1. ALAT TIDAK STERIL
NO
|
JENIS ALAT
|
JUMLAH
STANDAR
|
|||
1
|
Tensimeter
|
1
|
|||
2
|
Stetoskop
|
1
|
|||
3
|
Timbangan dewasa
|
1
|
|||
4
|
Timbangan bayi
|
1
|
|||
5
|
Pengukur panjang bayi
|
1
|
|||
6
|
Termometer
|
1
|
|||
7
|
Oksigen dengan regulator
|
1
|
|||
8
|
Ambubag dan masker` resusitasi
|
1
|
|||
9
|
Penghisap lender
|
1
|
|||
10
|
Lampu sorot
|
1
|
|||
11
|
Sterilisator
|
1
|
|||
12
|
Bak instrument dengan penutup
|
1
|
|||
13
|
Reflek hammer
|
1
|
|||
14
|
Alat pemeriksa hemoglobin ( sahli )
|
1
|
|||
15
|
Set pemeriksa urin ( reduksi /
protein )
|
1
|
|||
16
|
Pita pengukur
|
1
|
|||
17
|
Plastik penutup instrument
steril
|
1
|
|||
14
|
Sarung tangan karet untuk mencuci alat
|
1
|
|||
19
|
Celemek
|
1
|
|||
20
|
Masker
|
1
|
|||
21
|
Pengaman mata
|
1
|
|||
22
|
Sarung kaki plastic
|
1
|
|||
23
|
Infuse set
|
1
|
|||
24
|
Spuit disposable
|
1
|
|||
25
|
Tempat sampah
|
1
|
|||
26
|
Tempat kain kotor
|
1
|
|||
27
|
Tempat plasenta
|
1
|
|||
28
|
Pot
|
1
|
|||
29
|
Bengkok
|
1
|
|||
30
|
Sikat dan sabun pada tempatnya
|
1
|
|||
31
|
Kertas lakmus
|
1
|
|||
32
|
Semprit gliserin
|
1
|
|||
33
|
Gunting verban
|
1
|
|||
34
|
Gelas ukur darah
|
1
|
|||
35
|
Tongspatel
|
1
|
|||
36
|
IUD kit
|
1
|
|||
37
|
Implant kit
|
1
|
|||
38
|
Gergaji obat
|
1
|
|||
39
|
Vakum eksraktor
|
1
|
|||
2.
PERALATAN STERIL
NO
|
JENIS ALAT
|
JUMLAH
STANDAR
|
1
|
Klem pean / klem tali pusat
|
2
|
2
|
Klem kocker
|
1
|
3
|
Korentang
|
1
|
4
|
Gunting tali pusat
|
1
|
5
|
Gunting benang
|
1
|
6
|
Gunting episiotomy
|
1
|
7
|
Kateter metal
|
1
|
8
|
Kateter karet
|
1
|
9
|
Pinset anatomis
|
1
|
10
|
Pinset cirrurgis
|
1
|
11
|
Speculum vagina
|
1
|
12
|
Pengikat tali pusat
|
1
|
13
|
Penghisap lender
|
1
|
14
|
Tampon tang dan tampon vagina
|
1/1
|
15
|
Nalvoeder
|
1
|
16
|
Jarum kulit dan otot
|
1/1
|
17
|
Sarung tangan
|
6 pasang
|
18
|
Benang sutera dan cutget
|
1
|
19
|
Duk steril
|
1
|
3.
BAHAN HABIS PAKAI
NO
|
JENIS ALAT
|
JUMLAH
STANDAR
|
1
|
Kapas
|
2 pack
|
2
|
Kain kasa
|
2 pack
|
v3
|
Plester
|
2
|
4
|
Handuk
|
2
|
5
|
Pembalut wanita
|
3 pack
|
4.
OBAT – OBATAN
NO
|
JENIS ALAT
|
JUMLAH
STANDAR
|
1
|
Roborantia
1.
Vit, B1, B6, Bkomplek
2.
Vit C
3.
SF
4.
Kalsium
5.
Lain – lain. . . .
|
|
2
|
Vaksin
6.
BCG
7.
Polio
8.
DPT
9.
HB
10.
Campak
11.
Lain – lain . . . .
|
|
3
|
Untuk syok anafilaktik
|
5 ampul
|
4
|
Sedative
|
|
5
|
Antibiotic
|
|
6
|
Uterotonika
|
|
7
|
Antipiretika
|
|
8
|
Koagulansia
|
|
9
|
Anti kejang
|
|
10
|
Gliserin
|
|
11
|
Cairan infuse
|
|
12
|
Obat luka
|
|
13
|
Cairan desinfektan
|
|
14
|
Obat penanganan asfiksia BBL
|
|
E . FORMULIR – FORMULIR YANG HARUS
DISEDIAKAN
NO
|
JENIS ALAT
|
JUMLAH
STANDAR
|
1
|
Informed consent
|
10
|
2
|
Kartu ibu hamil
|
10
|
3
|
Partograf
|
10
|
4
|
Kartu persalinan
|
10
|
5
|
Kartu ibu nifas
|
10
|
6
|
Kartu peserta KB
|
10
|
7
|
Laporan
|
10
|
8
|
Rujukan
|
10
|
9
|
Surat kelahiran
|
10
|
10
|
Surat kematian
|
10
|
11
|
Permintaan darah
|
10
|
12
|
Register Ibu
|
1
|
13
|
Register bayi / imunisasi
|
1
|
14
|
Register Anak
|
1
|
15
|
Register KB
|
1
|
###Reproduced with permission of the copyright owner. Further
reproduction prohibited without permission###
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