Format Analisa Data.docx
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FORMAT ANALISA DATA
TANGGAL/JAM
PENGELOMPOKAN DATA
KEMUNGKINAN PENYEBAB/ETIOLOGI
MASALAH
Inisial Pasien
:
No. Reg
:
DAFTAR DIAGNOSA KEPERAWANAN SESUAI PRIORITAS
FORMAT RENCANA KEPERAWATAN TANGGAL/JAM
NOMOR DIAGNOSA KEPERAWATAN
TUJUAN DAN KRITERIA HASIL
RENCANA KEPERAWATAN
RASIONAL
PARAF
FORMAT PELAKSANAAN TINDAKAN/IMPLEMENTASI KEPERAWATAN NO DIAGNOSA KEPERAWATAN
TANGGAL/ PUKUL
TINDAKAN
PARAF
FORMAT EVALUASI KEPERAWATAN
NO DIAGNOSA KEPERAWATAN
TANGGAL/JAM
EVALUASI
PARAF
Palangka Raya,......................2017 PEMBIMBING KLINIK
(..................................)
PRATIKAN
(....................................)
TANGGAL/JAM
PENGELOMPOKAN DATA
KEMUNGKINAN PENYEBAB/ETIOLOGI
MASALAH
Inisial Pasien
:
No. Reg
:
DAFTAR DIAGNOSA KEPERAWANAN SESUAI PRIORITAS
FORMAT RENCANA KEPERAWATAN TANGGAL/JAM
NOMOR DIAGNOSA KEPERAWATAN
TUJUAN DAN KRITERIA HASIL
RENCANA KEPERAWATAN
RASIONAL
PARAF
FORMAT PELAKSANAAN TINDAKAN/IMPLEMENTASI KEPERAWATAN NO DIAGNOSA KEPERAWATAN
TANGGAL/ PUKUL
TINDAKAN
PARAF
FORMAT EVALUASI KEPERAWATAN
NO DIAGNOSA KEPERAWATAN
TANGGAL/JAM
EVALUASI
PARAF
Palangka Raya,......................2017 PEMBIMBING KLINIK
(..................................)
PRATIKAN
(....................................)
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