Program Studi D III Keperawatan – STIKes Dr.

Sismadi Jakarta
Jl. Warakas Raya No. 5B Tanjung Priok, Jakarta Utara
Telp. 4351713/4351714

STRATEGI PELAKSANAAN
TINDAKAN KEPERAWATAN

Pertemuan :
Hari/tgl :
Inisial Klien :
RS/ruangan :
A. PROSES KEPERAWATAN
1. Kondisi klien ..........................................................................
2. Diagnosa keperawatan ..........................................................................
3. Tujuan khusus ..........................................................................
4. Tindakan keperawatan ..........................................................................
B. STRATEGI KOMUNIKASI
1. Orientasi
a. Salam terapeutik
..............................................................................................................................
b. Evaluasi/validasi
..............................................................................................................................
c. Kontrak (topik, waktu dan tempat)
..............................................................................................................................
d. Tujuan tindakan
..............................................................................................................................
2. Kerja (menjabarkan langkah-langkah tindakan keperawatan secara operasional)
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
3. Terminasi
a. Evaluasi (respon klien terhadap tindakan keperawatan)
1). Evaluasi subjektif .......................................................................................
2). Evaluasi objektif .......................................................................................
b. Rencana tindak lanjut (yang perlu dilatih klien sesuai hasil tindakan yang
dilakukan)
.......................................................................................................
c. Kontrak yang akan datang (topik, waktu dan tempat)
..............................................................................................................................
Program Studi S1 Keperawatan – STIKes Dr. Sismadi Jakarta
Jl. Warakas Raya No. 5B Tanjung Priok, Jakarta Utara
Telp. 4351713/4351714

STRATEGI PELAKSANAAN
TINDAKAN KEPERAWATAN

Pertemuan :
Hari/tgl :
Inisial Klien :
RS/ruangan :
C. PROSES KEPERAWATAN
1. Kondisi klien ..........................................................................
2. Diagnosa keperawatan ..........................................................................
3. Tujuan khusus ..........................................................................
4. Tindakan keperawatan ..........................................................................
D. STRATEGI KOMUNIKASI
1. Orientasi
a. Salam terapeutik
..............................................................................................................................
b. Evaluasi/validasi
..............................................................................................................................
c. Kontrak (topik, waktu dan tempat)
..............................................................................................................................
d. Tujuan tindakan
..............................................................................................................................
2. Kerja (menjabarkan langkah-langkah tindakan keperawatan secara operasional)
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
3. Terminasi
a. Evaluasi (respon klien terhadap tindakan keperawatan)
1). Evaluasi subjektif .......................................................................................
2). Evaluasi objektif .......................................................................................
b. Rencana tindak lanjut (yang perlu dilatih klien sesuai hasil tindakan yang
dilakukan)
.......................................................................................................
c. Kontrak yang akan datang (topik, waktu dan tempat)
..............................................................................................................................