Dody Firmanda 2012 - RSK Sumberglagah Mojokerto Jawa Timur Clinical Pathways 30 Juli 2012

7/31/2019 Dody Firmanda 2012 - RSK Sumberglagah Mojokerto Jawa Timur Clinical Pathways 30 Juli 2012

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5

Jlfcfjel Qe{nxevz*

K}# K`kv Bf}gecke, Zq#E, GEId{te I`gf{d Gdkfi

]ZTQ Be{gexe{f, Oeie}{e#

Qdckentltec

Kdchec {d}mf{cve Tckech Tckech ]dqtmlfi Fck`cdzfe C`g`} =; [entc =155

{dc{ech Mekec Qdcvdldchhe}e Oegfcec Z`zfel .MOQZ&5# Zdztef kdchec egece{

qd}tckechec {d}zdmt{ ' qd}e{t}ec gdchdcef qdleizeceec MQOZ Idzdne{ec

ne}tz {dlen eke qelfch lege {echhel =4 C`rdgmd} =15= .5 {entc ke}fkftckechieccve&= kec ztken ne}tz gtlef md}`qd}ezf qeke {echhel 5 Oecte}f

=15;: zd}{e tc{ti MQOZ Idzdne{ec; {fkei kfzdldchhe}eiec lehf `ldn

Idgdc{d}fec Idzdne{ec4# Qd}{ecveec vech {fgmtl ekelen mehefgece zfz{dg

MQOZ Idzdne{ec {d}zdmt{0

Keleg Tckech Tckech ]F C`g`} =6 [entc =11; {dc{ech Q}ei{fi Idkì{d}ec

qeke qezel ;4 gdcd}echiec {dc{ech idxeofmec gdcvdldchhe}eiec idckelf

gt{t kec idckelf mfeve#2 Qeke Tckech Tckech ]F C`g`} ;; [entc =151

{dc{ech ]tgen Zeif{ qeke qezel :: gdcd}echiec {dc{ech `}hecfzezf}tgen zeif{ vech dbdi{fb, dbfzfdc, kec eitc{emdl# 8 Qd}e{t}ec Qdgd}fc{en

C`g`} =: [entc =114 {dc{ech Qdchdl`leec Idtechec Mekec Levecec Tgtg

kec Qd}e{t}ec Gdc{d}f Keleg Cdhd}f C`g`} 25 [entc =118 {dc{ech

Qdk`gec [dicfz Qdchdl`leec Idtechec Mekec Levecec Tgtg Ked}en qeke

qezel 5 eve{ 5 gdcvdmt{iec tc{ti gdgmd}fiec qdlevecec idqeke gezve}eie{

md}tqe qdcvdkfeec me}ech kec/e{et oeze vech kfotel {ecqe gdcht{egeiec

gdcje}f idtc{tchec kec keleg gdleitiec idhfe{eccve kfkeze}iec qeke

q}fczfq dbfzfdczf kec q}`kti{frf{ez#>,6

* Kfzegqefiec qeke Qdle{fnec Qdcvtztcec Jlfcfjel Qe{nxevz ]tgen Zeif{ Itz{e Ztgmd}hlehenGòìd}{` Oexe [fgt} :1':5 Otlf =15=#

5 Tckech Tckech ]F C`g`} =; [entc =155 {dc{ech Mekec Qdcvdldchhe}e Oegfcec Z`zfel= Tckech Tckech ]F C`#=; [entc =155 Qezel 81 eve{ e#: Tckech Tckech ]F C`#=; [entc =155 Qezel 21 eve{ .5 Tckech Tckech ]F C`#=; [entc =155 Qezel 4 eve{ .=&e#4 Tckech Tckech ]F C`#=; [entc =155 Qezel 21 eve{ .=&e#2 Tckech Tckech ]F C`g`} =6 [entc =11; {dc{ech Q}ei{fi Idkì{d}ec8 Tckech Tckech ]F C`g`} ;; [entc =151 {dc{ech ]tgen Zeif{> Qd}e{t}ec Qdgd}fc{en ]F C`g`} =: [entc =114 {dc{ech Qdchdl`leec Idtechec Mekec Levecec Tgtg6 Qd}e{t}ec Gdc{d}f Keleg Cdhd}f C`g`} 25 [entc =118 {dc{ech Qdk`gec [dicfz Qdchdl`leec Idtechec

Mekec Levecec Tgtg Ked}en


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=

Keleg gdleitiec dreltezf idmfoeiec kec zfz{dg levecec idzdne{ec

.ndel{nje}d zvz{dg eck q lfjfdz drelte{f`c& eke : i}f{d}fe itcjf veicf

i}f{d}fe dbdi{fbf{ez, dbfzfdczf, kec idmd}ekflec/ditf{f .dbbdj{frdcdzz,dbbfjfdcjv eck dutf{v&51 vech gd}tqeiec zte{t }echiefec zfz{dge{fi keleg

zte{t zfz{dg# Gdleitiec zte{t ecelfzfz di`c`gf keleg qdlevecec idkì{d}ec

q}`bdzf ekelen {fkei gtken, gdchfche{ mecvei bei{ } vech ne}tz

kfqd}{fgmechiec ke}f md}mehef kfgdczf {d}gezti je}e qdckdie{ec ke}f odcfz

ecelfzfz di`c`gf vech eiec kfhtceiec, me{ezec {d}gfc`l`hf di`c`gf f{t zdckf}f

gdchdcef t{flfe{f`c, q}`ktj{frf{v, mdcdbf{, dbbfjfdcjv, dbbdj{frdcdzz, reltd

b`} g`cdv, idmfoeiec bfziel kec {fchie{ fcble{f`c }e{d vech zd}fch ielf

md}tmen# Kfzegqfch id{d}me{ezec ztgmd} keve kec idmfoeiec di`c`gf vech

kfqdche}tnf q`lf{fz, zdnfchhe {fkei oe}ech (}dz`t}jdz( {d}zdmt{ {dlen kfqehtgdcoekf (bf~dk(#55

Zdkechiec kf zfzf kfgdczf lefc q}`bdzf f{t zdckf}f kf{tc{t{ tc{ti gdcfchie{iec

gt{t qdlevececcve kec idq}`bdzfeccve keleg i`}fk`} d{fi'z`zf`'mtkeve zd}{e

md}mehef qd}e{t}ec kec qd}tckechec ntitg#8

Zdkechiec fz{flen, kdbfcfzf kec kfgdczf eiec dbfzfdczf othe mdltg eke

idzdqeie{ec vech odlez kec dizqlfzf{ {d}hec{tch ke}f md}mehef qd}zqdi{fb#

Dbfzfdczf keqe{ kfh l`chiec idqeke dbfzfdczf {dncfi .{djncfjel dbbfjfdcjv&,dbfzfdczf q}`ktizf/nezfl .q}`ktj{frd dbbfjfdcjv& kec dbfzfdczf elìe{fb

.ell`je{frd/z`jfd{el dbbfjfdcjv& {d}gezti kfkelegcve mfkech ge}id{ kec

idzdne{ec#2,5= .[emdl 5&

51 Ekev LE, Mdhldv JD, Lef}z`c K]# Drelte{fch {nd ndel{nje}d zvz{dg? dbbdj{frdcdzz, dbbfjfdcjv eck

dutf{v# :}k dk# Xeznfch{`c KJ? Ndel{n Ekgfcfz{}e{f`c Q}dzz, =11;#55 Bf}gecke K# Eqlfiezf fc{dh}ezf zfcd}hfz ec{e}e Drfkdcrd'mezdk Gdkfjfcd, Drfkdcjd'mezdk Ndel{nje}d kec

Drfkdcjd'mezdk Q`lfjv keleg ze{t zfz{dg qdcfchie{ec gt{t qdlevecec idzdne{ec kec idkì{d}ec

.Jlfcfjel H`rd}cecjd&? zte{t {ec{echec q}`bdzf FKEF kf geze gdcke{ech#FF#J`z{ Dbbdj{frdcdzz Ecelvzdz

.JDE& Z{ecke} Qdlevecec Gdkfz .ZQG& Idzdne{ec Ecei FKEF Kfzegqefiec qeke Eje}e Qd}{dgtec

Qd}nfgqtcec @}hecfzezf Q}`bdzf kdchec Kf{odc Vec Gdkfi Kdqidz ]F kf M`h`} Zdq{dgmd} =114#

n{{q?//xxx#zj}fmk#j`g/k`j/5=>=86:2/K`kv'Bf}gecke'=114'1;='Eqlfiezf'fc{dh}ezf'zfcd}hfz'

Drfkdcrdmezdk'Gdkfjfcd'Drfkdcjdmezdk'Ndel{nje}d'kec'Drfkdcjdmezdk'Q`lfjv'keleg'Jlfcfjel'H`rd5= Bf}gecke K# Qdchdckelfec gt{t kec dbfzfdczf qdgmfeveec levecec idzdne{ec# Kfzegqefiec keleg

}echie dreltezf Q}`h}eg Qdlevecec Ezidz [d}qekt ]tgen Zeif{ .QQE[]Z& kfzdldchhe}eiec `ldn Iec{`}

Qtze{ Q[ Ezidz .Qd}zd}`& kf N`{dl Qec`}ege Me{eg 51 Kdzdgmd} =11>#

n{{q?//xxx#zj}fmk#j`g/k`j/6>11>8>/K`kv'Bf}gecke'=11>'Qdchdckelfec'Gt{t'Kec'Dbfzfdczf'Mfeve']Z'

51'Kdzdgmd}'=11>


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:

[emdl 5# Md}mehef kdbfcfzf keg kfgdczf {fchie{ ecelfzfz {dc{ech dbdi{fbf{ez,

dbfdczf kec idmd}ekflec/ditf{f#5=

Dr`ltzf zfz{dg levecec idzdne{ec kf ze}ece idzdne{ec .}tgen zeif{& zdje}e

q}fczfqcve gtlef ke}f vech md}jf}fiec k`fch {nfchz jndeqd} keleg nel fcf

dbbfjfdcjv qeke {entc 5681ec qeke xei{t i}fzfz idtechec kec hdo`lei @QDJ,idgtkfec di`c`gf gtlef qtlfn kec gezve}eie{ gdctc{t{ levecec idzdne{ec

md}jf}fiec k`fch {nfchz md{{d}keleg nel fcf utelf{v fgq}`rdgdc{# Zdlege kte

kdiekd {d}zdmt{ geceodgdc md}j`}ei k`fch {nfchz }fhn{ .kfidcel zdmehef

fcj}dezfch dbbdj{frdcdzz& vech gd}tqeiec i`gmfcezf k`fch {nfchz jndeqd}

kec k`fch {nfchz md{{d}# [d}cve{e q}fczfq k`fch {nfchz }fhn{{fkei gdgekef

gdchfit{f qd}idgmechec idgeotec {dic`l`hf getqtc {tc{t{ec gezve}eie{

vech zdgeifc i}f{fz9 kec q}fczfq geceodgdc k`fch {nfchz }fhn{{d}zdmt{ {dlen

id{fchhelec egec kec kfechheq zdmehef q}fczfq kec je}e geceodgdc itc`#


4/30

;

Qeke emek =5 fcf geze d}e hl`melfzezf kfmt{tniec {fkei necve k`fch {nfchz

}fhn{, eiec {d{eqf othe kfqd}ltiec q}fczfq geceodgdc k`fch {nd }fhn{ {nfchz

zdnfchhe i`gmfcezf idktecve kfzdmt{ zdmehef q}fczfq geceodgdc levececg`kd}c k`fch {nd }fhn{ {nfchz }fhn{# 5:

Gecbee{ Jlfcfjel Qe{nxevz keleg Dbfzfdczf Qdgmfeveec, Dbdi{fbf{ez

Qdlevecec kec Idmd}ekflec/Ditf{f

Jlfcfjel Qe{nxevz .JQ& ekelen zte{t i`czdq qd}dcjeceec qdlevecec {d}qekt

vech gd}echitg zd{feq lechien vech kfmd}fiec idqeke qezfdc md}keze}iec

z{ecke} qdlevecec gdkfz kec eztnec idqd}exe{ec vech md}mezfz mti{f kdchec

nezfl vech {d}tit} kec keleg oechie xei{t {d}{dc{t zdlege kf }tgenzeif{#5;,54,52

Md}fit{ nezfl qdcdlf{fec qdcd}eqec Jlfcfjel Qe{nxevz Qcdtg`cfe .Hegme} 5

kec =& vech kfleitiec keleg }echie gdgmti{fiec ekecve dbfzfdczf mfeve,

dbdi{fbf{ez levecec kec idmd}ekflec/ditf{f mehf zdgte qezfdc {ecqe

gdgeckech le{e} mdleiech idekeec z`zfel di`c`gf, qdckfkfiec getqtc

hdckd}# Ke}f Hegme} 5 kec = kf mexen tc{ti ieztz qcdtg`cfe mfeve

qd}exe{ec zegqef zdgmtn .kdchec {e}fb }tgen zeif{& gdgqd}htceiec Jlfcfjel

Qe{nxevz Qcdtg`cfe ekelen zdif{e} ]q ;64 111,' tc{ti idlez FFF, ]q 5 5=1111,' tc{ti idlez FF, ]q 5 ;>1 111,' tc{ti idlez F kec ]q = 541 111,' tc{ti

idlez RFQ# Zdkechiec mfle kfnf{tch md}keze}iec ilefg Oegidzgez tc{ti ieztz

vech zege ekelen ]q = 818 22:,'# Geie zdje}e ge{dge{fi kdchec

gdgqd}htceiec Jlfcfjel Qe{nxevz tc{ti ieztz qcdtg`cfe {d}zdmt{

gdchndge{ .= 818 22: ;64 111 7 ]q = =5= 22:,' Kdchec kdgfifec

5: Bf}gecke K# Qd}ec Dbdi{fbf{ez Ilfcfz keleg }echie gdxtotkiec idzdlege{ec/idegecec .zebd{v& kec

md}`}fdc{ezf idqeke qezfdc .qe{fdc{ jdc{}dkcdzzKfzegqefiec qeke N`zqf{el Gecehdgdc{ : vech

kfzdldchhe}eiec `ldn Qtze{ Ieofec Ekgfcfz{}ezf kec Idmfoeiec Idzdne{ec BIG TF kf H}eck Echieze

N`{dl Fc{d}ce{f`cel, Gdkec 55 Ehtz{tz =11># n{{q?//xxx#zj}fmk#j`g/k`j/6>5:555/K`kv'Bf}gecke'=11>'Qd}ec'Dbdi{frf{ez'Ilfcfz'Keleg'QE[N5; Bf}gecke K# Qdk`gec Qdcvtztcec Jlfcfjel Qe{nxevz keleg }echie fgqldgdc{ezf Zfz{dg K]Hz Jezdgf~

kf }tgen zeif{# Kfzegqefiec keleg Zfkech Qldc` I`gf{d Gdkfi ]Z Be{gexe{f, Oeie}{e 8 @i{`md}

=114#54 Bf}gecke K# Jlfcfjel Qe{nxevz? Qd}ec q} bdzf gdkfz keleg }echie gdcvtztc Zfz{dg K]Hz Jezdgf~ kf

}tgen zeif{# Kfzegqeiec qeke itcotchec leqechec id ]ZTQ Ekeg Gelfi Gdkec == Kdzdgmd} =114,

]ZTQ Nezec Zekfifc Mecktch =: Kdzdgmd} =114 kec Dreltezf Qdcvtztcec Jlfcfjel Qe{nxevz keleg

}echie qdcvdgqt}ceec Qdk`gec K]Hz Jezdgf~ Kdqidz ]F, N`{dl H}eck Jdgqeie Oeie}{e =6

Kdzdgmd} =114#52 Bf}gecke K, Q}e{fxf Eckevecf, Ct}efcf F}ge Ztzec{f, Z}fd Dchhe} IK kii# Jlfcfjel Qe{nxevz

Idzdne{ec Ecei keleg }echie fgqldgdc{ezf Zfz{dg K]Hz Jezdgf~ kf ]Z Be{gexe{f, Oeie}{e =112#


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4

{d}lfne{ odlez ke}f zdhf di`c`gf/qdgmfeveec }tgen zeif{ {d}zdmt{ zeche{

dbfzfdc kec gdchtc{tchiec mfle gdchhtceiec Jlfcfjel Qe{nxevz#

Kdchec gdgqd}htceiec Jlfcfjel Qe{nxevz keqe{ gdchnf{tch J`z{ Xdfhn{zd{feq idl`gq`i ieztz, j`c{`n tc{ti ieztz qcdtg`cfe kf e{ez }d}e{e

ztgmd}keve .}dz`t}jdz& }tgen zeif{ .`me{ `me{ec, menec kec ele{ kll& vech

{d}qeief ekelen ]q =41 111,' geie J`z{'Xdfhn{ cve ekelen .;41 111/=41

111 7 5#>


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2

Hegme} 5# J`c{`n nezfl qdcdlf{fec fgqldgdc{ezf zelen ze{t Jlfcfjel Qe{nxevztc{ti ieztz qcdtg`cfe


7/30

8

Hegme} =# J`c{`n ecelfzfz nezfl fgqldgdc{ezf zelen ze{t Jlfcfjel Qe{nxevz

qeke {entc =112 tc{ti ieztz qcdtg`cfe


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>

[dc{ech je}e lechien lechien qd}nf{tchec j`z{ xdfhn{, jezdgf~ fckd~, mezd

}e{d}tgen zeif{ kec el`iezf echhe}ec keqe{ kflfne{ keleg Hegme} : md}fit{#

Hegme} :# J`c{`n qd}nf{tchec md}keze}iec ke{e nezfl fgqldgdc{ezf Jlfcfjel

Qe{nxevz keleg gdcje}f ]dle{frd Xdfhn{ .j`z{ xdfhn{&, Jezd Gf~ Fckd~ kec

Mezd ]e{d#


9/30

6

Ehe} {fkei {tgqech {fckfn zd}{e zfcd}hfz kdchec idcve{eec kf leqechec

.}tgen zeif{&, geie fgqldgdc{ezf Jlfcfjel Qe{nxevz zdmeficve {d}qekt kdchec

{e{eidl`le geceoegdc .j`}q`}e{d h`rd}cecjd& kec {e{eidl`le ilfcfz .jlfcfjelh`rd}cecjd& vech {dlen md}leit zdztef gfzf }tgen zeif{ keleg mfkech

qdlevecec, qdckfkfiec kec qdcdlf{fec#

Kdchec {d}mf{cve Qd}e{t}ec Gdc{d}f Idzdne{ec ]F C`g`}

5:;>/GDCIDZ/QD]/F^/=151 vech kfhtceiec ekelen fz{flen Z{ecke}

Qdlevecec Idkì{d}ec .ZQI& vech {d}kf}f ke}f Qdk`gec Cezf`cel Qdlevecec

Idkì{d}ec .QCQI& kec Z{ecke} Q}`zdkt} @qd}ezf`cel .ZQ@ QCQI kfmte{

`ldn `}hecfzezf q}`bdzf kec kfzeniec `ldn Gdc{d}f Idzdne{ec ]F, zdkechiec

ZQ@ kfmte{ kf {fchie{ }tgen zeif{ `ldn q}`bdzf gdkfz kdchec i``}kfce{`}I`gf{d Gdkfz kec kf{d{eqiec qdchhtceeccve kf }tgen zeif{ {d}zdmt{ `ldn

qfgqfcec .kf}di{t}

Z{ecke} Q}`zdkt} @qd}ezf`cel tc{ti q}`bdzf gdkfz kf }tgen zeif{ keleg

mdc{ti Qecktec Q}ei{fi Ilfcfz58 ' qeke tgtgcve keqe{ kfek`qzf ke}f Qecktec

Cezf`cel Qdlevecec Idkì{d}ec .QCQI& vech {dlen kfmte{ `ldn `}hecfzezf

q}`bdzf gezfch gezfch, {fchhel kfj`jìiec kec kfzdztefiec kdchec i`ckfzf

ze}ece kec i`gqd{dczf vech eke kf }tgen zeif{# Mfle QCQI vech {dlen kfmte{

`ldn `}hecfzezf q}`bdzf {d}zdmt{ kec {dlen kfzeniec `ldn Gdc{d}f Idzdne{ec]F zd}{e zdztef kdchec i`ckfzf }tgen zeif{ geie {fchhel kfzdqeie{f `ldn

echh`{e q}`bdzf .ZGB& {d}ief{ zdmehef Qecktec Q}ei{fi Ilfcfz .QQI& kec

kfzeniec qdchhtceeccve kf }tgen zeif{ `ldn kf}di{t} }tgen zeif{ {d}zdmt{#

Cegtc mfle QCQI {d}zdmt{ mdltg eke e{et {fkei zdztef kdchec i`ckfzf

}tgen zeif{ e{et keleg QCQI mdltg gdcjec{tgiec odcfz qdcveif{ vech zdztef

kdchec idekeec dqfkdgf l`hf qdcveif{ kf ked}en/}tgen zeif{ {d}zdmt{

geie q}`bdzf kf }tgen zeif{ {d}zdmt{ xeofm gdgmte{ Qecktec Q}ei{fi Ilfcfz

.QQI& tc{ti }tgen zeif{ {d}zdmt{ kec kfzeniec qdchhtceeccve kf }tgen zeif{

`ldn kf}di{t} }tgen zeif{# Keleg gdcvtztc QCQI ke}f `}hecfzezf q}`bdzf

getqtc QQI tc{ti }tgen zeif{ ' q}`bdzf gdkfz gdgmd}fiec qdlevecec

idq}`bdzfeccve zdje}e dbdi{fb .jlfcfjel dbbdj{frdcdzz& keleg nel gdcdheiiec

kfehc`zfz kec gdgmd}fiec {d}eqf md}keze}iec qdckdie{ec drfkdcjd'mezdk

gdkfjfcd# Zdje}e zdkd}nece qd}e{t}ec {d}zdmt{ keqe{ kflfne{ zdmehefgece

keleg Hegme} ; md}fit{#

58 Qd}e{t}ec Gdc{d}f Idzdne{ec ]F C`g`} 5:;>/GDCIDZ/QD]/F^/=151


10/30

51

Hegme} ;# ]fchiezec Qd}e{t}ec Gdc{d}f Idzdne{ec ]F C`g`}

5:;>/GDCIDZ/QD]/F^/=151 {dc{ech Z{ecke} Qdlevecec Idk`i{d}ec QCQI,

ZQ@ kec QQI#

Q}`zdz zdlecot{cve zd{dlen gdcvtztc Qecktec Q}ei{fi Ilfcfz .QQI& ]tgen

Zeif{ ekelen gdgmte{ Jlfcfjel Qe{nxevz zdmehef zelen ze{t i`gq`cdc ke}fZfz{dg Jezdgf~ .FCE JMH& vech zee{ fcf kfqd}htceiec tc{ti Oegfcec

Qdgdlfne}eec Idzdne{ec .Oegidzgez& kf }tgen zeif{ ' geie FCE JMH eiec

ldmfn kfzdgqt}ceiec kdchec gdchnf{tch K]H ]dle{frd Xdfhn{ kec Jezdgf~

Fckd~ zd}{e Mezd ]e{d zd{feq qdchdl`gq`iiec odcfz qdcveif{ kec

zdlecot{cve keqe{ gdgmeckfchiec .mdcjnge}ifch& j`z{ dbbfjfdcjv ec{e}}tgen zeif{ keleg gdgmd}fiec levecec idzdne{ec md}keze}iec idekeec

zdmdce}cve kfmd}fiec gdleltf Jlfcfjel Qe{nxevz#


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55

Zfz{dg Jezdgf~ ekelen zte{t je}e gdchdl`le ztgmd} keve }tgen zeif{

zddbdi{fb gtchifc keleg gdgmd}fiec levecec idzdne{ec vech {d}oechiet

idqeke gezve}eie{ md}keze}iec qdchdl`gqìiec zqdi{}tg kfehc`zfzqdcveif{ vech n`g`hdc kec q} zdkt} {fckeiec vech kfmd}fiec ' zdje}e

}fchiezcve {d}kf}f ke}f : i`gq`cdc t{ege veicf i`kdbfiezf kfehc`zfz .FJK

51& kec q}`zdkt} {fckeiec .FJK 6 JG&, qdgmfeveec .j`z{fch& vech keqe{

md}tqe {`q'k`xc eqq}èjn, ej{frf{v mezdk j`z{fch kec e{et i`gmfcezfidktecve, kec gdleltf Jlfcfjel Qe{nxevz#5>,56,=1,=5,==

FCE'K]H ekelen re}fezf zfz{dg jezdgf~ rd}zf Idgdc{d}fec Idzdne{ec ]F

tc{ti Fck`cdzfe vech kfztztc md}keze}iec ke{e ke}f 54 }tgen zeif{ rd}{fiel,

gdgqd}htceiec FJK 51 tc{ti kfehc`zfz kec FJK 6 JG tc{ti q}`zdkt}{fckeiec zd}{e mfeve md}keze}iec {e}fb vech md}leit qeke xei{t {d}zdmt{#

Tqeve {d}zdmt{ gdgech mdltg zdgqt}ce kec mdltg gdcjd}gfciec }delf{ez

idekeec zdlt}tn qdl`zì {ecen ef} cegtc zdmehef {f{fi {`chhei exel, nel

{d}zdmt{ gd}tqeiec zte{t idmd}nezflec keleg gdgmte{ zte{t zfz{dg

qdgmfeveec levecec idzdne{ec }tgen zeif{ kec tzene mefi gdctot idqez{fec

kec keqe{ kfqd}mefif zd}{e kf{fchie{iec itelf{ez getqtc relfkf{ez ke{ecve

vech }dq}dzdc{e{fb tc{ti Fck`cdzfe# Zdmehef zfz{dg vech me}t lenf} FCE'

K]H eiec {d}tz md}htlf} kec md}idgmech zdztef {tc{t{ec qd}idgmechec

levecec idzdne{ec mefi cezf`cel getqtc }dhf`cel#

=:

Kdchec md}einf}cve lfzdczfh}`tqd} FCE'K]H {d}nf{tch {echhel :1 Zdq{dgmd} =151, geie cege zf{dg

Jezdgf~ FCE'K]H md}tmen gdcoekf FCE'JMH=;#

5> H`lkgec L# J`z{'Dbbdj{frdcdzz fc e ble{ x`}lk Jec FJKz ndlq {nd Tcf{dk Z{e{dz hd{ }nv{ng0 C

Dchl O Gdk=1149:4:.5; &?545:'4#56 Kece M Gtiegd KM, _xecfhd} O, Megdef E# N`zqf{el j`gqd{f{f`c, }dz`t}jd ell`je{f`c eck utelf{v

`b je}d# MGJ Ndel{n Zd}rfjdz ]dzde}jn =11=9 =.51&? 5;8='>5#

=1 Kfecd ]`xleck K# Gdkfjefk Fgqlfje{f`cz b`} {nd ndel{n zebd{v cd{#C Dchl O Gdk =1149 :4:.5;&?5;:6';5#

=5 H}dellv J# Eb{d} 5= vde}z `b Jezdgf~ fc F}dleck, e geo`} }drfdx ldekfch {` f{z g`kd}cfze{f`c eck

d~qeczf`c ez e jdc{}el qflle} fc n`zqf{el btckfch q`lfjv# F}dleck Kdqe}{gdc{ `b Ndel{n, =11;#== Jezdgf~ Tcf{ Kdqe}{gdc{ `b Ndel{n eck Jnflk}dc# Jezdgf~ Gdezt}dgdc{ fc F}fzn N`zqf{elz# F}dleck

Kdqe}{gdc{ `b Ndel{n, =114#=: Bf}gecke K# Ecelfzfz Qdgmeve}ec idqeke Qdgmd}f Levecec Idzdne{ec .QQI& gdchhtceiec FCE'JMH

gdckdie{f ne}eqec zdgte qfnei zdztef Jlfcfjel Qe{nxevz# Kfzegqefiec qeke X`}izn`q Fgqldgdc{ezf

FCE'JMH Qd}jdqe{ec [}eczb`}gezf kf ]tgen Zeif{ Ked}en .]ZK& kfzdldchhe}eiec `ldn Ez`zfezf

]tgen Zeif{ Ked}en Zdlt}tn Fck`cdzfe .E]ZEKE& Oexe Me}e{ kf N`{dl Ez{`c [}`qfjece Mecktch, =:

Otcf =155#=; Zt}e{ Dke}ec Kf}di{t} Odckd}el Mfce Qdlevecec Gdkfi Idgdc{d}fec Idzdne{ec ]F C`g`} F]#1:#15/

F/481851 [echhel 5> @i{`md} =151#


12/30

5=

Q=OI Idgdc{d}fec Idzdne{ec ]F {dlen gdchekeiec qd}{dgtec kdchec

zdlt}tn qd}nfgqtcec q}`bdzf kec i`ldhftg kf Kdcqeze} Melf qeke {echhel =:

C`rdgmd} =116 kec gdchnezfliec idqt{tzec zdmehef md}fit{?

5# Idzdqeie{ec kec i`gf{gdc md}zege zdlt}tn qd}nfgqtcec q}`bdzf kec

I`ldhftg zd{feq qd}nfgqtcec q}`bdzf gdgmte{ 51 qdcveif{ {d}mecvei

Z{ecke}/Qdk`gec Qdlevecec Gdkfz .Z/QQG& kec Jlfcfjel Qe{nxevz

tc{ti gdldchieqf FCE'K]H keleg Q}`h}eg Oegfcec Idzdne{ec#

=# Qd}{dgtec zdlecot{cve {echhel == Oecte}f =151 kfzdldchhe}eiec `ldn

Qtze{ Qdgmfeveec kec Oegfcec Idzdne{ec .Q=OI& Zdi}d{e}fe{ Odckd}el

Kdqidz ]F gdgmenez zdlt}tn ZQG kec JQ#

]dcjece qd}{dgtec lecot{ec {echhel == Oecte}f =151 kftckt} kec {d}delfzezf

qeke {echhel 8'6 Eq}fl =151 kf Me{eg kdchec qdgmenezec idgmelf gdchdcef

Z{ecke} Qdlevecec Idk`i{d}ec zd{feq qd}nfgqtcec q}`bdzf# Cegtc zd{dlen

f{t {fkei eke {fckei lecot{ zd{d}tzcve#

[d}ldqez ke}f idckele qdchhtceec Jlfcfjel Qe{nxevz zdmehef qdldchieq FCE'JMH9 fgqldgdc{ezf Jlfcfjel Qe{nxevz zeche{ md}gecbee{ mehf q}`bdzf keleg

gdgmd}fiec qdlevecec, qdckfkfiec getqtc qdcdlf{fec kf }tgen zeif{

zdmehefgece keqe{ kflfne{ keleg hegme} 4 zegqef 8 md}fit{#


13/30

5:

Hegme} 4# Fgqldgdc{ezf Jlfcfjel Qe{nxevz keleg mfkech qdlevecec kf }tgen

zeif{#


14/30

5;

Hegme} 2# Fgqldgdc{ezf Jlfcfjel Qe{nxevztc{ti qdcdlf{fec kf }tgen zeif{#


15/30

54

Hegme} 8# Fgqldgdc{ezf Jlfcfjel Qe{nxevz kfief{ec kdchec ezdzgdc qdcflefec

tc{ti qdzd}{e kfkfi genezfzxe kec qdzd}{e q}`h}eg k`i{d} zqdzfelfz kf

}tgen zeif{ getqtc }tgen zeif{ odoe}fch qdckfkfiec#


16/30

52

I`czdq# i`cz{}tizf getqtc g`kdl fgqldgdc{ezf Jlfcfjel Qe{nxevzzdje}e {fkei

lechztch zdmehefgece kft{e}eiec kfe{ez menxe?

Jlfcfjel Qe{nxevz zdmehef fcz{}tgdc qdlevecec md}bìtz idqeke qezfdc

.qe{fdc{'b`jtzdk je}d&, {d}fc{dh}ezf, md}idzfcegmtchec ke}f qezfdc gezti

kf}exe{ zegqef qtlech zdgmtn .j`c{fct`tz je}d&, odlez eiec kì{d}/qd}exe{

qdcechhtch oexem qezfdc .kt{v `b je}d&, t{flf{ez qdgd}fizeec qdctcoech,qdchhtceec `me{ `me{ec {d}gezti ec{fmf {fie, q}`zdkt} {fckeiec `qd}ezf,

ec{fzfqezf idgtchifcec {d}oekfcve gdkfjel d}}`}z .le{dc kec ei{fb, cve}fz

{d}oekf getqtc idoekfec {fkei kfne}eqiec/I[K& kec qdcjdhenec idgtchifcec

jdkd}e .ne}gz& zd}{e fcbdizf c`zì`gfel keleg }echie idzdlege{ec qezfdc

.qe{fdc{ zebd{v&, gdckd{dizf kfcf {f{fi {f{fi q`{dczfel md}fzfi` zdlege q}`zdzlevecec qd}exe{ec qezfdc .{}ejd}z gd{n`k`l`hv& keleg }echie geceodgdc

}fzfi` .}fziz gecehdgdc{&, }dcjece qdgtlechec qezfdc .qe{fdc{ kfzjne}hd& ,tqeve qdcfchie{ec gt{t levecec md}idzfcegmtchec .j`c{fct`tz utelf{vfgq}`rdgdc{& mefi kdchec qdckdie{ec {dncfi [@J .[nd`}v `b J`cz{}efc{z&

tc{ti zfz{dg getqtc fckfrfkt q}`bdzf, qdctltzt}ec ifcd}oe .qd}b`}gecjd&

fckfrfkt q}`bdzf getqtc idl`gqì .{deg'x`}i

Gd}tqeiec zte{t }echiefec zfz{dg vech keqe{ kfqd}htceiec zdmehef

fcz{}tgdc tc{ti gdgdctnf qd}zve}e{ec qdcflefec Ei}dkf{ezf ke}f I`gf{dEi}dkf{ezf ]tgen Zeif{ .IE]Z& rd}zf me}t getqtc ke}f O`fc{ J`ggfzzf`c

Fc{d}ce{f`cel b`} N`zqf{el .OJF& rd}zf =155 tc{ti z{ecke} z{ecke} keleg

Zdj{f`c F# Qe{fdc{ Jdc{d}dk Z{ecke}k getqtc keleg Zdj{f`c FF# Ndel{nje}d

@}hecfe{f`c Gecehdgdc{ Z{ecke}k zdmehefgece fltz{}ezf Hegme} > zegqef

51 md}fit{#


17/30

58

Hegme} ># Jlfcfjel Qe{nxevzkec OJF =155 Ejj}dkf{e{f`c Z{ecke}kz


18/30


19/30

56

Hegme} 51# Jlfcfjel Qe{nxevz kec {dncfi [}ejd} Gd{n`k`l`hv vech kfhtceiec

`ldn zt}rdv`} keleg }echie Ei}dkf{ezf OJF =155


20/30

=1

Q}fczfq q}fczfq keleg gdcvtztc Jlfcfjel Qe{nxevz

Jlfcfjel Qe{nxevz .JQ& ekelen zte{t i`czdq qd}dcjeceec qdlevecec {d}qektvech gd}echitg zd{feq lechien vech kfmd}fiec idqeke qezfdc md}keze}iecz{ecke} qdlevecec gdkfz kec eztnec idqd}exe{ec vech md}mezfz mti{f kdchec

nezfl vech {d}tit} kec keleg oechie xei{t {d}{dc{t zdlege kf }tgen

zeif{#=4,=2,=8

Keleg gdgmte{ Jlfcfjel Qe{nxevz qdcechecec ieztz qezfdc }exe{ fceq kf

}tgen zeif{ ne}tz md}zfbe{?

e# Zdlt}tn idhfe{ec qdlevecec vech kfmd}fiec ne}tz zdje}e{d}qekt/fc{dh}ezf kec md}`}fdc{ezf bìtz {d}nekeq qezfdc .Qe{fdc{

B`jtzdk Je}d&zd}{e md}idzfcegmtchec .j`c{fct`tz `b je}d&m# Gdlfme{iec zdlt}tn q}`bdzf .kì{d}, qd}exe{/mfkec, qdce{e,

lem`}e{`}fz kec be}gezfz&

j# Keleg me{ezec xei{t vech {dlen kf{dc{tiec zdztef kdchec idekeec

qd}oelecec qdcveif{ qezfdc kec kfje{e{ keleg mdc{ti qd}f`kd ne}fec

.tc{ti ieztz }exe{ fceq& e{et oeg .tc{ti ieztz hexe{ ke}t}e{ kf tcf{

dgd}hdczf

k# Qdcje{e{ec JQ zdlt}tn idhfe{ec qdlevecec vech kfmd}fiec idqeke qezfdczdje}e {d}qekt kec md}idzfcegmtchec {d}zdmt{ keleg mdc{ti

kìtgdc vech gd}tqeiec mehfec ke}f ]dieg Gdkfz#

d# Zd{feq qdcvfgqechec lechien keleg qdcd}eqec JQ kfje{e{ zdmehef

re}fecz kec kfleitiec ieofec ecelfzfz keleg mdc{ti etkf{#

b# Re}fecz {d}zdmt{ keqe{ ie}dce i`ckfzf qd}oelecec qdcveif{, qdcveif{

qdcvd}{e e{et i`gqlfiezf getqtc idzelenec gdkfz .gdkfjel d}}`}z

h# Re}fecz {d}zdmt{ kfqd}htceiec zdmehef zelen ze{t qe}egd{d} keleg

}echie gdgqd}{eneciec kec gdcfchie{iec gt{t qdlevecec#

=4 Bf}gecke K# Qdk`gec Qdcvtztcec Jlfcfjel Qe{nxevz keleg }echie fgqldgdc{ezf Zfz{dg K]Hz Jezdgf~

kf }tgen zeif{# Kfzegqefiec keleg Zfkech Qldc` I`gf{d Gdkfi ]Z Be{gexe{f, Oeie}{e 8 @i{`md}

=114#=2 Bf}gecke K# Jlfcfjel Qe{nxevz? Qd}ec q} bdzf gdkfz keleg }echie gdcvtztc Zfz{dg K]Hz Jezdgf~ kf

}tgen zeif{# Kfzegqeiec qeke itcotchec leqechec id ]ZTQ Ekeg Gelfi Gdkec == Kdzdgmd} =114,

]ZTQ Nezec Zekfifc Mecktch =: Kdzdgmd} =114 kec Dreltezf Qdcvtztcec Jlfcfjel Qe{nxevz keleg

}echie qdcvdgqt}ceec Qdk`gec K]Hz Jezdgf~ Kdqidz ]F, N`{dl H}eck Jdgqeie Oeie}{e =6

Kdzdgmd} =114#=8 Bf}gecke K, Q}e{fxf Eckevecf, Ct}efcf F}ge Ztzec{f, Z}fd Dchhe} IK kii# Jlfcfjel Qe{nxevz

Idzdne{ec Ecei keleg }echie fgqldgdc{ezf Zfz{dg K]Hz Jezdgf~ kf ]Z Be{gexe{f, Oeie}{e =112#


21/30

=5

Jlfcfjel Qe{nxevz {d}zdmt{ keqe{ gd}tqeiec zte{t Z{ecke} Q}`zdkt}

@qd}ezf`cel vech gd}echitg?

e# Q}`bdzf gdkfz? Z{ecke} Qdlevecec Gdkfz ke}f zd{feq Idl gq`i Z{ebGdkfz/Z{eb Gdkfz Btchzf`cel .ZGB& ilfcfz kec qdctcoech#

m# Q}`bdzf idqd}exe{ec? Eztnec Idqd}exe{ec

j# Q}`bdzf be}gezf? Tcf{ K`zd Keflvkec Z{`q @}kd}fch

k# Elt} Qdlevecec Qezfdc ]exe{ Fceq kec @qd}ezf ke}f Zfz{dg Idl`gq`i

Z{eb Gdkfz/Z{eb Gdkfz Btchzf cel .ZGB&, Fcz{elezf kec Zfz{dg

Geceodgdc ]tgen Zeif{#

Lechien lechien qdcvtztcec Jlfcfjel Qe{nxevz

Lechien lechien keleg gdcvtztc B`}ge{ Jlfcfjel Qe{nxevz vech ne}tz

kfqd}ne{fiec?

5# I`gq`cdc vech ne}tz kfjeitq zdmehefgece kdbfcfzf ke}f JlfcfjelQe{nxevz

=# Gecbee{iec ke{e vech {dlen eke kf leqechec }tgen zeif{ kec i`ckfzf

zd{dgqe{=> zdqd}{f ke{e Leq`}ec ]L= .Ke{e Idekeec G`}mfkf{ez

Qezfdc& vech kfmte{ zd{feq }tgen zeif{ md}keze}iec Mtit Qd{tcoti

Qdchfzfec, Qdch`lenec kec Qdcveofec Ke{e ]tgen Zeif{=6 kec zdcztz

ne}fec tc{ti?e# Qdcd{eqec otktl/{`qfi Jlfcfjel Qe{nxevzvech eiec kfmte{#

m# Qdcd{eqec lege ne}f }exe{#

:# Tc{ti re}femdl {fckeiec kec `me{ `me{ec gdchejt idqeke Z{ecke}

Qdlevecec Gdkfz, Z{ecke} Q}`zdkt} @qd}ezf`cel kec Keb{e} Z{ecke}

B`}gtle}ftg vech {dlen eke kf }tgen zeif{ zd{dgqe{, Mfle qd}lt

z{ecke} z{ecke} {d}zdmt{ keqe{ kfleitiec }drfzf zdztef idzdqeie{ec

zd{dgqe{#

;# Qd}htceiec Mtit FJK 51 tc{ti nel i`kdbfiezf kfehc`zfz kec FJK 6 JG

tc{ti nel {fckeiec q}`zdkt} zdztef kdchec q}`bdzf/ZGB gezfch

gezfch#=2

=> Bf}gecke K# I`kdbfiezf FJK 51 kec FJK 6 JG? fckfie{`} gt{t }dieg gdkfi keleg }echie

gdcfchie{iec gt{t qdlevecec }tgen zeif{# Kfzegqefiec qeke Z`zfelfzezf Q`le Zfz{dg Fcb`}gezf

Geceodgdc ]tgen Zeif{# Kfzdldchhe}eiec `ldn Kf}di{`}e{ Odckd}el Mfce Qdlevecec Gdkfi Kdqidz ]Fkf N`{dl Qechndhe} Mecktch 5': Otcf =112#

=6 Kdqe}{dgdc Idzdne{ec ]F# Mtit Qd{tcoti Qdchfzfec, Qdch`lenec kec Qdcveofec Ke{e ]tgen

Zeif{# Kf}di{`}e{ Odckd}el Mfce Qdlevecec Gdkfi Kdqidz ]F, Oeie}{e =114#


22/30

==

Qd}zfeqec keleg qdcvtztcec Jlfcfjel Qe{nxevz

Ehe} keleg gdcvtztc Jlfcfjel Qe{nxevz {d}e}en kec gdcjeqef zeze}ec zd}{edbfzfdc xei{t, geie kfqd}ltiec id}oezege kec i``}kfcezf ec{e} q}`bdzf kf

ZGB, Fcz{elezf ]exe{ Fceq .gtlef ke}f hexe{ ke}t}e{, }techec }exe{ fceq,

}techec {fckeiec, fcz{elezf mdken, FJT/QFJT/CFJT& kec ze}ece qdctcoech

.fcz{elezf hff, be}gezf, }dieg gdkfi, eitc{ezf idtechec, }ekf`l`hf kec

zdmehefcve

5# Q}`bdzf Gdkfz gdgqd}zfeqiec Z{ecke} Qdlevecec Gdkfz e{et Qecktec

Q}ei{fi Ilfcfz kec z{ecke} q}`zdkt} `qd}ezf`cel .ZQG/QQI/ZQ@& zdztef

kdchec mfkech idenlfeccve# Q}`bdzf Gdkfz ke}f zd{feq kfrfzfmd}keze}iec ke{e ke}f }dieg gdkfz kfe{ez ' gdgqd}zfeqiec

ZQG/QQI/ZQ@, mfle mdltg eke keqe{ gdcvtztc ktlt ZQG/QQI/ZQ@cve

zdztef idzdqeie{ec#

=# Q}`bdzf ]dieg Gdkfz/I`kd} gdgqd}zfeqiec mtit FJK 51 kec FJK 6

JG, Leq`}ec ]L5 zegqef kdchec 2 .{d}t{ege ]L= Q}`bdzf ]dieg

Gdkfz gdgmte{ keb{e} 4 ' 51 qdcveif{ t{ege kec {d}zd}fch ke}f zd{feq

kfrfzf ZGB/Fcz{elezf kdchec i`kd FJK 51 zd}{e }d}e{e lege ne}f }exe{

md}keze}iec ke{e leq`}ec g`}mfkf{ez ]L=#

:# Q}`bdzf Qd}exe{ gdgqd}zfeqiec Eztnec Idqd}exe{ec#;# Q}`bdzf Be}gezf gdgqd}zfeqiec Keb{e} B`}gtle}ftg, zfz{dg tcf{

k`zdkec z{`q `}kd}fch#

4# Q}`bdzf Eitc{ezf/Idtechec gdgqd}zfeqiec Keb{e} [e}fb }tgen zeif{

Zd{feq re}fecz vech kfkeqe{iec eiec kfleitiec {fckei lecot{ keleg mdc{ti

qdleizeceec etkf{ gdkfz zdmehefgece vech kfecot}iec keleg Tckech Tckech

]F C`g`} =6 [entc =11; kec Qd}e{t}ec Gdc{d}f Idzdne{ec ]F C`g`}

844/Gdcidz/Qd}/FR/=155#

Idzfgqtlec?

Ke}f t}efec zfchie{ kfe{ez kdchec necve zdldgme} Jlfcfjel Qe{nxevz '

gd}tqeiec zte{t fcz{}tgdc vech i`gq}dndczfb gd}echitg zdje}e {d}qekt

mfkech qdlevecec, qdckfkfiec kec qdcdlf{fec getqtc ei}dkf{ezf zd}{e mfle

kf{fcoet ke}f zdhf di`c`gf idzdne{ec keqe{ gdleizeceiec dbfzfdczf

qdgmfeveec kdchec gdgecbee{iec zd`q{fgel gtchifc ne}f }exe{ qezfdc,

gdchdlfgfcezf qdgd}fizeec qdctcoech/lem`}e{`}ftg/{fckeiec vech {fkei


23/30

=:

kfqd}ltiec, gdchhtceiec `me{ `me{eec .{d}t{ege ec{fmf`{fi& zdztef drfkdcjd'

mezdk9 zdnfchhe qdlevecec dbdi{fb kfzegqfch {fkei gdgmdkeiec le{e}

mdleiech qezfdc ie}dce bìtz idqeke qezfdc kec qdcveif{cve.idmd}ekflec/ditf{f& kec zdielfhtz gdgdctnf zdlt}tn {fhe {totec ke}f

Tckech Tckech ]F C`g`} =6 [entc =11; kec dgqe{ {totec Tckech

Tckech ]F C`g`} ;; [entc =116# Meniec mfle kfleizeceiec Jlfcfjel

Qe{nxevz zdje}e i`czfz{dc kfgece eiec kfkeqe{iec ke{e ke{e j`z{'xdfhn{,

jezdgf~ fckd~kec mezd'}e{dzdje}e ldchieq .tc{ti gfj}`'zvz{dg& eiec keqe{

kfztztc zte{t Ce{f`cel Ndel{n Ejj`tc{z zdnfchhe Tcfrd}zel J`rd}ehd eiec

ldmfn gtken {d}jfq{e kec Tckech Tckech ]F C`g`} ;1 [entc =11; zd}{e

Tckech Tckech ]F C`g`} =; [entc =155 tc{ti mfkech idzdne{ec

{d}xtotk .zdje}e gej}`'zvz{dg

[d}fge iezfn, zdg`he md}gecbee{#

Gòìd}{ , :1 Otlf =15=

K`kv Bf}gecke

Id{te I`gf{d Gdkfi

]ZTQ Be{gexe{f Oeie}{e#

n{{q?//xxx#zj}fmk#j`g/I`gf{d$=1Gdkfi


24/30

=;

LEGQF]EC?

Qecktec Q}ei{fi Ilfcfz

ZGB ?

]ZI ZTGMD]HLEHEN G@O@ID][@

=15= =15;

########################

5# Qdchd}{fec .Kdbfcfzf& ##

=# Ecegcdzfz ####

##

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:# Qdgd}fizeec Bfzfi ####

##

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####

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;# I}f{d}fe Kfehc`zfz 5# #=#

:#

;# ##

4# #########################

4# Kfehc`zfz #

2# Kfehc`zfz Meckfch 5# #=# #

:#

8# Qdgd}fizeec Qdctcoech 5# =#

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25/30

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26/30

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27/30

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29/30

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Dody Firmanda 2012 - RSK Sumberglagah Mojokerto Jawa Timur Clinical Pathways 30 Juli 2012

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