ANALISIS ADVERSE DRUG EVENTS (ADEs) PADA PENGGUNAAN OBAT-OBAT HIGH ALERT DI INTENSIVE CARE UNIT (ICU) DAN CARDIAC INTENSIVE CARE UNIT (CICU) RUMAH SAKIT PANTI RAPIH YOGYAKARTA

Maria Yangsye Lenggu, Dr. I Dewa Putu Pramantara S.,Sp.PD.,K-Ger.

2013 | Tesis | S2 Ilmu Farmasi

Adverse Drug Events (ADEs) menempati urutan utama insiden berisiko terhadap keselamatan pasien. Lingkungan perawatan kritis, dan pengobatan dengan high alert adalah faktor risiko terjadinya ADEs. Empat golongan obat high alert yang mempunyai dampak terbesar menyebabkan risiko antara lain antikoagulan, insulin, narkotik/Opioid, dan sedatif. Penelitian ini bertujuan untuk menganalisis insiden ADEs terhadap penggunaan obat-obat high alert di ICU/CICU RS. Panti Rapih Yogyakarta. Penelitian non-eksperimental dengan rancangan penelitian deskriptif evaluatif melalui penelusuran data secara retrospektif terhadap rekam medik pasien yang menggunakan obat high alert (antikoagulan, insulin, narkotik/opioid, dan sedatif) di ICU/CICU RS. Panti Rapih Yogyakarta selama Januari - Desember 2012. Identifikasi ADEs berdasarkan trigger tool for Measuring Adverse Drug Events dan ICU Adverse Event Trigger Tool. Insiden yang ditemukan kemudian dikategorikan dalam kategori bahaya menurut the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). Analisis terhadap 400 rekam medik pasien ditemukan ADEs pada penggunaan antikoagulan meliputi 51% Adverse Drug reactions (ADRs), 9% medication errors (MEs) dan 5% preventable ADE, dengan 29% kategori bahaya E, dan 1% kategori bahaya H. Adverse Drug Events pada penggunaan insulin meliputi 38% ADRs, 26% MEs dan 10% preventable ADE, dengan 36% kategori bahaya E. Adverse Drug Events pada penggunaan narkotik/opioid meliputi 22% ADRs, 1% MEs, dengan 6% kategori bahaya E. Adverse Drug Events pada penggunaan sedatif meliputi 23% ADRs, 2% MEs, dengan 11% kategori bahaya E. Pasien ICU/CICU yang menggunakan antikoagulan mempunyai persentase paling tinggi mengalami ADRs sebanyak 51%, sedangkan insulin paling tinggi berkaitan dengan MEs (26%) dan preventable ADE (9%).

Adverse Drug Events (ADEs) places first in the high risk incidents in patient safety. Critical care environment and high alert medications are the main risk factors in causing ADEs. Four categories of high alert drugs that have the greatest effect in increasing the risks are anticoagulants, insulin, narcotics/opioids, and sedatives. This research was aimed to analyze ADE incidence as the results from the use of high alert drugs in ICU/CICU in Panti Rapih Hospital, Yogyakarta. This is a non-experimental research with a evaluative-descriptive design through analyses of retrospective data collection from the medical records using high alert drugs (anticoagulant, insulin, narcotic/opioid, and sedative) in ICU/CICU in Panti Rapih Hospital, Yogyakarta, from January to December 2012. ADEs were identified using trigger tool for Measuring Adverse Drug Events and ICU Adverse Event Trigger Tool. The incidents that were encountered then were categorized in harm categories based on the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). Analyses on 400 medical records showed ADEs in the use of anticoagulant consisting of 51% Adverse Drug reactions (ADRs), 9% medication errors (MEs) dan 5% preventable ADE, 29% in harm category E, and 1% harm category H. Adverse Drug Events for insulin use consisted of 38% ADRs, 26% MEs and 10% preventable ADE, with 36% in harm category E. Adverse Drug Events for use of narcotic/opioid comprised of 22% ADRs and 1% MEs, with 6% in harm category E. Adverse Drug Events in sedative use included 23% ADRs keywordsand 2% MEs, with 11% in harm category E. ICU/CICU patients who use anticoagulant had the highest percentage for experiencing ADRs (51%), while insulin was related to the highest MEs (26%) dan preventable ADE (9%) incidence.

Kata Kunci : Adverse Drug Events (ADEs), antikoagulan, insulin, narkotik/ opioid, sedatif