STIKes Dr.

Sismadi Jakarta
Jl. Warakas Raya No 5B
Tanjung Priuk Jakarta Utara

SURAT PEMBERITAHUAN PERGANTIAN PRAKTEK

Menerangkan mahasiswa STIKes Dr. Sismadi Jakarta

Nama : ..........................................................................................
NIM : ..........................................................................................
Tingkat : ..........................................................................................
Program Studi : ..........................................................................................

Tidak Hadir Pada

Hari : .........................................................................................
Tanggal : .........................................................................................
Jadwal Dinas : .........................................................................................

Akan Mengganti pada

Hari : .........................................................................................
Tanggal : .........................................................................................
Jadwal Dinas : .........................................................................................

Mengetahui, Disetujui Oleh

Koordinator MA Kepala Ruangan/CI

(....................................) (.....................................)
SIiKes Dr. Sismadi Jakarta
Jl. Warakas Raya No 5B
Tanjung Priuk Jakarta Utara

STRATEGI PELAKSANAAN
TINDAKAN KEPERAWATAN

Pertemuan :
Hari/ Tanggal :
Nama Klien :
Ruangan :

A. Proses Keperawatan
1. Kondisi klien : ......................................................................................................................
................................................................................................................................................
2. Diagnosa Keperawatan : .......................................................................................................
................................................................................................................................................
3. Tujuan Khusus : ....................................................................................................................
................................................................................................................................................
4. Tindakan keperawatan : ........................................................................................................
................................................................................................................................................

B. Strategi Komunikasi
1. Orientasi
a. Salam Terapeutik
.........................................................................................................................................

b. Evaluasi/Validasi
.........................................................................................................................................

c. Kontrak (Topik, Waktu, dan tempat)

.........................................................................................................................................

d. Tujuan Tindakan
.........................................................................................................................................
2. Kerja (Menjabarkan langkah-langkah tindakan keperawatan secara operasional )
...............................................................................................................................................
...............................................................................................................................................

3. Terminasi
a. Evaluasi respon (Respon klien terhadap tindakan keperawatan)
1) Evaluasi Subjektif
...................................................................................................................................

2) Evaluasi Objektif
...................................................................................................................................

b. Rencana tindak lanjut (yang perlu dilatih klien sesuai hasil tindakan yang dilakukan)
.........................................................................................................................................

c. Kontrak yang akan datang (topik, waktu dan tempat)

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