1 Undana Penuntun Kepaniteraan Di Puskesmas

KATA PENGANTAR

Buku ini disusun sebagai pedoman bagi mahasiswa dalam melaksanakan kepaniteraan di puskesmas pada bagian Ilmu Kesehatan Masyarakat dan Ilmu Kedokteran Komunitas Fakultas Kedokteran Universitas Hasanuddin.

Buku pedoman ini diharapkan dapat menjadi acuan bagi mahasiswa dan bagi dosen pembimbing untuk mencapai kompetensi yang seharusnya dimiliki oleh mahasiswa.

Guna mencapai kompetensi tersebut buku ini berisi informasi tentang PHC (Primary Health Care), serta pedoman dalam melaksanakan kepaniteraan sekaligus sebagai acuan dalam menyusun laporan pelaksanaan kepaniteraan di puskesmas yang berisi kegiatan kepaniteraan selama dua minggu stase di Puskesmas.

Demikian modul ini dibuat dan sangat diharapkan masukan berbagai pihak terutama dari mahasiswa, dosen pembimbing dan kepala beserta staf puskesmas, guna menyempurnakan pedoman kepaniteraan PHC (Primary Health Care) di puskesmas.

Kepala Bagian IKM IKK

Fak. Kedokteran UNHAS

DR. dr. A.Armyn

Nurdin.M.Sc

Bagian IKM- IKK Fak.Kedokteran UNHAS 1

Pendahuluan

Pelayanan kesehatan primer di Indonesia mulai dirintis sejak tahun 1950 dipelopori oleh Prof dr J Soelianti. Kegiatan dalam layanan primer tersebut menggabungkan kegiatan kuratif dan preventif bersama - sama antara lain pengobatan, pemberantasan dan pencegahan penyakit menular, usaha kesehatan ibu dan anak, pendidikan kesehatan, pemulihan kesehatan keluarga, usaha perbaikan makanan rakyat dan pengumpulan data untuk mengadakan penelitian. Pada tahun 1967 diadakan seminar tentang program kesehatan masyarakat dan memutuskan membentuk puskesmas. Tahun 1968 keputusan tersebut ditindaklanjuti dengan pendifinisian puskesmas sebagai suatu kesatuan organisasi kesehatan yang langsung memberi pelayanan kepada masyarakat di bidang kesehatan dan bertanggung jawab atas tercapainya tingkat kesehatan yang setinggi-tingginya untuk masyarakat di wilayah kerjanya. Layanan kesehatan primer yang dilaksanakan di puskesmas meliputi pengobatan sederhana, kesejahteraan ibu dan anak, pendidikan kesehatan, public health nursing, pencegahan dan pemberantasan penyakit menular, kesehatan lingkungan, gizi, statistik kesehatan dan keluarga berencana.

Pada tahun 1977 World Health Essembly telah menghasilkan kesepakatan global untuk mencapai “Kesehatan Bagi Semua atau Health For All” pada tahun 2000 ( KBS 2000 / HFA by The Year 2000 ), yaitu Tercapainya suatu derajat kesehatan yang optimal yang memungkinkan setiap orang hidup produktif baik secara sosial maupun ekonomi. Selanjutnya pada bulan September 1978, bertempat di Alma Ata - Kazakhstan, perwakilan dari 134 negara, 67 organisasi internasional dan NGO duduk bersama dalam sebuah Konferensi Internasional yang pertama tentang Primary Health Care atau pelayanan kesehatan primer. Pada saat itu dicanangkan tujuan umum pelayanan kesehatan primer adalah “kesehatan yang lebih baik bagi semua” (Health for All), yang pada dasarnya dimaksudkan untuk mengatasi inequality atau perbedaan status kesehatan di berbagai negara, menyempitkan kesenjangan antara kelompok kaya dan miskin, serta meratakan akses bagi semua ras dan golongan. Penerapan konsep ini di negara berkembang memberi implikasi lebih luas, yaitu bukan sekedar pengobatan penyakit saja

Dalam konferensi tersebut Indonesia juga ikut menandatangani dan telah mengambil kesepakatan global pula dengan menyatakan bahwa untuk mencapai Kesehatan Bagi Semua Tahun 2000 (HFA’200 ) kuncinya adalah PHC (Primary Health Care) dan Bentuk Opersional dari PHC tersebut di Indonesia adalah PKMD ( Pembangunan Kesehatan Masyarakat Desa

PHC merupakan hasil pengkajian, pemikiran, pengalaman dalam pembangunan kesehatan di banyak Negara yang diawali dengan kampanye masal pada tahun 1950-an dalam pember antasan penyakit menular, karena pada waktu itu banyak Negara tidak mampu mengatasi dan menaggulangi wabah penyakit TBC, Campak, Diare dsb.


Pada tahun 1960 teknologi Kuratif dan Preventif dalam struktur pelayanan kesehatan telah mengalami kemajuan. Sehingga timbullah pemikiran untuk mengembangkan konsep ”Upaya Dasar Kesehatan ”.

Pada tahun 1972/1973, WHO mengadakan studi dan mengungkapkan bahwa banyak negara tidak puas atas sistem kesehatan yang dijalankan dan banyak issue tentang kurangnya pemerataan pelayanan kesehatan di daerah – daerah pedesaan. Akhirnya pada tahun 1977 dalam Sidang Kesehatan Sedunia (World Health Essembly) dihasilkan kesepakatan ”Health For All by The Year 2000 atau Kesehatan Bagi Semua Tahun 2000 dengan Sasaran Semesta Utamanya adalah : ”Tercapainya Derajat Kesehatan yang Memungkinkan Setiap Orang Hidup Produktif Baik Secara Sosial Maupun Ekonomi”. Oleh karena itu untuk mewujudkan hal tersebut diperlukan perubahan orientasi dalam pembangunan kesehatan yang meliputi perubahan – perubahan dari :

• Pelayanan Kuratif ke Promotif dan Preventif • Daerah Perkotaan ke Pedesaan • Golongan Mampu ke Golongan Masyarakat Berpenghasilan Rendah • Kampanye Massal ke Upaya Kesehatan terpadu.

Primary Health Care ( PHC ) adalah : Pelayanan kesehatan pokok yang berdasarkan kepada metode dan teknologi praktis, ilmiah dan sosial yang dapat diterima secara umum baik oleh individu maupun keluarga dalam masyarakat melalui partisipasi mereka sepenuhnya, serta dengan biaya yang dapat terjangkau oleh masyarakat dan negara untuk memelihara setiap tingkat perkembangan mereka dalam semangat untuk hidup mandiri ( self reliance ) dan menentukan nasib sendiri ( self determination ).

Pada tahun 1978, dalam konferensi Alma Alta ditetapkan prinsip-prinsip Primary Health Care sebagai pendekatan atau strategi global guna mencapai kesehatan bagi semua. Lima prinsip dasar Primary Health Care meliputi tiga unsur utama yaitu: upaya dasar kesehatan, peran serta masyarakat dan kerjasama lintas sektoral, sebagai berikut:

1. Pemerataan upaya kesehatan2. Penekanan pada upaya preventif3. Penggunaan teknologi tepat guna dalam upaya kesehatan4. Peran serta masyarakat dalam semangat kemandirian5. Kerjasama lintas sektoral dalam membangun kesehatan

Pengertian Primary Health Care, menurut deklarasi Alma Alta 1978, adalah sebagai berikut:

“Primary Health Care is essential health care, based on practical, scientifically sound socially acceptable methods and technology made universally accessible to individuals and families in the community, through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development, in the spirit of self reliance and self determination”

“It forms and integral part both of the country’s health system, of which it is the central function and its main focus, and of the overall social and


economic development of the community. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process”.

Primary Health Care (PHC) : Menggambarkan keadaan sosial ekonomi, budaya dan politik masyarakat dan

berdasarkan penerapan hasil penelitian kesehatan-sosial-biomedis dan pelayanan kesehatan masyarakat.

Ditujukan untuk mengatasi masalah utama kesehatan masyarakat dengan upaya preventif, promotif, kuratif dan rehabilitatif.

Minimal mencakup: penyuluhan tentang masalah kesehatan utama dan cara pencegahan dan pengendaliannya, penyediaan makanan dan peningkatan gizi, penyediaan sanitasi dasar dan air bersih, pembinaan kesehatan ibu dan anak termasuk keluarga berencana, imunisasi terhadap penyakit menular utama dan penyegahan penyakit endemik, pengobatan penyakit umum dan cedera serta penyediaan obat esensial.

Melibatkan dan meningkatkan kerjasama lintas sektor dan aspek-aspek pembangunan nasional dan masyarakat di samping sektor kesehatan, terutama pertanian, peternakan, industri makanan, pendidikan, penerangan, agama, perumahan, pekerjaan umum, perhubungan dan sebagainya.

Membutuhkan sekaligus meningkatkan kepercayaan diri serta masyarakat dalam perencanaan, pengorganisasian, pelaksanaan, dan pengendalian PHC serta penggunaan sumberdaya yang ada.

Ditunjang oleh system rujukan upaya kesehatan secara terpadu fungsional dan timbal balik guna memberikan pelayanan secara menyeluruh, dengan memprioritaskan golongan masyarakat yang paling membutuhkan.

Didukung oleh tenaga kesehatan professional dan masyarakat, termasuk tenaga kesehatan tradisonal yang terlatih di bidang teknis dan sosial untuk bekerja sebagai tim kesehatan yang mampu bekerja bersama masyarakat dan membangunkan peran serta masyarakat.

PHC hendaknya memenuhi fungsi – fungsi sebagai berikut : 1. Pemeliharaan Kesehatan 2. Pencegahan Penyakit 3. Diagnosis dan Pengobatan 4. Pelayanan Tindak Lanjut 5. Pemberian Sertifikat

Dalam pelaksanaan PHC harus memiliki 8 elemen essensial yaitu :1. Pendidikan mengenai masalah kesehatan dan cara pencegahan panyakit

serta pengendaliannya. 2. Peningkatan penyediaan makanan dan perbaikan gizi 3. Penyediaan Air Bersih dan Sanitasi Dasar 4. Kesehatan Ibu dan Anak termasuk KB 5. Imunisasi terhadap Penyakit – penyakit Infeksi Utama 6. Pencegahan dan Pengendalian Penyakit Endemik Setempat 7. Pengobatan Penyakit Umum dan Ruda Paksa


8. Penyediaan Obat – obat Esensial

PHC mempunyai ciri-ciri sebagai berikut :1. Pelayanan yang utama dan intim dengan masyarakat 2. Pelayanan yang menyeluruh 3. Pelayanan yang terorganisasi 4. Pelayanan yang mementingkan kesehatan individu maupun masyarakat 5. Pelayanan yang berkesinambungan 6. Pelayanan yang progresif 7. Pelayanan yang berorientasi kepada keluarga 8. Pelayanan yang tidak berpandangan kepada salah satu aspek saja

Tanggung jawab tenaga kesehatan dalam PHC lebih dititik beratkan kepada hal hal sebagai berikut :

1 Mendorong partisipasi aktif masyarakat dalam pengembangan dan implementasi pelayanan kesehatan dan program pendidikan kesehatan.

2. Kerja sama dengan masyarakat, keluarga dan individu 3. Mengajarkan konsep kesehatan dasar dan teknik asuhan diri sendiri pada

masyarakat 4. Memberikan bimbingan dan dukungan kepada petugas pelayanan kesehatan

dan kepada masyarakat 5. Koordinasi kegiatan pengembangan kesehatan masyarakat

KONSEP DASAR PUSKESMAS

1. Pengertian Puskesmas adalah unit pelaksana teknis dinas kesehatan kabupaten/kota yang

bertanggungjawab menyelenggarakan pembangunan kesehatan di suatu wilayah kerja.

1. Unit Pelaksana Teknis Sebagai unit pelaksana teknis Dinas Kesehatan Kabupaten/Kota (UPTD),

puskesmas berperan menyelenggarakan sebagian dari tugas teknis operasional Dinas Kesehatan Kabupaten/Kota dan merupakan unit pelaksana tingkat pertama serta ujung tombak pembangunan kesehatan di Indonesia.

2. Pembangunan Kesehatan Pembangunan kesehatan adalah penyelenggaraan upaya kesehatan oleh bangsa Indonesia untuk meningkatkan kesadaran, kemauan dan kemampuan hidup sehat bagi setiap orang agar terwujud derajat kesehatan masyarakat yang optimal.

3. Penanggungjawab Penyelenggaraan Penanggungjawab utama penyelenggaraan seluruh upaya pembangunan kesehatan di wilayah kabupaten/kota adalah Dinas Kesehatan Kabupaten/Kota, sedangkan puskesmas bertanggungjawab hanya sebagian


upaya pembangunan kesehatan yang dibebankan oleh dinas kesehatan kabupaten/kota sesuai dengan kemampuannya.

4. Wilayah Kerja Secara nasional, standar wilayah kerja puskesmas adalah satu kecamatan, tetapi apabila di satu kecamatan terdapat lebih dari dari satu puskesmas, maka tanggungjawab wilayah kerja dibagi antar puskesmas, dengan memperhatikan keutuhan konsep wilayah (desa/kelurahan atau RW). Masing-masing puskesmas tersebut secara operasional bertanggungjawab langsung kepada Dinas Kesehatan Kabupaten/Kota.

2. Visi

Visi pembangunan kesehatan yang diselenggarakan oleh puskesmas adalah tercapainya Kecamatan Sehat menuju terwujudnya Indonesia Sehat. Kecamatan Sehat adalah gambaran masayarakat kecamatan masa depan yang ingin dicapai melalui pembangunan kesehatan, yakni masyarakat yang hidup dalam lingkungan dan berperilaku sehat, memiliki kemampuan untuk menjangkau pelayanan kesehatan yang bermutu secara adil dan merata serta memiliki derajat kesehatan yang setinggi-tingginya. Indikator Kecamatan Sehat yang ingin dicapai mencakup 4 indikator utama yakni:

1. Lingkungan sehat 2. Perilaku sehat 3. Cakupan pelayanan kesehatan yang bermutu 4. Derajat kesehatan penduduk kecamatan

Rumusan visi untuk masing-masing puskesmas harus mengacu pada visi pembangunan kesehatan puskesmas di atas yakni terwujudnya Kecamatan Sehat, yang harus sesuai dengan situasi dan kondisi masyarakat serta wilayah kecamatan setempat.

3. Misi Misi pembangunan kesehatan yang diselenggarakan oleh puskesmas adalah mendukung tercapainya misi pembangunan kesehatan nasional. Misi tersebut adalah:

a. Menggerakkan pembangunan berwawasan kesehatan di wilayah kerjanya. b. Puskesmas akan selalu menggerakkan pembangunan sektor lain yang

diselenggarakan di wilayah kerjanya, agar memperhatikan aspek kesehatan, yakni pembangunan yang tidak menimbulkan dampak negatif terhadap kesehatan, setidak-tidaknya terhadap lingkungan dan perilaku masyarakat.

c. Mendorong kemandirian hidup sehat bagi keluarga dan masyarakat di wilayah kerjanya. Puskesmas akan selalu berupaya agar setiap keluarga dan masyarakat yang bertempat tinggal di wilayah kerjanya makin berdaya di bidang kesehatan, melalui peningkatan pengetahuan dan kemampuan menuju kemandirian untuk hidup sehat.

d. Memelihara dan meningkatkan mutu, pemerataan dan keterjangkauan pelayanan kesehatan yang diselenggarakan. Puskesmas akan selalu berupaya menyelenggarakan pelayanan kesehatan yang sesuai dengan


standar dan memuaskan masyarakat, mengupayakan pemerataan pelayanan kesehatan serta meningkatkan efisiensi pengelolaan dana sehingga dapat dijangkau oleh seluruh anggota masyarakat.

e. Memelihara dan meningkatkan kesehatan perorangan, keluarga dan masyarakat berserta lingkungannya. Puskesmas akan selalu berupaya memelihara dan meningkatkan kesehatan, mencegah dan menyembuhkan penyakit, serta memulihkan kesehatan perorangan, keluarga dan masyarakat yang berkunjung dan yang bertempat tinggal di wilayah kerjanya, tanpa diskriminasi dan dengan menerapkan kemajuan ilmu dan teknologi kesehatan yang sesuai. Upaya pemeliharaan dan peningkatan kesehatan yang dilakukan puskesmas mencakup pula aspek lingkungan dari yang bersangkutan.

4. Tujuan Tujuan pembangunan kesehatan yang diselenggarkan oleh puskesmas adalah mendukung tercapainya tujuan pembangunan kesehatan nasional yakni meningkatkan kesadaran, kemauan dan kemampuan hidup sehat bagi setiap orang yang bertempat tinggal di wilayah kerja puskesmas agar terwujud derajat kesehatan yang setinggi-tingginya dalam rangka mewujudkan Indonesia Sehat

5. Fungsi 1. Pusat penggerak pembangunan berwawasan kesehatan.

Puskesmas selalu berupaya menggerakkan dan memantau penyelenggaraan pembangunan lintas sektor termasuk oleh masyarakat dan dunia usaha di wilayah kerjanya, sehingga berwawasan serta mendukung pembangunan kesehatan. Di samping itu puskesmas aktif memantau dan melaporkan dampak kesehatan dari penyelenggaraan setiap program pembangunan di wilayah kerjanya. Khusus untuk pembangunan kesehatan, upaya yang dilakukan puskesmas adalah mengutamakan pemeliharaan kesehatan dan pencegahan penyakit tanpa mengabaikan penyembuhan penyakit dan pemulihan kesehatan.

2. Pusat pemberdayaan masyarakat. Puskesmas selalu berupaya agar perorangan terutama pemuka masyarakat, keluarga dan masyarakat termasuk dunia usaha memiliki kesadaran, kemauan, dan kemampuan melayani diri sendiri dan masyarakat untuk hidup sehat, berperan aktif dalam memperjuangkan kepentingan kesehatan termasuk pembiayaannya, serta ikut menetapkan, menyelenggarakan dan memantau pelaksanaan program kesehatan. Pemberdayaan perorangan, keluarga dan masyarakat ini diselenggarakan dengan memperhatikan kondisi dan situasi, khususnya sosial budaya masyarakat setempat.

3. Pusat pelayanan kesehatan strata pertama. Puskesmas bertanggungjawab menyelenggarakan pelayanan kesehatan tingkat pertama secara menyeluruh, terpadu dan berkesinambungan. Pelayanan kesehatan tingkat pertama yang menjadi tanggungjawab puskesmas meliputi:


1. Pelayanan kesehatan perorangan Pelayanan kesehatan perorangan adalah pelayanan yang bersifat pribadi (private goods) dengan tujuan utama menyembuhkan penyakit dan pemulihan kesehatan perorangan, tanpa mengabaikan pemeliharaan kesehatan dan pencegahan penyakit. Pelayanan perorangan tersebut adalah rawat jalan dan untuk puskesmas tertentu ditambah dengan rawat inap.

2. Pelayanan kesehatan masyarakat Pelayanan kesehatan masyarakat adalah pelayanan yang bersifat publik (public goods) dengan tujuan utama memelihara dan meningkatkan kesehatan serta mencegah penyakit tanpa mengabaikan penyembuhan penyakit dan pemulihan kesehatan.Pelayanan kesehatan masyarakat tersebut antara lain promosi kesehatan, pemberantasan penyakit, penyehatan lingkungan, perbaikan gizi, peningkatan kesehatan keluarga, keluarga berencana, kesehatan jiwa serta berbagai program kesehatan masyarakat lainnya.

6. Kedudukan Kedudukan Puskesmas dibedakan menurut keterkaitannya dengan Sistem Kesehatan Nasional, Sistem Kesehatan Kabupaten/Kota dan Sistem Pemerintah Daerah:

1. Sistem Kesehatan Nasional Kedudukan puskesmas dalam Sistem Kesehatan Nasional adalah sebagai sarana pelayanan kesehatan strata pertama yang bertanggungjawab menyelenggarakan upaya kesehatan perorangan dan upaya kesehatan masyarakat di wilayah kerjanya.

2. Sistem Kesehatan Kabupaten/Kota Kedudukan puskesmas dalam Sistem Kesehatan Kabupaten/Kota adalah sebagai Unit Pelaksana Teknis Dinas Kesehatan Kabupaten/Kota yang bertanggungjawab menyelenggarakan sebagian tugas pembangunan kesehatan kabupaten/kota di wilayah kerjanya.

3. Sistem Pemerintah Daerah Kedudukan puskesmas dalam Sistem Pemerintah Daerah adalah sebagai Unit Pelaksana Teknis Dinas Kesehatan Kabupaten/Kota yang merupakan unit struktural Pemerintah Daerah Kabupaten/Kota bidang kesehatan di tingkat kecamatan.

4. Antar Sarana Pelayanan Kesehatan Strata Pertama Di wilayah kerja puskesmas terdapat berbagai organisasi pelayanan kesehatan strata pertama yang dikelola oleh lembaga masyarakat dan swasta seperti praktek dokter, praktek dokter gigi, praktek bidan, poliklinik dan balai kesehatan masyarakat. Kedudukan puskesmas di antara berbagai sarana pelayanan kesehatan strata pertama ini adalah sebagai mitra. Di wilayah kerja puskesmas terdapat pula berbagai bentuk upaya kesehatan berbasis dan bersumber daya masyarakat seperti posyandu, polindes, pos obat desa dan pos UKK. Kedudukan puskesmas di antara berbagai sarana pelayanan kesehatan berbasis dan bersumberdaya masyarakat adalah sebagai pembina.


7. Organisasi 1. Struktur Organisasi

Struktur organisasi puskesmas tergantung dari kegiatan dan beban tugas masing-masing puskesmas. Penyusunan struktur organisasi puskesmas di satu kabupaten/kota dilakukan oleh dinas kesehatan kabupaten/kota, sedangkan penetapannya dilakukan dengan Peraturan Daerah. Sebagai acuan dapat dipergunakan pola struktur organisasi puskesmas sebagai berikut:

1. Kepala Puskesmas 2. Unit Tata Usaha yang bertanggungjawab membantu Kepala

Puskesmas dalam pengelolaan: Data dan informasi Perencanaan dan penilaian Keuangan Umum dan pengawasan

3. Unit Pelaksana Teknis Fungsional Puskesmas Upaya kesehatn masyarakat, termasuk pembinaan terhadap UKBM Upaya kesehatan perorangan

4. Jaringan pelayanan puskesmas Unit puskesmas pembantu Unit puskesmas keliling Unit bidan di desa/komunitas

8. Upaya Penyelenggaraan

Untuk tercapainya visi pembangunan kesehatan melalui puskesmas, yakni terwujudnya Kecamatan Sehat Menuju Indonesia Sehat, puskesmas bertanggungjawab menyelenggarakan upaya kesehatan perorangan dan upaya kesehatan masyarakat, yang keduanya jika ditinjau dari sistem kesehatan nasional merupakan pelayanan kesehatan tingkat pertama. Upaya kesehatan tersebut dikelompokkan menjadi dua yakni:

Upaya Kesehatan Wajib

Upaya kesehatan wajib puskesmas adalah upaya yang ditetapkan berdasarkan komitmen nasional, regional dan global serta yang mempunyai daya ungkit tinggi untuk peningkatan derajat kesehatan masyarakat. Upaya kesehatan wajib ini harus diselenggarakan oleh setiap puskesmas yang ada di wilayah Indonesia.

Upaya kesehatan wajib tersebut adalah:

1. Upaya Promosi Kesehatan 2. Upaya Kesehatan Lingkungan

3. Upaya Kesehatan Ibu dan Anak serta Keluarga Berencana


4. Upaya Perbaikan Gizi

5. Upaya Pencegahan dan Pemberantasan Penyakit Menular

6. Upaya Pengobatan

Upaya Kesehatan Pengembangan

Upaya kesehatan pengembangan puskesmas adalah upaya yang ditetapkan berdasarkan permasalahan kesehatan yang ditemukan di masyarakat serta yang disesuaikan dengan kemampuan puskesmas. Upaya kesehatan pengembangan dipilih dari daftar upaya kesehatan pokok puskesmas yang telah ada, yakni:

1. Upaya Kesehatan Sekolah 2. Upaya Kesehatan Olah Raga

3. Upaya Perawatan Kesehatan Masyarakat

4. Upaya Kesehatan Kerja

5. Upaya Kesehatan Gigi dan Mulut

6. Upaya Kesehatan Jiwa

7. Upaya Kesehatan Mata

8. Upaya Kesehatan Usia Lanjut

9. Upaya Pembinaan Pengobatan Tradisional

Primary Health Care dan Puskesmas

Puskesmas merupakan focal point dari Primary Health Care (PHC), dibawahnya terdapat Puskesmas Pembantu (Pustu), Puskesmas Keliling (Pusling), Dokter Praktik dan Bidan Praktik. Di tingkat desa terdapat Polindes, Poskesdes, Posyandu, Pendidikan Anak Usia Dini (PAUD), Bina Keluarga Balita (BKB). Di tingkat supra-sistemnya terdapat Dinkes Kab/kota dan RS Kab/kota.

Masalah yang dihadapi saat ini dalam proses terkait PHC adalah Puskesmas dinilai masih berat ke kuratif. Oleh karena itu perlu mengembalikan fungsi Puskesmas yang sebenarnya sesuai dengan Permenkes ……….yang menyebutkan……….

PHC yang diinginkan adalah : Puskesmas berfungsi sebagai pusat penggerak pembangunan berwawasan kesehatan; pusat pemberdayaan masyarakat; pusat pelayanan kesehatan komprehensif di strata pertama dan (UKM dan UKP). Disamping itu Upaya Kesehatan Berbasis Masyarakat (UKBM) dapat berjalan secara lintas sektor, Puskesmas sebagai pembina teknis, terdapat alokasi anggaran yang


cukup untuk upaya kesehatan masyarakat (public goods), serta terdapat sistem yang jelas mengenai peran Puskesmas dan jejaringnya termasuk dengan Dinkes Kab/Kota, RS Kab/Kota

PHC (Deklarasi Alma Ata tahun 1978) adalah kontak pertama individu, keluarga, atau masyarakat dengan sistem pelayanan kesehatan. Pengertian ini sesuai dengan definisi SKN 2009, yang menyatakan bahwa Upaya Kesehatan Primer adalah upaya kesehatan dasar dimana terjadi kontak pertama perorangan atau masyarakat dengan pelayanan kesehatan sebagai proses awal pelayanan kesehatan langsung maupun pelayanan kesehatan penunjang, dengan mekanisme rujukan timbal-balik. Termasuk penanggulangan bencana dan pelayanan gawat darurat. Pelaku PHC adalah Pemerintah dan/atau Swasta. Di jajaran Pemerintah, PHC dilaksanakan oleh Puskesmas dan jejaringnya. Sedangkan di kalangan swasta, PHC dilaksanakan oleh dokter praktik, bidan praktik, dan bahkan oleh pengobat tradisional (Batra).


Puskesmas dirancang untuk mewujudkan derajat kesehatan yang optimal bagi seluruh masyarakat. Jangkauan pelayanan melalui puskesmas dianggap dapat

menghemat biaya dan terjangkau bagi semua lapisan masyarakat.

Tantangan yang dihadapi oleh Puskesmas pada saat ini adalah tuntutan masyarakat akan pelayanan kesehatan yang berkualitas. Kondisi ini harus disikapi oleh jajaran Dinas Kesehatan maupun pengelola Puskesmas untuk

meningkatkan pelayanan Puskesmas kepada masyarakat

KOMPETENSI Diakhir kepaniteraan, mahasiswa diharapkan memiliki pengetahuan, keterampilan dan sikap sbb :

1. Mampu menjelaskan PRIMARY HEALTH CARE (PHC)2. Memahami dan mampu menjelaskan tentang ORGANISASI DAN

MANAJEMEN PUSKESMAS.3. Memahami dan mampu menjelaskan tentang PROGRAM KIA/KB4. Memahami dan mampu menjelaskan tentang KESEHATAN LINGKUNGAN5. Memahami dan mampu menjelaskan tentang PROGRAM GIZI6. Memahami dan mampu menjelaskan tentang UPAYA PROMOSI

KESEHATAN7. Memahami dan mampu menjelaskan tentang P2M PLP8. Memahami dan mampu menjelaskan tentang PENGOBATAN 9. Memahami dan mampu menjelaskan tentang UPAYA PERAWATAN

KESEHATAN MASYARAKAT10. Memahami dan mampu menjelaskan tentang UPAYA KESEHATAN

SEKOLAH11. Memahami dan mampu menjelaskan tentang UPAYA KESEHATAN USIA

LANJUT12. Memahami dan mampu menjelaskan tentang UPAYA KESEHATAN KERJA13. Memahami dan mampu menjelaskan tentang UPAYA KESEHATAN GIGI

DAN MULUT14. Memahami dan mampu menjelaskan tentang UPAYA KESEHATAN JIWA15. Memahami dan mampu menjelaskan tentang UPAYA KESEHATAN MATA

DAN PENCEGAHAN KEBUTAAN16. Memahami dan mampu menjelaskan tentang UPAYA PENYULUHAN

KESEHATAN MASYARAKAT17. Memahami dan mampu menjelaskan tentang PEMBINAAN PERAN SERTA

MASYARAKAT


18. Memahami dan mampu menjelaskan tentang UPAYA KESEHATAN OLAH RAGA

19. Memahami dan mampu menjelaskan tentang LABORATORIUM SEDERHANA

URAIAN PROGRAM PUSKESMAS

Program puskesmas Uraian

1 Manajemen Pelayanan Kesehatan Sistem Kesehatan Nasional (SKN) sebagai acuan pelayanan kesehatan

Penerapan fungsi manajemen di puskesmas Upaya pelayanan kesehatan (individu & masyarakat) Permasalahan kesehatan yang ada di Puskesmas ........................................................................ ........................................................................

2 Upaya Kesehatan Ibu, Anak dan Keluarga Berencana

Pelayanan Antenatal Care Pertolongan Persalinan Pelayanan Postnatal care Deteksi dini ibu hamil beresiko tinggi Penanganan komplikasi kebidanan Pelayanan kesehatan neonatal Pelayanan keluarga berencana Penyuluhan keluarga berencana ........................................................................... ..........................................................................

3 Upaya kesehatan lingkungan Penyehatan lingkungan pemukiman Penyehatan tempat umum Penyehatan tempat pengelola makanan Klinik sanitasi Penyediaan sarana air bersih dan sanitasi dasar Pemeliharaan dan pengawasan kualitas lingkungan Pengendalian dampak resiko pencemaran lingkungan Pengembangan wilayah sehat. ..................................................................... .....................................................................

4 Upaya perbaikan gizi masyarakat Pengukuran dan pemantauan status gizi masyarakat Perbaikan status gizi masyarakat Pemberdayaan masyarakat untuk mencapai kelaurga sadar

gizi Pengawasan pelayanan gizi masyarakat .............................................................................. .............................................................................

5 Upaya pencegahanan dan pemberantasan penyakit menular

Peningkatan Pengamatan Penyakit (surveilens epidemiologi) Peningkatan Pencegahan dan Penanggulangan Penyakit


Program puskesmas Uraian Penanggulangan Bencana Penanggulangan Penyakit Tidak Menular Pelaksanaan Imunisasi Pelaksanaan koordinasi dengan instansi /lembaga terkait; Pelaksanaan monitoring dan evaluasi serta pelaporan

kegiatan; ………………………………………………………. ……………………………………………………….

6 Upaya Promosi Kesehatan Pengembangan media promosi kesehatan dan teknologi Komunikasi Informasi dan Edukasi (KIE).

Pengembangan upaya kesehatan bersumber dari masyarakat (seperti pos pelayanan terpadu, pondok bersalin desa, dan usaha kesehatan sekolah).

Peningkatan pendidikan kesehatan kepada masyarakat. Peningkatan jaminan pemeliharaan kesehatan masyarakat

(JKPM) secara kapitasi dan pra upaya terutama bagi keluarga miskin.

Peningkatan pendanaan operasional Puskesmas dan revitalisasi Puskesmas sebagai Pusat Promotive dan Preventive bidang kesehatan.

……………………………………………………………………… ………………………………………………………………………

7 Upaya pengobatan Melakukan diagnose sedini mungkin Melaksanakan tindakan pengobatan Melakukan rujukan bila dipandang perlu Peningkatan ketersediaan dan pemerataan obat dan

perbekalan kesehatan diseluruh Puskesmas dan jaringannya. Peningkatan mutu penggunaan obat dan perbekalan

kesehatan Melaksanakan peningkatan mutu pelayanan kesehatan dasar. Melaksanakan peningkatan jangkauan pelayanan kesehatan

dasar, termasuk pelayanan kesehatan terhadap keluarga miskin.

……………………………………………………………….. ………………………………………………………………..

8 Upaya Kesehatan Pengembangan

1. Upaya Perawatan Kesehatan Masyarakat

2. Upaya Kesehatan Sekolah 3. Upaya Kesehatan Usia Lanjut 4. Upaya Kesehatan Olah Raga 5. Upaya Kesehatan Kerja 6. Upaya Kesehatan Gigi dan

Mulut 7. Upaya Kesehatan Jiwa 8. Upaya Kesehatan Mata 9. Upaya Pembinaan Pengobatan

Tradisional

10. ………………………………….

11. ………………………………….

12. ………………………………….

13. …………………………………..

14. …………………………………..

Upaya yang ditetapkan berdasarkan permasalahan kesehatan yang ditemukan di masyarakat serta yang disesuaikan dengan kondisi dan kemampuan puskesmas.

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Laporkan hasil observasi anda tentang Manajemen dan Upaya Pelayanan Kesehatan di Puskesmas

1. Penerapan Fungsi Manajemen di Puskesmas

a. Gambarkan struktur organisasi puskesmas di tempat kepaniteraan anda

b. Uraikan secara singkat manajemen puskesmas di tempat kepaniteraan anda


Planning

Organizing

Actuating

Controlling

c. Jelaskan peran seorang dokter di Puskesmas :

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d. Uraikan Peranan, Fungsi dan Tugas dari tenaga kesehatan di Puskesmas.

Tenaga Peranan Fungsi Tugas


1.Dr.umum

2.Dr.Spesialis

3.Dokter Gigi

4. Bidan

5.Perawat

6.Apoteker

7.Petugas Gizi

8.Petugas Kesling

9.Juru Imunisasi

10………….

11…………..

12…………..

13………….

(Contoh )Kepala Puskesmas

(Contoh )1. Manajer 2. Konsultan

Medik

1. Pembinaan Ketenagaan yg ada di wil kerja Puskesmas (Contoh )

e. Apa yang anda ketahui tentang Sistem Kesehatan Nasional di Indonesia ?

f.Uraikan tentang Upaya Pelayanan Kesehatan yang ada di Puskesmas


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Perlu ditambahkan tentang point leadership dan system thinking

2. Upaya Pelayanan Kesehatan Ibu dan Anak, dan Pelayanan Keluarga Berencana

Laporkan hasil stase anda di Poliklinik KIA – KB Pelayanan KIA-KB :

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Tujuan Pelayanan KIA-KB.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup Pelayanan KIA - KB.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Kegiatan yang dilakukan dalam Pelayanan ANC (Antenatal Care): ……..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................………………………………...................................................................................................

Deteksi Dini Ibu Hamil beresiko tinggi.....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................


Pelayanan Kesehatan Neonatal ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Penjelasan tentang penggunaan KMS ibu hamil dan KMS balita.........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Penjelasan tentang penggunaan indikator PWS (Pemantauan Wilayah Setempat) di poli KIA-KB...........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

. Kegiatan Pelayanan Keluarga Berencana

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Sasaran Pelayanan KB, Indikator Program KB, Pencapaian Program KB........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Jenis alat Kontrasepsi yang tersedia (indikasi,pemasangan,efek samping)....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Kegiatan pelayanan KIA-KB lainnya di Puskesmas .....................................- ..............................................................................................................................- .............................................................................................................................


- ..............................................................................................................................- ..............................................................................................................................- ..............................................................................................................................- ...............................................................................................................................

Uraikan dukungan petugas kesehatan dalam pelayanan KIA - KB Peran Petugas Kesehatan di Poliklinik KIA - KB............................................................................................................................................ .........................................................................................................................................................................................................................................................................

Peran petugas kesehatan di Posyandu............................................................................................................................................ .......................................................................................................................................................................................................................................................................................................................................................................................................................

3. Upaya Kesehatan Lingkungan

Laporkan hasil stase anda di unit Kesehatan Lingkungan

Upaya Kesehatan Lingkungan adalah : ..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tujuan dan sasaran “Upaya kesehatan Lingkungan” “.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup “Upaya Kesehatan Lingkungan”....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Uraikan kegiatan yang dilakukan dalam “Program Upaya Kesehatan Lingkungan”, antara lain :

Penyehatan Sumber Air Bersih (SAB) Penyehatan Lingkungan Pemukiman (Jamban, SPAL,tempat sampah)


Penyehatan Tempat-tempat Umum (TTU) Penyehatan Tempat Pengelola Makanan (TPM) Pemeriksaan Jentik Nyamuk Klinik Sanitasi Program lainnya di Puskesmas ..............................................

Penjelasan....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

4. Program Upaya Peningkatan Gizi

Laporkan hasil stase anda di unit Pelayanan GIZI Puskesmas

Upaya Peningkatan Gizi adalah : ..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tujuan dan sasaran “Upaya Peningkatan Gizi” “.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup “Upaya Peningkatan Gizi”............................................................................................................................................................................................................................................................................................


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Uraikan masalah gizi yang anda temukan di Puskesmas........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Penanggulangan masalah gizi di puskesmas........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Pengukuran dan pemantauan status gizi masyarakat (penimbangan bayi balita , penggunaan PWS di posyandu:N/S,N/D, D/S, pelacakan dan perawatan gizi buruk)..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Perbaikan status gizi masyarakat.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Pemberdayaan masyarakat untuk mencapai keluarga sadar gizi (Upaya perbaikan gizi keluarga)..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Upaya pencegahan dan penanggulangan anemia gizi, kekurangan vit A, gondok endemik di puskesmas...................................................................................................................................................................................................................................................................................................................................................................................................................................................


Upaya perbaikan Gizi pada keluarga yang tidak mampu (program puskesmas yang sementara berjalan)........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

5. Program Promosi Kesehatan

Laporkan hasil stase anda pada program Promosi Kesehatan di Puskesmas

Upaya Promosi Kesehatan di Puskesmas adalah : ..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tujuan dan sasaran “Promosi Kesehatan “.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup Upaya Promosi Kesehatan”..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Pengembangan media promosi kesehatan dan teknologi Komunikasi Informasi dan Edukasi (KIE) yang digunakan di puskesmas........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Pengembangan upaya kesehatan bersumber dari masyarakat (seperti pos pelayanan terpadu, pondok bersalin desa, dan usaha kesehatan sekolah).


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Upaya yang dilakukan dalam peningkatan pendidikan kesehatan kepada masyarakat.........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Kegiatan promosi kesehatan yang anda lakukan di Puskesmas ( bias dianggap skill memberikan penyuluhan.....penilaian oleh dosen lb/kapus

Penyuluhan kelompok

Tujuan ..................................................................................................................................................................................................................................................................................Sasaran.................................................................................................................................................................................................................................................................................Metode........................................................................................................................................Media / Alat bantu.......................................................................................................................................Waktu dan Tempat.........................................................................................................................................Uraikan isi penyuluhan ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Penyuluhan individu (skill menyuluh)

Tujuan ..................................................................................................................................................................................................................................................................................

Sasaran..............................................................................................................................................................................................................................................................................Metode


........................................................................................................................................ Media / Alat bantu ....................................................................................................................................... Waktu dan Tempat .........................................................................................................................................

Uraikan isi penyuluhan ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Kegiatan promosi kesehatan lainnya yang dilaksanakan di Puskesmas

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6. Program Pencegahan dan Pengendalian Penyakit

Laporkan hasil stase anda pada Program Pencegahan dan Pengendalian Penyakit

Upaya Pencegahan dan Pengendalian Penyakit adalah : ..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tujuan dan sasaran “Upaya Pencegahan dan Pengendalian Penyakit “.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup “Upaya Pencegahan dan Pengendalian Penyakit”


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Jelaskan kegiatan Pengamatan Penyakit (surveilens epidemiologi) yang dilakukan di Puskesmas....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Jelaskan kegiatan yang dilakukan dalam Upaya Pencegahan dan Penanggulangan Penyakit Menular ( Penyakit TB. Kusta, ISPA, Diare, DBD, Malaria, HIV AIDS. dll)..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Jelaskan kegiatan yang dilakukan dalam Upaya Pencegahan dan Penanggulangan Penyakit Tidak Menular..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Penanggulangan Bencana............................................................................................................................................................................................................................................................................................


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Pelaksanaan Imunisasi..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Pelaksanaan koordinasi dengan instansi /lembaga terkait;........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Pelaksanaan monitoring dan evaluasi serta pelaporan kegiatan;......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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7. Upaya Pengobatan

Upaya Pengobatan Dasar di Puskesmas adalah : ..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tujuan dan sasaran “Upaya Pengobatan Dasar“.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup “Upaya Pengobatan Dasar”


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Jelaskan kegiatan Yang dilakukan dalam Upaya Pengobatan Dasar

- Pelayanan Medik dasar

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- Pelayanan Farmasi / Penggunaan Obat

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- Pemeriksaan laboratorium

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- Proses Rujukan

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Melakukan diagnose sedini mungkin Melaksanakan tindakan pengobatan Melakukan rujukan bila dipandang perlu Peningkatan ketersediaan dan pemerataan obat dan perbekalan

kesehatan diseluruh Puskesmas dan jaringannya. Peningkatan mutu penggunaan obat dan perbekalan kesehatan Melaksanakan peningkatan mutu pelayanan kesehatan dasar. Melaksanakan peningkatan jangkauan pelayanan kesehatan dasar,

termasuk pelayanan kesehatan terhadap keluarga miskin.

Melaksanakan peningkatan jangkauan pelayanan kesehatan dasar, termasuk pelayanan kesehatan terhadap keluarga miskin

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8. Program UKS (Upaya Kesehatan Sekolah) / UKGS

Laporkan hasil stase anda di unit UPAYA KESEHATAN SEKOLAH

Jelaskan pengertian, tujuan dan sasaran UKS.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Uraikan kegiatan yang dilakukan UKS- Pendidikan kesehatan di sekolah............................................................................................................................................ .........................................................................................................................................................................................................................................................................- Pemeliharaan kesehatan sekolah............................................................................................................................................ .........................................................................................................................................................................................................................................................................- Pemeliharaan lingkungan sekolah sehat............................................................................................................................................ .........................................................................................................................................................................................................................................................................

- ........................................................................................................................

- .......................................................................................................................

- .......................................................................................................................

Uraikan dukungan petugas kesehatan dalam pelaksanaan UKS Pengelolaan Usaha Kesehatan Sekolah


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.................................................................................................................................... Peran petugas kesehatan............................................................................................................................................ .........................................................................................................................................................................................................................................................................

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9. Upaya Kesehatan Usila

Laporkan hasil stase anda di bagian Upaya Kesehatan Usila

Jelaskan pengertian, tujuan dan sasaran Upaya Kesehatan Usila.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Uraikan kegiatan yang dilakukan Puskesmas dalam “Upaya Kesehatan Usila”

- Pemeriksaan kesehatan usila............................................................................................................................................ .....................................................................................................................................................................................................................................................................................................................................................................................................................

- Pemeliharaan kesehatan usila............................................................................................................................................ .........................................................................................................................................................................................................................................................................

- Pembinaan Posyandu Usila............................................................................................................................................ .....................................................................................................................................................................................................................................................................................................................................................................................................................

- ........................................................................................................................

- .......................................................................................................................


Uraikan dukungan petugas kesehatan dalam pelaksanaan “Kesehatan Usila” Pengelolaan Upaya Kesehatan Usila

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Peran petugas kesehatan....................................................................................................................................................................................................................................................................................................................................................................................................................

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10. Upaya Kesehatan Jiwa

Laporkan hasil stase anda di bagian Upaya Kesehatan Jiwa

Jelaskan pengertian, tujuan dan sasaran Upaya Kesehatan Jiwa.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Uraikan kegiatan yang dilakukan Puskesmas dalam “Upaya Kesehatan Jiwa”- Upaya Kesehatan Jiwa Masyarakat............................................................................................................................................ .........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

- Upaya Kesehatan Jiwa Dasar...........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................


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- Upaya Kesehatan Jiwa Rujukan...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

- Upaya kesehatan jiwa yang terintegrasi dengan program puskesmas lainnya............................................................................................................................................ ..................................................................................................................................................................................................................................................................................................................................................................................................................... .................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Uraikan dukungan petugas kesehatan dalam pelaksanaan “Upaya Kesehatan Jiwa” Pengelolaan Upaya Kesehatan Jiwa............................................................................................................................................ .........................................................................................................................................................................................................................................................................

Peran petugas kesehatan............................................................................................................................................ .........................................................................................................................................................................................................................................................................

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11. Upaya Kesehatan Kerja

Laporkan hasil stase anda di bagian Upaya Kesehatan Kerja

Jelaskan pengertian, tujuan, ruang lingkup dan sasaran Upaya Kesehatan Kerja


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Uraikan kegiatan yang dilakukan Puskesmas dalam menjalankan program “Upaya Kesehatan Kerja”...................................................................................................................................................................................................................................................................................................................................................................................................................................

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Uraikan kegiatan dalam Pembinaan Pos UKK (Usaha Kesehatan Kerja)

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Uraikan dukungan petugas kesehatan dalam pelaksanaan “Kesehatan Kerja”

Pengelolaan Upaya Kesehatan Kerja............................................................................................................................................ .....................................................................................................................................................................................................................................................................................................................................................................................................................

Peran petugas kesehatan............................................................................................................................................ .........................................................................................................................................................................................................................................................................

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12. Upaya Kesehatan Gigi dan Mulut

Laporkan hasil stase anda di bagian Upaya Kesehatan Gigi dan Mulut


Upaya Kesehatan Gigi dan Mulut di Puskesmas adalah : ..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tujuan dan sasaran “Upaya Kesehatan Gigi dan Mulut“.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup “Upaya Kesehatan Gigi dan Mulut”...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Jelaskan kegiatan Yang dilakukan dalam Upaya Kesehatan Gigi dan Mulut

- Pelayanan Medik Gigi Dasar

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- Proses Rujukan

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13. Upaya Perawatan Kesehatan Masyarakat ( Perkesmas )

Laporkan hasil stase anda di bagian Upaya Perawatan Kesehatan Masyarakat

Upaya Perawatan Kesehatan Masyarakat di Puskesmas adalah : .............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tujuan dan sasaran “Upaya Perkesmas“.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup “Upaya Perkesmas”...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Jelaskan kegiatan Yang dilakukan dalam Upaya Perkesmas di Puskesmas

- Pelayanan asuhan keperawatan (individu, keluarga,kelompok khusus,masyarakat

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- Upaya Perkesmas yang berintegrasi dengan upaya kesehatan wajib

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- Upaya Perkesmas sebagai upaya kesehatan pengembangan

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- Peran dan Fungsi Perawat Kesehatan Masyarakat

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14. Laporkan hasil kegiatan / pengamatan anda dalam kegiatan UKBM (Upaya kesehatan berbasis masyarakat)

Upaya kesehatan berbasis masyarakat (UKBM) di Puskesmas adalah : .....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tujuan dan sasaran “UKBM “..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Ruang Lingkup “UKBM”...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Jelaskan kegiatan Yang dilakukan dalam UKBM


- POSYANDU

Jelaskan tentang pelaksanaan Posyandu yang ada kunjungi (kegiatan posyandu, kegiatan kader posyandu, pelayanan kesehatan yang diberikan di posyandu,dll)

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Jelaskan tentang apa yang anda lakukan di Posyandu

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- UKBM Lainnya ( POLINDES,Pos Obat Desa,Pos UKK,Dana Sehat)

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15. Laporkan hasil stase / pengamatan anda pada program-program upaya kesehatan pengembangan lainnya (upaya kesehatan yang ada di Puskesmas tempat stase; upaya keseahtan remaja, upaya kesehatan mata, upaya kesehatan olah raga, poliklinik HIV AIDS, upaya pembinaan pengobatan tradisional, upaya Peran Sera Masyarakat,dll)

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16. Laporkan hasil pengamatan anda pada “Upaya Pelayanan Penunjang di Puskesmas”

Laporkan hasil pengamatan anda di Laboratorium Dasar Puskesmas

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Laporkan hasil pengamatan anda di bagian Farmasi Puskesmas

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Laporkan hasil pengamatan anda pada Pencatatan dan Pelaporan di Puskesmas

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17. Uraikan permasalahan yang ada temukan di Puskesmas (pelayanan kesehatan, pelaksanaan program, dll)...............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................


18. Saran yang anda berikan untuk perbaikan pelayanan kesehatan di Puskesmas..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Tanggal : ..................... Tanggal : .....................

Pembimbing : Pembimbing

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Tanggal ................................. Mengetahui

KPM Bagian IKM IKK Fak.Kedokteran UNHAS

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NILAI : ..............


Documents

1 Undana Penuntun Kepaniteraan Di Puskesmas