Nomor Ijazah

1.6 Diploma Number 153/J14901/073127/II/2020

Gelar Ners
1.7 Title Ners

1. IN F O R M A S I T E N T A N G I D E N T I T A S P E N Y E L E N G G A R A P R O
GRAM
INFO RM AT IO N IDENTIFYING THE AWARDING INSTITUTION
Surat Keterangan Pendirian SK. MENDIKNAS Nomor : 141/D/O/2005 tentang
Awarding Institution’s License Pendirian Sekolah Tinggi Ilmu Kesehatan Insan Cendekia
2.1
Medika Jombang
SEKOLAH TINGGI ILMU KESEHATAN Nama Perguruan Tinggi Sekolah Tinggi Ilmu Kesehatan Insan Cendekia Medika
INSAN CENDEKIA MEDIKA JOMBANG 2.2 Awarding Institution Jombang
INSTITUTE OF HEALTH SCIENCE Nama Program Studi Profesi Ners
INSAN CENDEKIA MEDIKA JOMBANG 2.3 Major Nurse Professions

Jenis Pendidikan Perawat

SURAT KETERANGAN PENDAMPING IJAZAH 2.4 Type of Education Nurse
DIPLOMA SUPPLEMENT
Nomor : 001/Ners/073127/IX/2019 Jenjang Pendidikan Profesi
2.5 Level of Education Profession

Surat Keterangan Pendamping Ijazah sebagai Pelengkap Ijazah yang Menerangkan Jenjang Kualifikasi Sesuai KKNI Level 7
Capaian Pembelajaran dan Prestasi dari Pemegang Ijazah selama Masa Studi Level of Qualification in the National Level 7
2.6
The Diploma Supplement Accompanies a Higher Education Certificate Providing a Standardized Description Qualification Framework
of the Nature, Level, Context, Content and Status of the Studies Completed y its Holder
Persyaratan Penerimaan Lulus Sarjana Keperawatan dan Seleksi Mahasiswa Baru
INFROMASI TENTANG IDENTITAS DIRI PEMEGANG SKPI 2.7 Entry Requirements Graduated from Nursing Diploma and New
INFORMATION IDENTIFYING THE H O LD E R OF DIPLOMA SUPPLEMENT
Bahasa Pengantar Kuliah Bahasa Indonesia
2.8 Languange of Instruction Indonesian

Sistem Penilaian A: 4, B:3, C:2, D:1,E: 0

2.9 Grading System
4 Years
Nama Lengkap Tedy Aris Kencana Lama Studi Reguler 42 Tahun
Semester
1.1 Full Name 2.10 Regular Length of Study 2 Semesters
First Name Surname
Tempat dan Tanggal Lahir Magetan, 17 April 1990 Jenis dan Jenjang Pendidikan Pasca Sarjana
1.2 Place and Date of Birth Magetan, 17th of April 1990 Lanjutan Post Graduate Study
2.11
Nomor Induk Mahasiswa 186410310 Access to Further Study
1.3 Student Identification
Number Status Profesi Ada
2.12 Professional Status Available
Tanggal Masuk 10 Februari 2019
1.4 Admission Date 10th of February 2019

Tanggal Lulus 10 Februari 2020

1.5 Completion Date 10th of February 2020
 Jombang, spesialis
Ketua Program Studi 3.C.3 Menguasai tekhnik BTCLS dan asuhan bencana Mastering the techniques of BTCLS and disaster
Profesi Ners sesuai standar dan kewenangannya care according to standards and authorities

3.C.4 Mampu mengelola sistem layanan keperawatan Able to manage nursing service system in
dalam layanan keperawatan nursing service

Dwi Prasetyaningati, S.Kep.,Ns.,M.Kep. Mampu melakukan komunikasi terapeutik pada Able to communicate therapeutic to clients and
3.C.5 klien dan keluarga family
NIK. 04.10.289
Keterampilan Umum
D
2. INFORMASI TENTANG KUALIFIKASI DAN HASIL YANG DI General Skills
CAPAI Bekerja dibidang keahlian pokok untuk jenis Working in key areas of expertise for specific
I N F O R M A T I O N OF Q U A L I F I C A T I O N A N D L E A R N I N G O U T C O M E 3.D.1 pekerjaan yang spesifik sesuai dengan standar types of work in accordance with the standards
Capaian Pembelajaran kompetensi profesi of professional competence
Learning Outcomes 3.D.2 Mampu melakukan penelitian bidang Able to conduct research in the field of nursing /
Sikap keperawatan/ kesehatan health
A
Attitute 3.D.3 Mampu memimpin tim kerja untuk memecahkan Able to lead the work of team to solve problems
Bertakwa kepada Tuhan Yang Maha Esa dan Being piety of Almighty God and showing masalah sesuai bidang profesinya according to the field of his/her profession
3.A.1
menunjukkan sikap religius religious attitude
Menjunjung tinggi nilai kemanusiaan dalam Upholding the value of humanity in carrying out 3.D.4 Mampu bekerja sama dengan profesi lain dalam Able to work with other professions in solving
3.A.2 menjalankan tugas berdasarkan agama, moral, duties based on religion, morals, and ethics menyelesaikan masalah keperawatan nursing problems
dan etika 3.D.5 Meningkatkan kapasitas pembelajaran mandiri Enhancing independent and sustainable learning
Mampu melaksanakan praktik keperawatan Able to carry out nursing practice with ethical dan berkelanjutan capacity
3.A.3 dengan prinsip etis dan peka budaya sesuai kode and culturally sensitive principles in accordance
etik keperawatan with the code of ethics of nursing 3. INFORMASI TAMBAHAN
Menunjukan sikap bertanggung jawab dan Showing responsible and accountable attitude ADDITIONAL INFORMATION
3.A.4 bertangggung gugat terhadap praktik towards professional practice 4.1 Aktivitas mahasiswa Pelatihan Basic Trauma and Cardiac Life Support
professional Student Activity (BTCLS) tahun 2015
Taat hukum, berkontribusi dan peduli Obeying the law, contributing and caring to Pengalaman organisasi -
4.2
3.A.5 meningkatkan mutu kehidupan bermasyarakat improve the quality of life of society and state Organizational Experience
dan bernegara Prestasi dan Penghargaan -
4.3
Pengetahuan Achievements and Awards
B
Knowledge
Menguasai filosofi, teori, konseptual model dan Mastering philosophy, theory, conceptual model 4. SKEMA TENTANG SISTEM PENDIDIKAN TINGGI DI INDONESIA
3.B.1
paradigma keperawatan and nursing paradigm HIGHER EDUCATION SYSTEM SCHEME IN INDONESIA
3.B.2 Menguasai konsep teoritis ilmu biomedik dan Mastering the theoretical concepts of biomedical
nilai-nilai kemanusiaan science and human values
3.B.3 Menguasai konsep dan teknik melakukan asuhan Mastering the concepts and techniques of basic
keperawatan dasar, medikal bedah, maternitas, nursing care, medical surgery, maternity, child,
anak, jiwa, komunitas dan gerontik mental, community and geriatric
3.B.4 Menguasai konsep dan prinsip dasar manejemen Mastering basic concepts and principles of
keperawatan nursing management
3.B.5 Menguasai sistem informasi asuhan Mastering the information system of nursing
keperawatan, komunikasi terapeutik dan teknik care, therapeutic communication and extension
penyuluhan techniques
3.B.6 Menguasai K3, hak dan perlindungan kerja ners, Mastering K3, right and protection of working
serta prosedur bantuan hidup dasar nurse, as well as basic life support procedures
Keterampilan Khusus
C Jombang, 14 September 2019
Special Skills
Mampu memberikan asuhan keperawatan Able to provide nursing care with the principle Ketua Program Studi
3.C.1 dengan prinsip patient safety of patient safety Profesi Ners

3.C.2 Mampu memberikan asuhan keperawatan pada Able to provide nursing care in a specialization
area spesialisasi sesuai dengan delegasi dari ners area according to delegates from specialist ners
Dwi Prasetyaningati, S.Kep.,Ns.,M.Kep.
NIK. 04.10.289