DAFTAR USULAN ALAT KESEHATAN RSUD PRATAMA REDA BOLO BERDASARKAN

PERMENKES NOMOR 24 TAHUN 2014

JENIS PERALATAN

NO Jumlah
Standar Permenkes 24 Tahun 2014
Ada diusulkan

DAK

A PELAYANAN GAWAT DARURAT

I Triage

1 Lampu Periksa (mobile) 1 1

2 Patient Stretcher 2 2

3 Stetoskop 2 2

4 Tensimeter 2 2

5 Diagnostik Set terdiri dari :

penlight 0 1

senter kepala (head lamp ) 1 1

spatula lidah 0 4

reflex hammer 0 1

spekulum hidung 0 1

otoskop 1 2

ophtalmoskop 0 1

6 Kursi roda 2 2

II Resusitasi dan Tindakan

1 Meja Periksa 3 3

2 Lampu Tindakan (mobile) 1 1

3 Stetoskop dewasa 2 2

4 Stetoskop anak 1 1

5 Stetoskop Neonatus 1 1

6 Tensimeter Analog Standing 1 1

7 Tensimeter Analog table 1 1

8 Film Viewer 1 1

9 Termometer Digital 3 3

10 EKG 1 0

11 Nebulizer Dewasa 1 1

12 Nebulizer Anak 1 1

13 Portable Pulse Oximetri 1 1

14 Long Spine Board 1 1

15 Syringe Pump 1 1

16 Tiang infus 3 23

17 Suction Pump 1 1

18 Infustion Pump 1 1

19 Monitor Pasien 1 1

20 Resucitation Crash Cart (Troli Emergensi) terdiri dari :

Defibrilator 1 0

Nasopharyngeal tube 1 1

Oropharyngeal tube 1 1

Nasotracheal tube 1 1

Orotracheal tube 1 1

Laryngoscope set anak 1 1

 Laryngoscope set dewasa 1 1

Bag valve Mask dewasa 2 2

Bag valve Mask anak 2 2

Kanul oksigen 15 15

Chest tube 1 1

21 Minor Surgery Set 1 1

22 Tabung Oksigen + Regulator flowmeter + Troli 1 1

23 Tabung Oksigen Kecil + Regulator + Troli 1 1

24 Autoclave 1 1

25 Baki logam, SS 2 2

26 Tromol/Korentang (Dressing Drum) 1 1

27 Nierbeken, SS 1 1

28 Waskom antiseptik + tutup 2 2

29 Waskom Kassa + tutup 2 2

B. POLIKLINIK (RUANG RAWAT JALAN)

I Poliklinik OBSGYN

1 Tempat tidur periksa 1 2

2 Tempat tidur Ginekologi 1 1

3 USG + 2 Probe (Convage dan Vaginal) + Printer 1

4 Film Viewer 1

5 Timbangan dewasa + pengukur tinggi badan 1

6 Lampu Periksa (mobile) 1

7 Stetoskop 1 2

8 Stetoskop Laenec 2

9 Tensimeter Analog Standing 1 1

10 Tensimeter Analog Table 1

11 Examination lamp 1

12 Set Minor Surgery 1

13 Doppler 1

14 Cardiotocography 1

15 Gynecologycal Examination set 1

16 Pap Smear Kit 1

17 IUD kit 1

18 Implant kit 2

19 Forcep Biopsi 2

20 Autoclave 1

21 Nierbekhen 2

22 Sonde uterus 1

23 Tampon Tang 2

24 Tromol/Korentang (Dressing Drum) 2

25 Kursi Dorong 1

Obgyn dan Materna

- Tempat Tidur

- Sterilisator kering

- Cardiotocograph

Belanja Alkes RAJAL

- Kursi roda

- nebulizer

- Pad pasien elektro surgery UNIT

- Pensil elektro surgery UNIT

II Poliklinik Umum / Poliklinik Penyakit Dalam

1 Tempat tidur periksa 1 0

2 Timbangan dewasa + pengukur tinggi badan 1 0

3 Lampu Periksa (mobile) 1 0

4 Examination lamp 1 0

5 Diagnostik Set terdiri dari : 1 0

penlight 1 1

senter kepala (head lamp ) 1 1

spatula lidah 5 5

reflex hammer 1 2

spekulum hidung 1 1

otoskop 1 0

ophtalmoskop 1 1

6 Stetoskop 2 4

7 Tensimeter Analog Standing 1 0

8 Tensimeter Analog Table 1 1

9 EKG 1 0

10 Film Viewer 1 0

11 Termometer Digital 2 5

12 Defibrilator 1 1

13 Set Minor Surgery 1 0

14 Spirometri 1 1

15 Suction pump 1 0

16 Utility trolley 1 0

17 Tromol kasa 2 0

18 Tampon Tang 2 0

19 Bak instrument 2 0

20 Tromol/Korentang (Dressing Drum) 2 0

21 Kursi Roda 1 0

1 USG/Canon Medical System (Japan) 1

2 EKG 6 chanel 1

3 Meja Instrument 3 rak 2

4 INAMI Trial Frame k-0391 8

5 Lensa Periksa Refraksi Mata set 1

6 Medical Head Lamp 5

7 Ultrasonic Nebulizer 2

8 Finger Tip Pulse Oximetri 2 in 1 2

9 Advand CPR Training Manekin with CPR displayer 1

10 Infant CPR Training Manekin 1

11 Speculum Hidung (Hartmann) 2

12 Ear Specula Set (Hartmann) 2

- IRNA I Penyakit Dalam

- bed side monitor

- EKG 6 channels

- troli emergency

- ENT examination set

film viewer

- infusion pump

- matras dekubitus

- minor surgery set

- bed pasien elektrik

- Probe linier USG ultrasonic

III Poliklinik Kesehatan Anak

1 Tempat tidur periksa 1

2 Stetoskop Anak 1 2

3 Stetoskop Neonatus 1 0

4 Tensimeter dengan manset untuk bayi dan anak 1 1

5 Examination lamp 1

6 Infant dan baby weighting scale 1

7 Termometer rectal 2 0

8 Termometer axial (digital) 1 2

9 Reflex Hammer 1 2

10 Tongue spatel (Stainless steel ) 2

11 EKG 1

12 Nebulizer 1 1

13 Infant dan baby pediatric resusitation 1 0

14 Vena section set : 2 0

Gunting lurus 1 0

Gunting bengkok 1 0

Hak 2 bh 1 0

Klem lurus 2 bh 1 0

Klem bengkok 2 bh 1 0

Pinset anatomi 1 bh 1 0

Pinset chirurgi 1 bh 1 0

Pinset bengkok 2 bh 1 0

Bisturi 1 buah 1 0

Gagang bisturi 1 bh 1 0

Needle holder (pemegang jarum jahit) 1 bh 1 0

Kom stainless steel wadah 60 cc 1 bh 1 0

Bak stainless steel wadah dengan tutup 1 bh 1 0

Kom stainless steel wadah 60 cc 1 bh 0

Bak stainless steel wadah dengan tutup 1 bh 0

15 Baby Suction pump 1 0

16 Oxygen set dan flow meter 2 0

17 Tromol/Korentang (Dressing Drum) 2 0

18 Refrigerator Medical Grade 1 0

II Poliklinik Kesehatan Anak

1 Cuff Pediatric 2

2 Cuff Infant 2

3 Baby Medical Scale 2 in 1 1

4 Termometer Ear 3G Bag Light Free Probe Cover 2

5 Children Pulse Oximetri 1

6 Patient Strecher 1

7 Meja Instrument 3 rak 2

8 NeoPAP Neonatal CPAP 1

ANAK

- inkubator GEA

- infant warmer

- fototherapy

- laringoscope handle + macintosh blade intubation set

- intubation set child

- cpap fisher and paykel

- baby and infant resuscitation set BVM

examination lamp

Tempat Tidur anak

infant baby stetoscope

tongue spatel

lumbal punction set

oxygen concentrator portable

infant baby weighting scale

timbangan anak

box bayi (baby cot) stainless steel poly medical deluxe

IV Poliklinik Bedah

1 Tempat tidur periksa 2 0

2 Stetoskop 1 0

3 Examination lamp 1 0

4 Reflex hammer 2 0

5 Termometer 2 0

6 Film Viewer 1 0

7 Set Minor Surgery 1 0

8 Hecting set 2 0

9 Alat pembuka gips (manual dan elektrik) 1 0

10 Lokal Anestesi Set 1 0

11 Circumsisi set 2 0

12 Suction Pump 1 0

13 Autoclave 1 0

14 Nierbeken 5 0

III Poliklinik Bedah

1 Cervical Collar Orthotic 2

V Klinik Gigi

A Dental Unit terdiri dari :

1 Kursi Gigi: 1 0

Up Down Movement 1 0

Reclining 1 0

Head Rest 1 0

Lampu Halogen Tanpa Bayangan 1 0

2 Cuspidor Unit: 0

Spitton Bowl + Bowl Flush 1 0

Water Cup Filler 1 0

Saliva Ejector 1 0

Transparent Water Tank (1000 cc) 1 0

3 Meja Instrumen 0

Air Turbin Hand Piece 400.000 rpm 1 0

Air Motor 20.000 rpm dengan Straight dan Contra Angle Hand 1 0

Triple Syringe 1 0

4 Foot Controller untuk Hand Piece 1 0

5 Kompresor Oilless 1 PK 1 0

B Dental Instrument Set 0

1 1 Atraumatic Restorative Treatment (ART) 0

1.1. Enamel Access Cutter 1 0

 1.2. Eksavator Berbentuk Sendok Ukuran Kecil (Spoon Triple Syringe 1 0

1.3. Eksavator Berbentuk Sendok Ukuran Sedang (Spoon Triple Syringe Excavator Medium) 1 0

1.4. Eksavator Berbentuk Sendok Ukuran Besar (Spoon Excavator Large) 1 0

1.5. Double Ended Applier and Carver 1 0

1.6. Spatula Plastik 1 0

1.7. Hatchet 1 0

1.8. Batu Asah 0

2 Bein Lurus Besar 1 0

3 Bein Lurus Kecil 1 0

Bor Intan (Diamond Bur Assorted) untuk Air Jet Hand Piece (Kecepatan Tinggi) (round,
4 1 0
inverted dan fissure)
5 Bor Intan Kontra Angle Hand Piece Conventional (Kecepatan Rendah) (round, inverte 1 0

6 Polishing Bur 1 1

7 Ekskavator Berujung Dua (Besar) 5 0

8 Ekskavator Berujung Dua (Kecil) 5 0

9 Gunting Operasi Gusi (Wagner) (12 cm ) 1 0

10 Handpiece Contra Angle 0

11 Handpiece Straight 0

12 Kaca Mulut Datar No.4 Tanpa Tangkai 0

13 Tangkai Untuk Kaca Mulut 0

14 Klem/Pemegang Jarum Jahit (Mathieu Standar) 0

15 Korentang, Penjepit Sponge (Foerster) 0

16 Light Curing 1 0

17 Mikromotor dengan Straight dan Contra Angle Hand Piece (Low Speed Micro Motor portable) 1 0

18 Pelindung Jari 1 0

19 Pemegang Matriks (Matrix Holder) 1 0

20 Penahan Lidah 1 0

21 Pengungkit Akar Gigi Kanan Mesial (Cryer Distal) 1 0

22 Pengungkit Akar Gigi Kanan Mesial (Cryer Mesial) 1 0

23 Penumpat Plastis 1 0

24 Periodontal Probe 1 1

25 Penumpat Semen Berujung Dua 1 0

26 Pinset Gigi 1 0

27 Skeler Standar , Bentuk Cangkul Kiri (Type Chisel/Mesial) 1 0

28 Skeler Standar , Bentuk Cangkul Kanan (Type Chisel/Mesial) 1 0

29 Skeler Standar, Bentuk Tombak (Type Hook) 1 0

30 Skeler Standar, Black Kiri dan Kanan (Type Chisel/Mesial) 1 0

31 Skeler Standar, Black Kiri dan Kiri (Type Chisel/Mesial) 1 0

32 Skeler Ultrasonik 1 0

33 Sonde Lengkung 5 0

34 Sonde Lurus 5 5

35 Spatula Pengaduk Semen 1 0

36 Spatula Pengaduk Semen Ionomer 1 0

37 Set Tang Pencabutan Dewasa 1 0

37.1. Tang gigi anterior rahang atas dewasa 1 0

37.2. Tang gigi premolar rahang atas 1 0

37.3. Tang gigi molar kanan rahang atas 1 0

37.4. Tang gigi molar kiri rahang atas 1 0

37.5. Tang molar 3 rahang atas 1 0

37.6. Tang sisa akar gigi anterior rahang atas 1 0

37.7. Tang sisa akar gigi posterior rahang atas 1 0

 37.8. Tang gigi anterior dan premolar rahang bawah 1 0

37.9. Tang gigi molar rahang bawah kanan/kiri 1 0

37.10. Tang gigi molar 3 rahang bawah 1 0

37.11. Tang sisa akar rahang bawah 1 0

38 Set Tang pencabutan anak 0

38.1. Tang gigi anterior rahang atas 1 0

38.2. Tang molar rahang atas 1 0

38.3. Tang molar susu rahang atas 1 0

38.4. Tang sisa akar rahang atas 1 0

38.5. Tang gigi anterior rahang bawah 1 0

38.6. Tang molar rahang bawah 1 0

38.7. Tang sisa akar rahang bawah 1 0

39 Skalpel, Mata Pisau Bedah (Besar) 1 0

40 Skalpel, Mata Pisau Bedah (Kecil) 1 0

41 Skalpel, Tangkai Pisau Operasi 1 0

42 Silinder Korentang Steril 1 0

43 Tempat Alkohol (Dappen Glas) 1 0

44 Toples Kapas Logam dengan Pegas dan Tutup (50 x 70 mm ) 1 0

45 Toples Pembuangan Kapas (50 x 75 mm) 1 0

46 Baki Logam Tempat Alat Steril 1 0

47 Lempeng Kaca Pengaduk Semen 1 0

IV Klinik Gigi

A extraction set 1

1 Tooth forcep 2600 set 1

2 Bur diamond set 6 RA Edenta 1

3 Bur diamond set 6 FG Edenta 1

4 Root elevator 60/set 1

5 Extracting forceps 786-129 Fig.51 1

6 Tooth forceps dewasa 2500 set 12 1

- GIGI

- Dental X-ray (untuk posisi gigi tertentu)

- Diamond bur high speed set

- Handle kaca mulut (12)

- Kaca mulut

- Sendok cetak set

- Sonde bengkok

- Eksavator

- Camera intraoral

- Sterilisator dy heat

- Dental floss

- Model gigi karies

- Model Gigi

C RUANG TINDAKAN : 0

I Ruang persiapan (sebelum tindakan) 0

1 Bed Side Monitor 1 0

2 tensimeter 1 1

3 Stethoscope 2 1

4 Suction Pump 1 0

5 Film Viewer 1 0

6 Saturasi Oksigen 1 1
V RUANG TINDAKAN :

1 Laryngoscope set dewasa 1

2 Meja Instrumet 2 rak 3

3 Meja Instrumet 3 rak 3

4 Gynecology Instrument Set 1

5 Appendectomy Instrument set 1

6 Herniotomy Set 1

7 Infant Radiant Warmer 1

8 Incubator Transport 1

9 Micro Gynecology Instrument Set 1

10 Minor Surgery Instrument Set 1

11 Mayor Surgery Instrument Set 1

12 Circumsisi Set 2

13 Patient Stretcher/Transport Stretcher 0

14 Cervical Collar Orthotic 2

15 - Reflex hammer 8

16 Steamer Sterilization 1

II Kamar Bedah

1 Meja Operasi (gynecologi) 1 0

2 Meja Operasi 1 1

3 Lampu Operasi 1 1

4 Mesin Anestesi 1 1

5 Film Viewer 1 2

6 Monitor Pasien 1 0

7 EKG 1 0

8 Defibrilator 1 0

9 Ventilator 1 0

10 Oxygen Set (tabung oksigen+ Flow meter) 1 1

11 Electrosurgical unit 1 1

12 UV lamp for room sterilization 1 0

13 Vacum pump 1 1

14 Infusion pump 1 1

15 Suction pump 1 1

16 Syringe Pump 1 0

17 ETT, LMA, Nasotracheal, dewasa dan pediatric 1 0

18 Laringoscope set (dewasa dan pediatric) 1 1

19 Mayo table stand mobile 1 3

20 Sectio caesarian set 1 1

21 Laparatomy set 1 1

22 Histerectomy set 1 1

23 Histeroscopy set 1 0

24 Embriotomi set 1 1

25 Inkubator bayi 1 0

26 Micro Surgery set 1 0

27 Patient Strecher 1 0

28 Utility Troly 1 0

29 Ultrasonic cleaner 1 0

30 Ambubag 1 3

31 Ring aplikator set 1 0

32 Kocher 1 0
33 Chirurgical pinset 1 0

34 Gunting lurus 1 0

35 Jarum lumbal 1 0

36 Needle holder 1 0

37 Tromol kasa 1 6

38 Pean lurus 1 0

39 Spekulum cocor bebek 1 0

40 Hak langen beck 1 0

41 Speculum Shim 3 0

42 Aligator 1 0

43 Mini Laparotomy Set 1 0

44 Folding Endurance Tester 1 0

45 Fenster Klem 1 0

46 Bak bengkok 4 20

47 Standar Infus 2 2

48 Autoclave 1 0

III Recovery Room

1 Monitor Pasien 1 0

2 Patient Strecher 1 0

3 Defibrilator 1 0

4 Emergency trolley 1 4

5 nfusion pump 1 0

6 Suction pump 1 0

D RAWAT INAP

I Rawat Umum

1 Tempat Tidur dewasa 40 30

2 Tempat Tidur Anak 10 10

3 Termometer rectal 1 0

4 Termometer axial 1 5

5 Examination lamp 1 0

6 Stetoskop dewasa 6 5

7 Stetoskop bayi dan anak 3 5

8 Tensimeter anaroid with stand 1 3

9 Tensimeter dengan manset untuk bayi dan anak 1 2

10 Timbangan Bayi 1 5

11 Timbangan Dewasa 3 10

12 Doppler 1 0

13 Reflex Hammer 3 8

14 Film Viewer 3 5

15 Pen light 3 3

16 Defibrilator 1 1

17 EKG 1 1

18 Suction pump 1 0

19 Monitor Pasien 1 1

20 Infusion set 3 0

21 Infusion Pump 3 8

22 Oxygen Set + Flow meter 3 10

23 Recusitation Set 2 0

24 Minor surgery instrument set 1 0

25 Emergency set 2 0
26 Nebulyzer 1 2

27 Vena section set 1 0

28 Lumbal needle Punction 0

- Lumbal needle 1 0

- Kom stainless steel wadah 60 cc 1 bh 3 0

- Bak stainless steel wadah dengan tutup 1 bh 3 0

- Kom stainless steel wadah 60 cc 1 bh 3 0

- Bak stainless steel wadah dengan tutup 1 bh 3 0

-Duk Steril Bolong 6 0

29 Pulse Oxymetry 1 0

30 UV Lamp 4 0

31 Branchard 1 0

32 Anatomische pinset 3 0

33 Trokar 3 0

34 Glukometer 1 0

35 Chirurgical pinset 3 0

36 Transfusion set 1 0

37 Vena section set 1 0

38 Buli-buli panas 3 3

39 Gilyserine Spuit 1 0

40 Irigator 1 0

41 Korentang 2 0

42 Nierbekhen 2 30

43 Standar Infus 10 20

44 Sputum bak 3 0

45 Set Perawatan Luka 2 0

46 Emergency trolley 3 0

47 Oxygen set + Flowmeter 2 0

48 Syringe Pump 3 5

49 Matras Dekubitus 1 0

50 Pisfot dewasa 8 50

51 Bak instrument 2 0

52 Bak Catheter 1 0

53 Kursi Roda 1 0

B RAWAT INAP

I Rawat Umum

1 Wafle and standart Mattress 30

2 Matras 2/3 Crank 10

3 Digital Termometer Pen Type 20

4 Spymomanometer Mercuri Free Wall Mounted 10

5 Ambubag dewasa 1

6 Ambubag anak 1

7 Ambubag bayi 1

8 Hecting Instrumen Set 3

9 Vena section set 2

10 Lumbal needle punction 1

11 Lumbal needle 1

12 Kom stainless steel wadah 60cc 1bh 3

13 Bak stainless steel wadah dg tutup 1 bh 3

14 Duk steril bolong 6

15 Trokar 3

16 Glukometer 1

17 Hecting Instrumen Set 3

18 Standard Infus IV for Pump 5

19 Emergency trolley 3 Drawer 4

20 Oxygen Set +Flow meter 10

21 Syringe Pump 5

22 Infuse Pump 5

23 Pispot dewasa perempuan/Onemed Stikpand Plstik 50

24 Pispot dewasa laki/Onmed Urinal Plstik+Tutup 50

25 Kursi Roda 4

26 UV Lamp/GEA Ultraviolet Lamp Trolley 2

27 Automatic Blood Pressure Monitor 1

28 Meja Instrument 2 rak 12

29 Overbed Table 10

30 Caretek Bedside Cabinets 50

31 Trolly patient monitor 4

32 Meja resuscitator bayi 2

II Ruang Bayi (gabung rawat inap)

1 Tempat tidur bayi 3 5

2 Stetoskop Bayi 1 3

3 Tensimeter dengan manset untuk bayi 1 5

4 Termometer rectal 2 0

5 Infant Incubator 2 3

6 Infant Warmer 1 3

7 Incubator Transpor 1 1

8 Vena section set 2 0

9 Baby Resusitasion Set 1 3

10 Baby Suction pump 1 0

11 Lumbal needle Punction 0 1

II Ruang Bayi (gabung rawat inap)

1 Bubble CPAP 1

2 ECG 3 chanel 1

E RADIOLOGI

1 Mobile X-Ray Unit 100mA 1 0

2 Vertical Bucky Stand 0

3 Peralatan protektif radiasi terdiri dari : 0

- Lead apron , tebal 0.25 ·0,5 mm Pb, 0

- Sarung tangan, 0.25 -0.5 mm Pb 0

- Kaca mata Pb, 1 mm Pb 0

- Pelindung tiroid Pb, 1 mm Pb 0

- Pelindung gonad Pb, 0.25 -0.5 mm Pb 0

- Tabir mobile minimal 200 Mm (t}x100 cm 0

4 Perlengkapan proteksi radiasi terdiri dari : 0

Survei meter 0

Digital Pocket Dosimeter 0

Film badge/TLD 0 10

5 Film viewer (doule film) 1 0

6 Cassette X-ray (Stand) 0

7 Film X-ray semua ukuran : 0

 – 18 x 24 cm 0

– 24 x 30 cm 0

– 30 x 40 cm 0

– 35 x 35 cm 0

8 X-Ray Automatic Processing Film 0

9 Film marker 0

10 Film dryer 0

11 X - Ray Protection Screen with Lead Glass (untuk operator) 0

C ERADIOLOGI

kaca Pb ukuran 40 x 60 cm

Film TLD

F RUANG LABORATORIUM 0

1 Mikroskop Binokuler 2 0

2 Waterbath 1 0

3 Sentrifus hematocrit 1 0

4 Mikrosentrifus 1 0

5 Fotometer / Spektrofotometer 1 0

6 Peralatan Laju Endap Darah (LED) 1 0

7 Hematologi Analyzer (Three Parts differential) 1 0

8 Urine analyzer 1 1

9 Reagensia 1 0

10 Rapid Test : Gula Darah, Kolesterol 1 0

11 Set pemeriksaan faeces 1 0

12 Mikropipet 1 0

13 Perlengkapan dan pengambilan Sample set 1 0

14 Peralatan Gelas 1 0

15 Medical Refrigerator 1 0

16 Rak Tabung Reaksi 1 0

17 Rak untuk pewarnaan 1 0

18 Sink Laboratorium 1 0

- LAB

- Sysmex xn 450
- Rak tabung Reaksi Azlon RWK 030

- Centrifugase Darah ( Centrifigase EBA 200)

- Elektrolit Analyzer CBS 400

- Akray Urine Analzer AE-4020

- Beaker gelas 100 ml

- Beaker gelas 500 ml

- Kirsch blood refrigerator BL V 100

- Manual blood donation chair XS 104

- Compact digital mini rotator DH orbital shaker

- Semical Analyzer ( DIAPRO Biolis 30i)

- Kursi transfusi darah

G INSTALASI FARMASI 0

1 Cawan + Mortir Obat 0 0

2 Timbangan gram dan miligram 0 0

3 Refrigerator Medical Grade 0 0

4 Meja peracikan obat (Work Table for Medicine) 0 0

H RUANG GIZI/PANTRY 0 0

1 Kitchen Set 0 0
2 Kulkas 0 0

3 Kompor Gas 0 0

4 Tabung Gas 0 0

5 Timbangan 0 0

6 Perlengkapan Masak Set 0 0

7 Perlengkapan Makan Set 0 0

8 Pantry Trolley 0 0

HOSPITAL FURNITURE 0 0

1 Lemari Instrumen 13 0

2 Lemari obat kaca 2 0

3 Lemari Steril 0

4 Penyekat ruangan 10 0

5 Meja obat 1 0

6 Meja Suntik Beroda 1 0

7 Food Troly 3 0

8 Instrument trolley 2 0

9 Meja laboratorium 0

10 Tempat Sampah (Tutup) 0

9 Food model 0

I RUANG STERILISASI dan LOUNDRY 0

1 Autoclave 0 0

2 Washing Machine 0 0

3 Instrument Cabinet 0 0

4 Laundry Trolley, SS 0 0

5 Meja setrika + Setrika 0 0

6 Instrument Tray + tutup 0 0

J RUANG REKAM MEDIK 0 0

1 Filling Cabinet 0

2 Writing Desk 0

3 Chair 0

4 Komputer + Printer + UPS + Table 0 0

5 Lemari Arsip 0 0

K RUANG ADM/KANTOR 0

1 Filling Cabinet 0 0

2 Writing Desk 0 0

3 Chair 0 0

4 Komputer Desk Set 0 0

5 Lemari Arsip 0 0

6 Lemari penyimpanan narkotika 0 0

7 Lemari penyimpanan psikotropika 0 0

8 Meja Tulis 4 0

9 Kursi 8 0

10 Waskom mandi 0 0
Sysmex xn 450
Akray Urine Analzer AE-4020
Elektrolit Analyzer CBS 400
Compact digital mini rotator DH orbital shaker
DAFTAR USULAN ALAT -ALAT KESEHATAN YANG DIBUTUHKAN
TETAPI TIDAK SESUAI PERMENKES NOMOR 24 TAHUN 2014

NO JENIS ALKES JML KEBUTUHAN tambahan

A RAWAT JALAN

I Poliklinik Umum / Poliklinik Penyakit Dalam

1 USG/Canon Medical System (Japan) 1

2 EKG 6 chanel 1
3 Meja Instrument 3 rak 2
4 INAMI Trial Frame k-0391 8
5 Lensa Periksa Refraksi Mata set 1
6 Medical Head Lamp 5
7 Ultrasonic Nebulizer 2
8 Finger Tip Pulse Oximetri 2 in 1 2

9 Advand CPR Training Manekin with CPR displayer 1

10 Infant CPR Training Manekin 1
11 Speculum Hidung (Hartmann) 2
12 Ear Specula Set (Hartmann) 2
II Poliklinik Kesehatan Anak

1 Cuff Pediatric 2
2 Cuff Infant 2
3 Baby Medical Scale 2 in 1 1
4 Termometer Ear 3G Bag Light Free Probe Cover 2
5 Children Pulse Oximetri 1
6 Patient Strecher 1
7 Meja Instrument 3 rak 2
8 NeoPAP Neonatal CPAP 1
III Poliklinik Bedah

1 Cervical Collar Orthotic 2

IV Klinik Gigi

A extraction set 1
1 Tooth forcep 2600 set 1
2 Bur diamond set 6 RA Edenta 1
3 Bur diamond set 6 FG Edenta 1
4 Root elevator 60/set 1
5 Extracting forceps 786-129 Fig.51 1
6 Tooth forceps dewasa 2500 set 12 1
V RUANG TINDAKAN :

1 Laryngoscope set dewasa 1

2 Meja Instrumet 2 rak 3
3 Meja Instrumet 3 rak 3
4 Gynecology Instrument Set 1
5 Appendectomy Instrument set 1
6 Herniotomy Set 1
7 Infant Radiant Warmer 1
8 Incubator Transport 1
9 Micro Gynecology Instrument Set 1
10 Minor Surgery Instrument Set 1
11 Mayor Surgery Instrument Set 1
12 Circumsisi Set 2
13 Patient Stretcher/Transport Stretcher 0
14 Cervical Collar Orthotic 2
15 - Reflex hammer 8
16 Steamer Sterilization 1
B RAWAT INAP

I Rawat Umum

1 Wafle and standart Mattress 30

2 Matras 2/3 Crank 10
3 Digital Termometer Pen Type 20
4 Spymomanometer Mercuri Free Wall Mounted 10
5 Ambubag dewasa 1
6 Ambubag anak 1
7 Ambubag bayi 1
8 Hecting Instrumen Set 3
9 Vena section set 2
10 Lumbal needle punction 1
11 Lumbal needle 1
12 Kom stainless steel wadah 60cc 1bh 3
13 Bak stainless steel wadah dg tutup 1 bh 3
14 Duk steril bolong 6
15 Trokar 3
16 Glukometer 1
17 Hecting Instrumen Set 3
18 Standard Infus IV for Pump 5
19 Emergency trolley 3 Drawer 4
20 Oxygen Set +Flow meter 10
21 Syringe Pump 5
22 Infuse Pump 5
23 Pispot dewasa perempuan/Onemed Stikpand Plstik 50
24 Pispot dewasa laki/Onmed Urinal Plstik+Tutup 50
25 Kursi Roda 4
26 UV Lamp/GEA Ultraviolet Lamp Trolley 2
27 Automatic Blood Pressure Monitor 1
28 Meja Instrument 2 rak 12
29 Overbed Table 10
30 Caretek Bedside Cabinets 50
31 Trolly patient monitor 4

32 Meja resuscitator bayi 2

II Ruang Bayi (gabung rawat inap)

1 Bubble CPAP 1
2 ECG 3 chanel 1
DAFTAR USULAN ALAT -ALAT KESEHATAN YANG DIBUTUHKAN
TETAPI TIDAK SESUAI PERMENKES NOMOR 24 TAHUN 2014

NO JENIS ALKES

A RAWAT JALAN

I Poliklinik Umum / Poliklinik Penyakit Dalam PD

1 USG/Canon Medical System (Japan) 1

2 EKG 6 chanel 1
3 Meja Instrument 3 rak 2
4 INAMI Trial Frame k-0391 8
5 Lensa Periksa Refraksi Mata set 1
6 Medical Head Lamp 5
7 Ultrasonic Nebulizer 2
8 Finger Tip Pulse Oximetri 2 in 1 2

9 Advand CPR Training Manekin with CPR displayer 1

10 Infant CPR Training Manekin 1
11 Speculum Hidung (Hartmann) 2
12 Ear Specula Set (Hartmann) 2
II Poliklinik Kesehatan Anak

1 Cuff Pediatric
2 Cuff Infant
3 Baby Medical Scale 2 in 1
4 Termometer Ear 3G Bag Light Free Probe Cover
5 Children Pulse Oximetri
6 Patient Strecher
7 Meja Instrument 3 rak
8 NeoPAP Neonatal CPAP
III Poliklinik Bedah

1 Cervical Collar Orthotic 2

IV Klinik Gigi

A extraction set 1
1 Tooth forcep 2600 set 1
2 Bur diamond set 6 RA Edenta 1
3 Bur diamond set 6 FG Edenta 1
4 Root elevator 60/set 1
5 Extracting forceps 786-129 Fig.51 1
6 Tooth forceps dewasa 2500 set 12 1
V RUANG TINDAKAN :

1 Laryngoscope set dewasa 1

2 Meja Instrumet 2 rak 3
3 Meja Instrumet 3 rak 3
4 Gynecology Instrument Set 1
5 Appendectomy Instrument set 1
6 Herniotomy Set 1
7 Infant Radiant Warmer 1
8 Incubator Transport 1
9 Micro Gynecology Instrument Set 1
10 Minor Surgery Instrument Set 1
11 Mayor Surgery Instrument Set 1
12 Circumsisi Set 2
13 Patient Stretcher/Transport Stretcher 0
14 Cervical Collar Orthotic 2
15 - Reflex hammer 8
16 Steamer Sterilization 1
B RAWAT INAP

I Rawat Umum

1 Wafle and standart Mattress 30

2 Matras 2/3 Crank 10
3 Digital Termometer Pen Type 20
4 Spymomanometer Mercuri Free Wall Mounted 10
5 Ambubag dewasa 1
6 Ambubag anak 1
7 Ambubag bayi 1
8 Hecting Instrumen Set 3
9 Vena section set 2
10 Lumbal needle punction 1
11 Lumbal needle 1
12 Kom stainless steel wadah 60cc 1bh 3
13 Bak stainless steel wadah dg tutup 1 bh 3
14 Duk steril bolong 6
15 Trokar 3
16 Glukometer 1
17 Hecting Instrumen Set 3
18 Standard Infus IV for Pump 5
19 Emergency trolley 3 Drawer 4
20 Oxygen Set +Flow meter 10
21 Syringe Pump 5
22 Infuse Pump 5
23 Pispot dewasa perempuan/Onemed Stikpand Plstik 50
24 Pispot dewasa laki/Onmed Urinal Plstik+Tutup 50
25 Kursi Roda 4
26 UV Lamp/GEA Ultraviolet Lamp Trolley 2
27 Automatic Blood Pressure Monitor 1
28 Meja Instrument 2 rak 12
29 Overbed Table 10
30 Caretek Bedside Cabinets 50
II Ruang Bayi (gabung rawat inap)

1 Bubble CPAP 1
2 ECG 3 chanel 1
C ERADIOLOGI

1 Fujifilm FCR Prima Tm Medical Computed Radiography 1

2 Fujifilm Drypix Smart 1
3 Kaca Pb ukuran 40 x 60 cm 3
D LABORATORIUM

1 VIVOLIGHT Projection Vein Finder-Vivo 500 2

2 Sysmex xn 450 1
3 Elektrolit Analyzer CBS 400 1

4 Compact digital mini rotator DH orbital shaker 1

 JML KEBUTUHAN

RAJAL UGD BEDAH

UMUM POLI ANAK BEDAH GIGI RT

1
1
2 1
8
1
5
2
2

1
1
2
2

2
2
1
2
1
1 1

1
1
1
1
1
1
1

1
3
3
1
1
1
1
1
1
1
1
2

8
1
 RANAP
RADIOLOGI LAB
UMUM BAYI
30
10
20
10
1
1
1
3
2
1
1
3
3
6
3
1
3
5
4
10
5
5
50
50
4
2
1
12
10
50

1
1

1
1
3

2
1
1