EVALUASI PEMBERIAN OBAT MELALUI ENTERAL FEEDING TUBE DI RUMAH SAKIT: LITERATURE REVIEW

SORAYA INDIRA SARI, Dr. Apt. Fita Rahmawati, Sp.FRS; , Dr. Apt. Chairun Wiedyaningsih, M.Kes., M.App.Sc.

2021 | Skripsi | S1 FARMASI

Pemberian nutrisi dan medikasi melalui Enteral feeding tube (EFT) telah banyak digunakan untuk pasien yang megalami kesulitan menelan atau beberapa sebab lain seperti tidak mau makan. Medication error sering teridentifikasi pada pemberian obat melalui EFT. Penelitian bertujuan mengetahui gambaran karakteristik pasien, karakteristik obat yang diberikan, proses pemberian obat melalui feeding tube serta problem yang terjadi pada pemberian obat melalui EFT pasien rawat inap di rumah sakit melalui kajian literatur. Studi ini merupakan literature review dengan penelusuran artikel penelitian di database jurnal elektronik PubMed, ClinicalKey, Scopus, dan Google Scholar. Penelusuran dilakukan dengan menggunakan kata "Enteral Feeding Tube", "Feeding Tube", "Nasogastric Tube", "Medication Preparation", "Drug Preparation", "Medication Administration", "Drug Administration", "Medication Error", "Medication Incidents", dan "Hospital". Setelah menyeleksi berdasarkan kriteria yang ditetapkan, didapatkan sebanyak 23 artikel. Dari artikel 23 yang didapat, 9 artikel membahas tentang karakteristik pasien, 9 artikel membahas tentang karakteristik obat, 17 artikel membahas tentang pemberian obat melalui Enteral Feeding Tube, dan 20 artikel membahas tentang problem yang terjadi dalam pemberian obat melalui Enteral Feeding Tube. Karakteristik pasien pengguna EFT sebagian besar pasien pria, berumur >40 tahun dengan diagnose kardiologi. Obat yang paling banyak diresepkan adalah captopril, amlodipin, dan pantoprazol dalam bentuk sediaan padat. Proses penyiapan obat dilakukan dengan penggerusan dan/atau pelarutan menggunakan air 10-20 mL dengan alat mortar dan pestle. Pemberian obat menggunakan syiringe pada waktu bersamaan dengan nutrisi enteral (EN). Flush sebelum dan diantara pemberian obat jarang dilakukan. Flush dilakukan sesudah pemberian obat. Problem yang terjadi berupa obat yang dikontrol pelepasannya dan obat salut enterik banyak digerus, beberapa obat digerus dalam waktu yang bersamaan, volume pelarut yang digunakan tidak sesuai, obat sediaan cair tidak dikocok atau diencerkan, pemberian obat secara bersamaan dan tidak dijeda dengan EN, tidak mem-flush EFT sebelum, diantara, dan setelah pemberian obat, serta terjadinya kesalahan teknis dan penyumbatan EFT.

Enteral Feeding Tube (EFT) has been used as nutrition and medication deliverer tool for patient who having difficulties in swallowing or unable to eat through the oral route. Medication error often occurs in administration of medication through EFT. This research objectives are to find the characteristics of patient, charactetristics medication given through EFT, medication delivering via feeding tube and problems following it in hospital inpatients through literature review. The study method used was literature review by searching research articles in several electronic journal databases, including PubMed, ClinicalKey, Scopus, and Google Scholar. The keywords used are "Enteral Feeding Tube", "Feeding Tube", "Nasogastric Tube", "Medication Preparation", "Drug Preparation", "Medication Administration", "Drug Administration", "Medication Error", "Medication Incidents", and "Hospital". After selecting based on the established criterias, 23 articles were obtained. From 23 articles obtained. 9 articles evaluated about characteristics of patients, 9 articles evaluated about characteristics of the medication, 17 articles evaluated about medication administration through EFT, and 20 articles evaluated about the problems occurs in medication administration through Enteral Feeding Tube. Characteristics of patient with EFT is most of them are men with age range >40 years old with diagnose cardiology. Medicine which are most given to patient are captopril, amlodipine, and pantoprazole with solid form. Preparation process consist of triturating and/or diluting medication with 10-20 mL water with tool mortar and pestle. From administration process can be concluded that medication is given by syringe at one time, without time pause with EN. Flushing is always done in after administrating. Problem that occurs in can be concluded as time release-controlled tablets and enteric-coated tablets are being triturated, few medications are triturated at the same time, liquid form medication is not shaken or diluted, administration of few medications in one time and without time pause with EN, there is no flush before, in between, and after administration of medication, technical issues and EFT clogging also occurs.

Kata Kunci : Enteral Feeding Tube, Penyiapan obat, Pemberian obat, Medication Error, Medication Preparation, Medication Administration