Pharmacy Bulletin Year 2022/2023 PREPARED BY DRUG INFORMATION SERVICE HOSPITAL REHABILITASI CHERAS
"Welcome to our Hospital Pharmacy Bulletin! We are delighted to extend a warm welcome to all our dedicated pharmacy professionals who play an integral role in delivering exceptional healthcare services to our patients. This bulletin serves as a vital communication channel, fostering collaboration and knowledgesharing among our pharmacy team. At Hospital Rehabilitation Cheras, we are committed in providing the highest quality of pharmaceutical care, driven by compassion, innovation, and excellence. Our pharmacy department stands at the forefront of patient safety, medication management, and clinical expertise. Within this bulletin, you will find a wealth of information, educational resources, and updates that will empower you in your day-to-day responsibilities. It serves as a platform to disseminate best practices, highlight advancements in pharmaceutical research, and showcase the remarkable contributions of our pharmacy staff. We encourage you to actively engage with this bulletin, leveraging it as a tool for professional growth, networking, and staying informed about the latest developments in our field. Feel free to share your insights, success stories, and ideas for future content. We value your expertise and input. As a team, we are dedicated to fostering a collaborative environment where we support and learn from one another. Together, we can make a significant impact on patient outcomes and contribute to the advancement of pharmaceutical care. Thank you for your unwavering commitment to our hospital's mission and for being an essential part of our pharmacy family. We hope you find this bulletin informative, engaging, and inspiring. Wishing you continued success in your pharmacy journey. With gratitude, Nurul Zaidah Binti Badarudin Head Of Pharmacy Deparment Hospital Rehabilitation Cheras Welcoming Words
Advisor Nurul Zaidah Binti Badarudin Chief Editor Iylia Nur Diyana Binti Ibrahim Publication Coordinator Nur Eillena Binti Mat Deris Assistant Chief Editor 3 Mohd Shahfreeza Bin Omar Assistant Chief Editor 2 Muhammad Danial Izwan Bin Mohamad Roslin Assistant Chief Editor 1 Lavinya A/P Premanand Bulletin Committee
01 Role Of Pharmacist In Rehabilitation Medicine Page 4 - 5 Save The Earth-Benefits Of Patient's Own Medicines (POMs) Staff Movement Page 18 Table Of Contents 02 03 Page 6 - 7 Medical Device Authority (MDA) Page 8 - 9 04 05 Outpatient Pharmacy Corner Page 10 - 12 06 Yearly Activities Page 19 - 31 07 Drug Information Service Corner Page 13 - 17
Roles of pharmacist in rehabilitation medicine By: Puan Syazzana Binti Dzulkifli, Pegawai Farmasi UF54, Farmasi Klinikal, Hospital Rehabilitasi Cheras The role of pharmacist in the healthcare system has broadened from dispensing services at pharmacy counter to direct patient care. The perspectives of pharmacist are essential in rehabilitation medicine. Pharmacists’ recommendations for appropriate medications, optimization and minimizing polypharmacy and Potentially Inapopropriate Medications (PIMs) may have a positive impact on rehabilitation outcomes especially in elderly. In patients undergoing rehabilitation, pharmacist involvement in pharmacotherapy is necessary to enhance patients’ life functions from the perspective of rehabilitation pharmacotherapy to minimize drug-induced functional impairment. Drug-related functional impairment in rehabilitation medicine commonly involved dysphagia, depression, drowsiness, falls and fractures, constipation and fecal incontinence, dysuria and incontinence, malnutrition, anemia and parkinsonism. These drug-related functional impairment somehow will affected patients’ Activities of Daily Living (ADL), cognition and nutrition status which interfere with rehabilitation. 4
Generally, role for Pharmacist in rehabilitation ward : Medication history review Medication reconciliation. Adherence prior to hospitalization. History of medicationrelated problems. . Review medication according to ADL as patient might improve. Review medication that limiting activity or participation in rehabilitation. Involved in Interdisciplinary Round (IDR) to discuss patient conditions and outcomes. Education and counseling on medication to patient and family members. Review medication list according to patient's place of care. For example, from hospital to own home or institutional care. Organize prescription medications with a focus on simplified regimen. Provide medication counseling ensure compliance. IN WARD DDUURRIINNGG AADDMMIISSSSIIOONN DDUURRIINNGG DDIISSCCHHAARRGGEE CCLLIINNIICCAALL RREEHHAABBIILLIITTAATTIIOONN PPHHAARRMMAACCIISSTT TTEEAAMM RROOUUTTIINNEE WWAARRDD ROUND IINNTTEERRDDIISSCCIIPPLLIINNAARRYY ROUND (IDR) 5
Save The Earth-Benefit Of Patient's Own Medicines (POMs) By: Loke Ee Ching, Pegawai Farmasi UF48, Farmasi Pesakit Dalam, Hospital Rehabilitasi Cheras There is high prevalence of medicines waste in Malaysia. A study conducted in a Malaysia Hospital found a total of 20,799 excessive pills from visiting hypertensive patients' houses in 2007 (total wastage RM4,362). In the same study, returned medicines collected at Pharmacy Counter in the hospital is 131,098 pills (total wastage RM59,566). Some common reasons for medicines wastage are when patient's own drugs are left unused during their hospitalisation or when patients transferred without any of their medicines. In addition, discharge medications are supplied to patients who already have supplies at home. To eradicate this matter, reducing unnecessary supply of medicines is an important way of reducing wastes. Hospitals should encourage the use of Patient's Own Medicines (POMs) as it can improve treatment quality, save the environment, and is financially beneficial to our health economy. In Ministry of Health Malaysia, POMs referred to the medications obtained from hospital or community settings and brought by patients during hospitalisation. Complementary medications (traditional medications / certain supplements are not included as POMs as there are no clear indications and identifications of their contents. Further research on their safety and drug interactions may be needed. Hospital Rehabilitasi Cheras (HRC) is one of the facility in Ministry of Health practising the use of POMs. During patient's admission, all POMs must be submitted to the ward pharmacist which are evaluated in terms of suitability (according to the POMs Criteria – eg. expiry date, condition of medications). Patient's consent will be obtained and documented if POMs are used. If the medications are not suitable, medications will be supplied instead. 6
When the medication is unavailable in the hospital formulary, by utilizing POMs, patients can continue their current stable treatment, without changing or using alternative drugs. This ensures treatment quality and helps prevent any unwanted side effects. The use of POMs has also shown to improve patient's knowledge on their medications. In conclusion, various studies have shown that usage of POMs is economically and environmentally friendly. Pharmacists play an important role in ensuring correct use of medicines, avoiding unnecessary supply of medicines, and proper disposal of medicines waste. The use of POMs is definitely cost effective and can help in reducing medicines waste, ultimately, saving resources. References 1)Polisi dan Garis Panduan Program Patient's Own Medicines, 2nd Edition, 2018 2)Clive Newman 2011,The Pharmaceutical Journal,accessed Nov 2022, <https://pharmaceutical-journal.com/article/ld/how-to-reduce-medicineswaste>. Clinical Pharmacist, CP, 2011;()::DOI:10.1211/PJ.2021.1.66385,Hamimatul Hayat Abdul Nasir, Jagjit Singh Dhaliwal, Hui Poh Goh, et al. 3)Patient’s Own Medication Use During Hospitalization. PMMB 2022, 5, 1; a0000266. doi: 10.36877/pmmb.a0000266.Hassali, Mohamed & Supian, A. & Mohamed Ibrahim, et al. (2012). The characteristics of drug wastage at the hospital, Tuanku Jaafar Seremban, Malaysia: A descriptive study. Journal of Clinical and Diagnostic Research. 6. 787-790. 7
Medical device authority (mda) Dokumen yang diperlukan ·Salinan lesen Establishmen ·Salinan Sijil Pendaftaran Peranti Perubatan ·Surat Pelantikan ejen penendar dari establishmen Dokumen yang tidak boleh digunakan ·Acknowledgement on the payment of application fee for establishment license ·Receipt Licensing Fee & Registration Fee Agensi berkanun di bawah Kementerian Kesihatan Malaysia untuk melaksanakan dan menguatkuasakan Akta Peranti Perubatan 2012 (Akta 737) bagi menangani isu kesihatan dan keselamatan awam yang berkaitan dengan peranti perubatan dan memudahkan perdagangan serta industri peranti perubatan Peralatan Radas Perkakas Mesin Implan Reagen (In Vitro) Peranti perubatan : keperluan perolehan By: Rohani Binti Taha, Pegawai Farmasi UF54, Farmasi Logistik, Hospital Rehabilitasi Cheras digunakan bagi tujuan rawatan, diagnosis, pencegahan, pemantauan atau pemulihan. Pengenalan Peranti perubatan elakkan membeli Peranti Yang Tidak Berdaftar 8
Risiko kecederaan Bahaya pencemaran biologi atau bahan kontiminasi lain pada peranti. Kerosakan alam sekitar apabila dilupuskan. Bahaya peranti diguna semula Beli peranti berdaftar dari establishmen yang berlesen Gunakan peranti seperti yang diarahkan pengilang. Pastikan peranti digunakan oleh pengguna yang bertauliah Pastikan peranti diselenggara mengikut jadual. Jalankan pelupusan peranti mengikut saranan pengilang. Laporkan segera sebarang insiden kepada establishmen (salinan pada MDA) ·Semak nombor pendaftaran MDA pada label atau pembungkusan peranti. ·Semak nama produk atau nombor pendaftaran MDA di /https://mdar.mda.gov.my/ Saranan daripada MDA Tip semakan peranti Risiko peranti tidak berdaftar 9
Mulai bulan Julai 2021, aplikasi Myubat telah mula digunakan bagi memudahkan permohonan pesakit mendapatkan perkhidmatan Ubat Melalui Pos (UMP) dan seterusnya telah dipanjangkan pada Januari 2022 meliputi perkhidmatan pengambilan ubat melalui Temujanji menggantikan penggunaan kad temujanji. outpatient pharmacy corner a. Pengedaran pamphlet di kaunter bagi pesakit HRC dan penjaga. b. Memasang bunting di kaunter bagi pesakit HRC dan penjaga. c. Pameran semasa majlis Ulangtahun ke 10 penubuhan Hospital Rehabilitasi Cheras pada 12 September 2022 sehingga 15 hb September 2022 bagi jemputan kehormat dari KKM, JKWPKL dan para jemputan nyang meliputi hebahan dalam media sosial facebook, Instagram Hospital Rehabilitasi Cheras. Promosi Penggunaan aplikasi telah dibuat melalui : 10
Laporan farmasi klinik pakar Pada awal negara menerima arahan Kawalan Pergerakan disebabkan peningkatan kes jangkitan Covid -19 pada tahun 2020, FKP telah membuat sedikit modifikasi ke atas tatacarakerja pembekalan ubat melalui Pos agar lebih sesuai untuk digunakan sepanjang pandemik COVID-19. Pesakit yang tidak dapat hadir ke hospital untuk konsultasi dengan Pegawai Perubatan boleh memohon supaya ubat dipos kepada mereka melalui bantuan Pegawai Perubatan yang menjalankan konsultasi/ Jururawat dengan memberi maklumat seperti borang yang digunakan. Mulai bulan Julai 2021, Farmasi Klinik Pakar HRC telah memperkenalkan aplikasi yang dibangunkan oleh Bahagian Perkhidmatan Farmasi KKM iaitu aplikasi Myubat bagi memudahkan permohonan pesakit bagi memohon perkhidmatan Ubat Melalui Pos (UMP). Semasa tempoh kawalan pergerakan, pesakit yang tidak dapat hadir mengambil ubat di HRC disebabkan kuarantin kendiri/ di hospital atau fasiliti kuarantin atau berada di luar Kuala Lumpur boleh memohon menggunakan aplikasi tersebut setelah menjalani sesi konsultasi dengan Pegawai Perubatan berbanding hadir ke kaunter mengisi borang UMP sebelum ini. 11
Peningkatan ubat yang perlu dipos setiap hari. Setiap preskripsi perlu disemak silang sebelum di’pack’ Selepas semakan,’consignment note’ akan diprint dari laman web ezisend dan ubat akan dibungkuskan . Laporan farmasi klinik pakar a. Peningkatan jumlah bungkusan UMP yang perlu disiapkan dalam masa yang terhad. Bagi memastikan tiada pesakit mengalami putus ubat disebabkan perintah sekatan antara cara telah digunakan oleh pihak FKP seperti pengeposan semula jika dimaklumkan pesakit. b. Pesakit yang tinggal dikawasan yang diarahkan Arahan Kawalan Pergerakan diperketatkan dimana pihak Pos Malaysia tidak dapat menghantar ubat kepada pesakit secara terus. c. Pesakit yang terperangkap diluar Kawasan yang telah didaftarkan untuk ubat diposkan, pihak FKP perlu mengepos semula dan mendapatkan alamat terkini pesakit yang boleh dicapai seperti rumah waris/ ketua kampung. d. Pesakit yang tiada di rumah/ meninggal bungkusan akan dipulangkan oleh Pos Malaysia e. Menggunakan masa yang banyak membantu pesakit cara menggunakan aplikasi f. Pesakit tidak tahu / tua / mempunyai disability untuk menggunakan telefon/aplikasi Bagi penjimatan masa menunggu pesakit dengan ubat-ubatan extemporaneous atau Psikotropik pula (ubat tidak dapat dipos), boleh memohon menggunakan aplikasi Myubat bagi melakukan temujanji mulai Januari 2022. Aplikasi ini menggantikan proses manual sebelum ini yang menggunakan kad temujanji. Antara cabaran yang dihadapi adalah : 12
drug infomation service (dis) corner By: Iylia Nur Diyana Binti Ibrahim, Pegawai Farmasi UF52, Farmasi Maklumat Ubat, Hospital Rehabilitasi Cheras 13 hrc formulary updated innovation project this year Meditips offers a comprehensive solution for empowering doctors and nurses through two essential packs: the doctor empowerment pack and the nurses knowledge pack. By simply scanning the QR code, they gain access to a wealth of resources, including all necessary references, updated formulary, and much more.
Error that has potential to cause patient harm but did not reach patient. Medication error Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, carer or consumer. Error occurred and reached the patient. 14 Medication error Near miss error actual error errors in the medication cycle
langkah -langkah pencegahan kesilapan berkaitan ubat-ubata lasa januari - december 2022 15 januari - july 2023
penggunaan tall man lettering (look-alike) penggunaan tall man lettering (sound-alike) 16
contoh penggunaan tall man lattering label amaran dan susun secara berasingan 17 penggunaan label amaran lasa a) bin penyimpanan b) troli kecemasan
staff movement 2022/2023 NURUL ZAIDAH BINTI BADARUDIN GRACE GOH SIEW YING WINNIE ONG JIAN YING JUDIANA AMALDASS PILLAI A/P FELIX AMALDASS VINAYAGASELVI A/P CHIGAMBARAN FIRAH HAYYANIH BINTI ZULKIPLI MUHD DANIAL IZWAN BIN MOHD ROSLIN LAVINYA A/P PREMANAND 1. 2. 3. 4. 5. 6. 7. 8. 18 ALICE A/P PHILIPOSE KAYATHERI A/P SIMACHALAM NORAINNA BT ANUWAR RINA NOR IDAYU BINTI KAMAN NOOR HAFIZAH BINTI TAJUDIN NURUL IJABAH BINTI AIDZUHAR NUR HAZWANI BINTI IBRAHIM DR. HADIJAH BT MOHD TAIB NURUL YUMIZA BINTI MD YUSOF CHE NOR AKMAL BINTI CHE HASHIM 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. TAN XUAN HUI NOR ZURIANI BINTI AMIR GHANI SAFAWI BIN TUKIMAN 1. 2. 3. People may come and go, lives may change in an instant, but love and friendship will last forever. — Elizabeth Sims 1.HASLINDA BINTI HASSAN
yearly activities masjlis perpisahan puan pauline, pegawai farmasi masjlis perpisahan dr hadijah, ketua jabatan farmasi 5 januar 2022 19 2022
masjlis perpisahan puan ijabah, pembantu pegawai farmasi 10 februari 2022 masjlis perpisahan puan kayatheri, pegawai farmasi 1 april 2022 20 majlis jamuan hari raya aidilfitri 2022 30 mei 2022
masjlis perpisahan puan norainna@effi, pembantu pegawai farmasi 16 jun 2022 mesyuarat pengurusan hospital rehabilitasi cheras 16 jun 2022 majlis perpisahan puan rina nor idayu pembantu tadbir 14 september 2022 21
masjlis sambutan ulangtahun sedekat bersama hrc 15 september 2022 world pharmacists day sunway velocity mall jkwpkl&P 25 september 2022 cme peringkat hospital anjuran jabatan farmasi hrc 5 oktober 2022 22
bengkel geriatric pharmacotherapy: mastering the complexity 12-13 oktober 2022 majlis persaraan puan alice pembantu pegawai farmasi 1 november 2022 10th kl & putrajaya pharmacy research & quality conference 2022 3 november 2022 23
jamuan akhir tahun 2022 jabatan farmasi 28 disember 2022 24
jamuan akhir tahun 2022 jabatan farmasi 28 disember 2022 End Year 2022 25
yearly activities 2023 perhimpunan jabatan farmasi x patologi peringkat hospital rehabilitasi cheras 6 january 2023 26 THE EVENT WITH THE THEME OF WINTER TOOK PLACE IN AUDITORIUM OF CHERAS REHABILITATION HOSPITAL. THE EVENT PROVIDED SEVERAL BENEFITS INCLUDING OPPORTUNITIES OF NETWORKING, KNOWLEDGE SHARING AND FOSTERING COLLABORATION BETWEEN TWO DEPARTMENTS.
yearly activities 2023 majlis perpisahan puan haslinda, pembantu perawatan kesihatan 20 january 2023 AMIDST THE TRANQUIL AMBIANCE OF THE OUTPATIENT PHARMACY AREA, A SPLENDID FAREWELL PARTY AWAITS AS WE BID ADIEU TO OUR ESTEEMED COLLEAGUE, MADAM HASLINDA, WHO EMBARKS ON A NEW JOURNEY IN ANOTHER DEPARTMENT. THIS ENCHANTING GATHERING, FILLED WITH WARMTH AND HEARTFELT WISHES, IS DESTINATED TO BRING A SMILE TO HER FACE AND IGNITE THE FLAMES OF SUCCESS IN HER FUTURE ENDEAVORS. 27
yearly activities 2023 SUMBANGAN BUBUR LAMBUK ANJURAN JABATAN FARMASI DAN DUTA UBAT ZON CHERAS 2023 13 APRIL 2023 THE PHARMACY DEPARTMENT, IN COLLABORATION WITH THE MEDICINE AMBASSADOR OF CHERAS ZONE, ORCHESTRATES A REMARKABLE CONTRIBUTION PROGRAM FEATURING LAMBUK PORRIDGE, EXTENDING ITS WARMTH AND NOURISHMENT TO BOTH PATIENTS AND DEDICATED HOSPITAL STAFF. WITNESSING THE PROFOUND DELIGHT AND JOY ON THEIR FACES AS THEY RECEIVE THIS COMFORTING DELICACY AMPLIFIES OUR SHARED SENSE OF UNITY AND STRENGTHENS THE SPIRIT OF COOPERATION AMONG ALL MEMBERS OF HOSPITAL COMMUNITY. 28
yearly activities 2023 majlis sambutan jamuan hari raya aidilfitri 19 may 2023 IN ANTICIPATION OF THE JOYOUS HARI RAYA CELEBRATION, THE DILIGENT STAFF OF THE PHARMACY DEPARTMENT POUR THEIR HEARTS INTO THE METICULOUS PREPARATION OF LAVISH FEAST. WITH AN ABUNDANT ARRAY OF DELECTABLE DISHES METICULOUSLY CRAFTED, THE GUESTS ARE TREATED TO A GASTRONOMIC DELIGHT THAT TRANSCENDS BOUNDARIES, FOSTERING A SPIRIT OF TOGETHERNESS AND REAPING THE COUNTLESS BENEFITS OF COM CELEBRATION. 29
yearly activities 2023 AS THE HARI RAYA CELEBRATION UNFOLDS, A WAVE OF JOY ENVELOPS THE HEARTS OF ALL PHARMACY STAFF, WHO REVEL IN THE FESTIVITIES . AMIDST THE LAUGHTER AND MERRIMENT, THE DEPARTMENT GENEROUSLY PRESENTS EACH STAFF MEMBER WITH TOKEN OF APPRECIATION IN THE FORM OF "DUIT RAYA", FURTHER FUELING THE EXCITEMENT AND HAPPINESS THAT PERMEATES THE ATMOSPHERE, CREATING A MEMORABLE AND BLISSFUL OCCASION FOR EVERYONE INVOLVED. 30 majlis sambutan jamuan hari raya aidilfitri 19 may 2023
yearly activities 2023 IN THE SPIRIT OF FOSTERING CAMARADERIE AND SPREADING JOY, THE PHARMACY DEPARTMENT EXTENDED A WARM INVITATION TO THE STAFF MEMBERS FROM ANOTHER DEPARTMENT, ENRICHING THE HARI RAYA CELEBRATION AND ADDING AN EXTRA LAYER OF HAPPINESS TO THE OCCASION. AS THE FESTIVITIES DREW TO A CLOSE, THE PHARMACY STAFF GATHERED TOGETHER, CAPTURING A TREASURED PHOTOGRAPH AS A TIMELESS MEMENTO, PRESERVING THE MEMORIES CREATED DURING THIS REMARKABLE CELEBRATION. 31 majlis sambutan jamuan hari raya aidilfitri 19 may 2023
THANK YOU