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DAFTAR ISI

Halaman

BAB I Pendahuluan ................................................................................................. 1

1. Tujuan ............................................................................................................ 2
2. Defenisi........................................................................................................... 2

BAB II Pelaporan Insiden ......................................................................................... 6

1. Alur Pelaporan Insiden ke Tim KP di RS (Internal) ......................................... 7


2. Alur Pelaporan Insiden Kesalamatan Pasien Ke KKPRS
(Eksternal) ...................................................................................................... 8

BAB III AnalisisMatriks GradingRisiko ................................................................... 9

BAB IV Petunjuk Pengisian LaporanI nsiden Keselamatan Pasien .................... 13


1. Data Pasien .................................................................................................. 13
2. Rincian Kejadian........................................................................................... 14
3. . Tipe Insiden .................................................................................................. 18
4. Analisa Penyebab Masalah .......................................................................... 28
5. Faktor Contributor,Komponen dan Sub Komponen ...................................... 28

BAB V Penutup ........................................................................................................ 34


DETASEMEN KESEHATAN WILAYAH 02.04.04
RUMAH SAKIT Tk. IV 02.07.05 dr. NOESMIR

PEDOMAN PELAPORAN INSIDEN KESELAMTAN PASIEN (IKP)

(PATIENT SAFETY INCIDENT REPORT)

RUMAH SAKIT Tk. IV 02.07.05 dr. Noesmir

Baturaja, Maret 2018