Table 1.
Description of nursing activities in providing nursing care in Dr. Kariadi Hospital of Semarang (n = 240)
| Category | Frequency (%) |
|---|---|
| A Patient Identification | |
| Name | 240 (100%) |
| Medical record number | 240 (100%) |
| Age | 240 (100%) |
| Weight | 232 (96.7%) |
| Height | 232 (96.7%) |
| B Initial Assessment | |
| General appearance | 240 (100%) |
| Consciousness level | 239 (99.6%) |
| Vital signs | 238 (99.2%) |
| History of allergy | 240 (100%) |
| Nutritional screening | 240 (100%) |
| Pain | 238 (99.2%) |
| C Functional Status | |
| Barthel index | 238 (99.2%) |
| Risk of fall | 239 (99.6%) |
| Risk of pressure ulcer | 50 (20.8%) |
| Educational need | 231 (96.3%) |
| Cultural need | 211 (87.9%) |
| D Focused Assessment | |
| Biology | 1 (0.4%) |
| Psychology | 240 (100%) |
| Spiritual | 235 (97.9%) |
| Cultural | 212 (88.3%) |
| E Nursing Diagnosis | 50 (20.8%) |
| F Discharge Planning | |
| Identification during hospitalization | 239 (99.6%) |
| Identification of requirements at home | 99 (41.3%) |
| Quality of life | 159 (66.3%) |
| G Education | 237 (98.8%) |
| H Intervention | |
| Vital signs intervention | 213 (88.8%) |
| Other interventions | 238 (99.2%) |
| Collaboration: Drug administration | 146 (60.8%) |
| I Monitoring and Evaluation | |
| Monitoring vital signs | 56 (23.3%) |
| Monitoring activity of daily living | 91 (37.9%) |
| Other monitoring | 239 (99.6%) |
| J Mobilization/Rehabilitation | 90 (37.5%) |
| K Outcome | 112 (46.7%) |
| L Discharge Planning/Education | |
| Nursing resumé | 2 (0.8%) |
| Initial of nurse in charge | 239 (99.6%) |