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All Journal Jurnal Kesehatan Tambusai Journal of Applied Nursing and Health
Ulfa, Marina
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Biochemistry, Genetics & Molecular Biology Chemistry Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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ARTIKEL REVIEW : IDENTIFIKASI DRUG-RELATED PROBLEMS (DRPs) PADA PASIEN CONGESTIVE HEART FAILURE (CHF) oktari, baiq khaeratinnisa; Putri, Fawwaz Aqila; Aryana, Baiq Putri; Ulfa, Marina
Jurnal Kesehatan Tambusai Vol. 7 No. 1 (2026): MARET 2026
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v7i1.54699

Abstract

Congestive Heart Failure (CHF) merupakan suatu kondisi patologis ketika ada gangguan fungsi struktural jantung sehingga tidak mampu memompa darah secara efektif untuk memenuhi kebutuhan oksigen jaringan. Kompleksitas terapi, komorbiditas, serta penggunaan obat dalam jumlah banyak (polifarmasi) menjadikan pasien CHF rentan mengalami Drug-Related Problems (DRP). Artikel review ini bertujuan untuk menganalisis prevalensi, pola distribusi, faktor penyebab, serta dampak klinis DRP pada pasien CHF berdasarkan berbagai penelitian dalam sepuluh tahun terakhir. Hasil telaah menunjukkan bahwa prevalensi DRP pada pasien CHF sangat tinggi, berkisar antara 44,5%–97%. Jenis DRP yang paling sering terjadi adalah interaksi obat, diikuti oleh indikasi tanpa obat, ketidaktepatan dosis, dan kebutuhan terapi tambahan yang belum terpenuhi. Obat yang paling berkontribusi terhadap DRP meliputi ACE inhibitor/ARB, beta-blocker, diuretik, MRA, serta antiplatelet–antikoagulan. Faktor risiko utama DRP terdiri dari polifarmasi, usia lanjut, adanya komorbid seperti hipertensi dan penyakit ginjal, serta ketidaksesuaian praktik terapi dengan guideline. DRP terbukti memberikan dampak klinis signifikan berupa peningkatan gejala, rawat ulang, ketidakefektifan terapi, hingga peningkatan mortalitas. Upaya penanganan DRP mencakup medication review, pemantauan fungsi organ dan elektrolit, perbaikan regimen obat, serta intervensi farmasis secara aktif. Artikel ini menegaskan bahwa identifikasi dan manajemen DRP pada pasien CHF sangat penting untuk mengoptimalkan keberhasilan terapi dan meningkatkan keselamatan pasien.
Pre-Clinical Laboratory Evaluation of Chlorhexidine for Disinfection of Semi-Critical Respiratory Equipment in Nursing Practice Ariningpraja, Rustiana Tasya; Ulfa, Marina; Jayadi, Lukky; Maslukha, Andini; Effendy, Nuraeni
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.546

Abstract

Background: Healthcare-associated infections (HAIs) remain a persistent challenge in nursing practice, particularly in the reprocessing of semi-critical respiratory equipment. Although chlorhexidine is widely used as an antiseptic, evidence regarding its pre-clinical disinfectant performance, physicochemical suitability, and waste safety within nurse-led device reprocessing workflows remains limited. This gap is especially relevant in settings where reusable respiratory devices are routinely handled by nurses. Methods: This study employed a pre-clinical experimental laboratory design. The independent variable was chlorhexidine concentration, while dependent variables included antimicrobial efficacy (phenol coefficient), physicochemical parameters (pH, specific gravity, viscosity), and acute toxicity. Antimicrobial testing was conducted against Staphylococcus aureus and Pseudomonas aeruginosa. Physicochemical assessments followed standardized laboratory procedures, and acute toxicity was evaluated using Danio rerio (zebrafish) larvae to inform waste disposal safety. Expert validation was conducted using the Content Validity Index (CVI). Descriptive and endpoint-based analyses were applied without inferential statistics. Results: Chlorhexidine demonstrated strong bactericidal activity against both test organisms, with phenol coefficient values indicating effective disinfectant performance. Physicochemical characteristics remained within acceptable ranges for semi-critical respiratory device reprocessing. Toxicity assessment showed dose-dependent larval mortality, indicating the need for dilution before waste discharge. Expert validation identified chlorhexidine 7.5% as the most clinically relevant concentration for nurse-led practice. No p-values were applied due to the endpoint-based experimental design. Conclusion: Chlorhexidine shows effective pre-clinical disinfectant potential for semi-critical respiratory equipment within controlled laboratory conditions. Its application in nursing practice should be accompanied by standardized concentration control and mandatory dilution before disposal to mitigate environmental toxicity. Further clinical and field-based validation is recommended.
Co-Authors Ariningpraja, Rustiana Tasya Aryana, Baiq Putri Effendy, Nuraeni Lukky jayadi Maslukha, Andini Oktari, Baiq Khaeratinnisa Putri, Fawwaz Aqila