CONTOH ICRA

By ELYANA
 BAB 2
PENCEGAHAN DAN PENGENDALIAN INFEKSI
(PPI)

FOKUS AREA :
Program kepemimpinan dan koordinasi (PPI 1; 2; 3; 4)
Fokus dari program (PPI 5; 5.1; 6; 7; 7.1; 7.1.1; 7.2; 7.3; 7.4; 7.5)
Prosedur Isolasi (PPI 8 )
Teknik pengamanan dan hand hygiene ( PPI 9)
Integrasi program dng peningkatan mutu dan keselamatan
pasien (PPI 10; 10.1; 10.2; 10.3; 10.4; 10.5; 10.6)
Pendidikan staf tentang program (PPI 11)

LUWI-PPI 2062013
 INTEGRASI KEGIATAN
DNG PMKP

SDM :
- Komite PPI
- Tim PPI SURVEILANCE
- IPCN
- IPCLN APD &
ICRA HAND
HYGIENE
DIKLAT PPI :
- Staf RS PROGRAM
- Px & pengunjung PPI
- Mhs praktik

STERILISASI ISOLASI
ANGGARAN :
- APD HYGIENE
- Desinfectan &
- Diklat SANITASI
LUWI-21 FEB 2014
PROSES INFECTION CONTROL RISK ASSESSMENT

INFECTION CONTROL

KOMUNIKASI DAN KONSULTASI

IDENTIFIKASI RISIKO INFEKSI

MONITOR DAN REVIEW

ANALISA RISIKO INFEKSI

ASESMEN RISIKO

EVALUASI RISIKO INFEKSI

KELOLA RISIKO  PROGRAM PPI

RISK REGISTER

4
 RISK ASESMEN
SETAHUN
SEKALI (PPI 6
RISK EP4)
ASSESSMEN RISK
RENOVASI/DE ASESMENT
MOLISI, PEMBERIAN
PEMBANGUN OBAT IV (PPI 7
AN (PPI7 EP3, INFECTION EP 1 & 2)
7.5
CONTROL
RISK
RISK ASSESMENT
ASSESSMENT (ICRA) RISK
PELAYANAN ASSESMENT
MAKANAN & STERILISASI &
PERMESINAN LINEN (PPI 7EP
(PPI 7 EP3, & RISK 3, PPI 7.1)
7.4) ASSESSMENT
PEMBUANGA
N SAMPAH
(PPI 7 EP 3,
7.2 & 7.3)

luwi-edit 18 mei 2014

 Risk assessment
ISSUE INFEKSI DAMPAK PROBABILITAS SKOR RANGKI PIC
RISIKO NG
RISIKO
Device related infeksi 1 2 3 4 5 1 2 3 4 5

1 BSI

2 VAP

3 ISK

dst

Komisi Akreditasi Rumah Sakit

 INFECTION CONTROL RISK ASSESSMENT
PROBABILITY RISK IMPACT (HEALTH, CURRENT SYSTEM/ SCO
FINANCIAL, LEGAL, PREPAREDNESS RE
POTENSIAL RISK/PROBLEM REGULATORY)
4 3 2 1 0 5 4 3 2 1 5 4 3 2 1

LUWI-ICRA HAI-12062013 7
 IDENTIFIKASI RISIKO PADA PPI 7.1 sd PPI 7.5

PPI STANDAR IDENTIFIKASI ANALISA RISIKO

RISIKO
7.1 Sterilisasi alkes Sterilisasi in adekuat RCA
FMEA
Risk grading

Laundry & linen Manajemen laundry RCA

dan linen in adequat FMEA
Risk grading

7.1.1 Alkes kadaluwarsa Pengelolaan alat RCA

kadaluwarsa in FMEA
adeqkuat Risk grading

Single use – re use Pengelolaan Single RCA

use – re use FMEA
In adekuat Risk grading
LUWI-PPI 1 SEPT 2014
 SALURAN
PERNAFASAN

EMERGING/
SALURAN
RE-
KENCING
EMERGING

SURVEILANCE

MULTI PERALATAN
DRUG INTRAVAS
RESISTEN KULER
ORGANISM INVASIF

LOKASI
OPERASI

LUWI-21 FEB 2014

 Infection Control Construction Permit
    Permit No:
Location of Construction: Project Start Date:
Project Coordinator: Estimated Duration:
Contractor Performing Work Permit Expiration Date:
Supervisor: Telephone:
YES NO CONSTRUCTION ACTIVITY YES NO INFECTION CONTROL RISK GROUP
    TYPE A: Inspection, non-invasive activity     GROUP 1: Low Risk
    TYPE B: Small scale, short duration,     GROUP 2: Medium Risk
moderate to high levels
    TYPE C: Activity generates moderate to high levels of     GROUP 3: Medium/High Risk
dust, requires greater 1 work shift for completion
    TYPE D: Major duration and construction activities     GROUP 4: Highest Risk
Requiring consecutive work shifts
CLASS I 1. Execute work by methods to minimize raising dust from construction 3. Minor Demolition for Remodeling
operations.
2. Immediately replace any ceiling tile displaced for visual inspection.
CLASS II 1. Provides active means to prevent air-borne dust from dispersing into 1. Contain construction waste before transport in tightly
atmosphere covered containers.
2. Water mist work surfaces to control dust while cutting. 2. Wet mop and/or vacuum with HEPA filtered vacuum before
3. Seal unused doors with duct tape. leaving work area.
4. Block off and seal air vents. 3. Place dust mat at entrance and exit of work area.
5. Wipe surfaces with cleaner/disinfectant. 4. Isolate HVAC system in areas where work is being
  performed; restore when work completed.

  1. Obtain infection control permit before construction begins. 6. Vacuum work with HEPA filtered vacuums.
CLASS III 2. Isolate HVAC system in area where work is being done to prevent 7. Wet mop with cleaner/disinfectant
  contamination of the duct system. 8. Remove barrier materials carefully to minimize spreading of
3. Complete all critical barriers or implement control cube method before dirt and debris associated with construction.
construction begins. 9. Contain construction waste before transport in

Date 4. Maintain negative air pressure within work site utilizing HEPA equipped tightly covered containers.
Initial air filtration units. 6. Cover transport receptacles or carts. Tape covering.
  5. Do not remove barriers from work area until complete project is 7. Upon completion, restore HVAC system where work was
checked by Infection Prevention & Control and thoroughly cleaned by performed.
Environmental Services.

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 Infection Control Construction Permit
  1. Obtain infection control permit before construction begins. 1. Do not remove barriers from work area until
CLASS IV 2. Isolate HVAC system in area where work is being done to completed project is checked by Infection
  prevent contamination of duct system. Prevention & Control and thoroughly cleaned by
  3. Complete all critical barriers or implement control cube Environmental. Services.
method before construction begins. 2. Vacuum work area with HEPA filtered vacuums.
4. Maintain negative air pressure within work site utilizing 3. Wet mop with disinfectant.
HEPA equipped air filtration units. 4. Remove barrier materials carefully to minimize
Date 5. Seal holes, pipes, conduits, and punctures appropriately. spreading of dirt and debris associated with
6. Construct anteroom and require all personnel to pass construction.
Initial through this room so they can be vacuumed using a HEPA 5. Contain construction waste before transport in
  vacuum cleaner before leaving work site or they can wear tightly covered containers.
cloth or paper coveralls that are removed each time they 6. Cover transport receptacles or carts. Tape
leave the work site. covering.
7. All personnel entering work site are required to wear shoe 7. Upon completion, restore HVAC system where
covers. work was performed.

 
Additional Requirements:

 
___________ ___________ Exceptions/Additions to this permit
Date Initials Date Initials are noted by attached memoranda

Permit Request By: Permit Authorized By:

Date: Date:

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