BHN TUKERAN

7/21/2019 BHN TUKERAN

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SISTEMATIKA IRAD



SISTEMATIKA

1. Falsafah dan Tujuan

2. Administrasi & Pengellaan

!. Staf dan Pim"inan#. Fasilitas & Peralatan

$. Ke%ijaan & Prsedur

'. Pengem%angan & PrgramPendidian

(. E)aluasi & Pengendalian Mutu



SISTEMATIKA

1. Falsafah dan Tujuan * ! Parameter+

2. Administrasi & Pengellaan * 2 +

!. Staf dan Pim"inan * # +

#. Fasilitas & Peralatan * # +

$. Ke%ijaan & Prsedur * 2 +

'. Pengem%angan & Prg Pendidian*1+

(. E)aluasi & Pengendalian Mutu * 2 +

Ttal , 1- Parameter



SISTEMATIKA*FAS FKPE+








Ttal , 1- Parameter



IMI/0A/ AKREDITASI

DI

RMA SAKIT M343SARI

15 MARET 255-36E TIM

DI/AS KESEATA/ PR3PI/SI 4A7A

TIMR



SISTEMATIKA

PE/I6AIA/ PE6A8A/A/RADI3630I RMASAKIT



SISTEMATIKA

1. Falsafah dan Tujuan

2. Administrasi & Pengellaan

!. Staf dan Pim"inan#. Fasilitas & Peralatan

$. Ke%ijaan & Prsedur

'. Pengem%angan & PrgramPendidian

(. E)aluasi & Pengendalian Mutu



SISTEMATIKA








Ttal , 1- Parameter



SISTEMATIKA*FASFKPE+








Ttal , 18 Parameter



AKREDITASI

PE6A8A/A/RADI3630I TIM AKREDITASI

DI/KES PR3PI/SI 4A7A TIMRM343SARI 255-



STD.1 FA6SAFA DA/ T4A/

Pela9anan Radilgi %eru"aradidiagnsti & raditera"i denganmem"ertim%angan as"e,

1. aha9a radiasi

2. Perem%angan I"te

!. :st;%ene<t rati

#. Kemam"uan SDM



S.1.P1

5 , Ta ada falsafah & tuj instalasi

1 , Ada ta"i lisan= di%uat Ka.Inst.

2 , Ada tertulis=ta"i td menga>u )isi&

misi=%9 Ka.Inst

! , Ada tertulis=%lm menga>u=%9

Ka.Inst & staf # , Ada tertulis=menga>u=%9 Ka.Inst &

Staf

$ , sda # "lus di%erlauan %9



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5 , Tida ada standar "ela9anan

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Std "ela9 "rfesi tertulis tida ada

2 , sda= ta ada std SMF Radilgi &SK

Diretur! , Ada S Dir= tida ada Std SMF Rad

RS

# , lenga"



S.1.P.!. 8A/ RAD 2# 4AM

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saja="etugas

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luar jam erja %9 nn DrS"R

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$ , Ada rutin 2# jam="etugas nsite=es"ertise leh Dr.S"R di luar jamerja



. .&PENGELOLAAN: Bagan Organisasi & uraian

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# ,

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S.2.P.2 ,

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m"uter

2. Arsi"!. StandarB"la etenagaan



Std.!. STAF & PIMPI/A/

Pim"inan unit "ela9anan Radilgise%ain9a leh dter s"esialisRadilgi terdaftar di%antu staf 9ang

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ati)itas "ela9anan



S.!.P.1, Ke"ala S"RD

5 , Pim"inan %uan naes

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S.!.P.2 Staf Medi FungsinalRadilgi

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D3

Su% S"esialisasi Radilgi,

1. Radilgi ana

2. Radilgi neur!. Radilgi inter)ensinal

#. Kedteran nulir



idang Kehususan ,

1. Multi Sli>e :T

2. eli>al :T

!. MRI

#. Angigra<

$. S0 D"ler , S0 "lus )isualisasi

"em%uluh darah'. Mammgra< , Khusus "a9udara



S.3.P.3 STAF PELAKSANARADIOGRAPER

5 , 3"eratr nn naes= nn training

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S.!.P.# Ra"at erala

5 , Tida ada ra"at

1

2!

#

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dan RT6

Std ! Fasi"itas & P#ra"atan



Std.!.Fasi"itas & P#ra"atanStandar Ruangan

I$aging%a$an"uas &

n'a$an(



Ruang Ka%inet



Ruang a>a



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RA/0 T/00



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muniasi



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2. Std Pela9anan Radilgi elas A&*1$+

!. Ijin ATA/



S.#.P.2 , Ti"e Ruangan

5 , Ruang a, R.Perisaamar gela"

1 , Ruang a R.TungguPasien

2 , R. Petugas! , R.R.Adm

# , R.Es"ertise

$ , 1 R.Perisa



S.#.P.!. Kualitas Peralatan

5 , 4umlah minim=ta teraCat

1

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D3

RBF Ta%le, uB urs>"9 Image intensifer , Gming gam%ar u>9stand , aset <lm uB Gming ft

thra@ M%ile unit I"te ,

; :T S>an heli>al=MRI; :lr S0; Digital H;ra9; Multi sli>e :T



:T S:A/



MEDI:A6 S3/30RAP8





IMA0E TRA/SFER



:K8 STA/D



:ase StudiesMultisli>e :T



:ase 1

ISTOR): -! 8B3 M= EA6ATEI/FRARE/A6 A3RTI: A/ER8SM.

FINDINGS: TERE IS EIDE/:E 3F A/I/FRARE/A6 A3RTI: A/ER8SM 7IT AMAHIMM DIAMETER AT ITS MID P3RTI3/3F $ :M AP H $.2 :M

A/ER8SM PR34E:TS I/FERI3R68 T3 4STPR3HIMA6 T3 TE IFR:ATI3/ 3F TEI6IA: ARTERIES

S*ANNING PARAMETERS: ! H !IMA0E TI:K/ESS 7IT A 1.$ MMRE:3/STR:TI3/ AT !.$ PIT:. TE:3/TRAST I/4E:TI3/ RATE 7AS !::BSE:.IT 7AS M3/ITERED 7IT SRESTART F3R

TIMI/0 3F TE S:A/.



!D rendering :ur)edmulti"lanar refrmat



:ase 2

ISTOR): '- 8B3 M 7IT A/ I/FRARE/A6AAA $ H $ :M 8 :T 3/ 468 2. F36637P SIJE 3F TE AAA.

FINDINGS: I/ TE AD3ME/= TERE IS

STA6E SIJE 3F A $ :M AP H $ :M TRA/SH $.# :M :: I/FRARE/A6 AAA. IMPRESSION: /:A/0ED SIJE A/D

63:ATI3/ 3F A AAA 7I: IS I/FRARE/A6I/ 63:ATI3/ T I/36ES TE IMA.

S*ANNING PARAMETERS: ! H !IMA0E

TI:K/ESS 7IT A 1.$ MMRE:3/STR:TI3/ AT !.$ PIT:. TE

:3/TRAST I/4E:TI3/ RATE 7AS !::BSE:.IT 7AS M3/ITERED 7IT SRESTART F3R TIMI/0 3F TE S:A/.



!D rendering



:ase !

ISTOR): # 8R M= STATS P3STAS:E/DI/0BDES:E/DI/0 A3RTADISSE:TI3/ REPAIRBE/TA66 PR3:EDRE.R6E 3T DISSE:TI3/.

FINDINGS: TERE IS :3/TI/ED

EIDE/:E 3F A3RTI: DISSE:TI3/EHTE/DI/0 FR3M TE A3RTI: R33T T3I/:6DE TE AR:= DES:E/DI/0 A3RTA=IFR:ATI3/ I/T3 :3MM3/ I6IA:S= A/DIFR:ATI3/ I/T3 I/TER/A6 A/DEHTER/A6 I6IA:.

S*ANNING PARAMETERS, $ H $ IMA0E TI:K/ESS 7IT A ! MMRE:3/STR:TI3/ AT !.$ PIT:. TE:3/TRAST I/4E:TI3/ RATE 7AS !::BSE:.IT 7AS M3/ITERED 7IT SRESTART F3R

TIMI/0 3F TE S:A/.



!D rendering



:ase #

ISTOR): #2 8B3 M. RI0T TIIA6 P6ATEA :T7IT TI/ :TS ASSESS FRA:TRE.

FINDINGS: TERE IS A S:ATJKER T8PE FRA:TRE 3F TE PR3HIMA6 TIIA. I/ ADDITI3/=

TERE IS S3ME :3MMI/TI3/ I/36I/0 TE TIIA6 P6ATEA A/TERI3R68 A/D TIIA6 P6ATEAP3STERI3R68.

IMPRESSION: :3MMI/TED S:ATJKER T8PE I:3/D86AR FRA:TRE.

S*ANNING PARAMETERS: 2 H 2IMA0E TI:K/ESS 7IT A 1MM RE:3/STR:TI3/ AT!.$ PIT:.



!D rendering f APti%ia



Case 5

HISTORY: 29 Y/O M. FRACTURE. EVALUATE.

FINDINGS: THERE IS POSTERIOR FRACTURE

DISLOCATION OF THE RIGHT SHOULDER. THERE

IS A FRACTURE THROUGH THE NECK OF THE

GLENOID

IMPRESSION: 1. POSTERIOR FRACTURE

DISLOCATION OF THE RIGHT SHOULDER AND

COMMINUTED FRACTURE OF THE SCAPULA

MAINLY INVOLVING THE NECK OF THE GLENOID

WITH INTERARTICULAR EXTENSION AT THE

SUPERIOR ASPECT OF THE GLENOHUMERAL

JOINT.

SCANNING PARAMETERS: 3 X 3 X 1.5 MM HELICAL

AXIAL CT IMAGES WERE OTAINED THROUGH

THE RIGHT SHOULDER.



3D rendering of AP

scap!a



:ase '

IST3R8, !2 8B3 F 7IT I0 0RADE 6EFTI/TER/A6 :AR3TID ARTER8 STE/3SIS A/DP33R IMA0I/0 3F TE DISTA6 I/TER/A6:AR3TID ARTER8.

FI/DI/0S, TERE IS APPR3HIMATE68 $5STE/3SIS 3F TE DISTA6 RI0T I/TER/A6:AR3TID ARTER8 AT TE 0E/ 3F TE:AR3TID SIP3/. 6EFT :AR3TID ARTER8, TERE IS A TI0T STE/3SIS I/ TE

PR3HIMA6 6EFT I/TER/A6 :AR3TIDARTER8

S:A//I/0 PARAMETERS, 1 @ 1 S6I:E TI:K/ESS 7IT A .$MMRE:3/STR:TI3/= E6I:A6 PIT: 7AS

!.$. 155 :: :3/TRAST 7AS I/4E:TED AT! :: PER SE:3/D 7IT 1- SE:3/D S:A/



6t. and Rt. >artid arteries

S # P # 3AT & PERA6ATA/ ASI: 6IFE



S.#.P.#. 3AT & PERA6ATA/ ASI: 6IFESPP3RT

F3R A6ER0I AA/ K3/TRAS

5 , Ta ada

1

2

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#

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"eralatan



DAFTAR 3AT & PERA6ATA/

Daftar %at

; adrenalin inj

; anti histamin

; Krtisn; D"amin

Daftar Peralatan

; ales, needle=s"uit

; infus set dan standar infus

; su>tin "um"



DAFTAR MEDIA K3/TRAS

L Idinated agents Ihe@l *3mni"aNueO= 0E ealth>are+ Idi@anl *isi"aNueO= 0E ealth>are+ I"rmide *ltra)istO= a9er ealth>are+

I)ersl *3"tira9O= T9>BMallin>rdt+ I"amidl *Is)ueO= ra>> Diagnsti>s+L 0adlinium agents 0ad%enate *Multian>eO= ra>>Diagnsti>s+ 0addiamide *3mnis>anO= 0E ealth>are+ 0adteridl *Pran>eO= ra>> Diagnsti>s+ 0ad)ersetamide *3"tiMARK O=

T9>BMallin>rdt+

0ad"entetate *Magne)istO= erle@+

Std $ KEI4AKA/ DA/



Std.$ KEI4AKA/ DA/PR3SEDR

PER6 PR3TAP *S3P+

7RITTE/ S3P



PR3TAP ATA S3P

PROTOKOL

B+d' Pr+t+,+"s



B+d' Pr+t+,+"s

A""endi>itis S>an i"hasi> :T f 6i)er i"hasi> Pan>reas *Pan>reati> Prt>l+ :hest= A%dmen= Pel)is S>an Adrenal Mass *Phe>hrm>9tma IS sus"

e>ted+

Renal Mass E)aluatin Rutine A%dmenBPel)is I Thin There Is a Stne S>anQ *Stne S>a

n+

http://www.radiology.uiowa.edu/CT/body/CT%20appendicitis%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20biphasic%20liver%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20biphasic%20pancreas%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20chestabdpel%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20pheo%20revise.htm


http://www.radiology.uiowa.edu/CT/body/CT%20renal%20mass%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20routine%20abd%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20stone%20scan%20revise.htm




http://www.radiology.uiowa.edu/CT/body/CT%20routine%20abd%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20renal%20mass%20revise.htm



http://www.radiology.uiowa.edu/CT/body/CT%20chestabdpel%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20biphasic%20pancreas%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20biphasic%20liver%20revise.htm

http://www.radiology.uiowa.edu/CT/body/CT%20appendicitis%20revise.htm



*-#st Pr+t+,+"s

A%dminal Arti> Aneur9sm *AAA+ Arti> Disse>tin :rnar9 :al>i<>atin n E:T re)isin

:rnar9 :al>i<>atin n Multisli>e Interstitial 6ung Disease *R:T+ AirCa9 Stud9 M>6ennan Pulmnar9 Em%lism *PE+ :hest nl9 Pulmnar9 Em%lism *PE+ Cith Dee" enus Thr

m%sis *DT+ Pulmnar9 /dule Standard :hest :T

http://www.radiology.uiowa.edu/CT/chest/AAA.html

http://www.radiology.uiowa.edu/CT/chest/AorticDissectio.htm

http://www.radiology.uiowa.edu/CT/chest/Coronary.htm

http://www.radiology.uiowa.edu/CT/chest/CoronaryCal.htm

http://www.radiology.uiowa.edu/CT/chest/InterstitialLungdisease.html

http://www.radiology.uiowa.edu/CT/chest/McLennanAirway.html

http://www.radiology.uiowa.edu/CT/chest/PEChestonly.html

http://www.radiology.uiowa.edu/CT/chest/PEDVT.html


http://www.radiology.uiowa.edu/CT/chest/PulmNoduleStudy.html

http://www.radiology.uiowa.edu/CT/chest/StandardChest.html

http://www.radiology.uiowa.edu/CT/chest/StandardChest.html

http://www.radiology.uiowa.edu/CT/chest/PulmNoduleStudy.html



http://www.radiology.uiowa.edu/CT/chest/PEChestonly.html

http://www.radiology.uiowa.edu/CT/chest/McLennanAirway.html

http://www.radiology.uiowa.edu/CT/chest/InterstitialLungdisease.html

http://www.radiology.uiowa.edu/CT/chest/CoronaryCal.htm

http://www.radiology.uiowa.edu/CT/chest/Coronary.htm

http://www.radiology.uiowa.edu/CT/chest/AorticDissectio.htm

http://www.radiology.uiowa.edu/CT/chest/AAA.html



N#ur+ Pr+t+,+"s

Adult ead :T Adult Sinus :T Adult 3r%it :T Adult /e> :T Sali)ar9 0land :T Fun>tinal 6ar9n@ :T :TA :ir>le f 7illis :TA :artids 6um%ar M9elgram Thra>i> M9elgram :er)i>al M9elgram Adult Trauma Fa>e and Trauma 3r%it :T *fr "atients Ch >annt ha)e dire>t

>rnals+ Adult IA: :T ; A@ial Cith >rnal re>nstru>tins *Dire>t >rnals shuld %e d

ne if "ssi%le= using ther "rt>l+ Adult IA: :T Adult TM4 :T

http://www.radiology.uiowa.edu/CT/neuro/neuroprotocols.htm




































Ort-+#di, Pr+t+,+"s

Trauma Pel)is :T Prt>l Anle :T Prt>l :er)i>al S"ine Thra>i> S"ine 6um%ar S"ine :T Prt>l Shulder :T

Sa>r;Ilia> 4int :T 7rist :T Prt>l Single :ut i" :T

http://www.radiology.uiowa.edu/CT/ortho/orthoprotocols.html




















P#diatri, Pr+t+,+"s

Rutine ead :T :ranis9natsis /e>B6ar9n@ SinusBMa@illfa>ial :T

3r%itBSella :T IA: r TM4 :T :;S"ine Trauma :T :hest :T andBr A%dmen :T andBr Pel)is :T igh;Reslutin :hest :T D9nami> AirCa9 Stud9 *n Imatrn+ E:T S>anning Prt>l fr :F Su%je>ts 7h a)e Signed :

nsent Frm

:T Prt>l fr :9sti> Fi%rsis in :hildren

S / P 0 SOP PERSIAPAN PEMERIKSAAN

http://www.radiology.uiowa.edu/CT/peds/pediatricctprotocols.html









http://www.radiology.uiowa.edu/CT/peds/pedsairwaykao.html

http://www.radiology.uiowa.edu/CT/peds/pedscf.html


http://www.radiology.uiowa.edu/CT/peds/PedsCFprotoKao.html

http://www.radiology.uiowa.edu/CT/peds/PedsCFprotoKao.html



http://www.radiology.uiowa.edu/CT/peds/pedsairwaykao.html












S./.P.0. SOP PERSIAPAN PEMERIKSAANTEKNIS & ADMINISTRASI

5 ,Tida ada

1

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Std.'. PE/0EMA/0A/ STAF



DA/

PR30RAM PE/DIDIKA/ SEMA STAF I/STA6ASI

PE6ATIA/

SEMI/AR

D66



S.'.P.1. P6A//I/0 SDM

5 , TIDAK ADA P6A/ & A/A6ISIS

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$ , 7RITTE/ P6A//I/0



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%. Pemerisaan ginjal

>. S0 A%dmend. :T S>an A%dmen



PR3TAP ADMI/ISTRATIP

; Prsedur "endaftaran

; Prsedur "em%a9aran

; Prsedur Pengam%ilan "emerisaan

; Prsedur "en9im"anan dumen

; dll

Std 1 EALASI DAN PENGENDALIAN



Std.1. EALASI DAN PENGENDALIANMT

ADA PR3SEDR EA6ASI

MET3DE , 0KM=A=T:

SE6F ASSESTME/T

S ( P 1 Ada e)aluasi



S.(.P.1. Ada e)aluasi"r)ider

5 ,tida ada

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$ ,Ada analisa darie)aluasi tertulis=RT6



D3

:nth E)aluasi,; Anget=Kta saran

; As"e eamanan "etugas

; As"e "en9im"anan %ahan radilgi

; Efe sam"ing dan Medi>al Errr; Re)ieC "em%uatan dan la%eling i) >ntras

Meanisme e)aluasi mutu & "rfesinal "r)ider ,

; e)aluasi teni

; e)aluasi teni ualitas "en>u>ian; e)aluasi e@"ertise

; e)aluasi e>e"atan "ela9ananBe@"ertise



Ad)erse Rea>tins

/n;ana"h9la>tid rea>tins *nausea=)miting=

>ardia> arrh9thmia= "ulmnar9 edema=seiGure=

renal failure+

Ana"h9la>tid rea>tins *urti>aria=lar9ngeal

edema= %rn>hs"asm= >ir>ulatr9>lla"se+

Medi>atin Errrs in



Medi>atin Errrs inRadilg9

7rng time 1( ! 7rng rute 1 ! E@tra dse 25 !

7rng "atient !! $ 7rng drug "re"aratin !! $ Pres>ri%ing errr $2 - 7rng administratin te>hniNue -2 1!

3missin errr ' 1$ nauthriGedBCrng drug 1!$ 22 Im"r"er dseBNuantit9 1'' 2(

PR3PER68 A/D SAFE68



PR3PER68 A/D SAFE68ST3RED

Medi>atins are stred and se>uredunder >nditins suita%le fr "rdu>t

sta%ilit9 and safet9 safe strage

safe handling

se>urit9

Medi>atins are Pr"erl9



Medi>atins are Pr"erl9and Safel9 Stred

nauthriGed "ersns= in a>>rdan>e Cithhs"ital "li>9 and a""li>a%le laC r

regulatin >annt ha)e a>>ess tmedi>atins

7hat medi>atins >an radilg9te>hni>ians a>>ess

7hat medi>atins >an radilg9te>hni>ians administer



S.(.P.2. PR30RAM MT

5 , TIDAK ADA

1

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PRI/SIP , PD:A*P6A/=D3=:EK=A:TI3/+



D3

PR30RAM ME6IPTI ,

; MT ADMI/ISTARTIP

; RESP3/ TIME PE6A8A/A/

; MT FI6M =RADI30RAFER=PE/::IA/

; REISI S3P * KE;ERAPA+

; PR30. PE/I/0KATA/ SKI66

*TRAINING,WORKSHOP+

:3/T3 RESP3/ TIME



:3/T3 RESP3/ TIME1. reast ltrasund,

Patient Pre"aratin, / "re"aratin Duratin f this "r>edure, a%ut 1$

minutes

Te>hni>al Details, This in>ludes 2D and D""ler ltrasundimaging f %reasts.

This stud9 is useful in,U Dete>tin f f>al %reast diseaseU :hara>teriGatin f the lesinsU Assessment f )as>ularit9 "attern f the

lesins

2 :hest *Thra@+ ultrasund



2.:hest *Thra@+ ultrasund

Patient Pre"aratin, / "re"aratin Duratin f this "r>edure, a%ut 1$ minutes Te>hni>al Details,

This test is dne usuall9 as se>ndar9 in)estigatin t>larif9 the du%ts in >hest radigra"h9.:hest ultrasund >an image the stru>tures Chi>h are nt air

<lled and Chen there in n air <lled stru>ture %etCeen itand the ultrasund "r%e.:hest ultrasund is useful in,U Dete>ting "leural and "eri>ardial eVusin= e)en Chen the9are minimalU DiVerentiatin %etCeen >nslidatin f lung and "leural

eVusinU Assessment f "leural mass= "ulmnar9 mass that isa%utting the >hest Call r heart. Pint t %e nted here that=if the mass is l>ated dee" inside the lung= there CnWt %ean9 CindC fr ultrasund %eam= s assessment CnWt %e"ssi%le.

MEDI:ATI3/ RE:3/:I6IATI3/



MEDI:ATI3/ RE:3/:I6IATI3/I/ RADI36308

7hat is ReNuired %9 the 4int :mmissin Three ReNuired Ste"s t the Pr>ess

1. 3%tain and d>ument a >m"lete list f "atientXs >urrent medi>atins n entr9 t the rganiGatin *Cith in)l)ement f the "atient+ 2. :m"are the medi>atins the rganiGatin

"r)ides t thse n the list t identif9 and resl)e dis>re"an>ies 15

MEDI:ATI3/ RE:3/:I6IATI3/



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Medi>atin Re>n>iliatin 7hat is ReNuired %9 the 4int

:mmissin Three ReNuired Ste"s t the Pr>ess !. :mmuni>ate the "atientXs >urrent medi>atin

list

t the ne@t "r)ider n "atient transfer rdis>harge Medi>atin Re>n>iliatin

3ur :hallenge



3ur :hallenge*Tantangan+

Im"r)e medi>atin "r>ess and medi>atin safet9 in Radilg9 Meet regulatr9 standards esta%lished %9 4int

:mmissin

De>isin t use r nt use >ntrast is nt alCa9sdetermined at the time the "r>edure is rdered

Failure t "er>ei)e >ntrast as a drug= %elief that>ntrast is safe= ina%ilit9 t )isualiGe a Cra%le"r>ess= du%t that "harma>ists >an add safet9 r

)alue t "r>ess= >m"uteriGed "res>ri%er rderentr9= the de>isin t use >ntrast is nt alCa9smade Chen the "r>edure is rdered= and>ntrast media is "ur>hased and stred in theradilg9 de"artment.



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