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Biaya dan Prosedur Tes HIV RSUD Indramayu

- The document is a clinical pathway from RSUD Indramayu hospital outlining the treatment of a patient with HIV over 7 days. - Key details include the patient's name, age, weight, height and medical record number. The initial diagnosis and ICD10 code are also provided. - A daily schedule is outlined documenting assessments, examinations, medications and treatments administered. Test results are also included. - The final diagnosis, discharge plan and total costs are summarized at the end.

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RSUD INDRAMAYU PMKP
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285 views2 pages

Biaya dan Prosedur Tes HIV RSUD Indramayu

- The document is a clinical pathway from RSUD Indramayu hospital outlining the treatment of a patient with HIV over 7 days. - Key details include the patient's name, age, weight, height and medical record number. The initial diagnosis and ICD10 code are also provided. - A daily schedule is outlined documenting assessments, examinations, medications and treatments administered. Test results are also included. - The final diagnosis, discharge plan and total costs are summarized at the end.

Uploaded by

RSUD INDRAMAYU PMKP
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

CLINICAL PATHWAYS

RSUD INDRAMAYU
PENYAKIT HIV
TAHUN 2021
Nama Pasien: Umur: Berat Badan: Tinggi Badan: Nomor Rekam Medis

……………………………………… ……………. ……………..kg …………..cm ……………………………..


Diagnosis Awal: ………………………………. Kode ICD 10 : …………………… Rencana rawat : 7 hari
R. Rawat Tgl/Jam Tgl/Jam Lama Kelas : Tarif/hr (Rp): Biaya (Rp)
masuk: keluar: Rwt
……………. …………….. …………… …….hari …………… …………………….. ………………
Aktivitas Pelayanan
IGD HR 1 HR 2 HR 3 HR 4 HR 5 HR 6
HS HS HS …… HS …… HS ….. HS …… HS ..…
……… ……… …
Diagnosis : HIV
 Penyakit Utama HIV
 Penyakit Penyerta
 Komplikasi
Asessmen Klinis:
 Pemeriksaan dokter
- Dokter jaga +/-
- Dokter Sp.PD +/- +/- +/- +/- +/- +/-
 Konsultasi
Pemeriksaan Penunjang:
DTL, U, F, Faal Ginjal, …………….. …………….. …………… …………. …………… …………. ………… ……………..
CD 4, Limfosit total, …………….. …………….. …………… …………. …………… …………. ………… ……………..
Serologi HIV, PCR-RNA, …………….. …………….. …………… …………. …………… …………. ………… ……………..
CXR PA/Lat, Tes Mt …………….. …………….. …………… …………. …………… …………. ………… ……………..
…………….. …………….. …………… …………. …………… …………. ………… ……………..
Tindakan:
Obat obatan: ……………..
ZDV + 3 TC 2mg/kgbb +/- +/- +/- +/- +/- +/- ……………..
NVP 2 mg/kgbb +/- +/- +/- +/- +/- +/- ……………..
SMT-TMP 6 mg/kgbb +/- +/- +/- +/- +/- +/- ……………..
Parasetamol 3 x …….mg +/- +/- +/- +/- +/- +/- ……………..
Nutrisi: NGT ……… ……… ……… ……… ……… ……… ……………
Mobilisasi: …………….. ……… ……… ……… ……… ……… ……… ……………..
Hasil (Outcome):
……… ……… ……… ……… ……… ……… ………
……… ……… ……… ……… ……… ……… ………
……… ……… ……… ……… ……… ……… ………
Pendidikan/Rencana
Penjelasan penyakit Gizi dan Imunisasi Kontrol poliklinik
Pemulangan:
Varians: …………… …………. ………….
…………… …………… …………
Jumlah Biaya …………
Nama Perawat:
Kode Kode ICD 9 – CM
Diagnosis Akhir: C
ICD 10 89.0 dan 89.7
……………………………………….
Visite/Konsul: Anamnesis & PF
Utama …………….. ……………
Penyerta
Nama Dokter:
Pemeriksaan darah tepi
Penyerta …………….. ……………
lengkap, Urin dan Feses rutin
…………………………….
Nama Pelaksana Verifikasi: Komplikasi Serologi HIV, CD 4, Limfosit
…………….. ……….…
Total, PCR -RNA
……………………………. …………….. …………… CXR PA/Lateral
…………….. …………… Tes Mantoux
Pemeriksaan Faal Hati dan
…………….. ……………
Ginjal

Ketua Tim Clinikal Pathway Ketua KSM Dalam


RSUD Indramayu RSUD Indramayu

dr.EKA BUDHI SATYAWARDHANA,SpBs dr.MOCHAMAD REZA MAHDI,Sp.PD


NIP. 197802092015031001 NIP198708022014121001

Menyetujui,
Direktur RSUD Indramayu

dr.DEDEN BONNI KOSWARA,MM


Pembina Utama Muda
NIP: 19740110 200212 1 008

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