ASESMEN 10-11-2015.xlsx

8/16/2019 ASESMEN 10-11-2015.xlsx

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8/16/2019 ASESMEN 10-11-2015.xlsx


NAMA FASILITAS: PUSKESMAS KAMPILI

TIPE FASILITAS: PONED

KECAMATAN: PALLANGGAKABUPATEN: GOWA

PROVINSI : SULAWAISI SELATAN

Developed by Yo!" A#$%!& O'(obe! )*+)& All !",-( !ee!ved.

INSTRUMEN PENILAIAN STAND

KINERJA Pelayanan O

Neonatal Emergensi

RESPONS EMERGENSI OBSTETRI-NEONATAL

PENEGA!AN IN"EKSI

R#J#KAN EMERGENSI OBSTETRI $ NEONAT#S

Gra%& '

TABEL REKAP

8/16/2019 ASESMEN 10-11-2015.xlsx


(ersi Matri&s "EBR#ARI )*'+ - Re, '

(ersi Instrmen ). JAN#ARI )*'+

Rstetri-

EmON PENILAIAN KETERAMPILAN

PONED PERLENGKAPAN $ PERALATAN

Gra%& )

8/16/2019 ASESMEN 10-11-2015.xlsx


)/''/)*'+

STANDAR PROSES STANDAR

I4(!52e4 + I4(!5

*8

+*8

)*8

6*87*8

/*8

9*8

*8

;*8

<*8

+**8

*.*8 *.*8 *.*8

Gra%& ) Tabel

S(%4d%!d Obe!ved

S(%4d%!d To(%l

8/16/2019 ASESMEN 10-11-2015.xlsx


Gra%& '

PUSKESMAS KAMPILI & ++ Feb )*+/

INER0A PELA0ANAN EMERGENSI OBSTETRI $ NEONATAL 1E2ONC3

PROSES STANDAR PROSES STANDAR PROSES STANDAR PROSES

e4 ) I4(!52e4 6 I4(!52e4 7 I4(!52e4 /

*.*8 *.*8 *.*8 *.*8 *.*8 *.*8 *.*8

8/16/2019 ASESMEN 10-11-2015.xlsx


a

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NS S S S S

NS

STANDAR PROSES

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*1*2 *1*2

8/16/2019 ASESMEN 10-11-2015.xlsx


Pen5a6aian

KINER0A PEL

++ O'( +/ Ae )

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+*8

)*8

6*8

7*8

/*8

9*8

*8

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/.78).;8

Gra%& ' Tabel

S(%4d%!d Obe!ved

S(%4d%!d To(%l

8/16/2019 ASESMEN 10-11-2015.xlsx


Gra%& )

PUSKESMAS KAMPILI

++ O'( )*+/

0ANAN EMERGENSI OBSTETRI $ NEONATAL 1E2ONC3

Ae 6 Ae 7 Ae /

+71*2 +71*2 +71*2 +

).;8 ).;8 ).;8

STANDAR PROSES

8/16/2019 ASESMEN 10-11-2015.xlsx


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8/16/2019 ASESMEN 10-11-2015.xlsx


INSTR#MEN

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Pe4"l%"%4 Ke(e!%2p"l%4 E2ONC

R5>5?%4 E2ONC

Pe!le4,?%p%4 Pe!%l%(%4 PONED

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TOTAL PUSKESMAS

(Standard Total)

Gra%& ' Gra%& )

S(%4d%!d Obe!ved

S(%4d%!d To(%l

8/16/2019 ASESMEN 10-11-2015.xlsx


Tabel

PUSKESMAS KAMPILI

ASESMEN ' ASESMEN ) ASESMEN 3 ASES

++ O'( )*+/ Ae ) Ae 6 Ae

STANDAR PROSES STANDAR PROSES STANDAR PROSES STANDAR

;*.*8 <;.)8

*.*8 .+8

+**.*8 +**.*8

+**.*8 +**.*8

9/.*8 ;/.*8

9+./8 /.78 /<.*8 ).;8 /<.*8 ).;8 /<.*8

KINER0A PELA0ANAN EMERGENSI OBSTETRI $ NEONATAL 1E

8/16/2019 ASESMEN 10-11-2015.xlsx


EN 4 ASESMEN + ASESMEN .

7 Ae / Ae 9

PROSES STANDAR PROSES STANDAR PROSES

).;8 /<.*8 ).;8 /<.*8 ).;8

ONC3

8/16/2019 ASESMEN 10-11-2015.xlsx


PUSKESMAS KAMPILI

NO1 STANDAR KINERJA

'1

)1

31

41

+1

I4(!52e4 +: Res6onse Emergensi Obstetri-Neonatal 8i P

T"2 E2e!,e4" "%p d"p%4,,"l 54(5? pe4%(%l%?%4%%4 e("%p Ibu hamil,bersalin atau postpartum dan neonatus y%4, be!%d% d%l%2 ?o4d""2e4,%4'%2 >"$% (e!?%"( %d%4y% ?o2pl"?%"

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8/16/2019 ASESMEN 10-11-2015.xlsx


8/16/2019 ASESMEN 10-11-2015.xlsx


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KRITERIA (ERI"IKASI 0/T

'Tim emergensi terdiri dari: bidan, perawat, dokter umum

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Lihat Lampiran daftar standar kelengkapan troli emergensi obstetri- neonatal

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● Troli emergensi OBSTETRIK

● Troli emergensi N!N"T"L

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8/16/2019 ASESMEN 10-11-2015.xlsx


8/16/2019 ASESMEN 10-11-2015.xlsx


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8/16/2019 ASESMEN 10-11-2015.xlsx


8/16/2019 ASESMEN 10-11-2015.xlsx


Troli Emergensi Obstetrik: PUSKES!S K!PI"I

DA"TAR KELENGKAPAN TROLI EMERGENSI IB#NO1 N A M A

' PERALATAN

A2b5 b%,& 54,?5p& l%4, o?",e4& ?%45l% o?",e4

K%(e(e! pe4,-"%p 5?5!%4 +;

,5del de4,%4 d5% 5?5!%4 <*22 d%4 +** 22

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Folley '%(-e(e! 4o +9& +;& d%4 ?%4(o4, 5!"4

P%l5 !ee?

) PERSEDIAAN OBAT EMERGENSI

Obat-obat mm<

Ad!e4%l"4

A(!op"4e 5l@%(e DeJ(!oe 7*8

D"p-e4-yd!%2"4e %(%5 p-e4e!,%4

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Sp5"( No. +& )& 6& /& +*& )*& /* ''

mergen#$ obstetri# #are "%&& hal b-',!N& buku a#uan hal *+-' dan petunuk teknis penggun

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8/16/2019 ASESMEN 10-11-2015.xlsx


Troli Emergensi #eonatal: PUSKES!S K!PI"I

DA"TAR KELENGKAPAN TROLI EMERGENSI NEONAT#SNO1 N A M A

' PERALATAN BALON $ S#NGK#P

A2b5 b%,

S52be! o?",e4 de4,%4 pe4,%(5! %l"!%4 15?5!%4 d +* L23

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P"p% l%2b54, No. ;F d%4 p5"( )* 2l

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PUS

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MENU UTAMA

RESPONS EMERGENSI

EmNOC DI PUSKESMAS

RUJUKAN EMERGENSI

PERLENGKAPAN & PERALATAN

REKAPIT#LASI $ GRA"IK

PENCEGAHAN INFEKSI

8/16/2019 ASESMEN 10-11-2015.xlsx


8/16/2019 ASESMEN 10-11-2015.xlsx


ESMAS KAMPILI

STANDAR KINERJA

52e4 ): EmON Penilaian Keteram6ilan 8i Ps&esma

Te4%,% ?ee-%(%4 d" @%"l"(% ?ee-%(%4 ?o2pe(e4 2e2pe!%,%?%4Penatala&sanaan Per8ara>an 6ost6artm p%d% ?l"e4 %(%5 2odel

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Te4%,% ?ee-%(%4 d" @%"l"(% ?ee-%(%4 ?o2pe(e4 2e2pe!%,%?%4Penatala&sanaan Pre-E&lam6sia Berat/E&lam6sia p%d% ?l"e4 %(%52odel

Te4%,% ?ee-%(%4 d" @%"l"(% ?ee-%(%4 ?o2pe(e4 2e2pe!%,%?%4Pe4%(%l%?%4%%4 Ressitasi Neonats p%d% ?l"e4 %(%5 2odel

Te4%,% ?ee-%(%4 d" @%"l"(% ?ee-%(%4 ?o2pe(e4 2e2pe!%,%?%4l%4,?%-l%4,?%- Inisiasi Menys Dini 1IMD3 d%4 2e2be!"?%4 ASI y%4,be4%!

Te4%,% ?ee-%(%4 d" @%"l"(% ?ee-%(%4 ?o2pe(e4 2e2pe!%,%?%4Pera9atan Meto8e Kangr 1PMK3

8/16/2019 ASESMEN 10-11-2015.xlsx


8/16/2019 ASESMEN 10-11-2015.xlsx


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*

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Me4do?52e4(%"?%4 ?o2pe(e4" de4,%4 pe4"l%"%4 ede!-%4% ?e(e!%2p"l%

5enilaian keterampilan dapat dilakukan setelah penilaian fasilitas dalamsesi $ang berbeda.

5&okumentasi menunukan bahwa 6/7 petugas kesehatan kompetenmelakukan keterampilan $g dinilai dgn penilaian sederhana langsung dlm pela$anan atau simulasi kasus menggunakan daftar tilik


5enilaian keterampilan dapat dilakukan setelah penilaian fasilitas dalam

sesi $ang berbeda.5&okumentasi menunukan bahwa 6/7 petugas kesehatan kompetenmelakukan keterampilan $g dinilai dgn penilaian sederhana langsung dlm pela$anan atau simulasi kasus menggunakan daftar tilik













8/16/2019 ASESMEN 10-11-2015.xlsx


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8/16/2019 ASESMEN 10-11-2015.xlsx


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8/16/2019 ASESMEN 10-11-2015.xlsx


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8/16/2019 ASESMEN 10-11-2015.xlsx


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8/16/2019 ASESMEN 10-11-2015.xlsx


PUS

NO1

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31

41

+1

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MENU UTAMA

RESPONS EMERGENSI

EmNOC DI PUSKESMAS

RUJUKAN EMERGENSI



PENCEGAHAN INFEKSI

8/16/2019 ASESMEN 10-11-2015.xlsx


8/16/2019 ASESMEN 10-11-2015.xlsx


ESMAS KAMPILI

STANDAR KINERJA

52e4 6: R:&an Emergensi Obstetri5 8an neonats

P5?e2% Kl"4"? S$%(% 2e2p54y%" %2b5l%4 !od% e2p%( y%4, be!@54,"54(5? !5>5?%4 e2e!,e4" ob(e(!"? d%4 4eo4%(5

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P5?e2%Kl"4"? S$%(% 2e2"l"?" S(%4d%! P!oed5! Ope!%"o4%l 1SPO3%(%5 pedo2%4 54(5? !5>5?%4 4eo4%(5 %?"( ?e RS y%4, d"d%l%24y%2e4'%4(52?%4 : R"$%y%( pe4y%?"(& pe2e!"?%%4 "?& (e!%p" y%4, d"be!"?%4 ebel52 d"!5>5?

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: PONED STANDARDS T

ASES ASESOR TANGGAL EON'T EON)T EON3T

+ FASILITAS +++*+/ / 9

) * / 9

6 * / 9

7 * / 9

/ * / 9

9 * / 9

RES#ME PENAPAIAN ST 2 Inst ' - 4

Ases Tanggal 2 Inst ' 2 Inst ) 2 Inst 3 2 Inst 4

+ +++*+/ ;*.* *.* +**.* E!!:/*<

) =DIV* =DIV* =DIV* =VALUE

6 =DIV* =DIV* =DIV* =VALUE


/ =DIV* =DIV* =DIV* =VALUE


<atatan :

> ? umlah standar $ang di#apai

5) > % ? 3nst * sd +

55) > Total % ? 3nst * sd @

<ara perhitungan 7 bukan berdasarkan rata-rata tetapi berdasarkan umlah semu

NAMA PKM P#SKESMAS KAMPILI

KAB#PATEN GO@A

PROPINSI S#LA@AISI SELATAN

"ORMAT ENTRI DATA KE

Maternal NeonatalI4(!52e4 +. Repo4 Ked%!5!%(%4 : 052l%- (%4d%!

52l%- S(%4d%! y%4, NA

I4(!52e4 ). Pe4"l%"%4 Ke(e!%2p"l%4 : 052l%- (%4d

P%&S'&: P ? PuskesmasB %& ? <lini#al 3nstrumen *B S'& ? Standar /*

8/16/2019 ASESMEN 10-11-2015.xlsx


52l%- S(%4d%! y%4, NA

I4(!52e4 6. R5>5?%4 ?ed%!5!%(%4 : 052l%- (%4d%!

52l%- S(%4d%! y%4, NA

I4(!52e4 7. Pe!%4,?%( d%4 Pe!%l%(%4 : 052l%- (%

52l%- S(%4d%! y%4, NA

PENEGA!AN IN"EKSII4(!52e4 +. Pe4'e,%-%4 I4@e?" : 052l%- (%4d%!

52l%- S(%4d%! y%4, NA

RANGK#MAN

S&or Ib NeonatsA1 Jmla> total Stan8ar yang Di

B1 Persentase Stan8ar yang 8i5

S&or Pen5ega>an In?e&siA1 Jmla> total Stan8ar yang Di


S&or Total Penilaian KlinisA1 Jmla> total Stan8ar yang Di


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TAL STANDARDS OBSERVED

EON4T EON+T EON'O EON)O EON3O EON4O

E!!:/*< )* / 9 E!!:/*<

E!!:/*< )* * * * E!!:/*<

E!!:/*< )* * * * E!!:/*<

E!!:/*< )* * * * E!!:/*<

E!!:/*< )* * * * E!!:/*<

E!!:/*< )* * * * E!!:/*<

PI PKM

F PKM 2 PKM F PI PKM F Total PKM 2 TOTAL PKM

E!!:/*< E!!:/*< +6 9;.78 E!!:/*< E!!:/*<

* =VALUE * =VALUE

* =VALUE * =VALUE

* =VALUE * =VALUE

* =VALUE * =VALUE

* =VALUE * =DIV* * =VALUE

standar $ang di#apai dibagi umlah semua standar $ang diobserAasi

@EB ONLINEPE

&e-' &e-)

y%4, d"'%p%" d%!" / %d%l%-7 *

* /

%! y%4, d"'%p%" d%!" %d%l%-* *

PKM () TOTAL PKM(()

2 PI PKMInst +C

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8/16/2019 ASESMEN 10-11-2015.xlsx


CAPAIAN STANDARDS

EON+O EON'S EON)S EON3S EON4S EON+S

+< 7 * 9 E!!:/*< +6

* * * * *

* * * * *

* * * * *

* * * * *

* * * * *

RIODE ASSESSMENT

&e-3 &e-4 &e-+ &e-.

* * * *

/ / / /

* * * *

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8/16/2019 ASESMEN 10-11-2015.xlsx


CAPAIAN PROSES

EON'P EON)P EON3P EON4P EON+P P'S*' P'S*) P'S*3 P'S*4

7.<+ *./* 9.** E!!:/*< +9.<< + + + *

*.** *.** *.** *.** * * * *

*.** *.** *.** *.** * * * *

*.** *.** *.** *.** * * * *

*.** *.** *.** *.** * * * *

*.** *.** *.** *.** * * * *

Ke2b%l" ?e MENU

Ke2b%l" ?e I4( +

Ke2b%l" ?e I4( )

8/16/2019 ASESMEN 10-11-2015.xlsx


Ke2b%l" ?e I4( 6

Ke2b%l" ?e I4( 7

Ke2b%l" ?e I4( /

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8/16/2019 ASESMEN 10-11-2015.xlsx


INSTR#MEN KLINIS P#SKESMAS STANDARC

P3S*) P3S*3 P3S*4 P3S*+ P3S*. P4S*' P+S*' P+S*) P+S*3

+ + + + + E!!:/*< E!!:/*< E!!:/*< E!!:/*<

* * * * * E!!:/*< E!!:/*< E!!:/*< E!!:/*<

* * * * * E!!:/*< E!!:/*< E!!:/*< E!!:/*<

* * * * * E!!:/*< E!!:/*< E!!:/*< E!!:/*<

* * * * * E!!:/*< E!!:/*< E!!:/*< E!!:/*<

* * * * * E!!:/*< E!!:/*< E!!:/*< E!!:/*<

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8/16/2019 ASESMEN 10-11-2015.xlsx


P+S*4 P+S*+ P+S*. P+S*= P+S*; P+S*7 P+S'* P+S'' P+S')

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

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8/16/2019 ASESMEN 10-11-2015.xlsx


P+S'3 P+S'4 P+S'+ P+S'. P'P*' P'P*) P'P*3 P'P*4 P'P*+

E!!:/*< E!!:/*< E!!:/*< E!!:/*< +.** +.** +.** *.<+ +.**

E!!:/*< E!!:/*< E!!:/*< E!!:/*< *.** *.** *.** *.** *.**

E!!:/*< E!!:/*< E!!:/*< E!!:/*< *.** *.** *.** *.** *.**

E!!:/*< E!!:/*< E!!:/*< E!!:/*< *.** *.** *.** *.** *.**

E!!:/*< E!!:/*< E!!:/*< E!!:/*< *.** *.** *.** *.** *.**

E!!:/*< E!!:/*< E!!:/*< E!!:/*< *.** *.** *.** *.** *.**

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8/16/2019 ASESMEN 10-11-2015.xlsx


P)P*' P)P*) P)P*3 P)P*4 P)P*+ P)P*. P)P*= P3P*' P3P*)

*.** *.** *.** *.** *.** *.** *./* +.** +.**

*.** *.** *.** *.** *.** *.** *.** *.** *.**

*.** *.** *.** *.** *.** *.** *.** *.** *.**

*.** *.** *.** *.** *.** *.** *.** *.** *.**

*.** *.** *.** *.** *.** *.** *.** *.** *.**

*.** *.** *.** *.** *.** *.** *.** *.** *.**

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8/16/2019 ASESMEN 10-11-2015.xlsx


INSTR#MEN KLINIS P#SKESMAS PROSESC

P3P*3 P3P*4 P3P*+ P3P*. P4P*4 P+P*' P+P*) P+P*3 P+P*4

+.** +.** +.** +.** E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

*.** *.** *.** *.** E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

*.** *.** *.** *.** E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

*.** *.** *.** *.** E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

*.** *.** *.** *.** E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

*.** *.** *.** *.** E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

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8/16/2019 ASESMEN 10-11-2015.xlsx


P+P*+ P+P*. P+P*= P+P*; P+P*7 P+P'* P+P'' P+P') P+P'3

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*< E!!:/*<

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8/16/2019 ASESMEN 10-11-2015.xlsx


P+P'4 P+P'+ P+P'.

E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*<

E!!:/*< E!!:/*< E!!:/*<

8/16/2019 ASESMEN 10-11-2015.xlsx


ASESMEN 10-11-2015.xlsx

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