Nomor :

UNIVERSITAS FORT DE KOCK BUKITTINGGI

FORT DE KOCK UNIVERSITY BUKITTINGGI
ILMU KEPERAWATAN PROGRAM SARJANA
NURSING SCIENCE

SK Pendirian/SK Perubahan : 77/D/O/2004 /786/KPT/I/2019

Establishment of decree/The Change of decree : 77/D/O/2004 /786/KPT/I/2019

SURAT KETERANGAN PENDAMPING IJAZAH

DIPLOMA SUPLEMENT
Surat Keterangan Pendamping Ijazah (SKPI) sebagai pelengkap Ijazah yang menerangkan Capaian Pembelajaran dan Prestasi
dari Pemegang Ijazah selama masa studi.
Diploma Supplement as a complementary diploma that explains Learning Achievement and Achievement from Holders of
diploma during the study period)

I. INFORMASI TENTANG IDENTITAS DIRI PEMEGANG SKPI

INFORMATION OF PERSONAL INFORMATION DIPLOMA SUPPLEMENT HOLDER
1.1 Nama Lengkap
Athiyya Gusman
Name
1.2 Tempat dan Tanggal Lahir Batam, 27 September 1999
Place and Date of Birth Batam, September 27, 1999
1.3 Nomor Induk Mahasiswa
1814201017
Student Identification Number
1.4 Tanggal / Bulan / Tahun Masuk 03 September 2018
Date/Month/Admission Year September 03, 2018
1.5 Tanggal / Bulan / Tahun Lulus -
Date/Month/Graduation Year January 01, 1970
1.6 Nomor Ijazah
Number of Certification
1.7 Gelar / Singkatan Sarjana Keperawatan / S.Kep
Title Sarjana Keperawatan / S.Kep

II. INFORMASI TENTANG IDENTITAS PENYELENGGARAAN PROGRAM STUDI

INFORMATION ABOUT THE IDENTITY OF PROGRAM IMPLEMENTATION
2.1 Surat Keterangan Pendirian
77/D/O/2004
Certificate of Establishment
2.2 Nama Perguruan Tinggi Universitas Fort De Kock Bukittinggi
Name of Collage
2.3 Nama Program Studi Ilmu Keperawatan Program Sarjana
Study Program Nursing Science
2.4 Jenis Pendidikan Akademik
Classification Studi Academic
2.5 Jenjang Pendidikan S1
Education Bachelor
2.6 Jenjang Kualifikasi sesuai KKNI Level 6
Appropriate Level of Qualification KKNI Level 6
2.7 Persyaratan Penerimaan Seleksi Mandiri PTS
Access Requirements College Selection
2.8 Bahasa Pengantar Kuliah Bahasa Indonesia
Language Study Indonesian Language
2.9 Sistem Penilaian Penilaian Acuan Norma (PAN)
Valuation System Norm Reference Evaluation

Penilaian Acuan Patokan (PAP)

Standard Reference Evaluation
2.10 Lama Studi 4 Tahun
Study Period 4 Years
2.11 Jenis dan Jenjang Pendidikan Lanjutan Profesi / S2
Access to Further Study Profession / Master
2.12 Skema tentang Sistem Pendidikan Tinggi Sistem Pendidikan Tinggi di Indonesia dan Kerangka
Scheme of Higher Education Kualifikasi Nasional Indonesia (KKNI)
Higher Education System in Indonesia and Indonesian
National Qualification Framework

III. INFORMASI TENTANG KUALIFIKASI DAN HASIL YANG DICAPAI

INFORMATION ABOUT ACHIEVEMENT OF QUALIFICATIONS AND RESULTS
Capaian Pembelajaran
ALearning Outcome
Ilmu Keperawatan Program Sarjana (KKNI Level 6)
Nursing Science (KKNI Level 6)
PENGUASAAN PENGETAHUAN / MASTERY OF KNOWLEDGE

3.1.a Menguasai filosofi, paradigma, teori keperawatan, Mastering the philosophy, paradigm, nursing theory,
khususnya konseptual model dan middle range theory especially conceptual model and middle range theory

3.2.a Menguasai konsep teoritis ilmu biomedik Mastering the theoretical concepts of biomedical
science
3.3.a Menguasai nilai-nilai kemanusiaan Mastering the values of humanity
3.4.a Menguasai teknik, prinsip dan prosedur pelaksanaan Mastering the techniques, principles and procedures
asuhan/praktik keperawatan yang dilakukan secara for the implementation of nursing care / practice
mandiri atau berkelompok pada bidang keilmuan undertaken independently or in groups in basic nursing
keperawatan dasar, keperawatan medikal bedah, science, medical surgical nursing, pediatric nursing,
keperawatan anak, keperawatan maternitas, maternity nursing, mental health nursing, family
keperawatan jiwa, keperawatan keluarga, keperawatan nursing, geriatrics nursing, community nursing, and
gerontik, keperawatan komunitas, serta keperawatan disaster nursing
bencana

3.5.a Menguasai konsep dan teknik penegakkan diagnosis Mastering the concepts and techniques of diagnosing
asuhan keperawatan nursing care
3.6.a Menguasai konsep teoritis komunikasi terapeutik Mastering the theoretical concepts of therapeutic
communication
3.7.a Menguasai konsep, prinsip dan teknik penyuluhan Mastering the concept, principles and techniques of
kesehatan sebagai bagian dari upaya pencegahan health education as part of prevention of disease
penularan penyakit pada level primer, sekunder dan transmission at primary, secondary and tertiary levels
tertier
3.8.a Menguasai prinsip dan prosedur bantuan hidup lanjut Mastering the principles and procedures of life support
dan penanganan trauma (BTCLS) pada kondisi and trauma management (BTCLS) on emergency and
kegawatdaruratan dan bencana disaster conditions
3.9.a Menguasai konsep dan prinsip manajemen keperawatan Mastering the concept and principles of nursing
secara umum dan dalam pengelolaan asuhan management in general and in managing nursing care
keperawatan kepada klien di berbagai tatanan to clients in various health care settings
pelayanan kesehatan
3.10.a Menguasai pengetahuan faktual tentang sistem Mastering the factual knowledge about information
informasi asuhan keperawatan dan kesehatan systems of nursing care and health care

3.11.a Menguasai prinsip-prinsip K3, hak dan perlindungan Mastering the principles of K3, right and protection of
kerja ners, keselamatan pasien dan perawatan berpusat nurses work, patient safety and patient centered or
atau berfokus pada pasien patient-centered care

3.11.a Menguasai prinsip-prinsip K3, hak dan perlindungan Mastering the principles of K3, right and protection of
kerja ners, keselamatan pasien dan perawatan berpusat nurses work, patient safety and patient centered or
atau berfokus pada pasien patient-centered care

KEMAMPUAN KERJA / WORK ABILITY

3.1.b Mampu memberikan asuhan keperawatan yang lengkap
dan berkesinambungan yang menjamin keselamatan
klien, sesuai standar asuhan keperawatan dan
berdasarkan perencanaan keperawatan yang telah atau
belum tersedia, kekhususan medikal bedah
Being able to provide complete and continuous nursing
care that guarantees patient safety, as the standards of
nursing care and based on nursing plan that has or has
not been available, especially on medical surgical
nursing.

3.1.b Mampu memberikan asuhan keperawatan yang lengkap
dan berkesinambungan yang menjamin keselamatan
klien, sesuai standar asuhan keperawatan dan
berdasarkan perencanaan keperawatan yang telah atau
belum tersedia, kekhususan medikal bedah
Being able to provide complete and continuous nursing
care that guarantees patient safety, as the standards of
nursing care and based on nursing plan that has or has
not been available, especially on medical surgical
nursing.

3.2.b Mampu memberikan asuhan keperawatan pada area
kekhususan (keperawatan medikal bedah, keperawatan
anak, keperawatan maternitas, keperawatan jiwa, atau
keperawatan komunitas, keperawatan gerontik, dan
keperawatan keluarga)
Being able to provide nursing care in the specific area
(medical surgical nursing, pediatric nursing, maternity
nursing, mental nursing, or community nursing,
geriatrics nursing, and family nursing)

3.2.b Mampu memberikan asuhan keperawatan pada area
kekhususan (keperawatan medikal bedah, keperawatan
anak, keperawatan maternitas, keperawatan jiwa, atau
keperawatan komunitas, keperawatan gerontik, dan
keperawatan keluarga)
Being able to provide nursing care in the specific area
(medical surgical nursing, pediatric nursing, maternity
nursing, mental nursing, or community nursing,
geriatrics nursing, and family nursing)

3.3.b Mampu melaksanakan prosedur penanganan trauma Being able to perform basic and cardiac trauma
dasar dan jantung pada situasi gawat darurat/bencana handling procedures in emergency / disaster situations
sesuai standar dan kewenangannya according to standards and authorities

3.3.b Mampu melaksanakan prosedur penanganan trauma Being able to perform basic and cardiac trauma
dasar dan jantung pada situasi gawat darurat/bencana handling procedures in emergency / disaster situations
sesuai standar dan kewenangannya according to standards and authorities

3.4.b Mampu memberikan obat oral, topical, nasal, Being able to deliver oral, topical, nasal, parenteral
parenteral dan supositoria sesuai standar pemberian and suppository drugs according to standard giving
obat dan kewenangan yang didelegasikan drugand delegated authorities.

3.4.b Mampu memberikan obat oral, topical, nasal, Being able to deliver oral, topical, nasal, parenteral
parenteral dan supositoria sesuai standar pemberian and suppository drugs according to standard giving
obat dan kewenangan yang didelegasikan drugand delegated authorities.

3.5.b Mampu menegakkan diagnosis kedalaman dan Being able to establish a depth diagnosis and limited
keluasan terbatas berdasarkan analisa data, informasi extent based on data analysis, information and study
dan hasil kajian dari berbagai sumber untuk results from various sources to establish nursing care
menetapkan prioritas asuhan keperawatan priority.

3.5.b Mampu menegakkan diagnosis kedalaman dan Being able to establish a depth diagnosis and limited
keluasan terbatas berdasarkan analisa data, informasi extent based on data analysis, information and study
dan hasil kajian dari berbagai sumber untuk results from various sources to establish nursing care
menetapkan prioritas asuhan keperawatan priority.

3.6.b Mampu menyusun dan mengimplementasikan Being able to arrange and implement nursing care
perencanaan asuhan keperawatan sesuai standar asuhan planning according to nursing care standards and
keperawatan dan kode etik perawat, yang peka budaya, nursing code of ethics which are culturally sensitive,
menghargai keragaman etnik, agama dan faktor lain respect ethnic diversity, religion and other factors of
dari klien individu, keluarga dan masyarakat individual clients, families and communities

3.6.b Mampu menyusun dan mengimplementasikan Being able to arrange and implement nursing care
perencanaan asuhan keperawatan sesuai standar asuhan planning according to nursing care standards and
keperawatan dan kode etik perawat, yang peka budaya, nursing code of ethics which are culturally sensitive,
menghargai keragaman etnik, agama dan faktor lain respect ethnic diversity, religion and other factors of
dari klien individu, keluarga dan masyarakat individual clients, families and communities
3.7.b Mampu melakukan tindakan asuhan keperawatan atas Being able to perform nursing care actions on changes
perubahan kondisi klien yang tidak diharapkan secara in client conditions that are not expected quickly and
cepat dan tepat dan melaporkan kondisi dan tindakan accurately and report the conditions and care actions
asuhan kepada penangung jawab perawatan to the care taker

3.7.b Mampu melakukan tindakan asuhan keperawatan atas Being able to perform nursing care actions on changes
perubahan kondisi klien yang tidak diharapkan secara in client conditions that are not expected quickly and
cepat dan tepat dan melaporkan kondisi dan tindakan accurately and report the conditions and care actions
asuhan kepada penangung jawab perawatan to the care taker

3.8.b Mampu melakukan evaluasi dan revisi rencana asuhan Being able to regularly evaluate and revise nursing
keperawatan secara reguler dengan/atau tanpa tim care plans with / or without other health teams
kesehatan lain

3.8.b Mampu melakukan evaluasi dan revisi rencana asuhan Being able to regularly evaluate and revise nursing
keperawatan secara reguler dengan/atau tanpa tim care plans with / or without other health teams
kesehatan lain
3.9.b Mampu melakukan komunikasi terapeutik dengan klien Being able to do therapeutic communication with
dan memberikan informasi yang akurat kepada klien clients and provide accurate information to the client
dan/atau keluarga/pendamping/penasehat untuk and / or family / guardian / advisor to get the approval
mendapatkan persetujuan keperawatan yang menjadi of nursing which is the responsibility
tanggung jawabnya

3.9.b Mampu melakukan komunikasi terapeutik dengan klien Being able to do therapeutic communication with
dan memberikan informasi yang akurat kepada klien clients and provide accurate information to the client
dan/atau keluarga/pendamping/penasehat untuk and / or family / guardian / advisor to get the approval
mendapatkan persetujuan keperawatan yang menjadi of nursing which is the responsibility
tanggung jawabnya

3.10.b Mampu melaksanakan penanggulangan bencana sesuai Being able to implement disaster management
SOP according to SOP (Standard of Procedure)
3.10.b Mampu melaksanakan penanggulangan bencana sesuai Being able to implement disaster management
SOP according to SOP (Standard of Procedure)
3.11.b Mampu melakukan upaya pencegahan terjadinya Being able to make efforts to prevent the occurrence of
pelanggaran dalam praktik asuhan keperawatan violations in the practice of nursing care

3.11.b Mampu melakukan upaya pencegahan terjadinya Being able to make efforts to prevent the occurrence of
pelanggaran dalam praktik asuhan keperawatan violations in the practice of nursing care

3.12.b Mampu merencanakan, melaksanakan dan Being able to plan, implement and evaluate health
mengevaluasi prigram promosi kesehatan, melalui promotion programs, in coordinationwith others
kerjasama dengan sesama perawat, profesional lain nurses, other professionals and community groups to
serta kelompok masyarakat untuk mengurangi angka reduce morbidity, improve lifestyle and healthy
kesakitan, meningkatkan gaya hidup dan lingkungan environment
yang sehat

3.12.b Mampu merencanakan, melaksanakan dan Being able to plan, implement and evaluate health
mengevaluasi prigram promosi kesehatan, melalui promotion programs, in coordinationwith others
kerjasama dengan sesama perawat, profesional lain nurses, other professionals and community groups to
serta kelompok masyarakat untuk mengurangi angka reduce morbidity, improve lifestyle and healthy
kesakitan, meningkatkan gaya hidup dan lingkungan environment
yang sehat

3.13.b Mampu melakukan studi kasus secara teratur dengan Being able to conduct case studies regularly by
cara refleksi, telaah kritis, dan evaluasi serta peer reflection technique, critical analyze, and evaluation
review tentang praktik keperawatan yang and peer review of nursing practice which are doing.
dilaksanakannya

3.13.b Mampu melakukan studi kasus secara teratur dengan Being able to conduct case studies regularly by
cara refleksi, telaah kritis, dan evaluasi serta peer reflection technique, critical analyze, and evaluation
review tentang praktik keperawatan yang and peer review of nursing practice which are doing.
dilaksanakannya
3.14.b Mampu melakukan penelitian dalam bidang Being able to conduct research in the field of nursing to
keperawatan untuk menghasilkan langkah-langkah produce organizational strategic development steps
pengembangan strategis organisasi
3.14.b Mampu melakukan penelitian dalam bidang Being able to conduct research in the field of nursing to
keperawatan untuk menghasilkan langkah-langkah produce organizational strategic development steps
pengembangan strategis organisasi

SIKAP / ATTITUDE

3.1.c Bertakwa kepada Tuhan yang Maha Esa dan mampu
menunjukkan sikap yang religius
3.1.c Bertakwa kepada Tuhan yang Maha Esa dan mampu
menunjukkan sikap yang religius
3.2.c Menjunjung tinggi nilai kemanusiaan dalam
menjalankan tugas berdasarkan agama, moral, dan etika
Be piously of God Almighty and capable of showing a
religious attitude
Be piously of God Almighty and capable of showing a
religious attitude
Upholding the value of humanity in carrying out duties
based on religion, morals, and ethics

3.2.c Menjunjung tinggi nilai kemanusiaan dalam Upholding the value of humanity in carrying out duties
menjalankan tugas berdasarkan agama, moral, dan etika based on religion, morals, and ethics

3.3.c Menginternalisasikan nilai, norma, dan etika akademik Internalizing academic values, norms, and ethics

3.3.c Menginternalisasikan nilai, norma, dan etika akademik Internalizing academic values, norms, and ethics

3.4.c Berperan sebagai warga negara yang bangga dan cinta Serving as a proud citizen and love of the homeland,
tanah air, memiliki nasionalisme serta rasa tanggung having nationalism and a sense of responsibility to the
jawab pada negara dan bangsa state and nation

3.4.c Berperan sebagai warga negara yang bangga dan cinta Serving as a proud citizen and love of the homeland,
tanah air, memiliki nasionalisme serta rasa tanggung having nationalism and a sense of responsibility to the
jawab pada negara dan bangsa state and nation

3.5.c Menghargai keanekaragaman budaya, pandangan Appreciating cultural diversity, religious views, and
agama, dan kepercayaan serta pendapat atau temuan beliefs as well as the original opinions or findings of
orisinil orang lain others

3.5.c Menghargai keanekaragaman budaya, pandangan
agama, dan kepercayaan serta pendapat atau temuan
orisinil orang lain
3.6.c Berkontribusi dalam peningkatan mutu kehidupan
bermasyarakat, berbangsa, bernegara dan kemajuan
peradaban berdasarkan Pancasila
Appreciating cultural diversity, religious views, and
beliefs as well as the original opinions or findings of
others
Contributing to improve the quality of life of society ,
nation, state and civilization progress based on
Pancasila

3.6.c Berkontribusi dalam peningkatan mutu kehidupan Contributing to improve the quality of life of society ,
bermasyarakat, berbangsa, bernegara dan kemajuan nation, state and civilization progress based on
peradaban berdasarkan Pancasila Pancasila

3.7.c Bekerjasama dan memiliki kepekaan sosial serta Cooperating and having social sensitivity and concern
kepedulian terhadap masyarakat dan lingkungan for society and environment

3.7.c Bekerjasama dan memiliki kepekaan sosial serta Cooperating and having social sensitivity and concern
kepedulian terhadap masyarakat dan lingkungan for society and environment

3.8.c Taat hukum dan disiplin dalam kehidupan Obeying the law and discipline in social life and state
bermasyarakat dan bernegara

3.8.c Taat hukum dan disiplin dalam kehidupan Obeying the law and discipline in social life and state
bermasyarakat dan bernegara
3.9.c Menginternalisasi semangat kemandirian, kejuangan, Internalizing the spirit of independence, struggle, and
dan kewirausahaan entrepreneurship
3.9.c Menginternalisasi semangat kemandirian, kejuangan, Internalizing the spirit of independence, struggle, and
dan kewirausahaan entrepreneurship
3.10.c Menunjukan sikap bertanggung jawab atas pekerjaan di Showing a responsible attitude towards the work in the
bidang keahliannya secara mandiri field of expertise independently

3.10.c Menunjukan sikap bertanggung jawab atas pekerjaan di Showing a responsible attitude towards the work in the
bidang keahliannya secara mandiri field of expertise independently
3.11.c Mampu bertanggung gugat terhadap praktik profesional
meliputi kemampuan menerima tanggung gugat
terhadap keputusan dan tindakan profesional sesuai
dengan lingkup praktik dibawah tanggung jawabnya,
dan hukum/peraturan perundangan
Being accountable to professional practice including
the ability to accept accountability for decisions and
professional actions in accordance with the scope of
the practice under its responsibility, and laws /
regulations

3.11.c Mampu bertanggung gugat terhadap praktik profesional
meliputi kemampuan menerima tanggung gugat
terhadap keputusan dan tindakan profesional sesuai
dengan lingkup praktik dibawah tanggung jawabnya,
dan hukum/peraturan perundangan
Being accountable to professional practice including
the ability to accept accountability for decisions and
professional actions in accordance with the scope of
the practice under its responsibility, and laws /
regulations

3.12.c Mampu melaksanakan praktik keperawatan dengan Being able to carry out nursing practice with ethical
prinsip etis dan peka budaya sesuai dengan Kode Etik and cultural-sensitive principles in accordance with the
Perawat Indonesia Indonesian Nurse Code of ethics

3.12.c Mampu melaksanakan praktik keperawatan dengan Being able to carry out nursing practice with ethical
prinsip etis dan peka budaya sesuai dengan Kode Etik and cultural-sensitive principles in accordance with the
Perawat Indonesia Indonesian Nurse Code of ethics

3.13.c Memiliki sikap menghormati hak privasi, nilai budaya
yang dianut dan martabat klien, menghormati hak
klienuntuk memilih dan menentukan sendiri asuhan
keperawatan dan kesehatan yang diberikan, serta
bertanggung jawab terhadap kerahasiaan dan kemanan
informasi tertulis, verbal da elektronik yang diperoleh
dalam kapasitas sesuai dengan lingkup tanggung
jawabnya
Having an attitude of respect for the right to privacy,
cultural value of the client and the dignity of the client,
respecting the client's right to choose and determine his
own nursing care and health provided, and responsible
for the confidentiality and security of written, verbal
and electronic information obtained in capacity in
accordance with his scope of responsibility

3.13.c Memiliki sikap menghormati hak privasi, nilai budaya
yang dianut dan martabat klien, menghormati hak
klienuntuk memilih dan menentukan sendiri asuhan
keperawatan dan kesehatan yang diberikan, serta
bertanggung jawab terhadap kerahasiaan dan kemanan
informasi tertulis, verbal da elektronik yang diperoleh
dalam kapasitas sesuai dengan lingkup tanggung
jawabnya
Having an attitude of respect for the right to privacy,
cultural value of the client and the dignity of the client,
respecting the client's right to choose and determine his
own nursing care and health provided, and responsible
for the confidentiality and security of written, verbal
and electronic information obtained in capacity in
accordance with his scope of responsibility

IV. INFORMASI TENTANG KUALIFIKASI DAN HASIL YANG DICAPAI

INFORMATION ABOUT ACHIEVEMENT OF QUALIFICATIONS AND RESULTS
B. Informasi Tambahan
Additional Information
Ilmu Keperawatan Program Sarjana (KKNI Level 6)
Nursing Science (KKNI Level 6)
KEMAMPUAN KERJA / WORK ABILITY
4.1 Penghargaan dan Pelatihan
Honors and Award
4.2 Pengalaman Berorganisasi (Jabatan dalam Organisasi)
Organisational Experiences

4.3 Bahasa Internasional

International Language
4.4 Pendidikan Berkarakter
Soft Skill Training

Bukittinggi, 17 September 2021

Bukittinggi, September 17, 2021
Dekan / Dean

Oktavianis, S.ST, M.Biomed