MAKALAH+MEDICATION+ERROR+2A

MAKALAH PELAYANAN PELAYANAN KEFARMASIAN

MEDICATION ERROR 

Oleh : Kelompok 2A Aditta Meisafitri 1006753526

Ki(i Ri.(i L!

1006753-16

Anin Anindy dya aat atii P! P!

1006 100675 7535 3551 51

Maria /!!

1006753-+1

Ay" Ay" Fi#ani

10067535$6

M! Re..a !

1006753--6

%ede S"&iat

1006753620

 N"rina P!100675 P!1006753$23 3$23

%'itya A!

1006753665

Prieya

1006753$55

E() Setiy) Hadi 10067536$0

Renny ,!4!

1006753$$3

Fris Fris(a (a Sia* Sia*aan aan

1006 100675 7537 373+ 3+

R"s#a R"s#ait itaa P!S! 1006 100675 75+0 +02+ 2+

,enni Sarti(a

10067537-5

PROGRAM PROFESI APOTEKER  DEPARTEMEN FARMASI FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM UNIVERSITAS INDONESIA DEPOK  2010

MEDICATION ERROR 

I

De!"#"$"

Pen&&"naan )at yan& se#a(in esat tea* #enin&(at(an a*aya (esaa*an )at yan& #"n&(in teradi! A)te(er #e#"nyai eranan yan& san&at entin& daa# #ene&a* teradinya medication error ata" (esaa*an )at! A)te(er *ar"s daat e(erasa#a den&an d)(ter era'at dan i#inan r"#a* sa(it daa# #e#eri(sa dan #enye#"rna(an siste# "nt"( #e#asti(an a*'a r)ses en&)atan eran&s"n& den&an a#an! %itina" dari asa (atanya error  adaa*  adaa* (esaa*an ada erenanaan "nt"( #enaai t""an 8error  8error   ada erenanaan9 ata" (e&a&aan dari ses"at" yan& tea* direnana(an "nt"( "nt"( disee diseesai( sai(an an ses"ai ses"ai den&an den&an t""an t""an 8 error  ada ada ea(s ea(sana anaan9 an9!! S"at" error   daat teradi (arena *asi dari (eerayaan ata" en&aaian 8The 8The Institute of Medicine Medicine 200+9!  Medication error   adaa* error  yan&   yan& teradi ada saat r)ses en&&"naan )at! Misanya seerti (esaa*an e#erian d)sis ada rese (esaa*an ada saat e#erian )at )e* )ran )ran& & yan& yan& er' er'en enan an& & #e# #e#eri eri(a (an n )at )at ata" ata" (esa (esaa* a*an an asie asien n sendi sendiri ri ada ada saat saat  en&)atan  Medication error adaa* adaa* s"at" s"at" (esaa* (esaa*an an daa# daa# r)ses r)ses en&) en&)ata atan n yan& yan& #asi* #asi*  erada daa# en&a'asan dan tan&&"n& a'a r)fesi (ese*atan asien ata" ()ns"#en dan dan se*a se*ar" r"sny snyaa daa daatt die& die&a* a* 8/)* 8/)*en en 1$$1 1$$1 asse asse : Myers Myers 1$$1$$-9! 9! %aa# %aa# S"rat S"rat Ke"t"san Menteri Kese*atan RI N)#)r 1027;MENKES;SK;I<;200+ dise"t(an a*'a  en&ertian medica medicatio tion n error error adaa* adaa* (eadia (eadian n yan& yan& #er"&i #er"&i(an (an  asien a(iat e#a(aian )at sea#a daa# enan&anan tena&a (ese*atan yan& seet"nya daat die&a*!

2

II

L%&%' (el%k%#)

Sasaran terai )at adaa* enaaian *asi yan& tea* diteta(an "nt"(  #enin&(at(an #"t" (e*id"an dan #e#ini#a(an resi() asien! %aa# terai )at ada resi()=resi() yan& tea* ata" daat di(eta*"i #a""n yan& tida( er(aitan den&an  en&&"naan terai )at 8)at rese dan n)nrese9 dan aat e#erian )at! Resi() yan& tida( er(aitan terse"t dise"t (eea(aan )at!  Medication error   *ar"s daat die&a* #ea"i en&endaian siste# yan& efe(tif #eiat(an a)te(er d)(ter era'at ers)ne #anae#en resi() enase*at *"("# i#inan r"#a* sa(it serta asien!  Medication error   #er"sa( (eerayaan asien daa# siste# eayanan (ese*atan dan #enin&(at(an iaya eayanan (ese*atan! anya( medication error   #"n&(in tida(  terdete(si! A(iat (ini( dari sea&ian medication error   #"n&(in #ini#a den&an sedi(it ata" tida( ada a(iat yan& #er"&i(an asien! Na#"n ada "&a yan& #enyea(an (esa(itan asien yan& seri"s dan (e#atian! ,adi medication error   tida( )e* diandan& enten& dan er" diita(an s"at" siste# yan& daat #ene&a* teradinya (esaa*an )at! Misi a)te(er adaa* "nt"( #e#ant" #e#asti(an a*'a asien #endaat en&&"naan )at yan& terai(!

III K%&e)o'" Medication Error 

Men"r"t  National Coordinating Council for Medication error Reporting and   Prevention 8N// MERP9 (ate&)ri medication error  adaa* sea&ai eri("t> ?ie err)r  N@ ERR@R ERR@R=N@ HARM

Kate&)ri A

Keteran&an Keadaan ata" (eadian yan& )tensia #enyea(an

 /

teradinya err)r  Err)r teradi tetai )at e"# #enaai asien Err)r teradi )at s"da* #enaai asien tetai tida(  #eni#"(an risi() a9 @at #enaai asien dan s"da* teran"r di#in"#;di&"na(an  9 @at #enaai asien tetai e"# se#at

%

di#in"#;di&"na(an Err)r teradi dan #)nit)rin&

ERR@R=HARM

E

ter*ada

()nse("ensinya asien

dier"(an

tetai

tida( 

#eni#"(an resi() 8*ar#9 ada asien Err)r teradi dan asien #e#er"(an terai ata" interensi serta #eni#"(an resi() 8*ar#9 ada 3

F

 asien yan& ersifat se#entara Err)r teradi : asien #e#er"(an era'atan ata"  eranan&an era'atan di r"#a* sa(it disertai aat

B

yan& ersifat se#entara Err)r teradi dan #enyea(an resi() 8*ar#9

H

 er#anen Err)r teradi dan nyaris #eni#"(an (e#atian 8#is!

anafia(sis *enti ant"n&9 ERR@R=%EA?H I Err)r teradi dan #enyea(an (e#atian asien ?ae 1! ?a(s)n)#i : (ate&)risasi medication error 

IV

(e#&*k Ke+%,"%# Medication Error 

Ada"n ent"(=ent"( (eadian medication error antara ain> 

F%$e prescribing adaa* err)r yan& teradi ada !%$e pe#*l"$%# 'e$ep  #ei"ti )at

yan& direse(an tida( teat indi(asi tida(  teat asien ata" ()ntraindi(asi tida(  teat )at ata" ada )at yan& tida( ada indi(asinya tida( teat d)sis dan at"ran  a(ai! 

F%$e transcribing  adaa*  error yan& teradi ada saat pem-%.%%# 'e$ep "nt"( 

 r)ses dispensing  antara ain saa* #e#aa rese (arena t"isan yan& tida( eas #isanya L)seC 8omeprazole9 diaa LasiDC 8 furosemide9 at"ran a(ai 2 (ai se*ari 1 taet teraa 3 (ai se*ari 1 taet! Saa* daa# #enere#a*(an )rder   e#"atan rese dan signature "&a daat teradi ada (as"s ini! 

F%$e dispensing  iaa* err)r yan& teradi ada saat pe#/"%p%# h"#))% pe#/e'%h%# 'e$ep  )e* et"&as a)te(! Saa* sat" (e#"n&(inan teradinya error adaa* saa*

daa# #en&a#i )at dari ra( enyi#anan (arena (e#asan ata" na#a )at yan& #iri ata" daat "a teradi (arena erde(atan eta(nya! Seain it" saa* daa# #en&*it"n& "#a* taet yan& a(an dirai( ata""n saa* daa# #e#eri(an inf)r#asi! 

F%$e administrasi adaa* error yan& teradi p%,% p'o$e$ pe#))*#%%# o-%&  yait"

 r)ses yan& di#ana teradi saat )at dieri(an dari et"&as a)te( (e asien ata" dari et"&as a)te( (eada (e"ar&a asien! %an ada r)ses ini "&a #ei"ti fase di&"na(annya )at! Fase ini daat #eiat(an et"&as a)te( dan asien ata" (e"ar&anya! iasanya ada fase ini (etida(en&(aan yan& teradi yait" saa*  e#erian inf)r#asi tentan& en&&"naan )at!  Error yan& teradi #isanya saa* #en&&"na(an s")sit)ria yan& se*ar"snya #ea"i d""r tai di#a(an den&an 4

 ""r saa* 'a(t" #in"# )atnya se*ar"snya 1 a# see"# #a(an tetai di#in"#  ersa#a #a(an! Presriin& 1 Ko#&'%"#,"k%$"

?ransriin& 1! /)y err)r 

2 D*pl"k%$"

2! %iaa (eir"

 T",%k &e'-%.%

3! Ada instr"(si yan&

 I#$&'*k$" &",%k +el%$

tere'at(an

 I#$&'*k$" kel"'*

+! Mis=sta#ed

3 I#$&'*k&" &",%k le#)k%p

5! Instr"(si tida( di(era(an

4 Pe#)h"&*#)%# ,o$"$

6! Instr"(si era

kel"'*

ditere#a*(an saa*

%isensin& 1! K)ntraindi(asi 2! %)sis erei* 3! Ke&a&aan #enere#a*(an instr"(si +! K"ran&nya ersediaan )at 5! Instr"(si en&&"naan )at tida(   eas 6! Saa* #en&*it"n& d)sis 7! Saa* #e#eri ae -! Saa* #en"is instr"(si $! %)sis (eir" 10! Pe#erian )at di "ar instr"(si 11! Instr"(si era diaan(an (eir"

Ada"n ent"(=ent"( (eadian medication error  disai(an daa# ?ae 2!

?ae 2! ent"(=ent"( (eadian medication error 

5

%ari ?ae 2 teri*at a*'a medication error   san&at "as a("annya #"ai dari saat  eresean e#aaan rese )e* a)te(er enyera*an )at *in&&a e#erian; en&&"naan )at )e* asien! Mea"i &a#aran terse"t #a(a (esaa*an yan& teradi di saa* sat" ()#)nen daat saa seara erantai #eni#"(an (esaa*an ain di ()#)nen=()#)nen sean"tnya!

V

5e#"$6+e#"$ Ke$%l%h%# O-%& 7 Medication Error 8

Men"r"t /*ares 82005 *a 3-3=3-69 enis dari (esaa*an )at dan #asaa* yan&  er(aitan den&an )at iaa* sea&ai eri("t> 1!

Kesaa*an rese See(si )at 8didasar(an ada indi(asi ()ntraindi(asi aer&i yan& di(eta*"i terai )at yan& ada dan fa(t)r ain9 d)sis ent"( sediaan #"t" r"te ()nsentrasi (eeatan  e#erian ata" instr"(si "nt"( #en&&"na(an s"at" )at yan& dis)rder ata" di)t)risasi(an )e* d)(ter 8ata" en"is ain yan& sa*9 yan& tida( enar rese ata" )rder )at yan& tida( teraa yan& #enyea(an (esaa*an yan& sa#ai ada asien! Co#&oh :

Pasien er"sia +2 ta*"n yan& #e#ii(i ri'ayat &an&&"an ant"n& dieri(sa )e* (ardi))&is! Pasien terse"t dieri Is)rdi "nt"( *eart ain! Rese terse"t #en&instr"(si(an a*'a )at *ar"s di()ns"#si seanya( 20 #& + (ai se*ari! Keti(a  asien #e#a'a rese terse"t dia'a (e a)te( "nt"( dite"s a)te(er #e#aa Is)rdi sea&ai Pendi! @at yan& di&"na(an "nt"( #en"r"n(an te(anan dara*! aa""n d)sis #a(si#"# se*ari Pendi yan& dire()#endasi(an adaa* 10 #& tetai a)te(er teta #e#eri(an )at terse"t ses"ai den&an d)sis yan& direse(an )e* d)(ter yait" 20 #&! ,adi asien terse"t tida( *anya #eneri#a )at yan& saa* tai dia "&a *ar"s #en&()ns"#si )at den&an d)sis #a(si#"# er*ari - (ai ei* esar diandin&(an den&an d)sis #a(si#"# yan& dire()#endasi(an! Setea* #e#in"# eeraa d)sis  asien terse"t at"* sa(it dan dia'a (e 4B% di#ana d)(ter yan& #e#eri(sanya #enyata(an a*'a asien ter(ena seran&an ant"n&! Pasien terse"t #enin&&a d"a #in&&" (e#"dian!

6

2!

Kesaa*an (arena aai #e#eri(an )at Ba&a #e#eri(an sat" d)sis see"# d)sis terad'a eri("tnya! ,i(a asien #en)a(  #en&()ns"#si )at ata" i(a )at tida( di()ns"#si (arena ()ntraindi(asi #a(a *a terse"t "(an (esaa*an! Co#&oh :

Pera'at ata" a)te(er "a #e#eri(an )at ada asien ra'at ina!

3!

Kesaa*an (arena 'a(t" e#erian yan& (eir" Pe#erian )at di"ar s"at" ara( 'a(t" yan& ditent"(an see"#nya dari ad'a 'a(t"  e#erian )at! Co#&oh :

a! ,ad'a )at ei* ata" ("ran& dari 30 #enit  ! F"r)se#id di#in"# #aa# *ari se*ar"snya a&i *ari ! R; Si#astatin S 0=0=1 dieri s)re *ari se*ar"snya #aa# *ari

+!

Kesaa*an )at (arena )at yan& tida( di)t)risasi Pe#erian (eada asien )at yan& tida( di)t)risasi )e* se)ran& en"is rese yan& sa* "nt"( asien! Mena(" s"at" )at yan& (eir" s"at" d)sis dieri(an (eada asien yan& (eir" )at yan& tida( di)rder d"i(asi d)sis #a""n d)sis yan& dieri(an di "ar ed)#an ata" r)t)() (ini( yan& tea* diteta(an! Co#&oh :

Se)ran& era'at #e#eri(an 300 #& #)rfin yan& se*ar"snya direse(an "nt"(   asien yan& sedan& ter(ena (an(er (eada asien ain yan& er"sia 77 ta*"n yan& sedan& dira'at a(iat e#fise#a ara* dan ne"#))ni)sis ! Kira=(ira 11 a# setea*  e#erian #)rfin asien terse"t dite#"(an daa# (eadaan ()as dan ()#a! Para#edis (e#"dian #e#eri(an na)D)ne dan asien daat tersadar! Na#"n asien terse"t a(*irnya #en&aa#i (ean&=(ean& dan (e#"dian #enin&&a d"nia!

5!

Kesaa*an )at (arena d)sis tida( enar  Pe#erian (eada asien s"at" d)sis yan& ei* esar ata" ei* (ei dari "#a* yan& di)rder )e* d)(ter en"is rese ata" e#erian d)sis d"i(at (eada asien yait" sat" ata" ei* "nit d)sis sea&ai ta#a*an ada d)sis )at yan& di)rder!

7

Co#&oh :

Pi*a( P)res an&(a ?en&a* a(*irnya #eneta(an

M)n )(n"# era'at di

RS4% an&(a ?en&a* 8aten&9 #enadi tersan&(a antaran did"&a ("at aai daa# #enaan(an t"&as *in&&a #enyea(an asiennya ,iran #enin&&a d"nia eeraa 'a(t" a"! Pada ,"i 200$ a" ,iran yan& ar" er"sia 13 "an ana( (eti&a asan&an M"star 8+09 dan Hidayati 8359 'ar&a %esa Ni"n& Kea#atan K)a #enaani  era'atan di RS4% an&(a ?en&a* (arena #enderita #aaria! Saat it" M)n se#at #e#eri(an )at #aaria enis ()r)("in (eada ,iran! Na#"n eeraa saat (e#"dian sa(it ,iran #aa* erta#a* ara* dan a(*irnya #enin&&a d"nia! Ka)res an&(a ?en&a* AKP Ase A*diatna #e#enar(an a*'a i*a(nya tea* #eneta(an M)n sea&ai tersan&(a! GHasi e#eri(saan daa# see(an ini dia 8M)n==red9 (ita teta(an sea&ai tersan&(a! Ia diteta(an sea&ai tersan&(a se#in&&" yan& a" (ata Ase A*diatna saat di()nfir#asi an&(a P)s Br)" #ea"i )nse Min&&" 817;19 s)re! See"#nya (ata Ase A*diatna *asi e#eri(saan La)rat)ri"# F)rensi(  8Laf)r9 Pae#an& S"#se ter*ada sa#e )r&an t""* ,iran #en"n"((an a*'a ()r)("in yan& dieri(an M)n (eada asiennya it" #ea#a"i d)sis! GIa #e#eri(an )at #aaria ()r)("in den&an d)sis yan& tida( se#estinya "n&(a Ase A*diatna! Seain it" i*a( P)res an&(a ?en&a* "&a s"da* #endaat(an (eteran&an sa(si a*i d)(ter f)rensi( dr! "di dari R"#a* Sa(it Seran& anten "nt"( #en&"n&(a(an (as"s terse"t! %i*""n&i seara terisa* Kasat Res(ri# P)res an&(a ?en&a* AKP %)y B"#ara sei.in Ka)res an&(a ?en&a* AKP Ase A*diatna #en&ata(an M)n seara res#i diteta(an #enadi tersan&(a ada Senin 811;19 a"! GKeaaiannya #e#eri(an ()r)("in #eei*i d)sis yan& seenarnya! ,adi  eranan dia di sit" (ata %)y (eada an&(a P)s Br)" Min&&" 817;19 s)re! Atas (eaaiannya it" an"t %)y B"#ara tersan&(a terana# *"("#an i#a ta*"n  enara!  Na#"n de#i(ian tersan&(a sea"* ini tida( dita*an di Ma)res an&(a ?en&a* #en&in&at yan& ersan&("tan #asi* ert"&as di RS4% sete#at dan sea#a ini diniai ())eratif #e#en"*i an&&ian enyidi( "nt"( #enaani e#eri(saan! G%ia di(ena(an  ena*anan r"#a*! %ia era'at yan& #asi* erstat"s *)n)rer di RS4% an&(a ?en&a* i#"* %)y B"#ara! Lei* an"t ia #en&ata(an (as"s ini #asi* ter"s di(e#an&(an 8

dan tida( #en"t" (e#"n&(inan a(an ada tersan&(a ainnya yan& did"&a "&a teriat atas (e#atian ,iran!

6!

Kesaa*an )at (arena ent"( sediaan Pe#erian (eada asien s"at" sediaan )at daa# ent"( ereda dari yan& di)rder  )e* d)(ter! Co#&oh :

a! Keir" en&&"naan sae #ata aaia yan& di)rder s"at" ar"tan "nt"( #ata  ! Pen&&er"san taet eas a#at

7!

Kesaa*an )at (arena e#"atan ata" enyiaan )at yan& (eir" Sediaan )at dif)r#"asi ata" disia(an seara tida( enar see"# e#erian! Co#&oh :

a! Pen&eneran ata" re()nstit"si s"at" sediaan yan& tida( enar   ! ?ida( #en&))( s"sensi ! Mena#"r )at=)at yan& seara fisi( ata" (i#ia daat erintera(si d! Pen&&"naan )at (ada"arsa e! ?ida( #eind"n&i )at ter*ada e#aaran a*aya /)nt)* (as"s> ISMP tea* #eneri#a a)ran #en&enai (esaa*an fata yan& #eiat(an es#)) 8rei)R9 di#ana asien yan& se*ar"snya #eneri#a ine(si 10 # 8100 #&9 ia "nt"( )adin& d)se tai asien terse"t dieri 10 # a#" 825 &9 dari rei)R! Pada*a ada e*er a#" tea* diant"#(an )e* r)d"sennya ae yan& #enyata(an  a*'a isi a#" *ar"s diar"t(an! Pera'at #e#as"((an airan yan& ada ada a#" (e daa# s"nti(an (e#"dian #enyera*(annya

(e

d)(ter

den&an

eras"#si

a*'a

d)(ter

terse"t

a(an

#ear"t(annya! ?ernyata d)(ter terse"t an&s"n& #en&ine(si(an (e asien! A*asi  ant"n& asien terse"t er*enti den&an se&era (arena )erd)sis!

-!

Kesaa*an (arena te(ni( e#erian yan& (eir" Pr)sed"r yan& tida( teat ata" te(ni( yan& tida( enar daa# e#erian s"at" )at yan& daat #ena(" (esaa*an (arena r"te e#erian yan& (eir" ereda den&an yan& dit"is #ea"i r"te yan& enar tetai te#at yan& (eir" #a""n (esaa*an (arena (eeatan e#erian yan& (eir"! 9

Co#&oh :

Ana( a(i=a(i er"sia 16 ta*"n den&an e"(e#ia #eneri#a (e#)terai er"a ine(si intraena in(ristin dan intrate(a #et)tre(sat! ?"s"(an ada "#ais a(an dia("(an )e* se)ran& d)(ter "ni)r! %)(ter terse"t #enyera*(an d"a ar"# s"nti(   ada te#annya dan te#annya #eny"nti((an isi (ed"a ar"# terse"t seara intrate(a tana dieri(sa! Ana( terse"t ada a(*irnya ter(ena ara*n)iditis yan& #enya(it(an yan& #ana didia&n)sa setea* d"a *ari dieri(an r)sed"r yan& saa*! %an ada a(*irnya ia #enin&&a d"nia!

$!

Kesaa*an (arena e#erian )at yan& r"sa(  Pe#erian s"at" )at yan& tea* (ada"arsa ata" (e"t"*an fisi( ata" (i#ia ent"(  sediaan tea* #e#a*aya(an ter#as"( )at=)at yan& disi#an seara tida( teat! Co#&oh :

isnis Ind)nesia Ka#is 1- Mei 2006 *a! -===R"#a* Sa(it Pantai Inda* Ka"(  8RS PIK9 ,a(arta dia)r(an (e"ar&a asien a#ar*"# Pa""s Fa#iard) (e Menteri Kese*atan dan I(atan %)(ter Ind)nesia 8I%I9 er(aitan d"&aan e#erian )at (ada"arsa! Saat datan& (e r"#a* sa(it aya* (ien (a#i #asi* daa# (eadaan ai(! ?ai 12  a# setea* dieri(an )at (ada"arsa dia #enin&&a (ata ,)*n H! airy ("asa *"("# L"na Fa#iard) 8ana( (and"n& Pa""s Fa#iard)9 yan& a(an #en"nt"t seara  idana dan erdata RS it" di ,a(arta (e#arin! Pada $ Maret a" Pa""s datan& (e RS PIK dan #enaani en&)atan (an(er   ar"=ar" *in&&a 20 Maret! 4nt"( #e#"n"* se (an(ernya ada 22 Maret Pa""s datan& a&i dan dieri(an )at &e#.ar yan& erf"n&si #e#"n"* se (an(er! Men&e#ai(an ()ndisi (ese*atan yan& #ee#a* i*a( RS #e#eri(an )at er"a airan inf"s i)en)"s! Na#"n airan )at it" ternyata (ada"arsa 10 Maret 2006! Ia #en&"n&(a(an i*a( RS #e#an& s"da* #enya#ai(an er#intaan #aafnya! Keaa %iisi S"#er %aya Man"sia 8S%M9 dan Le&a RS PIK Ri.a #en&ata(an tida( in&in #en"t"=n"t"i er#asaa*an terse"t! ?ai iara (as"snya saya no comment !

10!

Kesaa*an (arena e#anta"an yan& (eir" Ba&a #en&(ai s"at" re&i#en tert"is "nt"( (eteatan dan endete(sian #asaa* ata" &a&a #en&&"na(an data (ini( ata" data a)rat)ri"# "nt"( en&(aian res)n asien yan& #e#adai ter*ada terai yan& dit"is! 10

Co#&oh :

Se)ran& a(i=a(i er"sia 33 ta*"n #enin&&a 6 "an setea* dia #enderita *enti  ant"n& sea#a )erasi retina deta*#ent! Henti ant"n& terse"t dia(iat(an *i)(sia yan& teradi (eti(a sa"ran end)tra(ea asien tida( ter*""n& den&an s"#er )(si&en! Anestesis #enyadari #asaa* terse"t *anya (eti(a aar# te(anan dara* er"nyi +5 #enit setea* s"#er )(si&en &a&a ter*""n& (e sa"ran and)tra(ea asien! Perta#a= ta#a dia ya(in a*'a teradi (esaa*an ada #esin te(anan dara* tetai saa* sat" d)(ter eda* #enyadari adanya radi(ardi sian)sis dan ter"t"snya *""n&an antara sa"ran end)tra(ea asien den&an s"#er )(si&en!

11!

Kesaa*an (arena tida( at"* Peria(" asien yan& tida( teat er(enaan den&an (etaatan ada s"at" re&i#en )at yan& dit"is! /)nt)* ain& "#"# adaa* (etida(at"*an asien enderita *iertensi #en&&"na(an terai )at anti*iertensi Co#&oh :

a! Kas"s=(as"s yan& teradi di #asyara(at #en&enai (etida(at"*an ter*ada at"ran  e#a(aian )at seaya(nya #enadi er*atian! Pe#a(aian antii)ti( #isanya *ar"s dieri(an daa# 'a(t" tertent" "nt"( #en&*indari ti#"nya resistensi! ?etai serin& teradi a*'a e#a(aian di*enti(an (arena #erasa &eaa sa(it #"ai  er("ran&! A(iatnya ia )ran& terse"t #enderita sa(it yan& ser"a terai yan& sa#a tida( a(an er*asi!  ! Pen&)atan ? se*ar"snya #en&&"na(an ()#inasi )at=)at anti=? se*in&&a daat #e#"n"* ("#an ? den&an t"ntas! H@ #ere()#endasi ()#inasi )at= )at terse"t> Is)ni.id 8H9 Rifa#isin 8R9 Pyra.ina#ide 89 Et*a#"t) 8E9 dan Stret)#yine 8S9 den&an d)sis dan d"rasi en&)atan yan& tea* diteta(an! Kenyataan di aan&an #isanya asien tida( #ene"s dan #e#in"# se#"a )at yan& s"da* direse(an sa#ai atas 'a(t" yan& diteta(an! Ketida(at"*an asien  ai( daa# #e#in"# "#a* dan #aa# )at (etida(terat"ran serta tida(  t"ntasnya en&)atan dari yan& dian"r(an #er"a(an e#i" teradinya resistansi &anda ?!

12!

Kesaa*an (arena r"te e#erian yan& tida( enar  Pe#erian s"at" )at #ea"i r"te yan& ain dari yan& di)rder )e* d)(ter ter#as"(  d)sis yan& dieri(an #ea"i r"te yan& enar tetai ada te#at yan& (eir" 11

Co#&oh :

a! Ja&ina s")sit)ria yan& se*ar"snya dieri(an #ea"i a&ina tetai dieri(an e'at d""r;re(ta  ! Pe#erian )at s")sit)ria yan& di&"na(an #ea"i d""r tetai dieri e'at )ra ! Pe#erian taet s"in&"a tetai dieri(an an&s"n& ditean d! Pe#erian taet *isa tetai dieri(an an&s"n& ditean e! Pe#erian )at ine(si s"("tan tetai dieri(an intra ena f! Pe#erian tetes #ata ada #ata seea* (iri yan& se*ar"snya seea* (anan

13!

Kesaa*an (arena (eeatan yan& (eir" Pe#erian s"at" )at den&an (eeatan yan& (eir"! Keeatan yan& enar diteta(an d)(ter daa# )rder ata" diteta(an daa# (eia(an r)sed"r r"#a* sa(it! Co#&oh :

Setea* #ea("(an enyeidi(an seara #endaa# ter#as"( #enden&ar(an (eteran&an sa(si a*i Satres(ri# P)res Sid)ar) #eneta(an d)(ter erinisia PA 82$9 yan& #enan&ani %aa /*ayanata @(taiant) 8359 saat er)at *in&&a te'as di r"#a* sa(it Krian H"sada sea&ai tersan&(a! S"rat enetaan tersan&(a yan& di(e"ar(an enyidi( P)res Sid)ar) ta( *anya (eada PA #eain(an "&a (eada SM 8259 yan& err)fesi sea&ai era'at di r"#a* sa(it terse"t! %i(ata(an Kasatres(ri# P)res Sid)ar) AKP Ernest) Saiser dari *asi  enyidi(an #ere(a diniai sea&ai i*a( yan& *ar"s ertan&&"n& a'a seara idana atas te'asnya %aa! Ked"anya adaa* yan& #enadi tena&a #edis yan& #era'at ()ran saat dira'at ina di r"#a* sa(it Krian H"sada "arnya Seasa 83;-;20109! %ari *asi e#eri(saan ada tinda(an #edis yan& tida( ses"ai den&an Standard  Operational Procedure 8S@P9 daa# enan&anan ()ran! M"anya ()ran (e#"n& setea* dia)r(an i*a( d)(ter 8PA red9 an&s"n& #e#eri(an rese (ai"#! %ari sa(si a*i d)(ter sesiais ana( ada rese yan& #as"( daa# (ate&)ri dr"& a"se 8enyaa*&"naan )at9! %aa# rese dise"t(an a*'a asien *ar"s dieri (ai"# seara ter"s #ener"s sea#a +5 #enit! Pada*a ses"ai S@P e#erian (ai"# "nt"( ana( 35 ta*"n #a(si#a 30 #enit! atasan #a(si#a inia* yan& dian&&ar teran& #antan Kasatres(ri# P)res Bresi( it"!

12

Ernest) "&a #eneran&(an e#erian )at seara ter"s #ener"s sea#a +5 #enit di)e*(an asa(an ()ran dira'at di r"an& I/4! Kenyatannya %aa *anya dira'at di r"an& era'atan iasa se*in&&a tida( enar i(a #en&&"na(an an&(a 'a(t" +5 #enit! Se#entara it" SM diteta(an sea&ai tersan&(a (arena #enyera*(an r)ses  eny"nti(an )at it" (eada #a*asis'a #a&an& yan& e"# "nya isensi #en&a#i tinda(an #edis! Saat #a*asis'a it" tanya tentan& ara eny"nti(an SM #ena'a seerti iasanya! Setea* dis"nti((an #ea"i inf"s eeraa deti( (e#"dian %aa (ean&=(ean& dan an&s"n& te'as! SM "&a tida( #a" tanya (e d)(ter dan #e#eri(an saran se(enanya yan& era(iat ()ran #enin&&a! Ked"a tersan&(a it" dierat den&an asa 361 K4HP ya(ni #ea("(an tinda(   idana yan& ter(ait den&an aatan se*in&&a #enyea(an )ran& #enin&&a d"nia serta  asa 35$ yan& #enyata(an a*'a (esaa*an yan& #enyea(an )ran& #enin&&a d"nia "n&(asnya!

1+!

Kesaa*an (arena indi(asi tida( di)ati K)ndisi #edis asien #e#er"(an terai )at tetai tida( #eneri#a s"at" )at "nt"(  indi(asi terse"t! Co#&oh :

a! Pasien yan& #en&e"* sa(it (eaa dan setea* dia("(an e( a)rat)ri"# #enanda(an adanya *iertensi dan ()ester)! ?etai *anya dieri(an )at  "sin&nya saa  ! Pasien #en&e"* sa(it at"( ie( tetai yan& dieri(an *anya )at at"(nya saa

15!

Kesaa*an (arena en&&"naan )at yan& tida( dier"(an Pasien #eneri#a s"at" )at "nt"( s"at" ()ndisi #edi( yan& tida( #e#er"(an terai )at! Co#&oh:

Se)ran& asien #en&aa#i (e"*an (eaa "sin& #"a dan (erin&at din&in! %)(ter #e#eri era&ai #aa# )at "nt"( "sin& #"a de#a# dan (e#"n&! ?ernyata setea* dite"s"ri asien *anya ter(ena #aa& se*ar"snya *anya dieri )at #aa&!

13

16!

Kesaa*an (arena &a&a #eneri#a )at K)ndisi #edis asien #e#er"(an terai )at tetai "nt"( aasan far#aseti(  si())&is s)si))&is ata" e()n)#is asien tida( #eneri#a;tida( #en&&"na(an )at! Co#&oh :

Ketida(at"*an #enaani terai *iertensi diaetes ata" terai den&an antii)ti(!

17!

Kesaa*an (arena rea(si )at #er"&i(an 8R@M9 Pasien #en&aa#i s"at" #asaa* #edis sea&ai a(iat dari R@M ata" efe( sa#in&! Rea(si di*ara(an ata" tida( di*ara(an seerti r"a# a(iat en&&"naan antii)ti( #e#er"(an asien #e#inta er*atian eayanan #edis! Co#&oh :

a! Efe( sa#in& at"( ada en&&"naan (at)ri  ! Nyeri a#"n& setea* #en&()ns"#si asirin! ! ?erent"(nya at" asa# "rat ada en&&"naan r)enesid d! Rea(si aer&i ada e#erian antii)ti( &))n&an enisiin Co#&oh k%$*$:

anita #"da den&an sindr)# B"iian=arre 8()ndisi yan& daat #enyea(an  adan #enadi e#a* ata" araisis9 *enda( #enaani r)sed"r )erasi tetai (e#"dian seara tia=tia dia #enin&&a d"nia! S"a#inya er&i (e se)ran& en&aara "nt"( #en&"n&(a(an enyea (e#atian istrinya! Sese)ran& den&an sindr)# B"iian arre tida( )e* dieri(an )at anestesi yan& dise"t s"(sini ()in (arena daat #en&a(iat(an rea(si yan& #e#ati(an! %an ternyata 'anita terse"t dieri )at ini dan inia* yan& #enyea(an ia #enin&&a d"nia!

1-!

Kesaa*an (arena intera(si )at Pasien #en&aa#i #asaa* #edis sea&ai a(iat dari intera(si )at=)at )at= #a(anan ata" )at=r)sed"r a)rat)ri"#! Co#&oh :

a! In()#atiiitas intraena seerti n"trisi arentera en&(a ata" a#"ran sediaan intraena  ! Pen&&"naan ersa#aan d"a )at yan& e(era di SSP 8#isa> antideressant dan anti*ista#in9 #enyea(an rasa (ant"( yan& erei*an

14

! Pe#erian en&*a#at MA@

ersa#a

den&an tira#in;(e" #en&*asi(an

 en"#"((an a#in di ""n& saraf adrener&i(  d! Jita#in 6 #enin&(at(an a(tiitas en.i# yan& #e#eta)is#e e)d)a se*in&&a efe( e)d)a #en"r"n e! Pen&&"naan (at)ri ersa#aan den&an sir)n)a(t)n daat #enyea(an *ier(ae#ia f! ?etrasi(in den&an #a(anan (aya (asi"# daat #e#ent"( (eat se*in&&a as)rsinya ter&an&&" 1$!

Kesaa*an )at ain Setia (esaa*an yan& tida( dia(" saa* sat" dari (ete&)ri terse"t di atas!

VI F%k&o'6F%k&o' Pe#/e-%- Medication Error 

Men"r"t A#erian H)sita Ass)iati)n medication error  antara ain daat teradi ada sit"asi eri("t> a! Inf)r#asi asien yan& tida( en&(a #isanya tida( ada inf)r#asi tentan& ri'ayat aer&i dan en&&"naan )at see"#nya!  ! ?ida( dieri(an inf)r#asi )at yan& aya( #isanya ara #in"# ata" #en&&"na(an )at fre("ensi dan a#a e#erian *in&&a erin&atan i(a ti#" efe( sa#in&! ! Kesaa*an ()#"ni(asi daa# eresean #isanya interretasi a)te(er yan& (eir" daa# #e#aa rese d)(ter (esaa*an #e#aa na#a )at yan& reatif #iri den&an )at ainnya (esaa*an #e#aa desi#a e#aaan "nit d)sis *in&&a sin&(atan  eresean yan& tida( eas 8!d ata" !i!d;%9! d! Peaean (e#asan )at yan& tida( eas se*in&&a erisi() diaa (eir" )e* asien! e Fa(t)r=fa(t)r in&("n&an seerti r"an& a)te(;r"an& )at yan& tida( teran& *in&&a

s"asana te#at (era yan& tida( nya#an yan& daat #en&a(iat(an ti#"nya medication error.

%i a'a* ini di"rai(an eeraa fa(t)r yan& daat #enyea(an teradinya medication error > 1! K)ndisi s"#er daya #an"sia Instaasi Far#asi R"#a* Sa(it 8IFRS9 a! ,"#a* dan #"t" a)te(er tida( #e#adai  ! Pers)ne n)n=r)fessi)na daa# idan& e(eraan a)te(er 

2! Siste# distri"si )at "nt"( PR? yan& tida( ses"ai 15

3! e"# ditera(annya eayanan far#asi (ini(  Peayanan far#asi (ini( #er"a(an s"at" (e&iatan a#inan #"t" eayanan )at (eada asien! %aa# eayanan ini a)te(er #e#ii(i tan&&"n& a'a sea&ai "aya  enaaian dan enin&(atan (ese*atan asien dan #"t" (e*id"annya! ,i(a eayanan ini tida( ditera(an di r"#a* sa(it #a(a tida( #en"t" (e#"n&(inan (esaa*an )at ata" #asaa* yan& er(aitan den&an )at a(an anya( teradi!

+! ?ida( ditera(annya ed)#an /ara %isensin& @at yan& ai( 8/%@9 era&ai (e&iatan daa# /%@ tida( dia("(an seerti> interretasi rese ri'ayat en&)atan asien e#erian inf)r#asi yan& tida( en&(a ada eti(et ("ran&nya inf)r#asi ada era'at daat #enyea(an teradinya (esaa*an ai( )e* d)(ter a)te(er era'at #a""n asien!

5! Keia(an dan r)sed"r en&e)aan en&endaian serta eayanan )at yan& tida(  #e#adai Keia(an dan r)sed"r san&at entin& serta er&"na (arena #er"a(an en"nt"n "nt"( #ea(sana(an en&e)aan en&endaian dan eayanan )at yan& efe(tif dan efisien di r"#a* sa(it! K"ran&nya (eia(an dan r)sed"r terse"t di r"#a* sa(it daat  er()ntri"si ada (esaa*an )at di r"#a* sa(it!

6! Pea(sanaan siste# f)r#"ari"# dan en&adaan f)r#"ari"# yan& e"# #e#adai Siste# f)r#"ari"# yan& e"# ditera(an #en&a(iat(an f)r#"ari"# tida(  a()#)datif a&i asien! ,"#a* enis #"t" )at serta en&&"naan di r"#a* sa(ir tida(  ter(endai dan ()ndisi terse"t daat #enyea(an (esaa*an )at!

7! Panitia Far#asi dan ?erai 8PF?9 e"# erdaya ?ida( erdayanya PF? di r"#a* sa(it antara ain siste# f)r#"ari"# tida(  tera(sana f)r#"ari"# tida( ai( dan en&e#an&an (eia(an serta r)sed"r   er(aitan den&an )at san&at a#at! Ha=*a terse"t daat er()ntri"si ada (esaa*an )at di r"#a* sa(it!

-! K"ran& #e#adainya en&eta*"an asien dan r)fesi)na tentan& )at 16

Pen&eta*"an

asien yan&

("ran& #e#adai

tentan&

)at #enyea(an

(etida(at"*an asien dan saa* en&&"naan )atnya! Sedan&(an r)fesi)na (ese*atan yan& #e#ii(i en&eta*"an ("ran& ter*ada )at daat #enyea(an (esaa*an e#ii*an )at yan& teat a&i asien!

$! Kesaa*an ()#"ni(asi 8communication errors9! Kesaa*an ()#"ni(asi daat teradi a(iat ("ran&nya (e#a#"an d)(ter;a)te(er  daa# er()#"ni(asi den&an asien! %aat "&a dia(iat(an (arena asien tida(  #e#erita*"(an &eaa enya(it yan& dirasa(annya den&an eas!

10!

Menin&(atnya sesiaisasi dan fra&#entasi era'atan (ese*atan! Se#a(in anya( tena&a (ese*atan yan& #enan&ani se)ran& asien #a(in esar 

(e#"n&(inan (esaa*an inf)r#asi yan& disa#ai(an!

11!

Masi* e"# adanya standar eayanan #edis yan& dit"an&(an daa# standar 

 r)sed"r )erasi)na se*in&&a tida( ada a"an a(" daa# enataa(sanaan s"at"  enya(it den&an ai(! Misanya enataa(sanaan #aaria ai( )e* tena&a #i(r)s()is #a""n tena&a #edis *anya didasar(an atas en&aa#an!

12!

Penyea (esaa*an )at yan& "#"# a! Ke("atan )at ada eti(et ata" daa# (e#asan yan& #e#in&"n&(an Ke("atan ata" d)sis sediaan tida( eas di#ana sediaan terse"t terdiri dari  er#aa#=#aa# )at den&an erandin&an yan& ada )nt)* )tri#)(sa.) 8tri#etr)ri# -00 #&  s"fa#et)(sa.) +00 #&9!  ! Na#a ata" "nyi na#a )at yan& teri*at #iri Pena#aan sediaan )at yan& *a#ir sa#a daat #enyea(an medication error ! /)nt)* )at yan& serin& #enyea(an (esaa*an en&)atan adaa* )at  ene&a* e#e("an dara* /)"#adinC dan )at anti ar(ins)n Ke#adrinC! ?aD)C 8aitaDe9 s"at" a&en anti(an(er (eden&arannya *a#ir sa#a den&an PaDiC 8ar)Detine9 yan& #er"a(an s"at" antideresan! ! Kesaa*an aat /)nt)*nya )#a intraena di#ana (at"nya tida( erf"n&si #enyea(an  eri)de e#erian )at #enadi tera" eat! d! ?"isan tan&an tida( teraa ?"isan tan&an yan& ("ran& eas daat #enyea(an (esaa*an daa# d"a  en&)atan yan& #e#"nyai na#a yan& ser"a! Seain it" anya( na#a )at 17

yan& na#a( ser"a ter"ta#a saat era(aan di tee)n ("ran& eas ata" saa* #eafa(an! Per#asaa*annya #enadi ()#e(s aaia )at terse"t #e#ii(i ara e#erian yan& sa#a dan d)sis yan& *a#ir sa#a! e! Pen"isan (e#ai rese ata" )rder d)(ter yan& tida( teat f! Per*it"n&an d)sis yan& tida( teiti Kesaa*an daa# #en&*it"n& d)sis sea&ian esar teradi ada en&)atan ediatri dan ada r)d"(=r)d"( intraena! eeraa st"di #en"n"((an a*'a (esaa*an daa# er*it"n&an d)sis tida( *anya rin&an tetai "&a (esaa*an yan& fata #isa (esaa*an 10 (ai iat ata" #enaai 15! &! Kesaa*an dia&n)sis Kesaa*an d)(ter daa# #endia&n)sis enya(it daat #enyea(an (esaa*an tinda(an #edis sean"tnya! *! Men&&"na(an sin&(atan yan& tida( teat daa# en"isan rese Pen&"naan sin&(atan daa# rese ter(adan& daat #enyea(an teradinya (esaa*an )at seerti #isanya> Sin&(atan 4 8"nit9 "nt"( ins"in dan it)sin daat #enyea(an (esaa*an • • •

 e#aaan #enadi 0 yan& #enyea(an )erd)sis yan& era*aya! Sin&(atan I4 8Internati)na 4nit9 daat teraa sea&ai IJ 8intraena9 ata" 10! Sin&(atan !d! !ua!ue die" yan& erarti setia *ari daat #enyea(an (esaa*an e#aaan #enadi id 8!uarter in die ata" e#at (ai se*ari9 ata"

•

)d 8setia *ari yan& ereda9 An&(a desi#a se*ar"snya tida( dit"is! An&(a 1!0 daat teraa sea&ai 10

a(iat tanda desi#anya erada ada &aris (eras rese! i! Kesaa*an en"isaneti(et  ! ean (era erei*an (! @at=)atan yan& tida( tersedia VII Up%/% Pe#.e)%h%# Medication Errors

Pene&a*an medication errors daat dia("(an den&an "aya="aya di a'a* ini antara ain> 1! Adanya e#a*a#an yan& ai( ada setia indiid" a*'a medication errors  daat teradi (aan saa dan #eni#a siaa saa ter"ta#a yan& er(aitan den&an )at dan  en&)atan #"ai dari d)(ter a)te(er asisten a)te(er dan era'at! 2! A)te(er 'ai #enera(an siste# distri"si )at yan& teat "nt"( asien di s"at" r"#a* sa(it a&ar daat #e#en"*i ersyaratan enya#aian )at yan& ai( yait" teat  asien teat )at teat ad'a tan&&a 'a(t" dan #et)de e#erian teat inf)r#asi "nt"( asien dan "nt"( era'at e#eri )at (eada asien!

18

3! Siste# en"isan rese yan& ter()#"terisasi ada instaasi far#asi yan& #e#"da*(an  en&ee(an )t)#atis "nt"( d)sis terai d"i(asi intera(si )at dan ase(   en&&"naan ain! +! %esain "an& siste# yan& ada i(a ter"(ti (eadian medication error   ers"#er dari siste# se*in&&a daat #ene&a* teradinya (esaa*an yan& a(an datan&! 5! Instaasi far#asi *ar"s #e#ii(i Standard Operating Procedure  8S@P9 daa# r)ses  prescri#ing$ transcri#ing$ dispensing  dan administering   "nt"( #e#ini#a(an resi() teradinya medication errors! 6! A)te(er *ar"s #en&i("ti en&eta*"an #"ta(*ir #ea"i (eiasaan #e#aa "sta(a  er()ns"tasi den&an re(an sea'at dan ea(" eayan (ese*atan ain! @e* (arena it" s"#er inf)r#asi )at yan& #e#adai *ar"s tersedia a&i se#"a ea(" eayan (ese*atan daa# r)ses en&&"naan )at! 7! A)te(er tida( )e* #ener(a #a(s"d dari en"isan di eresean )at yan& #e#in&"n&(an! ,i(a ada #asaa* a)te(er *ar"s #en&*""n&i d)(ter en"is rese terse"t! -! A)te(er *ar"s erartisiasi daa# e#anta"an terai )at yait" (eteatan terai (eteatan e#erian )at (e#"n&(inan adanya terai d"i(at intera(si yan& #"n&(in ea"asi data (ini( serta a)rat)ri"# asien se*in&&a daat teraai  en&&"naan )at yan& a#an efe(tif dan rasi)na! $! Adanya daftar sin&(atan a(" standar yan& diset""i "nt"( di&"na(an daa# eresean )at! 10! Pers)ne yan& "(" *ar"s tersedia "nt"( #ea("(an t"&as den&an #e#adai dan #e#ii(i tin&(at ean serta a# (era yan& 'aar! Seain it" dia("(an ea"asi (inera  et"&as se*in&&a daat #en&eta*"i *a=*a aa saa yan& sea#a ini dia("(an yan&  er)tensi #eni#"(an medication errors. %en&an de#i(ian et"&as di*ara(an tida( #en&"an&i *a yan& sa#a di(e#"dian *ari! 11! Lin&("n&an (era yan& nya#an "nt"( e#"atan sediaan )at! S"#er (esaa*an yan& daat teradi di in&("n&an (era yait" (etida(f)("san ada e(eraan yan& sedan& dia("(an! 12! A)te(er *ar"s erartisiasi ada r)ses en&ee(an "an& daa# e#aaan rese  er*it"n&an d)sis dan e#erian eti(et! Aaia #"n&(in daat dia("(an en&ee(an sian& )e* a)te(er yan& ain! 13! A)te(er #e#eri(an inf)r#asi dan e#a*a#an #en&enai )at (eada asien ata"  en&as"*nya seara ()#"ni(atif dan #e#erifi(asi a*'a #ere(a #en&eta*"i dan #en&erti ara en&&"naan )at eserta inf)r#asi ainnya! ,i(a er" a)te(er daat #e#eri(an inf)r#asi tert"is ada asien!

19

VIIIPem%#&%*%# ,%# Pe#)elol%%# Medication Errors

Penin&(atan #"t" seara ter"s=#ener"s dier"(an "nt"( e#anta"an medication errors! Kes"itan daa# #endete(si (esaa*an tea* a#a di(eta*"i sea&ai saa* sat"  en&*aan& "nt"( #eneiti #asaa* it" den&an teiti! era&ai te(ni( e#anta"an (esaa*an tersedia 8#isa dia)r(an sendiri tana na#a ea)ran eristi'a te(ni( en&a#atan terse#"nyi9! Pr)&ra# e#anta"an medication errors *enda(nya #e#erti#an&(an > 1! Biiran (era 8a" (esaa*an ei* tin&&i seara (*as teradi sea#a &iiran sian&9 2! Staf yan& tida( eren&aa#an dan ("ran& eati*an 3! Peayanan #edis 8#isa (e"t"*an (*"s"s "nt"( )"asi asien ter#as"( &eriatri(  ediatri( dan )n())&i9 +! Menin&(atnya ("antitas )at er asien 5! era&ai fa(t)r in&("n&an 6! ean (era dan (eeti*an staf  7! K)#"ni(asi yan& "r"( di antara ea(" eayan (ese*atan -! ent"( sediaan $! ?in&(at en&"("ran dan er*it"n&an yan& dier"(an 10! N)#en(at"r sediaan )at en&e#asan en&eti(etan yan& #e#in&"n&(an 11! ?"isan tan&an yan& "r"(  12! K"ran& erdayanya f"n&si era&ai ()#ite ter"ta#a PF? Lan&(a*=an&(a* en&e)aan medication errors > 1! Kasifi(asi(an enis medication errors yan& teradi! 2! ?ent"(an enyea teradinya medication errors. 3!  Medication errors *ar"s did)("#entasi(an dan dia)r(an se&era (eada d)(ter era'at dan (eaa IFRS! +! 4nt"( (esaa*an yan& si&nifi(an seara (ini( en&"#"an fa(ta dan inesti&asi *ar"s se&era di#"ai! Fa(ta yan& *ar"s diteta(an dan did)("#entasi(an ter#as"( aa yan& teradi di #ana eristi'a teradi #en&aa dan a&ai#ana eristi'a teradi siaa yan& teriat! "(ti r)d"( 8#isa eti(et dan (e#asan9 *ar"s diari dan disi#an "nt"( a"an di (e#"dian *ari! 5! Identifi(asi(an an&(a*=an&(a* yan& a(an dia("(an den&an enar dan d)("#entasi(an 6! ?erai erai(an dan terai s")rtif *ar"s dieri(an (eada asien! 7! Kesaa*an )at *ar"s dia)r(an (eada r)&ra# e#anta"an r"#a* sa(it "nt"(  (eentin&an erai(an #"t" enin&(atan (ea#anan asien "nt"( ene&a*an (esaa*an yan& a(an datan&! ,i(a teradi &eaa (era"nan ada asien #a(a sea&ai et"&as (ese*atan se)ran& a)te(er *ar"s #a#" #en&e)a (eadian (era"nan ters e"t den&an si&a dan enar! 4nt"(  it" daat dia("(an a("(an an&(a*=an&(a* eri("t>

20

1! Se#"a asien yan& #en"n"((an &eaa=&eaa (era"nan *ar"s se&era dir""( (e r"#a* sa(it! 2! eri(an terai s")rtif dan en&)atan yan& ert""an "nt"( #enan&ani &eaa 8)nt)*nya *iertensi9! F"n&si ita asien "&a *ar"s sea" di#)nit)r! a! Pen&e"aran ra"n dari sa"ran enernaan O La("(an r)sed"r "i a#"n& O Pen&e"aran ra"n dari sa"ran enernaan *anya dia("(an den&an  erti#an&an yan& #atan& yait" i(a "#a* ra"n yan& #as"( (e t""*  asien erada ada "#a* yan& #en&ana# i'a daa# 'a(t" yan& eat!  ! Pene&a*an as)rsi ra"n La("(an den&an #en&&"na(an (ar)n a(tif (arena (ar)n #e#ii(i (e#a#"an #en&i(at ra"n dan #en&"ran&i as)rsinya! Pen&&"naan (ar)n reatif a#an dan ei* efe(tif! ! Pen&&"naan antid)t ?erdaat eeraa antid)t yan& daat di&"na(an seara teratas "nt"(  se"#a* ra"n diantaranya adaa*> O Pada (era"nan araseta#) eri(an asetisistein "nt"( #eind"n&i *ati i(a  e#erian araseta#) d)sis tin&&i e"# #ee'ati 10=12 a#! O Pada (era"nan esi eri(an desferri)Da#in yan& deat #en&(*eat esi O Pada (era"nan )iat yan& #"n"( den&an sedasi s"resi at"( dan deresi  ernafasan eri(an na)(s)n yan& #er"a(an anta&)nis reset)r )i)id yan& tersedia sea&ai ine(si intra ena d! Penin&(atan ei#inasi ra"n den&an a(ainisasi "rin Pada (era"nan )at yan& ersifat asa# #isanya ada (era"nan asirin yan& ditandai den&an sti#"asi "sat ernafasan dan nyeri ad)#en na"sea tinnit"s erti&) serta (et"ian daat dia("(an re*idrasi dan a(ainisasi "rin! Ha terse"t dia("(an "nt"( #enin&(at(an ei#inasi )at yait" den&an #enin&(at(an i)nisasi asirin dan #ene&a* reas)rsinya ada &ina!

Res)n setea* teradi #ediati)n err)r> 1!

Me#ini#aisasi efe( dari (esaa*an #edi(asi ada asien

2!

eri(an asien er*atian en"*

3!

Pinda*(an asien (e te#at terisa* i(a #e#"n&(in(an

+!

/ari enyea teradinya (esaa*an #edi(asi

5!

Me#inta #aaf (eada asien dan eas(an (esaa*an yan& tea* teradi

6!

Perai(i (esaa*an yan& teradi 21

7!

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DAFTAR PUSTAKA

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