FORMAT LAPORAN ANALISA SINTESA KOMPETENSI TINDAKAN

KEPERAWATAN
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Nama Mahasisiwa :
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Tanggal

NIM
:
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Nama Klien

Ruangan

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Diagnosa Medis : ____________________________________________

A. Tindakan Keperawatan Yang Dilakukan :

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B. Diagnosa Keperawatan Yang Mendasari Tindakan :
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C. Tujuan Tindakan Dilakukan :
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D. Prinsip dan Rasionalisasi Tindakan :

N
O

PRINSIP

RASIONALISASI

E. Bahaya Yang Dapat Terjadi Akibat Tindakan Tersebut :

N
O

BAHAYA

PENCEGAHAN

F. Hasil Yang Didapat :

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G. Evaluasi Diri :
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Mengetahui :
Pembimbing Klinik

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Pembimbing Akademik