GAMBARAN PENYIMPANAN OBAT-OBAT HIGH ALERT DI DI INSTALASI FARMASI FARMASI RSUD DR. MOHAMAD SALEH KOTA PROBOLINGGO
KARYA KARYA TULIS ILMIAH IL MIAH
OLEH FARIDA NUR AINI NIM 11032
AKADEMI FARMASI PUTRA INDONESIA MALANG JANUARI 2014
ABSTRAK
Aini, Faria N!r" 2014" Gambaran Penyimpanan Obat-obat High Alert Di Instalasi Farmasi RSUD Dr. Dr. Mohamad Saleh ota Probolinggo" Probolinggo" Kar#a T!$i% I$&ia'" A(a)&i A(a)&i Far&a%i Far&a%i P!*ra In+n)%ia Ma$an" P)&-i&-in P)&-i&-in Erna S!%an*i",M" S!%an*i",M" Bi+&)",A.*" Ka*a (!n/i Ga&-aran, P)n#i&.anan +-a*, O-a* High O-a* High Alert , In%*a$a%i Far&a%i, !he" list O-a* High O-a* High Alert aa$a' aa$a' +-a* #an &)n#)-a-(an r)%i(+ *ini ()*i(a *)rai ()%a$a'an a$a& a$a& .)&-)r .)&-)rian iann#a n#a"" P)n#i&. P)n#i&.anan anan +-a* High Alert i In%*a$ In%*a$a%i a%i Far&a% Far&a%ii aa$a' aa$a' ()ia* ()ia*an an .)na* .)na*!ra !ran n +-a* +-a* #an #an &)$i.!* &)$i.!*ii +-a* i%i&. i%i&.an an i *)&.a* *)&.a* *)r.i% *)r.i%a' a' *ia( *ia( i/a&.!r )nan +-a* $ain, .)n!$i%an na&a +-a* an (+n%)n*ra%i )$a% an *ia( i%in(a*, .)&-)rian *ana .)rina*an High .)rina*an High Alert , an &)n!na(an %i%*)& #all man !n*!( +-a* +$+nan LASA $oo" $oo" Ali"e So%nd Ali"e" Ali"e" T!!an .)n)$i*ian ini aa$a' !n*!( &)na&-ar(an &)na&-ar(an .)n#i&.anan .)n#i&.anan +-a* High +-a* High Alert i i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ an &)na&-i$ ()%i&.!$an (a*)+ri .)n#i&.anan +-a* High +-a* High Alert -)ra%ar(an -)ra%ar(an ana$i%i% a*a &)n!na(an $)&-ar /')/($i%*" P)n)$i*ian ini a.a* i+$+n(an a$a& .)n)$i*ian )%(ri.*i i&ana a*a i%ai(an a$a& -)n*!( *a-)$ ari 'a%i$ .)n+$a'an a*a )nan in%*r!&)n* .)n)$i*ian -)r!.a /')( $i%* #an ()&!ian ()&!ian ia&-i$ ia&-i$ ()%i&.!$an"H ()%i&.!$an"Ha%i$ a%i$ .)n)$i*ian .)n)$i*ian ia.a*(an ia.a*(an 4 +$+nan +$+nan +-a* #an *)r&a%!( Hi' A$)r* #ai*! +$+nan nar(+*i( an .%i(+*r+.i(, +$+nan LASA $oo" $oo" Ali"e So%nd Ali"e, Ali"e, +$+ +$+n nan an )$)( )$)(*r *r+$ +$i* i* (+n% (+n%)n )n*r *ra* a* an an +$+ +$+n nan an +-a* +-a* )na )nan n .)r$a(!an ('!%!% a$a& .)&-)rian" B)ra%ar(an .)n a&a*an .)n#i&.anan +-a*5+-a* *)r% *)r%)-! )-!** a.a a.a** i%i i%i&. &.!$ !$(a (an n -a'6a -a'6a .)n# .)n#i& i&.an .anan an &a%! &a%!( ( a$a& a$a& (a*) (a*)+r +rii -ai( -ai("" P)n#i&.anan P)n#i&.anan +-a*5+-a* High +-a*5+-a* High Alert i i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ Pr+-+$in+ i'ara.(an i'ara.(an i*in(a*(an i*in(a*(an *)r!*a&a *)r!*a&a a$a& 'a$ &)&i%a'(an &)&i%a'(an +-a* High Alert ari +-a* #an $ain, .)&-)rian .)&-)rian *ana .)rina*an -)r*!$i%(an -)r*!$i%(an High High Alert , an .)n!$i%an na&a +-a* LASA $oo" $oo" Ali"e So%nd Ali"e Ali"e &)n!na(an %i%*)& #all man. S)'in S)'in aa ()6a ()6a%. %.a aaa aan n *)na *)naa a ()%)'a ()%)'a*a *an n *)r' *)r'a aa. a. +-a* +-a* High Alert $)-i' &)nin(a*"
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ABSTRAK
Aini, Faria N!r" 2014" Gambaran Penyimpanan Obat-obat High Alert Di Instalasi Farmasi RSUD Dr. Dr. Mohamad Saleh ota Probolinggo" Probolinggo" Kar#a T!$i% I$&ia'" A(a)&i A(a)&i Far&a%i Far&a%i P!*ra In+n)%ia Ma$an" P)&-i&-in P)&-i&-in Erna S!%an*i",M" S!%an*i",M" Bi+&)",A.*" Ka*a (!n/i Ga&-aran, P)n#i&.anan +-a*, O-a* High O-a* High Alert , In%*a$a%i Far&a%i, !he" list O-a* High O-a* High Alert aa$a' aa$a' +-a* #an &)n#)-a-(an r)%i(+ *ini ()*i(a *)rai ()%a$a'an a$a& a$a& .)&-)r .)&-)rian iann#a n#a"" P)n#i&. P)n#i&.anan anan +-a* High Alert i In%*a$ In%*a$a%i a%i Far&a% Far&a%ii aa$a' aa$a' ()ia* ()ia*an an .)na* .)na*!ra !ran n +-a* +-a* #an #an &)$i.!* &)$i.!*ii +-a* i%i&. i%i&.an an i *)&.a* *)&.a* *)r.i% *)r.i%a' a' *ia( *ia( i/a&.!r )nan +-a* $ain, .)n!$i%an na&a +-a* an (+n%)n*ra%i )$a% an *ia( i%in(a*, .)&-)rian *ana .)rina*an High .)rina*an High Alert , an &)n!na(an %i%*)& #all man !n*!( +-a* +$+nan LASA $oo" $oo" Ali"e So%nd Ali"e" Ali"e" T!!an .)n)$i*ian ini aa$a' !n*!( &)na&-ar(an &)na&-ar(an .)n#i&.anan .)n#i&.anan +-a* High +-a* High Alert i i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ an &)na&-i$ ()%i&.!$an (a*)+ri .)n#i&.anan +-a* High +-a* High Alert -)ra%ar(an -)ra%ar(an ana$i%i% a*a &)n!na(an $)&-ar /')/($i%*" P)n)$i*ian ini a.a* i+$+n(an a$a& .)n)$i*ian )%(ri.*i i&ana a*a i%ai(an a$a& -)n*!( *a-)$ ari 'a%i$ .)n+$a'an a*a )nan in%*r!&)n* .)n)$i*ian -)r!.a /')( $i%* #an ()&!ian ()&!ian ia&-i$ ia&-i$ ()%i&.!$an"H ()%i&.!$an"Ha%i$ a%i$ .)n)$i*ian .)n)$i*ian ia.a*(an ia.a*(an 4 +$+nan +$+nan +-a* #an *)r&a%!( Hi' A$)r* #ai*! +$+nan nar(+*i( an .%i(+*r+.i(, +$+nan LASA $oo" $oo" Ali"e So%nd Ali"e, Ali"e, +$+ +$+n nan an )$)( )$)(*r *r+$ +$i* i* (+n% (+n%)n )n*r *ra* a* an an +$+ +$+n nan an +-a* +-a* )na )nan n .)r$a(!an ('!%!% a$a& .)&-)rian" B)ra%ar(an .)n a&a*an .)n#i&.anan +-a*5+-a* *)r% *)r%)-! )-!** a.a a.a** i%i i%i&. &.!$ !$(a (an n -a'6a -a'6a .)n# .)n#i& i&.an .anan an &a%! &a%!( ( a$a& a$a& (a*) (a*)+r +rii -ai( -ai("" P)n#i&.anan P)n#i&.anan +-a*5+-a* High +-a*5+-a* High Alert i i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ Pr+-+$in+ i'ara.(an i'ara.(an i*in(a*(an i*in(a*(an *)r!*a&a *)r!*a&a a$a& 'a$ &)&i%a'(an &)&i%a'(an +-a* High Alert ari +-a* #an $ain, .)&-)rian .)&-)rian *ana .)rina*an -)r*!$i%(an -)r*!$i%(an High High Alert , an .)n!$i%an na&a +-a* LASA $oo" $oo" Ali"e So%nd Ali"e Ali"e &)n!na(an %i%*)& #all man. S)'in S)'in aa ()6a ()6a%. %.a aaa aan n *)na *)naa a ()%)'a ()%)'a*a *an n *)r' *)r'a aa. a. +-a* +-a* High Alert $)-i' &)nin(a*"
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KATA KAT A PENGAN PEN GANTAR TAR
P!i P!i %#!(! %#!(!rr ()'ai ()'aira ra** A$$a' $$a' S7 S7T T #an #an *)$a *)$a' ' &)$i &)$i&. &.a' a'(an (an ra'& ra'&a* a* an 'ia#a'5N#a %)'ina .)n!$i% a.a* &)n#)$)%ai(an Kar#a T!$i% I$&ia' #an -)r!!$ 8Ga&-ar 8Ga&-aran an P)n#i&. P)n#i&.anan anan O-a*5+ O-a*5+-a* -a* Hi' Hi' A$)r* A$)r* i In%*a$ In%*a$a%i a%i Far&a% Far&a%ii RSUD RSUD Dr" Dr" M+'a&a Sa$)' K+*a Pr+-+$in+9 ini *).a* .aa 6a(*!n#a" Aa.!n *!!an .)n!$i%an Kar#a T!$i% I$&ia' ini aa$a' %)-aai .)r%#ara*an !n*!( &)n#)$)%ai(an .r+ra& D III A(a)&i Far&a%i P!*ra In+n)%ia Ma$an" S)'!-!n )nan *)r%)$)%ai *)r%)$)%ai(ann#a (ann#a .)n!$i%an Kar#a T!$i% T!$i% I$&ia' ini, %a#a &)n!/a.(an *)ri&a (a%i' ().aa .i'a(5.i'a( #ai*! 1" I-! Lai$ii#a*!% Lai$ii#a*!% S#aa', S#aa', S"Far&, S"Far&, A.*", A.*", %)$a(! %)$a(! Dir)(*!r Dir)(*!r A(a)&i A(a)&i Far&a%i Far&a%i P!*ra P!*ra
2" 3" 4" :"
In+n)%ia Ma$an I-! Erna Erna S!%an*i, S!%an*i, M"Bi+& M"Bi+&), ), A.*", A.*", %)$a(! %)$a(! +%)n .)&-i& .)&-i&-in -in I-! Enan Enan S!%i$+6 S!%i$+6a*i, a*i, M"Far&5 M"Far&5K$in" K$in",A.*" ,A.*",, %)$a(! %)$a(! +%)n +%)n .)n!i .)n!i Ba.a( Ba&-an Ba&-an Ari, Ari, S"%i", S"%i", A.*", A.*", %)$a(! %)$a(! +%)n +%)n .)n!i .)n!i I-! Dra" Sri Sri P!r6an*i" P!r6an*i" A.* A.* %)$a(! %)$a(! .)&-i&-in .)&-i&-in i RSUD RSUD Dr" M+'a&a M+'a&a Sa$)'
K+*a Pr+-+$in+ ;" Ba.a( an i-! i-! +%)n +%)n A(a)&i A(a)&i Far&a% Far&a%ii an %)&!a %*a <" K)!a +ran +ran *!a, #an #an &)&-)ri(an &)&-)ri(an +a +a an &+*i=a%i &+*i=a%i -ai( -ai( %)/ara %)/ara &a*)ri$ &a*)ri$ an an %.iri*!a$ >" R)(a R)(an5r n5r)(a )(an n &a'a% &a'a%i% i%6a 6a an an %)&! %)&!aa .i'a( .i'a( #an *)$a *)$a' ' &)&&)&-an an*! *! ().a ().aa a .)n!$i% P)n!$i% P)n!$i% &)n#a &)n#aari ari -a'6a -a'6a a$a& a$a& .)n!$i% .)n!$i%an an Kar#a Kar#a T!$i% T!$i% I$&ia' I$&ia' ini -)$!& -)$!& %)&.!rna" %)&.!rna" O$)' %)-a- i*!, (ri*i( (ri*i( an %aran a(an %ana* %ana* i'ara.(an" i'ara.(an" S)&+a Kar#a T!$i% I$&ia' ini a.a* -)r!na an -)r&anaa*"
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Ma$an, J!ni 2014
P)n!$i%
DAFTAR ISI
ABSTRAK ..................................................................................................... . i KATA PENGANTAR .......................................................................... .............. ii
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DAFTAR ISI.................................................................................................. iv DAFTAR TABEL............................................................................................ vi DAFTAR GAMBAR ....................................................................................... vii DAFTAR LAMPIRAN.................................................................................... viii BAB I PENDAHULUAN.................................................................................................. 1 1.1 Latar belakan........................................................................................................1 1.! R"#"$an Ma$ala%..................................................................................................& 1.' T"("an Penel)t)an...................................................................................................* 1.& Man+aat Penel)t)an................................................................................................., 1., R"an l)nk" an Keterbata$an enel)t)an......................................................../ 1./ De+)n)$) )$t)la%........................................................................................................./ BAB II TIN0AUAN PUSTAKA........................................................................................ !.1 De+)n)$) R"#a% Sak)t............................................................................................. !.! De+)n)$) Ke$ela#atan Pa$)en................................................................................12 !.' De+)n)$) In$)en Ke$ela#atan Pa$)en..................................................................1 !.& De+)n)$) In$tala$) Far#a$) R"#a% Sak)t.............................................................!& !.* De+)n)$) 3bat-3bat High Alert ...............................................................................!4 Tabel !.& Fakt3r Re$)k3 Obat-3bat High Alert ...............................................................'1 !., Keranka te3r)......................................................................................................'' BAB III METODOLOGI PENELITIAN.......................................................................', '.1 Ran5ananPenel)t)an............................................................................................', '.! P3"la$).................................................................................................................', '.' L3ka$) an 6akt" enel)t)an................................................................................', '.& De+)n)$) Oera$)3nal 7ar)abel..............................................................................'/ Tabel '.1 De+)n)$) Oera$)3nal 7ar)abel.........................................................................'/ '.* In$tr"#en enel)t)an............................................................................................'4 '., Pen"#"lan ata................................................................................................'4 './ Anal)$)$ ata..........................................................................................................' BAB I7 HASIL PENELITIAN............................................................................... ........ &1 &.1 Ha$)l Penel)t)an.....................................................................................................&1 &.! Pe#ba%a$an..........................................................................................................*& BAB 7 PENUTUP............................................................................................................ ,! *.1 Ke$)#"lan...........................................................................................................,! *.! Saran.....................................................................................................................,! Da+tar R"("kan................................................................................................................ ,& La#)ran-la#)ran.................................................................................................... .....,*
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DAFTAR TABEL
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DAFTAR GAMBAR
6
DAFTAR LAMPIRAN
7
BAB I PENDAHULUAN
1.1
Latar belakan
T)&.a* .)$a#anan ()%)'a*an &a%#ara(a* #an &)&-)ri(an .)$a#anan &)i% an(a .anan &a!.!n .)n)( aa$a' r!&a' %a(i* i&ana *)&.a* ini &)r!.a(an a%i$i*a% .)$a#anan ()%)'a*an #an &)&i$i(i +rani%a%i #an %ana* -)raa& an %ana* i.)r$!(an a$a& &)n!(!n .)n#)$)naraan ()%)'a*an"R!&a' %a(i* &)&i$i(i -)r-aai )ni% *)naa ()%)'a*an )nan i$&!n#a #an -)raa& an -)rin*)ra(%i %a*! %a&a $ain" B)ra%ar(an !n%in#a &)n!(!n .)n#)$)naraan ()%)'a*an %!a' %)'ar!%n#a r!&a' %a(i* &)r!.a(an *)&.a* !n*!( .)n#)&-!'an .)n#a(i* an .)&!$i'an ()%)'a*an K).&)n()% RI n+"12? *a'!n 200>" B)r-aai !.a#a !n*!( &)nin(a*(an !n%i r!&a' %a(i* %)-aai -aan .)$a#anan ()%)'a*an !n*!( !&!& *)$a' i$a(!(an"Sa$a' %a*!n#a )nan &)&-!a* %*anar* &ini&a$ r!&a' %a(i* i&ana *)ra.a* .)ra*!ran5.)ra*!ran #an &)nai *+$a( !(!r .)n/a.aian %*anar* .)$a#anan #an -ai( -ai .a%i)n" Hara.an aan#a %*anar* &ini&a$ r!&a' %a(i* *)r%)-!* a.a* &)nin(a*(an ().!a%an .a%i)n an &)&-an*! .r+%)% .)&!$i'an ()%)'a*an .a%i)n %)$a&a ira6a* i r!&a' %a(i*"Na&!n !.a#a #an i$a(!(an *ia( 'an#a +(!% .aa ().!a%an an .)&!$i'an ()%)'a*an .a%i)n *)*a.i ()%)$a&a*an .a%i)n !a 'ar!% i*in(a*(an" K)%)$a&a*an .a%i)n aa$a' %!a*! %i%*)& i&ana r!&a' %a(i* &)&-!a* %!a*! a%!'an .a%i)n $)-i' a&an #an &)$i.!*i a%)%&)n r)%i(+, i)n*ii(a%i, an .)n)$+$aan 'a$ #an -)r'!-!nan )nan r)%i(+ .a%i)n, P)$a.+ran an ana$i%i% in%i)n, ()&a&.!an -)$aar ari in%i)n an *ina( $an!*n#a %)r*a i&.$)&)n*a%i %+$!%i !n*!( &)&ini&a$(an *i&-!$n#a r)%i(+ an
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&)n/)a' *)rain#a /))ra #an i%)-a-(an +$)' ()%a$a'an a(i-a* &)$a(%ana(an %!a*! *ina(an a*a! *ia( &)na&-i$ *ina(an #an %)'ar!%n#a ia&-i$" Di a$a& ()%)$a&a*an .a%i)n *)ra.a* i%*i$a' in%i)n ()%)$a&a*an .a%i)n #ai*! %)*ia. ()aian #an *ia( i%)naa an (+ni%i #an &)na(i-a*(an a*a! -)r.+*)n%i &)na(i-a*(an /))ra #an a.a* i/)a' .aa .a%i)n, *)riri ari ()aian #an *ia( i'ara.(an KTD, ()aian n#ari% /))ra KN@, K)aian *ia( /))ra KT@, K)aian .+*)n%ia$ /))ra KP@" B)ra%ar(an $a.+ran in%i)n ()%)$a&a*an .a%i)n KKP5RS *a'!n 2011 &)n!r!* )ni% in%i)n *)ra.a* KN@ 1>,:3, KTD 14,41, *ia( aa a*a 2,;" B)ra%ar(an !ni* .)n#)-a- ().)ra6a*an &)n!!(i .)rin(a* .)r*a&a 11,32, ar&a%i &)n!!(i .)rin(a* ()!a ;,1<" B)ra%ar(an *i.) in%i)n .r+%)% a*a! .r+%)!r ($ini( an &)i(a%i %a&a &)&i$i(i .r+%)n*a%) ()aian ?, 2;" B)ra%ar(an ()aian5()aian *)r%)-!* a.a* &)ni&-!$(an medi&ation error #ai*! ()aian #an &)r!i(an .a%i)n a(i-a* ()%a$a'an a$a& .r+%)% .)n+-a*an %)$a&a a$a& .)nananan *)naa ()%)'a*an, #an %)-)*!$n#a a.a* i/)a' K).&)n()% n+ 102<" P)n#)-a- ()%a$a'an .)n+-a*an an*ara $ain (!rann#a i%)&ina%i .)n)*a'!an *)r!*a&a .ara +(*)r #an &)n#)-a-(an 22 ()%a$a'an, *ia( /!(!.n#a in+r&a%i &)n)nai .a%i)n &i%a$n#a a*a !i $a-+ra*+ri!&, S)-an#a( 10 ()%a$a'an +%i% #an
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()ra,()*ia(*a'!an .a%i)n" B)ra%ar(an $a.+ran JAMA #he 'o%rnal o( the Ameri&an Medi&al Asso&iation 1??: &)n!n!((an -a'6a .)rin(a* .a$in *ini ()%a$a'an .)n+-a*an .aa *a'a. ordering 4?, ii(!*i *a'a. administration management 2;, pharma&y management 14, trans&ribing 11" B)ra%ar(an ()*)ranan *)r%)-!* a.a* i$i'a* &ana)&)n ar&a%i !a *!r!* ani$ a$a& &)ni&-!$(an ()%a$a'an .)n+-a*an" Medi&ation error a$a& ()ar&a%ian a.a* *)rai (ar)na ()%a$a'an .)&-)rian +-a* &)$i.!*i %a$a' +-a*, %a$a' +%i%, %a$a' r!*) .)&-)rian, %a$a' .)r)%).an, .)$a-)$an #an *ia( *).a*, *ia( a.a* &)&-a/a r)%). (ar)na .)n!$i%an #an *ia( )$a%, an &ana)&)n +-a*" Un*!( &)n/)a' medi&ation error ('!%!%n#a a$a& .)&-)rian +-a* ar&a%i% 'ar!% $)-i' 6a%.aa %aa* &)$a(!(an .)$a#anan +-a*, ('!%!%n#a .)&-)rian +-a*5+-a* High Alert "O-a*5+-a* #an .)r$! i6a%.aai )High Alert aa$a' +-a* #an -)r)%i(+ *ini i(a *)rai ()%a$a'an an -)r.+*)n%i &)ni&-!$(an ()%a$a'an .)n+-a*an a*a! medi&ation error.ISMP Instit%te (orSa(e Medi&ation Pra&ti&e* *)$a' &)&-!a* a*ar +-a* #an *)r&a%!( a$a& +$+nan +-a* 'i' a$)r* ian*aran#a )$)(*r+$i* .)(a*, an*i*r+&-+*i(, an*iia-)*i( +ra$, an .ar)n*)ra$, an*iari*&ia, an)%*)*i( an .)n'a&-a* n)!r+&!%/!$ar" U.a#a #an a.a* i$a(!(an !n*!( &)n/)a' ()%a$a'an a(i-a* .)n!naan +-a* High Alert %a$a' %a*!n#a aa$a' &)na*!r .)n#i&.anan +-a* *)r%)-!*"Ha$ *)r%)-!* !n*!( &)n/)a' ()%a$a'an -)r!.a %a$a' +-a* !n*!( +$+nan LASA an %a$a' +%i% !n*!( $ar!*an (+n%)n*ra*"
3
Aa.!n !.a#a #an a.a* i$a(!(an ar&a%i% ian*aran#a &)na*!r .)n#i&.anan +-a* High Alert #an aa i In%*a$a%i Far&a%i, i(!* %)r*a a$a& *i& &)i% !n*!( &)n#)ia(an in+r&a%i .)n+-a*an i(a &)n!na(an +$+nan +-a* High Alert , &)&-!a* ana$i%a, &)nin*)r.r)%*a%i(an ar&a(+(in)*i( .)n+-a*an, &)&+ni*+r ))( %a&.in an in*)ra(%i +-a*, &)n)!( a%i .r+)%%i+na$ ()%)'a*an $ain, an &)ni)n*ii(a%i ()%a$a'an" B)ra%ar(an !n%i r!&a' %a(i* %)-aai .)$a#anan ()%)'a*an %!a' %)'ar!%n#a &)nin(a*(an ()%)$a&a*an .a%i)n aar .a%i)n &)na.a*(an .)$a#anan #an &a(%i&a$"O$)' (ar)na i*! .)r$! i*in(a*(an !.a#a5!.a#a !n*!( &)&.)r-ai(i ()-ia(an #an aa %)%!ai )nan %*anar* #an -)r$a(!"Far&a%i% !a .)r$! &)$a(!(an !.a#a5!.a#a .)nin(a*an ()%)$a&a*an .a%i)n a$a& 'a$ .)n)$+$aan +-a*5 +-a*an"O$)' (ar)na i*! i$a(!(an .)n)$i*ian #an -)r!!$ 8Ga&-aran P)n#i&.anan O-a*5+-a* High Alert i In%*a$a%i Far&a%i R!&a' Sa(i*9" D)nan &)$a(!(an .)n)$i*ian ini i'ara.(an 'a%i$n#a &)&-)ri(an
an &)&-an*! a$a& &)n)$+$a
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B)ra%ar(an .)na'!$!an ia*a%, &a(a r!&!%an &a%a$a' a$a& .)n)$i*ian ini 1"2"1
Baai&ana
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RSUD Dr"M+'a&a Sa$)' K+*a Pr+-+$in+
4
1.' T"("an Penel)t)an
1"3"1 T!!an !&!& T!!an !&!& ari .)n)$i*ian ini aa$a' !n*!( &)n)*a'!i a&-aran .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%iRSUD Dr"M+'a&a Sa$)' K+*a Pr+-+$in+ 1"3"2
T!!an K'!%!%
1" Un*!( &)ni%(ri.%i(an -aai&ana /ara .)$a-)$an +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr"M+'a&a Sa$)' K+*a Pr+-+$in+ 2" Un*!( &)n)%(ri.%i(an -aai&ana a*!ran *a*a $)*a( .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr"M+'a&a Sa$)' K+*a Pr+-+$in+ 3" Un*!( &)ni%(ri.%i(an a.a(a' &)n!na(an %i%*)& FIFO a*a! FEFO a$a& .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr"M+'a&a Sa$)' K+*a Pr+-+$in+ 4" Un*!( &)ni%(ri.%i(an a.a(a' .)n#i&.anan +-a*5+-a* High Alert &)n!r!* )ni% %)iaan an %)%!ai a$.'a-)*i% i In%*a$a%i Far&a%i RSUD Dr"M+'a&a Sa$)' K+*a Pr+-+$in+ :" Un*!( &)ni%(ri.%i(an .)n#i&.anan +-a* LASA $oo" Ali"e So%nd Ali"e #an *)r&a%!( High Alert %!a' &)n!na(an %i%*)& Ta$$&an i In%*a$a%i Far&a%i RSUD Dr"M+'a&a Sa$)' K+*a Pr+-+$in+ 1.& Man+aat Penel)t)an
1"4"1 Bai *)naa ()%)'a*an Ha%i$ .)n)$i*ian ini
i'ara.(an a.a*
&)&-)ri(an in+r&a%i #an
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&)&a'a&i +-a*5+-a* +$+nan High Alert aar &)nin(a*(an .)$a#anan #an a&an an -)r&!*! *ini" 1"4"2 Bai &a%#ara(a* Ha%i$ .)n)$i*ian ini i'ara.(an a.a* &)nin(a*(an .)$a#anan ()%)'a*an i r!&a' %a(i* %)'ina &a%#ara(a* a(an &)na.a*(an .)$a#anan #an &a(%i&a$" 1"4"3 Bai *)&.a* .)n)$i*ian Ha%i$ .)n)$i*ian ini i'ara.(an a.a* iai(an &a%!(an in+r&a%i a$a& ()ia*an .)n#i&.anan +-a*5+-a* High Alert an a.a* &)&-an*! &)nanani .)n)$+$aan +-a*5+-a* High Alert " 1": A%!&%i P)n)$i*ian Di.)r$!(an .)r'a*ian ('!%!% a$a& .)n#i&.anan +-a*5+-a* High Alert %)'ina &)na.a* .)na6a%an $)-i' an ()aian medi&ation error a.a* i/)a'" 1"; R!an $in(!. an K)*)r-a*a%an .)n)$i*ian R!an $in(!. ari .)n)$i*ian ini aa$a' .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr"M+'a&a Sa$)' K+*a Pr+-+$in+ " K)*)r-a*a%an .)n)$i*ian ini aa$a' .)na&a*an #an i$a(!(an 'an#a &)n#+r+*i .)n#i&.anan %aa %)'ina *ia( -i%a &)na&-ar(an %)$!r!' .r+%)% .)n)$+$aan ari +-a*5+-a* High Alert " 1./ De+)n)$) )$t)la%
Medi&ation error aa$a' i%*i$a' ari ()%a$a'an a$a& .)n+-a*an #ai*! ()aian &)r!i(an .aa .a%i)n a(i-a* .)&a(aian +-a* %)$a&a a$a& .)nananan *)naa ()%)'a*an, #an %)-)*!$n#a a.a* i/)a'"
6
O-a* High Alert aa$a' +-a* #an -)r)%i(+ *ini i(a *)rai ()%a$a'an an -)r.+*)n%i &)ni&-!$(an ()%a$a'an .)n+-a*anmedi&ation error " Patient sa(ety aa$a' aa$a' %#%*)& i&ana r!&a' %a(i* &)&-!a* a%!'an .a%i)n #an $)-i' a&an &)$i.!*i a%)%&)n r)%i(+, i)n*ii(a%i, an .)n)$+$aan ' a$ #an -)r'!-!nan )nan r)%i(+ .a%i)n, .)$a.+ran an ana$i%i% in%i)n, ()&a&.!an -)$aar ari in%i)n an *ina( $an!*n#a %)r*a i&.$)&)n*a%i %+$!%i !n*!( &)&ini&a$(an *i&-!$n#a r)%i(+ an &)n/)a' *)rain#a /))ra #an i%)-a-(an +$)' ()%a$a'an a(i-a* &)$a(%ana(an %!a*! *ina(an a*a! *ia( &)na&-i$ *ina(an #an %)'ar!%n#a ia&-i$" P)n)$+$aan +-a* &)r!.a(an %)ran(aian ()ia*an #an &)n#an(!* a%.)( .)r)n/anaan, .)naaan, .)n)ri&aan, .)n#i&.anan, .)ni%*ri-!%ian, .)n!naan, %)r*a .)n/a*a*an an .)$a.+ran +-a* )nan &)&anaa*(an %!&-)r5%!&-)r #an *)r%)ia %).)r*i *)naa ana, %arana, an .)ran(a* $!na( a$a& !.a#a &)n/a.ai *!!an #an i*)*a.(an i -)r-aai *in(a* !ni* ()ra D)."K)% RI, 1??2"
7
BAB II TIN0AUAN PUSTAKA
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8
%*r!(*!r *)r+rani%a%i #an &)na-!n(an -)r%a&a5%a&a %)&!a .r+)%i ()%)'a*an, a%i$i*a% ian+%*i( an *)ra.i, a$a* an .)r-)(a$an %)r*a a%i$i*a% i%i( () a$a& %!a*! %i%*)& *)r(++rina%i !n*!( .)n'an*aran .)$a#anan ()%)'a*an -ai &a%#ara(a*" 2"1"1 T!a% an F!n%i r!&a' %a(i* M)n!r!* ().!*!%an M)n*)ri K)%)'a*an R).!-$i( In+n)%ia
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De+)n)$) Ke$ela#atan Pa$)en
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9
R!&a' %a(i* aa$a' in%*i*!%i .)$a#anan ()%)'a*an #an &)n#)$)nara(an .)$a#anan ()%)'a*an .)r+ranan %)/ara .ari.!rna #an &)n#)ia(an .)$a#anan ra6a* ina., ra6a* a$an an a6a* ar!ra*"
2"2"1 Sa%aran ()%)$a&a*an .a%i)n r!&a' %a(i* Sa%aran Sa%aran ()%)$a&a*an ()%)$a&a*an .a%i)n .a%i)n &)r!.a(an &)r!.a(an %#ara* %#ara* !n*!( i*)ra.(an i%)&!a R!&a' Sa(i* #an ia(r)i*a%i +$)' K+&i%i A(r)i*a%i R!&a' Sa(i*" P)n#!%!nan %a%a %a%ara ran n ini ini &)n &)na/! a/! .aa +ine $i(e-Sa,ing Patient Sa(ety Sol%tions dari HO Patient Sa(ety 200< #an i!na(an i!na(an !a +$)' K+&i*)K)%)$ K+&i*)K)%)$a&a*an a&a*an Pa%i)n R!&a' Sa(i* PERSI KKPRS PERSI, an ari oint ari oint !ommission International J@I"
2"2"1"1 Sa%aran I K)*).a*an I)n*ii(a%i Pa%i)n
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*)r*!$ *)r*!$i%" i%"K+& K+&!ni !ni(a% (a%ii #an &!a' &!a' *)ra *)raii ()%a$a ()%a$a'an 'an ()-an#a ()-an#a(an (an *)ra *)raii .aa %aa* %aa* .)rin*a' i-)ri(an %)/ara $i%an a*a! &)$a$!i *)$).+n" K+&!ni(a%i #an &!a' *)rai
11
()%a$a ()%a$a'an 'an #an $ain $ain aa$a' aa$a' .)$a.+ .)$a.+ran ran ()&-a$ ()&-a$ii 'a%i$ 'a%i$ .)&)ri .)&)ri(%a (%aan an (ri*i% (ri*i%,, %).)r* %).)r*ii &)$a.+r(an 'a%i$ $a-+ra*+ri!& ($ini( &ito &)$a$!i *)$).+n () !ni* .)$a#anan" R!&a' %a(i* %)/ara (+$a-+ra*i &)n)&-an(an %!a*! ()-ia(an anCa*a! .r+%)!r !n*!( .)rin*a' $i%an an *)$).+n *)r&a%!( &)n/a*a* a*a! &)&a%!((an () (+&.!*)r .)rin*a' #an $)n(a. a*a! 'a%i$ .)&)ri(%aan +$)' .)n)ri&a .)rin*a', ()&!ian ()&!ian .)n)ri&a .)rin*a' &)&-a/a(an &)&-a/a(an ()&-a$i )read )read ba&"* ba&"* .)rin*a' a*a! 'a%i$ .)&)ri(%aan an &)n(+nir&a%i -a'6a a.a #an %!a' i*!$i%(an an i-a/a !$an aa$a' a(!ra*" K)-ia(an K)-ia(an anCa*a! anCa*a! .r+%)!r .r+%)!r .)ni)n*ii .)ni)n*ii(a%ia (a%ian n !a &)n)$a%(an &)n)$a%(an -a'6a i.)r-+$)'(an *ia( &)$a(!(an .)&-a/aan ()&-a$i read ba&" -i$a *ia( &)&!n(in(an %).)r*i i (a&ar +.)ra%i an %i*!a%i a6a* ar!ra* i IGD a*a! I@U" E$)&)n P)ni$aian Sa%aran II 1" P)rin*a' $)n(a. %)/ara $i%an an #an &)$a$!i *)$).+n a*a! 'a%i$ .)&)ri(%aan i*!$i%(an %)/ara $)n(a. +$)' .)n)ri&a .)rin*a'" 2" P)rin*a' $)n(a. $i%an an *)$.+n a*a! 'a%i$ .)&)ri(%aan i-a/a(an ()&-a$i %)/ara $)n(a. +$)' .)n)ri&a .)rin*a'"
3" P)rin*a' a*a! 'a%i$ .)&)ri(%aan i(+nir&a%i +$)' .)&-)ri .) rin*a' a*a! #an &)n#a&.ai(an 'a%i$ .)&)ri(%aan 4" K)-ia(an an .r+%)!r &)nara'(an .)$a(%anaan =)rii(a%i ()a(!ra*an (+&!ni(a%i $i%an a*a! &)$a$!i *)$).+n %)/ara (+n%i%*)n"
12
2"2"1"3 Sa%aran III P)nin(a*an K)a&anan O-a* Yan P)r$! Di6a%.aai High Alert
Bi$a +-a*5+-a*an
&)nai
-aian ari r)n/ana
.)n+-a*an .a%i)n,
&ana)&)n 'ar!% -)r.)ran %)/ara (ri*i% !n*!( &)&a%*i(an ()%)$a&a*an .a%i)n" O-a*5 +-a*an #an .)r$! i6a%.aai high-alert medi&ations aa$a' +-a* #an %)rin &)n#)-a-(an *)rai ()%a$a'anC()%a$a'an %)ri!% sentinele,ent , +-a* #an -)ri%i(+ *ini &)n#)-a-(an a&.a( #an *ia( iinin(an ad,erse o%t&ome* %).)r*i +-a*5 +-a* #an *)r$i'a* &iri. an ())narann#a &iri. Na&a O-a* R!.a an U/a.an Miri.CNORUM, a*a! $oo" Ali"e So%n Ali"e/$ASA*. O-a*5+-a*an #an %)rin i%)-!*(an a$a& i%! ()%)$a&a*an .a%i)n aa$a' .)&-)rian )$)(*r+$i* (+n%)n*ra* %)/ara *ia( %)naa &i%a$n#a, (a$i!& ($+ria 2&)C&$ a*a! #an $)-i' .)(a*, (a$i!& +%a*, na*ri!& ($+ria $)-i' .)(a* ari 0"?, an &an)%i!& %!$a* :0 a*a! $)-i' .)(a*" K)%a$a'an ini -i%a *)rai -i$a .)ra6a* *ia( &)na.a*(an +ri)n*a%i )nan -ai( i !ni* .)$a#anan .a%i)n, a*a! -i$a .)ra6a* (+n*ra( *ia( i+ri)n*a%i(an *)r$)-i' a'!$! %)-)$!& i*!a%(an, a*a! .aa ()aaan a6a* ar!ra*" @ara #an .a$in ))(*i !n*!( &)n!rani a*a! &)n)$i&ina%i ()aian *)r%)-!* aa$a' )nan &)nin(a*(an .r+%)% .)n)$+$aan +-a*5+-a* #an .)r$! i6a%.aai *)r&a%!( &)&ina'(an )$)(*r+$i* (+n%)n*ra* ari !ni* .)$a#anan .a%i)n () ar&a%i" R!&a' %a(i* %)/ara (+$a-+ra*i &)n)&-an(an %!a*! ()-ia(an anCa*a! .r+%)!r !n*!( &)&-!a* a*ar +-a*5+-a* #an .)r$! i6a%.aai -)ra%ar(an a*a #an aa i r!&a' %a(i*" K)-ia(an anCa*a! .r+%)!r !a &)ni)n*ii(a%i ar)a
13
&ana %aa #an &)&-!*!'(an )$)(*r+$i* (+n%)n*ra*, %).)r*i i IGD a*a! (a&ar +.)ra%i, %)r*a .)&-)rian $a-)$ %)/ara -)nar .aa )$)(*r+$i* an -aai&ana .)n#i&.anann#a i ar)a *)r%)-!*, %)'ina &)&-a*a%i a(%)%, !n*!( &)n/)a' .)&-)rian #an *ia( %)naaC(!ran 'a*i5'a*i" E$)&)n P)ni$aian Sa%aran III 1" K)-ia(an anCa*a! .r+%)!r i()&-an(an aar &)&!a* .r+%)% i)n*ii(a%i, &)n)*a.(an $+(a%i, .)&-)rian $a-)$, an .)n#i&.anan )$)(*r+$i* (+n%)n*ra*" 2" I&.$)&)n*a%i ()-ia(an an .r+%)!r" 3" E$)(*r+$i* (+n%)n*ra* *ia( -)raa i !ni* .)$a#anan .a%i)n ()/!a$i i(a i-!*!'(an %)/ara ($ini% an *ina(an ia&-i$ !n*!( &)n/)a' .)&-)rian #an (!ran 'a*i5'a*i i ar)a *)r%)-!* %)%!ai ()-ia(an" 4" E$)(*r+$i* (+n%)n*ra* #an i%i&.an .aa !ni* .)$a#anan .a%i)n 'ar!% i-)ri $a-)$ #an )$a%, an i%i&.an .aa ar)a #an i-a*a%i ()*a* )restri&ted*"
2"2"1"4 Sa%aran I K).a%*ian T).a* L+(a%i, T).a* Pr+%)!r, T).a* .a%i)n O.)ra%i Sa$a' $+(a%i, %a$a'5.r+%)!r, .a%i)n5%a$a' .aa +.)ra%i, aa$a' %)%!a*! #an &)n('a6a*ir(an an *ia( aran *)rai i r!&a' %a(i*" K)%a$a'an ini aa$a' a(i-a* ari (+&!ni(a%i #an *ia( ))(*i a*a! #an *ia( a)(!a* an*ara an+*a *i& -)a', (!ranC*ia( &)$i-a*(an .a%i)n i a$a& .)nanaan $+(a%i )site mar"ing*, an *ia( aa .r+%)!r !n*!( =)rii(a%i $+(a%i +.)ra%i" Di %a&.in i*!, a%)%&)n .a%i)n #an *ia( a)(!a*, .)n)$aa'an !$an /a*a*an &)i% *ia( a)(!a*, -!a#a #an *ia( &)n!(!n (+&!ni(a%i *)r-!(a an*ar an+*a *i& -)a', .)r&a%a$a'an #an
14
-)r'!-!nan )nan *!$i%an *anan #an *ia( *)r-a/a )illegiblehand0ritting* an .)&a(aian %in(a*an aa$a' a(*+r5a(*+r (+n*ri-!%i #an %)rin *)rai" R!&a' %a(i* .)r$! !n*!( %)/ara (+$a-+ra*i &)n)&-an(an %!a*! ()-ia(an anCa*a!
.r+%)!r
&)n('a6a*ir(an
#an
))(*i
ini"Di!na(an
i !a
a$a&
&)n)$i&ina%i
&a%a$a'
#an
.ra(*)(
-)r-a%i% -!(*i, %).)r*i
#an
ia&-ar(an i S%rgi&al Sa(ety !he&"list ari HO Patient Sa(ety 200?, !a i #he oint !ommission1s Uni,ersal Proto&ol (or Pre,enting rongSite2 rong Pro&ed%re2 rong Person S%rgery.P)nanaan $+(a%i +.)ra%i .)r$! &)$i-a*(an .a%i)n an i$a(!(an a*a% %a*! .aa *ana #an a.a* i()na$i" Tana i*! 'ar!% i!na(an %)/ara (+n%i%*)n i r!&a' %a(i* an 'ar!% i-!a* +$)' +.)ra*+rC+ran #an a(an &)$a(!(an *ina(an, i$a(%ana(an %aa* .a%i)n *)raa an %aar i(a &)&!n(in(an, an 'ar!% *)r$i'a* %a&.ai %aa* a(an i%a#a*" P)nanaan $+(a%i +.)ra%i i$a(!(an .aa %)&!a (a%!% *)r&a%!( %i%i )laterality*2 &!$*i.)$ %*r!(*!r ari *anan, ari (a(i, $)%i a*a! &!$*i.)$ $)=)$ *!$an -)$a(an" Ma(%! .r+%)% =)rii(a%i .ra+.)ra*i aa$a' !n*!( 1" M)&=)rii(a%i $+(a%i, .r+%)!r, an .a%i)n #an -)nar 2" M)&a%*i(an -a'6a %)&!a +(!&)n, +*+ )imaging*, 'a%i$ .)&)ri(%aan#an r)$)=an *)r%)ia, i-)ri $a-)$ )nan -ai(, an i.a&.an, an &)$a(!(an =)rii(a%i ()*)r%)iaan .)ra$a*an ('!%!% anCa*a! i&.$an* #an i-!*!'(an" Ta'a. 8S)-)$!& in%i%i9 )#ime o%t* &)&!n(in(an %)&!a .)r*an#aan a*a! ()()$ir!an i%)$)%ai(an"#ime o%t i$a(!(an i *)&.a*, i&ana *ina(an a(an i$a(!(an, *).a* %)-)$!& *ina(an i&!$ai, an &)$i-a*(an %)$!r!' *i& +.)ra%i"
15
R!&a' %a(i* &)n)*a.(an -aai&ana .r+%)% i*! i+(!&)n*a%i(an %)/ara rin(a%, &i%a$n#a &)n!na(an &he&"list " E$)&)n P)ni$aian Sa%aran I 1" R!&a' %a(i* &)n!na(an %!a*! *ana #an )$a% an i&)n)r*i !n*!( i)n*ii(a%i $+(a%i +.)ra%i an &)$i-a*(an .a%i)n i a$a& .r+%)% .)nanaan" 2" R!&a' %a(i* &)n!na(an %!a*! &he&"list a*a! .r+%)% $ain !n*!( &)&=)rii(a%i %aa* .r)+.)ra%i *).a* $+(a%i, *).a* .r+%)!r, an *).a* .a%i)n an %)&!a +(!&)n %)r*a .)ra$a*an #an i.)r$!(an *)r%)ia, *).a*, an !n%i+na$" 3" Ti& +.)ra%i #an $)n(a. &)n)ra.(an an &)n/a*a* .r+%)!r 8%)-)$!& in%i%iCtime-o%t 9 *).a* %)-)$!& i&!$ain#a %!a*! .r+%)!r a*a! *ina(an .)&-)a'an" 4" K)-ia(an an .r+%)!r i()&-an(an !n*!( &)n!(!n .r+%)% #an %)raa& !n*!( &)&a%*i(an *).a* $+(a%i, *).a* .r+%)!r, an *).a* .a%i)n, *)r&a%!( .r+%)!r &)i% an )n*a$ #an i$a(%ana(an i $!ar (a&ar +.)ra%i"
2"2"1": Sa%aran P)n!ranan Ri%i(+ In)(%i T)r(ai* P)$a#anan K)%)'a*an
P)n/)a'an an .)n)na$ian in)(%i &)r!.a(an *an*anan *)r-)%ar a$a& *a*anan .)$a#anan ()%)'a*an, an .)nin(a*an -ia#a !n*!( &)na*a%i in)(%i #an -)r'!-!nan )nan .)$a#anan ()%)'a*an &)r!.a(an ().ri'a*inan -)%ar -ai .a%i)n &a!.!n .ara .r+)%i+na$ .)$a#anan ()%)'a*an"In)(%i -ia%an#a i!&.ai a$a& %)&!a -)n*!( .)$a#anan ()%)'a*an *)r&a%!( in)(%i %a$!ran ()&i', in)(%i .aa a$iran ara' bloodstream in(e&tions* an .n)!&+nia %)rin (a$i i'!-!n(an )nan =)n*i$a%i &)(ani%"
16
P!%a* ari )$i&ina%i in)(%i ini &a!.!n in)(%i5in)(%i $ain aa$a' /!/i *anan hand hygiene* #an *).a*" P)+&an hand hygiene -i%a i-a/a ().!%*a(aan 7HO, an -)r-aai +rani%a%i na%i+na$ an in*)rna%i+na$" R!&a' %a(i* &)&.!n#ai .r+%)% (+$a-+ra*i !n*!( &)n)&-an(an ()-ia(an anCa*a! .r+%)!r #an &)n#)%!ai(an a*a! &)na+.%i .)*!n!( hand hygiene #an i*)ri&a %)/ara !&!& an !n*!( i&.$)&)n*a%i .)*!n!( i*! i r!&a' %a(i*" E$)&)n P)ni$aian Sa%aran 1" R!&a' %a(i* &)na+.%i a*a! &)naa.*a%i .)+&an hand hygiene *)r-ar! #an i*)r-i*(an an %!a' i*)ri&a %)/ara !&!& ari HO Patient Sa(ety*" 2" R!&a' %a(i* &)n)ra.(an .r+ra& hand hygiene #an ))(*i" 3" K)-ia(an an a*a! .r+%)!r i()&-an(an !n*!( &)nara'(an .)n!ranan %)/ara -)r()$an!*an ri%i(+ ari in)(%i #an *)r(ai* .)$a#anan ()%)'a*an" 2"2"1"; Sa%aran I P)n!ranan R)%i(+ Pa%i)n Ja*!'
J!&$a' (a%!% a*!' /!(!. -)r&a(na %)-aai .)n#)-a- /))ra -ai .a%i)n ra6a* ina."Da$a& (+n*)(% .+.!$a%iC&a%#ara(a* #an i$a#ani, .)$a#anan #an i%)ia(an, an a%i$i*a%n#a, r!&a' %a(i* .)r$! &)n)=a$!a%i ri%i(+ .a%i)n a*!' an &)na&-i$ *ina(an !n*!( &)n!rani ri%i(+ /))ra -i$a %a&.ai a*!'" E=a$!a%i -i%a *)r&a%!( ri6a#a* a*!', +-a* an *)$aa' *)r'aa. (+n%!&%i a$(+'+$, a#a a$an an ()%)i&-anan, %)r*a a$a* -an*! -)ra$an #an i!na(an +$)' .a%i)n" Pr+ra& *)r%)-!* 'ar!% i*)ra.(an r!&a' %a(i*"
17
E$)&)n P)ni$aian Sa%aran I 1" R!&a' %a(i* &)n)ra.(an .r+%)% a%)%&)n a6a$ a*a% .a%i)n *)r'aa. ri%i(+ a*!' an &)$a(!(an a%)%&)n !$an .a%i)n -i$a iini(a%i(an *)rai .)r!-a'an (+ni%i a*a! .)n+-a*an, an $ain5$ain" 2" Lan(a'5$an(a' i*)ra.(an !n*!( &)n!rani ri%i(+ a*!' -ai &)r)(a #an .aa 'a%i$ a%)%&)n iana. -)ri%i(+ a*!'" 3" Lan(a'5$an(a' i&+ni*+r 'a%i$n#a, -ai( ()-)r'a%i$an .)n!ranan /))ra a(i-a* a*!' an a&.a( ari ()aian *ia( i'ara.(an" 4" K)-ia(an anCa*a! .r+%)!r i()&-an(an !n*!( &)nara'(an .)n!ranan -)r()$an!*an ri%i(+ .a%i)n /))ra a(i-a* a*!' i r!&a' %a(i*" !.'
De+)n)$) In$)en Ke$ela#atan Pa$)en
In%i)n ()%)$a&a*an .a%i)n #an %)$an!*n#a i%)-!* in%i)n aa$a' %)*ia. ()aian #an *ia( i%)naa an (+ni%i #an &)na(i-a*(an a*a! -)r.+*)n%i &)na(i-a*(an /))ra #an a.a* i/)a' .aa .a%i)n"In%i)n ()%)$a&a*an .a%i)n !a &)r!.a(an ari &)$a(%ana(an %!a*! *ina(an &ommission a*a! *ia( &)na&-i$ *ina(an #an %)'ar!%n#a ia&-i$ omission"Na&!n )&i(ian, .)n#)-a*)rain#a in%i)n ()%)$a&a*an .a%i)n i r!&a' %a(i* %ana* (+&.$)(%, &)$i-a*(an %)&!a -aian a$a& %#%*)& #an -)r$a(! a$a& r!&a' %a(i*" 2"3"1 J)ni%5)ni% in%i)n ()%)$a&a*an .a%i)n B)ra%ar(an P)r&)n()% N+" 1;?1 *a'!n 2011, *)n*an ()%)$a&a*an .a%i)n i r!&a' %a(i*, in%i)n ()%)$a&a*an .a%i)n *)riri ari 2"3"1"1 K)aian Tia( Di'ara.(an KTD
18
S!a*! ()aian #an *ia( i'ara.(an #an &)na(i-a*(an /))ra .aa .a%i)n a(i-a* &)$a(%ana(an %!a*! *ina(an a*a! *ia( &)na&-i$ *ina(an #an %)'ar!%n#a ia&-i$, an -!(an (ar)na .)n#a(i* a%arn#a a*a! (+ni%i .a%i)n"K)aian *)r%)-!* a.a* *)rai i%)&!a *a'a.an .)ra6a*an ari ian+%i%, .)n+-a*an an .)n/)a'an"
2"3"1"2 K)aian Tia( @))ra KT@ S!a*! in%i)n #an %!a' *)r.a.ar () .a%i)n, *)*a.i *ia( &)na(i-a*(an /))ra" 2"3"1"3 K)aian N#ari% @))ra KN@ K)aian N#ari% @))ra aa$a' *)rain#a in%i)n #an -)$!& %)&.a* *)r.a.ar () .a%i)n" Mi%a$n#a %!a*! +-a* )nan +=)r+%i% $)*'a$ a(an i-)ri(an, *)*a.i %*a$ain &)n)*a'!i an &)&-a*a$(ann#a %)-)$!& +-a* i-)ri(an ().aa .a%i)n" 2"3"1"4 K)aian P+*)n%ia$ @))ra KP@ K)aian P+*)n%ia$ @))ra aa$a' (+ni%i #an %ana* -)r.+*)n%i !n*!( &)ni&-!$(an /))ra, *)*a.i -)$!& *)rai in%i)n" Mi%a$n#a +-a*5+-a*an LASA ) $oo" Ali"e So%nd Ali"e i%i&.an -)r)(a*an" 2"3"1": K)aian S)n*in)$ Aa$a' %!a*! KTD #an &)na(i-a*(an ()&a*ian a*a! /))ra #an %)ri!%" Bia%an#a i.a(ai !n*!( ()aian #an %ana* *ia( i'ara.(an a*a! *ia( a.a* i*)ri&a %).)r*i +.)ra%i .aa -aian *!-!' #an %a$a' Mi%a$n#a a&.!*a%i .aa (a(ai #an %a$a'" 2"3"2 Fa(*+r5a(*+r #an &)&.)nar!'i in%i)n ()%)$a&a*an .a%i)n Ban#a( a(*+r #an &)n#)-a-(an *)rain#a in%i)n ()%)$a&a*an .a%i)n, na&!n *ia( %)&!a a/*+r -)ra%a$ ari *)naa ()%)'a*an #an -)r*!a%" M)n!r!*
19
Agen&y (or health&are Resear&h and 3%ality 2003 &)na*a(an -a'6a a/*+r #an a.a* &)ni&-!$(an in%i)n ()%)$a&a*an .a%i)n aa$a' %)-aai -)ri(!* 2"3"2"1 K+&!ni(a%i Aan#a (+&!ni(a%i #an *ia( *).a* an*ara .a%i)n an *)naa ()%)'a*an, *)naa ()%)'a*an )nan %)%a&a *)naa ()%)'a*an, in+r&a%i *ia( i+(!&)n*a%i(an a.a* &)ni&-!$(an in%i)n ()%)$a&a*an .a%i)n"O$)' (ar)na i*! i.)r$!(an (+&!ni(a%i #an *)r-!(a an )$a% *)n*an %)a$a 'a$ #an -)r(ai*an )nan .)n+-a*an an .)nananan .a%i)n" Ji(a an*ara *)naa ()%)'a*an, .a%i)n an *)naa ()%)'a*an $ainn#a a.a* -)()ra %a&a a$a& -)n*!( (+&!ni(a%i #an $)-i' -ai( &a(a .)n/)a'an in%i)n ()%)$a&a*an .a%i)n a.a* i$a(!(an" 2"3"2"2 Ar!% in+r&a%i #an *ia( a)(!a* Ar*in#a aa$a' ar!% in+r&a%i #an *ia( &)&aai i&ana %!&-)r in+r&a%i .)n+-a*an an .)$a#anan .a%i)n i .)$a#anan ()%)'a*an *ia( %)%!ai )nan .r+%)!r #an aa a*a! -a'(an *ia( &)&i$i(i .r+%)!r .)$a#anan .a%i)n" K)&!ian i(a .a%i)n ir!!( () *)&.a* $ain in+r&a%i #an .)n*in *ia( i%)r*a(an" 2"3"2"3 SDM S!&-)r Da#a Man!%ia S!&-)r a#a &an!%ia &)$i.!*i +ran5+ran #an -)r*!a% i *)&.a* .)$a#anan ()%)'a*an"M)r)(a -)r*!a% &)&-an*! a$a& .)n+-a*an an .)&!$i'an ()%)'a*an .a%i)n %)$a&a i ra6a* i *)&.a* &a!.!n ra6a* a$an"O$)' (ar)na i*! ()&a&.!an #an i&i$i(i +$)' +ran #an -)()ra i *)&.a* .)$a#anan ()%)'a*an ('!%!%n#a *)naa ()%)'a*an 'ar!% -)nar5-)nar &)&aai an i!na(an )nan -ai("Ji(a *)naa ()%)'a*an -)$!& -an#a( &)&i$i(i ()&a&.!an *)r*)n*! a$a& .)nananan .a%i)n %)-ai(n#a -)r'a*i5'a*i %)*ia. (a$i -)()ra aar *ia( &)ni&-!$(an
20
()%a$a'an #an -)r!!n .aa in%i)n ()%)$a&a*an .a%i)n" R!&a' %a(i* aa$ &)ni(!*i ()-ia(an, SOP an .r+%)% +(!&)n*a%i $ainn#a *)r&a%!( a$a& SDM" 2"3"2"4 Ha$5'a$ #an -)r'!-!nan )nan .a%i)n Ha$5'a$ #an -)r'!-!nan )nan .a%i)n aa$a' %)-aai -)ri(!* I)nii(a%i .a%i)n #an *ia( *).a*, a%)%&)n .a%i)n #an *ia( $)n(a." Tia( %)&!a .a%i)n &)n)*a'!i *)n*an +-a*5+-a*an an /ara .)n+-a*an" S)-aai *)naa ()%)'a*an %!a' %)'ar!%n#a &)&-)ri(an in+r&a%i *)n*an .)n+-a*an #an %)an ia$ani +$)' .a%i)n"Ban#a( .a%i)n #an *ia( &)&a*!'i a*!ran .)n+-a*an #an %)'ar!%n#a, %)'ina *)rai ()%a$a'an *)r*)n*! #an &)na(i-a*(an ()r!ian .aa .a%i)n"Ha$ *)r%)-!* 'ar!% i/)a' aar .a%i)n *ia( ir!i(an -a'(an &)n#)-a-(an -a'a#a %)ri!%" 2"3"2": Tran%)r .)n)*a'!an i r!&a' %a(i* M)$i.!*i ()(!ranan .aa +ri)n*a%i a*a! *rainin, *in(a* .)n)*a'!an %*a !n*!( &)na$an(an *!a%, a$!r ()ra *ia( &)&aai, .ara +(*)r, .)ra6a* an %*a $ain %i-!( (ar)na SDM *ia( &)&aai, .)na6a%an #an *ia( &)&aai" 2"3"2"; K)aa$an *)(ni% K)aa$an a$a* a*a! .)r$)n(a.an .+&.a in!%, &+ni*+r" K+&.$i(a%i a*a! ()aa$an i&.$an*% "In%*r!(%i *ia( a)(!a*, .)ra$a*an iran/an %)/ara -!r!( -i%a %)-a-(an .a%i)n /))ra"K)aa$an a$a* *ia( *)ri)n*ii(a%i %)/ara *).a* %)-aai a%ar /))ra .a%i)n, an ia%!&%i(an ()%a$a'an *)naa ()%)'a*an" 2"3"2"< K)-ia(an an .r+%)!r #an *ia( a)(!a* P)+&an /ara .)$a#anan a.a* &)r!.a(an a(*+r .)n)n*! *)rain#a -an#a( medi&al errors" K)aa$an a$a& .r+%)% $a#anan a.a* i*)$!%!ri %)-a-n#a .aa -!r!(n#a +(!&)n*a%i, -a'(an *ia( aa .)n/a*a*an, a*a! SOP ($ini% #an a)(!a*" 21
!.&
De+)n)$) In$tala$) Far#a$) R"#a% Sak)t
In%*a$a%i aa$a' a%i$i*a% .)n#)$)nara .)$a#anan &)i(, .)$a#anan .)n!nan &)i(, ()ia*an .)n)$i*ian, .)n)&-anan, .)nii(an, .)$a*i'an, an .)&)$i'araan %arana R!&a' Sa(i*"Far&a%i R!&a' Sa(i* aa$a' %)$!r!' a%.)( ()ar&a%ian #an i$a(!(an i %!a*! R!&a' Sa(i*" Jai, In%*a$a%i Far&a%i R!&a' Sa(i* IFRS aa$a' %!a*! -aian a*a! a%i$i*a% i r!&a' %a(i*, *)&.a* .)n#)$)naraan %)&!a ()ia*an .)()raan ()ar&a%ian #an i*!!(an !n*!( ().)r$!an r!&a' %a(i* i*! %)niri"P)()raan ()ar&a%ian aa$a' .)&-!a*an, *)r&a%!( .)n)na$ian &!*! %)iaan ar&a%i, .)na&anan .)naaan, .)n#i&.anan an i%*ri-!%i +-a*, .)n)$+$aan +-a*, .)$a#anan +-a* a*a% r)%). +(*)r, .)$a#anan in+r&a%i +-a*, %)r*a .)n)&-anan +-a*, -a'an +-a* an +-a* *rai%i+na$" B)ra%ar(an 'a$ *)r%)-!* )ini%i !&!& ari In%*a$a%i Far&a%i R!&a' Sa(i* aa$a' %!a*! ).ar*)&)n a*a! !ni* a*a! -aian i %!a*! r!&a' %a(i* i -a6a' .i&.inan %)+ran a.+*)()r an i-an*! +$)' -)-)ra.a +ran a.+*)()r #an &)&)n!'i .)r%#ara*an .)ra*!ran .)r!nan5!nanan #an -)r$a(! an (+&.)*)n %)/ara .r+)%%i+na$, *)&.a* a*a! a%i$i*a% .)n#)$)naraan #an -)r*an!n a6a- a*a% %)$!r!' .)()raan %)r*a .)$a#anan ()ar&a%ian, #an *)riri a*a% .)$a#anan .ari.!rna, &)n/a(!. .)r)n/anaan, .)naaan, .r+!(%i, .)n#i&.anan .)r-)(a$an ()%)'a*an a*a! %)iaan ar&a%i, i%.)n%in +-a* -)ra%ar(an r)%). -ai .)n)ri*a ra6a* *ina$ an ra6a* a$an, .)n)na$ian &!*! an .)n)na$ian i%*ri-!%i an .)n!naan %)$!r!' .)r-)(a$an ()%)'a*an i R!&a' Sa(i*, .)$a#anan ar&a%i ($ini( !&!& an %.)%ia$i%, &)n/a(!. .) $a#anan $an%!n .aa .)n)ri*a an .)$a#anan ($ini("
22
In%*a$a%i Far&a%i R!&a' Sa(i* aa$a' %!a*! !ni* a*a! -aian i r!&a' %a(i*, *)&.a* a*a! a%i$i*a% .)n#)$)naraan %)&!a !n%i .)()raan ()ar&a%ian #an &)n)$+$a %)&!a a%.)( +-a* &!$ai ari .r+!(%i, .)n)&-anan, .)$a#anan ar&a%i !n*!( %)&!a ini=i! .a%i)n, .r+)%i+na$ ()%)'a*an, an .r+ra& r!&a' %a(i*" Sir)ar, @'ar$)%"J"P, Enan (!&+$+%a%i"Far&a%i ($ini(, 20042 2"4"1
T!a% an F!n%i In%*a$a%i Far&a%i R!&a' Sa(i* T!a% !*a&a IFRS aa$a' .)n)$+$aan &!$ai ari .)r)n/anaan, .)naaan,
.)n#i&.anan, .)n#ia.an, .)ra/i(an, .)$a#anan $an%!n ().aa .)n)ri*a %a&.ai )nan .)n)na$ian %)&!a .)r-)(a$an ()%)'a*an #an -)r)ar an i!na(an a$a& r!&a' %a(i* -ai( !n*!( .)n)ri*a ra6a* *ina$, ra6a* a$an, &a!.!n !n*!( %)&!a !ni* *)r&a%!( .+$i($ini( r!&a' %a(i*" B)r(ai*an )nan .)n)$+$aan *)r%)-!*, IFRS 'ar!% &)n#)ia(an *)ra.i +-a* #an +.*i&a$ -ai %)&!a .)n)ri*a an &)na&in .)$a#anan -)r&!*! *ini an #an .a$in -)r&anaa* )nan -ia#a &ini&a$"Jai, IFRS aa$a' %a*!5%a*!n#a !ni* a$a& r!&a' %a(i* #an -)r*!a% an -)r*an!n a6a%).)n!'n#a .aa .)n)$+$aan %)&!a a%.)( #an -)r(ai*an )nan +-a* a*a! .)r-)(a$an ()%)'a*an #an -)r)ar an i!na(an i r!&a' %a(i* *)r%)-!*"IFRS -)r*an!n a6a- &)n)&-an(an %!a*! .)$a#anan ar&a%i #an $!a% an *)r(++rina%i )nan -ai( an *).a*, !n*!( &)&)n!'i ()-!*!'an -)r-aai -aian a*a! !ni* ian+%i% an *)ra.i, !ni* .)$a#anan ().)ra6a*an, %*a &)i(, an r!&a' %a(i* ()%)$!r!'an !n*!( ().)n*inan .)$a#anan .)n)ri*a #an $)-i' -ai(" 2"4"2 Di%*ri-!%i an .)n)na$ian +-a* +$)' IFRS IFRS aa$a' %a*!5%a*!n#a !ni* a*a! -aian #an 'ar!% -)r*an!n a6aa$a& .)n)$+$aan &)n#)$!r!' &!$ai ari .)r)n/anaan, .)naaan .)&-)$ian, an
23
&an!a(*!r, .)n)na$ian &!*!, .)n#i&.anan, .)n#ia.an an .)ra/i(an, .)$a#anan r)%). a*a! +r)r, i%*ri-!%i %a&.ai )nan .)n)na$ian %)&!a .)r-)(a$an ()%)'a*an #an -)r)ar, an i!na(an ir!&a' %a(i* *)r&a%!( .)$a#anan #an -)r(ai*an )nan +-a* ().aa .)n)ri*a a&-!$a*+r# @'ar$)% J"P Sir)ar, 2003" Da$a& &)$a(%ana(an *!a% an *an!n a6a- IFRS, %ana* .)n*in an *).a* -a'6a a.+*)()r %)/ara r!*in 'air a$a& %)&!a a)ra' .)ra6a*an .)n)ri*a, &)naa(an '!-!nan )nan .)r%+n)$ -)r(ai*an an a(an &)n)*a'!i an -)r(+n*ri-!%i .aa .r+%)!r &)i( #an -)r(ai*an )nan +-a*, #ai*! 1" K)-ia(an an .r+%)!r .)n)na$ian .)n!naan +-a* in=)%*ia%i i(a i!na(an i r!&a' %a(i* 'ar!% i()&-an(an an ii(!*i" IFRS 'ar!% -)r*an!n a6a!n*!(
.)n#i&.anan,
.)n)&a%an,
.)&-)rian
$a-)$,
.)ni%*ri-!%ian,
an
.)&)$i'araan r)(a&an in=)n*ari% +-a* in=)%*ia%i" IFRS !a -)r*an!n a6a-)()ra %a&a )nan in=)%*ia*+r !*a&a !n*!( &)&-)ri(an in+r&a%i *)n*an +-a* in=)%*ia%i *)r%)-!*" 2" A.+*)()r 6ai- &)n(ai r)%). a*a! +r)r a%$i +(*)r, %)-)$!& &)ni%.)n%in %)*ia. +-a*" Tia( i.)r()nan(an &)n#a$in ()&-a$i +r)r +-a* +$)' .)ra6a* a*a! .)r%+n)$ $ain !n*!( i%a&.ai(an ().aa IFRS" Si%*)& (+&.!*)ri%a%i ()%)$!r!'an r!&a' %a(i* an IFRS %)niri, 'ar!% i$in!ni an a&an *)r'aa. .)&a%!(an a*a #an *ia( %a'" S)&!a %#%*)& 'ar!% i$)n(a.i !n*!( .)n(aian an =)rii(a%i +r)r a%$i +(*)r %)-)$!& i i%.)n%in" Un*!( i*!, IFRS 'ar!% &)&-!a* .r+%)!r a*a! in%*r!(%i ()ra *)r*!$i%" 3" Pr+i$ .)n+-a*an .)n)ri*a P53 !n*!( %)&!a .)n)ri*a ra6a* *ina$ an ra6a* a$an a*a! #an i.i$i' 'ar!% i-!a*, i.)$i'ara, an i!na(an
24
4" A.+*)()r 6ai- &)naa(an .r+%)!r .)n)na$ian #an i.)r$!(an !na &)&a%*i(an -a'6a .)n)ri*a &)n)ri&a +-a* #an -)nar .aa 6a(*! #an *).a*" Un*!( &)n/a.ai 'a$ *)r%)-!*, %)&!a +-a* #an i!na(an i r!&a' %a(i* ii%*ri-!%i(an +$)' IFRS" S)n!a +-a* 'ar!% i()&a%, i-)ri )*i()*, an ii%*ri-!%i(an a$a& /ara #an &)&)n!'i %*anar .r+)%i+na$ #an -)r$a(! an .)r%#ara*an '!(!&" :" Un*!( ().)n*inan ()%)$a&a*an .)n)ri*a, %)&!a +-a* #an i i%.)n%in +$)' a.+*)()r !n*!( i(+n%!&%i(an .aa .)n)ri*a %)-ai(n#a a$a& ()&a%an !ni* *!na$ an %)a.a* &!n(in a$a& -)n*!( %ia. (+n%!&%i" P)r$!n#a .)ra6a* &)n#ia.(an +-a* &i%a$n#a &)na&-i$ +%i% ari 6aa' &!$*i+%i%, &)&-)ri )*i()* .aa 6aa', an r)(+n%*i*!%i %)-)$!& i(+n%!&%i(an 'ar!% i&ini&a$(an" ;" P)r%+n)$ IFRS 'ar!% &)n#ia.(an %)&!a .r+!( %*)ri$ an*ara $ain in)(%i ()&+*)ra.i, %)iaan in!%), %)iaan .ar)n*)ra$ $ainn#a, .)n/a&.!ran %)iaan in*ra=)na, an $ar!*an iria%i" <" A.+*)()r -)()ra %a&a )nan %*a r!&a' %a(i* 6ai- &)n)*a.(an ()-ia(an an .r+%)!r *)r+(!&)n*a%i !n*!( .)nananan +-a* #an i!a -)r-a'a#a a$a& .)()raan o&&%pational ha4ard " Pr+%)!r *)r%)-!* 'ar!% &)&)$i'ara ()!*!'an %)iaan +-a* an &)$in!ni .)r%+n)$ r!&a' %a(i*" !.*
De+)n)$) 3bat-3bat High Alert
O-a*5+-a* High Alert aa$a' +-a*5+-a*an #an &)n#)-a-(an r)%i(+ *ini ()*i(a *)rai ()%a$a'an a$a& .)&-)riann#a" M)%(i.!n ()%a$a'an &!n(in a*a! *ia( &!n(in )nan +-a*, (+n%)(!)n%i ari ()%a$a'an a(an $)-i' &)r!i(an .a%i)n ISMP, 2012"
25
2":"1 Mana)&)n +-a* High Alert i R!&a' Sa(i* ISMP )Instit%te (or Sa(e Medi&ation Pra&ti&e* &)&-)ri(an %*ra*)i !n*!( &ana)&)n +-a*5+-a* High aAlert #ai*! &)nin(a*(an in+r&a%i *)n*an +-a*5+-a*an High Alert , &)&-a*a%i a(%)% () +-a*5+-a* High Alert , &)n!na(an $a-)$ an *ana .)rina*an, &)n!na(an %#%*)& /)( ana -i$a i.)r$!(an" M)n!r!* Ameri&an Hospital Asso&iation 2002 *)ra.a* 3 .rin%i. #an a.a* i!na(an !n*!( &)$in!ni .)&a(aian +-a*5+-a* High Alert %)-aai -)ri(!* 1" M)n!rani a*a! &)n'i$an(an ()&!n(inan ()%a$a'an Mi%a$n#a &)n!rani .)n#)-aran +-a*5+-a* High Alert i r!&a' %a(i*, &)n!rani .)r%)iaan $ar!*an (+n%)n*ra*, &)n'i$an(an +-a*5+-a* High Alert ari a)ra' ($ini%" 2" M)n+(!&)n*a%i(an ()%a$a'an #an *)rai Mi%a$n#a aan#a .)*!a% #an &)&)ri(%a .)na*!ran .+&.a in!%) !n*!( +-a* 'i' a$)r* aa$a' %a$a' %a*! /ara !n*!( &)n+(!&)n*a%i(an i(a *)rai ()%a$a'an )nan )&i(ian a.a* i/)a' %)-)$!& ia.$i(a%i(an .aa .a%i)n" 3" M)&ini&a$(an (+n%)(!)n%i ari ()%a$a'an Mi%a$n#a *)rai ()%a$a'an a*a$ ()*i(a $i+(ain 2 :0 &$ #an i%!n*i((an -!(an &ani*+$ #an &)&i$i(i .)na&.i$an #an %a&a" Ameri&an Hospital Asso&iation 2002 !a *)$a' &)&-!a* (+n%). (!n/i !n*!( &)$in!ni .)n!naan +-a*5+-a* High Alert #ai*! 1" M)&-an!n %#%*)& r)!an%i &i%a$n#a !ni* +%i% i%*ri-!%i +-a* 2" G!na(an -ran(a% ('!%!% &i%a$n#a .+&.a )$)(*r+ni( )nan &)(ani%&) &)n).i* !n*!( &)n/)a' a$iran -)-a%
26
3" M)n!rani .i$i'an &i%a$n#a &)&i$i(i -an#a( .i$i'an !n*!( &)&)%an ').arin a$a& -)r-aai (+n%)n*ra%i%).)r*i20"000!ni*%C2:0&Lan20"000!ni*%C:00&Lan2:"000!ni*%C:00 &L" !n*!( &)n'inari ()%a$a'an %)-ai(n#a 'an#a *)ra.a* %a*! .i$i'an" 4" M)n!na(an %!a*! !n%i, #ai*! *)(ni( !n*!( &)n!rani ()&!n(inan i(a +-a* #an i-)ri(an -)r.+*)n%i &)&a*i(an :" M)n)(%*)rna$i%a%i a*a! %)n*ra$i%a%i .r+%)% ()%a$a'an &)&!%a*(an .)r%ia.an $ar!*an I ;" M)n!na(an i)r)n%ia%i &i%a$n#a &)ni)n*ii(a%i an &)n('!%!%(an +-a* #an &)&i$i(i na&a an -!n#i &iri. %aa* i%)-!*(an, &)n!na(an na&a )n)ri( #an /)n)r!n *ia( *)r)nar %a&a )nan na&a &)r)( <" T)&.a* .)n#i&.anan +-a* #an *).a* &i%a$n#a &)&i%a'(an +-a* -)r.+*)n%i -)r-a'a#a )nan na&a #an &iri. a*a! ()&a%an #an %)r!.a >" Ga&-aran .r+!( -ar! &i%a$n#a -aian ar&a%i an *)ra.i 'ar!% &)&)ri(%a +-a*5+-a* -ar! an .)niri&an +-a* #an *ia( *)ra.a* $a-)$ ?" S*anari%a%i an &)n#))r'ana(an a$a& .)&)%anan &i%a$n#a &)&ini&a$(an .)rin*a' a$a& -)n*!( $i%an an &)n!rani %in(a*an 10" M)n!rani a(%)% +-a* &i%a$n#a +-a*5+-a* High Alert 'an#a -+$)' i%i&.an i a.+*)( an 'an#a a.+*)()r #an a.a* &)na(%)%n#a 11" M)n!na(an -a*a%an &i%a$n#a ar&a%i% &)&)ri(%a %)&!a .)r&in*aan !n*!( +-a*5+-a* 'i' a$)r* %)-)$!& .)r%ia.an an a&ini%*ra%i, &)n')n*i(an .)r&in*aan, &)&-a*a%i +%i% an !ra%i 12" M)n!na(an .)nina* &i%a$n#a &)n!na(an $a-)$ .aa +-a*5+-a* High Alert , .aa a*a i /+&.!*)r *)ra.a* .)rina*an an in+r&a%i *)n*an +-a*5+-a* High Alert *)r%)-!* 13" S*anari%a%i +%i% !na(an *a-)$ +%i% %*anar* $)-i' -ai( ari.aa &)n'i*!n +%i% -)ra%ar(an -)ra* -aan"
27
2":"3 Fa(*+r r)%i(+ +-a*5+-a* High Alert Fa(*+r r)%i(+ ari +-a*5+-a* high alert aa$a' a/*+r .)n)n*! #an &)n)n*!(an -)ra.a -)%ar ()&!n(inan +-a* *)r%)-!* &)ni&-!$(an -a'a#a" B)ri(!* a/*+r r)%i(+ ari -)-)ra.a /+n*+' +-a* High Alert Tabel !.& Fakt3r Re$)k3 Obat-3bat High Alert
Ti.) +-a* In%!$in
O.ia*)% nar(+*i(
an
P)n#!n*i(an .+*a%%i!& /'$+ri)C.'+%. 'a*) /+n/)n*ra*)
An*i(+a!$an In*ra=)na C
Fa(*+r R)%i(+ U&!& P)nananan 1" Tia( aa %#%*)& /)( +%i% 1" M)n)*a.(an %i%*)& 2" -+*+$5-+*+$ in%!$in an .)n)/)(an #an &ana *)naa ').arin i/a&.!r an iaa ()%)'a*an &)&-!a* .r).ara* a$a& ())(a*an *)r*!*!. +%i% an *)naa ()%)'a*an %a*! %a&a $ainn#a .aa !ni* $ainn#a &)$a(!(an r)=i)6 ().)ra6a*an" *)r'aa.n#a" 3" An(a ()%a$a'an *)rai () 2" M)n#i&.an in%!$in an a$a& /airan in!% ').arin *ia( -)r)(a*an" 3" M)$a(!(an )aan !n*!( %)*ia. !ni* $)-i' -ai( ari.aa &)n#in(a*n#a" 4" M)n)*a.(an %)-!a' %i%*)& .)n)/)(an #an in).)n)n !n*!( an(a .+&.a in!%) an .)na*!ran (+n%)n*ra%i" 1" Nar(+*i( .ar)n*)ra$ 1" M)&-a*a%i ()*)r%)iaan +.i!& i%i&.an %)-aai %*+( a%ar an nar(+*i( a$a& %*+( a%ar" i ar)a ().)ra6a*an" 2" M)naar(an .ara %*a *)n*an 2" H#r+&+r.'in) .)n!/a.an ()&!n(inan .)n/a&.!ran 'a&.ir %a&a )nan '#r+&+r.'in) an &+r.'in)" &+r.'in) 3" M)n#)ia(an a*!ran .)ra$a*an !n*!( !a (a$i /)( +-a*, .)na*!ran .+&.a, an +%i%" 1" M)n#i&.an /+n/)n*ra*) 1" M)&ina'a(an .+*a%%i!& .+*a%%i!& /'$+ri)C.'+%.'a*) ari %*+( /'$+ri)C.'+%.'a*) i $!ar a%ar" ar&a%i" 2" M)&ina'a(an .r).ara%i +-a* 2" M)n/a&.!r *an.a .)r%ia.an an !na(an .ra /a&.!ran ari .+*a%%i!& (+&)r%ia$ ari I" /'$+ri)C.'+%.'a*) 3" M)n)*a.(an %*anar an -a*a%i (+n%)n*ra%i +-a*" 1" K+n%)n*ra%i an *+*a$ 1" M)n)*a.(an %*anar =+$!&) *ia( *)r$a-)$ (+n%)n*ra%i an &)n!na(an )nan )$a%" .r)&i) %+$!*i+n%"
28
H).arin
S+i!& /'$+rin) %+$!*i+n% a*a% 0"?
i
2" B+*+$ &!$*i+%i% -+*+$5-+*+$ 2" M)n!na(an -+*+$ %in$)5 in%!$in an ').arin +%i% i/a&.!r an iaa a$a& M)&i%a'(an ').arin an ())(a*an *)r*!*!. %a*! in%!$in %a&a $ainn#a .aa !ni* ().)ra6a*an" 1" &)n#i&.an %+i!& /'$+ri) 1. M)&-a*a%i a$an &a%!( %+$!*i+n i a*a% 0"? i a*a% %+i!& /'$+ri) %+$!*i+n% i n!r%in !ni*" a*a% 0"? .ina'(an %+$!*i+n% 2" T)r%)ian#a -an#a( ini ari n!r%in !ni*" (+n%)n*ra%iC+r&!$a !. M)&-!a* %*anar an -a*a%an 3" Tia( aa %i%*)& +-a* an (+n%)n*ra%i" .)n)/)(an !a (a$i" M)n#)ia(an .r+*+(+$ .)ra$a*an !n*!( +!-$)5/')/( an(a .+&.a +-a*, (+n%)n*ra%i, an ari% *a&-a'an"
Fa(*+r r)%i(+ ari +-a*5+-a* High Alert *ia( 'an#a -)r(ai*an )nan .)nanaan *)*a.i a.a* .!$a -)r(ai*an )nan +-a* High Alert #an &)&i$i(i na&a an .)n!/a.an %a&a" O$)' (ar)na i*! %*a r!&a' %a(i* iaar(an !n*!( &)n/)a' -!n#i #an ())narann#a %a&a *)*a.i -)r-)a )nan &)n!na(an 1" M)n!$i%(an )nan -)nar an &)n!/a.(an ()*i(a &)n(+&!ni(a%i(an in+r&a%i a$a& .)n+-a*an" B!a* .)n)nar *)r%)-!* &)n!$an ()&-a$i .)n+-a*an *)r%)-!* !n*!( &)#a(in(an &)r)(a &)n)r*i )nan -)nar" 2" M)nina*(an &)r)( *)r%)-!* an na&a +-a* )n)ri( #an -ia%a i!/a.a(an an %).)r*i *)r$i'a*"
29
3" M)&.)r'a*i(an !n*!( ()%a$a'an ()%a$a'an .)&-aian ()*i(a &)na&-a'(an +-a* 4"
K)$+&.+((an +-a* )nan (a*)+ri ari.aa )nan a$.a-)*" :" M)nina*(an &)n)&.a*(an a$a& %i%*)& (+&.!*)r an ia*a% $a-)$ .aa *)&.a* .)n+-a*an !n*!( *ana +(*)r, .)ra6a*, an ar&a%i .aa &a%a$a' #an .+*)n%ia$" ;" M)$a(!(an &he&" *)&.a* a*a! $a-)$ .)n+-a*an %)$ain $a-)$ .a%i)n %)-)$!& &)&-)ri(an +%i% ().aa .a%i)n"
!.,
Keranka te3r)
R!&a'
%a(i*
&)r!.a(an
*)&.a*
%arana
.)n#)$)naraan
!.a#a
()%)'a*an"U.a#a *)r%)-!* -)r!.a ()ia*an &)&)$i'ara an &)nin(a*(an ()%)'a*an )nan .)n)(a*an .)&)$i'araan, .)nin(a*an ()%)'a*an, .)n/)a'an .)n#a(i*, .)n#)&-!'an .)n#a(i* an .)&!$i'an ()%)'a*an"Dari .)n)$a%an i a*a% .a%*i *)ra.a* '!-!nan #an )ra* )nan .)n)r*ian ()%)$a&a*an .a%i)n, (ar)na !.a#a #an i$a(!(an %)&!a i*!!(an !n*!( ().)n*inan .a%i)n"Jai %!a' %)'ar!%n#a %)-!a' r!&a' %a(i* -)%)r*a %*an#a &)n!%a'a(an *in(a* ()%)$a&a*an .a%i)n )&i ()a&anan an ()n#a&anan" Ban#a( !%a'a #an *)$a' i$a(!(an !n*!( &)nin(a*(an ()%)$)&a*an .a%i)n %a$a' %a*!n#a )nan aan#a %*anar &ini&a$ .)$a#anan r!&a' %a(i*"Di'ara.(an )nan aan#a a*!ran *)r%)-!* ()%)$a&a*an .a%i)n $)-i' &)nin(a*, na&!n *ia( -)i*! %aa 'ara.an *)r%)-!* *)r/a.ai"M)%(i.!n *)$a' aa -)r-aai a*!ran ()aian ()%a$a'an .)n+-a*an a*a! Medi&ation 5rror &a%i' *)rai" Da$a& 'a$ ini ()aian
30
*)r%)-!* a(an %ana* &)r!i(an .a%i)n" Pa%i)n a*an () r!&a' %a(i* !n*!( -)r+-a* an &)&!$i'(an ()%)'a*an -!(an !n*!( &)nai (+r-an ari ()aian Medi&ation 5rror " Ban#a( a/*+r #an &)n#)-a-(an ()aian Medi&ation 5rror *ia( 'an#a (ar)na %*anar* #an i-!a* *ia( &)&aai, *)*a.i a.a* .!$a -)ra%a$ ari *)naa ()%)'a*an, $in(!nan, .a%i)n, .)&-)rian +-a* an *)rai ()%a$a'an *)(ni% ari a$a* ()%)'a*an #an i!na(an" Da$a& .)&-)rian +-a* a(an -)ra(i-a* a*a$ i(a (i*a %)-aai *)naa ()%)'a*an %a$a' a$a& .)&-)riann#a" A(an $)-i' -)r-a'a#a i(a #an i-)ri(an aa$a' +-a*5+-a* High Alert " P)n)r*ian +-a*5+-a* High Alert aa$a' +-a* #an -)r)%i(+ *ini i(a a$a& .)&-)riann#a *)rai ()%a$a'an"+-a* LASA $oo" Ali"e So%nd Ali"e !a *)r&a%!( a$a& (a*)+ri High Alert a a$a' +-a* #an na&a an .)n!/a.ann#a &iri." B)r-a'a#a i(a (i*a %)-aai *)naa ()%)'a*an %a$a' a$a& &)na&-i$ +-a* LASA ini i(ar)na(an aa ()&iri.an an*ara +-a* #an %a*! )nan #an $ain" Ji(a %!a' -)i*! %)'ar!%n#a +-a*5+-a* High Alert .)r$! &)na.a*(an .)r'a*ian #an $)-i'"P)r'a*ian *)r%)-!* a.a* -)r!.a &)&-!a* .)nananan ('!%!% (a*)+ri +-a* ini )nan &)na*!r .)n#i&.anann#a"M)na*!r .)n#i&.anan +-a*5+-a* High Alert &)&an -!(an %a*!5%a*!n#a !%a'a !n*!( &)nin(a*(an ()%)$a&a*an .a%i)n"Na&!n i(a i$a(%ana(an )nan -ai( a.a* &)&-an*! &)nin(a*(an ()%)$a&a*an .a%i)n i R!&a' Sa(i*" B)i*! !a )nan *)naa ()%)'a*an &)r)(a a(an $)-i' .a'a& an -)r'a*i5'a*i a$a& &)$a(!(an .)$a#anan ().aa .a%i)n"
31
BAB III METODOLOGI PENELITIAN
'.1 Ran5ananPenel)t)an
Da$a& .)n)$i*ian ini i!na(an &)*+) .)n)$i*ian %!r=)# )%(ri.*i #ai*! i$a(!(an *)r'aa. %)(!&.!$an +-)( #an -ia%an#a -)r*!!an !n*!( &)$i'a* a&-aran )n+&)na *)r&a%!( ()%)'a*an" M)*+) .)n)$i*ian %!r=)# )%(ri.*i -)r*!!an !n*!( &)na&-ar(an .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+"
32
Aa.!n ran/anan .)n)$i*ian &)$i.!*i *a'a.an %)-aai -)ri(!* Ta'a. .)r*a&a, &)$a(!(an %!r=)# *)r'aa. +-a*5+-a* +$+nan High Alert #an i%i&.an i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+" Ta'a. ()!a &)$a(!(an ana$i%a a*a #an -)r%ia* (!a$i*a*i #ai*! ari 'a%i$ .)na&a*an ()&!ian ia&-i$ ()%i&.!$an" '.! P3"la$)
P+.!$a%i a$a& .)n)$i*ian ini aa$a' +-a*5+-a* High Alert #an aa i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ " '.' L3ka$) an 6akt" enel)t)an
P)n)$i*ian ini i$a(!(an i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+"7a(*! .)$a(%anaan i&!$ai .aa -!$an M)i 2014" '.& De+)n)$) Oera$)3nal 7ar)abel
D)ini%i +.)ra%i+na$ =aria-$) aa$a' !raian *)n*an -a*a%an =aria-$) #an i&a(%!, a*a! *)n*an a.a #an i!(!r +$)' =aria-$) #an -)r%an(!*an" B)ri(!* aa$a' *a-$) )ini%i +.)ra%i+na$ =aria-)$ Tabel '.1 De+)n)$) Oera$)3nal 7ar)abel
aria-$) .)n)$i*ian P)n#i&.an an +-a*
S!=aria-)$ T)&.a* .)n#i&.an an
D)ini%i +.)ra%i+na$
P)$a-)$an
P)$a-)$an%).)r*i na&a +-a*, *ana$ (aa$!ar%a, ()(!a*an +-a*,*ana.)rina*an+-a* High Alert an $a-)$
A$a* !(!r
T)&.a* P)n#i&.anan L)&-ar +-a*5+-a* High Alert /')/($i%* i%)niri(an *ia( %*anar* i/a&.!r"
33
Ha%i$ !(!r
S(a$a
Ja6a-a N+&in n Ya a$ %(+r 1 .)n#i&.an Tia( an +-a* %(+r 0 High Alert
$ar!*an (+n%)n*ra* Si%*)& FIFO a*a! FEFO
FIFO Fir%* In Fir%* O!* aa$a' i&ana -aran #an .)r*a&a &a%!( 'ar!% $)-i' !$! ()$!ar i%-anin -aran #an -ar! a*an" FEFO aa$a' i&ana -aran #an &)n)(a*i (aa$!ar%a i()$!ar(an $)-i' !$!"
P)n#i&.an an &)n!r!* )ni% O-a*5+-a* +$+nan High %)iaan Alert i%i&.an &)n!r!* -)n*!( %)iaan an %)%!ai a$.'a-)*"
Si%*)& Ta$$&an !n*!( LASA
Si%*)& Ta$$&an i&ana na&a ()!a +-a* #an %a&a i-!a* '!r! -)%ar an i-)ri 6arna #an &!a' *)r$i'a*"
'.* In$tr"#en enel)t)an
In%*r!&)n #an i!na(an a$a& .)n)$i*ian ini aa$a' a*ar +-a*5+-a* #an &a%!( (a*)+ri High Alert ,an a*ar &he" list ()$)n(a.an %*anar* .)n#i&.anan +-a* +$+nan High Alert . '., Pen"#"lan ata
34
Pr+%)!r #an i!na(an a$a& .)n!&.!$an a*a aa$a' .)na&a*an a*a! +-%)r=a%i $an%!n"M)*+) .)na&a*an a*a! +-%)r=a%i $an%!n #ai*! &)$a(!(an .)na&a*an *)r'aa. .)$a(%anaan ()ia*an .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+" B)ri(!* *)(ni( .)n!&.!$an a*a #an i!na(an 3";"1 P)na&a*an $an%!n 3";"1"1 M)n!&.!$(an a*a +-a*5+-a*an High Alert #an aa i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+" 3";"1"2 M)$i'a* -aai&ana .)n#i&.anan +-a*5+-a* High Alert #an aa i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ &)$i.!*i -aai&ana *)&.a* .)n#i&.anann#a, Si%*)& .)n#i&.anan, an P)$a-)$an" 3";"1"3 K)&!ian 'a%i$ i-anin(an )nan %*anar* .)n#i&.anan 3";"1"4 Di'i*!n .r+%)n*a%) ()&!ian ia&-i$ ()%i&.!$an './ Anal)$)$ ata
Da$a& .)n)$i*ian ini &)n!na(an ana$i%i% a*a (!a$i*a*i #ai*! 'a%i$ ari .)na&a*an $an%!n iana$i%i% ()&!ian ia&-i$ ()%i&.!$an -)r!.a )%(ri.%i" Ana$i%i% a*a a$a& .)n)$i*ian ini %)-aai -)ri(!* 1" Da*a #an i.)r+$)' ari $)&-ar /')/($i%* i-)ri %(+r, a6a-an #a &)na.a* %(+r 1, a6a-an *ia( &)na.a* %(+r 0 2" Ha%i$ a*a #an *)$a' i-)ri %(+r i!&$a'(an an i-ai )nan %(+r *)r*ini $a$! i(a$i(an )nan 100 3" Di'i*!n ni$ai ra*a5ra*a #an i.)r+$)' 6. Dari ni$ai *)r%)-!* a.a* i%i&.!$(an (a*)+ri *)n*an .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+"
35
P)r'i*!nan %(+r i!na(an r!&!% n
P
N
100
K)*)ranan P Pr+%)n*a%) #an ia.a* n S(+r #an ia.a* N S(+r *)r*ini a*a! &a(%i&a$ Dari 'a%i$ .)&-)rian %(+r &a(a a.a* i%i&.!$(an (a*)+ri .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ )nan &)n!na(an .r+%)n*a%) %)-aai -)ri(!* N+ 1" 2" 3" 4" :"
HASIL YANG DIPEROLEH >15100 ;15>0 415;0 21540 0520
KRITERIA BAIK SEKALI BAIK @UKUP KURANG KURANG SEKALI
BAB I7 HASIL PENELITIAN &.1 Ha$)l Penel)t)an
Da*a 'a%i$ .)na&a*an iana$i%i% &)n!na(an $)&-ar &he" list )nan /ara i$a(!(an %(+rin #ai*! i(a i*)& .)r*an#aan %)%!ai )nan %*anar &a(a i-)ri %(+r 1, i(a *ia( %)%!ai )nan %*anar i-)ri %(+r 0" Un*!( &)$i'a* a.a(a' %)%!ai )nan %*anar* a*a! -)$!& )nan /ara %(+r #an ia.a* i-ai )nan %(+r &a(%i&a$ ()&!ian i(a$i )nan 100" Ha%i$ #an ia.a* -)r!.a .r+%)n*a%) #an &)n!n!((an a&-aran .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD
36
Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ a.a(a' %!a' -ai( a*a! (!ran an a.a(a' %)%!ai )nan %*anar*"
&.1.1
Obat-3bat H)% Alert ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3
O-a* +$+nan High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ *)riri a$a& 4 +$+nan #ai*! +$+nan nar(+*i( an .%i(+*r+.i(, +$+nan LASA $oo" Ali"e So%nd Ali"e, +$+nan )$)(*r+$i* (+n%)n*ra*, an +$+nan +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian"
Tabel &.1.1.1 Obat-3bat High Alert 3l3nan nark3t)k an $)k3tr3)k ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3
N+ 1 2 3 4 : ; < > ? 10 11 12 13 14 1: 1; 1< 1>
NARKOTIKA @+)in 10 & Ta@+)in 1: & Ta@+)in 20 & Ta@+i.r+n* @a. @+i.r+n* @" E., @a. MST 1: & M+r.'in In F)n*an#$ In P)*'iin In 5 5 5 5 5 5 5 5 5
PSIKOTROPIKA A$.ra+$a& 0,: & TaA$ana 0,2: & TaA$ana 0,: & TaAna$%i( TaBraiin Ta@$+-aa& TaDia).a& 2 & TaDia).a& : & TaL!&ina$ 30 & TaSan&a Taa$i%an-) 2 & Taa$i%an-) : & TaA$.ra+$a& 1 & TaMi$+ In a$i%an-) In S)a$!& In P')n*a$ In Fri%i!& In
O-a* High Alert +$+nan nar(+*i( an .%i(+*r+.i( i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ *)ra.a* 2 i*)& +-a* #ai*! *a-$)* an 37
in)(%i #an &a%in5&a%in &)&i$i(i +%i% -)r-)a" O-a*5+-a* *)r%)-!* i%i&.an i $)&ari ('!%!% 2 .in*! an *)r.i%a' ari +-a* $ain" P)$a-)$an i$a(!(an %)%!ai )nan .r+*a. r!&a' %a(i* #ai*! i-)ri $a-)$ -)r*!$i%(a %)a*i )nan 6arna a%ar &)ra'" P)n!$i%an na&a +-a* an +%i% %!a' )$a% an a.a* )nan &!a' i-a/a" Na&!n &a%i' -)$!& *)ra.a* *ana .)rina*an -a'6a +-a* *)r%)-!* High Alert. Tabel &.1.1.!
Obat-3bat High Alert 3l3nan LASA 8 Look Alike Sound Alike9 ata"
N3r"# 8Na#a Obat R"a U5aan M)r)9 ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3
N+ 1 2 3 4
A$.ra+$a& Hi%*a.an @i$+% D+.a&in)
Miri. U/a.an L+ra).a& H).*a%an @i$+n D+-!*a&in)
G+$+nan LASA $oo" Ali"e So%nd Ali"e a*a! N+r!& Na&a O-a* R!.a U/a.an Miri. #an &iri. !/a.an ini &a%i' -)$!& i$)*a((an %)/ara *)r.i%a'" O-a*5 +-a* ini &a%i' i$)*a((an -)r/a&.!r )nan +-a* $ain" P)n!$i%an na&a +-a* an +%i% %!a' i*!$i% )nan )$a%" Na&!n a$a& .)n!$i%an !n*!( (a*)+ri LASA &a%i' -)$!& &)n!na(an %i%*)& Ta$$ &an" Si%*)& *)r%)-!* aa$a' /ara .)n!$i%an na&a +-a* #an *)r)nar &iri. an *)r$i'a* %a&a" S)'ina i(a &)n!na(an %i%*)& Ta$$ &an i'ara.(an *)naa ()%)'a*an a(an $)-i' *)$i*i %aa* a(an &)na&-i$ +-a* LASA ini" G+$+nan +-a* ini &a%i' -)$!& i-)ri *ana .)rina*an High Alert. P)$a-)$an +-a* LASA i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ &)ni(!*i .r+*a. ari .i'a( R!&a' Sa(i* #ai*! $a-)$ -)r*!$i%(an N+r!& )nan 6arna a%ar 'ia!"
38
Tabel &.1.1.' Obat-3bat High Alert 3l3nan LASA 8 Look Alike Sound Alike9 ata" N3r"# 8Na#a Obat R"a U5aan M)r)9 ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3
N+ 1 2 3 4 : ; < >
ALPRA+$a& @iLON @)FA:+$in Di&)n'#DRINATE M)*FORMIN G)n*a&i/in K)TOROLA< A&$+DIPINE
Miri. Na&a LORA).a& @i LOS @)TRIA; +n) Di.')n'#r AMINE M)*r+NIDA:OL G)n*ian =i+$)* K)TALAR A&i$+RIDE
G+$+nan LASA $oo" Ali"e So%nd Ali"e a*a! N+r!& Na&a O-a* R!.a U/a.an Miri. #an &iri. na&a ini !a &a%i' -)$!& i$)*a((an %)/ara *)r.i%a'" P)n!$i%an na&a +-a* #an *)r&a%!( LASA ini !a &a%i' -)$!& &)n!na(an %i%*)& Ta$$ &an" Na&!n .)n!$i%an na&a +-a* an +%i% %!a' )$a%" P)$a-)$an #an i$a(!(an !a &)ni(!*i .r+*a. ari .i'a( R!&a' Sa(i* #ai*! $a-)$ -)r*!$i%(an N+r!& )nan 6arna a%ar 'ia!" G+$+nan +-a* ini &a%i' -)$!& i-)ri *ana .)rina*an High Alert
Tabel &.1.1.& Obat-3bat High Alert 3l3nan LASA 8 Look Alike Sound Alike9 ata" N3r"# 8Na#a Obat R"a U5aan M)r)9 ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3
N+ 1 2 3
A/ran In @)+*ai&) In S+'+$in In
Miri. K)&a%an B)/$+ In @)*ria+n) In @)nran*r+n In
39
4 : ; <
A$ina&in F In I&.!an In G)*iin) In P$a%&in) In
A&in+.'i$in In F!r+%)&i In @a&i)%i/ In Tra=)n*i% In
G+$+nan LASA $oo" Ali"e So%nd Ali"e a*a! N+r!& Na&a O-a* R!.a U/a.an Miri. #an &iri. ()&a%an ini !a &a%i' -)$!& i$)*a((an %)/ara *)r.i%a'" P)$a-)$an +-a* i$a(!(an %a&a )nan #an $ain na&a +-a* an +%i% i*!$i% )nan )$a%" G+$+nan +-a* ini &a%i' -)$!& i-)ri *ana .)rina*an High Alert " P)n!$i%an +-a* !a -)$!& &)n!na(an %i%*)& Ta$$ &an" P)$a-)$an #an i$a(!(an !a &)ni(!*i .r+*a. ari .i'a( R!&a' Sa(i* #ai*! $a-)$ -)r*!$i%(an N+r!& )nan 6arna a%ar 'ia!" Tabel &.1.1.* Obat-3bat High Alert 3l3nan 3bat enan erlak"an k%"$"$ ala# e#ber)an ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3
K)$a% T)ra.i Ar)n)ri( a+ni% I Ana%*)*i( An*iari*&i(a I An*i*r+&-+*i(a P)n+-a*an In+*r+.i( I A)n %)a%i Hi.+$i()&i( +ra$
Na&a +-a* N+r).in)rin, P')n#*+in Sa+$ I Li+(ain Ari*ra ICS@ Far+in, Fa%+r-i In Mia+$a& M)*+r&in, $i-)n($a&i, G$!/+-a#,
In%!$in S@ an I A)n rai+(+n*ra% K)&+*)ra.i a)n
G$i&).iri), G$i.ii), San%!$in N, N+=+&i, Lan*!%, S+$+%*ar, N+=+ra.i I+.a&ir+ O(%i*+%in I
G$iani$,
G+$+nan +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ &a%i' -)$!& i$)*a((an %)/ara *)r.i%a'" P)n!$i%an na&a +-a* an +%i% %!a' )$a% an *ia( i%in(a*" G+$+nan +-a* ini
40
&a%i' -)$!& i-)ri *ana .)rina*an High Alert. Da$a& .r+*a. R!&a' Sa(i* !n*!( +-a* +$+nan ini &a%i' -)$!& aa in%*r!(%i .)$a-)$an ('!%!%" Kar)na +-a*5+-a* #an *)r&a%!( +$+nan ini *ia( -)raa i In%*a$a%i Far&a%i" Na&!n %)irin .)r()&-anan in+r&a%i an !n*!( ().)n*inan ()%)$a&a*an .a%i)n , +-a*5+-a* ini &!$ai i.ina'(an () In%*a$a%i Far&a%i *a'a. )&i *a'a." Ha$ *)r%)-!* i!.a#a(an !n*!( &)ninari aan#a ()%a$a'an a$a& .)n+-a*an an a(an &)nin(a*(an ()%)$a&a*an .a%i)n" Tabel &.1.1., Obat-3bat High Alert 3l3nan elektr3l)t k3n$entrat ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3
N+ 1 2 3 4 : ; <
Na&a O-a* D 40 M S!$a* 20 M S!$a* 40 M)#$+n K@$ <,: P+*a%%i!& +%a* In M S!$a* In
G+$+nan )$)(*r+$i* (+n%)n*ra* i In%*a$a%i Far&a%i Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ %!a' i$)*a((an %)/ara *)r.i%a'" P)n!$i%an na&a +-a* an (+n%)n*ra%i %!a' )$a%" G+$+nan +-a* ini &a%i' -)$!& i-)ri *ana .)rina*an High Alert. P)$a-)$an #an i$a(!(an !a &)ni(!*i .r+*a. ari .i'a( R!&a' Sa(i* #ai*! $a-)$ -)r*!$i%(an )$)(*r+$i* (+n%)n*ra* )nan 6arna a%ar (!nin"
41
&.1.! Ha$)l Pena#atan Tabel &.1.!.1 Ha$)l Pena#atan en=)#anan 3bat-3bat High Alert 3l3nan nark3t)k an $)k3tr3)k ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3.
N+
KETERANGAN
JA7ABAN
HASIL SKOR
SKOR MAKSIMAL
1
P)n#i&.anan +-a*5+-a* High Alert i%)niri(an an *ia( i/a&.!r
Tia(
0
1
2
Na&a +-a* )$a% an *ia( i%in(a*
Ya
1
1
3
T)ra.a* *ana$ (aa$!ar%a .aa ()&a%an +-a*
Ya
1
1
4
T)ra.a* ()(!a*an +-a* a*a! +%i% -ai( .aa ()&a%an &a!.!n 6aa' +-a*
Ya
1
1
:
T)ra.a* *ana .)rina*an +-a* High Alert
Tia(
0
1
;"
T)ra.a* $a-)$ $ar!*an (+n%)n*ra* -)%)r*a (+n%)n*ra%in#a
Ya
1
1
<"
P)n#!%!nan +-a* &)n!na(an %i%*)& FIFO a*a! FEFO
Ya
1
1
>"
P)n#!%!nan +-a* %)/ara a$a-)*i% an &)n!r!* )ni% %)iaan
Ya
1
1
;
>
J!&$a'
42
Paa *a-$) 4"1"2"1 &)n!n!((an -a'6a %(+r *+*a$ #an i.)r+$)' ari .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ aa$a' ; )nan .r+%)n*a%) <:, %)an(an %(+r &a(%i&a$ aa$a' > )nan .r+%)n*a%) 100" Tabel &.1.!.! Ha$)l Pena#atan en=)#anan 3bat-3bat High Alert LASA 8 Look Alike Sound Alike9 ata" N3r"# 8Na#a Obat R"a U5aan M)r)9 ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3.
N+
JA7ABAN
HASIL SKOR
SKOR MAKSIMAL
P)n#i&.anan +-a*5+-a* High Alert i%)niri(an an *ia( i/a&.!r Na&a +-a* )$a% an *ia( i%in(a*
Tia(
0
1
Ya
1
1
3
T)ra.a* *ana$ (aa$!ar%a .aa ()&a%an +-a*
Ya
1
1
4
T)ra.a* ()(!a*an +-a* a*a! +%i% -ai( .aa ()&a%an &a!.!n 6aa' +-a*
Ya
1
1
:
T)ra.a* *ana .)rina*an +-a* High Alert
Tia(
0
1
;"
P)n#!%!nan +-a* &)n!na(an %i%*)& FIFO a*a! FEFO
Ya
1
1
<"
P)n#!%!nan +-a* %)/ara a$a-)*i% an &)n!r!* )ni% %)iaan
Ya
1
1
>"
P)n!$i%an na&a +-a* &)n!na(an %i%*)& Ta$$ &an
Tia(
0
1
1
2
KETERANGAN
43
J!&$a'
:
>
Paa *a-$) 4"1"2"2 &)n!n!((an -a'6a %(+r *+*a$ #an i.)r+$)' ari .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ aa$a' : )nan .r+%)n*a%) ;2,: , %)an(an %(+r &a(%i&a$ aa$a' > )nan .r+%)n*a%) 100"
Tabel &.1.!.' Ha$)l Pena#atan en=)#anan 3bat 3l3nan 3bat enan erlak"an k%"$"$ ala# e#ber)an ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l) n3.
N+
JA7ABAN
HASIL SKOR
SKOR MAKSIMAL
P)n#i&.anan +-a*5+-a* High Alert i%)niri(an an *ia( i/a&.!r Na&a +-a* )$a% an *ia( i%in(a*
Tia(
0
1
Ya
1
1
3
T)ra.a* *ana$ (aa$!ar%a .aa ()&a%an +-a*
Ya
1
1
4
T)ra.a* ()(!a*an +-a* a*a! +%i% -ai( .aa ()&a%an &a!.!n 6aa' +-a*
Ya
1
1
:
T)ra.a* *ana .)rina*an +-a* High Alert
Tia(
0
1
;"
P)n#!%!nan +-a* &)n!na(an %i%*)& FIFO a*a! FEFO
Ya
1
1
1
2
KETERANGAN
44
<"
P)n#!%!nan +-a* %)/ara a$a-)*i% an &)n!r!* )ni% %)iaan
Ya
J!&$a'
1
1
:
<
Paa *a-$) 4"1"2"3 &)n!n!((an -a'6a %(+r *+*a$ #an i.)r+$)' ari .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ aa$a' : )nan .r+%)n*a%) <1,4 , %)an(an %(+r &a(%i&a$ aa$a' < )nan .r+%)n*a%) 100" Tabel &.1.!.& Ha$)l Pena#atan en=)#anan 3bat 3l3nan elektr3l)t k3n$entrat ) In$tala$) Far#a$) RSUD Dr. M3%a#a Sale% K3ta Pr3b3l)n3.
N+
JA7ABAN
HASIL SKOR
SKOR MAKSIMAL
P)n#i&.anan +-a*5+-a* High Alert i%)niri(an an *ia( i/a&.!r Na&a +-a* )$a% an *ia( i%in(a*
Ya
1
1
Ya
1
1
3
T)ra.a* *ana$ (aa$!ar%a .aa ()&a%an +-a*
Ya
1
1
4
T)ra.a* ()(!a*an +-a* a*a! +%i% -ai( .aa ()&a%an &a!.!n 6aa' +-a*
Ya
1
1
:
T)ra.a* *ana .)rina*an +-a* High Alert
Tia(
0
1
;"
P)n#!%!nan +-a* &)n!na(an %i%*)& FIFO a*a! FEFO
Ya
1
1
1
2
KETERANGAN
45
<"
P)n#!%!nan +-a* %)/ara a$a-)*i% an &)n!r!* )ni% %)iaan
Ya
J!&$a'
1
1
;
<
Paa *a-$) 4"1"2"4 &)n!n!((an -a'6a %(+r *+*a$ #an i.)r+$)' ari .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ aa$a' ; )nan .r+%)n*a%) >; , %)an(an %(+r &a(%i&a$ aa$a' < )nan .r+%)n*a%) 100" Tabel &.1.' Reka)t"la$) Pr3$enta$e Ha$)l Pena#atan
N+
Da*a P)n#i&.anan
S(+r a6a-an
Pr+%)n*a%) S(+r #an i a.a*
1
G+$+nan nar(+*i( an
;
<:
2
.%i(+*r+.i( G+$+nan LASA $oo"
:
;2,:
3
Ali"e So%nd Ali"e G+$+nan +-a* )nan
:
<1,4
;
>;
.)r$a(!an ('!%!% a$a& .)&-)rian G+$+nan
4
)$)(*r+$i*
(+n%)n*ra* J!&$a'
2?4,?
Pr+%)n*a%) ni$ai ra*a5ra*a 75 + 62,5 + 71,4
+
86
4
294,9
4
<3,< 46
Dari 'a%i$ i.)r+$)' %(+r ra*a5ra*a a&-aran .)n#i&.anan +-a* Hi' A$)r* i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ %)-)%ar <3,<
&.! Pe#ba%a$an
P)n)$i*ian ini &)&-a'a% *)n*an -aai&ana a&-aran .)n#i&.anan +-a*5+-a* High Alert #ai*! +-a*5+-a* #an .)r$! i6a%.aai i In%*a$a%i Far&a%i R!&a' Sa(i*" T!!an !&!& ari .)n)$i*ian ini aa$a' !n*!( &)n)*a'!i a&-aran .)n#i&.anan +-a*5+-a* High Alert i In%*a$a%i Far&a%i R!&a' Sa(i*" S)an(an *!!an ('!%!% ari .)n)$i*ian ini aa$a' !n*!( &)ni%(ri.%i(an (ri*)ria5(ri*)ria .)n#i&.anan ('!%!% !n*!( +-a* +$+nan High Alert " Kri*)ria .)n#i&.anan *)r%)-!* aa$a' /ara .)$a-)$an an*ara $ain -aai&ana *ana .)rina*an !n*!( +-a* High Alert , -aai&ana $a-)$ +%i% +-a*, *ana$ (aa$!ar%a, an $a-)$ $ar!*an (+n%)n*ra*" Kri*)ria %i%*)& .)n#!%!nan +-a* +$+nan High Alert &)n!na(an FEFO a*a! FIFO an a.a(a' i%!%!n &)n!r!* a$.'a-)* an -)n*!( %)iaan" Kri*)ria *a*a $)*a( .)n#i&.anan a.a(a' +-a*5+-a* High Alert i%)niri(an a*a! i/a&.!r )nan #an $ain, an -aai&ana (ri*)ria .)n#i&.anan !n*!( +-a* LASA $oo" Ali"e So%nd Ali"e " M)*+) .)n)$i*ian #an i!na(an aa$a' .)na&a*an %)/ara $an%!n )nan a$a* !(!r -)r!.a $)&-ar &he" list -)ri%i (ri*)ria .)n#i&.anan ('!%!% +-a*5 +-a* High Alert " Dari $)&-ar &he" list 'a%i$ i/+/+((an -)ra%ar(an .)na&a*an $an%!n" P+.!$a%i .)n)$i*ian ini aa$a' +-a*5+-a* High Alert #an aa i In%*a$a%i
47
Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+" Da$a& .)n)$i*ian ini %)&!a .+.!$a%i iai(an %a&.)$" Ana$i%i% a*a #an i$a(!(an aa$a' )nan &)&-)ri(an .r+%)n*a%) a&-aran .)n#i&.anan +-a*5+-a* High Alert #an *)$a' i$a(!(an" T)ra.a* -)-)ra.a *+$a( !(!r *)n*an -aai&ana .)n#i&.anan #an %!a' i$a(!(an #ai*! -ai(, (!ran, /!(!. a*a! (!ran %)(a$i &)n!r!* .r+%)n*a%) #an *)$a' i.)r+$)'" D)nan &)n!na(an .r+%)n*a%) *)r%)-!* a(an &)&!a'(an &)n+$a' a*a 'a%i$ .)na&a*an" Manaa* #an i.)r+$)' )nan aan#a .)n)$i*ian ini i'ara.(an -ai in%*an%i #an &)nai *)&.a* .)n)$i*ian a.a* iai(an &a%!(an in+r&a%i a$a& &)n)$+$a .)n#i&.anan ('!%!% +-a*5+-a* High Alert %)'ina a.a* &)nin(a*(an ()%)$a&a*an .a%i)n" Manaa* -ai *)naa ()%)'a*an &)na.a* .)&a'a&an *)n*an .)n*inn#a .)na*!ran .)n#i&.anan ('!%!% +-a*5+-a* High Alert , %)'ina i(a &)na.a* r)%). +-a*5+-a* High Alert a(an $)-i' -)r'a*i5'a*i" Manaa* -ai &a%#ara(a* aa$a' )nan &)nin(a*n#a ()%aaran .)n*inn#a ()%)$a&a*an .a%i)n &a(a .)$a#anan ()%)'a*an a(an $)-i' &a(%i&a$" K)*)r-a*a%an .)n)$i*ian ini aa$a' 'an#a &)na&a*i .)n#i&.anan +-a* %aa %)'ina *ia( a.a* &)na&-ar(an %)$!r!' .r+%)% .)n)$+$aan ari +-a*5+-a* High Alert " B)ra%ar(an 'a%i$ .)na&a*an ia.a*(an a*a 4 +$+nan +-a* #an &a%!( a$a& (a*)+ri High Alert , #ai*! +$+nan nar(+*i( an .%i(+*r+.i(, +$+nan LASA $oo" Ali"e So%nd Ali"e, +$+nan )$)(*r+$i* (+n%)n*ra* an +$+nan +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian" G+$+nan +-a* #an &a%!( (a*)+ri High Alert
48
*)r%)-!* 'ar!% i.)r'a*i(an /ara .)n#i&.anann#a !n*!( &)n/)a' ()%a$a'an %aa* .)na&-i$an &a!.!n %aa* a(an i%ia.(an !n*!( i-)ri(an ().aa .a%i)n" P)na*!ran *)n*an .)n#i&.anan +-a*5+-a* #an .)r$! i6a%.aai High Alert *)r&a%!( a$a& %a%aran ()%)$a&a*an .a%i)n"Ma(%! ari %a%aran ()%)$a&a*an .a%i)n aa$a' &)n+r+n .)r-ai(an %.)%ii( a$a& ()%)$a&a*an .a%i)n" R!&a' Sa(i* .)r$! &)n)&-an(an %!a*! .)n)(a*an !n*!( &)&.)r-ai(i ()a&anan +-a*5+-a* #an .)r$! i6a%.aai High Alert " R!&a' Sa(i* %)/ara (+$a-+ra*i &)n)&-an(an ()-ia(an an a*a! .r+%)!r !n*!( &)&-!a* a*ar +-a*5+-a* #an .)r$! i6a%.aai -)ra%ar(an a*a #an aa i r!&a' %a(i*" D).K)% RI, 2011" B)ra%ar(an 'a%i$ .)n)$i*ian ia.a*a(an .)n#i&.anan +-a* High Alert +$+nan nar(+*i( an .%i(+*r+.i( i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ &)na.a* .r+%)n*a%) %)-)%ar <: #an ar*in#a .)n#i&.anan &a%!( a$a& (a*)+ri -ai(" L)*a( .)n#i&.anan +-a* nar(+*i( an .%i(+*r+.i( *)$a' i%)niri(an %)%!ai a*!ran #an -)r$a(! #ai*! a$a& $)&ari ('!%!% )nan !a .in*!"Na&a +-a* *)$a' i*!$i% )nan )$a% an *ia( i%in(a*, %)$ain i*! a$a& 6aa' +-a* *)$a' *)r*!$i% (+n%)n*ra%i +-a* a*a! +%i% #an )$a%"Da$a& ()&a%an +-a* !a *)$a' *)r*)ra *ana$ (aa$!ar%a #an )$a%"O-a* +$+nan nar(+*i(a an .%i(+*r+.i(a i%i&.an %)%!ai a$a-)*i% an -)n*!( %)iaan, !a *)$a' i%!%!n &)n!na(an %i%*)& FIFO" O-a*5+-a* #an aa i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ i$)*a((an i6aa' *)r%)niri *ia( &)&a(ai (ar!% +-a* %)'ina $)-i' *)r*a*a ra.i" Na&!n a$a& .)n#i&.anann#a *ia( i-)ri $a-)$ .)rina*an -)r*!$i%(an High Alert " P)$a-)$an +-a* +$+nan nar(+*i( an .%i(+*r+.i( i In%*a$a%i Far&a%i 49
RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ i$a(!(an -)ra%ar(an .r+*a. #an i()$!ar(an +$)' .i'a( r!&a' %a(i*" La-)$ *)r%)-!* -)r*!$i%(an %)a*i !n*!( +$+nan nar(+*i( an .%i(+*r+.i( )nan 6arna a%ar &)ra'" O-a* +$+nan nar(+*i( an .%i(+*r+.i( &a%!( a$a& (a*)+ri High Alert i(ar)na(an +-a*5+-a* *)r%)-!* a.a* &)&.)nar!'i i6a an .i(iran %)%)+ran #an a('irn#a ra6an i%a$a'!na(an"S)'ina .)n!naann#a .)r$! ia6a%i &!$ai ari .)naaan,
.)r)aran,
.)n+-a*an,
.)$a.+ran
an
.)n#i&.anan"Jai
%aa*
.)n#i&.anan i%aran(an i-)ri *ana .)rina*an aar *)naa ()%)'a*an &)n)*a'!i -a'6a +-a* *)r%)-!* .)r$! i6a%.aai aar 'a*i5'a*i %aa* &)n#ia.(an, &)n!na(an an %aa* i-)ri(an ().aa .a%i)n 'ar!% i)$a%(an )nan -)nar" P)n#i&.anan +-a* High Alert +$+nan +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ &)na.a* .r+%)n*a%) %)-)%ar <1,4 #an ar*in#a .)n#i&.anan &a%!( a$a& (a*)+ri -ai(" L)*a( .)n#i&.anan +-a* +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian -)$!& i%)niri(an "Na&a +-a* *)$a' i*!$i% )nan )$a% an *ia( i%in(a*, %)$ain i*! a$a& 6aa' +-a* *)$a' *)r*!$i% (+n%)n*ra%i +-a* a*a! +%i% #an )$a%"Da$a& ()&a%an +-a* !a *)$a' *)r*)ra *ana$ (aa$!ar%a #an )$a%"O-a* +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian i%i&.an %)%!ai a$a-)*i% an -)n*!( %)iaan, !a *)$a' i%!%!n &)n!na(an %i%*)& FIFO" O-a* High Alert +$+nan +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ -)$!& i-)ri $a-)$ *ana .)rina*an High Alert " La-)$ *ana .)rina*an High Alert i.)r$!(an aar
50
*)naa ()%)'a*an #an a(an &)n!na(an +-a* ini $)-i' 6a%.aa %aa* &)n)*a'!i -a'6a +-a* *)r%)-!* High Alert. O-a* +$+nan ini .)r$! i.)r'a*i(an .)n#i&.ananann#a (ar)na ini(a%in#a !n*!( .)n#a(i* a$a& an &a#+ri*a% &)&i$i(i r)n*an *)ra.i %)&.i*"R)n*an *)ra.i %)&.i* aa$a' i&ana ara( an*ara ))( *)ra.i an ))( *+(%i% +-a* )(a*"D+%i% +-a*5 +-a* ini .)r$! i.)r'a*i(an %aa* &)n#ia.(an !n*!( i%)ra'(an ().aa .a%i)n" B)i*! !a i(a +-a* %)-)$!& i!na(an 'ar!% i)n/)r(an a'!$!, 'a$ *)r%)-!* 'ar!% i6a%.aai %)*ia. a(an &)n!na(an +-a* +$+nan ini !n*!( &)&ini&a$i%ir ()%a$a'an" O-a*5+-a* %).)r*i in%!$in !n*!( S@ a*a! I .)r$! i.)r'a*i(an +%i%n#a %aa* a(an &)n#!n*i((an, (ar)na +%i% %)*ia. .)n)ri*a ia-)*)% -)r-)a" Un*!( .)n+-a*an .)n#a(i* an*!n an .)&-!$!' !a .)r$! i.)r'a*i(an %aa* a(an &)na&-i$, &)n#ia.(an an &)ra/i( +-a* !n*!( .a%i)n" Kar)na +-a*5+-a* *)r%)-!* -an#a( #an &)&i$i(i r)n*an *)ra.i %)&.i* %)'ina .)n!naan 'ar!% 'a*i5'a*i an ia6a%i )nan -ai( !n*!( &)n/)a' ()%a$a'an +-a*"S)an(an !n*!( a)n ()&+*)ra.i *)naa ()%)'a*an !a 'ar!% -)r'a*i5'a*i %aa* &)na&-i$, &)n#ia.(an an .)ra/i(an +-a* *)r%)-!*" Kar)na i(a *ia( a(an *)r.a.ar a* ()&+*)ra.i *)r%)-!*, *ia( 'an#a i*! .)r'i*!nan +%i% !a 'ar!% i.)r'a*i(an" D+%i% +-a* ()&+*)ra.i #an *)r$a$! ()/i$ *ia( a.a* &)&a*i(an .)r*!&-!'an %)$ (an()r, -i$a *)r$a$! -)%ar ))(n#a -)r-a'a#a %a&.ai &)n#)-a-(an ()&a*ian" P)n#i&.anan +-a* High Alert +$+nan )$)(*r+$i* (+n%)n*ra* i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ &)na.a* .r+%)n*a%) %)-)%ar >; #an ar*in#a .)n#i&.anan &a%!( a$a& (a*)+ri -ai( %)(a$i" L)*a( 51
.)n#i&.anan )$)(*r+$i* (+n%)n*ra* *)$a' i%)niri(an "Na&a +-a* *)$a' i*!$i% )nan )$a% an *ia( i%in(a*, %)$ain i*! a$a& 6aa' +-a* *)$a' *)r*!$i% (+n%)n*ra%i +-a* a*a! +%i% #an )$a%"Da$a& ()&a%an +-a* !a *)$a' *)r*)ra *ana$ (aa$!ar%a #an )$a%"E$)(*r+$i* (+n%)n*ra* i%i&.an %)%!ai a$a-)*i% an -)n*!( %)iaan, !a *)$a' i%!%!n &)n!na(an %i%*)& FIFO" P)n#i&.anan )$)(*r+$i* (+n%)n*ra* *ia( i-)ri $a-)$ .)rina*an -)r*!$i%(an High Alert " P)$a-)$an )$)(*r+$i* (+n%)n*ra* i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ i$a(!(an -)ra%ar(an .r+*a. #an i()$!ar(an +$)' .i'a( r!&a' %a(i*" La-)$ *)r%)-!* -)r*!$i%(an )$)(*r+$i* (+n%)n*ra* )nan 6arna a%ar (!nin" E$)(*r+$i* (+n%)n*ra* i!na(an !n*!( .)&-)rian in!% an in)(%i"E$)(*r+$i* (+n%)n*ra* )nan (+n%)n*ra%i *ini %)rin i-)ri(an %)/ara *ia( %)naa i !ni* .)$a#anan .a%i)n a*a! .aa ()aaan ar!ra*" Bia%an#a #an i-)ri(an %)/ara *ia( %)naa aa$a' )$)(*r+$i* (+n%)n*ra* )nan (+n%)n*ra%i *ini #an %)'ar!%n#a i)n/)r(an *)r$)-i' a'!$!" O-a*5+-a* ini %)rin ii%!(an a$a& ()%)$a&a*an .a%i)n aa$a' .)&-)rian $ar!*an (+n%)n*ra* %)/ara *ia( %)naa&i%a$n#a, (a$i!& ($+ria 2&)C&$ a*a! #an $)-i' .)(a*, (a$i!& +%a*, na*ri!& ($+ria $)-i' .)(a* ari 0"?, an &an)%i!& %!$a* :0 a*a! $)-i' .)(a*" @ara #an .a$in ))(*i !n*!( &)n!rani a*a! &)n)$i&ina%i ()aian *)r%)-!* aa$a' )nan &)nin(a*(an .r+%)% .)n)$+$aan +-a*5+-a* #an .)r$! i6a%.aai *)r&a%!( &)&ina'(an )$)(*r+$i* (+n%)n*ra* ari !ni* .)$a#anan .a%i)n () ar&a%i"D).K)% RI, 2011 Ji(a $ar!*an )nan (+n%)n*ra%i *ini *)*a. i-)ri(an &a(a a(an -)ra(i-a* a*a$ 'ina ()&a*ian .aa .a%i)n"O$)' (ar)na i*! )$)(*r+$i* (+n%)n*ra* *ia( -+$)' -)raa i 52
r!an
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&)&.)r-+$)'(an aan#a )$)(*r+$i* (+n%)n*ra* an*ara $ain In%*a$a%i Far&a%i, In%*a$a%i Ra6a* Dar!ra* an In%*a$a%i Ra6a* In*)n%i" Da$a& .)n#i&.anann#a !a 'ar!% i-)ri $a-)$ #an )$a% aar *)naa ()%)'a*an $)-i' 6a%.aa %aa* a(an &)n!na(an ('!%!%n#a .)ra6a*" P)n#i&.anan +-a* High Alert +$+nan LASA $oo" Ali"e So%nd Ali"e i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ &)na.a* .r+%)n*a%) %)-)%ar ;2,: #an ar*in#a .)n#i&.anan &a%!( a$a& (a*)+ri -ai(" L)*a( .)n#i&.anan +-a* LASA &a%i' -)$!& i%)niri(an "Na&a +-a* +$+nan LASA *)$a' i*!$i% )nan )$a% an *ia( i%in(a*"%)$ain i*! a$a& 6aa' +-a* *)$a' *)r*!$i% (+n%)n*ra%i +-a* a*a! +%i% #an )$a%" Da$a& ()&a%an +-a* !a *)$a' *)r*)ra *ana$ (aa$!ar%a #an )$a%"O-a* +$+nan LASA i%i&.an %)%!ai a$a-)*i% an -)n*!( %)iaan, !a *)$a' i%!%!n &)n!na(an %i%*)& FIFO" O-a* High Alert +$+nan LASA $oo" Ali"e So%nd Ali"e i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ -)$!& i-)ri $a-)$ *ana .)rina*an High Alert " La-)$ *ana .)rina*an High Alert i.)r$!(an aar *)naa ()%)'a*an #an a(an &)n!na(an +-a* ini $)-i' 6a%.aa %aa* &)n)*a'!i -a'6a +-a* *)r%)-!* High Alert. S)$ain i*! .)n!$i%an na&a +-a* LASA *ia( &)&a(ai %i%*)& Ta$$ &an, i&ana na&a +-a* #an *)r)nar an *)r$i'a* &iri. i*!$i% '!r! -)%ar an i-)ri 6arna #an &)n/+$+( %)'ina $)-i' &!a' &)&-)a(an" P)n!$i%an *)r%)-!* !n*!( &)&!a'(an *)naa ()%)'a*an &)n)na$i +-a* #an &)&.!n#ai !/a.an, ()&a%an an na&a #an 'a&.ir %a&a" S)$ain i*! .)n*in a$a& &)n!$i%(an +-a* LASA )$a% an *ia( i%in(a* %aa* .)r)%).an -)i*! !a a$a& &)n!$i%(an +%i% 53
+-a* 'ar!% )$a%"ISMN, 2010 Ji(a *)rai ()()$ir!an %aa* &)na&-i$ +-a* LASA a(an -)ra(i-a* a*a$ .aa .a%i)n" Mi%a$n#a .a%i)n #an &)n)ri*a an!an .)n/)rnaan #an %)'ar!%n#a i-)ri L+%)/ O&).ra+$),
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S)$ain
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54
BAB 7 PENUTUP *.1 Ke$)#"lan
B)ra%ar(an 'a%i$ .)n)$i*ian an .)&-a'a%an #an i$a(!(an *)r'aa. a&-aran .)n#i&.anan +-a* High Alert #an i$a(!(an i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ %)-aai -)ri(!* :"1"1
P)n#i&.anan +-a* Hi' A$)r* +$+nan nar(+*i( an .%i(+*r+.i( i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ *)r&a%!( a$a&
:"1"2
(ri*)ria -ai( )nan .r+%)n*a%) <: P)n#i&.anan +-a* Hi' A$)r* +$+nan LASA $oo" Ali"e So%nd Ali"e i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ *)r&a%!(
:"1"3
a$a& (ri*)ria -ai( )nan .r+%)n*a%) ;2,: P)n#i&.anan +-a* Hi' A$)r* +$+nan +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+
:"1"4
*)r&a%!( a$a& (ri*)ria -ai( )nan .r+%)n*a%) <1,4 P)n#i&.anan +-a* Hi' A$)r* +$+nan )$)(*r+$i* (+n%)n*ra* i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ *)r&a%!( a$a& (ri*)ria -ai( %)(a$i )nan .r+%)n*a%) >;
55
B)ra%ar(an a*a #an *)$a' i.)r+$)' a.a* i%i&.!$(an -a'6a .)n#i&.anan +-a*5+-a* Hi' A$)r* i In%*a$a%i Far&a%i RSUD Dr" M+'a&a Sa$)' K+*a Pr+-+$in+ i(a i.r+%)n*a%)(an %)-)%ar <3,< an &a%!( a$a& (a*)+ri -ai(" *.! Saran :"2"1 Di'ara.(an .)n#i&.anan +-a* Hi' A$)r* +$+nan LASA L++( A$i()
S+!n A$i() an +-a* )nan .)r$a(!an ('!%!% a$a& .)&-)rian
:"2"2
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56
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57
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60
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61