FORM CLINICAL PATHWAY

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FORM CLINICAL PATHWAY

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* Indicates required question

Tanggal *

MM

/

DD

/

YYYY

Ruangan *

Choose

PAV. WIJAYA KUSUMA

PAV. KENANGA

PAV. ALAMANDA

PAV. TULIP

PAV. NUSA INDAH

PAV. ASTER

NICU

MNE

INTERMEDIETE

IGD

Nama Clinical Pathway *

Your answer

No RM Pasien *

Your answer

Nama Pasien *

Your answer

Kesesuaian CP *

Iya

Tidak

Terapi *

Sesuai CP

Tidak

Other:

Kelengkapan Pengkajian Keperawatan *

Lengkap

Tidak

kelengkapan Pengkajian awal medis *

Ya

Tidak

Apakah termasuk Kriteria Discharge Planning *

Ya

Tidak

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