IBS

INSTALASI BEDAH SENTRAL

Disusun oleh:

Fitri Budiarti
200070600011041
Definisi
IBS
Your Picture Here Instalasi farmasi IBS di RSUD
Kanjuruhan Malang yang bertugas
memenuhi semua perbekalan farmasi
baik obat maupun alat kesehatan
yang dibutuhkan oleh Instalasi
Bedah Sentral untuk tindakan operasi
yang dilakukan di
SDM
Instalasi Bedah Sentral
Kepala instalasi farmasi IBS: 1 orang
(TTK)
Kepala perawat Anestesi: 1 orang
Kepala perawat RIKO: 1 orang

Jam Kerja
sistem satu shift, yaitu mulai
jam 07.00 - 14.00 WIB
 Jenis tindakan operasi
Operasi Cito / Operasi Emergency

• operasi yang dilakukan untuk keadaan atau kasus

tertentu yang memerlukan penanganan bedah
dengan segera

Operasi Terprogram / Operasi Elektif

• operasi bedah yang pelaksanaannya

sudah terjadwal atau telah direncanakan minimal
sehari sebelumnya, dimana pasien berasal dari
bangsal atau ruang rawat inap dan rawat jalan
Paket Operasi berdasarkan jenis o
perasi

Anestesi RA & Bedah Bedah Plastik Bedah Saraf

GA Ortopedi

Bedah Umum Bedah Operasi Mata Obgyn

Digestive

Spine THT Urologi

Pengelolaan Sediaan Farmasi & B
MHP di IBS Pemilihan
&
Perencana Your Picture Here
an
Administr Pengadaa
asi n

Pengendal Pengelolaa Penerimaa

ian n n

Pemusnah
an Penyimpa
& nan
Penarikan
Pendistrib
usian
 1. Perencanaan
Instalasi Farmasi Bedah Sentral
menyediakan perbekalan farmasi
dan alat kesehatan yang diperoleh dari
gudang farmasi

Didasarkan pada
pola konsumsi

Perencanaan dilakukan setiap hari.

2. Pengadaan
• Melalui
Permintaan o/ IBS
SIMRS

• Jika
Gudang farmasi
persediaan yg
menyiapkan
diminta tidak
perbekalan
ada di gudang
farmasi
farmasi

IBS melakukan
peminjaman • Melalui
barang ke depo SIMRS
lain

Permintaan barang dari Instalasi Farmasi Bedah Sentral ke gudang

dilakukan setiap hari selama 5 hari kerja. Permintaan khusus setiap hari rabu
dilakukan untuk setiap ruangan, sementara untuk pengadaan yang bersifat
bulanan dilakukan untuk Poliklinik
3. Penyimpanan

Penyimpanannya menggunakan sistem FEFO (First

Expired First Out) dan FIFO (First In First Out)

Larutan/cairan
Gol. Gol. Psiko dan khusus yg High
Narkotika obat keras  alert disimpan di
double lock lemari khusus lemari khusus

Suhu penyimpanan (suhu ruangan: 15-25 ̊C dan

suhu lemari pendingin : 2-8 oC)
4. Distribusi
RSUD Kanjuruhan Malang menggunakan sistem paket
yang berisi obat dan alkes sesuai paket serta blangko yang telah
terisi sesuai dengan isi paket sebelum digunakan, paket
dibedakan berdasarkan jenis tindakan dan anestesi yaitu
diantaranya, yaitu RA (Regional anestesi), GA (General anestesi),
dan GA Tripanasi (General anestesi + tripanasi).
Alur Operasi Elektif
Perawat mendaftarkan pasien di
administrasi IBS, minimal satu
hari sebelum dilaksanakannya
operasi.
Petugas farmasi memberi label
atau keterangan jenis operasi
pada setiap box.
Petugas farmasi mencocokkan
keterangan pada blangko
pemakaian perbekalan farmasi
IBS dengan jumlah obat dan alat
kesehatan yang ada di box.
Petugas farmasi menerima
daftar jadwal operasi setiap pagi
dari petugas administrasi IBS
Perawat ruang IBS mengambil
box paket perbekalan farmasi di
instalasi farmasi bedah sentral,
sesuai dengan urutan tindakan
operasi dijadwalkan
Jika ditemukan ketidaksesuaian
jumlah obat kembali dengan
keterangan pada blangko
pemakain obat dan alat
kesehatan maka
dilakukan konfirmasi kepada
perawat yang melakukan
tindakan operasi
Petugas farmasi menyiapkan
perbekalan farmasi sesuai
dengan jadwal dan jenis
tindakan masing-masing
pasien dalam bentuk paket
sebuah box disertai blanko
Setelah selesai tindakan operasi,
petugas farmasi mengambil box
paket operasi yang telah
digunakan di ruang operasi.
Setelah diketahui jumlah obat
dan alat kesehatan yang dipakai
dilakukan entry untuk data ke
billing pasien melalui
SIMRS dan akumulasi biaya
operasi yang menjadi
tanggungan pasien di upload di
sistem SIMRS.
Alur Operasi CITO di jam kerja
Petugas IBS memberi
informasi kepada petugas
farmasi bahwa akan ada
tindakan operasi cito dan
menyebutkan jenis tindakan
operasinya.
Petugas farmasi menyertakan
blangko sesuai dengan
Petugas Farmasi segera
perbekalan farmasi yang
menyiapkan paket perbekalan
disediakan, blangko tersebut
farmasi sesuai dengan
sudah diberi keterangan jenis
tindakan yang akan dilakukan.
tindakan operasi yang akan
dilakukan.

Perawat IBS mengambil box

Setelah selesai operasi, Jika ada ketidaksesuaian
paket operasi cito di instalasi
perawat mengembalikan box antara blangko dan sisa
farmasi IBS. Apabila ada obat
paket operasi ke instalasi pemakaian perbekalan farmasi
dan alkes yang diperlukan dan
farmasi IBS disertai dengan di dalam box maka dilakukan
tidak terdapat di box, maka
blangko pemakaian yang telah konfirmasi kepada perawat
perawat mengambilnya
diisi keterangan pemakaian yang melakukan tindakan
langsung ke instalasi farmasi
perbekalan farmasi dan alkes. operasi.
IBS.

Setelah diketahui jumlah obat

dan alkes yang digunakan saat
operasi maka petugas farmasi
melakukan entry data ke
SIMRS untuk menghitung
total billing dan di upload
secara online ke administrasi
IBS.
Alur Operasi CITO di luar jam kerja
Petugas farmasi membuat
persediaan floor stock di
instalasi farmasi IBS dan di
dekat RIKO lantai 2
berdasarkan konsumsi obat
dan alkes di IBS pada hari
efektif.
Perawat menuliskan
pemakaian obat dan alkes
yang telah dipakai selama
tindakan operasi cito di
blangko pemakaian obat dan
alkes.
Jika terdapat ketidaksesuaian
antara jumlah sisa persediaan
dengan penulisan blangko
pemakaian, maka petugas
farmasi melakukan konfirmasi
pada perawat yang
bertanggung jawab.
Jika ada tindakan cito, perawat
memakai persediaan obat dan
Petugas farmasi telah
alkes floor stock yang telah
menyediakan blangko
disediakan di dekat RIKO
pemakaian obat dan alkes di
lantai 2 ataupun di lemari
setiap persediaan floor stock.
pendingin penyimpanan obat
instalasi farmasi IBS.
Perawat meletakkan blangko
Petugas farmasi mencocokkan
pemakaian obat dan alkes di
jumlah pemakaian obat dan
meja atau ruangan instalasi
alkes yang tertulis pada
farmasi IBS untuk di cek oleh
blangko dengan sisa
petugas farmasi pada hari
persediaan floor stock.
berikutnya.
Petugas farmasi meng-entry
Petugas farmasi mengisi
harga obat dan alkes yang
kembali persediaan floor stock
telah digunakan pada tindakan
yang berkurang sesuai dengan
operasi. Billing di upload di
jumlah pemakaian obat dan
SIMRS untuk diserahkan
alkes selama tindakan operasi
kepada pihak administrasi
cito.
secara online.
5. Pengendalian
Instalasi Farmasi Bedah Sentral
Pengendalian melakukan stock opname setiap 3
bulan sekali.

Obat yang Near Expired Date

Pengendalian (NED dapat diinformasikan ke
instalasi farmasi lain yang
membutuhkan obat tersebut

Pengendalian Apabila tidak ada yang

membutuhkan obat tersebut
dengan kondisi obat yang tanggal
kadaluwarsanya dekat maka IBS
mengembalikan ke gudang farmasi
sebelum expired date
 6. Jenis Perbekalan Farmasi IBS
Perbekalan farmasi yang terdapat di Farmasi IBS ± 70%
merupakan alat kesehatan, dan sisanya berupa obat-obat
dengan bentuk sediaan injeksi, inhalasi, dan larutan
(infus). Anestesi: lidocaine 2%, ketamine,
propofol, midazolam

Analgesik opioid: morfin,

pethidine, fentanyl.
Pelumpuh otot: atracurium

(NSAID): tramadol, ketorolac

Antiemetik: ondansentron,
metoclopramide

Cairan infus: NaCl 0,9%, ringer

laktat, dextrose 5%, dextrose 10%,
mannitol
7. Pelaporan

Instalasi Farmasi Bedah Sentral RSUD Kanjuruhan

Malang membuat laporan kepada kepala instalasi farmasi
setiap akhir bulan. Laporan yang dibuat adalah Laporan
penggunaan obat narkotika sesuai resep yang memuat nama
dan umur pasien, alamat lengkap, dokter penulis resep, jumlah
narkotik yang tertulis.
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