Pengoptimalan Peran Apoteker dalam Pemantauan dan Evaluasi Insiden Keselamatan Pasien

Abstract

Apoteker dapat berkontribusi dalam perawatan pasien dengan mengoptimalkan penggunaan obat dan meminimalisasi efek obat yang tidak diharapkan dengan cara mengidentifikasi Medication Related Problems (MRPs), memberikan solusi terhadap MRPs, dan mencegah MRPs melalui pelayanan farmasi klinik. Tujuan penelitian ini adalah mengintegrasikan kegiatan farmasi klinik dengan kegiatan keselamatan pasien untuk mengoptimalkan peran apoteker dalam pemantauan dan evaluasi insiden keselamatan pasien (IKP). Penelitian ini merupakan penelitian kuasi eksperimental dengan pengambilan data secara prospektif yang dilakukan pada bulan Mei–Juli 2012 dengan subjek penelitian pasien rawat inap sebanyak 5173 pasien. Hasil penelitian ini menunjukkan terdapat 150 MRPs yang terjadi pada 142 pasien. MRPs dikelompokkan dalam 5 kategori insiden, yaitu Kondisi Potensial Cedera (2,67%), Kondisi Nyaris Cedera (16,67%), Kondisi Tidak Cedera (58,66%), Kejadian Tidak Diharapkan (22%), dan sentinel (0%). Setiap MRPs ditindaklanjuti dengan rekomendasi yang diukur tingkat penerimaannya, yaitu diterima sesuai rekomendasi (81,64%), diterima dengan modifikasi (5,70%), diterima tanpa dilakukan perubahan (12,56%.). Setelah itu dilakukan pemetaan risk grading matrix. Integrasi kegiatan farmasi klinik dengan kegiatan keselamatan pasien diwujudkan melalui sistem pelaporan yang memuat MRPs, kategori insiden, dampak klinik, rekomendasi pemecahan masalah, dan risk grading matrix.

Kata kunci: Apoteker farmasi klinik, keselamatan pasien, risk grading matrix

Optimization of Pharmacists Roles in Patient Safety Monitoring and
Evaluation

Pharmacists can contribute to patient care by optimizing the use of drugs and minimizing adverse drugs effect. This can be performed by identifying the presence of Medication Related Problems (MRPs) and providing a solution to prevent the MRPs through clinical pharmacy services. The aim of this study was to integrate clinical pharmacy activities with patient safety activities in order to optimize the roles of pharmacists both in monitoring and evaluation of patient safety incidents. This study was a quasi-experimental study with prospective data collection which was conducted in May–July 2012 with 5173 hospitalized patients as subjects. The results showed that there were 150 MRPs occurred in 142
patients. The existing MRPs were grouped in 5 categories of incidents; Potential Injury (2.67%), Almost Injury (16.67%), No Injury (58.66%), Unexpected Incidents (22%), and Sentinel (0%). Each MRPs was followed by recommendations which level of acceptance were measured; accepted according to the recommendations (81.64%), accepted with modifications (5.70%), and accepted without changes (12.56%). Furthermore, risk grading matrix mapping was also performed. Based on these results,
integration of clinical pharmacy activities to patient safety activities was performed through report system. This report including MRP, incident categories, clinical impacts, recommendation, and risk grading matrix.

Key words: Clinical pharmacists, patient safety, risk grading matrix