HUBUNGAN KETEPATAN PREPARASI DAN PEMBERIAN OBAT INTRAVENA VESICANT DENGAN KEJADIAN PLEBITIS; KAJIAN DI RUANG ICU RSUD PANEMBAHAN SENOPATI BANTUL

Kardhina Apryliani, Prof. Dr. Suwaldi M.,M.Sc., Apt.

2013 | Tesis | S2 Mag.Farmasi Klinik

sakit. Obat vesikan dapat menyebabkan kerusakan pada jaringan, termasuk salah satu efek yaitu plebitis. Plebitis akibat pengaruh obat dapat diminimalkan dengan prosedur penggunaan yang tepat. Penelitian bertujuan mengetahui hubungan ketepatan preparasi dan pemberian obat intravena vesikan dengan efek plebitis. Penelitian dilakukan dengan desain Cross Sectional dengan pengamatan/observasional terhadap proses preparasi obat, pemberian obat dan efek plebitis di ruang ICU RSUD Panembahan Senopati Bantul. Lima aspek pengamatan preparasi dan empat aspek pengamatan pemberian akan dinilai dan data disajikan secara diskriptif. Hasil penilaian aspek ketepatan dan preparasi yang potensial berpengaruh terhadap plebitis disajikan dalam bentuk skor nilai pada tiap pasien. Efek plebitis dinilai dengan skala dikotomus. Analisis dilakukan menggunakan analisis korelasi dengan program SPSS versi 15.0. Pengamatan dilakukan pada sembilan jenis obat vesikan yang bukan obat antineoplastik (dopamin, dobutamin, amiodaron, diazepam, norepinefrin, vankomisin, aminofilin, kalsium glukonas dan manitol) dari 28 pasien. Hasil pengamatan ketepatan preparasi menunjukkan ketepatan: teknik aseptis sebanyak 34 obat (100%), pemberian label sebanyak 26 obat (78,8%), pemeriksaan produk akhir pencampuran sebanyak 0%, pemilihan pelarut 31 obat (100%), dan jumlah pelarut sebanyak 25 obat (80,6%). Hasil pengamatan ketepatan pemberian menunjukkan ketepatan: teknis aseptis sebanyak 34 obat (100%), lama pemberian 28 obat (82,35%), kecepatan pemberian 30 obat (88,23%), dan kompatibilitas 30 obat (88,23%). Efek plebitis terjadi pada 4 pasien (80%) pengguna obat vesikan. Analisis korelasi menunjukkan bahwa variabel kompatibilitas memiliki hubungan dengan kejadian plebitis (p=0,027). Perbaikan standar operasional prosedur preparasi dan pemberian perlu dilakukan Perbaikan standar operasional prosedur preparasi dan pemberian perlu dilakukan, juga dibutuhkan peran apoteker terutama dalam aspek kompatibilitas obat intravena.

Intravenous medication administration is widely performed in the hospitals. Vesicant drugs have the potential to cause tissue damage including phlebitis. Phlebitis can be avoided by appropriate preparation and admininistration. The aim of this study was to investigate correlation of appropriate prepraration and administration of vesicant drugs and phlebitis effect. Cross sectional study design was carried out using prospective observation of preparing, administering intravenous medications and phlebitis effect in Intensive Care Unit of Panembahan Senopati Hospital Bantul. Five aspects of preparation and four aspects of administration were assessed and presented descriptively. The result of assessment of preparation and administration aspects which have potential effects of phlebitis were presented as patient’s score. Phlebitis was categorized by dichotomous scale in each patient respectively. Correlation analysis of SPSS 15.0 program was used for analysis the data. Nine non-antineoplastic vesicant drugs (i.e., dopamine, dobutamine, amiodarone, diazepam, norepinephrine, vancomycin, aminophylline, calcium glukonate and mannitol) for 28 patients were observed. The number of appropriate preparations of: aseptic technique preparations observed were 34 (100%), proper labelling observed were 26 (78,8%), final checking observed were 0%, type of diluent observed were 31 (100%), and volume of diluent observed were 25 (80,6%). The number of appropriate administration of: aseptic technique administration observed were 34 (100%), duration of administration observed were 28 (82,35%), rate of administration observed were 30 (88,23%), and drug compatibility observed were 30 (88,23%). Phlebitis effects occured in 4 patient (80%) who were given the vesicant drugs. Correlation analysis showed that compatibility aspect have significant correlation with phlebitis (p=0,027). Standard operational procedures of preparation and administration must be improved, the role of pharmacist in compatibility of intravenous drugs is required.

Kata Kunci : obat vesikan, plebitis, intravena perifer, intensive care