Plan Of Care

Tanggal/ Jam Hari :........................

Diagnosa Kerja

Masalah/ Kebutuhan
(Prioritaskan)
Kewaspadaan □ Standar □ Airbone
□ Kontak □ Droplet

Tim Dokter ■ DPJP Tim :

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Pemeriksaan □ Laboratorium □ Radiologi :.......................
Prosedur / Tindakan
Nutrisi Diet....................................
Batasan Cairan :
□ Tidak □ Ya....................................
Aktivitas □ Tirah Baring Total □ Tirah Baring Parsial □ Mandiri
Pengobatan □ Sesuai IMR □ Revisi Pengobatan
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Keperawatan □ Observasi Asuhan Keperawatan □ Prosedur Keperawatan

□ Pendidikan Kesehatan □ Kolaborasi dengan Medis
Tindakan Rehabilitasi □ Ya □ Tidak
Medik
Konsultasi

Sasaran

Nama dan Paraf Dokter