TRANSFÜZYON MERKEZİ FAALİYET FORMU

Örnek Doküman

TH.FR.033 - TRANSFÜZYON MERKEZİ FAALİYET FORMU

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Demo Hastanesi (Prokalite.Com) TRANSFÜZYON MERKEZİ FAALİYET FORMU

Doküman Kodu: TH.FR.033

Yayın Tarihi: 01.11.2021

Revizyon Tarihi: 11.11.2022

Revizyon No: 1

Sayfa: Otomatik

Kan Hizmet Biriminin Adı	………………………………………….
Bildirim Dönemi	01/01/20 . . . - 31/12/20 ....
TRANSFÜZE EDİLEN
KAN VE KAN BİLEŞENİ	BİLEŞEN ÜNİTE SAYISI	HASTA SAYISI
Tam Kan
Eritrosit Konsantresi (Toplam)
Ek İşlem Görmemiş
Lökosit Azaltılmış
Işınlanmış
Yıkanmış
Lökosit Azaltılmış + Işınlanmış
Aferez Eritrosit Konsantresi (Toplam)
Ek İşlem Görmemiş
Lökosit azaltılmış
Işınlanmış
Yıkanmış
Lökosit Azaltılmış + Işınlanmış
Trombosit Konsantresi (Toplam)
Ek İşlem Görmemiş
Lökosit azaltılmış
Işınlanmış
Lökosit azaltılmış + Işınlanmış
Trombosit Konsantresi Havuzlanmış (Toplam)
Ek İşlem Görmemiş
Lökosit azaltılmış
Işınlanmış
Lökosit azaltılmış + Işınlanmış
Aferez Trombosit Konsantresi (Toplam)
Ek İşlem Görmemiş
Lökosit azaltılmış
Işınlanmış
Lökosit azaltılmış + Işınlanmış
Plazma (Toplam)
Taze Plazma
Taze Donmuş
İnaktive Edilmiş
Kriyopresipitatı Uzaklaştırılmış
Kriyopresipitat (Toplam)
Aferez Granülosit Konsantresi

<table style="border-collapse:collapse; width:882px" class=" cke_show_border" cellspacing="0"><tbody><tr><td style="border-color:black; border-style:solid; border-width:1px; height:13px; vertical-align:middle; width:352px">Kan Hizmet Biriminin Adı</td><td colspan="2" style="border-color:black black black currentcolor; border-style:solid solid solid none; border-width:1px 1px 1px medium; vertical-align:middle; width:522px">………………………………………….</td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Bildirim Dönemi</td><td colspan="2" style="border-color:black black black currentcolor; border-style:solid solid solid none; border-width:1px 1px 1px medium; vertical-align:middle; width:522px">01/01/20 . . . - 31/12/20 ....</td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:13px; text-align:center; vertical-align:middle">TRANSFÜZE EDİLEN</td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">KAN VE KAN BİLEŞENİ</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; text-align:center; vertical-align:middle; width:295px">BİLEŞEN ÜNİTE SAYISI</td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:middle">HASTA SAYISI</td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Tam Kan</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Eritrosit Konsantresi (Toplam)</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Ek İşlem Görmemiş</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit Azaltılmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Yıkanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit Azaltılmış + Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Aferez Eritrosit Konsantresi (Toplam)</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Ek İşlem Görmemiş</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit azaltılmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Yıkanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit Azaltılmış + Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Trombosit Konsantresi (Toplam)</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Ek İşlem Görmemiş</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit azaltılmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit azaltılmış + Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Trombosit Konsantresi Havuzlanmış (Toplam)</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Ek İşlem Görmemiş</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit azaltılmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit azaltılmış + Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Aferez Trombosit Konsantresi (Toplam)</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Ek İşlem Görmemiş</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit azaltılmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Lökosit azaltılmış + Işınlanmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Plazma (Toplam)</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Taze Plazma</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Taze Donmuş</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">İnaktive Edilmiş</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; text-align:left; vertical-align:middle; width:352px">Kriyopresipitatı Uzaklaştırılmış</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Kriyopresipitat (Toplam)</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:13px; vertical-align:middle; width:352px">Aferez Granülosit Konsantresi</td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; vertical-align:middle; width:295px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle"> </td></tr></tbody></table>

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Transfüzyon Hizmetleri - Form

TH.FR.033 - TRANSFÜZYON MERKEZİ FAALİYET FORMU

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