PROGRAM TANGGAP
PANDEMI COVID-19 DI LAYANAN KECAMATAN
PRIMER KABUPATEN/
Dr. …. KOTA
No KTA PDKI….. PROPINSI
Dokter Keluarga di Kecamatan
PERHIMPUNAN DOKTER………….
KELUARGA INDONESIA 1
Maret-Juli 2020
DAFTAR ISI
1. DATA DIRI
1.1. Riwayat singkat diri
1.2. Motivasi berpartisipasi dalam Program Tanggap Pandemi Covid-19
1.3. Mutiara yang diperoleh pada Program ini
1.4. Rencana dalam meningkatkan kompetensi
1.5. Mutiara yang diperoleh selama berpartisipasi dalam Program Tanggap Pandemi Covid-19
9. KALENDER KEGIATAN
2.2. Kelompok
2.3. Kelompok
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2.4. Kelompok
Hasil kuesioner Lorem Ipsum is simply dummy text of the printing
and typesetting industry. Lorem Ipsum has been
the industry's standard dummy text ever since the
1500s, when an unknown printer took a galley of
type and scrambled it to make a type specimen
1st Qtr
book. It has survived not only five centuries, but
2nd Qtr
3rd Qtr
also the leap into electronic typesetting, remaining
4th Qtr essentially unchanged. It was popularised in the
1960s with the release of Letraset sheets
containing Lorem Ipsum passages, and more
recently with desktop publishing software like
Aldus PageMaker including versions of Lorem
Ipsum.
2.5. Kelompok
Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has
been the industry's standard dummy text ever since the 1500s, when an unknown printer took a
galley of type and scrambled it to make a type specimen book. It has survived not only five
centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was
popularised in the. It was unchanged. It was popularised in the 1960s with the release of
Letraset sheets containing Lorem Ipsum make a type specimen book. It has survived not only
five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It
was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum
passages, and more recently with desktop publishing software like Aldus PageMaker including
versions of Lorem Ipsum.
Letraset sheets containing Lorem Ipsum make a type specimen book. It has survived not only
five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It
was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum make
a type specimen book, but also the leap into electronic typesetting, remaining essentially
unchanged. It was popularised in the 1960s with the release of Letraset sheets containing
Lorem Ipsum make a type specimen book. It has survived not only five centuries, but also the
leap into electronic typesetting, remaining essentially
A. IDENTITAS PASIEN
Nama :
Usia :
Jenis kelamin :
Alamat :
Pendidikan :
Agama :
Suku :
Pekerjaan :
Tanggal pemeriksaan :
Tanggal home visit :
1. Keluhan Utama:
2. Riwayat Penyakit Sekarang:
(Uraikan sejak timbul hingga berkembangnya penyakit, obat-obatan yang telah diminum, pelayanan
kesehatan yang telah didapatkan termasuk sikap dan perilaku klien, keluarga dan lingkungan terhadap
masalah yang ada)
E. PEMERIKSAAN FISIK
1. Keadaan Umum =
2. Kesadaran =
3. Tanda Vital =
4. Antropometri =
Tinggi Badan : cm Indeks Massa Tubuh (IMT): kg/m2
Berat Badan : kg [TB (meter)/ BB (kg) 2]
Lingkar Pinggang: cm
Lingkar Panggul : cm Waist-Hip Ratio:
Lingkar Lengan Atas: cm
Status Gizi :
5. Pemeriksaan Umum=
Kepala :
Leher :
Thoraks
Abdomen
Anogenital :
Ekstremitas :
1. Laboratorium =
2. Radiologi =
3. Lainnya =
H. DIAGNOSIS BANDING
I. DIAGNOSIS HOLISTIK
Diagnosis Holistik
(Gabungan dari diagnosis klinis plus masalah psiko-sosial-kultural-spiritual pasien dan keluarga)
Aspek Klinis :
Aspek Personal :
J. PENGELOLAAN KOMPREHENSIF
(Meliputi Lima Tahap Pencegahanan)
1. Patient-Centered
3. Community-Oriented:
1. Kondisi Rumah
(Jelaskan tentang kepemilikan rumah, situasi lokasi rumah, ukuran rumah, jenis dinding, lantai dan
atap, kepadatan, kebersihan, pencahayaan, ventilasi, sumber dan penampungan air serta sanitasi., denah
jika diperlukan)
3. Lingkungan Pekerjaan
5. PENGALAMAN PEMERIKSAAN
PENUNJANG COVID19
PERHIMPUNAN DOKTER KELUARGA INDONESIA 16
Keluaran ke 4 program pemutihan ini adalah dilakukannya pemeriksaan penunjang diagnosis
pada kelompok yang kemungkinan terinfeksi Covid-19 sebagai tindak lanjut hasil skrining.
7. EDUKASI PHBS
PERHIMPUNAN DOKTER KELUARGA INDONESIA 18
Keluaran ke 6 program pemutihan ini adalah meningkatnya perilaku gaya hidup sehat
(7 keterampilan perawatan mandiri) pada kelompok komorbid (diabetes dan hipertensi), serta
Tuberkulosis, dan dampaknya secara klinis.
Keluaran berikutnya dalam program pemutihan adalah meningkatnya kapasitas SDM dan
kolaborasi pelayanan primer dan pelayanan rujukan