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PENDEKATAN LEAN HOSPITAL UNTUK MENINGKATKAN EFISIENSI PELAYANAN INSTALASI FARMASI RAWAT JALAN DI RSUD TOBELO: LEAN HOSPITAL APPROACH IN IMPROVING SERVICE EFFICIENCY IN AMBULATORY PATIENT PHARMACEUTICAL INSTALLATION IN RSUD TOBELO Sisca Latue; Jason Merari Peranginangin; Tri Wijayanti
Medical Sains : Jurnal Ilmiah Kefarmasian Vol 8 No 2 (2023)
Publisher : Sekolah Tinggi Farmasi Muhammadiyah Cirebon

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37874/ms.v8i2.608

Abstract

Pendekatan lean adalah metode pendekatan sistemik yang digunakan untuk menghilangkanatau meminimalkan waste yang terjadi dalam pelayanan dan meningkatkan efesiensipelayanan di suatu instalasi. Tujuan penelitian ini untuk mengidentifikasi waste dan akarpenyebab waste yang terjadi pada Instalasi Farmasi Rawat Jalan (IFRJ) RSUD Tobelo. Metodepenelitian ini adalah penelitian non-esperimental dengan pendekatan kualitatif secaradeskriptif eksploratif melalui kuesioner, observasi dan wawancara mendalam pada responden.Prosedur penelitian yaitu observasi alur proses pelayanan yang dibuat dalam bentuk valuestream mapping, penyebaran kuisioner value pasien dan waste, melakukan wawancara denganmetode 5 why untuk mengetahui akar penyebab dan waste kritis, serta usulan terhadappemecahan masalah. Hasil penelitian menunjukan bahwa waste kritis berupa waste waitingyang diperoleh nilai sebesar 25%. Akar penyebab dari waste waiting adalah kekurangansumber daya manusia, serta pembagian kerja bagi tenaga kefarmasian belum maksimal,sehingga menyebabkan penumpukan resep obat. Usulan perbaikan waste waiting adalahpenambahan sumber daya manusia serta penerapan SOP dalam pelayanan, selain itu jugamenambah unit computer dan printer. Kata kunci : Lean hospital, Instalasi Farmasi, RSUD Tobelo, Waste kritis, perbaikanpelayanan
Analisis Pengendalian Persediaan Obat Kategori Av Dengan Metode Abc, Ven Dan Eoq Di Instalasi Farmasi Rumah Sakit Aura Syifa Kediri Chandra Arifin; Tri Wijayanti; Gunawan Pamudji Widodo
Jurnal Farmasi Indonesia Vol 20 No 1 (2023): Jurnal Farmasi Indonesia
Publisher : Fakultas Farmasi Universitas Setia Budi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31001/jfi.v20i1.1086

Abstract

ABSTRACT Inventory Control Analysis Of AVMedicine CategoriesbyABC, VEN and EOQ Method In Pharmacy Installation at Aura Syifa Hospital Kediri.Pharmaceutical logistics management and pharmaceutical services aim to identify, prevent and resolve drug-related problems. Broadness of services and Aura Syifa Hospital Kediri participation in Jaminan Kesehatan Nasional (JKN) requires an efficient pharmaceutical supplies management. Regulations changes in Badan Penyelenggara Jaminan Sosial (BPJS) regarding tiered referral also change the pattern of drug consumption. In addition, arrears of BPJS patient claim payment at Aura Syifa Hospital Kediri during the last few months caused hospital to be slightly constrained in terms of operations and services, especially related to the procurement of medicines. Purpose of this study was to analyze control system and improve the efficiency of managing AV classification medicine using ABC, VEN and EOQ methods inpharmacy installation at Aura Syifa Hospital Kediri.This study wasdescriptive with retrospective data collected, data used in the period January 2018 - December 2018. Medicine analyzed were oral drugs, injections and infusions that were included in group A from the results of ABC analysis, group V from the results of VEN analysis so it was obtained BPJS medicine AV categories. Result of this study were combination of ABC and VEN analysis methods could identify drugs that require strict inventory control and prioritize 12 BPJS medicine in AV category. Pharmacy installation at Aura Syifa Hospital Kediri in 2018 did not meet cost efficiency that is: procurement frequency was higher than the EOQ method. Calculation of ABC, VEN and EOQ methods may improve efficiency in controlling AV classification medicine supplies in BPJS patients at IFRS Aura Syifa Kediri.
Uji Aktivitas Hepatoprotektor Ekstrak Etanol dan Fraksi N-Heksana, Etil Asetat, dan Air Umbi Bawang Dayak (Eleutherine palmifolia (L.) Merr.) pada Tikus Jantan Galur Wistar Putri Rinda Pratiwi; Wiwin Herdwiani; Tri Wijayanti
Jurnal Penelitian Kesehatan SUARA FORIKES Vol 14, No 1 (2023): Januari 2023
Publisher : FORIKES

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/sf14116

Abstract

Dayak onion bulbs (Eleutherine palmifolia (L.) Merr.) are plants that contain flavonoids which act as high antioxidants. The process of liver damage caused by free radicals can be prevented by the role of antioxidants. This study aims to look at the hepatoprotective effect of the Dayak onion bulbs by looking at the inhibition of SGOT and SGPT levels and looking at the decrease in MDA in vivo. This study used 35 male Wistar rats divided into 7 groups each containing 5 rats. Normal control group, negative control, positive control, ethanol extract of Dayak onion bulbs 162 mg/kgBW, n-hexane fraction at a dose of 2.79 mg/200gBW, ethyl acetate fraction at a dose of 3.06 mg/200gBW, water fraction at a dose of 4.04 mg /200gBB given for 13 days. Then on the 14th day, treatment was given with paracetamol at a dose of 2.5 g/kg BW except for normal controls. Data on levels of SGOT, SGPT, and MDA were tested using Shapiro-Wilk to determine the normality of the data, then analyzed using One Way Anova followed by the Tukey test. The results showed that the ethanol extract and fraction of n-hexane, ethyl acetate and water of Dayak bulbs can reduce levels of SGOT, SGPT and MDA in male rats induced by paracetamol. The dose that was effective in reducing SGOT, SGPT and MDA levels in male rats was the ethyl acetate fraction at a dose of 3.06 mg/200gBW.Keywords: Dayak onion bulbs (Eleutherine palmifolia (L.) Merr.); hepatoprotectors; antioxidants ABSTRAK Umbi bawang dayak (Eleutherine palmifolia (L.) Merr.) merupakan tanaman yang mengandung flavonoid yang beraktivitas sebagai antioksidan yang tinggi. Proses kerusakan hati akibat radikal bebas dapat dicegah dengan peran antioksidan. Penelitian ini bertujuan untuk melihat efek hepatoprotektor dari bagian umbi bawang dayak dengan melihat daya hambat terhadap kadar SGOT dan SGPT dan melihat penurunan MDA secara in vivo. Penelitian ini menggunakan 35 ekor tikus jantan galur wistar di bagi dalam 7 kelompok masing-masing berisi 5 ekor tikus. Kelompok kontrol normal, kontrol negatif, kontrol positif, ekstrak etanol umbi bawang dayak 162 mg/kgBB, fraksi n-heksana dosis 2,79 mg/200gBB, fraksi etil asetat dosis 3,06 mg/200gBB, fraksi air dosis 4,04 mg/200gBB diberikan selama 13 hari. Kemudian pada hari ke 14 diberikan perlakuan dengan parasetamol dosis 2,5 g/kgBB kecuali pada kontrol normal. Data kadar SGOT, SGPT, dan MDA diuji menggunakan Shapiro-wilk untuk mengetahui normalitas data, kemudian dianalisi menggunakan One Way Anova yang dilanjutkan uji Tukey. Hasil penelitian menunjukkan bahwa ekstrak etanol dan fraksi n-heksana, etil asetat dan air umbi bawang dayak dapat menurukan kadar SGOT, SGPT dan MDA pada tikus jantan galur wistar yang diinduksi parasetamol. Dosis yang efektif dalam menurunkan kadar SGOT, SGPT dan MDA pada tikus jantan yaitu fraksi etil asetat pada dosis 3,06 mg/200gBB.Kata kunci: umbi bawang dayak (Eleutherine palmifolia (L.) Merr.); hepatoprotektor; antioksidan
Analisis Penggunaan Obat Antihipertensi pada Pasien Program Rujuk Balik (PRB) di Apotek Kabupaten “A” Dengan Metode ATC/DDD dan DU 90% Wahyu Apriliany; Ganet Eko Pramukantoro; Tri Wijayanti
Jurnal Farmasi Komunitas Vol. 10 No. 1 (2023): JURNAL FARMASI KOMUNITAS
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfk.v10i1.38159

Abstract

Hipertensi adalahckondisi dimanactekanancdarah tinggi (sistolik>140cmmHg ataucdiastolik>90 mmHg) yang menetap. Hipertensictermasuk salah satu penyakit kronis yang membutuhkancpengobatan jangkacpanjang. Pasienchipertensi yang mengikuti Program RujukcBalik memerlukancpengobatan jangka panjangcsehingga perlunya dilakukancevaluasi. Oleh karena itu penelitian ini dilakukan untuk mengetahui konsumsi obatcantihipertensi pasien PRB dengan metode ATC/DDD dan DU 90%. Penelitian menggunakan rancangan crosscsectional dan pengambilan data secara retrospektif. Sampel penelitian adalah pasienchipertensi yang mengikuti PRBcpada periode Januari-Desemberc2021. Data yang diambilcberupa data penggunaancobat hipertensi pada Apotek X dan Apotek Y kemudiancdianalisis dengan metode Anatomical TherapeuticcChemical Defined DailycDose (ATC/DDD). Hasil penelitian menunjukkan bahwa antihipertensi terbanyak adalah golongan CCB yaitu amlodipine dengan 3212,5 DDD/KPRJ di Apotek X dan 1075,833 di Apotek Y. Obat yang masuk dalam segmen DU 90% adalah amlodipine, candesartan, lisinopril, bisoprolol, ramipril, dan furosemide pada Apotek X serta amlodipine, candesartan, ramipril, furosemide, dan hidrochlorothiazid pada Apotek X. Kesesuaian penggunaan obat dengan FORNAS adalah 62,285% di Apotek X dan 68,75% di Apotek Y.
Hasil Evaluasi Kinerja Berbasis Balance Scorecard di Instalasi Farmasi Klinik Telkomedika Health Center Madiun Isna Nur Khasanah; Gunawan Pamudji Widodo; Tri Wijayanti
Jurnal Penelitian Kesehatan SUARA FORIKES Vol 14, No 1 (2023): Januari 2023
Publisher : FORIKES

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/sf14146

Abstract

The Telkomedika Health Center (THC) Madiun Clinic requires a good performance evaluation/measurement of the THC Madiun Clinic Pharmacy Installation. Therefore, research is needed which aims to determine the performance of the THC Madiun Clinical Pharmacy Installation using the Balanced Scorecard method based on 4 perspectives, namely finance, internal business processes, growth and learning, and customers. This research was a descriptive study. Data were obtained retrospectively and concurrently through interviews with pharmacists at pharmacy installations, filling out questionnaires by employees and patients, as well as direct observation. Data were analyzed descriptively and compared with applicable standards. The research results showed that: 1) finance was efficient, but still needs to be improved; 2) provision of drug information needs to be improved; 3) employee job satisfaction was in the moderate range; 4) patients were satisfied with the quality of service, but there was a gap between patient expectations and performance. It was concluded that the performance of the Madiun THC Clinic Pharmacy Installation was quite good, but there were still a number of things that needed to be improved. Managers should conduct regular monitoring and evaluation to improve organizational performance.Keywords: performance evaluation; balanced scorecard; clinical pharmacy installation ABSTRAK Klinik Telkomedika Health Center (THC) Madiun membutuhkan evaluasi/pengukuran kinerja Instalasi Farmasi Klinik THC Madiun secara baik. Maka diperlukan penelitian yang bertujuan untuk mengetahui kinerja Instalasi Farmasi Klinik THC Madiun dengan metode Balance Scorecard berbasis 4 perpesktif yaitu keuangan, proses bisnis internal, pertumbuhan dan pembelajaran, serta customer. Penelitian ini merupakan studi deskriptif. Data diperoleh secara  retrospektif dan concurrent melalui wawancara kepada apoteker instalasi farmasi, pengisian kuesioner oleh karyawan dan pasien, serta observasi langsung. Data dianalisis secara deskriptif dan dibandingkan dengan standar yang berlaku. Hasil penelitian menunjukkan bahwa: 1) keuangan sudah efisien, namun masih perlu ditingkatkan; 2) pemberian informasi obat perlu ditingkatkan; 3) kepuasan kerja karyawan berada pada rentang cukup; 4) pasien merasa puas dengan kualitas pelayanan, namun terdapat gap antara harapan dan kinerja pasien. Disimpulkan bahwa kinerja Instalasi Farmasi Klinik THC Madiun cukup baik, namun masih ada beberapa hal yang perlu ditingkatkan. Sebaiknya pengelola melakukan monitoring dan evaluasi secara berkala untuk meningkatkan kinerja organisasi.Kata kunci: evaluasi kinerja; balanced scorecard; instalasi farmasi klinik
Strategy for improving pharmaceutical services based on SNARS edition 1 at the "X" hospital pharmacy installation in tomohon city Priska Juanita Pakingki; Opstaria Saptarini; Tri Wijayanti
Journal of Health Management and Pharmacy Exploration Vol. 1 No. 2 (2023): August 2023
Publisher : Surya Hijau Manfaat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52465/johmpe.v1i2.191

Abstract

Accreditation is a process of evaluating a hospital by KARS to improve patient safety and evaluate the quality of a hospital. This research was conducted at the "X" Hospital Pharmacy Installation in Tomohon City. To find out the level of conformity of the seven Pharmaceutical Services and Drug Use standards against the 1st Edition of 2018 National Hospital Accreditation Standards and problem solving strategies using a priority scale with the matrix method. The research design is a non-experimental research. analyzed descriptively quantitative and qualitative. The research data were processed in tabular form and repaired with a priority scale of problems using the matrix method. The conformity level of Pharmaceutical Services and Drug Use in the "X" Hospital Pharmacy Installation has not fully met the National Hospital Accreditation Standards. Improvement strategy based on priority scale of problems using the matrix method: Pharmaceutical Services and Drug Use Point 5 Preparation and delivery, Point 4 Prescription and copying, Point 3 Storage, Point 7 Monitoring drug effects, Point 6 Drug Administration, Point 1 Organizing and Point 2 Selection and procurement. Pharmaceutical services in the Pharmacy Installation as a whole are good but there are several points that have not met the standards and must be improved.
Drug utilization pattern and cost estimates of antihypertensive drugs in pharmacies BPJS Kesehatan back-referral program in Kudus Regency Wildayanti; Tri Wijayanti; Tri Murti Andayani
Jurnal Ilmiah Farmasi Vol. 19 No. 1 (2023): Jurnal Ilmiah Farmasi
Publisher : Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/jif.vol19.iss1.art3

Abstract

AbstractBackground: Hypertension is one of the main causes of mortality and morbidity in Indonesia. Drug usage, utilization patterns, and cost estimates are important elements in calculating drug needs in the forecasting of drug needs plans for pharmacies.Objective: to determine the pattern of drug use with the Anatomical Therapeuetik Chemical (ATC)/Defined Daily Dose (DDD) and Drug Use 90% (DU90%) methods and the estimated cost of antihypertensives with the use of antihypertensive drugs based on the national formulary.Methods: This research uses observational methods using a cross-sectional design. Retrospective data collection includes prescription from BPJS Kesehatan back-referral program (PRB) which goes into pharmacy A, B, and C for the period 2020.Results: The most widely used drugs at pharmacy A, B and C based on ATC/DDD classification were amlodipine, candesartan, ramipril, hydrochlorothiazide, and lisinopril. Amlodipine was the most frequent drug in the DU segment 90%. The highest cost of using the drug was candesartan 16 mg (Rp 4,381,531). The percentages of adherence to the use of antihypertensive drugs with the national formulary in pharmacy A, B, and C were 73.91%, 80%, and 68.42%, respectively.Conclusion: In general, the highest consumption of antihypertensive drugs in Back-Referral Program (PRB) pharmacies in the area of Kudus Regency, which is included in the DU segment 90%, was amlodipine, and the suitability of drugs with the National Formulary has not reached 100%. Referring to the results of the pattern of use of PRB drugs in this study, it is hoped that there will be better coordination between BPJS Kesehatan and pharmacies regarding the distribution and availability of PRB drugs.Keywords: ATC/DDD, DU 90%, hypertension, national formulary, PRB IntisariLatar belakang: Hipertensi merupakan salah satu penyebab utama mortalitas dan morbiditas di Indonesia. Pola pemakaian obat dan perkiraan biaya merupakan elemen penting dalam menghitung rencana kebutuhan obat di apotek. Tujuan: Penelitian ini bertujuan untuk mengetahui pola penggunaan obat dengan metode Anatomical Therapeuetik Chemical (ATC)/ Defined Daily Dose (DDD), DU 90%, perkiraan biaya antihipertensi dan kesesuaian penggunaan obat antihipertensi dengan Formularium Nasional (Fornas).Metode: Penelitian menggunakan metode observasional dengan desain cross sectional. Pengumpulan data dilakukan secara retrospektif meliputi resep Program Rujuk Balik (PRB) yang masuk ke apotek A, B dan C pada periode 2020.Hasil: Penggunaan obat di apotek A, B dan C berdasarkan ATC/DDD yang banyak digunakan yaitu amlodipin, candesartan, ramipril, hidroklorotiazid dan lisinopril. Segmen DU 90% penggunaan obat tertinggi adalah amlodipin dan biaya penggunaan obat tertinggi yaitu candesartan 16mg sebesar Rp4.381.531,00. Persentase kesesuaian penggunaan obat antihipertensi dengan Fornas pada apotek A, B, dan C yaitu 73,91%, 80%, dan 68,42%. Kesimpulan: Secara umum konsumsi obat antihipertensi terbanyak di apotek PRB Kabupaten Kudus yang masuk dalam segmen DU 90% adalah amlodipin serta kesesuaian obat dengan Fornas belum mencapai 100%. Merujuk pada hasil pola penggunaan obat PRB pada penelitian ini, diharapkan adanya koordinasi yang lebih baik antara BPJS Kesehatan dengan pihak apotek mengenai distribusi dan ketersediaan obat PRB.Kata kunci: ATC/DDD, DU 90%, hipertensi, formularium nasional, PRB
Efektivitas rimpang kunyit hitam (curcuma caesia roxb.) terhadap penurunan glukosa darah dan perbaikan ginjal tikus diabetes nefropati Zakiyyah Qurrotul Aini; Wiwin Herdwiani; Tri Wijayanti
MEDIA ILMU KESEHATAN Vol 12 No 2 (2023): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v12i2.874

Abstract

Background: Diabetes Mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. Diabetic nephropathy is a degenerative kidney vascular disorder that has a relationship with impaired carbohydrate metabolism or sugar intolerance (Diabetes Mellitus). Black turmeric (Curcuma Caesia Roxb.) is widely used by the community as a traditional medicine and has potential as an antidiabetic.Objective: This study aims to determine the effect of black turmeric extract on decreasing blood glucose levels and its effect on improving kidney histopathology in diabetic nephropathy rats.Method: This research was conducted at the Laboratory of the Center for Food and Nutrition Studies, University of Gajah Mada for the period October-November 2022 consisting of 6 groups. STZ-Na induced rats to obtain a state of hyperglycemia. Examination of blood glucose levels using the GOD-PAP method (enzymatic photometric test).Results: The percentage of blood glucose is decreased levels was 16.75% and repaired kidney histopathology was 6.67% as a score mild damage category (1).Conclusion: Black turmeric rhizome extract (Curcuma Caesia Roxb.) can reduce blood glucose levels and improve kidney function at a dose of 400 mg/kg BW.
Antihyperglycemic Activity of Red Fruit Oil (Pandanus conoideus Lam) on Improving Kidney Function in STZ- NA-Induced Nephropathy Rats Ayudia Cipta Khairani; Tri Wijayanti; Gunawan Pamudji Widodo
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 10 No. 2 (2023): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v10i22023.173-183

Abstract

Background: Type 2 diabetes mellitus can cause complications, one of which is diabetic nephropathy. Parameters that indicate damage to the kidneys are the increase in creatinine and albumin levels. One of the traditional medicines used in the treatment of DM is  red fruit (Pandanus conoideus Lam). Objective: The purpose of this study was to determine the antihyperglycemic activity and the effect of red fruit oil administration on creatinine levels, microalbumin, and renal histopathology in STZ-NA-induced rats. Methods: This study used 30 male Wistar rats conditioned with type 2 DM with STZ-NA induction. The rats have grouped into 6 groups: group I, the normal control, group II, the negative control, group III, the positive control (pioglitazone 15 mg/kg BW), and groups IV, V, and VI, the red fruit oil respectively 1.35 mL/kg BW,2.7 mL/kg BW, and 5.4 mL/kg BW. Red fruit oil is made in traditional way and prepared for 2 days. Parameters tested in the study include blood glucose levels, creatinine, microalbumin, and kidney histopathology. Data analysis used the ANOVA method followed by Tukey's post hoc test. Results: The results showed that a red fruit oil dose of 5.4 mL/kg BW was an effective dose in reducing blood glucose levels, microalbuminuria, and serum creatinine, and repairing damage to the kidneys of rats. The percent activity of a red fruit oil dose of 5.4 mL/kgBW for blood glucose levels, microalbuminuria and serum creatinine were 84.69%, 76.30%, and 92.20% respectively. Conclusion: Red fruit oil can reduce blood glucose levels, creatinine levels, microalbumin and can repair kidney damage.
Pengembangan Inovasi Dan Branding Produk UMKM Wedang Uwuh “Sari Asih” Tri Wijayanti; Desmana Mei Yuliyanti; Fitri Melati; Maria Nona Adriana Lering; Yovi Pranata
Jurnal Mandala Pengabdian Masyarakat Vol. 4 No. 2 (2023): Jurnal Mandala Pengabdian Masyarakat
Publisher : Progran Studi Farmasi STIKES Mandala Waluya

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Wedang uwuh merupakan salah satu minuman herbal yang berkhasiat untuk kesehatan. Saat ini penjualan wedang uwuh di pasaran masih dalam bentuk kemasan konvensional yaitu simplisia yang dikemas persatuan minum. Tujuan kegiatan pengabdian ini yaitu melakukan inovasi dan branding kemasan celup wedang uwuh yang bekerja sama dengan produsen Wedang uwuh “Sari Asih” untuk meningkatkan minat pembeli dan nilai jual produk. Kegiatan pengabdian ini dilakukan dengan metode observasi, persiapan, pendampingan, dan evaluasi. Hasil pengabdian berupa  pembuatan desain kemasan primer dan sekunder yang lebih moderen sehingga meningkatkan minat pembeli dan meningkatkan nilai jual terhadap produk wedang uwuh “Sari Asih”.