AUDIT IAD BUNDLE CHECKLIST

Ruangan( Bulan ) Ta*un(

RSKG NY.R.A. HABIBIE

Jl. Tubagus Ismail No.46
Banung ! 4"#$4

Ta ng
ng ga
ga l No N
Na
a ma
ma hand Menggunakan Pembersihan Lokasi Slang infuse Swab alcohol Spuit yang Penutup Perawatan Menggunakan
Setiap injeksi
%asi&n' hygiene APD kulit dengan pemasangan
pemasangan diganti digunakan insersi lokasi insersi stopper needles
No B& Sesuai
chlorhexidine sesuai disposable dengan setiap 4 hari
standar
transparan dan jika kotor
dressing

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T+TAL
K&,&-angan(
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%&ng*i,ungan( Ʃ /a
1 #""2
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AUDIT ISK BUNDLE CHECKLIST
Ruangan( Bulan ) Ta*un(

Tanggal No Nama %a
%asi&n Pemasangan APD Pemasangan and Segera Pengisian %iksasi &rine bag
sesuai tepat menggunakan ygiene kateter
dilepas balon sesuai menggantung
indikasi alat steril dengan
jika tidak ! "# ml$ plester
indikasi
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T+TAL
K&,&-angan(
 /a
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%&ng*i,ungan( /a 1 #""2
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AUDIT ID+ BUNDLE CHECKLIST

Ruangan( Bulan ' (ahun)

Tanggal No Nama %asi&n *ukur
Dengan
,aktu cukur Mandi Antibiotic Pasien tidak 0ula darah
e+ clipper ! - . jam$ cholrhexidine / jam sebelum sedang (erkontrol
sebelum operasi insisi infeksi

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T+TAL
K&,&-angan(
 /a
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%&ng*i,ungan( Ʃ /a
1 #""2
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AUDIT 3ENTILAT+R BUNDLE CHECKLIS

CHECKLIST
T
Ruangan( Bulan) Ta*un(

Tangga
anggall No Nama
Nama %as
%asi&n
i&n'' H+B %&ng0a7ian Han +-al %&n/i0a,an Su:,ion ' %-o;ila0sis D3T %-o;ila0sis
No B& $""54" s&,ia8 *a-i */gi&n& H/gi&n& gigi s&,ia8 mana7&m&n 8&8,i: ul:&-
,&-*aa8 s&asi 4 ! 6 7am #9 7am s&0-&si
an &1,ubasi
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T+TAL
K&,&-angan(
 /a
  ,ia0
%&ng*i,ungan( Ʃ /a
1 #""2
Ʃ/a ) ,ia0