Evaluasi Dampak Penerapan Automated Dispensing Machine berdasarkan Jam Pelayanan Klinik terhadap Dispensing Error

DEVI YANTHRE S M, Dr. Chairun W., M. Kes., M. App.Sc., Apt. ; Dra. Pramuji Eko Wardani, MAB., Apt.

2018 | Tesis | MAGISTER ILMU FARMASI

Instalasi Farmasi Rumah Sakit (IFRS) memegang peranan penting dalam penyediaan obat dan memastikan bahwa penggunaannya aman, efektif dan benar. Kesalahan pemberian obat (dispensing error) dapat terjadi kapan saja hingga pasien mengalami efek yang berbahaya. Penerapan automated dispensing machine memiliki potensi menurunkan tingkat kejadian dispensing error. Namun pada jam pelayanan tertentu, kejadian dispensing error tetap terjadi karena penumpukan resep yang disebabkan adanya pergeseran jam pelayanan klinik. Penelitian ini bertujuan untuk mengevaluasi dampak penerapan automated dispensing machine berdasarkan jam pelayanan klinik terhadap dispensing error di instalasi farmasi rawat jalan RS Bethesda Yogyakarta. Penelitian ini merupakan penelitian observasional concurrent dengan rancangan penelitian cross sectional. Data kuantitatif diperoleh dengan mengamati perbedaan kejadian dispensing error dari pelayanan resep melalui automated dispensing machine dan manual serta kombinasi keduanya lalu dianalisa deskriptif terhadap mean dan standar deviasi. Data kualitatif diperoleh melalui wawancara mendalam kepada narasumber yang dianggap memiliki pengetahuan dan pengalaman mengenai penerapan ADM di farmasi rawat jalan RS Bethesda. Analisis hasil menggunakan software SPSS versi 16.0 dengan metode analisis Kruskal Wallis. Hasil pada penelitian ini: 1) Kejadian dispensing error paling banyak terjadi pada rentang jam pelayanan klinik pukul 10.00-14.00 WIB. Persentase kejadian terbanyak dispensing error terjadi pada resep yang berasal dari klinik paru (5,13%) dan klinik kulit dan kelamin (5,13%). 2) Rerata jumlah kejadian dispensing error dengan penerapan ADM sebesar 0,54 ± 0,71, rerata jumlah kejadian dispensing error dengan pelayanan resep secara manual sebesar 2,38 ± 1,77 dan rerata jumlah kejadian dispensing error dengan pelayanan resep kombinasi sebesar 2,69 ± 1,91. 3) ADM sangat berperan penting di instalasi farmasi rawat jalan RS Bethesda terutama dalam mencegah dispensing error, dan mengurangi space ruang pelayanan serta kemasan obat menjadi lebih menarik.

Hospital Pharmacy Department plays an important role as a final solution in providing medicine and also ensuring that its use is safe, effective and correct. Dispensing error can happen any time until the patient is experiencing the harmful effect. Automated dispensing machine (ADM) implementation has a potential to decrease dispensing error occurrence. In certain service hours, the occurrence of dispensing errors still happen due to accumulation of drug prescriptions, caused by the shift in clinical service hours. This study aims to evaluate the impact of ADM implementation on dispensing error occurrence during clinic service hours at outpatient pharmacy department of Bethesda Hospital Yogyakarta. This research was a concurrent observational research with cross sectional study design. Quantitative data obtained by observing differences in dispensing error occurrence from prescription service through ADM, manual and combination of both then analyzed descriptively to mean and standard deviation. Qualitative data obtained through in-depth interviews of informant that are considered to have knowledge and experiences regarding ADM implementation in outpatient pharmacy department. The results were analyzed using SPSS software version 16.00 with Kruskal Wallis and Mann Whitney. There was a correlation between clinical service hours and dispensing error occurrence at the outpatient pharmacy department (p < 0.05). Dispensing errors most occurred in clinic service hours at 10:00 to 14:00 pm. Highest dispensing errors occurred on prescriptions from pulmonary clinics (5.13%) and dermatology and venereal clinics (5.13%). There is a correlation between prescribing that served with ADM and dispensing error occurrence (p < 0.05). The average number of dispensing error occurrence with ADM implementation is 0,54 ± 0.71, while the average number of dispensing error occurrence with manual service is 2.38 ± 1.77. ADM have important role in outpatient pharmacy of Bethesda Hospital especially in preventing dispensing errors, reducing service space and drug packaging becomes more attractive.

Kata Kunci : automated dispensing machine, dispensing error, jam pelayanan klinik /automated dispensing machine, dispensing error, clinic service hours