1. Panduan High Alert

PANDUAN

RSIA RESTU BUNDA

NOMOR :

009/RSIARB/KEPDIR.WAT.001/2017

HALAMAN : 1 dari 15

PENANGANAN OBAT HIGH ALERT

DAFTAR ISI

Hal.

KATA PENGANTAR.......................................................................iii DAFTAR ISI....................................................................................1 1. BAB I DEFINISI DEFINISI………………………………………………… …………………………………………………………… ………… 2 2. BAB II RUANG LINGKUP……………………………………………….. LINGKUP……………………………………………….. 5 3. BAB III TATA LAKSANA…………………………………………………. LAKSANA………………………………………………….  !. D"KU#ENTASI……………………………………………………………. 15

1

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RSIA RESTU BUNDA


HALAMAN : 2 dari 15


BAB I DEFINISI

A. Latar Belakang "$a% &a'(

)*+l,

-ia)a-ai

High

Medications 

Alert

*+,)aa' 4$a% &a'( )+**'%ai'&a %i'((i -ala *'&*$a$a' %*+a-i'&a *ala6a'/*++4+ -a'/*a-ia' *'%i'*l sentinel event  4$a%

&a'(

%a)a

i+i)

'aa

4$a%

+,)a

-a'

,8a)a'

i+i)/N"RU# a%a, Look-Alike Sound-Alike /LASA %*+a, ),la *l*%+4li% 4'*'%+a% %i'((i. a-i 4$a% &a'( )*+l, -ia)a-ai *+,)aa' 4$a% &a'( **+l,a' *a)a-aa' %i'((i %*+-a:%a+ -ala a%*(4+i 4$a% $*+*i4 %i'((i -a)a% *'&*$a$a' 8i-*+a *+i, )a-a )ai*' ia %*+a-i *ala6a' -ala )*'((,'aa'. B. Definisi High alert medications a-ala6 4$a%;4$a%a' &a'( *ilii +*i4 l*$i6

%i'((i

,'%,

*'&*$a$a'/*'i$,la'

a-a'&a

4)liai/*$a6a&aa' )ai*' *8a+a i('i:ia' ia %*+-a)a% *ala6a' )*'((,'aa' -4i i'%*+
high alert

medication = Tabel 1. Contoh Obat-obatan dalam Kategori High Alert Medications.

Kategori A(4'i a-'*+(i I> A'%a(4'i a-+*'*+(i8 I> A(*' a'*%*i ,, i'6alai -a' I> A'%ia+i%ia I>

Jenis Obat E)i'*:+i' :*'il*:+i' '4+*)i'*:+i' i4)+4%*+ P+4)+a'4l4l *%4)+4l4l la$*%al4l P+4)4:4l *%ai' Li-48ai' ai4-a+4'

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A'%i%+4$4%i %*+a,= a. A'%i4a(,la'

$. I'6i$i%4+ :a%4+ ?a 8. Di+*8% %6+4$i' i'6i$i%4+ -. T+4$4li%i *. I'6i$i%4+ (li4)+4%*i' li$

a. Wa+:a+i' L#WH Low Molecular Weight Heparin  unfactionated heparin $. F4'-a)a+i',@ 8. A+(a%+4$a' $i
La+,%a'/4l,i4 a+-i4)l*(i A(*' *4%*+a)i )a+*'%*+al -a' 4+al D*@%+4a 6i)*+%4'i 20 La+,%a' -ial&i )*+i%4'*al -a' 6*4-ialii "$a%;4$a%a' *)i-,+al a%a, i'%+a%*al "$a% 6i)4(li*i 4+al "$a% i'4%+4)i I> Di(4@i' il+i'4'* I',li' SC -a' I>

I',li' +*(,la+ a)a+% (la+(i' $*'%, A:4%*+ii' B li)44al

NPH

"$a%;4$a%a' -*'(a' li)44al A(*' *-ai 4-*+a%*/*-a'( D*@*-*%4i-* #i-a4la I> A(*' *-ai 4-*+a%*/*-a'( C6l4+al 6&-+a%* 4+al ,'%, a'a ")i4i-/'a+4* a. I> $. T+a'-*+al 8. "+al %*+a, 4'*'%+a% 8ai+ :4+,la +a)i- -a' l*)a la$a% A(*' $l4 '*,+4,8,la+ S,i'il4li' +48,+4'i, <*,+4'i, a%+a8,+i, )a',+4'i,. P+*)a+a% ',%+ii )a+*'%*+al A(*' +a-i44'%+a I> A,a $i -*%ila%a i'6alai -a' i+i(ai -ala *aa' 100l

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HALAMAN : 4 dari 15


NaCl ,'%, i'*i 6i)*+%4'i -*'(a' 4'*'%+ai  09 K4'*'%+a% KCl ,'%, i'*i E)4)+4%*'4l I> I'*i #a('*i, S,l:a% #(S"! Di(4@i' I> #*%4%+*a% 4+al )*'((,'aa' '4';4'4l4(i ")i, %i'8%,+* "i%4i' I> I'*i 'a%+i, 'i%+4)+,i-* I'*i ali, :4:a% P+4*%ai' I> Kali, i'%+a<*'a >a4)+*i' I> a%a, i'%+a4*, A'%i4'<,la' B*'4-ia*)i'*

C. Tuuan 1. #*'&*-iaa' )a'-,a' ,'%, +,a6 ai% *'(*'ai *$iaa' a'a**' )*$*+ia' 4$a%;4$a%a' &a'( %*+(4l4'( -ala a%*(4+i high alert medications. 2. #*'i'(a%a' *a)a-aa' aa' high alert medications *6i'((a *'i'(a%a' **laa%a' )ai*'. 3. #*'8*(a6 %*+a-i'&a sentinel event a%a, adverse outcome. 4. #*'8*(a6 %*+a-i'&a *ala6a'/*++4+ -ala )*la&a'a' 4$a% &a'( )*+l, -ia)a-ai *)a-a )ai*'. 5. #*'i'(a%a' ,%, )*la&a'a' +,a6 ai%.

BAB II R!AN" LIN"K!# A. R,a'( Li'(,) L4ai 1. I'%alai Fa+ai 2. U'i% Raa% I'a) 3. U'i% Gaa% Da+,+a% !. U'i% P*+i'a%4l4(i 5. U'i% Kaa+ B*-a6

4

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HALAMAN : 5 dari 15


BAB III TATA LAKSANA U'%, *i'iala' +*i4 %*+a-i'&a *ala6a' -ala *%ia) ,'i% )*la&a'a' -i +,a6 ai% -i)*+l,a' ,a%, *%4-* )*'(*l4laa' 4$a%;4$a% high alert. A. $eto%e untuk &enurunkan kesala'an antara lain( 1. #*'i'(a%a' a* -ala *'-a)a%a' i':4+ai 4$a% &a'(

)*+l, -ia)a-ai &ai%, -*'(a' *$*+ia' Da:%a+ "$a% High Alert )a-a *%ia) +,a'(a'/,'i% )*la&a'a' &a'( -i)*+$4l*6a' *'&i)a' 4$a% %*+*$,%.

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HALAMAN : 6 dari 15


2. #*$a%ai a* 4$a% high alert = a. $ila 4$a% high alert %*+a, -ala 4$a% **+(*'i  aa

4$a% high alert %*+*$,% -i)*+$4l*6a' $*+a-a -i 4%a **+(*'i -i +,a'( +aa% i'a) -a' UGD. $. $*+-aa+a' )*la&a'a' *-i &a'( -i$*+ia'

*)a-a

)ai*' aa ,'i% &a'( -i'ilai *$,%,6a' )*'*)a%a' *l*%+4li% 4'*'%+a% %i'((i -i ,'i% )*la&a'a' 6a'&a $*+a-a -i=I'%alai Fa+ai UGD U'i% Gaa% Da+,+a% >K -a' Kaa+ ")*+ai. 8. *l*%+4li% 4'*'%+a%

%i-a

$4l*6

$*+a-a

-i

+,a'(

)*+aa%a' *8,ali -i +,a'( %*+*$,% -ia%a -*'(a' &a+a% -ii)a' -i %*)a% %*+)ia6 -a' )a-a a+*a &a'( -i$a%ai *%a% retricted  ,la6 %*+$a%a -a' -i$*+i la$*l &a'( *la ,'%, *'(6i'-a+i )*'((,'aa' &a'( %i-a -i*'(aa. 3. P*+**)a' )*'&i)a'a' )*'&ia)a' )*$*+ia' *l*%+4li% 4'*'%+a% -i +,a'( %*+*$,% *,ai -*'(a' *%*'%,a' &a'( $*+la, %*'%a'( a'a**' 4$a% &a'( )*+l, -ia)a-ai Hi(6 Al*+% #*-i8a%i4'. 4. P*'&i)a'a' 4$a% high alert 6a+, -i)ia6a' -*'(a' 4$a% lai' *'((,'aa' la$*l &a'( *la -a' -ii)a' *,ai -*'(a' +i%*+ia )*'&i)a'a' )*+$*ala' :a+ai ,%aa'&a -*'(a'

*)*+6a%ia'

*'i

*-iaa'

4$a%

+a/4%a

)*'&i)a'a' l*a+i )*'-i'(i' -*'(a' *'((,'aa' i%* FIF" First In First ",% -a' FEF" First !pired First "ut  *+%a -i%*)a%a' *,ai *%*'%,a' 4$a% )*I"* ALERT+. 5. #*'((,'aa' i%* )*+i'%aa' )*'&i)a'a' )*'&ia)a' -a' )*$*+ia' &a'( %*+%a'-a+. 6. P*%,(a *la,a' dou#le check. 7. Pa'i%ia Fa+ai -a' T*+a)i *a'%a, 4$a%;4$a% &a'( a, a%*(4+i

4$a%

&a'(

)*+l,

-ia)a-ai

*,ai

:4+,la+i, -a' i':4+ai &a'( %*+i'i. B. #engelolaan obat ,ang &asuk kategori high alert. 1. #*$,a% Da:%a+ "$a% High Alert RSIA R*%, B,'-a 2. K*%*'%,a' )*'&i)a'a' 4$a% high alert.

6

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HALAMAN : 7 dari 15


a. Ai%*' a)4%**+ l4(i%i :a+ai/)*la&a'a' :a+ai &a'(

*'*+ia

4$a%

*(*+a

*ia6a'

4$a%

&a'(

%*+a,

*l4)4 4$a% high alert *,ai Daftar Obat *ig' Alert RSIA Restu Bun%a. b. T,lia' %i*+ *+a6 $*+%,lia' )*I"* ALERT+ )a-a *%ia) *aa' 4$a% high alert. c. B*+ia' *l4%i)/la$*l

*+a6

)a-a

**lili'(

%*)a%

)*'&i)a'a' 4$a% high alert &a'( %*+)ia6 -a+i 4$a% lai'. 3. P*'&i)a'a' "$a% LASA Look-Alike$ Sound-Alike  a. LASA %Look Alike Sound Alike& *+,)aa' *$,a6 )*+i'(a%a' %warning& ,'%, **laa%a' %patient safet'& = 4$a%;4$a%a' &a'( $*'%,/+,)a'&a i+i) -a' )*'(,8a)a''&a/'aa'&a i+i) TIDAK BOLE* -il*%aa' $*+-*a%a'. $. Wala,),' %*+l*%a )a-a *l4)4 a$a- &a'( aa 6a+, -i*li'(i -*'(a' i'ial -,a 4$a% -*'(a' a%*(4+i NON LASA -ia'%a+a a%a, -i%*'(a6'&a. 8. Biaaa' *'(*a 'aa 4$a% -*'(a' a%*(4+i LASA aa% *$*+i/*'*+ia i'%+,i. 4. "$a% high alert -i$*+i la$*l %a'-a )*+i'(a%a' -*'(a' la$*l a+'a

*+a6 )a-a %*)a% )*'&i)a'a' a-a6 *aa' ali -a' 4$a% &a'( %*la6 -i*l,a+a' -a+i *aa' ali *8,ali 4$a% &a'( -i$*+ia' *)a-a )ai*' *8a+a la'(,'( %i-a )*+l, -i$*+ia' la$*l )*+i'(a%a'.

"a&bar -. Label #eringatan Obat High Alert #a%a Se%iaan ial/Ineksi ,ang Tela' Dikeluarkan %ari Ke&asan Asli

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"a&bar 0. Label #eringatan #a%a Larutan Konsentrasi Tinggi

"a&bar 1. Stiker untuk Kolf Infus

5. U'%, 4$a%;4$a% &a'( %*+a, *l4)4 LASA/N"RU#. a. "$a% a%*(4+i look alike sound alike LASA -i$*+ia' )*'a'-a

-*'(a' %i*+ )LASA+ )a-a %*)a% )*'&i)a'a' 4$a%. b. A)a$ila 4$a% -i*a -ala )a*% ,'%, *$,%,6a' )ai*' aa -i$*+ia' %a'-a LASA )a-a *aa' )+i*+ 4$a%.

"a&bar 2. Label )LASA+ C. #erese3an %an Instruksi $e%is P*',lia' +**) ,'%, 4$a% &a'( %*+a, *l4)4 4$a%

&a'( )*+l, -ia)a-ai %High Alert Medication& 6a+, *,ai -*'(a' *%*'%,a' )*',lia' +**) &a'( $a, *+%a $*$*+a)a 6al )*'%i'( $*+i,% = 1. I'%+,i

lia'

6*'-a'&a

-i6i'-a+i

ia

a'(a%

%*+)aa

-i)*+$4l*6a' -ala *a-aa' **+(*'i &a'( -ia%,+ *,ai 2.

-*'(a' )*-4a' 4,'iai *:*%i: -*'(a' %*'i SBAR. I'%+,i 6a+, *'8a,) i'ial = a. 'aa )ai*' -a' '44+ +*a *-i $. %a'((al -a' a%, i'%+,i -i$,a% 8. 'aa 4$a% (*'*+i -4i al,+ )*$*+ia' -a' %a'((al )*$*+ia' *%ia) 4$a% -. *8*)a%a' -a' a%, -,+ai )*$*+ia' 4$a%

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HALAMAN :  dari 15

PENANGANAN OBAT HIGH ALERT 3.

D4%*+

6a+,

*),'&ai

-ia('4i

4'-ii

-a'

i'-iai

4.

)*'((,'aa' *%ia) high alert medications *8a+a %*+%,li P*',lia' 4$a% &a'( %*+a, *l4)4 4$a% LASA/N"RU# 6a+, *'((,'aa' 6,+,: 8a)i%al *,a *+%a *'8a'%,a' -*'(a' *la -4i -a' a%,a' 4$a%. C4'%46 = IR 15 I! *6a+,'&a

5.

-i%,lia' IR 15 International !nit. A)4%**+ a%a, Ai*' A)4%**+ &a'( *'*+ia +**) 6a+, *la,a' 4':i+ai ia %*+-a)a% )*',lia' &a'( %i-a *,ai 'aa 4$a%/*-iaa' a%,a' -ll. C4'%46 = R/ N*,+4$a% %a$l*% 500 N4.?> 1 -- %a$ 1 4*arus elas BEDA 3enulisann,a %engan R/ Neurobat A tablet5

P*',lia' i'%+,i %*+a)i 4l*6 -4%*+ -a' )*+aa% -i +*a )*+aa% -a' -i +*a *-i )ai*' 8a%a%a' %*+i'%*(+ai ,(a *,ai -*'(a' )*',lia' +**) &ai%,=    

Di%,li -*'(a' 6,+,: a)i%al. Sa%,a' %*+%*'%, 6a+, -i%,li l*'(a). D4i -a' +,%* )*$*+ia' 6a+, -i%,li *la. P*$*+ia' *l*%+4li% 4'*'%+a% 6*'-a'&a

*$*+ia'

)*'*laa' ,'%, *'(i'(a%a' )*+aa% %*'%a'( -4i -a' 8a+a )*$*+ia''&a. Satuan obat ,ang 'arus %itulis lengka3( &isaln,a 6 I! *AR!S DIT!LIS International !nit . #en,ia3an Obat High Alert 1. A)4%**+/Ai%*' A)4%**+ *<*+i:iai +**) 4$a% high alert

*,ai P*-4a' P*la&a'a' Fa+ai )*'a'(a'a' 4$a% high alert. 2. Ga+i $aa6i *%ia) 4$a% high alert )a-a l*$a+ +**) -*'(a' %i'%a *+a6. 3. ia A)4%**+ %i-a a-a -i%*)a% aa )*'a'(a'a' 4$a% high alert -a)a% -i-*l*(aia' )a-a Ai%*' A)4%**+ &a'( ,-a6 -i%*'%,a'.

9

PANDUAN

NOMOR :

RSIA RESTU BUNDA


HALAMAN : 1! dari 15


4. Dila,a' )**+iaa' *-,a 4l*6 )*%,(a :a+ai &a'( $*+$*-a

*$*l, 4$a% -i*+a6a' *)a-a )*+aa%. 5. P*%,(a :a+ai )*+%aa -a' *-,a *$,$,6a' %a'-a %a'(a' -a' 'aa *la -i$a(ia' $*laa'( +**) *$a(ai $,%i %*la6 -ila,a' dou#le check . 6. "$a% -i*+a6a' *)a-a

)*+aa%/)ai*'

-i*+%ai

-*'(a'

i':4+ai &a'( *a-ai -a' *'a'-a%a'(a'i l*$a+ *)*-ii +**) 4$a% +aa% i'a). !. #e&berian Obat High Alert 1. P*'&ia)a' "$a% High Alert -i R,a'( P*+aa%a' P*'&ia)a' -a' )*$*+ia' 4$a% *)a-a )ai*'

-ia)a-ai

%*+a,

*l*%+4li%

4'*'%+ai

&a'( )*+l,

%i'((i

6a+,

*)*+6a%ia' ai-a6 $*+i,% = a. S*%ia) )*$*+ia' 4$a% *'*+a)a' PRINSIP 7 BENAR. $. P*$*+ia' *l*%+4li% )*a% -*'(a' )*'(*'8*+a'

-a'

)*'((,'aa' la$*l 6,,. 8. Pa%ia' )*'(*'8*+a' -a' )*'8a),+a' 4$a% -ila,a' 4l*6 4+a'( $*+4)*%*'. -. Pia6a' a%a, $*+i a+a )*'&i)a'a' 4$a% -*'(a' a%*(4+i LASA. *. Ti-a *'&i)a' 4$a% a%*(4+i *a)a-aa' %i'((i -i*a -*a% )ai*' %a')a )*'(aaa'. :. Biaaa' *'(*a 'aa 4$a%

-*'(a'

a%*(4+i

4$a%

LASA/N"RU# aa% *$*+i/*'*+ia i'%+,i. 2. Ca+a P*'(*'8*+a' "$a% High Alert -i R,a'( P*+aa%a' a. KCl 7! i'*i 4'*'%+ai *-iaa' &a'( a-a a-ala6 1 E 

1

l

6a+,

-i*'8*+a'

*$*l,

-i(,'aa'

-*'(a'

)*+$a'-i'(a' 1 l KCl = 10 l )*la+,% WFI/NaCl 09. K4'*'%+ai -ala la+,%a' ai, a-ala6 10 E/100 l. P*$*+ia' KCl *lal,i )*+i:*+ -i$*+ia' *8a+a )*+la6a';la6a' -*'(a' *8*)%a%a' i':, 10 E/a a%a, 10 E KCl -ala 100 l )*la+,%/a. P*$*+iaa' 4$a% KCl *lal,i 8*'%+al li'* <*'a *'%+al 4'*'%+ai ai, a-ala6 20 E/100 l *8*)a%a'

i':,

ai,

)*la+,%/a.

10

20

E

-ala

100

l

PANDUAN

RSIA RESTU BUNDA

NOMOR :


HALAMAN : 11 dari 15


$. NaCl 3 i'*i i'%+a<*'a -i$*+ia' *lal,i <*'a *'%+al -*'(a' *8*)a%a' i':, %i-a l*$i6 -a+i 100 l/a. 8. Na%+i, Bi8a+$4'a% #*&l4'
6a+,

-i*'8*+a' *$*l, -i(,'aa'. U'%, )*'((,'aa' $4l, -i*'8*+a' -*'(a' )*+$a'-i'(a' 1 l Na $i8a+$4'a% = 1 l )*la+,%

WFI

,'%,

)*$*+ia'

$4l,

-*'(a' *8*)a%a'

ai, 10 E/*'i%. U'%, )*'((,'aa' i':, -+i) -i*'8*+a' -*'(a' )*+$a'-i'(a' 05 l Na Bi8+$4'a% = 1 l D*@%+4* 5 )*$*+ia' -+i) i':, -ila,a' -*'(a' *8*)a%a' ai, 1 E/(BB/a. 3. C* 7 T,,6 B*'a+ "$a% Pai*' S*%ia) )*'&*+a6a' 4$a% *)a-a )ai*' -ila,a' <*+i:iai 7 %,,6 $*'a+ ,'%, *'8a)ai medication safet' ( a. B*'a+ )ai*'. $. B*'a+ 4$a%. 8. B*'a+ 8a+a. -. B*'a+ -4i. *. B*'a+ a%,. :. B*'a+ -4,*'%ai. (. B*'a+ i':4+ai. !. P*$*+ia' "$a% High Alert -i R,a'( P*+aa%a' a. S*$*l, )*+aa% *$*+ia' 4$a% high alert )a-a )ai*' aa

)*+aa%

lai'

6a+,

*la,a'

)**+iaa'

*$ali%dou#le check& *8a+a i'-*)*-*' = K**,aia' a'%a+a 4$a% -*'(a' +*a *-i/i'%+,i 

-4%*+. K*%*)a%a' )*+6i%,'(a' -4i 4$a%. I-*'%i%a )ai*'. $. "$a% high alert i':, 6a+, -i)a%ia' = K*%*)a%a' *8*)a%a' )4)a i':, %infuse pump& ia 4$a% l*$i6 -a+i a%, %*)*la' la$*l 'aa 4$a% )a-a  

 

s'ringe pump -a' -i*%ia) ,','( al,+ *la'(. 8. "$a% high alert *l*%+4li% 4'*'%+ai %i'((i 6a+, -i$*+ia' *,ai )*+6i%,'(a' %a'-a+ &a'( %*la6 $a, &a'( $*+la, -i*,a +,a'( )*+aa%a'. -. S*%ia) ali )ai*' )i'-a6 +,a'( +aa% )*+aa% )*'(a'%a+ *'*laa' *)a-a )*+aa% )*'*+ia )ai*' $a6a )ai*'

11

PANDUAN

RSIA RESTU BUNDA

NOMOR :




*'-a)a%a' 4$a% high alert$ -a' *'&*+a6a' :4+,li+ )*'8a%a%a' 4$a%. *. Dala *a-aa' **+(*'i &a'( -a)a% *'&*$a$a' )*la$*la' -a' %i'-aa' )*'8*(a6a' %*+a-i'&a *ala6a' 4$a% high alert -a)a%

*'(ai$a%a'

%*+%,'-a'&a

)*$*+ia'

%*+a)i -a'

*$*+ia' -a)a &a'( $,+, )a-a )ai*' aa -4%*+ -a' )*+aa% 6a+, *a%ia' %*+l*$i6 -a6,l, *a-aa' li'i )ai*' &a'( *$,%,6a' %*+a)i *(*+a 8i%4 *6i'((a dou#le check

-a)a%

%i-a

-ila,a'

'a,'

*aa%

*$*l,

*$*+ia' 4$a% )*+aa% 6a+, *'&*$,%a' *8a+a la'%a'( *,a *'i 4$a% &a'( -i$*+ia' *)a-a )ai*' *6i'((a -i*%a6,i -a' -i-4,*'%aia' -*'(a' $ai 4l*6 )*+aa% lai''&. *AL7*AL 8AN" #ERL! DI#ER*ATIKAN 1. S*%ia) -*)4 :a+ai +,a'( +aa% )4li li'i 6a+, *ilii

Da:%a+ "$a% High Alert RSIA R*%, B,'-a 2. S*%ia) %*'a(a **6a%a' 6a+, *'(*%a6,i )*'a'(a'a' 6,, ,'%, 4$a% high alert. 3. "$a% high alert -ii)a' -i%*)a% %*+)ia6 a* %*+$a%a -i$*+i la$*l )*I"* ALERT DO!BLE C*ECK+. 4. P*'(*8*a' -*'(a' -,a 4+a'( )*%,(a &a'( $*+$*-a ,'%, *'ai' *$*'a+a' 4$a% high alert &a'( -i(,'aa'. 5. Ti-a *'&i)a' 4$a% high alert -i *a -*a% )ai*' %a')a )*'(aaa'

12

PANDUAN

NOMOR :

RSIA RESTU BUNDA




BAB I DOK!$ENTASI

1. Da:%a+ 'aa "$a% Hi(6 Al*+% 2. Da:%a+ 'aa "$a% Laa

13

1. Panduan High Alert

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