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Adapun kegiatan surveilans di Puskesmas Kecamatan Kramat Jati :
1. Pelacakan kasus penyakit potensial KLB
2. Pengambilan dan pengiriman sampel spesimen penyakit potensial KLB
3. Entry laporan W2 + SKDR Mingguan Puskesmas kecamatan ke Puskesmas kelurahan
4. Entry data C1 Campak
5. Entry data kematian by name
6. Verifikasi dan membuat SKMK/SKPK
7. Autopsi verbal kematian
8. Monev Petugas Surveilans & Kematian
9. Sosialisasi SKPK/SKMK
10. Sosialisasi dan advokasi lintor dalam pembentukan tim surveilans tk RW
11. Pembentukan tim surveilans TK RW
KELENGKAPAN DOKUMEN YANG DIERLUKAN UNTUK :
I. Surat keterangan penyebab kematian (SKPK), bagi jenazah yang masih ada atau belum
dikubur :
1. KTP & KK yang meninggal
2. Surat pengantar dari RT/RW
3. Surat pernyataan dari anggota yang meninggal disebabkan kematian.
II. Surat keterangan melapor kematian (SKMK) untuk jenazah yang sudah dimakamkan :
1. Foto copy KTP dan KK yang meninggal
2. Foto copy KTP dan KK anggota keluarga yang mengurus SKMK
3. Surat pernyataan dari anggota keluarga yang menerangkan kalau meninggal disebabkan
oleh kematian wajar (sakit), ditanda tangani diatas materai 6.000 dan saksi dari pihak
keluarga 2 orang serta mengetahui RT dan RW
4. Surat Kuasa dan foto copy KTP (bila yang mengajukan permintaan bukan anggota
keluarga harus melampirkan surat kuasa diatas materai 6.000)
5. Asli surat pengantar dari RT dan RW
6. Asli surat keterangan dari tempat pemakaman umum (TPU) yang menerangkan kalau
jenazah benar telah dimakamkan di TPU tersebut + foto copy
7. Setelah lengkap buat foto copy 1 rangkap
8. Dilakukan Autopsi Verbal kematian pada keluarga terdekat.
III. Rekomendasi Angkut Jenazah :
1. Surat pengantar dari RT
2. Form model dari Puskesmas (SKPK) atau Rumah Sakit (SMPK)
3. Foto copy KTP/KK almarhum
4. Foto copy KTP pemohon
IV. Rekomendasi Tahan Jenazah :
1. Surat Pengantar dari RT
2. Form Model A dari Puskesmas atau Rumah Sakit
3. Foto copy KTP/KK Almarhum
4. Foto copy KTP pemohon
5. Foto copy surat keterangan pegawetan jenazah (Sertifikat Of Embalming)

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latihan surveilans.docx

  • 1. Adapun kegiatan surveilans di Puskesmas Kecamatan Kramat Jati : 1. Pelacakan kasus penyakit potensial KLB 2. Pengambilan dan pengiriman sampel spesimen penyakit potensial KLB 3. Entry laporan W2 + SKDR Mingguan Puskesmas kecamatan ke Puskesmas kelurahan 4. Entry data C1 Campak 5. Entry data kematian by name 6. Verifikasi dan membuat SKMK/SKPK 7. Autopsi verbal kematian 8. Monev Petugas Surveilans & Kematian 9. Sosialisasi SKPK/SKMK 10. Sosialisasi dan advokasi lintor dalam pembentukan tim surveilans tk RW 11. Pembentukan tim surveilans TK RW KELENGKAPAN DOKUMEN YANG DIERLUKAN UNTUK : I. Surat keterangan penyebab kematian (SKPK), bagi jenazah yang masih ada atau belum dikubur : 1. KTP & KK yang meninggal 2. Surat pengantar dari RT/RW 3. Surat pernyataan dari anggota yang meninggal disebabkan kematian. II. Surat keterangan melapor kematian (SKMK) untuk jenazah yang sudah dimakamkan : 1. Foto copy KTP dan KK yang meninggal 2. Foto copy KTP dan KK anggota keluarga yang mengurus SKMK 3. Surat pernyataan dari anggota keluarga yang menerangkan kalau meninggal disebabkan oleh kematian wajar (sakit), ditanda tangani diatas materai 6.000 dan saksi dari pihak keluarga 2 orang serta mengetahui RT dan RW 4. Surat Kuasa dan foto copy KTP (bila yang mengajukan permintaan bukan anggota keluarga harus melampirkan surat kuasa diatas materai 6.000) 5. Asli surat pengantar dari RT dan RW 6. Asli surat keterangan dari tempat pemakaman umum (TPU) yang menerangkan kalau jenazah benar telah dimakamkan di TPU tersebut + foto copy 7. Setelah lengkap buat foto copy 1 rangkap 8. Dilakukan Autopsi Verbal kematian pada keluarga terdekat. III. Rekomendasi Angkut Jenazah : 1. Surat pengantar dari RT 2. Form model dari Puskesmas (SKPK) atau Rumah Sakit (SMPK) 3. Foto copy KTP/KK almarhum 4. Foto copy KTP pemohon IV. Rekomendasi Tahan Jenazah : 1. Surat Pengantar dari RT 2. Form Model A dari Puskesmas atau Rumah Sakit 3. Foto copy KTP/KK Almarhum 4. Foto copy KTP pemohon 5. Foto copy surat keterangan pegawetan jenazah (Sertifikat Of Embalming)