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STRUKTUR ORGANISASI INSTALASI FARMASI RSU KERTAYASA NEGARA

DIREKTUR UTAMA

DIREKTUR EKSECUTIVE

KABID. YAN MED & YAN JANG MED

KA. SEKSI YAN JANG MED

KA. INSTALASI FARMASI

Administrasi Instalasi Farmasi

Pelayanan Farmasi Pengelolaan Perbekalan Sediaan Farmasi Farmasi Klinik


Rumah Sakit Umum Kertayasa
Jl. Ngurah Rai No. 143 Negara 82217
Telp. (0365) 41248, 4501243 Fax. (0365) 44378
Email : rsukertayasa@gmail.com

Evaluasi Kepatuhan Penulisan Resep dengan Formularium RS


Jumlah % kesesuaian FORNAS
No Poliklinik
item obat Sesuai Tidaksesuai
1 Poli Anak
2 Poli Obsgyn
3 Poli Bedah
4 Poli Umum
5 Poli Penyakit Dalam
Rata-rata
% kesesuaian resep dengan Formularium RS :
𝑇𝑜𝑡𝑎𝑙𝑖𝑡𝑒𝑚𝑜𝑏𝑎𝑡 𝑠𝑒𝑠𝑢𝑎𝑖 𝐹𝑜𝑟𝑚𝑢𝑙𝑎𝑟𝑖𝑢𝑚 𝑅𝑆
𝑥 100 %
𝑇𝑜𝑡𝑎𝑙𝑖𝑡𝑒𝑚𝑜𝑏𝑎𝑡𝑦𝑎𝑛𝑔 𝑑𝑖𝑟𝑒𝑠𝑒𝑝𝑘𝑎𝑛
% ketidaksesuaian resep dengan formularium RS :
𝑇𝑜𝑡𝑎𝑙𝑖𝑡𝑒𝑚𝑜𝑏𝑎𝑡 𝑡𝑖𝑑𝑎𝑘 𝑠𝑒𝑠𝑢𝑎𝑖 𝐹𝑜𝑟𝑚𝑢𝑙𝑎𝑟𝑖𝑢𝑚 𝑅𝑆
𝑥 100 %
𝑇𝑜𝑡𝑎𝑙𝑖𝑡𝑒𝑚𝑜𝑏𝑎𝑡𝑦𝑎𝑛𝑔 𝑑𝑖𝑟𝑒𝑠𝑒𝑝𝑘𝑎𝑛
Pasien datang membawa resep dari dokter

Pasien diberi nomor urut/antri

Petugas melakukan skrining administrasi, klinis dan farmasetis

Petugas melakukan entry data kedalam komputer

Petugas mengkonfirmasi harga obat ke pasien

Apabila pasien kurang setuju dengan harga yang ditawarkan, obat disubsitusi dengan
obat generik atau diberikan sesusai kemampuan keuangan pasien

Pasien melakukan pembayaran

Dispensing obat oleh petugas farmasi (resep obat racikan/non racikan)

Pemberian etiket dan pengemasan obat kedalam wadah obat/plastik


Pengecekkan akhir, penyerahan obat ke pasien dan memberikan PIO kepada
pasien.Bila diperlukan, melakukan konseling.

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Printer friendly version
High-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in error.
Although mistakes may or may not be more common with these drugs, the consequences of an error are clearly more devastating to
patients. We hope you will use this list to determine which medications require special safeguards to reduce the risk of errors. This
may include strategies like improving access to information about these drugs; limiting access to high-alert medications; using
auxiliary labels and automated alerts; standardizing the ordering, storage, preparation, and administration of these products; and
employing redundancies such as automated or independent doublechecks when necessary. (Note: manual independent double-
checks are not always the optimal error-reduction strategy and may not be practical for all of the medications on the list).

Classes/Categories of Medications Specific Medications

adrenergic agonists, IV (e.g., EPINEPHrine, phenylephrine, EPINEPHrine, subcutaneous


norepinephrine)
epoprostenol (Flolan), IV
adrenergic antagonists, IV (e.g., propranolol, metoprolol,
labetalol) insulin U-500 (special emphasis)*

anesthetic agents, general, inhaled and IV (e.g., propofol, magnesium sulfate injection
ketamine)
methotrexate, oral, nononcologic use
antiarrhythmics, IV (e.g., lidocaine, amiodarone)
opium tincture
antithrombotic agents, including: oxytocin, IV

 anticoagulants (e.g., warfarin, low molecular nitroprusside sodium for injection


weight heparin, IV unfractionated heparin)
potassium chloride for injection concentrate
 Factor Xa inhibitors (e.g., fondaparinux,
apixaban, rivaroxaban) potassium phosphates injection
 direct thrombin inhibitors (e.g., argatroban,
bivalirudin, dabigatran etexilate) promethazine, IV
 thrombolytics (e.g., alteplase, reteplase,
tenecteplase) vasopressin, IV or intraosseous
 glycoprotein IIb/IIIa inhibitors (e.g.,
eptifibatide) *All forms of insulin, subcutaneous and IV, are considered a
class of high-alert medications. Insulin U500 has been singled
cardioplegic solutions
out for special emphasis to bring attention to the need for distinct
chemotherapeutic agents, parenteral and oral strategies to prevent the types of errors that occur with this
concentrated form of insulin.
dextrose, hypertonic, 20% or greater

dialysis solutions, peritoneal and hemodialysis Background

epidural or intrathecal medications Based on error reports submitted to the ISMP National
Medication Errors Reporting Program, reports of harmful
hypoglycemics, oral errors in the literature, studies that identify the drugs most
often involved in harmful errors, and input from practitioners
inotropic medications, IV (e.g., digoxin, milrinone) and safety experts, ISMP created and periodically updates a list
of potential highalert medications. During May and June 2014,
insulin, subcutaneous and IV practitioners responded to an ISMP survey designed to identify
liposomal forms of drugs (e.g., liposomal amphotericin B) and which medications were most frequently considered highalert
conventional counterparts (e.g., amphotericin B desoxycholate) drugs by individuals and organizations. Further, to assure
relevance and completeness, the clinical staff at ISMP,
moderate sedation agents, IV (e.g., dexmedetomidine, members of the ISMP advisory board, and safety experts
midazolam) throughout the US were asked to review the potential list. This
list of drugs and drug categories reflects the collective thinking
moderate sedation agents, oral, for children (e.g., chloral of all who provided input.
hydrate)
© ISMP 2014. Permission is granted to reproduce material with proper attribution for internal use within
narcotics/opioids healthcare organizations. Other reproduction is prohibited without written permission from ISMP. Report
actual and potential medication errors to the ISMP National Medication Errors Reporting Program
(ISMP MERP) via the website (www.ismp.org) or by calling 1800FAILSAF(E).
 IV
 transdermal
 oral (including liquid concentrates, immediate
and sustained release formulations)

neuromuscular blocking agents (e.g., succinylcholine,


rocuronium, vecuronium)

parenteral nutrition preparations

radiocontrast agents, IV

sterile water for injection, inhalation, and irrigation (excluding


pour bottles) in containers of 100 mL or more

sodium chloride for injection, hypertonic, greater than 0.9%


concentration

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200 Lakeside Drive, Suite 200, Horsham, PA 19044, Phone: (215) 947-7797, Fax: (215) 914-1492
© 2017 Institute for Safe Medication Practices. All rights reserved
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ISMP LIST OF HIGH-ALERT MEDICATIONS IN Resources


COMMUNITY/AMBULATORY HEALTHCARE Tools
(printer-friendly version) Assess-ERR
Community Pharmacy
High-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in Medication Safety Tool
error. Although mistakes may or may not be more common with these drugs, the consequences of an error are clearly Resources
more devastating to patients. We hope you will use this list to determine which medications require special safeguards Contact Us
to reduce the risk of errors and minimize harm. This may include strategies like providing mandatory patient education;
improving access to information about these drugs; using auxiliary labels and automated alerts; employing automated
or independent double checks when necessary; and standardizing the prescribing, storage, dispensing, and
administration of these products.

Classes/Categories of Medications Specific Medications

antiretroviral agents (e.g., efavirenz, lamiVUDine,


carBAMazepine
raltegravir, ritonavir, combination antiretroviral
products)
chloral hydrate liquid, for sedation of
chemotherapeutic agents, oral (excluding hormonal children
agents) (e.g., cyclophosphamide, mercaptopurine,
temozolomide) heparin, including unfractionated and low
molecular weight heparin
hypoglycemic agents, oral
metFORMIN
immunosuppressant agents (e.g., azaTHIOprine,
cycloSPORINE, tacrolimus)
insulin, all formulations methotrexate, non-oncologic use

opioids, all formulations midazolam liquid, for sedation of children

pediatric liquid medications that require measurement propylthiouracil

pregnancy category X drugs (e.g.,


warfarin
bosentan, ISOtretinoin)

Background
Based on error reports submitted to the ISMP Medication Errors Reporting Program (ISMP MERP), reports of harmful
errors in the literature, and input from practitioners and safety experts, ISMP created a list of potential highalert
medications. During June-August 2006, 463 practitioners responded to an ISMP survey designed to identify which
medications were most frequently considered highalert drugs by individuals and organizations. In 2008, the preliminary
list and survey data as well as data about preventable adverse drug events from the ISMP MERP, the Pennsylvania
Patient Safety Reporting System, the FDA MedWatch database, databases from participating pharmacies, public
litigation data, literature review, and a small focus group of ambulatory care pharmacists and medication safety experts
were evaluated as part of a research study funded by an Agency for Healthcare Research and Quality (AHRQ) grant.
This list of drugs and drug categories reflects the collective thinking of all who provided input. This list was created as
part of the AHRQ funded project “Using risk models to identify and prioritize outpatient highalert medications” (Grant
# 1P20HS01710701).

Copyright 2011 Institute for Safe Medication Practices (ISMP). This document may be freely redistributed without charge in its entirety provided that this copyright notice is not removed. It may not be sold or distributed for a charge or for
profit or used in commercial documents without the written permission of ISMP. Any quotes or references to this document must be properly cited. This document is provided “as is” without any express or implied warranty. This document
is for educational purposes only and does not constitute legal advice. If you require legal advice, you should consult with an attorney.

Posted on January 30, 2011


Home | Contact Us | Employment | Legal Notices | Privacy Policy | Help Support ISMP

Med-ERRS | Medication Safety Officers Society | For consumers

ISMP Canada | ISMP Spain | ISMP Brasil | International Group | Pennsylvania Patient Safety Authority

200 Lakeside Drive, Suite 200, Horsham, PA 19044, Phone: (215) 947-7797, Fax: (215) 914-1492
© 2017 Institute for Safe Medication Practices. All rights reserved