MODUL

LOGBOOK PRAKTIK KLINIK

KEPERAWATAN MEDIKAL BEDAH

Tim Penyusun :

Tim Keperawatan Medikal Bedah

PROGRAM STUDI NERS

PROGRAM PROFESI NERS

UNIVERSITAS CITRA BANGSA

TAHUN AKADEMIK 2021

 KATA PENGANTAR

Seiring dengan perkembangan ilmu pengetahuan dan teknologi, sistem

pendidikan tinggi keperawatan telah mengalami perubahan prinsip yang sangat
mendasar terutama pada Program Studi Ners. Program Studi Ners termasuk
dalam tahap pendidikan di lahan praktik baik di rumah sakit, puskesmas maupun
di masyarakat dimana pembelajaran berbasis kompetensi. Evaluasi proses
pelaksanaan Program Studi Ners tidak terbatas pada mahasiswa tetapi
diberlakukan pada para dosen.

Log book ini merupakan pedoman yang membantu pembimbing institusi

(dosen) dalam melakukan bimbingan dengan mengevaluasi setiap perkembangan
mahasiswa didikan baik secara pengetahuan, skill dan sikap. Dengan pedoman ini
pembimbing instusi akan membantu dalam menilai kinerjanya.

Semoga buku pedoman ini dapat dimanfaatkan oleh pembimbing institusi

dengan baik sekaligus sebagai bahan untuk pengontrolan kinerja. Buku ini masih
jauh dari sempurna, oleh karena itu segala bentuk saran, masukan dan perbaikan
masih sangat dibutuhkan.

Kupang, Juni 2021

Tim Penyusun
 IDENTITAS DOSEN PEMBIMBING KLINIK

DIRSU S.K.LERIK, RST WIRASAKTI, RS BHAYANGKARA KUPANG

Nama Dosen :...............................................................................................

NIDN :...............................................................................................
Alamat :...............................................................................................
Bidang Ilmu :...............................................................................................
Riwayat Pendidikan :
Sarjana :...............................................................................................
Ners :...............................................................................................
Magister :...............................................................................................
Spesialis :...............................................................................................
Doktor :...............................................................................................

Riwayat Pelatihan :
1. ........................................................................................................................
2. ........................................................................................................................
3. ........................................................................................................................
4. ........................................................................................................................
5. ........................................................................................................................
 STRUKTUR ORGANISASI PROGRAM STUDI NERS
DIRSU S.K.LERIK, RST WIRASAKTI, RS BHAYANGKARA KUPANG

Ketua Program Studi :Ns.Balbina A. M. Wawo,

M.Kep.,Sp,Kep.J.
Sekretaris Program Studi : Ns. Maryati Barimbing, M.Kep
Koordinator Praktik Klinik KMB : Ns. Erna Febriyanti, MAN

Dosen Pembimbing
No NAMA TELPON/HP
1 Ns. Erna Febriyanti, MAN 082237767234
2 Ns. Sebastianus K. Tahu, M.Kep 081359131975
3 Ns. Istha Leani Muskananfola, M.Kep 085239163123
4 Ns. Yulia M.K Letor, MAN 08113838122
NAMA SUPERVISOR/INISIAL :............................................................................
KASUS RAWAT JALAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
KASUS RAWAT JALAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
KASUS RAWAT JALAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
NAMA SUPERVISOR/INISIAL :............................................................................
KASUS RAWAT JALAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
KASUS RAWAT JALAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
SUPERVISI TINDAKAN KEPERAWATAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
SUPERVISI TINDAKAN KEPERAWATAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
SUPERVISI TINDAKAN KEPERAWATAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
SUPERVISI TINDAKAN KEPERAWATAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
SUPERVISI TINDAKAN KEPERAWATAN YANG DITANGANI
BULAN......................................................................................................................
NO TGL DIAGNOSIS KEPERAWATAN RUANG PARAF CI
RAWAT
NAMA SUPERVISOR/INISIAL :............................................................................
MATA KULIAH :......................................................................................................
MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF

MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF

MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF
NAMA SUPERVISOR/INISIAL :............................................................................
MATA KULIAH :......................................................................................................
MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF

MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF

MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF
NAMA SUPERVISOR/INISIAL :............................................................................
MATA KULIAH :......................................................................................................
MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF

MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF

MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF
NAMA SUPERVISOR/INISIAL :............................................................................
MATA KULIAH :......................................................................................................
MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF

MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF

MATERI KULIAH
TOPIK

TANGGAL
WAKTU
TEMPAT
JUMLAH MAHASISWA
PARAF
DISKUSI KASUS PASIEN
TOPIK
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
NAMA MAHASISWA NERS
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
TANGGAL :.........................................
WAKTU :.........................................
TEMPAT :.........................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
DISKUSI KASUS PASIEN
TOPIK
1. ..........................................................................................................
2. .................................................................................................................
3. .................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
NAMA MAHASISWA NERS
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
TANGGAL :.........................................
WAKTU :.........................................
TEMPAT :.........................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
DISKUSI KASUS PASIEN
TOPIK
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
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6. ..........................................................................................................
7. ..........................................................................................................
NAMA MAHASISWA NERS
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
TANGGAL :.........................................
WAKTU :.........................................
TEMPAT :.........................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
DISKUSI KASUS PASIEN
TOPIK
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
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6. ..........................................................................................................
7. ..........................................................................................................
NAMA MAHASISWA NERS
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
TANGGAL :.........................................
WAKTU :.........................................
TEMPAT :.........................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
DISKUSI KASUS PASIEN
TOPIK
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
NAMA MAHASISWA NERS
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
TANGGAL :.........................................
WAKTU :.........................................
TEMPAT :.........................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
DISKUSI KASUS PASIEN
TOPIK
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
NAMA MAHASISWA NERS
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
TANGGAL :.........................................
WAKTU :.........................................
TEMPAT :.........................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
DISKUSI KASUS PASIEN
TOPIK
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
NAMA MAHASISWA NERS
1. ..........................................................................................................
2. ..........................................................................................................
3. ..........................................................................................................
4. ..........................................................................................................
5. ..........................................................................................................
6. ..........................................................................................................
7. ..........................................................................................................
TANGGAL :.........................................
WAKTU :.........................................
TEMPAT :.........................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
PEMBIMBING BED SIDE TEACHING
TOPIK
1. .......................................................................................................

2. .......................................................................................................

NAMA MAHASISWA NERS

1. ........................................................................................................

TANGGAL :............................................
WAKTU :............................................
TEMPAT :............................................
PARAF PEMBIMBING INSTITUSI

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

PEMBIMBING BED SIDE TEACHING

TOPIK
3. .......................................................................................................

4. .......................................................................................................

NAMA MAHASISWA NERS

2. ........................................................................................................

TANGGAL :............................................
WAKTU :............................................
TEMPAT :............................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
PEMBIMBING BED SIDE TEACHING
TOPIK
1. .......................................................................................................

2. .......................................................................................................

NAMA MAHASISWA NERS

1. ........................................................................................................

TANGGAL :............................................
WAKTU :............................................
TEMPAT :............................................
PARAF PEMBIMBING INSTITUSI

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

PEMBIMBING BED SIDE TEACHING

TOPIK
1. .......................................................................................................

2. .......................................................................................................

NAMA MAHASISWA NERS

1. ........................................................................................................

TANGGAL :............................................
WAKTU :............................................
TEMPAT :............................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
PEMBIMBING BED SIDE TEACHING
TOPIK
1. .......................................................................................................

2. .......................................................................................................

NAMA MAHASISWA NERS

1. ........................................................................................................

TANGGAL :............................................
WAKTU :............................................
TEMPAT :............................................
PARAF PEMBIMBING INSTITUSI

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

PEMBIMBING BED SIDE TEACHING

TOPIK
1. .......................................................................................................

2. .......................................................................................................

NAMA MAHASISWA NERS

1. ........................................................................................................

TANGGAL :............................................
WAKTU :............................................
TEMPAT :............................................
PARAF PEMBIMBING INSTITUSI

(.......................................................)
PEMBIMBING BED SIDE TEACHING
TOPIK
1. .......................................................................................................

2. .......................................................................................................

NAMA MAHASISWA NERS

1. ........................................................................................................

TANGGAL :............................................
WAKTU :............................................
TEMPAT :............................................
PARAF PEMBIMBING INSTITUSI

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

PEMBIMBING BED SIDE TEACHING

TOPIK
1. .......................................................................................................

2. .......................................................................................................

NAMA MAHASISWA NERS

1. ........................................................................................................

TANGGAL :............................................
WAKTU :............................................
TEMPAT :............................................
PARAF PEMBIMBING INSTITUSI

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