peraktek report learning field
PRACTICE REPORT FIELD LEARNING ACADEMY
NURSING HOPE MAMA
DISTRICT Deli Serdang
IN HEALTH MANDALA
YEAR 2016
DI SUSUN OLEH :
Beautiful Names NIM: 13.01.002
Nuriana NIM: 13.01.028
PURNAMA IRAWAN NIM: 13.01.029
RINALDI HASIBUAN NIM: 13.01.031
YENI ELFIA NIM: 13.01.035
HADI ASRUL NIM: 13.01.037
ADAMSYAH Nim: 13.01.038
MULYADI NIM: 13.01.024
MAMA HOPE ACADEMY OF NURSING
DISTRICT Deli Serdang
YEAR 2016
BAB I
PRELIMINARY
1.1 Background
Health is one of the rights of every individual. Therefore, each country guarantees freedom of every citizen to achieve the highest possible health. It
is also likely to encourage the formation of a country's development
objectives, particularly Indonesia contained health development goals.
Health
development goals towards Healthy Indonesia is to raise awareness, the
nation, and the state is characterized by people in healthy living and
behavior, have the ability to reach quality health services as a whole
and evenly, and has a degree of optimal health throughout the territory
of the Republic of Indonesia. To realize these goals, it is
necessary effort - effort to prepare human resources capable of meeting
the demands and needs of the health sector, both present and future.
Community Health Centres (PHC)
is the Functional Health Unit which is a community development center,
as well fostering community participation in addition to providing
health care to the public a comprehensive and integrated its territory
in the form of principal activity (Atik 2010).
Interest
Indonesian nation, as stated in the opening paragraph 4 of the 1945
Constitution is to protect the entire Indonesian nation and the entire
homeland of Indonesia and to promote the general welfare and educating
the nation. To achieve these objectives organized national sustainable development program, planned and directed.
In Article 5 of Law No. health 23
of 1992 states that every person is obliged to participate in
maintaining and improving the health of individuals, families and the
environment. In carrying out his duties as a public service
health center has the task - the main tasks, and has the goal of
improving public health.
The background of the authors make in
this report is to apply a course of nursing community
as curriculum requirements to undergraduate courses Diploma in nursing
conducted on 04 s / d 16 April 2016 in the clinic Mandala, so that the
student / I be able to explain and implement various programs and
working mechanisms of health services in health centers.
1.2
Objectives
1.2.1
General Purpose
In
order for nursing students to carry out health promotion, community
nursing and community health centers to describe the geographic and
demographic, health center organization structure and work programs in
Puskesmas Mandala 2015.
1.2.2
Special Purpose
·
Preparing to know the Puskesmas Mandala work program in the community.
·
To determine the primary health care clinic.
·
To know the organizational structure of health centers and programs of each of the existing units.
·
Mengetahaui program - mandatory courses and the development of health centers Mandala.
·
Knowing the extent of the program - the program has been run through
the data - data that has been available in the clinic Mandala.
·
Ability to conduct the counseling of health in society.
·
Able to provide health services in health centers.
·
Understand the working area health centers.
·
Reviewing the extent of public awareness for healthy living as well as utilizing existing facilities.
·
Understand how to design a survey to collect, manage, analyze and interpret the data so that it can formulate health problems.
·
Conducting direct field observations on the issue - health issues in Puskesmas Mandala.
1.3 Mamfaat PBL
a.
to know the program - a program in puskesmas
b.
to carry out health education in the community
c.
Can understand how to design surveys, collect, manage, analyze and interpret the data so that it can formulate health problems.
d.
Conducting direct field of the problem - the problem of health in the working area health centers.
1.4
Scope of PBL
1.4.1
Working Procedure
a.
Recording the data geographically and demographically in Puskesmas Mandala.
b.
Conducting direct field observation, and participate in health care.
c.
Conducting health education.
1.4.2
Points
Points are used to obtain the above skills are puskesmas Mandala.
1.4.3
time
Learn
practical implementation in the field by the student health center
Nursing Academy Mama Hope VI semester III level for 2 weeks is from the
date of April 4, 2016 s / d 16 April 2016.
1.4.4
Participants
Who
participated in the Health Center Practice Learning Courses Mandala is a
student of sixth semester of level III Nursing Academy of Hope Mama
Deli Serdang which amounted to 7 people.
BAB II
REVIEW OF THEORY
2.1 Definition of PHC
PHC
is a health care facility that organizes public health efforts and the
efforts of individual health first rate, with more emphasis promontif
and preventive efforts, to achieve a high level of public health for -
height in its working area. (MOH, 2014)
PHC
is a functional organizational unit that proportionally efforts core
health services that use active community participation in order to
provide comprehensive and integrated services to the people in the
region work. A unified health organizations is central to
public health developers are also fostering community participation in
addition to the provision of comprehensive services and integrated to
the society working area in the form of principal activity.
2.2 History of PHC
Pukesmas concept was born in Indonesia in 1968, when it held the first national work meeting in Jakarta. Prior to 1968 the basic level of health care is already there just as KIA, BP, PAM, etc. Each
- each running its own and has not been organized so that viewed less
favorably and did not meet the target, therefore, the organization and
was named Public Health Center (Puskesmas).
Since
1979, initiated the construction of health centers in the regions the
level of village or village which has a total of about 30,000. And
to coordinate activities that live in some districts, it is one of the
health centers are designated as responsible and called by the name of PHC sub-district or health center builder. Average health centers at the village or the village called Puskesmas village or Puskesamas maid. Categorizing health center as this, is still used.
2.3 Functions Health Center
In KEPMENKES No. 128 2004 stated that the function of the health center is divided into three main functions:
1) First, as organizers attempt Health
Society (SMEs) in the region first level primary
2)
Second, as the central provider of data and health information in the
areas they once associated with his role as a driver of health oriented
development in the region, and
3) Third, as the organizer of Individual Health Effort (UKP) primary / first-rate quality and user-oriented services
Health
efforts in Puskesmas divided into two categories namely: First, the
community health service centers primer namely health centers as service
providers promotion and prevention with the target groups and
communities to maintain and improve health and prevent disease, and
second, the health center as a center for health care individual primary
where PHC role interpreted as a gate keeper or first contact on the
formal health care and referral in accordance with the standards of
medical service.
There are some functions are written in general health centers, namely:
1.
Health Center For Health Perspective Building Movers
PHC role to
mobilize and monitor the implementation of cross-cutting, including by
the public and businesses in the working area, so insightful and
supporting the development of health. Besides, health
centers actively monitor and report on the health impacts of the
implementation of any program of development in the works. Especially for health development efforts made puskesmas is prioritizing the maintenance of health and prevention of disease without ignoring cure disease and restore health.
2.
Health Center For Community Empowerment
PHC is always working to make individuals particularly community leaders, families and society ,
including the business consciousness, willingness and ability to serve
yourself and people to live healthy, active role in fighting for the
interests of health, including its financing, as well as participate
establish, organize and monitor the implementation of health programs. Empowerment
of individuals, families and society is organized with attention to the
condition and situation, especially the local social and cultural
msyarakat.
3.
Health Center For Primary Health Care Strata
PHC is responsible for health service delivery first rate overall, integrated and sustainable. Primary
health care is the responsibility of the health center include
individual services, among others, outpatient and inpatient care as well
as, public health services are public with the primary objective to
maintain and maningkatkan health and prevent disease without ignoring
cure disease and restore health.
2.4 Purpose Health Center
2.4.1 General Purpose
Health development goals which was held by the health center is to promote the goals of national health development. Namely
improving national health., The willingness and ability of healthy life
for everyone who lives in the working area of Puskesmas to manifest
the highest health standard - height in order to achieve Healthy
Indonesia.
2.4.2 Special Purpose
a.
Reducing deaths in the health centers
b.
Reduce the prevalence of KEP specialized in health centers
c.
Improving the examination in the clinic.
d.
Improving health services on vulnerable families in the working area health center
e.
Improving the quality of health counseling by health workers in community health centers in the region.
2.5 Vision and Mission Health Center
2.5.1 Vision Health Center
Vision health development held puskesmas is the achievement of a healthy health towards the creation of Healthy Indonesia 2016.
Indicators healthy districts to be achieved covers four main indicators, namely:
1)
Healthy environment
2)
Healthy behavior
3)
Coverage of quality health services
4)
The degree of the population's health district.
2.5.2 Mission Health Center
1.
Moving the sound development of health in the working area.
2.
Encouraging healthy independence of families and communities in their working area.
3.
Maintain and improve the quality of equity and affordability of health services being.
4.
Maintain and enhance the health of individuals, families and communities and their environment.
2.5.3
Motto
We are not the best but give us a chance to serve you well.
2.6. Principles and organizing efforts Puskesmas
Implementation
of compulsory health efforts and the efforts of health development must
apply the principle of operation of an integrated health center.
2.6.1 Principle of operation of health centers Mandala
The principle of operation of health centers in question are:
1.
The principle of accountability region.
2.
The principle of empowerment.
3.
The integration principle.
4.
Principles of reference.
2.6.2 Efforts to organizing health centers Mandala
In
achieving the vision of health development through the establishment of
sub-district health centers healthy, health centers responsible for
organizing the efforts of individual health and public health efforts.
The health efforts can be classified into two, namely:
2.6.2.1 Efforts compulsory health / PHC principal Mandala
Efforts
mandatory health centers health is determined by the commitment of
national efforts, regional, and global as well as having a high
attraction to increase the degree of each clinic.
1.
Efforts Health Promotion
a.
Objectives
1)
In order for the individual and society as a whole to implement perilku healthy life.
2)
For individual communities play an active role in planning in the administration.
3)
Improving health knowledge, willingness and ability of people to live a
clean and healthy as well as develop and implement optimal health
status.
b.
Target
1)
Order of households
2)
Order the education sector (schools) madrasah and pesantren.
3)
Order the workplace (office, factory)
4)
Order places - public places, markets, terminals, places of worship and places of entertainment.
c.
Activity
1)
Provide health education to the community health center environment
working areas inside and outside Mandala shaped building, growth
monitoring sessions, Posyandu, UKS, UKGS, Nutrition, PKM, PHN, Sanitas,
health care is carried out every working day.
2)
Providing health services to the community by distributing brochures / lefleat health information.
3)
Looking for a trained health worker
4)
IHC.
2.
Efforts Environmental Health
a.
Objectives
To
improve the quality of the environmental quality of the environment to
ensure the health, through basic sanitation and prevention activities.
b.
Target
1)
The area is prone to water
2)
The area prone communicable diseases
3)
Regional pilot and new settlements.
3.
Prevention and Eradication of Communicable Diseases
a.
Objectives
1)
Preventing the outbreak of disease
2)
To improve optimal health
3)
Reduce mortality and morbidity.
b.
Target
Whole community health centers in the region of Mandala.
c.
Activity
1)
for the case as early as possible for treatment
2)
Provide health education outbreak areas in health centers
3)
Provide immunization include: BCG, DPT, Measles, Polio, DT and TT.
4)
Step - steps taken in the observation and eradication of diseases
5)
Collect and analyze data about disease
6)
Reporting of infectious diseases
7)
Investigate in the field to see whether there is any incoming reports,
found the case - the case to determine the source of infection.
8)
Action start to resist the propagation
9)
Cure the patient back to health
10) immunization
11) Elimination of mosquito vectors
12) Health education
4.
Efforts Treatment
a.
Objectives
Treating the entire community in the work area so that community health centers Mandala healthy.
b.
Target
The whole community health centers in the region of Mandala.
c.
Activity
1)
Examination diagnose diseases and deliver drugs through pharmacies in health centers
2)
Education in patients during examination
3)
Giving patients who can not afford to hospital and continue treatment after the patient returned
4)
Care and treatment of patients puskesmas Mandala include a public patient, Askes, BPJS, and Medan healthy.
5.
Efforts recording and reporting
a.
Objectives
1)
To assess the work that has been done
2)
To be used as an ingredient in the work plan.
b.
Activity
a. Recording
1)
Administrative activities
2)
Activity family forder
3)
Registration other activities
b. Reporting
1)
Report of the extraordinary incident
2)
report that records the number of regular visitors of diseases and health centers mandala
3)
The weekly report is recorded cases of infectious diseases
4)
The monthly report that records the activities mandala and Posyandu health centers in the area of health centers keja mandala.
5)
The report quarterly which records all activities of health centers mandala and work plan for quarterly
6)
The annual report is a record of all reports in one year is taken from the monthly report
7)
The case reports in the form of illness, death and drugs.
2.6.2.2. PHC development program Mandala
a.
Efforts School Health,
b.
Health Services Sports,
c.
Efforts Community Health Care,
d.
Efforts Occupational Health,
e.
Efforts Dental and Oral Health,
f.
Efforts Mental Health
g.
Efforts Eye Health
h.
Efforts Elderly Health
i.
Efforts Development of Traditional Medicine
2.7. Position Puskesmas
Notch
health centers according to its relevance to the national health
system, the district health system / and the system of local government:
1. The national health system
Notch
health centers in national health is a health-care facility Starata
responsible for organizing the first public health efforts in their
working area. As a development task.
2. The health system districts / cities
Notch
health centers in the local government system is a technical
implementation unit of district health offices / cities in the work
areas.
3. The system of local government
Notch
health centers in the local government system is a technical
implementation unit of district health offices / city health sector at
the district level.
4. Between the first strata of health care facilities
In
the working area of the health center there are various strata first
health care organization managed by public and private institutions such
as: Practice physician, dentist, midwife practice, clinic and community
health centers.
2.8. PHC organizations
a. Organizational Structure
According
to the decree number 128 Indonesian health minister / minister of
health / RI / SK / II / 2004, the organizational structure of health
centers depends on the activities and responsibility of each health
center. Preparation of the organizational structure of
health centers in one district / city health bureau carried out by the
district / city, while its adoption is done with local regulations.
Can be used as a reference pattern puskesmas organizational structure as follows:
1. Head of Puskesmas
2. Unit Administration
3. Technical Implementation Unit Functional namely the efforts of public health and individual health effort
4. Network Services
a) health center,
b) Health Center Tour
c) Unit midwife / community
c.
Criteria Personnel
Criteria
personnel who fill the organizational structure of health centers
adapted to the duties and responsibilities of each - each unit clinic.
d. Echelon Head of Puskesmas
Head of the health center is in charge of health development at the district level. In
accordance with the responsibilities and the large role of head of
puskesmas in penyelnggaraan health development at the district level,
the post of head of the health center is a structural position echelon
IV.
2.9. Working procedures of health centers
a. the District Office
In
carrying out its functions, health centers health centers in
coordination with the district office through regular meetings held at
the district level, the coordination of planning, movement,
implementation, monitoring, and control and assessment. In
this case, implementation of the functions of extracting resources of
the community by the health center, in coordination with the district
office also include the activities of the facility .
b. District health offices / city
Puskesmas
a technical unit of district health offices / city thus, technically of
administrative, public health is responsible head of health districts /
cities. Instead, the health department district / city is
responsible to foster and provide administrative and technical
assistance to community health centers.
c.
health care network first strata
As
a partner of the first strata health services managed by public and
private institutions, health centers established cooperation including
organizing references and monitor the activities organized. Meanwhile,
as a builder of community based health activities, health centers carry
out technical guidance, empowerment and referrals as needed. Examples such as posyandu, pokeles, and others - others.
d.
Network referral health services
In
the conduct of the undertakings of individual health and public health
efforts, health center cooperates closely with various health care
referral. For individual health undertakings, via
cooperation was held with various srana personal health services such as
hospitals (Kabuapate / town) and a variety of community health centers.
As
for public health efforts, jalainan same keraj held with various
community referral health-care facilities, such as district health
offices / city hall environmental health engineering, medical laboratory
centers, as well as various community health centers. The
cooperation is organized through a thorough application of the concept
of reference in the coordination of district health offices / city.
e.
Cross-Sector
The
responsibility of health centers as technical executing unit is part of
the duties menyelenggaraka health development which is distinguished by
the district health department / town. For optimal
results, the implementation of health development should be coordinated
with existing across relevant sectors in the district. It
is hoped the one hand the implementation of health development in the
district has the support of various related sectors, while on the other
hand, the construction of which held by other sectors at the district
level have a positive impact on the district.
f.
Community
As
the person in charge of the implementation of health development in
working areas, health centers requires active encouragement from the
community as an object and subject of development. The
active Dukumhan realized through the establishment of health centers
supporting bodies (BPP) collected a variety of potential community, such
as community leaders, religious leaders, NGOs, community organizations
and the business world. The BPP role as mita puskesmas in conducting health development.
BAB
III
RESULTS AND DISCUSSION
3.1. Implementation Practice Learning Courses
Learn
practical implementation of student / student Academy of Nursing Mama
Hope VI Deli Serdang meter conducted in Puskesmas Mandala subdistrict of
Medan Tembung for 2 weeks (April 4 to April 16, 2016) during the hours
of health centers.
3.2 Overview Health Center
3.2.1. History puskesmas mandala
PHC
mandala stood in June 1982. Located in the village of New Memories
districts Percut Sei Tuan founded by Pemko field at this point mandala
health centers led by dr. Hafni headland with 35 employees.
3.2.2. The working area of Puskesmas Mandala
Limitation
of working area health centers established by the health department
based on the geographical location, transportation advice, local health
problems, resources and other - other.
In
the working area of the mandala health center, there are two
sub-health centers located in urban villages and sub Tembung Bantan. Spacious working area is 384 Ha Mandala health centers, namely:
Ø Sub Urban Safety : 90 Ha
O Kelurahan Bantan : 151 Ha
O Kelurahan Bantan Timur : 89 Ha
Ø The Village : 65 Ha
a.
Population : 72,341 Jiwa
b.
Total Overall : 4 Village
1.
Bantan East located on the street trawl III No. 56
2.
Safe City located on the street Captain Jamil M. Lubis No.54
3.
Bantan located on the street Pertiwi end 110 B
4.
The word on the street is 17 Bantan
3.2.3. Geographic Data
Mandala Health Center located in the district of Medan Tembung precisely in the straw-headed bulbul II Housing Mandala Medan. Geographically, puskesmas mandala is bordered by:
a.
North : Bordering the district Percut Sei Tuan district. Deli Serdang
b.
The South : Bordering the district. Medan Denai
c.
Next to West : Bordering the district. terrain Struggle
d.
in the east : Bordered by the district. Percut Sei Tuan district. Deli Serdang
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