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FORMAT
STRATEGI PELAKSANAAN TINDAKAN KEPERAWATAN KE ..........
(Dibuat setiap kali sebelum interaksi / pertemuan dengan klien)
Tanggal.................................. Jam ............................

A. PROSES KEPERAWATAN.

1. Kondisi Klien:
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2. Diagnosa Keperawatan.
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3. Tujuan SPTK
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4. Tindakan Keperawatan
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B. STRATEGI KOMUNIKASI DALAM PELAKSANAAN TINDAKAN KEPERAWATAN

a. FASE ORIENTASI
1. Salam Terapeutik
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2. Evaluasi / validasi
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3. Kontrak
Topik : ............................................................................................................
Waktu : ...........................................................................................................
Tempat : ...........................................................................................................

b. FASE KERJA
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c. FASE TERMINASI
1. Evaluasi respon klien terhadap tindakan keperawatan
Evaluasi Subyektif (Klien)
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Evaluasi Obyekti (Perawat)
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2. Rencana Tindak Lanjut
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3. Kontrak yang akan datang
Topik : ............................................................................................................
Waktu : ...........................................................................................................
Tempat : ...........................................................................................................