FORMAT LAPORAN DISKUSI REFLEKSI KASUS (DRK)

RUANG RAWAT : ...........................................

Nama Ruangan :
Tanggal Pelaksanaan :
Topik Diskusi Kasus :

A. Masalah/ Isu yang Muncul :

1. ...................................................................................................................
2. ...................................................................................................................
3. ...................................................................................................................
4. ...................................................................................................................
5. dst
B. Pembahasan:

C. Rencana Tindak Lanjut:

Isu Kegiatan Indikator

No
1.

2.

3.

4.

dst

Peserta DRK

1.
 (......................................)

(.......................................)

(.......................................)

(........................................)

dst

(........................................)
............,................
Kepala Ruangan

( .........................)

……)