e-buletin tinta farmasi johor, volume 1, 2015

TINTA FARMASI

TINTA FARMASIVOLUME 1

BAHAGIAN PERKHIDMATAN FARMASIJABATAN KESIHATAN NEGERI JOHOR

UNTUK EDARAN DALAMAN SAHAJA

, 2015

DARI PENA KETUA EDITOR Pn. Hamidah binti Arsal

Assalamualaikum Warahmatullahi Wabarakatuh, Salam Sejahtera, Salam Sehati Sejiwa dan Salam Muafakat Johor. Alhamdulillah syukur ke hadrat Allah SWT kerana dengan limpah kurniaNya, Tinta Farmasi Johor Volume 1 telah dapat diterbitkan. Saya ingin merakamkan ucapan setinggi-tinggi tahniah dan syabas kepada ahli sidang redaksi yang telah berjaya dalam penerbitan buletin kali ini hasil kerjasama dan komitmen warga farmasi di negeri Johor.

Tinta Farmasi ini merupakan cerminan aspirasi warga farmasi negeri Johor dalam memberikan perkhidmatan yang terbaik kepada masyarakat. Aktiviti-aktiviti sepanjang

tahun yang dipaparkan di dalam buletin adalah sebagai tanda penghargaan dan diharap dapat menjadi pemangkin dalam menyemarakkan semangat kerjasama di kalangan warga farmasi negeri Johor.

Sepanjang Januari hingga Jun tahun 2015 sahaja, dua perkara penting telah berlangsung dengan jayanya iaitu Karnival Sukan Farmasi 2015 dari 24 April hingga 12 Jun 2015 dan Konvensyen Mini R&D ke-3 negeri Johor pada 17 Jun 2015 yang telah diadakan di Hospital Permai.

Saya amat berbangga dengan komitmen dan kerjasama padu yang diberikan serta kejayaan yang dicapai hasil dari titik peluh dan lontaran idea yang bernas dari semua warga farmasi yang terlibat secara langsung atau tidak langsung. Oleh itu, saya berharap agar aktiviti-aktiviti seumpama ini dapat diteruskan lagi pada masa-masa akan datang.

Akhir kalam, saya mendoakan semoga semua warga farmasi negeri Johor akan terus cemerlang dan Tinta Farmasi terus menjadi wadah yang unggul dalam memacu kegemilangan warga farmasi.

DARI MEJA TPKN(F) Pn. Hjh. Rosidah Binti Md Din

Assalamualaikum wbt, Salam Sejahtera, Salam Sehati Sejiwa dan Salam Muafakat Johor. Alhamdulillah, syukur kerana dengan limpah kurnia-Nya kita bertemu kembali melalui Tinta Farmasi Negeri Johor Volume 1. Dalam menyokong aspirasi Bahagian Perkhidmatan Farmasi, sidang redaksi Tinta Farmasi mengorak langkah lebih jauh dengan penghasilan dua edisi keluaran pada tahun ini. Tujuan wadah ini tidak lain hanyalah sebagai menghargai komitmen

yang diberikan oleh semua warga farmasi hospital dan kesihatan negeri Johor dalam menaiktaraf mutu perkhidmatan dan memperkukuhkan profesyen farmasi di mata masyarakat. Saya selaku Ketua Pengarang ingin mengucapkan tahniah dan terima kasih kepada ahli sidang redaksi yang bertungkus lumus dalam penghasilan Tinta Farmasi Negeri Johor kali ini. Diharap agar sumbangan yang tidak berbelah bahagi ini dapat diteruskan pada keluaran-keluaran akan datang. Kepada semua warga farmasi negeri Johor, selamat menyempurnakan tugas dan amanah yang diberikan dengan penuh tanggungjawab dan mencapai tahap yang terbaik dan terus gemilang. Cadangan dan idea tuan/puan amat dialu-alukan dan dihargai demi menjadikan Tinta Farmasi Negeri Johor ini sebagai salah satu wadah yang dibanggakan oleh semua. Akhir bicara, selamat maju jaya dan semoga bersua lagi di keluaran yang akan datang.

Sekian, salam hormat dari saya untuk semua pembaca.

SIDANG REDAKSI Tinta Farmasi

Volume 1

PENASIHAT: PN. HJH. ROSIDAH BINTI MD DIN

KETUA EDITOR: PN. HAMIDAH BINTI ARSAL

SIDANG EDITOR:

PN. ZAHRINA BINTI ABDUL KADIR

PN. NURUL

ASHIKIN BINTI MUSTAFA

PN. HAFIZAH BINTI

HAMIDI

PN. NORHAFIZAH

BINTI AB RAHIM

PN. NOR LAILAH

BINTI MOHAMAD

PN. SIAW JIA YI

Disclaimer: While all care is taken to ensure that the information presented in this bulletin is accurate, the board of editors and authors of this bulletin disclaim all responsibilities for any liability, loss or harm incurred as a result of mispresentation or inaccuracies within the bulletin. The content of the bulletin is provided for general informational purposes only and is not intended as, nor should it be considered substitute for professional medical advice.

KANDUNGAN MUKA SURAT

� Personaliti Tinta - Puan Hjh Kamaliah Binti Md Saman 4

� Naik Taraf Perkhidmatan Tambah Nilai (VAS) Melalui

Gerbang MySMS 15888 5

� Farmasi Pandu Lalu Hospital Sultanah Nora Ismail,

Batu Pahat 6

� Respiratory MTAC Hospital Sultanah Aminah,

Johor Bahru 7

� Antimicrobial Stewardship (AMS) Programme 8 & 9

� Karnival Sukan Farmasi Negeri Johor 2015 10 & 11

� Aktiviti Kenali Ubat Anda 12 & 13

� 3rd Johor Pharmacy Mini R&D Convention 2015 14

� Kursus Anjuran Bahagian Perkhidmatan Farmasi, JKNJ 15

� Interactive Corner 16

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FARMASI KLINIK PAKARR

HOSPITAL SULTAN ISMAILL

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PERKHIDMATAN SMS & AMBIL

Kos: RM 0.35

Masa menunggu: 2-5 minit

Kos perjalanan: Kos Petrol

Lokasi pilihan: Kaunter Farmasi

Kecemasan Aras 2/ Farmasi Klinik Pakar Aras 3

Masa pengambilan: 24 jam/ 8am—�pm

24 jam

PERKHIDMATAN PANDU LALU

Kos:

RM 0.35 Masa menunggu:

Tiada Kos perjalanan:

Kos Petrol Lokasi pilihan:

Kiosk Farmasi Pandu Lalu KKSI Masa pengambilan: 8.00 am—��pm

PERKHIDMATAN UBAT

MELALUI POS 1MALAYSIA

Kos: RM5.30—RM 8.50 Masa menunggu:

Tiada Kos perjalanan:

Tiada Lokasi pilihan:

Rumah/ Tempat kerja Masa pengambilan: 8.00 am—��pm

TINTA FARMASI JOHOR VOL. 1

5

Perkhidmatan Farmasi Pandu Lalu telah diperkenalkan di Hospital Sultanah Nora Ismail (HSNI), Batu Pahat pada Januari 2012 dalam usaha meningkatkan mutu perkhidmatan di Jabatan Farmasi HSNI. Melalui perkhidmatan ini, pesakit yang sudah berdaftar dengan perkhidmatan ini boleh membuat temujanji dengan pihak farmasi sekurang-kurangnya 3 hari sebelum tarikh pesakit ingin mengambil ubat. Selepas membuat temujanji pesakit hanya perlu hadir di Farmasi Pandu Lalu pada hari yang dijanjikan dan ubat yang telah disediakan akan dibekalkan kepada pesakit.

PENGENALAN

FAEDAH PERKHIDMATAN: �� MUDAH

�� CEPAT

�� TIADA MASALAH TEMPAT LETAK KENDERAAN

WAKTU OPERASI FARMASI PANDU LALU:

9.00 PAGI� 5.30 PETANG (Ahad� Khamis)

10.30 PAGI� 3.00 PETANG (Jumaat, Sabtu & Cuti Umum)

�FARMASI PANDU LALU HOSPITAL SULTANAH NORA ISMAIL

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INOVASI PERKHIDMATAN TAMBAH NILAI- PERKHIDMATAN FARMASI PANDU LALU TANPA TEMUJANJI Perkhidmatan Farmasi Pandu Lalu Tanpa Temujanji (FPLTT)diperkenalkan sebagai tambahan kepada Perkhidmatan Farmasi Pandu Lalu biasa HSNI. Perkhidmatan ini mensasarkan pesakit daripada Klinik Pakar Mata yang dipreskrib dengan: 1.Ubat titis mata Hypromellose 0.3% (Dacrolux®) 2.Ubat titis mata Timolol Maleate 0.5% (Timolast®) 3.Ubat titis mata Dorzolamide 2% (Trusopt®) 4.Ubat titis mata Latanoprost 0.005% (Xalatan®) 5.Ubat mata Fusidic Acid 2% (Fucithalmic®) 6.Ubat mata Oxytetracycline with Polymyxin B Sulphate (Terramycin®) 7.Ubat mata Chloramphenicol

KELEBIHAN PERKHIDMATAN TAMBAH NILAI- PERKHIDMATAN FARMASI PANDU LALU TANPA TEMUJANJI

�� Proses pendaftaran yang lebih mudah di kaunter saringan Farmasi Klinik Pakar.

�� Lebih cepat dan ringkas. Selepas mendaftar, pesakit boleh mengambil ubat mereka dari kaunter farmasi pandu lalu tanpa perlu membuat sebarang temujanji dengan pihak farmasi.

�� Sesuai untuk semua kategori umur.�� Tidak memerlukan pesakit menghantar pesanan ringkas (SMS) atau

membuat panggilan telefon kepada pihak farmasi.�

PROSES PENDAFTARAN PERKHIDMATAN FARMASI PANDU LALU TANPA TEMUJANJI


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RESPIRATORY MTAC at HSAJB

Respiratory Medication Therapy Adherence Clinic (RMTAC) in Hospital Sultanah Aminah is a pharmacist-managed clinic in collaboration with Chest Clinic aimed at improving patient asthma and COPD control by enhancing compliance and improving inhaler technique. Thus, it ��!��"��!#$�'��the year of 2010 in HSAJB, every Tuesday from 8.00am-1.00pm, RMTAC is a clinical pharmacy service under the directive and supervision of Pharmaceutical Services *��+9��9��9��;��9�� role in the out patient setting. The clinic is conducted by dedicated pharmacists who help asthma and COPD patients to gain better knowledge and understanding of their medications, and �9��<� ��=� �� 9�� 9�� =��$� >9��=9�� 9�� <� �9�� 9��does pharmacotherapy review of the patients, identifies pharmaceutical care issues, provides solution to drug-related problems, educates patients, and monitors the therapeutic outcome to ensure therapeutic goal is achieved.

References: 1. Medication Therapy Adherence Clinic: Respiratory 1st Edition 2010, BPF KKM

Example form for technique assessment


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Introduction Antimicrobials have been one of the major medical advances; having saved millions of lives since the discovery of penicillin in the 1940s. Treatment with antimicrobial agents seems so effective and safe that sometimes prescribed for uncertain indications and for longer than necessary, with little concern for adverse effects and the development of resistance.

First Protocol on Antimicrobial Stewardship (AMS) Committee members from National infection and antibiotic Control Committee, Medical Care Quality Section, Pharmaceutical Division and Family Health Development Division.

ANTIMICROBIAL STEWARDSHIP PROGRAMME

Hamizah binti Ahmad Kamal �

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resistance, in 2011, WHO

declared it as global health

threat mainly by the overuse

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-WHO 2011

OBJECTIVES of AMS 1. To improve patient outcome. 2. To optimize antimicrobial therapy.

�� Judicious use, optimizing antimicrobial selection, dose, route and duration.

3. T o l i m i t t h e u n i n te n d e d consequences. �� Emergence of antimicrobial

resistance, ADR. 4. To reduce the healthcare cost without adversely impacting quality of care.

POLICY OF AMS

�� Formulation of AMS team in each hospital, Health District Office & Health Clinics* (Core Strategy)

�� Surveillance & feedback mechanism on specific antimicrobial consumption* (Core Strategy)

�� Implementation of prospective audit & feedback according to local needs* (Core Strategy)

�� Formalize regular antimicrobial rounds by AMS team especially in state & specialist hospital* (Core Strategy)

�� Establishment of formulary restriction & authorization & preauthorization/ approval system* (Core Strategy)

�� Establishment of antimicrobial order tools for restricted antimicrobial

�� Streamlining the antibiotic usage

�� Antimicrobial selection & dose optimization of the antimicrobial*

�� Initiation of intravenous (IV) to oral (PO) switch program

�� Education on AMS program via CME & antibiotic awareness campaign*

ANTIMICROBIAL STEWARDSHIP PROGRAMME IN HOSPITALS

AMS TEAM MEMBERS

1) Head of AMS team

2) ID Physician or Physician (if possible)

3) Microbiologist/ Clinical microbiologist

4) Ward Pharmacist, Infection Control Nurse, Interested Clinicians, etc

5) Antimicrobial Pharmacist or Clinical Pharmacist

ANTIMICROBIAL STEWARDSHIP PROGRAMME IN PRIMARY HEALTHCARE

GOVERNANCE

Under the purview of the Hospital Infection Control and Antibiotic Committee and is supported by the:

�� Hospital Director (AMS Team should be appointed by Hospital Director)

�� Head of various clinical departments

�� Head of Pharmacy Department

�� Head of Medical Microbiology

The ASP in Primary Care should be formulated at both District & Health Clinics level & is under the purview of the District Infection Control & Antibiotic Committee:

District Level Health Clinic Level

�� Appointed Family Medicine Specialist �� Family Medicine Specialist

Medical Officer-In-Charge from each KK

�� Pharmacist In Charge of District (Secretariat)

�� Pharmacist from each KK �� Senior Assistant Medical

Officer �� MLT In Charge of District-

Link Nurse (Optional) �� Information Technology

Officer (Optional)

�� Family Medicine Specialist/Medical Officer-In-Charge

�� Pharmacist (Secretariat) �� Medical Lab Technician �� Link Nurse (Optional) �� Information Technology

Officer (Optional)


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ANTIMICROBIAL STEWARDSHIP PROGRAMME IN HOSPITALS

ANTIMICROBIAL STEWARDSHIP PROGRAMME IN PRIMARY HEALTHCARE

AMS ACTIVITIES

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GENERAL ROLE OF ANTIMICROBIAL STEWARDSHIP TEAM

Encourage formulation of local guidelines & clinical pathways Should be formulated based on the national antibiotic guideline, evidence in the literature and local microbiology and resistance patterns.

Surveillance & feedback Surveillance can show how and why antimicrobial are being used and misused by patients and healthcare providers.

Prospective audit & feedback

Involves a multidisciplinary team who regularly reviews patients.

Formulary restriction & p r e - a u t h o r i z a t i o n Pre-approval (can only be started after getting a specific approval).

Temporary approval (Can be started but would need approval for continued usage and this can be done via antimicrobial order tools).

Education (through CNE/CME, newsletter)

Antimicrobial order tools

To encourage the clinician to review basic cl in ical and laboratory information and to categorize antimicrobial use as prophylaxis, empirical or therapeutic. May improve the qual i ty of prescriptions by increasing the awareness of clinician of desired antimicrobial spectrum. Can be an effective measure to decrease antimicrobial consumption by implementing automatic stop orders and/or requiring clinicians to justify. Antimicrobial streamlining

The de-escalation strategy:

To narrow spectrum agents once culture and sensitivity are available.

If the dosage was initially high, it can be de-escalated to a standard dosage for a susceptible organism.

Discontinuing empirical therapy if testing subsequently fai ls to demonstrate evidence of infection.

Discontinuing dual antimicrobial therapy if there is overlapping in the spectrum of activity.

Advising on the optimal choice of antimicrobials for the specific clinical setting.

IV to PO antibiotics conversion

Implementation of Treatment Guidelines and Clinical Should be developed for URTI and diarrhea as these are most common inappropriate uses of antimicrobial. Surveillance and Feedback �� Surveillance can show how and why

antimicrobial are being used and misused by patients and healthcare providers.

�� Monitoring antimicrobial patterns and cost using �� Collection and analysis of local

antimicrobial consumption and expenditure.

�� Indicators for reporting antimicrobial usage pattern.

Audit & Feedback �� The scope of clinical audit is to

include appropriateness of antimicrobial prescription.

�� Annual report of the clinical audit should be presented in ASP District Meeting.

Education (through CNE/CME, newsletter)

Formulary Restriction ��

with MOH programme such as Integrated Management of Childhood Illnesses and Modified Systemic Approach.

�� Prescribers should comply with formulary restriction either locally or national.

�� Can be implemented through pre-approval through forms or verbally.

Antibiotic Selection and Dose Optimization

�� c h a r a c t e r i s t i c s , c a u s a t i v e organism, site of infection, and pharmacodynamic characteristic of the antimicrobial agent.

�� Strategies includes

�� Weight-based dosing of antimicrobials in paediatric.

�� Dose adjustments in renal dysfunction patients.

AMS PROGRAMME MEASUREMENT

PROCESS MEASURES OUTCOME INDICATORS

�� Rate of clinician acceptance of AMS recommendations

�� Rate of adherence to documentation policy at time of antimicrobial initiation

�� Rate of review of carbapenem and polymyxin in prescription at 72 hours by primary team

�� Rate of appropriate empirical prescription according to antimicrobial guideline

�� Specific antibiotic DDDs over every 6 months

�� Cost differences

**Other suggested indicators (where applicable) : Readmission within 30 days or mortality within 30 days

PROCESS MEASURES OUTCOME INDICATORS

�� Number of clinical audits including antibiotic

�� Annual report of antibiotic Prescriber Profilling for Electronically enabled clinic annually

�� Annual report of total antimicrobial expenditure

�� Specific antibiotics DDDs annually �� Reduction of URTI patient

prescribed with antibiotics for Electronically enabled clinic annually

�� Increase in appropriate antibiotic prescription


9

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nologies or innovations in your field.

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economic trends, or make predictions for

your customers or clients.

If the newsletter is distributed internally,

you might comment upon new procedures

or improvements to the business. Sales

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KARNIVAL SUKAN FARMASI 2015 BAHAGIAN PERKHIDMATAN FARMASI , JKNJ

12 JUN 2015

DAIMAN BOWL JOHOR JAYA

25 APRIL 2015

KOLEJ SAINS KESIHATAN BERSEKUTU

BOWLING

BOLA JARING


10

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Inside Story Headline

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KARNIVAL SUKAN FARMASI 2015 BAHAGIAN PERKHIDMATAN FARMASI , JKNJ

FUTSAL

30 MEI 2015

DAIMAN SPORTS COMPLEX

16 MEI 2015

GELANGGANG KOTA JAYA

BADMINTON

FUTSAL


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CERAMAH

AKTIVITI KENALI UBAT ANDA

CERAMAH KENALI UBAT ANDA Hospital Sultanah Aminah Johor Bahru

CERAMAH KENALI UBAT ANDA Sek. Men. Keb. Dato Ali Haji Ahmad, Pontian

Hospital Pontian

CERAMAH KENALI UBAT ANDA PKD Johor Bahru

CERAMAH KENALI UBAT ANDA PKD Muar

CERAMAH KENALI UBAT ANDA PKD Batu Pahat

CERAMAH KENALI UBAT ANDA PKD Kluang

CERAMAH KENALI UBAT ANDA PKD Pontian

CERAMAH KENALI UBAT ANDA Hospital Sultanah Nora Ismail Batu Pahat

CERAMAH KENALI UBAT ANDA PKD Kota Tinggi

CERAMAH KENALI UBAT ANDA HEBHK, Kluang

CERAMAH KENALI UBAT ANDA Hospital Tangkak


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PAMERAN

AKTIVITI KENALI UBAT ANDA

PAMERAN KENALI UBAT ANDA Hospital Sultanah Nora Ismail Batu Pahat

PAMERAN KENALI UBAT ANDA sempena World Kidney Day

Hospital Sultan Ismail Johor Bahru

PAMERAN KENALI UBAT ANDA Hospital Pontian

PAMERAN KENALI UBAT ANDA Hospital Mersing

PAMERAN KENALI UBAT ANDA PKD Johor Bahru

PAMERAN KENALI UBAT ANDA PKD Muar

PAMERAN KENALI UBAT ANDA PKD Batu Pahat

PAMERAN KENALI UBAT ANDA sempena Hari Sukan Negara 2015

PKD Ledang

PAMERAN KENALI UBAT ANDA sempena sambutan Bulan Kemerdekaan

PKD Kota Tinggi

PAMERAN KENALI UBAT ANDA PKD Mersing

PAMERAN KENALI UBAT ANDA PKD Kluang

PAMERAN KENALI UBAT ANDA sempena 17th Johor Mental Health Convention

Hospital Permai

PAMERAN KENALI UBAT ANDA sempena Minggu Keselamatan Pesakit Hospital Sultanah Aminah Johor Bahru

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TEMA: COMBATING COMMUNICABLE DISEASES: R&D PERSPECTIVES

TEMPAT: AUDITORIUM IXORA, HOSPITAL PERMAI JOHOR BAHRU

TARIKH: 17 JUN 2015

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14

��Find and circle all of the words that are hidden in the grid.

The remaining 11 letters spell an additional word. �

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AMUSED ANNOYED

ANTSY ANXIOUS CARING

CONTEMPT CONTENT CONTRITE DELIGHT DESPAIR

DISLIKE DOUBT

EMPATHY ENVY

EUPHORIA GLUM GREED

GROUCHY GUILT

HATRED

HORROR INFATUATED

JOYOUS LEERY PRIDE RAGE SAD

SATISFIED SERENITY SHAME

SHOCK SULKY SULLEN

TERRIFIED TRANQUIL UNCERTAIN UNHAPPY

WARY

e-buletin tinta farmasi johor, volume 1, 2015

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