Perbandingan Dispensing Error di Ruang Perawatan dengan Sistem Unit Dose Dispensing (UDD) dan Non Unit Dose Dispensing (Non UDD) di RSM Ahmad Dahlan Kota Kediri

Abstrak Latar belakang: Unit Dose Dispensing (UDD) adalah metode pelayanan farmasi dimana sediaan obat oral dan injeksi pada pasien diberikan dalam bentuk dosis tunggal. Kelebihan dari metode UDD adalah terdapat profil pengecekan obat untuk pasien sehingga insiden medication error tahap dispensing dapat dihindarkan atau dikoreksi terlebih dahulu. Penelitian ini bertujuan untuk mengetahui perbandingan dispensing error di ruangan dengan sistem UDD dan non UDD di RSM Ahmad Dahlan Kediri.Metode: Penelitian ini bersifat observasi analitik studi komparasi dengan desain cross-sectional pada unit rawat inap dengan sistem UDD dan Non UDD di RSM Ahmad Dahlan Kediri selama periode 15-17 November 2018.Hasil: Didapatkan jumlah sampel penelitian sebanyak 336 sampel dengan distribusi 147 (43,2%) sampel dari ruang Non UDD dan 189 (56,8%) sampel dari ruangan UDD. Terjadi dispensing error pada 58 sampel yaitu sebanyak 39 (67%) sampel di ruang Non UDD dan 19 (33%) sampel di ruang UDD. Dispensing error meliputi pemberian etiket yang tidak lengkap sebanyak 40 (69%) kejadian, adanya pemberian obat di luar instruksi sebanyak 15 (24%) kejadian, dan omission atau obat yang kurang sebanyak 4 (7%) kejadian. Pada uji chi-square didapatkan p-value 0,009 (<0,05) yang berarti terdapat perbedaan yang bermakna pada kejadian dispensing error di ruangan dengan sistem UDD dan Non UDD.Kesimpulan: Medication error pada fase dispensing di unit rawat inap dengan sistem UDD lebih rendah dibandingkan dengan unit rawat inap dengan sistem Non UDD.Kata kunci: Dispensing error, Unit Dose Dispensing (UDD), FarmasiAbstractBackground: Unit Dose Dispensing (UDD) is a pharmaceutical service method wherein oral and injection preparations in patients are given in the form of a single dose. The advantage of the UDD method is that there is a profile of drug checking for patients so that the incidence of medication errors in the dispensing phase can be avoided or corrected first. This study was aimed to determine the comparison of dispensing errors in the ward with the UDD and non UDD systems at Ahmad Dahlan Kediri Hospital.Method: This research is analytical observation comparative study with cross-sectional design in the ward with a system of UDD and Non UDD in Ahmad Dahlan Muhammadiyah Hospital Kediri for the period November 15-17th 2018.Result: There were 336 total samples with 147 (43.2%) distribution from Non-UDD ward and 189 (56.8%) from UDD ward. There were 58 dispensing errors namely 39 (67%) samples in the Non-UDD ward and 19 (33%) samples in the UDD ward. Dispensing errors include the administration of incomplete etiquette of 40 (69%) samples, the presence of drugs outside the instructions of 15 (24%) samples, and omission or less of drugs of 4 (7%) samples. In the chi-square test the p-value is 0.009 (<0.05) which means that there were significant differences in dispensing error in the UDD and Non-UDD ward.Conclusion: Dispensing error in the ward with UDD system is lower compared to the ward with Non-UDD system.Key words: Dispensing error, Unit Dose Dispensing (UDD), Pharmacy

Implementasi Manajemen Lean di Unit Farmasi Rumah Sakit Islam Surabaya A. Yani

Dampak era uncertainty ini membuat rumah sakit harus cepat dalam mengambil keputusan dan melakukan efisiensi diberbagai sumber pembiayaan. Saat ini, selisih biaya operasional dengan pendapatan di RSI Surabaya A. Yani hanya 15%-17%, sedangkan kebijakan direksi menginginkan selisih bisa mencapai 30%. Untuk mewujudkan hal tersebut, efisiensi harus dilakukan diberbagai sumber pembiayaan, salah satunya di unit farmasi. Salah satu metode memperbaiki proses efisiensi pelayanan adalah manajemen lean. Tujuan penelitian adalah melakukan implementasi manaje-men lean di unit farmasi RS Islam Surabaya A. Yani. Desain peneltiian adalah studi observasional dengan pendekatan exiperimental melalui 2 tahapan. Tahap pertama dilakukan identifikasi masalah, dan tahap kedua dilakukan implementasi manajemen lean per tahap pelayanan farmasi yakni perencanaan, pengadaan dan pembelian, penyimpanan, penyiapan dan distribusi dan pengembalian. Selanjutnya menyusun hasil monitoring dan evaluasi implement-tasi manajeman lean serta mengukur secara kuantitatif dan kualitatif hasil implementasi manajeman lean per tahap pelayanan. Hasil yang diperoleh adalah implementasi manajemen lean di unit farmasi RS Islam Surabaya A Yani dapat dilakukan mulai tahap perencanaan, pengadaan dan pembelian, penyimpanan, penyiapan serta distribusi dan pengem-balian. Saran yang diberikan adalah implementasi manajemen lean dapat dilakukan secara berkelanjutan dan diterapkan di unit lain serta diikuti dengan pembenahan SIMRS dalam menunjang proses efisiensi pelayanan, melakukan monitoring pelaksanaan perencanaan perbekalan, meningkatkan peran manaje-men dalam penyusunan kontrak, evaluasi kerjasama, evaluasi kepatuhan pelabelan, menghitung cost benefit peresepan elektronik, menerapkan resep elektronik, melakukan komunikasi mendalam dan terus menerus, meningkatkan peran Komite Medis dalam evaluasi dan peningkatan mutu clinical pathway serta memberi motivasi staf dalam implementasi metode distribusi Unit Dose Dispensing

Effectiveness of the automated drug dispensing system: systematic review and meta-analysis

ABSTRACT Objectives: to compare the effectiveness of the decentralized automated drug dispensing system with pockets. Methods: an effectiveness study based on a systematic review guided by the question: for patients admitted to hospital units, is the use of automated drug dispensing effective for reducing medication errors when compared to manual unit dose dispensing? The evidence was evaluated by the Grading of Recommendations Assessment, Development and Evaluation and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses instrument, used in the report. Results: the sample was composed of 15 studies and none of them directly compared both technologies; however, the meta-analysis showed that there is no difference in effectiveness between them [OR 1.03 95%CI (0,12 - 8,99)]. Conclusions: the conclusion is that the recommendation in favor of the automated dispensing system is weak.

Analisis Faktor Yang Mempengaruhi Peran Perawat Dalam Pencegahan Medication Error Diruang Rawat Inap Rumah Sakit Awal Bros Batam

Medication Error is an event that not only can harm the patient but also may endanger the safety of patients conducted by health workers, especially for patient safety. This study aims to examine and analyze the role of factors that contribute to the nurse's role in preventing medication error in hospitals Awal Bros Batam. This research method is quantitative using observational analytic study design to examine the relationship between the two variables studied. This research was conducted on a sample of 73 nurses at the Awal Bros Batam inpatient room consisting of six general rooms and two high-care units. The results of this study indicate that the statistical test showed p-value = 0.042; thus, there is no significant correlation between the perception of the workload with the role of nurses. There is a significant relationship of knowledge to the role of nurses p-value = 0.014, no significant association between the attitudes of nurses with nurse's role p-value = 0.009. The further recommendation to the hospital improves medication safety at the inpatient ward Awal Bros Batam Hospital, to use unit-dose dispensing system (UDD), as well as the use of electronic in the form of barcodes. Keywords: The role of the nurse, the perception of the workload, medication error AbstrakMedication error adalah peristiwa yang tidak hanya dapat membahayakan pasien tetapi juga dapat membahayakan keselamatan pasien yang dilakukan oleh petugas kesehatan, terutama untuk keselamatan pasien. Penelitian ini bertujuan untuk menguji dan menganalisis faktor-faktor yang berkontribusi terhadap peran perawat dalam mencegah Medication error di rumah sakit Awal Bros Batam. Metode penelitian ini adalah kuantitatif dengan menggunakan desain penelitian analitik observasional untuk menguji hubungan antara kedua variabel yang diteliti. Penelitian ini dilakukan pada sampel 73 perawat di ruang rawat inap di Rumah Sakit Awal Bros Batam yang terdiri dari enam kamar umum dan dua unit perawatan tinggi. Hasil penelitian ini menunjukkan bahwa uji statistik menunjukkan p-value = 0,042; dengan demikian, terdapat hubungan yang signifikan antara persepsi beban kerja dengan peran perawat, terdapat hubungan yang signifikan antara pengetahuan dengan peran perawat (p-value = 0,014), dan terdapat yang signifikan antara sikap perawat dengan peran perawat (p-value = 0,009). Rekomendasi lebih lanjut ke rumah sakit meningkatkan keamanan obat di bangsal rawat inap Rumah Sakit Awal Bros Batam, untuk menggunakan unit-dosis dispensing system (UDD), serta penggunaan elektronik dalam bentuk barcode.Kata kunci: : The role of the nurse, the perception of the workload, medication error

Hubungan Sistem Unit Dose Dispensing dengan Kepuasan Pasien di Rumah Sakit Muhammadiah Babat Kabupaten Lamongan

Background: Unit dose dispensing adalah obat yang dioder oleh dokter untuk pasien, terdiri satu atau beberapa jenis obat yang masing-masing dalam jumlah persediaan yang cukup untuk suatu waktu tertentu sehingga kebutuhan pasien terpenuhi dan pasien merasa puas.Objectives: Tujuan dalam penelitian ini adalah Untuk mengetahui hubungan sistem unit dose dispensing dengan kepuasan pasien di RS Muhammadiyah Babat Kabupaten Lamongan Tahun 2018Design: Desain penelitian menggunakan metode Discriptive Correlation dengan pendekatan Cross Sectional. Populasi Seluruh pasien/keluarga rawat inap di Ruang Keperawatan RS Muhammadiyah Babat Lamongan sebanyak 44 dengan teknik Simpel Random Sampling. Instrumen penelitian ini adalah kuesioner observasi dan dianalisa menggunakan uji Spearman’s RhoResults: Hasil penelitian didapatkan kepuasan pasien tentang sistem unit dose dispensing yang dilakukan perawat sebagian besar sangat puas dengan presentase 88.6% (39 responden) dan pelaksanaan sistem unit dose dispensing sebagian besar berjalan dengan baik. Dengan uji Spearman’s Rho didapatkan p=0,000 dimana p < 0,05 artinya ada Hubungan Antara Sistem Unit Dose Dispensing Dengan Kepuasan Pasien Di RS Muhammadiyah Babat LamonganConclusions: Melihat hasil penelitian di atas maka untuk meningkatkan kualitas pelayanan sistem unit dose dispensing terhadap kepuasan pasien pemberian pelayanan seperti : sikap, pelayanan, pengetahuan, ketrampilan, treatment, fasilitas, dan standar prosedural pelayanan diberikan oleh pihak pemberi pelayanan terhadap pasien.

Assessment of an Online Training Tool for the Automated Unit-Dose Dispensing System (ADS) Process

Background Automated unit-dose dispensing system (ADS) of oral solid medication is a complex and sensitive production process in the drug distribution system. Hence, an appropriate training of hospital pharmacy technicians (HPT) is essential. A basic training (observational and practical) of 3 weeks is first organized to evaluate the HPT, followed by an interview with both the pharmacist and the HPT chief. The importance of the human factor (daily routine and repetitive tasks) showed by the risks analysis within this process has led us to search new learning methods to keep the team engaged. An e-learning training was selected in order to further complete the HPT initial training but also as a continuous training to the HPTs who are already working in the ADS process. Process and Methods The e-learning tool was developed using the Google® platform and includes four theoretical training modules (Google® Slides): Module 1 “General organization”, Module 2 “Automatic preparation machine”, Module 3 “Repackaging” and Module 4 “Non-automated drug dispensing”. Each module ends with a self-assessment (Google® Forms). Various teaching materials are included: links to institutional procedures, videos, photos, quizzes, simulations … A minimum of 75 % of correct answers is requested to validate each module. The e-learning, once final, was validated with a new HPT and with five HPTs already in place for more than a year. A satisfaction form is available at the end of the training. Results The 6 HPTs obtained an average of 17.75/20 correct answers. The most successful modules were 1 and 4 (average per module: M1 = 18.5/20; M2=16.8/20; M3=17/20; M4=18.7/20). For module 3, two HPTs scored below 75 % and therefore had to pass this module again. The average time to complete this training was 1.5 hours. HPTs are 100 % satisfied with the training and the teaching materials used. Discussion/Conclusions The e-learning tool fit well with the initial training and the continuous training of the HPTs. Its set up is simple. The duration length spent on the training is shortened for both the pharmacist and the learner. This tool is tailored to the learner needs and constraints. It allows the integration of playful and interactive teaching tool which were appreciated. An audit will be conducted to assess the impact of this training tool on the overall ADS process.

Implementation of Unit Dose Dispensing using Management Information System in Pharmacy Installation of Panti Rapih Hospital

Unit Dose Dispensing (UDD) is a drug distribution system in hospitals, where drugs are packaged in the form of a single dose and submitted to patients for one use during treatment. One of the hospitals that has applied UDD with information system utilization is Panti Rapih Hospital. The purpose of this study is to evaluate the application of UDD using Management Information System (SIM RS) with the Technology Acceptance Model (TAM) method. This research used descriptive quantitative analytic to present facts systematically. This method is also used to understand and conclude the facts more easily. Hypothesis testing was conducted to see the relationship and influence between variables. This test was conducted using Partial Least Square (PLS) analysis. The hypothesis testing applied was two-way probability with a significant level (α) of 5%. When the p-value of less than 0,05, the data is significant. In addition, the relationship between variables is seen from the original sample value. The result shows the relationship of perceived ease of use to perceived usefulness, the relationship of perceived usefulness to attitude toward using, and the relationship of perceived usefulness to behavioral intention to use has a negative and insignificant effect. On the other hand, the relationship of perceived ease of use to the attitude toward using, the relationship of attitude toward using to the behavioral intention to use, and the relationship of behavioral intention to use towards actual system usage conditions have a positive and significant effect on implementation of UDD using the SIM RS in Pharmacy Installation Panti Rapih Hospital.