GUIDELINE OF CLINICAL PRACTICE

NAME : ____________________ N I M __________________

ORTHOTIC PROSTHETIC STUDY PROGRAM SUB FACULTY PHYSIOTHERAPY

POLITEKNIK KESEHATAN SURAKARTA HEALTH DEPARTMENT OF RI

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SECTION I

2

TABLE OF CONTENT TITLE............................................................................................................ i VIII FINISHING ......................................................................................... 25 MOTTO ........................................................................................................ ii

PREFACE...................................................................................................... i i i

IX IMPLEMENTATION, EVALUATION AND DOCUMENTATION............. 25

X OP SERVICE ON CERTAIN CASES.....................................................25

XI REMARKS ........................................................................................ 27 GENERAL INSTRUCTION............................................................................... iv

RULES AND REGULATIONS ........................................................................ v

TABLE OF CONTENT ...................................................................................vi

SECTION ONE ............................................................................................. 1-20

SECTION TWO ............................................................................................. 21-27

I DATA ANALYSIS / OP DATA GATHERING......................................... 21

A. ANAMNESIS ................................................................................. 21

B. SENSORY EXAMINATION .............................................................. 21

C. MOTOR EXAMINATION .................................................................. 21

D. FUNCTIONAL ABILITY EXAMINATION ........................................ 21

E. COGNITIVE, INTRA & INTER PERSONAL EXAMINATION 21

F. SPECIFIC EXAMINATION .............................................................. 22

G. SECONDARY DATA

23 II PROBLEM ANALYSIS / ASSESSMENT ON PATIENT’S NEED OF OP

SERVICE

23

III MEASUREMENT PROCESS...................................................................... 23-24

IV OP DIAGNOSIS....................................................................................... 25

V OP PLAN & EVALUATION PLAN .............................................................. 25 VI OP FABRICATION PROCESS .................................................................. 25

vii VII FITTING PROCESS ............................................................................... 25

PREFACE

MOTTO: Clinical Practice is a good way to apply knowledge, attitude and skills

acquired from the learning process. Motivated by the hope of being the best Diploma III Ortohtic Prosthetic

graduates, this book is written, as well as to complete documentation in Clinical Practice of Orthotic Prosthetic Study Program students, Sub Faculty Physiotherapy Politeknik Kesehatan Surakarta. This book is expected to be a way of:

1. Supervising students’ activity in clinical practicing in a hospital or a

workshop / OP Laboratory.

2. Evaluating students’ achievement during the clinical practice in a hospital or Workshop / OP Laboratory.

3. Collecting data about illnesses/deformities/diseases taken care by the OP in a

respected hospital / other health services.

To accomplish the objectives, it is hoped that there’s a cooperation between students, students and instructors as well as students and Director/the Head of where the practice lays.

Surakarta, 5th October 2005 Behalf of Director of Politeknik Kesehatan Surakarta Head of Sub Faculty Physiotherapy Iq. Sujatno, SMPh, SPd. NIP. 140 125 297

TO STUDY THE PHENOMENON OF DISEASE WITHOUT BOOKS IS TO SAIL AN UNCHARTED SEA, WHILE TO STUDY BOOKS WITHOUT PATIENTS IS NOT TO GO TO SEA AT ALL. (Sir William Osler)

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CHAPTER VI CLOSING

6. Students who are absent for any other notice, a letter must be given and must be approved by the respected advisor and he/she has to replace all absent days.

7. Students who are absent in order to take a retest or another activity in the campus, a letter must be given and must be approved by the Academic and he/she has to replace all absent days.

8. a. Students who don’t participate in the seminar held by Orthotic Prosthetic Study Program – Sub Faculty Physiotherapy on the beginning of the month every once in 2 (two) months, for 2 titles or less in 2 (two) months, are compulsory to make a paper.

b. Students who don’t participate in the seminar held by Orthotic Prosthetic Study Program – Sub Faculty Physiotherapy on the beginning of the month every once in 2 (two) months, for more than 2 titles in 2 (two) months, are compulsorty to make 2 (two) papers.

c. Students who don’t follow the seminar on time, and came to the seminar when the presentation is over (± 20 minutes), are considered absent on the respected seminar and are compulsory to make 1 (one) paper.

d. Students who don’t carry out his/her job as stated on number a, b and c, are compulsory to repeat the whole period of practice.

9. Students who don’t submit a clinical status report during the relevant month, are compulsory to repeat the practice and make a report of the same location.

Particular matters which have not been stated in this book will be

arranged in the future.

Surakarta, 5th October 2005 Acknowledged by: Head of Sub Faculty Physiotherapy, Head of OP Study Program (Ad interim) lg. Suiatno, SMPh, SPd. Drs. Alfan Zubaidi, AMFNIP 140 057 848. N I P 140 228 979

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GENERAL INSTRUCTION

4. Column sign is filled by the Advisor/Instructor where the practice takes place.

b. Section II ( Two) 1. Every material in the practice is reported 6 (six) times. For every

practice location is reported 2 (two) times maximum. 2. Practice date is filled according to the date when the activity is carried

out. 3. Practice location is filled using these codes:

A. Unit OP RS.Ortopedi Prof. Dr. R. Soeharso Surakarta. B. BBRSBD Prof. Dr. R. Soeharso Surakarta. C. RSUP dr. Kariadi Semarang D. RSUD dr. Sutomo Surabaya. E. RSPAD Gatot Subroto Jakarta. F. Pusat Rehabilitasi YAKKUM Yogyakarta. G. PRSBD (Panti Rehabilitasi Sosial Bina Daksa) Suryatama Bangil

Pasuruhan. H. RSAL Dr. Ramelan Surabaya.

1. Since the beginning of clinical practice in a hospital or a certain place, every student is to possess a clinical practice guideline book. Students can get the book from the Administration unit.

2. Clinical Practice Guideline Book is divided into 2 (two) sections. Section I (one), contains the record of students’ activities during the OP practice. Whilst section II (two), functions as a sort of catalog for reviewing students’ activities.

3. How to fill the form: a. Section I (one)

1. Column No. is filled in according to the sequence of activities. 2. Patient’s identity includes: Name, Age and Sex. 3. Medical diagnosis taken is the last or the prominent diagnosis (enclose the

date according to the clinical status of the patient) 4. Data analysis contains the examination done to the patient as well as the

result. 5. OP diagnosis is in accordance to the establishment of the diagnosis, i.e:

Cock up splint on drop-hand patient for paralysis and radials, Above Knee Prothese on above knee amputee patient, Correction shoes on club-footed patient.

6. Plan on OP service is filled in according to the objective and determination of materials and tools to produce Orthosis/Prosthesis/ABM programmed according to the goal.

7. Implementation of OP service is filled according to the process of casting-fabrication-fitting through finishing completed with education.

8. Evaluation contains the evaluation of OP process in general. 9. Column Advisor is signed by the Advisor.

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• Female : Wear white shirt and dark green pantaloon in shape according to the rules of Pusdiknakes Health Dept. of RI.

• For those who wear jilbab: - White-long-sleeved shirt and dark green pantaloon. - White jilbab/head scarf with no veil covering student’s face.

• Wear Lab coat whenever needed. • For some certain places, students are compulsory to wear outfit in

accordance to the local regulation. 10. Keep self-tidiness:

• Hair neatly combed, no fringe, front part not blocking student’s sights, hair neatly trimmed and stay above collar (for male) or not possibly bother students from practicing (for female).

• Nails are cut short, neat and clean. • Always take good care of his/her orderliness and health.

11. Self appearance: • Not put on too much make up and or excessive jewelries. • Not wear high heel shoes which causes uncomforting sounds. • Always look clean.

12. Self safety: • Wear black safety shoes (shoes must cover all parts of feet

including toes) with socks in suitable color. • Wear goggles whenever needed. • Wear a mask whenever needed.

CHAPTER III ATTITUDE

A student of Poltekkes Surakarta – Sub Faculty Physiotherapy –

Orthotic Prosthetic Study Program, who is under clinical practice in a hospital / another practice site should:

1. Carry out his/her duty in accordance with Advisor’s instructions. 2. Respect his/her advisor, every employee in the hospital or institution where

the practice takes place, as well as to other students. 3. Have sincere compassion to patients as human beings. 4. Do his/her duty without taking advantage for him/herself or any certain

groups and not accept any compensate in any forms from any patients or their families.

5. Avoid excessive self-praise and defiling others. 6. Not involve in indecency and defiling health corps and or the institution

where the student comes from. 7. Be polite, decent, and always make a good name of the institution. 8. Be honest and sportive, including in using tools and materials. 9. Dress up according to the rules :

• Always put on an ID as a proof of a student of Poltekkes Surakarta – Sub Faculty Physiotherapy – Orthotic Prosthetic Study Program, which consists of : - name / Identity card - badge of Poltekkes Surakarta Sub Faculty Physiotherapy.

• Male : Wear white shirt and dark green pantaloon in shape according to the rules of Pusdiknakes Health Dept. of RI.

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No. Patient Identity

Medical Diagnosis

Patient Examination

Orthotic Prosthetic Diagnosis

Orthotic Prosthetic Plan

Orthotic Prosthetic Implementation

Evaluation Advisor’s Signature

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RULES AND REGULATION OF CLINICAL PRACTICE STUDENT OF ORTHOTIC PROSTHETIC

CHAPTER II KNOWLEDGE

JURUSAN FISIOTERAPI POLTEKKES SURAKARTA

Students of Poltekkes Surakarta – Sub Faculty Physiotherapy -

Orthotic Prosthetic Study Program who is taking clinical practice a hospital/practice area :

BACKGROUND

The succes of an O/P to do his/her duties can’t be apart from the educational process he/she went through in Politeknik Kesehatan (Poltekkes) Surakarta – Sub Faculty Physiotherapy - Orthotic Prosthetic Study Program, including the experience of practice learning as a part of it.

Through practice in the hospital as well as in the practice field, a student are able to apply his/her knowledge and skills into a real situation in a form of giving physiotherapy service in a hospital/practice field by getting guidance and instruction from an instructor/practice advisor.

1. Are to carry out their duty according to the reliable information,

and always self prepared with reference books. 2. Are to study on Orthotic Prosthetic implementation on a condition

through an orthotic prosthetic examination; identify the objective,either long term and short term goal; decide which technique isbest, followed by orthotic prosthetic action; then re-evaluate to formulate the next program and document the whole process.

3. Are to respect other’s opinion and be open minded to anydeveloping science and knowledge.

To support the implementation and upholding students’ discipline in the practice, it is required to compose a rule and regulation for student’s clinical practice.

4. Discuss with other students in group, consult to the instructor. 5. Are able and compulsory to present a case.

CHAPTER I GENERAL

In general, Students of Poltekkes Surakarta – Sub Faculty Physiotherapy - Orthotic Prosthetic who are in clinical practice: 1. Think, act, and behave academically as well as uphold the name of

Poltekkes alma mater. 2. Obey all the rules in the hospital or whatever institution where the

practice takes place. 3. Have self motivation to develop health programs based on the

knowledge obtained, through maximum skill, with merit and excellent behavior.

4. Are not allowed to give untrue information or irresponsible opinion outside of their knowledge.

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CHAPTER IV DUTY AND OBLIGATION

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Students of Poltekkes Surakarta Sub Faculty Physiotherapy - Orthotic

Prosthetic Study Program, who are under clinical practice in a hospital or a certain institution, have the duty and obligation to : 1. Make clinical status report in every period of practice, which has to be

consulted and approved by the advisor/instructor. The minimum number of clinical status report of every location of practice is arranged as follows: a) OP RS Ortopedi Prof. Dr. Soeharso Surakarta Unit : 1 report. b) BBRSBD Prof. Dr. Soeharso Surakarta : 1 report. c) Pusat Rehabilitasi Yakkum Yogyakarta : 1 report. d) OP RS dr.. Karyadi Semarang Unit: 1 report. e) OP RS dr. Soetomo Surabaya Unit: 1 report. f) OP RSPAD Gatot Subroto Jakarta Unit : 1 report.

2. Make group activities report in every site of practice, which is a report about the OP service management as well as general health service of the respected location, on condition that student is still in clinical practice.

3. To follow a seminar / case discussion in Sub Faculty Physiotherapy – Orthotic Prosthetic Study Program at the beginning of the month, once every 2 (two) months.

4. Have a seminar about group work, and also done in groups, according to the schedule of Academic Administration Division.

5. Fill in the clinical practice Guideline Book and ask for approval from the advisor every day or depends on the agreement between student-advisor, for every action done by the students.

6. Be able to withstand his/her clinical practice report and Guideline book in front of his/her advisor during the verbal test.

7. Participate in regular classes or extra class, either in a form of case presentation as well as discussions which related to the practice, either held by Orthotic Prosthetic Study Program – Sub Faculty Physiotherapy or the institution where the practice takes place.

8. Be active in discussions and consultation with the advisor.

CHAPTER V SANCTION

Sanction will be given to a student of Poltekkes Surakarta Sub

Faculty Physiotherapy - Orthotic Prosthetic Study Program, under these circumstances:

1. Students who are indiscipline or committed major violation of the rules, and have to be spelled out of the clinical practice, are those:

a. Students who are proven of committing a crime related to the practice.

b. Students who are officially proven of committing indecency related to the practice.

c. Students who are absent minimum in 5 consecutive days or minimal 10 days in alternate during 1 month period.

2. Students who are absent in 4 consecutive days or 7 alternate days, have to repeat clinical practice in total 1 (one) period of time in the same place and given a strong warning and so have to write a statement to the Director through Academic Administration Division. Note: Examination will be held when students repeat the practice.

3. Students who are absent in 3 consecutive days or 6 alternate days, have to replace half of days of the respected period. Note: Examination will be held when students repeat the practice.

4. Students who are 1 day or 2 alternate day absent, have to replace the 2 (two) times of number of absent days.

5. Students who are ill and has doctor’s recommendation, have to replace all absent days.

DEPARTMENT OF HEALTH OF RI NAME : HEALTH POLYTECHNIC SURAKARTA REG NO : PHYSIOTHERAPY FACULTY PLACE : STUDY PROGRAM ORTHOTIC AND PROSTHETIC

THE INSTRUMENT SCORE OF STUDENTS ATTITUDE AND BEHAVIOR

DURING CLINICAL INTERSHIP In scoring to the attitude and behaviors of the clinical internship students, the

scoring method is done based on the examiner’s impressions wholly to each item with

the criteria as follows:

1 = Never

2 = rare

3 = sometime

4 = often

5 = always

QUESTIONS SCORE

1

2 3 4 5

1. He/she always pleased and do heartily if given task 0 0 0 0 0

2. He/she always behave politely in giving services 0 0 0 0 0

3. Friendly in facing clients 0 0 0 0 0

4. During the practice behaves proactive 0 0 0 0 0

5. Come and go based on the determined time of internal enrollment 0 0 0 0 0

6. Is the students respect the tutor or other seniors 0 0 0 0 0

7. He/she always ask clients based on clinical status before or after giving services/ OP process

0 0 0 0 0

8. He/she will report the result on time if given task 0 0 0 0 0

9. Able to communicate well to the other health staffs 0 0 0 0 0

10. In giving services to the clients, not discriminate sex, status, position, religion, etc

0 0 0 0 0

,

Tutor

( )

The Instrument Score of Student Clinical Internship Study Program Orthotic Prosthetic

Physiotherapy Faculty Health Polytechnic Surakarta I. ASSESMENT/DIAGNOSIS (weight 20%) Score score I

1. 2. 3. 4. 5. 6.

Anamnesis ……………………………………………………………… Physical assessment and relevant measurement …...…………….. Functional asessment …………………………………………………. Assessment to other resource data………………………………….. Accessible ………….…………………………………………………… Determined of OP diagnoses …………………………………………

………………………………………………

Total Score = ………

Total Score Total Item X Weight (20%) = …………

II PROGRAM PLANNING & EVALUATION (weight 15%) Score Score II 1. 2. 3.

Determined of the priority clients need. …………………………….. Determined devices and material needed …………………………. Determined of time manufacture and fitting process………. ……..

………………………

Total Score = ………

Total Score Total Item X weight (15%) = …………

III MANUFACTURE PROSESS OF ORTHOSE & PROSTHESE (weight 60%)

Score Score III

1. 2. 3. 4. 5.

Measuring and making plaster (casting)……..………………….….. Manufacture (production)…………………………………….….. Fitting : Student should respond towards the device i.e. comfortable Finishing : Student observe and evaluate the result of device ………..…….. Student doing instruction or advise (Home program: how to taking care the device and procedure to use the divice) …………………

………... ………...

………... ………... ………...

Total Score = ………...

Total Score Total Item X Weight (60%) = ………

IV NOTICE (weight 5%) Score Score IV

Name : Reg.no : Place :

1. 2.

System ……………………………………………………………

Fit and correct data ...........……………………………………..

………... ………...

Total Score = ………...

Total Score Total Item X Weight (5%) = ………

Total score I + II + III + IV =

……….

Note : Borderline of passing the exam = 2,75 (= 68)

…………………. , ………………200... Tutor

( ………………………………………..)

Results for the 2003 intake internship are shown below Name BBRSBD RSOS RSP Kariadi

Soetomo YAKKUM Result

Achmad 81.00% 68.00 77.00 75.33/3.25 Adhi 81.30 68.00 82.78 77.35/3.42 Adi 70.48 71.49 70.99/3.00 Agus 74.62 61.40 73.01/3.16 Agus Tri 75.47 71.83 73.50/3.24 Aris 72.00 63.00 67.50/2.75 Daliman 74.25 69.71 71.98/3.08 Danny 81.50 68.00 81.05 76.85/3.42 Dariono 83.00 68.10 78.75 76.62/3.42 Didit 81.00 70.00 83.22 78.07/3.50 Ekky 82.00 73.39 84.45 79.95/3.59 Endra 73.00 62.00 67.50/2.75 Eny 76.29 71.20 73.75/3.24 Giyanto 75.26 62.78 69.02/2.97 Hari 75.00 71.90 73.45/3.16 Hariyadi 80.00 68.75 81.17 76.64/3.42 Hendi 74.65 69.75 72.20/3.08 Komang 69.83 70.00 69.92/2.99 Kuncoro 83.00 68.95 83.00 78.32/3.50 Margono 81.50 68.40 81.17 77.02/3.42 M. Yusuf 69.30 66.22 67.76/2.75 M.Iswanto 75.00 70.45 72.73/3.16 Muizzah 75.00 70.35 72.68/3.16 Muslimin 82.00 71.66 81.33 78.33/3.50 Ni’amah 83.10 68.00 81.63 77.58/3.50 Noventri 75.00 77.95 76.48/3.34 Nuri 82.80 68.00 85.13 78.64/3.51 Putut 81.30 68.10 77.20 75.53/3.34 Rohmad 82.00 69.47 79.41 76.96/3.42 Sri Lestari 81.50 68.60 80.28 76.79/3.42 Sugeng 83.00 71.78 85.22 80.00/3.59 Suparjo 81.30 68.10 77.33 75.58/3.34 Teguh 70.01 71.70 70.86/3.00 Triwanto 83.00 70.75 84.29 79.35/3.51 Umi 70.11 56.80 63.48/2.49 Vivid 71.00 67.16 69.08/2.87 Yulius 75.00 66.95 70.98/3.00 Yusuf H. 81.00 73.20 86.01 80.07/3.59