DISUSUN OLEH:
NIP :
PANGKAT/GOLONGAN :
RSJD SURAKARTA
2022
BUTIR KEGIATAN PELAYANAN KEPERAWATAN
PERAWAT TERAMPIL
NO KEGIATAN OUTPUT
Laporan/
5 Membuat laporan hasil pelatihan keperawatan Sertifikat
PENGKAJIAN KEPERAWATAN
TGL NO CM KETERANGAN
1 Libur
2
3
4
5
6
7 Libur
8 Libur
9
10
11
12
13 Libur
14
15 Libur
16 Libur
17
18 Libur
19 Libur
20 Libur
21
22
23 Libur
24
25
26
27 Libur
28
29
30
31
Jumlah 0 0 0
Mengetahui,
PNS yang dinilai: Kepala Ruang Geranium
DIAGNOSA KEPERAWATAN
TGL DEFISIT
PERILAKU RESIKO
HALUSINASI WAHAM PERAWATAN NYERI
KEKERASAN DIRI JATUH
1 Libur
2
3
4
5
6
7 Libur
8 Libur
9
10
11
12
13 Libur
14
15 Libur
16 Libur
17
18 Libur
19 Libur
20 Libur
21
22
23 Libur
24
25
26
27 Libur
28
29
30
31
JML 0 0 0 0 0 0
Mengetahui,
PNS yang dinilai: Kepala Ruang Geranium
2 061689 1 1 1 1 17
095001 1 1 1 1
095860 1 1 1 1
3 095001 1 1 1 1 18
095860 1 1 1 1
061689 1 1 1 1
4 061689 1 1 1 1 19 042731 1 1 1 1
068911 1 1 1 1 097286 1 1 1 1
095860 1 1 1 1 040988 1 1 1 1
5 061689 1 1 1 1 20 097376 1 1 1 1
096882 1 1 1 1 042731 1 1 1 1
6 21 097430 1 1 1 1
097376 1 1 1 1
042731 1 1 1 1
7 095001 1 1 1 1 22 048243 1 1 1 1
061689 1 1 1 1 042731 1 1 1 1
096882 1 1 1 1
8 23 097692 1 1 1 1
097430 1 1 1 1
9 096957 1 1 1 1 24
095001 1 1 1 1
10 096958 1 1 1 1 25
095001 1 1 1 1
11 26
12 27 097430 1 1 1 1
097822 1 1 1 1
13 28 040604 1 1 1 1
14 097283 1 1 1 1 29 097430 1 1 1 1
028520 1 1 1 1 097822 1 1 1 1
047654 1 1 1 1 040604 1 1 1 1
15 097283 1 1 1 1 30
047654 1 1 1 1
028520 1 1 1 1
31 097430 1 1 1 1
097822 1 1 1 1
040604 1 1 1 1
Sub Total 24 24 24 24 0 Sub Total 23 23 23 23 0
Total 47 47 47 47 0
Kepala Ruang PNS yang bersangkutan
2 17 098140 1 1 1 1
097875 1 1 1 1
098156 1 1 1 1
3 18
4 063225 1 1 1 1 19
058662 1 1 1 1
5 058622 1 1 1 1 20
063222 1 1 1 1
6 058622 1 1 1 1 21 098156 1 1 1 1
097871 1 1 1 1 098005 1 1 1 1
7 070259 1 1 1 1 22 098005 1 1 1 1
058622 1 1 1 1 098156 1 1 1 1
8 070259 1 1 1 1 23 098201 1 1 1 1
058622 1 1 1 1 098305 1 1 1 1
097871 1 1 1 1
9 24 098305 1 1 1 1
098201 1 1 1 1
10 097871 1 1 1 1 25 330211 1 1 1 1
0987802 1 1 1 1
11 26
12 27
13 098103 1 1 1 1 28 098305 1 1 1 1
098137 1 1 1 1 029689 1 1 1 1
098155 1 1 1 1
14 098137 1 1 1 1
098155 1 1 1 1
098103 1 1 1 1
15
3 098305 1 1 1 1 18
098201 1 1 1 1
4 021534 1 1 1 1 19
098104 1 1 1 1
5 20 098305 1 1 1 1
090543 1 1 1 1
063583 1 1 1 1
6 021534 1 1 1 1 21 098726 1 1 1 1
098104 1 1 1 1 090543 1 1 1 1
098378 1 1 1 1 056695 1 1 1 1
7 089752 1 1 1 1 22 056695 1 1 1 1
049359 1 1 1 1 047228 1 1 1 1
8 091640 1 1 1 1 23 047228 1 1 1 1
045408 1 1 1 1 056695 1 1 1 1
049359 1 1 1 1
9 24
10 25 1
11 006255 1 1 1 1 26
089756 1 1 1 1
049359 1 1 1 1
12 27 056695 1 1 1 1
083242 1 1 1 1
13 28 083242 1 1 1 1
056695 1 1 1 1
047228 1 1 1 1
14 29
15 30
31 083242 1 1 1 1
047228 1 1 1 1
056695 1 1 1 1
Sub Total 17 17 17 17 0 Sub Total 23 23 23 23 1
Total 40 40 40 40 1
Kepala Ruang PNS yang bersangkutan
2 090543 1 1 1 1 17 098986 1 1 1 1
083242 1 1 1 1 084882 1 1 1 1
047228 1 1 1 1
3 18 021732 1 1 1 1
039214 1 1 1 1
4 083242 1 1 1 1 19
047228 1 1 1 1
5 083242 1 1 1 1 20
090543 1 1 1 1
047228 1 1 1 1
6 21 063252 1 1 1 1
034943 1 1 1 1
7 22
8 025101 1 1 1 1 23
098907 1 1 1 1
098908 1 1 1 1
9 055191 1 1 1 1 24 063815 1 1 1 1
099070 1 1 1 1
021732 1 1 1 1
10 25 099077 1 1 1 1
021732 1 1 1 1
063815 1 1 1 1
11 051654 1 1 1 1 26
007893 1 1 1 1
12 098916 1 1 1 1 27
067101 1 1 1 1
13 007893 1 1 1 1 28 099070 1 1 1 1
024139 1 1 1 1 098986 1 1 1 1
14 29 099070 1 1 1 1
15 034943 1 1 1 1 30 099070 1 1 1 1
098950 1 1 1 1 099105 1 1 1 1
049431 1 1 1 1
31
2 17
3 099152 1 1 1 1 18
099070 1 1 1 1
4 099152 1 1 1 1 19 034607 1 1 1 1
099070 1 1 1 1 099150 1 1 1 1
098319 1 1 1 1 044782 1 1 1 1
5 099070 1 1 1 1 20
099152 1 1 1 1
6 21
7 22 099157 1 1 1 1
044782 1 1 1 1
099150 1 1 1 1
8 099153 1 1 1 1 23
099070 1 1 1 1
9 099152 1 1 1 1 24 030204 1 1 1 1
099153 1 1 1 1 099226 1 1 1 1
099070 1 1 1 1
10 25 099215 1 1 1 1
051653 1 1 1 1
1
11 26
12 099152 1 1 1 1 27 099247 1 1 1 1
099070 1 1 1 1 099229 1 1 1 1
13 28 099229 1 1 1 1
099239 1 1 1 1
099247 1 1 1 1
14 099070 1 1 1 1 29
15 099153 1 1 1 1 30
099070 1 1 1 1
099152 1 1 1 1
31
2 099396 1 1 1 1 17
099433 1 1 1 1
044782 1 1 1 1
3 18 083242 1 1 1 1
056695 1 1 1 1
4 19 099157 1 1 1 1
044782 1 1 1 1
099150 1 1 1 1
5 051877 1 1 1 1 20 099157 1 1 1 1
099454 1 1 1 1 044782 1 1 1 1
099150 1 1 1 1 099150 1 1 1 1
6 099355 1 1 1 1 21
099459 1 1 1 1
7 22
8 23 099152 1 1 1 1
099070 1 1 1 1
098319 1 1 1 1
9 044734 1 1 1 1 24 099070 1 1 1 1
099433 1 1 1 1 099152 1 1 1 1
10 064359 1 1 1 1 25
051877 1 1 1 1
11 26 099152 1 1 1 1
099070 1 1 1 1
12 27 099152 1 1 1 1
099070 1 1 1 1
13 099070 1 1 1 1 28 099152 1 1 1 1
099070 1 1 1 1
14 099070 1 1 1 1 29 098319 1 1 1 1
099105 1 1 1 1 099070 1 1 1 1
049431 1 1 1 1
15 30
31
2 17
3 019603 1 1 1 1 18 075035 1 1 1 1
099855 1 1 1 1 100020 1 1 1 1
099502 1 1 1 1 028339 1 1 1 1
4 019603 1 1 1 1 19 075035 1 1 1 1
099855 1 1 1 1 100045 1 1 1 1
099502 1 1 1 1
5 20 001470 1 1 1 1
075035 1 1 1 1
6 21
7 099855 1 1 1 1 22
099502 1 1 1 1
8 099855 1 1 1 1 23 075035 1 1 1 1
099502 1 1 1 1 100045 1 1 1 1
099893 1 1 1 1 078413 1 1 1 1
9 099893 1 1 1 1 24 001470 1 1 1 1
091459 1 1 1 1
10 099893 1 1 1 1 25 100045 1 1 1 1
091459 1 1 1 1 078413 1 1 1 1
100024 1 1 1 1
11 26 100024 1 1 1 1
042188 1 1 1 1
12 27
13 091459 1 1 1 1 28 100024 1 1 1 1
099969 1 1 1 1 042188 1 1 1 1
14 075035 1 1 1 1 29 100331 1 1 1 1
100020 1 1 1 1 042188 1 1 1 1
100020 1 1 1 1
15 028339 1 1 1 1 30
099389 1 1 1 1
31
3 18 0091816 1 1 1 1
100894 1 1 1 1
4 100448 1 1 1 1 19 100448 1 1 1 1
099938 1 1 1 1 100883 1 1 1 1
5 100582 1 1 1 1 20
100702 1 1 1 1
6 21 000404 1 1 1 1
100448 1 1 1 1
7 22 100932 1 1 1 1
100938 1 1 1 1
8 100448 1 1 1 1 23 100938 1 1 1 1
099938 1 1 1 1 180119 1 1 1 1
9 099938 1 1 1 1 24 100969 1 1 1 1
100582 1 1 1 1 100938 1 1 1 1
10 100448 1 1 1 1 25
000404 1 1 1 1
11 100448 1 1 1 1 26
000404 1 1 1 1
12 000404 1 1 1 1 27 100969 1 1 1 1
0091816 1 1 1 1 100894 1 1 1 1
100448 1 1 1 1
13 28 100894 1 1 1 1
100932 1 1 1 1
14 000404 1 1 1 1 29 100969 1 1 1 1
0091816 1 1 1 1 100894 1 1 1 1
15 000404 1 1 1 1 30
0091816 1 1 1 1
100448 1 1 1 1
31 100894 1 1 1 1
2 100938 1 1 1 1 17 101056 1 1 1 1
101056 1 1 1 1 054974 1 1 1 1
3 18 101056 1 1 1 1
054974 1 1 1 1
4 19
5 100938 1 1 1 1 20 054974 1 1 1 1
101056 1 1 1 1 101220 1 1 1 1
101237 1 1 1 1
6 100938 1 1 1 1 21 054974 1 1 1 1
101056 1 1 1 1
101068 1 1 1 1
7 22 101220 1 1 1 1
101237 1 1 1 1
095230 1 1 1 1
8 23 101220 1 1 1 1
101237 1 1 1 1
095230 1 1 1 1
9 101056 1 1 1 1 24
093725 1 1 1 1
10 25
11 26 101237 1 1 1 1
095230 1 1 1 1
101194 1 1 1 1
12 101056 1 1 1 1 27
13 101056 1 1 1 1 28 101319 1 1 1 1
101144 1 1 1 1 101237 1 1 1 1
095230 1 1 1 1
14 29 101338 1 1 1 1
101237 1 1 1 1
095230 1 1 1 1
15 101056 1 1 1 1 30 101237 1 1 1 1
054974 1 1 1 1 095230 1 1 1 1
101194 1 1 1 1
31
2 17 095533 1 1 1 1
001724 1 1 1 1
101454 1 1 1 1
3 18
4 101237 1 1 1 1 19 101371 1 1 1 1
101194 1 1 1 1
5 101371 1 1 1 1 20 101529 1 1 1 1
101338 1 1 1 1 095533 1 1 1 1
6 101371 1 1 1 1 21
101338 1 1 1 1
7 101371 1 1 1 1 22
101338 1 1 1 1
101237 1 1 1 1
8 23 095533 1 1 1 1
101529 1 1 1 1
9 24 095533 1 1 1 1
101529 1 1 1 1
10 063778 1 1 1 1 25 101529 1 1 1 1
101237 1 1 1 1 101454 1 1 1 1
11 101237 1 1 1 1 26
101371 1 1 1 1
063779 1 1 1 1
12 27 101561 1 1 1 1
101529 1 1 1 1
13 28 101529 1 1 1 1
101454 1 1 1 1
14 101237 1 1 1 1 29
101371 1 1 1 1
15 095533 1 1 1 1 30 101561 1 1 1 1
001724 1 1 1 1 101529 1 1 1 1
31 101561 1 1 1 1
101529 1 1 1 1
2 081130 1 1 1 1 17 081130 1 1 1 1
101954 1 1 1 1 054983 1 1 1 1
3 18
4 19 054983 1 1 1 1
101443 1 1 1 1
5 20 101443 1 1 1 1
081130 1 1 1 1
075035 1 1 1 1
6 21 101443 1 1 1 1
081130 1 1 1 1
7 101656 1 1 1 1 22
100665 1 1 1 1
8 101656 1 1 1 1 23 081130 1 1 1 1
100665 1 1 1 1 075035 1 1 1 1
9 101656 1 1 1 1 24 069697 1 1 1 1
100665 1 1 1 1 081130 1 1 1 1
10 25 069697 1 1 1 1
081130 1 1 1 1
11 101656 1 1 1 1 26
101443 1 1 1 1
12 101443 1 1 1 1 27 069697 1 1 1 1
081130 1 1 1 1 081130 1 1 1 1
13 101656 1 1 1 1 28 053639 1 1 1 1
101443 1 1 1 1 081130 1 1 1 1
14 101443 1 1 1 1 29
081130 1 1 1 1
15 30
31
5 054983 1 1 1 1 20
0536396 1 1 1 1
6 054983 1 1 1 1 21 095533 1 1 1 1
0536396 1 1 1 1 063778 1 1 1 1
101954 1 1 1 1 055419 1 1 1 1
7 22 063778 1 1 1 1
055419 1 1 1 1
102262 1 1 1 1
8 23
9 054983 1 1 1 1 24
0536396 1 1 1 1
101954 1 1 1 1
10 0536396 1 1 1 1 25
102163 1 1 1 1
11 102163 1 1 1 1 26
063778 1 1 1 1
12 054983 1 1 1 1 27 095533 1 1 1 1
0536396 1 1 1 1 063778 1 1 1 1
063778 1 1 1 1
13 28 095533 1 1 1 1
14 29 095533 1 1 1 1
15 30 095533 1 1 1 1
31
2 Pebruari 37 37 37 37 0
3 Maret 40 40 40 40 1
4 April 40 40 40 40 0
5 Mei 34 34 34 34 1
6 Juni 37 37 37 37 0
7 Juli 44 44 44 44 0
8 Agustus 44 44 44 44 0
9 September 43 43 43 43 0
10 Oktober 41 41 41 41 0
11 November 38 38 38 38 0
12 Desember 39 39 39 39 0
KET ;
1 Melaksanakan assesmen awal keperawatan di ruang rawat inap
2 Melaksanakan dokumentasi edukasi pada individu di ruang rawat inap
0
0
Wahyu Koes W, A.Md Kep
NIP. 199605262019022011