Automated Dispensing Machine Sebagai Salah Satu Upaya Menurunkan Medication Errors Di Farmasi Rumah Sakit

Abstrak

Medication Errors merupakan penyebab kematian tertinggi keempat di Amerika Serikat. Untuk menurunkan kejadian medication errors, khususnya dispensing errors, Amerika Serikat sudah menggunakan sistem dispensing otomatis. Di Indonesia, hampir semua instalasi farmasi masih menggunakan tenaga manual. Studi ini menganalisis dampak ADM (Automated Dispensing Machine) terhadap medication errors, khususnya dispensing errors di instalasi farmasi rumah sakit. Metode: Systematic Review menggunakan metode PRISMA diambil dari online database seperti Scopus, Tripdatabase, Springerlink dan Google Scholar dengan kata kunci “Automated Dispensing Machine” dan “Medication Error” dengan rentang waktu studi 10 tahun terakhir (Bulan Januari 2008 - Januari 2018). Hasil dan Diskusi: Sebelas penelitian menunjukkan dampak positif automated dispensing machine (ADM) menurunkan dispensing errors, baik di instalasi rawat jalan maupun rawat inap. Lima penelitian menunjukkan ADM harus terintegrasi dengan e-Prescription, sistem barcoding, dan Sistem Informasi Rumah Sakit, agar dapat berdampak optimal. Sistem filling ADM otomatis dapat mendukung penurunan angka dispensing errors. ADM juga berdampak positif menurunkan beban kerja di farmasi, waktu tunggu obat, nilai inventory farmasi, dan biaya karyawan. Kelemahan sistem ADM adalah sulit digunakan dalam pelayanan emergency, membutuhkan sumber daya manusia terlatih, dan biaya tinggi. Simpulan: ADM berdampak positif menurunkan angka medication errors. Untuk hasil maksimal ADM harus diintegrasikan dengan sistem informasi rumahsakit.

Medication Error are the 4th leading cause of death in USA; to decrease medication error particularly dispensing error, Automated Dispensing System had been used in USA. In Indonesia, most pharmaceutical departments still use manual system in drugs dispensing. This study analyze the effect of ADM (Automated Dispensing Machine) to medication errors, particularly dispensing errors in hospital pharmacy. Method: Systematic Review with PRISMA method retrieved from online database such as Scopus, Tripdatabase, Springerlink, and Google Scholar using keywords “Automated Dispensing Machine” AND “Medication Error” studied in the last ten years. Results and Discussion: All eleven studies show beneficial effects in ADM implementation, decreasing dispensing error, both at outpatient and inpatient ward. Five studies suggest that ADM should be integrated with e-Prescription, barcoding system, and hospital information system for optimal result. Automatic filling system also decrease dispensing error. ADM also gives beneficial effect in reducing pharmacy staffs’ workload, drug waiting time, drug inventory cost, and employee costs. ADM systems have some weaknesses: difficult to apply at emergency services, need trained staffs, and high costs. Conclusion ADM gives beneficial effect in reducing medication errors. For better results, ADM should be integrated with the hospital information system.