KEPUTUSAN KEPUTUSAN
KEPALA UPT PUSKESMAS KALITANJUNG KEPALA UPT PUSKESMAS KALITANJUNG
NOMOR : 265/PKM.KTJ/XII/2015 NOMOR : 265/PKM.KTJ/XII/2015
Lampiran : 1 ( satu ) !r"as Lampiran : 1 ( satu ) !r"as
T#NT$N% T#NT$N%
PENERAPAN MANAJEMEN RESIKO KLINIS PENERAPAN MANAJEMEN RESIKO KLINIS
DI PUSKESMAS KALITANJUNG DI PUSKESMAS KALITANJUNG
KEPALA PUSKESMAS KALITANJUNG KEPALA PUSKESMAS KALITANJUNG
Menimbang
Menimbang :: a.a. &a'a &a'a Pusat Pusat K!s!'atan K!s!'atan Masara"at Masara"at (Pus"!smas) (Pus"!smas) a*a+a' a*a+a' ,nit ,nit P!+a"sanaP!+a"sana T
T!"!"ninis s (,(,PTPT) ) *a*ari ri -i-inanas s K!K!ss!'!'atatan an aan n mm!r!rupupa"a"an an aasisi++iitatass p!n!+!nara p!+aanan "!s!'atan tin"at p!rtama (KTP)
p!n!+!nara p!+aanan "!s!'atan tin"at p!rtama (KTP) &.
&. &a'a &a'a Pus"!smas Pus"!smas a*a+a' a*a+a' asi+itas asi+itas p!+aanan p!+aanan "!s!'atan "!s!'atan an an m!n!+!nara"anm!n!+!nara"an upaa "!s!'atan masara"at *an upaa "!s!'atan p!rs!ranan tin"at p!rtama3 upaa "!s!'atan masara"at *an upaa "!s!'atan p!rs!ranan tin"at p!rtama3 *!n
*!nan an +!&i+!&i' ' m!num!nutama"atama"an n upaupaa a prmprmti ti *an *an pr!4pr!4!nti!nti3 3 untuuntu" " m!nam!napaipai *!raat "!s!'atan masara"at an
*!raat "!s!'atan masara"at an s!tini7tins!tini7tinina *ii+aa' "!ranaina *ii+aa' "!rana .
. &a&a''a a ununtutu" " m!m!nininn"a"at"t"an an !!!"!"titi4i4itatas s *a*an n !!isisi!i!nsnsi i s!s!'i'inna a titi*a*a" " t!t!rra*a*ii "!t!r
"!t!r+am&a+am&atan *an "!sa+a'atan *an "!sa+a'an *a+am upaa p!+aann *a+am upaa p!+aanan "!s!'atan "!s!'atan ma"a an ma"a *i&u*i&uatat P!n!rapan Mana!m!n R!si" K+inis *i ,PT- Pus"!smas 8um&!r
P!n!rapan Mana!m!n R!si" K+inis *i ,PT- Pus"!smas 8um&!r *.
*. &a'&a'a *a+am P!n!ra *a+am P!n!rapaapan n manmana!a!m!n r!sim!n r!si" "+ini" "+inis s ma"ma"a a PusPus"!s"!smas m!+amas m!+a"u""u"anan p!ni+aian "in!ran
p!ni+aian "in!rana s!ara man*iri *i ,PT- Pus"!sa s!ara man*iri *i ,PT- Pus"!smas 8um&!rmas 8um&!r !.
!. &a&a''a a *a*a+a+am m rarann"a "a p!p!+a+a"s"sananaaaan n t!t!rsrs!&!&utut3 3 p!p!r+r+u u *i*itutuanan""an an *a*a+a+am m 8u8uraratt K!putusan K!pa+a ,PT- Pus"!smas 8um&!r.
K!putusan K!pa+a ,PT- Pus"!smas 8um&!r. Mengingat
Mengingat :: 1.
1. ,n*an,n*an7,n*an7,n*an R!pu&+R!pu&+i" i" In*n!In*n!sia3 Nmr sia3 Nmr 96 96 TTa'un a'un 2003 2003 t!ntat!ntann K!s!'atan
K!s!'atan 2.
2. ,n*an,n*an7un*an R!pu&+i" In*n!sia3 Nmr 7un*an R!pu&+i" In*n!sia3 Nmr 96 96 TTa'un a'un 201;3 t!ntan201;3 t!ntan T
T!naa !naa "!s!'atan"!s!'atan 9.
9. P!raturan Pr!si*!n R!pu&+i" In*n!sia Nmr <2 Ta'un 2012 t!ntanP!raturan Pr!si*!n R!pu&+i" In*n!sia Nmr <2 Ta'un 2012 t!ntan 8ist!m K!s!'atan Nasina+
8ist!m K!s!'atan Nasina+ ;.
;. P!P!raratuturaran n PrPr!s!si*i*!n !n N N 12 12 TTa'a'un un 202019193 3 papasasa+ + ;2 ;2 t!t!ntntanan JaJamiminanann K!s!'atan Nasina+
K!s!'atan Nasina+ 5.
5. P!ratP!raturan K!m!uran K!m!nt!rint!rian K!s!'an K!s!'atan N. 161atan N. 161/M#N/M#NK#8/K#8/P#R/=P#R/=III/2III/2010113 t!ntan13 t!ntan K!s!+amatan Pasi!n Ruma' 8a"it
K!s!+amatan Pasi!n Ruma' 8a"it 6.
6. P!rP!ratuaturan K!m!ran K!m!nt!nt!riarian n K!sK!s!'a!'atantan3 3 NmNmr <1 r <1 TTa'ua'un n 2012019 9 t!nt!ntantan JamJaminainann K!
K!s!s!'a'atatan n NaNasisinna+a+3 3 TTa'a'un un 20201 1 a"a"r!r!*i*itatasi si s!s!&a&aaai i sasa+a+a' ' sasatu tu ssararatat r!*!ntia+in
r!*!ntia+in <.
<. P!ratP!raturan M!nuran M!nt!ri K!st!ri K!s!'at!'atan3 Nman3 Nmr <5 Tr <5 Ta'un 201a'un 201; t!ntan; t!ntan Pusat K!s Pusat K!s!'ata!'atann Masara"at
Masara"at >.
>. KK!!ppuuttuussan an MM!!nntt!!rri i KK!!ss!!'a'attaan n RR!!pupu&&++ii" " IIn*n*nn!!ssiiaa3 3 NNmmr r >2>/M!
>2>/M!n"!s/n"!s/8K/IX8K/IX/200> /200> t!ntat!ntan n 8tan*a8tan*ar r P!+aaP!+aanan nan MiniMinima+ ma+ i*ani*an K!s!'atan *i Ka&upat!n/Kta
K!s!'atan *i Ka&upat!n/Kta
PEMERINTAH KABUPATEN CIREBON PEMERINTAH KABUPATEN CIREBON
DINAS KESEHATAN DINAS KESEHATAN
PUSKESMAS KALITANJUNG
PUSKESMAS KALITANJUNG
J+. Ka+itanun N. 20 T!+p. (0291) ;>9>>9 J+. Ka+itanun N. 20 T!+p. (0291) ;>9>>9.
. P!P!raratuturaran n -a-a!r!ra' a' KKta ta ?i?ir!r!&&n3 n3 NNmmr r 5 5 TTa'a'un un 20200>0>3 3 t!t!ntntanan p!m&!ntu"an ranisasi *inas *a!ra' Kta ?ir!&n
p!m&!ntu"an ranisasi *inas *a!ra' Kta ?ir!&n MEMUTUSKAN
MEMUTUSKAN Menetapkan
Menetapkan :: K#P,K#P,T,8$N K#T,8$N K#PP$L$ $L$ P,8K#P,8K#8M$8 T#N8M$8 T#NTT$N% P#N#$N% P#N#R$PR$P$N M$N$J$N M$N$J#M#N#M#N R#8IKO KLINI8 -I P,8K#8M$8 K$LIT$NJ,N%
R#8IKO KLINI8 -I P,8K#8M$8 K$LIT$NJ,N% K
K!!ssaattuu :: P!n!P!n!raprapan an ManMana!a!m!n m!n R!sR!si" i" K+iK+inis nis s!ps!p!rt!rti i t!rt!rt!rt!ra a *a+*a+am am +am+ampirpiran an sursuratat "!putusan ini
"!putusan ini K
K!!**uuaa :: PP!!rr++u a*u a*aanna sua suaattu m!u m!""aanniissmm! "!! "!rra aa ann t! t!rriinntt!!rraassi i ss!!''iinna tia ti**aa" t" t!!rraa**ii "!t!r+am&atan *an "!sa+a'an *a+am p!+a"sanaan "!iatan
"!t!r+am&atan *an "!sa+a'an *a+am p!+a"sanaan "!iatan K!
K!ttiiaa :: K!K!ssa+a+a'a'an an anan m muunn"i"in tn t!r!ra*a*i *i *a+a+am am prprs!s!s "s "!!iaiatatan pn p!r!r+u +u **iaiantntisisipipaasi si ss!'!'ininaa upaa p!n!a'an *apat *i+a"u"an s!'ina ti*a" t!ra*i "!sa+a'an ataupun r!si" upaa p!n!a'an *apat *i+a"u"an s!'ina ti*a" t!ra*i "!sa+a'an ataupun r!si" *a+am p!n!+!naraan prs!s "!iatan
*a+am p!n!+!naraan prs!s "!iatan K!
K!!!mpmpatat :: 8urrat K!8uat K!ppuututusasan n iinni i &&!r!r++a"a"u u ss!!a" taa" tanna+ *ia+ *itt!t!tapap"a"an *!n *!nnan "!an "!t!t!nntutuan apan apa&a&ii+a+a *i"!mu*ian 'ari t!r*apat "!"!+iruan *an atau "!sa+a'an *i*a+amna3 a"an *ia*a"an *i"!mu*ian 'ari t!r*apat "!"!+iruan *an atau "!sa+a'an *i*a+amna3 a"an *ia*a"an p!r&ai"an/p!ru&a'an s!&
p!r&ai"an/p!ru&a'an s!&aaimana m!stina.aaimana m!stina.
-it!tap"an
-it!tap"an *i *i : Ka+itanun: Ka+itanun Pa
Pa*a *a TanTana+ a+ : : 2 2 -!s-!s!m!m&!r &!r 20 20 1 1 55 K#P K#P$L$ $L$ P,8K#8M$8 P,8K#8M$8 K$LIT$NJ,N%K$LIT$NJ,N% *r.@. *r.@.AA$L$LBB$N$$N$@3 @3 M@M@ NIP NIP. : 1<10;1020060;2020. : 1<10;1020060;2020
KABUPATEN GARUT KABUPATEN GARUT SISTEM MANAJEMEN SISTEM MANAJEMEN DINAS KESEHATAN DINAS KESEHATAN KAB. GARUT KAB. GARUT PUSKESMAS PUSKESMAS CIBATCIBATUU
PENERAPAN MANAJEMEN RESIKO KLINIS PENERAPAN MANAJEMEN RESIKO KLINIS
UPTD PUSKESMAS SUMBER
UPTD PUSKESMAS SUMBER
Jl. Ki Hajardewantara
Jl. Ki Hajardewantara No. 10. Kecamatan Cibat Kode Po! ""1#$ No. 10. Kecamatan Cibat Kode Po! ""1#$
%& ' 0()( * "))01#%& ' 0()( * "))01# N. -"um!n : N. -"um!n : 002/8K/K$7PKM.?I$T,/I/2016 002/8K/K$7PKM.?I$T,/I/2016 N. R!4isi :
N. R!4isi : 00 T+. TT+. T!r&it : !r&it : 2 Januari 20162 Januari 2016 @a+.: 1/;@a+.: 1/;
L$
L$MPIRMPIR$N $N K#PK#P,T,,T,8$N 8$N K#PK#P$L$ $L$ P,8P,8K#8K#8M$8M$8 NOMOR 265/8K/K$7PK
NOMOR 265/8K/K$7PKM.?I$M.?I$T,/I/2016T,/I/2016 T#NT
T#NT$N% $N% : P#N#R$: P#N#R$PP$N M$N$J$N M$N$J#M#N R#8I#M#N R#8IKOKO KLINI8.
KLINI8.
MANAJEMEN RESIKO KLINIS MANAJEMEN RESIKO KLINIS
A.
A. PePenna!a!"#"#"a"ann Man
Mana!a!m!n m!n R!sR!si" i" K+iK+inis nis m!rm!rupaupa"an "an suasuatu tu upaupaa a sisist!st!matmatis is anan *i+*i+a"ua"u"an "an *i*i Pus"!smas *a+am ran"a m!nurani r!si" a"i&at p!+a"sanaan p!+aanan m!*i. R!si" Pus"!smas *a+am ran"a m!nurani r!si" a"i&at p!+a"sanaan p!+aanan m!*i. R!si" K+i
K+inis nis *apa*apat t &!r&!rupa upa &a'a&a'aa3 a3 "!s"!sa+aa+a'an'an3 3 musmusi&ai&a' ' ataatau u ptpt!ns!nsi i t!rt!ra*a*inina a 'a+'a+7'a7'a+ + anan m!r
m!ruiui"an "an paspasi!ni!n3 3 t!rt!r"ai"ait t *!n*!nan an ataatau u s!&s!&aaaai i *am*ampa" pa" asuasu'an 'an "+i"+inis nis anan *i&*i&!ri!ri"an"an "!pa*ana.
"!pa*ana. B
B.. TT""$"$"aann 1.
1. M!mM!miniinimummum"an "an t!rt!ra*a*inina a Cm!Cm!*i*ia+ a+ !rr!rrrD3rD3D a*4!rD a*4!rs! s! !4!n!4!ntsDtsD3 3 *an *an C'aC'armsrmsD pa*a D pa*a paspasi!ni!n (m!m&uat asu'an pasi!n +!&i' aman).
(m!m&uat asu'an pasi!n +!&i' aman). 2.
2. M!mM!miniinimummum"an "!mun"an "!mun"in"inan an t!rt!ra*a*inina a "+a"+aim *an im *an m!nm!n!n!n*a+*a+i"ai"an n &ia&iaa a "+a"+aim anim an 'arus m!na*i tanunan institusi (M!n!a' "!ruian inansia+ &ai Pus"!smas) *an 'arus m!na*i tanunan institusi (M!n!a' "!ruian inansia+ &ai Pus"!smas) *an *"t!r. *"t!r. C C.. SSAASASARRAANN 1 1.. PPuuss""!!ssmmaass 2.
2. PuPus"s"!s!smamas P!ms P!m&a&antntuu 9.
9. PPss"!"!ss*!*!s/s/PKPK- -;
;.. PPssaann**uu D.
D. TTa!apa!apan Manaan Mana$eme$emen Re%ikn Re%ik& K#ini& K#ini%% 1.
1. I*!ntI*!ntii"ii"asi r!siasi r!si" : "!+u" : "!+u'an pas'an pasi!n3 "+ai!n3 "+aim3 iniim3 ini*!nt r!*!nt r!prtprt3 au*it m!*3 au*it m!*i".i". 2.
2. P!m&a'P!m&a'asan : asan : TiTim Manam Mana!m!n M!*!m!n M!*i"3 Ki"3 Kr*inr*inatr P!matr P!m!an Pr!an Prraram.m. 9
9.. KK!!ssiimmppuu++aan :n : Root Root Cause Cause Analysis Analysis (RCA)(RCA) ana+isa a"ar masa+a': Tip! M!*ia+ #rrr3 8um&!r ana+isa a"ar masa+a': Tip! M!*ia+ #rrr3 8um&!r M!
M!**iiaa+ + ##rrrrrr33 Failur Failure e Mode Mode Effect Effect Analysis Analysis (FMEA)/(FMEA)/ p!n*!"atan p!n*!"atan sist!mi" sist!mi" untu" untu" m!ni*!ntii"asi "!aa+an pt!nsia+ *an !!"na
m!ni*!ntii"asi "!aa+an pt!nsia+ *an !!"na : p!r&ai"an prs!*ur3 "!&ia"an3 p!raturan: p!r&ai"an prs!*ur3 "!&ia"an3 p!raturan *++.
*++. ;
;.. TTinin*a*a" L" Lananuutt
N. -"um!n :
265/8K/K$7 265/8K/K$7
PKM.?I$T,/I/2016 PKM.?I$T,/I/2016 E.
E. InIn'i'ieent Rent Rep&p&(t(t 1.
1. P!+aprP!+apran s!tian s!tiap masa+ap masa+a' atau "!a' atau "!a*ian ana*ian an m!nim m!nimpan *arpan *ari an *iri an *ir!nana"!nana"an atauan atau s!
s!ara nrmaara nrma+ + s!'s!'aruarusnsna a ti*ti*a" a" t!rt!ra*a*i i *an &!r*a*an &!r*ampampa" " pa*a "!s!+pa*a "!s!+amaamatan tan paspasi!ni!n ( Pati!nt ?ar! an* Pati!nt 8a!t)
( Pati!nt ?ar! an* Pati!nt 8a!t) 2.
2. P!P!+a+appraran n atatas as mamasasa+a+a' ' atatau au "!"!aa*i*ian an aan n m!m!nn'a'a*a*ap"p"an an papasisi!n !n papa*a *a "!"!a*a*aaaann &!r!si".
&!r!si". 9.
9. P!+aprP!+apran atas masaan atas masa+a'/"+a'/"!a*ia!a*ian an &!rt!n*n an &!rt!n*!nsi/!nsi/&!rpt&!rpt!nsi m!n!nsi m!n'a*ap"an pus'a*ap"an pus"!smas"!smas t!r'a*ap tuntutan 'u"um.
t!r'a*ap tuntutan 'u"um. ;.
;. MasMasa+aa+a'/"'/"!a!a*ia*ian n titi*a" *a" 'ar'arus us s!+s!+a+u su*a' m!n!&a+u su*a' m!n!&a&"aa&"an n !*!*!ra!ra3 3 t!tt!tapi t!rmaapi t!rmasu" uasu" ua "!a*ian an pt!nsia+ m!n!&a&"an !*!ra.
"!a*ian an pt!nsia+ m!n!&a&"an !*!ra. 5.
5. P!+P!+aprapran an ataatas s masmasa+aa+a'/"'/"!a!a*ia*ian n an *apat *ia*an *apat *ia*i"ai"an n p!+p!+aaaaran untu" ran untu" m!nm!n!+!+imiiminasnasii atau m!nurun"an r!si".
atau m!nurun"an r!si". 6.
6. P!+P!+aprapran an masmasa+aa+a'/"'/"!a!a*ia*ian n anan m!mm!mpunpunai ai *am*ampa" t!r'apa" t!r'a*ap anar*ap anaran an *an r!si*an r!si"" "!t!rs!*iaan "!uanan3 p!ra+atan maupun supp+i!s.
"!t!rs!*iaan "!uanan3 p!ra+atan maupun supp+i!s. )
).. S"S"mbmbe( e( MeMei'i'a# Ea# E((((&(&( 1
1.. MMaannuussiiaa:: aa.. KK!!++!!++aa''aann &.
&. Kuran t!r+ati'Kuran t!r+ati' .
. KKmumunini"a"asi si anan &u &ururu" " *.
*. K!K!"ua"uasasaan/an/p!p!n!n!n*n*a+a+iaiann !.
!. K!K!t!t!r&r&atatasasan an a"a"tutu .. PPr r uu**mm!!nntt .
. K!K!rarauu7r7raauauann '.
'. LLii !r!rrrr r ii.. OO44!!r r nnii**!n!n!! 2
2.. OOrraanniissaassii a.
a. RaRannanan & &ananuun "n "!r!raa &.
&. P!r!nanaan "!&ia"anP!r!nanaan "!&ia"an .
. $*$*mimininiststrarasisi/ p!m/ p!m&i&iaaaaanan *.
*. InsIns!nt!nti/i/*is*isinsins!nti!nti/ "!p!m/ "!p!mimpimpinainann !.
!. MaManana!!mm!n s!n supup+a+a
N. -"um!n :
265/8K/K$7 265/8K/K$7
PKM.?I$T,/I/2016 PKM.?I$T,/I/2016
.
. 8u8up!p!r4r4isisi/i/umumpapan &an &a+i+i" " .
. K!K!titi*a*a""!+!+asasan an tutuaass '.
'. 8a8a+a+a' m!n' m!n!m!mpatpat"a"an p!rn p!rssnini++ 9
9.. TT!!""nnii""aa++ a.
a. PPr r auauttmmatatiinn &.
&. P!ra+atan an &uru"/rusa" P!ra+atan an &uru"/rusa" .
. K!K!t!t!r&r&atatasasan an p!p!rara+a+atatann *.
*. TTi*ai*a" m!" m!mi+mi+i"i i"i *!*!isiisin sn suppupprtrt !.
!. KKmpmp++!"!"ssititasas .
. KuKuraran n inintt!!rrasasii .
. TT!r!r+a+a+u &a+u &anana" in" inrrmamasisi '.
'. TTi*i*a" m!na" m!nuunana"an '"an '!!"+"+isistt
G.
G. TIPTIPE ME MEDICEDICAL AL ERRERROR OR 1.
1. K#K#K#K#LILIR,R,$N K$N KONON8#8#PP a.
a. WrWrong Concept ong Concept of Diseaseof Disease ( K!sa+a'an *a+am "ns!p p!na"it )( K!sa+a'an *a+am "ns!p p!na"it ) &.
&. WrWrong Concepong Concept of t of TreatmentTreatment ( K!sa+a'an *a+am "ns!p p!n&atan )( K!sa+a'an *a+am "ns!p p!n&atan ) 2.
2. K#K#K#K#LILIR,R,$N $N -I-I$%$%NONO8T8TIK IK a.
a. Misdiagnosis Misdiagnosis ( ( "!sa+a'an *iansis )"!sa+a'an *iansis ) &.
&. Late diagnosis Late diagnosis ( "!t!r+am&atan m!n*iansis ) ( "!t!r+am&atan m!n*iansis ) .
. %a%aa+ ma+ m!+a!+a"u""u"an pan prsrs!*u!*ur *r *iaiansnsisis *.
*. M!nM!nununa"aa"an prn prs!*s!*ur aur an "an "a*a+*a+uauarsarsa !.
!. %a%aa+ ma+ m!+a!+a"u""u"an p!an p!manmantautauan *aan *an n ++++7u7upp .
. @a@asisi+ + p!p!m!m!riri"s"saaaan n p!p!nunnunaann.. 9.
9. K#K#K#K#LILIR,R,$N T$N T#R#R$P$PII a.
a. K!K!sasa+a+a'a'an n m!m!+a+a"u""u"an an titin*an*a"a"an n m!m!*i*i" " &.
&. K!sa+a'an m!m&!ri"an t!rapiK!sa+a'an m!m&!ri"an t!rapi .
. K!K!sasa+a+a'a'an m!n m!n!n!tatap"p"an *an *ssisis *.
*. K!K!sasa+a+a'a'an mn m!n!n!t!tap"ap"an an !!ninis s &a&att !.
!. TT!r+am!r+am&at m!m&at m!m&!ri"&!ri"an t!raan t!rapi pa*api pa*a'a+ in'a+ in*i"as*i"asi &!r*i &!r*asar"aasar"an *iann *ianstisti" su*a' " su*a' !+as!+as .
. M!+M!+a"ua"u"an t"an tin*in*a"aa"an m!*n m!*i" ai" an tin ti*a" a*a" a*!"*!"uat *uat *an tian ti*a" a*a" a*a in*a in*i"*i"asiasi .
. TT!"!"nini" " anan " "!+!+iriruu
N. -"um!n :
265/8K/K$7 265/8K/K$7 PKM.?I$T,/I/2016 PKM.?I$T,/I/2016 ;. ;. K#K#K#K#LILIR,R,$N $N P#P#N?N?#%#%$@$@$N$N a.
a. %aa+ %aa+ m!+a"m!+a"u"an u"an t!rapt!rapi p!ni p!n!a'an !a'an s!suas!suai ani an *i *ip!r+up!r+u"an."an. &.
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