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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