FORMAT PENILAIAN FORMAT PENILAIAN

PENGUKURAN CVP PENGUKURAN CVP

NAMA : NAMA :
NIM : NIM :

SKOR SKOR
NO TINDAKAN BOBOT NO TINDAKAN BOBOT
1 2 3 4 1 2 3 4
1 Memperkenalkan diri 1 1 Memperkenalkan diri 1
2 Menjelaskan tujuan tindakan 1 2 Menjelaskan tujuan tindakan 1
3 Sterilitas 2 3 Sterilitas 2
4 Persiapan alat 2 4 Persiapan alat 2
5 Menentukan letak zero point 5 5 Menentukan letak zero point 5
Mensejajarkan letak zero point dengan Mensejajarkan letak zero point dengan
6 6
titik nol di manometer 2 titik nol di manometer 2
Mengalirkan cairan dari sumber cairan Mengalirkan cairan dari sumber cairan
7 7
ke pasien (sistem 1) 2 ke pasien (sistem 1) 2
Mengalirkan cairan dari sumber cairan Mengalirkan cairan dari sumber cairan
8 8
ke manometer (sistem 2) 2 ke manometer (sistem 2) 2
Mengalirkan cairan dari manometer ke Mengalirkan cairan dari manometer ke
9 9
pasien (sistem 3) 2 pasien (sistem 3) 2
Mengukur nilai CVP saat undulasi cairan Mengukur nilai CVP saat undulasi
10 10
di manometer stabil 2 cairan di manometer stabil 2
Mengalirkan kembali cairan infus dan
Mengalirkan kembali cairan infus dan
11 11 menutup arah aliran yang ke
menutup arah aliran yang ke manometer
2 manometer 2
12 Dokumentasi 1 12 Dokumentasi 1
13 Sistematis 1 13 Sistematis 1
Total 25 Total 25

NILAI = Total ( Bobot x Skor ) NILAI = Total ( Bobot x Skor )

Penguji, Penguji,
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