Bundle Ido 2019.docx

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BUNDLE INFEKSI DAERAH OPERASI RUMAH SAKIT ISLAM KARAWANG

Nama pasien

: ................................., ..........., L / P

Auditor

: ........................................

Tindakan

: ...............................................

Tgl Audit

: ........................................

AUDIT PRE OPERATIF NO 1 2 3 4

ITEM

YA

TIDAK

KET

YA

TIDAK

KET

YA

TIDAK

KET

Edukasi pasien dan keluarga tentang resiko infeksi dan pencegahannya Cukur atas indikasi dan menggunakan “ Clipper “ Mandi dan keramas antiseptik hari “H” Antibiotik profilaksis atas indikasi Right Drug Right Time Right Duration

Hasil =

_____ x 100 = _____

AUDIT INTRA OPERATIF Auditor

: .......................................

Tgl Audit

: .......................................

NO 1 2 3 4 5

ITEM Durasi cuci tangan bedah dengan khlorhexidin tepat waktu Preparasi kulit pasien dengan khlorhexidin 2 % Suhu pasien normothermia Saturasi O2 >95% Luka operasi dibalut sebelum melepas “ Drape”

Hasil =

_____ x 100 = _____

AUDIT PASCA OPERATIF Auditor

: .......................................

Tgl Audit

: .......................................

NO

ITEM

1

Balutan diganti setelah 48 jam

2

Tehnik aseptik “ No Touch” saat ganti balutan

3

Kepatuhan petugas melakukan cuci tangan

4

Pelaksanaan surveilens IDO

Hasil =

_____ x 100 = _____

Komite Pencegahan Dan Pengendalian Infeksi RSIK

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