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Model Dokumentasi Keperawatan

Model Dokumentasi Keperawatan

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Published by DinaRasmita

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Published by: DinaRasmita on Dec 12, 2012
Copyright:Attribution Non-commercial

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10/17/2013

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MODEL DOKUMENTASIKEPERAWATAN
 
Dokumentasi keperawatan ada beberapamodel yang sering dibahas dalam literaturantara lain : 
SOR (Source
 – 
Oriented Record)
POR (Problem- Oriented Record)
PROGRESS NOTES
CBE (Charting By Exception)
PIE (Problems Intervention andEvaluation)
FOCUS
 
A.Source - Oriented Record
(Catatan berorientasi pd sumber)
Bagian penerimaan klien mempunyailembar isian tersendiri
Dokter
menggunakan lembar untukmencatat instruksi, lembar riwayatpenyakit dan perkembangan penyakit
Perawat
menggunakan catatankeperawatan begitu pula multi disiplin lainmempunyai cacatan masing-masing

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