PRE PLANNING

NAMA MAHASISWA :
HARI/TGGL :....
PERTEMUAN :
RUANGAN :

A. LATAR BELAKANG
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B. RENCANA ASUHAN KEPERAWATAN

1. Diagnosa Keperawatan
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2. Tujuan Umum
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 3. Tujuan Khusus
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C. PELAKSANAAN
1. Topik :.
2. Media :.
3. Waktu dan Tempat :.
4. Metode :.

D. STRATEGI PELAKSANAAN

NO TAHAP KEGIATAN WAKTU

1 PRA
INTERAKSI

2 INTERAKSI
3 TERMINASI

E. KRITERIA EVALUASI
1. Evaluasi Struktur
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2. Evaluasi Proses
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3. Evaluasi Hasil
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