P P L S S L
3 Yulianti D3 Kep S S C C C S M L L S S S L P P M L L
4 Imam Subhan D3 Kep L SO S S S P L S L L P M M L P P M M
5 Maulida D3 Kep L L P P P P S S L M M L S S P P S M
6 Ragil Trimartono Skep.Ners C C M M L L P P SO S L P P S L SO M M
TIM II
7 Sofiati D3 Kep P M M L S S P M M L L P P M M L P P
8 Parmini D3 Kep P P P L P P M M L L P P S M M L L P
9 Hidayaturrohmah D3 Kep S L S S M M L S S L S S M M L L P S
10 Wahyuningsih D3 Kep S S S L M M L L P S M M L L S S L S
11 Tony Arifianto Skep.Ners M L L P P S S L S P L M M L P M M L

12 Insriyati SLTA P L P P P P L P P P P L P P
13 Rina Hidayat SLTA P L P P P P P P L P P P P P P L P P
Catatan : SHIFT
PJ shif PAGI 5 2 5 5 5 5 5 5 2 5 5 5 5 5 6 2 5 5
HARI MINGGU SIANG 3 2 3 3 3 3 3 3 2 3 3 3 3 3 2 2 3 3
Rujuk MALAM 2 2 2 2 3 3 3 2 2 2 2 3 3 3 2 2 3 3
Cadangan SO 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0
SO : 11 - 18 CUTI 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0
LIBUR 3 6 3 3 1 2 3 4 7 4 4 2 2 3 3 7 3 3
JUMLAH 14 14 14 14 13 13 14 14 14 14 14 13 13 14 14 14 14 14

Mengetahui
Bidang Keperawatan

Johar Nuraini, Skep.Ners

II BULAN DESEMBER 2018
RUMUS BAKU KRITERIA P
NGGAL 7
P S M SO L JAM
19 20 21 22 23 24 25 26 27 28 29 30 31 PAGI
P P P P L P L P P P P L P 24 0 0 0 6 175 168
0
M M L S S S M L P P P S L 5 11 7 0 8 182 35
P P S L M M L P P P S M L 9 7 7 0 8 182 63
P L M M L P L P P P P M M 8 6 6 0 8 179 56
L P P P L C C S M M L P P 9 5 6 0 8 179 63
M L S S L P S S M M L P S 8 10 6 0 7 186 56
L S S L M M L P S C S L S 5 7 6 2 8 179 35
0
P S L S SO L L S S S M L P 8 7 7 1 8 182 56
S S L M L P P C C C C C C 10 3 5 0 7 183 70
S M L P P S P L S S M L P 5 12 6 0 8 179 35
S M M L P S M M L S S L S 2 12 8 0 9 178 14
L P P P S L S M M L L S M 7 6 8 0 10 171 49
0 0 0 0 0 0 0
0 0 0 0 0 0 0

P C L C L C C C P L P 14 0 0 0 6 133 98
P P P P L C L P P P P L C 23 0 0 0 6 175 161
180
5 5 5 5 2 4 2 5 5 5 5 2 5
3 3 3 3 2 3 2 3 3 3 3 2 3
2 3 2 2 2 2 2 2 3 2 2 2 2
0 0 0 0 1 0 0 0 0 0 0 0
0 0 0 1 0 3 1 2 2 3 1 1
3 2 4 3 7 2 7 2 1 1 3 7
13 13 14 14 14 14 14 14 14 14 14 14

Kepala Ruang Rawat I InapII

Sa'adah, AMK
RUMUS BAKU KRITERIA PENGHITUNGAN JAM KERJA
7 10 7 7
SIANG MALAM SO CUTI JUMLAH
0 0 0 7 175
0 0 0 0
77 70 0 0 182
49 70 0 0 182
42 60 0 21 179
35 60 7 14 179
70 60 0 0 186
49 60 14 21 179
0 0 0 0 0
49 70 7 0 182
21 50 0 42 183
84 60 0 0 179
84 80 0 0 178
42 80 0 0 171
0 0 0 0 0
0 0 0 0 0

0 0 0 35 133
0 0 0 14 175
 JADWAL DINAS RAWAT INAP II BULAN NOVEMBE

TANGGAL
NO NAMA PEND
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Saadah AMK P P P L P P P P P P L P P P P P P L
TIM I
1 Dwi Agustini D3 Kep S L P L M M L P P P L M M L P P P S
2 Wiyoso D3 Kep P S L P P S M L L P M M L P S S M M
3 Yulianti D3 Kep P P M L S S M M L L P S M M L P P P
4 Imam Subhan D3 Kep P M M L P S S L P P L P S M M L S SO
5 Maulida D3 Kep M L S L P P S S L S S M M L P S S S

TIM II
6 Sofiati D3 Kep S L S S M M L P S S S S L P S M M L
7 Parmini D3 Kep L S S S L P P M M L P P P S L M M L
8 Hidayaturrohmah D3 Kep M L L P S M L S S M M L P S S L S M
9 Wahyuningsih D3 Kep M M L SO S L M M L C SO S S M M L L C
10 Tony Arifianto Skep.Ners L P P M M L P P S S L P S S M M L L
11 Ragil Trimartono Skep.Ners S S M M L L S S M M L L P P P S L P

Istik Shoehah SLTA P P P L P P P P P P L P P P P P P L

Rina Hidayat SLTA P P P L P P P P P P L P P P P P P L
Catatan : SHIFT
PJ shif PAGI 6 5 5 2 6 5 5 6 5 6 2 6 6 6 6 5 5 2
HARI MINGGU SIANG 3 3 3 2 3 3 3 3 3 3 2 3 3 3 3 3 3 2
Rujuk MALAM 3 2 3 2 3 3 3 3 2 2 2 3 3 3 3 3 3 2
Cadangan SO 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1
SO : 11 - 18 CUTI 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
LIBUR 2 4 3 7 2 3 3 2 4 2 7 2 2 2 2 3 3 6
JUMLAH 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14

Mengetahui
Bidang Keperawatan

Johar Nuraini, Skep.Ners

I BULAN NOVEMBER 2018
RUMUS BAKU KRITERIA P
NGGAL 7
P S M SO L JAM
19 20 21 22 23 24 25 26 27 28 29 30 PAGI
P L P P P P L P P P P P 25 0 0 0 5 175 175
0
L M M L P P P M L S S S 10 5 7 0 8 175 70
L L P M M L P P S L P S 9 6 7 0 8 175 63
L P S P S L S S M M L L 8 7 7 0 8 175 56
S L P P P M L L S M M L 8 6 7 1 8 175 56
S L P S S M L P P L M M 6 11 6 0 7 179 42
0 0 0 0 0 0 0
0
L S S S L P M M L P P P 6 11 6 0 7 179 42
P P L S M M L P P S M L 9 6 7 0 8 175 63
M L C C C L M M L P S S 3 8 8 0 8 178 21
S C S M L S SO S S S L L 0 9 7 3 8 175 0
P S M M L S S L L P S M 7 8 7 0 8 175 49
M M L P S S L S M L P P 7 8 7 0 8 175 49
0 0 0 0 0 0 0

P L P P P P L P P P P P 25 0 0 0 5 175 175
P L P P P P L P P P P P 25 0 0 0 5 175 175
159
5 2 6 6 5 5 2 6 5 6 6 5
3 2 3 3 3 3 2 3 3 3 3 3
2 2 2 3 2 3 2 3 2 2 3 2
0 0 0 0 0 0 1 0 0 0 0 0
0 1 1 1 1 0 0 0 0 0 0 0
4 7 2 1 3 3 7 2 4 3 2 4
14 14 14 14 14 14 14 14 14 14 14 14

Kepala Ruang Rawat I InapII

Sa'adah, AMK
RUMUS BAKU KRITERIA PENGHITUNGAN JAM KERJA
7 10 7 7
SIANG MALAM SO CUTI JUMLAH
0 0 0 0 175
0 0 0 0
35 70 0 0 175
42 70 0 0 175
49 70 0 0 175
42 70 7 0 175
77 60 0 0 179
0 0 0 0 0
0 0 0 0 0
77 60 0 0 179
42 70 0 0 175
56 80 0 21 178
63 70 21 21 175
56 70 0 0 175
56 70 0 0 175
0 0 0 0 0

0 0 0 0 175
0 0 0 0 175
 JADWAL DINAS RAWAT INAP II BULAN SEPTEMBER 2

TANGGAL
NO NAMA PEND
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Saadah AMK P L P P P P P P L P L P P P P L P P
TIM I
1 Dwi Agustini D3 Kep L L S S I I P M M L P P P P L S M M
2 Wiyoso D3 Kep L P M M L P L P S L S S P M M L L P
3 Yulianti D3 Kep S M M L P S S L L P S M L P S P P S
4 Imam Subhan D3 Kep P S M M L L P S M M L P P L P P S L
5 Maulida D3 Kep S L P P S S M M L L P P S M M L L P

TIM II
1 Sofiati D3 Kep S L P P M M L S S S L S S S L M M L
2 Parmini D3 Kep P P L P S M M L P P M L L P P S L M
3 Hidayaturrohmah D3 Kep M M L L P P P L S S L M M L S S S L
4 Wahyuningsih D3 Kep M L S S S S M L L S C C M M L L S S
5 Tony Arifianto Skep.Ners L S L M M L S P P M M L S S S L P M
6 Dahlia Sukma Skep.Ners P S S L P P S S L P C M M L L P P S
7 Ragil Skep.Ners L P P S M M L P P L SO S L S P M M L
Istik Shoehah SLTA P L P P P P P P L P L P P P P L P P
Rina Hidayat SLTA P L P P P P P P L P L P P P P L P P
Catatan : SHIFT
PJ shif PAGI 6 3 6 6 6 6 6 6 3 6 2 6 6 6 6 3 6 5
HARI MINGGU SIANG 3 3 3 3 3 3 3 3 3 3 2 3 3 3 3 3 3 3
Rujuk MALAM 2 2 3 3 3 3 3 2 2 2 2 3 3 3 2 2 3 3
Cadangan SO 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
SO : 11 - 18 CUTI 0 0 0 0 0 0 0 0 0 0 2 1 0 0 0 0 0 0
LIBUR 4 7 3 3 2 2 3 4 7 4 6 2 3 3 4 7 3 4
JUMLAH 15 15 15 15 14 14 15 15 15 15 15 15 15 15 15 15 15 15

Mengetahui
Bidang Keperawatan

Johar Nuraini, Skep.Ners

 BULAN SEPTEMBER 2018

RUMUS BAKU KRITERIA P

NGGAL 7
P S M SO L JAM
19 20 21 22 23 24 25 26 27 28 29 30 PAGI
P P P P L P P P P P P L 24 0 0 0 6 168 168
0
L P S S M M L L P P L P 9 5 6 0 8 158 63
P S M L SO P S L P S M M 8 6 7 1 8 175 56
L M M L P P L P M M L S 8 7 7 0 8 175 56
P P P M L L S S M L S S 9 7 6 0 8 172 63
S S S S L S P P L M M L 7 9 6 0 8 172 49
0 0 0 0 0 0 0
0
C C C P S L M M L P P L 5 8 6 0 8 172 35
M L P P S M M L S S S L 9 6 7 0 8 175 63
S C C C L S M M L P S S 4 9 6 0 8 172 28
S M L S C S S S L M L P 1 12 6 0 8 172 7
M L P P P L P P S L P M 9 6 7 0 8 175 63
L M M L L P P M M L P C 9 5 6 0 8 172 63
P S S M M L L S S S L P 7 8 6 1 8 172 49
P P P P L P P P P P P L 24 0 0 0 6 168 168
P P P P L P P P P P P L 24 0 0 0 6 168 168
156
6 5 6 6 2 6 6 6 5 6 6 3 0
3 3 3 3 2 3 3 3 3 3 3 3 0
2 3 3 2 2 2 3 3 3 3 2 2 0
0 0 0 0 1 0 0 0 0 0 0 0 0
1 2 2 1 1 0 0 0 0 0 0 1 0
3 2 1 3 7 4 3 3 4 3 4 6 0
15 15 15 15 15 15 15 15 15 15 15 15

Kepala Ruang Rawat I InapII

Sa'adah, AMK
RUMUS BAKU KRITERIA PENGHITUNGAN JAM KERJA
7 10 7 7
SIANG MALAM SO CUTI JUMLAH
0 0 0 0 168
0 0 0 0
35 60 0 0 158
42 70 7 0 175
49 70 0 0 175
49 60 0 0 172
63 60 0 0 172
0 0 0 0 0
0 0 0 0 0
56 60 0 21 172
42 70 0 0 175
63 60 0 21 172
84 60 0 21 172
42 70 0 0 175
35 60 0 14 172
56 60 7 0 172
0 0 0 0 168
0 0 0 0 168
 JADWAL DINAS RAWAT INAP II BULAN JULI 2019

TANGGAL
NO NAMA PEND P S M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Sri Indrawat D3 Kep P P P P P P L P P P P P P L P P P P P P L P P P P P P L P P P 27 0 0
TIM I
1 Dwi Agustini D3 Kep M M L S S S S L P M L P P M M L P P S L S P P L M M L L P S S 8 8 7
2 Wiyoso D3 Kep S S L P P P L P M M L S S S M M L S S M M L L P P S S L M L P 7 9 7
3 Yulianti D3 Kep C M M L L P P M L P P P L SO S S M M L L P S S S L M M L P P P 9 5 7
4 Maulida D3 Kep P P M L L S C L P S S M M C L L P P S S L M M L S P P L P M M 8 6 7
5 Ragil Trimartono Skep.Ners L P P S S L M M L L S S L P P M M L P P P S L M M L P P S S M 9 7 7
6 Lailatul Husna Skep.Ners M L P S S S L M M L S S S L S P P L P P M M L L P P S S M M L 7 9 7

TIM II
7 Imam Subhan D3 Kep S S S L M M L P P P M L S L P S S M M L L P P S L M M L S P P 8 8 7
8 Puji Lestari D3 Kep P S M M L P P S S L P M L P P P C S M L L P S M M L L M L C C 8 5 7
9 Wahyuningsih D3 Kep S L S M M L L S S S M L M M L S S M L S L S M M L S S S S L S 0 14 8
10 Abdul Khamid Skep.Ners M L P P P L S S M M L L P S S L S S M M L L P P S P M M L S S 7 9 7
11 Siti Nur Farida D3 Kep P P S L P M M L S S M L P L M M L P P S S L S S S S L P L M M 7 9 7

Insriyati SLTA P P P P C C L P P P P P P L P P P P P P L P P P P P P L P P P 25 0 0
Rina Hidayat SLTA P P P P P P L P P P P P P L P P P P P P L P P P P P P L P P P 27 0 0
Catatan : SHIFT
PJ shif PAGI 6 6 6 5 5 5 2 5 6 5 5 5 6 2 6 5 6 6 6 5 2 6 6 5 5 6 5 2 6 5 6
HARI MINGGU SIANG 3 3 3 3 3 3 2 3 3 3 3 3 3 2 3 3 3 3 3 3 2 3 3 3 3 3 3 2 3 3 3
Rujuk MALAM 3 2 3 2 2 2 2 3 3 3 3 2 2 2 3 3 2 3 3 2 2 2 2 3 3 3 3 2 2 3 3
Cadangan SO 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
CUTI 1 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1
LIBUR 1 3 2 4 3 3 7 3 2 3 3 4 3 6 2 3 2 2 2 4 8 3 3 3 3 2 3 8 3 2 1
JUMLAH 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14
Mengetahui
Bidang Keperawatan Kepala Ruang RaInaII

Lathifah Diana, Amd Kep Sri indrawat,Amd Kep

 RUMUS BAKU KRITERIA PENGHITUNGAN JAM KERJA
7 7 10 7 7
SO L JAM
PAGI SIANG MALAM SO CUTI JUMLAH
0 4 189 189 0 0 0 0 189
0 0 0 0 0
0 8 182 56 56 70 0 0 182
0 8 182 49 63 70 0 0 182
1 8 182 63 35 70 7 7 182
0 8 182 56 42 70 0 14 182
0 8 182 63 49 70 0 0 182
0 8 182 49 63 70 0 0 182

0 0 0 0 0 0
0 8 182 56 56 70 0 0 182
0 8 182 56 35 70 0 21 182
0 9 178 0 98 80 0 0 178
0 8 182 49 63 70 0 0 182
0 8 182 49 63 70 0 0 182
0 0 0 0 0 0
0 0 0 0 0 0

0 4 189 175 0 0 0 14 189

0 4 189 189 0 0 0 0 189
182
PASIEN MASUK

TRI WULAN I TRI WULAN II

NO KASUS JUMLAH % JUMLAH %
JANUARI FEBRUARI MARET APRIL MEI JUNI

1 DALAM 39 53 50 142 49.65 33 37 39 109 42.91

2 BEDAH UMUM 32 24 23 79 27.62 22 27 25 74 29.13
3 ORTHOPEDI 4 13 14 31 10.84 13 15 12 40 15.75
4 SYARAF 6 1 5 12 4.20 7 5 4 16 6.30
5 MATA 1 0 0 1 0.35 1 0 2 3 1.18
6 PARU 2 1 4 7 2.45 0 1 0 1 0.39
7 THT 6 3 5 14 4.90 3 6 2 11 4.33
JUMLAH 90 95 101 286 79 91 84 254

PASIEN KELUAR

TRI WULAN I TRI WULAN II

NO KEADAAN KELUAR JUMLAH % JUMLAH %
JANUARI FEBRUARI MARET APRIL MEI JUNI
1 SEMBUH 67 74 78 219 82.33 65 61 59 185 74.90
2 APS 7 6 6 19 7.14 6 14 12 32 12.96
3 APS PINDAH JKM 0 0 1 1 0.38 2 4 2 8 3.24
4 RUJUK 4 0 0 4 1.50 1 0 1 2 0.81
5 MATI <48 JAM 2 1 3 6 2.26 0 0 1 1 0.40
6 MATI > 48 JAM 0 0 0 0 0.00 1 0 1 2 0.81
7 PINDAH RUANG 4 4 9 17 6.39 4 9 4 17 6.88
JUMLAH 84 85 97 266 79 88 80 247

TRIWULAN I TRIWULAN II
NO CARA PEMBAYARAN JUMLAH % JUMLAH %
JANUARI FEBRUARI MARET APRIL MEI JUNI
1 BIAYA SENDIRI 50 56 65 171 45 56 51 152
2 ASKES WAJIB 0 0 0 0 1 1
3 JAMKESMAS 34 28 32 94 32 32 28 92
4 JAMSOSTEK 0 1 0 1 1 1 2
JUMLAH 84 85 97 266 79 88 80 247
 JADWAL DINAS RAWAT INAP II BULAN JUNI 20

TANGGAL
NO NAMA PEND
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Saadah AMK L P L P P P P P P L P P P P L L L P
TIM I
1 Dwi Agustini D3 Kep S M L P P S S L P M M L L P S P L M
2 Wiyoso D3 Kep S M L L P P S L P P M M L L S M S S
3 Yulianti D3 Kep L P P M M L P P S S L L P P M S C C
4 Imam Subhan D3 Kep P P S L S M M L L P S L P P P M M L
5 Maulida D3 Kep S L M M L P P S L P P M M L P P P L
6
TIM II
1 Sofiati D3 Kep L S M M L L S S S L S S L S P L M M
2 Parmini D3 Kep M L L P P S L P M M L P S L C C C C
3 Hidayaturrohmah D3 Kep P S L S M M L S S S L P P S C C L M
4 Wahyuningsih D3 Kep L S S L S S M M L L S S S S M L P S
5 Tony Arifianto Skep.Ners L L P P S L P M M L P P S M L P P P
6 Adit Skep.Ners M L P S M M L P P S M M L L S S S S
7 Ragil Skep.Ners P P S S L L M M L L P S M M L S S P
Istik Shoehah SLTA L P L P P P P P P L P P P P L L L P
Rina Hidayat SLTA L P L P P P P P P L P P P P L L L P
Catatan : SHIFT
PJ shif PAGI 3 6 3 6 6 5 6 6 6 3 6 6 6 6 3 3 3 5
HARI MINGGU SIANG 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
Rujuk MALAM 2 2 2 3 3 3 3 3 2 2 3 3 2 2 2 2 2 3
Cadangan SO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
CUTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2
LIBUR 7 4 7 3 3 4 3 3 4 7 3 3 4 4 5 5 5 2
JUMLAH 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15

Mengetahui
Bidang Keperawatan

Johar Nuraini, Skep.Ners

AP II BULAN JUNI 2018

RUMUS BAKU KRITERI

NGGAL 7
P S M SO L JAM
19 20 21 22 23 24 25 26 27 28 29 30 31 PAGI
P P P P P L P P L P P P 22 0 0 0 8 154 154
0
M L P P P P L P M M L P 11 4 7 0 8 175 77
L P L M M L P P P P M L 9 5 7 0 9 168 63
P S L P S M M L L P M L 9 5 6 0 8 172 63
P P P S L S S S M M L P 10 7 6 0 7 179 70
S M M L P P S S S L P S 10 7 6 0 7 179 70
0 0 0 0 0 0 0
0
L S S S L S M M L S S M 1 13 7 0 9 168 7
C C P M M L L P P S M L 7 3 6 0 8 172 49
M L S S S L M M L L P P 5 9 6 0 8 172 35
S M M L S S L M M L L S 1 13 7 0 9 168 7
P S L P M M L L S S S M 10 6 6 0 8 172 70
L P S M L P S S S L S S 5 12 6 0 7 179 35
S M L L P P P L P P P M 10 6 6 0 8 172 70
P P P P P L C C L P P P 20 0 0 0 8 154 140
P P P C P L P C L C P P 19 0 0 0 8 154 133
155
6 6 6 5 6 3 5 4 3 5 6 6
3 3 3 3 3 3 3 3 3 3 3 3
2 3 2 3 3 2 3 3 3 2 3 3
0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 1 0 0 1 2 0 1 0 0
3 2 4 3 3 7 3 3 6 4 3 3
15 15 15 15 15 15 15 15 15 15 15 15

Kepala Ruang RawatInapII

Sa'adah, AMK
RUMUS BAKU KRITERIA PENGHITUNGAN JAM KERJA
7 10 7 7
SIANG MALAM SO CUTI JUMLAH
0 0 0 0 154
0 0 0 0
28 70 0 0 175
35 70 0 0 168
35 60 0 14 172
49 60 0 0 179
49 60 0 0 179
0 0 0 0 0
0 0 0 0 0
91 70 0 0 168
21 60 0 42 172
63 60 0 14 172
91 70 0 0 168
42 60 0 0 172
84 60 0 0 179
42 60 0 0 172
0 0 0 14 154
0 0 0 21 154
 JADWAL DINAS RAWAT INAP II BULAN FEBRUAR
TANGGAL
NO NAMA PEND
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Saadah AMK P P L P L P P P P L P P P P P P L P
TIM I
1 Dwi Agustini D3 Kep S S L P P S S P L S S M M L P S S S
2 Wiyoso D3 Kep L P P P M M L S P L P S S S S L M M
3 Yulianti D3 Kep M L S S P M M L S SO P L P P M M L P
4 Imam Subhan D3 Kep L I L I SO P P M M L S L P P L P P P
5 Maulida D3 Kep S S P S L C C C S P M M L P P S P L
6 Ragil Trimartono Skep.Ners S L S M M L L S P L M M L L S C C S
TIM II
7 Sofiati D3 Kep P S M M L L S P M M L S S S M M L L
8 Parmini D3 Kep P P L S S S P M L P P P M M L P L S
9 Hidayaturrohmah D3 Kep L M M L L P S S S M L P S S S L M M
10 Wahyuningsih D3 Kep M M L L S S M M L S S S L M L S S S

11 Insriyati SLTA P P L P L P P P P L C P P P P P L P
12 Rina Hidayat SLTA P P L P L P P P P L P P P P P P L P
Catatan : SHIFT
PJ shif PAGI 5 5 2 5 2 5 5 5 5 2 5 5 5 6 5 5 2 5
HARI MINGGU SIANG 3 3 2 3 2 3 3 3 3 2 3 3 3 3 3 3 2 4
Rujuk MALAM 2 2 2 2 2 2 2 3 2 2 2 3 2 2 2 2 2 2
Cadangan SO 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0
SO : 11 - 18 CUTI 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 1 1 0
LIBUR 3 2 7 2 6 2 2 1 3 6 2 2 3 2 3 2 6 2
JUMLAH 13 12 13 12 13 13 13 13 13 13 13 13 13 13 13 13 13 13

SISTEM PENUGASAN SHIFT PAGI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

1 DALAM & SYARAF F P K D Y H P F K P Y P Y Y D P I Y
2 ANAK & THT P I M H D I I D R M P H I I M I M I
3 BEDAH & MATA P I M H D I I D R Y K H I I M I M I

Mengetahui
Bidang Keperawatan

Johar Nuraini, Skep.Ners

 II BULAN FEBRUARI 2019
NGGAL 7
P S M SO L JAM
19 20 21 22 23 24 25 26 27 28 PAGI
P P P P P L P P P P 23 0 0 0 5 161 161
0
S L S S M M L L P M 5 12 5 0 6 169 35
L P S L P L P M M L 8 6 6 0 8 158 56
S S P L S S P S L P 8 8 5 1 6 169 56
P L M M L P S S M M 9 3 6 1 7 151 63
M M L P S L S M L P 7 7 5 0 6 169 49
P S P P M L P P P S 7 7 5 0 7 162 49
0
P S L S S S L P S S 4 11 6 0 7 165 28
M M L P P SO M L L P 10 4 6 1 7 165 70
L P S S L M M L S S 3 10 7 0 8 161 21
S L M M L P S S S L 1 12 7 0 8 161 7
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

P P P P P L P P P P 22 0 0 0 5 161 154
P P P P P L P P P P 23 0 0 0 5 161 161
146
6 5 5 6 5 2 6 5 5 6
3 3 3 3 3 2 3 3 3 3
2 2 2 2 2 2 2 2 2 2
0 0 0 0 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 3 3 2 3 6 2 3 3 2
13 13 13 13 13 13 13 13 13 13

19 20 21 22 23 24 25 26 27 28 29 30 31 DWI: D IMAM: I SAADAH:S

F K Y P P I Y F D Y YOSO: K MAULIDA:M
I H R R K P K R R P YULI: Y RAGIL : R
I H R R K W R R R M SOFI:F HIDA : H
MINI:P WAHYUNI:W

Kepala Ruang Rawat Inap III

Sa'adah, AMK
 7 10 7 7
SIANG MALAM SO CUTI JUMLAH
0 0 0 0 161
0 0 0 0
84 50 0 0 169
42 60 0 0 158
56 50 7 0 169
21 60 7 0 151
49 50 0 21 169
49 50 0 14 162
0 0 0 0 0
77 60 0 0 165
28 60 7 0 165
70 70 0 0 161
84 70 0 0 161
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 7 161
0 0 0 0 161