KATA PENGANTAR

Puji syukur ke hadirat Tuhan Yang Maha Esa atas segala rahmat dan

karunia-Nya sehingga penulis dapat menyelesaikan Praktek Kerja Profesi (PKP)

dan menyusun laporan Praktik Kerja Profesi Apoteker (PKPA) Farmasi

Komunitas di Rumah Sakit Umum Sembiring Deli Tua. Laporan ini disusun

sebagai salah satu syarat untuk memperoleh gelar apoteker di Fakultas Farmasi

Institusi Kesehatan Deli Husada Deli Tua yang ditulis berdasarkan teori dan hasil

pengamatan selama melakukan PKPA di Rumah Sakit Umum Sembiring Deli

Tua.

Terlaksananya Praktik Kerja Profesi ini tidak terlepas dari bantuan

berbagai pihak. Pada kesempatan ini dengan segala kerendahan hati penulis

mengucapkan banyaj terima kasih kepada Bapak apt. Linta Meilala, S.Si., M.Si

selaku Dekan Fakultas Farmasi Institusi Kesehatan Deli Husada Deli Tua, Ibu apt,

Bunga Rimta Barus, S.Farm., M.Si. Selaku Ketua Program Studi Pendidikan

Profesi Apoteker Fakultas Farmasi Institusi Kesehatan Deli Husada Deli Tua, Ibu

apt, Yustika Rahayu S.Farm. selaku Apoteker Penanggung Jawab di Instalasi

Farmasi Rumah Sakit Umum Sembiring Deli Tua, Bapak dan Ibu Staf Pengajar

Program Studi Profesi Apoteker (PSPA) Fakultas Farmasi Intitusi Kesehatan Deli

Husada Deli Tua atas kerja sama dan bantuan yang diberikan selama penulis

melakukan PKPA.

Penulis menyadari sepenuhnya bahwa dalam penulisan laporan ini masih

jauh dari kesempurnaan. Oleh karena itu, penulis mengharapkan kritik dan saran

yang membangun untuk menyempurnakan laporan ini. Akhir kata, penulis

berharap laporan ini dapat memberikan gambaran yang jelas dan benar mengenai

vi
Rumah Sakit Deli Tua serta memberi manfaat bagi ilmu pengetahuan khususnya

di bidang farmasi.

Delitua, Maret 2020

Penulis,

Lara Chairani Naibaho, S.Farm

NPM: 19.24.121

vi
 DAFTAR ISI

Halaman

JUDUL .............................................................................................................. i

KATA PENGANTAR.......................................................................................

DAFTAR ISI ..................................................................................................... iv

DAFTAR LAMPIRAN.....................................................................................

BAB I PENDAHULUAN ................................................................................. 1

1.1 Latar Belakang ................................................................................ 1

1.2 Tujuan Kegiatan .............................................................................. 3
1.3 Manfaat Kegiatan ............................................................................ 3
1.4 Pelaksaan Kegiatan .........................................................................3

BAB II TINJAUAN UMUM RUMAH SAKIT..............................................4

2.1 Uraian Rumah Sakit .......................................................................... 4
2.1.2 Visi dan Misi Rumah Sakit........................................................4
2.1.2 Tugas Rumah Sakit ...................................................................4
2.1.3 Fungsi Rumah Sakit ..................................................................4
2.1.4 Kladifikasi Rumah Sakit ...........................................................5
2.1.5 Struktur Organisasi Rumah Sakit .............................................7
2.2 Komite/Tim Farmasi dan Terapi (TFT) ...........................................8
2.3 Formularium .....................................................................................9
2.3.1 Formularium Nasional ..............................................................9
2.3.2 Formularium Rumah Sakit .......................................................10
2.4 Instalasi Farmasi Rumah Sakit .........................................................11
2.4.1 Tugas Instalasi Farmasi Rumah Sakit ......................................11
2.4.2 Fungsi Instalasi Farmasi Rumah Sakit .....................................12
2.5 Sumber Daya Manusia Instalasi Farmasi Rumah Sakit ...................13
2.5.1 Klasifikasi Sumber Daya Manusia ...........................................14
2.5.2 Persyaratan Sumber Daya Manusia ..........................................14
2.6 Sarana dan Peralatan Instalasi Farmasi Rumah Sakit ......................15

vi
 2.6.1 Sarana .......................................................................................15
2.6.2 Peralatan ...................................................................................16
2.7 Pengelolaan Sediaan Farmasi, Alat Kesehatan, dan Bahan Medis...17
2.7.1 Pemilihan ................................................................................19
2.7.2 Perencanaan ............................................................................20
2.7.3 Pengadaan ..............................................................................21
2.7.4 Penerimaan .............................................................................22
2.7.5 Penyimpanan ..........................................................................22
2.7.6 Pendistribusian .......................................................................24
2.7.7 Pemusnahan dan Penarikan ....................................................26
2.7.8 Pengendalian ..........................................................................27
2.8 Pelayanan Farmasi Klinis .................................................................28
2.8.1 Pengkajian dan Pelayanan Resep ...........................................28
2.8.2 Penelusuran Riwayat Penggunaan Obat .................................29
2.8.3 Rekonsiliasi Obat ...................................................................31
2.8.4 Pelayanan Informasi Obat (PIO) ...........................................31
2.8.5 Konseling ...............................................................................31
2.8.6 Visite ......................................................................................32
2.8.7 Pemantauan Terapi Obat ........................................................32
2.8.8 Monitoring Efek Samping Obat (MESO) ..............................33
2.8.9 Evaluasi Penggunaan Obat .....................................................33
2.8.10 Dispensing Sediaan Steril ....................................................33
2.8.11 Pemantauan Kadar Obat dalam Darah .................................34
2.9 Instalasi Gas Medis dan Vakum Medik ...........................................34
BAB III TINJAUAN KHUSUS RSU SEMBIRING DELI TUA .................35
3.1 Sejarah RSU Sembiring Deli Tua.....................................................35
3.2 Visi, Misi dan Motto RSU Sembiring Deli Tua................................35
3.3 Struktur Organisasi ...........................................................................36
3.4 Peran Apoteker di RSU Sembiring Deli Tua ...................................37
3.5 Instalasi Farmasi ...............................................................................37
3.5.1 Sistem Pelayanan Perbekalan Farmasi Dan Alat Kesehatan....38

vi
 2.5.2 Sistem Pelayanan Farmasi Klinis.............................................46
3.6 Unit Rawat Inap ...............................................................................53
3.7 Unit Rawat Jalan ..............................................................................54
3.8 Instalasi Gawat Darurat ....................................................................55
3.9 Instalasi Gas Medik ..........................................................................56
3.10 Instalasi CSSD (Central Sterile Supply Departement) ...................56
BAB IV PEMBAHASAN .................................................................................58
4.1 Rumah Sakit Umum Sembiring Deli Tua ........................................58
4.2.1 Pengelolaan Sediaan Farmasi, Alat Kesehatan, dan Bahan ......61
4.2.1.1 Pemilihan ......................................................................61
4.2.1.2 Perencanaan ..................................................................62
4.2.1.3 Pengadaan ....................................................................62
4.2.1.4 Penerimaan ...................................................................63
4.2.1.5 Penyimpanan ................................................................64
4.2.1.6 Pendistribusian .............................................................69
4.2.2.Sistem Pelayanan Farmasi Klinis ............................................70
4.2.2.1 Pengkajian dan Pelayanan Resep .................................70
4.2.2.2 Penelusuran Riwayat Penggunaan Obat .......................72
4.2.2.3 Rekonsiliasi Obat .........................................................72
4.2.2.4 Pelayanan Informasi Obat (PIO) ..................................73
4.2.2.4 Konseling .....................................................................74
4.2.2.5 Visite ............................................................................75
4.2.2.6 Pemantauan Terapi Obat (PTO) ...................................75
4.2.2.7 Pelayanan Kemoterapi .................................................75

BAB V KESIMPULAN DAN SARAN ...........................................................77

1.1 Kesimpulan ............................................................................................77
1.2 Saran .......................................................................................................78
DAFTAR PUSTAKA
LAMPIRAN

vi
 DAFTAR LAMPIRAN

Lampiran 1. Sistem Organisasi Rumah Sakit .....................................................

Lampiran 2. Surat Pesanan Narkotika.................................................................

Lampiran 3. Surat Pesanan Narkotika/Prekusrsor ..............................................

Lampiran 4. Formulir Pesanan Pembelian ..........................................................

Lampiran 5. Tanda Terima Pelaporan Narkotika ...............................................

vi
 DAFTAR ISI

Halaman

JUDUL ................................................................................................................ i

KATA PENGANTAR......................................................................................... ii

DAFTAR ISI ....................................................................................................... iv

DAFTAR TABEL ............................................................................................... iv

BAB I PENDAHULUAN ................................................................................... 1

1.1 Latar Belakang ............................................................................. 1
1.2 Tujuan Kegiatan .......................................................................... 2

BAB II TINJAUAN PUSTAKA......................................................................... 3

2.1 Tuberkulosis ........................................................................................ 3
2.1.1 Defenisi ....................................................................................... 3
2.1.2 Tuberkulosis Paru ....................................................................... 4
2.2 Etimologi dan Patogenesis .................................................................. 4
2.3 Tanda-Tanda dan Gejala Klinis .......................................................... 7
2.4 Patofisiologi ........................................................................................ 8
2.5 Regimen Pengobatan .......................................................................... 8
2.6 Gastritis ...............................................................................................13
BAB III STUDI KASUS .....................................................................................15
3.1 Identifikasi Pasien ...............................................................................15
3.2 Riwayat Penyakit dan Pengobatan ......................................................15
3.2.1 Riwayat Penyakit Terdahulu .....................................................15
3.2.2 Riwayat Penyakit Keluarga ......................................................15
3.2.3 Riwayat Alergi...........................................................................15
3.2.4 Riwayat Penggunaan Obat Terdahulu ......................................15
3.3 Ringkasan PadaWaktu Pasien di RSU Sembiring .............................16
3.4 Pemeriksaan Menunjang .....................................................................17
3.5 Pemeriksaan Fisik ...............................................................................17
3.6 Pemeriksaan Laboratorium .................................................................15

vi
 3.7 Obat-Obat yang Digunakan Pasien .....................................................18
3.8 Daftar pemberian Obat .......................................................................19
3.9 Obat PBJ (Pasien Berobat Jalan).........................................................20
3.10 Catatan Perkembangan Pasien Terintegritas.....................................21
3.11 Informasi Konseling dan Edukasi Pasien .........................................26
3.11.1 Tepat Pasien ............................................................................27
3.11.2 Terpat Obat .............................................................................27
3.11.3 Tepat Indikasi .........................................................................28
3.11.4 Tepat Dosis .............................................................................29
3.11.5 Waspada Efek Samping ..........................................................29
BAB IV PEMBAHASAN ...................................................................................31
BAB V KESIMPULAN DAN SARAN .............................................................34
5.1 Kesimpulan ..................................................................................34
5.2 Saran ............................................................................................34
DAFTAR PUSTAKA

vi
 DAFTAR TABEL

Tabel 2.1 Paduan pengobatan standar yang direkomendasi oleh WHO dan
IUATLD (International Union Agains Tuberculosis and Lung
Disease).................................................................................................10
Tabel 2.2 Jenis OAT-FDC yang tersedia di program penanggulangan TBC.......11
Tabel 2.3 Dosis Pengobatan OAT FDC tablet FDC (4FDC atau 2FDC).............11
Tabel 3.1 Hasil pemeriksaan Laboratorium .........................................................17
Tabel 3.2 Hasil Pemeriksaan Microscopik BTA..................................................18
Tabel 3.3 Obat-Obat yang Digunakan Pasien.......................................................18
Tabel 3.4 Daftar Pemberian Obat........................................................................19
Tabel 3.5 Obat PBJ (Pasien Berobat Jalan)..........................................................20
Tabel 3.6 Informasi Konseling dan Edukasi Pasien.............................................26
Tabel 3.7 Tabel tepat Obat....................................................................................27
Tabel 3.8 Tabel Tepat Indikasi.............................................................................28
Tabel 3.9 Tabel dosis............................................................................................29
Tabel 3.10 Tabel Waspada Efek Samping ...........................................................29
Tabel 4.1 Penggunaan terapi pengobatan ............................................................31

vi