Scribd Logo
Upload

Welcome to Scribd!

  • SKP Riswarti Bidan Penyelia

    Uploaded by

    Asniarti Yeni
    100 views7 pages
    The document is a performance assessment form for a civil servant midwife in Indonesia. It contains details of the assessment including the assessor's information, the midwife's personal details, and 22 key job activities with targets for quantity, quality, timeliness and cost. The form is used to evaluate the midwife's performance on clinical tasks like examinations, procedures, counseling and documentation for different types of obstetric and gynecological cases over a 12 month period.

    Original Description:

    Original Title

    Skp Riswarti Bidan Penyelia

    Copyright

    © © All Rights Reserved

    Available Formats

    TXT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    The document is a performance assessment form for a civil servant midwife in Indonesia. It contains details of the assessment including the assessor's information, the midwife's personal details, and 22 key job activities with targets for quantity, quality, timeliness and cost. The form is used to evaluate the midwife's performance on clinical tasks like examinations, procedures, counseling and documentation for different types of obstetric and gynecological cases over a 12 month period.

    Copyright:

    © All Rights Reserved
    Download as TXT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as txt, pdf, or txt
    100 views7 pages

    SKP Riswarti Bidan Penyelia

    Uploaded by

    Asniarti Yeni
    The document is a performance assessment form for a civil servant midwife in Indonesia. It contains details of the assessment including the assessor's information, the midwife's personal details, and 22 key job activities with targets for quantity, quality, timeliness and cost. The form is used to evaluate the midwife's performance on clinical tasks like examinations, procedures, counseling and documentation for different types of obstetric and gynecological cases over a 12 month period.

    Copyright:

    © All Rights Reserved
    Download as TXT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as txt, pdf, or txt
    of 7

    <style>

    .text_a {
    font-family: font-family: Arial,Verdana,Helvetica, sans-serif; font-size
    : 8pt; color: #000000;
    font-size: 10pt;
    color: #000000;
    }
    </style>
    <style>
    *
    {
    font-family: Tahoma, Arial;
    }
    td
    {
    padding:2px 10px;
    }
    th
    {
    padding:2px 10px;
    border:1px solid #000000;
    font-weight:bold;
    background-color:#dddddd;
    }
    </style>
    <table width="100%" cellpadding="2" cellspacing="0" style="font-size: 9pt;">
    <tr>
    <td align="center" style="font-size: 11pt;">
    <b>PENILAIAN SASARAN KINERJA PEGAWAI (SKP)<br>PEGAWAI NEGERI SIP
    IL</b>
    </td>
    </tr>
    <tr><td>&nbsp;</td></tr>
    <tr>
    <td>
    <table width="100%" cellpadding="2" cellspacing="0" styl
    e="border-collapse:collapse; font-size: 9pt;" border="1" bordercolor="#000000">
    <tr>
    <td width="5%" align="center"><b>NO</b><
    /td>
    <td width="45%" colspan="2"><b>I. PEJABA
    T PENILAI</b></td>
    <td width="5%" align="center"><b>NO</b><
    /td>
    <td width="45%" colspan="2"><b>II. PEGAW
    AI NEGERI SIPIL YANG DINILAI</b></td>
    </tr>
    <tr>
    <td align="center">1</td>
    <td>Nama</td>
    <td>Ns. ANNA FALUZI, S.Kep</td>
    <td align="center">1</td>
    <td>Nama</td>
    <td>R I S W A R T I</td>
    </tr>
    <tr>
    <td align="center">2</td>
    <td>NIP</td>
    <td>196909181989032002</td>
    <td align="center">2</td>

    <td>NIP</td>
    <td>196608241992032001</td>
    </tr>
    <tr>
    <td align="center">3</td>
    <td>Pangkat/Gol.Ruang</td>
    <td>Penata Tk. I - III/d</td>
    <td align="center">3</td>
    <td>Pangkat/Gol.Ruang</td>
    <td>Penata - III/c</td>
    </tr>
    <tr>
    <td align="center">4</td>
    <td>Jabatan</td>
    <td>Kepala Seksi Monitoring dan Evaluasi
    Pelayanan Keperawatan</td>
    <td align="center">4</td>
    <td>Jabatan</td>
    <td>Bidan Penyelia</td>
    </tr>
    <tr>
    <td align="center">5</td>
    <td>Unit Kerja</td>
    <td>Rumah Sakit Umum Pusat Dr. M. Djamil
    Padang</td>
    <td align="center">5</td>
    <td>Unit Kerja</td>
    <td>Rumah Sakit Umum Pusat Dr. M. Djamil
    Padang</td>
    </tr>
    </table>
    </td>
    </tr>
    <tr>
    <td>
    <table width="100%" cellpadding="2" cellspacing="0" styl
    e="border-collapse:collapse; font-size: 9pt;" border="1" bordercolor="#000000">
    <tr>
    <th width="5%" rowspan="2" align="center
    "><b>NO</b></th>
    <th width="45%" rowspan="2" align="cente
    r"><b>III. KEGIATAN TUGAS POKOK JABATAN</b></th>
    <th width="5%" rowspan="2" align="center
    "><b>AK</b></th>
    <th width="45%" colspan="6" align="cente
    r"><b>TARGET</b></th>
    </tr>
    <tr>
    <th align="center"><b>KUANT/OUTPUT</b></
    th>
    <th align="center"><b>KUAL/MUTU</b></th>
    <th align="center"><b>WAKTU</b></th>
    <th align="center"><b>BIAYA</b></th>
    </tr>
    <tr align="center">
    <td width="5%">1</td>
    <td width="42%" align="left">Mempersiapk
    an pelayanan kebidanan (0.005/Kegiatan)</td>
    <td width="5%">1.44</td>
    <td width="13%">288&nbsp;Kegiatan</td>

    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">2</td>
    <td width="42%" align="left">Melaksanaka
    n anamnesa klien/ pasien pada: Kasus patologis kegawatdaruratan kebidanan (0.01/
    10 10 Kegiatan)</td>
    <td width="5%">2.88</td>
    <td width="13%">288&nbsp;Kegiatan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">3</td>
    <td width="42%" align="left">Melaksanaka
    n pemeriksaan fisik klien/ pasien pada: Kasus patologis kegawatdaruratan kebidan
    an (0.01/10 10 Kegiatan)</td>
    <td width="5%">2.88</td>
    <td width="13%">288&nbsp;Kegiatan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">4</td>
    <td width="42%" align="left">Pengambilan
    /penyediaan bahan laboratorium Melakukan pengambilan sediaan/bahan laboratorium
    melakukan pengambilan sekret vagina (0.003/klien/pasien)</td>
    <td width="5%">0.864</td>
    <td width="13%">288&nbsp;pasien</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">5</td>
    <td width="42%" align="left">Pengambilan
    /penyediaan bahan laboratorium Melakukan pengambilan sediaan/bahan laboratorium
    melakukan pengambilan sekret cervix (0.003/klien/pasien)</td>
    <td width="5%">0.864</td>
    <td width="13%">288&nbsp;Pasien</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">6</td>
    <td width="42%" align="left">Membuat dia
    gnosa kebidanan sesuai dengan hasil pengkajian pada: Kasus patologis kegawatdaru
    ratan kebidanan (0.01/10 10 Kegiatan)</td>
    <td width="5%">2.88</td>
    <td width="13%">288&nbsp;Kegiatan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan2</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">

    <td width="5%">7</td>
    <td width="42%" align="left">Melakukan k
    olaborasi dengan tim kesehatan lain pada: Kasus patologis kegawatdaruratan kebid
    anan (0.01/10 10 Kegiatan)</td>
    <td width="5%">2.88</td>
    <td width="13%">288&nbsp;Kegiatan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;b</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">8</td>
    <td width="42%" align="left">Menyusun re
    ncana operasional asuhan kebidanan pada: Kasus patologis kegawatdaruratan kebida
    nan (0.02/10 10 rencana)</td>
    <td width="5%">40.32</td>
    <td width="13%">2.016&nbsp;Rencana</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">9</td>
    <td width="42%" align="left">Melakukan p
    ersiapan pelayanan asuhan kebidanan Mempersiapkan pasien/klien pada: Kasus patol
    ogis kegawatdaruratan kebidanan (0.02/10 10 kegiatan)</td>
    <td width="5%">5.76</td>
    <td width="13%">288&nbsp;Kegiatan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">10</td>
    <td width="42%" align="left">Melakukan p
    ersiapan pelayanan asuhan kebidanan Mempersiapkan alat dan obat pada: Kasus pato
    logis kegawatdaruratan kebidanan (0.02/10 10 kegiatan)</td>
    <td width="5%">5.76</td>
    <td width="13%">288&nbsp;Kegiatan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">11</td>
    <td width="42%" align="left">Melakukan p
    ersiapan pelayanan asuhan kebidanan Mempersiapkan tindakan operatif gynecology &
    obstetri pada: kasus sedang (0.005/kegiatan)</td>
    <td width="5%">1.44</td>
    <td width="13%">288&nbsp;Kegiatan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">12</td>
    <td width="42%" align="left">Melaksanaka
    n asuhan kebidanan pada klien/pasien Kasus patologis kegawatdaruratan kebidanan
    (0.06/10 10 kegiatan)</td>
    <td width="5%">120.96</td>

    <td
    <td
    <td
    <td

    width="13%">2.016&nbsp;Kegiatan</td>
    width="10%">100</td>
    width="12%">12&nbsp;bulan</td>
    width="10%">-</td>

    </tr>
    <tr align="center">
    <td width="5%">13</td>
    <td width="42%" align="left">Melakukan k
    onseling pada klien/pasien pada: Kasus Fisiologis Bermasalah (0.006/klien/pasien
    )</td>
    <td width="5%">1.728</td>
    <td width="13%">288&nbsp;Pasien</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">14</td>
    <td width="42%" align="left">Melakukan k
    onseling pada klien/pasien pada: Kasus patologis kegawatdaruratan kebidanan (0.0
    13/10 10 klien/pasien)</td>
    <td width="5%">3.744</td>
    <td width="13%">288&nbsp;Pasien</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">15</td>
    <td width="42%" align="left">Melaksanaka
    n evaluasi asuhan kebidanan klien/pasien pada: Kasus Fisiologis Bermasalah (0.06
    /10 10 laporan)</td>
    <td width="5%">51</td>
    <td width="13%">864&nbsp;Laporan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">16</td>
    <td width="42%" align="left">Melaksanaka
    n evaluasi asuhan kebidanan klien/pasien pada: Kasus patologis kegawatdaruratan
    kebidanan (0.02/10 10 laporan)</td>
    <td width="5%">17</td>
    <td width="13%">864&nbsp;Laporan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">17</td>
    <td width="42%" align="left">Melakukan d
    okumentasi pada asuhan kebidanan Kasus Fisiologis Bermasalah (0.05/10 10 laporan
    )</td>
    <td width="5%">14.4</td>
    <td width="13%">288&nbsp;Laporan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>

    <tr align="center">
    <td width="5%">18</td>
    <td width="42%" align="left">Melakukan d
    okumentasi pada asuhan kebidanan Kasus patologis kegawatdaruratan kebidanan (0.0
    2/10 10 laporan)</td>
    <td width="5%">5.76</td>
    <td width="13%">288&nbsp;Laporan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">19</td>
    <td width="42%" align="left">Melaksanaka
    n tugas sebagai pengelola RS Ketua tim kebidanan (0.007/tiap kegiatan)</td>
    <td width="5%">2.016</td>
    <td width="13%">288&nbsp;kegiatan</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">20</td>
    <td width="42%" align="left">Melaksanaka
    n tugas jaga/shif : di tempat/rumah sakit (0.16/8 tiap 8 jam)</td>
    <td width="5%">46.08</td>
    <td width="13%">288&nbsp;Tugas jaga</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">21</td>
    <td width="42%" align="left">Membuat kar
    ya tulis/karya ilmiah berupa tinjauan atau ulasan ilmiah dengan gagasan sendiri
    di bidang kebidanan yang tidak dipublikasikan Dalam bentuk buku (7.5/Buku)</td>
    <td width="5%">-</td>
    <td width="13%">1&nbsp;makalah</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    <tr align="center">
    <td width="5%">22</td>
    <td width="42%" align="left">Pengurus (1
    /Tahun)</td>
    <td width="5%">1</td>
    <td width="13%">1&nbsp;pengurus</td>
    <td width="10%">100</td>
    <td width="12%">12&nbsp;bulan</td>
    <td width="10%">-</td>
    </tr>
    </table>
    </td>
    </tr>
    <tr>
    <td>&nbsp;<br><br></td>
    </tr>
    <tr>
    <td>

    <table width="100%" cellpadding="2" cellspacing="0" styl


    e="font-size: 9pt;">
    <tr align="center">
    <td width="30%"></td>
    <td width="40%"></td>
    <td width="30%">...................., 18
    Februari 2014</td>
    </tr>
    <tr align="center">
    <td>Pejabat Penilai</td>
    <td></td>
    <td>Pegawai Negeri Sipil yang dinilai</t
    d>
    </tr>
    <tr align="center">
    <td>&nbsp;<br><br><br><br></td>
    <td></td>
    <td></td>
    </tr>
    <tr align="center">
    <td><u>Ns. ANNA FALUZI, S.Kep</u></td>
    <td></td>
    <td><u>R I S W A R T I</u></td>
    </tr>
    <tr align="center">
    <td>NIP.196909181989032002</td>
    <td></td>
    <td>NIP.196608241992032001</td>
    </tr>
    </table>
    </td>
    </tr>
    <tr>
    <td align="center">
    Atasan Pejabat Penilai, <br><br><br><br><br><u>YULIUS, S
    .Kp</u><br>NIP. 196107071988031001
    </td>
    </tr>
    </table>
    </body>
    </html>

    You might also like